Cade Brian E, Chen Han, Stilp Adrienne M, Gleason Kevin J, Sofer Tamar, Ancoli-Israel Sonia, Arens Raanan, Bell Graeme I, Below Jennifer E, Bjonnes Andrew C, Chun Sung, Conomos Matthew P, Evans Daniel S, Johnson W Craig, Frazier-Wood Alexis C, Lane Jacqueline M, Larkin Emma K, Loredo Jose S, Post Wendy S, Ramos Alberto R, Rice Ken, Rotter Jerome I, Shah Neomi A, Stone Katie L, Taylor Kent D, Thornton Timothy A, Tranah Gregory J, Wang Chaolong, Zee Phyllis C, Hanis Craig L, Sunyaev Shamil R, Patel Sanjay R, Laurie Cathy C, Zhu Xiaofeng, Saxena Richa, Lin Xihong, Redline Susan
1 Division of Sleep and Circadian Disorders and.
2 Division of Sleep Medicine and.
Am J Respir Crit Care Med. 2016 Oct 1;194(7):886-897. doi: 10.1164/rccm.201512-2431OC.
Obstructive sleep apnea is a common disorder associated with increased risk for cardiovascular disease, diabetes, and premature mortality. Although there is strong clinical and epidemiologic evidence supporting the importance of genetic factors in influencing obstructive sleep apnea, its genetic basis is still largely unknown. Prior genetic studies focused on traits defined using the apnea-hypopnea index, which contains limited information on potentially important genetically determined physiologic factors, such as propensity for hypoxemia and respiratory arousability.
To define novel obstructive sleep apnea genetic risk loci for obstructive sleep apnea, we conducted genome-wide association studies of quantitative traits in Hispanic/Latino Americans from three cohorts.
Genome-wide data from as many as 12,558 participants in the Hispanic Community Health Study/Study of Latinos, Multi-Ethnic Study of Atherosclerosis, and Starr County Health Studies population-based cohorts were metaanalyzed for association with the apnea-hypopnea index, average oxygen saturation during sleep, and average respiratory event duration.
Two novel loci were identified at genome-level significance (rs11691765, GPR83, P = 1.90 × 10 for the apnea-hypopnea index, and rs35424364; C6ORF183/CCDC162P, P = 4.88 × 10 for respiratory event duration) and seven additional loci were identified with suggestive significance (P < 5 × 10). Secondary sex-stratified analyses also identified one significant and several suggestive associations. Multiple loci overlapped genes with biologic plausibility.
These are the first genome-level significant findings reported for obstructive sleep apnea-related physiologic traits in any population. These findings identify novel associations in inflammatory, hypoxia signaling, and sleep pathways.
阻塞性睡眠呼吸暂停是一种常见疾病,与心血管疾病、糖尿病和过早死亡风险增加相关。尽管有强有力的临床和流行病学证据支持遗传因素在影响阻塞性睡眠呼吸暂停方面的重要性,但其遗传基础仍大多未知。先前的遗传研究集中于使用呼吸暂停低通气指数定义的性状,该指数包含关于潜在重要的遗传决定的生理因素(如低氧血症倾向和呼吸唤醒能力)的有限信息。
为了确定阻塞性睡眠呼吸暂停新的遗传风险位点,我们对来自三个队列的西班牙裔/拉丁裔美国人的数量性状进行了全基因组关联研究。
对西班牙裔社区健康研究/拉丁裔研究、多民族动脉粥样硬化研究和斯塔尔县健康研究等基于人群的队列中多达12558名参与者的全基因组数据进行荟萃分析,以确定与呼吸暂停低通气指数、睡眠期间平均血氧饱和度和平均呼吸事件持续时间的关联。
在全基因组水平上发现了两个新位点具有显著意义(rs11691765,GPR83,呼吸暂停低通气指数的P = 1.90×10,以及rs35424364;C6ORF183/CCDC162P,呼吸事件持续时间的P = 4.88×10),另外还发现了七个具有提示意义的位点(P < 5×10)。继发性别的分层分析也发现了一个显著关联和几个提示性关联。多个位点与具有生物学合理性的基因重叠。
这些是在任何人群中首次报道的与阻塞性睡眠呼吸暂停相关生理性状的全基因组水平显著发现。这些发现确定了炎症、缺氧信号传导和睡眠途径中的新关联。