1
|
Verma A, Minnier J, Wan ES, Huffman JE, Gao L, Joseph J, Ho YL, Wu WC, Cho K, Gorman BR, Rajeevan N, Pyarajan S, Garcon H, Meigs JB, Sun YV, Reaven PD, McGeary JE, Suzuki A, Gelernter J, Lynch JA, Petersen JM, Zekavat SM, Natarajan P, Dalal S, Jhala DN, Arjomandi M, Gatsby E, Lynch KE, Bonomo RA, Freiberg M, Pathak GA, Zhou JJ, Donskey CJ, Madduri RK, Wells QS, Huang RDL, Polimanti R, Chang KM, Liao KP, Tsao PS, Wilson PWF, Hung AM, O’Donnell CJ, Gaziano JM, Hauger RL, Iyengar SK, Luoh SW. A MUC5B Gene Polymorphism, rs35705950-T, Confers Protective Effects Against COVID-19 Hospitalization but Not Severe Disease or Mortality. Am J Respir Crit Care Med 2022; 206:1220-1229. [PMID: 35771531 PMCID: PMC9746845 DOI: 10.1164/rccm.202109-2166oc] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Rationale: A common MUC5B gene polymorphism, rs35705950-T, is associated with idiopathic pulmonary fibrosis (IPF), but its role in severe acute respiratory syndrome coronavirus 2 infection and disease severity is unclear. Objectives: To assess whether rs35705950-T confers differential risk for clinical outcomes associated with coronavirus disease (COVID-19) infection among participants in the Million Veteran Program (MVP). Methods: The MUC5B rs35705950-T allele was directly genotyped among MVP participants; clinical events and comorbidities were extracted from the electronic health records. Associations between the incidence or severity of COVID-19 and rs35705950-T were analyzed within each ancestry group in the MVP followed by transancestry meta-analysis. Replication and joint meta-analysis were conducted using summary statistics from the COVID-19 Host Genetics Initiative (HGI). Sensitivity analyses with adjustment for additional covariates (body mass index, Charlson comorbidity index, smoking, asbestosis, rheumatoid arthritis with interstitial lung disease, and IPF) and associations with post-COVID-19 pneumonia were performed in MVP subjects. Measurements and Main Results: The rs35705950-T allele was associated with fewer COVID-19 hospitalizations in transancestry meta-analyses within the MVP (Ncases = 4,325; Ncontrols = 507,640; OR = 0.89 [0.82-0.97]; P = 6.86 × 10-3) and joint meta-analyses with the HGI (Ncases = 13,320; Ncontrols = 1,508,841; OR, 0.90 [0.86-0.95]; P = 8.99 × 10-5). The rs35705950-T allele was not associated with reduced COVID-19 positivity in transancestry meta-analysis within the MVP (Ncases = 19,168/Ncontrols = 492,854; OR, 0.98 [0.95-1.01]; P = 0.06) but was nominally significant (P < 0.05) in the joint meta-analysis with the HGI (Ncases = 44,820; Ncontrols = 1,775,827; OR, 0.97 [0.95-1.00]; P = 0.03). Associations were not observed with severe outcomes or mortality. Among individuals of European ancestry in the MVP, rs35705950-T was associated with fewer post-COVID-19 pneumonia events (OR, 0.82 [0.72-0.93]; P = 0.001). Conclusions: The MUC5B variant rs35705950-T may confer protection in COVID-19 hospitalizations.
Collapse
Affiliation(s)
- Anurag Verma
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania;,Department of Medicine, Perelman School of Medicine, and
| | - Jessica Minnier
- OHSU-PSU School of Public Health and,Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon;,VA Portland Health Care System, Portland, Oregon
| | - Emily S. Wan
- Department of Medicine, Pulmonary, Critical Care, Sleep, and Allergy Section,,Channing Division of Network Medicine and
| | | | - Lina Gao
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon;,VA Portland Health Care System, Portland, Oregon
| | - Jacob Joseph
- Department of Medicine,,Medicine, Cardiovascular, Brigham & Women’s Hospital, Boston, Massachusetts
| | | | - Wen-Chih Wu
- Department of Medicine, Cardiology, Providence VA Healthcare System, Providence, Rhode Island;,Alpert Medical School & School of Public Health, Brown University, Providence, Rhode Island
| | - Kelly Cho
- MAVERIC,,Medicine, Aging, Brigham & Women’s Hospital and
| | | | - Nallakkandi Rajeevan
- Yale Center for Medical Informatics,,Clinical Epidemiology Research Center (CERC)
| | - Saiju Pyarajan
- MAVERIC,,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | | | - Yan V. Sun
- Epidemiology, School of Public Health and,Atlanta VA Healthcare System, Decatur, Georgia
| | - Peter D. Reaven
- Department of Medicine, Phoenix VA Healthcare System, Phoenix, Arizona;,College of Medicine, University of Arizona, Phoenix, Arizona
| | - John E. McGeary
- Department of Psychiatry and Human Behavior, Providence VA Medical Center, Providence, Rhode Island;,Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island
| | - Ayako Suzuki
- Department of Medicine, Gastroenterology, Durham VA Medical Center, Durham, North Carolina;,Department of Medicine, Gastroenterology, Duke University, Durham, North Carolina
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, and,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Julie A. Lynch
- VA Informatics & Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System, Salt Lake City, Utah;,Department of Medicine and
| | - Jeffrey M. Petersen
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania;,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Seyedeh Maryam Zekavat
- Computational Biology & Bioinformatics, Yale University School of Medicine, New Haven, Connecticut;,Program in Medical and Population Genetics, Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Pradeep Natarajan
- Department of Medicine, Harvard Medical School, Boston, Massachusetts;,Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts;,Program in Medical and Population Genetics, Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Sharvari Dalal
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania;,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darshana N. Jhala
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania;,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mehrdad Arjomandi
- Medicine, Pulmonary and Critical Care, San Francisco VA Healthcare System, University of California, San Francisco, San Francisco, California
| | - Elise Gatsby
- VA Informatics & Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System, Salt Lake City, Utah
| | - Kristine E. Lynch
- VA Informatics & Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System, Salt Lake City, Utah;,Internal Medicine, Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - Gita A. Pathak
- Division of Human Genetics, Department of Psychiatry, and,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Jin J. Zhou
- Department of Medicine, University of California, Los Angeles, Los Angeles, California;,Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona
| | | | - Ravi K. Madduri
- Data Science and Learning, Argonne National Laboratory, Lemont, Illinois
| | - Quinn S. Wells
- Department of Medicine,,Department of Biomedical Informatics, and,Department of Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Renato Polimanti
- Division of Human Genetics, Department of Psychiatry, and,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Kyong-Mi Chang
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | | | - Philip S. Tsao
- Precision Medicine, VA Palo Alto Health Care System, Palo Alto, California
| | - Peter W. F. Wilson
- Emory University, Atlanta, Georgia;,Atlanta VA Healthcare System, Decatur, Georgia
| | - Adriana M. Hung
- Department of Veteran’s Affairs, Tennessee Valley Healthcare System, Vanderbilt University Medical Center, Division of Nephrology & Hypertension, Nashville, Tennessee
| | | | | | - Richard L. Hauger
- Center of Excellence for Stress & Mental Health, VA San Diego Healthcare System, San Diego, California; and,Center for Behavioral Genetics of Aging, University of California, San Diego, La Jolla, California
| | - Sudha K. Iyengar
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio;,Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | - Shiuh-Wen Luoh
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon;,VA Portland Health Care System, Portland, Oregon
| | | |
Collapse
|
2
|
Verma A, Huffman JE, Gao L, Minnier J, Wu WC, Cho K, Ho YL, Gorman BR, Pyarajan S, Rajeevan N, Garcon H, Joseph J, McGeary JE, Suzuki A, Reaven PD, Wan ES, Lynch JA, Petersen JM, Meigs JB, Freiberg MS, Gatsby E, Lynch KE, Zekavat SM, Natarajan P, Dalal S, Jhala DN, Arjomandi M, Bonomo RA, Thompson TK, Pathak GA, Zhou JJ, Donskey CJ, Madduri RK, Wells QS, Gelernter J, Huang RDL, Polimanti R, Chang KM, Liao KP, Tsao PS, Sun YV, Wilson PWF, O’Donnell CJ, Hung AM, Gaziano JM, Hauger RL, Iyengar SK, Luoh SW. Association of Kidney Comorbidities and Acute Kidney Failure With Unfavorable Outcomes After COVID-19 in Individuals With the Sickle Cell Trait. JAMA Intern Med 2022; 182:796-804. [PMID: 35759254 PMCID: PMC9237798 DOI: 10.1001/jamainternmed.2022.2141] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Sickle cell trait (SCT), defined as the presence of 1 hemoglobin beta sickle allele (rs334-T) and 1 normal beta allele, is prevalent in millions of people in the US, particularly in individuals of African and Hispanic ancestry. However, the association of SCT with COVID-19 is unclear. Objective To assess the association of SCT with the prepandemic health conditions in participants of the Million Veteran Program (MVP) and to assess the severity and sequelae of COVID-19. Design, Setting, and Participants COVID-19 clinical data include 2729 persons with SCT, of whom 353 had COVID-19, and 129 848 SCT-negative individuals, of whom 13 488 had COVID-19. Associations between SCT and COVID-19 outcomes were examined using firth regression. Analyses were performed by ancestry and adjusted for sex, age, age squared, and ancestral principal components to account for population stratification. Data for the study were collected between March 2020 and February 2021. Exposures The hemoglobin beta S (HbS) allele (rs334-T). Main Outcomes and Measures This study evaluated 4 COVID-19 outcomes derived from the World Health Organization severity scale and phenotypes derived from International Classification of Diseases codes in the electronic health records. Results Of the 132 577 MVP participants with COVID-19 data, mean (SD) age at the index date was 64.8 (13.1) years. Sickle cell trait was present in 7.8% of individuals of African ancestry and associated with a history of chronic kidney disease, diabetic kidney disease, hypertensive kidney disease, pulmonary embolism, and cerebrovascular disease. Among the 4 clinical outcomes of COVID-19, SCT was associated with an increased COVID-19 mortality in individuals of African ancestry (n = 3749; odds ratio, 1.77; 95% CI, 1.13 to 2.77; P = .01). In the 60 days following COVID-19, SCT was associated with an increased incidence of acute kidney failure. A counterfactual mediation framework estimated that on average, 20.7% (95% CI, -3.8% to 56.0%) of the total effect of SCT on COVID-19 fatalities was due to acute kidney failure. Conclusions and Relevance In this genetic association study, SCT was associated with preexisting kidney comorbidities, increased COVID-19 mortality, and kidney morbidity.
Collapse
Affiliation(s)
- Anurag Verma
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Perelman School of Medicine, Department of Medicine, University of Pennsylvania, Philadelphia
| | | | - Lina Gao
- Knight Cancer Institute, Biostatistics Shared Resource, Oregon Health & Science University, Portland
- VA Portland Health Care System, Portland, Oregon
| | - Jessica Minnier
- VA Portland Health Care System, Portland, Oregon
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland
- Knight Cancer Institute, Biostatistics Shared Resource, Oregon Health & Science University, Portland
| | - Wen-Chih Wu
- Department of Medicine, Cardiology, Providence VA Healthcare System, Providence, Rhode Island
- Alpert Medical School & School of Public Health, Brown University, Providence, Rhode Island
| | - Kelly Cho
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts
- Medicine, Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yuk-Lam Ho
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts
| | | | - Saiju Pyarajan
- VA Boston Healthcare System, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Nallakkandi Rajeevan
- Yale Center for Medical Informatics, Yale School of Medicine, New Haven, Connecticut
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven
| | - Helene Garcon
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts
| | - Jacob Joseph
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
- Brigham & Women’s Hospital, Boston, Massachusetts
| | - John E. McGeary
- Department of Psychiatry and Human Behavior, Providence VA Medical Center, Providence, Rhode Island
- Brown University Medical School, Providence, Rhode Island
| | - Ayako Suzuki
- Department of Medicine, Gastroenterology, Durham VA Medical Center, Durham, North Carolina
- Department of Medicine, Gastroenterology, Duke University, Durham, North Carolina
| | - Peter D. Reaven
- Department of Medicine, Phoenix VA Healthcare System, Phoenix, Arizona
- University of Arizona, Phoenix
| | - Emily S. Wan
- Department of Medicine, Pulmonary, Critical Care, Sleep, and Allergy Section, VA Boston Healthcare System, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
| | - Julie A. Lynch
- VA Informatics & Computing Infrastructure, VA Salt Lake City Utah & University of Utah, School of Medicine, Salt Lake City
| | - Jeffrey M. Petersen
- Pathology and Laboratory Medicine, Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - James B. Meigs
- Medicine, General Internal Medicine, Massachusetts General Hospital, Boston
| | | | - Elise Gatsby
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System, Salt Lake City, Utah
| | - Kristine E. Lynch
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Healthcare System, Salt Lake City, Utah
- Internal Medicine, Epidemiology, University of Utah School of Medicine, Salt Lake City
| | - Seyedeh Maryam Zekavat
- Computational Biology & Bioinformatics, Yale School of Medicine, New Haven, Connecticut
- Program in Medical and Population Genetics, Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Pradeep Natarajan
- Program in Medical and Population Genetics, Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Cardiovascular Research Center, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Clinical Data Science Research Group, ORD, Portland VA Medical Center, Portland, Oregon
| | - Sharvari Dalal
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Pathology and Laboratory Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Darshana N. Jhala
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Pathology and Laboratory Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Mehrdad Arjomandi
- Medicine, Pulmonary and Critical Care, San Francisco VA Healthcare System, San Francisco, California
- University of California San Francisco
| | - Robert A. Bonomo
- Cleveland VA Medical Center, Cleveland, Ohio
- Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Gita A. Pathak
- Department of Psychiatry, Division of Human Genetics, Yale School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven
| | - Jin J. Zhou
- Medicine, University of California, Los Angeles
- Epidemiology and Biostatistics, University of Arizona, Phoenix
| | - Curtis J. Donskey
- Infectious Disease Section, Louis Stokes Cleveland VA, Cleveland, Ohio
- Case Western Reserve University, Cleveland, Ohio
| | - Ravi K. Madduri
- Data Science and Learning, Argonne National Laboratory, Lemont, Illinois
| | - Quinn S. Wells
- Departments of Medicine, Biomedical Informatics, and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Joel Gelernter
- VA Connecticut Healthcare System, West Haven
- Psychiatry, Human Genetics, Yale University School of Medicine, West Haven, Connecticut
| | | | - Renato Polimanti
- Departments of Medicine, Biomedical Informatics, and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee
- Psychiatry, Human Genetics, Yale University School of Medicine, West Haven, Connecticut
| | - Kyong-Mi Chang
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Katherine P. Liao
- Medicine, Rheumatology, VA Boston Healthcare System, Boston, Massachusetts
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Medicine & Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Philip S. Tsao
- Precision Medicine, VA Palo Alto Health Care System, Palo Alto, California
| | - Yan V. Sun
- Epidemiology, Emory University School of Public Health, Atlanta, Georgia
- Atlanta VA Health Care System, Decatur, Georgia
| | - Peter W. F. Wilson
- Atlanta VA Health Care System, Decatur, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | | | - Adriana M. Hung
- Vanderbilt University Medical Center, Nashville, Tennessee
- Nashville VA Medical Center, Nashville, Tennessee
| | - J. Michael Gaziano
- VA Boston Health Care System, Boston, Massachusetts
- Medicine, Harvard Medical School, Boston, Massachusetts
| | - Richard L. Hauger
- Center of Excellence for Stress & Mental Health, VA San Diego Healthcare System, San Diego, California
- Center for Behavioral Genetics of Aging, University of California, San Diego, La Jolla
| | - Sudha K. Iyengar
- Departments of Population and Quantitative Health Sciences, Ophthalmology and Visual Sciences and Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | - Shiuh-Wen Luoh
- VA Portland Health Care System, Portland, Oregon
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland
| |
Collapse
|
3
|
Clarke SL, Huang RDL, Hilliard AT, Tcheandjieu C, Lynch J, Damrauer SM, Chang KM, Tsao PS, Assimes TL. Race and Ethnicity Stratification for Polygenic Risk Score Analyses May Mask Disparities in Hispanics. Circulation 2022; 146:265-267. [PMID: 35861770 PMCID: PMC10063323 DOI: 10.1161/circulationaha.122.059162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shoa L Clarke
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Department of Medicine, Division of Cardiovascular Medicine (S.L.C., A.T.H., C.T., P.S.T., T.L.A.), Stanford University School of Medicine, CA
| | - Rose D L Huang
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Center for Population Genomics, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System (R.D.L.H.)
| | - Austin T Hilliard
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Department of Medicine, Division of Cardiovascular Medicine (S.L.C., A.T.H., C.T., P.S.T., T.L.A.), Stanford University School of Medicine, CA
| | - Catherine Tcheandjieu
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Department of Medicine, Division of Cardiovascular Medicine (S.L.C., A.T.H., C.T., P.S.T., T.L.A.), Stanford University School of Medicine, CA
| | - Julie Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, UT (J.L.)
| | - Scott M Damrauer
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (S.M.D., K.-M.C.)
- Departments of Surgery (S.M.D.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kyong-Mi Chang
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (S.M.D., K.-M.C.)
- Medicine (K.-M.C.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Philip S Tsao
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Department of Medicine, Division of Cardiovascular Medicine (S.L.C., A.T.H., C.T., P.S.T., T.L.A.), Stanford University School of Medicine, CA
- Cardiovascular Institute (P.S.T., T.L.A.), Stanford University School of Medicine, CA
| | - Themistocles L Assimes
- VA Palo Alto Health Care System, CA (S.L.C., R.D.L.H., A.T.H., C.T., P.S.T., T.L.A.)
- Department of Medicine, Division of Cardiovascular Medicine (S.L.C., A.T.H., C.T., P.S.T., T.L.A.), Stanford University School of Medicine, CA
- Cardiovascular Institute (P.S.T., T.L.A.), Stanford University School of Medicine, CA
| |
Collapse
|
4
|
Huang RDL, Nguyen XMT, Peloso GM, Trinder M, Posner DC, Aragam KG, Ho YL, Lynch JA, Damrauer SM, Chang KM, Tsao PS, Natarajan P, Assimes T, Gaziano JM, Djousse L, Cho K, Wilson PWF, Huffman JE, O’Donnell CJ. Genome-wide and phenome-wide analysis of ideal cardiovascular health in the VA Million Veteran Program. PLoS One 2022; 17:e0267900. [PMID: 35613103 PMCID: PMC9132265 DOI: 10.1371/journal.pone.0267900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Genetic studies may help identify causal pathways; therefore, we sought to identify genetic determinants of ideal CVH and their association with CVD outcomes in the multi-population Veteran Administration Million Veteran Program. METHODS An ideal health score (IHS) was calculated from 3 clinical factors (blood pressure, total cholesterol, and blood glucose levels) and 3 behavioral factors (smoking status, physical activity, and BMI), ascertained at baseline. Multi-population genome-wide association study (GWAS) was performed on IHS and binary ideal health using linear and logistic regression, respectively. Using the genome-wide significant SNPs from the IHS GWAS, we created a weighted IHS polygenic risk score (PRSIHS) which was used (i) to conduct a phenome-wide association study (PheWAS) of associations between PRSIHS and ICD-9 phenotypes and (ii) to further test for associations with mortality and selected CVD outcomes using logistic and Cox regression and, as an instrumental variable, in Mendelian Randomization. RESULTS The discovery and replication cohorts consisted of 142,404 (119,129 European American (EUR); 16,495 African American (AFR)), and 45,766 (37,646 EUR; 5,366 AFR) participants, respectively. The mean age was 65.8 years (SD = 11.2) and 92.7% were male. Overall, 4.2% exhibited ideal CVH based on the clinical and behavioral factors. In the multi-population meta-analysis, variants at 17 loci were associated with IHS and each had known GWAS associations with multiple components of the IHS. PheWAS analysis in 456,026 participants showed that increased PRSIHS was associated with a lower odds ratio for many CVD outcomes and risk factors. Both IHS and PRSIHS measures of ideal CVH were associated with significantly less CVD outcomes and CVD mortality. CONCLUSION A set of high interest genetic variants contribute to the presence of ideal CVH in a multi-ethnic cohort of US Veterans. Genetically influenced ideal CVH is associated with lower odds of CVD outcomes and mortality.
Collapse
Affiliation(s)
- Rose D. L. Huang
- Center for Population Genomics, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Xuan-Mai T. Nguyen
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Gina M. Peloso
- Center for Population Genomics, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Mark Trinder
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Daniel C. Posner
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Krishna G. Aragam
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yuk-Lam Ho
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Julie A. Lynch
- VA Informatics & Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America
- College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States of America
| | - Scott M. Damrauer
- Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States of America
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Kyong-Mi Chang
- Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States of America
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Philip S. Tsao
- VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Pradeep Natarajan
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Themistocles Assimes
- VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - J. Michael Gaziano
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Luc Djousse
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Kelly Cho
- MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Peter W. F. Wilson
- Atlanta VA Medical Center, Decatur, Georgia, United States of America
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Jennifer E. Huffman
- Center for Population Genomics, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Christopher J. O’Donnell
- Center for Population Genomics, Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Heart & Vascular Center, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | | |
Collapse
|