一百万退伍军人计划中的腹腔大动脉瘤的遗传结构
Derek Klarin1,2,3,4, Shefali Setia Verma5, Renae Judy6,7
1Malcolm Randall VA Medical Center, Gainesville, FL (D.K., S.T.S., S.A.B.).
Circulation
|September 28, 2020
概括
这项研究确定了14种新的腹主动脉动脉瘤 (AAA) 遗传风险因素,揭示了透气血压作为病因因素. 多基因风险评分有助于识别具有高基因AAA风险的个体.
科学领域:
- 遗传学
- 心血管疾病
- 流行病学
背景情况:
- 腹腔大动脉瘤 (AAA) 是心血管死亡的重要原因.
- 导致AAA的遗传因素尚未完全理解,只有10个已知的风险位解释了其遗传性的小部分.
研究的目的:
- 通过大规模的全基因组关联研究,确定腹腔大动脉瘤 (AAA) 的新遗传决定因素.
- 通过孟德尔随机化研究血压在AAA发展中的因果关系.
- 开发和验证多基因风险评分 (PRS),以识别AAA的基因风险较高的人.
主要方法:
- 在百万退伍军人计划 (MVP) 中进行了全基因组关联研究 (GWAS),约有1800万个DNA序列变异.
- 在其他队伍中进行独立复制.
- 采用孟德尔随机化方法来评估心压和心压对AAA风险的因果关系.
- 检查了AAA风险变体与其他血管动脉瘤的相关性,并得出29个变体的多基因风险评分 (PRS).
主要成果:
- 发现了14个与AAA相关的新基因位点, 总数达到24个.
- 在基因上增加的透析血压和AAA发育之间存在因果关系 (OR=1.43,P=1.6×10−6).
- 一个29个变异的PRS强烈预测AAA风险 (OR=1.26,P=2.7×10−11),独立于家族史和吸烟.
结论:
- 对AAA的新遗传关联具有治疗意义.
- 不管家族病史如何,PRS有效地识别出具有显著增加AAA遗传风险的个体.
- 将PRS纳入查指南可以提高早期检测和成本效益.
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