Department of Clinical Sciences Malmö, Lund University, Malmo, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Cardiovasc Diabetol. 2022 Nov 3;21(1):230. doi: 10.1186/s12933-022-01661-y.
Reduced lung function and adverse health outcomes are often observed. This study characterizes genetic susceptibility for reduced lung function and risk of developing a range of adverse health outcomes.
We studied 27,438 middle-aged adults from the Malmö Diet and Cancer study (MDCS), followed up to 28.8 years. Trait-specific Polygenic scores (PGS) for forced expiratory volume in 1 s (FEV) and forced vital capacity (FVC) were constructed for each participant using MDCS genetic data and summary statistics from the latest GWAS of lung function. Linear regression models and cox proportional hazards regression models were used to assess associations between adverse health outcomes and lung function-PGS.
FEV-PGS and FVC-PGS were significantly associated with mean sBP at baseline after adjustments (FEV-PGS Q1 (highest PGS = highest lung function): 140.7mmHg vs. Q4: 141.5mmHg, p-value 0.008). A low FVC-PGS was significantly associated with the risk of future diabetic events after adjustments (Q4 vs. Q1 HR: 1.22 (CI 1.12-1.32), p-trend < 0.001) and had added value to risk prediction models for diabetes. Low FEV-PGS was significantly associated with future coronary events (Q4 vs. Q1 HR: 1.13 (CI: 1.04-1.22), p-trend 0.008). No significant association was found between PGS and sudden cardiac death, chronic kidney disease or all-cause mortality. Results remained largely unchanged in a subgroup of subjects when further adjusted for apolipoproteins.
Genetic susceptibility for reduced lung function is associated with higher sBP, increased risk of diabetes and to a lesser extent, future coronary events, suggesting etiological roles of lung function on these outcomes. Using PGS, high-risk groups could be early detected to implement early lifestyle changes to mitigate the risk.
通常观察到肺功能降低和不良健康结果。本研究描述了肺功能降低的遗传易感性和一系列不良健康结果的风险。
我们研究了来自马尔默饮食与癌症研究(MDCS)的 27438 名中年成年人,随访时间长达 28.8 年。使用 MDCS 遗传数据和最新的肺功能全基因组关联研究的汇总统计数据,为每位参与者构建了特定于特质的用力呼气量(FEV)和用力肺活量(FVC)的多基因评分(PGS)。线性回归模型和 Cox 比例风险回归模型用于评估不良健康结果与肺功能-PGS 之间的关联。
FEV-PGS 和 FVC-PGS 与调整后的基线平均收缩压显著相关(FEV-PGS Q1(最高 PGS=最高肺功能):140.7mmHg 与 Q4:141.5mmHg,p 值 0.008)。调整后,低 FVC-PGS 与未来糖尿病事件的风险显著相关(Q4 与 Q1 HR:1.22(CI 1.12-1.32),p-trend<0.001),并为糖尿病风险预测模型提供了额外的价值。低 FEV-PGS 与未来冠心病事件显著相关(Q4 与 Q1 HR:1.13(CI:1.04-1.22),p-trend 0.008)。PGS 与心脏性猝死、慢性肾脏病或全因死亡率之间无显著相关性。当进一步调整载脂蛋白时,在亚组人群中,结果基本保持不变。
肺功能降低的遗传易感性与更高的收缩压、糖尿病风险增加有关,在一定程度上与未来的冠心病事件有关,这表明肺功能在这些结果中的病因作用。使用 PGS,可以早期发现高危人群,实施早期生活方式改变,以降低风险。