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Liu X, Sun X, Zhang Y, Jiang W, Lai M, Wiggins KL, Raffield LM, Bielak LF, Zhao W, Pitsillides A, Haessler J, Zheng Y, Blackwell TW, Yao J, Guo X, Qian Y, Thyagarajan B, Pankratz N, Rich SS, Taylor KD, Peyser PA, Heckbert SR, Seshadri S, Boerwinkle E, Grove ML, Larson NB, Smith JA, Vasan RS, Fitzpatrick AL, Fornage M, Ding J, Carson AP, Abecasis G, Dupuis J, Reiner A, Kooperberg C, Hou L, Psaty BM, Wilson JG, Levy D, Rotter JI, Bis JC, Satizabal CL, Arking DE, Liu C. Association Between Whole Blood-Derived Mitochondrial DNA Copy Number, Low-Density Lipoprotein Cholesterol, and Cardiovascular Disease Risk. J Am Heart Assoc 2023; 12:e029090. [PMID: 37804200 PMCID: PMC10757530 DOI: 10.1161/jaha.122.029090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
Background The relationship between mitochondrial DNA copy number (mtDNA CN) and cardiovascular disease remains elusive. Methods and Results We performed cross-sectional and prospective association analyses of blood-derived mtDNA CN and cardiovascular disease outcomes in 27 316 participants in 8 cohorts of multiple racial and ethnic groups with whole-genome sequencing. We also performed Mendelian randomization to explore causal relationships of mtDNA CN with coronary heart disease (CHD) and cardiometabolic risk factors (obesity, diabetes, hypertension, and hyperlipidemia). P<0.01 was used for significance. We validated most of the previously reported associations between mtDNA CN and cardiovascular disease outcomes. For example, 1-SD unit lower level of mtDNA CN was associated with 1.08 (95% CI, 1.04-1.12; P<0.001) times the hazard for developing incident CHD, adjusting for covariates. Mendelian randomization analyses showed no causal effect from a lower level of mtDNA CN to a higher CHD risk (β=0.091; P=0.11) or in the reverse direction (β=-0.012; P=0.076). Additional bidirectional Mendelian randomization analyses revealed that low-density lipoprotein cholesterol had a causal effect on mtDNA CN (β=-0.084; P<0.001), but the reverse direction was not significant (P=0.059). No causal associations were observed between mtDNA CN and obesity, diabetes, and hypertension, in either direction. Multivariable Mendelian randomization analyses showed no causal effect of CHD on mtDNA CN, controlling for low-density lipoprotein cholesterol level (P=0.52), whereas there was a strong direct causal effect of higher low-density lipoprotein cholesterol on lower mtDNA CN, adjusting for CHD status (β=-0.092; P<0.001). Conclusions Our findings indicate that high low-density lipoprotein cholesterol may underlie the complex relationships between mtDNA CN and vascular atherosclerosis.
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Affiliation(s)
- Xue Liu
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Xianbang Sun
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Yuankai Zhang
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Wenqing Jiang
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Meng Lai
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Laura M. Raffield
- Department of GeneticsUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Lawrence F. Bielak
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
| | - Wei Zhao
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | | | - Jeffrey Haessler
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Yinan Zheng
- Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | | | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Yong Qian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of HealthBaltimoreMDUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of MinnesotaMinneapolisMNUSA
| | - Nathan Pankratz
- Department of Computational PathologyUniversity of MinnesotaMinneapolisMNUSA
| | - Stephen S. Rich
- Center for Public Health GenomicsUniversity of VirginiaCharlottesvilleVAUSA
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit and Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Department of NeurologyBoston University School of MedicineBostonMAUSA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science Center at HoustonHoustonTXUSA
- Human Genome Sequencing Center, Baylor College of MedicineHoustonTXUSA
| | - Megan L. Grove
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science Center at HoustonHoustonTXUSA
| | - Nicholas B. Larson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and ScienceRochesterMNUSA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | - Ramachandran S. Vasan
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Sections of Preventive Medicine and Epidemiology, and Cardiovascular MedicineBoston University School of MedicineBostonMAUSA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global HealthUniversity of WashingtonSeattleWAUSA
| | - Myriam Fornage
- Center for Human GeneticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Jun Ding
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of HealthBaltimoreMDUSA
| | - April P. Carson
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Goncalo Abecasis
- TOPMed Informatics Research CenterUniversity of MichiganAnn ArborMIUSA
| | - Josée Dupuis
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global HealthMcGill University Faculty of Medicine and Health SciencesMontréalQuebecCanada
| | - Alexander Reiner
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Charles Kooperberg
- Fred Hutchinson Cancer Center, Division of Public Health ScienceSeattleWAUSA
| | - Lifang Hou
- Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
- Departments of Epidemiology, and Health Systems and Population HealthUniversity of WashingtonSeattleWAUSA
| | - James G. Wilson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical CenterBostonMAUSA
| | - Daniel Levy
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Population Sciences BranchNational Heart, Lung, and Blood Institute, National Institutes of HealthMDBethesdaUSA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor‐UCLA Medical CenterTorranceCAUSA
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWAUSA
| | | | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative DiseasesUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
- Department of NeurologyBoston University School of MedicineBostonMAUSA
| | - Dan E. Arking
- McKusick‐Nathans InstituteDepartment of Genetic MedicineJohns Hopkins University School of MedicineMDBaltimoreUSA
| | - Chunyu Liu
- Department of Biostatistics, School of Public HealthBoston UniversityBostonMAUSA
- Framingham Heart Study, National Heart, Lung, and Blood InstituteFraminghamMAUSA
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Shah RV, Miller P, Colangelo LA, Chernofsky A, Houstis NE, Malhotra R, Velagaleti RS, Jacobs DR, Gabriel KP, Reis JP, Lloyd‐Jones DM, Clish CB, Larson MG, Vasan RS, Murthy VL, Lewis GD, Nayor M. Blood-Based Fingerprint of Cardiorespiratory Fitness and Long-Term Health Outcomes in Young Adulthood. J Am Heart Assoc 2022; 11:e026670. [PMID: 36073631 PMCID: PMC9683648 DOI: 10.1161/jaha.122.026670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
Background Cardiorespiratory fitness is a powerful predictor of health outcomes that is currently underused in primary prevention, especially in young adults. We sought to develop a blood-based biomarker of cardiorespiratory fitness that is easily translatable across populations. Methods and Results Maximal effort cardiopulmonary exercise testing for quantification of cardiorespiratory fitness (by peak oxygen uptake) and profiling of >200 metabolites at rest were performed in the FHS (Framingham Heart Study; 2016-2019). A metabolomic fitness score was derived/validated in the FHS and was associated with long-term outcomes in the younger CARDIA (Coronary Artery Risk Development in Young Adults) study. In the FHS (derivation, N=451; validation, N=914; age 54±8 years, 53% women, body mass index 27.7±5.3 kg/m2), we used LASSO (least absolute shrinkage and selection operator) regression to develop a multimetabolite score to predict peak oxygen uptake (correlation with peak oxygen uptake r=0.77 in derivation, 0.61 in validation; both P<0.0001). In a linear model including clinical risk factors, a ≈1-SD higher metabolomic fitness score had equivalent magnitude of association with peak oxygen uptake as a 9.2-year age increment. In the CARDIA study (N=2300, median follow-up 26.9 years, age 32±4 years, 44% women, 44% Black individuals), a 1-SD higher metabolomic fitness score was associated with a 44% lower risk for mortality (hazard ratio [HR], 0.56 [95% CI, 0.47-0.68]; P<0.0001) and 32% lower risk for cardiovascular disease (HR, 0.68 [95% CI, 0.55-0.84]; P=0.0003) in models adjusted for age, sex, and race, which remained robust with adjustment for clinical risk factors. Conclusions A blood-based biomarker of cardiorespiratory fitness largely independent of traditional risk factors is associated with long-term risk of cardiovascular disease and mortality in young adults.
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Affiliation(s)
- Ravi V. Shah
- Vanderbilt Translational and Clinical Research CenterCardiology DivisionVanderbilt University Medical CenterNashvilleTN
| | - Patricia Miller
- Department of BiostatisticsBoston University School of Public HealthBostonMA
| | - Laura A. Colangelo
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Ariel Chernofsky
- Department of BiostatisticsBoston University School of Public HealthBostonMA
| | - Nicholas E. Houstis
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
| | - Rajeev Malhotra
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
| | | | - David R. Jacobs
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | | | - Jared P. Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood InstituteBethesdaMD
| | - Donald M. Lloyd‐Jones
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | | | - Martin G. Larson
- Department of BiostatisticsBoston University School of Public HealthBostonMA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
| | - Ramachandran S. Vasan
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyFraminghamMA
- Sections of Cardiovascular Medicine and Preventive Medicine and EpidemiologyDepartment of MedicineBoston University School of MedicineBostonMA
- Department of EpidemiologyBoston University School of Public Health, and the Center for Computing and Data SciencesBoston UniversityBostonMA
| | - Venkatesh L. Murthy
- Department of EpidemiologyBoston University School of Public Health, and the Center for Computing and Data SciencesBoston UniversityBostonMA
- Division of Cardiovascular MedicineDepartment of Medicine, and Frankel Cardiovascular Center University of MichiganAnn ArborMI
| | - Gregory D. Lewis
- Cardiology DivisionDepartment of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA
- Pulmonary Critical Care UnitMassachusetts General HospitalBostonMA
| | - Matthew Nayor
- Sections of Cardiovascular Medicine and Preventive Medicine and EpidemiologyDepartment of MedicineBoston University School of MedicineBostonMA
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