FUT2 Nonsecretor Status Links Type 1 Diabetes Susceptibility and Resistance to Infection

OBJECTIVE FUT2 encodes the α(1,2) fucosyltransferase that determines blood group secretor status. Homozygotes (A/A) for the common nonsense mutation rs601338A>G (W143X) are nonsecretors and are unable to express histo-blood group antigens in secretions and on mucosal surfaces. This mutation has been reported to provide resistance to Norovirus and susceptibility to Crohn’s disease, and hence we aimed to determine if it also affects risk of type 1 diabetes. RESEARCH DESIGN AND METHODS rs601338A>G was genotyped in 8,344 patients with type 1 diabetes, 10,008 control subjects, and 3,360 type 1 diabetic families. Logistic regression models were used to analyze the case-control collection, and conditional logistic regression was used to analyze the family collection. RESULTS The nonsecretor A/A genotype of rs601338A>G was found to confer susceptibility to type 1 diabetes in both the case-control and family collections (odds ratio for AA 1.29 [95% CI 1.20–1.37] and relative risk for AA 1.22 [95% CI = 1.12–1.32]; combined P = 4.3 × 10−18), based on a recessive effects model. CONCLUSIONS Our findings linking FUT2 and type 1 diabetes highlight the intriguing relationship between host resistance to infections and susceptibility to autoimmune disease.

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