Raffield Laura M, Cox Amanda J, Carr J Jeffrey, Freedman Barry I, Hicks Pamela J, Langefeld Carl D, Hsu Fang-Chi, Bowden Donald W
Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Acta Diabetol. 2015 Aug;52(4):743-51. doi: 10.1007/s00592-015-0720-5. Epub 2015 Feb 21.
It remains unclear whether the high cardiovascular disease (CVD) burden in people with type 2 diabetes (T2D) is associated with genetic variants that contribute to CVD in general populations. Recent studies have examined genetic risk scores of single-nucleotide polymorphisms (SNPs) identified by genome-wide association studies for their cumulative contribution to CVD-related traits. Most analyses combined SNPs associated with a single phenotypic class, e.g., lipids. In the present analysis, we examined a more comprehensive risk score comprised of SNPs associated with a broad range of CVD risk phenotypes.
The composite risk score was analyzed for potential associations with subclinical CVD, self-reported CVD events, and mortality in 983 T2D-affected individuals of European descent from 466 Diabetes Heart Study (DHS) families. Genetic association was examined using marginal models with generalized estimating equations for subclinical CVD and prior CVD events and Cox proportional hazards models with sandwich-based variance estimation for mortality; analyses were adjusted for age and sex.
An increase in genetic risk score was significantly associated with higher levels of coronary artery calcified plaque (p = 1.23 × 10(-4)); however, no significant associations with self-reported myocardial infarction and CVD events and all-cause and CVD mortality were observed.
These results suggest that a genetic risk score of SNPs associated with CVD events and risk factors does not significantly account for CVD risk in the DHS, highlighting the limitations of applying current genetic markers for CVD in individuals with diabetes.
2型糖尿病(T2D)患者中心血管疾病(CVD)负担较高是否与一般人群中导致CVD的基因变异相关尚不清楚。最近的研究已经检验了全基因组关联研究中鉴定出的单核苷酸多态性(SNP)的遗传风险评分对CVD相关性状的累积贡献。大多数分析将与单一表型类别(如血脂)相关的SNP进行了合并。在本分析中,我们检验了一个更全面的风险评分,该评分由与广泛的CVD风险表型相关的SNP组成。
对来自466个糖尿病心脏研究(DHS)家族的983名欧洲血统的T2D患者,分析综合风险评分与亚临床CVD、自我报告的CVD事件和死亡率之间的潜在关联。使用带有广义估计方程的边际模型检验亚临床CVD和既往CVD事件的遗传关联,使用带有基于三明治方差估计的Cox比例风险模型检验死亡率;分析对年龄和性别进行了调整。
遗传风险评分的增加与冠状动脉钙化斑块水平升高显著相关(p = 1.23×10⁻⁴);然而,未观察到与自我报告的心肌梗死、CVD事件以及全因死亡率和CVD死亡率有显著关联。
这些结果表明,与CVD事件和风险因素相关的SNP的遗传风险评分在DHS中不能显著解释CVD风险,突出了在糖尿病患者中应用当前CVD遗传标记的局限性。