Hardy Dale S, Garvin Jane T, Mersha Tesfaye B, Racette Susan B
Department of Internal Medicine, Morehouse School of Medicine, Atlanta Georgia.
School of Nursing, University of Saint Augustine for Health Sciences, Saint Augustine, Florida.
Medicine (Baltimore). 2020 Feb;99(6):e18820. doi: 10.1097/MD.0000000000018820.
Cross-sectional studies indicate that the fat mass and obesity-associated (FTO) rs9939609 gene variant is associated with metabolic syndrome (MetS) primarily in European ancestry. However, the association is not fully elucidated in African Americans.We hypothesized that rs9939609 (AT = moderate-risk carriers or AA = high-risk carriers compared to TT = low-risk carriers) is associated with MetS and its component risk factors over time; and that its association is ancestry-specific. A secondary hypothesis was that higher levels of physical activity can decrease the deleterious effect of rs9939609 at higher body mass index (BMI).Atherosclerosis Risk in Communities study repeated measures data from 4 visits (1987-1998) were obtained from the database of Genotypes and Phenotypes for 10,358 participants (8170 Whites and 2188 African Americans) aged 45 to 64 years at baseline. Guidelines for elevated blood pressure by the American College of Cardiology and American Heart Association Task Force were updated within the MetS criteria. Risk ratios (RR) and 95% confidence intervals from generalized estimating equations assessed population-average risks.MetS was present among 3479 (42.6%) Whites and 1098 (50.2%) African Americans at baseline, and 50.3% Whites and 57% African Americans over 11-years of follow-up. Among MetS component risk factors, high waist circumference was most prevalent among White AT (RR = 1.07; 1.06-1.09) and AA (RR = 1.12; 1.10-1.14) higher-risk carriers. High triglycerides were elevated among African American AA high-risk carriers (RR = 1.11; 1.02-1.21) compared to TT low-risk carriers. Over time, White AT-and AA higher-risk carriers had 1.07 and 1.08-fold increase (P < .0001) in MetS risk. Physical activity had independent protective effects on MetS among both races (P < .05). White AA high-risk carriers with normal BMI and low vs high physical activity had higher MetS risk (RR = 1.69; 1.25-2.30 and RR = 0.68;0.53-0.87, respectively). In rs9939609 × BMI× physical activity interaction, White A-allele high-risk carriers had lower MetS risk (RR = 0.68; 0.53-0.87). Among Whites, physical activity can lessen the effect of rs9939609 and high BMI on risk for MetS.
横断面研究表明，脂肪量和肥胖相关（FTO）基因的rs9939609变体主要在欧洲血统人群中与代谢综合征（MetS）相关。然而，在非裔美国人中，这种关联尚未完全阐明。我们假设，与TT = 低风险携带者相比，rs9939609（AT = 中度风险携带者或AA = 高风险携带者）随时间推移与MetS及其组成风险因素相关；并且这种关联具有种族特异性。第二个假设是，较高水平的身体活动可以降低rs9939609在较高体重指数（BMI）时的有害影响。社区动脉粥样硬化风险研究中，从基因型和表型数据库获取了10358名参与者（8170名白人及2188名非裔美国人）在基线时年龄为45至64岁的4次随访（1987 - 1998年）的重复测量数据。美国心脏病学会和美国心脏协会工作组关于血压升高的指南在MetS标准内进行了更新。通过广义估计方程得出的风险比（RR）和95%置信区间评估了总体平均风险。基线时，3479名（42.6%）白人及1098名（50.2%）非裔美国人存在MetS，在11年的随访中，50.3%的白人及57%的非裔美国人患有MetS。在MetS组成风险因素中，高腰围在白人AT（RR = 1.07；1.06 - 1.09）和AA（RR = 1.12；1.10 - 1.14）高风险携带者中最为普遍。与TT低风险携带者相比，非裔美国人AA高风险携带者的高甘油三酯水平升高（RR = 1.11；1.02 - 1.21）。随着时间推移，白人AT和AA高风险携带者患MetS的风险分别增加了1.07倍和1.08倍（P < 0.0001）。身体活动对两个种族的MetS均有独立的保护作用（P < 0.05）。BMI正常且身体活动水平低与高的白人AA高风险携带者，患MetS的风险更高（RR分别为1.69；1.25 - 2.30和RR为0.68；0.53 - 0.87）。在rs9939609×BMI×身体活动的交互作用中，白人A等位基因高风险携带者患MetS的风险较低（RR = 0.68；0.53 - 0.87）。在白人中，身体活动可以减轻rs9939609和高BMI对MetS风险的影响。
