Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
Department of Epidemiology, UAB, Birmingham, AL, USA.
Eur J Hum Genet. 2021 Sep;29(9):1438-1445. doi: 10.1038/s41431-021-00830-z. Epub 2021 Feb 26.
Hypertension, obesity, chronic kidney disease and type 2 diabetes are comorbidities that have very high prevalence among persons with hyperuricemia (serum urate > 6.8 mg/dL) and gout. Here we use multivariate genetic models to test the hypothesis that the co-association of traits representing hyperuricemia and its comorbidities is genetically based. Using Bayesian whole-genome regression models, we estimated the genetic marker-based variance and the covariance between serum urate, serum creatinine, systolic blood pressure (SBP), blood glucose and body mass index (BMI) from two independent family-based studies: The Framingham Heart Study-FHS and the Hypertension Genetic Epidemiology Network study-HyperGEN. The main genetic findings that replicated in both FHS and HyperGEN, were (1) creatinine was genetically correlated only with urate and (2) BMI was genetically correlated with urate, SBP, and glucose. The environmental covariance among the traits was generally highest for trait pairs involving BMI. The genetic overlap of traits representing the comorbidities of hyperuricemia and gout appears to cluster in two separate axes of genetic covariance. Because creatinine is genetically correlated with urate but not with metabolic traits, this suggests there is one genetic module of shared loci associated with hyperuricemia and chronic kidney disease. Another module of shared loci may account for the association of hyperuricemia and metabolic syndrome. This study provides a clear quantitative genetic basis for the clustering of comorbidities with hyperuricemia.
高血压、肥胖、慢性肾脏病和 2 型糖尿病是高尿酸血症(血清尿酸>6.8mg/dL)和痛风患者常见的合并症。在这里,我们使用多变量遗传模型来检验代表高尿酸血症及其合并症的特征共同关联具有遗传基础的假设。我们使用贝叶斯全基因组回归模型,从两个独立的基于家庭的研究中估计了代表血清尿酸、血清肌酐、收缩压(SBP)、血糖和体重指数(BMI)的遗传标记方差和协方差:弗雷明汉心脏研究-FHS 和高血压遗传流行病学网络研究-HyperGEN。在 FHS 和 HyperGEN 中均复制的主要遗传发现为:(1)肌酐仅与尿酸具有遗传相关性,(2)BMI 与尿酸、SBP 和葡萄糖具有遗传相关性。涉及 BMI 的特征之间的环境协方差通常最高。代表高尿酸血症和痛风合并症的特征的遗传重叠似乎聚集在两个单独的遗传协方差轴上。由于肌酐与尿酸具有遗传相关性,但与代谢特征没有遗传相关性,这表明存在一个与高尿酸血症和慢性肾脏病相关的共享基因座的遗传模块。另一个共享基因座模块可能解释了高尿酸血症与代谢综合征的关联。本研究为高尿酸血症合并症的聚类提供了明确的定量遗传基础。