Clinical worthlessness of genetic prediction of common forms of diabetes mellitus and related chronic complications.

卷:27

Buzzetti, R. ; Prudente, S. ; Copetti, M. ; Dauriz, M. ; Zampetti, S. ; Garofolo, M. ; Penno, G. ; Trischitta, V.

Sapienza Univ Rome

关键词: Precision medicine;    Molecular medicine;    Genetic prediction;   

DOI  :  10.1016/j.numecd.2016.08.005

学科分类：食品科学和技术

【 摘 要 】

Aim: We are currently facing several attempts aimed at marketing genetic data for predicting multifactorial diseases, among which diabetes mellitus is one of the more prevalent. The present document primarily aims at providing to practicing physicians a summary of avai-lable data regarding the role of genetic information in predicting diabetes and its chronic compli-cations. Data synthesis: Firstly, general information about characteristics and performance of risk predic-tion tools will be presented in order to help clinicians to get acquainted with basic methodolog-ical information related to the subject at issue. Then, as far as type 1 diabetes is concerned, available data indicate that genetic information and counseling may be useful only in families with many affected individuals. However, since no disease prevention is possible, the utility of predicting this form of diabetes is at question. In the case of type 2 diabetes, available data really question the utility of adding genetic information on top of well performing, easy available and inexpensive non-genetic markers. Finally, the possibility of using the few available genetic data on diabetic complications for improving our ability to predict them will also be presented and discussed. For cardiovascular complication, the addition of genetic information to models based on clinical features does not translate in a substantial improvement in risk discrimination. For all other diabetic complications genetic information are currently very poor and cannot, therefore, be used for improving risk stratification. Conclusions: In all, nowadays the use of genetic testing for predicting diabetes and its chronic complications is definitively of little value in clinical practice. (C) 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Feder-ico II University. Published by Elsevier B. V. All rights reserved.