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Verbeek R, Oldoni F, Surendran RP, Zwinderman AH, Khaw KT, Stroes ESG, Wareham NJ, Boekholdt SM, Dallinga-Thie GM. A 3-SNP gene risk score and a metabolic risk score both predict hypertriglyceridemia and cardiovascular disease risk. J Clin Lipidol 2019; 13:492-501. [PMID: 30910668 DOI: 10.1016/j.jacl.2019.02.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 01/24/2019] [Accepted: 02/19/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Evidence on the causal link between plasma triglyceride (TG) levels and risk for cardiovascular disease (CVD) has recently emerged. Individuals with the metabolic syndrome have an increased risk for acquiring elevated TG levels later in life. Moreover, common DNA sequence variations in genes affecting TG levels identify individuals at risk for elevated plasma TG levels. OBJECTIVE We evaluated whether a 3-single nucleotide polymorphism (SNP) TG gene risk score (GRS) and a metabolic risk score (MetRS) both improved CVD risk prediction. METHODS A 3-SNP GRS and MetRS were generated in the EPIC-Norfolk cohort (n = 20,074) based on 3 SNPs in LPL and APOA5 or the number of Metabolic Syndrome criteria present (maximum 5), respectively. The associations between the 3-SNP GRS, MetRS, TG levels, and CVD risk were evaluated. RESULTS The 3-SNP GRS and MetRS were both linearly associated with plasma TG levels, that is, +0.25 mmol/L [95% CI 0.22-0.27] per allele change (P < .001) and +0.72 mmol/L [95% CI 0.70-0.73] per increase of number of metabolic syndrome risk score points (P < .001), respectively. We observed a positive association between the 3-SNP GRS and the risk of CVD with an adjusted hazard ratio (HR) of 1.35 [95% CI 1.04-1.74] for the highest versus the lowest GRS, which was independent of the MetRS. For the MetRS, the adjusted HR was 2.03 [95% CI 1.73-2.40] for the highest versus the lowest MetRS. CONCLUSION Both the 3-SNP GRS and the MetRS are associated with increased plasma TG levels and increased risk for CVD.
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Affiliation(s)
- Rutger Verbeek
- Departments of Vascular Medicine and Experimental Vascular Medicine, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Federico Oldoni
- Department of Pediatrics, Section of Molecular Genetics, University Medical Center Groningen, Groningen, the Netherlands
| | - R Preethi Surendran
- Departments of Vascular Medicine and Experimental Vascular Medicine, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Ailko H Zwinderman
- Department of Biostatistics, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Kay T Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Erik S G Stroes
- Departments of Vascular Medicine and Experimental Vascular Medicine, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Nick J Wareham
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
| | - S Matthijs Boekholdt
- Department of Cardiology, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Geesje M Dallinga-Thie
- Departments of Vascular Medicine and Experimental Vascular Medicine, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, the Netherlands.
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Surendran RP, Udayyapan SD, Clemente-Postigo M, Havik SR, Schimmel AWM, Tinahones F, Nieuwdorp M, Dallinga-Thie GM. Decreased GPIHBP1 protein levels in visceral adipose tissue partly underlie the hypertriglyceridemic phenotype in insulin resistance. PLoS One 2018; 13:e0205858. [PMID: 30408040 PMCID: PMC6224034 DOI: 10.1371/journal.pone.0205858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/02/2018] [Indexed: 01/29/2023] Open
Abstract
GPIHBP1 is a protein localized at the endothelial cell surface that facilitates triglyceride (TG) lipolysis by binding lipoprotein lipase (LPL). Whether Glycosyl Phosphatidyl Inositol high density lipoprotein binding protein 1 (GPIHBP1) function is impaired and may underlie the hyperTG phenotype observed in type 2 diabetes is not yet established. To elucidate the mechanism underlying impaired TG homeostasis in insulin resistance state we studied the effect of insulin on GPIHBP1 protein expression in human microvascular endothelial cells (HMVEC) under flow conditions. Next, we assessed visceral adipose tissue GPIHBP1 protein expression in type 2 diabetes Leprdb/db mouse model as well as in subjects with ranging levels of insulin resistance. We report that insulin reduces the expression of GPIHBP1 protein in HMVECs. Furthermore, GPIHBP1 protein expression in visceral adipose tissue in Leprdb/db mice is significantly reduced as is the active monomeric form of GPIHBP1 as compared to Leprdb/m mice. A similar decrease in GPIHBP1 protein was observed in subjects with increased body weight. GPIHBP1 protein expression was negatively associated with insulin and HOMA-IR. In conclusion, our data suggest that decreased GPIHBP1 availability in insulin resistant state may hamper peripheral lipolysis capacity.
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Affiliation(s)
- R. Preethi Surendran
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Shanti D. Udayyapan
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Mercedes Clemente-Postigo
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Malaga, Malaga, Spain
- CIBER Fisiopatologia de la Obesidad y Nutrición (CB06/03), Barcelona, Spain
| | - Stefan R. Havik
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Alinda W. M. Schimmel
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Fransisco Tinahones
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Malaga, Malaga, Spain
- CIBER Fisiopatologia de la Obesidad y Nutrición (CB06/03), Barcelona, Spain
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - Geesje M. Dallinga-Thie
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Malaga, Malaga, Spain
- * E-mail:
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Hassing HC, Surendran RP, Derudas B, Verrijken A, Francque SM, Mooij HL, Bernelot Moens SJ, ’t Hart LM, Nijpels G, Dekker JM, Williams KJ, Stroes ESG, Van Gaal LF, Staels B, Nieuwdorp M, Dallinga-Thie GM. SULF2 strongly prediposes to fasting and postprandial triglycerides in patients with obesity and type 2 diabetes mellitus. Obesity (Silver Spring) 2014; 22:1309-16. [PMID: 24339435 PMCID: PMC4008695 DOI: 10.1002/oby.20682] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 09/20/2013] [Revised: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Hepatic overexpression of sulfatase-2 (SULF2), a heparan sulfate remodeling enzyme, strongly contributes to high triglyceride (TG) levels in obese, type 2 diabetic (T2DM) db/db mice. Nevertheless, data in humans are lacking. Here, the association of human hepatic SULF2 expression and SULF2 gene variants with TG metabolism in patients with obesity and/or T2DM was investigated. METHODS Liver biopsies from 121 obese subjects were analyzed for relations between hepatic SULF2 mRNA levels and plasma TG. Associations between seven SULF2 tagSNPs and TG levels were assessed in 210 obese T2DM subjects with dyslipidemia. Replication of positive findings was performed in 1,316 independent obese T2DM patients. Postprandial TRL clearance was evaluated in 29 obese T2DM subjects stratified by SULF2 genotype. RESULTS Liver SULF2 expression was significantly associated with fasting plasma TG (r = 0.271; P = 0.003) in obese subjects. The SULF2 rs2281279(A>G) SNP was reproducibly associated with lower fasting plasma TG levels in obese T2DM subjects (P < 0.05). Carriership of the minor G allele was associated with lower levels of postprandial plasma TG (P < 0.05) and retinyl esters levels (P < 0.001). CONCLUSIONS These findings implicate SULF2 as potential therapeutic target in the atherogenic dyslipidemia of obesity and T2DM.
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Affiliation(s)
- H. Carlijne Hassing
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - R. Preethi Surendran
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Bruno Derudas
- University of Lille 2; INSERM U1011; EGID; Institute Pasteur de Lille, France
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Belgium
| | - Sven M. Francque
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, Belgium
| | - Hans L. Mooij
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Leen M. ’t Hart
- Departments of Molecular Epidemiology and Molecular Cell Biology, Leiden University Medical Center
| | - Giel Nijpels
- Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Center
| | - Jacqueline M. Dekker
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center
| | - Kevin Jon Williams
- Section of Endocrinology, Diabetes and Metabolism, Temple University School of Medicine, Philadelphia, PA USA
- Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Göthenborg, Sweden
| | - Erik S. G. Stroes
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Luc F. Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Belgium
| | - Bart Staels
- University of Lille 2; INSERM U1011; EGID; Institute Pasteur de Lille, France
| | - Max Nieuwdorp
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Geesje M. Dallinga-Thie
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
- Corresponding author: G.M.Dallinga-Thie, PhD Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, room K1.262, 1105 AZ Amsterdam, the Netherlands,
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Surendran RP, Visser ME, Heemelaar S, Wang J, Peter J, Defesche JC, Kuivenhoven JA, Hosseini M, Péterfy M, Kastelein JJP, Johansen CT, Hegele RA, Stroes ESG, Dallinga-Thie GM. Mutations in LPL, APOC2, APOA5, GPIHBP1 and LMF1 in patients with severe hypertriglyceridaemia. J Intern Med 2012; 272:185-96. [PMID: 22239554 PMCID: PMC3940136 DOI: 10.1111/j.1365-2796.2012.02516.x] [Citation(s) in RCA: 175] [Impact Index Per Article: 14.6] [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] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The severe forms of hypertriglyceridaemia (HTG) are caused by mutations in genes that lead to the loss of function of lipoprotein lipase (LPL). In most patients with severe HTG (TG > 10 mmol L(-1) ), it is a challenge to define the underlying cause. We investigated the molecular basis of severe HTG in patients referred to the Lipid Clinic at the Academic Medical Center Amsterdam. METHODS The coding regions of LPL, APOC2, APOA5 and two novel genes, lipase maturation factor 1 (LMF1) and GPI-anchored high-density lipoprotein (HDL)-binding protein 1 (GPIHBP1), were sequenced in 86 patients with type 1 and type 5 HTG and 327 controls. RESULTS In 46 patients (54%), rare DNA sequence variants were identified, comprising variants in LPL (n = 19), APOC2 (n = 1), APOA5 (n = 2), GPIHBP1 (n = 3) and LMF1 (n = 8). In 22 patients (26%), only common variants in LPL (p.Asp36Asn, p.Asn318Ser and p.Ser474Ter) and APOA5 (p.Ser19Trp) could be identified, whereas no mutations were found in 18 patients (21%). In vitro validation revealed that the mutations in LMF1 were not associated with compromised LPL function. Consistent with this, five of the eight LMF1 variants were also found in controls and therefore cannot account for the observed phenotype. CONCLUSIONS The prevalence of mutations in LPL was 34% and mostly restricted to patients with type 1 HTG. Mutations in GPIHBP1 (n = 3), APOC2 (n = 1) and APOA5 (n = 2) were rare but the associated clinical phenotype was severe. Routine sequencing of candidate genes in severe HTG has improved our understanding of the molecular basis of this phenotype associated with acute pancreatitis and may help to guide future individualized therapeutic strategies.
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Affiliation(s)
- R P Surendran
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
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