Bos Daniel, Ikram M Arfan, Isaacs Aaron, Verhaaren Benjamin F J, Hofman Albert, van Duijn Cornelia M, Witteman Jacqueline C M, van der Lugt Aad, Vernooij Meike W
Departments of Radiology, Erasmus MC, Rotterdam, the Netherlands.
Circ Cardiovasc Genet. 2013 Feb;6(1):47-53. doi: 10.1161/CIRCGENETICS.112.963934. Epub 2012 Dec 16.
Atherosclerosis in different vessel beds shares lifestyle and environmental risk factors. It is unclear whether this holds for genetic risk factors. Hence, for the current study genetic loci for coronary artery calcification and serum lipid levels, one of the strongest risk factors for atherosclerosis, were used to assess their relation with atherosclerosis in different vessel beds.
From 1987 persons of the population-based Rotterdam Study, 3 single-nucleotide polymorphisms (SNPs) for coronary artery calcification and 132 SNPs for total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol or triglycerides were used. To quantify atherosclerotic calcification as a marker of atherosclerosis, all participants underwent nonenhanced computed tomography of the aortic arch and carotid arteries. Associations between genetic risk scores of the joint effect of the SNPs and of all calcification were investigated. The joint effect of coronary artery calcification-SNPs was associated with larger calcification volumes in all vessel beds (difference in calcification volume per SD increase in genetic risk score: 0.15 [95% confidence interval, 0.11-0.20] in aorta, 0.14 [95% confidence interval, 0.10-0.18] in extracranial carotids, and 0.11 [95% confidence interval, 0.07-0.16] in intracranial carotids). The joint effect of total cholesterol SNPs, low-density lipoprotein SNPs, and of all lipid SNPs together was associated with larger calcification volumes in both the aortic arch and the carotid arteries but attenuated after adjusting for the lipid fraction and lipid-lowering medication.
The genetic basis for aortic arch and carotid artery calcification overlaps with the most important loci of coronary artery calcification. Furthermore, serum lipids share a genetic predisposition with both calcification in the aortic arch and the carotid arteries, providing novel insights into the cause of atherosclerosis.
不同血管床的动脉粥样硬化具有共同的生活方式和环境风险因素。目前尚不清楚遗传风险因素是否也是如此。因此,在本研究中,我们使用冠状动脉钙化的基因位点以及动脉粥样硬化最强的风险因素之一——血脂水平,来评估它们与不同血管床动脉粥样硬化的关系。
在基于人群的鹿特丹研究的1987名参与者中,我们使用了3个冠状动脉钙化的单核苷酸多态性(SNP)以及132个总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇或甘油三酯的SNP。为了将动脉粥样硬化钙化量化为动脉粥样硬化的标志物,所有参与者均接受了主动脉弓和颈动脉的非增强计算机断层扫描。我们研究了SNP联合效应的遗传风险评分与所有钙化之间的关联。冠状动脉钙化-SNP的联合效应与所有血管床中更大的钙化体积相关(遗传风险评分每增加1个标准差,主动脉钙化体积差异:0.15[95%置信区间,0.11 - 0.20],颅外颈动脉为0.14[95%置信区间,0.10 - 0.18],颅内颈动脉为0.11[95%置信区间,0.07 - 0.16])。总胆固醇SNP、低密度脂蛋白SNP以及所有血脂SNP的联合效应与主动脉弓和颈动脉中更大的钙化体积相关,但在调整血脂成分和降脂药物后减弱。
主动脉弓和颈动脉钙化的遗传基础与冠状动脉钙化的最重要位点重叠。此外,血脂与主动脉弓和颈动脉的钙化具有共同的遗传易感性,这为动脉粥样硬化的病因提供了新的见解。