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Mendez IJ, Manemann SM, Bell EJ, Larson NB, Decker PA, Guerrero MA, Hanson NQ, Heckbert SR, Pankow JS, Tsai MY, Bielinski SJ. Adhesion pathway proteins and risk of atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis. BMC Cardiovasc Disord 2021; 21:436. [PMID: 34521347 PMCID: PMC8442417 DOI: 10.1186/s12872-021-02241-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/01/2021] [Indexed: 11/12/2022] Open
Abstract
Background The cellular adhesion pathway has been suggested as playing an important role in the pathogenesis of atrial fibrillation (AF). However, prior studies that have investigated the role of adhesion pathway proteins in risk of AF have been limited in the number of proteins that were studied and in the ethnic and racial diversity of the study population. Therefore we aimed to study the associations of fifteen adhesion pathway proteins with incident AF in a large, diverse population. Methods Multi-Ethnic Study of Atherosclerosis participants from four races/ethnicities (n = 2504) with protein levels measured were followed for incident AF (n = 253). HGF protein was measured on Exam 1 samples (N = 6669; AF n = 851). Cox proportional hazards regression was used to assess the association of AF with 15 adhesion pathway proteins. Bonferroni correction was applied to account for multiple comparisons. Results After adjusting for potential confounding variables (age, sex, race/ethnicity, height, body mass index, systolic blood pressure, antihypertension therapy, diabetes status, current smoker, current alcohol use, and total and HDL cholesterol), and accounting for multiple testing (P < 0.05/15 = 0.0033), circulating levels of the following proteins were positively associated with a higher risk of AF: MMP-2 (HR per standard deviation increment, 1.27; 95% CI 1.11‒1.45), TIMP-2 (HR 1.28; 95% CI 1.12‒1.46), VCAM-1 (HR 1.32; 95% CI 1.16‒1.50), and SLPI (HR 1.22; 95% CI 1.07‒1.38). The association between proteins and AF did not differ by race/ethnicity. Conclusions Circulating levels of MMP-2, TIMP-2, VCAM-1, and SLPI were positively associated with an increased risk of incident AF in a diverse population. Our findings suggest that adhesion pathway proteins may be important risk predictors of AF. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02241-w.
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Affiliation(s)
- Israel J Mendez
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street Southwest, Rochester, MN, USA.,University of Puerto Rico-School of Medicine, San Juan, PR, USA
| | - Sheila M Manemann
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street Southwest, Rochester, MN, USA
| | - Elizabeth J Bell
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.,Optum, Life Sciences, Eden Prairie, MN, USA
| | - Nicholas B Larson
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street Southwest, Rochester, MN, USA
| | - Paul A Decker
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street Southwest, Rochester, MN, USA
| | | | - Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Suzette J Bielinski
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street Southwest, Rochester, MN, USA.
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Decker PA, Larson NB, Bell EJ, Pankow JS, Hanson NQ, Wassel CL, Tsai MY, Bielinski SJ. Erratum to "Increased hepatocyte growth factor levels over 2 years are associated with coronary heart disease: The Multi-Ethnic Study of Atherosclerosis (MESA)" [Am Heart J (2019) 30-34]. Am Heart J 2019; 216:151. [PMID: 31439267 DOI: 10.1016/j.ahj.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Elizabeth J Bell
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | | | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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Decker PA, Larson NB, Bell EJ, Pankow JS, Hanson NQ, Wassel CL, Tsai MY, Bielinski SJ. Increased hepatocyte growth factor levels over 2 years are associated with coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J 2019; 213:30-34. [PMID: 31085382 DOI: 10.1016/j.ahj.2019.03.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/27/2019] [Indexed: 11/28/2022]
Abstract
Hepatocyte growth factor (HGF) is associated with subclinical and clinical atherosclerosis. However, the significance of change in HGF and development of atherosclerotic disease is unknown. In a large and diverse population-based cohort, we report that change in the biomarker HGF is an independent predictor of incident CHD.
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Affiliation(s)
- Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Elizabeth J Bell
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | | | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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Bielinski SJ, Berardi C, Decker PA, Larson NB, Bell EJ, Pankow JS, Sale MM, Tang W, Hanson NQ, Wassel CL, de Andrade M, Budoff MJ, Polak JF, Sicotte H, Tsai MY. Hepatocyte growth factor demonstrates racial heterogeneity as a biomarker for coronary heart disease. Heart 2017; 103:1185-1193. [PMID: 28572400 DOI: 10.1136/heartjnl-2016-310450] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/19/2017] [Accepted: 01/27/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine if hepatocyte growth factor (HGF), a promising biomarker of coronary heart disease (CHD) given its release into circulation in response to endothelial damage, is associated with subclinical and clinical CHD in a racial/ethnic diverse population. METHODS HGF was measured in 6738 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Highest mean HGF values (pg/mL) were observed in Hispanic, followed by African, non-Hispanic white, then Chinese Americans. RESULTS In all races/ethnicities, HGF levels were associated with older age, higher systolic blood pressure (SBP) and body mass index, lower high-density lipoprotein, diabetes and current smoking. In fully adjusted models, each SD higher HGF was associated with an average increase in coronary artery calcium (CAC) of 55 Agatston units for non-Hispanic whites (p<0.001) and 51 Agatston units for African-Americans (p=0.007) but was not in the other race/ethnic groups (interaction p=0.02). There were 529 incident CHD events, and CHD risk was 41% higher in African (p<0.001), 17% in non-Hispanic white (p=0.026) and Chinese (p=0.36), and 6% in Hispanic Americans (p=0.56) per SD increase in HGF. CONCLUSION In a large and diverse population-based cohort, we report that HGF is associated with subclinical and incident CHD. We demonstrate evidence of racial/ethnic heterogeneity within these associations, as the results are most compelling in African-Americans and non-Hispanic white Americans. We provide evidence that HGF is a biomarker of atherosclerotic disease that is independent of traditional risk factors.
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Affiliation(s)
- Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Cecilia Berardi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.,Department of Internal Medicine, Albert Einstein College of Medicine, and Montefiore Medical Center, Bronx, New York, USA
| | - Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth J Bell
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michele M Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Colchester, Vermont, USA
| | - Mariza de Andrade
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute, Harbor-UCLA, Torrance, California, USA
| | - Joseph F Polak
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Hugues Sicotte
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
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Pike MM, Larson NB, Wassel CL, Cohoon KP, Tsai MY, Pankow JS, Hanson NQ, Decker PA, Berardi C, Alexander KS, Cushman M, Zakai NA, Bielinski SJ. ABO blood group is associated with peripheral arterial disease in African Americans: The Multi-Ethnic Study of Atherosclerosis (MESA). Thromb Res 2017; 153:1-6. [PMID: 28267600 DOI: 10.1016/j.thromres.2017.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/25/2017] [Accepted: 02/22/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Peripheral artery disease (PAD) affects 8.5 million Americans and thus improving our understanding of PAD is critical to developing strategies to reduce disease burden. The objective of the study was to determine the association of ABO blood type with ankle brachial index (ABI) as well as prevalent and incident PAD in a multi-ethnic cohort. METHODS The Multi-Ethnic Study of Atherosclerosis includes non-Hispanic White, African, Hispanic, and Chinese Americans aged 45-84. ABO blood type was estimated using ABO genotypes in 6027 participants who had ABI assessed at the baseline exam. Associations with ABO blood type were evaluated categorically and under an additive genetic model by number of major ABO alleles. After excluding those with ABI>1.4, prevalent PAD was defined as ABI≤0.9 at baseline and incident PAD as ABI≤0.9 for 5137 participants eligible for analysis. RESULTS There were 222 prevalent cases and 239 incident cases of PAD. In African Americans, each additional copy of the A allele was associated with a 0.02 lower baseline ABI (p=0.006). Each copy of the A allele also corresponded to 1.57-fold greater odds of prevalent PAD (95% CI, 1.17-2.35; p=0.004), but was not associated with incident PAD. No associations were found in other racial/ethnic groups for ABI, prevalent PAD, or incident PAD across all races/ethnicities. CONCLUSIONS Blood type A and the A allele count were significantly associated with baseline ABI and prevalent PAD in African Americans. Further research is needed to confirm and study the mechanisms of this association in African Americans.
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Affiliation(s)
- Mindy M Pike
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA.
| | - Kevin P Cohoon
- Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA.
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Cecilia Berardi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
| | | | - Mary Cushman
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA.
| | - Neil A Zakai
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA.
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
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Bell EJ, Larson NB, Decker PA, Pankow JS, Tsai MY, Hanson NQ, Wassel CL, Longstreth WT, Bielinski SJ. Hepatocyte Growth Factor Is Positively Associated With Risk of Stroke: The MESA (Multi-Ethnic Study of Atherosclerosis). Stroke 2016; 47:2689-2694. [PMID: 27729582 DOI: 10.1161/strokeaha.116.014172] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Hepatocyte growth factor (HGF) is positively associated with ischemic and hemorrhagic stroke risk factors. However, understanding the relation between HGF and stroke is in its infancy. Therefore, we sought to examine the association of circulating HGF with incident stroke using data from the MESA (Multi-Ethnic Study of Atherosclerosis). We hypothesized that circulating HGF would be positively associated with an increased risk of stroke. METHODS Participants aged 45 to 84 years (n=6711) had HGF measured between 2000 and 2002 and were followed for incident stroke through 2013 (n=233). Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals for incident stroke. A secondary analysis stratified results by adjudicated stroke type (n=183 ischemic; n=39 hemorrhagic; n=11 other). RESULTS After adjustment for potential confounding variables, risk of stroke was 17% higher with each standard deviation increase in HGF (hazard ratio, 1.17; 95% confidence interval, 1.03-1.34). This association was mainly driven by ischemic stroke and did not change on exclusion of cardioembolic strokes, although the number of excluded cases was small. The few hemorrhagic and other types of stroke were not associated with HGF. CONCLUSIONS Circulating HGF was positively associated with the incidence of stroke in a diverse, population-based cohort of men and women from the United States. Our findings support the hypothesis that circulating HGF is a marker of endothelial damage and suggest that HGF may have utility as a prognostic marker of stroke risk.
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Affiliation(s)
- Elizabeth J Bell
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Nicholas B Larson
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Paul A Decker
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - James S Pankow
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Michael Y Tsai
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Naomi Q Hanson
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Christina L Wassel
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - W T Longstreth
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.)
| | - Suzette J Bielinski
- From the Division of Epidemiology (E.J.B., S.J.B.) and Division of Biomedical Statistics and Informatics (N.B.L., P.A.D.), Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Division of Epidemiology and Community Health (J.S.P.) and Laboratory of Medicine and Pathology (M.Y.T., N.Q.H.), University of Minnesota, Minneapolis; Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester (C.L.W.); and Departments of Neurology and Epidemiology, University of Washington, Seattle, WA (W.T.L.).
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Berardi C, Wassel CL, Decker PA, Larson NB, Kirsch PS, Andrade MD, Tsai MY, Pankow JS, Sale MM, Sicotte H, Tang W, Hanson NQ, McDermott MM, Criqui MH, Allison MA, Bielinski SJ. Elevated Levels of Adhesion Proteins Are Associated With Low Ankle-Brachial Index. Angiology 2016; 68:322-329. [PMID: 27436494 DOI: 10.1177/0003319716659178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Inflammation plays a pivotal role in peripheral artery disease (PAD). Cellular adhesion proteins mediate the interaction of leukocytes with endothelial cells during inflammation. To determine the association of cellular adhesion molecules with ankle-brachial index (ABI) and ABI category (≤1.0 vs >1.0) in a diverse population, 15 adhesion proteins were measured in the Multi-Ethnic Study of Atherosclerosis (MESA). To assess multivariable associations of each protein with ABI and ABI category, linear and logistic regression was used, respectively. Among 2364 participants, 23 presented with poorly compressible arteries (ABI > 1.4) and were excluded and 261 had ABI ≤ 1.0. Adjusting for traditional risk factors, elevated levels of soluble P-selectin, hepatocyte growth factor, and secretory leukocyte protease inhibitor were associated with lower ABI ( P = .0004, .001, and .002, respectively). Per each standard deviation of protein, we found 26%, 20%, and 19% greater odds of lower ABI category ( P = .001, .01, and .02, respectively). Further investigation into the adhesion pathway may shed new light on biological mechanisms implicated in PAD.
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Affiliation(s)
- Cecilia Berardi
- 1 Department of Internal Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.,2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Christine L Wassel
- 3 Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Colchester, VT, USA
| | - Paul A Decker
- 2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Nicholas B Larson
- 2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Phillip S Kirsch
- 2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mariza de Andrade
- 2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Michael Y Tsai
- 4 Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - James S Pankow
- 5 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Michele M Sale
- 6 Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Hugues Sicotte
- 2 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Weihong Tang
- 5 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q Hanson
- 4 Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Mary M McDermott
- 7 Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael H Criqui
- 8 Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Michael A Allison
- 8 Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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Pankow JS, Decker PA, Berardi C, Hanson NQ, Sale M, Tang W, Kanaya AM, Larson NB, Tsai MY, Wassel CL, Bielinski SJ. Circulating cellular adhesion molecules and risk of diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabet Med 2016; 33:985-91. [PMID: 26937608 PMCID: PMC4914403 DOI: 10.1111/dme.13108] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Abstract
AIMS To test the hypothesis that soluble cellular adhesion molecules would be positively and independently associated with risk of diabetes. METHODS Soluble levels of six cellular adhesion molecules (ICAM-1, E-selectin, VCAM-1, E-cadherin, L-selectin and P-selectin) were measured in participants in the Multi-Ethnic Study of Atherosclerosis, a prospective cohort study. Participants were then followed for up to 10 years to ascertain incident diabetes. RESULTS Sample sizes ranged from 826 to 2185. After adjusting for age, sex, race/ethnicity, BMI and fasting glucose or HbA1c , four cellular adhesion molecules (ICAM-1, E-selectin, VCAM-1 and E-cadherin) were positively associated with incident diabetes and there was a statistically significant trend across quartiles. Comparing the incidence of diabetes in the highest and lowest quartiles of each cellular adhesion molecule, the magnitude of association was largest for E-selectin (hazard ratio 2.49; 95% CI 1.26-4.93) and ICAM-1 (hazard ratio 1.76; 95% CI 1.22-2.55) in fully adjusted models. Tests of effect modification by racial/ethnic group and sex were not statistically significant for any of the cellular adhesion molecules (P > 0.05). CONCLUSIONS The finding of significant associations between multiple cellular adhesion molecules and incident diabetes may lend further support to the hypothesis that microvascular endothelial dysfunction contributes to risk of diabetes.
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Affiliation(s)
- J S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - P A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - C Berardi
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - N Q Hanson
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN
| | - M Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA
| | - W Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - A M Kanaya
- Department of Medicine, University of California, San Francisco, CA
| | - N B Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - M Y Tsai
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN
| | - C L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Colchester, VT, USA
| | - S J Bielinski
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Larson NB, Bell EJ, Decker PA, Pike M, Wassel CL, Tsai MY, Pankow JS, Tang W, Hanson NQ, Alexander K, Zakai NA, Cushman M, Bielinski SJ. ABO blood group associations with markers of endothelial dysfunction in the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2016; 251:422-429. [PMID: 27298014 DOI: 10.1016/j.atherosclerosis.2016.05.049] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 05/24/2016] [Accepted: 05/31/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS ABO blood type is associated with cardiovascular disease, although the underlying mechanisms are presumed to be complex. While the relationship between non-O blood types and von Willebrand Factor (vWF) is well-established, associations with cellular adhesion molecules (CAMs) across diverse populations are understudied. METHODS We genetically inferred ABO alleles for N = 6202 participants from the Multi-Ethnic Study of Atherosclerosis. Linear regression was used to evaluate associations between major ABO allele dosages and log-transformed measurements of vWF (N = 924), soluble E-selectin (sE-selectin, N = 925), soluble P-selectin (sP-selectin, N = 2392), and soluble ICAM-1 (sICAM-1, N = 2236) by race/ethnicity. RESULTS For the selectins, the A1 allele was associated with significantly lower levels for all races/ethnicities, with each additional allele resulting in a 28-39% decrease in sE-selectin and 10-18% decrease in sP-selectin relative to Type O subjects. However, the A2 allele demonstrated effect heterogeneity across race/ethnicity for sE-selectin, with lower levels for non-Hispanic whites (p = 0.0011) but higher levels for Hispanics (p = 0.0021). We also identified elevated sP-selectin levels for B-allele carriers solely in Hispanic participants (p = 1.0E-04). ABO-by-race/ethnicity interactions were significant for both selectins (p < 0.0125). More modest associations were observed between A1 allele dosage and levels of sICAM-1, with ABO alleles explaining 0.8-1.1% of the total phenotypic variation within race/ethnicity. ABO associations with vWF activity were consistent across race/ethnicity, with B allele carriers corresponding to the highest vWF activity levels. CONCLUSIONS ABO blood type demonstrates complex associations with endothelial markers that are largely generalizable across diverse populations.
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Affiliation(s)
- Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Elizabeth J Bell
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mindy Pike
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Kristine Alexander
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA
| | - Neil A Zakai
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA
| | - Mary Cushman
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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10
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Bancks MP, Bielinski SJ, Decker PA, Hanson NQ, Larson NB, Sicotte H, Wassel CL, Pankow JS. Circulating level of hepatocyte growth factor predicts incidence of type 2 diabetes mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA). Metabolism 2016; 65:64-72. [PMID: 26892517 PMCID: PMC4857763 DOI: 10.1016/j.metabol.2015.10.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 10/12/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hepatocyte growth factor (HGF) is a pleotropic factor posited to have metabolic homeostatic properties. The purpose of this study is to examine whether level of HGF is associated with the development of type 2 diabetes. METHODS Data from the Multi-Ethnic Study of Atherosclerosis (MESA) were used to examine the prospective association between serum level of HGF and incident diabetes. Fasting HGF was measured at Exam 1 (2000-2002) in 5395 participants free from diabetes (61.5±10.2 years old) and incidence of diabetes was determined at four subsequent follow-up exams over 12 years. Hazard ratios (HR) for incident diabetes were estimated according to 1 standard deviation (SD) unit increment of HGF (1 SD=26 μg/l), before and after adjustment for age, sex, race/ethnicity, education, study center, smoking status, alcohol consumption, body mass index, waist circumference, fasting glucose and insulin, C-reactive protein, and interleukin-6 levels. RESULTS A 1 SD increment of baseline HGF was associated with a 46% (95% CI=1.37, 1.56) increased risk of diabetes before adjustment. After adjustment, diabetes risk per 1 SD increment of HGF was attenuated but remained significantly increased (HR=1.21; 95% CI=1.12, 1.32). Men had a significantly greater HR compared to women per equivalent increase of HGF (p-value for sex interaction=0.04). There was no evidence of effect modification by race/ethnicity. CONCLUSIONS This study advances understanding from cross-sectional studies and investigation of incident insulin resistance, demonstrating higher level of HGF is associated with incident diabetes and may reflect a unique type of impaired metabolism.
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Affiliation(s)
- Michael P Bancks
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, 55454, USA.
| | - Suzette J Bielinski
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, 55454, USA.
| | - Nicholas B Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Hugues Sicotte
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Christina L Wassel
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Colchester, VT, 05446, USA.
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, 55454, USA.
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Larson NB, Decker PA, Wassel CL, Pankow JS, Tang W, Hanson NQ, Tsai MY, Bielinski SJ. Blood group antigen loci demonstrate multivariate genetic associations with circulating cellular adhesion protein levels in the Multi-Ethnic Study of Atherosclerosis. Hum Genet 2016; 135:415-423. [PMID: 26883866 DOI: 10.1007/s00439-016-1643-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/03/2016] [Indexed: 11/28/2022]
Abstract
The cellular adhesion pathway is critical in the pathophysiology of atherosclerosis, and genetic factors contributing to regulation of circulating levels of related proteins may be relevant to risk prediction of cardiovascular disease. In contrast to conducting separate genome-wide protein quantitative trait loci (pQTL) mapping analyses of each individual protein, joint genetic association analyses of multiple quantitative traits can leverage cross-trait co-variation and identify simultaneous regulatory effects on protein levels across the pathway. We conducted a multi-pQTL (mpQTL) analysis of 15 proteins related to cellular adhesion assayed on 2313 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). We applied the MQFAM multivariate association analysis method in PLINK on normalized protein level residuals derived from univariate linear regression, adjusting for age, sex, and principal components of ancestry. Race/ethnicity-stratified analyses identified nine genome-wide significant (P < 5e-08) loci associated with co-variation of protein levels. Although the majority of these SNPs were in proximity to structural genes of the assayed proteins, we discovered multiple loci demonstrating co-association with the circulation of at least two proteins. Of these, two significant loci specific to non-Hispanic white participants, rs17074898 at ALOX5AP (P = 1.78E-08) and rs7521237 at KIAA1614 (P = 2.2E-08), would not have met statistical significance using univariate analyses. Moreover, common patterns of multi-protein associations were discovered at the ABO locus across race/ethnicity. These results indicate the biological relevance of blood group antigens on regulation of circulating cellular adhesion pathway proteins while also demonstrating race/ethnicity-specific co-regulatory effects.
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Affiliation(s)
- Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Christina L Wassel
- Department Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Burlington, VT, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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12
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Christoph MJ, Allison MA, Pankow JS, Decker PA, Kirsch PS, Tsai MY, Sale MM, de Andrade M, Sicotte H, Tang W, Hanson NQ, Berardi C, Wassel CL, Larson NB, Bielinski SJ. Impact of adiposity on cellular adhesion: The Multi-Ethnic Study of atherosclerosis (MESA). Obesity (Silver Spring) 2016; 24:223-30. [PMID: 26638193 PMCID: PMC4688228 DOI: 10.1002/oby.21245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/13/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE At the cellular level, how excess adiposity promotes atherogenesis is not fully understood. One pathway involves secretion of adipokines that stimulate endothelial dysfunction through increased expression of adhesion molecules. However, the relationship of adiposity to adhesion molecules that promote atherosclerosis is largely unknown. METHODS Linear regression models were used to assess the sex-specific associations of soluble cellular adhesion molecules (sP- and sL-selectin, sICAM-1, sVCAM-1, and sHGF) and adiposity in 5,974 adults examined as part of the Multi-Ethnic Study of Atherosclerosis (MESA). Adiposity measures included body mass index (BMI), waist-to-hip-ratio (WHR), and computed tomography measures of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). RESULTS The mean age was 64 years and 52% were female. In multivariable models adjusting for traditional cardiovascular risk factors, sHGF was positively associated with BMI, WHR, and VAT in both males and females, and sP-selectin with WHR and VAT in males. sVCAM-1 was inversely associated with VAT in females only. CONCLUSIONS Our results showed the relation of adiposity to soluble cellular adhesion proteins was similar across adiposity measures and for both sexes. However, the relationship between adiposity and sVCAM-1 and P-selectin may be modified by sex and the measure used to assess adiposity.
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Affiliation(s)
- Mary J. Christoph
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Matthew A. Allison
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Phillip S. Kirsch
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Michael Y. Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Michele M. Sale
- Center for Public Health Genomics, University of Virginia, VA, USA
| | - Mariza de Andrade
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hugues Sicotte
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q. Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Cecilia Berardi
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Montefiore Medical Center, Bronx, NY, USA
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13
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Cao J, Seegmiller J, Hanson NQ, Zaun C, Li D. A microfluidic multiplex proteomic immunoassay device for translational research. Clin Proteomics 2015; 12:28. [PMID: 26692826 PMCID: PMC4676148 DOI: 10.1186/s12014-015-9101-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/30/2015] [Indexed: 01/08/2023] Open
Abstract
Objective Microfluidic technology has the potential to miniaturize and automate complex laboratory procedures. The objective of this study was to assess a microfluidic immunoassay device, Simple Plex, which simultaneously measured IL-1β, TNF-α, IL-6, and IL-10 in serum samples. This assessment is important to understanding the potentials of this microfluidic device as a valuable tool in translational research efforts. Methods We studied the operational characteristics of Simple Plex, and compared to other immunoassay systems including bead-based (i.e., Bio-Plex® from Bio-Rad) and planar micro-spot based (i.e., Multi-Array from Meso Scale Discovery) multiplex assays. We determined imprecisions for each of the Simple Plex assays and evaluated the ability of Simple Plex to detect IL-1β, TNF-α, IL-6, and IL-10 in serum samples. Results Simple Plex assays required 25 µL serum, and 1.5 h to run 16 samples per cartridge per instrument. Assay imprecisions, evaluated by measurement of 6 replicates in duplicate from a serum pool using three different cartridges, were less than 10 % for all 4 cytokine protein biomarkers, comparable to the imprecisions of traditional ELISAs. The Simple Plex assays were able to detect 32, 95, 97, and 100 % [i.e., percentages of the results within the respective analytical measurement ranges (AMRs)] of IL-1β, TNF-α, IL-6, and IL-10, respectively, in 66 serum samples. Conclusions Simple Plex is a microfluidic multiplex immunoassay device that offers miniaturized, and automated analysis of protein biomarkers. Microfluidic devices such as Simple Plex represent a promising platform to be used in translational research to measure protein biomarkers in real clinical samples.
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Affiliation(s)
- Jing Cao
- Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Jesse Seegmiller
- Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Christopher Zaun
- Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
| | - Danni Li
- Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, 420 Delaware Street SE, MMC 609, Minneapolis, MN 55455 USA
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14
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Larson NB, Berardi C, Decker PA, Wassel CL, Kirsch PS, Pankow JS, Sale MM, de Andrade M, Sicotte H, Tang W, Hanson NQ, Tsai MY, Taylor KD, Bielinski SJ. Trans-ethnic meta-analysis identifies common and rare variants associated with hepatocyte growth factor levels in the Multi-Ethnic Study of Atherosclerosis (MESA). Ann Hum Genet 2015; 79:264-74. [PMID: 25998175 PMCID: PMC4474777 DOI: 10.1111/ahg.12119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/08/2015] [Indexed: 01/03/2023]
Abstract
Hepatocyte growth factor (HGF) is a mesenchyme-derived pleiotropic factor that regulates cell growth, motility, mitogenesis, and morphogenesis in a variety of cells, and increased serum levels of HGF have been linked to a number of clinical and subclinical cardiovascular disease phenotypes. However, little is currently known regarding which genetic factors influence HGF levels, despite evidence of substantial genetic contributions to HGF variation. Based upon ethnicity-stratified single-variant association analysis and trans-ethnic meta-analysis of 6201 participants of the Multi-Ethnic Study of Atherosclerosis (MESA), we discovered five statistically significant common and low-frequency variants: HGF missense polymorphism rs5745687 (p.E299K) as well as four variants (rs16844364, rs4690098, rs114303452, rs3748034) within or in proximity to HGFAC. We also identified two significant ethnicity-specific gene-level associations (A1BG in African Americans; FASN in Chinese Americans) based upon low-frequency/rare variants, while meta-analysis of gene-level results identified a significant association for HGFAC. However, identified single-variant associations explained modest proportions of the total trait variation and were not significantly associated with coronary artery calcium or coronary heart disease. Our findings indicate that genetic factors influencing circulating HGF levels may be complex and ethnically diverse.
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Affiliation(s)
- Nicholas B. Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Cecilia Berardi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Internal Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Paul A. Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Phillip S. Kirsch
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Michele M. Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Mariza de Andrade
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hugues Sicotte
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q. Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Y. Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute and Department of Pediatrics at Harbor-UCLA, Torrance, CA, USA
| | - Suzette J. Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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15
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Bielinski SJ, Berardi C, Decker PA, Kirsch PS, Larson NB, Pankow JS, Sale M, de Andrade M, Sicotte H, Tang W, Hanson NQ, Wassel CL, Polak JF, Tsai MY. P-selectin and subclinical and clinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2015; 240:3-9. [PMID: 25744700 DOI: 10.1016/j.atherosclerosis.2015.02.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/06/2015] [Accepted: 02/14/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE P-selectin is a cellular adhesion molecule that has been shown to be crucial in development of coronary heart disease (CHD). We sought to determine the role of P-selectin on the risk of atherosclerosis in a large multi-ethnic population. METHODS Data from the Multi-Ethnic Study of Atherosclerosis (MESA), including 1628 African, 702 Chinese, 2393 non-Hispanic white, and 1302 Hispanic Americans, were used to investigate the association of plasma P-selectin with CHD risk factors, coronary artery calcium (CAC), intima-media thickness, and CHD. Regression models were used to investigate the association between P-selectin and risk factors, Tobit model for CAC, and Cox regression for CHD events. RESULTS Mean levels of P-selectin differed by ethnicity and were higher in men (P<0.001). For all ethnic groups, P-selectin was positively associated with measures of adiposity, blood pressure, current smoking, LDL, and triglycerides and inversely with HDL. A significant ethnic interaction was observed for the association of P-selectin and prevalent diabetes; however, P-selectin was positively associated with HbA1c in all groups. Higher P-selectin levels were associated with greater prevalence of CAC. Over 10.1 years of follow-up, there were 335 incident CHD events. There was a positive linear association between P-selectin levels and rate of incident CHD after adjustment for traditional risk factors. However, association was only significant in non-Hispanic white Americans (HR: 1.81, 95% CI 1.07 to 3.07, P=0.027). CONCLUSION We observed ethnic heterogeneity in the association of P-selectin and risk of CHD.
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Affiliation(s)
- Suzette J Bielinski
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Cecilia Berardi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Montefiore Medical Center, Bronx, NY, USA.
| | - Paul A Decker
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Phillip S Kirsch
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Nicholas B Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Michele Sale
- Center for Public Health Genomics, University of Virginia, VA, USA.
| | - Mariza de Andrade
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Hugues Sicotte
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Naomi Q Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
| | - Christina L Wassel
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Joseph F Polak
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
| | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
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Berardi C, Larson NB, Decker PA, Wassel CL, Kirsch PS, Pankow JS, Sale MM, de Andrade M, Sicotte H, Tang W, Hanson NQ, Tsai MY, Chen YDI, Bielinski SJ. Multi-ethnic analysis reveals soluble L-selectin may be post-transcriptionally regulated by 3'UTR polymorphism: the Multi-Ethnic Study of Atherosclerosis (MESA). Hum Genet 2015; 134:393-403. [PMID: 25576479 DOI: 10.1007/s00439-014-1527-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/29/2014] [Indexed: 01/01/2023]
Abstract
L-Selectin is constitutively expressed on leukocytes and mediates their interaction with endothelial cells during inflammation. Previous studies on the association of soluble L-selectin (sL-selectin) with cardiovascular disease (CVD) are inconsistent. Genetic variants associated with sL-selectin levels may be a better surrogate of levels over a lifetime. We explored the association of genetic variants and sL-selectin levels in a race/ethnicity stratified random sample of 2,403 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Through a genome-wide analysis with additive linear regression models, we found that rs12938 on the SELL gene accounted for a significant portion of the protein level variance across all four races/ethnicities. To evaluate potential additional associations, elastic net models were used for variants located in the SELL/SELP/SELE genetic region and an additional two SNPs, rs3917768 and rs4987361, were associated with sL-selectin levels in African Americans. These variants accounted for a portion of protein variance that ranged from 4 % in Hispanic to 14 % in African Americans. To investigate the relationship of these variants with CVD, 6,317 subjects were used. No significant association was found between any of the identified SNPs and carotid intima-media thickness or presence of carotid plaque using linear and logistic regression, respectively. Similarly no significant results were found for coronary artery calcium or coronary heart disease events. In conclusion, we found that variants within the SELL gene are associated with sL-selectin levels. Despite accounting for a significant portion of the protein level variance, none of the variants was associated with clinical or subclinical CVD.
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Affiliation(s)
- Cecilia Berardi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Harwick Building 6-56, 200 First Street SW, Rochester, MN, 55905, USA
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Djoussé L, Petrone AB, Weir NL, Hanson NQ, Glynn RJ, Tsai MY, Gaziano JM. Repeated versus single measurement of plasma omega-3 fatty acids and risk of heart failure. Eur J Nutr 2014; 53:1403-8. [PMID: 24395612 DOI: 10.1007/s00394-013-0642-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/17/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies have previously examined the relation between a single measure of plasma fatty acids and risk of heart failure. However, it is unclear whether the use of repeated measures of fatty acids over time is required for the assessment of omega-3 fatty acids heart failure relation. METHODS Using a nested case-control design, this ancillary study used 421 cases and 421 matched controls from the Physicians' Health Study to assess the variability of plasma phospholipid fatty acids over time and compare the results of omega-3 fatty acids heart failure associations using a single versus repeated measurements of plasma phospholipid fatty acids. Plasma omega-3 fatty acids were measured at baseline (1982) and approximately 15 years later using gas chromatography. RESULTS Spearman's correlation coefficients between baseline and follow-up measures of α-linolenic acid (ALA), EPA, DPA, and DHA were 0.20, 0.45, 0.28, and 0.50, respectively, in the control series. Multivariable adjusted odds ratios for heart failure per standard deviation higher plasma ALA were 0.98 (95% CI 0.85-1.13) when using baseline ALA and 0.86 (95% CI 0.74-1.01) when using the average of baseline and follow-up ALA measurements. Corresponding odds ratios for total long chain omega-3 FAs (EPA + DHA + DPA) were 0.87 (0.73-1.03) and 0.88 (0.75-1.04). CONCLUSIONS Our data demonstrate modest correlation between measurements of plasma phospholipid fatty acids spaced by 15 years. A single measurement of plasma phospholipid fatty acids appears reasonable to estimate the risk of heart failure over long-term follow-up.
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Affiliation(s)
- Luc Djoussé
- Division of Aging, Brigham and Women's Hospital, 1620 Tremont St. 3rd Floor, Boston, MA, 02120, USA,
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Engebretson SP, Hyman LG, Michalowicz BS, Schoenfeld ER, Gelato MC, Hou W, Seaquist ER, Reddy MS, Lewis CE, Oates TW, Tripathy D, Katancik JA, Orlander PR, Paquette DW, Hanson NQ, Tsai MY. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA 2013; 310:2523-32. [PMID: 24346989 PMCID: PMC4089989 DOI: 10.1001/jama.2013.282431] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Chronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control. OBJECTIVE To determine if nonsurgical periodontal treatment reduces levels of glycated hemoglobin (HbA1c) in persons with type 2 diabetes and moderate to advanced chronic periodontitis. DESIGN, SETTING, AND PARTICIPANTS The Diabetes and Periodontal Therapy Trial (DPTT), a 6-month, single-masked, multicenter, randomized clinical trial. Participants had type 2 diabetes, were taking stable doses of medications, had HbA1c levels between 7% and less than 9%, and untreated chronic periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with 5 academic medical centers. INTERVENTIONS The treatment group (n = 257) received scaling and root planing plus chlorhexidine oral rinse at baseline and supportive periodontal therapy at 3 and 6 months. The control group (n = 257) received no treatment for 6 months. MAIN OUTCOMES AND MEASURES Difference in change in HbA1c level from baseline between groups at 6 months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose level, and Homeostasis Model Assessment (HOMA2) score. RESULTS Enrollment was stopped early because of futility. At 6 months, mean HbA1c levels in the periodontal therapy group increased 0.17% (SD, 1.0), compared with 0.11% (SD, 1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference, -0.05% [95% CI, -0.23% to 0.12%]; P = .55). Periodontal measures improved in the treatment group compared with the control group at 6 months, with adjusted between-group differences of 0.28 mm (95% CI, 0.18 to 0.37) for probing depth, 0.25 mm (95% CI, 0.14 to 0.36) for clinical attachment loss, 13.1% (95% CI, 8.1% to 18.1%) for bleeding on probing, and 0.27 (95% CI, 0.17 to 0.37) for gingival index (P < .001 for all). CONCLUSIONS AND RELEVANCE Nonsurgical periodontal therapy did not improve glycemic control in patients with type 2 diabetes and moderate to advanced chronic periodontitis. These findings do not support the use of nonsurgical periodontal treatment in patients with diabetes for the purpose of lowering levels of HbA1c. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00997178.
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Affiliation(s)
- Steven P. Engebretson
- Department of Periodontology and Implant Dentistry, New York University, New York, NY
| | - Leslie G. Hyman
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Bryan S. Michalowicz
- Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, MN
| | - Elinor R. Schoenfeld
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Marie C. Gelato
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Wei Hou
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | | | - Michael S. Reddy
- Dept. of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Cora E. Lewis
- Preventive Medicine, University of Alabama, Birmingham, AL
| | - Thomas W. Oates
- School of Dentistry, University of Texas at San Antonio, San Antonio, TX
| | - Devjit Tripathy
- Medicine, University of Texas - San Antonio / Health Science Center, San Antonio, TX
| | | | - Philip R. Orlander
- Internal Medicine, Endocrinology, University of Texas - Houston/Health Science Center, Houston, TX
| | - David W. Paquette
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Naomi Q. Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
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Djoussé L, Matsumoto C, Hanson NQ, Weir NL, Tsai MY, Gaziano JM. Plasma cis-vaccenic acid and risk of heart failure with antecedent coronary heart disease in male physicians. Clin Nutr 2013; 33:478-82. [PMID: 23880347 DOI: 10.1016/j.clnu.2013.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/17/2013] [Accepted: 07/03/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Although an inverse association of red blood cell cis-vaccenic acid and risk of myocardial infarction has been reported, it is unclear whether cis-vaccenic acid might lower the risk of heart failure (HF) with antecedent coronary heart disease (CHD). We sought to examine the relation of plasma cis-vaccenic acid with HF with antecedent CHD. METHODS This nested case-control study was based on 788 incident HF cases (of whom 258 cases had antecedent CHD) and 788 controls. Each control was selected using a risk set sampling technique at the time of the occurrence of the index case and matched on year of birth, age at blood collection, and race. Fatty acids were measured using gas chromatography and incident HF was self-reported on annual questionnaires and validation in a subsample using medical records. RESULTS In a multivariable conditional logistic regression, the odds ratio (95% confidence interval) for HF with prior CHD were 1.0 (ref), 0.72 (0.33-1.57), 0.28 (0.12-0.67), and 0.23 (0.09-0.58) across consecutive quartiles of cis-vaccenic acid (p_trend 0.0004). Each standard deviation of cis-vaccenic acid was associated with a 41% lower risk of HF with antecedent CHD (95% CI: 17%-59%) in a multivariable adjusted model. CONCLUSIONS Our data suggest that higher plasma levels of plasma cis-vaccenic acid may be associated with a lower risk of HF with antecedent CHD. Confirmation of these results in the general population including women and other ethnic groups is warranted.
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Affiliation(s)
- Luc Djoussé
- Division of Aging, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; The Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) and Geriatric Research (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA.
| | | | | | | | | | - J Michael Gaziano
- Division of Aging, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; The Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) and Geriatric Research (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA
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Tokede OA, Petrone AB, Hanson NQ, Tsai MY, Weir NA, Glynn RJ, Gaziano JM, Djoussé L. Plasma phospholipid trans fatty acids and risk of heart failure. Am J Clin Nutr 2013; 97:698-705. [PMID: 23446892 PMCID: PMC3607651 DOI: 10.3945/ajcn.112.050120] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although trans fatty acids (TFAs) may increase the risk of dyslipidemia and coronary artery disease (CAD), limited data are available on their association with heart failure (HF). OBJECTIVE Our goal was to assess associations of plasma and dietary TFAs with HF and CAD. DESIGN We used a prospective, nested case-control design to select 788 incident HF cases and 788 matched controls from the Physicians' Health Study for biomarker analyses and a prospective cohort for the dietary analyses. Plasma fatty acids were assessed by using gas chromatography, and dietary intake was estimated by using a food-frequency questionnaire. Self-reported HF was ascertained by using annual follow-up questionnaires with validation in a subsample. We used conditional logistic (or Cox) regression to estimate multivariable-adjusted ORs (or HRs) for HF and CAD. RESULTS Multivariable-adjusted ORs (95% CIs) for HF across consecutive quintiles of plasma trans 18:2 (linoleic acid) fatty acids were 1.0 (reference), 1.10 (0.79, 1.54), 0.88 (0.62, 1.25), 0.71 (0.49, 1.02), and 0.67 (0.45, 0.98) (P-trend = 0.01). Each SD of plasma trans 18:2 was associated with a 22% lower risk of HF (95% CI: 6%, 36%). Plasma trans 16:1 and 18:1 were not associated with risk of HF (P > 0.05). Dietary trans fats were not associated with incident HF or CAD. CONCLUSIONS Our data are consistent with a lower risk of HF with higher concentrations of plasma trans 18:2 but not with trans 16:1 or trans 18:1 fatty acids in male physicians. Dietary TFAs were not related to incident HF or CAD.
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Affiliation(s)
- Oluwabunmi A Tokede
- Divisions of Aging and Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
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Djoussé L, Wilk JB, Hanson NQ, Glynn RJ, Tsai MY, Gaziano JM. Association between adiponectin and heart failure risk in the physicians' health study. Obesity (Silver Spring) 2013; 21:831-4. [PMID: 23712986 PMCID: PMC3479315 DOI: 10.1002/oby.20260] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 05/15/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the association between adiponectin and incident heart failure (HF). DESIGN AND METHODS In the current ancillary study to the Physicians' Health Study (PHS), we used a prospective nested case-control design to examine whether plasma adiponectin concentration was related to the risk of HF. We selected 787 incident HF cases and 787 matched controls for the current analysis. Each control was selected using a risk set sampling technique at the time of the occurrence of the index case and matched on year of birth, age at blood collection, and race. Adiponectin was measured using enzyme-linked immunosorbent assay. HF occurrence was self-reported in annual follow-up questionnaire. Validation of self-reported HF in this cohort has been published. RESULTS The mean age was 58.7 years. In a conditional logistic regression adjusting for age, race, time of blood collection, year of birth, hypertension, atrial fibrillation, smoking, alcohol intake, and exercise, estimates of the relative risk (95% confidence interval) were 1.0 (reference), 0.74 (0.53-1.04), 0.67 (0.48-0.94), 0.70 (0.50-0.99), and 0.92 (0.65-1.30) from the lowest to the highest quintile of adiponectin, respectively, P for quadratic trend 0.004. Additional adjustment for potential mediating factors including diabetes, C-reactive protein, and BMI led to the attenuation of the estimate of effect (1.0 (reference), 0.81 (0.57-1.15), 0.75 (0.53-1.06), 0.83 (0.58-1.18), and 1.26 (0.87-1.81) across consecutive quintiles of adiponectin). CONCLUSIONS Our data are consistent with a J-shaped association between total adiponectin and the risk of HF among US male physicians.
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Affiliation(s)
- Luc Djoussé
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Matsumoto C, Hanson NQ, Tsai MY, Glynn RJ, Gaziano JM, Djoussé L. Plasma phospholipid saturated fatty acids and heart failure risk in the Physicians' Health Study. Clin Nutr 2013; 32:819-23. [PMID: 23473794 DOI: 10.1016/j.clnu.2013.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/28/2013] [Accepted: 02/13/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS Previous studies have suggested that some plasma phospholipid saturated fatty acids (SFA) are associated with an increased risk of coronary heart disease and hypertension, major risk factors for heart failure (HF). However, little is known about the association between SFA and HF. This study examines associations of individual plasma phospholipid SFA with HF risk in US male physicians. METHODS The current ancillary study used a prospective nested matched case-control design to select 788 cases of incident HF and 788 controls. Plasma phospholipid SFAs were measured using gas chromatography. HF was self-reported on follow-up questionnaires and validated by review of medical records in a subsample. We used conditional logistic regression to estimate relative risks. RESULTS Mean age was 58.7 ± 8.0 years. One standard deviation higher plasma phospholipid 16:0 was associated with an odds ratio (95% CI) of 1.20 (1.04, 1.38) controlling for established HF risk factors and other SFAs (p = 0.042). However, this association was not significant after Bonferroni correction (p > 0.008). We did not observe associations between other SFAs (14:0, 15:0, 18:0, 20:0, or 22:0) and HF risk (all p for trend > 0.05). CONCLUSIONS Our data suggested no association between plasma phospholipid SFAs and HF in US male physicians.
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Affiliation(s)
- Chisa Matsumoto
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Petrone AB, Weir N, Hanson NQ, Glynn R, Tsai MY, Gaziano JM, Djoussé L. Omega-6 fatty acids and risk of heart failure in the Physicians' Health Study. Am J Clin Nutr 2013; 97:66-71. [PMID: 23193008 PMCID: PMC3522140 DOI: 10.3945/ajcn.112.048991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although 1 in 5 adults will develop heart failure (HF) in their lifetime, data on the effect of plasma omega-6 (n-3) PUFAs on risk of HF are currently sparse. OBJECTIVES We investigated whether plasma phospholipid omega-6 concentrations are associated with risk of HF in US male physicians. In a secondary analysis, we evaluated whether such an association differs between HF with and without previous myocardial infarction (MI). DESIGN With the use of a nested case-control design, this ancillary study comprised 788 cases and 788 matched controls from the Physicians' Health Study. Plasma omega-6 PUFAs were measured by using gas chromatography. RESULTS The mean age of subjects was 58.7 y with a mean follow-up time of 17.1 y. We did not show any evidence of a statistically significant relation between total omega-6 PUFAs and HF [OR (95% CI): 1.00; 0.85 (0.63, 1.14); 0.84 (0.63, 1.13); and 0.87 (0.63, 1.20) across consecutive quartiles of omega-6 PUFAs; P-linear trend = 0.39]. Results were similar for HF with and without previous MI. CONCLUSION Our data showed no significant association between total plasma omega-6 PUFAs and risk of developing HF.
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Abstract
BACKGROUND Although plasma palmitoleic acid has been positively associated with blood pressure, inflammation, and insulin resistance, its association with heart failure has not been investigated. We assessed whether plasma phospholipid cis-palmitoleic acid was associated with heart failure risk. METHODS AND RESULTS This ancillary study of the Physicians' Health Study used a risk set sampling method to select 788 matched pairs. For each case of incident heart failure, we randomly selected a control among subjects that were free of heart failure and alive at the time of index case diagnosis and matched on age, year of birth, race, and time of blood collection. Plasma phospholipid fatty acids were measured using gas chromatography. Heart failure was ascertained using annual follow-up questionnaire and validated in a subsample. In a multivariable conditional logistic regression, odds ratios (95% CI) for heart failure were 1.0 (ref), 1.06 (0.75-1.48), 1.20 (0.85-1.68), and 1.58 (1.11-2.25) across consecutive quartiles of cis-palmitoleic acid (P for trend 0.009). Each SD increase in plasma cis-palmitoleic acid was associated with 17% higher odds of heart failure (95% CI: 2% to 33%) in a multivariable model. In a secondary analysis, each SD increase of log-stearoyl-coA desaturase activity (16:1n-7/16:0 ratio) was positively associated with the risk of heart failure (odds ratio: 1.14 [95% CI: 1.00 to 1.29]), whereas oleic acid and cis-vaccenic acid concentrations were not related to heart failure risk. CONCLUSIONS Our data showed a positive association between plasma phospholipid cis- palmitoleic acid and heart failure risk in male physicians.
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Affiliation(s)
- Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA.
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Wilk JB, Tsai MY, Hanson NQ, Gaziano JM, Djoussé L. Plasma and dietary omega-3 fatty acids, fish intake, and heart failure risk in the Physicians' Health Study. Am J Clin Nutr 2012; 96:882-8. [PMID: 22952185 PMCID: PMC3441114 DOI: 10.3945/ajcn.112.042671] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Data on the relation of plasma and dietary omega-3 (n-3) fatty acids (FAs) with heart failure (HF) risk have been inconsistent. OBJECTIVE We evaluated the relation of n-3 FAs with HF in US male physicians. DESIGN We used nested case-control (n = 1572) and prospective cohort study designs (n = 19,097). Plasma phospholipid n-3 FAs were measured by using gas chromatography, and food-frequency questionnaires were used to assess dietary n-3 FAs and fish intake. Incident HF was ascertained via annual follow-up questionnaires and validated in a subsample. RESULTS The mean age was 58.7 y at blood collection. In a multivariable model, plasma α-linolenic acid (ALA) was associated with a lower risk of HF in a nonlinear fashion (P-quadratic trend = 0.02), and the lowest OR was observed in quintile 4 (0.66; 95% CI: 0.47, 0.94). Plasma EPA and DHA were not associated with HF, whereas plasma docosapentaenoic acid (DPA) showed a nonlinear inverse relation with HF for quintile 2 (OR: 0.55; 95% CI: 0.39, 0.79). Dietary marine n-3 FAs showed a trend toward a lower risk of HF in quintile 4 (HR: 0.81; 95% CI: 0.64, 1.02) and a nonlinear pattern across quintiles. Fish intake was associated with a lower risk of HF, with RRs of ~0.70 for all categories of fish consumption greater than one serving per month. CONCLUSIONS Our data are consistent with an inverse and nonlinear relation of plasma phospholipid ALA and DPA, but not EPA or DHA, with HF risk. Fish consumption greater than once per month was associated with a lower HF risk.
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Affiliation(s)
- Jemma B Wilk
- Divisions of Aging and Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA
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Steffen BT, Steffen LM, Tracy R, Siscovick D, Jacobs D, Liu K, He K, Hanson NQ, Nettleton JA, Tsai MY. Ethnicity, plasma phospholipid fatty acid composition and inflammatory/endothelial activation biomarkers in the Multi-Ethnic Study of Atherosclerosis (MESA). Eur J Clin Nutr 2012; 66:600-5. [PMID: 22215136 DOI: 10.1038/ejcn.2011.215] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES It has been recognized that certain long-chain polyunsaturated fatty acids (LC-PUFAs) are involved in inflammation and its resolution. It has also been shown that ethnicity may be a factor in affecting systemic inflammation, and limited evidence suggests it may influence plasma LC-PUFA composition. Given the links among these three factors, we aim to determine ethnicity-based differences in plasma LC-PUFA composition among White, Black, Hispanic and Chinese participants, and whether such differences contribute to variations in markers of inflammation and endothelial activation in a sub-cohort of the Multi-Ethnic Study of Atherosclerosis (MESA). SUBJECTS/METHODS Plasma phospholipid LC-PUFAs levels (%) were determined in 2848 MESA participants using gas chromatography-flame ionization detection. Enzyme immunoassays determined inflammatory markers levels for high-sensitivity C-reactive protein (n=2848), interleukin-6 (n=2796), soluble tumor necrosis factor-α receptor type 1 (n=998), and endothelial activation markers soluble intercellular adhesion molecule-1 (n=1192) and soluble E-selectin (n=998). The modifying influence of ethnicity was tested by linear regression analysis. RESULTS Chinese adults were found to have the highest mean levels of plasma eicosapentaenoic acid (EPA, 1.24%) and docosahexaenoic acid (DHA, 4.95%), and the lowest mean levels of γ-linolenic (0.10%), dihomo-γ-linolenic (DGLA, 2.96%) and arachidonic (10.72%) acids compared with the other ethnicities (all P ≤ 0.01). In contrast, Hispanics had the lowest mean levels of plasma EPA (0.70%) and DHA (3.49%), and the highest levels of DGLA (3.59%; all P ≤ 0.01). Significant differences in EPA and DHA among ethnicities were attenuated following adjustment for dietary non-fried fish and fish oil supplementation. Ethnicity did not modify the associations of LC-PUFAs with markers of inflammation or endothelial activation (all P (interaction)>0.05). CONCLUSIONS The absence of a modifying effect of ethnicity indicates that the putative benefits of LC-PUFAs with respect to inflammation are pan-ethnic. Future longitudinal studies may elucidate the origin(s) of ethnicity-based differences in LC-PUFA composition and whether certain patterns, that is, high plasma levels of DGLA and low levels of EPA/DHA, contribute to inflammation-associated health outcomes.
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Affiliation(s)
- B T Steffen
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455-0392, USA
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Tsai AK, Steffen BT, Ordovas JM, Straka R, Zhou X, Hanson NQ, Arnett D, Tsai MY. Short-term fenofibrate treatment reduces elevated plasma Lp-PLA2 mass and sVCAM-1 levels in a subcohort of hypertriglyceridemic GOLDN participants. Transl Res 2011; 158:99-105. [PMID: 21757154 PMCID: PMC3138503 DOI: 10.1016/j.trsl.2011.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 01/21/2011] [Accepted: 01/27/2011] [Indexed: 12/28/2022]
Abstract
High levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with inflammation, atherosclerosis, and coronary heart disease events. In addition, Lp-PLA(2) has been linked to classical markers of endothelial activation, including soluble vascular cell adhesion molecule-1 (sVCAM-1). Although treatment with fenofibrate reduces Lp-PLA(2) mass, it is unclear whether fenofibrate reduces sVCAM-1 levels or whether an association exists between any changes observed in Lp-PLA(2) and sVCAM-1. Concentrations of Lp-PLA(2) mass and sVCAM-1 levels were measured in plasma at baseline and after 3 weeks of fenofibrate treatment (160 mg/d) in 96 hypertriglyceridemic participants of the Genetics of Lipid-lowering Drugs and Diet Network study. Lp-PLA(2) and sVCAM-1 were stratified by tertiles as determined by baseline levels of the respective target. Fenofibrate treatment resulted in a 30.1% mean increase in Lp-PLA(2) mass (P = 0.0003) and a 14.7% mean increase in sVCAM-1 levels (P = 0.0096) but only in tertile1 of either target. In contrast, Lp-PLA(2) mass was reduced by 35.3% (P < 0.0001) in tertile 3. Soluble VCAM-1 levels were significantly reduced by 7.74% (P = 0.0109) and 17.2% (P < 0.0001) in tertiles 2 and 3, respectively. No associations were observed between Lp-PLA(2) and sVCAM-1 at baseline or post-treatment. In conclusion, fenofibrate treatment in hypertriglyceridemic subjects reduced the levels of Lp-PLA(2) mass and sVCAM-1, but only in those with elevated baseline levels of these biomarkers. The greatest reductions in Lp-PLA(2) levels were observed in individuals with Lp-PLA(2) concentrations indicative of increased cardiovascular disease risk (>200 ng/mL).
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Affiliation(s)
- Alexander K Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455-0392, USA.
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Dong Y, Steffen BT, Cao J, Tsai AK, Ordovas J, Straka R, Zhou X, Kabagambe E, Hanson NQ, Arnett D, Tsai MY. Effects of fenofibrate on plasma oxidized LDL and 8-isoprostane in a sub-cohort of GOLDN participants. Atherosclerosis 2010; 214:422-5. [PMID: 21159339 DOI: 10.1016/j.atherosclerosis.2010.11.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 11/17/2010] [Accepted: 11/19/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fenofibrate significantly reduces circulating triglyceride (TG) concentrations, particularly in individuals with elevated levels. The purpose of the current study was to determine whether fenofibrate treatment reduces markers of oxidative stress, oxidized low density lipoprotein (ox-LDL) and 8-isoprostane (8-isoP), in a manner similar to TG where those with the highest levels show the greatest reductions. MATERIALS/METHODS The concentrations of TG, 8-isoP, and ox-LDL were measured in plasma before and after 3 weeks of fenofibrate treatment (160 mg/d) in a sub-cohort (n=187) of the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study. RESULTS Data were divided into tertiles as determined by pre-treatment values of the respective target. Fenofibrate treatment resulted in significant reductions in TG concentrations by 24.2% (p<0.0001), 41.9% (p < 0.0001), and 46.6% (p < 0.0001) in tertiles 1, 2, and 3, respectively. Significant reductions were also observed in ox-LDL of 7.2% (p=0.0096), 8.5% (p = 0.0019) and 12.1% (p < 0.0001) in tertiles 1, 2, and 3, respectively. Finally, fenofibrate treatment resulted in a 32.7% increase (p=0.0201) in 8-isoP levels in tertile 1, but a significant decrease of 34.4% (p < 0.0001) in tertile 3. CONCLUSIONS This study is the largest to date to demonstrate that fenofibrate reduces oxidative stress and the first to show a suppressive effect on 8-isoP levels in individuals with a high oxidative burden following short term (3 wk) drug therapy. Those with the highest baseline levels of ox-LDL and 8-isoP showed the greatest reductions following fenofibrate treatment. Given the role of oxidative stress in atherosclerosis and coronary heart disease, our observations may partially explain the efficacy of fenofibrate in reducing cardiovascular events in select patients.
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Affiliation(s)
- Yan Dong
- Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455, United States
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Tsai MY, Ordovas JM, Li N, Straka RJ, Hanson NQ, Arends VL, Arnett D. Effect of fenofibrate therapy and ABCA1 polymorphisms on high-density lipoprotein subclasses in the Genetics of Lipid Lowering Drugs and Diet Network. Mol Genet Metab 2010; 100:118-22. [PMID: 20346718 PMCID: PMC3598593 DOI: 10.1016/j.ymgme.2010.03.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 03/01/2010] [Accepted: 03/01/2010] [Indexed: 01/01/2023]
Abstract
BACKGROUND Previous studies have shown that ATP-binding cassette transporter 1 (ABCA1) polymorphisms associated with increased ABCA1 expression result in increased small HDL (high-density lipoprotein) subclass particle concentration. This study examines the effect of treatment with fenofibrate, a drug known to bind peroxisome proliferator-activated receptor alpha (PPARalpha) which increases the expression of ABCA1 gene, on lipoprotein subclass profiles of individuals stratified by ABCA1 genotypes. METHODS Participants of Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) were treated with fenofibrate over a three week period. We analyzed six ABCA1 polymorphisms in 287 GOLDN participants with triglyceride concentrations >or=150mg/dL and studied their associations with HDL subclass particle concentrations, as measured by nuclear magnetic resonance spectroscopy, before and after treatment. RESULTS Fenofibrate treatment did not result in significant changes in small HDL subclass particle concentration. When changes in HDL subclasses were stratified by ABCA1 polymorphism genotypes, there were no statistically significant associations between ABCA1 genotypes and small HDL subclasses before fenofibrate treatment. However, after fenofibrate treatment the KK genotype of R1587K (mean 4.40micromol/L; p=0.004) and the RK genotype of R219K (mean 1.60micromol/L; p=0.02) polymorphisms were associated with significantly increased small HDL. The R1587KKK genotype (mean 4.80micromol/L; p=0.0002) and the R219K KK genotype (mean 2.50micromol/L; p=0.02) were also associated with increased HDL particle concentrations. CONCLUSION There is a synergistic effect between ABCA1 polymorphisms and fenofibrate. Thus, our study indirectly confirms the role of fenofibrate and genotype in increasing cholesterol efflux, as evidenced by increased small HDL particles.
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Affiliation(s)
- Michael Y Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455-0392, USA.
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Tsai AK, Li N, Hanson NQ, Tsai MY, Tang W. Associations of genetic polymorphisms of arachidonate 5-lipoxygenase-activating protein with risk of coronary artery disease in a European–American population. Atherosclerosis 2009; 207:487-91. [DOI: 10.1016/j.atherosclerosis.2009.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 06/11/2009] [Accepted: 06/12/2009] [Indexed: 12/21/2022]
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Tsai MY, Loria CM, Cao J, Kim Y, Siscovick DS, Schreiner PJ, Hanson NQ. Polygenic association with total homocysteine in the post-folic acid fortification era: the CARDIA study. Mol Genet Metab 2009; 98:181-6. [PMID: 19577940 PMCID: PMC3578421 DOI: 10.1016/j.ymgme.2009.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Revised: 05/30/2009] [Accepted: 05/30/2009] [Indexed: 11/18/2022]
Abstract
Elevated plasma concentration of total homocysteine (tHcy) has been linked with many diseases. tHcy is associated with a variety of factors, including polymorphisms in genes involved in homocysteine metabolism. It is not clear whether US-mandated fortification of grain products with folic acid has affected the association of genetic variants with tHcy levels. We determined tHcy concentrations in sera from 997 Caucasians and 692 African Americans participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study before and after folic acid fortification. DNA was genotyped for variants present in four genes involved in homocysteine metabolism: cystathionine beta-synthase (CBS) 844ins68, methionine synthase (MS) 2756A>G; methionine synthase reductase (MTRR) 66A>G and methylenetetrahydrofolate reductase (MTHFR) 677C>T and 1298A>C. A greater number of African Americans were homozygous for the MS 2756GG, MTRR 66GG and CBS 844ins68 genotypes compared to Caucasians, while prevalence of MTHFR 677TT and 1298CC genotypes was substantially lower in African Americans compared to Caucasians. The overall variance in tHcy levels at y 0, 7 and 15 that can be explained by the combined presence of all five variants increased slightly over time in Caucasians (17%, y 0; 21%, y 7; and 26%, y 15) and in African Americans (13%, y 0; 17% y 7; and 18% y 15) largely due to decrease in tHcy variance.
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Affiliation(s)
- Michael Y Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA.
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Tsai MY, Loria CM, Cao J, Kim Y, Siscovick D, Schreiner PJ, Hanson NQ. Clinical utility of genotyping the 677C>T variant of methylenetetrahydrofolate reductase in humans is decreased in the post-folic acid fortification era. J Nutr 2009; 139:33-7. [PMID: 19056652 PMCID: PMC2646209 DOI: 10.3945/jn.108.096511] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Moderate hyperhomocysteinemia is associated with many diseases. Major factors affecting plasma total homocysteine (tHcy) concentrations include folate concentrations and polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene. Because U.S.-mandated fortification of grain products with folic acid has improved folate and tHcy status in Americans, we investigated the effect of the MTHFR 677C>T variant before and after fortification. We determined tHcy and folate concentrations in sera from 844 Caucasian and 587 African American participants in the Coronary Artery Risk Development in Young Adults study before and after fortification and we genotyped the MTHFR 677C>T variant. MTHFR 677TT homozygotes had higher (P < 0.01) tHcy concentrations both before and after fortification compared with MTHFR 677CC homozygotes. However, the difference between these 2 genotypes decreased from 2.5 micromol/L before fortification to <0.7 micromol/L postfortification (P < 0.01). In addition, the prevalence of moderate hyperhomocysteinemia (tHcy > 13 micromol/L) in 677TT homozygotes decreased from 33% before fortification to 12% postfortification (P < 0.01). Using a cutoff value of 13 micromol/L to define moderate hyperhomocysteinemia, the sensitivity of the MTHFR 677TT genotype to predict elevations in homocysteine was low (approximately 30%) both before and after folic acid fortification. Increasing the cutoff from 13 to 19 micromol/L increased the sensitivity of the assay before fortification to 62% but decreased the sensitivity to 17% postfortification. We conclude that after folic acid fortification in the US, measurement of tHcy rather than genotyping of MTHFR 677TT should be used as the primary assay for the diagnosis and monitoring of moderate hyperhomocysteinemia.
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Affiliation(s)
- Michael Y. Tsai
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - Catherine M. Loria
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - Jing Cao
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - Yongin Kim
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - David Siscovick
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - Pamela J. Schreiner
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
| | - Naomi Q. Hanson
- Department of Laboratory Medicine and Pathology and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455; Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20824; Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294; and Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98101
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Abstract
BACKGROUND The sum of eicosapentaenoic acid (EPA, 20:5 omega3) and docosahexaenoic acid (DHA, 22:6 omega3) in erythrocyte membranes, termed the omega-3 index, can indicate suboptimal intake of omega-3 fatty acids, a risk factor for cardiovascular disease (CVD). To study the effects of fatty acid supplementation, we investigated the rate of incorporation and clearance of these fatty acids in erythrocyte membranes and plasma after intake of supplements. METHODS Twenty study participants received supplementation with either fish oil (1296 mg EPA + 864 mg DHA/day) or flaxseed oil (3510 mg alpha-linolenic acid + 900 mg linoleic acid/day) for 8 weeks. We obtained erythrocyte membrane and plasma samples at weeks 0, 4, 8, 10, 12, 14, 16, and 24 and extracted and analyzed fatty acids by gas chromatography. RESULTS After 8 weeks of fish oil supplementation, erythrocyte membrane EPA and DHA increased 300% (P < 0.001) and 42% (P < 0.001), respectively. The mean erythrocyte omega-3 index reached a near optimal value of 7.8%, and remained relatively high until week 12. EPA and DHA showed greater increases and more rapid washout period decreases in plasma phospholipids than in erythrocyte membranes. Flaxseed oil supplementation increased erythrocyte membrane EPA to 133% (P < 0.05) and docosapentaenoic acid (DPA, 22:5 omega3) to 120% (P < 0.01) of baseline, but DHA was unchanged. In plasma phospholipids, EPA, DPA, and DHA showed a slight but statistically insignificant increase. CONCLUSIONS Erythrocyte membrane EPA+DHA increases during relatively short intervals in response to supplementation at rates related to amount of supplementation. These results may be useful to establish appropriate dosage for omega-3 fatty acid supplementation.
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Affiliation(s)
- Jing Cao
- University of Minnesota, Minneapolis, MN 55455, USA
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Tsai MY, Hanson NQ, Straka RJ, Hoke TR, Ordovas JM, Peacock JM, Arends VL, Arnett DK. Effect of influenza vaccine on markers of inflammation and lipid profile. ACTA ACUST UNITED AC 2005; 145:323-7. [PMID: 15976761 DOI: 10.1016/j.lab.2005.03.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite wide use of the influenza vaccine, relatively little is known about its effect on the measurement of inflammatory markers. Because inflammatory markers such as C-reactive protein (CRP) are increasingly being used in conjunction with lipids for the clinical assessment of cardiovascular disease and in epidemiologic studies, we evaluated the effect of influenza vaccination on markers of inflammation and plasma lipid concentrations. We drew blood from 22 healthy individuals 1 to 6 hours before they were given an influenza vaccination and 1, 3, and 7 days after the vaccination. Plasma CRP, interleukin (IL)-6, monocyte chemotactic protein 1, tumor necrosis factor alpha, IL-2 soluble receptor alpha, and serum amyloid A were measured, and differences in mean concentrations of absolute and normalized values on days 1, 3, and 7 were compared with mean baseline values. There was a significant increase in mean IL-6 (P < .01 absolute values, P < .001 normalized values) on day 1 after receiving the influenza vaccine. The mean increases in normalized high sensitivity CRP values were significant on day 1 (P < .01) and day 3 (P = .05), whereas the mean increase in normalized serum amyloid A was significant only on day 1 (P < .05). No significant changes were seen in mean concentrations of IL-2 soluble receptor alpha, monocyte chemotactic protein-1, or tumor necrosis factor-alpha. Of the lipids, significant decreases in mean concentrations of normalized triglyceride values were seen on days 1 (P < .05), 3 (P < .001), and 7 (P < .05) after vaccination. Our findings show that the influenza vaccination causes transient changes in select markers of inflammation and lipids. Consequently, clinical and epidemiologic interpretation of the biomarkers affected should take into account the possible effects of influenza vaccination.
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Affiliation(s)
- Michael Y Tsai
- Laboratory of Medicine and Pathology, University of Minnesota, Minneapolis, USA.
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Woll PS, Hanson NQ, Arends VL, Tsai MY. Effect of Two Common Polymorphisms in the ATP Binding Cassette Transporter A1 Gene on HDL-Cholesterol Concentration. Clin Chem 2005; 51:907-9. [PMID: 15855668 DOI: 10.1373/clinchem.2004.047126] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Petter S Woll
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392, USA
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Tsai MY, Aras O, Sozen H, Hanson NQ, Woll PS, Arends VL, Hunninghake DB, Matas AJ. Plasma homocysteine levels in living kidney donors before and after uninephrectomy. ACTA ACUST UNITED AC 2004; 143:340-3. [PMID: 15192649 DOI: 10.1016/j.lab.2004.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An increased prevalence of hyperhomocysteinemia has been observed among patients with end-stage renal disease, and numerous studies have demonstrated that kidney function is one of the most important determinants of plasma total homocysteine (tHcy) concentration. In an effort to understand the mechanism of hyperhomocysteinemia in renal disease, we chose, as our model, living kidney donors who had undergone uninephrectomy. We studied 10 living kidney donors and measured fasting plasma tHcy, plasma creatinine, folate, vitamins B(12) and B(6), and high-sensitivity C-reactive protein (hsCRP) 24 hours before nephrectomy and 2 days, 6 weeks, and 6 months after nephrectomy compared to the values 24 hours before nephrectomy. Mean fasting tHcy and creatinine concentrations were significantly higher in donors 2 days, 6 weeks and 6 months after nephrectomy they were 24 hours before nephrectomy. Both the increases in tHcy levels 2 days after nephrectomy and subsequent decreases 6 weeks and 6 months after are paralleled by the changes in plasma creatinine values, although neither returned to its presurgery value. Decreases in tHcy are significantly correlated with decreases in creatinine values. The B vitamins were unchanged, and the hsCRP level was increased 2 days after surgery but had returned to the baseline level after 6 weeks. We conclude that tHcy and creatinine levels parallel each other after uninephrectomy and that the gradual decrease in tHcy is accounted for by hypertrophy of the remaining kidney. Our results, the first to be obtained from living kidney donors, support the hypothesis that renal metabolism of tHcy is the mechanism responsible for the correlation between renal function and plasma tHcy level.
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Affiliation(s)
- Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, 55455-0392, USA.
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Tsai MY, Georgopoulos A, Otvos JD, Ordovas JM, Hanson NQ, Peacock JM, Arnett DK. Comparison of ultracentrifugation and nuclear magnetic resonance spectroscopy in the quantification of triglyceride-rich lipoproteins after an oral fat load. Clin Chem 2004; 50:1201-4. [PMID: 15142979 DOI: 10.1373/clinchem.2004.032938] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The measurement of triglyceride (TG)-rich particles after an oral fat challenge has been used to provide a measure of risk for coronary artery disease independent of the fasting plasma triglyceride concentration. The analytical "gold standard" for measuring TG-rich lipoproteins uses density gradient ultracentrifugation; however, this technique is labor-intensive. Because of our need to perform numerous postprandial analyses of TG-rich lipoproteins for a large interventional study (Genetics of Lipid Lowering Drugs and Diet Network), we evaluated the use of nuclear magnetic resonance (NMR) spectroscopy for measuring TG-rich particles. METHODS EDTA-blood samples were obtained 0, 3.5, 6, and 8 h after ingestion of an oral fat meal (89% of calories from fat) in 20 apparently healthy individuals. The plasma TG concentrations of chylomicron and chylomicron remnant/VLDL fractions were analyzed by ultracentrifugation and NMR spectroscopy. RESULTS Comparison of all values (n = 78) by ultracentrifugation (x) and NMR (y) produced a linear regression equation of y = 0.979x - 0.035 mmol/L (R(2) = 0.90) for chylomicrons and y = 1.398x + 0.067 mmol/L (R(2) = 0.96) for the fraction containing chylomicron remnants and VLDL. Postprandial response of chylomicrons and chylomicron remnant/VLDL was similar, with maximum response occurring between 3.5 to 6 h regardless of method of measurement. CONCLUSION Chylomicron and chylomicron remnant/VLDL fraction measurements obtained by NMR have a high degree of correlation with results produced by ultracentrifugation. NMR may therefore be suitable as an alternative method for the measurement of postprandial TG-rich lipoproteins in individuals consuming a high-fat meal.
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Affiliation(s)
- Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
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Gülec S, Aras O, Atmaca Y, Akyürek O, Hanson NQ, Sayin T, Tsai MY, Akar N, Oral D. Deletion polymorphism of the angiotensin I converting enzyme gene is a potent risk factor for coronary artery ectasia. Heart 2003; 89:213-4. [PMID: 12527685 PMCID: PMC1767548 DOI: 10.1136/heart.89.2.213] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Ermis C, Tsai MY, Hanson NQ, Akar N, Aras O. Angiotensin I converting enzyme, angiotensin II type 1 receptor and angiotensinogen polymorphisms and early myocardial infarction in Turkish population. Thromb Haemost 2002; 88:693-4. [PMID: 12362249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Hanson NQ, Eckfeldt JH, Schwichtenberg K, Aras O, Tsai MY. Interlaboratory Variation of Plasma Total Homocysteine Measurements: Results of Three Successive Homocysteine Proficiency Testing Surveys. Clin Chem 2002. [DOI: 10.1093/clinchem/48.9.1539] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background: Numerous studies have demonstrated that increased plasma total homocysteine (tHcy), whether measured after fasting or after a methionine load, is associated with increased risk for cardiovascular and thromboembolic diseases. However, little information is available regarding interlaboratory variation of tHcy measurements, especially at the increased tHcy concentrations observed after loading.
Methods: We conducted three Homocysteine Proficiency Testing Surveys at 6-month intervals. Sets of five plasma pools with endogenous tHcy concentrations ranging from 5 to 48 μmol/L were sent to participants. We received 11, 23, and 17 responses in the first, second, and third surveys, respectively. The following methods were used by participating laboratories: fluorescence polarization immunoassay (FPIA); HPLC with fluorescent detection (HPLC-FD), further subdivided by type of reduction/derivatization; HPLC with electrochemical detection (HPLC-ED); amino acid analyzer with ninhydrin detection; and liquid chromatography–electrospray tandem mass spectrometry (LC-MS/MS).
Results: In surveys 1 and 2, no notable differences among the mean tHcy values obtained by the different methods performed were observed. In survey 3, tHcy values obtained by the FPIA method were significantly lower (P <0.05) at increased tHcy concentrations (34 μmol/L) compared with values obtained by HPLC-FD regardless of reduction/derivatization agents used. Our laboratory confirmed the observation that tHcy values obtained by the FPIA method differed from those obtained by HPLC-FD at increased tHcy concentrations by reanalyzing each pool 10 times by FPIA and HPLC-FD using tributylphosphine–ammonium 7-fluoro-2,1,3-benzoxadiazole-4-sulfonate (P <0.001 for tHcy >19 μmol/L). The mean among-method variations in surveys 1, 2, and 3 were 19%, 12%, and 9.6%, respectively. When results of the three surveys were combined, the mean among-method variation on 170 samples was 13%. Within-method variation was lowest for the FPIA method (4.4%), and ranged from 11–20% for HPLC methods.
Conclusions: Various degrees of imprecision and lack of correlation among tHcy methods indicate that there is a need to improve analytical precision, decrease analytical difference, and standardize tHcy measurements among laboratories.
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Affiliation(s)
- Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455
| | - John H Eckfeldt
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Kerry Schwichtenberg
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Ömer Aras
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455
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Hanson NQ, Eckfeldt JH, Schwichtenberg K, Aras O, Tsai MY. Interlaboratory variation of plasma total homocysteine measurements: results of three successive homocysteine proficiency testing surveys. Clin Chem 2002; 48:1539-45. [PMID: 12194931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Numerous studies have demonstrated that increased plasma total homocysteine (tHcy), whether measured after fasting or after a methionine load, is associated with increased risk for cardiovascular and thromboembolic diseases. However, little information is available regarding interlaboratory variation of tHcy measurements, especially at the increased tHcy concentrations observed after loading. METHODS We conducted three Homocysteine Proficiency Testing Surveys at 6-month intervals. Sets of five plasma pools with endogenous tHcy concentrations ranging from 5 to 48 micromol/L were sent to participants. We received 11, 23, and 17 responses in the first, second, and third surveys, respectively. The following methods were used by participating laboratories: fluorescence polarization immunoassay (FPIA); HPLC with fluorescent detection (HPLC-FD), further subdivided by type of reduction/derivatization; HPLC with electrochemical detection (HPLC-ED); amino acid analyzer with ninhydrin detection; and liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS). RESULTS In surveys 1 and 2, no notable differences among the mean tHcy values obtained by the different methods performed were observed. In survey 3, tHcy values obtained by the FPIA method were significantly lower (P <0.05) at increased tHcy concentrations (34 micromol/L) compared with values obtained by HPLC-FD regardless of reduction/derivatization agents used. Our laboratory confirmed the observation that tHcy values obtained by the FPIA method differed from those obtained by HPLC-FD at increased tHcy concentrations by reanalyzing each pool 10 times by FPIA and HPLC-FD using tributylphosphine-ammonium 7-fluoro-2,1,3-benzoxadiazole-4-sulfonate (P <0.001 for tHcy >19 micro mol/L). The mean among-method variations in surveys 1, 2, and 3 were 19%, 12%, and 9.6%, respectively. When results of the three surveys were combined, the mean among-method variation on 170 samples was 13%. Within-method variation was lowest for the FPIA method (4.4%), and ranged from 11-20% for HPLC methods. CONCLUSIONS Various degrees of imprecision and lack of correlation among tHcy methods indicate that there is a need to improve analytical precision, decrease analytical difference, and standardize tHcy measurements among laboratories.
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Affiliation(s)
- Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, 420 Delaware Street, Minneapolis, MN 55455-0392, USA
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Aras O, Hanson NQ, Bakanay SM, Tsai MY, Gulec S. Endothelial nitric oxide gene polymorphism (Glu298Asp) is not associated with coronary artery disease in Turkish population. Thromb Haemost 2002; 87:347-9. [PMID: 11858501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Aras O, Hanson NQ, Tsai MY, Key NS. Is homozygosity for the HR2 haplotype a risk factor for venous thromboembolism? Thromb Haemost 2002; 87:173-4. [PMID: 11848451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Tsai MY, Hanson NQ, Bailey R, Rao G, Hunninghake DB. Cystatin C is an independent predictor of fasting and post-methionine load total homocysteine concentrations among stable renal transplant recipients. Clin Chem 2001; 47:1263-8. [PMID: 11427458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND An increased prevalence of hyperhomocysteinemia with an increased incidence of cardiovascular disease events has been reported among stable renal transplant recipients (RTRs). Preliminary studies in a small number of these individuals have shown that serum creatinine and cystatin C, both markers of kidney function and glomerular filtration rate, are independent determinants of fasting tHcy concentrations; however, determinants of tHcy concentrations after a methionine load have not been studied. METHODS We determined the prevalence of both fasting and 4-h post-methionine load (PML) tHcy concentrations in 78 stable RTRs and compared the role of cystatin C with the role of serum creatinine as determinants of fasting and PML tHcy. RESULTS Of the 78 RTRs, 21 (26.9%) had fasting and PML tHcy within the respective reference intervals, and 57 (73.1%) had increased plasma tHcy. Of these 57 RTRs, 22 had fasting hyperhomocysteinemia, 9 had PML hyperhomocysteinemia, and 26 had combined hyperhomocysteinemia (both fasting and PML). Unadjusted Pearson correlations showed that fasting plasma tHcy correlated with both cystatin C (r = 0.564; P <0.001) and creatinine (r = 0.519; P <0.001) and that increases in PML tHcy modestly correlated with cystatin (r = 0.205; P = 0.072), but not creatinine (r = 0.057; P = 0.624). General linear regression modeling with stepwise analysis of covariance showed that both cystatin C (partial R = 0.554; P <0.001) and creatinine (partial R = 0.535; P <0.001) were independent predictors of fasting tHcy, but of the two, only cystatin C (partial R = 0.242; P = 0.035) was an independent predictor of increased PML tHcy. CONCLUSIONS Clinically stable RTRs have an excess prevalence of moderate hyperhomocysteinemia, and additional cases can be detected by methionine loading. Both creatinine and cystatin C are independent predictors of fasting tHcy in these individuals; however, only cystatin C is a determinant of tHcy concentration after a methionine load, probably because cystatin C is a more sensitive marker of glomerular filtration rate than serum creatinine.
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Aras O, Tsai MY, Hanson NQ, Bailey R, Rao G, Hunninghake DB. Cystatin C Is an Independent Predictor of Fasting and Post-Methionine Load Total Homocysteine Concentrations among Stable Renal Transplant Recipients. Clin Chem 2001. [DOI: 10.1093/clinchem/47.7.1263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background: An increased prevalence of hyperhomocysteinemia with an increased incidence of cardiovascular disease events has been reported among stable renal transplant recipients (RTRs). Preliminary studies in a small number of these individuals have shown that serum creatinine and cystatin C, both markers of kidney function and glomerular filtration rate, are independent determinants of fasting tHcy concentrations; however, determinants of tHcy concentrations after a methionine load have not been studied.
Methods: We determined the prevalence of both fasting and 4-h post-methionine load (PML) tHcy concentrations in 78 stable RTRs and compared the role of cystatin C with the role of serum creatinine as determinants of fasting and PML tHcy.
Results: Of the 78 RTRs, 21 (26.9%) had fasting and PML tHcy within the respective reference intervals, and 57 (73.1%) had increased plasma tHcy. Of these 57 RTRs, 22 had fasting hyperhomocysteinemia, 9 had PML hyperhomocysteinemia, and 26 had combined hyperhomocysteinemia (both fasting and PML). Unadjusted Pearson correlations showed that fasting plasma tHcy correlated with both cystatin C (r = 0.564; P <0.001) and creatinine (r = 0.519; P <0.001) and that increases in PML tHcy modestly correlated with cystatin (r = 0.205; P = 0.072), but not creatinine (r = 0.057; P = 0.624). General linear regression modeling with stepwise analysis of covariance showed that both cystatin C (partial R = 0.554; P <0.001) and creatinine (partial R = 0.535; P <0.001) were independent predictors of fasting tHcy, but of the two, only cystatin C (partial R = 0.242; P = 0.035) was an independent predictor of increased PML tHcy.
Conclusions: Clinically stable RTRs have an excess prevalence of moderate hyperhomocysteinemia, and additional cases can be detected by methionine loading. Both creatinine and cystatin C are independent predictors of fasting tHcy in these individuals; however, only cystatin C is a determinant of tHcy concentration after a methionine load, probably because cystatin C is a more sensitive marker of glomerular filtration rate than serum creatinine.
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Affiliation(s)
- Ömer Aras
- Departments of Laboratory Medicine and Pathology
| | | | | | | | - Gundu Rao
- Departments of Laboratory Medicine and Pathology
| | - Donald B Hunninghake
- Pharmacology, and
- Medicine, University of Minnesota Medical School, Minneapolis, MN 55455-0392
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Hanson NQ, Aras O, Yang F, Tsai MY. C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase gene: incidence and effect of combined genotypes on plasma fasting and post-methionine load homocysteine in vascular disease. Clin Chem 2001; 47:661-6. [PMID: 11274015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Moderately increased plasma concentrations of total homocysteine (tHcy) have been shown to be an important risk factor for vascular diseases. Two common polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene, the thermolabile C677T and a more recently reported A1298C polymorphism, may contribute to hyperhomocysteinemia. METHODS Using PCR and restriction fragment length polymorphism analysis, we studied the prevalence of the C677T and A1298C MTHFR genotypes and the combined effect of these polymorphisms on plasma tHcy concentrations, as measured by HPLC with fluorometric detection, both fasting and post-methionine load (PML), in 1238 individuals. RESULTS The prevalences of the C677T and A1298C genotypes did not differ significantly in 772 individuals with documented coronary artery disease (CAD), 137 individuals with deep-vein thrombosis (DVT), and 329 individuals without documented vascular disease. Individuals homozygous for the 677T allele had significantly increased fasting tHcy, particularly in the presence of low folate, compared with individuals homozygous for the wild-type allele. Neither the 1298AC nor the 1298CC genotype was associated with significantly increased fasting or PML tHcy concentrations irrespective of serum folate. Of the nine combined MTHFR genotypes, six were present in >10% of the population. Of these, the difference in mean fasting tHcy reached statistical significance (P<0.005) only in individuals with the 677TT/1298AA genotype compared with individuals with the wild-type 677CC/1298AA genotype. Differences in mean fasting tHcy did not reach statistical significance in individuals heterozygous for both MTHFR variants. We detected two 677CT/1298CC and three 677TT/1298AC individuals; only one, an 677TT/1298AC individual, had increased tHcy (both fasting and PML). No individuals had the 677TT/1298CC genotype. CONCLUSIONS The prevalences of the C677T and A1298C polymorphisms did not differ among individuals with CAD, DVT, or those without documented vascular disease. In contrast to the C677T polymorphism, the A1298C polymorphism is not associated with increased fasting tHcy. Although the two polymorphisms usually exist in trans configuration, crossover may occur rarely to form recombinant chromosomes.
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Affiliation(s)
- N Q Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392, USA
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Hanson NQ, Aras O, Yang F, Tsai MY. C677T and A1298C Polymorphisms of the Methylenetetrahydrofolate Reductase Gene: Incidence and Effect of Combined Genotypes on Plasma Fasting and Post-Methionine Load Homocysteine in Vascular Disease. Clin Chem 2001. [DOI: 10.1093/clinchem/47.4.661] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background: Moderately increased plasma concentrations of total homocysteine (tHcy) have been shown to be an important risk factor for vascular diseases. Two common polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene, the thermolabile C677T and a more recently reported A1298C polymorphism, may contribute to hyperhomocysteinemia.
Methods: Using PCR and restriction fragment length polymorphism analysis, we studied the prevalence of the C677T and A1298C MTHFR genotypes and the combined effect of these polymorphisms on plasma tHcy concentrations, as measured by HPLC with fluorometric detection, both fasting and post-methionine load (PML), in 1238 individuals.
Results: The prevalences of the C677T and A1298C genotypes did not differ significantly in 772 individuals with documented coronary artery disease (CAD), 137 individuals with deep-vein thrombosis (DVT), and 329 individuals without documented vascular disease. Individuals homozygous for the 677T allele had significantly increased fasting tHcy, particularly in the presence of low folate, compared with individuals homozygous for the wild-type allele. Neither the 1298AC nor the 1298CC genotype was associated with significantly increased fasting or PML tHcy concentrations irrespective of serum folate. Of the nine combined MTHFR genotypes, six were present in >10% of the population. Of these, the difference in mean fasting tHcy reached statistical significance (P <0.005) only in individuals with the 677TT/1298AA genotype compared with individuals with the wild-type 677CC/1298AA genotype. Differences in mean fasting tHcy did not reach statistical significance in individuals heterozygous for both MTHFR variants. We detected two 677CT/1298CC and three 677TT/1298AC individuals; only one, an 677TT/1298AC individual, had increased tHcy (both fasting and PML). No individuals had the 677TT/1298CC genotype.
Conclusions: The prevalences of the C677T and A1298C polymorphisms did not differ among individuals with CAD, DVT, or those without documented vascular disease. In contrast to the C677T polymorphism, the A1298C polymorphism is not associated with increased fasting tHcy. Although the two polymorphisms usually exist in trans configuration, crossover may occur rarely to form recombinant chromosomes.
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Affiliation(s)
- Naomi Q Hanson
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392
| | - Ömer Aras
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392
| | - Feng Yang
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455-0392
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Abstract
OBJECTIVES Hyperhomocysteinemia is associated with premature cerebral, peripheral and coronary vascular disease. Evaluation of the significance of changes in plasma total homocysteine (tHcy) results obtained by analysis of serial specimens may be accomplished only by taking into account biologic (between-person and within-person) as well as analytical variation. Since the repeatability of a measurement significantly determines our ability to associate tHcy level with the presence of disease, this study was performed to evaluate various components of variation in tHcy values. DESIGN AND METHODS We report the within-person, between-person, and methodological variability of tHcy, both fasting and postmethionine load (PML) values, in 20 healthy volunteers from whom samples were drawn weekly for 4 weeks. RESULTS The short-term reliability coefficient (R) was 0.72 for fasting tHcy and 0.83 for PML tHcy. CONCLUSIONS The current study demonstrates for the first time that the short-term reliability coefficient for PML tHcy is relatively high (0.83), suggesting that an individual's PML tHcy, like fasting tHcy, is relatively constant over at least one month, and that a single measurement should provide a reasonable characterization of an individual's PML tHcy concentration.
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Affiliation(s)
- M Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Medical School, 420 Delaware St., SE, Box 609, Minneapolis, MN, USA.
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Yang F, Hanson NQ, Schwichtenberg K, Tsai MY. Variable number tandem repeat in exon/intron border of the cystathionine beta-synthase gene: a single nucleotide substitution in the second repeat prevents multiple alternate splicing. Am J Med Genet 2000; 95:385-90. [PMID: 11186895 DOI: 10.1002/1096-8628(20001211)95:4<385::aid-ajmg16>3.0.co;2-v] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We studied a large number of individuals with respect to the 31-bp variable number tandem repeat (VNTR) in the cystathionine beta-synthase (CBS) gene. The number of repeats varies from 15-20, with 17 repeats the most common allele. Significantly, we found that the first repeat of the 31-bp VNTR originates 12 bp from the 5' end of exon 13 and extends 19 bp into intron 13. Since this VNTR spans across the exon-intron border, it can theoretically create multiple alternate splice sites. However, a substitution of g-->a at the exon-intron border is uniquely present in the second repeat, preventing alternate splicing at that site. While the g-->a substitution is absent from all subsequent 31-bp repeats, alternate splicing probably does not occur at those distal sites due to the lack of exon 13 sequences not contained in the repeats but needed for the binding of spliceosomes. Investigation of five individuals with normal plasma total homocysteine (tHcy) and five individuals with mild hyper-homocysteinemia shows that all have the g-->a substitution in the second repeat. Nonetheless, we speculate that the absence of this substitution may be found in rare individuals with normal CBS cDNA and unexplained hyperhomocysteinemia. Gene scanning and direct nucleotide sequencing were used to characterize the VNTR in 398 patients with premature coronary artery disease and 137 controls. Five alleles and 10 genotypes were found; 17/17 is the most prevalent genotype in our study population. The two other prevalent genotypes, 16/17 and 17/18, are associated with significantly decreased tHcy levels as compared to the 17/ 17 genotype, suggesting that the 16 and 18 repeats haplotype may be in linkage disequilibrium with regulatory elements which upregulate CBS gene transcription.
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Affiliation(s)
- F Yang
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, USA
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