The association between glutathione S-transferase T1 and M1 gene polymorphisms and cardiovascular autonomic neuropathy in Slovak adolescents with type 1 diabetes mellitus

Glutathione S-transferase (GST), as antioxidant enzyme, protects tissue from oxidative damage typical for many pathologic conditions as type 1 diabetes (T1D) and its chronic complications. The aim of the study was to compare the prevalence of GST T1/M1 gene polymorphisms between diabetic adolescents with (CAN +) and without (CAN −) cardiovascular autonomic neuropathy. Forty-six subjects with T1D at the age 15-19 years were enrolled. CAN was diagnosed in 19 patients (41.3%) based on standard cardiovascular tests. GST M1 null genotype was more prevalent in CAN + subjects but this was not statistically significant (OR = 1.889, 0.61-6.55, p > 0.05). GST T1 wild genotype nearly 5-fold increased the risk of CAN (OR = 4.952, 1.13-21.739, p < 0.05). Regarding genotype combination, GST T1/M1 wild/null genotype was significantly more frequent in CAN + compared to the CAN − subjects (OR = 3.96, 1.024-15.302, p < 0.05). No significant difference was found in any biochemical parameters between CAN + and CAN − subgroups. Multivariable logistic regression showed that none of the biochemical parameters estimated was considered a risk factor for CAN, however GST T1 wild and GST T1/M1 wild/null represented a risk factor for CAN development (OR = 2.227, 1.079-4.587, p < 0.05 and OR = 1.990, 1.026-3.859, p < 0.05, respectively). GST T1 wild allele and GST T1/M1 wild/null genotype can be considered as risk factors for CAN in Slovak adolescents with T1D.