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Hou J, Deng Q, Guo X, Deng X, Zhong W, Zhong Z. Association between apolipoprotein E gene polymorphism and the risk of coronary artery disease in Hakka postmenopausal women in southern China. Lipids Health Dis 2020; 19:139. [PMID: 32546237 PMCID: PMC7298959 DOI: 10.1186/s12944-020-01323-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 06/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background Apolipoprotein E (APOE) is involved in the pathogenesis of atherosclerosis and conveys a higher risk of coronary artery disease (CAD). The aim of the present study was to investigate the possible association between APOE gene polymorphism and the risk of CAD in postmenopausal Hakka women in southern China. Methods The APOE genotypes of 653 CAD patients and 646 control participants were determined by the polymerase chain reaction (PCR) and hybridization to a Sinochip. Results The prevalence of each APOE genotype differed between CAD patients and control participants (P = 0.011). The E3/E3 genotype was the most common and the E2/E2 genotype was the least common in the study sample. Moreover, the presence of ε4 allele was associated with higher serum concentrations of triglycerides (TG), total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C), and lower concentration of high-density lipoprotein-cholesterol (HDL-C). Multiple logistic regression analysis revealed that participants with ε4 allele have a significantly higher risk of CAD after adjustment for the presence of diabetes mellitus and hypertension, and their serum uric acid, TC, and LDL-C concentrations (adjusted odds ratio (OR) 1.50, 95% confidence interval (CI) 1.10–2.05, P = 0.010). Conclusions The present results suggest that APOE polymorphism is associated with a higher risk of CAD in postmenopausal Hakka women in southern China.
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Affiliation(s)
- Jingyuan Hou
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Qiaoting Deng
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Xuemin Guo
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Xunwei Deng
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Wei Zhong
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China.,Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, No. 63 Huangtang Road, Meijiang District, Meizhou, 514031, People's Republic of China
| | - Zhixiong Zhong
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China. .,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China. .,Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, No. 63 Huangtang Road, Meijiang District, Meizhou, 514031, People's Republic of China.
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2
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Said MA, van de Vegte YJ, Zafar MM, van der Ende MY, Raja GK, Verweij N, van der Harst P. Contributions of Interactions Between Lifestyle and Genetics on Coronary Artery Disease Risk. Curr Cardiol Rep 2019; 21:89. [PMID: 31352625 PMCID: PMC6661028 DOI: 10.1007/s11886-019-1177-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF THE REVIEW To summarize current knowledge on interactions between genetic variants and lifestyle factors (G×L) associated with the development of coronary artery disease (CAD) and prioritize future research. RECENT FINDINGS Genetic risk and combined lifestyle factors and behaviors have a log-additive effect on the risk of developing CAD. First, we describe genetic and lifestyle factors associated with CAD and then focus on G×L interactions. The majority of G×L interaction studies are small-scale candidate gene studies that lack replication and therefore provide spurious results. Only a few studies, of which most use genetic risk scores or genome-wide approaches to test interactions, are robust in number and analysis strategy. These studies provide evidence for the existence of G×L interactions in the development of CAD. Further G×L interactions studies are important as they contribute to our understanding of disease pathophysiology and possibly provide insights for improving interventions or personalized recommendations.
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Affiliation(s)
- M. Abdullah Said
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Yordi J. van de Vegte
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Muhammad Mobeen Zafar
- PMAS University of Arid Agriculture Rawalpindi, University Institute of Biochemistry and Biotechnology, 46000 Murree Road, Rawalpindi, Pakistan
| | - M. Yldau van der Ende
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Ghazala Kaukab Raja
- PMAS University of Arid Agriculture Rawalpindi, University Institute of Biochemistry and Biotechnology, 46000 Murree Road, Rawalpindi, Pakistan
| | - N. Verweij
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
- Genomics plc, Oxford, OX1 1JD UK
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
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3
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Larifla L, Armand C, Bangou J, Blanchet-Deverly A, Numeric P, Fonteau C, Michel CT, Ferdinand S, Bourrhis V, Vélayoudom-Céphise FL. Association of APOE gene polymorphism with lipid profile and coronary artery disease in Afro-Caribbeans. PLoS One 2017; 12:e0181620. [PMID: 28727855 PMCID: PMC5519172 DOI: 10.1371/journal.pone.0181620] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/04/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Apolipoprotein E gene (APOE) polymorphism is associated with the lipid profile and cardio-vascular disease. However, these relationships vary between ethnic groups. We evaluated, for the first time in an Afro-Caribbean population, the distribution of APOE polymorphisms and their associations with coronary artery disease (CAD), the lipid profile and other cardio-metabolic risk factors. METHODS We studied 712 Afro-Caribbean subjects including 220 with documented CAD and 492 healthy subjects. TaqMan assays were performed to genotype rs7412 and rs429358, the two variants that determine the APOE alleles ε2, ε3 and ε4. The association between APOE genotype and the lipid profile was analysed by comparing ε2 carriers, ε3 homozygotes and ε4 carriers. RESULTS The frequencies of ε2, ε3 and ε4 in the overall sample were 8%, 70% and 22%, respectively. CAD was not associated with APOE polymorphism. The total cholesterol level was higher in ε4 carriers compared with ε2 carriers: 5.07 vs 4.59 mmol/L (P = 0.016). The LDL-cholesterol level was lower in APOE ε2 carriers compared with ε3 homozygotes and ε4 carriers: 2.65 vs 3.03 and 3.17 mmol/L, respectively (p = 0.002). The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were similar in the three allelic groups. APOE polymorphism was not associated with diabetes, hypertension, waist circumference or body mass index. CONCLUSIONS Our results indicate that APOE gene polymorphism is associated with the lipid profile but not with CAD in Afro-Caribbean people. This lack of association with CAD may be explained by the low atherogenic profile observed in ε4 carriers, which may warrant further investigation.
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Affiliation(s)
- Laurent Larifla
- Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University of Antilles, Pointe-à-Pitre, France
- Department of Cardiology, University Hospital of Guadeloupe, Pointe-à-Pitre, France
- * E-mail: ,
| | - Christophe Armand
- Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University of Antilles, Pointe-à-Pitre, France
- Department of Medical Information and Public Health, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Jacqueline Bangou
- Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University of Antilles, Pointe-à-Pitre, France
- Biochemistry Unit, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Anne Blanchet-Deverly
- Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University of Antilles, Pointe-à-Pitre, France
| | - Patrick Numeric
- Department of Internal Medicine Unit, University Hospital of Martinique, Fort-de France, France
| | - Christiane Fonteau
- Biochemistry Unit, University Hospital of Martinique, Fort-de France, France
| | - Carl-Thony Michel
- Department of Cardiology, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Séverine Ferdinand
- Department of Medical Information and Public Health, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Véronique Bourrhis
- Department of Medicine, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Fritz-Line Vélayoudom-Céphise
- Research Group Clinical Epidemiology and Medicine, ECM/L.A.M.I.A EA 4540, University of Antilles, Pointe-à-Pitre, France
- Department of Endocrinology and Diabetology, University Hospital of Guadeloupe, Pointe-à-Pitre, France
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4
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Saleheen D, Zhao W, Young R, Nelson CP, Ho W, Ferguson JF, Rasheed A, Ou K, Nurnberg ST, Bauer RC, Goel A, Do R, Stewart AF, Hartiala J, Zhang W, Thorleifsson G, Strawbridge RJ, Sinisalo J, Kanoni S, Sedaghat S, Marouli E, Kristiansson K, Zhao JH, Scott R, Gauguier D, Shah SH, Smith AV, van Zuydam N, Cox AJ, Willenborg C, Kessler T, Zeng L, Province MA, Ganna A, Lind L, Pedersen NL, White CC, Joensuu A, Kleber ME, Hall AS, März W, Salomaa V, O’Donnell C, Ingelsson E, Feitosa MF, Erdmann J, Bowden DW, Palmer CN, Gudnason V, De Faire U, Zalloua P, Wareham N, Thompson JR, Kuulasmaa K, Dedoussis G, Perola M, Dehghan A, Chambers JC, Kooner J, Allayee H, Deloukas P, McPherson R, Stefansson K, Schunkert H, Kathiresan S, Farrall M, Frossard PM, Rader DJ, Samani NJ, Reilly MP. Loss of Cardioprotective Effects at the ADAMTS7 Locus as a Result of Gene-Smoking Interactions. Circulation 2017; 135:2336-2353. [PMID: 28461624 PMCID: PMC5612779 DOI: 10.1161/circulationaha.116.022069] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/21/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Common diseases such as coronary heart disease (CHD) are complex in etiology. The interaction of genetic susceptibility with lifestyle factors may play a prominent role. However, gene-lifestyle interactions for CHD have been difficult to identify. Here, we investigate interaction of smoking behavior, a potent lifestyle factor, with genotypes that have been shown to associate with CHD risk. METHODS We analyzed data on 60 919 CHD cases and 80 243 controls from 29 studies for gene-smoking interactions for genetic variants at 45 loci previously reported to be associated with CHD risk. We also studied 5 loci associated with smoking behavior. Study-specific gene-smoking interaction effects were calculated and pooled using fixed-effects meta-analyses. Interaction analyses were declared to be significant at a P value of <1.0×10-3 (Bonferroni correction for 50 tests). RESULTS We identified novel gene-smoking interaction for a variant upstream of the ADAMTS7 gene. Every T allele of rs7178051 was associated with lower CHD risk by 12% in never-smokers (P=1.3×10-16) in comparison with 5% in ever-smokers (P=2.5×10-4), translating to a 60% loss of CHD protection conferred by this allelic variation in people who smoked tobacco (interaction P value=8.7×10-5). The protective T allele at rs7178051 was also associated with reduced ADAMTS7 expression in human aortic endothelial cells and lymphoblastoid cell lines. Exposure of human coronary artery smooth muscle cells to cigarette smoke extract led to induction of ADAMTS7. CONCLUSIONS: Allelic variation at rs7178051 that associates with reduced ADAMTS7 expression confers stronger CHD protection in never-smokers than in ever-smokers. Increased vascular ADAMTS7 expression may contribute to the loss of CHD protection in smokers.
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Affiliation(s)
- Danish Saleheen
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
- Center for Non-Communicable Diseases, Karachi, Pakistan
| | - Wei Zhao
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
| | - Robin Young
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Christopher P. Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - WeangKee Ho
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Jane F. Ferguson
- Cardiology Division, Department of Medicine, Vanderbilt University, Nashville, TN
| | - Asif Rasheed
- Center for Non-Communicable Diseases, Karachi, Pakistan
| | - Kristy Ou
- Cardiology Division, Department of Medicine, Vanderbilt University, Nashville, TN
| | - Sylvia T. Nurnberg
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Robert C. Bauer
- Cardiology Division, Department of Medicine and the Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, NY
| | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine & Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Ron Do
- The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexandre F.R. Stewart
- Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jaana Hartiala
- Institute for Genetic Medicine and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Cardiology, Ealing Hospital NHS Trust, Middlesex, United Kingdom
| | - Gudmar Thorleifsson
- deCODE Genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
- University of Iceland, School of Medicine, Reykjavik, Iceland
| | - Rona J Strawbridge
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | | | - Stavroula Kanoni
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sanaz Sedaghat
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eirini Marouli
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Department of Dietetics-Nutrition, Harokopio University, 70 El. VenizelouStr, Athens, Greece
| | | | - Jing Hua Zhao
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Robert Scott
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | | | - Svati H. Shah
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Natalie van Zuydam
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Amanda J. Cox
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christina Willenborg
- Institut für Integrative und Experimentelle Genomik, Universität zu Lübeck, Lübeck, Germany
- DZHK (German Research Center for Cardiovascular Research) partner site Hamburg–Lübeck–Kiel, Lübeck, Germany
| | - Thorsten Kessler
- Deutsches Herzzentrum München, Technische Universität München, München, Germany
- Klinikum rechts der Isar, München, Germany
| | - Lingyao Zeng
- Deutsches Herzzentrum München, Technische Universität München, München, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, München, Germany
| | - Michael A. Province
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Andrea Ganna
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Charles C. White
- Department of Biostatistics Boston University School of Public Health Framingham Heart Study, Boston, MA
| | - Anni Joensuu
- National Institute for Health and Welfare, Helsinki, Finland
- University of Helsinki, Institute for Molecular Medicine, Finland (FIMM)
| | - Marcus Edi Kleber
- Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Alistair S. Hall
- Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom
| | - Winfried März
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany and Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Christopher O’Donnell
- National Heart, Lung, and Blood Institute and the Framingham Heart Study, National Institutes of Health, Bethesda, MD
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA
| | - Mary F. Feitosa
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Jeanette Erdmann
- Institut für Integrative und Experimentelle Genomik, Universität zu Lübeck, Lübeck, Germany
- DZHK (German Research Center for Cardiovascular Research) partner site Hamburg–Lübeck–Kiel, Lübeck, Germany
| | - Donald W. Bowden
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Colin N.A. Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ulf De Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pierre Zalloua
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Nicholas Wareham
- INSERM, UMRS1138, Centre de Recherche des Cordeliers, Paris, France
| | - John R. Thompson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Kari Kuulasmaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - George Dedoussis
- Department of Dietetics-Nutrition, Harokopio University, 70 El. VenizelouStr, Athens, Greece
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland
- University of Helsinki, Institute for Molecular Medicine, Finland (FIMM)
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Cardiology, Ealing Hospital NHS Trust, Middlesex, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Jaspal Kooner
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- Cardiovascular Science, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Hooman Allayee
- Institute for Genetic Medicine and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Panos Deloukas
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ruth McPherson
- Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kari Stefansson
- deCODE Genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
- University of Iceland, School of Medicine, Reykjavik, Iceland
| | - Heribert Schunkert
- Deutsches Herzzentrum München, Technische Universität München, München, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, München, Germany
| | - Sekar Kathiresan
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine & Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - EPIC-CVD
- Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | | | - Daniel J. Rader
- Department of Genetics, University of Pennsylvania, Philadelphia, PA
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Nilesh J. Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - PROMIS
- Center for Non-Communicable Diseases, Karachi, Pakistan
| | | | - Muredach P. Reilly
- Cardiology Division, Department of Medicine and the Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, NY
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5
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Zhao Z, Liu X, Xing X, Lu Y, Sun Y, Ou X, Su X, Jiang J, Yang Y, Chen J, Shen B, He Y. The Activation Effects of Low Level Isopropyl Alcohol Exposure on Arterial Blood Pressures Are Associated with Decreased 5-Hydroxyindole Acetic Acid in Urine. PLoS One 2016; 11:e0162762. [PMID: 27622502 PMCID: PMC5021351 DOI: 10.1371/journal.pone.0162762] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/29/2016] [Indexed: 12/16/2022] Open
Abstract
Purposes The objectives of this paper are to study the impact of low level isopropyl alcohol exposure on blood pressure and to explore its potential mechanism. Methods This cross-sectional study was based on a prospective occupational cohort in south China, which focusing on occupational risk factors related cardiovascular health problems. A total of 283 participants (200 low isopropyl alcohol exposed workers and 83 controls) was finally enrolled in this study. Linear regression models were used to analyze the relationship between arterial blood pressures and low level isopropyl alcohol exposure. We used mediation method to explore possible mediated roles of neurogenic factors. Results Systolic blood pressure (SBP, 123±10 vs. 118±11), diastolic blood pressure (DBP, 79±7 vs. 74±7) and mean blood pressure (MBP, 93±8 vs. 89±9) were different between the exposed group and the control group (p < 0.01). After adjusting for covariates, the difference was still significant. Besides, isopropyl alcohol and smoking had an interactive effect on DBP and MBP (p < 0.05). Furthermore, we observed a mediated effect of 5-hydroxyindole acetic acid (5-HIAA) on isopropyl alcohol exposure induced arterial blood pressure increase, which accounted for about 25%. Conclusions Our results suggest that low level isopropyl alcohol exposure is a potential risk factor for the increased arterial blood pressure and 5-HIAA partly mediates the association between low level isopropyl alcohol exposure and arterial blood pressures.
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Affiliation(s)
- Zhiqiang Zhao
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xinxia Liu
- Prevention and Control Center for Occupational Diseases, Zhongshan Center for Disease Control and Prevention, Zhongshan, Guangdong, China
| | - Xiumei Xing
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yao Lu
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Sun
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyan Ou
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolin Su
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jun Jiang
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yarui Yang
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jingli Chen
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Biling Shen
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yun He
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail:
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6
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LDLR , ApoB and ApoE genes polymorphisms and classical risk factors in premature coronary artery disease. Gene 2016; 590:263-9. [DOI: 10.1016/j.gene.2016.05.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/18/2016] [Accepted: 05/21/2016] [Indexed: 12/13/2022]
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7
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Iacono D, Zandi P, Gross M, Markesbery WR, Pletnikova O, Rudow G, Troncoso JC. APOε2 and education in cognitively normal older subjects with high levels of AD pathology at autopsy: findings from the Nun Study. Oncotarget 2016; 6:14082-91. [PMID: 26101858 PMCID: PMC4546453 DOI: 10.18632/oncotarget.4118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/30/2015] [Indexed: 11/25/2022] Open
Abstract
Asymptomatic Alzheimer's disease (ASYMAD) subjects are individuals characterized by preserved cognition before death despite substantial AD pathology at autopsy. ASYMAD subjects show comparable levels of AD pathology, i.e. β-amyloid neuritic plaques (Aβ-NP) and tau-neurofibrillary tangles (NFT), to those observed in mild cognitive impairment (MCI) and some definite AD cases. Previous clinicopathologic studies on ASYMAD subjects have shown specific phenomena of hypertrophy in the cell bodies, nuclei, and nucleoli of hippocampal pyramidal neurons and other cerebral areas. Since it is well established that the allele APOε4 is a major genetic risk factor for AD, we examined whether specific alleles of APOE could be associated with the different clinical outcomes between ASYMAD and MCI subjects despite equivalent AD pathology. A total of 523 brains from the Nun Study were screened for this investigation. The results showed higher APOε2 frequency (p < 0.001) in ASYMAD (19.2%) vs. MCI (0%) and vs. AD (4.7%). Furthermore, higher education in ASYMAD vs. MCI and AD (p < 0.05) was found. These novel autopsy-verified findings support the hypothesis of the beneficial effect of APOε2 and education, both which seem to act as contributing factors in delaying or forestalling the clinical manifestations of AD despite consistent levels of AD pathology.
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Affiliation(s)
- Diego Iacono
- Neuropathology Division, Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.,Neuropathology Research, Biomedical Research Institute of New Jersey, Cedar Knolls, NJ, USA.,Atlantic Neuroscience Institute, Overlook Medical Center, Summit, NJ, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Zandi
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - Myron Gross
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - William R Markesbery
- Department of Pathology, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA.,Department of Neurology, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA.,Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Olga Pletnikova
- Neuropathology Division, Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Gay Rudow
- Neuropathology Division, Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Juan C Troncoso
- Neuropathology Division, Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
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8
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Koopal C, Geerlings MI, Muller M, de Borst GJ, Algra A, van der Graaf Y, Visseren FLJ. The relation between apolipoprotein E (APOE) genotype and peripheral artery disease in patients at high risk for cardiovascular disease. Atherosclerosis 2016; 246:187-92. [PMID: 26800308 DOI: 10.1016/j.atherosclerosis.2016.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/23/2015] [Accepted: 01/08/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The apolipoprotein E gene (APOE) is associated with coronary heart disease and stroke, but the relation with peripheral artery disease (PAD) is unknown. We investigated the relation of APOE genotype with PAD and other types of vascular disease. METHODS The cross-sectional association between APOE genotype and ankle-brachial index (ABI) and vascular disease prevalence; and the prospective relation with incident PAD and other types of vascular disease (coronary artery disease, stroke and vascular mortality) were evaluated in 7418 patients from the Secondary Manifestations of ARTerial disease (SMART) study. This is a prospective cohort study in patients with cardiovascular disease or a cardiovascular risk factor. Analyses were adjusted for age and sex. RESULTS Mean age was 56.7 ± 12.4 years and 68% of the patients was male. APOE genotype frequencies were ε2ε2 1.3%; ε2ε3 9.9%; ε2ε4 2.4%; ε3ε3 56.9%; ε3ε4 26.7% and ε4ε4 2.8%. Median follow-up time was 8.1 years (IQR 5.4-11.4) in which 452 new PAD events occurred. The ε2ε2 genotype was significantly associated with a lower ABI (regression coefficient -0.04, 95%CI -0.07 to -0.01), increased PAD prevalence (prevalence ratio 1.54, 95%CI 1.01-2.17) and a higher risk of incident PAD (HR 2.31, 95%CI 1.29-4.12) compared with ε3ε3. No relations between APOE genotypes and other vascular disease were observed. CONCLUSION Of the six APOE genotypes, the ε2ε2 variant is associated with an increased risk for PAD in patients at high risk for cardiovascular disease. No association was observed between APOE genotype and coronary artery disease, stroke or vascular mortality in this population.
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Affiliation(s)
- Charlotte Koopal
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Majon Muller
- Department of Geriatrics, University Medical Center, Leiden, The Netherlands
| | - G J de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ale Algra
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
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9
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Weuve J, Proust-Lima C, Power MC, Gross AL, Hofer SM, Thiébaut R, Chêne G, Glymour MM, Dufouil C. Guidelines for reporting methodological challenges and evaluating potential bias in dementia research. Alzheimers Dement 2015; 11:1098-109. [PMID: 26397878 PMCID: PMC4655106 DOI: 10.1016/j.jalz.2015.06.1885] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 06/05/2015] [Accepted: 06/17/2015] [Indexed: 01/26/2023]
Abstract
Clinical and population research on dementia and related neurologic conditions, including Alzheimer's disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on "best practices." We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research.
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Affiliation(s)
- Jennifer Weuve
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - Cécile Proust-Lima
- INSERM U897, Epidemiology and Biostatistics Center, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France
| | - Melinda C Power
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA; Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Scott M Hofer
- Department of Psychology and Centre on Aging, University of Victoria, Victoria, BC, Canada
| | - Rodolphe Thiébaut
- INSERM U897, Epidemiology and Biostatistics Center, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France; Clinical Investigation Center-Clinical Epidemiology-CIC-1401 of INSERM U897, Bordeaux, France; Bordeaux University Hospital (Public Health Department), Bordeaux, France
| | - Geneviève Chêne
- INSERM U897, Epidemiology and Biostatistics Center, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France; Clinical Investigation Center-Clinical Epidemiology-CIC-1401 of INSERM U897, Bordeaux, France; Bordeaux University Hospital (Public Health Department), Bordeaux, France
| | - M Maria Glymour
- Department of Social and Behavioral Sciences, Harvard School of Public Heath, Boston, MA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Carole Dufouil
- INSERM U897, Epidemiology and Biostatistics Center, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France; Clinical Investigation Center-Clinical Epidemiology-CIC-1401 of INSERM U897, Bordeaux, France; Bordeaux University Hospital (Public Health Department), Bordeaux, France.
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10
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Corella D, Ordovás JM. Aging and cardiovascular diseases: the role of gene-diet interactions. Ageing Res Rev 2014; 18:53-73. [PMID: 25159268 DOI: 10.1016/j.arr.2014.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/15/2014] [Accepted: 08/18/2014] [Indexed: 12/21/2022]
Abstract
In the study of longevity, increasing importance is being placed on the concept of healthy aging rather than considering the total number of years lived. Although the concept of healthy lifespan needs to be defined better, we know that cardiovascular diseases (CVDs) are the main age-related diseases. Thus, controlling risk factors will contribute to reducing their incidence, leading to healthy lifespan. CVDs are complex diseases influenced by numerous genetic and environmental factors. Numerous gene variants that are associated with a greater or lesser risk of the different types of CVD and of intermediate phenotypes (i.e., hypercholesterolemia, hypertension, diabetes) have been successfully identified. However, despite the close link between aging and CVD, studies analyzing the genes related to human longevity have not obtained consistent results and there has been little coincidence in the genes identified in both fields. The APOE gene stands out as an exception, given that it has been identified as being relevant in CVD and longevity. This review analyzes the genomic and epigenomic factors that may contribute to this, ranging from identifying longevity genes in model organisms to the importance of gene-diet interactions (outstanding among which is the case of the TCF7L2 gene).
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Holmes MV, Frikke-Schmidt R, Melis D, Luben R, Asselbergs FW, Boer JMA, Cooper J, Palmen J, Horvat P, Engmann J, Li KW, Onland-Moret NC, Hofker MH, Kumari M, Keating BJ, Hubacek JA, Adamkova V, Kubinova R, Bobak M, Khaw KT, Nordestgaard BG, Wareham N, Humphries SE, Langenberg C, Tybjaerg-Hansen A, Talmud PJ. A systematic review and meta-analysis of 130,000 individuals shows smoking does not modify the association of APOE genotype on risk of coronary heart disease. Atherosclerosis 2014; 237:5-12. [PMID: 25173947 PMCID: PMC4232362 DOI: 10.1016/j.atherosclerosis.2014.07.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 11/24/2022]
Abstract
Background Conflicting evidence exists on whether smoking acts as an effect modifier of the association between APOE genotype and risk of coronary heart disease (CHD). Methods and results We searched PubMed and EMBASE to June 11, 2013 for published studies reporting APOE genotype, smoking status and CHD events and added unpublished data from population cohorts. We tested for presence of effect modification by smoking status in the relationship between APOE genotype and risk of CHD using likelihood ratio test. In total 13 studies (including unpublished data from eight cohorts) with 10,134 CHD events in 130,004 individuals of European descent were identified. The odds ratio (OR) for CHD risk from APOE genotype (ε4 carriers versus non-carriers) was 1.06 (95% confidence interval (CI): 1.01, 1.12) and for smoking (present vs. past/never smokers) was OR 2.05 (95%CI: 1.95, 2.14). When the association between APOE genotype and CHD was stratified by smoking status, compared to non-ε4 carriers, ε4 carriers had an OR of 1.11 (95%CI: 1.02, 1.21) in 28,789 present smokers and an OR of 1.04 (95%CI 0.98, 1.10) in 101,215 previous/never smokers, with no evidence of effect modification (P-value for heterogeneity = 0.19). Analysis of pack years in individual participant data of >60,000 with adjustment for cardiovascular traits also failed to identify evidence of effect modification. Conclusions In the largest analysis to date, we identified no evidence for effect modification by smoking status in the association between APOE genotype and risk of CHD. We examined evidence for an interaction between APOE genotype, smoking and risk of coronary heart disease. This was conducted in the largest meta-analysis of published and unpublished data sets to date (>130,000 individuals). Our analysis did not identify evidence of interaction. These findings bring into question presence of a clinically meaningful interaction between APOE genotype and smoking.
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Affiliation(s)
- Michael V Holmes
- Department of Surgery, Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Epidemiology & Public Health, University College London, London, UK.
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Daniela Melis
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - Robert Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center, Utrecht, The Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands; Institute of Cardiovascular Science, faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Jackie Cooper
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - Jutta Palmen
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - Pia Horvat
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Jorgen Engmann
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Ka-Wah Li
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Marten H Hofker
- Department of Pediatrics, Molecular Genetics, University Medical Center Groningen and Groningen University, Groningen, The Netherlands
| | - Meena Kumari
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Brendan J Keating
- Department of Surgery, Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jaroslav A Hubacek
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague 4, 14021, Czech Republic
| | - Vera Adamkova
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague 4, 14021, Czech Republic
| | - Ruzena Kubinova
- National Institute of Public Health, Srobarova 48, 10042 Prague, Czech Republic
| | - Martin Bobak
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Børge G Nordestgaard
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nick Wareham
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
| | - Claudia Langenberg
- Department of Epidemiology & Public Health, University College London, London, UK; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, UK
| | - Anne Tybjaerg-Hansen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philippa J Talmud
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, UK
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