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用于预测高甘油三酯血症的基因评分:来自捷克病例对照研究的新见解。

The Gene Score for Predicting Hypertriglyceridemia: New Insights from a Czech Case-Control Study.

机构信息

Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM-DEM-LAR), Videnska 1958/9, 140 21, Prague 4, Czech Republic.

Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

出版信息

Mol Diagn Ther. 2019 Aug;23(4):555-562. doi: 10.1007/s40291-019-00412-2.

Abstract

BACKGROUND

Plasma triglyceride (TG) values are significant predictors of cardiovascular and total mortality. The plasma levels of TGs have an important genetic background. We analyzed whether 32 single nucleotide polymorphisms (SNPs) identified in genome-wide association studies are discriminators of hypertriglyceridemia (HTG) in the Czech population.

OBJECTIVES

The objective of this study was to replicate and test the original findings in an independent study and to re-analyze the gene score leading to HTG.

METHODS

In total, we analyzed 32 SNPs in 209 patients with plasma TG levels over 10 mmol/L (HTG group) and compared them in a case-control design with 524 treatment-naïve controls (normotriglyceridemic [NTG] group) with plasma TG values below 1.8 mmol/L.

RESULTS

Sixteen SNPs were significantly associated with an increased risk of HTG development, with odds ratios (ORs) (95% confidence interval [CI]) varying from 1.40 (1.01-1.95) to 4.69 (3.29-6.68) (rs964184 within the APOA5 gene). Both unweighted (sum of the risk alleles) and weighted gene scores (WGS) (log of the achieved ORs per individual genotype) were calculated, and both gene scores were significantly different between groups. The mean score of the risk alleles was significantly increased in the HTG group compared to the NTG group (18.5 ± 2.5 vs. 15.7 ± 2.3, respectively; P < 0.00001). Subjects with a WGS over 9 were significantly more common in the HTG group (44.5%) than in the NTG group, in which such a high score was observed in only 4.7% of subjects (OR 16.3, 95% CI 10.0-36.7; P < 0.0000001).

CONCLUSIONS

An increased number of risk genetic variants, calculated both in a weighted or unweighted manner, significantly discriminates between the subjects with HTG and controls. Population-specific sets of SNPs included into the gene score seem to yield better discrimination power.

摘要

背景

血浆甘油三酯(TG)值是心血管和总死亡率的重要预测指标。血浆 TG 水平有重要的遗传背景。我们分析了全基因组关联研究中确定的 32 个单核苷酸多态性(SNP)是否可区分捷克人群中的高甘油三酯血症(HTG)。

目的

本研究的目的是在独立研究中复制和检验原始发现,并重新分析导致 HTG 的基因评分。

方法

共分析了 209 例血浆 TG 水平超过 10mmol/L(HTG 组)的患者中的 32 个 SNP,并在病例对照设计中与 524 例未经治疗的对照者(血浆 TG 值低于 1.8mmol/L 的正常 TG 组)进行比较。

结果

16 个 SNP 与 HTG 发病风险增加显著相关,比值比(OR)(95%置信区间[CI])范围为 1.40(1.01-1.95)至 4.69(3.29-6.68)(APOA5 基因内的 rs964184)。计算了未加权(风险等位基因之和)和加权基因评分(WGS)(个体基因型的 OR 对数),两组间基因评分差异均有统计学意义。与 NTG 组相比,HTG 组的风险等位基因评分明显升高(18.5±2.5 对 15.7±2.3;P<0.00001)。WGS 评分超过 9 的患者在 HTG 组中更为常见(44.5%),而在 NTG 组中仅观察到 4.7%的患者有如此高的评分(OR 16.3,95%CI 10.0-36.7;P<0.0000001)。

结论

无论采用加权还是未加权方式计算,风险遗传变异数量的增加均可显著区分 HTG 患者和对照组。包含在基因评分中的特定人群 SNP 似乎具有更好的区分能力。

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