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Goyal S, Tanigawa Y, Zhang W, Chai JF, Almeida M, Sim X, Lerner M, Chainakul J, Ramiu JG, Seraphin C, Apple B, Vaughan A, Muniu J, Peralta J, Lehman DM, Ralhan S, Wander GS, Singh JR, Mehra NK, Sidorov E, Peyton MD, Blackett PR, Curran JE, Tai ES, van Dam R, Cheng CY, Duggirala R, Blangero J, Chambers JC, Sabanayagam C, Kooner JS, Rivas MA, Aston CE, Sanghera DK. APOC3 genetic variation, serum triglycerides, and risk of coronary artery disease in Asian Indians, Europeans, and other ethnic groups. Lipids Health Dis 2021; 20:113. [PMID: 34548093 PMCID: PMC8456544 DOI: 10.1186/s12944-021-01531-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/25/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hypertriglyceridemia has emerged as a critical coronary artery disease (CAD) risk factor. Rare loss-of-function (LoF) variants in apolipoprotein C-III have been reported to reduce triglycerides (TG) and are cardioprotective in American Indians and Europeans. However, there is a lack of data in other Europeans and non-Europeans. Also, whether genetically increased plasma TG due to ApoC-III is causally associated with increased CAD risk is still unclear and inconsistent. The objectives of this study were to verify the cardioprotective role of earlier reported six LoF variants of APOC3 in South Asians and other multi-ethnic cohorts and to evaluate the causal association of TG raising common variants for increasing CAD risk. METHODS We performed gene-centric and Mendelian randomization analyses and evaluated the role of genetic variation encompassing APOC3 for affecting circulating TG and the risk for developing CAD. RESULTS One rare LoF variant (rs138326449) with a 37% reduction in TG was associated with lowered risk for CAD in Europeans (p = 0.007), but we could not confirm this association in Asian Indians (p = 0.641). Our data could not validate the cardioprotective role of other five LoF variants analysed. A common variant rs5128 in the APOC3 was strongly associated with elevated TG levels showing a p-value 2.8 × 10- 424. Measures of plasma ApoC-III in a small subset of Sikhs revealed a 37% increase in ApoC-III concentrations among homozygous mutant carriers than the wild-type carriers of rs5128. A genetically instrumented per 1SD increment of plasma TG level of 15 mg/dL would cause a mild increase (3%) in the risk for CAD (p = 0.042). CONCLUSIONS Our results highlight the challenges of inclusion of rare variant information in clinical risk assessment and the generalizability of implementation of ApoC-III inhibition for treating atherosclerotic disease. More studies would be needed to confirm whether genetically raised TG and ApoC-III concentrations would increase CAD risk.
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Affiliation(s)
- Shiwali Goyal
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., Rm 317 BMSB, Oklahoma City, OK, 73104, USA
| | - Yosuke Tanigawa
- Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California, USA
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UB1 3HW, UK
| | - Jin-Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore , 117549, Singapore
| | - Marcio Almeida
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore , 117549, Singapore
| | - Megan Lerner
- Department of Surgery, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Juliane Chainakul
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - Jonathan Garcia Ramiu
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - Chanel Seraphin
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - Blair Apple
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - April Vaughan
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - James Muniu
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., Rm 317 BMSB, Oklahoma City, OK, 73104, USA
| | - Juan Peralta
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Donna M Lehman
- Departments of Medicine and Epidemiology and Biostatistics, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Sarju Ralhan
- Hero DMC Heart Institute, Ludhiana, Punjab, India
| | | | - Jai Rup Singh
- Central University of Punjab, Bathinda, Punjab, India
| | - Narinder K Mehra
- All India Institute of Medical Sciences and Research, New Delhi, India
| | - Evgeny Sidorov
- Department of Neurology, University of Oklahoma Health Sciences Center, 920 S. L Young Blvd #2040, Oklahoma City, OK, 73104, USA
| | - Marvin D Peyton
- Department of Surgery, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Piers R Blackett
- Department of Pediatrics, Section of Endocrinology, Oklahoma University of Health Sciences Center, Oklahoma City, OK, USA
| | - Joanne E Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore , 117549, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore , 119228, Singapore
- Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Rob van Dam
- Department of Cardiology, Ealing Hospital, Middlesex, UB1 3HW, UK
- Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, Singapore , 119228, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ching-Yu Cheng
- Duke-NUS Medical School, Singapore, 169857, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
- National University of Singapore, Singapore, 119077, Singapore
| | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK
- Department of Cardiology, Ealing Hospital, Middlesex, UB1 3HW, UK
- Lee Kong Chan School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore
- Imperial College Healthcare NHS Trust, Imperial College London, London, W12 0HS, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, W2 1PG, UK
| | - Charumathi Sabanayagam
- Duke-NUS Medical School, Singapore, 169857, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Jaspal S Kooner
- Department of Cardiology, Ealing Hospital, Middlesex, UB1 3HW, UK
- Imperial College Healthcare NHS Trust, Imperial College London, London, W12 0HS, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, W2 1PG, UK
- National Heart and Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Manuel A Rivas
- Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California, USA
| | - Christopher E Aston
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., Rm 317 BMSB, Oklahoma City, OK, 73104, USA
| | - Dharambir K Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., Rm 317 BMSB, Oklahoma City, OK, 73104, USA.
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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