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Giratallah H, Chenoweth MJ, Pouget JG, El-Boraie A, Alsaafin A, Lerman C, Knight J, Tyndale RF. CYP2A6 associates with respiratory disease risk and younger age of diagnosis: a phenome-wide association Mendelian Randomization study. Hum Mol Genet 2024; 33:198-210. [PMID: 37802914 PMCID: PMC10772040 DOI: 10.1093/hmg/ddad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023] Open
Abstract
CYP2A6, a genetically variable enzyme, inactivates nicotine, activates carcinogens, and metabolizes many pharmaceuticals. Variation in CYP2A6 influences smoking behaviors and tobacco-related disease risk. This phenome-wide association study examined associations between a reconstructed version of our weighted genetic risk score (wGRS) for CYP2A6 activity with diseases in the UK Biobank (N = 395 887). Causal effects of phenotypic CYP2A6 activity (measured as the nicotine metabolite ratio: 3'-hydroxycotinine/cotinine) on the phenome-wide significant (PWS) signals were then estimated in two-sample Mendelian Randomization using the wGRS as the instrument. Time-to-diagnosis age was compared between faster versus slower CYP2A6 metabolizers for the PWS signals in survival analyses. In the total sample, six PWS signals were identified: two lung cancers and four obstructive respiratory diseases PheCodes, where faster CYP2A6 activity was associated with greater disease risk (Ps < 1 × 10-6). A significant CYP2A6-by-smoking status interaction was found (Psinteraction < 0.05); in current smokers, the same six PWS signals were found as identified in the total group, whereas no PWS signals were found in former or never smokers. In the total sample and current smokers, CYP2A6 activity causal estimates on the six PWS signals were significant in Mendelian Randomization (Ps < 5 × 10-5). Additionally, faster CYP2A6 metabolizer status was associated with younger age of disease diagnosis for the six PWS signals (Ps < 5 × 10-4, in current smokers). These findings support a role for faster CYP2A6 activity as a causal risk factor for lung cancers and obstructive respiratory diseases among current smokers, and a younger onset of these diseases. This research utilized the UK Biobank Resource.
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Affiliation(s)
- Haidy Giratallah
- Department of Pharmacology and Toxicology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
| | - Meghan J Chenoweth
- Department of Pharmacology and Toxicology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Jennie G Pouget
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Ahmed El-Boraie
- Department of Pharmacology and Toxicology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
| | - Alaa Alsaafin
- Department of Pharmacology and Toxicology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
| | - Caryn Lerman
- Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Jo Knight
- Department of Psychiatry, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Data Science Institute, Lancaster University Medical School, Lancaster LA1 4YE, United Kingdom
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College St, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
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Kuppusamy P, Prusty RK, Khan SA. Assessing the prevalence and predictors of anemia among pregnant women in India: findings from the India National Family Health Survey 2019-2021. Curr Med Res Opin 2024; 40:51-58. [PMID: 37888841 DOI: 10.1080/03007995.2023.2276851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. METHODS This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019-2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. RESULTS The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27-1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51-1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18-1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75-8.36) than their highly educated counterparts. CONCLUSION Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India.
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Affiliation(s)
- Periyasamy Kuppusamy
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Shagufta A Khan
- Clinical Research Laboratory, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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