Colicino Elena, Fiorito Giovanni
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
IRCCS Istituto G. Gaslini, Genoa, Italy.
Curr Opin Epidemiol Public Health. 2023 Jun;2(2):25-31. doi: 10.1097/pxh.0000000000000020.
The prevalence of cardiometabolic syndrome in adults is increasing worldwide, highlighting the importance of biomarkers for individuals' classification based on their health status. Although cardiometabolic risk scores and diagnostic criteria have been developed aggregating adverse health effects of individual conditions on the overall syndrome, none of them has gained unanimous acceptance. Therefore, novel molecular biomarkers have been developed to better understand the risk, onset and progression of both individual conditions and the overall cardiometabolic syndrome.
Consistent associations between whole blood DNA methylation (DNAm) levels at several single genomic (i.e. CpG) sites and both individual and aggregated cardiometabolic conditions supported the creation of second-generation DNAm-based cardiometabolic-related biomarkers. These biomarkers linearly combine individual DNAm levels from key CpG sites, selected by a two-step machine learning procedures. They can be used, even retrospectively, in populations with extant whole blood DNAm levels and without observed cardiometabolic phenotypes.
Here we offer an overview of the second-generation DNAm-based cardiometabolic biomarkers, discussing methodological advancements and implications on the interpretation and generalizability of the findings. We finally emphasize the contribution of DNAm-based biomarkers for risk stratification beyond traditional factors and discuss limitations and future directions of the field.
全球范围内,成人心脏代谢综合征的患病率正在上升,这凸显了基于个体健康状况进行分类的生物标志物的重要性。尽管已经开发出心脏代谢风险评分和诊断标准,以汇总个体疾病对整体综合征的不良健康影响,但它们都未获得一致认可。因此,已开发出新型分子生物标志物,以更好地了解个体疾病以及整体心脏代谢综合征的风险、发病和进展情况。
几个单基因组(即CpG)位点的全血DNA甲基化(DNAm)水平与个体及综合心脏代谢状况之间的一致关联,为创建基于DNAm的第二代心脏代谢相关生物标志物提供了支持。这些生物标志物通过两步机器学习程序,将关键CpG位点的个体DNAm水平进行线性组合。它们甚至可以用于回顾性研究,应用于具有现有全血DNAm水平且未观察到心脏代谢表型的人群。
在此,我们概述基于DNAm的第二代心脏代谢生物标志物,讨论方法学进展以及对研究结果解释和普遍性的影响。我们最后强调基于DNAm的生物标志物对超越传统因素的风险分层的贡献,并讨论该领域的局限性和未来方向。