冠状动脉疾病的遗传性：来自经典双胞胎研究的见解。
Heritability of Coronary Artery Disease: Insights From a Classical Twin Study.
机构信息
MTA-SE Cardiovascular Imaging Research Group, (Z.D.D., M.K., J.K., A.L.J., J.S., B.S., P.M.-H.), Semmelweis University, Budapest, Hungary.
Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA (M.K., J.K.).
出版信息
Circ Cardiovasc Imaging. 2022 Mar;15(3):e013348. doi: 10.1161/CIRCIMAGING.121.013348. Epub 2022 Mar 15.
BACKGROUND
Genetics have a strong influence on calcified atherosclerotic plaques; however, data regarding the heritability of noncalcified plaque volume are scarce. We aimed to evaluate genetic versus environmental influences on calcium (coronary artery calcification) score, noncalcified and calcified plaque volumes by coronary computed tomography angiography in adult twin pairs without known coronary artery disease.
METHODS
In the prospective BUDAPEST-GLOBAL (Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions) classical twin study, we analyzed twin pairs without known coronary artery disease. All twins underwent coronary computed tomography angiography to assess coronary atherosclerotic plaque volumes. Structural equation models were used to quantify the contribution of additive genetic, common environmental, and unique environmental components to plaque volumes adjusted for age, gender, or atherosclerotic cardiovascular disease risk estimate and statin use.
RESULTS
We included 196 twins (mean age±SD, 56±9 years, 63.3% females), 120 monozygotic and 76 same-gender dizygotic pairs. Using structural equation models, noncalcified plaque volume was predominantly determined by environmental factors (common environment, 63% [95% CI, 56%-67%], unique environment, 37% [95% CI, 33%-44%]), while coronary artery calcification score and calcified plaque volumes had a relatively strong genetic heritability (additive genetic, 58% [95% CI, 50%-66%]; unique environmental, 42% [95% CI, 34%-50%] and additive genetic, 78% [95% CI, 73%-80%]; unique environmental, 22% [95% CI, 20%-27%]), respectively.
CONCLUSIONS
Noncalcified plaque volume is mainly influenced by shared environmental factors, whereas coronary artery calcification score and calcified plaque volume are more determined by genetics. These findings emphasize the importance of early lifestyle interventions in preventing coronary plaque formation.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifier: NCT01738828.
背景
遗传学对钙化粥样硬化斑块有很强的影响；然而，关于非钙化斑块体积的遗传性数据却很少。我们旨在评估遗传与环境因素对冠状动脉计算机断层扫描血管造影显示无已知冠状动脉疾病的成年双胞胎的钙（冠状动脉钙化）评分、非钙化和钙化斑块体积的影响。
方法
在前瞻性的布达佩斯-全球（双胞胎中动脉粥样硬化斑块的遗传基因座研究和动脉粥样硬化病变的负担）经典双胞胎研究中，我们分析了无已知冠状动脉疾病的双胞胎。所有双胞胎均接受冠状动脉计算机断层扫描血管造影，以评估冠状动脉粥样硬化斑块体积。结构方程模型用于量化年龄、性别、或动脉粥样硬化性心血管疾病风险估计值和他汀类药物使用调整后，斑块体积的加性遗传、共同环境和独特环境成分的贡献。
结果
我们纳入了 196 对双胞胎（平均年龄±标准差，56±9 岁，63.3%为女性），包括 120 对同卵双胞胎和 76 对同性别异卵双胞胎。使用结构方程模型，非钙化斑块体积主要由环境因素决定（共同环境，63%[95%置信区间，56%-67%]，独特环境，37%[95%置信区间，33%-44%]），而冠状动脉钙化评分和钙化斑块体积具有较强的遗传遗传性（加性遗传，58%[95%置信区间，50%-66%]；独特环境，42%[95%置信区间，34%-50%]和加性遗传，78%[95%置信区间，73%-80%]；独特环境，22%[95%置信区间，20%-27%]）。
结论
非钙化斑块体积主要受共同环境因素影响，而冠状动脉钙化评分和钙化斑块体积则更多地受遗传因素决定。这些发现强调了早期生活方式干预预防冠状动脉斑块形成的重要性。
登记
网址：https://www.
临床试验
gov；独特标识符：NCT01738828。
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