rs5219

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This is a protein-altering variant in the KCNJ11 gene.

Key Literature Trait Associations

Type 2 Diabetes

The T allele of rs5219 encodes the Lys23 variant (E23K) in the KCNJ11 gene, which forms the pore-forming subunit of the pancreatic beta-cell ATP-sensitive potassium channel (KATP). The Lys23 variant increases the open probability of the channel, making beta cells slightly less responsive to glucose-stimulated ATP rises and reducing insulin secretion. The OR of ~1.15 per allele has been replicated across dozens of GWAS in European, East Asian, and South Asian populations.

Allele T
OR 1.15
p 1.0e-4
N 61,879
Meta-analysis
multi-ancestry
Boulanger MJ et al. Hexameric structure and assembly of the interleukin-6/IL-6 alpha-receptor/gp130 complex. Science (new York, N.y.) 300(5628):2101-2104 (2003)
Allele T
OR 1.15
p 6.7e-11
Large GWAS
Allele T
OR
β -0.069 ±0.005
p 3.0e-48
N 1,407,282
Meta-analysisLarge GWAS
multi-ancestry
Allele T
OR 1.06
p 6.0e-22
N 298,957
Large GWAS
European
Allele T
OR
p 1.0e-5
N 88,942
Meta-analysis
multi-ancestry
Allele T
OR 1.19
p 1.0e-4
N 21,464
Meta-analysis
multi-ancestry

Gestational diabetes mellitus

The rs5219 T allele is significantly associated with gestational diabetes mellitus (GDM) susceptibility across multiple meta-analyses. A 2012 meta-analysis of 22 studies (10,336 GDM cases, 17,445 controls) found rs5219 to be one of eight T2D-risk variants robustly associated with GDM. A 2024 comprehensive meta-analysis of 9 studies (3,108 GDM cases, 5,374 controls) confirmed a significant association globally and in Caucasian and Asian populations specifically, consistent with the shared KATP channel pathophysiology linking T2D and GDM.

Allele T
OR
p 1.0e-3
N 8,482
Meta-analysis
multi-ancestry
Allele T
OR
p 1.0e-2
N 27,781
Meta-analysis
multi-ancestry

Fasting glucose measurement

rs5219 T allele is associated with higher fasting plasma glucose in large-scale GWAS. A multi-ancestry GWAS (n=601,780) from the VA Million Veteran Program identified the T allele raising fasting glucose (beta=0.030, SE=0.003, p=1×10⁻²¹). A separate European GWAS (n=394,642) also found the C allele (protective direction) associated with lower glucose (beta=−0.017, p=3×10⁻¹⁴). These effects are mechanistically consistent with impaired ATP-sensitive potassium channel inhibition reducing insulin release and elevating basal glucose.

Verma A et al. Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. Science (new York, N.y.) 385(6706):eadj1182 (2024)
Allele T
OR
β 0.030 ±0.003
p 1.0e-21
N 601,780
Major Consortium StudyLarge GWAS
multi-ancestry
Allele T
OR
β -0.017 ±0.002
p 3.0e-14
N 394,642
Large GWAS
European

Systolic blood pressure

The T allele of rs5219 is associated with modestly higher systolic blood pressure. A large meta-analysis (n=327,288) including a discovery cohort of 146,562 individuals identified rs5219 T allele raising systolic BP (beta=0.32 mmHg per allele, SE=0.05, p=5×10⁻¹²) and mean arterial pressure (beta=0.29, SE=0.05, p=4×10⁻⁹). Effect sizes are small on an individual level but are statistically robust given the sample size. The association is plausible given the KATP channel's role in vascular smooth muscle tone regulation.

Allele T
OR
β 0.320 ±0.050
p 5.0e-12
N 327,288
Meta-analysisLarge GWAS
multi-ancestry

GWAS Catalog Trait Associations (10)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

ClinVar annotation

Likely Benign★★★
13 submitters39 publications

Diabetes mellitus type 2, susceptibility to; Permanent neonatal diabetes mellitus; not specified; Transient Neonatal Diabetes, Dominant; Hyperinsulinism, Dominant/Recessive; Maturity-onset diabetes of the young; Hyperinsulinemic hypoglycemia, familial, 2; Diabetes mellitus, transient neonatal, 3; Maturity-onset diabetes of the young type 13; not provided; Type 2 diabetes mellitus; KCNJ11-related disorder

View on ClinVar →

Research that mentions this SNP (17)

Genetic variation of FTO: rs1421085 T&gt;C, rs8057044 G&gt;A, rs9939609 T&gt;A, and copy number (CNV) in Mexican Mayan school‐aged children with obesity/overweight and with normal weight
ReviewLizbeth González‐Herrera et al.(2019)· American Journal of Human Biology

A literature review of 70 studies examining single nucleotide polymorphisms (SNPs) associated with obesity in Mexican populations published 2011-2021. The authors identified SNPs with differential behavior in Mexican compared to Caucasian populations, including rs17782313 (MC4R), rs6548238 (TMEM18), rs6265 (BDNF), rs7498665 (SH2B1), and notably rs6232 (PCSK1) associated with early-onset obesity in Mexican youth. The review emphasizes ethnicity-dependent genetic effects on BMI heritability (40-70%) and highlights genes involved in cholesterol metabolism and adipokine signaling pathways.

Traits studied:AdiposityBlood pressureBody mass index (BMI)Cardiovascular risk factorsDyslipidemiaInsulin resistanceMetabolic syndromeObesityOverweightType 2 diabetes
Relationship between melatonin receptor 1B (rs10830963 and rs1387153) with gestational diabetes mellitus: a case–control study and meta-analysis
Meta-analysisN=1,364Qiong Liu et al.(2016)· Archives of Gynecology and Obstetrics

A case-control study of 674 GDM patients and 690 controls combined with a meta-analysis found that the G allele of rs10830963 and T allele of rs1387153 in MTNR1B are significantly associated with increased risk of gestational diabetes mellitus (GDM). Meta-analysis of 6 studies showed rs10830963 G allele increased GDM risk in co-dominant model (OR 1.62, 95% CI 1.34-1.94) and rs1387153 T allele increased risk in co-dominant model (OR 1.53, 95% CI 1.26-1.86).

Traits studied:Gestational diabetes mellitusType 2 diabetes
Functional Interaction Between SNPs and Microsatellite in the Transcriptional Regulation of Insulin-Like Growth Factor 1
ReviewHolly Y. Chen et al.(2013)· Human Mutation

This comprehensive review examines the association between type 2 diabetes mellitus (T2DM) and multiple myeloma (MM) risk. Genetic variants linked to T2DM show opposite associations with MM compared to diabetes GWAS: variants like CDKN2A-2B rs2383208, IGF1 rs35767, KCNQ1 rs2237892, and MADD rs7944584 increase MM risk, while FTO rs8050136, KCNJ11 rs5215/rs5219, LTA rs1041981, and THADA rs7578597 decrease risk. The IGF1 rs35767 promoter polymorphism is strongly associated with MM risk via cell proliferation mechanisms. A meta-analysis of 20 observational studies (>3 million participants) found T2DM patients had OR=1.53 (95% CI, 1.30-1.81) for MM, and MetS patients had OR=1.39 (95% CI, 1.17-1.64), mediated through insulin resistance, hyperinsulinemia, inflammatory cytokines (IL-6, TNF-α, IL-1β), dyslipidemia, and acidosis pathways.

Traits studied:Insulin resistanceMetabolic syndromeMultiple myelomaNephropathyPeripheral neuropathyRetinopathyType 2 diabetes mellitus
Identification of CpG-SNPs associated with type 2 diabetes and differential DNA methylation in human pancreatic islets
AssociationN=84Dayeh TA et al.(2013)· Diabetologia

Of 40 SNPs previously associated with type 2 diabetes, 19 (48%) introduce or remove CpG sites. In 84 human pancreatic islet donors, all 16 analyzed CpG-SNPs showed statistically significant differential DNA methylation (p≤2.3×10⁻⁵). Several CpG-SNPs including rs391300 (SRR), rs5945326 (DUSP9), rs11708067 (ADCY5), rs5015480 (HHEX), rs13266634 (SLC30A8), rs1801214 (WFS1), rs564398 (CDKN2A), and rs2237895 (KCNQ1) were associated with differential gene expression, alternative splicing, or hormone secretion, suggesting DNA methylation-mediated mechanisms linking genetic variants to type 2 diabetes pathogenesis.

Traits studied:Glucagon secretionInsulin contentInsulin secretionType 2 diabetes
SNP in the genome-wide association study hotspot on chromosome 9p21 confers susceptibility to diabetic nephropathy in type 1 diabetes
AssociationN=5,943Fagerholm E. et al.(2012)· Diabetologia

This association study identified rs10811661 near CDKN2A/B on chromosome 9p21, a type 2 diabetes risk SNP, as significantly associated with diabetic nephropathy in 2,963 type 1 diabetes patients (OR 1.33, p=0.00045). The association was replicated in meta-analysis across four cohorts (n>5,000; OR 1.15, p=0.011) and was particularly strong for end-stage renal disease (OR 1.35, p=0.00038). The SNP was also associated with severe retinopathy but not cardiovascular disease.

Traits studied:Cardiovascular diseaseDiabetic nephropathyEnd-stage renal diseaseMacroalbuminuriaMicroalbuminuriaSevere retinopathyType 1 diabetes
Association of indices of liver and adipocyte insulin resistance with 19 confirmed susceptibility loci for type 2 diabetes in 6,733 non-diabetic Finnish men
AssociationN=6,733Vangipurapu J. et al.(2011)· Diabetologia

Population-based study of 6,733 non-diabetic Finnish men examining associations between 19 confirmed type 2 diabetes risk loci and tissue-specific insulin resistance indices. Type 2 diabetes risk SNPs in KCNJ11 (rs5219) and HHEX (rs1111875) showed significant associations with lower liver insulin resistance (p<0.0013 and p=5.4×10⁻⁵, respectively), while the Pro12 allele of PPARG2 (rs1801282) was significantly associated with higher adipocyte insulin resistance (p=6.2×10⁻⁵).

Traits studied:2-hour plasma glucoseAdipocyte insulin resistanceFasting plasma glucoseHepatic insulin resistanceInsulin sensitivityLiver insulin resistance indexType 2 diabetes
Association of TCF7L2 SNPs with age at onset of type 2 diabetes and proinsulin/insulin ratio but not with glucagon‐like peptide 1
AssociationN=26Guenther Silbernagel et al.(2011)· Diabetes/Metabolism Research and Reviews

This association study analyzed four T2D-related SNPs (rs5219, rs1801282, rs7903146, rs12255372) in 26 Yakut patients with type 2 diabetes via pyrosequencing. No statistically significant differences were found between Yakut T2D cases and control groups for KCNJ11, PPARG, or TCF7L2 polymorphisms. The study identified strong linkage disequilibrium between TCF7L2 rs7903146 and rs12255372 (D'=1, LOD=4.92) in Yakuts and demonstrated that the risk T-allele frequency of TCF7L2 SNPs is notably lower in Asian populations (3.8% in Yakuts, 2-3% in Japanese and Chinese) compared to European and African populations.

Traits studied:Type 2 Diabetes
Impact of repeated measures and sample selection on genome‐wide association studies of fasting glucose
AssociationN=9,133Laura J. Rasmussen‐Torvik et al.(2010)· Genetic Epidemiology

This GWAS of fasting glucose in the ARIC study examined 5,782-8,372 individuals across four longitudinal visits and identified five genomic regions significantly associated with fasting glucose (p < 5×10⁻⁸): GCKR, G6PC2, GCK, SLC30A8, and MTNR1B. The study demonstrated that averaging fasting glucose measures across visits improved statistical power and detected additional signals (GCKR rs780094, SLC30A8 rs13266634) not visible in single-visit analyses. Analysis of candidate SNPs revealed significant interactions with diabetes status: associations with fasting glucose were stronger in non-diabetic individuals than in those with prevalent diabetes for multiple SNPs including rs10830963 (MTNR1B), rs560887 (G6PC2), rs4607517 (GCK), and rs780094 (GCKR).

Traits studied:Fasting glucoseType 2 diabetes
Variability in Ethanol Biodisposition in Whites Is Modulated by Polymorphisms in the Adh1b and Adh1c Genes
ReviewCarmen Martínez et al.(2010)· Hepatology

A comprehensive review of nutrigenetics and nutrigenomics examining how genetic variants influence individual responses to nutrients and dietary interventions. The paper discusses associations between numerous SNPs (rs9939609 in FTO, rs2287019 in GIPR, rs7903146 in TCF7L2, rs5219 in KCNJ11, and many others) and metabolic traits including obesity, type 2 diabetes, and other chronic diseases, along with epigenetic mechanisms by which phytochemicals (curcumin, resveratrol, lycopene) modulate gene expression. The review synthesizes current evidence for precision nutrition approaches tailored to individual genetic profiles.

Traits studied:Bone density/osteoporosisCaffeine sensitivityCardiovascular diseaseCeliac diseaseCerebrovascular diseaseCoronary heart diseaseDetoxification capacityEating behaviorGlucose homeostasisHistamine intoleranceInflammatory diseasesInsulin resistanceLactose intoleranceLeptin resistanceMetabolic syndromeNickel intoleranceObesityOsteoarthritisOverweightType 2 diabetes
Type 2 diabetes risk alleles near ADCY5, CDKAL1 and HHEX-IDE are associated with reduced birthweight
AssociationN=4,213Andersson EA et al.(2010)· Diabetologia

This association study of 4,213 Danish individuals examined 25 type 2 diabetes risk variants and their association with birthweight. The study found that type 2 diabetes risk alleles near ADCY5 (rs11708067, β = -33 g, p = 0.004), CDKAL1 (rs7756992, β = -22 g, p = 0.04), and HHEX-IDE (rs1111875, β = -16 g in meta-analysis, p = 8×10⁻⁵, n = 25,164) were associated with reduced birthweight, supporting the fetal insulin hypothesis. Meta-analyses confirmed these associations and showed no strong general effect on birthweight from the 25 common type 2 diabetes risk alleles combined.

Traits studied:Birth lengthBirthweightPonderal indexType 2 diabetes
No association of multiple type 2 diabetes loci with type 1 diabetes
AssociationN=15,824Raj SM et al.(2009)· Diabetologia

This case-control and family-based association study tested whether 18 type 2 diabetes susceptibility loci are associated with type 1 diabetes in 7,606 type 1 diabetic cases and 8,218 controls. Only PPARG (rs1801282/Pro12Ala, OR=0.91, p=0.004) and HHEX-IDE (rs1111875, OR=0.94, p=0.003) showed evidence of association with type 1 diabetes. The authors conclude that type 1 and type 2 diabetes do not share a common genetic background, supporting the view that type 1 diabetes is primarily an autoimmune disease.

Traits studied:Type 1 diabetesType 2 diabetes
Type 2 diabetes-associated genetic variants discovered in the recent genome-wide association studies are related to gestational diabetes mellitus in the Korean population
AssociationN=1,501Cho YM et al.(2009)· Diabetologia

This case-control study in 869 Korean women with gestational diabetes mellitus (GDM) and 632 non-diabetic controls examined whether type 2 diabetes-associated genetic variants discovered in recent GWAS are also associated with GDM. Multiple variants showed significant associations with GDM, including rs7756992 and rs7754840 in CDKAL1 (OR 1.55, p=4.17×10⁻⁹), rs10811661 in CDKN2A-CDKN2B (OR 1.49, p=1.05×10⁻⁷), variants in HHEX, rs4402960 in IGF2BP2 (OR 1.18, p=0.03), rs13266634 in SLC30A8 (OR 1.24, p=0.005), and rs7903146 in TCF7L2 (OR 1.58, p=0.038).

Traits studied:Gestational diabetes mellitusType 2 diabetes
Update of mutations in the genes encoding the pancreatic beta-cell KATPchannel subunits Kir6.2 (KCNJ11) and sulfonylurea receptor 1 (ABCC8) in diabetes mellitus and hyperinsulinism
Case reportSarah E. Flanagan et al.(2009)· Human Mutation

This case report describes the first reported case of DEND (Developmental Delay, Epilepsy, and Neonatal Diabetes) syndrome in Malaysia, caused by a heterozygous Q52R missense mutation in the KCNJ11 gene (p.Gln52Arg). The patient presented with neonatal diabetes at 8 months (delayed onset), global developmental delay, and growth retardation, but notably without seizures. The Q52R mutation is known to confer the worst clinical outcome among KCNJ11 mutations. Treatment attempted transition from insulin to glibenclamide at 3 years 7 months, but the patient failed to respond and exhibited intolerance, highlighting phenotypic variability and variable treatment response even within the same genetic mutation.

Traits studied:DEND syndromeDevelopmental delayGlobal developmental delayNeonatal diabetesPermanent Neonatal Diabetes MellitusType 1 diabetesType 2 diabetes
Genetic analysis of recently identified type 2 diabetes loci in 1,638 unselected patients with type 2 diabetes and 1,858 control participants from a Norwegian population-based cohort (the HUNT study)
AssociationN=3,496Hertel JK et al.(2008)· Diabetologia

This replication study tested newly identified type 2 diabetes susceptibility loci in a Norwegian population-based cohort of 1,638 type 2 diabetes patients and 1,858 controls. The authors confirmed associations for rs10811661 near CDKN2B (OR 1.20, p=0.004), rs9939609 in FTO (OR 1.14, p=0.006), and rs13266634 in SLC30A8 (OR 1.20, p=3.9×10⁻⁴). They found borderline association for rs4402960 in IGFBP2 (OR 1.10, p=0.074) but no support for SNPs near FLJ39370 and PKN2.

Traits studied:BMICholesterolTriacylglycerolType 2 diabetesWHR
The search for putative unifying genetic factors for components of the metabolic syndrome
AssociationN=16,143Sjögren M. et al.(2008)· Diabetologia

This prospective study of 16,143 individuals from the Malmö Preventive Project (mean follow-up 23 years) investigated whether genetic variants in 26 genes previously associated with type 2 diabetes or metabolic syndrome components could predict future development of metabolic syndrome. Polymorphisms in TCF7L2 (rs7903146, OR 1.10, p=0.00097), FTO (rs9939609, OR 1.08, p=0.0065), WFS1 (rs10010131, OR 1.07, p=0.0078), and IGF2BP2 (rs4402960, OR 1.07, p=0.021) predicted metabolic syndrome development, with TCF7L2, WFS1, and IGF2BP2 acting through hyperglycemia and FTO through obesity. A composite genotype score of 17 polymorphisms predicted metabolic syndrome risk (OR 1.04, p<0.00001), with carriers of ≥19 risk alleles having 51% increased risk compared to carriers of ≤12 alleles.

Traits studied:DyslipidemiaHyperglycemiaHypertensionMetabolic syndromeObesityType 2 diabetes
Pharmacogenetics: data, concepts and tools to improve drug discovery and drug treatment
ReviewJürgen Brockmöller et al.(2008)· European Journal of Clinical Pharmacology

This comprehensive review article traces the evolution of pharmacogenetics from single-gene analysis to whole-genome approaches. It discusses validated pharmacogenetic biomarkers with clinical impact including CYP2D6, CYP2C9, CYP2C19, TPMT, DPD, VKORC1, UGT1A1, and ADRB1/ADRB2, providing examples of how genetic variants affect drug metabolism and response. The paper emphasizes the importance of integrating pharmacogenetic information into clinical practice and drug development.

Traits studied:5-fluorouracil toxicityanticoagulant responseantidepressant responseasthmaatrial fibrillationbeta-blocker responsebreast cancerclopidogrel responsecolorectal cancerdrug metabolismdrug responsehypertensionirinotecan toxicitylung cancerproton pump inhibitor metabolismrheumatoid arthritisthiopurine toxicitythrombosis risktype 2 diabeteswarfarin sensitivity
Variations in the HHEX gene are associated with increased risk of type 2 diabetes in the Japanese population
AssociationN=1,728Horikoshi M. et al.(2007)· Diabetologia

This case-control association study in 864 Japanese type 2 diabetes patients and 864 controls confirmed that three SNPs in HHEX (rs5015480 OR=1.46, rs7923837 OR=1.40, rs1111875 OR=1.30) were significantly associated with type 2 diabetes across ethnic groups. SNPs in FTO, CDKAL1, CDKN2B, and SLC30A8 showed nominal associations, while several SNPs were associated with impaired pancreatic beta cell function measured by HOMA-beta index.

Traits studied:Type 2 diabetes

Gene information from NCBI Gene. Variant classifications from ClinVar.

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