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Tikka A, Metso J, Jauhiainen M. ANGPTL3 serum concentration and rare genetic variants in Finnish population. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:601-609. [PMID: 28972399 DOI: 10.1080/00365513.2017.1379608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Genetic variants of angiopoietin-like protein 3 (ANGPTL3) are associated with serum triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) concentration in GWASs. ANGPTL3 deficiency causes declined TG, total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (apoB) and apolipoprotein A-I (apoA-I) serum concentration, a phenotype defined as familial combined hypolipidaemia (FHBL2). Our aim is to establish whether ANGPTL3 serum protein concentration correlates with lipoproteins and lipids in hyper- or hypolipidaemic subjects, and whether ANGPTL3 sequence variants are associated with untypical lipid profiles. Additionally, 10 subjects with very low lipoprotein concentrations were sequenced for ANGPTL3 for possible loss-of-function (LOF) variants. Study subjects were selected from Finnish FINRISK and Health 2000 surveys. ANGPTL protein concentrations were measured by ELISA method. As a result, ANGPTL3 serum concentration correlated positively with age, phospholipid transfer protein (PLTP) and cholesteryl ester transfer protein (CETP) activities, but not with any of the lipid or lifestyle attributes. No ANGPTL3 variants were found among sequenced samples. Subjects who carried ANGPTL3 sequence variants rs12563308 (n = 4) and rs199772471 (n = 1) had abnormally high TC and LDL-C concentrations. Whole exome sequencing data of these five subjects were further analyzed for rare and deleterious missense variants in genes associated with cholesterol metabolism. In conclusion, ANGPTL3 serum protein concentration did not predict lipid concentrations, unlike apolipoprotein C-III (apoC-III) which positively correlated with most of the lipid attributes. ANGPTL3 variant screen yielded five carriers with abnormally high TC concentration; the actual genetic causality, however, could not be verified.
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Affiliation(s)
- Anna Tikka
- a Genomics and Biomarkers Unit , National Institute for Health and Welfare , Helsinki , Finland
| | - Jari Metso
- a Genomics and Biomarkers Unit , National Institute for Health and Welfare , Helsinki , Finland.,b Minerva Foundation Institute for Medical Research , Biomedicum 2U , Helsinki , Finland
| | - Matti Jauhiainen
- a Genomics and Biomarkers Unit , National Institute for Health and Welfare , Helsinki , Finland.,b Minerva Foundation Institute for Medical Research , Biomedicum 2U , Helsinki , Finland
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Justesen JM, Andersson EA, Allin KH, Sandholt CH, Jørgensen T, Linneberg A, Jørgensen ME, Hansen T, Pedersen O, Grarup N. Increasing insulin resistance accentuates the effect of triglyceride-associated loci on serum triglycerides during 5 years. J Lipid Res 2016; 57:2193-2199. [PMID: 27777317 PMCID: PMC5321221 DOI: 10.1194/jlr.p068379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/18/2016] [Indexed: 11/20/2022] Open
Abstract
Blood concentrations of triglycerides are influenced by genetic factors as well as a number of environmental factors, including adiposity and glucose homeostasis. The aim was to investigate the association between a serum triglyceride weighted genetic risk score (wGRS) and changes in fasting serum triglyceride level over 5 years and to test whether the effect of the wGRS was modified by 5 year changes of adiposity, insulin resistance, and lifestyle factors. A total of 3,474 nondiabetic individuals from the Danish Inter99 cohort participated in both the baseline and 5 year follow-up physical examinations and had information on the wGRS comprising 39 genetic variants. In a linear regression model adjusted for age, sex, and baseline serum triglyceride, the wGRS was associated with increased serum triglyceride levels over 5 years [per allele effect = 1.3% (1.0-1.6%); P = 1.0 × 10-17]. This triglyceride-increasing effect of the wGRS interacted with changes in insulin resistance (Pinteraction = 1.5 × 10-6). This interaction indicated that the effect of the wGRS was stronger in individuals who became more insulin resistant over 5 years. In conclusion, our findings suggest that increased genetic risk load is associated with a larger increase in fasting serum triglyceride levels in nondiabetic individuals during 5 years of follow-up. This effect of the wGRS is accentuated by increasing insulin resistance.
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Affiliation(s)
- Johanne M Justesen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ehm A Andersson
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Kristine H Allin
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla H Sandholt
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Marit E Jørgensen
- Steno Diabetes Center, Gentofte, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Bittencourt MS, Hulten E, Polonsky TS, Hoffman U, Nasir K, Abbara S, Di Carli M, Blankstein R. European Society of Cardiology-Recommended Coronary Artery Disease Consortium Pretest Probability Scores More Accurately Predict Obstructive Coronary Disease and Cardiovascular Events Than the Diamond and Forrester Score: The Partners Registry. Circulation 2016; 134:201-11. [PMID: 27413052 DOI: 10.1161/circulationaha.116.023396] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/13/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The most appropriate score for evaluating the pretest probability of obstructive coronary artery disease (CAD) is unknown. We sought to compare the Diamond-Forrester (DF) score with the 2 CAD consortium scores recently recommended by the European Society of Cardiology. METHODS We included 2274 consecutive patients (age, 56±13 years; 57% male) without prior CAD referred for coronary computed tomographic angiography. Computed tomographic angiography findings were used to determine the presence or absence of obstructive CAD (≥50% stenosis). We compared the DF score with the 2 CAD consortium scores with respect to their ability to predict obstructive CAD and the potential implications of these scores on the downstream use of testing for CAD, as recommended by current guidelines. RESULTS The DF score did not satisfactorily fit the data and resulted in a significant overestimation of the prevalence of obstructive CAD (P<0.001); the CAD consortium basic score had no significant lack of fitness; and the CAD consortium clinical provided adequate goodness of fit (P=0.39). The DF score had a lower discrimination for obstructive CAD, with an area under the receiver-operating characteristics curve of 0.713 versus 0.752 and 0.791 for the CAD consortium models (P<0.001 for both). Consequently, the use of the DF score was associated with fewer individuals being categorized as requiring no additional testing (8.3%) compared with the CAD consortium models (24.6% and 30.0%; P<0.001). The proportion of individuals with a high pretest probability was 18% with the DF and only 1.1% with the CAD consortium scores (P<0.001) CONCLUSIONS: Among contemporary patients referred for noninvasive testing, the DF risk score overestimates the risk of obstructive CAD. On the other hand, the CAD consortium scores offered improved goodness of fit and discrimination; thus, their use could decrease the need for noninvasive or invasive testing while increasing the yield of such tests.
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Affiliation(s)
- Marcio Sommer Bittencourt
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Edward Hulten
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Tamar S Polonsky
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Udo Hoffman
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Khurram Nasir
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Suhny Abbara
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Marcelo Di Carli
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.)
| | - Ron Blankstein
- From the Center for Clinical and Epidemiological Research, University Hospital and São Paulo State Cancer Institute, University of São Paulo School of Medicine, Sao Paulo, Brazil (M.S.B.); Cardiovascular Imaging Program, Departments of Medicine and Radiology; Brigham and Women's Hospital; Harvard Medical School, Boston, MA (M.S.B., E.H., M.D.C., R.B.); Preventive Medicine Center, Hospital Israelita Albert Einstein, São Paulo, Brazil (M.S.B.); Cardiology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD (E.H.); Department of Medicine, University of Chicago, Chicago, IL (T.S.P.); Cardiac MR PET CT Program, Department of Radiology, Division of Cardiac Imaging, Massachusetts General Hospital; Harvard Medical School, Boston (U.H., S.A.); Baptist Health South Florida, Miami, FL (K.N.); and Department of Radiology, University of Texas Southwestern, Dallas (S.A.).
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