1
|
Aroke EN, Jackson P, Meng L, Huo Z, Overstreet DS, Penn TM, Quinn TL, Cruz-Almeida Y, Goodin BR. Differential DNA methylation in Black and White individuals with chronic low back pain enrich different genomic pathways. Neurobiol Pain 2022; 11:100086. [PMID: 35243180 PMCID: PMC8885563 DOI: 10.1016/j.ynpai.2022.100086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/07/2022] [Accepted: 02/20/2022] [Indexed: 02/01/2023]
Abstract
Compared to Non-Hispanic Whites (NHWs), individuals who self-identify as Non-Hispanic Blacks (NHBs) in the United States experience more severe and disabling chronic low back pain (cLBP). We hypothesized that differences in DNA methylation (DNAm) play a role in racial disparities in cLBP. PURPOSE To determine the relationship between DNAm levels and racial group differences in adults with cLBP. Our study's secondary purpose was to perform a race-stratified comparison of adults with cLBP and pain-free controls and identify functional genomic pathways enriched by annotated differentially methylated genes. PATIENTS AND METHODS We recruited 49 NHBs and 49 NHWs (49 cLBP and 49 pain-free controls, PFCs), analyzed DNAm from whole blood using reduced representation bisulfite sequencing, and identified enriched genomic pathways. RESULTS Among participants with cLBP, we identified 2873 differentially methylated loci (DML; methylation differences of at least 10% and p < 0.0001), many of which were annotated to genes of importance to pain pathology. These DMLs significantly enriched pathways to involved in nociception/pain processing (Dopamine-DARPP32 Feedback in cAMP signaling, GABA Receptor Signaling, Opioid Signaling) and neuronal differentiation (e.g., Calcium Signaling, Axon Guidance Signaling, and Endocannabinoid Neuronal Synapse). Our race stratified analyses of individuals with cLBP versus PFCs revealed 2356 DMLs in NHBs and 772 DMLs in NHWs with p < 0.0001 and > 10% methylation difference. Ingenuity Pathway Analysis revealed that many pathways of significance to pain such as Corticotropin Releasing Hormone Signaling, White Adipose Tissue Browning, and GABA Receptor Signaling pathways, were more significant in NHBs than NHWs. CONCLUSION Even though an individual's self-identified race is a social construct, not a biological variable, racism associated with that classification affects virtually every aspect of life, including disease risk. DNAm induced alterations in stress signaling pathways may explain worse pain outcomes in NHBs.
Collapse
Affiliation(s)
- Edwin N. Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pamela Jackson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lingsong Meng
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Zhiguang Huo
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | | | - Terence M. Penn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tammie L. Quinn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yenisel Cruz-Almeida
- College of Dentistry, University of Florida, Gainesville, FL, USA
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
2
|
Suarez A, Lahti J, Lahti-Pulkkinen M, Girchenko P, Czamara D, Arloth J, Malmberg ALK, Hämäläinen E, Kajantie E, Laivuori H, Villa PM, Reynolds RM, Provençal N, Binder EB, Räikkönen K. A polyepigenetic glucocorticoid exposure score at birth and childhood mental and behavioral disorders. Neurobiol Stress 2020; 13:100275. [PMID: 33344728 PMCID: PMC7739178 DOI: 10.1016/j.ynstr.2020.100275] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Maternal depression and anxiety during pregnancy may enhance fetal exposure to glucocorticoids (GCs) and harm neurodevelopment. We tested whether a novel cross-tissue polyepigenetic biomarker indicative of in utero exposure to GC is associated with mental and behavioral disorders and their severity in children, possibly mediating the associations between maternal prenatal depressive and anxiety symptoms and these child outcomes. METHODS Children (n = 814) from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study were followed-up from birth to age 7.1-10.7 years. A weighted polyepigenetic GC exposure score was calculated based on the methylation profile of 24 CpGs from umbilical cord blood. Child diagnosis of mental and behavioral disorder (n = 99) and its severity, defined as the number of days the child had received treatment (all 99 had received outpatient treatment and 8 had been additionally in inpatient treatment) for mental or behavioral disorder as the primary diagnosis, came from the Care Register for Health Care. Mothers (n = 408) reported on child total behavior problems at child's age of 2.3-5.8 years and their own depressive and anxiety symptoms during pregnancy (n = 583). RESULTS The fetal polyepigenetic GC exposure score at birth was not associated with child hazard of mental and behavioral disorder (HR = 0.82, 95% CI 0.54; 1.24, p = 0.35) or total behavior problems (unstandardized beta = -0.10, 95% CI -0.31; 0.10, p = 0.33). However, for one standard deviation decrease in the polyepigenetic score, the child had spent 2.94 (95%CI 1.59; 5.45, p < 0.001) more days in inpatient or outpatient treatment with any mental and behavioral disorder as the primary diagnosis. Criteria for mediation tests were not met. CONCLUSIONS These findings suggest that fetal polyepigenetic GC exposure score at birth was not associated with any mental or behavioral disorder diagnosis or mother-rated total behavior problems, but it may contribute to identifying children at birth who are at risk for more severe mental or behavioral disorders.
Collapse
Key Words
- 11β-HSD2, 11-beta-hydroxysteroid-dehydrogenase type 2
- ADHD, Attention deficit/hyperactivity disorder
- BMI, Body-mass index
- CES‐D, Center for epidemiologic studies depression scale
- Childhood mental health
- Cord blood methylation
- DNAm, DNA methylation
- GC, Glucocorticoid
- GR, Glucocorticoid receptor
- GRE, Glucocorticoid response element
- Glucocorticoids
- HILMO, Care register for health care
- HPA-axis, Hypothalamic-pituitary-adrenal axis
- PREDO, Prediction and prevention of preeclampsia and intrauterine growth restriction
- Polyepigenetic biomarker
- Prenatal psychopathology
- Prospective study
- STAI, Spielberger state anxiety inventory
- ZINB, Zero-inflated negative binomial regression
Collapse
Affiliation(s)
- Anna Suarez
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Janine Arloth
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, Germany
| | - Anni LK. Malmberg
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hannele Laivuori
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pia M. Villa
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Helsinki and Uusimaa Hospital District, Finland
| | - Rebecca M. Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nadine Provençal
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| |
Collapse
|
3
|
Trauner M, Gindin Y, Jiang Z, Chung C, Subramanian GM, Myers RP, Gulamhusein A, Kowdley KV, Levy C, Goodman Z, Manns MP, Muir AJ, Bowlus CL. Methylation signatures in peripheral blood are associated with marked age acceleration and disease progression in patients with primary sclerosing cholangitis. JHEP Rep 2019; 2:100060. [PMID: 32039401 PMCID: PMC7005566 DOI: 10.1016/j.jhepr.2019.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/17/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 02/06/2023] Open
Abstract
Background & Aims A DNA methylation (DNAm) signature derived from 353 CpG sites (the Horvath clock) has been proposed as an epigenetic measure of chronological and biological age. This epigenetic signature is accelerated in diverse tissue types in various disorders, including non-alcoholic steatohepatitis, and is associated with mortality. Here, we assayed whole blood DNAm to explore age acceleration in patients with primary sclerosing cholangitis (PSC). Methods Using the MethylationEPIC BeadChip (850K) array, DNAm signatures in whole blood were analyzed in 36 patients with PSC enrolled in a 96-week trial of simtuzumab (Ishak F0-1, n = 13; F5-6, n = 23). Age acceleration was calculated as the difference between DNAm age and chronological age. Comparisons between patients with high and low age acceleration (≥ vs. < the median) were made and Cox regression evaluated the association between age acceleration and PSC-related clinical events (e.g. decompensation, cholangitis, transplantation). Results Age acceleration was significantly higher in patients with PSC compared to a healthy reference cohort (median, 11.1 years, p <2.2 × 10-16). In PSC, demographics, presence of inflammatory bowel disease, and ursodeoxycholic acid use were similar between patients with low and high age acceleration. However, patients with high age acceleration had increased serum alkaline phosphatase, gamma glutamyltransferase, alanine aminotransferase, enhanced liver fibrosis test scores, and greater hepatic collagen and α-smooth muscle actin expression on liver biopsy (all p <0.05). Moreover, patients with high age acceleration had an increased prevalence of cirrhosis (89% vs. 39%; p = 0.006) and greater likelihood of PSC-related events (hazard ratio 4.19; 95% CI 1.15–15.24). Conclusion This analysis of blood DNAm profiles suggests that compared with healthy controls, patients with PSC – particularly those with cirrhosis - exhibit significant acceleration of epigenetic age. Future studies are required to evaluate the prognostic implications and effect of therapies on global methylation patterns and age acceleration in PSC. Lay summary An epigenetic clock based on DNA methylation has been proposed as a marker of age. In liver diseases such as non-alcoholic steatohepatitis, age acceleration based on this epigenetic clock has been observed. Herein, we show that patients with primary sclerosing cholangitis have marked age acceleration, which is further accentuated by worsening fibrosis. This measure of age acceleration could be a useful marker for prognostication or risk stratification in primary sclerosing cholangitis. A peripheral blood DNA methylation (DNAm) score identifies age acceleration in PSC patients vs. healthy controls. PSC patients with high age acceleration had significantly more PSC-related events than those with low age acceleration. These findings may enable stratification of at-risk PSC patients based on a DNAm score from peripheral blood.
Collapse
Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- Aging
- BMI, body mass index
- DNAm, DNA methylation
- ELF, enhanced liver fibrosis
- FDR, false discovery rate
- GGT, gamma-glutamyltransferase
- IBD, inflammatory bowel disease
- IL, interleukin
- LOXL2, lysyl oxidase-like-2
- NASH, non-alcoholic steatohepatitis
- PSC, primary sclerosing cholangitis
- SMA, smooth muscle actin
- UDCA, ursodeoxycholic acid
- biomarker
- inflammatory bowel disease
- primary sclerosing cholangitis
- prognosis
- ursodeoxycholic acid
Collapse
Affiliation(s)
- Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
- Corresponding author. Address: Division of Gastroenterology & Hepatology, Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
| | | | | | | | | | | | - Aliya Gulamhusein
- Division of Gastroenterology, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | - Christopher L. Bowlus
- Division of Gastroenterology and Hepatology, University of California at Davis, Sacramento, CA, USA
| |
Collapse
|
4
|
Oliver VF, Jaffe AE, Song J, Wang G, Zhang P, Branham KE, Swaroop A, Eberhart CG, Zack DJ, Qian J, Merbs SL. Differential DNA methylation identified in the blood and retina of AMD patients. Epigenetics 2016; 10:698-707. [PMID: 26067391 DOI: 10.1080/15592294.2015.1060388] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Age-related macular degeneration (AMD) is a major cause of blindness in the western world. While genetic studies have linked both common and rare variants in genes involved in regulation of the complement system to increased risk of development of AMD, environmental factors, such as smoking and nutrition, can also significantly affect the risk of developing the disease and the rate of disease progression. Since epigenetics has been implicated in mediating, in part, the disease risk associated with some environmental factors, we investigated a possible epigenetic contribution to AMD. We performed genome-wide DNA methylation profiling of blood from AMD patients and controls. No differential methylation site reached genome-wide significance; however, when epigenetic changes in and around known GWAS-defined AMD risk loci were explored, we found small but significant DNA methylation differences in the blood of neovascular AMD patients near age-related maculopathy susceptibility 2 (ARMS2), a top-ranked GWAS locus preferentially associated with neovascular AMD. The methylation level of one of the CpG sites significantly correlated with the genotype of the risk SNP rs10490924, suggesting a possible epigenetic mechanism of risk. Integrating genome-wide DNA methylation analysis of retina samples with and without AMD together with blood samples, we further identified a consistent, replicable change in DNA methylation in the promoter region of protease serine 50 (PRSS50). These methylation changes may identify sites in novel genes that are susceptible to non-genetic factors known to contribute to AMD development and progression.
Collapse
Key Words
- AMD, Age-related macular degeneration
- AMD-MMAP, Michigan, Mayo
- AREDS, Age-Related Eye Disease Study
- AREDS, and Pennsylvania
- DNA methylation
- DNAm, DNA methylation
- GA, geographic atrophy
- GWAS, genome-wide association study
- KEC, Kellogg Eye Center
- LCLs, lymphoblastoid cell lines
- NV, choroidal neovascularization
- RPE, retinal pigment epithelium
- age-related macular degeneration
- genome-wide methylation
- meQTL, methylation quantitative trait loci
- methyl-QTL
- peripheral blood leukocytes
- retina
Collapse
Affiliation(s)
- Verity F Oliver
- a Department of Ophthalmology; Johns Hopkins University; School of Medicine ; Baltimore , MD USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Hing B, Ramos E, Braun P, McKane M, Jancic D, Tamashiro KLK, Lee RS, Michaelson JJ, Druley TE, Potash JB. Adaptation of the targeted capture Methyl-Seq platform for the mouse genome identifies novel tissue-specific DNA methylation patterns of genes involved in neurodevelopment. Epigenetics 2016; 10:581-96. [PMID: 25985232 DOI: 10.1080/15592294.2015.1045179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Methyl-Seq was recently developed as a targeted approach to assess DNA methylation (DNAm) at a genome-wide level in human. We adapted it for mouse and sought to examine DNAm differences across liver and 2 brain regions: cortex and hippocampus. A custom hybridization array was designed to isolate 99 Mb of CpG islands, shores, shelves, and regulatory elements in the mouse genome. This was followed by bisulfite conversion and sequencing on the Illumina HiSeq2000. The majority of differentially methylated cytosines (DMCs) were present at greater than expected frequency in introns, intergenic regions, near CpG islands, and transcriptional enhancers. Liver-specific enhancers were observed to be methylated in cortex, while cortex specific enhancers were methylated in the liver. Interestingly, commonly shared enhancers were differentially methylated between the liver and cortex. Gene ontology and pathway analysis showed that genes that were hypomethylated in the cortex and hippocampus were enriched for neuronal components and neuronal function. In contrast, genes that were hypomethylated in the liver were enriched for cellular components important for liver function. Bisulfite-pyrosequencing validation of 75 DMCs from 19 different loci showed a correlation of r = 0.87 with Methyl-Seq data. We also identified genes involved in neurodevelopment that were not previously reported to be differentially methylated across brain regions. This platform constitutes a valuable tool for future genome-wide studies involving mouse models of disease.
Collapse
Key Words
- Apcdd1, Adenomatous Polyposis Coli Down-Regulated 1
- ChIP, Chromatin immunoprecipitation
- DMCs, Differentially methylated cytosines (DMCs)
- DMRs, Differentially methylated regions
- DNA methylation
- DNAm, DNA methylation
- FDR, False discovery rate
- GFAP, Glial fibrillary acidic protein
- GO, Gene ontology
- Gb, Gigabases
- H3K27ac, Histone 3 lysine 27 acetylation
- H3K4me1, Histone marks histone 3 lysine 4 monomethylation
- KEGG, Kyoto Encyclopedia of Genes and Genomes
- MAP, Mitogen activated protein
- Msx1, msh homeobox1
- PAVIS, Peak Annotation and Visualization
- RV, Range of variation
- TFBS, Transcription factor binding sites
- UTR, Untranslated regions.
- brain
- epigenetics
- genome-wide
- methylation array
Collapse
Affiliation(s)
- Benjamin Hing
- a Department of Psychiatry; University of Iowa Carver College of Medicine ; Iowa City , IA , USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Allard C, Desgagné V, Patenaude J, Lacroix M, Guillemette L, Battista MC, Doyon M, Ménard J, Ardilouze JL, Perron P, Bouchard L, Hivert MF. Mendelian randomization supports causality between maternal hyperglycemia and epigenetic regulation of leptin gene in newborns. Epigenetics 2015; 10:342-51. [PMID: 25800063 PMCID: PMC4622547 DOI: 10.1080/15592294.2015.1029700] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/16/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022] Open
Abstract
Leptin is an adipokine that acts in the central nervous system and regulates energy balance. Animal models and human observational studies have suggested that leptin surge in the perinatal period has a critical role in programming long-term risk of obesity. In utero exposure to maternal hyperglycemia has been associated with increased risk of obesity later in life. Epigenetic mechanisms are suspected to be involved in fetal programming of long term metabolic diseases. We investigated whether DNA methylation levels near LEP locus mediate the relation between maternal glycemia and neonatal leptin levels using the 2-step epigenetic Mendelian randomization approach. We used data and samples from up to 485 mother-child dyads from Gen3G, a large prospective population-based cohort. First, we built a genetic risk score to capture maternal glycemia based on 10 known glycemic genetic variants (GRS10) and showed it was an adequate instrumental variable (β = 0.046 mmol/L of maternal fasting glucose per additional risk allele; SE = 0.007; P = 7.8 × 10(-11); N = 467). A higher GRS10 was associated with lower methylation levels at cg12083122 located near LEP (β = -0.072 unit per additional risk allele; SE = 0.04; P = 0.05; N = 166). Direction and effect size of association between the instrumental variable GRS10 and methylation at cg12083122 were consistent with the negative association we observed using measured maternal glycemia. Lower DNA methylation levels at cg12083122 were associated with higher cord blood leptin levels (β = -0.17 log of cord blood leptin per unit; SE = 0.07; P = 0.01; N = 170). Our study supports that maternal glycemia is part of causal pathways influencing offspring leptin epigenetic regulation.
Collapse
Key Words
- BMI, Body Mass Index
- CDA, Canadian Diabetes Association
- CHUS, Centre hospitalier universitaire de Sherbrooke
- CpGs, CG dinucleotides
- DNA methylation
- DNAm, DNA methylation
- DOHaD, Developmental Origins of Health and Disease
- GCT, Glucose Challenge Test
- GDM, Gestational Diabetes Mellitus
- GRS, Genetic Risk Score
- IADPSG, International Association of the Diabetes and Pregnancy Study Groups
- IV, Instrumental Variable
- MAGIC, Meta-Analyses of Glucose and Insulin-related traits Consortium
- MDS, Multidimensional Scaling
- MR, Mendelian Randomization
- Mendelian randomization
- OGTT, Oral Glucose Tolerance Test
- SGA, Small for Gestational Age
- SNPs, Single Nucleotide Polymorphisms
- TSLS, Two-Stage Least Square
- fetal programming
- gestational diabetes
- glycemia
- leptin
- mQTL, methylation Quantitative Trait Locus
- obesity
- pregnancy
Collapse
Affiliation(s)
- C Allard
- Department of Mathematics; Faculty of Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - V Desgagné
- Department of Biochemistry; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de Recherche Clinique ECOGENE-21; CSSS de Chicoutimi; Chicoutimi, QC Canada
| | - J Patenaude
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - M Lacroix
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - L Guillemette
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - MC Battista
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - M Doyon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - J Ménard
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - JL Ardilouze
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - P Perron
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - L Bouchard
- Department of Biochemistry; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
- Centre de Recherche Clinique ECOGENE-21; CSSS de Chicoutimi; Chicoutimi, QC Canada
| | - MF Hivert
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
- Department of Population Medicine; Harvard Pilgrim Health Care Institute; Harvard Medical School; Boston, MA USA
- Diabetes Unit; Massachusetts General Hospital; Boston, MA USA
| |
Collapse
|