rs13266634 — SLC30A8 Arg325Trp (C>T)

SLC30A8 Arg325Trp — The Zinc-Insulin Connection

The SLC30A8 gene encodes zinc transporter 8¹¹ zinc transporter 8
ZnT8 is a transmembrane protein that pumps zinc ions from the cytoplasm into insulin secretory granules inside pancreatic beta cells (ZnT8), a protein found almost exclusively in the insulin-producing beta cells of the pancreas. Its job is simple but critical: load zinc into the granules where insulin is stored. Zinc is essential for insulin to crystallize into its stable hexameric form — without adequate zinc, insulin is less stable, harder to store, and released less efficiently.

The rs13266634 variant changes a single amino acid at position 325 from arginine (encoded by the common C allele) to tryptophan (encoded by the T allele). This was one of the first type 2 diabetes risk loci identified by genome-wide association²² genome-wide association
Sladek R et al. A genome-wide association study identifies novel risk loci for type 2 diabetes. Nature, 2007, and it carries an unusual twist: the common allele (C, found in ~70% of people globally) is the risk allele, while the less common T allele is protective.

The Mechanism

ZnT8 sits in the membrane of insulin secretory granules and actively pumps zinc ions³³ zinc ions
Each insulin hexamer contains two Zn2+ ions at its core; roughly 70% of beta cell zinc resides in these granules into these compartments. Inside the granule, two zinc ions bind six insulin molecules to form a crystalline hexamer — the storage form of insulin. This crystallization increases storage capacity and protects insulin from premature degradation.

The Arg325 (C allele) and Trp325 (T allele) forms of ZnT8 differ in their zinc transport efficiency. Counterintuitively, the Arg325 version associated with the common C risk allele appears to transport zinc at higher capacity, yet carriers show impaired insulin processing⁴⁴ impaired insulin processing
Including elevated proinsulin-to-insulin ratios, suggesting that excess zinc granule loading may paradoxically interfere with the conversion of proinsulin to mature insulin and reduced first-phase insulin release. The Trp325 variant (T allele) has reduced transport activity but is associated with better insulin secretion dynamics.

This paradox was dramatically underscored when Flannick and colleagues⁵⁵ Flannick and colleagues
Flannick J et al. Loss-of-function mutations in SLC30A8 protect against type 2 diabetes. Nat Genet, 2014 discovered that rare complete loss-of-function mutations in SLC30A8 confer a striking 65% reduction in type 2 diabetes risk. This inverted the prevailing assumption that more ZnT8 activity equals better insulin function, and established ZnT8 inhibition as a potential therapeutic target.

The Evidence

The original GWAS⁶⁶ original GWAS
Sladek R et al. Nature, 2007 identified rs13266634 in a French cohort, and replication was swift. A meta-analysis of 46 studies⁷⁷ meta-analysis of 46 studies
Fan M et al. Association of SLC30A8 gene polymorphism with type 2 diabetes, evidence from 46 studies. Endocrine, 2016 encompassing 71,890 cases and 96,753 controls confirmed the association across European, Asian, and African populations with an odds ratio of approximately 1.15 per C allele (CC vs TT: OR ~1.53).

The EUGENE2 study⁸⁸ EUGENE2 study
Staiger H et al. The common SLC30A8 Arg325Trp variant is associated with reduced first-phase insulin release. Diabetologia, 2008 showed that CC homozygotes had a 19% decrease in first-phase insulin release during intravenous glucose tolerance testing compared to T allele carriers, providing a functional mechanism linking genotype to diabetes risk.

Critically, the relationship between this variant and diabetes risk is modifiable by zinc status. Chu and colleagues⁹⁹ Chu and colleagues
Chu A et al. Interactions between zinc transporter-8 gene and plasma zinc concentrations for impaired glucose regulation and type 2 diabetes. Diabetes, 2014 found that each 10 ug/dL increase in plasma zinc was associated with 22% lower odds of type 2 diabetes in TT carriers, 17% lower in CT carriers, but only 7% lower in CC carriers — a significant gene-nutrient interaction.

A zinc supplementation trial¹⁰¹⁰ zinc supplementation trial
Maruthur NM et al. Effect of zinc supplementation on insulin secretion: interaction between zinc and SLC30A8 genotype in Old Order Amish. Diabetologia, 2015 in 55 non-diabetic Amish individuals found that after 14 days of zinc supplementation (50 mg elemental zinc twice daily), carriers of the T allele experienced a 26% increase in early insulin response to glucose at 5 minutes compared to CC homozygotes — the first direct evidence that zinc supplementation can differentially improve beta cell function based on SLC30A8 genotype.

Practical Implications

This SNP sits at the intersection of genetics and nutrition. The key insight is that zinc status matters more for some genotypes than others. CC homozygotes have the highest baseline diabetes risk but show the smallest benefit from zinc optimization, while T allele carriers — who already have lower risk — get the most benefit from adequate zinc intake.

For everyone, ensuring adequate zinc intake supports insulin function. Good dietary sources include oysters, red meat, poultry, beans, nuts, and pumpkin seeds. For CC homozygotes, the focus should extend beyond zinc to broader metabolic health: maintaining a healthy weight, regular physical activity, and monitoring blood glucose are important given the modestly elevated diabetes risk.

Interactions

SLC30A8 rs13266634 interacts with other type 2 diabetes risk loci. The combination of the CC genotype here with TCF7L2 rs7903146 risk alleles (TT or CT) compounds overall diabetes risk through independent but converging pathways — SLC30A8 affecting insulin storage and release, TCF7L2 affecting beta cell development and incretin signaling. Individuals carrying risk alleles at both loci should be especially vigilant about metabolic health monitoring.

The SLC30A8 variant also influences ZnT8 autoantibody specificity in type 1 diabetes. The Arg325 (C allele) form is the dominant autoantibody target. While this does not change the type 2 diabetes risk interpretation, it adds a layer of immunological significance to this variant.