genetic risk score

遗传风险评分
  • 文章类型: Journal Article
    慢性肾脏病(CKD)是一种影响肾脏结构和功能的异质性疾病。这项研究调查了遗传因素和饮食模式之间的相互作用对韩国成年人肾功能障碍的影响。
    基线数据来自韩国基因组和流行病学研究的Ansan和Ansung研究,涉及8230名40-69岁的参与者。肾功能障碍定义为估计的肾小球滤过率<90mL/分钟/1.73m2。从外周血中分离在Affymetrix®全基因组人类SNP阵列5.0上进行基因分型的基因组DNA。使用广义线性模型对1,590,162个单核苷酸多态性(SNP)进行了全基因组关联研究。要选择重要的SNP,阈值标准设定为P值<5×10-8。基于R2值进行连锁不平衡聚集,94个SNPs具有显著的效应。根据一般风险评分(GRS)将参与者分为两组:低GR组的GRS>0,而高GR组的GRS≤0。
    提取了三种不同的饮食模式,即,“谨慎的模式,“\”面粉和动物性食品模式,“和”白米图案,分析膳食模式对肾功能的影响。在“以面粉和动物性食品为主的模式中,在低GR组和高GR组中,较高的模式评分与较高的肾功能障碍患病率相关(低GR组的趋势P<0.0001,模型1的高GR组;低GR组的0.0050和0.0065,分别为模型2的高GR组)。
    结果突出表明,在低和高GR的个体中,“以面粉为基础的食物模式和动物食物模式”与更高的肾功能障碍患病率之间存在显着关联。这些发现表明,基于GR概况的个性化营养干预可能成为提出基于GR的个体饮食模式治疗肾功能障碍的基础。
    Chronic kidney disease (CKD) is a heterogeneous disorder that affects the kidney structure and function. This study investigated the effect of the interaction between genetic factors and dietary pattern on kidney dysfunction in Korean adults.
    Baseline data were obtained from the Ansan and Ansung Study of the Korean Genome and Epidemiology Study involving 8230 participants aged 40-69 years. Kidney dysfunction was defined as an estimated glomerular filtration rate < 90 mL/minute/1.73 m2. Genomic DNAs genotyped on the Affymetrix® Genome-Wide Human SNP array 5.0 were isolated from peripheral blood. A genome-wide association study using a generalized linear model was performed on 1,590,162 single-nucleotide polymorphisms (SNPs). To select significant SNPs, the threshold criterion was set at P-value < 5 × 10-8. Linkage disequilibrium clumping was performed based on the R2 value, and 94 SNPs had a significant effect. Participants were divided into two groups based on their generic risk score (GRS): the low-GR group had GRS > 0, while the high-GR group had GRS ≤ 0.
    Three distinct dietary patterns were extracted, namely, the \"prudent pattern,\" \"flour-based and animal food pattern,\" and \"white rice pattern,\" to analyze the effect of dietary pattern on kidney function. In the \"flour-based and animal food pattern,\" higher pattern scores were associated with a higher prevalence of kidney dysfunction in both the low and high GR groups (P for trend < 0.0001 in the low-, high-GR groups of model 1; 0.0050 and 0.0065 in the low-, high-GR groups of model 2, respectively).
    The results highlight a significant association between the \'flour-based and animal food pattern\' and higher kidney dysfunction prevalence in individuals with both low and high GR. These findings suggest that personalized nutritional interventions based on GR profiles may become the basis for presenting GR-based individual dietary patterns for kidney dysfunction.
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  • 文章类型: Journal Article
    目的:我们使用多基因风险评分(PRS)来确定基于人群的队列中原发性开角型青光眼(POAG)的高危人群。
    方法:对四项前瞻性基于人群的研究进行二次分析。
    方法:我们纳入了四个欧洲血统队列:美国(US)护士健康研究(NHS),NHS2和卫生专业人员后续研究,以及荷兰的鹿特丹研究(RS)。美国队列包括55岁以上的女护士和男性健康专业人员。RS包括居住在鹿特丹的45岁或以上的居民,荷兰。
    方法:通过对UK-Biobank的估算基因型和表型数据应用Lassosum方法估算PRS权重。这导致了144,020个变体,单核苷酸多态性(SNP)和indel,我们用来计算目标人群中的PRS的非零贝塔。使用多变量Cox比例风险模型,我们估计了标准化PRS与POAG相对风险之间的关系。此外,通过计算这些模型的一致性(Harrell的C统计量)来检验POAG预测。最后,我们评估了PRS三元性与青光眼相关性状之间的相关性.
    方法:POAG和Harrell的C统计量的相对风险(相当于纵向模型的曲线下面积)。
    结果:在1,046例和38,809例对照中,在美国队列中,PRS最高五分位数参与者的POAG相对风险(95%置信区间)为3.99(3.08,5.18),鹿特丹研究中的4.89(2.93,8.17),与遗传风险中位数(第3位)的参与者相比。在受限三次样条分析中,在美国和鹿特丹队列中,连续PRS和POAG风险之间的关系呈指数增长(Pspline<0.05)。结合年龄,性别,眼压>25mmHg,和家族史导致meta分析的一致性为0.75(0.73,0.75).将PRS添加到该模型中将一致性提高到0.82(0.80,0.84)。在对所有队列的荟萃分析中,最高三元组的病例在诊断时杯盘比较大,由0.11(0.07,0.15),需要青光眼手术的风险增加2.07倍(1.19,3.60)。
    结论:将PRS纳入POAG预测模型可将识别一致性从0.75提高到0.82,支持其指导更具成本效益的筛查策略的潜力。
    OBJECTIVE: We used a polygenic risk score (PRS) to identify high-risk groups for primary open-angle glaucoma (POAG) within population-based cohorts.
    METHODS: Secondary analysis of four prospective population-based studies.
    METHODS: We included four European-ancestry cohorts: the United States (US) based Nurses\' Health Study (NHS), NHS2, and the Health Professionals Follow-up Study, and the Rotterdam Study (RS) in the Netherlands. The US cohorts included female nurses and male health professionals aged 55+ years. The RS included residents aged 45 years or older living in Rotterdam, the Netherlands.
    METHODS: PRS weights were estimated by applying the Lassosum method on imputed genotype and phenotype data from the UK-Biobank. This resulted in 144,020 variants, single nucleotide polymorphism (SNPs) and indels, with non-zero betas that we used to calculate a PRS in the target populations. Using multivariable Cox proportional hazard models, we estimated the relationship between the standardized PRS and relative risk for POAG. Additionally, POAG prediction was tested by calculating these models\' concordance (Harrell\'s C-statistic). Finally, we assessed the association between PRS tertiles and glaucoma-related traits.
    METHODS: The relative risk for POAG and Harrell\'s C-statistic (the equivalent of an area-under-the-curve for longitudinal models).
    RESULTS: Among 1,046 cases and 38,809‬ controls, the relative risk (95% confidence interval) for POAG for participants in the highest PRS quintile was 3.99 (3.08, 5.18) in the US cohorts, and 4.89 (2.93, 8.17) in the Rotterdam Study, compared with participants with median genetic risk (3rd quintile). In restricted cubic spline analyses, the relation between continuous PRS and POAG risk increased exponentially in the US and Rotterdam cohorts (Pspline<0.05). Combining age, sex, intraocular pressure >25 mmHg, and family history resulted in a meta-analyzed concordance of 0.75 (0.73, 0.75). Adding the PRS to this model improved the concordance to 0.82 (0.80, 0.84). In a meta-analysis of all cohorts, cases in the highest tertile had a larger cup-disc ratio at diagnosis, by 0.11 (0.07, 0.15), and a 2.07-fold increased risk of requiring glaucoma surgery (1.19, 3.60).
    CONCLUSIONS: Incorporating a PRS into a POAG predictive model improves identification concordance from 0.75 up to 0.82, supporting its potential for guiding more cost-effective screening strategies.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是印度的主要死亡原因。许多基因多态性在调节氧化应激中起作用,血压和脂质代谢,有助于CAD的病理生理学。这项研究检查了印度北部JatSikh人群中十个多态性与CAD之间的关联,还考虑了多基因风险评分。这项研究包括177例CAD病例和175例健康对照。GSTM1的遗传信息(rs366631),GSTT1(rs17856199),ACE(rs4646994),AGTM235T(rs699),AGTT174M(rs4762),AGTR1A1166C(rs5186),APOA5(rs3135506),APOC3(rs5128),对APOE(rs7412)和APOE(rs429358)的临床资料进行整理。使用SPSS版本27.0和SNPstats进行统计分析。发现GST*M1、GST*T1、ACE、AGTM235T,AGTT174M,AGTR1A1166C和APOA5多态性与CAD风险(均p<0.05)。AGTCT单倍型与更高的CAD风险显著相关,即使在控制协变量之后(调整后的OR=3.93,95%CI[2.39-6.48],p<0.0001)。APOA5/C3CC单倍型也与CAD显著相关(校正OR=1.86,95%CI[1.14-3.03],p<0.05)。较高的多基因风险评分与CAD风险增加相关(校正OR=1.98,95%CI[1.68-2.34],p<0.001)。在这个北印度人群中,七个多态性与CAD风险的增加独立相关。AGT的相当大的风险关联,APOA5/C3单倍型和更高的遗传风险评分被记录,这可能对临床和公共卫生应用有影响。
    Coronary artery disease (CAD) is the leading cause of death in India. Many genetic polymorphisms play a role in regulating oxidative stress, blood pressure and lipid metabolism, contributing to the pathophysiology of CAD. This study examined the association between ten polymorphisms and CAD in the Jat Sikh population from Northern India, also considering polygenic risk scores. This study included 177 CAD cases and 175 healthy controls. The genetic information of GSTM1 (rs366631), GSTT1 (rs17856199), ACE (rs4646994), AGT M235T (rs699), AGT T174M (rs4762), AGTR1 A1166C (rs5186), APOA5 (rs3135506), APOC3 (rs5128), APOE (rs7412) and APOE (rs429358) and clinical information was collated. Statistical analyses were performed using SPSS version 27.0 and SNPstats. Significant independent associations were found for GST*M1, GST*T1, ACE, AGT M235T, AGT T174M, AGTR1 A1166C and APOA5 polymorphisms and CAD risk (all p < 0.05). The AGT CT haplotype was significantly associated with a higher CAD risk, even after controlling for covariates (adjusted OR = 3.93, 95% CI [2.39-6.48], p < 0.0001). The APOA5/C3 CC haplotype was also significantly associated with CAD (adjusted OR = 1.86, 95% CI [1.14-3.03], p < 0.05). A higher polygenic risk score was associated with increased CAD risk (adjusted OR = 1.98, 95% CI [1.68-2.34], p < 0.001). Seven polymorphisms were independently associated with an increase in the risk of CAD in this North Indian population. A considerable risk association of AGT, APOA5/C3 haplotypes and higher genetic risk scores is documented, which may have implications for clinical and public health applications.
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  • 文章类型: Journal Article
    心血管疾病(CVD),这是一个重要的全球卫生挑战,正在扩张。CVD发生的主要因素之一是高遗传风险。心血管疾病的遗传风险和营养之间的相互作用是有争议的。多酚是重要的饮食成分之一,可能对心脏代谢危险因素具有高遗传风险评分(GRS)的人具有保护作用。这项研究,在超重和肥胖的女性中进行,检查多酚摄入量与特定基因(MC4r,Cav-1和Cry1)与维持身体平衡及其与心脏代谢危险因素的相互作用有关。
    这项横断面研究包括391名超重或肥胖的女性,18至48岁,体重指数(BMI)在25和40kg/m2之间。使用InBody770扫描仪测量身体成分。用经过验证的147项食物频率问卷(FFQ)评估总膳食多酚摄入量(TDPI),和多酚的摄入量是使用Phenol-Explorer数据库确定的。血清样本进行生化测试。遗传风险评分(GRS)基于三个基因的风险等位基因计算:MC4r,Cav-1和Cry1.
    女性的平均±标准差(SD)年龄和BMI分别为36.67(9.1)岁和30.98(3.9)kg/m2。高GRS和高TDPI组与空腹血糖(FBS)呈显著负交互作用(p=0.01)。发现具有高GRS和高酚酸摄入量的个体与甘油三酯具有显著的负相互作用(p=0.04)。同样,在调整模型中,高GRS和高黄酮摄入量的个体与TG具有显着的负相互作用(p<0.01),与高密度脂蛋白(HDL)具有显着的正相互作用(p=0.01)。
    根据我们的发现,那些具有高GRS的人可能通过消耗大量的多酚对心脏代谢危险因素具有保护作用。将来需要进一步的研究来验证这种关联。
    UNASSIGNED: Cardiovascular disease (CVD), which is an important global health challenge, is expanding. One of the main factors in the occurrence of CVD is a high genetic risk. The interaction between genetic risk in CVD and nutrition is debatable. Polyphenols are one of the important dietary components that may have a protective role in people who have a high genetic risk score (GRS) for cardiometabolic risk factors. This study, conducted in overweight and obese women, examines the interaction between polyphenol intake and specific genes (MC4r, Cav-1, and Cry1) related to maintaining body balance and their interaction with cardiometabolic risk factors.
    UNASSIGNED: This cross-sectional study included 391 women who were overweight or obese, aged 18 to 48 years, with a body mass index (BMI) between 25 and 40 kg/m2. Body composition was measured using the InBody 770 scanner. Total dietary polyphenol intake (TDPI) was assessed with a validated 147-item food frequency questionnaire (FFQ), and polyphenol intakes were determined using the Phenol-Explorer database. Serum samples underwent biochemical tests. The Genetic Risk Score (GRS) was calculated based on the risk alleles of three genes: MC4r, Cav-1, and Cry1.
    UNASSIGNED: The mean ± standard deviation (SD) age and BMI of women were 36.67 (9.1) years and 30.98 (3.9) kg/m2, respectively. The high GRS and high TDPI group had a significant negative interaction with fasting blood glucose (FBS) (p = 0.01). Individuals who had a high GRS and a high phenolic acid intake were found to have a significant negative interaction with Triglyceride (p = 0.04). Similarly, individuals with high GRS and a high intake of flavonoids had a significant negative interaction with TG (p < 0.01) and a significant positive interaction with High-density lipoprotein (HDL) (p = 0.01) in the adjusted model.
    UNASSIGNED: According to our findings, those with a high GRS may have a protective effect on cardiometabolic risk factors by consuming high amounts of polyphenols. Further studies will be necessary in the future to validate this association.
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  • 文章类型: Journal Article
    药物基因组多基因风险评分(PRS)已成为解决药物遗传表型的多基因性质的工具,增加预测药物反应的潜力。大多数药物基因组PRS是从通过全基因组关联研究(GWAS)鉴定的疾病相关变异中推断出来的,尽管有些已经开始利用药物基因组GWAS的遗传变异。由于药物基因组学PRS有望实现精准医学,包括分层治疗方法,重要的是评估当前数据带来的机遇和挑战。该评估将有助于确定药物基因组PRS如何被推进并过渡到临床使用。在这次审查中,我们总结了最近的证据,评估当前状态,并确定了阻碍药物基因组PRS进展的几个挑战。这些挑战包括依赖疾病遗传学外推和药物基因组学研究固有的局限性,如低样本量,表型不一致,在其他人中。最后,我们提出了克服挑战并促进临床实施的建议。这些建议包括表型标准化方法,加强合作努力,开发新的统计方法,利用药物特异性遗传关联进行PRS构建。其他建议包括增强可以将基因组数据与临床预测因子集成的基础设施,随着用户友好的临床决策工具的实施,和病人的教育。道德和监管方面的考虑应解决与患者隐私相关的问题,知情同意和安全使用PRS。尽管面临这些挑战,正在进行的研究和大规模合作可能会推进该领域并实现药物基因组PRS的潜力。
    Pharmacogenomic Polygenic Risk Scores (PRS) have emerged as a tool to address the polygenic nature of pharmacogenetic phenotypes, increasing the potential to predict drug response. Most pharmacogenomic PRS have been extrapolated from disease-associated variants identified by genome wide association studies (GWAS), although some have begun to utilize genetic variants from pharmacogenomic GWAS. As pharmacogenomic PRS hold the promise of enabling precision medicine, including stratified treatment approaches, it is important to assess the opportunities and challenges presented by the current data. This assessment will help determine how pharmacogenomic PRS can be advanced and transitioned into clinical use. In this review, we present a summary of recent evidence, evaluate the current status, and identify several challenges that have impeded the progress of pharmacogenomic PRS. These challenges include the reliance on extrapolations from disease genetics and limitations inherent to pharmacogenomics research such as low sample sizes, phenotyping inconsistencies, among others. We finally propose recommendations to overcome the challenges and facilitate the clinical implementation. These recommendations include standardizing methodologies for phenotyping, enhancing collaborative efforts, developing new statistical methods to capitalize on drug-specific genetic associations for PRS construction. Additional recommendations include enhancing the infrastructure that can integrate genomic data with clinical predictors, along with implementing user-friendly clinical decision tools, and patient education. Ethical and regulatory considerations should address issues related to patient privacy, informed consent and safe use of PRS. Despite these challenges, ongoing research and large-scale collaboration is likely to advance the field and realize the potential of pharmacogenomic PRS.
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  • 文章类型: Journal Article
    使用遗传风险评分(GRS)来预测冠心病(CHD)可能会更早地发现疾病。本研究旨在评估GRS是否与CHD发病率相关,以及使用传统风险因素(TRF)和家族史评估GRS是否对改善预测临床有用。
    在本研究中分析了来自韩国基因组和流行病学研究的总共48,941名参与者的数据。基于已发表的全基因组关联研究,使用55种单核苷酸多态性构建加权GRS。采用Cox比例风险模型分析GRS与冠心病的相关性。对区分和重新分类进行了评估,以证明GRS的临床实用性。分析按性别分别进行。
    调整家族史和TRF后,GRS与男性冠心病发病率显著相关;与低GRS组相比,高GRS组男性的冠心病风险增加2.07倍(95%置信区间[CI]:1.51~2.85).在男人中,TRF的组合,家族史,GRS的性能优于单独的TRF(仅TRF模型的C统计数据,0.66,95%CI,0.64-0.69;组合模型的C统计,0.68,95%CI,0.65-0.71;无类别重分类指数,15%)。在女性中,然而,GRS与CHD之间无显著关联,模型间无改善.
    GRS与冠心病发病率相关,并有助于男性冠心病预测的小幅改善。GRS的潜在临床应用可能不会超过家族史的价值。
    UNASSIGNED: Using a genetic risk score (GRS) to predict coronary heart disease (CHD) may detect disease earlier. The current study aims to assess whether GRS is associated with CHD incidence and whether it is clinically useful for improving prediction using traditional risk factors (TRFs) as well as family history.
    UNASSIGNED: Data from a total of 48,941 participants in the Korean Genome and Epidemiology Study were analyzed in the current study. The weighted GRS was constructed using 55 single-nucleotide polymorphisms based on published genome-wide association studies. The association of GRS with incident CHD was analyzed using Cox proportional hazard model. Discrimination and reclassification were assessed to demonstrate the clinical utility of GRS. The analyses were performed separately by sex.
    UNASSIGNED: After adjusting for family history and TRFs, GRS was significantly associated with CHD incidence in men; compared to the low GRS group, men in the high GRS group had a 2.07-fold increased risk of CHD (95% confidence interval [CI]: 1.51-2.85). In men, the combination of TRFs, family history, and GRS had better performance than TRFs alone (C statistics for TRF-only model, 0.66, 95% CI, 0.64-0.69; C statistics for combination model, 0.68, 95% CI, 0.65-0.71; category-free reclassification index, 15%). In women, however, there was no significant association between GRS and CHD and no improvement between models.
    UNASSIGNED: GRS was associated with CHD incidence and contributed to a small improvement of CHD prediction in men. The potential clinical use of GRS may not outweigh the value of family history.
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  • 文章类型: Journal Article
    MI-GENES临床试验(NCT01936675),其中冠心病(CHD)中等风险的参与者被随机分配接受弗雷明汉风险评分(FRSg,n=103),或综合风险评分(IRSg,n=104),还包括多基因风险评分(PRS),证明六个月后,随机分配至IRSg组的参与者他汀类药物起始起始量较高,低密度脂蛋白胆固醇(LDL-C)较低.
    在对MI-GENES试验进行的为期10年的事后随访分析中,我们调查了CHD患者的PRS显示是否与心血管不良事件的减少相关.
    从2013年10月开始的随机分组到2023年9月对参与者进行随访,以确定不良心血管事件。CHD测试,和风险因素的变化,通过对电子健康记录的盲法审查。主要结局是从随机分组到第一次主要不良心血管事件(MACE)发生的时间,定义为心血管死亡,非致死性心肌梗死,冠状动脉血运重建,和非致命性中风。使用Cox比例风险回归和线性混合效应模型进行统计分析。
    我们跟踪了完成MI-GENES试验的所有203名参与者,FRSg为100,IRSg为103(随访结束时的平均年龄:68.2±5.2,男性48%)。在9.5年的中位随访期间,9个MACE发生在FRSg中,2个发生在IRSg中(危险比(HR),0.20;95%置信区间(CI),0.04至0.94;P=0.042)。在FRSg中,47人(47%)接受了至少一项CHD检查,与IRSg中的30(29%)相比(HR,0.51;95%CI,0.32~0.81;P=0.004)。IRSg参与者在随机化后的前四年中他汀类药物治疗的持续时间更长,并且在随机化后的3年内LDL-C降低更大。两组血红蛋白A1C无显著差异,收缩压和舒张压,体重,随访期间戒烟率。
    在十年的随访后,向处于冠心病中度风险的个体披露包含PRS的IRS与MACE发生率较低相关,可能是由于他汀类药物治疗的起始率和持续时间较长,降低LDL-C水平。
    UNASSIGNED: The MI-GENES clinical trial (NCT01936675), in which participants at intermediate risk of coronary heart disease (CHD) were randomized to receive a Framingham risk score (FRSg, n=103), or an integrated risk score (IRSg, n=104) that additionally included a polygenic risk score (PRS), demonstrated that after 6 months, participants randomized to IRSg had higher statin initiation and lower low-density lipoprotein cholesterol (LDL-C).
    UNASSIGNED: In a post hoc 10-year follow-up analysis of the MI-GENES trial, we investigated whether disclosure of a PRS for CHD was associated with a reduction in adverse cardiovascular events.
    UNASSIGNED: Participants were followed from randomization beginning in October 2013 until September 2023 to ascertain adverse cardiovascular events, testing for CHD, and changes in risk factors, by blinded review of electronic health records. The primary outcome was the time from randomization to the occurrence of the first major adverse cardiovascular event (MACE), defined as cardiovascular death, non-fatal myocardial infarction, coronary revascularization, and non-fatal stroke. Statistical analyses were conducted using Cox proportional hazards regression and linear mixed-effects models.
    UNASSIGNED: We followed all 203 participants who completed the MI-GENES trial, 100 in FRSg and 103 in IRSg (mean age at the end of follow-up: 68.2±5.2, 48% male). During a median follow-up of 9.5 years, 9 MACEs occurred in FRSg and 2 in IRSg (hazard ratio (HR), 0.20; 95% confidence interval (CI), 0.04 to 0.94; P=0.042). In FRSg, 47 (47%) underwent at least one test for CHD, compared to 30 (29%) in IRSg (HR, 0.51; 95% CI, 0.32 to 0.81; P=0.004). IRSg participants had a longer duration of statin therapy during the first four years post-randomization and a greater reduction in LDL-C for up to 3 years post-randomization. No significant differences between the two groups were observed for hemoglobin A1C, systolic and diastolic blood pressures, weight, and smoking cessation rate during follow-up.
    UNASSIGNED: The disclosure of an IRS that included a PRS to individuals at intermediate risk for CHD was associated with a lower incidence of MACE after a decade of follow-up, likely due to a higher rate of initiation and longer duration of statin therapy, leading to lower LDL-C levels.
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  • 文章类型: Journal Article
    癫痫的诊断对个体有重大影响,但在临床实践中通常具有挑战性。因此非常需要新的生物标志物。这里,我们调查了常见的遗传因素(癫痫多基因风险评分,[PRS])影响>700k芬兰人和爱沙尼亚人的详细纵向电子健康记录(EHR)中的癫痫风险。我们发现,高遗传性全身性癫痫PRS(PRSGGE)在一生中以及未指明的癫痫发作事件后10年内增加了遗传性全身性癫痫(GGE)的风险(风险比[HR]1.73/PRSGGE标准偏差[SD])。PRSGGE对特发性全身性癫痫的影响明显更大,女性和早期癫痫发作。类似地,我们发现,与非获得性局灶性癫痫(NAFE)相关的PRS负荷显著,但更为适度.这里,我们概述了癫痫特异性PRS在首次癫痫发作后作为生物标志物的潜力.
    A diagnosis of epilepsy has significant consequences for an individual but is often challenging in clinical practice. Novel biomarkers are thus greatly needed. Here, we investigated how common genetic factors (epilepsy polygenic risk scores, [PRSs]) influence epilepsy risk in detailed longitudinal electronic health records (EHRs) of > 700k Finns and Estonians. We found that a high genetic generalized epilepsy PRS (PRSGGE) increased risk for genetic generalized epilepsy (GGE) (hazard ratio [HR] 1.73 per PRSGGE standard deviation [SD]) across lifetime and within 10 years after an unspecified seizure event. The effect of PRSGGE was significantly larger on idiopathic generalized epilepsies, in females and for earlier epilepsy onset. Analogously, we found significant but more modest focal epilepsy PRS burden associated with non-acquired focal epilepsy (NAFE). Here, we outline the potential of epilepsy specific PRSs to serve as biomarkers after a first seizure event.
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  • 文章类型: Journal Article
    目的:本研究旨在确定供者或受者导致肝移植(LT)后脂肪性肝病(SLD)的遗传风险因素,研究基于单核苷酸多态性(SNPs)的SLD患者遗传风险评分(GRS)。
    方法:这项回顾性研究包括55名日本SLD受者及其各自的供体。进行PNPLA3,TM6SF2和HSD17B13的基因分型,并计算合并GRS。还评估了GRS与移植后SLD发生率之间的关系。
    结果:SLD受者的肝移植后脂肪变性/脂肪性肝炎患病率很高(76.4%和58.2%,分别)。尽管接受者的风险等位基因频率很高,每个SNP的风险等位基因数量与移植后SLD的发生率之间没有关系.相比之下,供体中任何SNP的风险等位基因数量增加与LT后脂肪变性和脂肪性肝炎的高发病率相关.多变量分析表明,高供体GRS是移植物脂肪变性的独立危险因素(比值比8.77;95%CI,1.94-52.94;p=0.009)。同样,高供体GRS是LT移植后脂肪性肝炎的独立危险因素(比值比6.76;95%CI,1.84-30.78;p=0.007).
    结论:PNPLA3,TM6SF2和HSD17B13的供体风险等位基因,而不是受体风险等位基因,与移植后SLD的发展有关。将这些供体风险等位基因组合到GRS中可以预测移植后SLD的发展。
    OBJECTIVE: This study aimed to identify the genetic risk factors from donors or recipients that contribute to postliver transplantation (LT) steatotic liver disease (SLD), focusing on the genetic risk score (GRS) based on single nucleotide polymorphisms (SNPs) in SLD patients.
    METHODS: This retrospective study included 55 Japanese SLD recipients and their respective donors. Genotyping of PNPLA3, TM6SF2, and HSD17B13 was undertaken, and the combined GRS was calculated. The relationship between the GRS and the incidence of posttransplant SLD was also evaluated.
    RESULTS: The SLD recipients had a high prevalence of post-LT graft steatosis/steatohepatitis (76.4% and 58.2%, respectively). Although the recipients had a high frequency of risk alleles, there was no relationship between the number of risk alleles for each SNP and the incidence of posttransplant SLD. In contrast, an increased number of risk alleles for any SNP in the donor was correlated with high incidence rates of both post-LT steatosis and steatohepatitis. A multivariable analysis showed that a high donor GRS was an independent risk factor for graft steatosis (odds ratio 8.77; 95% CI, 1.94-52.94; p = 0.009). Similarly, a high donor GRS was an independent risk factor (odds ratio 6.76; 95% CI, 1.84-30.78; p = 0.007) for post-LT graft steatohepatitis.
    CONCLUSIONS: Donor risk alleles of PNPLA3, TM6SF2, and HSD17B13, rather than recipient risk alleles, have been implicated in the development of posttransplant SLD. The combination of these donor risk alleles into a GRS could predict the development of posttransplant SLD.
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  • 文章类型: Journal Article
    背景:2型糖尿病(T2D)的母体遗传风险与胎儿生长有关,但是遗传祖先的影响还没有完全理解。我们旨在研究遗传距离(GD)和遗传血统比例(GAP)对T2D的母体遗传风险评分(GRST2D)与胎儿体重和出生体重的相关性的影响。
    方法:来自NICHD胎儿生长研究的多祖先孕妇(n=1,837)——单胎队列被纳入当前分析。胎儿体重(以克计,g)是根据胎儿生物测定的超声测量结果估计的,分娩时测量出生体重(g)。使用最新的跨祖先全基因组关联研究中鉴定的T2D相关变体计算GRST2D,并将其分类为四分位数。使用四个参考人群的基因型数据估计GD和GAP。GD被归类为最接近的,中间,和最远的三元,GAP被归类为最高,中等,和最低。进行线性回归分析以测试GRST2D与胎儿体重和出生体重的关联。对协变量进行调整,在每个GD和GAP类别中。
    结果:在来自非洲和美洲土著祖先的GD最接近的女性中,与第一个四分位数相比,第四个和第三个GRST2D四分位数与5.18至7.48g(17-20周)和6.83至25.44g(19-27周)的胎儿体重显着相关,分别。在来自欧洲血统的中GD女性中,第4个GRST2D四分位数与5.73~21.21g(18~26周)更大的胎儿体重显著相关.此外,在来自欧洲和非洲祖先的中间GD的女性中,与第一个四分位数相比,第四个和第二个GRST2D四分位数与117.04g(95%CI=23.88-210.20,p=0.014)和95.05g(95%CI=4.73-185.36,p=0.039)更大的出生体重显着相关,分别。与东亚血统最接近GD的女性之间没有显着关联,而与东亚GAP最高的女性之间存在正显著关联。
    结论:母体GRST2D与胎儿生长之间的关联始于孕中期早期,并受GD和GAP的影响。结果表明,遗传GD和GAP的使用可以提高GRS的普适性。
    BACKGROUND: Maternal genetic risk of type 2 diabetes (T2D) has been associated with fetal growth, but the influence of genetic ancestry is not yet fully understood. We aimed to investigate the influence of genetic distance (GD) and genetic ancestry proportion (GAP) on the association of maternal genetic risk score of T2D (GRST2D) with fetal weight and birthweight.
    METHODS: Multi-ancestral pregnant women (n = 1,837) from the NICHD Fetal Growth Studies - Singletons cohort were included in the current analyses. Fetal weight (in grams, g) was estimated from ultrasound measurements of fetal biometry, and birthweight (g) was measured at delivery. GRST2D was calculated using T2D-associated variants identified in the latest trans-ancestral genome-wide association study and was categorized into quartiles. GD and GAP were estimated using genotype data of four reference populations. GD was categorized into closest, middle, and farthest tertiles, and GAP was categorized as highest, medium, and lowest. Linear regression analyses were performed to test the association of GRST2D with fetal weight and birthweight, adjusted for covariates, in each GD and GAP category.
    RESULTS: Among women with the closest GD from African and Amerindigenous ancestries, the fourth and third GRST2D quartile was significantly associated with 5.18 to 7.48 g (weeks 17-20) and 6.83 to 25.44 g (weeks 19-27) larger fetal weight compared to the first quartile, respectively. Among women with middle GD from European ancestry, the fourth GRST2D quartile was significantly associated with 5.73 to 21.21 g (weeks 18-26) larger fetal weight. Furthermore, among women with middle GD from European and African ancestries, the fourth and second GRST2D quartiles were significantly associated with 117.04 g (95% CI = 23.88-210.20, p = 0.014) and 95.05 g (95% CI = 4.73-185.36, p = 0.039) larger birthweight compared to the first quartile, respectively. The absence of significant association among women with the closest GD from East Asian ancestry was complemented by a positive significant association among women with the highest East Asian GAP.
    CONCLUSIONS: The association between maternal GRST2D and fetal growth began in early-second trimester and was influenced by GD and GAP. The results suggest the use of genetic GD and GAP could improve the generalizability of GRS.
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