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冠状动脉疾病基因变异与亚临床动脉粥样硬化之间的关联:一项关联研究与荟萃分析

Association Between Coronary Artery Disease Genetic Variants and Subclinical Atherosclerosis: An Association Study and Meta-analysis.

作者信息

Zabalza Michel, Subirana Isaac, Lluis-Ganella Carla, Sayols-Baixeras Sergi, de Groot Eric, Arnold Roman, Cenarro Ana, Ramos Rafel, Marrugat Jaume, Elosua Roberto

机构信息

Servicio de Cardiología, Hospital Universitario Josep Trueta, Girona, Spain; Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Facultad de Medicina, Universidad de Girona, Girona, Spain.

Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Barcelona, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2015 Oct;68(10):869-77. doi: 10.1016/j.rec.2014.10.023. Epub 2015 Mar 21.

Abstract

INTRODUCTION AND OBJECTIVES

Recent studies have identified several genetic variants associated with coronary artery disease. Some of these genetic variants are not associated with classical cardiovascular risk factors and the mechanism of such associations is unclear. The aim of the study was to determine whether these genetic variants are related to subclinical atherosclerosis measured by carotid intima media thickness, carotid stiffness, and ankle brachial index.

METHODS

A cross-sectional study nested in the follow-up of the REGICOR cohort was undertaken. The study included 2667 individuals. Subclinical atherosclerosis measurements were performed with standardized methods. Nine genetic variants were genotyped to assess associations with subclinical atherosclerosis, individually and in a weighted genetic risk score. A systematic review and meta-analysis of previous studies that analyzed these associations was undertaken.

RESULTS

Neither the selected genetic variants nor the genetic risk score were significantly associated with subclinical atherosclerosis. In the meta-analysis, the rs1746048 (CXCL12; n = 10581) risk allele was directly associated with carotid intima-media thickness (β = 0.008; 95% confidence interval, 0.001-0.015), whereas the rs6725887 (WDR12; n = 7801) risk allele was inversely associated with this thickness (β = -0.013; 95% confidence interval, -0.024 to -0.003).

CONCLUSIONS

The analyzed genetic variants seem to mediate their association with coronary artery disease through different mechanisms. Our results generate the hypothesis that the CXCL12 variant appears to influence coronary artery disease risk through arterial remodeling and thickening, whereas the WDR12 risk variant could be related to higher plaque vulnerability.

摘要

引言与目的

近期研究已确定了几种与冠状动脉疾病相关的基因变异。其中一些基因变异与经典心血管危险因素无关,且此类关联的机制尚不清楚。本研究的目的是确定这些基因变异是否与通过颈动脉内膜中层厚度、颈动脉僵硬度和踝臂指数测量的亚临床动脉粥样硬化有关。

方法

在REGICOR队列随访中进行了一项横断面研究。该研究纳入了2667名个体。采用标准化方法进行亚临床动脉粥样硬化测量。对9种基因变异进行基因分型,以单独及加权遗传风险评分评估其与亚临床动脉粥样硬化的关联。对分析这些关联的既往研究进行了系统综述和荟萃分析。

结果

所选基因变异及遗传风险评分均与亚临床动脉粥样硬化无显著关联。在荟萃分析中,rs1746048(CXCL12;n = 10581)风险等位基因与颈动脉内膜中层厚度直接相关(β = 0.008;95%置信区间,0.001 - 0.015),而rs6725887(WDR12;n = 7801)风险等位基因与该厚度呈负相关(β = -0.013;95%置信区间,-0.024至-0.003)。

结论

分析的基因变异似乎通过不同机制介导其与冠状动脉疾病的关联。我们的结果提出了一个假设,即CXCL12变异似乎通过动脉重塑和增厚影响冠状动脉疾病风险,而WDR12风险变异可能与更高的斑块易损性有关。

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