Global Health Research Center Duke Kunshan University Kunshan Jiangsu China.
Shanghai Medical College Fudan University Shanghai China.
J Am Heart Assoc. 2023 Mar 21;12(6):e028200. doi: 10.1161/JAHA.122.028200. Epub 2023 Mar 9.
Background Myocardial infarction (MI) is a significant clinical and public health problem worldwide. However, little research has assessed the interplay between genetic susceptibility and social environment in the development of MI. Methods and Results Data were from the HRS (Health and Retirement Study). The polygenic risk score and polysocial score for MI were classified as low, intermediate, and high. Using Cox regression models, we assessed the race-specific association of polygenic score and polysocial score with MI and examined the association between polysocial score and MI in each polygenic risk score category. We also examined the joint effect of genetic (low, intermediate, and high) and social environmental risks (low/intermediate, high) on MI. A total of 612 Black and 4795 White adults aged ≥65 years initially free of MI were included. We found a risk gradient of MI across the polygenic risk score and polysocial score among White participants; no significant risk gradient across the polygenic risk score was found among Black participants. A disadvantaged social environment was associated with a higher risk of incident MI among older White adults with intermediate and high genetic risk but not those with low genetic risk. We revealed the joint effect of genetics and social environment in the development of MI among White participants. Conclusions Living in a favorable social environment is particularly important for people with intermediate and high genetic risk for MI. It is critical to developing tailored interventions to improve social environment for disease prevention, especially among adults with a relatively high genetic risk.
心肌梗死（MI）是全球范围内一个重大的临床和公共卫生问题。然而，很少有研究评估遗传易感性和社会环境在 MI 发展中的相互作用。
数据来自 HRS（健康与退休研究）。MI 的多基因风险评分和多社会评分被分为低、中、高。我们使用 Cox 回归模型评估了多基因风险评分和多社会评分与 MI 的种族特异性关联，并在每个多基因风险评分类别中检查了多社会评分与 MI 的关联。我们还研究了遗传（低、中、高）和社会环境风险（低/中、高）对 MI 的联合效应。共有 612 名黑人及 4795 名白人年龄≥65 岁、无初始 MI 的成年人被纳入研究。我们发现，在白人参与者中，多基因风险评分和多社会评分与 MI 之间存在风险梯度；而在黑人参与者中，多基因风险评分与 MI 之间没有显著的风险梯度。在中、高遗传风险的老年白人成年人中，不利的社会环境与 MI 发病风险增加有关，但在遗传风险较低的成年人中则没有。我们揭示了遗传因素和社会环境在 MI 发展中的联合作用，这种作用仅存在于白人参与者中。
生活在有利的社会环境中对具有中、高遗传风险的 MI 患者尤为重要。制定针对遗传风险较高的成年人的社会环境改善干预措施对于疾病预防至关重要。
