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Marchand M, Erickson AC, Gillman L, Haywood R, Morrison J, Jaworsky D, Drouin O, Laksman Z, Krahn AD, Arbour L. The Impact of Chronic Disease on the Corrected QT (QTc) Value in Women in a British Columbia First Nations Population. Can J Cardiol 2024; 40:89-97. [PMID: 37852605 DOI: 10.1016/j.cjca.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/27/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Indigenous women have higher rates of chronic disease than Indigenous men and non-Indigenous women. Long QT syndrome (LQTS) can be inherited or acquired; the latter may occur with chronic disease. A prolonged corrected QT value (QTc) is an independent risk factor for ventricular arrhythmias and sudden death, but few studies have quantified the impact of chronic disease on the QTc. We assessed the association between chronic disease and QTc prolongation in a population of First Nations women previously ascertained to study a high rate of inherited LQTS due to a unique genetic (founder) variant in their community. METHODS This substudy focusing on women expands on the original research where patients with clinical features of LQTS and their relatives were assessed for genetic variants discovered to affect the QTc. Medical records were retrospectively reviewed and chronic diseases documented. Using multivariate linear regression, adjusting for the effect of genetic variants, age, and QTc-prolonging medications, we evaluated the association between chronic disease and the QTc. RESULTS In total, 275 women were included. After adjustments, a prolonged QTc was associated with coronary artery disease (26.5 ms, 95% confidence interval [CI] 9.0-44.1 ms; P = 0.003), conduction system disease (26.8 ms, 95% CI 2.2-51.4 ms; P = 0.033), rheumatoid arthritis (28.9 ms, 95% CI 12.7-45.1 ms; P = 0.001), and type 2 diabetes mellitus (17.9 ms, 95% CI 3.6-32.3 ms; P = 0.015). CONCLUSIONS This quantification of the association between chronic disease and QTc prolongation in an Indigenous cohort provides insight into the nongenetic determinants of QTc prolongation. Corroboration in other populations will provide evidence for generalisability of these results.
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Affiliation(s)
- Miles Marchand
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada; Syilx Okanagan Nation, British Columbia, Canada
| | - Anders C Erickson
- Population and Public Health Division, British Columbia Ministry of Health, Victoria, British Columbia, Canada(‡)
| | - Lawrence Gillman
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada; Community Genetics Research Program, University of British Columbia, Island Medical Program, Victoria, British Columbia, Canada
| | - Rachel Haywood
- Community Genetics Research Program, University of British Columbia, Island Medical Program, Victoria, British Columbia, Canada
| | - Julie Morrison
- Community Member, Gitxsan Nation, British Columbia, Canada
| | - Denise Jaworsky
- Northern Health Authority, Terrace, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Olivier Drouin
- Northern Health Authority, Terrace, British Columbia, Canada
| | - Zachary Laksman
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew D Krahn
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada; Community Genetics Research Program, University of British Columbia, Island Medical Program, Victoria, British Columbia, Canada.
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Lima B, Razmjouei S, Bajwa MT, Shahzad Z, Shoewu OA, Ijaz O, Mange P, Khanal S, Gebregiorgis T. Polypharmacy, Gender Disparities, and Ethnic and Racial Predispositions in Long QT Syndrome: An In-Depth Review. Cureus 2023; 15:e46009. [PMID: 37900391 PMCID: PMC10600617 DOI: 10.7759/cureus.46009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Long QT syndrome (LQTS) is a complex disorder of cardiac electrophysiology. It is characterized by delayed myocardial polarization leading to QT prolongation and alterations on the ST segment and T wave visible on electrocardiogram (ECG). Syncope is a common manifestation, and torsade de pointes (TdP) can lead to sudden cardiac death. Three major LQTS genes (KCI31, KCNH2, and SCN5) lead to most of the cases of LQTS. Lifestyle modifications, beta blockers, and implantable cardioverter defibrillator (ICD) placement are the main treatments for LQTS. Polypharmacy, including QT-prolonging drugs, has been shown to worsen LQTS. The impact on potassium channels and the human ether-a-go-go-related gene (hERG) is the mechanism behind the QT interval prolongation caused by these medications. There is an increased incidence of LQTS among African-American men and women as compared to Caucasians. Women with LQTS tend to have a higher mortality rate from the condition, especially during menstruation and shortly after giving birth. Genetic testing is reserved to those patientswho exhibit either a strong clinical index of suspicion or experience persistent QT prolongation despite their lack of symptoms. Knowing the genetics, racial, and gender discrepancies can help improve patient management and a better comprehension on each case. Proper understanding of how ion channels function and their interaction with medications will lead to a better comprehension and to develop effective forms to treat those patients.
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Affiliation(s)
- Bruno Lima
- Medicine, University of Grande Rio, Rio Grande, USA
| | - Soha Razmjouei
- Anesthesiology, Case Western Reserve University School of Medicine, Cleveland, USA
| | | | - Zoha Shahzad
- Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK
| | | | - Osama Ijaz
- Internal Medicine, Services Hospital Lahore, Lahore, PAK
| | - Pooja Mange
- Internal Medicine, K.J. Somaiya Hospital and Research Center, Mumbai, IND
| | | | - Tsion Gebregiorgis
- General Practice, Addis Ababa University Medical Faculty, Addis Ababa, ETH
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Kondamudi N, Zeleke Y, Rosenblatt A, Hu G, Grubb C, Link MS. The Association of QRS Duration with Risk of Adverse Outcomes in Sex- and Race- Based Subgroups: The Dallas Heart Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.15.23290016. [PMID: 37293027 PMCID: PMC10246055 DOI: 10.1101/2023.05.15.23290016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Introduction We explored sex and race differences in the prognostic implications of QRS prolongation among healthy adults. Methods Participants from the Dallas Heart Study (DHS) free of cardiovascular (CV) disease who underwent ECG testing and cMRI evaluation were included. Multivariable linear regression was used to examine the cross-sectional association of QRS duration with left ventricular (LV) mass, LV ejection fraction (LVEF), and LV end diastolic volume (LVEDV). Association of QRS duration with risk of MACE was evaluated using Cox models. Interaction testing was performed between QRS duration and sex/race respectively for each outcome of interest. QRS duration was log transformed. Results The study included 2,785 participants. Longer QRS duration was associated with higher LV mass, lower LVEF, and higher LVEDV, independent of CV risk factors ([β: 0.21, P<0.001], [β: - 0.13, P<0.001], [β: 0.22, P<0.001] respectively). Men with longer QRS duration were more likely to have higher LV mass and higher LVEDV compared to women (P-int=0.012, P-int=0.01, respectively). Black participants with longer QRS duration were more likely to have higher LV mass as compared to White participants (P-int<0.001). In Cox analysis, QRS prolongation was associated with higher risk of MACE in women (HR = 6.66 [95% CI: 2.32, 19.1]) but not men. This association was attenuated after adjustment for CV risk factors, with a trend toward significance (HR = 2.45 [95% CI: 0.94, 6.39]). Longer QRS duration was not associated with risk of MACE in Black or White participants in the adjusted models. No interaction between sex/race and QRS duration for risk of MACE was observed. Discussion In healthy adults, QRS duration is differentially associated with abnormalities in LV structure and function. These findings inform the use of QRS duration in identifying subgroups at risk for CV disease, and caution against using QRS duration cut offs uniformly for clinical decision making. What is known? QRS prolongation in healthy adults is associated with higher risk of death, cardiovascular disease, and left ventricular hypertrophy. What the study adds? QRS prolongation may reflect a higher degree of underlying LV hypertrophy in Blacks compared to Whites. Longer QRS interval may reflect higher risk of adverse cardiac events, driven by prevalent cardiovascular risk factors. Graphic Abstract Risk of underlying left ventricular hypertrophy in demographic groups based on QRS prolongation.
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Hoffmann TJ, Lu M, Oni-Orisan A, Lee C, Risch N, Iribarren C. A large genome-wide association study of QT interval length utilizing electronic health records. Genetics 2022; 222:iyac157. [PMID: 36271874 PMCID: PMC9713425 DOI: 10.1093/genetics/iyac157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/22/2022] [Indexed: 12/13/2022] Open
Abstract
QT interval length is an important risk factor for adverse cardiovascular outcomes; however, the genetic architecture of QT interval remains incompletely understood. We conducted a genome-wide association study of 76,995 ancestrally diverse Kaiser Permanente Northern California members enrolled in the Genetic Epidemiology Research on Adult Health and Aging cohort using 448,517 longitudinal QT interval measurements, uncovering 9 novel variants, most replicating in 40,537 individuals in the UK Biobank and Population Architecture using Genomics and Epidemiology studies. A meta-analysis of all 3 cohorts (n = 117,532) uncovered an additional 19 novel variants. Conditional analysis identified 15 additional variants, 3 of which were novel. Little, if any, difference was seen when adjusting for putative QT interval lengthening medications genome-wide. Using multiple measurements in Genetic Epidemiology Research on Adult Health and Aging increased variance explained by 163%, and we show that the ≈6 measurements in Genetic Epidemiology Research on Adult Health and Aging was equivalent to a 2.4× increase in sample size of a design with a single measurement. The array heritability was estimated at ≈17%, approximately half of our estimate of 36% from family correlations. Heritability enrichment was estimated highest and most significant in cardiovascular tissue (enrichment 7.2, 95% CI = 5.7-8.7, P = 2.1e-10), and many of the novel variants included expression quantitative trait loci in heart and other relevant tissues. Comparing our results to other cardiac function traits, it appears that QT interval has a multifactorial genetic etiology.
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Affiliation(s)
- Thomas J Hoffmann
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Meng Lu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Akinyemi Oni-Orisan
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA 94143, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Neil Risch
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Carlos Iribarren
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
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Development and Validation of a Nomogram for Prediction of QT Interval Prolongation in Patients Administered Bedaquiline-Containing Regimens in China: a Modeling Study. Antimicrob Agents Chemother 2022; 66:e0203321. [PMID: 36047781 PMCID: PMC9487587 DOI: 10.1128/aac.02033-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Corrected QT duration (QTc) interval prolongation is the most frequent adverse event associated with bedaquiline (BDQ) use. It may affect the safety of antituberculosis therapy, which leads to the consequent demands of needing to monitor during therapy. Our objective was to establish and validate a prediction model for estimating the risk of QTc prolongation after initiation of BDQ-containing regimens to multidrug-resistant tuberculosis (MDR-TB) patients. We constructed an individualized nomogram model based on baseline demographic and clinical characteristics of each patient within a Chinese cohort during BDQ treatment. The generalizability of this model was further validated through use of externally acquired data obtained from Beijing Chest Hospital from 2019 to 2020. Overall, 1,215 and 165 patients were included in training and external validation cohorts, respectively, whereby during anti-TB drug treatment, QTc prolongation was observed in 273 (22.5%) and 29 (17.6%) patients within these respective cohorts, for whom QTc values were >500 ms in 86 (31.5%) and 10 (34.7%) patients, respectively. Next, a total of four Cox proportional hazards models were created and assessed; then, nomograms derived from the models were plotted based on independent predictors of clofazimine, baseline QTc interval, creatinine, extensive drug-resistance (XDR), moxifloxacin, levofloxacin, and sex. Nomogram analysis revealed concordance index values of 0.723 (95% confidence interval [CI], 0.695 to 0.750) for the training cohort and 0.710 (95% CI, 0.627 to 0.821) for the external validation cohort, thus indicating relatively fair agreement between predicted and observed probabilities of QTc prolongation occurrence based on data obtained during 8-week, 16-week, and 24-week anti-TB treatment of both cohorts. Taken together, results obtained using these models demonstrated that coadministration of clofazimine and abnormal baseline QTc interval significantly contributed to QTc prolongation development during MDR-TB patient treatment with a BDQ-containing anti-TB treatment regimen.
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Age, sex and race bias in automated arrhythmia detectors. J Electrocardiol 2022; 74:5-9. [PMID: 35878534 DOI: 10.1016/j.jelectrocard.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
Despite the recent explosion of machine learning applied to medical data, very few studies have examined algorithmic bias in any meaningful manner, comparing across algorithms, databases, and assessment metrics. In this study, we compared the biases in sex, age, and race of 56 algorithms on over 130,000 electrocardiograms (ECGs) using several metrics and propose a machine learning model design to reduce bias. Participants of the 2021 PhysioNet Challenge designed and implemented working, open-source algorithms to identify clinical diagnosis from 2- lead ECG recordings. We grouped the data from the training, validation, and test datasets by sex (male vs female), age (binned by decade), and race (Asian, Black, White, and Other) whenever possible. We computed recording-wise accuracy, area under the receiver operating characteristic curve (AUROC), area under the precision recall curve (AUPRC), F-measure, and the Challenge Score for each of the 56 algorithms. The Mann-Whitney U and the Kruskal-Wallis tests assessed the performance differences of algorithms across these demographic groups. Group trends revealed similar values for the AUROC, AUPRC, and F-measure for both male and female groups across the training, validation, and test sets. However, recording-wise accuracies were 20% higher (p < 0.01) and the Challenge Score 12% lower (p = 0.02) for female subjects on the test set. AUPRC, F-measure, and the Challenge Score increased with age, while recording-wise accuracy and AUROC decreased with age. The results were similar for the training and test sets, but only recording-wise accuracy (12% decrease per decade, p < 0.01), Challenge Score (1% increase per decade, p < 0.01), and AUROC (1% decrease per decade, p < 0.01) were statistically different on the test set. We observed similar AUROC, AUPRC, Challenge Score, and F-measure values across the different race categories. But, recording-wise accuracies were significantly lower for Black subjects and higher for Asian subjects on the training (31% difference, p < 0.01) and test (39% difference, p < 0.01) sets. A top performing model was then retrained using an additional constraint which simultaneously minimized differences in performance across sex, race and age. This resulted in a modest reduction in performance, with a significant reduction in bias. This work provides a demonstration that biases manifest as a function of model architecture, population, cost function and optimization metric, all of which should be closely examined in any model.
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Bloomfield GS, Weir IR, Ribaudo HJ, Fitch KV, Fichtenbaum CJ, Moran LE, Bedimo R, de Filippi C, Morse CG, Piccini J, Zanni MV, LU MT, Hoffmann U, Grinspoon SK, Douglas PS. Prevalence and Correlates of Electrocardiographic Abnormalities in Adults With HIV: Insights From the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE). J Acquir Immune Defic Syndr 2022; 89:349-359. [PMID: 35147583 PMCID: PMC8837824 DOI: 10.1097/qai.0000000000002877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND People with HIV (PWH) are at increased risk of cardiovasvular disease (CVD) and sudden cardiac death. Previous work has suggested an association between HIV infection and electrocardiographic (ECG) abnormalities. There are limited data on the burden of ECG abnormalities among PWH in a multiracial, multiethnic globally representative population. SETTING One hundred twenty sites in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE). METHODS ECG findings were grouped into clinically relevant categories using sex-specific thresholds when indicated. We used the Fisher exact tests to assess associations of demographic characteristics and ECG abnormalities. We used logistic regression model to assess associations between demographic and HIV management measures, with adjustment. RESULTS We analyzed data for 7720 PWH (99% of participants) (median age 50 years, 69% male participants). There were 3346 (43%) Black or African American, 2680 (35%) White, and 1139 (15%) Asian participants. Most of the participants (97%) had viral load that was <400 copies/mL or 400 copies/mL had approximately twice the odds of prolonged QTc compared with those that were undetectable (adjusted OR: 2.05, 95% CI: 1.22 to 3.45). CONCLUSIONS Prolonged QTc is common among male, Asian, and REPRIEVE participants with higher viral loads. These relationships warrant future investigation of linkages to ensuing CVD events among PWH.
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Affiliation(s)
| | - Isabelle R. Weir
- Center for Biostatistics in AIDS Research in the Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston MA
| | - Heather J. Ribaudo
- Center for Biostatistics in AIDS Research in the Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston MA
| | - Kathleen V. Fitch
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Laura E. Moran
- Social & Scientific Systems, a DLH Company, Silver Spring, Maryland, USA
| | | | | | | | - Jonathan Piccini
- Duke Clinical Research Institute, Duke University School of Medicine, Durham NC
| | - Markella V. Zanni
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael T. LU
- Massachusetts General Hospital Cardiovascular Imaging Research Center and Harvard Medical School, Boston, MA
| | - Udo Hoffmann
- Massachusetts General Hospital Cardiovascular Imaging Research Center and Harvard Medical School, Boston, MA
| | - Steven K. Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Pamela S. Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham NC
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VEGF-A, VEGFR1 and VEGFR2 single nucleotide polymorphisms and outcomes from the AGITG MAX trial of capecitabine, bevacizumab and mitomycin C in metastatic colorectal cancer. Sci Rep 2022; 12:1238. [PMID: 35075138 PMCID: PMC8786898 DOI: 10.1038/s41598-021-03952-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/24/2021] [Indexed: 02/08/2023] Open
Abstract
The phase III MAX clinical trial randomised patients with metastatic colorectal cancer (mCRC) to receive first-line capecitabine chemotherapy alone or in combination with the anti-VEGF-A antibody bevacizumab (± mitomycin C). We utilised this cohort to examine whether single nucleotide polymorphisms (SNPs) in VEGF-A, VEGFR1, and VEGFR2 are predictive of efficacy outcomes with bevacizumab or the development of hypertension. Genomic DNA extracted from archival FFPE tissue for 325 patients (69% of the MAX trial population) was used to genotype 16 candidate SNPs in VEGF-A, VEGFR1, and VEGFR2, which were analysed for associations with efficacy outcomes and hypertension. The VEGF-A rs25648 ‘CC’ genotype was prognostic for improved PFS (HR 0.65, 95% CI 0.49 to 0.85; P = 0.002) and OS (HR 0.70, 95% CI 0.52 to 0.94; P = 0.019). The VEGF-A rs699947 ‘AA’ genotype was prognostic for shorter PFS (HR 1.32, 95% CI 1.002 to 1.74; P = 0.048). None of the analysed SNPs were predictive of bevacizumab efficacy outcomes. VEGFR2 rs11133360 ‘TT’ was associated with a lower risk of grade ≥ 3 hypertension (P = 0.028). SNPs in VEGF-A, VEGFR1 and VEGFR2 did not predict bevacizumab benefit. However, VEGF-A rs25648 and rs699947 were identified as novel prognostic biomarkers and VEGFR2 rs11133360 was associated with less grade ≥ 3 hypertension.
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Tait BD. The importance of establishing genetic phase in clinical medicine. Int J Immunogenet 2021; 49:1-7. [PMID: 34958529 DOI: 10.1111/iji.12567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 12/27/2022]
Abstract
Haplotyping or determination of genetic phase has always played a pivotal role in MHC (HLA studies) both in helping to understand inheritance patterns in diseases such as type 1 diabetes (T1D) and in ensuring better matching in transplantation scenarios such as haematopoietic stem cell transplantation (HSCT), using donors genetically related to the patient. In recent years the need to establish genetic phase in a number of clinical scenarios has become apparent. These include: Genetic phasing for hematopoietic stem cell transplants using unrelated donors, where the HLA haplotypes are not known but where haplotype-matched recipients fare better clinically than allele matched, but haplotype mismatched patients. The use of checkpoint inhibitors is one of the most innovative and exciting developments in cancer treatment in years. An example is the use of the monoclonal ipilimumab to block the CTLA-4 receptor which is known to contain polymorphic sites. Until the phase of these polymorphisms is known it will not be possible to determine how effectively this monoclonal will perform in individual patients. The role of miRNA single strand molecules and their effect on gene expression. Thousands of non-coding genes have been identified and have been shown to be polymorphic, as have their target genes. Genetic phasing of polymorphism both in the miRNA source genes and their targets is clearly a fertile area of research In areas such a drug metabolism where the polymorphic family of CYP genes is responsible for the metabolism of the majority of prescription drugs, determining phase of SNPs is critical to understanding drug metabolism and efficacy. In multigenic disease studies combinations of single nucleotide polymorphisms (SNPs) in participating genes require accurate phasing in order to fully appreciate their role in the disease process. In addition, the level of expression of genes (point 3) is also important in understanding disease processes at the functional level. This review outlines the techniques that are currently available for approximating phase and discusses the clinical relevance of establishing genetic phase in areas of clinical medicine outlined in points 1-3.
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Affiliation(s)
- Brian D Tait
- Haplomic Technologies, Melbourne, Australia.,Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Australia
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Guo X, Li Z, Zhou Y, Yu S, Yang H, Sun G, Zheng L, Lee BK, Pletcher MJ, Sun Y. Corrected QT Interval Is Associated With Stroke but Not Coronary Heart Disease: Insights From a General Chinese Population. Front Cardiovasc Med 2021; 8:605774. [PMID: 34368239 PMCID: PMC8333696 DOI: 10.3389/fcvm.2021.605774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Prolonged heart rate-corrected QT (QTc) interval has been associated with incident cardiovascular diseases (CVD) in general Western populations. However, this association is unclear in Asian population. We aim to estimate the association between QTc interval and incident CVD in a general Chinese population. Methods: We analyzed 8,867 participants age ≥35 years and free of CVD at baseline in the Northeast China Rural Cardiovascular Health Study. A resting 12-lead electrocardiogram was performed on all participants, and QTc interval computed using the Framingham formula. Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for associations between QTc interval and incident stroke, coronary heart disease, and combined CVD events. Results: Over a median follow-up of 4.66 years, a total of 439 CVD events occurred (298 stroke cases and 152 CHD cases). After full adjustment, prolonged QTc defined by a sex-specific cutoff was associated with increased risk of developing stroke (HR: 1.82, 95% CI 1.20–2.75, P = 0.004) and combined CVD (HR: 1.52, 95% CI 1.05–2.19, P = 0.026). Spline analyses demonstrated no clear thresholds; when modeled as a linear relationship, each 10 ms increase of QTc interval was associated with an HR of 1.12 (95% CI 1.06–1.19, P < 0.001) for stroke and an HR of 1.10 (95% CI 1.05–1.15, P < 0.001) for combined CVD. Baseline QTc interval was not associated with incident CHD with either modeling strategy. Conclusions: Baseline QTc interval is associated with incident stroke and CVD in adults without prior CVD from a general Chinese population.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Ying Zhou
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Byron K Lee
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
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Winbo A, Earle N, Marcondes L, Crawford J, Prosser DO, Love DR, Merriman TR, Cadzow M, Stiles R, Donoghue T, Stiles MK, Hayes I, Skinner JR. Genetic testing in Polynesian long QT syndrome probands reveals a lower diagnostic yield and an increased prevalence of rare variants. Heart Rhythm 2020; 17:1304-1311. [PMID: 32229296 DOI: 10.1016/j.hrthm.2020.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND New Zealand has a multiethnic population and a national cardiac inherited disease registry (Cardiac Inherited Disease Registry New Zealand [CIDRNZ]). Ancestry is reflected in the spectrum and prevalence of genetic variants in long QT syndrome (LQTS). OBJECTIVE The purpose of this study was to study the genetic testing yield and mutation spectrum of CIDRNZ LQTS probands stratified by self-identified ethnicity. METHODS A 15-year retrospective review of clinical CIDRNZ LQTS probands with a Schwartz score of ≥2 who had undergone genetic testing was performed. RESULTS Of the 264 included LQTS probands, 160 (61%) reported as European, 79 (30%) NZ Māori and Pacific peoples (Polynesian), and 25 (9%) Other ethnicities, with comparable clinical characteristics across ethnic groups (cardiac events in 72%; age at presentation 28±19 years; corrected QT interval 512±55 ms). Despite comparable testing (5.3±1.4 LQTS genes), a class III-V LQTS variant was identified in 35% of Polynesian probands as compared with 63% of European and 72% of Other probands (P<.0001). Among variant-positive CIDRNZ LQTS probands (n=148), Polynesians were more likely to have non-missense variants (57% vs 39% and 25% in probands of European and Other ethnicity, respectively; P=.005) as well as long QT syndrome type 1-3 variants not reported elsewhere (71% vs European 22% and Other 28%; P<.0001). Variants found in multiple probands were more likely to be shared within the same ethnic group; P<.01). CONCLUSION Genetic testing of Polynesian LQTS probands has a lower diagnostic yield, despite comparable testing and clinical disease severity. Rare LQTS variants are more common in Polynesian LQTS probands. These data emphasize the importance of increasing the knowledge of genetic variation in the Polynesian population.
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Affiliation(s)
- Annika Winbo
- Department of Physiology, University of Auckland, Auckland, New Zealand; Department of Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.
| | - Nikki Earle
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Luciana Marcondes
- Department of Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand
| | - Jackie Crawford
- Department of Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand
| | - Debra O Prosser
- Diagnostic Genetics, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Donald R Love
- Diagnostic Genetics, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Tony R Merriman
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Rachael Stiles
- Department of Cardiology, Waikato Hospital, Waikato, New Zealand
| | - Tom Donoghue
- Department of Cardiology, Wellington Hospital, Wellington, New Zealand
| | - Martin K Stiles
- Department of Cardiology, Waikato Hospital, Waikato, New Zealand
| | - Ian Hayes
- Genetic Health Service NZ, Northern Hub, Auckland City Hospital, Auckland, New Zealand
| | - Jonathan R Skinner
- Department of Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand
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12
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Oliynyk RT. Future Preventive Gene Therapy of Polygenic Diseases from a Population Genetics Perspective. Int J Mol Sci 2019; 20:E5013. [PMID: 31658652 PMCID: PMC6834143 DOI: 10.3390/ijms20205013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 12/15/2022] Open
Abstract
With the accumulation of scientific knowledge of the genetic causes of common diseases and continuous advancement of gene-editing technologies, gene therapies to prevent polygenic diseases may soon become possible. This study endeavored to assess population genetics consequences of such therapies. Computer simulations were used to evaluate the heterogeneity in causal alleles for polygenic diseases that could exist among geographically distinct populations. The results show that although heterogeneity would not be easily detectable by epidemiological studies following population admixture, even significant heterogeneity would not impede the outcomes of preventive gene therapies. Preventive gene therapies designed to correct causal alleles to a naturally-occurring neutral state of nucleotides would lower the prevalence of polygenic early- to middle-age-onset diseases in proportion to the decreased population relative risk attributable to the edited alleles. The outcome would manifest differently for late-onset diseases, for which the therapies would result in a delayed disease onset and decreased lifetime risk; however, the lifetime risk would increase again with prolonging population life expectancy, which is a likely consequence of such therapies. If the preventive heritable gene therapies were to be applied on a large scale, the decreasing frequency of risk alleles in populations would reduce the disease risk or delay the age of onset, even with a fraction of the population receiving such therapies. With ongoing population admixture, all groups would benefit over generations.
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Affiliation(s)
- Roman Teo Oliynyk
- Centre for Computational Evolution, University of Auckland, Auckland 1010, New Zealand.
- Department of Computer Science, University of Auckland, Auckland 1010, New Zealand.
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13
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Chatterjee NA. Cardiac Ion Channelopathies and Stillbirth. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2018; 11:e002046. [PMID: 29874186 DOI: 10.1161/circgen.117.002046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Neal A Chatterjee
- From the Cardiac Arrhythmia Service, Cardiology Division, Massachusetts General Hospital, Boston.
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14
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Surendran S, Adaikalakoteswari A, Saravanan P, Shatwaan IA, Lovegrove JA, Vimaleswaran KS. An update on vitamin B12-related gene polymorphisms and B12 status. GENES AND NUTRITION 2018; 13:2. [PMID: 29445423 PMCID: PMC5801754 DOI: 10.1186/s12263-018-0591-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
Abstract
Background Vitamin B12 is an essential micronutrient in humans needed for health maintenance. Deficiency of vitamin B12 has been linked to dietary, environmental and genetic factors. Evidence for the genetic basis of vitamin B12 status is poorly understood. However, advancements in genomic techniques have increased the knowledge-base of the genetics of vitamin B12 status. Based on the candidate gene and genome-wide association (GWA) studies, associations between genetic loci in several genes involved in vitamin B12 metabolism have been identified. Objective The objective of this literature review was to identify and discuss reports of associations between single-nucleotide polymorphisms (SNPs) in vitamin B12 pathway genes and their influence on the circulating levels of vitamin B12. Methods Relevant articles were obtained through a literature search on PubMed through to May 2017. An article was included if it examined an association of a SNP with serum or plasma vitamin B12 concentration. Beta coefficients and odds ratios were used to describe the strength of an association, and a P < 0.05 was considered as statistically significant. Two reviewers independently evaluated the eligibility for the inclusion criteria and extracted the data. Results From 23 studies which fulfilled the selection criteria, 16 studies identified SNPs that showed statistically significant associations with vitamin B12 concentrations. Fifty-nine vitamin B12-related gene polymorphisms associated with vitamin B12 status were identified in total, from the following populations: African American, Brazilian, Canadian, Chinese, Danish, English, European ancestry, Icelandic, Indian, Italian, Latino, Northern Irish, Portuguese and residents of the USA. Conclusion Overall, the data analyzed suggests that ethnic-specific associations are involved in the genetic determination of vitamin B12 concentrations. However, despite recent success in genetic studies, the majority of identified genes that could explain variation in vitamin B12 concentrations were from Caucasian populations. Further research utilizing larger sample sizes of non-Caucasian populations is necessary in order to better understand these ethnic-specific associations.
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Affiliation(s)
- S Surendran
- 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, PO Box 226, Whiteknights, Reading, RG6 6AP UK
| | - A Adaikalakoteswari
- 2Warwick Medical School - Population Evidence and Technologies, University of Warwick, Coventry, CV4 7AL UK.,3UK Academic Department of Diabetes and Metabolism, George Eliot Hospital, Nuneaton, UK
| | - P Saravanan
- 2Warwick Medical School - Population Evidence and Technologies, University of Warwick, Coventry, CV4 7AL UK.,3UK Academic Department of Diabetes and Metabolism, George Eliot Hospital, Nuneaton, UK
| | - I A Shatwaan
- 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, PO Box 226, Whiteknights, Reading, RG6 6AP UK
| | - J A Lovegrove
- 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, PO Box 226, Whiteknights, Reading, RG6 6AP UK
| | - K S Vimaleswaran
- 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, PO Box 226, Whiteknights, Reading, RG6 6AP UK
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15
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Bigdeli TB, Ripke S, Peterson RE, Trzaskowski M, Bacanu SA, Abdellaoui A, Andlauer TFM, Beekman ATF, Berger K, Blackwood DHR, Boomsma DI, Breen G, Buttenschøn HN, Byrne EM, Cichon S, Clarke TK, Couvy-Duchesne B, Craddock N, de Geus EJC, Degenhardt F, Dunn EC, Edwards AC, Fanous AH, Forstner AJ, Frank J, Gill M, Gordon SD, Grabe HJ, Hamilton SP, Hardiman O, Hayward C, Heath AC, Henders AK, Herms S, Hickie IB, Hoffmann P, Homuth G, Hottenga JJ, Ising M, Jansen R, Kloiber S, Knowles JA, Lang M, Li QS, Lucae S, MacIntyre DJ, Madden PAF, Martin NG, McGrath PJ, McGuffin P, McIntosh AM, Medland SE, Mehta D, Middeldorp CM, Milaneschi Y, Montgomery GW, Mors O, Müller-Myhsok B, Nauck M, Nyholt DR, Nöthen MM, Owen MJ, Penninx BWJH, Pergadia ML, Perlis RH, Peyrot WJ, Porteous DJ, Potash JB, Rice JP, Rietschel M, Riley BP, Rivera M, Schoevers R, Schulze TG, Shi J, Shyn SI, Smit JH, Smoller JW, Streit F, Strohmaier J, Teumer A, Treutlein J, Van der Auwera S, van Grootheest G, van Hemert AM, Völzke H, Webb BT, Weissman MM, Wellmann J, Willemsen G, Witt SH, Levinson DF, Lewis CM, Wray NR, Flint J, Sullivan PF, Kendler KS. Genetic effects influencing risk for major depressive disorder in China and Europe. Transl Psychiatry 2017; 7:e1074. [PMID: 28350396 PMCID: PMC5404611 DOI: 10.1038/tp.2016.292] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 11/27/2016] [Indexed: 11/24/2022] Open
Abstract
Major depressive disorder (MDD) is a common, complex psychiatric disorder and a leading cause of disability worldwide. Despite twin studies indicating its modest heritability (~30-40%), extensive heterogeneity and a complex genetic architecture have complicated efforts to detect associated genetic risk variants. We combined single-nucleotide polymorphism (SNP) summary statistics from the CONVERGE and PGC studies of MDD, representing 10 502 Chinese (5282 cases and 5220 controls) and 18 663 European (9447 cases and 9215 controls) subjects. We determined the fraction of SNPs displaying consistent directions of effect, assessed the significance of polygenic risk scores and estimated the genetic correlation of MDD across ancestries. Subsequent trans-ancestry meta-analyses combined SNP-level evidence of association. Sign tests and polygenic score profiling weakly support an overlap of SNP effects between East Asian and European populations. We estimated the trans-ancestry genetic correlation of lifetime MDD as 0.33; female-only and recurrent MDD yielded estimates of 0.40 and 0.41, respectively. Common variants downstream of GPHN achieved genome-wide significance by Bayesian trans-ancestry meta-analysis (rs9323497; log10 Bayes Factor=8.08) but failed to replicate in an independent European sample (P=0.911). Gene-set enrichment analyses indicate enrichment of genes involved in neuronal development and axonal trafficking. We successfully demonstrate a partially shared polygenic basis of MDD in East Asian and European populations. Taken together, these findings support a complex etiology for MDD and possible population differences in predisposing genetic factors, with important implications for future genetic studies.
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Affiliation(s)
- T B Bigdeli
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - S Ripke
- Department of Psychiatry, Charite Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - R E Peterson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - M Trzaskowski
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - S-A Bacanu
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - A Abdellaoui
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T F M Andlauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - A T F Beekman
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Münster, Germany
| | - D H R Blackwood
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G Breen
- King's College London, NIHR BRC for Mental Health, London, UK
- King's College London, MRC Social Genetic and Developmental Psychiatry Centre, London, UK
| | - H N Buttenschøn
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - E M Byrne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - S Cichon
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Jülich, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - T-K Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - N Craddock
- Department of Psychological Medicine, Cardiff University, Cardiff, UK
| | - E J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - F Degenhardt
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - E C Dunn
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - A C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - A H Fanous
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - A J Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - J Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - M Gill
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - S D Gordon
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - S P Hamilton
- Department of Psychiatry, Kaiser-Permanente Northern California, San Fransisco, CA, USA
| | - O Hardiman
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - C Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - A C Heath
- Department of Psychiatry, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - A K Henders
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - S Herms
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - P Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - G Homuth
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - R Jansen
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - S Kloiber
- Max Planck Institute of Psychiatry, Munich, Germany
| | - J A Knowles
- Department of Psychiatry and The Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - M Lang
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Q S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, LLC, Titusville, NJ, USA
| | - S Lucae
- Max Planck Institute of Psychiatry, Munich, Germany
| | - D J MacIntyre
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - P A F Madden
- Department of Psychiatry, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - N G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - P J McGrath
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - P McGuffin
- King's College London, MRC Social Genetic and Developmental Psychiatry Centre, London, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - S E Medland
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - D Mehta
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - C M Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Y Milaneschi
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - G W Montgomery
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - B Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - D R Nyholt
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - M J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - B W J H Penninx
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - M L Pergadia
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - R H Perlis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - W J Peyrot
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - D J Porteous
- Medical Genetics Section, CGEM, IGMM, University of Edinburgh, Edinburgh, UK
| | - J B Potash
- Department of Psychiatry, University of Iowa, Iowa, IA, USA
| | - J P Rice
- Department of Psychiatry, Washington University in Saint Louis, St Louis, MO, USA
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - B P Riley
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - M Rivera
- Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
- King's College London, MRC Social Genetic and Developmental Psychiatry Centre, London, UK
| | - R Schoevers
- Department of Psychiatry, University of Groningen, University of Medical Center Groningen, Groningen, The Netherlands
| | - T G Schulze
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Institute of Psychiatric Phenomics and Genomics, Medical Center of the University of Munich, Campus Innenstadt, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, The Netherlands
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Human Genetics Branch, NIMH Division of Intramural Research Programs, Bethesda, MD, USA
| | - J Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - S I Shyn
- Division of Psychiatry, Group Health, Seattle, WA, USA
| | - J H Smit
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - J W Smoller
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - F Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - J Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - A Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - J Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - G van Grootheest
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - A M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - B T Webb
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - M M Weissman
- Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J Wellmann
- Institute of Epidemiology and Social Medicine, University of Muenster, Münster, Germany
| | - G Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - D F Levinson
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - C M Lewis
- King's College London, MRC Social Genetic and Developmental Psychiatry Centre, London, UK
- King's College London, Department of Medical and Molecular Genetics, London, UK
| | - N R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - J Flint
- Merton College, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - P F Sullivan
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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16
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Omer W, Naveed AK, Khan OJ, Khan DA. Role of Cytokine Gene Score in Risk Prediction of Premature Coronary Artery Disease. Genet Test Mol Biomarkers 2016; 20:685-691. [PMID: 27689253 DOI: 10.1089/gtmb.2016.0108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIMS Pro- and anti-inflammatory cytokines play a significant role in early atherosclerosis. Linkage disequilibrium patterns differ between ethnic groups pointing toward the need to develop population-specific gene risk scores. Our objective was to investigate the role of a cytokine gene score in the risk prediction of premature coronary artery disease (PCAD). METHODS A case-control study was performed at the National University of Sciences and Technology (NUST) in collaboration with the Cardiovascular Genetics Institute, University College London, United Kingdom. Three hundred forty subjects with >70% stenosis in at least one coronary vessel on angiography were labeled as PCAD cases and compared with 310 angio-negative controls. Genotyping of the rs187238 (interleukin [IL]-18), rs1800795 (IL-6), rs1800629 (tumor necrosis factor [TNF]-alpha), rs1800871 (IL-10), and rs1946519 (IL-18) SNPs was performed using KASPar and TaqMan assays. RESULTS The odds ratio for cytokine gene score was significantly higher for PCAD (p = 0.025) when adjusted for age, sex, and ethnicity. There was a highly significant difference in gene risk allele frequency between Pakistanis and Caucasians (Northwick Park Heart Study II [NPHSII]) for rs187238 (IL-18), rs1800795 (IL-6), rs1800629 (TNF-alpha), and rs1800871 (IL-10) (p < 0.01). CONCLUSIONS A cytokine gene score has significant discriminatory ability and potential in the risk prediction of PCAD. Cytokine gene risk allele frequencies differ significantly between Pakistanis and Caucasians supporting the need to develop population-specific gene scores.
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Affiliation(s)
- Wafa Omer
- 1 Department of Chemical Pathology, Azad Jammu and Kashmir Medical College , Muzaffarabad, Azad Jammu and Kashmir
| | - Abdul K Naveed
- 2 Riphah International University , Rawalpindi, Pakistan
| | - Omer J Khan
- 1 Department of Chemical Pathology, Azad Jammu and Kashmir Medical College , Muzaffarabad, Azad Jammu and Kashmir
| | - Dilshad A Khan
- 3 National University of Medical Sciences , Rawalpindi, Pakistan
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17
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Yu CC, Chia-Ti T, Chen PL, Wu CK, Chiu FC, Chiang FT, Chen PS, Chen CL, Lin LY, Juang JM, Ho LT, Lai LP, Yang WS, Lin JL. KCNN2 polymorphisms and cardiac tachyarrhythmias. Medicine (Baltimore) 2016; 95:e4312. [PMID: 27442679 PMCID: PMC5265796 DOI: 10.1097/md.0000000000004312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Potassium calcium-activated channel subfamily N member 2 (KCNN2) encodes an integral membrane protein that forms small-conductance calcium-activated potassium (SK) channels. Recent studies in animal models show that SK channels are important in atrial and ventricular repolarization and arrhythmogenesis. However, the importance of SK channels in human arrhythmia remains unclear. The purpose of the present study was to test the association between genetic polymorphism of the SK2 channel and the occurrence of cardiac tachyarrhythmias in humans. We enrolled 327 Han Chinese, including 72 with clinically significant ventricular tachyarrhythmias (VTa) who had a history of aborted sudden cardiac death (SCD) or unexplained syncope, 98 with a history of atrial fibrillation (AF), and 144 normal controls. We genotyped 12 representative tag single nucleotide polymorphisms (SNPs) across a 141-kb genetic region containing the KCNN2 gene; these captured the full haplotype information. The rs13184658 and rs10076582 variants of KCNN2 were associated with VTa in both the additive and dominant models (odds ratio [OR] 2.89, 95% confidence interval [CI] = 1.505-5.545, P = 0.001; and OR 2.55, 95% CI = 1.428-4.566, P = 0.002, respectively). After adjustment for potential risk factors, the association remained significant. The population attributable risks of these 2 variants of VTa were 17.3% and 10.6%, respectively. One variant (rs13184658) showed weak but significant association with AF in a dominant model (OR 1.91, CI = 1.025-3.570], P = 0.042). There was a significant association between the KCNN2 variants and clinically significant VTa. These findings suggest an association between KCNN2 and VTa; it also appears that KCNN2 variants may be adjunctive markers for risk stratification in patients susceptible to SCD.
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Affiliation(s)
- Chih-Chieh Yu
- Department of Internal Medicine, National Taiwan University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
| | - Tsai Chia-Ti
- Department of Internal Medicine, National Taiwan University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
| | - Pei-Lung Chen
- Department of Internal Medicine, National Taiwan University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
- Department of Medical Genetics, National Taiwan University Hospital
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei
| | - Cho-Kai Wu
- Department of Internal Medicine, National Taiwan University Hospital
| | - Fu-Chun Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
| | - Fu-Tien Chiang
- Department of Internal Medicine, National Taiwan University Hospital
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chi-Ling Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Lian-Yu Lin
- Department of Internal Medicine, National Taiwan University Hospital
| | - Jyh-Ming Juang
- Department of Internal Medicine, National Taiwan University Hospital
| | - Li-Ting Ho
- Department of Internal Medicine, National Taiwan University Hospital
| | - Ling-Ping Lai
- Department of Internal Medicine, National Taiwan University Hospital
| | - Wei-Shiung Yang
- Department of Internal Medicine, National Taiwan University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei
- Correspondence: Jiunn-Lee Lin, Wei-Shiung Yang, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung San South Road, Taipei City 100, Taiwan (R.O.C.) (e-mail: , )
| | - Jiunn-Lee Lin
- Department of Internal Medicine, National Taiwan University Hospital
- Correspondence: Jiunn-Lee Lin, Wei-Shiung Yang, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung San South Road, Taipei City 100, Taiwan (R.O.C.) (e-mail: , )
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18
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Santhanakrishnan R, Wang N, Larson MG, Magnani JW, Vasan RS, Wang TJ, Yap J, Feng L, Yap KB, Ong HY, Ng TP, Richards AM, Lam CSP, Ho JE. Racial Differences in Electrocardiographic Characteristics and Prognostic Significance in Whites Versus Asians. J Am Heart Assoc 2016; 5:e002956. [PMID: 27016575 PMCID: PMC4943269 DOI: 10.1161/jaha.115.002956] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Racial differences in electrocardiographic (ECG) characteristics and prognostic significance among Whites and Asians are not well described. Methods and Results We studied 2677 White Framingham Heart Study participants (57% women) and 2972 Asian (64% women) Singapore Longitudinal Aging Study participants (mean age 66 years in both) free of myocardial infarction or heart failure. Racial differences in ECG characteristics and effect on mortality were assessed. In linear regression models, PR interval was longer in Asians compared with Whites (multivariable‐adjusted β±SE 5.0±1.4 ms in men and 6.6±0.9 ms in women, both P<0.0006). QT interval was shorter in Asian men (β±SE −6.2±1.2 ms, P<0.0001) and longer in Asian women (β±SE 3.6±0.9 ms, P=0.02) compared to White men and women, respectively. Asians had greater odds of having ECG left ventricular hypertrophy (LVH) compared with Whites (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.36–9.35 for men, OR 1.93, 95% CI 1.35–2.76 for women, both P<0.02). Over a mean follow‐up of 11±3 years in Framingham and 8±3 years in Singapore, mortality rates were 24.5 and 13.4 per 1000 person‐years among Whites and Asians, respectively. In Cox models, the presence of LVH had a greater effect on all‐cause mortality in Asians compared with Whites (hazard ratio [HR] 2.66, 95% CI 1.83–3.88 vs HR 1.30, 95% CI 0.90–1.89, P for interaction=0.02). Conclusion Our findings from two large community‐based cohorts show prominent race differences in ECG characteristics between Whites and Asians, and also suggest a differential association with mortality. These differences may carry implications for race‐specific ECG reference ranges and cardiovascular risk.
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Affiliation(s)
| | - Na Wang
- Data Coordinating Center, Boston University School of Public Health, Boston, MA
| | - Martin G Larson
- Department of Mathematics and Statistics, Boston University, Boston, MA National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA
| | - Jared W Magnani
- Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA
| | - Ramachandran S Vasan
- Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA
| | - Thomas J Wang
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, TN
| | - Jonathan Yap
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Liang Feng
- Duke-NUS Graduate Medical School, Singapore
| | - Keng B Yap
- Geriatric Medicine, Ng Teng Fong Hospital, Singapore
| | - Hean Y Ong
- Department of Cardiology, Khoo Teck Puat Hospital, Singapore
| | - Tze P Ng
- Yong Loo Lin School of Medicine, Singapore
| | - Arthur Mark Richards
- Cardiovascular Research Institute, National University Health System, Singapore Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - Carolyn S P Lam
- Department of Cardiology, National Heart Centre Singapore, Singapore Duke-NUS Graduate Medical School, Singapore
| | - Jennifer E Ho
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA Cardiovascular Research Center and the Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
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19
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Dumitrescu L, Restrepo NA, Goodloe R, Boston J, Farber-Eger E, Pendergrass SA, Bush WS, Crawford DC. Towards a phenome-wide catalog of human clinical traits impacted by genetic ancestry. BioData Min 2015; 8:35. [PMID: 26566401 PMCID: PMC4642611 DOI: 10.1186/s13040-015-0068-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/02/2015] [Indexed: 01/13/2023] Open
Abstract
Background Racial/ethnic differences for commonly measured clinical variables are well documented, and it has been postulated that population-specific genetic factors may play a role. The genetic heterogeneity of admixed populations, such as African Americans, provides a unique opportunity to identify genomic regions and variants associated with the clinical variability observed for diseases and traits across populations. Method To begin a systematic search for these population-specific genomic regions at the phenome-wide scale, we determined the relationship between global genetic ancestry, specifically European and African ancestry, and clinical variables measured in a population of African Americans from BioVU, Vanderbilt University’s biorepository linked to de-identified electronic medical records (EMRs) as part of the Epidemiologic Architecture using Genomics and Epidemiology (EAGLE) study. Through billing (ICD-9) codes, procedure codes, labs, and clinical notes, 36 common clinical and laboratory variables were mined from the EMR, including body mass index (BMI), kidney traits, lipid levels, blood pressure, and electrocardiographic measurements. A total of 15,863 DNA samples from non-European Americans were genotyped on the Illumina Metabochip containing ~200,000 variants, of which 11,166 were from African Americans. Tests of association were performed to examine associations between global ancestry and the phenotype of interest. Results Increased European ancestry, and conversely decreased African ancestry, was most strongly correlated with an increase in QRS duration, consistent with previous observations that African Americans tend to have shorter a QRS duration compared with European Americans. Despite known racial/ethnic disparities in blood pressure, European and African ancestry was neither associated with diastolic nor systolic blood pressure measurements. Conclusion Collectively, these results suggest that this clinical population can be used to identify traits in which population differences may be due, in part, to population-specific genetics. Electronic supplementary material The online version of this article (doi:10.1186/s13040-015-0068-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Logan Dumitrescu
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Nicole A Restrepo
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Robert Goodloe
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Jonathan Boston
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Eric Farber-Eger
- Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232 USA
| | - Sarah A Pendergrass
- Center for Systems Genomics, Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA 16802 USA
| | - William S Bush
- Institute for Computational Biology, Department of Epidemiology and Biostatistics, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Suite 2527, Cleveland, OH 44106 USA
| | - Dana C Crawford
- Institute for Computational Biology, Department of Epidemiology and Biostatistics, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Road, Suite 2527, Cleveland, OH 44106 USA
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20
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Arbour L, Asuri S, Whittome B, Polanco F, Hegele RA. The Genetics of Cardiovascular Disease in Canadian and International Aboriginal Populations. Can J Cardiol 2015; 31:1094-115. [DOI: 10.1016/j.cjca.2015.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 12/16/2022] Open
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