Division of Medical Genetics, School of Medicine, University of Washington Medical Center, 1705 NE Pacific St, Box 357720, Seattle, WA, 98195, USA.
Department of Biomedical Informatics Medical Education, School of Medicine, University of Washington, Seattle, WA, USA.
BMC Med Genomics. 2021 Jan 6;14(1):11. doi: 10.1186/s12920-020-00854-2.
Elevated triglycerides (TG) are associated with, and may be causal for, cardiovascular disease (CVD), and co-morbidities such as type II diabetes and metabolic syndrome. Pathogenic variants in APOA5 and APOC3 as well as risk SNVs in other genes [APOE (rs429358, rs7412), APOA1/C3/A4/A5 gene cluster (rs964184), INSR (rs7248104), CETP (rs7205804), GCKR (rs1260326)] have been shown to affect TG levels. Knowledge of genetic causes for elevated TG may lead to early intervention and targeted treatment for CVD. We previously identified linkage and association of a rare, highly conserved missense variant in SLC25A40, rs762174003, with hypertriglyceridemia (HTG) in a single large family, and replicated this association with rare, highly conserved missense variants in a European American and African American sample.
Here, we analyzed a longitudinal mixed-ancestry cohort (European, African and Asian ancestry, N = 8966) from the Electronic Medical Record and Genomics (eMERGE) Network. We tested associations between median TG and the genes of interest, using linear regression, adjusting for sex, median age, median BMI, and the first two principal components of ancestry.
We replicated the association between TG and APOC3, APOA5, and risk variation at APOE, APOA1/C3/A4/A5 gene cluster, and GCKR. We failed to replicate the association between rare, highly conserved variation at SLC25A40 and TG, as well as for risk variation at INSR and CETP.
Analysis using data from electronic health records presents challenges that need to be overcome. Although large amounts of genotype data is becoming increasingly accessible, usable phenotype data can be challenging to obtain. We were able to replicate known, strong associations, but were unable to replicate moderate associations due to the limited sample size and missing drug information.
甘油三酯(TG)升高与心血管疾病(CVD)相关,并且可能是其病因,同时与 2 型糖尿病和代谢综合征等合并症相关。APOA5 和 APOC3 的致病性变异以及其他基因中的风险单核苷酸多态性[APOE(rs429358、rs7412)、APOA1/C3/A4/A5 基因簇(rs964184)、INSR(rs7248104)、CETP(rs7205804)、GCKR(rs1260326)]已被证明会影响 TG 水平。了解导致 TG 升高的遗传原因可能会导致针对 CVD 的早期干预和靶向治疗。我们之前在一个大型单一家族中发现 SLC25A40 中一个罕见的、高度保守的错义变异 rs762174003 与高甘油三酯血症(HTG)之间存在连锁和关联,并在欧洲裔美国人和非裔美国人样本中复制了这种与罕见的、高度保守的错义变异之间的关联。
在这里,我们分析了电子病历和基因组学(eMERGE)网络中的一个纵向混合种族队列(欧洲、非洲和亚洲血统,N=8966)。我们使用线性回归,通过性别、平均年龄、平均 BMI 和祖先的前两个主成分来调整,测试了与感兴趣的基因之间的 TG 中位数的关联。
我们复制了 TG 与 APOC3、APOA5 和 APOE、APOA1/C3/A4/A5 基因簇和 GCKR 风险变异之间的关联。我们未能复制 SLC25A40 中罕见的、高度保守的变异与 TG 之间的关联,以及 INSR 和 CETP 中风险变异与 TG 之间的关联。
使用电子健康记录中的数据进行分析带来了需要克服的挑战。尽管越来越容易获得大量的基因型数据,但可用的表型数据可能难以获取。我们能够复制已知的强关联,但由于样本量有限且缺乏药物信息,无法复制中等关联。