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基于临床数据的阿片类药物使用障碍全基因组关联分析:一种新方法

Genome-wide association analysis of opioid use disorder: A novel approach using clinical data.

机构信息

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, United States; Department of Biomedical Informatics, Harvard Medical School, United States; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, United States.

Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States; Division of Clinical Psychology and Psychotherapy, University of Basel, United States.

出版信息

Drug Alcohol Depend. 2020 Dec 1;217:108276. doi: 10.1016/j.drugalcdep.2020.108276. Epub 2020 Sep 15.

Abstract

BACKGROUND

Opioid use disorder (OUD) represents a large and pervasive global public health challenge. Previous genetic studies have demonstrated the significant heritability of OUD and identified several single-nucleotide polymorphisms (SNPs) associated with its prevalence.

METHODS

In this paper, we conducted a genome-wide association analysis on opioid use disorder that leveraged genetic and clinical data contained in a biobank of 21,310 patients of European ancestry. We identified 1039 cases of opioid use disorder based on diagnostic codes from nearly 16 million encounters in electronic health records (EHRs).

RESULTS

We discovered one novel OUD-associated locus on chromosome 4 that was significant at a genome-wide threshold (p = 2.40 × 10). Heritability analysis suggested that common SNPs explained 0.06 (se 0.02, p = 0.0065) of the phenotypic variation in OUD. When we restricted controls to those with previous opioid prescriptions, we were able to further strengthen the original signal and discovered another significant locus on chromosome 16. Pair-wise genetic correlation analysis yielded strong positive correlations between OUD and two other major substance use disorders, alcohol and nicotine, with the strongest correlation between nicotine and opioid use disorder (genetic correlation 0.65, se = 0.19, p = 0.00048), suggesting a significant shared genetic component across different substance disorders.

CONCLUSIONS

This pragmatic, clinically-focused approach may supplement more traditional methods to facilitate identification of new genetic underpinnings of OUD and related disorders.

摘要

背景

阿片类药物使用障碍(OUD)代表着一个庞大且普遍存在的全球公共卫生挑战。先前的遗传研究表明,OUD 具有显著的遗传性,并确定了几个与其流行相关的单核苷酸多态性(SNP)。

方法

在本文中,我们利用包含 21310 名欧洲血统患者的生物库中的遗传和临床数据,对阿片类药物使用障碍进行了全基因组关联分析。我们根据电子健康记录(EHR)中近 1600 万次就诊的诊断代码确定了 1039 例阿片类药物使用障碍病例。

结果

我们在染色体 4 上发现了一个与 OUD 相关的新基因座,该基因座在全基因组阈值下具有显著性(p = 2.40×10)。遗传分析表明,常见的 SNP 解释了 OUD 表型变异的 0.06(se 0.02,p = 0.0065)。当我们将对照限制为以前有阿片类药物处方的患者时,我们能够进一步加强原始信号,并在染色体 16 上发现了另一个显著的基因座。成对遗传相关性分析显示,OUD 与其他两种主要物质使用障碍(酒精和尼古丁)之间存在强烈的正相关性,尼古丁和阿片类药物使用障碍之间的相关性最强(遗传相关性 0.65,se = 0.19,p = 0.00048),这表明不同物质障碍之间存在显著的共同遗传成分。

结论

这种务实的、以临床为重点的方法可以补充更传统的方法,以促进识别 OUD 和相关障碍的新遗传基础。

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