MTARC1的编码变体(rs2642438;p.Ala165Thr)最近与欧洲个体免受肝硬化的保护有关。然而,其对总体死亡率和特定原因死亡率的影响仍然难以捉摸.
使用基因组优先的方法,我们在UKBiobank和Penn-MedicineBiobank中探索了一系列与MTARC1p.Ala165Thr相关的代谢表型和结局.
MTARC1p.Ala165Thr与高甘油三酯显著相关,降低总胆固醇,降低LDL-C,下ApoB,较低的HDL-C,较低的ApoA-I和较高的IGF-1。每个次要等位基因,NAFLD的风险降低约15%。MTARC1p.Ala165Thr的ALT降低和NAFLD保护作用被肥胖放大,糖尿病和PNPLA3rs738409:G的存在在非裔美国人和黑人英国人中,MTARC1p.Ala165Thr的等位基因频率较低,但是携带者表现出相同的独特脂质表型。重要的是,MTARC1p.Ala165Thr携带者未显示较高的心血管疾病负担,如心脏MRI和颈动脉超声所证明。在前瞻性分析中,纯合次要等位基因与肝脏相关死亡率降低39%相关,而没有观察到总体死亡或心血管死亡增加的风险。引人注目的是,糖尿病参与者或PNPLA3rs738409携带者的肝脏相关死亡率降低了50%以上:G.
这些数据一起突出了MTARC1作为一种重要的肝病修饰因子,它以等位基因剂量依赖性方式影响血脂,而不会增加心血管结局。我们的结果指出了潜在的机制,并揭示了与肝脏相关死亡率的显着关联,呼吁未来的研究探索其治疗潜力。
这项研究由德国研究基金会(DFG)资助。
A coding variant in
MTARC1 (rs2642438; p.Ala165Thr) was recently associated with protection from cirrhosis in European individuals. However, its impact on overall and cause-specific mortality remained elusive.
Using a genome-first approach, we explored a range of metabolic phenotypes and outcomes associated with MTARC1 p.Ala165Thr in the UKBiobank and the Penn-Medicine BioBank.
MTARC1 p.Ala165Thr was significantly associated with higher triglycerides, lower total cholesterol, lower LDL-C, lower ApoB, lower HDL-C, lower ApoA-I and higher IGF-1. Per each minor allele, the risk of NAFLD was reduced by ~15%. The ALT-lowering and NAFLD-protective effect of
MTARC1 p.Ala165Thr was amplified by obesity, diabetes mellitus and presence of PNPLA3 rs738409:G. In African-American and Black-British individuals, the allele frequency of
MTARC1 p.Ala165Thr was lower, but carriers showed the same distinctive lipid phenotype. Importantly,
MTARC1 p.Ala165Thr carriers did not show higher cardiovascular disease burden as evidenced by cardiac MRI and carotid ultrasound. In prospective analyses, the homozygous minor allele was associated with up to 39% lower rates of liver-related mortality, while no risk of increased overall or cardiovascular death could be observed. Strikingly, liver-related mortality was more than 50% reduced in diabetic participants or carriers of PNPLA3 rs738409:G.
Together these data highlight MTARC1 as an important liver disease modifier that influences plasma lipids in an allele-dose-dependent manner without increasing cardiovascular outcomes. Our results point toward potential mechanisms and reveal a remarkable association with liver-related mortality calling for future studies exploring its therapeutic potential.
This study was funded by the German Research Foundation (DFG).