A common 5′-UTR variant in MATE2-K is associated with poor response to metformin

J. H. Choi, S. W. Yee, A. H. Ramirez, K. M. Morrissey, G. H. Jang, P. J. Joski, J. A. Mefford, S. E. Hesselson, A. Schlessinger, G. Jenkins, R. A. Castro, S. J. Johns, D. Stryke, A. Sali, T. E. Ferrin, J. S. Witte, P. Y. Kwok, D. M. Roden, R. A. Wilke, C. A. McCartyR. L. Davis, K. M. Giacomini

Research output: Contribution to journalReview articlepeer-review

139 Scopus citations


Multidrug and toxin extrusion 2 (MATE2-K (SLC47A2)), a polyspecific organic cation exporter, facilitates the renal elimination of the antidiabetes drug metformin. In this study, we characterized genetic variants of MATE2-K, determined their association with metformin response, and elucidated their impact by means of a comparative protein structure model. Four nonsynonymous variants and four variants in the MATE2-K basal promoter region were identified from ethnically diverse populations. Two nonsynonymous variantsc.485CT and c.1177GAwere shown to be associated with significantly lower metformin uptake and reduction in protein expression levels. MATE2-K basal promoter haplotypes containing the most common variant, g.130GA (26% allele frequency), were associated with a significant increase in luciferase activities and reduced binding to the transcriptional repressor myeloid zinc finger 1 (MZF-1). Patients with diabetes who were homozygous for g.130A had a significantly poorer response to metformin treatment, assessed as relative change in glycated hemoglobin (HbA1c) (0.027 (0.076, 0.033)), as compared with carriers of the reference allele, g.130G (0.15 (0.17, 0.13)) (P = 0.002). Our study showed that MATE2-K plays a role in the antidiabetes response to metformin.

Original languageEnglish
Pages (from-to)674-684
Number of pages11
JournalClinical Pharmacology and Therapeutics
Issue number5
StatePublished - Nov 2011


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