1
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Zheng J, Wheeler E, Pietzner M, Andlauer TFM, Yau MS, Hartley AE, Brumpton BM, Rasheed H, Kemp JP, Frysz M, Robinson J, Reppe S, Prijatelj V, Gautvik KM, Falk L, Maerz W, Gergei I, Peyser PA, Kavousi M, de Vries PS, Miller CL, Bos M, van der Laan SW, Malhotra R, Herrmann M, Scharnagl H, Kleber M, Dedoussis G, Zeggini E, Nethander M, Ohlsson C, Lorentzon M, Wareham N, Langenberg C, Holmes MV, Davey Smith G, Tobias JH. Lowering of Circulating Sclerostin May Increase Risk of Atherosclerosis and Its Risk Factors: Evidence From a Genome-Wide Association Meta-Analysis Followed by Mendelian Randomization. Arthritis Rheumatol 2023; 75:1781-1792. [PMID: 37096546 PMCID: PMC10586470 DOI: 10.1002/art.42538] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE In this study, we aimed to establish the causal effects of lowering sclerostin, target of the antiosteoporosis drug romosozumab, on atherosclerosis and its risk factors. METHODS A genome-wide association study meta-analysis was performed of circulating sclerostin levels in 33,961 European individuals. Mendelian randomization (MR) was used to predict the causal effects of sclerostin lowering on 15 atherosclerosis-related diseases and risk factors. RESULTS We found that 18 conditionally independent variants were associated with circulating sclerostin. Of these, 1 cis signal in SOST and 3 trans signals in B4GALNT3, RIN3, and SERPINA1 regions showed directionally opposite signals for sclerostin levels and estimated bone mineral density. Variants with these 4 regions were selected as genetic instruments. MR using 5 correlated cis-SNPs suggested that lower sclerostin increased the risk of type 2 diabetes mellitus (DM) (odds ratio [OR] 1.32 [95% confidence interval (95% CI) 1.03-1.69]) and myocardial infarction (MI) (OR 1.35 [95% CI 1.01-1.79]); sclerostin lowering was also suggested to increase the extent of coronary artery calcification (CAC) (β = 0.24 [95% CI 0.02-0.45]). MR using both cis and trans instruments suggested that lower sclerostin increased hypertension risk (OR 1.09 [95% CI 1.04-1.15]), but otherwise had attenuated effects. CONCLUSION This study provides genetic evidence to suggest that lower levels of sclerostin may increase the risk of hypertension, type 2 DM, MI, and the extent of CAC. Taken together, these findings underscore the requirement for strategies to mitigate potential adverse effects of romosozumab treatment on atherosclerosis and its related risk factors.
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Affiliation(s)
- Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of BristolBristolUK
| | - Eleanor Wheeler
- MRC Epidemiology Unit, Institute of Metabolic ScienceUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Maik Pietzner
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK, and Computational Medicine, Berlin Institute of Health at Charité–Universitätsmedizin BerlinBerlinGermany
| | - Till F. M. Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of MedicineTechnical University of MunichMunichGermany
| | - Michelle S. Yau
- Marcus Institute for Aging Research, Hebrew SeniorLifeHarvard Medical SchoolBostonMassachusetts
| | | | - Ben Michael Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, and HUNT Research Centre, Department of Public Health and Nursing, NTNUNorwegian University of Science and TechnologyLevangerNorway
| | - Humaira Rasheed
- MRC IEU, Bristol Medical School, University of Bristol, Bristol, UK, and HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway, and Division of Medicine and Laboratory Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - John P. Kemp
- MRC IEU, Bristol Medical School, University of Bristol, Bristol, UK, and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia, and The University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneQueenslandAustralia
| | - Monika Frysz
- MRC IEU, Bristol Medical School, University of Bristol, and Musculoskeletal Research UnitUniversity of BristolBristolUK
| | - Jamie Robinson
- MRC IEU, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Sjur Reppe
- Unger‐Vetlesen Institute, Lovisenberg Diaconal Hospital and Department of Plastic and Reconstructive Surgery, Oslo University Hospital and Department of Medical BiochemistryOslo University HospitalOsloNorway
| | - Vid Prijatelj
- Department of Internal MedicineErasmus MC University Medical CenterRotterdamThe Netherlands
| | | | - Louise Falk
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK, and Computational Medicine, Berlin Institute of Health at Charité–Universitätsmedizin BerlinBerlinGermany
| | - Winfried Maerz
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria, and SYNLAB Academy, SYNLAB Holding Deutschland GmbH and Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty MannheimUniversity of HeidelbergMannheimGermany
| | - Ingrid Gergei
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, and Therapeutic Area Cardiovascular MedicineBoehringer Ingelheim International GmbHIngelheimGermany
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn Arbor
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Paul S. de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public HealthThe University of Texas Health Science Center at Houston
| | - Clint L. Miller
- Center for Public Health Genomics, Department of Public Health SciencesUniversity of VirginiaCharlottesville
| | - Maxime Bos
- Department of Epidemiology, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Sander W. van der Laan
- Central Diagnostics Laboratory, Division of Laboratories, Pharmacy, and Biomedical Genetics, University Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Rajeev Malhotra
- Cardiology Division, Department of MedicineMassachusetts General HospitalBoston
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
| | - Marcus Kleber
- SYNLAB Academy, SYNLAB Holding Deutschland GmbHMannheimGermany
| | - George Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and EducationHarokopio UniversityAthensGreece
| | - Eleftheria Zeggini
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, and Technical University of Munich (TUM) and Klinikum Rechts der IsarTUM School of MedicineMunichGermany
| | - Maria Nethander
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg and Bioinformatics and Data Centre, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Claes Ohlsson
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of MedicineUniversity of GothenburgGothenburgSweden
| | - Mattias Lorentzon
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden, and Mary McKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic ScienceUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK, and Computational Medicine, Berlin Institute of Health at Charité–Universitätsmedizin BerlinBerlinGermany
| | - Michael V. Holmes
- MRC IEU, Bristol Medical School, University of Bristol, and Medical Research Council Population Health Research Unit, University of Oxford, and Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population HealthUniversity of Oxford, and National Institute for Health Research, Oxford Biomedical Research Centre, Oxford University HospitalOxfordUK
| | | | - Jonathan H. Tobias
- MRC IEU, Bristol Medical School, University of Bristol, and Musculoskeletal Research UnitUniversity of BristolBristolUK
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2
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Grubler M, Fielder L, Tscharre M, Haiden A, Pfeffer M, Hartmann A, Thianich F, Roithinger FX, Verheyen N, Trummer C, Theiler-Schwetz V, Pilz S, Maerz W. Markers of bone metabolism are associated in all-cause mortality in heart failure with reduced ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.844] [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: 11/13/2022] Open
Abstract
Abstract
Background
In patients with heart failure an increased risk of fracture-related mortality has been reported. A growing body of evidence suggests that, heart failure (HF) itself may be related to disturbances in bone metabolism, but the exact mechanism remains unclear. In patients with HF previous studies indicated a loss of renal function and alterations in bone micro-architecture, but the clinical relevance remains unclear.
Purpose
We aimed to evaluate the association between markers of bone metabolism with mortality and pro-brain natriuretic peptide (proBNP) in patients with HF with reduced ejection fraction (HFrEF).
Methods
We analysed participants of a prospective cohort study of patients referred to coronary angiography (CA). The baseline examination was performed at a tertiary care centre in Germany. Indications for CA were based on clinical routine. For the current analysis only patients with HFrEF were included. Patients were selected based on echocardiographic left ventricular (LV)-EF≤40%, symptoms of heart failure and elevated proBNP concentrations, as recommended by current clinical guidelines.
We estimated the risk associated with parathyroid hormone (PTH), osteocalcin (OC), beta-crosslaps (βCL) and alkaline phosphatase (AP) and all-cause mortality using Cox proportional hazard models. Adjustments for demographic and clinical characteristics from the index hospital presentation were used as covariates. We included all individuals who had complete data for all variables in the study in our primary analysis. Additionally, we used linear regression analysis to investigate the correlation between proBNP and its association with PTH, OC, βCL and AP.
Results
A total of 297 participants (63.9±9.9 years; 17.9% females) were included in the analysis. Median follow-up was 10 years. Median LV-EF was 35%, median New York Heart Association functional class was 2 (IQR=1–3), mean pulmonary capillary wedge pressure was 15.3±7.4 mmHg and median proBNP levels of 2282 (IQR 1875–3758) ng/ml. Participants had in 42.3% multi-vessel atherosclerotic CAD (with stenosis of ≥50% considered diagnostic) with 66.4% had a previous myocardial infarction. In multivariate cox proportionate hazard models OC, βCL and AP were statistically significant associated with an increased risk for all-cause mortality (hazard ratio (HR)=1.6 [95% CI 1.2–2.2], HR=1.8 [95% CI 1.1–2.9] and HR=2.1 [95% CI 1.5–2.9], respectively).
In multivariate analysis proBNP was associated with PTH (β-coefficient = 0.076; P≤0.001), AP (β-coefficient = 0.125; P=0.001) and βCL (β-coefficient = 0.062; P=0.046), but not with osteocalcin (β-coefficient = −0.055; P=0.145).
Conclusion
In patients with HFrEF markers of bone metabolism were significantly associated with mortality and proBNP concentrations. Future studies should focus on different aspects of bone metabolism, fracture rates and fracture related mortality in patients with different stages of heart failure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Grubler
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - L Fielder
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - M Tscharre
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - A Haiden
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - M Pfeffer
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - A Hartmann
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - F Thianich
- Sigmund Freud Private University , Vienna , Austria
| | - F X Roithinger
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie , Wiener Neustadt , Austria
| | - N Verheyen
- Medical University of Graz, Department of Cardiology , Graz , Austria
| | - C Trummer
- Medical University of Graz , Graz , Austria
| | | | - S Pilz
- Medical University of Graz , Graz , Austria
| | - W Maerz
- Institute of Public Health , Mannheim , Germany
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3
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Leiherer A, Muendlein A, Brandtner E, Saely CH, Vonbank A, Mader A, Sprenger L, Maechler M, Jylha A, Laaperi M, Laaksonen R, Maerz W, Fraunberger P, Kleber M, Drexel H. Ceramide-based lipid profiles and the prevalence of type 2 diabetes differ between patients with coronary artery disease and those with peripheral artery disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3073] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Serum lipids and metabolic diseases, in particular type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD), predict the atherosclerotic diseases coronary artery disease (CAD) and peripheral arterial disease (PAD).
Purpose
The purpose of this study was to investigate in how far a more detailed characterization including serum lipids improves discrimination of PAD from CAD.
Method
A cohort of 274 statin-naïve patients with either PAD (n=89) or stable CAD (n=185) were referred to metabolic screening and were characterized using nuclear magnetic resonance- and liquid chromatography-tandem mass spectrometry based advanced lipid and lipoprotein analysis. Results were validated in an independent cohort of 1239 patients with PAD or CAD.
Results
We found a significant difference in T2D prevalence and in the ceramide-based lipid profile between PAD and CAD patients. However, neither cholesterol-based markers (including LDL-C, HDL-C) and detailed lipoprotein profiles nor the LD status differed significantly between PAD and CAD patients (figure). The difference between ceramide-based lipid profiles of CAD and PAD remained significant also after adjusting for body composition, smoking, inflammatory parameters, and T2D.
Conclusion
We conclude that PAD and CAD differ in ceramide-based lipid profiles and T2D status, but not in other lipid characteristics or metabolic diseases.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Leiherer
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - A Muendlein
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - E Brandtner
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - C H Saely
- Private University of the Principality of Liechtenstein , Triesen , Liechtenstein
| | - A Vonbank
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - A Mader
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - L Sprenger
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - M Maechler
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - A Jylha
- Zora Biosciences , Espoo , Finland
| | | | | | - W Maerz
- Medical University of Graz , Graz , Austria
| | | | - M Kleber
- Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - H Drexel
- County Hospital Bregenz , Bregenz , Austria
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4
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Haack I, Dressel A, Maerz W. Cascade screening and registry for patients with familial hypercholesterolemia in Germany – A follow-up survey. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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5
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Schmitz B, Gatsios D, Peña-Gil C, Juanatey J, Prieto D, Tsakanikas V, Scharnagl H, Habibovic M, Schmidt M, Kleber M, De Bruijn GJ, Malberg H, Mooren F, Widdershoven J, Maerz W, Fotiadis D, Kop W, Bosch J. Patient-centered cardiac rehabilitation by AI-powered lifestyle intervention – the timely approach. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Jarzebska N, Tselmin S, Kleber M, Maerz W, Jin H, Bornstein S, Mangoni A, Weiss N, Rodionov R. Asymmetric dimethylarginine (ADMA) mediates the effect of miRNA-762 on all-cause mortality in patients with coronary artery disease. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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7
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Silbernagel G, Duarte K, Sadiku S, Fauler G, Maerz W, Schmieder R, Jardine A, Massy Z, Girerd N, Fellström B, Scharnagl H, Zannad F. High cholesterol absorption is associated with increased cardiovascular risk in hemodialysis patients: Insights from the AURORA study. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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8
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LI Y, Cheng Y, Consolato F, Schiano G, Chong M, Pietzner M, Quynh Nguyen N, Scherer N, Biggs M, Kleber ME, Haug S, Göçmen B, Pigeyre M, Sekula P, Steinbrenner I, Schlosser P, Joseph C, Brody J, Grams M, Hayward C, Schultheiß UT, Kraemer B, Kronenberg F, Peters A, Seissler J, Steubl D, Then C, Wuttke M, Maerz W, Eckardt KU, Gieger C, Boerwinkle E, Psaty B, Coresh J, Oefner P, Pare G, Langenberg C, Scherberich JE, Yu B, Akilesh S, Devuyst O, Rampoldi L, Köttgen A. MO048: Genome-wide studies reveal factors associated with circulating uromodulin and its relations with complex diseases. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac062.029] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
UMOD is a major risk gene for monogenic and complex forms of kidney disease. The encoded kidney-specific protein uromodulin is the most abundant protein in urine and related to chronic kidney disease, hypertension and pathogen defense. Through basolateral release from kidney epithelial cells, uromodulin also reaches the blood, where its function is largely unknown. To gain insights into potential systemic roles, we performed genome-wide screens of circulating uromodulin in seven cohorts using two complementary assays.
METHOD
Separate genome-wide association study meta-analyses for circulating uromodulin were conducted for the antibody-based assay (five cohorts, N = 13 985) and the aptamer-based SOMAscan assay (two cohorts, N = 18 070). Genome-wide significant loci were placed into their functional genomic context using RNA-seq, ATAC-seq and Hi-C data generated from primary human kidney tissue. An array of downstream genetic analyses was then performed for significant loci, including fine-mapping, colocalization analyses and gene-by-gene interaction analyses. The B4GALNT2 p.Cys466Arg allele was expressed in MDCK cells and studied by immunofluorescence and Western blotting analyses.
RESULTS
We detected and replicated 13 genome-wide significant loci (P <5e−8; 12 novel). At the UMOD locus, functional genomics data of primary human kidney tissue highlighted an upstream regulatory variant with differential accessibility and UMOD transcription in uromodulin-synthesizing kidney cells. Shared association patterns with complex traits, including chronic kidney disease and blood pressure, placed the PRKAG2 locus in the same context as UMOD. Experimental validation of another locus, B4GALNT2, showed that the detected p.Cys466Arg variant of the encoded N-acetylgalactosaminyltransferase has a loss-of-function effect leading to higher serum uromodulin levels. Lastly, our results point to enzymes writing glycan marks present on uromodulin and to their receptors in the circulation.
CONCLUSION
This study provides human genetic evidence of new pathway members of uromodulin and delivers novel insights into its determinants and systemic role in the circulation.
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Affiliation(s)
- Yong LI
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Yurong Cheng
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | | | - Ngoc Quynh Nguyen
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nora Scherer
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Mary Biggs
- University of Washington, Seattle, WA, USA
| | - Marcus E Kleber
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haug
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Burulça Göçmen
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Peggy Sekula
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Inga Steinbrenner
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Pascal Schlosser
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | | | - Ulla T Schultheiß
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Bernhard Kraemer
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Annette Peters
- Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | | | | | | | - Matthias Wuttke
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Winfried Maerz
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Christian Gieger
- Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | | | | | | | - Bing Yu
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | - Anna Köttgen
- Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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9
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Schuchardt JP, Cerrato M, Ceseri M, DeFina LF, Delgado GE, Gellert S, Hahn A, Howard BV, Kadota A, Kleber ME, Latini R, Maerz W, Manson JE, Mora S, Park Y, Sala-Vila A, von Schacky C, Sekikawa A, Tintle N, Tucker KL, Vasan RS, Harris WS. Red blood cell fatty acid patterns from 7 countries: Focus on the Omega-3 index. Prostaglandins Leukot Essent Fatty Acids 2022; 179:102418. [PMID: 35366625 PMCID: PMC10440636 DOI: 10.1016/j.plefa.2022.102418] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022]
Abstract
Red blood cell (RBC) fatty acid (FA) patterns are becoming recognized as long-term biomarkers of tissue FA composition, but different analytical methods have complicated inter-study and international comparisons. Here we report RBC FA data, with a focus on the Omega-3 Index (EPA + DHA in% of total FAs in RBC), from samples of seven countries (USA, Canada, Italy, Spain, Germany, South Korea, and Japan) including 167,347 individuals (93% of all samples were from the US). FA data were generated by a uniform methodology from a variety of interventional and observational studies and from clinical laboratories. The cohorts differed in size, demographics, health status, and year of collection. Only the Canadian cohort was a formal, representative population-based survey. The mean Omega-3 Index of each country was categorized as desirable (>8%), moderate (>6% to 8%), low (>4% to 6%), or very low (≤4%). Only cohorts from Alaska (treated separately from the US), South Korea and Japan showed a desirable Omega-3 Index. The Spanish cohort had a moderate Omega-3 Index, while cohorts from the US, Canada, Italy, and Germany were all classified as low. This study is limited by the use of cohorts of convenience and small sample sizes in some countries. Countries undertaking national health status studies should utilize a uniform method to measure Omega-3 FA levels.
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Affiliation(s)
- Jan Philipp Schuchardt
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany; The Fatty Acid Research Institute, Sioux Falls, SD, USA.
| | - Marianna Cerrato
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Martina Ceseri
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Graciela E Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sandra Gellert
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, Hannover 30167, Germany
| | | | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Marcus E Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; SYNLAB MVZ Humangenetik Mannheim, Mannheim, Germany
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Winfried Maerz
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; SYNLAB Academy, Mannheim, Germany
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samia Mora
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yongsoon Park
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Food and Nutrition, Hanyang University, Seoul, South Korea
| | - Aleix Sala-Vila
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Cardiovascular risk and nutrition group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan Tintle
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Population Health Nursing Science, College of Nursing, University of Illinois - Chicago, Chicago, IL, USA
| | - Katherine L Tucker
- Department of Biomedical Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Ramachandran S Vasan
- Department of Medicine, Preventive Medicine & Epidemiology, School of Medicine, Boston University, Boston, MA, USA
| | - William S Harris
- The Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
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10
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Frysz M, Gergei I, Scharnagl H, Smith GD, Zheng J, Lawlor DA, Herrmann M, Maerz W, Tobias JH. Circulating Sclerostin Levels Are Positively Related to Coronary Artery Disease Severity and Related Risk Factors. J Bone Miner Res 2022; 37:273-284. [PMID: 34738659 PMCID: PMC9377011 DOI: 10.1002/jbmr.4467] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/11/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022]
Abstract
Romosozumab is a newly available treatment for osteoporosis acting by sclerostin inhibition. Its cardiovascular safety has been questioned after finding excess cardiovascular disease (CVD)-related events in a pivotal phase 3 trial. Previous studies of relationships between circulating sclerostin levels and CVD and associated risk factors have yielded conflicting findings, likely reflecting small numbers and selected patient groups. We aimed to characterize relationships between sclerostin and CVD and related risk factors in more detail by examining these in two large cohorts, Ludwigshafen Risk and Cardiovascular Health study (LURIC; 34% female, mean age 63.0 years) and Avon Longitudinal Study of Parents and Children study (ALSPAC) mothers (mean age 48.1 years). Together these provided 5069 participants with complete data. Relationships between sclerostin and CVD risk factors were meta-analyzed, adjusted for age, sex (LURIC), body mass index, smoking, social deprivation, and ethnicity (ALSPAC). Higher sclerostin levels were associated with higher risk of diabetes mellitus (DM) (odds ratio [OR] = 1.25; 95% confidence interval [CI] 1.12, 1.37), risk of elevated fasting glucose (OR 1.15; CI 1.04, 1.26), and triglyceride levels (β 0.03; CI 0.00, 0.06). Conversely, higher sclerostin was associated with lower estimated glomerular filtration rate (eGFR) (β -0.20; CI -0.38, -0.02), HDL cholesterol (β -0.05; CI -0.10, -0.01), and apolipoprotein A-I (β -0.05; CI -0.08, -0.02) (difference in mean SD per SD increase in sclerostin, with 95% CI). In LURIC, higher sclerostin was associated with an increased risk of death from cardiac disease during follow-up (hazard ratio [HR] = 1.13; 1.03, 1.23) and with severity of coronary artery disease on angiogram as reflected by Friesinger score (0.05; 0.01, 0.09). Associations with cardiac mortality and coronary artery severity were partially attenuated after adjustment for risk factors potentially related to sclerostin, namely LDL and HDL cholesterol, log triglycerides, DM, hypertension, eGFR, and apolipoprotein A-I. Contrary to trial evidence suggesting sclerostin inhibition leads to an increased risk of CVD, sclerostin levels appear to be positively associated with coronary artery disease severity and mortality, partly explained by a relationship between higher sclerostin levels and major CVD risk factors. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Monika Frysz
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Ingrid Gergei
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Therapeutic Area Cardiovascular Medicine, Boehringer Ingelheim International GmbH, Ingelheim, Germany
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jie Zheng
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried Maerz
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany
| | - Jon H Tobias
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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11
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Grubler M, Verheyen N, Meinitzer A, Tascharre M, Fiedler L, Roithinger F, Maerz W, Tomaschitz A, Pilz S. Association of female sexual hormones with QTc time in hypertensive subjects. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0639] [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: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The rate corrected QT time (QTc) is the most commonly used ECG derived parameter to identify and risk-stratify inherited and acquired arrhythmia risk. Among the many potentially influencing factors, the female menstrual cycle has been described to lead to minor intra-individual changes, but the overall influence of sexual hormones on the QTc is incompletely understood. We therefore aimed to elucidate this relationship in hypertensive subjects.
Purpose
To identify confounding factors in QTc determination and elucidate potential endocrine causes of variable QTc time.
Methods
The Styrian Hypertension study is a cohort study aiming to identify novel cardiovascular risk factors. Subjects were recruited from a tertiary care center outpatient clinic. QTc was calculated according to Framingham and linear regression formulas adhering to the AHA/ACCF/HRS 2009 guideline for surface ECG interpretation. Plasma concentrations of estrone (E1), estradiol (E2), 17α-Hydroxyprogesterone and progesterone were measured by Biocrates AbsoluteIDQ Stero17 Kit. Patients on QTc altering medication were excluded from the present analyses.
Results
A total of 142 participants (mean [SD] age, 59.4 [11.7] years; 52% women, 80,1% post-menopause) were eligible for the present analyses. Linear regression analyses adjusted for potassium, HbA1c, NTproBNP and mean systolic blood pressure revealed only an association of QTc with progesterone (beta coefficient [95% CI]) of 0.38 [0.14 – 0.62] (P=0.002) in males. Detailed analyses revealed an U-shaped association. The other hormones showed no significant association in the present cohort of patients. Subgroups of premenopausal women and of patients without elevated blood pressure revealed no statistically significant results.
Conclusions
Contrary to previous evidence we found no sign. association between female sexual hormones and QTc time. We observed increased QTc time in males depending on their progesterone plasma concentrations, but the isolated finding may be a statistical outlier.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Grubler
- University of Bern, Bern, Switzerland
| | - N.D Verheyen
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - A Meinitzer
- Medical University of Graz, Clinical and Laboratory medicine, Graz, Austria
| | - M Tascharre
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | - L Fiedler
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | - F.X Roithinger
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | - W Maerz
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | | | - S Pilz
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
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12
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Grubler M, Verheyen N, Meinitzer A, Fiedler L, Tscharre M, Roithinger F, Tomaschitz A, Pilz S, Maerz W. Digoxin treatment and long-term mortality depending on left ventricular ejection fraction and atrial fibrillation: a propensity score matched analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0502] [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: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Atrial fibrillation (AF) is a common heart rhythm disturbance, associated with an increased risk of stroke, hospital admissions and mortality, especially in patients with reduced ejection fraction. Among the oldest medications used for heart-rate control is digitalis, but largely due to observational studies showing an increased risk of death it has fallen out of favour. Recently newer clinical trials reported that the treatment with digitalis in permanent AF might be superior to beta blocker therapy in regard to functional status and symptom burden. Given this diverging results we attempt to analysis a large cohort of patients facilitating a propensity score matching algorithm.
Purpose
To assess the associations of digitalis treatment with mortality in patients with increased cardiovascular risk.
Methods
Patients were derived from a large cohort study including participants from a tertiary care centre who were referred to coronary angiography. The propensity score matching is based on a predefined list of variables, with digitalis as treatment. Matching strategy is nearest neighbour matching and to prove consistency, radius matching (radius = 0.1). For survival analysis we used a Cox proportional hazard regression comparing patients with and without digitalis for all-cause mortality. The analysis is conducted using STATA 13 MP. All patients provided written informed consent and the study was approved by the ethics committee.
Results
A total of 2457 patients (median age: 63.5 [IQR = 56.3–70.6] years, 30.1% women) referred to coronary angiography, with a median follow up of 9.9 (IQR = 8.5–10.7) years were included. The matching process and the resulting propensity score fulfilled all statistical assumptions and resulted in a balanced cohort. The risk for all-cause mortality was higher among propensity score matched participants not treated with digitalis compared to patients on treatment (n=514) HR 3.03 (95% CI 2.5 to 3.7). Total mortality in patients with AF on digitalis after a median follow-up of 9.9 years was 27.6%. At baseline, only 42.4% of patients with AF were on oral anticoagulation.
Conclusions
In the present cohort treatment with digitalis was associated with a lower risk of all-cause mortality after long-term follow-up. The patient population has a clinically significant 10-year mortality risk. The results may not apply to other cohorts but may help inform future clinical trials.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M.R Grubler
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Wiener Neustadt, Austria
| | - N.D Verheyen
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - A Meinitzer
- Medical University of Graz, Clinical and Laboratory medicine, Graz, Austria
| | - L Fiedler
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Cardiology, Wiener Neustadt, Austria
| | - M Tscharre
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Cardiology, Wiener Neustadt, Austria
| | - F.X Roithinger
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Cardiology, Wiener Neustadt, Austria
| | - A Tomaschitz
- LK Wiener Neustadt Abteilung fuer Kardiologie und Nephrologie, Cardiology, Wiener Neustadt, Austria
| | - S Pilz
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
| | - W Maerz
- University Hospital of Heidelberg, Heidelberg, Germany
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13
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Alesutan I, Luong TTD, Schelski N, Masyout J, Hille S, Schneider MP, Graham D, Zickler D, Verheyen N, Estepa M, Pasch A, Maerz W, Tomaschitz A, Pilz S, Frey N, Lang F, Delles C, Müller OJ, Pieske B, Eckardt KU, Scherberich J, Voelkl J. Circulating uromodulin inhibits vascular calcification by interfering with pro-inflammatory cytokine signalling. Cardiovasc Res 2021; 117:930-941. [PMID: 32243494 DOI: 10.1093/cvr/cvaa081] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/15/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022] Open
Abstract
AIMS Uromodulin is produced exclusively in the kidney and secreted into both urine and blood. Serum levels of uromodulin are correlated with kidney function and reduced in chronic kidney disease (CKD) patients, but physiological functions of serum uromodulin are still elusive. This study investigated the role of uromodulin in medial vascular calcification, a key factor associated with cardiovascular events and mortality in CKD patients. METHODS AND RESULTS Experiments were performed in primary human (HAoSMCs) and mouse (MOVAS) aortic smooth muscle cells, cholecalciferol overload and subtotal nephrectomy mouse models and serum from CKD patients. In three independent cohorts of CKD patients, serum uromodulin concentrations were inversely correlated with serum calcification propensity. Uromodulin supplementation reduced phosphate-induced osteo-/chondrogenic transdifferentiation and calcification of HAoSMCs. In human serum, pro-inflammatory cytokines tumour necrosis factor α (TNFα) and interleukin-1β (IL-1β) co-immunoprecipitated with uromodulin. Uromodulin inhibited TNFα and IL-1β-induced osteo-/chondrogenic signalling and activation of the transcription factor nuclear factor kappa-light-chain-enhancer of activated β cells (NF-kB) as well as phosphate-induced NF-kB-dependent transcriptional activity in HAoSMCs. In vivo, adeno-associated virus (AAV)-mediated overexpression of uromodulin ameliorated vascular calcification in mice with cholecalciferol overload. Conversely, cholecalciferol overload-induced vascular calcification was aggravated in uromodulin-deficient mice. In contrast, uromodulin overexpression failed to reduce vascular calcification during renal failure in mice. Carbamylated uromodulin was detected in serum of CKD patients and uromodulin carbamylation inhibited its anti-calcific properties in vitro. CONCLUSIONS Uromodulin counteracts vascular osteo-/chondrogenic transdifferentiation and calcification, at least in part, through interference with cytokine-dependent pro-calcific signalling. In CKD, reduction and carbamylation of uromodulin may contribute to vascular pathology.
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MESH Headings
- Adult
- Aged
- Animals
- Aorta/immunology
- Aorta/metabolism
- Cell Transdifferentiation/drug effects
- Cells, Cultured
- Chondrogenesis
- Cytokines/genetics
- Cytokines/metabolism
- Disease Models, Animal
- Female
- Humans
- Inflammation Mediators/metabolism
- Male
- Mice, Inbred C57BL
- Mice, Inbred DBA
- Mice, Knockout
- Middle Aged
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/immunology
- Muscle, Smooth, Vascular/metabolism
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/immunology
- Myocytes, Smooth Muscle/metabolism
- Osteogenesis
- Phenotype
- Protein Carbamylation
- Renal Insufficiency, Chronic/blood
- Renal Insufficiency, Chronic/immunology
- Signal Transduction
- Uromodulin/blood
- Uromodulin/genetics
- Uromodulin/pharmacology
- Vascular Calcification/blood
- Vascular Calcification/immunology
- Vascular Calcification/prevention & control
- Young Adult
- Mice
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Affiliation(s)
- Ioana Alesutan
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Hessische Strasse 3-4, 10115 Berlin, Germany
| | - Trang T D Luong
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nadeshda Schelski
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jaber Masyout
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Susanne Hille
- Department of Internal Medicine III, University of Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Martinistr. 52, 20246 Hamburg, Germany
| | - Markus P Schneider
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany
- German Chronic Kidney Disease (GCKD) Study
| | - Delyth Graham
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
| | - Daniel Zickler
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nicolas Verheyen
- Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Misael Estepa
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Andreas Pasch
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
- Calciscon AG, Aarbergstrasse 5, 2560 Nidau-Biel, Switzerland
- Nierenpraxis Bern, Bubenbergplatz 5, 3011 Bern, Switzerland
- Department of Nephrology, Lindenhofspital, Bremgartenstrasse 117, 3001 Bern, Switzerland
| | - Winfried Maerz
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Ludolf Krehl Street 7-11, 68167 Mannheim, Germany
- Synlab Academy, SYNLAB Holding Deutschland GmbH, P5,7, 68161 Mannheim, Germany
| | | | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Norbert Frey
- Department of Internal Medicine III, University of Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Martinistr. 52, 20246 Hamburg, Germany
| | - Florian Lang
- Department of Physiology, Eberhard-Karls University, Wilhelmstr. 56, 72076 Tübingen, Germany
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
| | - Oliver J Müller
- Department of Internal Medicine III, University of Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Martinistr. 52, 20246 Hamburg, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Hessische Strasse 3-4, 10115 Berlin, Germany
- Department of Internal Medicine and Cardiology, German Heart Center Berlin (DHZB), Augustenburger Platz 1, 13353 Berlin, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany
- German Chronic Kidney Disease (GCKD) Study
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Juergen Scherberich
- Department of Nephrology and Clinical Immunology, Klinikum München-Harlaching, Teaching Hospital of the Ludwig-Maximilians-Universität, Sanatoriumsplatz 2, 81545 München, Germany
| | - Jakob Voelkl
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Hessische Strasse 3-4, 10115 Berlin, Germany
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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14
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Schweighofer N, Genser B, Maerz W, Kleber ME, Trummer O, Pieber TR, Obermayer-Pietsch B. Intronic Variants in OCT1 are Associated with All-Cause and Cardiovascular Mortality in Metformin Users with Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:2069-2080. [PMID: 32606866 PMCID: PMC7308180 DOI: 10.2147/dmso.s235663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 05/01/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Organic cation transporters (Octs) use cations like endogenous compounds, toxins, and drugs, such as metformin, as substrates. Therefore, these proteins determine the pharmacokinetics and -dynamics of metformin and thus its efficacy. Of note, metformin is today the most commonly used pharmaceutical in the treatment of type 2 diabetes (T2DM) with nevertheless a great variability in clinical response, which attributes to genetic variances. The aim of this study was to determine the influence of intronic OCT1 SNPs on prevalence of all-cause and cardiovascular death. PATIENTS AND METHODS Genotypes of 27 intronic SNPs in OCT1 were investigated in the LURIC study, a prospective cohort of 3316 participants scheduled for coronary angiography. We investigated whether these variants were associated with all-cause and cardiovascular death in 73 individuals with T2DM under metformin therapy, in individuals without diabetes, individuals with T2DM and individuals with T2DM without metformin therapy. RESULTS In a multivariate Cox regression analysis adjusted for classical cardiovascular risk factors, 4 intronic OCT1 SNPs were significantly associated with all-cause and cardiovascular mortality in individuals with T2DM on metformin therapy. CONCLUSION According to their OCT1 genotype, some individuals with T2DM on metformin therapy might be prone to an increased risk of cardiovascular death.
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Affiliation(s)
- Natascha Schweighofer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - Bernd Genser
- BG Stats Consulting, Vienna, Austria
- Institute of Public Health, Social and Preventive Medicine, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Winfried Maerz
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- SynLaboratory Academy, SynLaboratory Holding Deutschland GmbH, Mannheim and Augsburg, Germany
| | - Marcus E Kleber
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Olivia Trummer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
| | - Thomas R Pieber
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
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15
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Drechsler C, Menitzer A, Maerz W, Gutjahr-Lengsfeld L, Oder D, Üçeyler N, Sommer C, Nordbeck P, Wanner C. P0076HOMOARGININE ASSOCIATES WITH RENAL AND CARDIAC FUNCTION IN FABRY DISEASE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0076] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Patients with Fabry disease frequently develop progressive Fabry nephropathy, hypertrophic cardiomyopathy with arrhythmias and subsequent death, transient ischemic attacks and early cerebral stroke. Homoarginine is an amino acid derivative, mainly produced in the kidney from its precursor lysine. Homoarginine may increase nitric oxide availability, decrease the release of cytokines, modulate the renin-angiotensin-aldosterone system and improve cardiac contractility. We hypothesize that high homoarginine levels associate with less clinical symptoms and better renal function in patients with Fabry disease.
Method
This study investigated the homoarginin status and its association with renal function, left ventricular (LV) mass and adverse clinical symptoms in patients with Fabry disease. Homoarginine was measured by high-performance liquid chromatography in 162 patients who were genetically proven to have Fabry disease. GFR was determined by DTPA clearance. LV mass and cardiomyopathy were assessed by magnetic resonance imaging and echocardiography. In cross-sectional analyses, associations with adverse clinical outcomes were determined by linear and binary logistic regression analyses, respectively, and were adjusted for age, sex, and BMI.
Results
Patients had a mean age of 39±14 years and 41% were male. The mean homoarginine concentration was 2.0±1.0 µmol/l. Patients had a mean BMI of 23.7±4.5 kg/m2 and a mean GFR of 93±37 ml/min. Homoarginine was significantly correlated with GFR and proteinuria. The better the homoarginine status of the patients, the higher was their GFR (r=0.20, p=0.04) and the lower proteinuria (r=-0.21, p=0.03). Furthermore, LV mass was significantly higher with lower homoarginine levels (r=-0.30, p<0.01). Patients of the lowest homoarginine tertile had a 4-fold higher risk of myocardial hypertrophy (OR 4.17, 95% CI 1.44-12.02), especially with septal and posterior hypertrophy, compared to those of the upper tertiles. Similarly, patients of the lowest homoarginine tertile had a higher rate of angina pectoris (OR 4.2, 95% CI 1.3-13.3) and chronic pain (OR 4.1, 95% CI 1.7-10.1), compared to patients of the upper tertiles. At lower homoarginine status, the median levels of proteinuria increased, as well as the prevalence rates of heart failure and the need for analgesic therapy.
Conclusion
In conclusion, low homoarginine status was strongly associated with cardiomyopathy, renal function and adverse clinical symptoms in patients with Fabry disease. Whether homoarginine supplementation improves complications of Fabry disease, requires a randomized controlled trial.
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Affiliation(s)
- Christiane Drechsler
- University Hospital Wuerzburg, Dept of Medicine 1, Div of Nephrology, Würzburg, Germany
| | - Andreas Menitzer
- Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | | | | | - Daniel Oder
- University Hospital Würzburg, Dept of Medicine 1, Div of Cardiology, Wuerzburg, Germany
| | - Nurcan Üçeyler
- University Hospital Wuerzburg, Dept of Neurology, Wuerzburg, Germany
| | - Claudia Sommer
- University Hospital Wuerzburg, Dept of Neurology, Wuerzburg, Germany
| | - Peter Nordbeck
- University Hospital Würzburg, Dept of Medicine 1, Div of Cardiology, Wuerzburg, Germany
| | - Christoph Wanner
- University Hospital Wuerzburg, Dept of Medicine 1, Div of Nephrology, Würzburg, Germany
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16
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Schunk S, Kleber ME, Maerz W, Zewinger S, Isabella J, Schmit D, Fliser D, Ulrich L, Speer T. SO003LIFE-LONG NLRP3 INFLAMMASOME-MEDIATED SYSTEMIC INFLAMMATION ASSOCIATES WITH CARDIOVASCULAR MORTALITY: A GENETIC ASSOCIATION STUDY OF >500,000 INDIVIDUALS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa139.so003] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Chronic kidney disease (CKD) represents one of the strongest cardiovascular risk factors. Recently, we have shown that activation of the NOD-like receptor protein-3 (NLRP3) inflammasome mediates progression of kidney injury and CKD-associated vascular disease (Zewinger et al. Nat Immunol 2013). Components of the NLRP3 inflammasome pathway such as interleukin-1β (IL-1β) can therapeutically be targeted. Associations of genetically determined life-long inflammasome-mediated systemic inflammation with CVD and mortality in humans are unknown.
Method
We explored the association of genetic NLRP3 variants with prevalent CVD and cardiovascular mortality in 3,061 patients enrolled in the LURIC study undergoing coronary angiography in a gene-centric approach. Functional relevance of the rs10754555 NLRP3 variant was studied in freshly isolated human monocytes. Findings were validated in 39,755 participants from eight independent studies (CV risk populations) as well as in 483,258 participants of the UKBiobank study (general population).
Results
Genetic analyses identified the highly prevalent (MAF 39.9%) intronic NLRP3 variant rs10754555 to affect NLRP3 gene expression. rs10754555 carriers showed significantly higher C-reactive protein and serum amyloid A plasma levels. Expression of NLRP3 mRNA and inflammasome-dependent effector responses of isolated human monocytes from rs10754555 carriers were significantly higher as compared to non-carriers. In homozygous rs10754555 carriers, the prevalence of coronary artery disease (CAD) was significantly higher as compared to non-carriers with a significant interaction between rs10754555 and age in LURIC and in UKBiobank. Importantly, in LURIC and in UKBiobank, homozygous rs10754555 carriers had significantly higher risk for cardiovascular mortality during follow-up (HR 1.37, 95%-CI 1.08-1.74 and HR 1.13, 95%-CI 1.02-1.25, respectively). Consistently, rs10754555 was associated with higher cardiovascular mortality (HR 1.11, 95%-CI 1.05-1.16; P<0.001) in an additive model in patients with prevalent CAD.
Conclusion
The NLRP3 intronic variant rs10754555 is associated with increased systemic inflammation, inflammasome activation, prevalent CAD and mortality. This study provides evidence for a substantial role of life-long, genetically-driven systemic inflammation in cardiovascular disease and highlights the NLRP3 inflammasome as a therapeutic target in the general population and particular in patients with CKD.
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17
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Passero K, He X, Zhou J, Mueller-Myhsok B, Kleber ME, Maerz W, Hall MA. Phenome-wide association studies on cardiovascular health and fatty acids considering phenotype quality control practices for epidemiological data. Pac Symp Biocomput 2020; 25:659-670. [PMID: 31797636] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Phenome-wide association studies (PheWAS) allow agnostic investigation of common genetic variants in relation to a variety of phenotypes but preserving the power of PheWAS requires careful phenotypic quality control (QC) procedures. While QC of genetic data is well-defined, no established QC practices exist for multi-phenotypic data. Manually imposing sample size restrictions, identifying variable types/distributions, and locating problems such as missing data or outliers is arduous in large, multivariate datasets. In this paper, we perform two PheWAS on epidemiological data and, utilizing the novel software CLARITE (CLeaning to Analysis: Reproducibility-based Interface for Traits and Exposures), showcase a transparent and replicable phenome QC pipeline which we believe is a necessity for the field. Using data from the Ludwigshafen Risk and Cardiovascular (LURIC) Health Study we ran two PheWAS, one on cardiac-related diseases and the other on polyunsaturated fatty acids levels. These phenotypes underwent a stringent quality control screen and were regressed on a genome-wide sample of single nucleotide polymorphisms (SNPs). Seven SNPs were significant in association with dihomo-γ-linolenic acid, of which five were within fatty acid desaturases FADS1 and FADS2. PheWAS is a useful tool to elucidate the genetic architecture of complex disease phenotypes within a single experimental framework. However, to reduce computational and multiple-comparisons burden, careful assessment of phenotype quality and removal of low-quality data is prudent. Herein we perform two PheWAS while applying a detailed phenotype QC process, for which we provide a replicable pipeline that is modifiable for application to other large datasets with heterogenous phenotypes. As investigation of complex traits continues beyond traditional genome wide association studies (GWAS), such QC considerations and tools such as CLARITE are crucial to the in the analysis of non-genetic big data such as clinical measurements, lifestyle habits, and polygenic traits.
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Affiliation(s)
- Kristin Passero
- Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA,
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18
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Elsner LK, Pilz S, Von Jeinsen B, Diouf K, Wolter JS, Gruen D, Kleber M, Drechsler C, Troidl C, Doerr O, Wanner C, Hamm CW, Liebetrau C, Maerz W, Keller T. P5478Information on weather conditions improves the prognostic ability of 25 OH-vitamin D in stable coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0432] [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: 11/13/2022] Open
Abstract
Abstract
Introduction and aim
Vitamin D deficiency is associated with an adverse prognosis in patients with coronary artery disease (CAD). Decreased levels of vitamin D are associated with low sunshine exposure, resulting in seasonal variations of vitamin D. The aims of this study were to investigate the influence of different specific weather conditions on vitamin D levels and to explore a possible improvement of risk stratification by vitamin D levels in stable patients with CAD using meteorological data.
Methods
The study population consists of two independent cohorts of stable patients undergoing coronary angiography with suspected or known CAD: as derivation cohort, the ongoing biomarker registry BioPROSPECTIVE with n=1,766 enrolled patients between 2010 and 2013 (median age 70.1 yrs; 30.8% females); and as validation cohort, the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study with n=3,299 patients (median age 63.5 yrs; 30.3% females). In the derivation cohort 235 (13.3%) patients were known to be deceased by 08/2018. In the validation cohort 760 (23.0%) patients died within a median follow-up time of 7.75 years. 25-OH vitamin D levels were measured by commercial assays. Vitamin D deficiency was defined as 25-OH vitamin D levels ≤20 ng/mL. Daily averaged data on six weather conditions of the 180 days prior to enrolment were collected for each patient from the weather station located closest to the respective study centre. Using air pressure, precipitation height, sunshine duration, temperature, relative humidity, and vapour pressure a weather model was constructed that significantly correlated with vitamin D levels (r=0.37; p<0.001).
Results
In the derivation cohort, median vitamin D levels were lower in non-survivors (13.3 [9.65–19.65] ng/mL) than in survivors (15.70 [10.7–22.65] ng/mL; p<0.001). Vitamin D predicted all-cause mortality with an area under the receiver operator characteristic curve (AUROC) of 0.576 (CI: 0.54–0.62). Adding the weather model to vitamin D significantly improved the AUROC to 0.601 (CI: 0.56–0.64; p=0.031). The vitamin D/weather model combination enhanced the prognostic value of the ESC SCORE to predict mortality (AUROC=0.571 [CI: 0.53–0.61] vs. 0.628 [CI: 0.59–0.67]; p=0.004). Comparable results were observed in the validation cohort. Here, vitamin D deficiency predicted mortality with a hazard ratio (HR) of 1.89 (CI: 1.59–2.26) after adjustment for ESC SCORE. Adding the weather model improved this HR to 1.92 (1.62–2.32). Reclassification analyses support the additive prognostic information of weather conditions with a continuous net reclassification improvement of 0.114 ([0.033–0.194]; p=0.006) if adding the weather model to vitamin D as base model for predicting mortality.
Conclusions
Different weather conditions show a significant impact on vitamin D levels in stable patients. Adding data on weather conditions improve the risk stratification by vitamin D for predicting mortality in stable CAD patients.
Acknowledgement/Funding
The study is financially supported by the Kerckhoff Heart Research Institute (KHFI) and the German Center for Cardiovascular Research (DZHK).
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Affiliation(s)
- L K Elsner
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - S Pilz
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria
| | - B Von Jeinsen
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - K Diouf
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - J S Wolter
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - D Gruen
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - M Kleber
- University Medical Centre of Mannheim, Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Mannheim, Germany
| | - C Drechsler
- University of Wuerzburg, Department of Medicine I, Division of Nephrology, Wurzburg, Germany
| | - C Troidl
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - O Doerr
- Justus-Liebig University of Giessen, Department of Cardiology, Giessen, Germany
| | - C Wanner
- University of Wuerzburg, Department of Medicine I, Division of Nephrology, Wurzburg, Germany
| | - C W Hamm
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - C Liebetrau
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
| | - W Maerz
- University Medical Centre of Mannheim, Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Mannheim, Germany
| | - T Keller
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
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19
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Zheng J, Maerz W, Gergei I, Kleber M, Drechsler C, Wanner C, Brandenburg V, Reppe S, Gautvik KM, Medina-Gomez C, Shevroja E, Gilly A, Park YC, Dedoussis G, Zeggini E, Lorentzon M, Henning P, Lerner UH, Nilsson KH, Movérare-Skrtic S, Baird D, Elsworth B, Falk L, Groom A, Capellini TD, Grundberg E, Nethander M, Ohlsson C, Davey Smith G, Tobias JH. Mendelian Randomization Analysis Reveals a Causal Influence of Circulating Sclerostin Levels on Bone Mineral Density and Fractures. J Bone Miner Res 2019; 34:1824-1836. [PMID: 31170332 PMCID: PMC6899787 DOI: 10.1002/jbmr.3803] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/14/2019] [Accepted: 05/23/2019] [Indexed: 12/21/2022]
Abstract
In bone, sclerostin is mainly osteocyte-derived and plays an important local role in adaptive responses to mechanical loading. Whether circulating levels of sclerostin also play a functional role is currently unclear, which we aimed to examine by two-sample Mendelian randomization (MR). A genetic instrument for circulating sclerostin, derived from a genomewide association study (GWAS) meta-analysis of serum sclerostin in 10,584 European-descent individuals, was examined in relation to femoral neck bone mineral density (BMD; n = 32,744) in GEFOS and estimated bone mineral density (eBMD) by heel ultrasound (n = 426,824) and fracture risk (n = 426,795) in UK Biobank. Our GWAS identified two novel serum sclerostin loci, B4GALNT3 (standard deviation [SD]) change in sclerostin per A allele (β = 0.20, p = 4.6 × 10-49 ) and GALNT1 (β = 0.11 per G allele, p = 4.4 × 10-11 ). B4GALNT3 is an N-acetyl-galactosaminyltransferase, adding a terminal LacdiNAc disaccharide to target glycocoproteins, found to be predominantly expressed in kidney, whereas GALNT1 is an enzyme causing mucin-type O-linked glycosylation. Using these two single-nucleotide polymorphisms (SNPs) as genetic instruments, MR revealed an inverse causal relationship between serum sclerostin and femoral neck BMD (β = -0.12, 95% confidence interval [CI] -0.20 to -0.05) and eBMD (β = -0.12, 95% CI -0.14 to -0.10), and a positive relationship with fracture risk (β = 0.11, 95% CI 0.01 to 0.21). Colocalization analysis demonstrated common genetic signals within the B4GALNT3 locus for higher sclerostin, lower eBMD, and greater B4GALNT3 expression in arterial tissue (probability >99%). Our findings suggest that higher sclerostin levels are causally related to lower BMD and greater fracture risk. Hence, strategies for reducing circulating sclerostin, for example by targeting glycosylation enzymes as suggested by our GWAS results, may prove valuable in treating osteoporosis. © 2019 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc.
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Affiliation(s)
- Jie Zheng
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Winfried Maerz
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany.,Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ingrid Gergei
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcus Kleber
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Christoph Wanner
- Department of Cardiology and Nephrology, Rhein-Maas-Klinikum Würselen, Germany
| | - Vincent Brandenburg
- Department of Cardiology and Nephrology, Rhein-Maas-Klinikum Würselen, Germany
| | - Sjur Reppe
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Kaare M Gautvik
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Enisa Shevroja
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Arthur Gilly
- Human Genetics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.,Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Young-Chan Park
- Human Genetics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.,University of Cambridge, Cambridge, UK
| | - George Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eleftheria Zeggini
- Human Genetics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.,Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Geriatric Medicine Clinic, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Petra Henning
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ulf H Lerner
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Karin H Nilsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Movérare-Skrtic
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Denis Baird
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Benjamin Elsworth
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Louise Falk
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Alix Groom
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Bioresource Laboratories, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Terence D Capellini
- Human Evolutionary Biology, Harvard University, Boston, MA, USA.,Broad Institute of MIT and Harvard, Boston, MA, USA
| | - Elin Grundberg
- Department of Human Genetics, McGill University, Quebec, Canada.,Center for Pediatric Genomic Medicine, Children's Mercy, Kansas City, MO, USA
| | - Maria Nethander
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan H Tobias
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK.,Musculoskeletal Research Unit, University of Bristol, Bristol, UK
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20
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Muendlein A, Leiherer A, Saely CH, Geiger K, Brandtner EM, Larcher B, Mader A, Fraunberger P, Kleber M, Dressel A, Maerz W, Drexel H. P4772Elevated parathyroid hormone is associated with an increased mortality risk in type 2 diabetes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Leiherer
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - C H Saely
- Bern University Hospital, Division of Angiology, Swiss Cardiovascular Center, Bern, Switzerland
| | - K Geiger
- VIVIT Institute, Feldkirch, Austria
| | | | - B Larcher
- Academic Teaching Hospital, Department of Medicine and Cardiology, Feldkirch, Austria
| | - A Mader
- Academic Teaching Hospital, Department of Medicine and Cardiology, Feldkirch, Austria
| | - P Fraunberger
- Academic Teaching Hospital, Medical Central Laboratory Feldkirch, Feldkirch, Austria
| | - M Kleber
- Mannheim Medical Faculty, Internal Medicine V, Mannheim, Germany
| | - A Dressel
- DACH-Association, Prevention of Cardiovascular Disease, Hamburg, Germany
| | - W Maerz
- Medical University of Graz, Clinical Institute for Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - H Drexel
- Drexel University College of Medicine, Philadelphia, United States of America
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21
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Werner C, Stojakovic T, Speer T, Zewinger S, Maerz W, Scharnagl H, Laufs U. P3632Apolipoprotein C-III concentrations in chylomicron-free serum predict cardiovascular outcomes in patients with coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Werner
- Universitätsklinikum des Saarlandes - Klinik für Innere Medizin III, Homburg, Germany
| | - T Stojakovic
- Medical University of Graz, Klinisches Institut für Medizinische und Chemische Labordiagnostik, Graz, Austria
| | - T Speer
- Saarland University Hospital, Klinik für Innere Medizin IV - Nephrologie, Homburg, Germany
| | - S Zewinger
- Saarland University Hospital, Klinik für Innere Medizin IV - Nephrologie, Homburg, Germany
| | - W Maerz
- Medical University of Graz, Klinisches Institut für Medizinische und Chemische Labordiagnostik, Graz, Austria
| | - H Scharnagl
- Medical University of Graz, Klinisches Institut für Medizinische und Chemische Labordiagnostik, Graz, Austria
| | - U Laufs
- Leipzig University Hospital, Klinik und Poliklinik für Kardiologie, Leipzig, Germany
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22
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Kassner U, Hollstein T, Grenkowitz T, Scharnagl H, Maerz W, Steinhagen-Thiessen E. 5001PCSK9-Inhibitor treatment of cardiovascular high risk patients in a real-world setting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- U Kassner
- Charité - Universitätsmedizin Berlin, Klinik für Endokrinologie, Berlin, Germany
| | - T Hollstein
- Charité - Universitätsmedizin Berlin, Klinik für Endokrinologie, Berlin, Germany
| | - T Grenkowitz
- Charité - Universitätsmedizin Berlin, Klinik für Endokrinologie, Berlin, Germany
| | | | - W Maerz
- University Medical Centre of Mannheim, Mannheim, Germany
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23
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Boeckel JN, Palapies L, Klotsche J, Zeller T, von Jeinsen B, Perret MF, Kleinhaus SL, Pieper L, Tzikas S, Leistner D, Bickel C, Stalla GK, Lehnert H, Lindahl B, Wittchen HU, Silber S, Baldus S, Maerz W, Dimmeler S, Blankenberg S, Münzel T, Zeiher AM, Keller T. Adjusted Troponin I for Improved Evaluation of Patients with Chest Pain. Sci Rep 2018; 8:8087. [PMID: 29799020 PMCID: PMC5967336 DOI: 10.1038/s41598-018-26120-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
Abstract
The use of cardiac troponins (cTn) is the gold standard for diagnosing myocardial infarction. Independent of myocardial infarction (MI), however, sex, age and kidney function affect cTn levels. Here we developed a method to adjust cTnI levels for age, sex, and renal function, maintaining a unified cut-off value such as the 99th percentile. A total of 4587 individuals enrolled in a prospective longitudinal study were used to develop a model for adjustment of cTn. cTnI levels correlated with age and estimated glomerular filtration rate (eGFR) in males/females with rage = 0.436/0.518 and with reGFR = -0.142/-0.207. For adjustment, these variables served as covariates in a linear regression model with cTnI as dependent variable. This adjustment model was then applied to a real-world cohort of 1789 patients with suspected acute MI (AMI) (N = 407). Adjusting cTnI showed no relevant loss of diagnostic information, as evidenced by comparable areas under the receiver operator characteristic curves, to identify AMI in males and females for adjusted and unadjusted cTnI. In specific patients groups such as in elderly females, adjusting cTnI improved specificity for AMI compared with unadjusted cTnI. Specificity was also improved in patients with renal dysfunction by using the adjusted cTnI values. Thus, the adjustments improved the diagnostic ability of cTnI to identify AMI in elderly patients and in patients with renal dysfunction. Interpretation of cTnI values in complex emergency cases is facilitated by our method, which maintains a single diagnostic cut-off value in all patients.
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Affiliation(s)
- Jes-Niels Boeckel
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
- Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
- Department of Internal Medicine, Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Lars Palapies
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Jens Klotsche
- Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Tanja Zeller
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
- Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany
| | - Beatrice von Jeinsen
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
| | - Maya F Perret
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Soeren L Kleinhaus
- Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Lars Pieper
- Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Stergios Tzikas
- 3rd Department of Cardiology, Ippokrateio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Medicine II, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - David Leistner
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
| | - Christoph Bickel
- Department of Internal Medicine, Federal Armed Forces Hospital, Koblenz, Germany
| | - Günter K Stalla
- Max Plank Institute for Psychiatry, Neuroendocrinology, Munich, Munich, Germany
| | - Hendrik Lehnert
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Bertil Lindahl
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala, Sweden
| | - Hans-Ulrich Wittchen
- Clinical Psychology und Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Sigmund Silber
- Praxisklinik, Kardiologische Gemeinschaftspraxis, Munich, Germany
| | - Stephan Baldus
- Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany
- Heart Center, University of Cologne, Cologne, Germany
| | - Winfried Maerz
- Synlab Akademie für ärztliche Fortbildung, Synlab Services GmbH, Mannheim, Germany
| | - Stefanie Dimmeler
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
- Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefan Blankenberg
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
- Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany
| | - Thomas Münzel
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
- Department of Medicine II, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Andreas M Zeiher
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany
| | - Till Keller
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.
- German Center for Cardiovascular Disease (DZHK), Berlin, Germany.
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
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Raedle-Hurst T, Mueller M, Meinitzer A, Maerz W, Dschietzig T. Homoarginine-A prognostic indicator in adolescents and adults with complex congenital heart disease? PLoS One 2017; 12:e0184333. [PMID: 28886170 PMCID: PMC5590899 DOI: 10.1371/journal.pone.0184333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background Homoarginine (hArg) has been shown to be of prognostic value in patients with chronic left heart failure. The present study aims to assess the clinical utility and prognostic value of hArg levels in patients with complex congenital heart disease (CHD). Methods Plasma hArg levels were measured in 143 patients with complex CHD and compared to clinical status, echocardiographic and laboratory parameters as well as the occurrence of adverse cardiac events. Results Median hArg levels were 1.5 μmol/l in CHD patients as compared to 1.70 μmol/l in healthy controls (p = 0.051). Median hArg levels were lowest in patients with Fontan palliation (1.27 μmol/l) and Eisenmenger physiology (0.99 μmol/l) and decreased with the severity of adverse cardiac events with lowest values found in patients prior to death or overt heart failure (0.89 μmol/l). According to ROC analysis, the most important predictors of adverse cardiac events were hArg levels (AUC 0.837, p<0.001, CI 0.726–0.947), NYHA class (AUC 0.800, p<0.001, CI 0.672–0.928) and NT-proBNP levels (AUC 0.780, p<0.001, CI 0.669–0.891). The occurrence of overt heart failure or death due to progressive heart failure were best predicted by NYHA class (AUC 0.945, p<0.001, CI 0.898–0.992), hArg levels (AUC 0.911, p<0.001, CI 0.850–0.971) and NT-proBNP levels (AUC 0.877, p<0.001, CI 0.791–0.962), respectively. Conclusion In patients with complex CHD, hArg levels can predict adverse cardiac events as reliably as or even better than NT-proBNP levels and thus might be of prognostic value in this subset of patients.
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Affiliation(s)
- Tanja Raedle-Hurst
- Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany
- * E-mail:
| | - Marieke Mueller
- Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried Maerz
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim and Augsburg, Germany
| | - Thomas Dschietzig
- Charité – University Medicine Berlin, Medical Clinic for Cardiology and Angiology, Campus Mitte, Berlin, Germany
- Immundiagnostik GmbH, Bensheim, Germany
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Werner C, Stojakovic T, Maerz W, Scharnagl H, Laufs U. P1510Prospective study of fasting and postprandial chylomicron triglyceride content and cardiovascular events in patients with stable coronary artery disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Keller T, Boeckel JN, Groß S, Klotsche J, Palapies L, Leistner D, Pieper L, Stalla GK, Lehnert H, Silber S, Pittrow D, Maerz W, Dörr M, Wittchen HU, Baumeister SE, Völker U, Felix SB, Dimmeler S, Zeiher AM. Improved risk stratification in prevention by use of a panel of selected circulating microRNAs. Sci Rep 2017; 7:4511. [PMID: 28674420 PMCID: PMC5495799 DOI: 10.1038/s41598-017-04040-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/08/2017] [Indexed: 01/08/2023] Open
Abstract
Risk stratification is crucial in prevention. Circulating microRNAs have been proposed as biomarkers in cardiovascular disease. Here a miR panel consisting of miRs related to different cardiovascular pathophysiologies, was evaluated to predict outcome in the context of prevention. MiR-34a, miR-223, miR-378, miR-499 and miR-133 were determined from peripheral blood by qPCR and combined to a risk panel. As derivation cohort, 178 individuals of the DETECT study, and as validation cohort, 129 individuals of the SHIP study were used in a case-control approach. Overall mortality and cardiovascular events were outcome measures. The Framingham Risk Score(FRS) and the SCORE system were applied as risk classification systems. The identified miR panel was significantly associated with mortality given by a hazard ratio(HR) of 3.0 (95% (CI): 1.09–8.43; p = 0.034) and of 2.9 (95% CI: 1.32–6.33; p = 0.008) after adjusting for the FRS in the derivation cohort. In a validation cohort the miR-panel had a HR of 1.31 (95% CI: 1.03–1.66; p = 0.03) and of 1.29 (95% CI: 1.02–1.64; p = 0.03) in a FRS/SCORE adjusted-model. A FRS/SCORE risk model was significantly improved to predict mortality by the miR panel with continuous net reclassification index of 0.42/0.49 (p = 0.014/0.005). The present miR panel of 5 circulating miRs is able to improve risk stratification in prevention with respect to mortality beyond the FRS or SCORE.
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Affiliation(s)
- Till Keller
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany. .,German Centre for Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany. .,Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.
| | - Jes-Niels Boeckel
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany.,Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefan Groß
- German Centre for Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Jens Klotsche
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Lars Palapies
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - David Leistner
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Günnter K Stalla
- Max Planck Institute of Psychiatry, Endocrinology, Munich, Munich, Germany
| | | | | | - David Pittrow
- Institute of Clinical Pharmacology, Technical University Dresden, Dresden, Germany
| | - Winfried Maerz
- Synlab Akademie für ärztliche Fortbildung, Synlab Services GmbH, Mannheim, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Sebastian E Baumeister
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, Department of Cardiology, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Germany
| | - Stefanie Dimmeler
- German Centre for Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany.,Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas M Zeiher
- Department of Internal Medicine III, Cardiology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.,German Centre for Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany
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Mueller V, Jakob A, Aktas B, Pott D, Grafe A, Jungberg P, Maerz W, Fett W, Bruch HR, Klare P, Boller E, Hoefflin S, Schneeweiss A. Abstract P6-13-02: Efficacy of first-line bevacizumab (BEV)-containing therapy for poor-prognosis advanced breast cancer (aBC): Subgroup analyses of the German AVANTI observational study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-13-02] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The multicenter AVANTI observational study is evaluating the safety and effectiveness of EU-approved BEV-containing regimens (BEV + paclitaxel [PAC] or BEV + capecitabine [CAP]) as first-line therapy for HER2-negative aBC in German routine oncology practice.
Methods: Eligible patients (pts) had received no prior chemotherapy (CT) for aBC and had no BEV contraindications. CT schedule, diagnostics, and frequency of follow-up visits are at the physician's discretion. Data are collected for 1 year after starting BEV, with 6-monthly follow-up for 1.5 years thereafter. We explored treatment outcomes in pts with triple-negative aBC (TNBC), pts considered at high risk according to a simple prognostic index for OS in BEV-treated pts [Llombart, 2014], and subgroups defined by timing of BEV+CT initiation.
Results: Between Oct 2009 and Feb 2015, 2168 pts treated at 331 centers received BEV+PAC (n=1774) or BEV+CAP (n=394). Of these, 445 (21%) had TNBC and 306 (14%) met the high-risk criteria. Within the hormone receptor-positive (HR+) subgroup, pts receiving endocrine therapy (ET) before BEV+CT were older than pts starting BEV+CT immediately (median age 65 vs 60 years, respectively) and included a smaller proportion with ECOG performance status 0 (39% vs 47%), visceral metastases (70% vs 77%), or prior (neo)adjuvant CT exposure (46% vs 57%). In all subgroups, median BEV treatment duration was longer than median CT duration. At the data cutoff for this interim analysis (Mar 1, 2015), median duration of observation was 10.8 (range <0.1–47.5) months. The table shows treatment exposure and efficacy overall and in selected subgroups.
table 1 All pts (n=2168)TNBC (n=445)aHR+ with immediate BEV+CT (n=1260)a,bHR+ with ET before BEV+CT (n=309)a,bHigh riskc (n=306)bBEV+PAC, n (%)1774 (82)352 (79)b1062 (84)238 (77)229 (75)Treated until PD, n (%)b,d640 (30)180 (40)314 (25)104 (34)125 (41)BEV+CT until PD449 (21)143 (32)210 (17)61 (20)99 (32)Single-agent BEV until PD191 (9)37 (8)104 (8)43 (14)26 (8)Median BEV duration, months (95% CI)5.9 (5.6–6.3)5.1 (4.9–5.6)6.4 (5.9–7.0)5.6 (5.1–6.5)5.1 (4.6–5.6)Median CT duration, months4.6 (4.4–4.9)3.9 (3.5–4.2)4.9 (4.6–5.1)4.6 (4.2–5.1)3.9 (3.3–4.4)No. of PFS events/pts (%)e1238/2154 (57)302/441 (68)667/1255 (53)187/307 (61)210/306 (69)Median PFS, months (95% CI)10.1 (9.7–10.7)7.2 (6.2–8.0)11.5 (10.8–12.3)9.0 (8.3–10.0)6.4 (5.9–7.4)a154 pts could not be classified as TNBC or HR+ because of missing HR status information. bPost hoc analysis. c≥3 of the 5 risk factors (disease-free interval ≤24 months; ECOG performance status ≥2; liver metastases and/or ≥3 metastatic organ sites; TNBC; prior (neo)adjuvant anthracycline and/or taxane). dData available only in pts with documented end of treatment. ePFS data missing in 14 pts.
Conclusions: Interim results from this large observational study indicate that first-line BEV+CT is an effective therapy in all risk subgroups of a general population of pts with HER2-negative aBC treated in routine oncology practice, including pts with a particularly poor prognosis. Results of these exploratory subgroup analyses suggest that BEV+CT could be considered irrespective of HR status.
Citation Format: Mueller V, Jakob A, Aktas B, Pott D, Grafe A, Jungberg P, Maerz W, Fett W, Bruch H-R, Klare P, Boller E, Hoefflin S, Schneeweiss A. Efficacy of first-line bevacizumab (BEV)-containing therapy for poor-prognosis advanced breast cancer (aBC): Subgroup analyses of the German AVANTI observational study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-13-02.
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Affiliation(s)
- V Mueller
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A Jakob
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - B Aktas
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - D Pott
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A Grafe
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - P Jungberg
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - W Maerz
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - W Fett
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - H-R Bruch
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - P Klare
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - E Boller
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - S Hoefflin
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A Schneeweiss
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynaekologie, Hamburg, Germany; Ortenau-Klinikum, Offenburg, Germany; Universitaetsklinikum Essen, Essen, Germany; Schwerpunktpraxis Haematologie und Onkologie, Bottrop, Germany; MVZ Nordhausen gGmbH, Praxis Dr. Grafe/Brustzentrum der Frauenklinik, Suedharz- Klinikum Nordhausen gGmbH, Nordhausen, Germany; Frauenarztpraxis Dr. Jungberg, Chemnitz, Germany; Onkologie Klinikum Kulmbach, Kulmbach, Germany; Onkologische Praxis, Wuppertal, Germany; Schwerpunktpraxis Bonn, Bonn, Germany; Brustzentrum Berlin, Berlin, Germany; iOMEDICO Clinical Research Organisation, Freiburg, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Universitaets-Klinikum Heidelberg, Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
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Schiekofer S, Kleber ME, Maerz W, Rasche FM, Schneider JG. The Proline 7 Substitution in the Preproneuropeptide Y Is Associated with Higher Hepatic Lipase Activity In Vivo. Int J Endocrinol 2017; 2017:2869090. [PMID: 28638407 PMCID: PMC5468775 DOI: 10.1155/2017/2869090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Hepatic lipase (HL) functions as a lipolytic enzyme that hydrolyzes triglycerides and phospholipids present in circulating plasma lipoproteins. Plasma HL activity is known to be regulated by hormonal and metabolic factors, but HL responsiveness to insulin as well as its role in modulating atherosclerotic risk is still controversial. We investigated on the influence of a known polymorphism in the neurotransmitter neuropeptide Y (NPY) on HL activity in two different cohorts consisting of diabetic and nondiabetic patients. HL activity was 24% and 34% higher on nondiabetic and diabetic subjects in the presence of the 7Pro allele in NPY, respectively. The presence of the 7Pro allele was an independent predictor of HL activity in multivariate analyses in both cohorts. These data suggest a regulatory effect of NPY on HL activity. Among carriers of the 7Pro allele, we also found a statistically significant lower absolute number of infarctions compared to noncarriers (p < 0.05) and a nonsignificant trend towards less myocardial infarction in the 7Pro allele diabetic carriers (p = 0.085). In conclusion, the common 7Pro allele in NPY was associated with higher HL activity in nondiabetic and diabetic subjects and its presence seems to coincide with a lower frequency of certain cardiovascular events.
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Affiliation(s)
| | - Marcus E. Kleber
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Winfried Maerz
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria
- Synlab Academy, Mannheim, Germany
- Synlab Holding Deutschland GmbH, Augsburg, Germany
| | - Franz M. Rasche
- Departments of Internal Medicine, Neurology, Dermatology, Clinic for Endocrinology, Diabetology, and Nephrology, Section of Nephrology, University Leipzig, Leipzig, Germany
| | - Jochen G. Schneider
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg and Centre Hospitalier Emile Mayrisch (CHEM), Esch-sur-Alzette, Luxembourg
- Department of Internal Medicine II, Saarland University Medical Center, Homburg, Saar, Germany
- *Jochen G. Schneider:
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Roeseler E, Julius U, Heigl F, Spitthoever R, Heutling D, Breitenberger P, Leebmann J, Lehmacher W, Kamstrup PR, Nordestgaard BG, Maerz W, Noureen A, Schmidt K, Kronenberg F, Heibges A, Klingel R, Schettler V, Benzing T, Christ H, Wehner S, Schulz-Merkel I, Kuehn R, Wagner A, Dschietzig W, Ernst C, Koziolek M, Bunia J, Kulzer P, Kraenzle KD, Toelle M, Riechers G, Kuehnel C, Marsen T, Saehn C, Ringel J, Messner H, Oehring A, Schuerfeld C, Wintergalen M, Schettler V, Neumann F, Kaul H, Haesner M, Passfall J, Benschneider A, Heidenreich S, März W, Klaes R, Binner P, Dieplinger H, Erhart G, Fassbender C, Christ H. Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2016; 36:2019-27. [DOI: 10.1161/atvbaha.116.307983] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 06/24/2016] [Indexed: 11/16/2022]
Abstract
Objective—
Lipoprotein(a)-hyperlipoproteinemia (Lp(a)-HLP) along with progressive cardiovascular disease has been approved as indication for regular lipoprotein apheresis (LA) in Germany since 2008. We aimed to study the long-term preventive effect of LA and to assess hypothetical clinical correlations of apolipoprotein(a) (apo(a)) by analyzing genotypes and phenotypes.
Approach and Results—
This prospective observational multicenter study included 170 patients with Lp(a)-HLP and progressive cardiovascular disease (48.9 years median age at diagnosis) despite other cardiovascular risk factors, including low-density lipoprotein cholesterol had maximally been treated (mean baseline low-density lipoprotein cholesterol: measured, 2.56 mmol/L [98.9 mg/dL] and corrected, 1.72 mmol/L [66.3 mg/dL]). Patients were prospectively investigated during a 5-year period about annual incidence rates of cardiovascular events. In addition, apo(a) isoforms and polymorphisms at the apo(a) gene (
LPA
) were characterized. One hundred fifty-four patients (90.6%) completed 5 years of follow-up. Mean Lp(a) concentration before commencing regular LA was 108.1 mg/dL. This was reduced by a single LA treatment by 68.1% on average. Significant decline of the mean annual cardiovascular event rate was observed from 0.58±0.53 2 years before regular LA to 0.11±0.15 thereafter (
P
<0.0001); 95.3% of patients expressed at least 1 small apo(a) isoform. Small apo(a) isoform (35.2%) carrying phenotypes were not tagged by single-nucleotide polymorphisms rs10455872 or rs3798220.
Conclusions—
Results of 5 years of prospective follow-up confirm that LA has a lasting effect on prevention of cardiovascular events in patients with Lp(a)-HLP. Patients clinically selected by progressive cardiovascular disease were characterized by a highly frequent expression of small apo(a) isoforms. Only Lp(a) concentration seemed to comprehensively reflect Lp(a)-associated cardiovascular risk, however.
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Affiliation(s)
- Eberhard Roeseler
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Ulrich Julius
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Franz Heigl
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Ralf Spitthoever
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Dennis Heutling
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Paul Breitenberger
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Josef Leebmann
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Walter Lehmacher
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Pia R. Kamstrup
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Børge G. Nordestgaard
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Winfried Maerz
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Asma Noureen
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Konrad Schmidt
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Florian Kronenberg
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Andreas Heibges
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
| | - Reinhard Klingel
- From the Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital at the Technische Universität, Dresden, Germany (U.J.); Medical Health and Care Center Kempten-Allgäu, Kempten, Germany (F.H.); Dialysis and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); 1st Medical Clinic, General Hospital, Passau, Germany (J.L.)
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Winkler TW, Justice AE, Graff M, Barata L, Feitosa MF, Chu S, Czajkowski J, Esko T, Fall T, Kilpeläinen TO, Lu Y, Mägi R, Mihailov E, Pers TH, Rüeger S, Teumer A, Ehret GB, Ferreira T, Heard-Costa NL, Karjalainen J, Lagou V, Mahajan A, Neinast MD, Prokopenko I, Simino J, Teslovich TM, Jansen R, Westra HJ, White CC, Absher D, Ahluwalia TS, Ahmad S, Albrecht E, Alves AC, Bragg-Gresham JL, de Craen AJM, Bis JC, Bonnefond A, Boucher G, Cadby G, Cheng YC, Chiang CWK, Delgado G, Demirkan A, Dueker N, Eklund N, Eiriksdottir G, Eriksson J, Feenstra B, Fischer K, Frau F, Galesloot TE, Geller F, Goel A, Gorski M, Grammer TB, Gustafsson S, Haitjema S, Hottenga JJ, Huffman JE, Jackson AU, Jacobs KB, Johansson Å, Kaakinen M, Kleber ME, Lahti J, Mateo Leach I, Lehne B, Liu Y, Lo KS, Lorentzon M, Luan J, Madden PAF, Mangino M, McKnight B, Medina-Gomez C, Monda KL, Montasser ME, Müller G, Müller-Nurasyid M, Nolte IM, Panoutsopoulou K, Pascoe L, Paternoster L, Rayner NW, Renström F, Rizzi F, Rose LM, Ryan KA, Salo P, Sanna S, Scharnagl H, Shi J, Smith AV, Southam L, Stančáková A, Steinthorsdottir V, Strawbridge RJ, Sung YJ, Tachmazidou I, Tanaka T, Thorleifsson G, Trompet S, Pervjakova N, Tyrer JP, Vandenput L, van der Laan SW, van der Velde N, van Setten J, van Vliet-Ostaptchouk JV, Verweij N, Vlachopoulou E, Waite LL, Wang SR, Wang Z, Wild SH, Willenborg C, Wilson JF, Wong A, Yang J, Yengo L, Yerges-Armstrong LM, Yu L, Zhang W, Zhao JH, Andersson EA, Bakker SJL, Baldassarre D, Banasik K, Barcella M, Barlassina C, Bellis C, Benaglio P, Blangero J, Blüher M, Bonnet F, Bonnycastle LL, Boyd HA, Bruinenberg M, Buchman AS, Campbell H, Chen YDI, Chines PS, Claudi-Boehm S, Cole J, Collins FS, de Geus EJC, de Groot LCPGM, Dimitriou M, Duan J, Enroth S, Eury E, Farmaki AE, Forouhi NG, Friedrich N, Gejman PV, Gigante B, Glorioso N, Go AS, Gottesman O, Gräßler J, Grallert H, Grarup N, Gu YM, Broer L, Ham AC, Hansen T, Harris TB, Hartman CA, Hassinen M, Hastie N, Hattersley AT, Heath AC, Henders AK, Hernandez D, Hillege H, Holmen O, Hovingh KG, Hui J, Husemoen LL, Hutri-Kähönen N, Hysi PG, Illig T, De Jager PL, Jalilzadeh S, Jørgensen T, Jukema JW, Juonala M, Kanoni S, Karaleftheri M, Khaw KT, Kinnunen L, Kittner SJ, Koenig W, Kolcic I, Kovacs P, Krarup NT, Kratzer W, Krüger J, Kuh D, Kumari M, Kyriakou T, Langenberg C, Lannfelt L, Lanzani C, Lotay V, Launer LJ, Leander K, Lindström J, Linneberg A, Liu YP, Lobbens S, Luben R, Lyssenko V, Männistö S, Magnusson PK, McArdle WL, Menni C, Merger S, Milani L, Montgomery GW, Morris AP, Narisu N, Nelis M, Ong KK, Palotie A, Pérusse L, Pichler I, Pilia MG, Pouta A, Rheinberger M, Ribel-Madsen R, Richards M, Rice KM, Rice TK, Rivolta C, Salomaa V, Sanders AR, Sarzynski MA, Scholtens S, Scott RA, Scott WR, Sebert S, Sengupta S, Sennblad B, Seufferlein T, Silveira A, Slagboom PE, Smit JH, Sparsø TH, Stirrups K, Stolk RP, Stringham HM, Swertz MA, Swift AJ, Syvänen AC, Tan ST, Thorand B, Tönjes A, Tremblay A, Tsafantakis E, van der Most PJ, Völker U, Vohl MC, Vonk JM, Waldenberger M, Walker RW, Wennauer R, Widén E, Willemsen G, Wilsgaard T, Wright AF, Zillikens MC, van Dijk SC, van Schoor NM, Asselbergs FW, de Bakker PIW, Beckmann JS, Beilby J, Bennett DA, Bergman RN, Bergmann S, Böger CA, Boehm BO, Boerwinkle E, Boomsma DI, Bornstein SR, Bottinger EP, Bouchard C, Chambers JC, Chanock SJ, Chasman DI, Cucca F, Cusi D, Dedoussis G, Erdmann J, Eriksson JG, Evans DA, de Faire U, Farrall M, Ferrucci L, Ford I, Franke L, Franks PW, Froguel P, Gansevoort RT, Gieger C, Grönberg H, Gudnason V, Gyllensten U, Hall P, Hamsten A, van der Harst P, Hayward C, Heliövaara M, Hengstenberg C, Hicks AA, Hingorani A, Hofman A, Hu F, Huikuri HV, Hveem K, James AL, Jordan JM, Jula A, Kähönen M, Kajantie E, Kathiresan S, Kiemeney LALM, Kivimaki M, Knekt PB, Koistinen HA, Kooner JS, Koskinen S, Kuusisto J, Maerz W, Martin NG, Laakso M, Lakka TA, Lehtimäki T, Lettre G, Levinson DF, Lind L, Lokki ML, Mäntyselkä P, Melbye M, Metspalu A, Mitchell BD, Moll FL, Murray JC, Musk AW, Nieminen MS, Njølstad I, Ohlsson C, Oldehinkel AJ, Oostra BA, Palmer LJ, Pankow JS, Pasterkamp G, Pedersen NL, Pedersen O, Penninx BW, Perola M, Peters A, Polašek O, Pramstaller PP, Psaty BM, Qi L, Quertermous T, Raitakari OT, Rankinen T, Rauramaa R, Ridker PM, Rioux JD, Rivadeneira F, Rotter JI, Rudan I, den Ruijter HM, Saltevo J, Sattar N, Schunkert H, Schwarz PEH, Shuldiner AR, Sinisalo J, Snieder H, Sørensen TIA, Spector TD, Staessen JA, Stefania B, Thorsteinsdottir U, Stumvoll M, Tardif JC, Tremoli E, Tuomilehto J, Uitterlinden AG, Uusitupa M, Verbeek ALM, Vermeulen SH, Viikari JS, Vitart V, Völzke H, Vollenweider P, Waeber G, Walker M, Wallaschofski H, Wareham NJ, Watkins H, Zeggini E, Chakravarti A, Clegg DJ, Cupples LA, Gordon-Larsen P, Jaquish CE, Rao DC, Abecasis GR, Assimes TL, Barroso I, Berndt SI, Boehnke M, Deloukas P, Fox CS, Groop LC, Hunter DJ, Ingelsson E, Kaplan RC, McCarthy MI, Mohlke KL, O'Connell JR, Schlessinger D, Strachan DP, Stefansson K, van Duijn CM, Hirschhorn JN, Lindgren CM, Heid IM, North KE, Borecki IB, Kutalik Z, Loos RJF. Correction: The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study. PLoS Genet 2016; 12:e1006166. [PMID: 27355579 PMCID: PMC4927064 DOI: 10.1371/journal.pgen.1006166] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pgen.1005378.].
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Alesutan I, Feger M, Tuffaha R, Castor T, Musculus K, Buehling SS, Heine CL, Kuro-O M, Pieske B, Schmidt K, Tomaschitz A, Maerz W, Pilz S, Meinitzer A, Voelkl J, Lang F. Augmentation of phosphate-induced osteo-/chondrogenic transformation of vascular smooth muscle cells by homoarginine. Cardiovasc Res 2016; 110:408-418. [DOI: 10.1093/cvr/cvw062] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Winkler TW, Justice AE, Graff M, Barata L, Feitosa MF, Chu S, Czajkowski J, Esko T, Fall T, Kilpeläinen TO, Lu Y, Mägi R, Mihailov E, Pers TH, Rüeger S, Teumer A, Ehret GB, Ferreira T, Heard-Costa NL, Karjalainen J, Lagou V, Mahajan A, Neinast MD, Prokopenko I, Simino J, Teslovich TM, Jansen R, Westra HJ, White CC, Absher D, Ahluwalia TS, Ahmad S, Albrecht E, Alves AC, Bragg-Gresham JL, de Craen AJM, Bis JC, Bonnefond A, Boucher G, Cadby G, Cheng YC, Chiang CWK, Delgado G, Demirkan A, Dueker N, Eklund N, Eiriksdottir G, Eriksson J, Feenstra B, Fischer K, Frau F, Galesloot TE, Geller F, Goel A, Gorski M, Grammer TB, Gustafsson S, Haitjema S, Hottenga JJ, Huffman JE, Jackson AU, Jacobs KB, Johansson Å, Kaakinen M, Kleber ME, Lahti J, Leach IM, Lehne B, Liu Y, Lo KS, Lorentzon M, Luan J, Madden PAF, Mangino M, McKnight B, Medina-Gomez C, Monda KL, Montasser ME, Müller G, Müller-Nurasyid M, Nolte IM, Panoutsopoulou K, Pascoe L, Paternoster L, Rayner NW, Renström F, Rizzi F, Rose LM, Ryan KA, Salo P, Sanna S, Scharnagl H, Shi J, Smith AV, Southam L, Stančáková A, Steinthorsdottir V, Strawbridge RJ, Sung YJ, Tachmazidou I, Tanaka T, Thorleifsson G, Trompet S, Pervjakova N, Tyrer JP, Vandenput L, van der Laan SW, van der Velde N, van Setten J, van Vliet-Ostaptchouk JV, Verweij N, Vlachopoulou E, Waite LL, Wang SR, Wang Z, Wild SH, Willenborg C, Wilson JF, Wong A, Yang J, Yengo L, Yerges-Armstrong LM, Yu L, Zhang W, Zhao JH, Andersson EA, Bakker SJL, Baldassarre D, Banasik K, Barcella M, Barlassina C, Bellis C, Benaglio P, Blangero J, Blüher M, Bonnet F, Bonnycastle LL, Boyd HA, Bruinenberg M, Buchman AS, Campbell H, Chen YDI, Chines PS, Claudi-Boehm S, Cole J, Collins FS, de Geus EJC, de Groot LCPGM, Dimitriou M, Duan J, Enroth S, Eury E, Farmaki AE, Forouhi NG, Friedrich N, Gejman PV, Gigante B, Glorioso N, Go AS, Gottesman O, Gräßler J, Grallert H, Grarup N, Gu YM, Broer L, Ham AC, Hansen T, Harris TB, Hartman CA, Hassinen M, Hastie N, Hattersley AT, Heath AC, Henders AK, Hernandez D, Hillege H, Holmen O, Hovingh KG, Hui J, Husemoen LL, Hutri-Kähönen N, Hysi PG, Illig T, De Jager PL, Jalilzadeh S, Jørgensen T, Jukema JW, Juonala M, Kanoni S, Karaleftheri M, Khaw KT, Kinnunen L, Kittner SJ, Koenig W, Kolcic I, Kovacs P, Krarup NT, Kratzer W, Krüger J, Kuh D, Kumari M, Kyriakou T, Langenberg C, Lannfelt L, Lanzani C, Lotay V, Launer LJ, Leander K, Lindström J, Linneberg A, Liu YP, Lobbens S, Luben R, Lyssenko V, Männistö S, Magnusson PK, McArdle WL, Menni C, Merger S, Milani L, Montgomery GW, Morris AP, Narisu N, Nelis M, Ong KK, Palotie A, Pérusse L, Pichler I, Pilia MG, Pouta A, Rheinberger M, Ribel-Madsen R, Richards M, Rice KM, Rice TK, Rivolta C, Salomaa V, Sanders AR, Sarzynski MA, Scholtens S, Scott RA, Scott WR, Sebert S, Sengupta S, Sennblad B, Seufferlein T, Silveira A, Slagboom PE, Smit JH, Sparsø TH, Stirrups K, Stolk RP, Stringham HM, Swertz MA, Swift AJ, Syvänen AC, Tan ST, Thorand B, Tönjes A, Tremblay A, Tsafantakis E, van der Most PJ, Völker U, Vohl MC, Vonk JM, Waldenberger M, Walker RW, Wennauer R, Widén E, Willemsen G, Wilsgaard T, Wright AF, Zillikens MC, van Dijk SC, van Schoor NM, Asselbergs FW, de Bakker PIW, Beckmann JS, Beilby J, Bennett DA, Bergman RN, Bergmann S, Böger CA, Boehm BO, Boerwinkle E, Boomsma DI, Bornstein SR, Bottinger EP, Bouchard C, Chambers JC, Chanock SJ, Chasman DI, Cucca F, Cusi D, Dedoussis G, Erdmann J, Eriksson JG, Evans DA, de Faire U, Farrall M, Ferrucci L, Ford I, Franke L, Franks PW, Froguel P, Gansevoort RT, Gieger C, Grönberg H, Gudnason V, Gyllensten U, Hall P, Hamsten A, van der Harst P, Hayward C, Heliövaara M, Hengstenberg C, Hicks AA, Hingorani A, Hofman A, Hu F, Huikuri HV, Hveem K, James AL, Jordan JM, Jula A, Kähönen M, Kajantie E, Kathiresan S, Kiemeney LALM, Kivimaki M, Knekt PB, Koistinen HA, Kooner JS, Koskinen S, Kuusisto J, Maerz W, Martin NG, Laakso M, Lakka TA, Lehtimäki T, Lettre G, Levinson DF, Lind L, Lokki ML, Mäntyselkä P, Melbye M, Metspalu A, Mitchell BD, 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Stefansson K, van Duijn CM, Hirschhorn JN, Lindgren CM, Heid IM, North KE, Borecki IB, Kutalik Z, Loos RJF. The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study. PLoS Genet 2015; 11:e1005378. [PMID: 26426971 PMCID: PMC4591371 DOI: 10.1371/journal.pgen.1005378] [Citation(s) in RCA: 253] [Impact Index Per Article: 28.1] [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: 11/19/2014] [Accepted: 06/22/2015] [Indexed: 01/11/2023] Open
Abstract
Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men ≤50y, men >50y, women ≤50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (≥50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape. Adult body size and body shape differ substantially between men and women and change over time. More than 100 genetic variants that influence body mass index (measure of body size) or waist-to-hip ratio (measure of body shape) have been identified. While there is evidence that some genetic loci affect body shape differently in men than in women, little is known about whether genetic effects differ in older compared to younger adults, and whether such changes differ between men and women. Therefore, we conducted a systematic genome-wide search, including 114 studies (>320,000 individuals), to specifically identify genetic loci with age- and or sex-dependent effects on body size and shape. We identified 15 loci of which the effect on BMI was different in older compared to younger adults, whereas we found no evidence for loci with different effects in men compared to women. The opposite was seen for body shape as we identified 44 loci of which the effect on waist-to-hip ratio differed between men and women, but no difference between younger and older adults were observed. Our observations may provide new insights into the biology that underlies weight change with age or the sexual dimorphism of body shape.
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Affiliation(s)
- Thomas W. Winkler
- Department of Genetic Epidemiology, Institute of Epidemiology and Preventive Medicine, University Regensburg, Regensburg, Germany
| | - Anne E. Justice
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mariaelisa Graff
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Llilda Barata
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Mary F. Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Su Chu
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jacek Czajkowski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tõnu Esko
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Divisions of Endocrinology and Genetics and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, Massachusetts, United States of America
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tove Fall
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Tuomas O. Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Department of Preventive Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Reedik Mägi
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | | | - Tune H. Pers
- Divisions of Endocrinology and Genetics and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, Massachusetts, United States of America
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
- Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Sina Rüeger
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Institute of Social and Preventive Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Georg B. Ehret
- Department of Specialties of Internal Medicine, Geneva University Hospital, Geneva, Switzerland
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Teresa Ferreira
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Nancy L. Heard-Costa
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- National Heart, Lung, and Blood Institute, the Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Juha Karjalainen
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Vasiliki Lagou
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Michael D. Neinast
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Inga Prokopenko
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
- Hammersmith Hospital, London, United Kingdom
- Department of Genomics of Common Diseases, School of Public Health, Imperial College London, London, United Kingdom
| | - Jeannette Simino
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tanya M. Teslovich
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Rick Jansen
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Harm-Jan Westra
- Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Divisions of Genetics and Rheumatology, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Partners Center for Personalized Genetic Medicine, Boston, Massachusetts, United States of America
| | - Charles C. White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Devin Absher
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, United States of America
| | - Tarunveer S. Ahluwalia
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center A/S, Gentofte, Denmark
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Shafqat Ahmad
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåne University Hospital Malmö, Malmö, Sweden
| | - Eva Albrecht
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Alexessander Couto Alves
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
| | - Jennifer L. Bragg-Gresham
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Anton J. M. de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Amélie Bonnefond
- CNRS UMR 8199, Lille, France
- European Genomic Institute for Diabetes, Lille, France
- Université de Lille 2, Lille, France
| | | | - Gemma Cadby
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Crawley, Western Australia, Australia
| | - Yu-Ching Cheng
- VA Maryland Health Care System, Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, United States of America
| | - Charleston W. K. Chiang
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Graciela Delgado
- Vth Department of Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Ayse Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nicole Dueker
- Universiy of Maryland School of Medicine, Department of Epidemiology & Public Health, Baltimore, Maryland, United States of America
| | - Niina Eklund
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
- National Institute for Health and Welfare, Public Health Genomics Unit, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | | | - Joel Eriksson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bjarke Feenstra
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Krista Fischer
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
| | - Francesca Frau
- Department of Health Sciences, University of Milan, Milan, Italy
- Filarete Foundation, Genomic and Bioinformatics Unit, Milano, Italy
| | - Tessel E. Galesloot
- Radboud university medical center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, The Netherlands
| | - Frank Geller
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovacular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mathias Gorski
- Department of Genetic Epidemiology, Institute of Epidemiology and Preventive Medicine, University Regensburg, Regensburg, Germany
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Tanja B. Grammer
- Vth Department of Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Stefan Gustafsson
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Saskia Haitjema
- Experimental Cardiology and laboratory of clinical chemistry, UMCU, Utrecht, The Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Jennifer E. Huffman
- National Heart, Lung, and Blood Institute, the Framingham Heart Study, Framingham, Massachusetts, United States of America
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Anne U. Jackson
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Kevin B. Jacobs
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- Core Genotyping Facility, SAIC-Frederick, Inc., NCI-Frederick, Frederick, Maryland, United States of America
| | - Åsa Johansson
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Marika Kaakinen
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Marcus E. Kleber
- Vth Department of Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Jari Lahti
- Folkhälsan Research Centre, Helsinki, Finland
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Irene Mateo Leach
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - Benjamin Lehne
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Youfang Liu
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chaper Hill, North Carolina, United States of America
| | - Ken Sin Lo
- Montreal Heart Institute, Montréal, Québec, Canada
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jian'an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Pamela A. F. Madden
- Washington University Medical School, St. Louis, Missouri, United States of America
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Barbara McKnight
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Program in Biostatistics and Biomathematics, Divison of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Carolina Medina-Gomez
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Keri L. Monda
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- The Center for Observational Research, Amgen Inc., Thousand Oaks, California, United States of America
| | - May E. Montasser
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Dept of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Gabriele Müller
- Center for Evidence Based Healthcare, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partnersite Munich Heart Alliance, Munich, Germany
| | - Ilja M. Nolte
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | | | - Laura Pascoe
- Institute of Cell & Molecular Biosciences, Newcastle University, Newcastle, United Kingdom
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Nigel W. Rayner
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
| | - Frida Renström
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåne University Hospital Malmö, Malmö, Sweden
| | - Federica Rizzi
- Department of Health Sciences, University of Milan, Milan, Italy
- Filarete Foundation, Genomic and Bioinformatics Unit, Milano, Italy
| | - Lynda M. Rose
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Kathy A. Ryan
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Dept of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Perttu Salo
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
- National Institute for Health and Welfare, Public Health Genomics Unit, Helsinki, Finland
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Italy
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Jianxin Shi
- National Cancer Institute, Bethesda, Maryland, United States of America
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lorraine Southam
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | | | - Rona J. Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Ioanna Tachmazidou
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | | | - Stella Trompet
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Natalia Pervjakova
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
- National Institute for Health and Welfare, Public Health Genomics Unit, Helsinki, Finland
- Institute of Cell and Molecular Biology, Department of Biotechnology, University of Tartu, Tartu, Estonia
- University of Helsinki, Helsinki, Finland
| | - Jonathan P. Tyrer
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sander W van der Laan
- Experimental Cardiology and laboratory of clinical chemistry, UMCU, Utrecht, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Jessica van Setten
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jana V. van Vliet-Ostaptchouk
- University of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, The Netherlands
| | - Niek Verweij
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - Efthymia Vlachopoulou
- Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Lindsay L. Waite
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, United States of America
| | - Sophie R. Wang
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts, United States of America
- Divisions of Genetics and Endocrinology and Program in Genomics, Boston's Children's Hospital, Boston, Massachusetts, United States of America
| | - Zhaoming Wang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- Core Genotyping Facility, SAIC-Frederick, Inc., NCI-Frederick, Frederick, Maryland, United States of America
| | - Sarah H. Wild
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
| | - Christina Willenborg
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
- Institut für Integrative und Experimentelle Genomik, Universität zu Lübeck, Lübeck, Germany
| | - James F. Wilson
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
| | - Andrew Wong
- MRC Unit for Lifelong Health & Ageing at UCL, London, United Kingdom
| | - Jian Yang
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Loïc Yengo
- CNRS UMR 8199, Lille, France
- European Genomic Institute for Diabetes, Lille, France
- Université de Lille 2, Lille, France
| | - Laura M. Yerges-Armstrong
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Dept of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Ealing Hospital NHS Trust, Middlesex, United Kingdom
| | - Jing Hua Zhao
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Ehm A. Andersson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephan J. L. Bakker
- University of Groningen, University Medical Center Groningen, Department of Medicine, Groningen, Netherlands
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy
| | - Karina Banasik
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Matteo Barcella
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Claire Bellis
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
- Genomics Research Centre, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Paola Benaglio
- Department of Pediatrics, University of California San Diego, La Jolla, California, United States of America
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
| | - John Blangero
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, Texas, United States of America
| | - Matthias Blüher
- University of Leipzig, IFB Adiposity Diseases, Leipzig, Germany
- University of Leipzig, Department of Medicine, Leipzig, Germany
| | | | - Lori L. Bonnycastle
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, United States of America
| | - Heather A. Boyd
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Marcel Bruinenberg
- University of Groningen, University Medical Center Groningen, The LifeLines Cohort Study, Groningen, The Netherlands
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
| | - Yii-Der Ida Chen
- Los Angeles BioMedical Resesarch Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Peter S. Chines
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, United States of America
| | - Simone Claudi-Boehm
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
| | - John Cole
- VA Maryland Health Care System, Baltimore, Maryland, United States of America
- Universiy of Maryland School of Medicine, Department of Neurology, Baltimore, Maryland, United States of America
| | - Francis S. Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, United States of America
| | - Eco J. C. de Geus
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Maria Dimitriou
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- Department of Dietetics-Nutrition, Harokopio University, Athens, Greece
| | - Jubao Duan
- NorthShore University HealthSystem, Evanston, Illinois, United States of America
- University of Chicago, Chicago, Illinois, United States of America
| | - Stefan Enroth
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Elodie Eury
- CNRS UMR 8199, Lille, France
- European Genomic Institute for Diabetes, Lille, France
- Université de Lille 2, Lille, France
| | - Aliki-Eleni Farmaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Nita G. Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Pablo V. Gejman
- NorthShore University HealthSystem, Evanston, Illinois, United States of America
- University of Chicago, Chicago, Illinois, United States of America
| | - Bruna Gigante
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Glorioso
- Hypertension and Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Alan S. Go
- Kaiser Permanente, Division of Research, Oakland, California, United States of America
| | - Omri Gottesman
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Jürgen Gräßler
- Department of Medicine III, Pathobiochemistry, University of Dresden, Dresden, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yu-Mei Gu
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Linda Broer
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annelies C. Ham
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland, United States of America
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Catharina A. Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Maija Hassinen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Nicholas Hastie
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Andrew T. Hattersley
- Institue of Biomedical & Clinical Science, University of Exeter, Exeter, United Kingdom
| | - Andrew C. Heath
- Washington University Medical School, St. Louis, Missouri, United States of America
| | - Anjali K. Henders
- QIMR Bergofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hans Hillege
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - Oddgeir Holmen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kees G Hovingh
- Department Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Jennie Hui
- Pathwest Laboratory Medicine of Western Australia, Nedlands, Western Australia,Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
- School of Population Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Lise L. Husemoen
- Research Centre for Prevention and Health, Glostrup Hospital, Glostrup, Denmark
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine, Tampere, Finland
- Department of Pediatrics,Tampere University Hospital, Tampere, Finland
| | - Pirro G. Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
- Institute of Human Genetics, Hannover Medical School, Hanover, Germany
| | - Philip L. De Jager
- Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts,United States of America
- Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts,United States of America
| | - Shapour Jalilzadeh
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovacular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Glostrup Hospital, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Medicine, University of Turku, Turku, Finland
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Kay Tee Khaw
- Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Leena Kinnunen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Steven J. Kittner
- VA Maryland Health Care System, Baltimore, Maryland, United States of America
- Universiy of Maryland School of Medicine, Department of Neurology, Baltimore, Maryland, United States of America
| | - Wolfgang Koenig
- Department of Internal Medicine II—Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Ivana Kolcic
- Department of Public Health, Faculty of Medicine, University of Split, Split, Croatia
| | - Peter Kovacs
- University of Leipzig, IFB Adiposity Diseases, Leipzig, Germany
| | - Nikolaj T. Krarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
| | - Janine Krüger
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Diana Kuh
- MRC Unit for Lifelong Health & Ageing at UCL, London, United Kingdom
| | - Meena Kumari
- Department of Epidemiology and Public Health, UCL, London, United Kingdom
| | - Theodosios Kyriakou
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovacular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
- Department of Epidemiology and Public Health, UCL, London, United Kingdom
| | - Lars Lannfelt
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Chiara Lanzani
- Chair of Nephrology, Università Vita Salute San Raffaele, Segrate (Milan), Italy
- Genomics of Renal Disease and Hypertension Unit, IRCCS San Raffaele Scientific Institute, Segrate (Milan), Italy
| | - Vaneet Lotay
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lenore J. Launer
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jaana Lindström
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup Hospital, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark
| | - Yan-Ping Liu
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Stéphane Lobbens
- CNRS UMR 8199, Lille, France
- European Genomic Institute for Diabetes, Lille, France
- Université de Lille 2, Lille, France
| | - Robert Luben
- Strangeways Research Laboratory Wort's Causeway, Cambridge, United Kingdom
| | - Valeriya Lyssenko
- Steno Diabetes Center A/S, Gentofte, Denmark
- Lund University Diabetes Centre and Department of Clinical Science, Diabetes & Endocrinology Unit, Lund University, Malmö, Sweden
| | - Satu Männistö
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
| | - Patrik K. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wendy L. McArdle
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Sigrun Merger
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
| | - Lili Milani
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
| | | | - Andrew P. Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Narisu Narisu
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, United States of America
| | - Mari Nelis
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
| | - Ken K. Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
- MRC Unit for Lifelong Health & Ageing at UCL, London, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- Massachusetts General Hospital, Center for Human Genetic Research, Psychiatric and Neurodevelopmental Genetics Unit, Boston, Massachusetts, United States of America
| | - Louis Pérusse
- Department of Kinesiology, Laval University, Québec City, Québec, Canada
- Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
| | - Irene Pichler
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy, Affiliated Institute of the University of Lübeck, Lübeck, Germany
| | - Maria G. Pilia
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Italy
| | - Anneli Pouta
- Department of Children, Young People and Families, National Institute for Health and Welfare, Helsinki, Finland
- Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Myriam Rheinberger
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Rasmus Ribel-Madsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marcus Richards
- MRC Unit for Lifelong Health & Ageing at UCL, London, United Kingdom
| | - Kenneth M. Rice
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Treva K. Rice
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Carlo Rivolta
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
| | - Veikko Salomaa
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
| | - Alan R. Sanders
- NorthShore University HealthSystem, Evanston, Illinois, United States of America
- University of Chicago, Chicago, Illinois, United States of America
| | - Mark A. Sarzynski
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Salome Scholtens
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Robert A. Scott
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - William R. Scott
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Ealing Hospital NHS Trust, Middlesex, United Kingdom
| | - Sylvain Sebert
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Sebanti Sengupta
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Seufferlein
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
| | - Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - P. Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan H. Smit
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas H. Sparsø
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kathleen Stirrups
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ronald P. Stolk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Heather M. Stringham
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Morris A Swertz
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Amy J. Swift
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, United States of America
| | - Ann-Christine Syvänen
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sian-Tsung Tan
- Ealing Hospital NHS Trust, Middlesex, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Anke Tönjes
- University of Leipzig, Department of Medicine, Leipzig, Germany
| | - Angelo Tremblay
- Department of Kinesiology, Laval University, Québec City, Québec, Canada
| | | | - Peter J. van der Most
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Marie-Claude Vohl
- Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada
- School of Nutrition, Laval University, Québec City, Québec,Canada
| | - Judith M. Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Melanie Waldenberger
- DZHK (German Centre for Cardiovascular Research), partnersite Munich Heart Alliance, Munich, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Ryan W. Walker
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Department of Preventive Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Roman Wennauer
- Department of Clinical Chemistry, Ulm University Medical Centre, Ulm, Germany
| | - Elisabeth Widén
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Gonneke Willemsen
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Tom Wilsgaard
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Alan F. Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - M. Carola Zillikens
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Suzanne C. van Dijk
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Natasja M. van Schoor
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- VUMC, Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands
| | - Folkert W. Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, Netherlands
- Durrer Center for Cardiogenetic Research, Interuniversity Cardiology Institute Netherlands-Netherlands Heart Institute, Utrecht, The Netherlands
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Paul I. W. de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Epidemiology, University Medical Center, Utrecht, The Netherlands
| | | | - John Beilby
- Pathwest Laboratory Medicine of Western Australia, Nedlands, Western Australia,Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - David A. Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Richard N. Bergman
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Sven Bergmann
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
| | - Carsten A. Böger
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - Bernhard O. Boehm
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
- Imperial College London, London, United Kingdom
- Lee Kong Chian School of Medicine, Singapore, Singapore
- Nanyang Technological University, Singapore, Singapore
| | - Eric Boerwinkle
- Human Genetics Center and Institute of Molecular Medicine, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Dorret I. Boomsma
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Stefan R. Bornstein
- Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - Erwin P. Bottinger
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Ealing Hospital NHS Trust, Middlesex, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- Program in Biostatistics and Biomathematics, Divison of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts,United States of America
| | - Francesco Cucca
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Italy
- University of Sassari, Sassari, Italy
| | - Daniele Cusi
- Department of Health Sciences, University of Milan, Milan, Italy
- Institute of Biomedical Technologies, National Institute of Research, Segrate-Milano, Italy
| | - George Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Jeanette Erdmann
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
- Institut für Integrative und Experimentelle Genomik, Universität zu Lübeck, Lübeck, Germany
| | - Johan G. Eriksson
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Denis A. Evans
- Rush Institute for Healthy Aging and Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovacular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - Lude Franke
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - Paul W. Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåne University Hospital Malmö, Malmö, Sweden
- Department of Public Health & Clinical Medicine, Umeå University Hospital, Umeå, Sweden, Umeå, Sweden
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Philippe Froguel
- CNRS UMR 8199, Lille, France
- European Genomic Institute for Diabetes, Lille, France
- Université de Lille 2, Lille, France
| | - Ron T. Gansevoort
- University of Groningen, University Medical Center Groningen, Department of Medicine, Groningen, Netherlands
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Henrik Grönberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ulf Gyllensten
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
- Durrer Center for Cardiogenetic Research, Interuniversity Cardiology Institute Netherlands-Netherlands Heart Institute, Utrecht, The Netherlands
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Markku Heliövaara
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Christian Hengstenberg
- DZHK (German Centre for Cardiovascular Research), partnersite Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Technische Universität München, München, Germany
| | - Andrew A Hicks
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy, Affiliated Institute of the University of Lübeck, Lübeck, Germany
| | - Aroon Hingorani
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Albert Hofman
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Frank Hu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Heikki V. Huikuri
- Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Kristian Hveem
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alan L. James
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chaper Hill, North Carolina, United States of America
| | - Antti Jula
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
- Department of Clinical Physiology, University of Tampere School of Medicine, Tampere, Finland
| | - Eero Kajantie
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sekar Kathiresan
- Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Center for Human Genetics Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Lambertus A. L. M. Kiemeney
- Radboud university medical center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, The Netherlands
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Urology, Nijmegen, The Netherlands
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, UCL, London, United Kingdom
| | - Paul B. Knekt
- National Institute for Health and Welfare, Helsinki, Finland
| | - Heikki A. Koistinen
- National Institute for Health and Welfare, Helsinki, Finland
- University of Helsinki and Helsinki University Central Hospital, Department of Medicine and Abdominal Center: Endocrinology, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Jaspal S. Kooner
- Ealing Hospital NHS Trust, Middlesex, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Seppo Koskinen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Winfried Maerz
- Vth Department of Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Nicholas G Martin
- QIMR Bergofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timo A. Lakka
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories and School of Medicine, University of Tampere, Tampere, Finland
| | - Guillaume Lettre
- Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | | | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Marja-Liisa Lokki
- Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Pekka Mäntyselkä
- Primary Health Care Unit, Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Mads Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Braxton D. Mitchell
- University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, United States of America
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, Maryland, United States of America
| | - Frans L. Moll
- Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jeffrey C. Murray
- Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States of America
| | - Arthur W. Musk
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Markku S. Nieminen
- HUCH Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
| | - Inger Njølstad
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Albertine J. Oldehinkel
- University of Groningen, University Medical Center, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - Ben A. Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lyle J Palmer
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Gerard Pasterkamp
- Experimental Cardiology and laboratory of clinical chemistry, UMCU, Utrecht, The Netherlands
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brenda W. Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Markus Perola
- Estonian Genome Center, Univeristy of Tartu, Tartu, Estonia
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Annette Peters
- DZHK (German Centre for Cardiovascular Research), partnersite Munich Heart Alliance, Munich, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Ozren Polašek
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
- Department of Public Health, Faculty of Medicine, University of Split, Split, Croatia
| | - Peter P. Pramstaller
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy, Affiliated Institute of the University of Lübeck, Lübeck, Germany
- Department of Neurology, General Central Hospital, Bolzano, Italy
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Departments of Epidemiology and Health Services, University of Washington, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health Cooperative, Seatte, Washington, United States of America
| | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Thomas Quertermous
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts,United States of America
| | - John D. Rioux
- Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Fernando Rivadeneira
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jerome I. Rotter
- Los Angeles BioMedical Resesarch Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland
| | - Hester M. den Ruijter
- Experimental Cardiology and laboratory of clinical chemistry, UMCU, Utrecht, The Netherlands
| | - Juha Saltevo
- Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Heribert Schunkert
- DZHK (German Centre for Cardiovascular Research), partnersite Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Technische Universität München, München, Germany
| | - Peter E. H. Schwarz
- Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
| | - Alan R. Shuldiner
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Dept of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Geriatric Research and Education Clinical Center, Vetrans Administration Medical Center, Baltimore, Maryland, United States of America
| | - Juha Sinisalo
- HUCH Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
| | - Harold Snieder
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Thorkild I. A. Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Jan A. Staessen
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R & D VitaK Group, Maastricht University, Maastricht, The Netherlands
| | | | - Unnur Thorsteinsdottir
- deCODE Genetics, Amgen inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Michael Stumvoll
- University of Leipzig, IFB Adiposity Diseases, Leipzig, Germany
- University of Leipzig, Department of Medicine, Leipzig, Germany
| | - Jean-Claude Tardif
- Montreal Heart Institute, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy
| | - Jaakko Tuomilehto
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Centre for Vascular Prevention, Danube-University Krems, Krems, Austria
- Instituto de Investigacion Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - André G. Uitterlinden
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Matti Uusitupa
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
- Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - André L. M. Verbeek
- Radboud university medical center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, The Netherlands
| | - Sita H. Vermeulen
- Radboud university medical center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | | | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Peter Vollenweider
- Department of Internal Medicine, University Hospital Lausanne (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Gérard Waeber
- Department of Internal Medicine, University Hospital Lausanne (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Mark Walker
- Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Institute of Cellular Medicine, Newcastle University, Newcastle, United Kingdom
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovacular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Eleftheria Zeggini
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
| | - CHARGE Consortium
- The Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium
| | | | | | | | | | - MAGIC Consortium
- The Meta-Analyses of Glucose and Insulin-related traits Consortium
| | - Aravinda Chakravarti
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Deborah J. Clegg
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - L. Adrienne Cupples
- National Heart, Lung, and Blood Institute, the Framingham Heart Study, Framingham, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Cashell E. Jaquish
- National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda, Maryland, United States of America
| | - D. C. Rao
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Goncalo R. Abecasis
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Themistocles L. Assimes
- Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science Addenbrooke’s Hospital, Cambridge, United Kingdom
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michael Boehnke
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Human Genetics, Hinxton, Cambridge, United Kingdom
- 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
| | - Caroline S. Fox
- National Heart, Lung, and Blood Institute, the Framingham Heart Study, Framingham, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts,United States of America
| | - Leif C. Groop
- Lund University Diabetes Centre and Department of Clinical Science, Diabetes & Endocrinology Unit, Lund University, Malmö, Sweden
- Finnish Institute for Molecular Medicine (FIMM), Helsinki University, Helsinki, Finland
| | - David J. Hunter
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Erik Ingelsson
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Robert C. Kaplan
- Department of Epidemiology and Popualtion Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Mark I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
- Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom
| | - Karen L. Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jeffrey R. O'Connell
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Dept of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - David Schlessinger
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David P. Strachan
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Kari Stefansson
- deCODE Genetics, Amgen inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Cornelia M. van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Center for Medical Systems Biology, Leiden, The Netherlands
| | - Joel N. Hirschhorn
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Divisions of Endocrinology and Genetics and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, Massachusetts, United States of America
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Cecilia M. Lindgren
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, United States of America
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Iris M. Heid
- Department of Genetic Epidemiology, Institute of Epidemiology and Preventive Medicine, University Regensburg, Regensburg, Germany
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- * E-mail: (IMH); (KEN); (IBB); (ZK); (RJFL)
| | - Kari E. North
- Carolina Center for Genome Sciences and Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail: (IMH); (KEN); (IBB); (ZK); (RJFL)
| | - Ingrid B. Borecki
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail: (IMH); (KEN); (IBB); (ZK); (RJFL)
| | - Zoltán Kutalik
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Institute of Social and Preventive Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
- * E-mail: (IMH); (KEN); (IBB); (ZK); (RJFL)
| | - Ruth J. F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Department of Preventive Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Genetics of Obesity and Related Metabolic Traits Program, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- The Mindich Child Health and Development Institute, The Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail: (IMH); (KEN); (IBB); (ZK); (RJFL)
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Rinde H, Genser B, Sonntag D, Kleber ME, Stojakovic T, Scharnagl H, Maerz W. Cost-Effectiveness And Budget Impact Analyses Of Risk Stratification Of Patients With Moderate Risk Of Cardiovascular Events Using Lp-Pla2 Testing. Value Health 2014; 17:A481. [PMID: 27201405 DOI: 10.1016/j.jval.2014.08.1393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H Rinde
- BioBridge Strategies, Binningen, Switzerland
| | - B Genser
- Mannheim Institue of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - D Sonntag
- Mannheim Institue of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - M E Kleber
- Mannheim Institue of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | | | | | - W Maerz
- Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
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Athanasiou Y, Zavros M, Arsali M, Papazachariou L, Demosthenous P, Savva I, Voskarides K, Deltas C, Pierides A, Feriozzi S, Perrin A, West M, Nicholls K, Sunder-Plassmann G, Torras J, Neumann P, Cybulla M, Cofiell R, Kukreja A, Bedard K, Yan Y, Mickle A, Ogawa M, Bedrosian C, Faas S, Meszaros K, Pruess L, Gondan M, Ritz E, Schaefer F, Testa A, Spoto B, Leonardis D, Sanguedolce MC, Pisano A, Parlongo MR, Tripepi G, Mallamaci F, Zoccali C, Trujillano D, Bullich G, Ballarin J, Torra R, Estivill X, Ars E, Kleber ME, Delgado G, Grammer TB, Silbernagel G, Kraemer BK, Maerz W, Riccio E, Pisani A, Abdalla AA, Malone AF, Winn MP, Goodship T, Cronin C, Conlon PJ, Casserly LF, Nishio S, Sakuhara Y, Matsuoka N, Yamamoto J, Nakazawa D, Nakagakaki T, Abo D, Shibazaki S, Atsumi T, Mazzinghi B, Giglio S, Provenzano A, Becherucci F, Sansavini G, Ravaglia F, Roperto RM, Murer L, Lasagni L, Materassi M, Romagnani P, Schmidts M, Christou S, Cortes C, McInerney-Leo A, Kayserili H, Zankl A, Peter S, Duncan E, Wicking C, Beales PL, Mitchison H, Magestro M, Vekeman F, Nichols T, Karner P, Duh MS, Srivastava B, Van Doorn-Khosrovani SBVW, Zonnenberg BA, Musetti C, Quaglia M, Ghiggeri GM, Fogazzi GB, Settanni F, Boldorini RL, Lazzarich E, Airoldi A, Izzo C, Giordano M, Stratta P, Garrido P, Fernandes JC, Ribeiro S, Belo L, Costa EC, Reis F, Santos-Silva A, Youssef DM, Alshal AS, Salah K, Rashed AE, Kingswood JC, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin EM, Korf B, Flamini JR, Kohrman MH, Sparagana S, Wu JY, Berkowitz N, Miao S, Segal S, Ridolfi A, Bissler JJ, Franz DN, Oud MM, Van Bon BW, Bongers EM, Hoischen A, Marcelis CL, De Leeuw N, Mol SJ, Mortier G, Knoers NV, Brunner HG, Roepman R, Arts HH, Van Eerde AM, Van Der Zwaag B, Lilien MR, Renkema KY, De Borst MH, Van Haaften G, Giles RH, Navis GJ, Knoers NVAM, Lu KC, Su SL, Gigante M, Santangelo L, Diella S, Argentiero L, Cianciotta F, Martino M, Ranieri E, Grandaliano G, Giordano M, Gesualdo L, Fernandes J, Ribeiro S, Garrido P, Sereno J, Costa E, Reis F, Santos-Silva A, Chub O, Aires I, Polidori D, Santos AR, Brito Costa A, Simoes C, Rueff J, Nolasco F, Calado J, Van Der Tol L, Biegstraaten M, Florquin S, Vogt L, Van Den Bergh Weerman MA, Hollak CE, Hughes DA, Lachmann RH, Oliveira JP, Ortiz A, Svarstad E, Terryn W, Tondel C, Waldek S, Wanner C, West ML, Linthorst GE, Kaesler N, Brandenburg V, Theuwissen E, Vermeer C, Floege J, Schlieper G, Kruger T, Xydakis D, Goulielmos G, Antonaki E, Stylianoy K, Sfakianaki M, Papadogiannakis A, Dafnis E, Mdimegh S, Ben Hadj Mbarek - Fredj I, Moussa A, Omezzine A, Zellama D, Mabrouk S, Zouari N, Hassayoun S, Chemli J, Achour A, Bouslama A, Abroug S, Spoto B, Leonardis D, Politi C, Pisano A, Cutrupi S, Testa A, Parlongo RM, D'Arrigo G, Tripepi G, Mallamaci F, Zoccali C, Mdimegh S, Ben Hadj Mbarek - Fredj I, Moussa A, Omezzine A, Mabrouk S, Zouari N, Hassayoun S, Chemli J, Zellama D, Achour A, Bouslama A, Abroug S, Hohenstein-Scheibenecker K, Schmidt A, Stylianou KG, Kyriazis J, Androvitsanea A, Tzanakakis M, Maragkaki E, Petrakis J, Stratakis S, Poulidaki R, Vardaki E, Petra C, Statigis S, Perakis K, Daphnis E, Cybulla M, West M, Nicholls K, Torras J, Neumann P, Sunder-Plassmann G, Feriozzi S, Metzinger-Le Meuth V, Taibi F, M'Baya-Moutoula E, Louvet L, Massy Z, Metzinger L, Mani LY, Sidler D, Vogt B, Nikolskaya N, Cox JA, Kingswood JC, Smirnov A, Zarayski M, Kayukov I, Karunnaya H, Sipovski V, Kukoleva L, Dobronravov V. GENETIC DISEASES AND MOLECULAR GENETICS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wheeler DC, Abdalla S, Chertow G, Parfrey P, Herzog C, Mikolasevic I, Racki S, Lukenda V, Milic S, Devcic B, Orlic L, Suttorp MM, Hoekstra T, Ocak G, Van Diepen ATN, Ott I, Mittelman M, Rabelink TJ, Krediet RT, Dekker FW, Simone S, Dell'Oglio MPS, Ciccone M, Corciulo R, Castellano G, Balestra C, Grandaliano G, Gesualdo L, Pertosa G, Nishida M, Ando M, Karasawa K, Iwamoto Y, Tsuchiya K, Nitta K, Krzanowski M, Janda K, Gajda M, Dumnicka P, Fedak D, Lis G, Ja kowski P, Litwin JA, Su owicz W, Freitas GR, Silva VB, Abensur H, Luders C, Pereira BJ, Castro MC, Oliverira RB, Moyses RM, Elias RM, Silva BC, Tekce H, Ozturk S, Aktas G, Kin Tekce B, Erdem A, Ozyasar M, Taslamacioglu Duman T, Yazici M, Kirkpantur A, Balci MM, Turkvatan A, Afsar B, Alkis M, Mandiroglu F, Voroneanu L, Siriopol D, Nistor I, Apetrii M, Hogas S, Onofriescu M, Covic A, An WS, Kim SE, Son YK, Oh YJ, Gelev S, Toshev S, Trajceska L, Selim G, Dzekova P, Shikole A, Park J, Lee JS, Shin ES, Ann SH, Kim SJ, Chung HC, Janda K, Krzanowski M, Gajda M, Dumnicka P, Fedak D, Lis G, Litwin JA, Sulowicz W, Elewa U, Bichari W, Abo-Seif K, Seferi S, Rroji M, Likaj E, Spahia N, Barbullushi M, Thereska N, Kopecky CM, Genser B, Maerz W, Wanner C, Saemann MD, Weichhart T, Sezer S, Gurlek Demirci B, Tutal E, Bal Z, Erkmen Uyar M, Ozdemir Acar FN, Macunluoglu B, Atakan A, Ari Bakir E, Georgianos P, Sarafidis PA, Stamatiadis DN, Liakopoulos V, Zebekakis PE, Papagianni A, Lasaridis AN, Eftimovska - Otovic N, Babalj-Banskolieva E, Kostadinska-Bogdanoska S, Grozdanovski R, Aono M, Sato Y, El Amrani M, Asserraji M, Benyahia M, Lee YK, Choi SR, Cho A, Kim JK, Choi MJ, Kim SJ, Yoon JW, Koo JR, Kim HJ, Noh JW, Inagaki H, Yokota N, Sato Y, Chiyotanda S, Fukami K, Fujimoto S, Kendi Celebi Z, Kutlay S, Sengul S, Nergizoglu G, Erturk S, Ates K, Vishnevskii KA, Rumyantsev AS, Zemchenkov AY, Smirnov AV, Reinhardt B, Knaup R, Esteve Simo V, Carneiro Oliveira J, Moreno Guzman F, Fulquet Nicolas M, Pou Potau M, Saurina Sole A, Duarte Gallego V, Ramirez De Arellano Serna M, Turkmen K, Demirtas L, Akbas EM, Bakirci EM, Buyuklu M, Timuroglu A, Georgianos PI, Sarafidis PA, Karpetas A, Liakopoulos V, Stamatiadis DN, Papagianni A, Lasaridis AN, Taira T, Nohtomi K, Takemura T, Chiba T, Hirano T, Chang CT, Huang CC, Chen CJ, El Amrani M, Mohamed A, Benyahia M, Kanai H, Tamura Y, Kaizu Y, Kali A, Yayar O, Erdogan B, Eser B, Ercan Z, Buyukbakkal M, Merhametsiz O, Haspulat A, Yildirim T, Bozkurt B, Ayli MD, Bal Z, Erkmen Uyar M, Gokustun D, Gurlek Demirci B, Tutal E, Sezer S, Markaki A, Grammatikopoulou M, Fragkiadakis G, Stylianou K, Venyhaki M, Chatzi V, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Gelev S, Petronievic Z, Sikole A, Moyseyenko V, Nykula T, Fernandes RT, Barreto DV, Rodrigues GGC, Misael A, Branco-Martins CT, Barreto FC, Yayar O, Ercan Z, Eser B, Merhametsiz O, Haspulat A, Buyukbakkal M, Erdogan B, Yildirim T, Bozkurt B, Ayli MD. DIALYSIS CARDIOVASCULAR COMPLICATIONS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kurnatowska I, Grzelak P, Masajtis-Zagajewska A, Kaczmarska M, Stefa czyk L, Vermeer C, Maresz K, Nowicki M, Patel L, Bernard LM, Elder GJ, Leonardis D, Mallamaci F, Tripepi G, D'Arrigo G, Postorino M, Enia G, Caridi G, Marino F, Parlongo G, Zoccali C, Genovese F, Boor P, Papasotiriou M, Leeming DJ, Karsdal MA, Floege J, Delmas-Frenette C, Troyanov S, Awadalla P, Devuyst O, Madore F, Jensen JM, Mose FH, Kulik AEO, Bech JN, Fenton RA, Pedersen EB, Lucisano S, Villari A, Benedetto F, Pettinato G, Cernaro V, Lupica R, Trimboli D, Costantino G, Santoro D, Buemi M, Carmone C, Robben JH, Hadchouel J, Rongen G, Deinum J, Navis GJ, Wetzels JF, Deen PM, Block G, Fishbane S, Shemesh S, Sharma A, Wolf M, Chertow G, Gracia M, Arroyo D, Betriu A, Valdivielso JM, Fernandez E, Cantaluppi V, Medica D, Quercia AD, Dellepiane S, Gai M, Leonardi G, Guarena C, Migliori M, Panichi V, Biancone L, Camussi G, Covic A, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Rakov V, Floege J, Floege J, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Braunhofer P, Covic A, Kaku Y, Ookawara S, Miyazawa H, Ito K, Ueda Y, Hirai K, Hoshino T, Mori H, Nabata A, Yoshida I, Tabei K, El-Shahawy M, Cotton J, Kaupke J, Wooldridge TD, Weiswasser M, Smith WT, Covic A, Ketteler M, Rastogi A, Spinowitz B, Sprague SM, Botha J, Braunhofer P, Floege J, Hanowski T, Jager K, Rong S, Lesch T, Knofel F, Kielstein H, McQuarrie EP, Mark PB, Freel EM, Taylor A, Jardine AG, Wang CL, Du Y, Nan L, :Hess K, Savvaidis A, Lysaja K, Dimkovic N, Floege J, Marx N, Schlieper G, Skrunes R, Larsen KK, Svarstad E, Tondel C, Singh B, Ash SR, Lavin PT, Yang A, Rasmussen HS, Block GA, Egbuna O, Zeig S, Pergola PE, Singh B, Braun A, Yu Y, Sohn W, Padhi D, Block G, Chertow G, Fishbane S, Rodriguez M, Chen M, Shemesh S, Sharma A, Wolf M, Delgado G, Kleber ME, Grammer TB, Kraemer BK, Maerz W, Scharnagl H, Ichii M, Ishimura E, Shima H, Ohno Y, Tsuda A, Nakatani S, Ochi A, Mori K, Inaba M, Filiopoulos V, Manolios N, Hadjiyannakos D, Arvanitis D, Karatzas I, Vlassopoulos D, Floege J, Botha J, Chong E, Sprague SM, Cosmai L, Porta C, Foramitti M, Masini C, Sabbatini R, Malberti F, Elewa U, Nastou D, Fernandez B, Egido J, Ortiz A, Hara S, Tanaka K, Kushiyama A, Sakai K, Sawa N, Hoshino J, Ubara Y, Takaichi K, Bouquegneau A, Vidal-Petiot E, Vrtovsnik F, Cavalier E, Krzesinski JM, Flamant M, Delanaye P, Kilis-Pstrusinska K, Prus-Wojtowicz E, Szepietowski JC, Raj DS, Amdur R, Yamamoto J, Mori M, Sugiyama N, Inaguma D, Youssef DM, Alshal AA, Elbehidy RM, Bolignano D, Palmer S, Navaneethan S, Strippoli G, Kim YN, Park K, Gwoo S, Shin HS, Jung YS, Rim H, Rhew HY, Tekce H, Kin Tekce B, Aktas G, Schiepe F, Draz Y, Rakov V, Yilmaz MI, Siriopol D, Saglam M, Kurt YG, Unal H, Eyileten T, Gok M, Cetinkaya H, Oguz Y, Sari S, Vural A, Mititiuc I, Covic A, Kanbay M, Filiopoulos V, Manolios N, Hadjiyannakos D, Arvanitis D, Karatzas I, Vlassopoulos D, Okarska-Napierala M, Ziolkowska H, Pietrzak R, Skrzypczyk P, Jankowska K, Werner B, Roszkowska-Blaim M, Cernaro V, Trifiro G, Lorenzano G, Lucisano S, Buemi M, Santoro D, Krause R, Fuhrmann I, Degenhardt S, Daul AE, Sallee M, Dou L, Cerini C, Poitevin S, Gondouin B, Jourde-Chiche N, Brunet P, Dignat-George F, Burtey S, Massimetti C, Achilli P, Madonna MPP, Muratore MTT, Fabbri GDD, Brescia F, Feriozzi S, Unal HU, Kurt YG, Gok M, Cetinkaya H, Karaman M, Eyileten T, Vural A, Oguz Y, Y lmaz MI, Sugahara M, Sugimoto I, Aoe M, Chikamori M, Honda T, Miura R, Tsuchiya A, Hamada K, Ishizawa K, Saito K, Sakurai Y, Mise N, Gama-Axelsson T, Quiroga B, Axelsson J, Lindholm B, Qureshi AR, Carrero JJ, Pechter U, Raag M, Ots-Rosenberg M, Vande Walle J, Greenbaum LA, Bedrosian CL, Ogawa M, Kincaid JF, Loirat C, Liborio A, Leite TT, Neves FMDO, Torres De Melo CB, Leitao RDA, Cunha L, Filho R, Sheerin N, Loirat C, Greenbaum L, Furman R, Cohen D, Delmas Y, Bedrosian CL, Legendre C, Koibuchi K, Aoki T, Miyagi M, Sakai K, Aikawa A, Pozna Ski P, Sojka M, Kusztal M, Klinger M, Fakhouri F, Bedrosian CL, Ogawa M, Kincaid JF, Loirat C, Heleniak Z, Aleksandrowicz E, Wierblewska E, Kunicka K, Bieniaszewski L, Zdrojewski Z, Rutkowski B. CKD PATHOPHYSIOLOGY AND CLINICAL STUDIES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Van Londen M, Humalda JK, Aarts BM, Sanders JS, Bakker SJL, Navis GJ, De Borst MH, Pazik J, O Dak M, Lewandowski Z, Podgorska M, Sadowska A, Sitarek E, Malejczyk J, Durlik M, Drechsler C, Philstrom H, Meinitzer A, Pilz S, Tomaschitz A, Abedini S, Fellstrom B, Jardine A, Wanner C, Maerz W, Holdaas H, Halleck F, Staeck O, Neumayer HH, Budde K, Khadzhynov D, Rostaing L, Allal A, Congy N, Aarninck A, Del Bello A, Maggioni S, Debiols B, Sallusto F, Kamar N, Stolyarevich E, Artyukhina L, Kim I, Tomilina N, Zaidenov V, Kurenkova L, Keyzer CA, De Borst MH, Van Den Berg E, Jahnen-Dechent W, Navis G, Bakker SJL, Van Goor H, Pasch A, Aulagnon F, Avettand-Fenoel V, Scemla A, Lanternier F, Lortholary O, Anglicheau D, Legendre C, Zuber J, Furic-Cunko V, Basic-Jukic N, Coric M, Kastelan Z, Hudolin T, Kes P, Mikolasevic I, Racki S, Lukenda V, Orlic L, Dobrowolski LC, Verberne HJ, Ten Berge IJM, Bemelman FJ, Krediet CTP, Ferreira AC, Silva C, Remedio F, Pena A, Nolasco F, Heldal K, Lonning K, Leivestad T, Reisaeter AV, Hartmann A, Foss AE, Midtvedt K, Vlachopanos G, Kassimatis T, Zerva A, Kokkona A, Stavroulaki E, Agrafiotis A, Sanchez Sobrino B, Lafuente Covarrubias O, Karsten Alvarez S, Zalamea Jarrin F, Rubio Gonzalez E, Huerta Arroyo A, Portoles Perez J, Basic-Jukic N, Kes P, Baek CH, Kim M, Kim JS, Yang WS, Han DJ, Park SK, Zulkarnaev A, Vatazin A, Cabiddu G, Maxia S, Castellino S, Loi V, Guzzo G, Piccoli GB, Pani A, Bucsa C, Tacu D, Harza M, Sinescu I, Mircescu G, Stefan G, Alfieri CM, Laura F, Danilovic B, Cresseri D, Meneghini M, Riccardo F, Regalia A, Messa P, Panuccio V, Tripepi R, Parlongo G, Quattrone S, Leonardis D, Tripepi G, Zoccali C, Mallamaci F, Amer H, Geerdes PA, Fettes TT, Prieto M, Walker RC, Edwards BS, Cosio FG, Khrabrova M, Nabokov A, Groene HJ, Weithofer P, Kliem V, Smirnov A, Dobronravov V, Sezer S, Gurlek Demirci B, Tutal E, Guliyev O, Say N CB, Ozdemir Acar FN, Haberal M, Albugami MM, Hussein M, Alsaeed S, Almubarak A, Bel'eed-Akkari K, Go biewska JE, Tarasewicz A, D bska- lizie A, Rutkowski B, Albugami MM, Hussein M, Almubarak A, Alsaeed S, Bel'eed-Akkari K, Ailioaie O, Arzouk N, Tourret J, Mercadal L, Szumilak D, Ourahma S, Parra J, Billault C, Barrou B, Alfieri CM, Floreani R, Ulivieri FM, Meneghini M, Regalia A, Zanoni F, Croci D, Rastaldi MP, Messa PG, Keyzer CA, Riphagen IJ, Joosten MM, Navis G, Muller Kobold AC, Kema IP, Bakker SJL, De Borst MH, Santos Lascasas J, Malheiro J, Fonseca I, Martins L, Almeida M, Pedroso S, Dias L, Henriques A, Cabrita A, Vincenti F, Weir M, Von Visger J, Kopyt N, Mannon R, Deng H, Yue S, Wolf M, Halleck F, Khadzhynov, D, Schmidt D, Petereit F, Slowinski T, Neumayer HH, Budde K, Staeck O, Hernandez Vargas H, Artamendi Larranaga M, Gil Catalinas F, Ramalle Gomara E, Bello Ovalle A, Pimentel Guzman G, Coloma Lopez A, Dall Anesse C, Gil Paraiso A, Beired Val I, Sierra Carpio M, Huarte Loza E, Slubowska K, Szmidt J, Chmura A, Durlik M, Staeck O, Khadzhynov D, Schmidt D, Niemann M, Petereit F, Lachmann N, Neumayer HH, Budde K, Halleck F, Alotaibi T, Nampoory N, Gheith O, Halim M, Aboatteya H, Mansour H, Abdulkawey H, Said T, Nair P, WazNa-Jab O Ska E, Durlik M, Elias M, Caillard S, Morelon E, Rivalan J, Moal V, Frimat L, Mourad G, Rerolle JP, Legendre C, Mousson C, Delahousse M, Pouteil-Noble C, Dantal J, Cassuto E, Subra JF, Lang P, Thervet E, Roosweil D, Molnar MZ, Fornadi K, Ronai KZ, Novak M, Mucsi I, Scale TM, Robertson S, Kumwenda M, Jibani M, Griffin S, Williams AJ, Mikhail A, Jeong JC, Koo TY, Jeon HJ, Han M, Oh KH, Ahn C, Yang J, Bancu I, Canas L, Juega J, Malumbres S, Guermah I, Bonet J, Lauzurica R, Basso E, Messina M, Daidola G, Mella A, Lavacca A, Manzione AM, Rossetti M, Ranghino A, Ariaudo C, Segoloni GP, Biancone L, Whang E, Son SH, Kwon H, Kong JJ, Choi WY, Yoon CS, Ferreira AC, Silva C, Aires I, Ferreira A, Remedio F, Nolasco F, Ratkovic M, Basic Jukic N, Gledovic B, Radunovic D, Prelevic V, Stefan G, Garneata L, Bucsa C, Harza M, Sinescu I, Mircescu G, Tacu D, Aniort J, Kaysi S, Mulliez A, Heng AE, Su owicz J, Wojas-Pelc A, Ignacak E, Janda K, Krzanowski M, Miarka P, Su owicz W, Filipov JJ, Zlatkov BK, Dimitrov EP, Svinarov DA, Champion L, Renoux C, Randoux C, Du Halgouet C, Azeroual L, Glotz D, Vrtovsnik F, Daugas E, Musetti C, Battista M, Cena T, Izzo C, Airoldi A, Magnani C, Stratta P, Fiskvik I, Holte H, Bentdal O, Holdaas H, Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Colak T, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Kara E, Ahbap E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Akgol C, Sevinc M, Unsal A, Seyahi N, Abdultawab K, Alotaibi T, Gheith O, Mansour H, Halim M, Nair P, Said T, Balaha M, Elsayed A, Awadeen W, Nampoory N, Hwang JC, Jiang MY, Lu YH, Weng SF, Madziarska K, Zmonarski SC, Augustyniak-Bartosik H, Magott-Procelewska M, Krajewska M, Mazanowska O, Banasik M, Penar J, Weyde W, Boraty Ska M, Klinger M, Swarnalatha G, Narendranath L, Shanta Rao G, Sawhney A, Subrahmanyam L, Kumar S, Jeon H, Hakim A, Patel U, Shrivastava S, Banerjee D, Kimura T, Yagisawa T, Nanmoku K, Kurosawa A, Sakuma Y, Miki A, Nukui A, Lee CH, Oh IH, Park JS, Watarai Y, Narumi S, Goto N, Hiramitsu T, Tsujita M, Yamamoto T, Kobayashi T, Muniz Pacios L, Molina M, Cabrera J, Gonzalez E, Garcia Santiago A, Aunon P, Santana S, Polanco N, Gutierrez E, Jimenez C, Andres A, Mohammed M, Hammam M, Housawi A, Goldsmith DJ, Cronin A, Frame S, Smalcelj R, Canoz MB, Yavuz DD, Altunoglu A, Yavuz R, Colak T, Haberal M, Tong A, Hanson CS, Chapman JR, Halleck F, Budde K, Papachristou C, Craig J, Zheng XY, Han S, Wang LM, Zhu YH, Zeng L, Zhou MS, Guliyev O, Erkmen Uyar M, Sezer S, Bal Z, Colak T, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Ranghino A, Diena D, De Rosa FG, Faletti R, Barbui AM, Guarnaccia C, Corcione S, Messina M, Ariaudo C, Segoloni GP, Biancone L, Patel R, Murray PD, Moiseev A, Kalachik A, Harden PN, Norby G, Mjoen G, Holdaas H, Gilboe IM, Shi Y, Luo L, Cai B, Wang T, Tao Y, Wang L, Erkmen Uyar M, Sezer S, Bal Z, Guliyev O, Tutal E, Gurlek Demirci B, Ozdemir Acar N, Haberal M, Di Vico MC, Messina M, Mezza E, Giraudi R, Nappo A, Boaglio E, Ranghino A, Fop F, Segoloni GP, Biancone L, Carta P, Dattolo E, Buti E, Zanazzi M, Villari D, Di Maria L, Santoro G, Li Marzi V, Minetti EE, Nicita G, Carta P, Zanazzi M, Buti E, Antognoli G, Dervishi E, Vignali L, Caroti L, Di Maria L, Minetti EE, Dorje C, Kovacevic G, Hammarstrom C, Strom EH, Holdaas H, Midtvedt K, Reisaeter AV, Alfieri CM, Floreani R, Meneghini M, Regalia A, Zanoni F, Vettoretti S, Croci MD, Rastaldi MP, Messa P, Heldal K, Lonning K, Reisaeter AV, Bernklev T, Midtvedt K, Strakosha A, Pasko N, Nasto F, Cadri V, Dedei A, Thereska N. TRANSPLANTATION CLINICAL 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dieplinger B, Egger M, Haltmayer M, Kleber ME, Scharnagl H, Silbernagel G, de Boer RA, Maerz W, Mueller T. Increased Soluble ST2 Predicts Long-term Mortality in Patients with Stable Coronary Artery Disease: Results from the Ludwigshafen Risk and Cardiovascular Health Study. Clin Chem 2014; 60:530-40. [DOI: 10.1373/clinchem.2013.209858] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
BACKGROUND
Soluble suppression of tumorigenicity 2 (sST2) has emerged as a strong prognostic biomarker in patients with heart failure and myocardial infarction. The aim of this study was to evaluate the long-term prognostic value of sST2 in patients with stable coronary artery disease (CAD).
METHODS
sST2 plasma concentrations were measured in 1345 patients with stable CAD referred for coronary angiography at a single tertiary care center. The primary endpoint was all-cause mortality.
RESULTS
During a median follow-up time of 9.8 years, 477 (36%) patients died. The median sST2 plasma concentration at baseline was significantly higher among decedents than survivors (21.4 vs 18.5 ng/mL; P < 0.001). In multivariate Cox proportional hazards regression analysis, sST2 was an independent predictor of all-cause mortality (risk ratio 1.16 per 1-SD increase in log-transformed values; 95% CI 1.05–1.29; P = 0.004). In the same multivariate analysis, amino-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) were also independent predictors, whereas galectin-3 was not. Patients with sST2 in the highest quartile (>24.6 ng/mL) displayed a 2-fold increased risk of death in univariate analysis, which was attenuated but remained significant in a fully adjusted model (risk ratio 1.39; 95% CI 1.10–1.76; P = 0.006). Further analysis showed that the prognostic impact of sST2 was additive to NT-proBNP and hs-cTnT. Using a multibiomarker approach combining these 3 complementary makers, we demonstrated that patients with all 3 biomarkers in the highest quartiles had the poorest outcome.
CONCLUSIONS
In this cohort of patients with stable CAD, increased sST2 was an independent predictor of long-term all-cause mortality and provided complementary prognostic information to hs-cTnT and NT-proBNP.
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Affiliation(s)
- Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | - Meinhard Haltmayer
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | - Marcus E Kleber
- Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Guenther Silbernagel
- Department of Angiology, Swiss Cardiovascular Center, Inselspital, University of Bern, Switzerland
| | - Rudolf A de Boer
- University of Groningen, Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Winfried Maerz
- Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy Mannheim, Mannheim, Germany
| | - Thomas Mueller
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
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Gylling H, Plat J, Turley S, Ginsberg HN, Ellegård L, Jessup W, Jones PJ, Lütjohann D, Maerz W, Masana L, Silbernagel G, Staels B, Borén J, Catapano AL, De Backer G, Deanfield J, Descamps OS, Kovanen PT, Riccardi G, Tokgözoglu L, Chapman MJ. Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis 2014; 232:346-60. [DOI: 10.1016/j.atherosclerosis.2013.11.043] [Citation(s) in RCA: 339] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 11/11/2013] [Indexed: 01/02/2023]
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Sigruener A, Kleber ME, Heimerl S, Liebisch G, Schmitz G, Maerz W. Glycerophospholipid and sphingolipid species and mortality: the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. PLoS One 2014; 9:e85724. [PMID: 24465667 PMCID: PMC3895004 DOI: 10.1371/journal.pone.0085724] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 12/02/2013] [Indexed: 01/23/2023] Open
Abstract
Vascular and metabolic diseases cause half of total mortality in Europe. New prognostic markers would provide a valuable tool to improve outcome. First evidence supports the usefulness of plasma lipid species as easily accessible markers for certain diseases. Here we analyzed association of plasma lipid species with mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Plasma lipid species were quantified by electrospray ionization tandem mass spectrometry and Cox proportional hazards regression was applied to assess their association with total and cardiovascular mortality. Overall no differences were detected between total and cardiovascular mortality. Highly polyunsaturated phosphatidylcholine species together with lysophosphatidylcholine species and long chain saturated sphingomyelin and ceramide species seem to be associated with a protective effect. The predominantly circulating phosphatidylcholine-based as well as phosphatidylethanolamine-based ether species and phosphatidylethanolamine species were positively associated with total and cardiovascular mortality. Saturated and monounsaturated phosphatidylcholine species, especially phosphatidylcholine 32∶0 (most probably dipalmitoyl-phosphatidylcholine) and palmitate containing sphingomyelin and ceramide species showed together with 24∶1 containing sphingomyelin and ceramide species strongest positive association with mortality. A quotient of the sums of the six most protective species and the six species with the strongest positive mortality association indicated an almost 3-fold increased risk of mortality, which was higher than the hazard ratio for known risk factors in our cohort. Plasma lipid species levels and especially ratios of certain species may be valuable prognostic marker for cardiovascular and total mortality.
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Affiliation(s)
- Alexander Sigruener
- Institute for Laboratory Medicine and Transfusion Medicine, Regensburg University Medical Center, Regensburg, Germany
- * E-mail:
| | - Marcus E. Kleber
- Medical Clinic V, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Susanne Heimerl
- Institute for Laboratory Medicine and Transfusion Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Gerhard Liebisch
- Institute for Laboratory Medicine and Transfusion Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Gerd Schmitz
- Institute for Laboratory Medicine and Transfusion Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Winfried Maerz
- Medical Clinic V, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany
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41
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Schiekofer S, Bobak I, Kleber ME, Maerz W, Rudofsky G, Dugi KA, Schneider JG. Association between a gene variant near ataxia telangiectasia mutated and coronary artery disease in men. Diab Vasc Dis Res 2014; 11:60-3. [PMID: 24281401 DOI: 10.1177/1479164113514232] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Type 2 diabetes is accompanied by increased mortality from coronary artery disease (CAD), but the mechanisms linking these conditions remain elusive. Hence, treatment of hyperglycaemia alone is not sufficient to avoid CAD in diabetes. Alternative views suggest that metabolic and vascular diseases share unifying cellular defects that could serve as targets for novel therapeutic strategies. Recently, a variant [single-nucleotide polymorphism (SNP); rs11212617] near the gene for ataxia telangiectasia mutated (ATM) has been associated with glycaemic response to metformin. MATERIALS AND METHODS We determined rs11212617 in 240 male patients who underwent elective coronary angiography. RESULTS While the variant was not associated with glucose concentrations, the A allele was significantly associated with the presence of CAD (chi-square, p = 0.003), as well as with logarithmically transformed quantitative CAD indices [severe score (SS): 0.5 (0.4-0.6) vs 0.3 (0.2-0.5); extent score (ES): 2.63 (2.4-2.9) vs 1.94 (1.4-2.4), both p < 0.05, respectively]. Multivariate analysis revealed an independent association between the A allele with ES (β = 0.17, p < 0.01). CONCLUSION Our data suggest that ATM-dependent signalling might play a role in the development of atherosclerotic vascular disease, but larger studies are necessary to substantiate such a hypothesis.
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Affiliation(s)
- Stephan Schiekofer
- Center for Geriatric Medicine at Bezirksklinikum Regensburg, Regensburg, Germany
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42
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Leebmann J, Roeseler E, Julius U, Heigl F, Spitthoever R, Heutling D, Breitenberger P, Maerz W, Lehmacher W, Heibges A, Klingel R. Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease. Circulation 2013; 128:2567-76. [DOI: 10.1161/circulationaha.113.002432] [Citation(s) in RCA: 233] [Impact Index Per Article: 21.2] [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: 11/16/2022]
Abstract
Background—
Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.
Methods and Results—
In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L
−1
(99.0±40.1 mg·dL
−1
) and Lp(a) 3.74±1.63 µmol·L
−1
(104.9±45.7 mg·dL
−1
), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (
P
<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (
P
<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (
P
=0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (
P
<0.0001) and to 0.05 from y+1 to y+2 (
P
=0.014).
Conclusions—
In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.
Clinical Trial Registration—
URL:
https://drks-neu.uniklinik-freiburg.de
. Unique identifier: DRKS00003119.
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Affiliation(s)
- Josef Leebmann
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Eberhard Roeseler
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Ulrich Julius
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Franz Heigl
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Ralf Spitthoever
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Dennis Heutling
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Paul Breitenberger
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Winfried Maerz
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Walter Lehmacher
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Andreas Heibges
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
| | - Reinhard Klingel
- From the 1st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine,
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Dieplinger B, Egger M, Haltmayer M, Kleber ME, Scharnagl H, Silbernagel G, Grammer TB, Maerz W, Mueller T. Increased soluble ST2 predicts long-term mortality in patients with stable coronary artery disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.2778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Stojakovic T, Scharnagl H, Winkelmann BR, Boehm BO, Maerz W. Ischemia modified albumin: diagnostic potential value beyond cardiac troponins. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Goliasch G, Silbernagel G, Kleber M, Grammer T, Pilz S, Tomaschitz A, Maurer G, Niessner A, Maerz W. Refining long-term prediction of cardiovascular risk in diabetes. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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van der Harst P, Zhang W, Mateo Leach I, Rendon A, Verweij N, Sehmi J, Paul DS, Elling U, Allayee H, Li X, Radhakrishnan A, Tan ST, Voss K, Weichenberger CX, Albers CA, Al-Hussani A, Asselbergs FW, Ciullo M, Danjou F, Dina C, Esko T, Evans DM, Franke L, Gögele M, Hartiala J, Hersch M, Holm H, Hottenga JJ, Kanoni S, Kleber ME, Lagou V, Langenberg C, Lopez LM, Lyytikäinen LP, Melander O, Murgia F, Nolte IM, O'Reilly PF, Padmanabhan S, Parsa A, Pirastu N, Porcu E, Portas L, Prokopenko I, Ried JS, Shin SY, Tang CS, Teumer A, Traglia M, Ulivi S, Westra HJ, Yang J, Zhao JH, Anni F, Abdellaoui A, Attwood A, Balkau B, Bandinelli S, Bastardot F, Benyamin B, Boehm BO, Cookson WO, Das D, de Bakker PIW, de Boer RA, de Geus EJC, de Moor MH, Dimitriou M, Domingues FS, Döring A, Engström G, Eyjolfsson GI, Ferrucci L, Fischer K, Galanello R, Garner SF, Genser B, Gibson QD, Girotto G, Gudbjartsson DF, Harris SE, Hartikainen AL, Hastie CE, Hedblad B, Illig T, Jolley J, Kähönen M, Kema IP, Kemp JP, Liang L, Lloyd-Jones H, Loos RJF, Meacham S, Medland SE, Meisinger C, Memari Y, Mihailov E, Miller K, Moffatt MF, Nauck M, Novatchkova M, Nutile T, Olafsson I, Onundarson PT, Parracciani D, Penninx BW, Perseu L, Piga A, Pistis G, Pouta A, Puc U, Raitakari O, Ring SM, Robino A, Ruggiero D, Ruokonen A, Saint-Pierre A, Sala C, Salumets A, Sambrook J, Schepers H, Schmidt CO, Silljé HHW, Sladek R, Smit JH, Starr JM, Stephens J, Sulem P, Tanaka T, Thorsteinsdottir U, Tragante V, van Gilst WH, van Pelt LJ, van Veldhuisen DJ, Völker U, Whitfield JB, Willemsen G, Winkelmann BR, Wirnsberger G, Algra A, Cucca F, d'Adamo AP, Danesh J, Deary IJ, Dominiczak AF, Elliott P, Fortina P, Froguel P, Gasparini P, Greinacher A, Hazen SL, Jarvelin MR, Khaw KT, Lehtimäki T, Maerz W, Martin NG, Metspalu A, Mitchell BD, Montgomery GW, Moore C, Navis G, Pirastu M, Pramstaller PP, Ramirez-Solis R, Schadt E, Scott J, Shuldiner AR, Smith GD, Smith JG, Snieder H, Sorice R, Spector TD, Stefansson K, Stumvoll M, Tang WHW, Toniolo D, Tönjes A, Visscher PM, Vollenweider P, Wareham NJ, Wolffenbuttel BHR, Boomsma DI, Beckmann JS, Dedoussis GV, Deloukas P, Ferreira MA, Sanna S, Uda M, Hicks AA, Penninger JM, Gieger C, Kooner JS, Ouwehand WH, Soranzo N, Chambers JC. Seventy-five genetic loci influencing the human red blood cell. Nature 2012; 492:369-75. [PMID: 23222517 DOI: 10.1038/nature11677] [Citation(s) in RCA: 245] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 10/15/2012] [Indexed: 11/09/2022]
Abstract
Anaemia is a chief determinant of global ill health, contributing to cognitive impairment, growth retardation and impaired physical capacity. To understand further the genetic factors influencing red blood cells, we carried out a genome-wide association study of haemoglobin concentration and related parameters in up to 135,367 individuals. Here we identify 75 independent genetic loci associated with one or more red blood cell phenotypes at P < 10(-8), which together explain 4-9% of the phenotypic variance per trait. Using expression quantitative trait loci and bioinformatic strategies, we identify 121 candidate genes enriched in functions relevant to red blood cell biology. The candidate genes are expressed preferentially in red blood cell precursors, and 43 have haematopoietic phenotypes in Mus musculus or Drosophila melanogaster. Through open-chromatin and coding-variant analyses we identify potential causal genetic variants at 41 loci. Our findings provide extensive new insights into genetic mechanisms and biological pathways controlling red blood cell formation and function.
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Affiliation(s)
- Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
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47
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Scott RA, Lagou V, Welch RP, Wheeler E, Montasser ME, Luan J, Mägi R, Strawbridge RJ, Rehnberg E, Gustafsson S, Kanoni S, Rasmussen-Torvik LJ, Yengo L, Lecoeur C, Shungin D, Sanna S, Sidore C, Johnson PCD, Jukema JW, Johnson T, Mahajan A, Verweij N, Thorleifsson G, Hottenga JJ, Shah S, Smith AV, Sennblad B, Gieger C, Salo P, Perola M, Timpson NJ, Evans DM, Pourcain BS, Wu Y, Andrews JS, Hui J, Bielak LF, Zhao W, Horikoshi M, Navarro P, Isaacs A, O'Connell JR, Stirrups K, Vitart V, Hayward C, Esko T, Mihailov E, Fraser RM, Fall T, Voight BF, Raychaudhuri S, Chen H, Lindgren CM, Morris AP, Rayner NW, Robertson N, Rybin D, Liu CT, Beckmann JS, Willems SM, Chines PS, Jackson AU, Kang HM, Stringham HM, Song K, Tanaka T, Peden JF, Goel A, Hicks AA, An P, Müller-Nurasyid M, Franco-Cereceda A, Folkersen L, Marullo L, Jansen H, Oldehinkel AJ, Bruinenberg M, Pankow JS, North KE, Forouhi NG, Loos RJF, Edkins S, Varga TV, Hallmans G, Oksa H, Antonella M, Nagaraja R, Trompet S, Ford I, Bakker SJL, Kong A, Kumari M, Gigante B, Herder C, Munroe PB, Caulfield M, Antti J, Mangino M, Small K, Miljkovic I, Liu Y, Atalay M, Kiess W, James AL, Rivadeneira F, Uitterlinden AG, Palmer CNA, Doney ASF, Willemsen G, Smit JH, Campbell S, Polasek O, Bonnycastle LL, Hercberg S, Dimitriou M, Bolton JL, Fowkes GR, Kovacs P, Lindström J, Zemunik T, Bandinelli S, Wild SH, Basart HV, Rathmann W, Grallert H, Maerz W, Kleber ME, Boehm BO, Peters A, Pramstaller PP, Province MA, Borecki IB, Hastie ND, Rudan I, Campbell H, Watkins H, Farrall M, Stumvoll M, Ferrucci L, Waterworth DM, Bergman RN, Collins FS, Tuomilehto J, Watanabe RM, de Geus EJC, Penninx BW, Hofman A, Oostra BA, Psaty BM, Vollenweider P, Wilson JF, Wright AF, Hovingh GK, Metspalu A, Uusitupa M, Magnusson PKE, Kyvik KO, Kaprio J, Price JF, Dedoussis GV, Deloukas P, Meneton P, Lind L, Boehnke M, Shuldiner AR, van Duijn CM, Morris AD, Toenjes A, Peyser PA, Beilby JP, Körner A, Kuusisto J, Laakso M, Bornstein SR, Schwarz PEH, Lakka TA, Rauramaa R, Adair LS, Smith GD, Spector TD, Illig T, de Faire U, Hamsten A, Gudnason V, Kivimaki M, Hingorani A, Keinanen-Kiukaanniemi SM, Saaristo TE, Boomsma DI, Stefansson K, van der Harst P, Dupuis J, Pedersen NL, Sattar N, Harris TB, Cucca F, Ripatti S, Salomaa V, Mohlke KL, Balkau B, Froguel P, Pouta A, Jarvelin MR, Wareham NJ, Bouatia-Naji N, McCarthy MI, Franks PW, Meigs JB, Teslovich TM, Florez JC, Langenberg C, Ingelsson E, Prokopenko I, Barroso I. Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways. Nat Genet 2012; 44:991-1005. [PMID: 22885924 PMCID: PMC3433394 DOI: 10.1038/ng.2385] [Citation(s) in RCA: 623] [Impact Index Per Article: 51.9] [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: 01/23/2012] [Accepted: 07/20/2012] [Indexed: 12/16/2022]
Abstract
Through genome-wide association meta-analyses of up to 133,010 individuals of European ancestry without diabetes, including individuals newly genotyped using the Metabochip, we have increased the number of confirmed loci influencing glycemic traits to 53, of which 33 also increase type 2 diabetes risk (q < 0.05). Loci influencing fasting insulin concentration showed association with lipid levels and fat distribution, suggesting impact on insulin resistance. Gene-based analyses identified further biologically plausible loci, suggesting that additional loci beyond those reaching genome-wide significance are likely to represent real associations. This conclusion is supported by an excess of directionally consistent and nominally significant signals between discovery and follow-up studies. Functional analysis of these newly discovered loci will further improve our understanding of glycemic control.
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Affiliation(s)
- Robert A Scott
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
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Genser B, Dias KC, Siekmeier R, Stojakovic T, Grammer T, Maerz W. Lipoprotein (a) and risk of cardiovascular disease--a systematic review and meta analysis of prospective studies. Clin Lab 2011; 57:143-56. [PMID: 21500721] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Several studies have investigated the role of Lipoprotein (a) as a risk factor for cardiovascular disease (CVD) and have produced controversial results. DATA SOURCES We conducted a systematic literature review in the databases MEDLINE, EMBASE, and COCHRANE aimed at retrieving prospective studies that investigated the prognostic value of Lipoprotein (a) concentrations on cardiovascular risk and mortality. METHODS From each study we extracted estimates of risk ratios (RR) with respect to the risk of CVD (endpoints: all coronary heart disease (CHD) events pooled, major coronary events, myocardial infarction, stroke) and all cause mortality. Study specific risk ratios were standardised to contrast the top third with the bottom third of the study specific Lipoprotein (a) distribution. Pooled summary estimates were calculated by using fixed and random effects meta analysis techniques, in total and stratified by study design and study population. RESULTS For the present meta analysis we selected 67 prospective studies including 181,683 individuals. Synthesising data from 37 studies that reported estimates for the endpoint 'CHD events' resulted in a RR of 1.57 (95% CI: 1.41 to 1.75, p < 0.001). For this endpoint subgroup analyses by design and population showed significant estimates: population based cohort studies: n = 15 studies, RR = 1.48 (95% CI: 1.26 to 1.74, p < 0.001), cohort studies including patients with previous disease: total: n = 11 studies, RR = 1.67 (95% CI: 1.28 to 2.17, p < 0.001), with CHD: n = 6 studies, RR = 2.37 (95% CI: 1.41 to 3.97, p = 0.001), nested case control studies: n = 11 studies, RR = 1.64 (95% CI: 1.47 to 1.83, p < 0.001). We did not find any significant effect on risk of stroke (n = 16 studies, RR = 1.10 (95% CI: 0.97 to 1.25, p = 0.137)) and mortality (n = 9 studies, RR = 1.12 (95% CI: 0.94 to 1.33, p = 0.200)). CONCLUSIONS This meta analysis of prospective studies shows a clear association between elevated Lipoprotein (a) levels and increased risk of CHD. This effect is substantially higher in individuals with previous CHD. Our systematic review showed no evidence of an effect on stroke and all cause mortality.
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Affiliation(s)
- Bernd Genser
- Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, University of Heidelberg, Germany
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Tomaschitz A, Maerz W, Pilz S, Ritz E, Scharnagl H, Renner W, Boehm BO, Fahrleitner-Pammer A, Weihrauch G, Dobnig H. Aldosterone/Renin Ratio Determines Peripheral and Central Blood Pressure Values Over a Broad Range. J Am Coll Cardiol 2010; 55:2171-80. [DOI: 10.1016/j.jacc.2010.01.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 10/30/2009] [Accepted: 01/06/2010] [Indexed: 10/19/2022]
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Buschmann EE, Utz W, Pagonas N, Schulz-Menger J, Busjahn A, Monti J, Maerz W, le Noble F, Thierfelder L, Dietz R, Klauss V, Gross M, Buschmann IR. Improvement of fractional flow reserve and collateral flow by treatment with external counterpulsation (Art.Net.-2 Trial). Eur J Clin Invest 2009; 39:866-75. [PMID: 19572918 DOI: 10.1111/j.1365-2362.2009.02192.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [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: 01/30/2023]
Abstract
BACKGROUND Arteriogenesis (collateral artery growth) is nature's most efficient rescue mechanism to overcome the fatal consequences of arterial occlusion or stenosis. The goal of this trial was to investigate the effect of external counterpulsation (ECP) on coronary collateral artery growth. MATERIALS AND METHODS A total of 23 patients (age 61 +/- 2.5 years) with stable coronary artery disease and at least one haemodynamic significant stenosis eligible for percutaneous coronary intervention were prospectively recruited into the two study groups in a 2 : 1 manner (ECP : control). One group (ECP group, n = 16) underwent 35 1-h sessions of ECP in 7 weeks. In the control group (n = 7), the natural course of collateral circulation over 7 weeks was evaluated. All patients underwent a cardiac catheterization at baseline and after 7 weeks, with invasive measurements of the pressure-derived collateral flow index (CFIp, primary endpoint) and fractional flow reserve (FFR). RESULTS In the ECP group, the CFIp (from 0.08 +/- 0.01 to 0.15 +/- 0.02; P < 0.001) and FFR (from 0.68 +/- 0.03 to 0.79 +/- 0.03; P = 0.001) improved significantly, while in the control group no change was observed. Only the ECP group showed a reduction of the Canadian Cardiovascular Society (CCS, P = 0.008) and New York Heart Association (NYHA, P < 0.001) classification. CONCLUSION In this study, we provide direct functional evidence for the stimulation of coronary arteriogenesis via ECP in patients with stable coronary artery disease. These data might open a novel noninvasive and preventive treatment avenue for patients with non-acute vascular stenotic disease.
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Affiliation(s)
- E E Buschmann
- Franz-Volhard-Klinik, Department for Cardiology, Helios-Klinikum Buch, Berlin, Germany.
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