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Satny M, Todorovova V, Altschmiedova T, Hubacek JA, Dlouha L, Lanska V, Soska V, Kyselak O, Freiberger T, Bobak M, Vrablik M. Genetic risk score in patients with the APOE2/E2 genotype as a predictor of familial dysbetalipoproteinemia. J Clin Lipidol 2024; 18:e230-e237. [PMID: 38044203 DOI: 10.1016/j.jacl.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Familial dysbetalipoproteinemia (FD) is an autosomal recessive (rarely dominant) inherited disorder that is almost exclusively associated with the apolipoprotein E gene (APOE) variability. Nonetheless, only a small proportion of APOE2/E2 subjects develop the phenotype for mixed dyslipidemia; the context of other trigger metabolic or genetic factors remains unknown. METHODS One hundred and one patients with FD and eighty controls (all APOE2/E2 homozygotes; rs429358) were screened for 18 single-nucleotide polymorphisms (SNPs) within the genes involved in triglyceride metabolism. RESULTS Two SNPs were significantly associated with the FD phenotype (rs439401 within APOE; P < 0.0005 and rs964184 within ZPR1/APOA5/A4/C3/A1 gene cluster; P < 0.0001). Unweighted genetic risk scores - from these two SNPs (GRS2), and, also, additional 13 SNPs with P-value below 0.9 (GRS15) - were created as an additional tool to improve the risk estimation of FD development in subjects with the APOE2/E2 genotype. Both GRS2 and GRS15 were significantly (P < 0.0001) increased in patients and both GRSs discriminated almost identically between the groups (P = 0.86). Subjects with an unweighted GRS2 of three or more had an almost four-fold higher risk of FD development than other individuals (odds ratio (OR) 3.58, 95% confidence interva (CI): 1.78-7.18, P < 0.0005). CONCLUSIONS We identified several SNPs that are individual additive factors influencing FD development. The use of unweighted GRS2 is a simple and clinically relevant tool that further improves the prediction of FD in APOE2/E2 homozygotes with corresponding biochemical characteristics.
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Affiliation(s)
- Martin Satny
- 3rd Department of Internal Medicine, First Faculty of Medicine Charles University, General University Hospital, Prague, Czech Republic (Drs Satny, Todorovova, Altschmiedova, Hubacek and Vrablik).
| | - Veronika Todorovova
- 3rd Department of Internal Medicine, First Faculty of Medicine Charles University, General University Hospital, Prague, Czech Republic (Drs Satny, Todorovova, Altschmiedova, Hubacek and Vrablik)
| | - Tereza Altschmiedova
- 3rd Department of Internal Medicine, First Faculty of Medicine Charles University, General University Hospital, Prague, Czech Republic (Drs Satny, Todorovova, Altschmiedova, Hubacek and Vrablik)
| | - Jaroslav A Hubacek
- 3rd Department of Internal Medicine, First Faculty of Medicine Charles University, General University Hospital, Prague, Czech Republic (Drs Satny, Todorovova, Altschmiedova, Hubacek and Vrablik); Centre of Experimental Medicine, Institute of Clinical and Experimental Medicine, Prague, Czech Republic (Drs Hubacek and Lanska)
| | - Lucie Dlouha
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic (Dr Dlouha)
| | - Vera Lanska
- Centre of Experimental Medicine, Institute of Clinical and Experimental Medicine, Prague, Czech Republic (Drs Hubacek and Lanska)
| | - Vladimir Soska
- Clinical Biochemistry Department, St. Anne University Hospital, Brno, Czech Republic (Drs Soska and Kyselak); 2nd Internal Department, Faculty of Medicine Masaryk University and St. Anne University Hospital, Brno, Czech Republic (Drs Soska and Kyselak)
| | - Ondrej Kyselak
- Clinical Biochemistry Department, St. Anne University Hospital, Brno, Czech Republic (Drs Soska and Kyselak); 2nd Internal Department, Faculty of Medicine Masaryk University and St. Anne University Hospital, Brno, Czech Republic (Drs Soska and Kyselak)
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Brno, and Medical Faculty, Masaryk University, Brno, Czech Republic (Dr Freiberger)
| | - Martin Bobak
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, United Kingdom, and Medical Faculty, Masaryk University, Brno, Czech Republic (Dr Bobak)
| | - Michal Vrablik
- 3rd Department of Internal Medicine, First Faculty of Medicine Charles University, General University Hospital, Prague, Czech Republic (Drs Satny, Todorovova, Altschmiedova, Hubacek and Vrablik)
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Hubacek JA, Dlouha L, Adamkova V, Dlouha D, Pacal L, Kankova K, Galuska D, Lanska V, Veleba J, Pelikanova T. Genetic risk score is associated with T2DM and diabetes complications risks. Gene X 2022; 849:146921. [PMID: 36174902 DOI: 10.1016/j.gene.2022.146921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/09/2022] [Accepted: 09/21/2022] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a prototypical complex disease with polygenic architecture playing an important role in determining susceptibility to develop the disease (and its complications) in subjects exposed to modifiable lifestyle factors. A current challenge is to quantify the degree of the individual's genetic risk using genetic risk scores (GRS) capturing the results of genome-wide association studies while incorporating possible ethnicity- or population-specific differences. METHODS This study included three groups of T2DM (T2DM-I, N=1,032; T2DM-II, N=353; and T2DM-III, N=399) patients and 2,481 diabetes-free subjects. The status of the microvascular and macrovascular diabetes complications were known for the T2DM-I patients. Overall, 21 single nucleotide polymorphisms (SNPs) were analyzed, and selected subsets were used to determine the GRS (both weighted - wGRS and unweighted - uGRS) for T2DM risk predictions (6 SNPs) and for predicting the risks of complications (7 SNPs). RESULTS The strongest T2DM markers (P<0.0001) were within the genes for TCF7L2 (transcription factor 7-like 2), FTO (fat mass and obesity associated protein) and ARAP1 (ankyrin repeat and PH domain 1). The T2DM-I subjects with uGRS values greater (Odds Ratio, 95% Confidence Interval) than six had at least twice (2.00, 1.72-2.32) the risk of T2DM development (P<0.0001), and these results were confirmed in the independent groups (T2DM-II 1.82, 1.45-2.27; T2DM-III 2.63, 2.11-3.27). The wGRS (>0.6) further improved (P<0.000001) the risk estimations for all three T2DM groups. The uGRS was also a significant predictor of neuropathy (P<0.0001), nephropathy (P<0.005) and leg ischemia (P<0.0005). CONCLUSIONS If carefully selected and specified, GRS, both weighted and unweighted, could be significant predictors of T2DM development, as well as the diabetes complications development.
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Affiliation(s)
- Jaroslav A Hubacek
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 3rd Department of Internal Medicine, 1(st) Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Lucie Dlouha
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic
| | - Vera Adamkova
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Czech Technical University of Prague, Faculty of Biomedical Engineering, Prague, Czech Republic
| | - Dana Dlouha
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lukas Pacal
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Katerina Kankova
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - David Galuska
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Vera Lanska
- Statistical Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jiri Veleba
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Terezie Pelikanova
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Todorovova V, Dlouha L, Hubacek JA, Satny M, Adamkova V, Pitha J, Ceska R, Vrablik M. Triglycerides, polymorphisms and the risk of acute coronary syndrome in the Czech population. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by Ministry of Health, Czech Republic - conceptual development of research organization 64165, General University Hospital in Prague, Czech Republic
Background and Aims
Elevated levels of plasma triglycerides (TG) have been identified as a risk factor for the development of cardiovacular disease, including acute coronary syndrome (ACS). Final TG levels are largely influenced by genetic factors. The most important genetic factors influencing TG levels in the Czech population are the polymorphisms in APOA5, GCKR, MAP3K1, CTF1, CYP26A1, LRP1, CILP2, LIPC, APOE, GALNT2 and LPL genes.
Methods
The variants in mentioned genes were analyzed in total 929 patients with ACS and 936 healthy controls (study post-MONICA). Only adult men under the age of 65 were included in the study.
Results
Plasma TG levels did not differ significantly between patients and controls (1.96 ± 1.30 mmol/L vs. 2.06 ± 1.47 mmol/L). CYP26A1 AA homozygotes (rs2068888) were more common (P <0.05; OR; 95% CI = 1.34; 1.03-1.74) among patients. The differences in the frequencies of the other variants were not statistically significant, however, with the exception of GCKR, LRP1, MAP3K1, GALNT2 and LPL variants, they were used to calculate the risk genetic score due to the higher OR value (above 1.15). Subjects with a score of 8 or more vs less than 3 occurred more frequently among patients with ACS than among controls (60% vs. 30%, P = 0.005; OR; 95% CI – 2.03; 1.24 – 3.31).
Conclusions
Genetic score calculated from six selected variants associated with plasma TG levels is a significant predictor of ACS in Czech Caucasian males.
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Affiliation(s)
| | - L Dlouha
- Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - JA Hubacek
- Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - M Satny
- General University Hospital, Prague, Czechia
| | - V Adamkova
- Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - J Pitha
- Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - R Ceska
- General University Hospital, Prague, Czechia
| | - M Vrablik
- General University Hospital, Prague, Czechia
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Dlouha L, Pelikanova T, Veleba J, Adamkova V, Lanska V, Sosna T, Pacal L, Kankova K, Hubacek JA. The APOE4 allele is associated with a decreased risk of retinopathy in type 2 diabetics. Mol Biol Rep 2021; 48:5873-5879. [PMID: 34328600 DOI: 10.1007/s11033-021-06581-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Common polymorphisms within the apolipoprotein E (APOE) gene are suggested to be associated with the development of type 2 diabetes mellitus (T2DM), but the potential association with T2DM complications (nephropathy, neuropathy and retinopathy) remains unclear. We perform the case-control study to analyse the association between the APOE polymorphism and risk of T2DM and to analysed the potential relationship between the APOE and T2DM complications. METHODS AND RESULTS APOE variants (rs429358 and rs7412) were genotyped by TaqMan assay in T2DM patients (N = 1274; N = 829 with complications including retinopathy, neuropathy and nephropathy status) and with PCR-RFLP in healthy nondiabetic controls (N = 2055). The comparison of subjects with genotypes associated with low plasma cholesterol (APOE2/E2 and APOE2/E3 carriers vs. others) did not show an association with T2DM (OR [95% CI] = 0.88 [0.71-1.08). The differences remained insignificant after adjusting for diabetes duration, sex and BMI. Carriers of at least one APOE4 allele (rs429358) are protected against T2DM related retinopathy (OR [95% CI] = 0.65 [0.42-0.99]. Protection against retinopathy is driven mostly by females (OR [95% CI] = 0.50 [0.25-0.99]); and remains significant (P = 0.044) after adjustment for diabetes duration and BMI. CONCLUSION Common APOE polymorphism was not associated with T2DM in the Czech population. Yet, APOE4 allele revealed an association with retinopathy. In particular, female T2DM patients with at least one APOE4 allele exhibit lower prevalence of retinopathy in our study subjects.
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Affiliation(s)
- Lucie Dlouha
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Vinicka 7, 12808, Prague, Czech Republic
| | - Terezie Pelikanova
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
| | - Jiří Veleba
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
| | - Vera Adamkova
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
| | - Vera Lanska
- Statistical Unit, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
| | - Tomas Sosna
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic
| | - Lukas Pacal
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 62500, Brno, Czech Republic
| | - Katerina Kankova
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 753/5, 62500, Brno, Czech Republic
| | - Jaroslav A Hubacek
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, 14021, Czech Republic.
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, U Nemocnice 1, 12808, Prague, Czech Republic.
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Hubacek JA, Dlouha L, Dusek L, Majek O, Adamkova V. Apolipoprotein E4 Allele in Subjects with COVID-19. Gerontology 2021; 67:320-322. [PMID: 33965962 PMCID: PMC8247822 DOI: 10.1159/000516200] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/26/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Jaroslav Alois Hubacek
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia.,Third Department of Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Lucie Dlouha
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia.,Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czechia
| | - Ladislav Dusek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ondrej Majek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Vera Adamkova
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czechia.,Department of Nephrology, First Faculty of Medicine, Charles University, Prague, Czechia
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