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Validating Harmful Alcohol Use as a Phenotype for Genetic Discovery Using Phosphatidylethanol and a Polymorphism in
Amy C Justice1,2,3, Kathleen A McGinnis2, Janet P Tate1
1Yale School of Medicine, New Haven, Connecticut.
Longitudinal trajectories of alcohol use, measured by AUDIT-C in electronic health records, offer a valid phenotype for genetic studies. This approach enhances the identification of genetic variants associated with harmful alcohol consumption.
Area of Science:
- Genetics
- Biomarkers
- Public Health
Background:
- Alcohol use disorder (AUD) risk is heritable, yet genetic risk variants are sparsely identified.
- Longitudinal electronic health records (EHR) offer a rich, underutilized source for phenotype discovery.
- Validating EHR-derived phenotypes for harmful alcohol exposure is crucial for genetic research.
Purpose of the Study:
- To develop and validate an EHR-based phenotype for harmful alcohol exposure.
- To assess the validity of three different metrics derived from the Alcohol Use Disorders Identification Test consumption measure (AUDIT-C) for this phenotype.
- To identify genetic variants associated with harmful alcohol use using validated phenotypes.
Main Methods:
- Compared three AUDIT-C metrics (closest, highest, trajectory) using longitudinal data from the Veterans Aging Cohort Biomarker Study Cohort (VACS-BC).
- Assessed the association of these AUDIT-C metrics with phosphatidylethanol (PEth), a direct alcohol biomarker, using chi-square tests for trend.
- Examined the association of the ADH1B gene polymorphism (rs2066702) with AUDIT-C metrics in African American (AA) subsample.
Main Results:
- Highest AUDIT-C and AUDIT-C trajectory showed strong correlation (r=0.86).
- All three AUDIT-C metrics associated with PEth, with the steepest gradient observed for AUDIT-C trajectory.
- AUDIT-C trajectory and highest AUDIT-C were significantly associated with rs2066702 in AAs, with a steeper gradient for the trajectory metric.
Conclusions:
- Electronic health record (EHR) data can effectively identify complex phenotypes like harmful alcohol use.
- Utilizing longitudinal trajectories of AUDIT-C scores enhances the validity of harmful alcohol use phenotypes.
- This validated EHR phenotype facilitates the identification of genetic variants influencing alcohol consumption.
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