polygenic risk scores

多基因风险评分
  • 文章类型: Journal Article
    一些先前的研究已经提出了各种脑区和细胞类型参与帕金森病(PD)病理学。这里,我们对一小部分死后对照和PD脑组织的前额叶皮质和前扣带回区域进行了snRNA-seq.我们发现少突胶质细胞(ODCs)和少突胶质细胞前体细胞(OPCs)与PD相关的风险位点显著相关,并报道了几个失调的基因和途径。包括调节tau蛋白激酶的活性,参与蛋白质靶向线粒体的包涵体组装和蛋白质加工的调节。在具有临床测量的独立PD队列中(681例和549例对照),来自失调基因的多基因风险评分显着预测了蒙特利尔认知评估(MoCA)-,和贝克抑郁量表-II(BDI-II)-得分,但不是运动损伤(UPDRS-III)。我们通过纳入以前由不同实验室发表的三个独立数据集的差异表达基因,扩展了我们对临床结果预测的分析。在前扣带回皮层的第一个数据集中,我们确定了ODC和BDI-II之间的关联。在从黑质(SN)获得的第二个数据集中,OPC显示与UPDRS-III的关联。在SN区域的第三个数据集中,OPCs的独特亚型,标记为OPC_ADM,表现出与UPDRS-III的关联。有趣的是,OPC_ADM簇也显示出PD样品的显着增加。这些结果表明,通过将我们的注意力扩展到神经胶质细胞,我们可以发现与PD症状相关的区域特异性分子通路。
    Several prior studies have proposed the involvement of various brain regions and cell types in Parkinson\'s disease (PD) pathology. Here, we performed snRNA-seq on the prefrontal cortex and anterior cingulate regions from a small cohort of post-mortem control and PD brain tissue. We found a significant association of oligodendrocytes (ODCs) and oligodendrocyte precursor cells (OPCs) with PD-linked risk loci and report several dysregulated genes and pathways, including regulation of tau-protein kinase activity, regulation of inclusion body assembly and protein processing involved in protein targeting to mitochondria. In an independent PD cohort with clinical measures (681 cases and 549 controls), polygenic risk scores derived from the dysregulated genes significantly predicted Montreal Cognitive Assessment (MoCA)-, and Beck Depression Inventory-II (BDI-II)-scores but not motor impairment (UPDRS-III). We extended our analysis of clinical outcome prediction by incorporating differentially expressed genes from three separate datasets that were previously published by different laboratories. In the first dataset from the anterior cingulate cortex, we identified an association between ODCs and BDI-II. In the second dataset obtained from the substantia nigra (SN), OPCs displayed an association with UPDRS-III. In the third dataset from the SN region, a distinct subtype of OPCs, labeled OPC_ADM, exhibited an association with UPDRS-III. Intriguingly, the OPC_ADM cluster also demonstrated a significant increase in PD samples. These results suggest that by expanding our focus to glial cells, we can uncover region-specific molecular pathways associated with PD symptoms.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    冠状动脉粥样硬化负担和不良冠心病事件是相关的表型,可能具有共同的遗传原因。
    我们分析了6021例冠状动脉造影患者,基因分型,和外显子组测序数据。我们测试了冠心病(PRSCHD)的多基因风险评分与多种冠状动脉疾病(CAD)严重程度的相关性。我们评估了3种家族性高胆固醇血症基因中PRSCHD与致病/可能致病变异之间的相互作用。我们进行了中介分析,以探讨CAD严重程度是否介导了PRSCHD与流行冠心病和急性心肌梗死的相关性。
    PRSCHD的1-SD增加与CAD严重程度的多种指标相关,包括对数Gensini评分(β,0.31[95%CI,0.28-0.33])。在校正PRSCHD后,携带致病性/可能致病性家族性高胆固醇血症变异与更高的logGensini评分相关(β,0.21[95%CI,0.03-0.38])。PRSCHD与平均9.2年随访期间的心肌梗死相关(风险比,1.20[95%CI,1.13-1.27];P=5×10-10),Gensini评分介导了90%的关联。
    PRSCHD与多种CAD严重程度指标相关。PRSCHD与心肌梗死的相关性几乎完全由CAD严重程度介导,表明两种表型之间存在相当大的遗传重叠。
    UNASSIGNED: Coronary atherosclerotic burden and adverse coronary heart disease events are related phenotypes with likely shared genetic cause.
    UNASSIGNED: We analyzed 6021 patients with available coronary angiography, genotyping, and exome sequencing data. We tested for associations of polygenic risk scores for coronary heart disease (PRSCHD) with multiple measures of coronary artery disease (CAD) severity. We assessed the interplay between PRSCHD and pathogenic/likely pathogenic variants in 3 familial hypercholesterolemia genes. We performed mediation analyses to explore whether CAD severity mediated the association of PRSCHD with prevalent coronary heart disease and incident myocardial infarction.
    UNASSIGNED: A 1-SD increase in PRSCHD was associated with multiple measures of CAD severity, including the log Gensini score (β, 0.31 [95% CI, 0.28-0.33]). Carrying a pathogenic/likely pathogenic familial hypercholesterolemia variant was associated with a higher log Gensini score after adjustment for PRSCHD (β, 0.21 [95% CI, 0.03-0.38]). PRSCHD was associated with incident myocardial infarction over a mean follow-up of 9.2 years (hazard ratio, 1.20 [95% CI, 1.13-1.27]; P=5×10-10), and the Gensini score mediated 90% of this association.
    UNASSIGNED: PRSCHD was associated with multiple measures of CAD severity. The association of PRSCHD with incident myocardial infarction was almost fully mediated by CAD severity, indicating a considerable genetic overlap between the 2 phenotypes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    多基因风险评分(PRS)可增强人群风险分层并推进个性化医疗,但是现有的方法面临着一些限制,涵盖与计算负担相关的问题,预测准确性,以及对广泛遗传结构的适应性。为了解决这些问题,我们建议使用汇总级数据(ALL-Sum)聚合L0Learn,一种快速且可扩展的集成学习方法,用于使用来自全基因组关联研究(GWAS)的汇总统计来计算PRS。ALL-Sum利用L0L2惩罚回归和跨调整参数的集成学习来灵活地对具有不同遗传架构的性状进行建模。在广泛的大规模模拟中,广泛的多遗传性和GWAS样本量,在预测准确性方面,ALL-Sum始终优于流行的替代方法,运行时,内存使用量减少10%,20倍,还有三个,分别,并证明了对不同遗传架构的稳健性。我们使用来自9个数据源的GWAS汇总统计数据验证了ALL-Sum在11个复杂性状的实际数据分析中的性能,包括全球脂质遗传学联盟,乳腺癌协会联合会,和FinnGen生物银行,在英国生物银行进行验证。我们的结果表明,平均而言,ALL-Sum获得的PRS平均准确度提高25%,比当前最先进的方法快15倍的计算速度和一半的内存,并且在广泛的特征和疾病中表现强劲。此外,当使用从不同数据源计算的连锁不平衡时,我们的方法显示出稳定的预测。ALL-Sum作为用户友好的R软件包提供,具有公开可用的参考数据,用于简化分析。
    Polygenic risk scores (PRS) enhance population risk stratification and advance personalized medicine, but existing methods face several limitations, encompassing issues related to computational burden, predictive accuracy, and adaptability to a wide range of genetic architectures. To address these issues, we propose Aggregated L0Learn using Summary-level data (ALL-Sum), a fast and scalable ensemble learning method for computing PRS using summary statistics from genome-wide association studies (GWAS). ALL-Sum leverages a L0L2 penalized regression and ensemble learning across tuning parameters to flexibly model traits with diverse genetic architectures. In extensive large-scale simulations across a wide range of polygenicity and GWAS sample sizes, ALL-Sum consistently outperformed popular alternative methods in terms of prediction accuracy, runtime, and memory usage by 10%, 20-fold, and threefold, respectively, and demonstrated robustness to diverse genetic architectures. We validated the performance of ALL-Sum in real data analysis of 11 complex traits using GWAS summary statistics from nine data sources, including the Global Lipids Genetics Consortium, Breast Cancer Association Consortium, and FinnGen Biobank, with validation in the UK Biobank. Our results show that on average, ALL-Sum obtained PRS with 25% higher accuracy on average, with 15 times faster computation and half the memory than the current state-of-the-art methods, and had robust performance across a wide range of traits and diseases. Furthermore, our method demonstrates stable prediction when using linkage disequilibrium computed from different data sources. ALL-Sum is available as a user-friendly R software package with publicly available reference data for streamlined analysis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:糖尿病的代谢危险因素和血浆生物标志物在临床糖尿病诊断之前已经显示出变化。然而,这些标记仅覆盖了与疾病相关的一小部分分子生物标志物.在这项研究中,我们旨在分析一组更全面的分子生物标志物,并探讨它们与糖尿病发病的时间关联.
    方法:我们在丹麦献血者研究(DBDS)中对性别和出生年份分布相匹配的324例糖尿病患者和359例非糖尿病患者进行了长达11年随访的三个连续样本中测量的54种蛋白质和171种代谢物和脂蛋白颗粒的靶向分析。我们使用线性混合效应模型来识别糖尿病诊断前的时间变化,对于任何意外糖尿病诊断或特别是1型和2型糖尿病诊断。我们进一步进行了线性和非线性特征选择,在生物标志物池中增加28项多基因风险评分。我们测试了具有最高变量重要性的生物标志物的事件时间预测增益,与选定的临床协变量和血浆葡萄糖进行比较。
    结果:我们确定了2种蛋白质和16种代谢物和脂蛋白颗粒,其水平在糖尿病诊断前发生了时间变化,并且在FDR调整后估计的边缘均值具有统计学意义。其中16个以前没有描述过。此外,在糖尿病诊断之前的几年中,有75种生物标志物始终较高或较低。我们确定了1型糖尿病的单一时间生物标志物,IL-17A/F,与多种其他自身免疫性疾病相关的细胞因子。纳入12种生物标志物改善了糖尿病诊断的10年预测(即受试者工作曲线下的面积从0.79增加到0.84)。与单独的临床信息和血浆葡萄糖进行比较。
    结论:在糖尿病诊断前几年,血浆中出现了系统性分子变化。一个特定的生物标志物子集显示出不同的,时间依赖的模式,提供作为糖尿病发病的预测标志物的潜力。值得注意的是,这些生物标志物在1型糖尿病和2型糖尿病之间显示出共同和不同的模式.独立复制后,我们的发现可用于开发新的临床预测模型.
    OBJECTIVE: Metabolic risk factors and plasma biomarkers for diabetes have previously been shown to change prior to a clinical diabetes diagnosis. However, these markers only cover a small subset of molecular biomarkers linked to the disease. In this study, we aimed to profile a more comprehensive set of molecular biomarkers and explore their temporal association with incident diabetes.
    METHODS: We performed a targeted analysis of 54 proteins and 171 metabolites and lipoprotein particles measured in three sequential samples spanning up to 11 years of follow-up in 324 individuals with incident diabetes and 359 individuals without diabetes in the Danish Blood Donor Study (DBDS) matched for sex and birth year distribution. We used linear mixed-effects models to identify temporal changes before a diabetes diagnosis, either for any incident diabetes diagnosis or for type 1 and type 2 diabetes mellitus diagnoses specifically. We further performed linear and non-linear feature selection, adding 28 polygenic risk scores to the biomarker pool. We tested the time-to-event prediction gain of the biomarkers with the highest variable importance, compared with selected clinical covariates and plasma glucose.
    RESULTS: We identified two proteins and 16 metabolites and lipoprotein particles whose levels changed temporally before diabetes diagnosis and for which the estimated marginal means were significant after FDR adjustment. Sixteen of these have not previously been described. Additionally, 75 biomarkers were consistently higher or lower in the years before a diabetes diagnosis. We identified a single temporal biomarker for type 1 diabetes, IL-17A/F, a cytokine that is associated with multiple other autoimmune diseases. Inclusion of 12 biomarkers improved the 10-year prediction of a diabetes diagnosis (i.e. the area under the receiver operating curve increased from 0.79 to 0.84), compared with clinical information and plasma glucose alone.
    CONCLUSIONS: Systemic molecular changes manifest in plasma several years before a diabetes diagnosis. A particular subset of biomarkers shows distinct, time-dependent patterns, offering potential as predictive markers for diabetes onset. Notably, these biomarkers show shared and distinct patterns between type 1 diabetes and type 2 diabetes. After independent replication, our findings may be used to develop new clinical prediction models.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    BACKGROUND: Anhedonia is characterized by a reduced ability to anticipate, experience, and/or learn about pleasure. This phenomenon has a transdiagnostic nature and is one of the key symptoms of mood disorders, schizophrenia, addictions, and somatic conditions.
    OBJECTIVE: To evaluate the genetic architecture of anhedonia and its overlap with other mental disorders and somatic conditions.
    METHODS: We performed a genome-wide association study of anhedonia on a sample of 4,520 individuals from a Russian non-clinical population. Using the available summary statistics, we calculated polygenic risk scores (PRS) to investigate the genetic relationship between anhedonia and other psychiatric or somatic phenotypes.
    RESULTS: No variants with a genome-wide significant association were identified. PRS for major depression, bipolar disorder, and schizophrenia were significantly associated with anhedonia. Conversely, no significant associations were found between PRS for anxiety and anhedonia, which aligns well with existing clinical evidence. None of the PRS for somatic phenotypes attained a significance level after correction for multiple comparisons. A nominal significance for the anhedonia association was determined for omega-3 fatty acids, type 2 diabetes mellitus, and Crohn\'s disease.
    CONCLUSIONS: Anhedonia has a complex polygenic architecture, and its presence in somatic diseases or normal conditions may be due to a genetic predisposition to mood disorders or schizophrenia.
    UNASSIGNED: Ангедония характеризуется снижением способности предвосхищать, испытывать и/или усваивать удовольствие. Этот феномен имеет трансдиагностическую природу и является одним из ключевых симптомов расстройств настроения, шизофрении, аддикций и соматических состояний.
    UNASSIGNED: Оценить генетическую архитектуру ангедонии и её перекрытие с другими психическими расстройствами и соматическими состояниями.
    UNASSIGNED: Проведено исследование полногеномного поиска ассоциаций ангедонии на выборке из 4 520 человек из российской неклинической популяции. Используя доступную сводную статистику, мы рассчитали шкалы полигенного риска (polygenic risk scores, PRS), чтобы исследовать генетическую связь между ангедонией и другими психиатрическими или соматическими фенотипами.
    UNASSIGNED: Не было идентифицировано ни одного варианта, достигшего полногеномного уровня значимости. PRS для депрессии, биполярного расстройства и шизофрении были значимо ассоциированы с ангедонией. И наоборот, не обнаружено значимых ассоциаций между PRS для тревожных расстройств и ангедонии, что хорошо согласуется с существующими клиническими данными. Ни один из PRS для соматических фенотипов не достиг уровня значимости после коррекции на множественные сравнения. При номинальном уровне значимости ассоциация с ангедонией выявлена для PRS ω-3 жирных кислот, сахарного диабета 2-го типа и болезни Крона.
    UNASSIGNED: Ангедония имеет сложную полигенную архитектуру, в связи с чем её присутствие при соматических заболеваниях или нормальных состояниях может быть обусловлено генетической предрасположенностью к расстройствам настроения или шизофрении.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Letter
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:比利时的植入前基因检测(PGT)患者对PGT多基因风险评分(PGT-P)的伦理学有何看法?
    方法:深入访谈(共18,10对夫妇,8女人,n=28)是在2017年至2019年间在比利时接受过PGT单基因/单基因缺陷(PGT-M)或染色体结构重排(PGT-SR)治疗的患者。参与者被问及他们自己使用PGT-M/SR的经历以及他们对PGT-P的观点,包括他们自己的兴趣和他们对其可取性的想法,范围和后果。采用归纳内容分析对访谈进行分析。
    结果:参与者表示,他们使用PGT-M/SR的经历是身体上的,心理上和实际上都很困难。大多数与会者指出,部分是因为这些困难,他们没有看到通过PGT-P了解胚胎风险评分的附加值。许多参与者担心PGT-P可能会导致额外的焦虑,生育和为人父母的责任和复杂选择。他们认为并非所有事情都应该控制,并认为PGT-P,尤其是非医学和广泛的筛查,太过分了.关于PGT-P的临床实施,参与者一般首选PGT-P仅限于有严重多基因家族史的人群,并希望由医疗保健专业人员做出胚胎选择决定.
    结论:这项研究表明,有PGT-M/SR经验的个体看到PGT-P不同于PGT-M/SR。他们对PGT-P有各种道德问题,特别是关于广泛提供PGT-P。关于潜在的PGT-P实施和指南,需要考虑这些利益相关者的观点。
    OBJECTIVE: What are the perspectives of preimplantation genetic testing (PGT) patients in Belgium on the ethics of PGT for polygenic risk scoring (PGT-P)?
    METHODS: In-depth interviews (18 in total, 10 couples, 8 women, n = 28) were performed with patients who had undergone treatment with PGT for monogenic/single-gene defects (PGT-M) or chromosomal structural rearrangements (PGT-SR) between 2017 and 2019 in Belgium. Participants were asked about their own experiences with PGT-M/SR and about their viewpoints on PGT-P, including their own interest and their ideas on its desirability, scope and consequences. Inductive content analysis was used to analyse the interviews.
    RESULTS: Participants stated that their experiences with PGT-M/SR had been physically, psychologically and practically difficult. Most participants stated that, partly because of these difficulties, they did not see the added value of knowing the risk scores of embryos via PGT-P. Many participants worried that PGT-P could lead to additional anxieties, responsibilities and complex choices in reproduction and parenthood. They argued that not everything should be controlled and felt that PGT-P, especially non-medical and broad screening, was going too far. With regards to the clinical implementation of PGT-P, participants in general preferred PGT-P to be limited to people with a serious polygenic family history and wanted embryo selection decisions to be made by healthcare professionals.
    CONCLUSIONS: This study shows that individuals with experience of PGT-M/SR saw PGT-P as different from PGT-M/SR. They had various ethical concerns with regards to PGT-P, especially regarding broadly offering PGT-P. These stakeholder viewpoints need to be considered regarding potential PGT-P implementation and guidelines.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    精神病学遗传学的最新进展使使用多基因风险评分(PRS)来估计精神疾病的遗传风险。然而,PRS在儿童和青少年精神病学中的潜在应用引起了人们的关注.这项研究深入检查了儿童和青少年精神病医生(CAP)对PRS在精神病学中使用的态度。我们对拥有遗传学专业知识的美国CAP(n=29)进行了半结构化访谈。大多数CAP表明PRS在其当前形式中具有有限的临床效用,并且还没有准备好临床实施。大多数临床医生表示,目前没有什么能激励他们产生PRS;然而,注意到一些例外情况(例如,父母/家庭请求)。临床医生谈到了与订购有关的挑战,口译,并向患者和家属解释PRS。CAP对这些信息可能被患者误解或滥用表示担忧,家庭,临床医生,以及保险公司等外部实体。最后,一些CAP指出,PRS可能导致精神疾病的污名化增加,在极端情况下,可以用来支持优生学。随着PRS测试的增加,这将是至关重要的检查CAP和其他利益相关者的意见,以确保负责任地实施这项技术。
    Recent advances in psychiatric genetics have enabled the use of polygenic risk scores (PRS) to estimate genetic risk for psychiatric disorders. However, the potential use of PRS in child and adolescent psychiatry has raised concerns. This study provides an in-depth examination of attitudes among child and adolescent psychiatrists (CAP) regarding the use of PRS in psychiatry. We conducted semi-structured interviews with U.S.-based CAP (n = 29) who possess expertise in genetics. The majority of CAP indicated that PRS have limited clinical utility in their current form and are not ready for clinical implementation. Most clinicians stated that nothing would motivate them to generate PRS at present; however, some exceptions were noted (e.g., parent/family request). Clinicians spoke to challenges related to ordering, interpreting, and explaining PRS to patients and families. CAP raised concerns regarding the potential for this information to be misinterpreted or misused by patients, families, clinicians, and outside entities such as insurance companies. Finally, some CAP noted that PRS may lead to increased stigmatization of psychiatric disorders, and at the extreme, could be used to support eugenics. As PRS testing increases, it will be critical to examine CAP and other stakeholders\' views to ensure responsible implementation of this technology.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    风湿性疾病(RD)的特征是自身免疫和自身炎症,并且由于多种遗传的相互作用而被认为是复杂的,环境,和生活方式因素在其发病机理中的作用。全基因组关联研究(GWAS)的快速发展使得能够鉴定与RD易感性相关的许多单核苷酸多态性(SNP)。基于这些SNP,多基因风险评分(PRS)已成为量化该疾病组遗传风险的有前景的工具.本章回顾了PRS在评估RD风险方面的现状,并讨论了它们通过区分不同RD的能力来提高这些复杂疾病的诊断准确性的潜力。PRS对各种RD表现出很高的辨别能力,并显示出潜在的临床实用性。随着GWAS的不断发展,PRS有望通过整合遗传,实现更精确的风险分层。环境,和生活方式因素,从而完善个人风险预测并推进疾病管理策略。
    Rheumatic diseases (RDs) are characterized by autoimmunity and autoinflammation and are recognized as complex due to the interplay of multiple genetic, environmental, and lifestyle factors in their pathogenesis. The rapid advancement of genome-wide association studies (GWASs) has enabled the identification of numerous single nucleotide polymorphisms (SNPs) associated with RD susceptibility. Based on these SNPs, polygenic risk scores (PRSs) have emerged as promising tools for quantifying genetic risk in this disease group. This chapter reviews the current status of PRSs in assessing the risk of RDs and discusses their potential to improve the accuracy of the diagnosis of these complex diseases through their ability to discriminate among different RDs. PRSs demonstrate a high discriminatory capacity for various RDs and show potential clinical utility. As GWASs continue to evolve, PRSs are expected to enable more precise risk stratification by integrating genetic, environmental, and lifestyle factors, thereby refining individual risk predictions and advancing disease management strategies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:已经报道了代谢状态和代谢变化与心血管结局风险之间的关联。然而,遗传易感性在这些关联背后的作用仍未被探索.我们的目的是检查代谢状态,代谢转变,和遗传易感性共同影响不同体重指数(BMI)类别的心血管结局和全因死亡率.
    方法:在我们对英国生物库的分析中,基线时,我们共纳入481,576名参与者(平均年龄:56.55岁;男性:45.9%).代谢健康(MH)状态定义为存在<3个异常成分(腰部情况、血压,血糖,甘油三酯,和高密度脂蛋白胆固醇)。正常体重,超重,肥胖定义为18.5≤BMI<25kg/m2,25≤BMI<30kg/m2,BMI≥30kg/m2。使用多基因风险评分(PRS)估计遗传易感性。进行Cox回归以评估代谢状态的关联,代谢转变,和PRS与不同BMI类别的心血管结局和全因死亡率。
    结果:在14.38年的中位随访中,31,883(7.3%)全因死亡,8133例(1.8%)心血管疾病(CVD)死亡,记录了67,260例(14.8%)CVD病例。在那些具有高PRS的人中,与代谢不健康的肥胖人群相比,代谢健康超重人群的全因死亡率(风险比[HR]0.70;95%置信区间[CI]0.65,0.76)和CVD死亡率(HR0.57;95%CI0.50,0.64)风险最低。在中度和低度PRS组中,有益的关联似乎更大。代谢健康正常体重的个体患CVD的风险最低(HR0.54;95%CI0.51,0.57)。此外,不同BMI类别的代谢状态和PRS与心血管结局和全因死亡率的负相关在65岁以下的个体中更为显著(P交互作用<0.05).此外,在BMI类别中,观察到代谢转变和PRS对这些结局的综合保护作用.
    结论:MH状态和低PRS与所有BMI类别的不良心血管结局和全因死亡率的较低风险相关。这种保护作用在65岁以下的个体中尤其明显。需要进一步的研究来确认不同人群的这些发现,并调查所涉及的潜在机制。
    BACKGROUND: Associations between metabolic status and metabolic changes with the risk of cardiovascular outcomes have been reported. However, the role of genetic susceptibility underlying these associations remains unexplored. We aimed to examine how metabolic status, metabolic transitions, and genetic susceptibility collectively impact cardiovascular outcomes and all-cause mortality across diverse body mass index (BMI) categories.
    METHODS: In our analysis of the UK Biobank, we included a total of 481,576 participants (mean age: 56.55; male: 45.9%) at baseline. Metabolically healthy (MH) status was defined by the presence of < 3 abnormal components (waist circumstance, blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol). Normal weight, overweight, and obesity were defined as 18.5 ≤ BMI < 25 kg/m2, 25 ≤ BMI < 30 kg/m2, and BMI ≥ 30 kg/m2, respectively. Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations of metabolic status, metabolic transitions, and PRS with cardiovascular outcomes and all-cause mortality across BMI categories.
    RESULTS: During a median follow-up of 14.38 years, 31,883 (7.3%) all-cause deaths, 8133 (1.8%) cardiovascular disease (CVD) deaths, and 67,260 (14.8%) CVD cases were documented. Among those with a high PRS, individuals classified as metabolically healthy overweight had the lowest risk of all-cause mortality (hazard ratios [HR] 0.70; 95% confidence interval [CI] 0.65, 0.76) and CVD mortality (HR 0.57; 95% CI 0.50, 0.64) compared to those who were metabolically unhealthy obesity, with the beneficial associations appearing to be greater in the moderate and low PRS groups. Individuals who were metabolically healthy normal weight had the lowest risk of CVD morbidity (HR 0.54; 95% CI 0.51, 0.57). Furthermore, the inverse associations of metabolic status and PRS with cardiovascular outcomes and all-cause mortality across BMI categories were more pronounced among individuals younger than 65 years (Pinteraction < 0.05). Additionally, the combined protective effects of metabolic transitions and PRS on these outcomes among BMI categories were observed.
    CONCLUSIONS: MH status and a low PRS are associated with a lower risk of adverse cardiovascular outcomes and all-cause mortality across all BMI categories. This protective effect is particularly pronounced in individuals younger than 65 years. Further research is required to confirm these findings in diverse populations and to investigate the underlying mechanisms involved.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号