%0 Journal Article %J J Clin Epidemiol %D 1992 %T Assessing the use of medications in the elderly: methods and initial experience in the Cardiovascular Health Study. The Cardiovascular Health Study Collaborative Research Group. %A Psaty, B M %A Lee, M %A Savage, P J %A Rutan, G H %A German, P S %A Lyles, M %K Aged %K Aged, 80 and over %K Cerebrovascular Disorders %K Coronary Disease %K Data Collection %K Drug Utilization %K Female %K Humans %K Male %K Prospective Studies %K Risk Factors %K United States %X

The Cardiovascular Health Study (CHS), a cohort study of risk factors for coronary heart disease and stroke, recruited 5201 community-dwelling adults aged 65 years or older. To assess the prevalence of medication use at baseline, we used the method of medication inventory and transcribed information about drug names and doses from prescription bottles. Using a specially-written computer program, persons without a knowledge of drug nomenclature coded 10,511 (89%) of the 11,846 medicines entered. We compared the results of the medication inventory and answers to questions on specific medications for reliability and validity. The use of beta-blockers and beta-agonists assessed by the method of medication inventory, but not by the method of directed recall, was associated with a significant effect on mean heart rate. Among 5197 participants with medication data, 76.1% were taking at least one medicine, and the mean number of drugs per person was 2.28. Among those with a reported history of high blood pressure, participants with cardiovascular disease (CVD) were more likely to be treated, and they were more likely to be taking beta-blockers and calcium-channel blockers than those without CVD. Daily aspirin use was also more common among those with CVD (30.5% of women and 43.2% of men) than among those without CVD (14.0% of women and 14.0% of men). The prevalence of post-menopausal estrogen use differed significantly among the four clinical centers (range = 5.5%-22.5% of women). We conclude that this method of assessing medications was easy to use and provided estimates of exposure to drugs that may affect risk of cardiovascular disease.

%B J Clin Epidemiol %V 45 %P 683-92 %8 1992 Jun %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/1607909?dopt=Abstract %R 10.1016/0895-4356(92)90143-b %0 Journal Article %J Ann Epidemiol %D 1992 %T The distribution of coagulation factors VII and VIII and fibrinogen in adults over 65 years. Results from the Cardiovascular Health Study. %A Tracy, R P %A Bovill, E G %A Fried, L P %A Heiss, G %A Lee, M H %A Polak, J F %A Psaty, B M %A Savage, P J %K African Continental Ancestry Group %K Age Factors %K Aged %K Cardiovascular Diseases %K Cohort Studies %K Factor VII %K Factor VIII %K Female %K Fibrinogen %K Humans %K Male %K Middle Aged %K Risk Factors %X

The Cardiovascular Health Study (CHS) was designed to examine cardiovascular disease and its risk factors in older adults. We report here the distributions of the coagulation factors fibrinogen, factor VII, and factor VIII in a population-based cohort of men and women 65 years or older. In other studies of middle-aged individuals, these factors were shown to be associated with cardiovascular risk. In the CHS cohort, all three factors were elevated, compared to levels reported in middle-aged individuals, and fibrinogen and factor VIII values were higher in each successive age group; factor VII values, in contrast, declined slightly with age in the CHS cohort. Compared to white subjects, blacks had higher values for fibrinogen and factor VIII and lower values for factor VII. While women had markedly higher values for factor VII and factor VIII than men at all ages in the CHS, mean fibrinogen values were not different between men and women.

%B Ann Epidemiol %V 2 %P 509-19 %8 1992 Jul %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/1342301?dopt=Abstract %R 10.1016/1047-2797(92)90100-5 %0 Journal Article %J J Am Soc Echocardiogr %D 1992 %T Echocardiographic design of a multicenter investigation of free-living elderly subjects: the Cardiovascular Health Study. %A Gardin, J M %A Wong, N D %A Bommer, W %A Klopfenstein, H S %A Smith, V E %A Tabatznik, B %A Siscovick, D %A Lobodzinski, S %A Anton-Culver, H %A Manolio, T A %K Allied Health Personnel %K Cerebrovascular Disorders %K Coronary Disease %K Echocardiography %K Echocardiography, Doppler %K Humans %K Prospective Studies %K Quality Control %K Risk Factors %K United States %X

The Framingham study has shown by M-mode echocardiography that left ventricular hypertrophy is a powerful, independent predictor for the development of coronary heart disease and that increased left atrial dimension has been associated with an increased risk of stroke. No previous population-based study has evaluated the risk factor correlates and predictive value for coronary heart disease and stroke of two-dimensional and Doppler, as well as M-mode, echocardiography. The Cardiovascular Health Study is a multi-year prospective epidemiologic study of 5201 men and women older than 65 recruited from four geographic sites in the United States. The main objectives of incorporating echocardiography were to determine whether echocardiographic indices, or changes in these indices, are (1) correlated with traditional risk factors for coronary heart disease and stroke; and (2) independent predictors of morbidity and mortality for coronary heart disease and stroke. Echocardiographic measurements of interest include those related to global and segmental left ventricular systolic and diastolic structure and function and left atrial size. For each subject, a baseline echocardiogram was recorded in super-VHS tape using a standard protocol and equipment. All studies were sent to a reading center where images were digitized and measurements were made using customized computer algorithms. Calculated data and images were stored on optical disks to facilitate retrieval and future comparisons in longitudinal studies. A second echocardiogram is scheduled in year 7, with a goal of determining whether changes in cardiac anatomy or function over a 5-year period are important predictors of morbidity or mortality from coronary heart disease and stroke. Quality control measures included standardized training of echocardiography technicians and readers, technician observation by a trained echocardiographer, periodic blind duplicate readings with reader review sessions, phantom studies, and quality control adults.

%B J Am Soc Echocardiogr %V 5 %P 63-72 %8 1992 Jan-Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/1739473?dopt=Abstract %R 10.1016/s0894-7317(14)80105-3 %0 Journal Article %J Hypertension %D 1992 %T Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. %A Rutan, G H %A Hermanson, B %A Bild, D E %A Kittner, S J %A LaBaw, F %A Tell, G S %K Aged %K Aging %K Dementia %K Demography %K Female %K Health Status %K Humans %K Hypotension, Orthostatic %K Male %K Multivariate Analysis %K Nervous System Diseases %K Prevalence %K Risk Factors %X

The purpose of the present study was to assess the prevalence of orthostatic hypotension and its associations with demographic characteristics, cardiovascular risk factors and symptomatology, prevalent cardiovascular disease, and selected clinical measurements in the Cardiovascular Health Study, a multicenter, observational, longitudinal study enrolling 5,201 men and women aged 65 years and older at initial examination. Blood pressure measurements were obtained with the subjects in a supine position and after they had been standing for 3 minutes. The prevalence of asymptomatic orthostatic hypotension, defined as 20 mm Hg or greater decrease in systolic or 10 mm Hg or greater decrease in diastolic blood pressure, was 16.2%. This prevalence increased to 18.2% when the definition also included those in whom the procedure was aborted due to dizziness upon standing. The prevalence was higher at successive ages. Orthostatic hypotension was associated significantly with difficulty walking (odds ratio, 1.23; 95% confidence interval, 1.02, 1.46), frequent falls (odds ratio, 1.52; confidence interval, 1.04, 2.22), and histories of myocardial infarction (odds ratio, 1.24; confidence interval, 1.02, 1.50) and transient ischemic attacks (odds ratio, 1.68; confidence interval, 1.12, 2.51). History of stroke, angina pectoris, and diabetes mellitus were not associated significantly with orthostatic hypotension. In addition, orthostatic hypotension was associated with isolated systolic hypertension (odds ratio, 1.35; confidence interval, 1.09, 1.68), major electrocardiographic abnormalities (odds ratio, 1.21; confidence interval, 1.03, 1.42), and the presence of carotid artery stenosis based on ultrasonography (odds ratio, 1.67; confidence interval, 1.23, 2.26). Orthostatic hypotension was negatively associated with weight. We conclude that orthostatic hypotension is common in the elderly and increases with advancing age. It is associated with cardiovascular disease, particularly those manifestations measured objectively, such as carotid stenosis. It is associated also with general neurological symptoms, but this link may not be causal. Differences in prevalence of and associations with orthostatic hypotension in the present study compared with others are largely attributed to differences in population characteristics and methodology.

%B Hypertension %V 19 %P 508-19 %8 1992 Jun %G eng %N 6 Pt 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/1592445?dopt=Abstract %R 10.1161/01.hyp.19.6.508 %0 Journal Article %J J Am Geriatr Soc %D 1993 %T Age-related trends in cardiovascular morbidity and physical functioning in the elderly: the Cardiovascular Health Study. %A Bild, D E %A Fitzpatrick, A %A Fried, L P %A Wong, N D %A Haan, M N %A Lyles, M %A Bovill, E %A Polak, J F %A Schulz, R %K Activities of Daily Living %K Age Distribution %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Female %K Humans %K Male %K Prevalence %K Sex Distribution %K Socioeconomic Factors %X

OBJECTIVE: To describe relationships between age and sub-clinical cardiovascular disease, manifest chronic disease, and physical functioning and limitations among persons aged 65 years and older, with emphasis on the "oldest old," those 85 years and older.

DESIGN: Observational population-based study.

SETTING: Four U.S. communities: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Pittsburgh, Pennsylvania.

PARTICIPANTS: 5,201 men and women aged 65 years and older.

MEASUREMENTS: Demographic data; histories of cardiovascular disease (CVD), chronic lung disease, arthritis, diabetes, and hypertension; measures of subclinical disease including arm and ankle blood pressures, internal carotid wall thickness and stenosis, ejection fraction, left ventricular mass, fractional shortening, and diastolic function, electrocardiographic left ventricular hypertrophy and cardiac injury score, forced expiratory flow and volume; functional status including self-reported physical functioning, hearing and sight limitations and health status, and performance-based measures of function. These variables were examined among men and women in three age groups: 65-74 years, 75-84 years, and 85 + years. Subgroups of participants with and without manifest CVD were also examined.

MAIN RESULTS: In women, the prevalence of CVD and other chronic conditions increased with age, and the highest rates occurred among those 85 years and older. In men, prevalence rates increased between the two younger groups, but the oldest group had lower than expected rates for coronary heart disease, cerebrovascular disease, hypertension, and chronic lung disease. In contrast, there were strong age-related linear trends in most of the subclinical measures of blood pressure, atherosclerosis and pulmonary function and in virtually all measures of functional status in both gender groups across the age range. There was a particularly marked decline in functional status between the two older age groups. While subclinical disease was greater and functional status was poorer among those with manifest CVD, with few exceptions, age-related trends were not significantly different between the two groups.

CONCLUSIONS: Lower than expected prevalence rates of CVD among those aged 85 years and older, particularly among men, in this study of community-dwelling elderly may represent selection bias or a real plateauing in disease prevalence with age. However, subclinical disease appears to increase and functional status to decline across the age range in both men and women regardless of the presence of CVD. The apparent increase in subclinical disease with age indicates potential for CVD prevention after age 65.

%B J Am Geriatr Soc %V 41 %P 1047-56 %8 1993 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/8409149?dopt=Abstract %0 Journal Article %J Circulation %D 1993 %T Epidemiology of low cholesterol levels in older adults. The Cardiovascular Health Study. %A Manolio, T A %A Ettinger, W H %A Tracy, R P %A Kuller, L H %A Borhani, N O %A Lynch, J C %A Fried, L P %K Aged %K Aged, 80 and over %K Aging %K Cardiovascular Diseases %K Cardiovascular Physiological Phenomena %K Cholesterol %K Female %K Health Status %K Humans %K Longitudinal Studies %K Male %K Prevalence %K Probability %K Regression Analysis %K Risk Factors %X

BACKGROUND: Low cholesterol levels have been associated with increased mortality from stroke, cancer, and other noncardiovascular diseases, but the reasons for this association remain unclear. One explanation is that persons with low cholesterol levels have early or occult disease that eventually leads to their deaths.

METHODS AND RESULTS: This possibility was explored in 2,091 men and 2,714 women 65-100 years old in the Cardiovascular Health Study, a multicenter observational study of risk factors for heart disease and stroke in older adults. Cholesterol levels < or = 160 mg/dL were present in 11.6% of men and 3.7% of women and increased in prevalence with age. After adjustment for age, total cholesterol levels in this range were associated with a twofold increased prevalence of treated diabetes in men and women and with a twofold increased prevalence of cancer diagnosed in the preceding 5 years in women only. Low cholesterol was also associated with lower levels of hemoglobin, albumin, and factor VII, suggesting a link with hepatic synthetic function. On multivariate analysis, factors most strongly associated with low cholesterol levels in men and women were decreased factor VII levels, decreased albumin, and diabetes.

CONCLUSIONS: Cross-sectional associations with low cholesterol levels differ by sex and suggest poorer health by some measures. The observed relations with treated diabetes and impaired hepatic synthetic function should be examined for risk of mortality in longitudinal data from this and other observational studies.

%B Circulation %V 87 %P 728-37 %8 1993 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/8443893?dopt=Abstract %0 Journal Article %J JAMA %D 1993 %T Smoking and lung function in elderly men and women. The Cardiovascular Health Study. %A Higgins, M W %A Enright, P L %A Kronmal, R A %A Schenker, M B %A Anton-Culver, H %A Lyles, M %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Anthropometry %K Cardiovascular Diseases %K Cross-Sectional Studies %K European Continental Ancestry Group %K Female %K Forced Expiratory Volume %K Humans %K Lung Diseases %K Male %K Prevalence %K Prospective Studies %K Reference Values %K Respiratory Function Tests %K Risk Factors %K Smoking %K United States %K Vital Capacity %X

OBJECTIVE: To investigate relationships between cigarette smoking and pulmonary function in elderly men and women.

DESIGN: Cross-sectional analysis of baseline data from a prospective, population-based study of risk factors, preclinical, and overt cardiovascular and pulmonary disease.

SETTING: Defined communities in Forsyth County, North Carolina; Pittsburgh, Pa; Sacramento County, California; and Washington County, Maryland.

POPULATION: A total of 5201 noninstitutionalized men and women 65 years of age and older.

MAIN OUTCOME MEASURES: Pulmonary function; means of forced expiratory volume in 1 second (FEV1) and forced vital capacity and prevalence of low FEV1 levels.

RESULTS: Prevalence of cigarette smoking was 10% to 20% and higher in women than men and in blacks than whites. Forced vital capacity and FEV1 levels were related positively to height and white race and negatively to age and waist girth. Age- and height-adjusted FEV1 means were 23% and 18% lower in male and female current smokers, respectively, than in never smokers but not reduced in never smokers currently living with a smoker. Smokers who quit before age 40 years had FEV1 levels similar to never smokers, but FEV1 levels were lower by 7% and 14% in smokers who quit at ages 40 to 60 years and older than 60 years, respectively. Lung function was related inversely to pack-years of cigarette use. Prevalence rates of impaired lung function were highest in current smokers and lowest in never smokers. Regression coefficients for the smoking variables were smaller in persons without cardiovascular or respiratory conditions than in the total cohort.

CONCLUSIONS: Cigarette smoking is associated with reduced pulmonary function in elderly men and women. However, smokers who quit, even after age 60 years, have better pulmonary function than continuing smokers.

%B JAMA %V 269 %P 2741-8 %8 1993 Jun 02 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/8492399?dopt=Abstract %0 Journal Article %J J Clin Epidemiol %D 1994 %T Physical disability in older adults: a physiological approach. Cardiovascular Health Study Research Group. %A Fried, L P %A Ettinger, W H %A Lind, B %A Newman, A B %A Gardin, J %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Chronic Disease %K Disabled Persons %K Factor Analysis, Statistical %K Female %K Geriatric Assessment %K Humans %K Logistic Models %K Male %K Outcome Assessment (Health Care) %K Risk Factors %K Sex Factors %K Socioeconomic Factors %K United States %X

Measures of physical function have been developed primarily to assess health status, prognosis, and service needs. They are now, increasingly, being used as outcome measures in studies seeking to determine the causes of disability. However, the extent to which these standardized measures, as they currently are constituted, are meaningful for the evaluation of underlying pathophysiology is not defined. To assess evidence for an etiologic rationale for these measures, we evaluated self-report of difficulty in physical function in the Cardiovascular Health Study, a study of 5201 men and women 65 years and older in four U.S. communities. We determined (by factor analysis) that self-reported difficulty with each of 17 tasks of daily life aggregates in four groups; i.e. difficulty in one task is associated with having difficulty in the other tasks in the group. These groups include (1) activities primarily dependent on mobility and exercise tolerance; (2) complex activities heavily dependent on cognition and sensory input; (3) selected basic self-care activities; and (4) upper extremity activities. Groups 2 and 3 are similar, but not identical, to Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL), respectively. We then tested whether these groupings were associated with different underlying impairments. Multiple logistic regression analyses indicate that there are constellations of physiologic and disease characteristics significantly (p < 0.01) associated with difficulty in each of these four groups of activities, among 15 chronic diseases and conditions ascertained. Some diseases are uniquely associated with difficulty in one group of tasks; some overlap, and are associated with 2, 3 or 4 groups of tasks. The associations found with difficulty in performing tasks in groups 2 and 3 were frequently stronger than those with the larger groups of ADL or IADL tasks, suggesting increased specificity of associations found with these new groupings. These results suggest that re-grouping of tasks of daily life may provide a more refined physiologically-based outcome measure for use in evaluating causes of disability. The ability to define risk factors for disability may be enhanced by choosing outcome measures with a demonstrated physiologic rationale.

%B J Clin Epidemiol %V 47 %P 747-60 %8 1994 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/7722588?dopt=Abstract %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 1995 %T Fibrinogen and factor VIII, but not factor VII, are associated with measures of subclinical cardiovascular disease in the elderly. Results from The Cardiovascular Health Study. %A Tracy, R P %A Bovill, E G %A Yanez, D %A Psaty, B M %A Fried, L P %A Heiss, G %A Lee, M %A Polak, J F %A Savage, P J %K Aged %K Aged, 80 and over %K Blood Pressure %K Cardiovascular Diseases %K Carotid Stenosis %K Cohort Studies %K Factor VII %K Factor VIII %K Fibrinogen %K Humans %K Multivariate Analysis %K Prospective Studies %K Regression Analysis %K Risk Factors %X

No studies have examined the associations of coagulation factor levels with measures of subclinical cardiovascular disease (CVD) in the elderly. The Cardiovascular Health Study (CHS) is a prospective, population-based cohort study of CVD in persons older than 65 years. At the baseline examination, we measured fibrinogen, factor VII, and factor VIII levels in 5024 of the 5201 participants of the CHS and examined the associations of these coagulation factors with measures of subclinical CVD in a cross-sectional analysis. Subclinical CVD measures were based on electrocardiography, carotid ultrasonography, echocardiography, and ankle-arm blood pressure measurements (AAI). For analyses, we used the full cohort as well as two mutually exclusive subgroups: those with prevalent clinical CVD at baseline and those without. Fibrinogen and to a lesser extent factor VIII showed positive associations with a variety of subclinical CVD measures. In age-adjusted analyses, fibrinogen and factor VIII were significantly associated with 8 of 10 measures. In multivariate analyses, fibrinogen was significantly associated with carotid artery stenosis, internal (but not common) carotid artery wall thickness, and AAI. Factor VIII was associated with abnormal wall motion and AAI in the full cohort only. Factor VII was not consistently associated with subclinical disease measures. In bivariate analyses that included data from all three groups, there were 5 positive subclinical disease associations and 5 negative associations for factor VII. In multivariate analyses, there were no significant associations between factor VII and subclinical CVD in the full cohort or in either subgroup. We conclude that in these cross-sectional analyses, fibrinogen and to a lesser extent factor VIII are associated with subclinical CVD in the elderly, even in those without symptoms or a history of clinical CVD. Factor VII, however, was not associated with subclinical CVD in the elderly.

%B Arterioscler Thromb Vasc Biol %V 15 %P 1269-79 %8 1995 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/7670938?dopt=Abstract %0 Journal Article %J J Am Geriatr Soc %D 1995 %T Hematological and biochemical laboratory values in older Cardiovascular Health Study participants. %A Robbins, J %A Wahl, P %A Savage, P %A Enright, P %A Powe, N %A Lyles, M %K Age Factors %K Aged %K Analysis of Variance %K California %K Cardiovascular Diseases %K Cohort Studies %K Female %K Health Status %K Humans %K Male %K Maryland %K Middle Aged %K North Carolina %K Pennsylvania %K Reference Values %K Risk Factors %K Sex Characteristics %X

OBJECTIVE: To define reference hematologic and biochemical lab values in older individuals.

DESIGN: Randomly selected, age- and gender-stratified participants.

SETTING: Visits by participants to four research clinics.

PATIENTS: A total of 5201 participants in the Cardiovascular Health Study, an observational study of older Medicare-eligible individuals living at home.

MEASUREMENT: Information about health status, previous illness, and medication use was obtained from participants and/or their MDs. This information was used to define a healthy subset of the population. Blood samples were obtained for Cholesterol, HDL and LDL cholesterol, fasting and 2-hour postload glucose and insulin, fibrinogen, factors VII and VIII, potassium, creatinine, albumin, uric acid, white blood count, hematocrit, hemoglobin, and platelet count.

RESULTS: Significant differences were found for age group and/or gender for all mean values. Many tests were significantly different from the generally accepted reference ranges used in clinical laboratories.

CONCLUSIONS: In some situations accepted laboratory norms for the general population can not be extrapolated to older adults. There are implications for both research and clinical practice.

%B J Am Geriatr Soc %V 43 %P 855-9 %8 1995 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/7636091?dopt=Abstract %0 Journal Article %J Circulation %D 1995 %T Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. The Cardiovascular Health Study. %A Gardin, J M %A Siscovick, D %A Anton-Culver, H %A Lynch, J C %A Smith, V E %A Klopfenstein, H S %A Bommer, W J %A Fried, L %A O'Leary, D %A Manolio, T A %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Coronary Disease %K Echocardiography %K Female %K Humans %K Hypertrophy, Left Ventricular %K Male %K Sex Factors %K Systole %X

BACKGROUND: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older.

METHODS AND RESULTS: M-mode LV mass adjusted for body weight increased modestly with age (P < .0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P < .001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34% of CHS participants, and this was highly related to age (29% in the 65 to 69 year versus 50% in the 85+ year age group, P < .001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P < .001). Of interest, 0.5% of men and 0.4% of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26% of men and 10% of women in the clinical CHD group (P < .0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P < .001) to be independent predictors of LV akinesis or dyskinesis.

CONCLUSIONS: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.

%B Circulation %V 91 %P 1739-48 %8 1995 Mar 15 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/7882482?dopt=Abstract %0 Journal Article %J Am J Epidemiol %D 1996 %T Association of fibrinogen and coagulation factors VII and VIII with cardiovascular risk factors in the elderly: the Cardiovascular Health Study. Cardiovascular Health Study Investigators. %A Cushman, M %A Yanez, D %A Psaty, B M %A Fried, L P %A Heiss, G %A Lee, M %A Polak, J F %A Savage, P J %A Tracy, R P %K Age Distribution %K Aged %K Aged, 80 and over %K Analysis of Variance %K Cardiovascular Diseases %K Cohort Studies %K Factor VII %K Factor VIII %K Female %K Fibrinogen %K Humans %K Linear Models %K Logistic Models %K Male %K Prevalence %K Risk Factors %K Sex Distribution %K United States %X

The cross-sectional correlates of three hemostatic factors--fibrinogen, factor VII, and factor VIII--were examined in the Cardiovascular Health Study, a population-based cohort study of 5,201 subjects over age 65 years. Subjects were recruited in 1989-1990 in Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Pittsburgh, Pennsylvania. In multivariate linear regression models, cardiac risk factors significantly associated with fibrinogen were current smoking, race, lipids, and white blood count. In women, alcohol use, obesity, physical activity, and insulin level were also significant, while in men hypertension was correlated. The significant correlates of factor VII were lipids and white blood count in men and estrogen use, alcohol use, race, lipids, insulin level, white blood count, and obesity in women. The independent correlates of factor VIII were insulin, glucose, and race in both sexes; low density lipoprotein cholesterol, white blood count, and diuretic use in men; and alcohol use in women. In multivariate models, factors known to be modifiable risk factors for cardiovascular disease accounted for more of the population variance of these hemostatic factors in women than in men, especially for factor VII. The hemostatic factors may mediate some effects of risk factors on disease, and this should be considered in longitudinal studies.

%B Am J Epidemiol %V 143 %P 665-76 %8 1996 Apr 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/8651228?dopt=Abstract %0 Journal Article %J J Asthma %D 1996 %T Asthma and its association with cardiovascular disease in the elderly. The Cardiovascular Health Study Research Group. %A Enright, P L %A Ward, B J %A Tracy, R P %A Lasser, E C %K Aged %K Aged, 80 and over %K Asthma %K Cardiovascular Diseases %K Cohort Studies %K Female %K Humans %K Lung %K Male %K Multivariate Analysis %K Prevalence %K Risk Factors %K Sex Distribution %K Smoking %X

Cardiovascular disease (CVD) is more prevalent in elderly than in middle-aged patients. Symptoms such as intermittent wheezing with dyspnea may then be due to either CVD or asthma. The objective of this study was to determine the prevalence and correlates of asthma in the elderly and their associations with CVD and CVD risk factors. A community sample of 5201 elderly persons from the Cardiovascular Health Study was asked if they had a physician diagnosis of asthma, and multiple cardiovascular risk and disease variables were measured. Six percent of the participants (309) recalled a history of asthma, and half of these were never smokers. Thirty percent of those with asthma were currently taking a bronchodilator, 14% inhaled steroids, and 10% oral prednisone. Men and women with asthma who were cigarette smokers were more likely to report a concurrent diagnosis of congestive heart failure than smokers without asthma (p = .04). However, when we determined the independent CVD correlates of asthma in this cohort, controlling for smoking status, age, gender, and diagnoses of chronic bronchitis and emphysema, only higher levels of high-density lipoprotein cholesterol (HDL-C) and higher plasma fibrinogen levels were significantly associated with asthma. It was concluded that asthma is as prevalent in the elderly as in middle-aged persons and is associated with higher HDL-C and higher fibrinogen levels, but not with prevalent cardiovascular disease.

%B J Asthma %V 33 %P 45-53 %8 1996 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/8621370?dopt=Abstract %0 Journal Article %J Stroke %D 1996 %T Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. %A Longstreth, W T %A Manolio, T A %A Arnold, A %A Burke, G L %A Bryan, N %A Jungreis, C A %A Enright, P L %A O'Leary, D %A Fried, L %K Age Factors %K Aged %K Aging %K Blood Pressure %K Brain %K Cardiovascular Diseases %K Cerebrovascular Disorders %K Cohort Studies %K Female %K Humans %K Ischemic Attack, Transient %K Magnetic Resonance Imaging %K Male %K Multivariate Analysis %K Risk Factors %K Sex Factors %X

BACKGROUND AND PURPOSE: Our aim was to identify potential risk factors for and clinical manifestations of white matter findings on cranial MRI in elderly people.

METHODS: Medicare eligibility lists were used to obtain a representative sample of 5888 community-dwelling people aged 65 years or older. Correlates of white matter findings were sought among 3301 participants who underwent MRI scanning and denied a history of stroke or transient ischemic attack. Participants underwent extensive standardized evaluations at baseline and on follow-up, including standard questionnaires, physical examination, multiple blood tests, electrocardiogram, pulmonary function tests, carotid sonography, and M-mode echocardiography. Neuroradiologists graded white matter findings from 0 (none) to 9 (maximal) without clinical information.

RESULTS: Many potential risk factors were related to the white matter grade, but in the multivariate model the factors significantly (all P < .01) and independently associated with increased grade were greater age, clinically silent stroke on MRI, higher systolic blood pressure, lower forced expiratory volume in 1 second (FEV1), and income less than $50,000 per year. If excluded, FEV1 was replaced in the model by female sex, history of smoking, and history of physician-diagnosed hypertension at the baseline examination. Many clinical features were correlated with the white matter grade, especially those indicating impaired cognitive and lower extremity function.

CONCLUSIONS: White matter findings were significantly associated with age, silent stroke, hypertension, FEV1, and income. The white matter findings may not be considered benign because they are associated with impaired cognitive and lower extremity function.

%B Stroke %V 27 %P 1274-82 %8 1996 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/8711786?dopt=Abstract %0 Journal Article %J Am J Hypertens %D 1996 %T Hypertension and outcomes research. From clinical trials to clinical epidemiology. %A Psaty, B M %A Siscovick, D S %A Weiss, N S %A Koepsell, T D %A Rosendaal, F R %A Lin, D %A Heckbert, S R %A Wagner, E H %A Furberg, C D %K Clinical Trials as Topic %K Epidemiologic Methods %K Evidence-Based Medicine %K Humans %K Hypertension %K Outcome Assessment (Health Care) %X

Outcomes research seeks to identify effective evidence-based methods of providing the best medical care. While randomized clinical trials (RCT) usually provide the clearest answers, they are often not done or not practicable. More than a decade after the introduction of calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors, clinical trial data about their effect on major disease endpoints in patients with hypertension are still not available. The primary alternatives are the use of randomized trials that include surrogate endpoints, such as level of blood pressure or extent of carotid atherosclerosis, and the use of observational studies that include major disease endpoints. Both approaches, their strengths and limitations, are discussed in detail. The possibility of residual confounding limits the strength of inferences that can be drawn from observational studies. Similarly, the possibility of important drug effects, other than those involving the surrogate endpoint, limits the inferences that can be drawn from randomized trials that rely solely on surrogate outcomes as guides to therapy. In the absence of evidence from large clinical trials that include major disease endpoints, treatment decisions and guidelines need to synthesize the best available information from a variety of sources. Consistency of findings across various study designs, outcomes, and populations is critical to the practice of evidence-based medicine and the effort to maximize the health benefits of antihypertensive therapies.

%B Am J Hypertens %V 9 %P 178-83 %8 1996 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/8924268?dopt=Abstract %0 Journal Article %J J Allergy Clin Immunol %D 1996 %T Lipoprotein levels in elderly patients with asthma. Cardiovascular Health Study Research Group. %A Enright, P L %A Lasser, E C %A Ward, B J %A Tracy, R P %K Aged %K Aging %K Arteriosclerosis %K Asthma %K Female %K Humans %K Lipoproteins %K Male %K Prospective Studies %K Risk Factors %K Sex Factors %B J Allergy Clin Immunol %V 98 %P 467-9 %8 1996 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/8757227?dopt=Abstract %0 Journal Article %J Am J Epidemiol %D 1996 %T White blood cell counts in persons aged 65 years or more from the Cardiovascular Health Study. Correlations with baseline clinical and demographic characteristics. %A Bovill, E G %A Bild, D E %A Heiss, G %A Kuller, L H %A Lee, M H %A Rock, R %A Wahl, P W %K Age Distribution %K Aged %K Aged, 80 and over %K Cerebrovascular Disorders %K Female %K Humans %K Leukocyte Count %K Leukocytosis %K Longitudinal Studies %K Male %K Myocardial Infarction %K Prevalence %K Reference Values %K Risk Factors %K United States %X

A higher white blood cell (WBC) count has been shown to be a risk factor for myocardial infarction and stroke in middle-aged populations. This study evaluated the relation between baseline WBC count and other risk factors, as well as subclinical and prevalent disease, in the Cardiovascular Health Study, an epidemiologic study of coronary heart disease and stroke in 5,201 persons aged 65 years or older. Baseline data were collected over a 12-month period in 1989-1990. WBC counts were statistically significantly higher in people with prevalent and subclinical atherosclerotic cardiovascular disease than in those who were free of disease. WBC counts correlated (p < 0.01) positively with coagulation factors, measures of glucose metabolism, creatinine, smoking, and triglycerides. In contrast, WBC counts correlated negatively with high density lipoprotein cholesterol, forced expiratory volume, forced vital capacity, and height. The correlations between WBC counts and risk factors were similar in both the entire cohort and the subgroup of persons who had never smoked. The authors conclude that WBC counts in the elderly are associated with prevalent and subclinical atherosclerotic cardiovascular disease, as well as its risk factors.

%B Am J Epidemiol %V 143 %P 1107-15 %8 1996 Jun 01 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/8633599?dopt=Abstract %0 Journal Article %J J Am Geriatr Soc %D 1997 %T The association of antihypertensive agents with MRI white matter findings and with Modified Mini-Mental State Examination in older adults. %A Heckbert, S R %A Longstreth, W T %A Psaty, B M %A Murros, K E %A Smith, N L %A Newman, A B %A Williamson, J D %A Bernick, C %A Furberg, C D %K Adrenergic beta-Antagonists %K Aged %K Aged, 80 and over %K Antihypertensive Agents %K Brain %K Calcium Channel Blockers %K Cognition %K Cohort Studies %K Cross-Sectional Studies %K Diuretics %K Female %K Geriatric Assessment %K Humans %K Magnetic Resonance Imaging %K Male %K Risk Factors %X

OBJECTIVES: To examine the association of antihypertensive regimen with magnetic resonance imaging (MRI) white matter hyperintensity and with cognitive impairment in older adults.

DESIGN: Cross-sectional study.

SETTING: The Cardiovascular Health study, an observational prospective cohort study of risk factors for coronary heart disease and stroke in men and women 65 years of age and older.

PARTICIPANTS: 1268 men and women with pharmacologically treated hypertension.

MEASUREMENTS: Information on medication use, medical history, and health habits was collected at clinic examinations. Participants completed the Modified Mini-Mental State Examination (3MS) and underwent MRI examination. Without clinical information, study neuroradiologists assigned an overall grade of white matter signal intensity on MRI on a scale from 0 (no findings) to 9 (extensive findings).

RESULTS: Adjusted mean white matter grade was higher for users of calcium channel blockers (2.59, P = .007) and users of loop diuretics (2.60, P = .015) than for users of beta blockers (2.12). The association was present for both dihydropyridine and non-dihydropyridine calcium channel blockers. Adjusted mean 3MS scores were lower for users of calcium channel blockers (89.6, P < .002), especially dihydropyridines, and users of loop diuretics (89.7, P < .006) than for users of beta blockers (92.3). No statistically significant association could be shown for users of other drug regimens, including thiazides and ACE inhibitors.

CONCLUSION: In this study, users of antihypertensive regimens which included calcium channel blockers or loop diuretics had more severe white matter hyperintensity on MRI and worse performance on 3MS than users of beta blockers.

%B J Am Geriatr Soc %V 45 %P 1423-33 %8 1997 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/9400550?dopt=Abstract %0 Journal Article %J Am J Hypertens %D 1997 %T The association of antihypertensive medication with serum creatinine changes in older adults. %A Smith, N L %A Psaty, B M %A Heckbert, S R %A Lemaitre, R N %A Kates, D M %A Rutan, G H %A Bleyer, A %K Aged %K Antihypertensive Agents %K Cohort Studies %K Creatinine %K Female %K Humans %K Male %X

Many of the potential effects of antihypertensive therapy, including renal function, have been inadequately investigated in clinical trials in older adults. In an observational study, we examined the association between treatment with various classes of antihypertensive agents and 3-year changes in serum creatinine in 1296 older adults with treated hypertension and without prior renal disease (mean age 72.2 years; 60% female; 30% diabetic; 42% with cardiovascular disease (CVD)) from the Cardiovascular Health Study. Baseline antihypertensive medications included thiazides (HCT), beta-adrenergic blockers, angiotensin converting enzyme inhibitors (ACE-I), calcium channel blockers (CCB), vasodilators (VAS), HCT + BB, HCT + ACE-I, HCT + CCB, HCT + VAS, loop diuretics (LOOP), and other combinations. Unadjusted results indicated that minimal changes in mean serum creatinine occurred over time for all therapies and only a few changes were statistically significant (HCT: +0.02 mg/dL, ACE-I: +0.04, CCB: +0.04; all P < .05; LOOP: +0.06 mg/dL; P < .001). In multivariate analyses with HCT users as the reference group and adjusting for baseline serum creatinine, age, sex, smoking, diabetes mellitus, CVD, height, weight, common carotid intima-media thickness, and use of allopurinol, phenytoin, cimetidine, and nonsteroidal antiinflammatory drugs, all of the relative changes were small and statistically nonsignificant except for HCT + VAS users (+0.07 mg/dL; P < .05). When users of the same therapy at baseline and follow-up were restricted, only LOOP users had significant albeit small changes in serum creatinine (+0.05 mg/dL; P < .05). Although results from clinical trials are needed to confirm these findings, these observational data suggest no major differences between specific antihypertensive therapies in 3-year serum creatinine changes in older adults without prior renal disease.

%B Am J Hypertens %V 10 %P 1368-77 %8 1997 Dec %G eng %N 12 Pt 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/9443772?dopt=Abstract %0 Journal Article %J Am J Clin Nutr %D 1997 %T Carrying the burden of cardiovascular risk in old age: associations of weight and weight change with prevalent cardiovascular disease, risk factors, and health status in the Cardiovascular Health Study. %A Harris, T B %A Savage, P J %A Tell, G S %A Haan, M %A Kumanyika, S %A Lynch, J C %K Aged %K Blood Pressure %K Body Constitution %K Body Weight %K Cardiovascular Diseases %K Cholesterol, LDL %K Female %K Health Status %K Humans %K Insulin %K Longitudinal Studies %K Male %K Middle Aged %K Odds Ratio %K Prevalence %K Risk Factors %K Sex Characteristics %X

Measured weight in old age, reported weight at age 50 y, and weight change from age 50 y to old age were studied in association with prevalent cardiovascular disease (CVD), CVD risk factors, and health status in a population of 4954 men and women aged > or = 65 y in the Cardiovascular Health Study (CHS). Heavier weight (i.e., generally weight in the fourth quartile for the cohort) at age 50 y was more closely associated with prevalent CVD than was current weight, with these associations stronger in women than in men. Heavier current weight and heavier weight at age 50 y were associated with cardiovascular risk factors, including higher blood pressure, lower high-density-lipoprotein cholesterol, and higher fasting insulin. Heavier weight at both time points was related to mobility problems in both men and women and to lower current physical activity levels; among women, strong associations were also seen with lower education and current income. Remaining within 10% of reported weight at age 50 y was associated with better health status as measured by reported health, mobility difficulty, number of medications, and prevalent CVD in men. Paradoxically, most cardiovascular risk factors were lowest for weight losers despite an association of weight loss with poorer health. In this cohort of persons aged > or = 65 y, heavier weight was associated with CVD and CVD risk factors, suggesting that prevention of overweight may prove beneficial in improving cardiovascular risk in older persons. Weight stability from age 50 y to old age was associated with better health status than was weight gain or loss.

%B Am J Clin Nutr %V 66 %P 837-44 %8 1997 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/9322558?dopt=Abstract %R 10.1093/ajcn/66.4.837 %0 Journal Article %J J Am Coll Cardiol %D 1997 %T Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. %A Stewart, B F %A Siscovick, D %A Lind, B K %A Gardin, J M %A Gottdiener, J S %A Smith, V E %A Kitzman, D W %A Otto, C M %K Aged %K Aged, 80 and over %K Aortic Valve %K Aortic Valve Stenosis %K Calcinosis %K Female %K Heart Valve Diseases %K Humans %K Male %K Prospective Studies %K Risk Factors %K Sclerosis %X

OBJECTIVES: The aim of this study was to determine the prevalence of aortic sclerosis and stenosis in the elderly and to identify clinical factors associated with degenerative aortic valve disease.

BACKGROUND: Several lines of evidence suggest that degenerative aortic valve disease is not an inevitable consequence of aging and may be associated with specific clinical factors.

METHODS: In 5,201 subjects > or = 65 years of age enrolled in the Cardiovascular Health Study, the relation between aortic sclerosis or stenosis identified on echocardiography and clinical risk factors for atherosclerosis was evaluated by using stepwise logistic regression analysis.

RESULTS: Aortic valve sclerosis was present in 26% and aortic valve stenosis in 2% of the entire study cohort; in subjects > or = 75 years of age, sclerosis was present in 37% and stenosis in 2.6%. Independent clinical factors associated with degenerative aortic valve disease included age (twofold increased risk for each 10-year increase in age), male gender (twofold excess risk), present smoking (35% increase in risk) and a history of hypertension (20% increase in risk). Other significant factors included height and high lipoprotein(a) and low density lipoprotein cholesterol levels.

CONCLUSIONS: Clinical factors associated with aortic sclerosis and stenosis can be identified and are similar to risk factors for atherosclerosis.

%B J Am Coll Cardiol %V 29 %P 630-4 %8 1997 Mar 01 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/9060903?dopt=Abstract %0 Journal Article %J Radiology %D 1997 %T Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. %A Yue, N C %A Longstreth, W T %A Elster, A D %A Jungreis, C A %A O'Leary, D H %A Poirier, V C %K Aged %K Aged, 80 and over %K Brain %K Brain Diseases %K Cardiovascular Diseases %K Cohort Studies %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %X

PURPOSE: To determine the prevalence of clinically serious findings unrelated to stroke on cranial magnetic resonance (MR) images in a population of community-dwelling elderly people.

MATERIALS AND METHODS: Neuroradiologists reviewed MR images of 3,672 people aged 65 years and older who were enrolled in a longitudinal, population-based study of cardiovascular and cerebrovascular disease. The neuroradiologists alerted MR imaging field centers about potentially serious abnormalities. Clinical information was obtained from clinical examinations performed before MR imaging, hospital discharge summaries, and the field centers at which MR imaging was performed.

RESULTS: On 3,672 image sets, 64 (1.74%) clinically serious abnormalities were found. Among the presumptive diagnoses were 19 meningiomas (0.52%), six pituitary adenomas (0.16%), five cavernous malformations (0.14%), eight vascular stenoses (0.22%), four aneurysms (0.11%), two intraventricular masses (0.05%), two subdural fluid collections (0.05%), and two other tumors (0.05%). Only nine participants with these abnormalities required surgery. All but one of the meningiomas were in women, and the prevalence of the tumor decreased with increasing age.

CONCLUSION: Physicians should be alert to the possible presence of clinically serious conditions in otherwise asymptomatic elderly individuals.

%B Radiology %V 202 %P 41-6 %8 1997 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/8988190?dopt=Abstract %R 10.1148/radiology.202.1.8988190 %0 Journal Article %J Am Heart J %D 1997 %T Diabetes mellitus and echocardiographic left ventricular function in free-living elderly men and women: The Cardiovascular Health Study. %A Lee, M %A Gardin, J M %A Lynch, J C %A Smith, V E %A Tracy, R P %A Savage, P J %A Szklo, M %A Ward, B J %K Aged %K Blood Flow Velocity %K Blood Pressure %K Diabetes Mellitus %K Echocardiography %K Female %K Glucose Tolerance Test %K Humans %K Male %K Mitral Valve %K Residence Characteristics %K Ventricular Function, Left %X

This report describes the relation among diabetes, blood pressure, and prevalent cardiovascular disease, and echocardiographically measured left ventricular mass and filling (transmitral valve flow) velocities in the Cardiovascular Health Study, a cohort of 5201 men and women > or = 65 years of age. Ventricular septal and left posterior wall thicknesses were greater in diabetic than in nondiabetic subjects, showing a significant linear trend (p = 0.025 for ventricular septal thickness in both sexes combined, p = 0.002 for posterior wall thickness) with increased duration of diabetes. Increased wall thickness of the ventricular septum or the left posterior wall was not associated with prevalent coronary heart disease (CHD) in the cohort. Increased left ventricular mass was associated with diabetic persons not reporting CHD and with all subjects with CHD regardless of glucose tolerance status. After adjusting for body weight, blood pressure, heart rate, and prevalent coronary or cerebrovascular disease, diabetes (as measured by glucose level, insulin use, oral hypoglycemic use, and a positive history of diabetes before baseline examination) remained an independent predictor of increased left ventricular mass among men and women (174.2 gm in diabetic men vs 169.8 gm in normal men, 138.2 gm in diabetic women vs 134.0 gm in normal women, p = 0.043 for both sexes combined). Both early and late diastolic transmitral peak flow velocities were higher with increased duration of diabetes, but the calculated ratio of the early peak flow velocity to the late velocity (E/A ratio) did not differ significantly between subjects with historical diabetes and those with normal fasting glucose (both genders combined, p = 0.190). Glucose level, insulin use, oral hypoglycemic use, and a positive history of diabetes before baseline examination were significant independent predictors of the late transmitral peak flow velocity and its integrated flow-velocity curve but not for the integral of the early peak flow velocity or the E/A ratio. Diabetes is associated with abnormal left ventricular structure and function in elderly persons. This association persists after adjustment for body weight, blood pressure, heart rate, and reported coronary or cerebrovascular disease.

%B Am Heart J %V 133 %P 36-43 %8 1997 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/9006288?dopt=Abstract %0 Journal Article %J Radiology %D 1997 %T Infarctlike lesions in the brain: prevalence and anatomic characteristics at MR imaging of the elderly--data from the Cardiovascular Health Study. %A Bryan, R N %A Wells, S W %A Miller, T J %A Elster, A D %A Jungreis, C A %A Poirier, V C %A Lind, B K %A Manolio, T A %K Aged %K Brain %K Cardiovascular Diseases %K Cerebral Infarction %K Cohort Studies %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Prevalence %X

PURPOSE: To determine the prevalence and anatomic characteristics of infarctlike lesions seen on cranial magnetic resonance (MR) images.

MATERIALS AND METHODS: The study cohort consisted of 5,888 community-living individuals aged 65 years and older enrolled in a longitudinal, population-based study of cardiovascular disease. MR images were obtained from 3,658 participants and evaluated by trained readers. Lesion size, anatomic location, and signal intensity were recorded. Infarctlike lesion was defined as a nonmass, hyperintense region on spin-density- and T2-weighted images and, in cerebral white matter and brain stem, a hypointense region on T1-weighted images.

RESULTS: Infarctlike lesions were depicted on MR images of 1,323 (36%) participants. Eighty-five percent (1,128 participants) had lesions 3 mm or larger in maximum dimension, although 70.9% (1,320 of 1,861) of these lesions were 10 mm or less. Lesion prevalence increased with age, especially with lesions 3 mm or larger, which increased from 22.1% (86 of 389) in the 65-69-year age group to 42.9% (88 of 205) in the over-85-year age group (P < .0001). Lesion prevalence was slightly greater in men (497 of 1,527 [32.5%]) than in women (631 of 2,131 [29.6%]), but did not differ between blacks and non-blacks. The deep nuclei were the most commonly affected anatomic sites, with 78.2% (1,451 of 1,856) of lesions. Lesions that involved the cerebrum and posterior fossa accounted for 11.7% (218 of 1,856) and 10.1% (187 of 1,856) of lesions, respectively.

CONCLUSION: If the lesions reported in this study indicate cerebrovascular disease, subclinical disease may be more prevalent than clinical disease, and the prevalence of disease may rise with age. Also, infarctlike lesions have a distinctive anatomic profile.

%B Radiology %V 202 %P 47-54 %8 1997 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/8988191?dopt=Abstract %R 10.1148/radiology.202.1.8988191 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 1997 %T Relationship of C-reactive protein to risk of cardiovascular disease in the elderly. Results from the Cardiovascular Health Study and the Rural Health Promotion Project. %A Tracy, R P %A Lemaitre, R N %A Psaty, B M %A Ives, D G %A Evans, R W %A Cushman, M %A Meilahn, E N %A Kuller, L H %K Aged %K Aging %K C-Reactive Protein %K Cardiovascular Diseases %K Case-Control Studies %K Female %K Humans %K Male %K Prospective Studies %K Sex Factors %X

Markers of inflammation, such as C-reactive protein (CRP), are related to risk of cardiovascular disease (CVD) events in those with angina, but little is known about individuals without prevalent clinical CVD. We performed a prospective, nested case-control study in the Cardiovascular Health Study (CHS; 5201 healthy elderly men and women). Case subjects (n = 146 men and women with incident CVD events including angina, myocardial infarction, and death) and control subjects (n = 146) were matched on the basis of sex and the presence or absence of significant subclinical CVD at baseline (average follow-up, 2.4 years). In women but not men, the mean CRP level was higher for case subjects than for control subjects (P < or = .05). In general, CRP was higher in those with subclinical disease. Most of the association of CRP with female case subjects versus control subjects was in the subgroup with subclinical disease; 3.33 versus 1.90 mg/L, P < .05, adjusted for age and time of follow-up. Case-control differences were greatest when the time between baseline and the CVD event was shortest. The strongest associations were with myocardial infarction, and there was an overall odds ratio for incident myocardial infarction for men and women with subclinical disease (upper quartile versus lower three quartiles) of 2.67 (confidence interval [CI] = 1.04 to 6.81), with the relationship being stronger in women (4.50 [CI = 0.97 to 20.8]) than in men (1.75 [CI = 0.51 to 5.98]). We performed a similar study in the Rural Health Promotion Project, in which mean values of CRP were higher for female case subjects than for female control subjects, but no differences were apparent for men. Comparing the upper quintile with the lower four, the odds ratio for CVD case subjects was 2.7 (CI = 1.10 to 6.60). In conclusion, CRP was associated with incident events in the elderly, especially in those with subclinical disease at baseline.

%B Arterioscler Thromb Vasc Biol %V 17 %P 1121-7 %8 1997 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/9194763?dopt=Abstract %0 Journal Article %J Radiology %D 1997 %T Sulcal, ventricular, and white matter changes at MR imaging in the aging brain: data from the cardiovascular health study. %A Yue, N C %A Arnold, A M %A Longstreth, W T %A Elster, A D %A Jungreis, C A %A O'Leary, D H %A Poirier, V C %A Bryan, R N %K Aged %K Aged, 80 and over %K Aging %K Brain %K Cardiovascular Diseases %K Cerebral Ventricles %K Cohort Studies %K Continental Population Groups %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Reproducibility of Results %K Sex Factors %X

PURPOSE: To determine the distribution of changes in sulcal size, ventricular size, and white matter signal intensity depicted on cranial magnetic resonance (MR) images, with stratification according to age, race, and sex.

MATERIALS AND METHODS: Ventricular size, sulcal size, and white matter signal intensity changes were graded on cranial MR images of 3,660 community-living, elderly participants in the Cardiovascular Health Study. A healthier subgroup was also defined. Summary statistics for both groups were generated for age, race, and sex.

RESULTS: Regression models of the entire imaged cohort showed higher grades of all variables with increasing age, and higher ventricular and sulcal grades in men and in nonblack individuals. White matter grade was greater in women and in black individuals. Regression models of the healthier subgroup showed similar associations, except for a lack of association of sulcal and ventricular size with race.

CONCLUSION: Sulcal width, ventricular size, and white matter signal intensity change with age, sex, and race. Knowledge of these changes is important in appropriate interpretation of MR images of the elderly.

%B Radiology %V 202 %P 33-9 %8 1997 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/8988189?dopt=Abstract %R 10.1148/radiology.202.1.8988189 %0 Journal Article %J Stroke %D 1998 %T Asymptomatic internal carotid artery stenosis defined by ultrasound and the risk of subsequent stroke in the elderly. The Cardiovascular Health Study. %A Longstreth, W T %A Shemanski, L %A Lefkowitz, D %A O'Leary, D H %A Polak, J F %A Wolfson, S K %K Aged %K Blood Flow Velocity %K Carotid Artery, Internal %K Carotid Stenosis %K Cerebrovascular Disorders %K Cohort Studies %K Female %K Humans %K Male %K Prevalence %K Risk Factors %K Systole %K Ultrasonography, Doppler %X

BACKGROUND AND PURPOSE: We sought in this study to relate carotid ultrasound findings in asymptomatic older adults to the 5-year risk of various cerebrovascular outcomes used in the Asymptomatic Carotid Atherosclerosis Study (ACAS).

METHODS: The Cardiovascular Health Study (CHS) is a longitudinal study of people 65 years and older. Analyses of internal carotid artery stenosis defined by multiple different cutoffs of peak systolic velocity, rather than one particular cutoff, were performed in the 5441 participants who underwent carotid ultrasound and lacked a history of transient ischemic attack or stroke. The 5-year risks of 7 cerebrovascular disease outcomes used in ACAS were estimated for each cutoff.

RESULTS: Associations with the 5-year risk of outcomes were substantially elevated only at cutoffs with high peak systolic velocities. In this population, the number of people with such high velocities was small. For example, with a cutoff of approximately 2.5 m/s, suggesting a stenosis of >70%, the 5-year risk of an ipsilateral fatal or nonfatal stroke was 5%, and only 0.5% of the group had velocities at least this high.

CONCLUSIONS: In a group of older adults likely to participate in a screening program, as evidenced by willingness to participate in CHS, high peak systolic velocities consistent with high-grade carotid stenosis were uncommon and risk of subsequent cerebrovascular disease outcomes was relatively low. These findings do not suggest that similar populations of older adults would benefit from a program using ultrasound to screen for asymptomatic carotid stenosis.

%B Stroke %V 29 %P 2371-6 %8 1998 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/9804651?dopt=Abstract %0 Journal Article %J J Neural Transm Suppl %D 1998 %T Brain abnormalities in the elderly: frequency and predictors in the United States (the Cardiovascular Health Study). Cardiovascular Health Study Collaborative Research Group. %A Longstreth, W T %K Aged %K Brain %K Brain Diseases %K Cerebral Infarction %K Cerebrovascular Disorders %K Humans %K Magnetic Resonance Imaging %K United States %X

PURPOSE: Characterize brain abnormalities in elderly people using cranial magnetic resonance imaging (MRI).

METHODS: Comprehensive lists of people 65 years and older living in the United States of America were used to obtain a representative sample of 5,888 community-dwelling participants who underwent extensive standardized evaluations. A subset of 3,660 underwent MRI. Without clinical information, neuroradiologists evaluated each scan.

RESULTS: Enlarged ventricles and sulci and prominent white matter changes were relatively common, even in a subset of the healthiest participants. Infarcts 3 mm or greater were present in 31% of all participants and 28% of those without a history of stroke. Most infarcts were clinically silent, small, and in the basal ganglia. Among those without a history of stroke, white matter changes were common but mostly of a mild degree. These changes were independently related to greater age, silent stroke, higher systolic blood pressure, lower forced expiratory volume in one second and income less than $50,000 per year. Changes were also associated with dysfunction, especially of cognition and the lower extremities.

CONCLUSION: MRI abnormalities are common in elderly people. Cautious interpretation is appropriate because participants are healthier than the general population and the study's design is cross-sectional.

%B J Neural Transm Suppl %V 53 %P 9-16 %8 1998 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/9700642?dopt=Abstract %0 Journal Article %J AJNR Am J Neuroradiol %D 1998 %T A brain image database for structure/function analysis. %A Letovsky, S I %A Whitehead, S H %A Paik, C H %A Miller, G A %A Gerber, J %A Herskovits, E H %A Fulton, T K %A Bryan, R N %K Brain %K Brain Mapping %K Cerebral Infarction %K Databases as Topic %K Humans %K Image Processing, Computer-Assisted %K Magnetic Resonance Imaging %K Neurologic Examination %X

BACKGROUND AND PURPOSE: Lesion-deficit-based structure-function analysis has traditionally been empirical and nonquantitative. Our purpose was to establish a new brain image database (BRAID) that allows the statistical correlation of brain functional measures with anatomic lesions revealed by clinical brain images.

METHODS: Data on 303 participants in the MR Feasibility Study of the Cardiovascular Health Study were tested for lesion/deficit correlations. Functional data were derived from a limited neurologic examination performed at the time of the MR examination. Image data included 3D lesion descriptions derived from the MR examinations by hand segmentation. MR images were normalized in-plane using local, linear Talairach normalization. A database was implemented to support spatial data structures and associated geometric and statistical operations. The database stored the segmented lesions, patient functional scores, and several anatomic atlases. Lesion-deficit association was sought by contingency testing (chi2-test) for every possible combination of each neurologic variable and each labeled atlas structure. Significant associations that confirmed accepted lesion-deficit relationships were sought.

RESULTS: Two-hundred thirty-five infarctlike lesions in 117 subjects were viewed collectively after mapping into Talairach cartesian coordinates. Anatomic structures most strongly correlated with neurologic deficits tended to be situated in anatomically appropriate areas. For example, infarctlike lesions associated with visual field defects were correlated with structures in contralateral occipital structures, including the optic radiations and occipital gyri.

CONCLUSION: Known lesion-deficit correlations can be established by a database using a standard coordinate system for representing spatial data and incorporating functional and structural data together with appropriate query mechanisms. Improvements and further applications of this methodology may provide a powerful technique for uncovering new structure-function relationships.

%B AJNR Am J Neuroradiol %V 19 %P 1869-77 %8 1998 Nov-Dec %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/9874539?dopt=Abstract %0 Journal Article %J Am J Geriatr Cardiol %D 1998 %T Factors Associated With Hospital Utilization in the Elderly: From the Cardiovascular Health Study. %A Robbins, J. A. %A Yanez, D. %A Powe, N. R. %A Savage, P. J. %A Ives, D. G. %A Gardin, J. M. %A Lyles, M. %X

OBJECTIVE: Analyze clinical, accepted biochemical, physiologic, and socioeconomic risk factors and correlate them with hospital utilization in an elderly population. DESIGN: Prospective, observational study in a defined, randomly recruited population. PARTICIPANTS: 5201 Medicare participants enrolled in the Cardiovascular Health Study (CHS). METHODS: Medicare recipients were randomly assigned to participate in an observational study. Baseline data were compared to hospital admissions and days of hospitalization over four years. DATA ANALYSIS: Data were grouped by type of risk factor and analyzed by Tobit analysis and logistic regression. RESULTS: Baseline variables associated with hospital use (p is less than 0.0001) were history of CHF, stroke, angina, hypertension, ln (timed walk), ln (blocks walked/week), age, gender, and clinic site. Factors not entering the model (p is greater than 0.05) were income, education, smoking, diabetes, weight, dietary fat, marital status, depression, and measures of mental function. CONCLUSIONS: In the elderly, existing health status is the major determinant of hospitalization and overwhelms many classic "risk factors" for morbidity.

%B Am J Geriatr Cardiol %V 7 %P 27-35 %8 1998 May %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/11416456?dopt=Abstract %0 Journal Article %J Am J Clin Nutr %D 1998 %T High body fatness, but not low fat-free mass, predicts disability in older men and women: the Cardiovascular Health Study. %A Visser, M %A Langlois, J %A Guralnik, J M %A Cauley, J A %A Kronmal, R A %A Robbins, J %A Williamson, J D %A Harris, T B %K Adipose Tissue %K Aged %K Aged, 80 and over %K Body Composition %K Cross-Sectional Studies %K Disability Evaluation %K Female %K Geriatric Assessment %K Health Surveys %K Humans %K Male %K Obesity %K Predictive Value of Tests %K Walking %X

Using data from the Cardiovascular Health Study, we studied the relation between body composition (fat mass and fat-free mass, assessed by bioelectrical impedance) and self-reported, mobility-related disability (difficulty walking or stair climbing) in 2714 women and 2095 men aged 65-100 y. In a cross-sectional analysis at baseline (1989-1990), disability was reported by 26.5% of the women and 16.9% of the men. A positive association was observed between fat mass and disability. The odds ratio for disability in the highest quintile of fat mass was 3.04 (95% CI: 2.18, 4.25) for women and 2.77 (95% CI: 1.82, 4.23) for men compared with those in the lowest quintile. Low fat-free mass was not associated with a higher prevalence of disability. In a longitudinal analysis among persons not reporting disability at baseline, 20.3% of the women and 14.8% of the men reported disability 3 y later. Fat mass at baseline was predictive of disability 3 y later, with odds ratios of 2.83 (95% CI: 1.80, 4.46) for women and 1.72 (95% CI: 1.03, 2.85) for men in the highest quintile of fat. The increased risk was not explained by age, physical activity, chronic disease, or other potential confounders. Low fat-free mass was not predictive of disability. The results showed that high body fatness is an independent predictor of mobility-related disability in older men and women. These findings suggest that high body fatness in old age should be avoided to decrease the risk of disability.

%B Am J Clin Nutr %V 68 %P 584-90 %8 1998 Sep %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/9734734?dopt=Abstract %R 10.1093/ajcn/68.3.584 %0 Journal Article %J Radiology %D 1998 %T Hypoechoic plaque at US of the carotid artery: an independent risk factor for incident stroke in adults aged 65 years or older. Cardiovascular Health Study. %A Polak, J F %A Shemanski, L %A O'Leary, D H %A Lefkowitz, D %A Price, T R %A Savage, P J %A Brant, W E %A Reid, C %K Aged %K Aged, 80 and over %K Carotid Artery, Internal %K Carotid Stenosis %K Cerebrovascular Disorders %K Cohort Studies %K Female %K Humans %K Intracranial Arteriosclerosis %K Male %K Proportional Hazards Models %K Risk %K Ultrasonography, Doppler, Duplex %K Ultrasonography, Doppler, Transcranial %X

PURPOSE: To investigate the association between incident (first) stroke and the echogenicity of internal carotid arterial plaque at ultrasonography (US).

MATERIALS AND METHODS: A cohort of 4, 886 individuals who, at baseline, were 65 years of age or older and without symptoms of cerebrovascular disease was followed up for an average of 3.3 years. Baseline clinical findings were from color Doppler and duplex US studies of the carotid arteries and a record of traditional risk factors: age, sex, presence of diabetes mellitus, pack-years of cigarette smoking, presence of hypertension, elevated systolic and diastolic blood pressure, elevated low-density lipoprotein cholesterol level.

RESULTS: Incident strokes, excluding hemorrhagic strokes and strokes of cardiac origin, were seen in 104 individuals (2.1%) at risk. Age- and sex-adjusted odds ratios for incident stroke were significant for hypoechoic plaque (odds ratio, 2.53; 95% CI, 1,42,4.53). After controlling for risk factors in a Cox proportional hazards model, the relative risk (RR) of incident stroke was 1.72 (p = .015) for hypoechoic plaque and 2.32 (P = .004) for internal carotid arterial narrowing of at least 50%. In addition, hypoechoic plaque (RR, 2.78; CI, 1.36,5.69) and 50%-100% stenosis (RR, 3.08; CI, 1.28, 7.41) were associated with ipsilateral, nonfatal stroke.

CONCLUSION: In asymptomatic adults aged 65 years or older, that risk of incident stroke was associated with two US features: hypoechoic internal carotid arterial plaque and an estimated internal carotid arterial stenosis of 50%-100%.

%B Radiology %V 208 %P 649-54 %8 1998 Sep %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/9722841?dopt=Abstract %R 10.1148/radiology.208.3.9722841 %0 Journal Article %J Arch Neurol %D 1998 %T Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study. %A Longstreth, W T %A Bernick, C %A Manolio, T A %A Bryan, N %A Jungreis, C A %A Price, T R %K Aged %K Cerebral Infarction %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Multivariate Analysis %K Risk Factors %X

OBJECTIVE: To identify risk factors for and functional consequences of lacunar infarct in elderly people.

METHODS: The Cardiovascular Health Study (CHS) is a longitudinal study of people 65 years or older, in which 3660 participants underwent cranial magnetic resonance imaging (MRI). Neuroradiologists read scans in a standard fashion without any clinical information. Lacunes were defined as subcortical areas consistent with infarcts measuring 3 to 20 mm. In cross-sectional analyses, clinical correlates were contrasted among groups defined by MRI findings.

RESULTS: Of the 3660 subjects who underwent MRI, 2529 (69%) were free of infarcts of any kind and 841 (23%) had 1 or more lacunes without other types present, totaling 1270 lacunes. For most of these 841 subjects, their lacunes were single (66%) and silent (89%), namely without a history of transient ischemic attack or stroke. In multivariate analyses, factors independently associated with lacunes were increased age, diastolic blood pressure, creatinine, and pack-years of smoking (listed in descending order of strength of association; for all, P < .005), as well as maximum internal carotid artery stenosis of more than 50% (odds ratio [OR], 1.81; P < .005), male sex (OR, 0.74; P < .005), and history of diabetes at entrance into the study (OR, 1.33; P < .05). Models for subgroups of single, multiple, silent, and symptomatic lacunes differed only minimally. Those with silent lacunes had more cognitive, upper extremity, and lower extremity dysfunction not recognized as stroke than those whose MRIs were free of infarcts.

CONCLUSIONS: In this group of older adults, lacunes defined by MRI are common and associated with factors that likely promote or reflect small-vessel disease. Silent lacunes are also associated with neurologic dysfunction.

%B Arch Neurol %V 55 %P 1217-25 %8 1998 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/9740116?dopt=Abstract %0 Journal Article %J Am J Cardiol %D 1998 %T Left ventricular diastolic filling in the elderly: the cardiovascular health study. %A Gardin, J M %A Arnold, A M %A Bild, D E %A Smith, V E %A Lima, J A %A Klopfenstein, H S %A Kitzman, D W %K Aged %K Aged, 80 and over %K Analysis of Variance %K Blood Flow Velocity %K Cardiovascular Diseases %K Cohort Studies %K Diastole %K Echocardiography, Doppler %K Electrocardiography %K Female %K Health Status %K Heart Ventricles %K Humans %K Male %K Ventricular Function, Left %X

Changes in left ventricular (LV) diastolic function (e.g., as measured by transmitral flow velocity) are known to occur with aging. In addition, impaired LV diastolic function plays an important role in such cardiovascular disorders common in the elderly as hypertension, ischemic heart disease, and congestive heart failure (CHF). Participants in the Cardiovascular Health Study, a multicenter study of community-dwelling men (n=2,239) and women (n=2,962) > or = 65 years of age, underwent an extensive baseline evaluation, including echocardiography. Early diastolic LV Doppler (transmitral) peak filling velocity decreased, and peak late diastolic (atrial) velocity increased with age in multivariate analyses (all p <0.001). Early and late diastolic peak filling velocities were both significantly higher in women than in men, even after adjustment for body surface area (or height and weight). In multivariate models in the entire cohort and a healthy subgroup (n=703), gender, age, heart rate, and blood pressure (BP) were most strongly related to early and late diastolic transmitral peak velocities. Early and late diastolic peak velocities both increased with increases in systolic BP and decreased with increases in diastolic BP (p <0.001). Doppler transmitral velocities were compared among health status subgroups. In multiple regression models adjusted for other covariates, and in analysis of variance models examining differences across subgroups adjusted only for age, the subgroup with CHF had the highest early diastolic peak velocities. All clinical disease subgroups had higher late diastolic peak velocities than the healthy subgroup, with the subgroups with either CHF or hypertension having the highest age-adjusted means. The subgroup with hypertension had the lowest ratio of early-to-late diastolic peak velocity, and men with CHF had the highest ratio. These findings are consistent with previous reports that hypertensive subjects exhibit an abnormal relaxation pattern, whereas patients with CHF develop a pattern suggestive of an increased early diastolic left atrial-LV pressure gradient.

%B Am J Cardiol %V 82 %P 345-51 %8 1998 Aug 01 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/9708665?dopt=Abstract %0 Journal Article %J Sleep %D 1998 %T Methods for obtaining and analyzing unattended polysomnography data for a multicenter study. Sleep Heart Health Research Group. %A Redline, S %A Sanders, M H %A Lind, B K %A Quan, S F %A Iber, C %A Gottlieb, D J %A Bonekat, W H %A Rapoport, D M %A Smith, P L %A Kiley, J P %K Electroencephalography %K Electromyography %K Feasibility Studies %K Humans %K Licensure %K Polysomnography %K Research Design %K Sleep Apnea Syndromes %K Teaching %X

This paper reviews the data collection, processing, and analysis approaches developed to obtain comprehensive unattended polysomnographic data for the Sleep Heart Health Study, a multicenter study of the cardiovascular consequences of sleep-disordered breathing. Protocols were developed and implemented to standardize in-home data collection procedures and to perform centralized sleep scoring. Of 7027 studies performed on 6697 participants, 5534 studies were determined to be technically acceptable (failure rate 5.3%). Quality grades varied over time, reflecting the influences of variable technician experience, and equipment aging and modifications. Eighty-seven percent of studies were judged to be of "good" quality or better, and 75% were judged to be of sufficient quality to provide reliable sleep staging and arousal data. Poor submental EMG (electromyogram) accounted for the largest proportion of poor signal grades (9% of studies had <2 hours artifact free EMG signal). These data suggest that with rigorous training and clear protocols for data collection and processing, good-quality multichannel polysomnography data can be obtained for a majority of unattended studies performed in a research setting. Data most susceptible to poor signal quality are sleep staging and arousal data that require clear EEG (electroencephalograph) and EMG signals.

%B Sleep %V 21 %P 759-67 %8 1998 Nov 01 %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/11300121?dopt=Abstract %0 Journal Article %J Arch Neurol %D 1998 %T Relationship between balance and abnormalities in cerebral magnetic resonance imaging in older adults. %A Tell, G S %A Lefkowitz, D S %A Diehr, P %A Elster, A D %K Accidental Falls %K Aged %K Aging %K Cerebral Cortex %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Postural Balance %K Risk Factors %X

BACKGROUND: Falling is a major cause of disability and morbidity among older adults. Because poor balance is a major reason for frequent falls, assessment of balance and its risk factors are important. In this study, we postulated that cerebral changes identified on magnetic resonance (MR) imaging are related to balance, and that older adults with balance problems would have significantly greater prevalence of such brain abnormalities than older adults without balance problems.

DESIGN AND MEASUREMENTS: Several measures of balance were examined in more than 700 community-dwelling older men and women, blacks and whites. Balance measures included dynamic posturography, functional reach, Romberg and 1-foot stand tests, tandem stand, and 1-foot stand. Cerebral MR imaging assessments included ventricular size, sulcal widening, white matter disease, and ischemic infarctions. Cardiovascular disease and hypertension were determined and controlled for in the analyses.

RESULTS: A summary of the balance measures was significantly related to each of the 4 MR imaging measures, with those with poorer balance having more disease. The strongest associations with balance were seen for white matter disease and ventricular size. All but the ischemic infarction variable remained significantly associated with balance after adjustments for sex, race, age, cardiovascular disease, and hypertension.

CONCLUSION: Cerebral changes identified by MR imaging are associated with poorer balance among older adults.

%B Arch Neurol %V 55 %P 73-9 %8 1998 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/9443713?dopt=Abstract %0 Journal Article %J Arch Neurol %D 1998 %T Sex differences in brain aging: a quantitative magnetic resonance imaging study. %A Coffey, C E %A Lucke, J F %A Saxton, J A %A Ratcliff, G %A Unitas, L J %A Billig, B %A Bryan, R N %K Age Distribution %K Aged %K Aged, 80 and over %K Aging %K Atrophy %K Brain %K Cerebrospinal Fluid %K Diagnosis, Computer-Assisted %K Female %K Health Status %K Humans %K Magnetic Resonance Imaging %K Male %K Regression Analysis %K Sex Characteristics %K Sex Distribution %X

BACKGROUND: Little is known about the effect of sex on age-related changes in brain structure.

METHODS: Quantitative magnetic resonance imaging of the brain was performed in 330 elderly (age range, 66-96 years) volunteers living independently in the community, all of whom were participants in the Cardiovascular Health Study. Blinded measurements of global and regional brain size were made from T1-weighted axial images by means of computer-assisted edge detection and trace methods. High measurement reliabilities were obtained.

RESULTS: Age-specific changes in brain size were significantly greater in men than women for the peripheral (sulcal) cerebrospinal fluid volume, the lateral (sylvian) fissure cerebrospinal fluid volume, and the parieto-occipital region area. Main effects of age were observed for all the remaining brain regions examined (cerebral hemisphere volume, frontal region area, temporoparietal region area, lateral ventricular volume, and third ventricle volume), but these effects were similar in men and women. Asymmetries in brain structures were not affected by aging in either sex.

CONCLUSIONS: Our results are generally consistent with the few published studies on sex differences in brain aging and suggest that, for at least some structures, aging effects may be more apparent in men than women. The neurobiological bases and functional correlates of these sex differences require further investigation.

%B Arch Neurol %V 55 %P 169-79 %8 1998 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/9482358?dopt=Abstract %0 Journal Article %J Arch Intern Med %D 1998 %T Time trends in the use of cholesterol-lowering agents in older adults: the Cardiovascular Health Study. %A Lemaitre, R N %A Furberg, C D %A Newman, A B %A Hulley, S B %A Gordon, D J %A Gottdiener, J S %A McDonald, R H %A Psaty, B M %K Aged %K Anticholesteremic Agents %K Cholesterol, LDL %K Cohort Studies %K Female %K Humans %K Hypercholesterolemia %K Male %K Prevalence %K Risk Factors %K United States %X

OBJECTIVES: To describe recent temporal patterns of cholesterol-lowering medication use and the characteristics that may have influenced the initiation of cholesterol-lowering therapy among those aged 65 years or older.

SUBJECTS AND METHODS: A cohort of 5201 adults 65 years or older were examined annually between June 1989 and May 1996. We added 687 African American adults to the cohort in 1992-1993. We measured blood lipid levels at baseline and for the original cohort in the third year of follow-up. We assessed the use of cholesterol-lowering drugs at each visit.

RESULTS: The prevalence of cholesterol-lowering drug use in 1989-1990 was 4.5% among the men and 5.9% among the women; these figures increased over the next 6 years to 8.1% and 10.0%, respectively, in 1995-1996. There was a 4-fold increase in the use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors during the 6 years of follow-up, from 1.9% of all participants in 1989-1990 to 7.5% in 1995-1996. The use of bile acid sequestrants, nicotinic acid, and probucol declined from initial levels of less than 1% each. Among the participants who were untreated in 1989-1990, but eligible for cholesterol-lowering therapy after a trial of dietary therapy according to the 1993 guidelines of the National Cholesterol Education Panel, less than 20% initiated drug therapy in the 6 years of follow-up, even among subjects with a history of coronary heart disease. Among participants untreated at baseline but eligible for either cholesterol-lowering therapy or dietary therapy, initiation of cholesterol-lowering drug therapy was directly associated with total cholesterol levels, hypertension, and a history of coronary heart disease, and was inversely related to age, high-density lipoprotein cholesterol levels, and difficulties with activities of daily living. Other characteristics that form the basis of the 1993 National Cholesterol Education Panel guidelines-diabetes, smoking, family history of premature coronary heart disease, and total number of risk factors-were not associated with the initiation of cholesterol-lowering drug therapy.

CONCLUSIONS: Given the clinical trial evidence for benefit, those aged 65 to 75 years and with prior coronary heart disease appeared undertreated with cholesterol-lowering drug therapy.

%B Arch Intern Med %V 158 %P 1761-8 %8 1998 Sep 14 %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/9738605?dopt=Abstract %0 Journal Article %J Am Heart J %D 1998 %T Utilities for major stroke: results from a survey of preferences among persons at increased risk for stroke. %A Samsa, G P %A Matchar, D B %A Goldstein, L %A Bonito, A %A Duncan, P W %A Lipscomb, J %A Enarson, C %A Witter, D %A Venus, P %A Paul, J E %A Weinberger, M %K Adult %K Age Distribution %K Aged %K Aged, 80 and over %K Attitude to Health %K Female %K Health Status %K Humans %K Intracranial Embolism and Thrombosis %K Male %K Middle Aged %K Quality of Life %K Sex Distribution %K Surveys and Questionnaires %K United States %X

BACKGROUND: Patient beliefs, values, and preferences are crucial to decisions involving health care. In a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke.

METHODS AND RESULTS: Respondents were obtained from the Academic Medical Center Consortium (n = 621), the Cardiovascular Health Study (n = 321 ), and United Health Care (n = 319). Preferences were primarily assessed by using the time trade off (TTO). Although major stroke is generally considered an undesirable event (mean TTO = 0.30), responses were varied: although 45% of respondents considered major stroke to be a worse outcome than death, 15% were willing to trade off little or no survival to avoid a major stroke.

CONCLUSIONS: Providers should speak directly with patients about beliefs, values, and preferences. Stroke-related interventions, even those with a high price or less than dramatic clinical benefits, are likely to be cost-effective if they prevent an outcome (major stroke) that is so undesirable.

%B Am Heart J %V 136 %P 703-13 %8 1998 Oct %G eng %N 4 Pt 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/9778075?dopt=Abstract %0 Journal Article %J N Engl J Med %D 1999 %T Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. %A Otto, C M %A Lind, B K %A Kitzman, D W %A Gersh, B J %A Siscovick, D S %K Aged %K Angina Pectoris %K Aortic Valve %K Calcinosis %K Cardiovascular Diseases %K Cerebrovascular Disorders %K Female %K Heart Failure %K Heart Valve Diseases %K Humans %K Male %K Mortality %K Myocardial Infarction %K Prospective Studies %K Risk %K Risk Factors %K Ultrasonography %K United States %K Ventricular Outflow Obstruction %X

BACKGROUND: Although aortic-valve stenosis is clearly associated with adverse cardiovascular outcomes, it is unclear whether valve sclerosis increases the risk of cardiovascular events.

METHODS: We assessed echocardiograms obtained at base line from 5621 men and women 65 years of age or older who were enrolled in a population-based prospective study. On echocardiography, the aortic valve was normal in 70 percent (3919 subjects), sclerotic without outflow obstruction in 29 percent (1610), and stenotic in 2 percent (92). The subjects were followed for a mean of 5.0 years to assess the risk of death from any cause and of death from cardiovascular causes. Cardiovascular morbidity was defined as new episodes of myocardial infarction, angina pectoris, congestive heart failure, or stroke.

RESULTS: There was a stepwise increase in deaths from any cause (P for trend, <0.001) and deaths from cardiovascular causes (P for trend, <0.001) with increasing aortic-valve abnormality; the respective rates were 14.9 and 6.1 percent in the group with normal aortic valves, 21.9 and 10.1 percent in the group with aortic sclerosis, and 41.3 and 19.6 percent in the group with aortic stenosis. The relative risk of death from cardiovascular causes among subjects without coronary heart disease at base line was 1.66 (95 percent confidence interval, 1.23 to 2.23) for those with sclerotic valves as compared with those with normal valves, after adjustment for age and sex. The relative risk remained elevated after further adjustment for clinical factors associated with sclerosis (relative risk, 1.52; 95 percent confidence interval, 1.12 to 2.05). The relative risk of myocardial infarction was 1.40 (95 percent confidence interval, 1.07 to 1.83) among subjects with aortic sclerosis, as compared with those with normal aortic valves.

CONCLUSIONS: Aortic sclerosis is common in the elderly and is associated with an increase of approximately 50 percent in the risk of death from cardiovascular causes and the risk of myocardial infarction, even in the absence of hemodynamically significant obstruction of left ventricular outflow.

%B N Engl J Med %V 341 %P 142-7 %8 1999 Jul 15 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/10403851?dopt=Abstract %R 10.1056/NEJM199907153410302 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 1999 %T Fibrinolytic activation markers predict myocardial infarction in the elderly. The Cardiovascular Health Study. %A Cushman, M %A Lemaitre, R N %A Kuller, L H %A Psaty, B M %A Macy, E M %A Sharrett, A R %A Tracy, R P %K Age Factors %K Aged %K Angina Pectoris %K Biomarkers %K Female %K Fibrin Fibrinogen Degradation Products %K Fibrinolysin %K Fibrinolysis %K Follow-Up Studies %K Heart Arrest %K Humans %K Male %K Myocardial Infarction %K Plasminogen Activator Inhibitor 1 %K Risk Factors %X

Coagulation factor levels predict arterial thrombosis in epidemiological studies, but studies of older persons are needed. We studied 3 plasma antigenic markers of fibrinolysis, viz, plasminogen activator inhibitor-1 (PAI-1), fibrin fragment D-dimer, and plasmin-antiplasmin complex (PAP) for the prediction of arterial thrombosis in healthy elderly persons over age 65. The study was a nested case-control study in the Cardiovascular Health Study cohort of 5201 men and women >/=65 years of age who were enrolled from 1989 to 1990. Cases were 146 participants without baseline clinical vascular disease who developed myocardial infarction, angina, or coronary death during a follow-up of 2.4 years. Controls remained free of cardiovascular events and were matched 1:1 to cases with respect to sex, duration of follow-up, and baseline subclinical vascular disease status. With increasing quartile of D-dimer and PAP levels but not of PAI-1, there was an independent increased risk of myocardial infarction or coronary death, but not of angina. The relative risk for D-dimer above versus below the median value (>/=120 microg/L) was 2.5 (95% confidence interval, 1.1 to 5.9) and for PAP above the median (>/=5.25 nmol/L), 3.1 (1.3 to 7.7). Risks were independent of C-reactive protein and fibrinogen concentrations. There were no differences in risk by sex or presence of baseline subclinical disease. D-dimer and PAP, but not PAI-1, predicted future myocardial infarction in men and women over age 65. Relationships were independent of other risk factors, including inflammation markers. Results indicate a major role for these markers in identifying a high risk of arterial disease in this age group.

%B Arterioscler Thromb Vasc Biol %V 19 %P 493-8 %8 1999 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/10073948?dopt=Abstract %R 10.1161/01.atv.19.3.493 %0 Journal Article %J Neurology %D 1999 %T Relation of education to brain size in normal aging: implications for the reserve hypothesis. %A Coffey, C E %A Saxton, J A %A Ratcliff, G %A Bryan, R N %A Lucke, J F %K Aged %K Aged, 80 and over %K Atrophy %K Brain %K Cerebral Cortex %K Cerebrospinal Fluid %K Educational Status %K Female %K Functional Laterality %K Health Status %K Humans %K Magnetic Resonance Imaging %K Male %K Mental Status Schedule %K Regression Analysis %K Sex Characteristics %X

OBJECTIVE: To examine the relations between education and age-related changes in brain structure in a nonclinical sample of elderly adults.

BACKGROUND: Education may protect against cognitive decline in late life--an observation that has led to the "reserve" hypothesis of brain aging. Little is known, however, about the effect of education on age-related changes in brain structure.

METHODS: Quantitative MRI of the brain was performed in 320 elderly volunteers (age range, 66 to 90 years) living independently in the community (Mini-Mental State Examination scores > or =24), all of whom were participants in the Cardiovascular Health Study. Blinded measurements of global and regional brain size were made from T1-weighted axial images using computer-assisted edge detection and trace methodology. High measurement reliabilities were obtained.

RESULTS: Regression analyses (adjusting for the effects of intracranial size, sex, age, age-by-sex interactions, and potential confounders) revealed significant main effects of education on peripheral (sulcal) CSF volume-a marker of cortical atrophy. Each year of education was associated with an increase in peripheral CSF volume of 1.77 mL (p<0.03). As reported previously, main effects of age (but not education) were observed for all of the remaining brain regions examined, including cerebral hemisphere volume, frontal region area, temporoparietal region area, parieto-occipital region area, lateral (Sylvian) fissure volume, lateral ventricular volume, and third ventricle volume.

CONCLUSIONS: The authors' findings demonstrate a relation between education and age-related cortical atrophy in a nonclinical sample of elderly persons, and are consistent with the reserve hypothesis as well as with a small number of brain imaging studies in patients with dementia. The neurobiological basis and functional correlates of this education effect require additional investigation.

%B Neurology %V 53 %P 189-96 %8 1999 Jul 13 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/10408558?dopt=Abstract %R 10.1212/wnl.53.1.189 %0 Journal Article %J Am J Respir Crit Care Med %D 1999 %T Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. %A Gottlieb, D J %A Whitney, C W %A Bonekat, W H %A Iber, C %A James, G D %A Lebowitz, M %A Nieto, F J %A Rosenberg, C E %K Aged %K Cardiovascular Diseases %K Cross-Sectional Studies %K Disorders of Excessive Somnolence %K Female %K Humans %K Male %K Middle Aged %K Polysomnography %K Respiration %K Retrospective Studies %K Severity of Illness Index %K Sleep Apnea Syndromes %K Surveys and Questionnaires %X

Obstructive sleep apnea syndrome is a well recognized cause of excessive sleepiness; however, the relation of sleepiness to mild sleep-disordered breathing (SDB), which affects as much as half the adult population, is uncertain. In order to explore this relation, we conducted a cross-sectional cohort study of community-dwelling adults participating in the Sleep Heart Health Study, a longitudinal study of the cardiovascular consequences of SDB. The study sample comprises 886 men and 938 women, with a mean age of 65 (SD 11) yr. Sleepiness was quantified using the Epworth Sleepiness Scale (ESS). Sleep-disordered breathing was quantified by the respiratory disturbance index (RDI), defined as the number of apneas plus hypopneas per hour of sleep, measured during in-home polysomnography. When RDI was categorized into four groups (< 5, 5 to < 15, 15 to < 30, >/= 30), a significantly progressive increase in mean ESS score was seen across all four levels of SDB, from 7.2 (4.3) in subjects with RDI < 5 to 9.3 (4.9) in subjects with RDI >/= 30 (p < 0.001). There was no significant modification of this effect by age, sex, body mass index, or evidence of chronic restriction of sleep time or periodic limb movement disorder. The percentage of subjects with excessive sleepiness, defined as an ESS score >/= 11, increased from 21% in subjects with RDI < 5 to 35% in those with RDI >/= 30 (p < 0. 001). We conclude that SDB is associated with excess sleepiness in community-dwelling, middle-aged and older adults, not limited to those with clinically apparent sleep apnea.

%B Am J Respir Crit Care Med %V 159 %P 502-7 %8 1999 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/9927364?dopt=Abstract %R 10.1164/ajrccm.159.2.9804051 %0 Journal Article %J Arch Intern Med %D 1999 %T Temporal trends in the use of anticoagulants among older adults with atrial fibrillation. %A Smith, N L %A Psaty, B M %A Furberg, C D %A White, R %A Lima, J A %A Newman, A B %A Manolio, T A %K Aged %K Anticoagulants %K Aspirin %K Atrial Fibrillation %K Cerebrovascular Disorders %K Drug Therapy %K Electrocardiography %K Female %K Humans %K Incidence %K Male %K Prevalence %K Treatment Outcome %K Warfarin %X

BACKGROUND: Several recent randomized clinical trials have demonstrated that warfarin sodium treatment, and to a lesser extent aspirin, reduces risk of stroke and death compared with placebo in persons with atrial fibrillation. Insufficient documentation exists on the extent to which the use of these therapies following trial publications has continued to increase in the elderly with atrial fibrillation.

METHODS: We used data from the Cardiovascular Health Study, a study of 5888 community-dwelling adults aged 65 years or older, to determine the prevalence of warfarin and aspirin use in persons with electrocardiogram-identified atrial fibrillation. Electrocardiogram examinations were conducted at baseline from 1989 through 1990, and at 6 subsequent annual examinations through 1995-1996. Medication data were collected by inventory methods at each examination. Temporal change in use of anticoagulants was analyzed by comparing percentage use in 1990 to use in each year through 1996.

RESULTS: The use of warfarin increased 4-fold from 13% in 1990 to 50% in 1996 among participants with prevalent atrial fibrillation (P<.001). Daily use of aspirin did not increase over time. Participants younger than 80 years were 4 times more likely to use warfarin in 1996 (P<.001) than those 80 years and older. Use of aspirin did not vary significantly with age.

CONCLUSIONS: Warfarin use in community-dwelling elderly persons with electrocardiogram-documented atrial fibrillation increased steadily following the first publication of its treatment benefit, reaching 50% by 1996. In contrast, use of aspirin was unchanged during this same period. Continued efforts to promote appropriate anticoagulation therapy to physicians and their patients may still be needed.

%B Arch Intern Med %V 159 %P 1574-8 %8 1999 Jul 26 %G eng %N 14 %1 https://www.ncbi.nlm.nih.gov/pubmed/10421280?dopt=Abstract %R 10.1001/archinte.159.14.1574 %0 Journal Article %J Chest %D 1999 %T Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group. %A Enright, P L %A McClelland, R L %A Newman, A B %A Gottlieb, D J %A Lebowitz, M D %K Age Factors %K Aged %K Aged, 80 and over %K Asthma %K Female %K Humans %K Male %K Peak Expiratory Flow Rate %K Quality of Life %K Risk Factors %K Spirometry %K Vital Capacity %X

OBJECTIVE: To describe the clinical correlates of asthma in a community-based sample of elderly persons.

PARTICIPANTS: A community sample of 4,581 persons > or = 65 years old from the Cardiovascular Health Study.

MEASUREMENTS: Standardized respiratory, sleep, and quality-of-life (QOL) questions, a medication inventory, spirometry, and ambulatory peak flow.

RESULTS: Four percent of the participants reported a current diagnosis of asthma (definite asthma), while another 4% reported at least one attack of wheezing accompanied by chest tightness or dyspnea during the previous 12 months (probable asthma). Smokers and those with congestive heart failure were excluded from the subsequent analyses, leaving 2,527 participants. Of those who had definite asthma, 40% were taking a sympathomimetic bronchodilator, 30% inhaled corticosteroids, 21% theophylline, and 18% oral corticosteroids; 39% were taking no asthma medications. The participants with definite or probable asthma were much more likely than the others to have a family history of asthma, childhood respiratory problems, a history of workplace exposures, dyspnea on exertion, hay fever, chronic bronchitis, nocturnal symptoms, and daytime sleepiness. They were also more likely to report poor general health, symptoms of depression, and limitation of activities of daily living. There was little difference in the morbidity and QOL of participants with recent asthma-like symptoms who had received the diagnosis of asthma versus those who had not.

CONCLUSIONS: Asthma in elderly persons is associated with a lower QOL and considerable morbidity when compared with those who do not have asthma symptoms. Asthma is underdiagnosed in this group and is often associated with allergic triggers; inhaled corticosteroids are underutilized.

%B Chest %V 116 %P 603-13 %8 1999 Sep %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/10492260?dopt=Abstract %R 10.1378/chest.116.3.603 %0 Journal Article %J JAMA %D 2000 %T Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. %A Nieto, F J %A Young, T B %A Lind, B K %A Shahar, E %A Samet, J M %A Redline, S %A D'Agostino, R B %A Newman, A B %A Lebowitz, M D %A Pickering, T G %K Adult %K Aged %K Cohort Studies %K Cross-Sectional Studies %K Female %K Humans %K Hypertension %K Logistic Models %K Male %K Middle Aged %K Obesity %K Polysomnography %K Sleep Apnea Syndromes %K Snoring %X

CONTEXT: Sleep-disordered breathing (SDB) and sleep apnea have been linked to hypertension in previous studies, but most of these studies used surrogate information to define SDB (eg, snoring) and were based on small clinic populations, or both.

OBJECTIVE: To assess the association between SDB and hypertension in a large cohort of middle-aged and older persons.

DESIGN AND SETTING: Cross-sectional analyses of participants in the Sleep Heart Health Study, a community-based multicenter study conducted between November 1995 and January 1998.

PARTICIPANTS: A total of 6132 subjects recruited from ongoing population-based studies (aged > or = 40 years; 52.8% female).

MAIN OUTCOME MEASURES: Apnea-hypopnea index (AHI, the average number of apneas plus hypopneas per hour of sleep, with apnea defined as a cessation of airflow and hypopnea defined as a > or = 30% reduction in airflow or thoracoabdominal excursion both of which are accompanied by a > or = 4% drop in oxyhemoglobin saturation) [corrected], obtained by unattended home polysomnography. Other measures include arousal index; percentage of sleep time below 90% oxygen saturation; history of snoring; and presence of hypertension, defined as resting blood pressure of at least 140/90 mm Hg or use of antihypertensive medication.

RESULTS: Mean systolic and diastolic blood pressure and prevalence of hypertension increased significantly with increasing SDB measures, although some of this association was explained by body mass index (BMI). After adjusting for demographics and anthropometric variables (including BMI, neck circumference, and waist-to-hip ratio), as well as for alcohol intake and smoking, the odds ratio for hypertension, comparing the highest category of AHI (> or = 30 per hour) with the lowest category (< 1.5 per hour), was 1.37 (95% confidence interval [CI], 1.03-1.83; P for trend = .005). The corresponding estimate comparing the highest and lowest categories of percentage of sleep time below 90% oxygen saturation (> or = 12% vs < 0.05%) was 1.46 (95% CI, 1.12-1.88; P for trend <.001). In stratified analyses, associations of hypertension with either measure of SDB were seen in both sexes, older and younger ages, all ethnic groups, and among normal-weight and overweight individuals. Weaker and nonsignificant associations were observed for the arousal index or self-reported history of habitual snoring.

CONCLUSION: Our findings from the largest cross-sectional study to date indicate that SDB is associated with systemic hypertension in middle-aged and older individuals of different sexes and ethnic backgrounds.

%B JAMA %V 283 %P 1829-36 %8 2000 Apr 12 %G eng %N 14 %1 https://www.ncbi.nlm.nih.gov/pubmed/10770144?dopt=Abstract %R 10.1001/jama.283.14.1829 %0 Journal Article %J Neuroepidemiology %D 2000 %T Clinical correlates of ventricular and sulcal size on cranial magnetic resonance imaging of 3,301 elderly people. The Cardiovascular Health Study. Collaborative Research Group. %A Longstreth, W T %A Arnold, A M %A Manolio, T A %A Burke, G L %A Bryan, N %A Jungreis, C A %A O'Leary, D %A Enright, P L %A Fried, L %K Age Distribution %K Age Factors %K Aged %K Aging %K Cerebral Ventricles %K Continental Population Groups %K Cross-Sectional Studies %K Diabetes Complications %K Female %K Humans %K Hypertrophy %K Linear Models %K Magnetic Resonance Imaging %K Male %K Multivariate Analysis %K Risk Factors %K Severity of Illness Index %K Sex Distribution %K Sex Factors %K Smoking %K Stroke %X

To identify potential risk factors for and clinical manifestations of ventricular and sulcal enlargement on cranial magnetic resonance imaging (MRI), 3,301 community-dwelling people 65 years or older without a history of stroke or transient ischemic attack underwent extensive standardized evaluations and MRI. In the multivariate model, increased age and white matter grade on MRI were the dominant risk factors for ventricular and sulcal grade. For ventricular grade, other than race, for which non-Blacks had higher grades, models for men and women shared no other factors. For sulcal grades, models for men and women shared variables reflecting cigarette smoking and diabetes. Clinical features were correlated more strongly with ventricular than sulcal grade and more strongly for women than men. Significant age-adjusted correlations between ventricular grade and the Digit-Symbol Substitution Test were found for men and women. Prospective studies will be needed to extend findings of this cross-sectional analysis.

%B Neuroepidemiology %V 19 %P 30-42 %8 2000 Jan-Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/10654286?dopt=Abstract %R 10.1159/000026235 %0 Journal Article %J Am J Epidemiol %D 2000 %T Clustering of procoagulation, inflammation, and fibrinolysis variables with metabolic factors in insulin resistance syndrome. %A Sakkinen, P A %A Wahl, P %A Cushman, M %A Lewis, M R %A Tracy, R P %K Aged %K Aged, 80 and over %K Antigens %K Blood Coagulation %K Cardiovascular Diseases %K Cluster Analysis %K Factor Analysis, Statistical %K Factor VII %K Female %K Fibrinogen %K Fibrinolysis %K Humans %K Inflammation %K Insulin Resistance %K Male %K Middle Aged %K Plasminogen Activator Inhibitor 1 %K Risk Factors %X

The known metabolic cardiovascular disease risk factors associated with insulin resistance syndrome (IRS) do not adequately explain the excess cardiovascular disease risk attributed to this syndrome, and abnormalities in hemostatic variables may contribute to this excess risk. Using data from 322 nondiabetic elderly men and women (aged 65-100 years) participating in the Cardiovascular Health Study during 1989-1990, the authors performed factor analysis on 10 metabolic risk factors associated with IRS and 11 procoagulation, inflammation, and fibrinolysis variables to examine the clustering of the metabolic and hemostatic risk markers. Factor analysis of the metabolic variables confirmed four uncorrelated factors: body mass, insulin/glucose, lipids, and blood pressure. Adding the hemostatic variables yielded three new factors interpreted as inflammation, vitamin K-dependent proteins, and procoagulant activity. Plasminogen activator inhibitor-1 clustered with the body mass factor, supporting the hypothesis that obesity is related to impaired fibrinolysis. Fibrinogen clustered with the inflammation summary factor rather than procoagulant activity, supporting the position that fibrinogen principally reflects underlying inflammation rather than procoagulant potential. The authors conclude that should hemostatic variables be shown to contribute to IRS-related cardiovascular disease, apart from plasminogen activator inhibitor-1, they may do so independently of the established metabolic abnormalities.

%B Am J Epidemiol %V 152 %P 897-907 %8 2000 Nov 15 %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/11092431?dopt=Abstract %R 10.1093/aje/152.10.897 %0 Journal Article %J J Am Geriatr Soc %D 2000 %T Daytime sleepiness predicts mortality and cardiovascular disease in older adults. The Cardiovascular Health Study Research Group. %A Newman, A B %A Spiekerman, C F %A Enright, P %A Lefkowitz, D %A Manolio, T %A Reynolds, C F %A Robbins, J %K Age Factors %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cohort Studies %K Female %K Health Status %K Heart Failure %K Humans %K Incidence %K Male %K Multivariate Analysis %K Myocardial Infarction %K Odds Ratio %K Risk Factors %K Sex Factors %K Sleep Apnea Syndromes %K Sleep Stages %K Sleep Wake Disorders %K Snoring %K Surveys and Questionnaires %K United States %X

INTRODUCTION: As part of the baseline examination in the Cardiovascular Health Study, sleep disturbance symptoms including snoring and daytime sleepiness, were assessed as potential risk factors or precipitants of cardiovascular disease (CVD). Because of the association of sleep disturbance with poorer health and the possible associations of sleep apnea with CVD, we hypothesized that those with poorer sleep or daytime sleepiness may be at increased risk of mortality or incident CVD.

SETTING: Participants (n = 5888) were recruited in 1989, with an additional minority cohort recruited in 1993, in four US communities for a cohort study designed to evaluate risk factors for cardiovascular disease.

METHODS: An interview-administered questionnaire regarding health and sleep habits with ongoing ascertainment of total mortality and cardiovascular disease morbidity and mortality, including total CVD morbidity and mortality, incident myocardial infarction, and congestive heart failure.

RESULTS: Daytime sleepiness was the only sleep symptom that was significantly associated with mortality in both men and women. The unadjusted hazard ratio was 2.12 (1.66, 2.72) in women and 1.40 (1.12, 1.73) in men. Men who reported difficulty falling asleep also had an increased mortality rate (HR = 1.43 (1.14, 1.80)) which was not seen in women. The risks were attenuated with adjustment for age but remained significant for daytime sleepiness in women (HR = 1.82 (1.42, 2.34)) and for difficulty falling asleep in men. (HR = 1.29 (1.03, 1.63)). Frequent awakenings, early morning awakening, and snoring were not associated with a significantly increased risk of mortality in these older men and women. Crude event rates were evaluated for total incident cardiovascular morbidity and mortality, incident myocardial infarction, and incident congestive heart failure (CHF). Incident CVD rates were higher in both men and women with daytime sleepiness. The aged adjusted HR was 1.35 (95% CI = 1.03, 1.76) in men and was 1.66 (95% CI = 1.28, 2.16) in women. Incident CVD was not higher in those with any other sleep disturbance including snoring. The risk of CVD events associated with daytime sleepiness was attenuated but remained significant in women after adjustment for age. Incident myocardial infarction (MI) rates were also higher in women with daytime sleepiness but were not significantly higher in men. Incident CHF rates were increased in both men and women with daytime sleepiness. In men, the age adjusted HR was 1.49 (95% CI, 1.12- 1.98) and in women, was 2.21 (95% CI, 1.64-2.98). Women reporting both daytime sleepiness and frequent awakening had a hazard ratio of 2.34 (95% CI, 1.66-3.29) for incident CHF compared with those with daytime sleepiness but without frequent awakening. This interaction was not found in men.

CONCLUSIONS: In this study, daytime sleepiness was the only sleep disturbance symptom that was associated with mortality, incident CVD morbidity and mortality, MI, and CHF. These findings were stronger in women than men, i.e., the associations persisted for mortality, CVD, and CHF in women after adjustment for age and other factors. Thus, a report of daytime sleepiness identifies older adults at increased risk for total and cardiovascular mortality, and is an independent risk factor in women.

%B J Am Geriatr Soc %V 48 %P 115-23 %8 2000 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/10682939?dopt=Abstract %R 10.1111/j.1532-5415.2000.tb03901.x %0 Journal Article %J J Am Geriatr Soc %D 2000 %T Estrogen replacement therapy and MRI-demonstrated cerebral infarcts, white matter changes, and brain atrophy in older women: the Cardiovascular Health Study. %A Luoto, R %A Manolio, T %A Meilahn, E %A Bhadelia, R %A Furberg, C %A Cooper, L %A Kraut, M %K Aged %K Aged, 80 and over %K Atrophy %K Brain %K Brain Infarction %K Estrogen Replacement Therapy %K Female %K Humans %K Intelligence Tests %K Life Style %K Magnetic Resonance Imaging %K Population Surveillance %K Prevalence %K Prospective Studies %K Social Class %K United States %X

OBJECTIVE: We studied the relationship between the use of estrogen replacement therapy (ERT) and cerebral magnetic resonance imaging (MRI) abnormalities among older women.

DESIGN: A population-based prospective study (Cardiovascular Health Study).

SETTING: Four regions in the United States.

PARTICIPANTS: A total of 2133 (62.9% of the eligible) women aged 65 to 95 years (mean age 74.8), on whom MRI was performed in 1992-1994.

MEASUREMENTS: Presence of global brain atrophy, white matter changes, small infarct-like lesion (ILL) (<3 mm), MRI infarcts (> or =3 mm, mostly small and asymptomatic), and cognitive function as measured by Mini-Mental State Exam (MMSE), and by ERT use (current/past/never), adjusted for a number of socioeconomic, lifestyle, and reproductive covariates.

RESULTS: Current use of ERT was reported by 15% and past use by another 23% of participants; 35% of all women had MRI infarcts. The prevalence of MRI infarcts did not differ in current or past users from those who had never used ERT (nonusers). Bifrontal distance, the largest distance between frontal horns, and the size of ventricles were larger among current ERT users compared to past users or nonusers (P (trend) = .01), adjusted for all other covariates, but no dose-response relationship to current or past ERT use was found. Duration of estrogen use was not associated with any atrophy measure. Cortical atrophy measure, sulcal widening, or white matter disease did not differ significantly by ERT use or duration of use. Central measures of atrophy, bifrontal distance, and ventricular size were significantly associated with cognition as measured by MMSE.

CONCLUSIONS: Current ERT users had much more clinically significant central atrophy than nonusers, but the implications remained unclear.

%B J Am Geriatr Soc %V 48 %P 467-72 %8 2000 May %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/10811537?dopt=Abstract %R 10.1111/j.1532-5415.2000.tb04990.x %0 Journal Article %J Am J Geriatr Cardiol %D 2000 %T Orthostatic Hypotension in the Elderly: Contributions of Impaired LV Filling and Altered Sympathovagal Balance. %A Gottdiener, John S. %A Yanez, David %A Rautaharju, Penttii %A Gardin, Julius M. %A Bild, Diane E. %A Lima, Joao %A Newman, Anne B. %X

Orthostatic hypotension, which occurs in 5%-18% of the elderly, may contribute to age-related disability. While autonomic dysfunction and alterations of cardiac structure and function likely to impair postural maintenance of blood pressure are common in the elderly, these have not been jointly studied in large cohorts. The authors evaluated the association of orthostatic hypotension with echocardiographic measures of cardiac structure and function, and with autonomic function determined by analysis of heart rate variability, in a large population of community-dwelling elderly. A total of 5201 men and women, aged 65-100 years and living in four geographically separate communities, were recruited from Medicare eligibility lists. In this prospective, observational cohort study, measurements included clinical questionnaires, standing and supine blood pressures, mini-glucose tolerance testing, echocardiography, and 24-hour Holter recording for assessment of heart rate variability. Orthostatic hypotension, defined as a decrease in standing systolic blood pressure of 20 mm Hg or more, was positively associated in bivariate analyses with left ventricular wall thickness, peak velocity of late diastolic filling, vagal tone on heart rate variability analysis, supine systolic pressure, supine diastolic pressure, age, and diabetes, and inversely associated with body weight. After statistical adjustment for the presence of myocardial infarction, stroke, and use of antihypertensive medication, the associations were maintained, and a previous trend toward an association with decreased left ventricular cavity size became statistically significant. The data suggest that in elderly, community-based individuals, orthostatic hypotension is associated with increased blood pressure and decreased weight; it possibly acts mechanistically via altered sympathovagal balance, increased left ventricular wall thickness, decreased left ventricular preload, and alterations of left ventricular diastolic filling. (c) 2000 by CVRR, Inc.

%B Am J Geriatr Cardiol %V 9 %P 273-280 %8 2000 Oct %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/11416580?dopt=Abstract %R 10.1111/j.1076-7460.2000.80051.x %0 Journal Article %J Stroke %D 2001 %T Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study. %A Mukamal, K J %A Longstreth, W T %A Mittleman, M A %A Crum, R M %A Siscovick, D S %K Aged %K Aging %K Alcohol Drinking %K Atrophy %K Brain %K Brain Diseases %K Cerebral Infarction %K Comorbidity %K Demography %K Female %K Health Surveys %K Humans %K Logistic Models %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Nerve Fibers, Myelinated %K Odds Ratio %K Prospective Studies %K Sensitivity and Specificity %K United States %X

BACKGROUND AND PURPOSE: Subclinical findings on MRI of the brain are associated with poorer cognitive and neurological function among older adults. We sought to determine how alcohol consumption is related to these findings.

METHODS: As part of the Cardiovascular Health Study, 3660 adults aged 65 years and older underwent MRI of the brain from 1992 to 1994. We excluded 284 participants with a confirmed history of cerebrovascular disease. We assessed self-reported intake of beer, wine, and liquor at the annual clinic visit closest to the date of the MRI and grouped participants into 6 categories: abstainers, former drinkers, <1 drink weekly, 1 to <7 drinks weekly, 7 to <15 drinks weekly, and >/=15 drinks weekly. Neuroradiologists assessed white matter grade, infarcts, ventricular size, and sulcal size in a standardized and blinded manner. We used multivariate regression to control for sociodemographic and clinical characteristics.

RESULTS: We found a U-shaped relationship between alcohol consumption and white matter abnormalities. Compared with abstainers, individuals consuming 1 to <7 drinks had an OR of 0.68, and those consuming >/=15 drinks weekly had an OR of 0.95 (p for quadratic term=0.01). Heavier alcohol consumption was associated with a lower prevalence of infarcts (OR for >/=15 drinks weekly relative to abstainers 0.59; P for trend=0.004), but larger ventricular size (OR for >/=15 drinks weekly relative to abstainers 1.32; P for trend=0.006) and sulcal size (OR for >/=15 drinks weekly relative to abstainers 1.53; P for trend=0.007).

CONCLUSIONS: Moderate alcohol consumption is associated with a lower prevalence of white matter abnormalities and infarcts, thought to be of vascular origin, but with a dose-dependent higher prevalence of brain atrophy on MRI among older adults. The extent to which these competing associations influence overall brain function will require further study.

%B Stroke %V 32 %P 1939-46 %8 2001 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/11546878?dopt=Abstract %R 10.1161/hs0901.095723 %0 Journal Article %J Arch Intern Med %D 2001 %T Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality: the cardiovascular health study. %A Psaty, B M %A Furberg, C D %A Kuller, L H %A Cushman, M %A Savage, P J %A Levine, D %A O'Leary, D H %A Bryan, R N %A Anderson, M %A Lumley, T %K Aged %K Blood Pressure %K Female %K Humans %K Male %K Myocardial Infarction %K Prognosis %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stroke %K Survival Rate %K United States %X

BACKGROUND: Recent reports have drawn attention to the importance of pulse pressure as a predictor of cardiovascular events. Pulse pressure is used neither by clinicians nor by guidelines to define treatable levels of blood pressure.

METHODS: In the Cardiovascular Health Study, 5888 adults 65 years and older were recruited from 4 US centers. At baseline in 1989-1990, participants underwent an extensive examination, and all subsequent cardiovascular events were ascertained and classified.

RESULTS: At baseline, 1961 men and 2941 women were at risk for an incident myocardial infarction or stroke. During follow-up that averaged 6.7 years, 572 subjects had a coronary event, 385 had a stroke, and 896 died. After adjustment for potential confounders, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure were directly associated with the risk of incident myocardial infarction and stroke. Only SBP was associated with total mortality. Importantly, SBP was a better predictor of cardiovascular events than DBP or pulse pressure. In the adjusted model for myocardial infarction, a 1-SD change in SBP, DBP, and pulse pressure was associated with hazard ratios (95% confidence intervals) of 1.24 (1.15-1.35), 1.13 (1.04-1.22), and 1.21 (1.12-1.31), respectively; and adding pulse pressure or DBP to the model did not improve the fit. For stroke, the hazard ratios (95% confidence intervals) were 1.34 (1.21-1.47) with SBP, 1.29 (1.17-1.42) with DBP, and 1.21 (1.10-1.34) with pulse pressure. The association between blood pressure level and cardiovascular disease risk was generally linear; specifically, there was no evidence of a J-shaped relationship. In those with treated hypertension, the hazard ratios for the association of SBP with the risks for myocardial infarction and stroke were less pronounced than in those without treated hypertension.

CONCLUSION: In this population-based study of older adults, although all measures of blood pressure were strongly and directly related to the risk of coronary and cerebrovascular events, SBP was the best single predictor of cardiovascular events.

%B Arch Intern Med %V 161 %P 1183-92 %8 2001 May 14 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/11343441?dopt=Abstract %R 10.1001/archinte.161.9.1183 %0 Journal Article %J Arch Neurol %D 2001 %T Cluster analysis and patterns of findings on cranial magnetic resonance imaging of the elderly: the Cardiovascular Health Study. %A Longstreth, W T %A Diehr, P %A Manolio, T A %A Beauchamp, N J %A Jungreis, C A %A Lefkowitz, D %K Aged %K Brain %K Cerebral Infarction %K Cerebrovascular Disorders %K Cluster Analysis %K Cohort Studies %K Discriminant Analysis %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Risk Factors %X

OBJECTIVE: To characterize patterns of findings on cranial magnetic resonance imaging (MRI) of the elderly using a statistical technique called cluster analysis.

SUBJECTS AND METHODS: The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people 65 years and older. Of these, 3230 underwent cranial MRI scans, which were coded for presence of infarcts and grades for white matter, ventricles, and sulci. Cluster analysis separated participants into 5 clusters based solely on patterns of MRI findings. Participants comprising each cluster were contrasted with respect to cardiovascular risk factors and clinical manifestations.

RESULTS: One cluster was low on all the MRI findings (normal) and another was high on all of them (complex infarcts). Another cluster had evidence for infarcts alone (simple infarcts), whereas the last 2 clusters lacked infarcts, one having enlarged ventricles and sulci (atrophy) and the other having prominent white matter changes and enlarged ventricles (leukoaraiosis). Factors that distinguished these clusters in a discriminant analysis were age, sex, several measures of hypertension, internal carotid artery wall thickness, smoking, and prevalent claudication before the MRI. The atrophy group had the highest percentage of men and the normal group had the lowest. Cognitive and motor performance also differed across clusters, with the atrophy cluster performing better than may have been expected.

CONCLUSIONS: These MRI patterns identified participants with different vascular disease risk factors and clinical manifestations. Results of these exploratory analyses warrant consideration in other populations of elderly people. Such patterns may provide clues about the pathophysiology of structural brain changes in the elderly.

%B Arch Neurol %V 58 %P 635-40 %8 2001 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/11295995?dopt=Abstract %R 10.1001/archneur.58.4.635 %0 Journal Article %J Chest %D 2001 %T Correlates of peak expiratory flow lability in elderly persons. %A Enright, P L %A McClelland, R L %A Buist, A S %A Lebowitz, M D %K Aged %K Aged, 80 and over %K Aging %K Asthma %K Female %K Heart Failure %K Humans %K Male %K Monitoring, Ambulatory %K Peak Expiratory Flow Rate %K Predictive Value of Tests %K Pulmonary Disease, Chronic Obstructive %K Reference Values %K Rhinitis, Allergic, Seasonal %K Risk Factors %K Signal Processing, Computer-Assisted %K Spirometry %X

OBJECTIVE: To determine the correlates of the lability of peak expiratory flow (PEF) in the elderly.

METHODS: A community sample of 4,581 persons > or = 65 years old from the Cardiovascular Health Study completed an asthma questionnaire and underwent spirometry. During a follow-up examination of the cohort, 1,836 persons agreed to measure PEF at home twice daily for 2 weeks, and 90% successfully obtained at least 4 days of valid measurements. PEF lability was calculated as the highest daily (PEF maximum - PEF minimum)/mean PEF.

RESULTS: Mean PEF measured at home was accurate when compared to PEF determined by spirometry in the clinic. Mean PEF lability was 18% in those with current asthma (n = 165) vs 12% in healthy nonsmokers (upper limit of normal, 29%). Approximately 26% of those with asthma and 14% of the other participants had abnormally high PEF lability (> 29%). After excluding participants with asthma, other independent predictors of high PEF lability included black race, current and former smoking, airway obstruction on spirometry, daytime sleepiness, recent wheezing, chronic cough, emphysema, and wheezing from lying in a supine position. Despite having a lower mean PEF, those reporting congestive heart failure (n = 82) did not have significantly higher PEF lability.

CONCLUSIONS: Measurement of PEF lability at home is highly successful in elderly persons. PEF lability > or = 30% is abnormal in the elderly and is associated with asthma.

%B Chest %V 120 %P 1861-8 %8 2001 Dec %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/11742914?dopt=Abstract %R 10.1378/chest.120.6.1861 %0 Journal Article %J Am J Respir Crit Care Med %D 2001 %T Echocardiographic features of the right heart in sleep-disordered breathing: the Framingham Heart Study. %A Guidry, U C %A Mendes, L A %A Evans, J C %A Levy, D %A O'Connor, G T %A Larson, M G %A Gottlieb, D J %A Benjamin, E J %K Adult %K Age Factors %K Aged %K Cohort Studies %K Cross-Sectional Studies %K Data Interpretation, Statistical %K Echocardiography %K Female %K Forced Expiratory Volume %K Humans %K Hypertrophy, Right Ventricular %K Linear Models %K Male %K Middle Aged %K Obesity %K Observer Variation %K Polysomnography %K Prospective Studies %K Sex Factors %K Sleep Apnea Syndromes %K Ventricular Function, Right %K Vital Capacity %X

The effect of sleep-disordered breathing (SDB) on right heart structure and function is controversial. Studies of patients referred for evaluation of possible sleep apnea have yielded conflicting results, and the impact of SDB on the right heart has not been investigated in the general population. We examined the echocardiographic features of subjects with SDB at the Framingham Heart Study site of the Sleep Heart Health Study. Of 1,001 polysomnography subjects, 90 with SDB defined as a respiratory disturbance index (RDI) score > 90th percentile (mean RDI = 42) were compared with 90 low-RDI subjects (mean RDI = 5) matched for age, sex, and body mass index. Right heart measurements, made without knowledge of clinical status, were compared between groups. The majority of the subjects were male (74%). After multivariable adjustment, right ventricle (RV) wall thickness was significantly greater (p = 0.005) in subjects with SDB (0.78 +/- 0.02 cm) than in the low-RDI subjects (0.68 +/- 0.02 cm). Right atrial dimensions, RV dimensions, and RV systolic function were not found to be significantly different between subjects with SDB and the low-RDI subjects. We conclude that in this community-based study of SDB and right heart echocardiographic features, RV wall thickness was increased in subjects with SDB. Whether the RV hypertrophy observed in persons with SDB is associated with increased morbidity and mortality remains unknown.

%B Am J Respir Crit Care Med %V 164 %P 933-8 %8 2001 Sep 15 %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/11587973?dopt=Abstract %R 10.1164/ajrccm.164.6.2001092 %0 Journal Article %J Neurology %D 2001 %T Frequency and predictors of stroke death in 5,888 participants in the Cardiovascular Health Study. %A Longstreth, W T %A Bernick, C %A Fitzpatrick, A %A Cushman, M %A Knepper, L %A Lima, J %A Furberg, C D %K Aged %K Aged, 80 and over %K Clinical Trials as Topic %K Female %K Humans %K Longitudinal Studies %K Male %K Predictive Value of Tests %K Stroke %K Survival Analysis %K United States %X

BACKGROUND: Few population-based studies have examined in detail issues of stroke-related deaths in elderly people.

METHODS: Participants in the Cardiovascular Health Study (CHS) are 65 years of age or older, have had extensive baseline evaluations, and have been followed-up for fatal and nonfatal cardiovascular and cerebrovascular disease outcomes. Investigators adjudicated these outcomes and classified strokes by types and subtypes.

RESULTS: Over 7 years, 1,310 (22.2%) of 5,888 participants died, and 455 (7.7%) experienced incident stroke. For the 5,888, stroke mortality was 3.2 per 1,000 person-years. For the 455, it was 36.1 per 1,000 person-years, with the most lethal type being hemorrhagic and the ischemic subtype being cardioembolic. After controlling for age and stroke type, the only other independent predictor of death after any stroke was poor performance on a timed walk measured before the incident stroke. Considering only ischemic stroke, the independent predictors of death were African American race and poor performance on timed walk.

CONCLUSION: In CHS, death attributable to stroke is common. As in other studies, the most lethal stroke type was hemorrhagic, and ischemic stroke subtype, cardioembolic. Slow walking, possibly a measure of frailty, was associated with an increased risk of death of stroke. Finally, African Americans faced a greater risk of death than others after an ischemic stroke.

%B Neurology %V 56 %P 368-75 %8 2001 Feb 13 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/11171903?dopt=Abstract %R 10.1212/wnl.56.3.368 %0 Journal Article %J Am J Cardiol %D 2001 %T Importance of heart failure with preserved systolic function in patients > or = 65 years of age. CHS Research Group. Cardiovascular Health Study. %A Kitzman, D W %A Gardin, J M %A Gottdiener, J S %A Arnold, A %A Boineau, R %A Aurigemma, G %A Marino, E K %A Lyles, M %A Cushman, M %A Enright, P L %K Aged %K Aged, 80 and over %K Analysis of Variance %K Chi-Square Distribution %K Echocardiography, Doppler %K Female %K Health Status %K Heart Failure %K Humans %K Logistic Models %K Longitudinal Studies %K Male %K Prevalence %K Risk Factors %K Surveys and Questionnaires %K United States %K Ventricular Function, Left %X

Although congestive heart failure (CHF) is a common syndrome among the elderly, there is a relative paucity of population-based data, particularly regarding CHF with normal systolic left ventricular function. A total of 4,842 independent living, community-dwelling subjects aged 66 to 103 years received questionnaires on medical history, family history, personal habits, physical activity, and socioeconomic status, confirmation of pre-existing cardiovascular and cerebrovascular disease, anthropometric measurements, casual seated random-zero blood pressure, forced vital capacity and expiratory volume in 1 second, 12-lead supine electrocardiogram, fasting glucose, creatinine, plasma lipids, carotid artery wall thickness by ultrasonography, and echocardiography-Doppler examinations. Participants with at least 1 confirmed episode of CHF by Cardiovascular Health Study criteria were considered prevalent for CHF. The prevalence of CHF was 8.8% and was associated with increased age, particularly for women, in whom it increased more than twofold from age 65 to 69 years (6.6%) to age > or = 85 years (14%). In multivariate analysis, subjects with CHF were more likely to be older (odds ratio [OR] 1.2 for 5-year difference, men OR 1.1), and more often had a history of myocardial infarction (OR 7.3), atrial fibrillation (OR 3.0), diabetes mellitus (OR 2.1), renal dysfunction (OR 2.0 for creatinine < or = 1.5 mg/ dl), and chronic pulmonary disease (OR 1.8; women only). The echocardiographic correlates of CHF were increased left atrial and ventricular dimensions. Importantly, 55% of subjects with CHF had normal left ventricular systolic function and 80% had either normal or only mildly reduced systolic function. Among subjects with CHF, women had normal systolic function more frequently than men (67% vs 42%; p < 0.001). Thus, CHF is common among community-dwelling elderly. It increases with age and is usually associated with normal systolic LV function, particularly among women. The finding that a large proportion of elderly with CHF have preserved LV systolic function is important because there is a paucity of data to guide management in this dominant subset.

%B Am J Cardiol %V 87 %P 413-9 %8 2001 Feb 15 %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/11179524?dopt=Abstract %R 10.1016/s0002-9149(00)01393-x %0 Journal Article %J JAMA %D 2001 %T Involvement in caregiving and adjustment to death of a spouse: findings from the caregiver health effects study. %A Schulz, R %A Beach, S R %A Lind, B %A Martire, L M %A Zdaniuk, B %A Hirsch, C %A Jackson, S %A Burton, L %K Aged %K Aged, 80 and over %K Antidepressive Agents %K Bereavement %K Caregivers %K Death %K Depression %K Female %K Follow-Up Studies %K Health Behavior %K Humans %K Male %K Socioeconomic Factors %K Spouses %K Weight Loss %X

CONTEXT: Most deaths in the United States occur among older persons who have 1 or more disabling conditions. As a result, many deaths are preceded by an extended period during which family members provide care to their disabled relative.

OBJECTIVE: To better understand the effect of bereavement on family caregivers by examining predeath vs postdeath changes in self-reported and objective health outcomes among elderly persons providing varying levels of care prior to their spouse's death.

DESIGN AND SETTING: Prospective, population-based cohort study conducted in 4 US communities between 1993 and 1998.

PARTICIPANTS: One hundred twenty-nine individuals aged 66 to 96 years whose spouse died during an average 4-year follow-up. Individuals were classified as noncaregivers (n = 40), caregivers who reported no strain (n = 37), or strained caregivers (n = 52).

MAIN OUTCOME MEASURES: Changes in depression symptoms (assessed by the 10-item Center for Epidemiological Studies-Depression [CES-D] scale), antidepressant medication use, 6 health risk behaviors, and weight among the 3 groups of participants.

RESULTS: Controlling for age, sex, race, education, prevalent cardiovascular disease at baseline, and interval between predeath and postdeath assessments, CES-D scores remained high but did not change among strained caregivers (9.44 vs 9.19; P =.76), while these scores increased for both noncaregivers (4.74 vs 8.25; F(1,116) = 14.33; P<.001) and nonstrained caregivers (4.94 vs 7.13; F(1,116) = 4.35; P =.04). Noncaregivers were significantly more likely to be using nontricyclic antidepressant medications following the death than the nonstrained caregiver group (odds ratio [OR], 12.85; 95% confidence interval [CI], 1.02-162.13; P =.05). The strained caregiver group experienced significant improvement in health risk behaviors following the death of their spouse (1.47 vs 0.66 behaviors; F(1,118) = 20.23; P<.001), while the noncaregiver and nonstrained caregiver groups showed little change (0.27 vs 0.27 [P =.99] and 0.46 vs 0.27 [P =.39] behaviors, respectively). Noncaregivers experienced significant weight loss following the death (149.1 vs 145.3 lb [67.1 vs 65.4 kg]; F(1,101) = 8.12; P =.005), while the strained and nonstrained caregiving groups did not show significant weight change (156.2 vs 155.2 lb [70.3 vs 69.8 kg] [P =.41] and 156.2 vs 154.0 lb [70.3 vs 69.3 kg] [P =.12], respectively).

CONCLUSIONS: These data indicate that the impact of losing one's spouse among older persons varies as a function of the caregiving experiences that precede the death. Among individuals who are already strained prior to the death of their spouse, the death itself does not increase their level of distress. Instead, they show reductions in health risk behaviors. Among noncaregivers, losing one's spouse results in increased depression and weight loss.

%B JAMA %V 285 %P 3123-9 %8 2001 Jun 27 %G eng %N 24 %1 https://www.ncbi.nlm.nih.gov/pubmed/11427141?dopt=Abstract %R 10.1001/jama.285.24.3123 %0 Journal Article %J Am J Cardiol %D 2001 %T M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study). %A Gardin, J M %A McClelland, R %A Kitzman, D %A Lima, J A %A Bommer, W %A Klopfenstein, H S %A Wong, N D %A Smith, V E %A Gottdiener, J %K Aged %K Aged, 80 and over %K Analysis of Variance %K Coronary Disease %K Echocardiography, Doppler %K Female %K Heart Failure %K Humans %K Incidence %K Male %K Predictive Value of Tests %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stroke %X

Previous studies have identified a number of echocardiographic variables that predict cardiovascular disease (CVD) events and mortality, but have not focused on a large elderly cohort. The purpose of this study was to determine whether M-mode echocardiographic variables predicted all-cause mortality, incident coronary heart disease (CHD), congestive heart failure (CHF), and stroke in a large prospective, multicenter, population-based study. In the Cardiovascular Health Study, a biracial cohort of 5,888 men and women (mean age 73 years) underwent 2-dimensional M-mode echocardiographic measurements of left ventricular (LV) internal dimensions, wall thickness, mass and geometry, as well as measurement of left atrial dimension and assessment for mitral annular calcium. Participants were followed for 6 to 7 years for incident events; analyses excluded subjects with prevalent disease. One or more echocardiographic measurements were independent predictors of all-cause mortality and incident CHD, CHF, and stroke. After adjustment for anthropometric and traditional CVD risk factors, LV mass was significantly related to incident CHD, CHF, and stroke. The highest quartile of LV mass conferred a hazards ratio of 3.36, compared with the lowest quartile, for incident CHF. Furthermore, incident CHF-free survival was significantly lower for participants with LV mass in the highest versus the 2 lowest quartiles (86% vs 97%, respectively, at 2,500 days). Eccentric and concentric LV hypertrophy, respectively, conferred adjusted hazards ratios, compared with normal LV geometry, of 2.05 and 1.61 for incident CHD, and 2.95 and 3.32 for incident CHF. Thus, in an elderly biracial population, selected 2-dimensional M-mode echocardiographic measurements were important markers of subclinical disease and conferred independent prognostic information for incident CVD events, especially CHF and CHD.

%B Am J Cardiol %V 87 %P 1051-7 %8 2001 May 01 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/11348601?dopt=Abstract %R 10.1016/s0002-9149(01)01460-6 %0 Journal Article %J Arch Neurol %D 2001 %T Patterns on cranial magnetic resonance imaging in elderly people and vascular disease outcomes. %A Longstreth, W T %A Diehr, P %A Beauchamp, N J %A Manolio, T A %K Aged %K Brain %K Cardiovascular Diseases %K Cluster Analysis %K Humans %K Magnetic Resonance Imaging %B Arch Neurol %V 58 %P 2074 %8 2001 Dec %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/11735783?dopt=Abstract %R 10.1001/archneur.58.12.2074 %0 Journal Article %J Am J Epidemiol %D 2001 %T Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study. %A Newman, A B %A Nieto, F J %A Guidry, U %A Lind, B K %A Redline, S %A Pickering, T G %A Quan, S F %K Adult %K Aged %K Analysis of Variance %K Cardiovascular Diseases %K Chi-Square Distribution %K Cross-Sectional Studies %K Female %K Humans %K Linear Models %K Longitudinal Studies %K Male %K Middle Aged %K Polysomnography %K Risk Factors %K Sleep Apnea Syndromes %K United States %X

Associations between sleep-disordered breathing and cardiovascular disease (CVD) may be mediated by higher cardiovascular risk factor levels in those with sleep-disordered breathing. The authors examined these relations in the Sleep Heart Health Study, a multiethnic cohort of 6,440 men and women over age 40 years conducted from October 1995 to February 1998 and characterized by home polysomnography. In 4,991 participants who were free of self-reported CVD at the time of the sleep study, moderate levels of sleep-disordered breathing were common, with a median Respiratory Disturbance Index (RDI) of 4.0 (interquartile range, 1.25-10.7). The level of RDI was associated cross-sectionally with age, body mass index, waist-to-hip ratio, hypertension, diabetes, and lipid levels. These relations were more pronounced in those under age 65 years than in those over age 65. Women under age 65 years with RDI in the higher quartiles were more obese than men with similar RDI. Although the pattern of associations was consistent with greater obesity in those with higher RDI, higher body mass index did not explain all of these associations. If sleep-disordered breathing is shown in future follow-up to increase the risk for incident CVD events, part of the risk is likely to be due to the higher cardiovascular risk factors in those with higher RDI.

%B Am J Epidemiol %V 154 %P 50-9 %8 2001 Jul 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/11434366?dopt=Abstract %R 10.1093/aje/154.1.50 %0 Journal Article %J Neurology %D 2001 %T Silent MRI infarcts and the risk of future stroke: the cardiovascular health study. %A Bernick, C %A Kuller, L %A Dulberg, C %A Longstreth, W T %A Manolio, T %A Beauchamp, N %A Price, T %K Aged %K Cerebral Infarction %K Cohort Studies %K Female %K Follow-Up Studies %K Humans %K Incidence %K Magnetic Resonance Imaging %K Male %K Predictive Value of Tests %K Risk Factors %K Stroke %X

BACKGROUND: Silent infarcts are commonly discovered on cranial MRI in the elderly.

OBJECTIVE: To examine the association between risk of stroke and presence of silent infarcts, alone and in combination with other stroke risk factors.

METHODS: Participants (3,324) in the Cardiovascular Health Study (CHS) without a history of stroke underwent cranial MRI scans between 1992 and 1994. Silent infarcts were defined as focal lesions greater than 3 mm that were hyperintense on T2 images and, if subcortical, hypointense on T1 images. Incident strokes were identified and classified over an average follow-up of 4 years. The authors evaluated the risk of subsequent symptomatic stroke and how it was modified by other potential stroke risk factors among those with silent infarcts.

RESULTS: Approximately 28% of CHS participants had evidence of silent infarcts (n = 923). The incidence of stroke was 18.7 per 1,000 person-years in those with silent infarcts (n = 67) compared with 9.5 per 1,000 person-years in the absence of silent infarcts. The adjusted relative risk of incident stroke increased with multiple (more than one) silent infarcts (hazard ratio 1.9 [1.2 to 2.8]). Higher values of diastolic and systolic blood pressure, common and internal carotid wall thickness, and the presence of atrial fibrillation were associated with an increased risk of strokes in those with silent infarcts (n = 53 strokes).

CONCLUSION: The presence of silent cerebral infarcts on MRI is an independent predictor of the risk of symptomatic stroke over a 4-year follow- up in older individuals without a clinical history of stroke.

%B Neurology %V 57 %P 1222-9 %8 2001 Oct 09 %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/11591840?dopt=Abstract %R 10.1212/wnl.57.7.1222 %0 Journal Article %J Am J Respir Crit Care Med %D 2001 %T Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. %A Shahar, E %A Whitney, C W %A Redline, S %A Lee, E T %A Newman, A B %A Nieto, F J %A O'Connor, G T %A Boland, L L %A Schwartz, J E %A Samet, J M %K Aged %K Cardiovascular Diseases %K Cohort Studies %K Cross-Sectional Studies %K Female %K Humans %K Male %K Middle Aged %K Sleep Apnea Syndromes %X

Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep- disordered breathing and self-reported CVD in 6,424 free-living individuals who underwent overnight, unattended polysomnography at home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)-the average number of apneas and hypopneas per hour of sleep. Mild to moderate disordered breathing during sleep was highly prevalent in the sample (median AHI: 4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16%) reported at least one manifestation of CVD (myocardial infarction, angina, coronary revascularization procedure, heart failure, or stroke). The multivariable-adjusted relative odds (95% CI) of prevalent CVD for the second, third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24), 1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing was associated more strongly with self-reported heart failure and stroke than with self-reported coronary heart disease: the relative odds (95% CI) of heart failure, stroke, and coronary heart disease (upper versus lower AHI quartile) were 2.38 (1.22-4.62), 1.58 (1.02- 2.46), and 1.27 (0.99-1.62), respectively. These findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.

%B Am J Respir Crit Care Med %V 163 %P 19-25 %8 2001 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/11208620?dopt=Abstract %R 10.1164/ajrccm.163.1.2001008 %0 Journal Article %J Am J Hypertens %D 2002 %T Correlates of aortic stiffness in elderly individuals: a subgroup of the Cardiovascular Health Study. %A Mackey, Rachel H %A Sutton-Tyrrell, Kim %A Vaitkevicius, Peter V %A Sakkinen, Pamela A %A Lyles, Mary F %A Spurgeon, Harold A %A Lakatta, Edward G %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Aging %K Aorta %K Female %K Heart Rate %K Humans %K Hypertension %K Insulin Resistance %K Longitudinal Studies %K Male %K Pulsatile Flow %K Risk Factors %K Sex Distribution %X

BACKGROUND: Arterial stiffness has been associated with aging, hypertension, and diabetes; however, little data has been published examining risk factors associated with arterial stiffness in elderly individuals.

METHODS: Longitudinal associations were made between aortic stiffness and risk factors measured approximately 4 years earlier. Aortic pulse wave velocity (PWV), an established index of arterial stiffness, was measured in 356 participants (53.4% women, 25.3% African American), aged 70 to 96 years, from the Pittsburgh site of the Cardiovascular Health Study during 1996 to 1998.

RESULTS: Mean aortic pulse wave velocity (850 cm/sec, range 365 to 1863) did not differ by ethnicity or sex. Increased aortic stiffness was positively associated with higher systolic blood pressure (SBP), age, fasting and 2-h postload glucose, fasting and 2-h insulin, triglycerides, waist circumference, body mass index, truncal fat, decreased physical activity, heart rate, and common carotid artery wall thickness (P < .05). After controlling for age and SBP, the strongest predictors of aortic stiffness in men were heart rate (P = .001) and 2-h glucose (P = .063). In women, PWV was positively associated with heart rate (P = .018), use of antihypertensive medication (P = .035), waist circumference (P = .030), and triglycerides (P = .081), and was negatively associated with physical activity (P = .111). Results were similar when the analysis was repeated in nondiabetic individuals and in those free of clinical or subclinical cardiovascular disease in 1992 to 1993.

CONCLUSIONS: In these elderly participants, aortic stiffness was positively associated with risk factors associated with the insulin resistance syndrome, increased common carotid intima-media thickness, heart rate, and decreased physical activity measured several years earlier.

%B Am J Hypertens %V 15 %P 16-23 %8 2002 Jan %G eng %N 1 Pt 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/11824854?dopt=Abstract %R 10.1016/s0895-7061(01)02228-2 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2002 %T In the elderly, interleukin-6 plasma levels and the -174G>C polymorphism are associated with the development of cardiovascular disease. %A Jenny, Nancy S %A Tracy, Russell P %A Ogg, Malcolm S %A Luong, Le Ahn %A Kuller, Lewis H %A Arnold, Alice M %A Sharrett, A Richey %A Humphries, Steve E %K Age Factors %K Aged %K Biomarkers %K Cardiovascular Diseases %K Case-Control Studies %K Cytosine %K Female %K Follow-Up Studies %K Genetic Predisposition to Disease %K Genotype %K Guanine %K Health Surveys %K Humans %K Inflammation %K Interleukin-6 %K Linear Models %K Male %K Polymorphism, Genetic %K Predictive Value of Tests %K Promoter Regions, Genetic %X

OBJECTIVE: Interleukin (IL)-6-mediated inflammation is involved in cardiovascular disease (CVD). We assessed IL-6 levels and the -174G>C genotype in a case-control study of men and women (average age 73 years) within the Cardiovascular Health Study.

METHODS AND RESULTS: Cases included incident angina, myocardial infarction (MI), and stroke (5-year follow-up), prevalent MI, and MRI-detectable infarcts. A control group and a group free of subclinical CVD were used for comparison. The -174C allele was associated with higher C-reactive protein (11% higher, P=0.02), fibrinogen (3% higher, P=0.02), and IL-6 (5% higher; P=0.16). IL-6 was associated with increased atherosclerosis when the control group was compared with the group free of subclinical CVD. No further association with CVD events was found when case groups were compared with the control group. Compared with its absence, presence of the -174C allele was associated with risk of MRI infarcts (odds ratio 1.5).

CONCLUSIONS: IL-6 levels differentiated those with subclinical CVD from those without. Although the -174C allele was not associated with incident events, associations of the genotype with inflammation and MRI infarcts, combined with the plasma IL-6 results, suggest that IL-6 may chronically predispose an individual to develop atherosclerosis.

%B Arterioscler Thromb Vasc Biol %V 22 %P 2066-71 %8 2002 Dec 01 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/12482836?dopt=Abstract %R 10.1161/01.atv.0000040224.49362.60 %0 Journal Article %J Stroke %D 2002 %T Incidence, manifestations, and predictors of brain infarcts defined by serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. %A Longstreth, W T %A Dulberg, Corinne %A Manolio, Teri A %A Lewis, Michael R %A Beauchamp, Norman J %A O'Leary, Daniel %A Carr, Jeff %A Furberg, Curt D %K Aged %K Brain Infarction %K California %K Cohort Studies %K Creatinine %K Follow-Up Studies %K Humans %K Incidence %K Longitudinal Studies %K Magnetic Resonance Imaging %K Maryland %K Multivariate Analysis %K Neuropsychological Tests %K North Carolina %K Odds Ratio %K Pennsylvania %K Predictive Value of Tests %K Risk Factors %X

BACKGROUND AND PURPOSE: MRI-defined infarcts are common in the elderly. We sought to explore incidence, manifestations, and predictors of such infarcts.

METHODS: The Cardiovascular Health Study (CHS) is a population-based, longitudinal study of 5888 people aged > or =65 years. Participants have had extensive baseline and follow-up evaluations; 1433 participants underwent 2 MRI scans separated by 5 years and had no infarcts on initial MRI.

RESULTS: On follow-up MRI, 254 participants (17.7%) had 1 or more infarcts. Most were single (75.6%), subcortical (79.9%), and small (3 to 20 mm in 87.0%). Only 11.4% of those with infarcts experienced a documented transient ischemic attack or stroke between the scans. Although participants were similar at initial MRI, those with MRI-defined infarcts on follow-up experienced greater decline than those without infarcts on the Modified Mini-Mental State Examination and Digit-Symbol Substitution test (both P<0.01). Severity of white matter changes on initial MRI was the strongest predictor of incident infarcts. When it was excluded from stepwise multivariable models, predictors were serum creatinine, age, and ankle-arm index.

CONCLUSIONS: Incident MRI-defined infarcts commonly affect the elderly. Most are small, subcortical, and not associated with acute symptoms recognized as a transient ischemic attack or stroke. Nonetheless, they cannot be considered silent because of their association with subtle cognitive deficits. These covert infarcts are associated with white matter changes, which may share a common pathophysiology. Whether control of vascular risk factors, such as blood pressure, would reduce the risk of developing these infarcts and associated cognitive decline deserves further investigation.

%B Stroke %V 33 %P 2376-82 %8 2002 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/12364724?dopt=Abstract %R 10.1161/01.str.0000032241.58727.49 %0 Journal Article %J JAMA %D 2002 %T Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. %A Lyketsos, Constantine G %A Lopez, Oscar %A Jones, Beverly %A Fitzpatrick, Annette L %A Breitner, John %A DeKosky, Steven %K Aged %K Aggression %K Anxiety %K Behavioral Symptoms %K Cognition Disorders %K Comorbidity %K Cross-Sectional Studies %K Delusions %K Dementia %K Depression %K Feeding and Eating Disorders %K Female %K Humans %K Longitudinal Studies %K Male %K Neuropsychological Tests %K Prevalence %K Sleep Wake Disorders %X

CONTEXT: Mild cognitive impairment (MCI) may be a precursor to dementia, at least in some cases. Dementia and MCI are associated with neuropsychiatric symptoms in clinical samples. Only 2 population-based studies exist of the prevalence of these symptoms in dementia, and none exist for MCI.

OBJECTIVE: To estimate the prevalence of neuropsychiatric symptoms in dementia and MCI in a population-based study.

DESIGN: Cross-sectional study derived from the Cardiovascular Health Study, a longitudinal cohort study.

SETTING AND PARTICIPANTS: A total of 3608 participants were cognitively evaluated using data collected longitudinally over 10 years and additional data collected in 1999-2000 in 4 US counties. Dementia and MCI were classified using clinical criteria and adjudicated by committee review by expert neurologists and psychiatrists. A total of 824 individuals completed the Neuropsychiatric Inventory (NPI); 362 were classified as having dementia, 320 as having MCI; and 142 did not meet criteria for MCI or dementia.

MAIN OUTCOME MEASURE: Prevalence of neuropsychiatric symptoms, based on ratings on the NPI in the previous month and from the onset of cognitive symptoms.

RESULTS: Of the 682 individuals with dementia or MCI, 43% of MCI participants (n = 138) exhibited neuropsychiatric symptoms in the previous month (29% rated as clinically significant) with depression (20%), apathy (15%), and irritability (15%) being most common. Among the dementia participants, 75% (n = 270) had exhibited a neuropsychiatric symptom in the past month (62% were clinically significant); 55% (n = 199) reported 2 or more and 44% (n = 159) 3 or more disturbances in the past month. In participants with dementia, the most frequent disturbances were apathy (36%), depression (32%), and agitation/aggression (30%). Eighty percent of dementia participants (n = 233) and 50% of MCI participants (n = 139) exhibited at least 1 NPI symptom from the onset of cognitive symptoms. There were no differences in prevalence of neuropsychiatric symptoms between participants with Alzheimer-type dementia and those with other dementias, with the exception of aberrant motor behavior, which was more frequent in Alzheimer-type dementia (5.4% vs 1%; P =.02).

CONCLUSIONS: Neuropsychiatric symptoms occur in the majority of persons with dementia over the course of the disease. These are the first population-based estimates for neuropsychiatric symptoms in MCI, indicating a high prevalence associated with this condition as well. These symptoms have serious adverse consequences and should be inquired about and treated as necessary. Study of neuropsychiatric symptoms in the context of dementia may improve our understanding of brain-behavior relationships.

%B JAMA %V 288 %P 1475-83 %8 2002 Sep 25 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/12243634?dopt=Abstract %R 10.1001/jama.288.12.1475 %0 Journal Article %J J Clin Epidemiol %D 2002 %T A stroke prediction score in the elderly: validation and Web-based application. %A Lumley, Thomas %A Kronmal, Richard A %A Cushman, Mary %A Manolio, Teri A %A Goldstein, Steven %K Aged %K Aged, 80 and over %K Blood Pressure %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Models, Cardiovascular %K Predictive Value of Tests %K Risk Factors %K ROC Curve %K Stroke %K United States %X

The objective of this study was to construct a prediction model for predicting stroke in an elderly U.S. population, and to assess the accuracy in this population of other previously published prediction models. The subjects were participants in the Cardiovascular Health Study: 2,495 men and 3,393 women age 65 years and older at baseline, and followed for 6.3 years. Among 5,711 participants free of baseline stroke, 399 strokes occurred. Sex-specific prediction equations were constructed using study variables that were most importantly related to incident stroke: age, systolic blood pressure, diabetes, ECG diagnosis of atrial fibrillation or left ventricular hypertrophy, confirmed history of cardiovascular disease, diabetes, time to walk 15 ft, and serum creatinine. The prediction rule was implemented as a risk score and in a Web-based interactive Java applet. Overall, the model predicted 5-year stroke risks ranging from less than 1 to 59%. The 20% of subjects in the highest predicted risk group had a 5-year actual stroke incidence rate of 15%, while the 20% lowest risk group had a 1% incidence. Risk scores from two other studies performed well in these study participants. Effective discrimination between low and high stroke risk in the elderly was possible in this cohort with data that are easy to obtain. Evaluation of the generalizability and clinical usefulness of this prediction model requires further research.

%B J Clin Epidemiol %V 55 %P 129-36 %8 2002 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/11809350?dopt=Abstract %R 10.1016/s0895-4356(01)00434-6 %0 Journal Article %J Arch Intern Med %D 2002 %T Therapy with hydroxymethylglutaryl coenzyme a reductase inhibitors (statins) and associated risk of incident cardiovascular events in older adults: evidence from the Cardiovascular Health Study. %A Lemaitre, Rozenn N %A Psaty, Bruce M %A Heckbert, Susan R %A Kronmal, Richard A %A Newman, Anne B %A Burke, Gregory L %K Aged %K Cholesterol, LDL %K Coronary Disease %K Female %K Follow-Up Studies %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Hypercholesterolemia %K Hypolipidemic Agents %K Incidence %K Male %K Multivariate Analysis %K Proportional Hazards Models %K Risk Factors %K United States %X

BACKGROUND: Recommendations to treat older adults with hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) for the primary prevention of coronary heart disease events are supported by a single clinical trial restricted to adults 73 years or younger with low levels of high-density lipoprotein cholesterol.

METHODS: We investigated the association of statin use with incident cardiovascular disease and all-cause mortality during up to 7.3 years' follow-up of 1250 women and 664 men from the Cardiovascular Health Study. Study participants were 65 years and older and free of cardiovascular disease at baseline. They received drug therapy to lower cholesterol levels at baseline or no treatment with a recommendation for therapy according to the National Cholesterol Education Program guidelines. Use of these drugs was assessed annually. We used proportional-hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for confounding variables.

RESULTS: We found 382 incident cardiovascular events (159 myocardial infarctions, 159 strokes, and 64 deaths due to coronary heart disease) and 362 total deaths from June 1, 1989, to May 31, 1997. Compared with no use of drugs to lower cholesterol levels, statin use was associated with decreased risk of cardiovascular events (multivariate HR, 0.44; 95% CI, 0.27-0.71) and all-cause mortality (HR, 0.56; 95% CI, 0.36-0.88). Similar associations were observed among participants 74 years or older at baseline.

CONCLUSIONS: Use of statins was associated with decreased risk of incident cardiovascular events among elderly adults. These findings lend support to the National Cholesterol Education Program guidelines, which recommend therapy for the lowering of cholesterol levels for older adults with hypercholesterolemia.

%B Arch Intern Med %V 162 %P 1395-400 %8 2002 Jun 24 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/12076239?dopt=Abstract %R 10.1001/archinte.162.12.1395 %0 Journal Article %J Arch Intern Med %D 2002 %T Time trends in high blood pressure control and the use of antihypertensive medications in older adults: the Cardiovascular Health Study. %A Psaty, Bruce M %A Manolio, Teri A %A Smith, Nicholas L %A Heckbert, Susan R %A Gottdiener, John S %A Burke, Gregory L %A Weissfeld, Joel %A Enright, Paul %A Lumley, Thomas %A Powe, Neil %A Furberg, Curt D %K Age Factors %K Aged %K Antihypertensive Agents %K Awareness %K Cohort Studies %K Drug Therapy %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Hypertension %K Male %K Prospective Studies %K Time Factors %X

BACKGROUND: Control of high blood pressure (BP) in older adults is an important part of public health efforts at prevention.

OBJECTIVE: To assess recent time trends in the awareness, treatment, and control of high BP and in the use of medications to treat high BP.

METHODS: In the Cardiovascular Health Study, 5888 adults 65 years and older were recruited from 4 US centers. At baseline, participants underwent an extensive examination that included the measurement of BP, use of medications, and other risk factors. Participants were followed up with annual visits that assessed BP and medication use from baseline in 1989-1990 through the examination in 1998-1999. The primary outcome measures were control of BP to levels lower than than 140/90 mm Hg and the prevalence of use of various classes of antihypertensive medications.

RESULTS: The awareness, treatment, and control of high BP improved during the 1990s. The proportions aware and treated were higher among blacks than whites, though control prevalences were similar. For both groups combined, the control of high BP to lower than 140/90 mm Hg increased from 37% at baseline to 49% in 1999. The 51% whose BP was not controlled generally had isolated mild to moderate elevations in systolic BP. Among treated persons, the improvement in control was achieved in part by a mean increase of 0.2 antihypertensive medications per person over the course of 9 years. Improved control was also achieved by increasing the proportion of the entire Cardiovascular Health Study population that was treated for hypertension, from 34.5% in 1990 to 51.1% in 1999. Time trends in antihypertensive drug use were pronounced. Among those without coronary disease, the use of low-dose diuretics and beta-blockers decreased, while the use of newer agents, such as calcium channel blockers, angiotensin-converting enzyme inhibitors, and alpha-blockers increased.

CONCLUSIONS: While control of high BP improved in the 1990s, about half the participants with hypertension had uncontrolled BP, primarily mild to moderate elevations in systolic BP. Low-dose diuretics and beta-blockers--the preferred agents since 1993 according to the recommendations of the Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure--remained underused. More widespread use of these agents will be an important intervention to prevent the devastating complications of hypertension, including stroke, myocardial infarction, and heart failure.

%B Arch Intern Med %V 162 %P 2325-32 %8 2002 Nov 11 %G eng %N 20 %1 https://www.ncbi.nlm.nih.gov/pubmed/12418946?dopt=Abstract %R 10.1001/archinte.162.20.2325 %0 Journal Article %J J Am Geriatr Soc %D 2003 %T The association between time since last meal and blood pressure in older adults: the cardiovascular health study. %A Smith, Nicholas L %A Psaty, Bruce M %A Rutan, Gale H %A Lumley, Thomas %A Yanez, David %A Chaves, Paulo H M %A Kronmal, Richard A %K Aged %K Blood Pressure %K Cardiovascular Diseases %K Cohort Studies %K Eating %K Female %K Humans %K Hypotension %K Male %K Postprandial Period %K Prospective Studies %K Risk Factors %K Time Factors %X

OBJECTIVES: To demonstrate a postprandial hypotensive (PPH) phenomenon in older adults.

DESIGN: Observational, prospective cohort study composed of baseline and nine follow-up visits.

SETTING: Cardiovascular Health Study, an epidemiological study of risk factors for cardiovascular disease in older adults.

PARTICIPANTS: Five thousand eight hundred eighty-eight community-dwelling adults aged 65 and older.

MEASUREMENTS: Blood pressure and time since last meal were recorded synchronously at baseline and at follow-up clinic visits. Generalized estimating equations were used to estimate associations between time since last meal and blood pressure and to adjust variance estimates to account for repeated blood pressure measures within subjects across fasting times.

RESULTS: Mean systolic and diastolic blood pressures were lower in the first hour after the last meal and were progressively higher through the fourth hour after the last meal than blood pressures measured immediately after the last meal (0 hour: 133.7/68.8 mmHg; 1st hour: 130.1/66.6 mmHg; 4th hour: 136.5/71.1 mmHg). Changes were significant for systolic and diastolic measures (P <.001 for both). Exploratory analyses suggested that the systolic PPH association was more pronounced in women. Little evidence was found that the degree of systolic or diastolic PPH varied by age, race, prevalent cardiovascular disease, heart rate, ejection fraction, treated hypertension or diabetes mellitus, or body mass index.

CONCLUSION: These data support previous observations that there is a significant drop in blood pressure within 1 hour after a meal in older adults. Time since last meal may be an important factor to consider when measuring blood pressure in older adults, and perhaps national standards need to be set.

%B J Am Geriatr Soc %V 51 %P 824-8 %8 2003 Jun %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/12757570?dopt=Abstract %R 10.1046/j.1365-2389.2003.51264.x %0 Journal Article %J Circulation %D 2003 %T Beta2-adrenergic receptor polymorphisms and risk of incident cardiovascular events in the elderly. %A Heckbert, Susan R %A Hindorff, Lucia A %A Edwards, Karen L %A Psaty, Bruce M %A Lumley, Thomas %A Siscovick, David S %A Tang, Zhonghua %A Durda, J Peter %A Kronmal, Richard A %A Tracy, Russell P %K African Continental Ancestry Group %K Aged %K Alleles %K Brain Ischemia %K Cardiovascular Diseases %K Cohort Studies %K Comorbidity %K Coronary Disease %K European Continental Ancestry Group %K Follow-Up Studies %K Gene Frequency %K Humans %K Incidence %K Linkage Disequilibrium %K Polymorphism, Genetic %K Receptors, Adrenergic, beta-2 %K Risk Assessment %K Stroke %K United States %X

BACKGROUND: Genetic polymorphisms at codons 16 and 27 of the beta2-adrenergic receptor have been associated with altered response to sympathetic stimulation. We examined these polymorphisms in relation to cardiovascular event risk in the Cardiovascular Health Study.

METHODS AND RESULTS: A total of 808 black and 4441 white participants (mean age, 73 years) were genotyped for the Arg16Gly and Gln27Glu polymorphisms of the beta2-adrenergic receptor. There were 702 incident coronary events, 438 ischemic strokes, and 1136 combined cardiovascular events during 7 to 10 years of follow-up. Allele frequencies differed by race but not by age or hypertension status. Glu27 carriers had a lower risk of coronary events than Gln27 homozygotes (hazard ratio, 0.82; 95% CI, 0.70 to 0.95), and there was a suggestion of decreased risk among Gly16 carriers compared with Arg16 homozygotes (hazard ratio, 0.88; 95% CI, 0.72 to 1.07). There was no association of beta2-adrenergic receptor genotype with ischemic stroke or combined cardiovascular events.

CONCLUSIONS: The Glu27 allele of the beta2-adrenergic receptor was associated with a lower risk of incident coronary events in this elderly population.

%B Circulation %V 107 %P 2021-4 %8 2003 Apr 22 %G eng %N 15 %1 https://www.ncbi.nlm.nih.gov/pubmed/12682000?dopt=Abstract %R 10.1161/01.CIR.0000065231.07729.92 %0 Journal Article %J Circulation %D 2003 %T Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study. %A Mozaffarian, Dariush %A Lemaitre, Rozenn N %A Kuller, Lewis H %A Burke, Gregory L %A Tracy, Russell P %A Siscovick, David S %K Aged %K Animals %K Arrhythmias, Cardiac %K Diet %K Eating %K Fatty Acids, Omega-3 %K Female %K Fishes %K Humans %K Male %K Myocardial Infarction %K Myocardial Ischemia %K Prospective Studies %K Risk %K Tuna %X

BACKGROUND: Few studies have examined associations of fish consumption with ischemic heart disease (IHD) risk among older adults or how different types of fish meals relate to IHD risk.

METHODS AND RESULTS: In a population-based prospective cohort study, usual fish consumption was ascertained at baseline among 3910 adults aged > or =65 years and free of known cardiovascular disease in 1989 and 1990. Consumption of tuna and other broiled or baked fish correlated with plasma phospholipid long-chain n-3 fatty acids, whereas consumption of fried fish or fish sandwiches (fish burgers) did not. Over 9.3 years' mean follow-up, there were 247 IHD deaths (including 148 arrhythmic deaths) and 363 incident nonfatal myocardial infarctions (MIs). After adjustment for potential confounders, consumption of tuna or other broiled or baked fish was associated with lower risk of total IHD death (P for trend=0.001) and arrhythmic IHD death (P=0.001) but not nonfatal MI (P=0.44), with 49% lower risk of total IHD death and 58% lower risk of arrhythmic IHD death among persons consuming tuna/other fish 3 or more times per week compared with less than once per month. In similar analyses, fried fish/fish sandwich consumption was not associated with lower risk of total IHD death, arrhythmic IHD death, or nonfatal MI but rather with trends toward higher risk.

CONCLUSIONS: Among adults aged > or =65 years, modest consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower risk of IHD death, especially arrhythmic IHD death. Cardiac benefits of fish consumption may vary depending on the type of fish meal consumed.

%B Circulation %V 107 %P 1372-7 %8 2003 Mar 18 %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/12642356?dopt=Abstract %R 10.1161/01.cir.0000055315.79177.16 %0 Journal Article %J JAMA %D 2003 %T Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. %A Mozaffarian, Dariush %A Kumanyika, Shiriki K %A Lemaitre, Rozenn N %A Olson, Jean L %A Burke, Gregory L %A Siscovick, David S %K Aged %K Cardiovascular Diseases %K Dietary Fiber %K Edible Grain %K Female %K Fruit %K Humans %K Male %K Nutrition Assessment %K Prospective Studies %K Risk %K Vegetables %X

CONTEXT: People older than 65 years are the fastest-growing segment of the population and account for the majority of cardiovascular disease (CVD) morbidity, mortality, and health care expenditures. Additionally, the influence of dietary habits on risk may be less pronounced in elderly persons, when atherosclerosis is more advanced. However, few data address the influence of diet on CVD risk in this population.

OBJECTIVE: To determine whether fiber consumption from fruit, vegetable, and cereal sources (including whole grains and bran) is associated with incident CVD in elderly persons.

DESIGN: Prospective cohort study conducted from 1989 to June 2000.

SETTING AND PARTICIPANTS: Population-based, multicenter study among 3588 men and women aged 65 years or older and free of known CVD at baseline in 1989-1990. Usual dietary fiber consumption was assessed at baseline (mean participant age, 72 years) using a 99-item food frequency questionnaire.

MAIN OUTCOME MEASURE: Incident CVD (combined stroke, ischemic heart disease death, and nonfatal myocardial infarction).

RESULTS: During 8.6 years mean follow-up, there were 811 incident CVD events. After adjustment for age, sex, education, diabetes, ever smoking, pack-years of smoking, daily physical activity, exercise intensity, alcohol intake, and fruit and vegetable fiber consumption, cereal fiber consumption was inversely associated with incident CVD (P for trend =.02), with 21% lower risk (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.62-0.99) in the highest quintile of intake, compared with the lowest quintile. In similar analyses, neither fruit fiber intake (P for trend =.98) nor vegetable fiber intake (P for trend =.95) were associated with incident CVD. When CVD events were separately evaluated, higher cereal fiber intake was associated with lower risk of total stroke and ischemic stroke and a trend toward lower risk of ischemic heart disease death. In a post hoc analysis, dark breads such as wheat, rye, or pumpernickel were associated with a lower risk of incident CVD (HR, 0.76; 95% CI, 0.64-0.90) rather than cereal fiber from other sources.

CONCLUSIONS: Cereal fiber consumption late in life is associated with lower risk of incident CVD, supporting recommendations for elderly individuals to increase consumption of dietary cereal fiber.

%B JAMA %V 289 %P 1659-66 %8 2003 Apr 02 %G eng %N 13 %1 https://www.ncbi.nlm.nih.gov/pubmed/12672734?dopt=Abstract %R 10.1001/jama.289.13.1659 %0 Journal Article %J Neuroepidemiology %D 2003 %T Evaluation of dementia in the cardiovascular health cognition study. %A Lopez, Oscar L %A Kuller, Lewis H %A Fitzpatrick, Annette %A Ives, Diane %A Becker, James T %A Beauchamp, Norman %K Age Distribution %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cognition Disorders %K Cohort Studies %K Cross-Sectional Studies %K Dementia %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Prevalence %K Risk Factors %K Sex Distribution %X

OBJECTIVE: To describe a methodology to evaluate dementia and frequency of different types of dementia and prevalence of the Cardiovascular Health Study (CHS).

METHODS: The CHS is a longitudinal study of cardiovascular disease among community-dwelling individuals over the age of 65. Of the 5,888 participants in the original study, 3,608 had a magnetic resonance imaging (MRI) of the brain in 1991, and formed the cohort for the dementia study. The CHS included yearly measures of cognitive function and, from 1998 to 2000, participants were evaluated for dementia by detailed neurological, and neuropsychological examinations. The possible cases of dementia and mild cognitive impairment (MCI) were adjudicated by a review committee of neurologists and psychiatrists.

RESULTS: There were 480 cases of (13.3%) incident dementia in the total sample, 227 (6.3%) prevalent dementia, 577 (16.0%) MCI, and 2,318 (64.4%) normal. The adjudication committee classified 69% of the incident dementia as Alzheimer's disease (AD), 11% as vascular dementia (VaD), 16% as both, and 4% as other types. There was a substantial agreement between pre- and postMRI diagnosis of types of dementia. The frequency of dementia within the CHS cohort which survived to the end of the study in 1998-1999, was 13.5% for white men, 14.5% for white women, 22.2% for black men and 23.4% for black women.

CONCLUSION: The CHS has developed a methodology for longitudinal studies of dementia in large cohorts and represents the largest study of dementia including cognitive testing, MRI and genetic markers.

%B Neuroepidemiology %V 22 %P 1-12 %8 2003 Jan-Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/12566948?dopt=Abstract %R 10.1159/000067110 %0 Journal Article %J J Womens Health (Larchmt) %D 2003 %T Hormone replacement therapy and the risk of incident congestive heart failure: the Cardiovascular Health Study. %A Rea, Thomas D %A Psaty, Bruce M %A Heckbert, Susan R %A Cushman, Mary %A Meilahn, Elaine %A Olson, Jean L %A Lemaitre, Rozenn N %A Smith, Nicholas L %A Sotoodehnia, Nona %A Chaves, Paulo H M %K Aged %K Aged, 80 and over %K Body Mass Index %K Cohort Studies %K Estrogen Replacement Therapy %K Female %K Heart Failure %K Humans %K Incidence %K Life Style %K Middle Aged %K Multivariate Analysis %K Obesity %K Osteoporosis, Postmenopausal %K Proportional Hazards Models %K Prospective Studies %K Risk %K Risk Factors %K United States %K Women's Health %X

BACKGROUND: The development of congestive heart failure (CHF) in older persons is related to a variety of mechanisms. Hormone replacement therapy (HRT) affects several of the pathways that may be important in the development of CHF. We hypothesized that HRT would be associated with a decreased risk of incident CHF.

METHODS: Using Cox proportional-hazards regression, we assessed the risk of incident CHF (n = 304) associated with time-dependent past and current use of HRT compared to never use. The Cardiovascular Health Study is a prospective cohort study of community-dwelling adults aged 65 years and older. This analysis included female participants without a history of CHF at baseline (n = 3223).

RESULTS: At baseline, 62% were never users, 26% were past users, and 12% were current users of HRT. Compared with never users, the multivariable relative risk (RR) of CHF was 1.01 (95% confidence interval [95% CI] 0.76,1.34) for past users and 1.34 (0.93,1.94) for current users. Results were similar among most treatment and clinical subgroups, except that the association of current HRT with CHF appeared to depend on body mass index (BMI) or osteoporosis status. The RR was 0.82 (0.43,1.60) for normal weight women, 1.65 (0.95,2.88) for overweight women, and 2.22 (1.06,4.67) for obese women (p = 0.01 for interaction). Similarly, the RR was 0.15 (0.04,0.65) for women with osteoporosis and 1.82 (1.25,2.65) for women without osteoporosis (p = 0.001 for interaction).

CONCLUSIONS: Overall, HRT was not associated with the risk of incident CHF, although BMI and osteoporosis appeared to modify the association of HRT with CHF. The risk of CHF was lower in patients with lower BMI or osteoporosis.

%B J Womens Health (Larchmt) %V 12 %P 341-50 %8 2003 May %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/12804341?dopt=Abstract %R 10.1089/154099903765448853 %0 Journal Article %J Circulation %D 2003 %T Inflammation as a risk factor for atrial fibrillation. %A Aviles, Ronnier J %A Martin, David O %A Apperson-Hansen, Carolyn %A Houghtaling, Penny L %A Rautaharju, Pentti %A Kronmal, Richard A %A Tracy, Russell P %A Van Wagoner, David R %A Psaty, Bruce M %A Lauer, Michael S %A Chung, Mina K %K Aged %K Atrial Fibrillation %K C-Reactive Protein %K Cross-Sectional Studies %K Female %K Humans %K Inflammation %K Longitudinal Studies %K Male %K Risk Factors %X

BACKGROUND: The presence of systemic inflammation determined by elevations in C-reactive protein (CRP) has been associated with persistence of atrial fibrillation (AF). The relationship between CRP and prediction of AF has not been studied in a large population-based cohort.

METHODS AND RESULTS: CRP measurement and cardiovascular assessment were performed at baseline in 5806 subjects enrolled in the Cardiovascular Health Study. Patients were followed up for a mean of 6.9+/-1.6 (median 7.8) years. AF was identified by self-reported history and ECGs at baseline and by ECGs and hospital discharge diagnoses at follow-up. Univariate and multivariate analyses were used to assess CRP as a predictor of baseline and future development of AF. At baseline, 315 subjects (5%) had AF. Compared with subjects in the first CRP quartile (<0.97 mg/L), subjects in the fourth quartile (>3.41 mg/L) had more AF (7.4% versus 3.7%, adjusted OR 1.8, 95% CI 1.2 to 2.5; P=0.002). Of 5491 subjects without AF at baseline, 897 (16%) developed AF during follow-up. Baseline CRP predicted higher risk for developing future AF (fourth versus first quartile adjusted hazard ratio 1.31, 95% CI 1.08 to 1.58; P=0.005). When treated as a continuous variable, elevated CRP predicted increased risk for developing future AF (adjusted hazard ratio for 1-SD increase, 1.24; 95% CI 1.11 to 1.40; P<0.001).

CONCLUSIONS: CRP is not only associated with the presence of AF but may also predict patients at increased risk for future development of AF.

%B Circulation %V 108 %P 3006-10 %8 2003 Dec 16 %G eng %N 24 %1 https://www.ncbi.nlm.nih.gov/pubmed/14623805?dopt=Abstract %R 10.1161/01.CIR.0000103131.70301.4F %0 Journal Article %J Am J Clin Nutr %D 2003 %T n-3 Polyunsaturated fatty acids, fatal ischemic heart disease, and nonfatal myocardial infarction in older adults: the Cardiovascular Health Study. %A Lemaitre, Rozenn N %A King, Irena B %A Mozaffarian, Dariush %A Kuller, Lewis H %A Tracy, Russell P %A Siscovick, David S %K Aged %K alpha-Linolenic Acid %K Biomarkers %K Case-Control Studies %K Cohort Studies %K Coronary Disease %K Dietary Supplements %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Fatty Acids, Omega-3 %K Female %K Fish Oils %K Humans %K Incidence %K Male %K Myocardial Infarction %K Odds Ratio %K Phospholipids %K Prevalence %K Prospective Studies %K Risk Factors %X

BACKGROUND: Little is known about the relation of the dietary intake of n-3 polyunsaturated fatty acids, ie, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from fatty fish and alpha-linolenic acid from vegetable oils, with ischemic heart disease among older adults.

OBJECTIVE: We investigated the associations of plasma phospholipid concentrations of DHA, EPA, and alpha-linolenic acid as biomarkers of intake with the risk of incident fatal ischemic heart disease and incident nonfatal myocardial infarction in older adults.

DESIGN: We conducted a case-control study nested in the Cardiovascular Health Study, a cohort study of adults aged > or = 65 y. Cases experienced incident fatal myocardial infarction and other ischemic heart disease death (n = 54) and incident nonfatal myocardial infarction (n = 125). Matched controls were randomly selected (n = 179). We measured plasma phospholipid concentrations of n-3 polyunsaturated fatty acids in blood samples drawn approximately 2 y before the event.

RESULTS: A higher concentration of combined DHA and EPA was associated with a lower risk of fatal ischemic heart disease, and a higher concentration of alpha-linolenic acid with a tendency to lower risk, after adjustment for risk factors [odds ratio: 0.32 (95% CI: 0.13, 0.78; P = 0.01) and 0.52 (0.24, 1.15; P = 0.1), respectively]. In contrast, n-3 polyunsaturated fatty acids were not associated with nonfatal myocardial infarction.

CONCLUSIONS: Higher combined dietary intake of DHA and EPA, and possibly alpha-linolenic acid, may lower the risk of fatal ischemic heart disease in older adults. The association of n-3 polyunsaturated fatty acids with fatal ischemic heart disease, but not with nonfatal myocardial infarction, is consistent with possible antiarrhythmic effects of these fatty acids.

%B Am J Clin Nutr %V 77 %P 319-25 %8 2003 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/12540389?dopt=Abstract %R 10.1093/ajcn/77.2.319 %0 Journal Article %J Arch Neurol %D 2003 %T Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1. %A Lopez, Oscar L %A Jagust, William J %A DeKosky, Steven T %A Becker, James T %A Fitzpatrick, Annette %A Dulberg, Corinne %A Breitner, John %A Lyketsos, Constantine %A Jones, Beverly %A Kawas, Claudia %A Carlson, Michelle %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cognition Disorders %K Cohort Studies %K Dementia %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Memory Disorders %K Neuropsychological Tests %K Pennsylvania %K Population %K Psychiatric Status Rating Scales %X

OBJECTIVE: To examine the prevalence of mild cognitive impairment (MCI) and its diagnostic classification in the Cardiovascular Health Study (CHS) Cognition Study.

DESIGN: The CHS Cognition Study is an ancillary study of the CHS that was conducted to determine the presence of MCI and dementia in the CHS cohort.

SETTING: Multicenter population study.

PATIENTS: We examined 3608 participants in the CHS who had undergone detailed neurological, neuropsychological, neuroradiological, and psychiatric testing to identify dementia and MCI.

MAIN OUTCOME MEASURES: The prevalence of MCI was determined for the whole cohort, and specific subtypes of MCI were examined in detail only at the Pittsburgh, Pa, center (n = 927). Mild cognitive impairment was classified as either MCI amnestic-type or MCI multiple cognitive deficits-type.

RESULTS: The overall prevalence of MCI was 19% (465 of 2470 participants); prevalence increased with age from 19% in participants younger than 75 years to 29% in those older than 85 years. The overall prevalence of MCI at the Pittsburgh center was 22% (130 of 599 participants); prevalence of the MCI amnesic-type was 6% and of the MCI multiple cognitive deficits-type was 16%.

CONCLUSIONS: Twenty-two percent of the participants aged 75 years or older had MCI. Mild cognitive impairment is a heterogeneous syndrome, where the MCI amnestic-type is less frequent than the MCI multiple cognitive deficits-type. Most of the participants with MCI had comorbid conditions that may affect their cognitive functions.

%B Arch Neurol %V 60 %P 1385-9 %8 2003 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/14568808?dopt=Abstract %R 10.1001/archneur.60.10.1385 %0 Journal Article %J Neuroepidemiology %D 2003 %T A prospective analysis of risk factors for white matter disease in the brain stem: the Cardiovascular Health Study. %A Ding, Jingzhong %A Nieto, F Javier %A Beauchamp, Norman J %A Longstreth, W T %A Manolio, Teri A %A Hetmanski, Jacqueline B %A Fried, Linda P %K Age Factors %K Aged %K Brain Diseases %K Brain Infarction %K Brain Stem %K Cardiovascular Diseases %K Female %K Fibrinogen %K Forced Expiratory Volume %K Humans %K Magnetic Resonance Imaging %K Male %K Prospective Studies %K Regression Analysis %K Risk Factors %K Smoking %X

BACKGROUND AND PURPOSE: White matter disease (WMD) in the brain stem may be a predictor of poor clinical outcome, independent of WMD in the periventricular and subcortical areas of the brain. Many cardiovascular risk factors such as older age, hypertension, and smoking have been suggested as risk factors for WMD in the periventricular and subcortical areas of the brain. However, no epidemiologic study has examined the associations between cardiovascular risk factors and WMD in the brain stem.

METHODS: A total of 789 participants, aged 65 years or older, from the Cardiovascular Health Study constituted the present study population. WMD, defined as hyperintensive lesions on magnetic resonance imaging (MRI), in the brain stem was measured in 1992/1993 and 1997/1998.

RESULTS: Of the 789 participants, 212 (26.9%) had WMD in the brain stem in 1997/1998. In multivariate logistic regression analysis, the presence of WMD in the brain stem in 1997/1998 was significantly associated with several variables measured in 1992/1993: an increase by 5 years of age (OR = 1.51, 95% CI: 1.25-1.83), a 10-pack-years increase in smoking (OR = 1.12, 95% CI: 1.04-1.21), a 0.1-liter increase in first-second forced expiratory volume (OR = 0.95, 95% CI: 0.92-0.99), a 1 micromol/l increase in fibrinogen level (OR = 1.13, 95% CI: 1.03-1.23), and MRI infarction (OR = 2.58, 95% CI: 1.78-3.74). Excluding those (n = 167) with WMD in the brain stem in 1992/1993, the pattern remained. Hypertension was not associated with WMD in the brain stem.

CONCLUSIONS: Increased age, smoking, lower forced expiratory volume, increased fibrinogen level, and MRI infarction, but not hypertension, may be independent risk factors for WMD in the brain stem in older adults.

%B Neuroepidemiology %V 22 %P 275-82 %8 2003 Sep-Oct %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/12902622?dopt=Abstract %R 10.1159/000071190 %0 Journal Article %J JAMA %D 2003 %T Prospective study of alcohol consumption and risk of dementia in older adults. %A Mukamal, Kenneth J %A Kuller, Lewis H %A Fitzpatrick, Annette L %A Longstreth, W T %A Mittleman, Murray A %A Siscovick, David S %K Aged %K Alcohol Drinking %K Apolipoprotein E4 %K Apolipoproteins E %K Brain %K Case-Control Studies %K Dementia %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Neuropsychological Tests %K Prospective Studies %K Risk %X

CONTEXT: Alcohol consumption has been associated with complex changes in cerebral vasculature and structure in older adults. How alcohol consumption affects the incidence of dementia is less clear.

OBJECTIVE: To determine the prospective relationship of alcohol consumption and risk of dementia among older adults.

DESIGN, SETTING, AND PARTICIPANTS: Nested case-control study of 373 cases with incident dementia and 373 controls who were among 5888 adults aged 65 years and older who participated in the Cardiovascular Health Study, a prospective, population-based cohort study in 4 US communities. The controls were frequency-matched on age, death before 1999, and their attendance of a 1998-1999 clinic. Participants in this study underwent magnetic resonance imaging (MRI) of the brain and cognitive testing between 1992 and 1994 and were followed up until 1999.

MAIN OUTCOME MEASURES: Odds of incident dementia, ascertained by detailed neurological and neuropsychological examinations according to average alcohol consumption, assessed by self-reported intake of beer, wine, and liquor at 2 visits prior to the date of the MRI.

RESULTS: Compared with abstention, the adjusted odds for dementia among those whose weekly alcohol consumption was less than 1 drink were 0.65 (95% confidence interval [CI], 0.41-1.02); 1 to 6 drinks, 0.46 (95% CI, 0.27-0.77); 7 to 13 drinks, 0.69 (95% CI, 0.37-1.31); and 14 or more drinks, 1.22 (95% CI, 0.60-2.49; P for quadratic term =.001). A trend toward greater odds of dementia associated with heavier alcohol consumption was most apparent among men and participants with an apolipoprotein E epsilon4 allele. We found generally similar relationships of alcohol use with Alzheimer disease and vascular dementia.

CONCLUSIONS: Compared with abstention, consumption of 1 to 6 drinks weekly is associated with a lower risk of incident dementia among older adults.

%B JAMA %V 289 %P 1405-13 %8 2003 Mar 19 %G eng %N 11 %1 https://www.ncbi.nlm.nih.gov/pubmed/12636463?dopt=Abstract %R 10.1001/jama.289.11.1405 %0 Journal Article %J Sleep Breath %D 2003 %T Recruitment of healthy adults into a study of overnight sleep monitoring in the home: experience of the Sleep Heart Health Study. %A Lind, Bonnie K %A Goodwin, James L %A Hill, Joel G %A Ali, Tauqeer %A Redline, Susan %A Quan, Stuart F %K Adult %K Body Mass Index %K Cardiovascular Diseases %K Catchment Area, Health %K Circadian Rhythm %K Cohort Studies %K Disorders of Excessive Somnolence %K Health Status %K Home Care Services %K Humans %K Hypertension %K Patient Selection %K Polysomnography %K Prospective Studies %K Severity of Illness Index %K Sleep Apnea Syndromes %K Surveys and Questionnaires %K United States %X

The Sleep Heart Health Study (SHHS) is a prospective cohort study using participants from several ongoing cardiovascular and respiratory disease research projects to investigate the relationship between sleep-disordered breathing and cardiovascular disease. This study design required unusual and different recruiting techniques to meet the study's enrollment goal of between 6000 and 6600 participants. Individuals were recruited to undergo an overnight home polysomnogram, completion of several questionnaires, and collection of a small amount of physical examination data. This article describes the methods used to recruit these participants and how these procedures influenced the final participation rate and the representativeness of SHHS to its parent cohorts. Of 30,773 people eligible for recruitment into SHHS, attempts were made to enroll 11,145 (36%). Of those contacted, 6441 ultimately agreed to participate (58%). Recruitment rates (38 to 91%) varied among sites. SHHS participants were slightly younger (63.0 vs. 65.0 years, p < 0.001), had more years of education (14.1 vs. 13.7, p < 0.001), more likely to snore (34% vs. 23%, p < 0.001), had higher Epworth sleepiness scores (7.7 vs. 6.5, p < 0.001), slightly higher higher systolic and diastolic blood pressures (127.6/73.9 vs. 127.2/72.1, p < 0.001 for diastolic only), and a slightly higher body mass index (BMI) (28.5 vs. 27.5, p < 0.001). We conclude that it is feasible to recruit existing participants from one large-scale epidemiologic study into another with a high degree of success. However, the characteristics of the new cohort may vary in several respects from their original cohorts and therefore interpretation of study results will have to consider these differences.

%B Sleep Breath %V 7 %P 13-24 %8 2003 Mar %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/12712393?dopt=Abstract %R 10.1007/s11325-003-0013-z %0 Journal Article %J Mov Disord %D 2003 %T Regional and racial differences in the prevalence of physician-diagnosed essential tremor in the United States. %A Louis, Elan D %A Fried, Linda P %A Fitzpatrick, Annette L %A Longstreth, William T %A Newman, Anne B %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Essential Tremor %K European Continental Ancestry Group %K Female %K Humans %K Male %K Physicians %K Prevalence %K United States %X

For reasons that are unclear, prevalence estimates of essential tremor (ET) differ considerably across the United States. Separate communities have never been sampled within the framework of the same study to substantiate these differences. We estimated the prevalence of physician-diagnosed ET in the elderly in four communities in the United States in whom the same screening questions were used, and examined whether this prevalence differed between Caucasians and African Americans. The Cardiovascular Health Study recruited a sample of Medicare beneficiaries >/=65 years of age from four communities in different regions of the United States. In 1998 to 1999, 3,494 participants (mean age, 80.0 years; range, 70-103 years) answered a 12-question screen for ET, including the question, "has a doctor diagnosed you as having familial tremor or benign essential tremor?" Fifty-four participants reported that a doctor had diagnosed them as having ET (1.5%; 95% confidence interval, [CI], 1.1-2.0%). Prevalence was similar across the four communities (1.1-2.0%). A larger proportion of Caucasians than African Americans reported a diagnosis of ET (1.7% vs. 0.4%; odds ratio = 4.9; 95% CI, 1.2-20.2; P = 0.028). In a logistic regression analysis, physician-diagnosed ET was associated with Caucasian ethnicity (P = 0.038) but not with age, gender, education, mental status or depression scores, income, smoking status, or alcohol consumption. When a standardized screening question was used, the proportion of participants with physician-diagnosed ET was similar across four communities, suggesting that the prevalence of this condition may be less variable than is often reported. Caucasians were five times more likely to have physician-diagnosed ET than were African Americans. This study does not provide an explanation for this difference, which deserves further study.

%B Mov Disord %V 18 %P 1035-40 %8 2003 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/14502671?dopt=Abstract %R 10.1002/mds.10492 %0 Journal Article %J Neuroepidemiology %D 2003 %T Risk factors for dementia in the cardiovascular health cognition study. %A Kuller, Lewis H %A Lopez, Oscar L %A Newman, Anne %A Beauchamp, Norman J %A Burke, Greg %A Dulberg, Corinne %A Fitzpatrick, Annette %A Fried, Linda %A Haan, Mary N %K Aged %K Aged, 80 and over %K Apolipoproteins E %K Cardiovascular Diseases %K Cognition Disorders %K Dementia %K Female %K Genotype %K Humans %K Magnetic Resonance Imaging %K Male %K Odds Ratio %K Predictive Value of Tests %K Proportional Hazards Models %K Risk Factors %X

BACKGROUND: The Cardiovascular Health Cognition Study has evaluated the determinants of dementia among 3,608 participants that had a magnetic resonance imaging (MRI) of the brain in 1991 and were followed to 1998-1999.

METHODS: There were 480 incident dementia cases, 330 (69%) were classified as Alzheimer's disease (AD).

RESULTS: In univariate analysis, low scores on the Modified Mini-Mental State Examination (3MSE) and on the Digit Symbol Substitution Test as well as declines in scores over time prior to the development of dementia were significant predictors of dementia. A high ventricular grade on the MRI (atrophy) as well as high white matter grade, a number of brain infarcts on the MRI were all determinants of dementia. Apolipoprotein E epsilon4 (Apo(E-4)) was also a powerful predictor of dementia. In a multivariate Cox proportional hazards model controlling for race, gender and grade, the hazard ratios for age (1.1), 3MSE score (0.9), ventricular size (1.4), white matter grade (1.8), presence of large infarcts >3 mm (1.3) and Apo(E-4) (2.1) were significant predictors of dementia. The combination of an Apo(E-4) genotype, 3MSE score <90, > or =5 ventricular grade, > or =3 white matter grade at the time of the MRI were associated with a 17-fold increased risk (95% CI: 8.6-34.9) of dementia as compared to individuals with none of the above attributes.

CONCLUSIONS: Measures of cognition, Apo(E-4) and MRI of the brain are strong predictors of both dementia and of AD.

%B Neuroepidemiology %V 22 %P 13-22 %8 2003 Jan-Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/12566949?dopt=Abstract %R 10.1159/000067109 %0 Journal Article %J Arch Neurol %D 2003 %T Risk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 2. %A Lopez, Oscar L %A Jagust, William J %A Dulberg, Corinne %A Becker, James T %A DeKosky, Steven T %A Fitzpatrick, Annette %A Breitner, John %A Lyketsos, Constantine %A Jones, Beverly %A Kawas, Claudia %A Carlson, Michelle %A Kuller, Lewis H %K Aged %K Apolipoprotein E4 %K Apolipoproteins E %K Brain %K Cardiovascular Diseases %K Cognition Disorders %K Cohort Studies %K Depressive Disorder %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Mood Disorders %K Pennsylvania %K Population %K Risk Factors %X

OBJECTIVE: To examine the risk factors for mild cognitive impairment (MCI) in a longitudinal population study-the Cardiovascular Health Study Cognition Study.

DESIGN: We examined the factors that in the period 1991 through 1994 predicted the development of MCI in all participants of the Cardiovascular Health Study Cognition Study. Further examination was conducted in the Pittsburgh, Pa, cohort (n = 927), where participants with MCI were classified as having either the MCI amnestic-type or the MCI multiple cognitive deficits-type.

SETTING: Multicenter population study.

PATIENTS: This study includes all participants of the Cardiovascular Health Study Cognition Study (n = 3608) who had a magnetic resonance imaging (MRI) scan of the brain between 1991 and 1994, and detailed neuropsychological, neurological, and medical evaluations to identify the presence of MCI or dementia in the period 1998 to 1999. The mean time between the closest clinical examination to the MRI and the diagnostic evaluation for cognitive disorders was 5.8 years for the Cardiovascular Health Study Cognition Study cohort and 6.0 years for the Pittsburgh cohort.

MAIN OUTCOME MEASURES: Risk factors for MCI at the time of the MRI were identified using logistic regression, controlling for age, race, educational level, baseline Modified Mini-Mental State Examination and Digit Symbol Test scores, measurements of depression, MRI findings (atrophy, ventricular volume, white matter lesions, and infarcts), the presence of the apolipoprotein E (APOE) epsilon4 allele, hypertension, diabetes mellitus, and heart disease.

RESULTS: Mild cognitive impairment (n = 577) was associated with race (African American), low educational level, low Modified Mini-Mental State Examination and Digit Symbol Test scores, cortical atrophy, MRI-identified infarcts, and measurements of depression. The MCI amnestic-type was associated with MRI-identified infarcts, the presence of the APOE epsilon4 allele, and low Modified Mini-Mental State Examination scores. The MCI multiple cognitive deficits-type was associated with low Modified Mini-Mental State Examination and Digit Symbol Test scores.

CONCLUSIONS: The development of MCI is associated with measurements of cognition and depression, racial and constitutional factors, and cerebrovascular disease. Early cognitive deficits seem to be a common denominator for the 2 forms of MCI; the presence of cerebrovascular disease and the APOE epsilon4 allele is associated with the amnestic type of MCI.

%B Arch Neurol %V 60 %P 1394-9 %8 2003 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/14568809?dopt=Abstract %R 10.1001/archneur.60.10.1394 %0 Journal Article %J Am J Respir Crit Care Med %D 2003 %T Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. %A Sanders, Mark H %A Newman, Anne B %A Haggerty, Catherine L %A Redline, Susan %A Lebowitz, Michael %A Samet, Jonathan %A O'Connor, George T %A Punjabi, Naresh M %A Shahar, Eyal %K Aged %K Cohort Studies %K Female %K Forced Expiratory Volume %K Humans %K Male %K Middle Aged %K Oxyhemoglobins %K Polysomnography %K Prospective Studies %K Pulmonary Disease, Chronic Obstructive %K Sleep %K Sleep Apnea, Obstructive %K Spirometry %K Vital Capacity %X

Neither the association between obstructive airways disease (OAD) and sleep apnea-hypopnea (SAH) nor the sleep consequences of each disorder alone and together have been characterized in an adult community setting. Our primary aims were (1) to determine if there is an association between OAD and SAH and (2) identify predictors of oxyhemoglobin desaturation during sleep in persons having OAD with and without SAH. Polysomnography and spirometry results from 5,954 participants in the Sleep Heart Health Study were analyzed. OAD was defined by a FEV1/FVC value less than 70%. Assessment of SAH prevalence in OAD was performed using thresholds of respiratory disturbance index (RDI) greater than 10 and greater than 15. A total of 1,132 participants had OAD that was predominantly mild (FEV1/FVC 63.81 +/- 6.56%, mean +/- SD). SAH was not more prevalent in participants with OAD than in those without OAD (22.32 versus 28.86%, with and without OAD, respectively, at RDI threshold values greater than 10; and 13.97 versus 18.63%, with and without OAD, respectively, at RDI threshold value greater than 15). In the absence of SAH, the adjusted odds ratio for sleep desaturation (> 5% total sleep time with saturation < 90%) was greater than 1.9 when FEV1/FVC was less than 65%. Participants with both OAD and SAH had greater sleep perturbation and desaturation than those with one disorder. Generally mild OAD alone was associated with minimally altered sleep quality. We conclude that (1) there is no association between generally mild OAD and SAH; (2) exclusive of SAH and after adjusting for demographic factors and awake oxyhemoglobin saturation, an FEV1/FVC value less than 65% is associated with increased risk of sleep desaturation; (3) desaturation is greater in persons with both OAD and SAH compared with each of these alone; and (4) individuals with generally mild OAD and without SAH in the community have minimally perturbed sleep.

%B Am J Respir Crit Care Med %V 167 %P 7-14 %8 2003 Jan 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/12502472?dopt=Abstract %R 10.1164/rccm.2203046 %0 Journal Article %J Sleep %D 2003 %T Variation in symptoms of sleep-disordered breathing with race and ethnicity: the Sleep Heart Health Study. %A O'Connor, George T %A Lind, Bonnie K %A Lee, Elisa T %A Nieto, F Javier %A Redline, Susan %A Samet, Jonathan M %A Boland, Lori L %A Walsleben, Joyce A %A Foster, Gregory L %K Adult %K Cross-Sectional Studies %K Electroencephalography %K Electrooculography %K Ethnic Groups %K Female %K Heart Rate %K Humans %K Male %K Polysomnography %K Severity of Illness Index %K Sleep Apnea Syndromes %K Snoring %K Surveys and Questionnaires %X

STUDY OBJECTIVES: To examine the relation of sleep-related symptoms to race and ethnicity in a diverse sample of middle-aged and older men and women.

DESIGN: Cross-sectional questionnaire survey.

SETTING: In the initial phase of the Sleep Heart Health Study, men and women enrolled in participating epidemiologic cohort studies were surveyed.

PARTICIPANTS: 13,194 men and women 40 years of age and older, including 11,517 non-Hispanic white, 648 black, 643 American Indian, 296 Hispanic, and 90 Asian-Pacific Islander.

INTERVENTIONS: Not applicable.

MEASUREMENTS AND RESULTS: After adjustment for BMI and other factors, frequent snoring was more common among Hispanic women (odds ratio (OR) = 2.25, 95% confidence interval (CI) = 1.48, 3.42) and black women (OR = 1.55, 95% Ci = 1.13, 2.13) than among non-Hispanic white women. Hispanic men were significantly more likely to report frequent snoring than non-Hispanic white men (OR = 2.30, 95% CI = 1.43, 3.69). Black, American Indian, and Asian men did not differ significantly from white men in snoring prevalence. American Indian women were significantly more likely to report breathing pauses during sleep than their white, non-Hispanic counterparts (OR = 1.52, 95% CI 1.03, 2.24), although polysomnography data on a subset of the sample suggested that the association between this symptom reported on questionnaire and objective evidence of sleep-disordered breathing may be weaker among American Indians than among other groups. Mean Epworth Sleepiness Scale scores were slightly higher in black men and women than in their white, non-hispanic counterparts.

CONCLUSIONS: Frequent snoring was more common among black and Hispanic women and Hispanic men than among their white non-Hispanic counterparts, even after adjusting for BMI and other factors. Further research including polysomnography and objective measurements of sleepiness is needed to assess the physiologic and clinical significance of these findings.

%B Sleep %V 26 %P 74-9 %8 2003 Feb 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/12627736?dopt=Abstract %0 Journal Article %J J Am Geriatr Soc %D 2004 %T The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study. %A Psaty, Bruce M %A Anderson, Melissa %A Kronmal, Richard A %A Tracy, Russell P %A Orchard, Trevor %A Fried, Linda P %A Lumley, Thomas %A Robbins, John %A Burke, Greg %A Newman, Anne B %A Furberg, Curt D %K African Americans %K African Continental Ancestry Group %K Aged %K Female %K Health Surveys %K Humans %K Incidence %K Lipids %K Male %K Mortality %K Myocardial Infarction %K Population Surveillance %K Prospective Studies %K Risk Factors %K Stroke %K United States %X

OBJECTIVES: To assess the association between lipid levels and cardiovascular events in older adults.

DESIGN: A prospective population-based study.

SETTING: Four field centers in U.S. communities.

PARTICIPANTS: A total of 5,201 adults aged 65 and older living in U.S. communities, plus a recruitment of 687 African Americans 3 years later.

MEASUREMENTS: Fasting lipid measures included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, and triglycerides.

RESULTS: At baseline, 1,954 men and 2,931 women were at risk for an incident myocardial infarction (MI) or stroke. During an average 7.5-year follow-up, 436 subjects had a coronary event, 332 had an ischemic stroke, 104 a hemorrhagic stroke, and 1,096 died. After adjustment, lipid measures were not major predictors of the outcomes of MI, ischemic stroke, hemorrhagic stroke, and total mortality. For total cholesterol and LDL-C, the associations with MI and ischemic stroke were only marginally significant. HDL-C was inversely associated with MI risk (hazard ratio=0.85 per standard deviation of 15.7 mg/dL, 95% confidence interval=0.76-0.96). For the outcome of ischemic stroke, high levels of HDL-C were associated with a decreased risk in men but not women. Lipid measures were generally only weakly associated with the risks of hemorrhagic stroke or total mortality.

CONCLUSION: In this population-based study of older adults, most lipid measures were weakly associated with cardiovascular events. The association between low HDL-C and increased MI risk was nonetheless strong and consistent.

%B J Am Geriatr Soc %V 52 %P 1639-47 %8 2004 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/15450039?dopt=Abstract %R 10.1111/j.1532-5415.2004.52455.x %0 Journal Article %J Vasc Endovascular Surg %D 2004 %T Associations between renovascular disease and prevalent cardiovascular disease in the elderly: a population-based study. %A Edwards, Matthew S %A Hansen, Kimberley J %A Craven, Timothy E %A Bleyer, Anthony J %A Burke, Gregory L %A Levy, Pavel J %A Dean, Richard H %K Aged %K Arteriosclerosis %K Cardiovascular Diseases %K Cohort Studies %K Humans %K Hypertension, Renovascular %K Longitudinal Studies %K Male %K Multivariate Analysis %K Prevalence %K Prospective Studies %K Renal Artery Obstruction %K Ultrasonography %K United States %X

Atherosclerotic renovascular disease (RVD) is a suspected contributor to the morbidity and mortality of cardiovascular disease (CVD) through its potential effects on blood pressure and excretory renal function as well as through its associations with other forms of CVD. However, population-based data regarding the associations between the presence of RVD and prevalent CVD are lacking. The Cardiovascular Health Study (CHS) is a prospective, multicenter cohort study of CVD among elderly Americans. As part of an ancillary study, participants in the Forsyth County, North Carolina, cohort of the CHS were invited to undergo renal duplex sonography (RDS) to establish the presence or absence of RVD (defined as any focal peak systolic velocity >/= 1.8 m/second or the absence of a Doppler-shifted signal from an imaged artery). Demographic, risk factor, and prevalent CVD data were obtained from the CHS coordinating center and matched with ancillary study participants. Eight hundred thirty-four CHS participants (including 525 women [63%], 309 men [37%], 194 African-Americans [23%], and 635 Caucasians [76%]) with a mean age of 77.2 +/-4.9 years underwent RDS examination. RVD was present in 57 participants (6.8%). Overall, clinical and/or subclinical manifestations of CVD were present in 603 participants (72.3%) at the time of RDS. Participants with RVD demonstrated a significantly greater prevalence of angina (p = 0.002), previous myocardial infarction (p < 0.001), >/= 25% diameter-reducing internal carotid artery stenosis (p = 0.010), increased carotid intimal medial thickness (p = 0.003), and major electrocardiographic abnormalities (p = 0.013). Following adjustment for demographics and cardiovascular risk factors, the presence of RVD demonstrated a significant and independent association with prevalent coronary artery disease but not with prevalent cerebrovascular or lower extremity vascular disease. These results suggest important population-based associations between RVD and both clinical and subclinical manifestations of CVD, especially coronary artery disease.

%B Vasc Endovascular Surg %V 38 %P 25-35 %8 2004 Jan-Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/14760474?dopt=Abstract %R 10.1177/153857440403800103 %0 Journal Article %J Ann Intern Med %D 2004 %T Cognitive impairment and decline are associated with carotid artery disease in patients without clinically evident cerebrovascular disease. %A Johnston, S Claiborne %A O'Meara, Ellen S %A Manolio, Teri A %A Lefkowitz, David %A O'Leary, Daniel H %A Goldstein, Steven %A Carlson, Michelle C %A Fried, Linda P %A Longstreth, W T %K Aged %K Carotid Stenosis %K Cognition Disorders %K Cohort Studies %K Cross-Sectional Studies %K Female %K Humans %K Male %K Neuropsychological Tests %K Odds Ratio %K Risk Factors %K Tunica Intima %X

BACKGROUND: Whether carotid artery disease is a cause of cognitive impairment in persons who have not had stroke is unknown. If this is the case, diminished performance on the Modified Mini-Mental State Examination should be more common in persons with left carotid artery disease than in those with right carotid artery disease.

OBJECTIVE: To determine whether left carotid artery disease is associated with cognitive impairment.

DESIGN: Cross-sectional and cohort study.

SETTING: Four U.S. communities participating in the Cardiovascular Health Study.

PATIENTS: 4006 right-handed men and women 65 years of age or older without history of stroke, transient ischemic attack, or carotid endarterectomy.

MEASUREMENTS: Internal carotid artery stenosis and intima-media thickness of the common carotid artery were assessed by using duplex ultrasonography. Cognitive impairment was defined as a score less than 80 on the Modified Mini-Mental State Examination, and cognitive decline was defined as an average decrease of more than 1 point annually in Modified Mini-Mental State Examination score during up to 5 years of follow-up. Multivariate logistic regression models were used to estimate the risk for cognitive impairment and decline associated with left internal carotid artery stenosis and intima-media thickness, after adjustment for measures of right-sided disease and risk factors for vascular disease.

RESULTS: After adjustment for right-sided stenosis, high-grade (> or =75% narrowing of diameter) stenosis of the left internal carotid artery (32 patients) was associated with cognitive impairment (odds ratio, 6.7 [95% CI, 2.4 to 18.1] compared with no stenosis) and cognitive decline (odds ratio, 2.6 [CI, 1.1 to 6.3]). Intima-media thickness of the left common carotid artery was associated with cognitive impairment and decline in univariate analysis, but this effect did not persist after adjustment.

CONCLUSIONS: Cognitive impairment and decline are associated with asymptomatic high-grade stenosis of the left internal carotid artery. The persistence of the association after adjustment for right-sided stenosis indicates that the association is not due to underlying vascular risk factors or atherosclerosis in general.

%B Ann Intern Med %V 140 %P 237-47 %8 2004 Feb 17 %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/14970146?dopt=Abstract %R 10.7326/0003-4819-140-4-200402170-00005 %0 Journal Article %J J Aging Health %D 2004 %T Concurrent and long-term predictors of older adults' use of community-based long-term care services: the Caregiver Health Effects Study. %A Bookwala, Jamila %A Zdaniuk, Bozena %A Burton, Lynda %A Lind, Bonnie %A Jackson, Sharon %A Schulz, Richard %K Aged %K Caregivers %K Community Health Services %K Disabled Persons %K Forecasting %K Health Services for the Aged %K Humans %K Long-Term Care %K Regression Analysis %K Spouses %K United States %X

OBJECTIVE: This study examined concurrent and long-term associations between caregiver-related characteristics and the use of community long-term care services in a sample of 186 older adults caring for a disabled spouse.

METHOD: We used two waves of data from the Caregiver Health Effects Study, an ancillary study of the Cardiovascular Health Study. Caregiver-related need variables as predictors of service use were of primary interest and included caregiving demands, caregiver mental and physical health, and mastery. Their contribution to service use was examined after controlling for known predictors of service use.

RESULTS: At Time 1, more caregiver depressive symptoms predicted greater service use; at Time 2, more caregiver activity restriction and depressive symptoms predicted greater formal service use; increases in caregiver activity restriction and depressive symptomatology over time predicted increases in service use.

DISCUSSION: Caregiver-related need variables play a significant role in defining utilization patterns of community-based long-term care services among older adults.

%B J Aging Health %V 16 %P 88-115 %8 2004 Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/14979312?dopt=Abstract %R 10.1177/0898264303260448 %0 Journal Article %J Circulation %D 2004 %T Fish intake and risk of incident atrial fibrillation. %A Mozaffarian, Dariush %A Psaty, Bruce M %A Rimm, Eric B %A Lemaitre, Rozenn N %A Burke, Gregory L %A Lyles, Mary F %A Lefkowitz, David %A Siscovick, David S %K Aged %K Animals %K Atrial Fibrillation %K Cardiotonic Agents %K Cohort Studies %K Cooking %K Diet %K Dietary Fats %K Fatty Acids, Omega-3 %K Fish Oils %K Fishes %K Follow-Up Studies %K Humans %K Incidence %K Massachusetts %K Proportional Hazards Models %K Prospective Studies %K Risk %K Seafood %K Tuna %X

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is particularly common in the elderly. Although effects of fish intake, including potential antiarrhythmic effects, may favorably influence risk of AF, relationships between fish intake and AF incidence have not been evaluated.

METHODS AND RESULTS: In a prospective, population-based cohort of 4815 adults > or =age 65 years, usual dietary intake was assessed at baseline in 1989 and 1990. Consumption of tuna and other broiled or baked fish correlated with plasma phospholipid long-chain n-3 fatty acids, whereas consumption of fried fish or fish sandwiches (fish burgers) did not. AF incidence was prospectively ascertained on the basis of hospital discharge records and annual electrocardiograms. During 12 years' follow-up, 980 cases of incident AF were diagnosed. In multivariate analyses, consumption of tuna or other broiled or baked fish was inversely associated with incidence of AF, with 28% lower risk with intake 1 to 4 times per week (HR=0.72, 95% CI=0.58 to 0.91, P=0.005), and 31% lower risk with intake > or =5 times per week (HR=0.69, 95% CI=0.52 to 0.91, P=0.008), compared with <1 time per month (P trend=0.004). Results were not materially different after adjustment for preceding myocardial infarction or congestive heart failure. In similar analyses, fried fish/fish sandwich consumption was not associated with lower risk of AF.

CONCLUSIONS: Among elderly adults, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower incidence of AF. Fish intake may influence risk of this common cardiac arrhythmia.

%B Circulation %V 110 %P 368-73 %8 2004 Jul 27 %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15262826?dopt=Abstract %R 10.1161/01.CIR.0000138154.00779.A5 %0 Journal Article %J J Am Geriatr Soc %D 2004 %T Incidence and prevalence of dementia in the Cardiovascular Health Study. %A Fitzpatrick, Annette L %A Kuller, Lewis H %A Ives, Diane G %A Lopez, Oscar L %A Jagust, William %A Breitner, John C S %A Jones, Beverly %A Lyketsos, Constantine %A Dulberg, Corinne %K African Americans %K Age Distribution %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Apolipoproteins E %K Dementia %K Dementia, Vascular %K Education %K European Continental Ancestry Group %K Female %K Humans %K Incidence %K Longitudinal Studies %K Male %K Prevalence %K Proportional Hazards Models %K Risk Factors %K Sex Distribution %K United States %X

OBJECTIVES: To estimate the incidence and prevalence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in the Cardiovascular Health Study (CHS) cohort.

DESIGN: Longitudinal cohort study using prospectively and retrospectively collected data to evaluate dementia.

SETTING: Four U.S. communities.

PARTICIPANTS: There were 3,602 CHS participants, including 2,865 white and 492 African-American participants free of dementia, who completed a cranial magnetic resonance image between 1992 and 1994 and were followed for an average of 5.4 years.

MEASUREMENTS: Dementia was classified by neurologist/psychiatrist committee review using neuropsychological tests, neurological examinations, medical records, physician questionnaires, and proxy/informant interviews. Demographics and apolipoprotein E (APOE) genotype were collected at baseline. Incidence by type of dementia was determined using National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD and Alzheimer's Disease Diagnostic and Treatment Center's State of California criteria for VaD.

RESULTS: Classification resulted in 227 persons with prevalent dementia at entry into the study and 480 incident cases during follow-up. Incidence rates of dementia scaled to age 80 were 34.7 per 1,000 person-years for white women, 35.3 for white men, 58.8 for African-American women, and 53.0 for African-American men. Sex differences were not significant within race. Adjusted for age and education, racial differences were only of borderline significance and may have been influenced by ascertainment methodology. Rates differed substantially by educational attainment but were only significant for whites. Those with the APOE epsilon4 allele had an incidence rate at age 80 of 56.4, compared with 29.6 for those without this allele (P<.001). In whites, type-specific incidence at age 80 was 19.2 for AD versus 14.6 for VaD. These rates were 34.7 and 27.2 for African Americans. At termination of observation, women had only a slightly higher prevalence of dementia (16.0%) than men (14.7%).

CONCLUSION: Sex and racial differences were not found, and VaD was higher than reported in other studies. These data provide new estimates of dementia incidence in a community sample for projection of future burden.

%B J Am Geriatr Soc %V 52 %P 195-204 %8 2004 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/14728627?dopt=Abstract %R 10.1111/j.1532-5415.2004.52058.x %0 Journal Article %J Arch Neurol %D 2004 %T Plasma total homocysteine levels and cranial magnetic resonance imaging findings in elderly persons: the Cardiovascular Health Study. %A Longstreth, W T %A Katz, Ronit %A Olson, Jean %A Bernick, Charles %A Carr, J Jeffrey %A Malinow, M René %A Hess, David L %A Cushman, Mary %A Schwartz, Stephen M %K Aged %K Aging %K Brain %K Brain Infarction %K Female %K Homocysteine %K Humans %K Magnetic Resonance Imaging %K Male %K Odds Ratio %K Radiography %K Risk Factors %X

BACKGROUND: An elevated plasma total homocysteine (tHcy) level is associated with an increased risk of vascular disease. Some studies have shown associations between tHcy level and small-vessel disease of the brain on magnetic resonance imaging (MRI).

DESIGN: In the Cardiovascular Health Study, 622 elderly participants without a history of transient ischemic attack or stroke had results for tHcy level and cranial MRI. We sought associations between tHcy level and MRI findings of ventricular grade, sulcal grade, white matter grade, and infarcts. We controlled for other factors, including levels of creatinine, folate, and vitamins B(6) and B(12) and methylenetetrahydrofolate reductase genotype.

RESULTS: After controlling for age and sex, tHcy level was not associated with the individual MRI findings. Further adjustments for other factors and other blood tests had little effect on these findings. The only significant finding was a linear trend across quintiles of tHcy level and a pattern of MRI findings combining infarcts and high white matter grade. The linear trend remained significant after controlling for other risk factors and atherosclerotic markers (top quintile vs bottom quintile odds ratio, 3.3; 95% confidence interval, 0.96-11.20; P =.04 for linear trend) but was slightly diminished after further controlling for creatinine, folate, and vitamins B(6) and B(12) (odds ratio, 3.2; 95% confidence interval, 0.81-13.10; P =.07 for linear trend).

CONCLUSION: We were unable to confirm the results of previous studies with respect to tHcy level and individual MRI findings, although an association was seen for an MRI pattern combining infarcts and high white matter grade.

%B Arch Neurol %V 61 %P 67-72 %8 2004 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/14732622?dopt=Abstract %R 10.1001/archneur.61.1.67 %0 Journal Article %J Neurology %D 2004 %T Preclinical Alzheimer disease: neuropsychological test performance 1.5 to 8 years prior to onset. %A Saxton, J %A Lopez, O L %A Ratcliff, G %A Dulberg, C %A Fried, L P %A Carlson, M C %A Newman, A B %A Kuller, L %K Age of Onset %K Alzheimer Disease %K Cardiovascular Diseases %K Cognition Disorders %K Cohort Studies %K Confounding Factors, Epidemiologic %K Disease Progression %K Early Diagnosis %K Educational Status %K Female %K Follow-Up Studies %K Humans %K Male %K Memory Disorders %K Neuropsychological Tests %K Predictive Value of Tests %K Proportional Hazards Models %K Risk %K Sensitivity and Specificity %K Time Factors %X

OBJECTIVE: To determine if individuals ultimately diagnosed with Alzheimer disease (AD) exhibited evidence of cognitive impairment on neuropsychological tests administered between 1.5 years and 8.1 years before dementia onset.

METHODS: A total of 693 community-dwelling individuals, part of the Cardiovascular Health Study, completed a neuropsychological test battery in 1991/92. Subjects were followed annually over the next 8 years (median follow-up = 7.4 years). Seventy-two individuals were ultimately diagnosed with AD (median follow-up = 4.5 years): 24 with AD onset 1.5 to 3.4 years after baseline neuropsychological testing, 20 with AD onset 3.5 to 5.0 years after testing, and 28 with onset 5.1 to 8.1 years after testing. A total of 621 individuals remained nondemented throughout the 8 years of follow-up (median follow-up = 7.5 years).

RESULTS: Subjects ultimately diagnosed with AD had poorer scores on baseline neuropsychological measures than subjects who remained nondemented. Although individuals closest to AD onset (i.e., 1.5 to 3.4 years) performed the most poorly, cognitive impairment was detected in individuals who did not develop AD until 5 to 8 years later.

CONCLUSIONS: Cognitive changes can be detected well before onset of Alzheimer disease.

%B Neurology %V 63 %P 2341-7 %8 2004 Dec 28 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/15623697?dopt=Abstract %R 10.1212/01.wnl.0000147470.58328.50 %0 Journal Article %J J Am Coll Cardiol %D 2004 %T Prevalence of specific variant carotid geometric patterns and incidence of cardiovascular events in older persons. The Cardiovascular Health Study (CHS E-131). %A Scuteri, Angelo %A Manolio, Teri A %A Marino, Emily K %A Arnold, Alice M %A Lakatta, Edward G %K Aged %K Cardiovascular Diseases %K Carotid Arteries %K Female %K Humans %K Hypertrophy %K Incidence %K Male %K Predictive Value of Tests %K Prevalence %K Prospective Studies %K Ultrasonography %X

OBJECTIVES: We hypothesized that variant geometric patterns of the common carotid artery (CCA) predict the incidence of cardiovascular disease (CVD), after accounting for CCA intima-medial thickness (IMT).

BACKGROUND: Common carotid artery intima-media thickness has been associated with the incidence of cardiovascular disease.

METHOD: Noninvasive measurements of IMT were made with high-resolution ultrasonography in 5,640 subjects 65 years of age or older participating in the Cardiovascular Health Study. New coronary and/or cerebrovascular events served as outcome variables over a median 10.2-year follow-up. To characterize different carotid structural geometric patterns (CGP), vascular mass (VM) was combined with the wall-to-lumen ratio (W/L). Normal values for W/L and VM were defined as age-adjusted, gender-specific 75th percentiles of the 1,899 normotensive subjects free of CVD at baseline. Four CGPs were defined: CGP1 = normal W/L ratio and VM; CGP2 = arterial remodeling (i.e., increased W/L ratio with normal VM); CGP3 = arterial hypertrophy (i.e., increased W/L ratio with increased VM); and CGP4 = arterial hypertrophy with dilation (i.e., normal W/L ratio and increased VM).

RESULTS: Coronary or cerebrovascular events (adjusted for age, gender, traditional risk factors, and IMT) were associated with CGP in subjects free of CVD at baseline. Specifically, the hazard ratio (Cox proportional-hazards analyses) for CGP3 (arterial hypertrophy) was 1.25 (95% confidence interval [CI] 1.03 to 1.53), and for CGP4 (arterial hypertrophy with dilation) was 1.43 (95% CI 1.16 to 1.75) compared with CGP1 (normal).

CONCLUSIONS: Arterial hypertrophy defined by variant CGP patterns is associated with the development of new CVD, independent of age, traditional risk factors, and CCA IMT.

%B J Am Coll Cardiol %V 43 %P 187-93 %8 2004 Jan 21 %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/14736436?dopt=Abstract %R 10.1016/j.jacc.2003.08.035 %0 Journal Article %J Am Heart J %D 2004 %T Racial differences in endothelial function in postmenopausal women. %A Loehr, Laura R %A Espeland, Mark A %A Sutton-Tyrrell, Kim %A Burke, Gregory L %A Crouse, John R %A Herrington, David M %K African Continental Ancestry Group %K Aged %K Brachial Artery %K Cohort Studies %K Endothelium, Vascular %K European Continental Ancestry Group %K Female %K Humans %K Multivariate Analysis %K Postmenopause %K Risk Factors %K Vasodilation %X

OBJECTIVE: Racial differences in cardiovascular mortality among women remain largely unexplained. Preliminary data suggest that African American and Caucasian differences in endothelial function may parallel differential cardiovascular disease (CVD) risk in women. To further study differences in endothelial function between African American and Caucasian women, we analyzed measures of brachial artery flow-mediated dilation (FMD) in women enrolled in the Cardiovascular Health Study (CHS).

METHODS AND RESULTS: Brachial artery FMD was measured in the fasting state using established ultrasound techniques in 1330 Caucasian and 297 African American female participants in CHS (mean age 78.4 +/- 4.4 years). General linear models were used to compare FMD between African American and Caucasian women after adjusting for baseline brachial diameter, hypertension, diabetes, smoking, cholesterol, systolic blood pressure, body mass index, waist/hip ratio, age, education, income level; use of angiotensin-converting enzyme inhibitors, beta-blockers, nitroglycerin, estrogens and lipid-lowering drugs; and presence of clinical or subclinical disease. Adjusted absolute change and percent change in brachial artery diameter was significantly reduced in African American women compared with Caucasian women (P <.0001 and P =.0002, respectively). Similar results were found when the women were stratified by history of CVD (- CVD, P =.02; + CVD, P =.001) and CVD or subclinical vascular disease (- disease, P =.01, + disease, P =.03).

CONCLUSIONS: In this cohort, brachial artery FMD was lower in African American women compared to Caucasian women, and this difference persisted after adjustment by multivariable analysis. The increased CVD risk in African American women may be related to impaired endothelial function. It remains to be determined whether African American women may uniquely benefit by interventions designed to improve endothelial health.

%B Am Heart J %V 148 %P 606-11 %8 2004 Oct %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15459590?dopt=Abstract %R 10.1016/j.ahj.2004.04.032 %0 Journal Article %J Thorax %D 2004 %T Respiratory muscle strength and the risk of incident cardiovascular events. %A van der Palen, J %A Rea, T D %A Manolio, T A %A Lumley, T %A Newman, A B %A Tracy, R P %A Enright, P L %A Psaty, B M %K Cardiovascular Diseases %K Female %K Follow-Up Studies %K Forced Expiratory Volume %K Humans %K Male %K Maximal Voluntary Ventilation %K Prospective Studies %K Respiratory Muscles %K Risk Factors %K Vital Capacity %X

BACKGROUND: Maximal inspiratory pressure (MIP) is a measure of inspiratory muscle strength. The prognostic importance of MIP for cardiovascular events among elderly community dwelling individuals is unknown. Diminished forced vital capacity (FVC) is a risk factor for cardiovascular events which remains largely unexplained.

METHODS: MIP was measured at the baseline examination of the Cardiovascular Health Study. Participants had to be free of prevalent congestive heart failure (CHF), myocardial infarction (MI), and stroke.

RESULTS: Subjects in the lowest quintile of MIP had a 1.5-fold increased risk of MI (HR 1.48, 95% CI 1.07 to 2.06) and cardiovascular disease (CVD) death (HR 1.54, 95% CI 1.09 to 2.15) after adjustment for non-pulmonary function covariates. There was a potential inverse relationship with stroke (HR 1.36, 95% CI 0.97 to 1.90), but there was little evidence of an association between MIP and CHF (HR 1.22, 95% CI 0.93 to 1.60). The addition of FVC to models attenuated the HR associated with MIP only modestly; similarly, addition of MIP attenuated the HR associated with FVC only modestly.

CONCLUSIONS: A reduced MIP is an independent risk factor for MI and CVD death, and a suggestion of an increased risk for stroke. This association with MIP appeared to be mediated through mechanisms other than inflammation.

%B Thorax %V 59 %P 1063-7 %8 2004 Dec %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/15563706?dopt=Abstract %R 10.1136/thx.2004.021915 %0 Journal Article %J J Am Geriatr Soc %D 2004 %T Risk of congestive heart failure in an elderly population treated with peripheral alpha-1 antagonists. %A Bryson, Chris L %A Smith, Nicholas L %A Kuller, Lewis H %A Chaves, Paulo H M %A Manolio, Teri A %A Lewis, William %A Boyko, Edward J %A Furberg, Curt D %A Psaty, Bruce M %K Adrenergic alpha-Antagonists %K Aged %K Antihypertensive Agents %K Benzothiadiazines %K Blood Pressure %K Cohort Studies %K Diuretics %K Female %K Heart Failure %K Humans %K Hypertension %K Male %K Risk Factors %K Sodium Chloride Symporter Inhibitors %K United States %X

OBJECTIVES: To compare the risk of congestive heart failure (CHF) in elderly individuals treated with any peripheral alpha-1 antagonist for hypertension with any thiazide, test whether the risk persists in subjects without cardiovascular disease (CVD) at baseline, and examine CHF risk in normotensive men with prostatism treated with alpha antagonists.

DESIGN: Prospective cohort study.

SETTING: Four U.S. sites: Washington County, Maryland; Allegheny County, Pennsylvania; Sacramento County, California; and Forsyth County, North Carolina.

PARTICIPANTS: A total of 5,888 community-dwelling subjects aged 65 and older.

MEASUREMENTS: Adjudicated incident CHF.

RESULTS: The 3,105 participants with treated hypertension were at risk for CHF; 22% of men and 8% of women took alpha antagonists during follow-up. The age-adjusted risk of CHF in those receiving monotherapy treated with alpha antagonists was 1.90 (95% confidence interval=1.03-3.50) compared with thiazides. In subjects without CVD at baseline receiving monotherapy, women taking an alpha antagonist had a 3.6 times greater age-adjusted risk of CHF, whereas men had no difference in risk. Adjustment for systolic blood pressure attenuated statistical differences in risk. There were 930 men without hypertension at risk for CHF; 5% used alpha antagonists during follow-up, with no observed increase in CHF risk.

CONCLUSION: Subjects receiving alpha antagonist monotherapy for hypertension had a two to three times greater risk of incident CHF, also seen in lower-risk subjects, but differences in blood pressure control partly explained this.

%B J Am Geriatr Soc %V 52 %P 1648-54 %8 2004 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/15450040?dopt=Abstract %R 10.1111/j.1532-5415.2004.52456.x %0 Journal Article %J J Am Geriatr Soc %D 2004 %T Self-reported alcohol consumption and falls in older adults: cross-sectional and longitudinal analyses of the cardiovascular health study. %A Mukamal, Kenneth J %A Mittleman, Murray A %A Longstreth, W T %A Newman, Anne B %A Fried, Linda P %A Siscovick, David S %K Accidental Falls %K Aged %K Alcohol Drinking %K Chi-Square Distribution %K Cross-Sectional Studies %K Female %K Humans %K Longitudinal Studies %K Male %K Regression Analysis %K Risk Factors %K Self Disclosure %K United States %X

OBJECTIVES: To assess the cross-sectional and longitudinal associations between alcohol consumption and risk of falls in older adults.

DESIGN: Cross-sectional and longitudinal analyses.

SETTING: Four U.S. communities.

PARTICIPANTS: A total of 5,841 older adults enrolled in the Cardiovascular Health Study, an ongoing, population-based, prospective cohort study, participated.

MEASUREMENTS: Self-reported alcohol consumption at baseline, self-reported frequent falls at baseline, and the 4-year risk of falls of participants who denied frequent falls at baseline.

RESULTS: Cross-sectional analysis indicated an apparent inverse association between alcohol consumption and risk of frequent falls (adjusted odds ratio in consumers of 14 or more drinks per week=0.41; 95% confidence interval (CI)=0.14-1.17; P for trend=.06), but longitudinal analysis indicated a similar 4-year risk of falls in abstainers and light to moderate drinkers but a 25% higher risk in consumers of 14 or more drinks per week (95% CI=3-52%; P for trend=.07). Similar results were found in analyses stratified by age, sex, race, and physical activity.

CONCLUSION: Consumption of 14 or more drinks per week is associated with an increased risk of subsequent falls in older adults. Cross-sectional studies may fail to identify this risk of heavier drinking, perhaps because older adults at risk for falls decrease their alcohol use over time or because heavier drinkers at risk for falls tend not to enroll in cohort studies. However, because this study relied upon annual reporting of falls, further prospective studies should be conducted to confirm these findings.

%B J Am Geriatr Soc %V 52 %P 1174-9 %8 2004 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/15209658?dopt=Abstract %R 10.1111/j.1532-5415.2004.52318.x %0 Journal Article %J Neurology %D 2004 %T Stroke risk factors and loss of high cognitive function. %A Elkins, J S %A O'Meara, E S %A Longstreth, W T %A Carlson, M C %A Manolio, T A %A Johnston, S C %K Aged %K Aged, 80 and over %K Aging %K Cognition Disorders %K Cohort Studies %K Comorbidity %K Female %K Follow-Up Studies %K Higher Nervous Activity %K Humans %K Incidence %K Male %K Risk Assessment %K Risk Factors %K Sampling Studies %K Sensitivity and Specificity %K Severity of Illness Index %K Stroke %K United States %X

BACKGROUND: Modifiable stroke risk factors may contribute to age-associated declines in cognitive function. Individuals with high levels of cognitive function after midlife may have less exposure to these stroke risk factors or may be less susceptible to their effects on cognition.

METHODS: The Cardiovascular Health Study (CHS)* is a population-based, longitudinal cohort study of 5,888 people age 65 years and older. Participants (n = 4,129) who were free of dementia, stroke, or TIA at the time of baseline cranial MRI were selected for analysis. High cognitive function at baseline was defined by performance at or above midlife norms on the Modified Mini-Mental State Examination (3MS).

RESULTS: The odds of having high cognitive function at baseline decreased by quartile of stroke risk (highest vs lowest risk quartile, adjusted odds ratio [OR] 0.68; 95% CI 0.52 to 0.88; p for trend = 0.005). Stroke risk was a predictor of decline on the 3MS in those with typical levels of cognitive function at baseline, even in the absence of incident stroke or TIA (highest vs lowest risk quartile for 3MS decline, adjusted OR 2.11; 95% CI 1.42 to 3.13; p for trend < 0.001). In contrast, stroke risk was not associated with decline on the 3MS in those with high cognitive function at baseline (p = 0.03 for interaction).

CONCLUSIONS: In a cohort of older adults without stroke, TIA, or dementia, cognitive function and incident cognitive decline were associated with risk for stroke. Additional studies are needed to determine whether modification of stroke risk factors can reduce the cognitive decline that is often attributed to normal aging.

%B Neurology %V 63 %P 793-9 %8 2004 Sep 14 %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/15365125?dopt=Abstract %R 10.1212/01.wnl.0000137014.36689.7f %0 Journal Article %J Am J Epidemiol %D 2004 %T Survival associated with two sets of diagnostic criteria for congestive heart failure. %A Schellenbaum, Gina D %A Rea, Thomas D %A Heckbert, Susan R %A Smith, Nicholas L %A Lumley, Thomas %A Roger, Veronique L %A Kitzman, Dalane W %A Taylor, Herman A %A Levy, Daniel %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Cohort Studies %K Diagnosis, Differential %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Incidence %K Male %K Prognosis %K Severity of Illness Index %K Survival Analysis %X

Congestive heart failure (CHF) definitions vary across epidemiologic studies. The Framingham Heart Study criteria include CHF signs and symptoms assessed by a physician panel. In the Cardiovascular Health Study, a committee of physicians adjudicated CHF diagnoses, confirmed by signs, symptoms, clinical tests, and/or medical therapy. The authors used data from the Cardiovascular Health Study, a population-based cohort study of 5,888 elderly US adults, to compare CHF incidence and survival patterns following onset of CHF as defined by Framingham and/or Cardiovascular Health Study criteria. They constructed an inception cohort of nonfatal, hospitalized CHF patients. Of 875 participants who had qualifying CHF hospitalizations between 1989 and 2000, 54% experienced a first CHF event that fulfilled both sets of diagnostic criteria (concordant), 31% fulfilled only the Framingham criteria (Framingham only), and 15% fulfilled only the Cardiovascular Health Study criteria (Cardiovascular Health Study only). No significant survival difference was found between the Framingham-only group (hazard ratio = 0.87, 95% confidence interval: 0.71, 1.07) or the Cardiovascular Health Study-only group (hazard ratio = 0.89, 95% confidence interval: 0.68, 1.15) and the concordant group (referent). Compared with Cardiovascular Health Study central adjudication, Framingham criteria for CHF identified a larger group of participants with incident CHF, but all-cause mortality rates were similar across these diagnostic classifications.

%B Am J Epidemiol %V 160 %P 628-35 %8 2004 Oct 01 %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/15383406?dopt=Abstract %R 10.1093/aje/kwh268 %0 Journal Article %J Am Heart J %D 2004 %T Time trends in the use of beta-blockers and other pharmacotherapies in older adults with congestive heart failure. %A Smith, Nicholas L %A Chan, Jeannie D %A Rea, Thomas D %A Wiggins, Kerri L %A Gottdiener, John S %A Lumley, Thomas %A Psaty, Bruce M %K Adrenergic beta-Antagonists %K Aged %K Angiotensin II Type 1 Receptor Blockers %K Angiotensin-Converting Enzyme Inhibitors %K Cohort Studies %K Drug Therapy %K Drug Therapy, Combination %K Female %K Heart Failure %K Humans %K Male %K Multivariate Analysis %K Prevalence %X

BACKGROUND: Evidence supporting pharmacotherapy of congestive heart failure (CHF) has grown substantially over the past decade and includes large, placebo-controlled trials with mortality end points. We describe beta-blocker and other medication temporal treatment trends of CHF in the Cardiovascular Health Study, a community-based cohort study of 5888 adults > or =65 years of age.

METHODS: Prescription medication data were collected from hospital discharge summaries for incident CHF events and at in-study annual clinic visits for prevalent CHF cases from 1989 to 2000. Change in use of agents over time was estimated by using generalized estimating equations while adjusting for potential confounding factors of age, sex, race, and cardiovascular and pulmonary comorbidities.

RESULTS: Among 1033 incident CHF events, beta-blocker use after diagnosis increased an average of 2.4 percentage points annually (95% CI, 1.5 to 3.4 points) from 1989 to 2000. The increasing trend was consistent throughout follow-up. Among participants with coronary disease and/or hypertension and among those with low ejection fractions (<45%), beta-blocker use remained flat from 1989 to 1994 and increased 4.7 points annually (2.5 to 6.9) and 10.0 points annually (6.1 to 13.8), respectively, from 1995 to 2000. Among participants without coronary disease or hypertension, there was no overall increase in use. Use of renin-angiotensin system inhibitors increased 2.3 points annually (1.0 to 3.5), digoxin use decreased 2.4 points annually (-3.6 to -1.1), and loop diuretic use remained flat between 1989 and 2000. In general, treatment trends were similar for prevalent CHF.

CONCLUSIONS: Treatment of CHF has changed gradually in the 1990s and may in part reflect the influence of CHF clinical trial evidence.

%B Am Heart J %V 148 %P 710-7 %8 2004 Oct %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15459605?dopt=Abstract %R 10.1016/j.ahj.2004.04.002 %0 Journal Article %J Stroke %D 2004 %T White matter hyperintensity on cranial magnetic resonance imaging: a predictor of stroke. %A Kuller, Lewis H %A Longstreth, W T %A Arnold, Alice M %A Bernick, Charles %A Bryan, R Nick %A Beauchamp, Norman J %K Aged %K Brain %K Female %K Humans %K Leukoaraiosis %K Magnetic Resonance Imaging %K Male %K Radiography %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: We have previously reported that several "silent" infarcts found on magnetic resonance imaging (MRI) were a risk factor for stroke. Several recent reports have shown that high white matter grade (WMG) and increasing WMG over time were risk factors for stroke. We tested the hypothesis that high WMG > or =2 was a predictor of risk for stroke, independent of other risk factors.

METHODS: We examined the extent of white matter hyperintensity on cranial MRI of 3293 participants from the Cardiovascular Health Study (CHS). The degree of white matter hyperintensity was graded from least severe (grade=0) to most severe (grade=9). Participants were followed-up for an average of 7 years for the occurrence of a stroke. Clinical stroke diagnoses were based on hospital records reviewed by an adjudication committee expert in stroke diagnosis. During this period, 278 strokes occurred. Results The relative risk of stroke increased significantly as the WMG increased. The risk of stroke was 2.8% per year for participants with high WMG (grades > or =5), compared with only 0.6% for participants with grades 0 to 1.Conclusions The risk of stroke with high WMG is independent of traditional stroke risk factors and persists when controlling for MRI infarcts, another subclinical imaging marker of cerebrovascular disease. Assessment of white matter disease may be valuable in assessing future risk of stroke.

%B Stroke %V 35 %P 1821-5 %8 2004 Aug %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/15178824?dopt=Abstract %R 10.1161/01.STR.0000132193.35955.69 %0 Journal Article %J Stroke %D 2005 %T Alcohol use and risk of ischemic stroke among older adults: the cardiovascular health study. %A Mukamal, Kenneth J %A Chung, Hyoju %A Jenny, Nancy S %A Kuller, Lewis H %A Longstreth, W T %A Mittleman, Murray A %A Burke, Gregory L %A Cushman, Mary %A Beauchamp, Norman J %A Siscovick, David S %K Aged %K Alcohol Drinking %K Apolipoproteins E %K Brain Infarction %K Brain Ischemia %K Cohort Studies %K Female %K Follow-Up Studies %K Genetic Predisposition to Disease %K Genotype %K Humans %K Hypertension %K Inflammation %K Ischemia %K Lipids %K Male %K Middle Aged %K Multivariate Analysis %K Myocardial Infarction %K Prospective Studies %K Risk %K Risk Factors %K Stroke %K Substance-Related Disorders %K Thrombosis %K Time Factors %K Vascular Diseases %X

BACKGROUND AND PURPOSE: The association of light to moderate alcohol consumption with risk of ischemic stroke remains uncertain, as are the roles of potentially mediating factors and modification by apolipoprotein E (apoE) genotype.

METHODS: We studied the prospective association of alcohol consumption and risk of ischemic stroke among 4410 participants free of cardiovascular disease at baseline in the Cardiovascular Health Study, a population-based cohort study of older adults from 4 US communities. Participants reported their consumption of alcoholic beverages yearly.

RESULTS: During an average follow-up period of 9.2 years, 434 cases of incident ischemic stroke occurred. Compared with long-term abstainers, the multivariate relative risks of ischemic stroke were 0.85 (95% CI, 0.63 to 1.13), 0.75 (95% CI, 0.53 to 1.06), 0.82 (95% CI, 0.51 to 1.30), and 1.03 (95% CI, 0.68 to 1.57) among consumers of <1, 1 to 6, 7 to 13, and > or =14 drinks per week (P quadratic trend 0.06). ApoE genotype appeared to modify the alcohol-ischemic stroke relationship (P interaction 0.08), with generally lower risks among drinkers than abstainers in apoE4-negative participants but higher risks among drinkers than abstainers among apoE4-positive participants. We could not identify candidate mediators among lipid, inflammatory, and prothrombotic factors.

CONCLUSIONS: In this study of older adults, the association of alcohol use and risk of ischemic stroke was U-shaped, with modestly lower risk among consumers of 1 to 6 drinks per week. However, apoE genotype may modify this association, and even moderate alcohol intake may be associated with an increased risk of ischemic stroke among apoE4-positive older adults.

%B Stroke %V 36 %P 1830-4 %8 2005 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16081863?dopt=Abstract %R 10.1161/01.STR.0000177587.76846.89 %0 Journal Article %J Ann Intern Med %D 2005 %T Association between screening for osteoporosis and the incidence of hip fracture. %A Kern, Lisa M %A Powe, Neil R %A Levine, Michael A %A Fitzpatrick, Annette L %A Harris, Tamara B %A Robbins, John %A Fried, Linda P %K Absorptiometry, Photon %K Aged %K Aged, 80 and over %K Cohort Studies %K Female %K Hip Fractures %K Humans %K Incidence %K Male %K Mass Screening %K Osteoporosis %K Risk Factors %K Sensitivity and Specificity %X

BACKGROUND: Because direct evidence for the effectiveness of screening is lacking, guidelines disagree on whether people should be screened for osteoporosis.

OBJECTIVE: To determine whether population-based screening for osteoporosis in older adults is associated with fewer incident hip fractures than usual medical care.

DESIGN: Nonconcurrent cohort study.

SETTING: Population-based cohort enrolled in the Cardiovascular Health Study (CHS) from 4 states (California, Pennsylvania, Maryland, and North Carolina).

PATIENTS: 3107 adults 65 years of age and older who attended their CHS study visits in 1994-1995.

MEASUREMENTS: 31 participant characteristics (including demographic characteristics, medical histories, medications, and physical examination findings) and incident hip fractures over 6 years of follow-up.

INTERVENTION: Bone density scans (dual-energy x-ray absorptiometry [DEXA] at the hip) for participants in California and Pennsylvania (n = 1422) and usual care for participants in Maryland and North Carolina (n = 1685).

RESULTS: The incidence of hip fractures per 1000 person-years was 4.8 in the screened group and 8.2 in the usual care group. Screening was associated with a statistically significant lower hazard of hip fracture than usual care after adjustment for sex and propensity to be screened (Cox proportional hazard ratio, 0.64 [95% CI, 0.41 to 0.99]).

LIMITATIONS: The mechanism of the association was unclear. A small unmeasured confounder that decreased the hazard of hip fracture could diminish or erase the observed association.

CONCLUSIONS: Use of hip DEXA scans to screen for osteoporosis in older adults was associated with 36% fewer incident hip fractures over 6 years compared with usual medical care. Further research is needed to explore the mechanism of this association.

%B Ann Intern Med %V 142 %P 173-81 %8 2005 Feb 01 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/15684205?dopt=Abstract %R 10.7326/0003-4819-142-3-200502010-00007 %0 Journal Article %J Am Heart J %D 2005 %T Association of beta-blocker use with mortality among patients with congestive heart failure in the Cardiovascular Health Study (CHS). %A Chan, Jeannie D %A Rea, Thomas D %A Smith, Nicholas L %A Siscovick, David %A Heckbert, Susan R %A Lumley, Thomas %A Chaves, Paulo %A Furberg, Curt D %A Kuller, Lewis %A Psaty, Bruce M %K Adrenergic beta-Antagonists %K Age Factors %K Aged %K Aged, 80 and over %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Male %X

BACKGROUND: In clinical trials, beta-blocker therapy reduces all-cause mortality among people with congestive heart failure (CHF) characterized by depressed systolic function, but few trials included large numbers of elderly participants. This study assessed the association between beta-blocker therapy and mortality among community-dwelling older adults with CHF.

METHODS: The Cardiovascular Health Study (CHS) is a longitudinal, population-based study of adults aged > or = 65 years. Recruitment began in 1989 with follow-up extending through June 2000 or death. Cox proportional hazard regression models were used to assess the association between beta-blocker therapy and all-cause mortality among 950 participants who developed new-onset CHF.

RESULTS: beta-Blocker users (n = 157) were more likely than nonusers (n = 793) to have treated hypertension, clinical coronary artery disease, and valvular disease at the time of CHF diagnosis. Death occurred in 67 users and 446 nonusers during a median follow-up of 2.3 years. Compared with nonuse, use of beta-blockers was associated with a multivariable adjusted hazard ratio (HR) of 0.74 (95% CI 0.56-0.98) for all-cause mortality. Among the 520 participants who had left ventricular ejection fraction assessed within 90 days after CHF diagnosis, the risk for all cause mortality associated with beta-blocker use did not differ significantly between those with ejection fraction of < 40% and those with ejection fraction of > or = 40% (HR 0.56, 95% CI 0.27-1.13; HR 0.82, 95% CI 0.56-1.22, respectively; interaction P = .34).

CONCLUSIONS: This observational study suggests that beta-blocker treatment is associated with a reduced risk of all-cause mortality among community-dwelling older adults with CHF.

%B Am Heart J %V 150 %P 464-70 %8 2005 Sep %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16169325?dopt=Abstract %R 10.1016/j.ahj.2004.12.022 %0 Journal Article %J Am J Hypertens %D 2005 %T beta(2)-Adrenergic receptor polymorphisms and determinants of cardiovascular risk: the Cardiovascular Health Study. %A Hindorff, Lucia A %A Heckbert, Susan R %A Psaty, Bruce M %A Lumley, Thomas %A Siscovick, David S %A Herrington, David M %A Edwards, Karen L %A Tracy, Russell P %K African Americans %K Antihypertensive Agents %K Arteriosclerosis %K Coronary Artery Disease %K European Continental Ancestry Group %K Female %K Genotype %K Homozygote %K Humans %K Hypertension %K Incidence %K Male %K Middle Aged %K Polymorphism, Genetic %K Receptors, Adrenergic, beta-2 %K Risk Factors %X

BACKGROUND: Common Arg16Gly and Gln27Glu polymorphisms of the beta(2)-adrenergic receptor (beta(2)AR) have been associated with hypertension and coronary disease. This analysis of older adults in the Cardiovascular Health Study examined whether these polymorphisms were associated with blood pressure (BP), subclinical atherosclerosis, and, among treated hypertensive individuals, differences in coronary disease risk according to antihypertensive drug class.

METHODS: Altogether, 5249 participants (4441 white and 808 African American, median follow-up time 10.2 years) were genotyped for both polymorphisms. Ankle-arm index (AAI), carotid intima-media thickness (IMT), and brachial flow-mediated dilation were measured cross-sectionally. All estimates were adjusted for ethnicity.

RESULTS: Relative to Gln27 homozygotes, carrying the Glu27 allele was not associated with new-onset hypertension (hazard ratio [HR] = 1.01, 95% confidence interval [CI] = 0.87 to 1.16), BP control (odds ratio [OR] = 0.97, 95% CI = 0.89 to 1.06), AAI (mean difference 0.0042 +/- 0.0052), carotid IMT (mean difference 0.0044 +/- 0.02 mm), or brachial flow-mediated dilation (mean difference in baseline diameter -0.028 +/- 0.036 mm; the most marked of three measures). Among treated hypertensive individuals, coronary disease risk was similar in Glu27 carriers relative to Gln27 homozygotes in subgroups defined by use of beta-blockers (HR = 1.09, 95% CI = 0.64 to 1.87) or other antihypertensive medications (HR = 1.00, 95% CI = 0.78 to 1.28). Results were similar for the Arg16Gly polymorphism.

CONCLUSIONS: The association of beta(2)AR genotype with coronary disease previously reported in this older adult population is not likely to be explained by BP levels, subclinical atherosclerosis, or antihypertensive treatment. Other measures of vascular response, gene-gene or gene-environment interactions, or characteristics developing earlier in life may mediate the association between beta(2)AR genotype and coronary disease and merit further research.

%B Am J Hypertens %V 18 %P 392-7 %8 2005 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/15797659?dopt=Abstract %R 10.1016/j.amjhyper.2004.10.014 %0 Journal Article %J Ophthalmology %D 2005 %T Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: the Atherosclerosis Risk in Communities & Cardiovascular Health studies. %A Wong, Tien Yin %A Larsen, Emily K Marino %A Klein, Ronald %A Mitchell, Paul %A Couper, David J %A Klein, Barbara E K %A Hubbard, Larry D %A Siscovick, David S %A Sharrett, A Richey %K Aged %K Aged, 80 and over %K Arterioles %K Blood Pressure %K Cardiovascular Diseases %K Carotid Stenosis %K Coronary Artery Disease %K Cross-Sectional Studies %K Embolism %K Female %K Fibrinogen %K Humans %K Hypertension %K Lipoprotein(a) %K Male %K Meta-Analysis as Topic %K Middle Aged %K Retinal Artery %K Retinal Vein Occlusion %K Risk Factors %X

OBJECTIVE: To examine the associations of retinal vein occlusion and arteriolar emboli with cardiovascular disease.

DESIGN: Population-based cross-sectional study.

PARTICIPANTS: Pooled from the Atherosclerosis Risk in Communities Study (n = 12,642; mean age, 60 years) and the Cardiovascular Health Study (n = 2824; mean age, 79 years).

METHODS: Retinal vein occlusion and arteriolar emboli were identified from a single nonmydriatic retinal photograph using a standardized protocol. Photographs were also graded for arteriovenous nicking and focal arteriolar narrowing. All participants had a comprehensive systemic evaluation, including standardized carotid ultrasonography.

MAIN OUTCOME MEASURES: Retinal vein occlusion and arteriolar emboli.

RESULTS: Prevalences of retinal vein occlusion and arteriolar emboli were 0.3% (n = 39 cases) and 0.2% (n = 34 cases), respectively. After adjusting for age, retinal vein occlusion was associated with hypertension (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.43-6.14), systolic blood pressure (BP) (OR, 4.12; 95% CI, 1.40-12.16; highest quartile vs. lowest), diastolic BP (OR, 2.64; 95% CI, 1.07-6.46; highest quartile vs. lowest), carotid artery plaque (OR, 5.62; 95% CI, 2.60-12.16), body mass index (OR, 3.88; 95% CI, 1.23-12.18; highest quartile vs. lowest), plasma fibrinogen (OR, 3.29; 95% CI, 1.08-10.02; highest quartile vs. lowest), arteriovenous nicking (OR, 4.09; 95% CI, 2.00-8.36), and focal arteriolar narrowing (OR, 5.17; 95% CI, 2.59-10.29). After adjusting for age, retinal arteriolar emboli were associated with hypertension (OR, 3.14; 95% CI, 1.44-6.84), systolic BP (OR, 3.46; 95% CI, 1.13-10.65; highest quartile vs. lowest), prevalent coronary heart disease (OR, 2.33; 95% CI, 1.01-5.42), carotid artery plaque (OR, 4.62; 95% CI, 1.85-11.57), plasma lipoprotein (a) (OR, 3.69; 95% CI, 1.20-11.41; highest quartile vs. lowest), plasma fibrinogen (OR, 3.09; 95% CI, 0.98-9.76; highest quartile vs. lowest), and current cigarette smoking (OR, 3.08; 95% CI, 1.47-6.47). Approximately a quarter of participants with retinal vein occlusion and arteriolar emboli had evidence of carotid artery plaque as defined from ultrasound.

CONCLUSIONS: Retinal vein occlusion and retinal arteriolar emboli are associated with carotid artery disease, hypertension, and other cardiovascular risk factors.

%B Ophthalmology %V 112 %P 540-7 %8 2005 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15808241?dopt=Abstract %R 10.1016/j.ophtha.2004.10.039 %0 Journal Article %J Neurology %D 2005 %T Classification of vascular dementia in the Cardiovascular Health Study Cognition Study. %A Lopez, O L %A Kuller, L H %A Becker, J T %A Jagust, W J %A DeKosky, S T %A Fitzpatrick, A %A Breitner, J %A Lyketsos, C %A Kawas, C %A Carlson, M %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Brain %K Cerebral Arteries %K Cohort Studies %K Dementia, Vascular %K Diagnosis, Differential %K Disease Progression %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Predictive Value of Tests %K Stroke %K United States %X

OBJECTIVE: To describe the diagnostic classification of subjects with incident vascular dementia (VaD) participating in the Cardiovascular Health Study (CHS) Cognition Study.

METHODS: The CHS classified 480 incident cases between 1994 and 1999 among 3,608 CHS participants who had brain MRI in 1992 through 1994 and in 1997 through 1998. The patients were diagnosed before and after reviewing the brain MRI.

RESULTS: The pre-MRI classification showed that 52 participants had VaD and 76 had both Alzheimer disease (AD) and VaD. The post-MRI classification showed that the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria classified 61 subjects as having VaD, the National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria classified 43 subjects as having probable VaD and 10 as possible VaD, and the State of California Alzheimer's Disease Diagnostic and Treatment Center (ADDTC) criteria classified 117 as having probable VaD and 96 as possible. The combination of the ADDTC and National Institute of Neurological and Communication Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria was used to examine the spectrum of vascular disease in dementia. The dementia was attributable to only vascular factors in 56 cases (probable VaD); VaD coexisted with AD in 61 cases, although the VaD component was the leading cause of dementia (probable VaD with AD); AD was the leading cause of dementia in 61 cases (possible VaD and probable AD); and in 29 cases, it was not clear that either AD or VaD was the primary diagnosis (possible AD and possible VaD).

CONCLUSIONS: None of the clinical criteria for VaD identified the same group of subjects. The diagnosis of vascular dementia is difficult in epidemiologic studies because poststroke dementia can be due to Alzheimer disease (AD) and evidence of vascular disease can be found in the MRI of dementia cases without clinical strokes. Whether the clinical progression is related to AD pathology or vascular disease is difficult to establish.

%B Neurology %V 64 %P 1539-47 %8 2005 May 10 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/15883314?dopt=Abstract %R 10.1212/01.WNL.0000159860.19413.C4 %0 Journal Article %J Atherosclerosis %D 2005 %T Common promoter polymorphisms of inflammation and thrombosis genes and longevity in older adults: the cardiovascular health study. %A Reiner, Alexander P %A Diehr, Paula %A Browner, Warren S %A Humphries, Stephen E %A Jenny, Nancy S %A Cushman, Mary %A Tracy, Russell P %A Walston, Jeremy %A Lumley, Thomas %A Newman, Anne B %A Kuller, Lewis H %A Psaty, Bruce M %K Aged %K Aging %K Carboxypeptidase B2 %K Cause of Death %K Cohort Studies %K Female %K Genotype %K Health Status %K Humans %K Inflammation %K Longevity %K Male %K Middle Aged %K Plasminogen Activator Inhibitor 1 %K Polymorphism, Genetic %K Promoter Regions, Genetic %K Prospective Studies %K Risk Factors %K Thrombosis %X

Inflammatory response genes may influence life span or quality at advanced ages. Using data from the population-based cardiovascular health study (CHS) cohort, we examined the associations between promoter polymorphisms of several inflammation and thrombosis genes with longevity. We ascertained genotypes for interleukin (IL)-6 -174 G/C, beta-fibrinogen -455 G/A, plasminogen activator inhibitor (PAI)-1 -675 4G/5G, and thrombin-activatable fibrinolysis inhibitor (TAFI) -438 G/A in 2224 men and women > or = 65 years old at baseline. During 10 years of follow-up, men with the TAFI -438 A/A genotype had decreased mortality due to all causes, and lived, on average, 0.9 more years of life, or 1.1 more years of healthy life, than men with the -438 G allele. The effects of TAFI -438 G/A in women were smaller and not statistically significant. PAI-1 4G/4G genotype appeared to be associated with lower non-cardiovascular mortality in men, but with greater cardiovascular mortality in women. In exploratory analyses, we observed a possible interaction among anti-inflammatory drugs, interleukin-6 -174 C/C genotype, and longevity. These findings suggest that modulators of fibrinolytic activity may have a generalized influence on aging, and merit further investigation in studies of genetic determinants of human longevity.

%B Atherosclerosis %V 181 %P 175-83 %8 2005 Jul %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/15939070?dopt=Abstract %R 10.1016/j.atherosclerosis.2005.01.028 %0 Journal Article %J J Am Geriatr Soc %D 2005 %T Coronary artery calcium: associations with brain magnetic resonance imaging abnormalities and cognitive status. %A Rosano, Caterina %A Naydeck, Barbara %A Kuller, Lewis H %A Longstreth, William T %A Newman, Anne B %K Aged %K Brain %K Calcinosis %K Cognition Disorders %K Coronary Artery Disease %K Cross-Sectional Studies %K Dementia %K Female %K Humans %K Logistic Models %K Magnetic Resonance Imaging %K Male %K Risk Factors %K United States %X

OBJECTIVES: To evaluate the association between coronary atherosclerosis and subclinical brain magnetic resonance imaging (MRI) abnormalities and between coronary atherosclerosis and abnormal cognitive function (dementia/mild cognitive impairment).

DESIGN: Cross-sectional.

SETTING: The Cardiovascular Health Study (CHS), an epidemiological study of risk factors for cardiovascular disease in older adults.

PARTICIPANTS: Four hundred nine men and women, mean age 79, recruited from the Pittsburgh center of the CHS.

MEASUREMENTS: Coronary atherosclerosis was defined according to the level of coronary artery calcification (CAC), as measured using electronic beam tomography. Subclinical brain MRI abnormalities included ventricular enlargement, white matter hyperintensities, and number of subcortical brain infarcts. Brain MRI and CAC measurements were performed between 1998 and 2000 at the Pittsburgh center of the CHS. Prevalence of brain MRI abnormalities and abnormal cognitive status were examined across quartiles of the CAC score, before and after controlling for age. Multivariate logistic regression models were used to assess whether CAC level was associated with abnormalities of brain MRI or abnormal cognitive status.

RESULTS: Older adults with high CAC scores were more likely to have more-severe brain MRI abnormalities, including subcortical infarction and high white matter hyperintensities. The associations between CAC and ventricular enlargement showed a similar but not significant trend. The presence of any of the MRI abnormalities attenuated the association between CAC and abnormal cognitive status.

CONCLUSION: Older adults with higher levels of CAC were more likely to have more-severe brain MRI abnormalities and abnormal cognitive status.

%B J Am Geriatr Soc %V 53 %P 609-15 %8 2005 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15817006?dopt=Abstract %R 10.1111/j.1532-5415.2005.53208.x %0 Journal Article %J J Am Geriatr Soc %D 2005 %T The course of functional decline in older people with persistently elevated depressive symptoms: longitudinal findings from the Cardiovascular Health Study. %A Lenze, Eric J %A Schulz, Richard %A Martire, Lynn M %A Zdaniuk, Bozena %A Glass, Thomas %A Kop, Willem J %A Jackson, Sharon A %A Reynolds, Charles F %K Activities of Daily Living %K Aged %K Case-Control Studies %K Depressive Disorder %K Disabled Persons %K Female %K Humans %K Longitudinal Studies %K Male %K Multivariate Analysis %K Risk %K United States %X

OBJECTIVES: To examine the relationship between persistently high depressive symptoms and long-term changes in functional disability in elderly persons.

DESIGN: A community-based, prospective, observational study.

SETTING: Participant data from the Cardiovascular Health Study.

PARTICIPANTS: From the overall sample of 5,888 subjects, three types of participants were identified for this study: (1) persistently depressed individuals, who experienced an onset of depressive symptoms that persisted over 4 years (n=119); (2) temporarily depressed individuals, who experienced an onset of depressive symptoms that resolved over time (n=259); and (3) nondepressed individuals, with persistently low depressive symptoms throughout the follow-up period who were matched on baseline activity of daily living (ADL) scores, sex, and age to the previous two groups combined (n=378).

MEASUREMENTS: Four consecutive years of data were assessed: validated measures of depression (10-item CES-D), functional disability (10-item ADL/instrumental ADL measure), physical performance, medical illness, and cognition.

RESULTS: The persistently depressed group showed a greater linear increase in functional disability ratings than the temporarily depressed and nondepressed groups. This association between persistent depression and functional disability was robust even when controlling for baseline demographic and clinical/performance measures, including cognition. The persistently depressed group had an adjusted odds ratio (OR) of 5.27 (95% confidence interval (CI) 3.03-9.16) for increased functional disability compared with the nondepressed group over 3 years of follow-up, whereas the temporarily depressed group had an adjusted OR of 2.39 (95% CI=1.55-3.69) compared with the nondepressed group.

CONCLUSION: Persistently elevated depressive symptoms in elderly persons are associated with a steep trajectory of worsening functional disability, generating the hypothesis that treatments for late-life depression need to be assessed on their efficacy in maintaining long-term functional status as well as remission of depressive symptoms. These results also demonstrate the need for studies to differentiate between persistent and temporary depressive symptoms when examining their relationship to disability.

%B J Am Geriatr Soc %V 53 %P 569-75 %8 2005 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15817000?dopt=Abstract %R 10.1111/j.1532-5415.2005.53202.x %0 Journal Article %J J Am Soc Nephrol %D 2005 %T Cystatin C and subclinical brain infarction. %A Seliger, Stephen L %A Longstreth, W T %A Katz, Ronit %A Manolio, Teri %A Fried, Linda F %A Shlipak, Michael %A Stehman-Breen, Catherine O %A Newman, Anne %A Sarnak, Mark %A Gillen, Daniel L %A Bleyer, Anthony %A Siscovick, David S %K Age Factors %K Aged %K Aged, 80 and over %K Biomarkers %K Brain Infarction %K Confidence Intervals %K Creatinine %K Cross-Sectional Studies %K Cystatin C %K Cystatins %K Disease Progression %K Female %K Geriatric Assessment %K Humans %K Incidence %K Ischemic Attack, Transient %K Magnetic Resonance Imaging %K Male %K Odds Ratio %K Predictive Value of Tests %K Prognosis %K Risk Assessment %K Sensitivity and Specificity %K Severity of Illness Index %K Sex Factors %K Survival Analysis %X

Subclinical brain infarcts (SBI) are common in the elderly and are associated with covert neurologic and cognitive impairment. Although renal impairment is associated with accelerated cerebrovascular disease and an increased risk for clinically apparent brain infarct, few studies have examined the relationship between renal function and SBI, and these may have been limited by the inaccuracy of creatinine as a renal function marker. A cross-sectional study was performed among older adults in the Cardiovascular Health Study to examine associations between SBI and two serum markers of renal function: Serum creatinine (SCr) and cystatin C (CysC). Patients had cranial magnetic resonance imaging and renal markers measured in 1992 to 1993. Logistic regression was used to estimate the associations between renal function (estimated by 1/SCr and 1/CysC) and SBI, controlling for potential confounding factors. SBI were present in 789 (28.7%) of 2784 participants. A linear association with SBI was observed for 1/CysC (per 1-SD decrement; odds ratio [OR] 1.20; 95% confidence interval [CI] 1.09 to 1.32; P < 0.001) but not for 1/SCr (OR 1.08; 95% CI 0.98 to 1.19; P = 0.14), for which a quadratic U-shaped association was suggested (P = 0.004). In a model with both markers, 1/CysC was linearly associated with SBI (OR 1.26; P < 0.001), whereas 1/SCr was not (OR 1.06; P = 0.3). The prevalence of SBI was directly associated with quintile of CysC, whereas the association between SCr and SBI was U-shaped, with greater prevalence at high and low levels. Compared with creatinine, CysC, a novel marker of renal function, has a stronger and more direct association with SBI in the elderly.

%B J Am Soc Nephrol %V 16 %P 3721-7 %8 2005 Dec %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/16236809?dopt=Abstract %R 10.1681/ASN.2005010006 %0 Journal Article %J J Am Geriatr Soc %D 2005 %T Dementia and Alzheimer's disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. %A Newman, Anne B %A Fitzpatrick, Annette L %A Lopez, Oscar %A Jackson, Sharon %A Lyketsos, Constantine %A Jagust, William %A Ives, Diane %A DeKosky, Steven T %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Cardiovascular Diseases %K Cohort Studies %K Coronary Disease %K Dementia %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Peripheral Vascular Diseases %K Risk Factors %X

OBJECTIVES: To determine whether coronary artery disease, peripheral arterial disease (PAD), or noninvasive markers of cardiovascular disease (CVD) predict the onset of dementia and Alzheimer's disease (AD).

DESIGN: Longitudinal cohort study.

SETTING: Four U.S. communities.

PARTICIPANTS: Men and women (N=3,602) with a brain magnetic resonance imaging (MRI) scan but no dementia were followed for 5.4 years. Participants with stroke were excluded.

MEASUREMENTS: Neurologists and psychiatrists classified incident cases of dementia and subtype using neuropsychological tests, examination, medical records and informant interviews. CVD was defined at the time of the MRI scan. Noninvasive tests of CVD were assessed within 1 year of the MRI. Apolipoprotein E allele status, age, race, sex, education, Mini-Mental State Examination score, and income were assessed as potential confounders.

RESULTS: The incidence of dementia was higher in those with prevalent CVD, particularly in the subgroup with PAD. The rate of AD was 34.4 per 1,000 person-years for those with a history of CVD, versus 22.2 per 1,000 person-years without a history of CVD (adjusted hazard ratio (HR)=1.3, 95% confidence interval (CI)=1.0-1.7). Rates of AD were highest in those with PAD (57.4 vs 23.7 per 100 person-years, adjusted HR=2.4, 95% CI=1.4-4.2). Results were similar with further exclusion of those with vascular dementia from the AD group. A gradient of increasing risk was noted with the extent of vascular disease.

CONCLUSION: Older adults with CVD other than stroke had a higher risk of dementia and AD than did those without CVD. The risk was highest in people with PAD, suggesting that extensive peripheral atherosclerosis is a risk factor for AD.

%B J Am Geriatr Soc %V 53 %P 1101-7 %8 2005 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/16108925?dopt=Abstract %R 10.1111/j.1532-5415.2005.53360.x %0 Journal Article %J Neurology %D 2005 %T Determinants of vascular dementia in the Cardiovascular Health Cognition Study. %A Kuller, L H %A Lopez, O L %A Jagust, W J %A Becker, J T %A DeKosky, S T %A Lyketsos, C %A Kawas, C %A Breitner, J C S %A Fitzpatrick, A %A Dulberg, C %K Age Factors %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Atrophy %K Brain %K Cardiovascular Diseases %K Cerebral Arteries %K Cerebral Infarction %K Cohort Studies %K Comorbidity %K Continental Population Groups %K Dementia, Vascular %K Female %K Humans %K Lateral Ventricles %K Magnetic Resonance Imaging %K Male %K Nerve Fibers, Myelinated %K Neuropsychological Tests %K Risk Factors %K Sex Factors %X

OBJECTIVE: The authors evaluated 3,375 participants without dementia at the time of MRI in 1991 to 1994 over 5.7 years for incident dementia and type of dementia.

METHODS: Incidence of and risk factors for vascular dementia (VaD) were measured using both pre-MRI and modified State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) post-MRI review and further classified Alzheimer disease (AD) by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.

RESULTS: Approximately 44% (213) of 480 incident dementia cases were classified as possible or probable VaD by ADDTC. The incidence of VaD increased with age and was greater in blacks than whites. Risk factors for VaD included age, Modified Mini-Mental State Examination, high white matter grade, number of MRI infarcts, ventricular size, and history of stroke.

CONCLUSIONS: Vascular disease in the brain is prevalent among incident dementia cases. There is a substantial overlap between cases classified as Alzheimer disease by Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association and vascular dementia (VaD) by modified State of California Alzheimer's Disease Diagnostic and Treatment Centers criteria. The substantial contribution of vascular disease would be missed without inclusion of MRI. Treatment of risk factors for VaD could have an important impact on incidence of dementia.

%B Neurology %V 64 %P 1548-52 %8 2005 May 10 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/15883315?dopt=Abstract %R 10.1212/01.WNL.0000160115.55756.DE %0 Journal Article %J Arch Intern Med %D 2005 %T Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. %A Mozaffarian, Dariush %A Longstreth, W T %A Lemaitre, Rozenn N %A Manolio, Teri A %A Kuller, Lewis H %A Burke, Gregory L %A Siscovick, David S %K Age Distribution %K Aged %K Aged, 80 and over %K Animals %K Cohort Studies %K Confidence Intervals %K Diet %K Fatty Acids, Omega-3 %K Female %K Fish Oils %K Fishes %K Humans %K Incidence %K Male %K Multivariate Analysis %K Probability %K Proportional Hazards Models %K Risk Assessment %K Seafood %K Sensitivity and Specificity %K Sex Distribution %K Stroke %K Surveys and Questionnaires %K Survival Rate %K United States %X

BACKGROUND: Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential.

METHODS: Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebrovascular disease at baseline in 1989-1990, usual dietary intake was assessed using a food frequency questionnaire. In a subset, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches (fish burgers), correlated with plasma phospholipid long-chain n-3 fatty acid levels. Incident strokes were prospectively ascertained.

RESULTS: During 12 years of follow-up, participants experienced 626 incident strokes, including 529 ischemic strokes. In multivariate analyses, tuna/other fish consumption was inversely associated with total stroke (P = .04) and ischemic stroke (P = .02), with 27% lower risk of ischemic stroke with an intake of 1 to 4 times per week (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.98) and 30% lower risk with intake of 5 or more times per week (HR, 0.70; 95% CI, 0.50-0.99) compared with an intake of less than once per month. In contrast, fried fish/fish sandwich consumption was positively associated with total stroke (P = .006) and ischemic stroke (P = .003), with a 44% higher risk of ischemic stroke with consumption of more than once per week (HR, 1.44; 95% CI, 1.12-1.85) compared with consumption of less than once per month. Fish consumption was not associated with hemorrhagic stroke.

CONCLUSIONS: Among elderly individuals, consumption of tuna or other broiled or baked fish is associated with lower risk of ischemic stroke, while intake of fried fish or fish sandwiches is associated with higher risk. These results suggest that fish consumption may influence stroke risk late in life; potential mechanisms and alternate explanations warrant further study.

%B Arch Intern Med %V 165 %P 200-6 %8 2005 Jan 24 %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/15668367?dopt=Abstract %R 10.1001/archinte.165.2.200 %0 Journal Article %J J Am Coll Cardiol %D 2005 %T Fish intake and risk of incident heart failure. %A Mozaffarian, Dariush %A Bryson, Chris L %A Lemaitre, Rozenn N %A Burke, Gregory L %A Siscovick, David S %K Aged %K Animals %K Cohort Studies %K Cooking %K Diet %K Diet Surveys %K Disease-Free Survival %K Female %K Fishes %K Heart Failure %K Humans %K Incidence %K Male %K Risk Factors %K United States %X

OBJECTIVES: Our aim was to investigate the relation between fish consumption and incidence of congestive heart failure (CHF).

BACKGROUND: The incidence and health burden of CHF are rising, particularly in older persons. Although n-3 fatty acids have effects that could favorably influence risk of CHF, the relation between fish intake and CHF incidence is unknown.

METHODS: Among 4,738 adults age > or =65 years and free of CHF at baseline in 1989-90, usual dietary intake was assessed using a food frequency questionnaire. In a participant subsample, consumption of tuna or other broiled or baked fish, but not fried fish, correlated with plasma phospholipid n-3 fatty acids. Incidence of CHF was prospectively adjudicated.

RESULTS: During 12 years' follow-up, 955 participants developed CHF. In multivariate-adjusted analyses, tuna/other fish consumption was inversely associated with incident CHF, with 20% lower risk with intake 1 to 2 times/week (hazard ratio [HR] = 0.80, 95% confidence interval [CI] = 0.64 to 0.99), 31% lower risk with intake 3 to 4 times/week (HR = 0.69, 95% CI = 0.52 to 0.91), and 32% lower risk with intake > or =5 times/week (HR = 0.68, 95% CI = 0.45 to 1.03), compared with intake <1 time/month (p trend = 0.009). In similar analyses, fried fish consumption was positively associated with incident CHF (p trend = 0.01). Dietary long-chain n-3 fatty acid intake was also inversely associated with CHF (p trend = 0.009), with 37% lower risk in the highest quintile of intake (HR = 0.73, 95% CI = 0.57 to 0.94) compared with the lowest.

CONCLUSIONS: Among older adults, consumption of tuna or other broiled or baked fish, but not fried fish, is associated with lower incidence of CHF. Confirmation in additional studies and evaluation of potential mechanisms is warranted.

%B J Am Coll Cardiol %V 45 %P 2015-21 %8 2005 Jun 21 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/15963403?dopt=Abstract %R 10.1016/j.jacc.2005.03.038 %0 Journal Article %J Sleep %D 2005 %T Haptoglobin phenotype, sleep-disordered breathing, and the prevalence of cardiovascular disease: the Sleep Heart Health Study. %A Levy, Andrew P %A Zhang, Lin %A Miller-Lotan, Rachel %A Redline, Susan %A O'Connor, George T %A Quan, Stuart F %A Resnick, Helaine E %K Aged %K Angioplasty, Balloon, Coronary %K Coronary Artery Bypass %K Cross-Sectional Studies %K Female %K Haptoglobins %K Humans %K Male %K Middle Aged %K Myocardial Infarction %K Oxidative Stress %K Phenotype %K Polysomnography %K Prevalence %K Sleep Apnea Syndromes %X

BACKGROUND: Diabetes is an independent risk factor for cardiovascular disease, and there is growing evidence that sleep-disordered breathing also may increase the risk of cardiovascular disease. The mechanism responsible for increased susceptibility of people with diabetes to cardiovascular disease is thought to share several features with sleep-disordered breathing, notably increased oxidative stress. We recently demonstrated that a particular haptoglobin phenotype that is associated with differential antioxidant activity is an independent risk factor for cardiovascular disease in individuals with diabetes. We therefore sought to determine whether sleep-disordered breathing and cardiovascular disease are more strongly associated among people with the unfavorable haptoglobin phenotype.

METHODS: We tested this hypothesis in 2612 middle-aged and older participants from the Sleep Heart Health Study. Haptoglobin phenotyping was performed by gel electrophoresis. Respiratory disturbance index was assessed by standard methods. Logistic regression analysis was performed to estimate the association between haptoglobin phenotype and cardiovascular disease, adjusting for known cardiovascular risk factors (age, sex, diabetes, smoking, lipid levels, and hypertension). Possible modification by haptoglobin phenotype of the association of sleep-disordered breathing with cardiovascular disease prevalence was explored by examining interaction terms.

RESULTS: We found no significant association between haptoglobin phenotype and prevalent cardiovascular disease in this cohort, nor were significant interactions found between haptoglobin phenotype and sleep-disordered breathing on the prevalence of cardiovascular disease.

CONCLUSIONS: Sleep-disordered breathing did not appear to interact with haptoglobin phenotype in modifying the association with prevalent cardiovascular disease in the Sleep Heart Health Study. These findings could be due to the absence of association or to survivor bias in these cross-sectional analyses.

%B Sleep %V 28 %P 207-13 %8 2005 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/16171245?dopt=Abstract %R 10.1093/sleep/28.2.207 %0 Journal Article %J J Am Geriatr Soc %D 2005 %T Hospitalization for pneumonia in the Cardiovascular Health Study: incidence, mortality, and influence on longer-term survival. %A O'Meara, Ellen S %A White, Mark %A Siscovick, David S %A Lyles, Mary F %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Cognition %K Comorbidity %K Diabetes Complications %K Female %K Hospitalization %K Humans %K Male %K Mortality %K Pneumonia %K Prospective Studies %K Respiratory Physiological Phenomena %K Risk Factors %K Smoking %X

OBJECTIVES: To estimate the rate of hospitalization for pneumonia in community-dwelling older adults and to assess its risk factors and contribution to mortality.

DESIGN: Prospective observational study.

SETTING: The Cardiovascular Health Study (CHS) in four U.S. communities.

PARTICIPANTS: Five thousand eight hundred eighty-eight men and women aged 65 and older who were followed for a median 10.7 years.

MEASUREMENTS: Participants were interviewed about medical history and demographics; evaluated for lung, physical, and cognitive function; and followed for hospitalizations, cardiovascular disease, and death.

RESULTS: Nearly 10% of the cohort was hospitalized for pneumonia, for a rate of 11.1 per 1,000 person-years (95% confidence interval (CI)=10.2-12.0). Risk factors included older age, male sex, current and past smoking, poor physical and lung function, and history of cardiovascular disease and chronic obstructive pulmonary disease. Ten percent of participants died during their incident pneumonia hospitalization, and death rates were high in those who survived to discharge. Compared with participants who had not been hospitalized for pneumonia, the relative risk of total mortality was 4.9 (95% CI=4.1-6.0) during the first year after hospitalization and 2.6 (95% CI=2.2-3.1) thereafter, adjusted for age, sex, and race. The respective relative risks were 3.9 (95% CI=3.1-4.8) and 2.0 (95% CI=1.6-2.4) after further adjustment for baseline history of cardiovascular disease; diabetes mellitus; smoking; and measures of lung, physical, and cognitive function.

CONCLUSION: In older people, hospitalization for pneumonia is common and is associated with an elevated risk of death, as shown in this population-based, prospective cohort.

%B J Am Geriatr Soc %V 53 %P 1108-16 %8 2005 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/16108926?dopt=Abstract %R 10.1111/j.1532-5415.2005.53352.x %0 Journal Article %J Stroke %D 2005 %T Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. %A Longstreth, W T %A Arnold, Alice M %A Beauchamp, Norman J %A Manolio, Teri A %A Lefkowitz, David %A Jungreis, Charles %A Hirsch, Calvin H %A O'Leary, Daniel H %A Furberg, Curt D %K Aged %K Brain %K Cardiovascular Diseases %K Cognition Disorders %K Female %K Humans %K Incidence %K Leukoaraiosis %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI) scans in the elderly commonly show white matter findings that may raise concerns. We sought to document incidence, manifestations, and predictors of worsening white matter grade on serial imaging.

METHODS: The Cardiovascular Health Study is a population-based, longitudinal study of 5888 people aged 65 years and older, of whom 1919 have had extensive initial and follow-up evaluations, including 2 MRI scans separated by 5 years. Scans were read without clinical information in standard side-by-side fashion to determine worsening white matter grade.

RESULTS: Worsening was evident in 538 participants (28%), mostly (85%) by 1 grade. Although similar at initial scan, participants with worsening white matter grade, compared with those without, experienced greater decline on modified Mini-Mental State examination and Digit-Symbol Substitution test (both P< or =0.001) after controlling for potential confounding factors, including occurrence of transient ischemic attack or stroke between scans. Independent predictors of worsening white matter grade included cigarette smoking before initial scan and infarct on initial scan. Otherwise, predictors differed according to white matter grade on initial scan. For low initial grade, increased age, increased diastolic blood pressure, increased high-density lipoprotein cholesterol, and decreased low-density lipoprotein cholesterol were associated with increased risk of worsening. For high initial grade, any cardiovascular disease and low ankle-arm index were associated with decreased risk of worsening, whereas use of diuretics and statins were associated with increased risk.

CONCLUSIONS: Worsening white matter grade on serial MRI scans in elderly is common, is associated with cognitive decline, and has complex relations with cardiovascular risk factors.

%B Stroke %V 36 %P 56-61 %8 2005 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/15569873?dopt=Abstract %R 10.1161/01.STR.0000149625.99732.69 %0 Journal Article %J Neuroepidemiology %D 2005 %T Morphometric analysis of gray matter volume in demented older adults: exploratory analysis of the cardiovascular health study brain MRI database. %A Rosano, C %A Becker, J %A Lopez, O %A Lopez-Garcia, P %A Carter, C S %A Newman, A %A Kuller, L %A Aizenstein, H %K Aged %K Aged, 80 and over %K Brain %K Dementia %K Educational Status %K Feasibility Studies %K Female %K Health Status %K Humans %K Image Processing, Computer-Assisted %K Magnetic Resonance Imaging %K Organ Size %K Reproducibility of Results %X

We tested the feasibility of a fully automated brain MRI voxel count technique--automated labeling pathway (ALP)--in a sample of 15 demented and 13 cognitively normal women (age 75-85 years) participating to the Cardiovascular Health Study (CHS). We hypothesized that ALP would replicate well-established findings of the anatomical correlates of dementia. In particular, we hypothesized that ALP volumetric measures would: (1) significantly differ between cognitively normal and demented women in those brain areas that are established markers for diagnosis of dementia (temporal and medial temporal lobes, hippocampus, amygdala and parahippocampus) but not in other brain areas (e.g., occipital lobe, visual cortex, motor cortex) and (2) correlate with visual ratings of brain disease which have been previously collected as part of the CHS. ALP required minimal operator intervention (input of brain images and verification of misalignments) and employed computer time of about 1 h per brain. ALP detected significant focal volumetric differences in the limbic system (p values between groups for hippocampus and parahippocampus: 0.002 and 0.005, respectively), temporal lobe (p < 0.0001) and caudate (p = 0.009), but not in other brain areas (e.g. occipital lobe, visual or motor cortex). Furthermore, ALP measures of medial temporal lobe atrophy strongly correlated with CHS visual ratings of ventricular enlargement (r(2) = 0.6, p = 0.002 for medial temporal lobe). In conclusion, ALP-detected focal brain atrophy was strongly associated with dementia. Because of its fully automated design, ALP technique is an ideal candidate to assess whether volumetric measures of specific areas can discriminate dementia better than currently available measures of global brain atrophy in large epidemiological studies.

%B Neuroepidemiology %V 24 %P 221-9 %8 2005 %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15832060?dopt=Abstract %R 10.1159/000085140 %0 Journal Article %J Am J Epidemiol %D 2005 %T Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. %A Podewils, Laura Jean %A Guallar, Eliseo %A Kuller, Lewis H %A Fried, Linda P %A Lopez, Oscar L %A Carlson, Michelle %A Lyketsos, Constantine G %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Apolipoproteins E %K Dementia %K Dementia, Vascular %K Female %K Genotype %K Humans %K Male %K Motor Activity %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K United States %X

Physical activity may help preserve cognitive function and decrease dementia risk, but epidemiologic findings are inconsistent. The authors conducted a prospective study to determine the association between physical activity and risk of dementia, Alzheimer's disease, and vascular dementia. The US study population comprised 3,375 men and women aged 65 years or older, free of dementia at baseline, who participated in the Cardiovascular Health Cognition Study in 1992-2000. Leisure-time energy expenditure and an activity index reflecting number of different physical activities were calculated. Analyses were based on Cox proportional hazards models. There were 480 incident cases of dementia over an average of 5.4 years of follow-up. After multivariate adjustment, participants in the highest quartile of physical energy expenditure had a relative risk of dementia of 0.85 (95% confidence interval: 0.61, 1.19) compared with those in the lowest quartile, and participants engaging in >or=4 activities had a relative risk of dementia of 0.51 (95% confidence interval: 0.33, 0.79) compared with those engaging in 0-1 activity. These associations were more marked in apolipoprotein E genotype (APOE) epsilon4 allele noncarriers but were absent in carriers. A similar pattern was observed for Alzheimer's disease and vascular dementia. Mechanisms to explain the observed relations deserve further study.

%B Am J Epidemiol %V 161 %P 639-51 %8 2005 Apr 01 %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/15781953?dopt=Abstract %R 10.1093/aje/kwi092 %0 Journal Article %J Am J Hum Genet %D 2005 %T Population structure, admixture, and aging-related phenotypes in African American adults: the Cardiovascular Health Study. %A Reiner, Alexander P %A Ziv, Elad %A Lind, Denise L %A Nievergelt, Caroline M %A Schork, Nicholas J %A Cummings, Steven R %A Phong, Angie %A Burchard, Esteban González %A Harris, Tamara B %A Psaty, Bruce M %A Kwok, Pui-Yan %K African Americans %K Aged %K Aging %K Algorithms %K Cardiovascular Diseases %K Cohort Studies %K Female %K Genetics, Population %K Genotype %K Humans %K Male %K Models, Genetic %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Risk Factors %K Socioeconomic Factors %X

U.S. populations are genetically admixed, but surprisingly little empirical data exists documenting the impact of such heterogeneity on type I and type II error in genetic-association studies of unrelated individuals. By applying several complementary analytical techniques, we characterize genetic background heterogeneity among 810 self-identified African American subjects sampled as part of a multisite cohort study of cardiovascular disease in older adults. On the basis of the typing of 24 ancestry-informative biallelic single-nucleotide-polymorphism markers, there was evidence of substantial population substructure and admixture. We used an allele-sharing-based clustering algorithm to infer evidence for four genetically distinct subpopulations. Using multivariable regression models, we demonstrate the complex interplay of genetic and socioeconomic factors on quantitative phenotypes related to cardiovascular disease and aging. Blood glucose level correlated with individual African ancestry, whereas body mass index was associated more strongly with genetic similarity. Blood pressure, HDL cholesterol level, C-reactive protein level, and carotid wall thickness were not associated with genetic background. Blood pressure and HDL cholesterol level varied by geographic site, whereas C-reactive protein level differed by occupation. Both ancestry and genetic similarity predicted the number and quality of years lived during follow-up, but socioeconomic factors largely accounted for these associations. When the 24 genetic markers were tested individually, there were an excess number of marker-trait associations, most of which were attenuated by adjustment for genetic ancestry. We conclude that the genetic demography underlying older individuals who self identify as African American is complex, and that controlling for both genetic admixture and socioeconomic characteristics will be required in assessing genetic associations with chronic-disease-related traits in African Americans. Complementary methods that identify discrete subgroups on the basis of genetic similarity may help to further characterize the complex biodemographic structure of human populations.

%B Am J Hum Genet %V 76 %P 463-77 %8 2005 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/15660291?dopt=Abstract %R 10.1086/428654 %0 Journal Article %J Cancer %D 2005 %T Prostate carcinoma incidence in relation to prediagnostic circulating levels of insulin-like growth factor I, insulin-like growth factor binding protein 3, and insulin. %A Chen, Chu %A Lewis, S Kay %A Voigt, Lynda %A Fitzpatrick, Annette %A Plymate, Stephen R %A Weiss, Noel S %K Aged %K Aged, 80 and over %K Carcinoma %K Case-Control Studies %K Humans %K Hypoglycemic Agents %K Incidence %K Insulin %K Insulin-Like Growth Factor Binding Protein 3 %K Insulin-Like Growth Factor I %K Male %K Prostatic Neoplasms %K Risk Factors %X

BACKGROUND: There have been several epidemiologic studies investigating the association between circulating levels of insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP-3), and insulin in relation to the risk of prostate carcinoma, with conflicting results. To examine this issue further, the authors conducted a nested case-control study within the Cardiovascular Health Study cohort.

METHODS: In men who were diagnosed with prostate carcinoma (cases) between 1990 and 1999 (n=174), the levels of IGF-I, IGFBP-3, and insulin were measured on blood samples that were obtained 1-9 years prior to diagnosis (mean, 3.4 years). Similar measurements were made on 174 male participants without prostate carcinoma (controls) who were matched to cases based on the year blood was drawn, survival until the date of diagnosis, race, and age.

RESULTS: Relative to the men with IGF-I levels in the first (lowest) quartile of the distribution, the risk of prostate carcinoma for men in the second, third, and fourth (upper) quartiles were 0.77 (95% confidence interval [95% CI], 0.43-1.38), 0.73 (95% CI, 0.41-1.30), and 0.67 (95% CI, 0.37-1.25), respectively. The results were influenced little by adjustment for levels of IGFBP-3 or, instead, by evaluating the molar IGF-I/IGFBP-3 ratio. An analysis that was restricted to men who had plasma prostate-specific antigen levels <4 ng/mL at the time of the blood draw yielded similar results. The corresponding relative risks for IGFBP-3 were 0.91 (95% CI, 0.49-1.68), 0.47 (95% CI, 0.25-0.94), and 0.65 (95% CI, 0.35-1.20), respectively. The distribution of serum insulin levels in cases and controls were nearly identical.

CONCLUSIONS: The IGF-I level was not associated positively with the risk of prostate carcinoma; however, an increase in the IGFBP-3 level was associated with a modest decrease in risk.

%B Cancer %V 103 %P 76-84 %8 2005 Jan 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/15540247?dopt=Abstract %R 10.1002/cncr.20727 %0 Journal Article %J Arch Neurol %D 2005 %T Statin use and the risk of incident dementia: the Cardiovascular Health Study. %A Rea, Thomas D %A Breitner, John C %A Psaty, Bruce M %A Fitzpatrick, Annette L %A Lopez, Oscar L %A Newman, Anne B %A Hazzard, William R %A Zandi, Peter P %A Burke, Gregory L %A Lyketsos, Constantine G %A Bernick, Charles %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cohort Studies %K Dementia %K Female %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Hyperlipidemias %K Male %X

BACKGROUND: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce cardiovascular risk through mechanisms that might affect the development of dementia.

OBJECTIVE: To evaluate whether statin use is associated with a lower risk of dementia compared with never use of lipid-lowering agents (LLAs).

DESIGN: Cohort study of community-dwelling adults 65 years and older. The analysis included 2798 participants free of dementia at baseline.

MAIN OUTCOME MEASURES: Using Cox proportional hazards regression analysis, we estimated the risk of incident all-cause and type-specific dementia associated with time-dependent statin therapy compared with never use of LLAs. The primary analyses incorporated a 1-year lag between exposure and outcome. Secondary analyses included the final year of exposure and modeled statin use as current use vs nonuse to simulate a case-control approach.

RESULTS: Compared with never use of LLAs, ever use of statins was not associated with the risk of all-cause dementia (multivariable-adjusted hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52), Alzheimer disease alone (HR, 1.21; 95% CI, 0.76-1.91), mixed Alzheimer disease and vascular dementia (HR, 0.87; 95% CI, 0.44-1.72), or vascular dementia alone (HR, 1.36; 95% CI, 0.61-3.06). In contrast, in secondary analyses, current use of statins compared with nonuse of LLAs was associated with HRs of 0.69 (95% CI, 0.46-1.02) for all-cause dementia and 0.56 (95% CI, 0.35-0.92) for any Alzheimer disease.

CONCLUSIONS: In this cohort study, statin therapy was not associated with a decreased risk of dementia. Methodological differences may explain why results of this cohort investigation differ from those of prior case-control studies. Additional investigation is needed to determine whether and for whom statin use may affect dementia risk.

%B Arch Neurol %V 62 %P 1047-51 %8 2005 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/16009757?dopt=Abstract %R 10.1001/archneur.62.7.1047 %0 Journal Article %J J Am Geriatr Soc %D 2005 %T Subclinical brain magnetic resonance imaging abnormalities predict physical functional decline in high-functioning older adults. %A Rosano, Caterina %A Kuller, Lewis H %A Chung, Hyoju %A Arnold, Alice M %A Longstreth, William T %A Newman, Anne B %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Brain %K Female %K Follow-Up Studies %K Gait %K Humans %K Incidence %K Magnetic Resonance Imaging %K Male %K Proportional Hazards Models %K Psychomotor Disorders %K Risk Factors %K United States %X

OBJECTIVES: To determine whether severity of subclinical brain magnetic resonance imaging (MRI) abnormalities predicts incident self-reported physical impairment or rate of decline in motor performance.

DESIGN: Longitudinal analysis, average follow-up time: 4.0 years.

SETTING: Cardiovascular Health Study (CHS).

PARTICIPANTS: CHS participants with modified Mini-Mental State Examination (3MS) score of 80 or greater, no self-reported disability, no history of stroke, and at least one assessment of mobility (n=2,450, mean age=74.4).

MEASUREMENTS: Brain MRI abnormalities (ventricular enlargement, white matter hyperintensities, subcortical and basal ganglia small brain infarcts), self-reported physical impairment (difficulty walking half a mile or with one or more activities of daily living), and motor performance (gait speed, timed chair stand).

RESULTS: After adjusting for demographics, cardiovascular risk factors, and diseases, risk of incident self-reported physical impairment was 35% greater for those with severe ventricular enlargement than for those with minimal ventricular enlargement, 22% greater for those with moderate white matter hyperintensities than for those with minimal white matter hyperintensities, and 26% greater for participants with at least one brain infarct than for those with no infarcts. Those with moderate to severe brain abnormalities experienced faster gait speed decline (0.02 m/s per year) than those with no MRI abnormalities (0.01 m/s per year). Further adjustment for incident stroke, incident dementia, and 3MS score did not substantially attenuate hazard ratios for incident self-reported physical impairment or coefficients for decline in gait speed.

CONCLUSION: Subclinical structural brain abnormalities in high-functioning older adults can increase the risk of developing physical disabilities and declining in motor performance.

%B J Am Geriatr Soc %V 53 %P 649-54 %8 2005 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/15817012?dopt=Abstract %R 10.1111/j.1532-5415.2005.53214.x %0 Journal Article %J J Neurol Sci %D 2005 %T Survival following dementia onset: Alzheimer's disease and vascular dementia. %A Fitzpatrick, Annette L %A Kuller, Lewis H %A Lopez, Oscar L %A Kawas, Claudia H %A Jagust, William %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Brain %K Capillaries %K Cerebral Amyloid Angiopathy %K Cerebrovascular Circulation %K Cerebrovascular Disorders %K Female %K Frontal Lobe %K Humans %K Male %K Middle Aged %K Prospective Studies %X

Survival following the onset of dementia has been reported to vary from 3 to over 9 years. We examined mortality in 3602 participants of the Cardiovascular Health (CHS) Cognition Study in four US communities evaluated for dementia incidence between 1992 and 1999 and followed for 6.5 years. By June 2000, 33 of 62 (53.2%) participants who developed vascular dementia (VaD) had died compared to 79 of 245 (32.2%) with Alzheimer's disease (AD), 66 of 151 (43.7%) with both AD and VaD, and 429 of 2318 (18.5%) with normal cognition. Using Cox proportional hazards regression with a time-dependent covariate for dementia status adjusted for age, gender and race, individuals with VaD were more than four times as likely to die during follow-up than those with normal cognition (HR: 4.4, 95% CI: 3.1-6.3). The hazard ratios were 2.1 (95% CI: 1.6-2.7) for AD and 2.5 (95% CI: 1.9-3.3) for both types. Adjusted accelerated life models estimated median survival from dementia onset to death as 3.9 years for those with VaD, 7.1 years for AD, 5.4 years for mixed dementia, and 11.0 years for matched controls with normal cognition. While persons with VaD died primarily from cerebrovascular disease, those with AD/mixed dementia died more frequently from dementia/failure to thrive.

%B J Neurol Sci %V 229-230 %P 43-9 %8 2005 Mar 15 %G eng %1 https://www.ncbi.nlm.nih.gov/pubmed/15760618?dopt=Abstract %R 10.1016/j.jns.2004.11.022 %0 Journal Article %J Neurology %D 2005 %T Vascular events, mortality, and preventive therapy following ischemic stroke in the elderly. %A Kaplan, R C %A Tirschwell, D L %A Longstreth, W T %A Manolio, T A %A Heckbert, S R %A Lefkowitz, D %A El-Saed, A %A Psaty, B M %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Anticoagulants %K Antihypertensive Agents %K Brain Ischemia %K Cohort Studies %K Comorbidity %K Coronary Artery Disease %K Drug Utilization %K Female %K Humans %K Hyperlipidemias %K Hypertension %K Hypolipidemic Agents %K Male %K Mortality %K Prospective Studies %K Recurrence %K Sex Factors %K Stroke %K Treatment Outcome %X

BACKGROUND: The authors studied mortality, vascular events, and preventive therapies following ischemic stroke among adults aged > or =65 years.

METHODS: The authors identified 546 subjects with first ischemic stroke during 1989 to 2001 among Cardiovascular Health Study participants. Deaths, recurrent strokes, and coronary heart disease (CHD) events were identified over 3.2 years (median) follow-up.

RESULTS: During the first year of follow-up, rates were 105.4/1,000 for recurrent stroke and 59.3/1,000 for CHD. After the first year, the stroke rate was 52.0/1,000 and the CHD rate was 46.5/1,000. Cardioembolic strokes had the highest mortality (185.4/1,000) and recurrence rates (86.6/1,000). Lacunar strokes had the lowest mortality (119.3/1,000) and recurrence rates (43.0/1,000). Age and male sex predicted death and CHD, but not recurrence. Outcomes did not differ by race. Following stroke, 47.8% used aspirin and 13.5% used other antiplatelet agents; 52.6% of patients with atrial fibrillation used warfarin; 31.3% of hyperlipidemic subjects, 57.0% of diabetic patients, and 81.5% of hypertensive patients were drug-treated; and 40.0% of hypertensive patients had blood pressure (BP) <140/90 mm Hg. Older subjects were less likely to use lipid-lowering therapy, women were less likely to have BP <140/90 mm Hg, and low-income subjects were less likely to use diabetes medications.

CONCLUSIONS: Recurrent strokes were nearly twice as frequent as coronary heart disease (CHD) events during the first year after initial stroke, but stroke and CHD rates were similar after the first year. Preventive drug therapies were underused, which may reflect clinical uncertainty due to the lack of clinical trials among the elderly. Utilization was lower among the oldest patients, women, and low-income individuals.

%B Neurology %V 65 %P 835-42 %8 2005 Sep 27 %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/16186519?dopt=Abstract %R 10.1212/01.wnl.0000176058.09848.bb %0 Journal Article %J J Am Geriatr Soc %D 2005 %T Weight loss, muscle strength, and angiotensin-converting enzyme inhibitors in older adults with congestive heart failure or hypertension. %A Schellenbaum, Gina D %A Smith, Nicholas L %A Heckbert, Susan R %A Lumley, Thomas %A Rea, Thomas D %A Furberg, Curt D %A Lyles, Mary F %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Angiotensin-Converting Enzyme Inhibitors %K Female %K Hand Strength %K Heart Failure %K Humans %K Hypertension %K Male %K Multivariate Analysis %K Outcome Assessment, Health Care %K Prospective Studies %K Statistics as Topic %K United States %K Weight Loss %X

OBJECTIVES: To determine whether angiotensin-converting enzyme (ACE) inhibitor use may be associated with weight maintenance and sustained muscle strength (measured by grip strength) in older adults.

DESIGN: Data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults, were used.

SETTING: Subjects were recruited from four U.S. sites beginning in 1989; this analysis included data through 2001.

PARTICIPANTS: CHS participants with congestive heart failure (CHF) or treated hypertension.

MEASUREMENTS: The exposure, current ACE inhibitor use, was ascertained by medication inventory at annual clinic visits; the outcomes were weight change and grip-strength change during the following year. Multivariate linear regression was used, accounting for correlations between observations on the same participant over time.

RESULTS: The average annual weight change was -0.38 kg in 2,834 participants (14,443 person-years) with treated hypertension and -0.62 kg in 342 participants (980 person-years) with CHF. ACE inhibitor use was associated with less annual weight loss after adjustment for potential confounders: a difference of 0.17 kg (95% confidence interval (CI)=0.05-0.29) in those with treated hypertension and 0.29 kg (95% CI=-0.25-0.83) in those with CHF. There was no evidence of association between ACE inhibitor use and grip-strength change.

CONCLUSION: ACE inhibitor use may be associated with weight maintenance, but not maintenance of muscle strength, in older adults with treated hypertension.

%B J Am Geriatr Soc %V 53 %P 1996-2000 %8 2005 Nov %G eng %N 11 %1 https://www.ncbi.nlm.nih.gov/pubmed/16274385?dopt=Abstract %R 10.1111/j.1532-5415.2005.53568.x %0 Journal Article %J J Am Geriatr Soc %D 2006 %T Alcohol consumption and risk of coronary heart disease in older adults: the Cardiovascular Health Study. %A Mukamal, Kenneth J %A Chung, Hyoju %A Jenny, Nancy S %A Kuller, Lewis H %A Longstreth, W T %A Mittleman, Murray A %A Burke, Gregory L %A Cushman, Mary %A Psaty, Bruce M %A Siscovick, David S %K Aged %K Alcohol Drinking %K Apolipoproteins E %K Beer %K Cohort Studies %K Coronary Disease %K Female %K Genotype %K Health Behavior %K Humans %K Incidence %K Male %K Residence Characteristics %K Risk Assessment %K Socioeconomic Factors %K United States %K Wine %X

OBJECTIVES: To evaluate several aspects of the relationship between alcohol use and coronary heart disease in older adults, including beverage type, mediating factors, and type of outcome.

DESIGN: Prospective cohort study.

SETTING: Four U.S. communities.

PARTICIPANTS: Four thousand four hundred ten adults aged 65 and older free of cardiovascular disease at baseline.

MEASUREMENTS: Risk of incident myocardial infarction or coronary death according to self-reported consumption of beer, wine, and spirits ascertained yearly.

RESULTS: During an average follow-up period of 9.2 years, 675 cases of incident myocardial infarction or coronary death occurred. Compared with long-term abstainers, multivariate relative risks of 0.90 (95% confidence interval (CI)=0.71-1.14), 0.93 (95% CI=0.73-1.20), 0.76 (95% CI=0.53-1.10), and 0.58 (95% CI=0.39-0.86) were found in consumers of less than one, one to six, seven to 13, and 14 or more drinks per week, respectively (P for trend=.007). Associations were similar for secondary coronary outcomes, including nonfatal and fatal events. No strong mediators of the association were identified, although fibrinogen appeared to account for 9% to 10% of the relationship. The associations were statistically similar for intake of wine, beer, and liquor and generally similar in subgroups, including those with and without an apolipoprotein E4 allele.

CONCLUSION: In this population, consumption of 14 or more drinks per week was associated with the lowest risk of coronary heart disease, although clinicians should not recommend moderate drinking to prevent coronary heart disease based on this evidence alone, because current National Institute on Alcohol Abuse and Alcoholism guidelines suggest that older adults limit alcohol intake to one drink per day.

%B J Am Geriatr Soc %V 54 %P 30-7 %8 2006 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/16420195?dopt=Abstract %R 10.1111/j.1532-5415.2005.00561.x %0 Journal Article %J Health Care Financ Rev %D 2006 %T Alcohol consumption in older adults and Medicare costs. %A Mukamal, Kenneth J %A Lumley, Thomas %A Luepker, Russell V %A Lapin, Pauline %A Mittleman, Murray A %A McBean, A Marshall %A Crum, Rosa M %A Siscovick, David S %K Aged %K Alcohol Drinking %K Cardiovascular Diseases %K Female %K Health Expenditures %K Hospitalization %K Humans %K Longitudinal Studies %K Male %K Medicare %K United States %X

We determined the relationship of alcohol consumption and Medicare costs among 4,392 participants in the Cardiovascular Health Study (CHS), a longitudinal, population-based cohort study of adults age 65 or over in four U.S. communities. We assessed 5-year Parts A and B costs and self-reported intake of beer, wine, and liquor at baseline. Among both sexes, total costs were approximately $2,000 lower among consumers of > 1-6 drinks per week than abstainers. The lower costs associated with moderate drinking were most apparent among participants with cardiovascular disease (CVD) and for hospitalization costs for CVD among healthy participants. Former drinkers had the highest costs.

%B Health Care Financ Rev %V 27 %P 49-61 %8 2006 Spring %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/17290648?dopt=Abstract %0 Journal Article %J JAMA %D 2006 %T Association of polymorphisms in the CRP gene with circulating C-reactive protein levels and cardiovascular events. %A Lange, Leslie A %A Carlson, Christopher S %A Hindorff, Lucia A %A Lange, Ethan M %A Walston, Jeremy %A Durda, J Peter %A Cushman, Mary %A Bis, Joshua C %A Zeng, Donglin %A Lin, Danyu %A Kuller, Lewis H %A Nickerson, Deborah A %A Psaty, Bruce M %A Tracy, Russell P %A Reiner, Alexander P %K African Continental Ancestry Group %K Aged %K C-Reactive Protein %K Cardiovascular Diseases %K Carotid Arteries %K European Continental Ancestry Group %K Female %K Genotype %K Humans %K Male %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K Risk %K Stroke %K Tunica Intima %X

CONTEXT: C-reactive protein (CRP) is an inflammation protein that may play a role in the pathogenesis of cardiovascular disease (CVD).

OBJECTIVE: To assess whether polymorphisms in the CRP gene are associated with plasma CRP, carotid intima-media thickness (CIMT), and CVD events.

DESIGN, SETTING, AND PARTICIPANTS: In the prospective, population-based Cardiovascular Health Study, 4 tag single-nucleotide polymorphisms (SNPs) (1919A/T, 2667G/C, 3872G/A, 5237A/G) were genotyped in 3941 white (European American) participants and 5 tag SNPs (addition of 790A/T) were genotyped in 700 black (African American) participants, aged 65 years or older, all of whom were without myocardial infarction (MI) or stroke before study entry. Median follow-up was 13 years (1989-2003).

MAIN OUTCOME MEASURES: Baseline CIMT; occurrence of MI, stroke, and CVD mortality during follow-up.

RESULTS: In white participants, 461 incident MIs, 491 incident strokes, and 490 CVD-related deaths occurred; in black participants, 67 incident MIs, 78 incident strokes, and 75 CVD-related deaths occurred. The 1919T and 790T alleles were associated with higher CRP levels in white and black participants, respectively. The 3872A allele was associated with lower CRP levels in both populations, and the 2667C allele was associated with lower CRP levels in white participants only. There was no association between CIMT and any CRP gene polymorphism in either population. In white participants, the 1919T allele was associated with increased risk of stroke for TT vs AA (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.06-1.87) and for CVD mortality (HR, 1.40; 95% CI, 1.10-1.90). In black participants, homozygosity for the 790T allele was associated with a 4-fold increased risk of MI compared with homozygosity for the 790A allele (95% CI, 1.58-10.53). The minor alleles of the 2 SNPs associated with lower plasma CRP concentration in white participants (2667C and 3872A) were associated with decreased risk of CVD mortality.

CONCLUSIONS: Genetic variation in the CRP gene is associated with plasma CRP levels and CVD risk in older adults.

%B JAMA %V 296 %P 2703-11 %8 2006 Dec 13 %G eng %N 22 %1 https://www.ncbi.nlm.nih.gov/pubmed/17164456?dopt=Abstract %R 10.1001/jama.296.22.2703 %0 Journal Article %J Circulation %D 2006 %T Beta2-adrenergic receptor genetic variants and risk of sudden cardiac death. %A Sotoodehnia, Nona %A Siscovick, David S %A Vatta, Matteo %A Psaty, Bruce M %A Tracy, Russell P %A Towbin, Jeffrey A %A Lemaitre, Rozenn N %A Rea, Thomas D %A Durda, J Peter %A Chang, Joel M %A Lumley, Thomas S %A Kuller, Lewis H %A Burke, Gregory L %A Heckbert, Susan R %K African Continental Ancestry Group %K Aged %K Case-Control Studies %K Death, Sudden, Cardiac %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Predisposition to Disease %K Genetic Variation %K Glutamine %K Haplotypes %K Homozygote %K Humans %K Male %K Polymorphism, Single Nucleotide %K Receptors, Adrenergic, beta-2 %K Reproducibility of Results %X

BACKGROUND: Sympathetic activation influences the risk of ventricular arrhythmias and sudden cardiac death (SCD), mediated in part by the beta2-adrenergic receptor (B2AR). We investigated whether variation in the B2AR gene is associated with SCD risk.

METHODS AND RESULTS: In this study, 4441 white and 808 black Cardiovascular Health Study (CHS) participants were followed up prospectively for SCD and genotyped for B2AR Gly16Arg and Gln27Glu polymorphisms. The study was replicated in 155 case and 144 control white subjects in a population-based case-control study of SCD, the Cardiac Arrest Blood Study (CABS). In CHS, Gly16 and Gln27 allele frequencies were 62.4% and 57.1% among white and 50.1% and 81.4% among black participants. Over a median follow-up of 11.1 years, 156 and 39 SCD events occurred in white and black participants, respectively. The Gln27Glu variant was associated with SCD risk (P=0.008 for general model). SCD risk was higher in Gln27 homozygous participants than in Glu27 carriers (ethnicity-adjusted hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.17 to 2.09; P=0.003). The increased risk did not differ significantly between white (HR, 1.62; 95% CI, 1.18 to 2.23) and black (HR, 1.23; 95% CI, 0.61 to 2.48) participants, although the confidence interval was wide in blacks. In the CABS replication study, Gln27 homozygous participants similarly had higher SCD risk than Glu27 carriers (odds ratio, 1.64; 95% CI, 1.02 to 2.63; P=0.040). Gly16Arg was not associated with SCD risk in either study.

CONCLUSIONS: Gln27 homozygous individuals have an increased risk of SCD in 2 study populations. Our findings suggest that B2AR plays a role in SCD in humans. Study of genetic variation within the B2AR gene may help identify those at increased SCD risk.

%B Circulation %V 113 %P 1842-8 %8 2006 Apr 18 %G eng %N 15 %1 https://www.ncbi.nlm.nih.gov/pubmed/16618831?dopt=Abstract %R 10.1161/CIRCULATIONAHA.105.582833 %0 Journal Article %J J Am Geriatr Soc %D 2006 %T Blood pressure level and outcomes in adults aged 65 and older with prior ischemic stroke. %A Kaplan, Robert C %A Tirschwell, David L %A Longstreth, W T %A Manolio, Teri A %A Heckbert, Susan R %A LeValley, Aaron J %A Lefkowitz, David %A El-Saed, Aiman %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Blood Pressure %K Brain Ischemia %K Female %K Follow-Up Studies %K Humans %K Male %K Outcome Assessment, Health Care %K Prospective Studies %K Recurrence %K Stroke %K Survival Rate %X

OBJECTIVES: To examine the association between blood pressure (BP) levels and long-term stroke outcomes in elderly stroke survivors.

DESIGN: Observational study.

SETTING: The Cardiovascular Health Study (CHS) of 5,888 community-dwelling adults.

PARTICIPANTS: Two hundred fifty-four adults aged 65 and older (mean age 78.6) who sustained a nonfatal first ischemic stroke.

MEASUREMENTS: BP levels assessed at prestroke and poststroke CHS visits were examined as predictors of stroke recurrence, coronary heart disease (CHD), combined vascular events (CVEs), and mortality.

RESULTS: Higher poststroke BP level, assessed 261.6 days (mean) after stroke, was associated with higher risk of stroke recurrence over 5.4 years (mean) of follow-up. The multivariate-adjusted hazard ratio for stroke recurrence was 1.42 (95% confidence interval (CI) = 1.03-1.99) per standard deviation (SD) of systolic BP (P = .04) and 1.39 (95% CI = 1.01-1.91) per SD of diastolic BP (P = .04). Mortality was significantly greater in patients with low or high poststroke BP than in those with intermediate BP. Poststroke BP was not associated with risk of CHD or CVE, although further analyses suggested that high systolic BP predicted CHD and CVE in younger but not older subjects. Prestroke BP did not predict poststroke outcomes.

CONCLUSION: In this observational study of adults aged 65 and older assessed approximately 8 months after stroke, low BP was associated with favorable risk of recurrent stroke, although high and low poststroke BP levels were associated with greater mortality. Long-term antihypertensive trials in older stroke survivors would increase knowledge about the benefits of lowering BP in this population.

%B J Am Geriatr Soc %V 54 %P 1309-16 %8 2006 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16970636?dopt=Abstract %R 10.1111/j.1532-5415.2006.00838.x %0 Journal Article %J Am J Cardiol %D 2006 %T Cardiovascular morbidity and mortality in community-dwelling elderly individuals with calcification of the fibrous skeleton of the base of the heart and aortosclerosis (The Cardiovascular Health Study). %A Barasch, Eddy %A Gottdiener, John S %A Marino Larsen, Emily K %A Chaves, Paulo H M %A Newman, Anne B %K Aged %K Aortic Valve %K Calcinosis %K Echocardiography %K Female %K Follow-Up Studies %K Heart Failure %K Heart Valve Diseases %K Humans %K Male %K Mitral Valve %K Prospective Studies %K Risk Factors %K Sclerosis %K Severity of Illness Index %K United States %X

In the elderly, mitral annular calcification (MAC) and aortic valve sclerosis (AVS) are associated with increased cardiovascular morbidity and mortality. Aortic annular calcification (AAC) commonly occurs with MAC. However, the prognostic value of AAC, singly or in combination with MAC and AVS, for incident cardiovascular disease and mortality is unknown. From the Cardiovascular Health Study, we analyzed 3,782 participants (76 +/- 5 years of age, 60% women) who had an echocardiogram at the 1994 to 1995 examination and who were prospectively followed for an average of 6.6 years (range 0.01 to 8.5). All 3 calcification categories were associated with incident congestive heart failure (MAC: hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.35 to 2.18, AAC: HR 1.62, 95% CI 1.28 to 2.06, and AVS: HR 1.50, 95% CI 1.19 to 1.89) and death. A stronger association with incident cardiovascular disease and mortality was observed with a larger number of calcification categories and with increased MAC severity. Moreover, in the participants with prevalent cardiovascular disease at echocardiographic examination (n = 1,054), MAC and AAC were still associated with cardiovascular mortality (MAC: HR 1.91, 95% CI 1.04 to 3.50; AAC: HR 2.11, 95% CI 1.16 to 3.85) even in fully adjusted models. In conclusion, MAC, AAC, and AVS are associated with a significant risk of incident congestive heart failure, cardiovascular and all-cause mortalities, and worse outcome in older patients with preexisting cardiovascular disease. Elderly patients with these findings represent a high-risk group and may require close medical attention.

%B Am J Cardiol %V 97 %P 1281-6 %8 2006 May 01 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16635596?dopt=Abstract %R 10.1016/j.amjcard.2005.11.065 %0 Journal Article %J Am Heart J %D 2006 %T Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS). %A Barasch, Eddy %A Gottdiener, John S %A Larsen, Emily K Marino %A Chaves, Paulo H M %A Newman, Anne B %A Manolio, Teri A %K Aged %K Aortic Valve %K Calcinosis %K Female %K Heart Valve Diseases %K Humans %K Male %K Mitral Valve %K Prevalence %K Prospective Studies %K Risk Factors %K Sclerosis %K Ultrasonography %X

BACKGROUND: Mitral annular calcification (MAC), aortic annular calcification (AAC), and aortic valve sclerosis (AVS) are associated with aging, and MAC and AVS are markers of advanced atherosclerosis. No studies have examined the prevalence and the clinical relevance of all 3 forms of calcification in a single free-living elderly population.

METHODS: We used 2-dimensional echocardiography to evaluate MAC, AAC, AVS and all 3 combined in 3929 participants, mean age 76 +/- 5 years, 60% women, in the Cardiovascular Health Study, a prospective community-based observational study designed to assess cardiovascular disease (CVD) risk factors and outcomes in elderly persons.

RESULTS: Mitral annular calcification was found in 1640 (42 %) subjects, AAC in 1710 (44 %), AVS in 2114 (54 %), and all 3 combined in 662 (17 %). The participants with these findings were older than those without them, and those with MAC had worse cardiovascular, renal, metabolic, and functional profile than those with AAC and AVS. Age-, sex-, and race-adjusted logistic regression analysis found a significant association between the 3 calcification categories and CVD, the strongest being between the combined group with congestive heart failure (odds ratio 2.04, 95% CI 1.34-3.09). In highly adjusted models, only MAC was associated with CVD, and the strength of association was related to the severity of MAC.

CONCLUSIONS: In free-living elderly, MAC, AAC, and AVS are highly prevalent and are associated with CVD. Mitral annular calcification in particular has strong association with CVD, and with an adverse biomedical profile.

%B Am Heart J %V 151 %P 39-47 %8 2006 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/16368289?dopt=Abstract %R 10.1016/j.ahj.2005.03.052 %0 Journal Article %J Am J Cardiol %D 2006 %T Comparison of mortality risk for electrocardiographic abnormalities in men and women with and without coronary heart disease (from the Cardiovascular Health Study). %A Rautaharju, Pentti M %A Ge, Sijian %A Nelson, Jennifer C %A Marino Larsen, Emily K %A Psaty, Bruce M %A Furberg, Curt D %A Zhang, Zhu-Ming %A Robbins, John %A Gottdiener, John S %A Chaves, Paulo H M %K Aged %K Coronary Disease %K Electrocardiography %K Female %K Humans %K Male %K Risk %X

Mortality risk associated with electrocardiographic (ECG) abnormalities has been commonly reported to be lower in women than in men. We compared coronary heart disease (CHD) and all-cause mortality risk for ECG variables during a mean 9.1-year follow-up in 4,912 participants in the Cardiovascular Health Study who were > or = 65 years of age. The hypothesis was that mortality risk for ECG abnormalities is not lower in women than in men. Five ECG variables were significant mortality predictors in Cox regression models that were adjusted for demographic, clinical, and medication variables. Gender differences were significant and mortality risk was higher in women for ECG estimates of left ventricular mass for both end points and for nondipolar QRS voltage for all-cause mortality. When evaluated simultaneously in multiple ECG variable risk models in subgroups that were stratified by baseline CHD status, no gender difference was significant. In the latter models, ST depression was a strong predictor of CHD mortality in groups with and without previous CHD. Other significant ECG predictors were previous myocardial infarction in the previous CHD group and nondipolar QRS voltage in the CHD-free group. Four ECG abnormalities were significant predictors of all-cause mortality in the CHD-free group, with risk increases of 18% to 50%. The risk of all-cause mortality in the previous CHD group was significantly increased for ST depression (by 64%), the ECG estimate of left ventricular mass (by 48%), and previous myocardial infarction (by 34%). In conclusion, we found no evidence that the relative risk of mortality for ECG abnormalities is lower in women than in men.

%B Am J Cardiol %V 97 %P 309-15 %8 2006 Feb 01 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16442387?dopt=Abstract %R 10.1016/j.amjcard.2005.08.046 %0 Journal Article %J Ann Epidemiol %D 2006 %T Congestive heart failure incidence and prognosis: case identification using central adjudication versus hospital discharge diagnoses. %A Schellenbaum, Gina D %A Heckbert, Susan R %A Smith, Nicholas L %A Rea, Thomas D %A Lumley, Thomas %A Kitzman, Dalane W %A Roger, Veronique L %A Taylor, Herman A %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Cohort Studies %K Female %K Heart Failure %K Humans %K Incidence %K Male %K Patient Discharge %K Prognosis %X

PURPOSE: We compared hospitalized congestive heart failure (CHF) incidence and prognosis estimates using hospital discharge diagnoses or central adjudication.

METHODS: We used the Cardiovascular Health Study (CHS), a population-based cohort study of 5888 elderly adults. A physician committee adjudicated potential CHF events, confirmed by signs, symptoms, clinical tests, and/or medical therapy. A CHF discharge diagnosis included any of these ICD-9 codes in any position: 428, 425, 398.91, 402.01, 402.11, 402.91, and 997.1. We constructed an inception cohort of 1209 hospitalized, nonfatal, incident CHF cases, identified by discharge diagnosis, adjudication, or both.

RESULTS: Incidence rates for hospitalized CHF were 24.6 per 1000 person-years using discharge diagnoses and 17.1 per 1000 person-years using central adjudication. Compared to the group identified as having CHF by both methods, the group with only a discharge diagnosis (hazard ratio=0.77, 95% confidence interval=0.65-0.91) and the group with central adjudication only (hazard ratio=0.72, 95% confidence interval=0.55-0.94) had lower mortality rates.

CONCLUSIONS: In the elderly, studies using only discharge diagnoses, as compared to central adjudication, may estimate higher rates of incident hospitalized CHF. Mortality following CHF onset may be similar for these methods and higher if both methods are used together.

%B Ann Epidemiol %V 16 %P 115-22 %8 2006 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/15964203?dopt=Abstract %R 10.1016/j.annepidem.2005.02.012 %0 Journal Article %J Arch Intern Med %D 2006 %T Costs for heart failure with normal vs reduced ejection fraction. %A Liao, Lawrence %A Jollis, James G %A Anstrom, Kevin J %A Whellan, David J %A Kitzman, Dalane W %A Aurigemma, Gerard P %A Mark, Daniel B %A Schulman, Kevin A %A Gottdiener, John S %K Aged %K Aged, 80 and over %K Comorbidity %K Echocardiography %K Health Care Costs %K Heart Failure %K Humans %K Incidence %K Medicare %K Prevalence %K Prospective Studies %K Regression Analysis %K Statistics, Nonparametric %K Stroke Volume %K Systole %K United States %K Ventricular Function, Left %X

BACKGROUND: Among the elderly population, heart failure (HF) with normal ejection fraction (EF) is more common than classic HF with low EF. However, there are few data regarding the costs of HF with normal EF. In a prospective, population-based cohort of elderly participants, we compared the costs and resource use of patients with HF and normal and reduced EF.

METHODS: A total of 4549 participants (84.5% white; 40.6% male) in the National Heart, Lung, and Blood Institute Cardiovascular Health Study were linked to Medicare claims from 1992 through 1998. By protocol echo examinations or clinical EF assessments, 881 participants with HF were characterized as having abnormal or normal EF. We applied semiparametric estimators to calculate mean costs per subject for a 5-year period.

RESULTS: There were 495 HF participants with normal EF (186 prevalent at study entry and 309 incident during the study period) and 386 participants with abnormal EF (166 prevalent and 220 incident). Participants with abnormal EF had more cardiology encounters and cardiac procedures. However, compared with abnormal EF participants, the 5-year costs for normal EF participants were similar in both the prevalent ($33,023 with abnormal EF and $32,580 with normal EF; P=.93) and incident ($49,128 with abnormal EF and $45,604 with normal EF; P=.55) groups. In models accounting for comorbid conditions, the costs with normal and abnormal EF remained similar.

CONCLUSIONS: Over a 5-year period, patients with HF and normal EF consume as many health care resources as those with reduced EF. These data highlight the substantial financial burden of HF with normal EF among the elderly population.

%B Arch Intern Med %V 166 %P 112-8 %8 2006 Jan 09 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/16401819?dopt=Abstract %R 10.1001/archinte.166.1.112 %0 Journal Article %J Arch Gen Psychiatry %D 2006 %T Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study. %A Barnes, Deborah E %A Alexopoulos, George S %A Lopez, Oscar L %A Williamson, Jeff D %A Yaffe, Kristine %K Aged %K Cerebrovascular Disorders %K Cognition Disorders %K Comorbidity %K Dementia %K Dementia, Vascular %K Depressive Disorder %K Female %K Follow-Up Studies %K Geriatric Assessment %K Humans %K Longitudinal Studies %K Male %K Prospective Studies %K Psychiatric Status Rating Scales %K Risk Factors %K Sampling Studies %K Vascular Diseases %X

CONTEXT: Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons.

OBJECTIVES: To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease.

DESIGN: Prospective, population-based, longitudinal study.

SETTING: Random sample of adults 65 years or older recruited from 4 US communities.

PARTICIPANTS: Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>/=8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria.

MAIN OUTCOME MEASURE: Diagnosis of MCI.

RESULTS: Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics.

CONCLUSION: Depressive symptoms were associated with increased risk of MCI, and this association was independent of underlying vascular disease.

%B Arch Gen Psychiatry %V 63 %P 273-9 %8 2006 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16520432?dopt=Abstract %R 10.1001/archpsyc.63.3.273 %0 Journal Article %J Neurology %D 2006 %T Education and the cognitive decline associated with MRI-defined brain infarct. %A Elkins, J S %A Longstreth, W T %A Manolio, T A %A Newman, A B %A Bhadelia, R A %A Johnston, S C %K Cerebral Infarction %K Cognition Disorders %K Cross-Sectional Studies %K Educational Status %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Neuropsychological Tests %X

OBJECTIVE: To assess whether educational attainment, a correlate of cognitive reserve, predicts the amount of cognitive decline associated with a new brain infarct.

METHODS: The Cardiovascular Health Study is a population-based, longitudinal study of people aged 65 years and older. Cognitive function was measured annually using the Modified Mini-Mental State Examination (3MS) and the Digit-Symbol Substitution Test (DSST). The authors tested whether education level modified 1) the cross-sectional association between cognitive performance and MRI-defined infarct and 2) the change in cognitive function associated with an incident infarct at a follow-up MRI.

RESULTS: In cross-sectional analysis (n = 3,660), MRI-defined infarct was associated with a greater impact on 3MS performance in the lowest education quartile when compared with others (p for heterogeneity = 0.012). Among those with a follow-up MRI who had no infarct on initial MRI (n = 1,433), education level was not associated with the incidence, size, or location of new brain infarct. However, a new MRI-defined infarct predicted substantially greater decline in 3MS scores in the lowest education group compared with the others (6.3, 95% CI 4.4- to 8.2-point decline vs 1.7, 95% CI 0.7- to 2.7-point decline; p for heterogeneity < 0.001). Higher education was not associated with smaller declines in DSST performance in the setting of MRI-defined infarct.

CONCLUSIONS: Education seems to modify an individual's decline on a test of general cognitive function when there is incident brain infarct. These findings are consistent with the hypothesis that cognitive reserve influences the impact of vascular injury in the brain.

%B Neurology %V 67 %P 435-40 %8 2006 Aug 08 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16894104?dopt=Abstract %R 10.1212/01.wnl.0000228246.89109.98 %0 Journal Article %J Stroke %D 2006 %T Factors associated with geographic variations in stroke incidence among older populations in four US communities. %A El-Saed, Aiman %A Kuller, Lewis H %A Newman, Anne B %A Lopez, Oscar %A Costantino, Joseph %A McTigue, Kathleen %A Cushman, Mary %A Kronmal, Richard %K Aged %K Brain %K California %K Female %K Humans %K Incidence %K Magnetic Resonance Imaging %K Male %K Maryland %K North Carolina %K Pennsylvania %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: In the Cardiovascular Health Study (CHS), we previously observed lower stroke incidence in Allegheny County, PA compared with the other 3 study sites. The purpose of this study was to study possible reasons for the lower stroke incidence in Allegheny County.

METHODS: CHS participants 65 years or older who were stroke-free at baseline (n=5639) were followed between 1989 to 1990 and 2000 for the development of stroke. Risk factors at baseline and their subsequent control were compared among both groups. Site-specific hazard ratios for stroke incidence were calculated using Cox regression models.

RESULTS: The unadjusted hazard ratio for total stroke incidence in Forsyth County, NC; Sacramento County, CA; and Washington County, MD combined compared with Allegheny County, PA was 1.74 (95% CI: 1.42, 2.14). After adjustment for age and other traditional risk factors, there was modest reduction of the excess hazard in non-Allegheny sites compared with Allegheny County (hazard ratio=1.52, 95% CI: 1.17, 1.98). Between baseline and the seventh-year visits, control of hypertension, diabetes, lipids, smoking, atrial fibrillation and transient ischemic attack were similar across sites. White matter grade > or = 3 on the baseline brain MRI was less common in Allegheny County (25.8% versus 36.3%, respectively; P<0.001) and accounted for 25% of the excess hazard in non-Allegheny sites compared with Allegheny County.

CONCLUSIONS: Site differences in stroke risk factors at baseline and subsequent control only partially explain site differences in stroke incidence. White matter grade as a possible integrated measure of exposure and control of risk factors may help in explaining geographic variations in stroke incidence.

%B Stroke %V 37 %P 1980-5 %8 2006 Aug %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/16794204?dopt=Abstract %R 10.1161/01.STR.0000231454.77745.d9 %0 Journal Article %J Stroke %D 2006 %T Geographic variations in stroke incidence and mortality among older populations in four US communities. %A El-Saed, Aiman %A Kuller, Lewis H %A Newman, Anne B %A Lopez, Oscar %A Costantino, Joseph %A McTigue, Kathleen %A Cushman, Mary %A Kronmal, Richard %K Aged %K Aged, 80 and over %K California %K Female %K Humans %K Incidence %K Male %K Maryland %K North Carolina %K Pennsylvania %K Stroke %X

BACKGROUND AND PURPOSE: Stroke is a leading cause of death and disability in the US. There is limited data on geographic variations in stroke incidence among older US populations who experience the majority of stroke burden. The purpose of this study was to compare stroke incidence and mortality rates in 4 US communities.

METHODS: Participants in the Cardiovascular Health Study (CHS) who had no history of stroke at baseline (n=5639) were followed for 10 or 7 years in predominantly white (n=5002) and black (n=637) participants, respectively. Incident stroke was validated by a stroke adjudication committee after ascertainment at annual visits, interim telephone contacts, and review of Medicare hospitalization data.

RESULTS: The 2000 US population age and sex standardized total stroke incidence rate for all CHS participants was 17.7 per 1000 person-years (95% CI: 15.9, 19.5). The rate was significantly lower in Allegheny County, Pennsylvania 9.6/1000 person-years (95% CI: 7.7, 11.5) than Forsyth County, North Carolina 19.2/1000 person-years (95% CI: 15.6, 22.8), Sacramento County, California 20.7/1000 person-years (95% CI: 16.9, 24.5), and Washington County, Maryland 19.8/1000 person-years (95% CI: 16.1, 23.5). The lower stroke incidence rate in Allegheny County was consistent in gender, race, and age groups. Though not statistically significant, stroke mortality was also lower in Allegheny County than other 3 sites. The 1-month case fatality rate was similar in the 4 sites for all strokes, and by stroke types.

CONCLUSIONS: Understanding geographic variations in stroke incidence may be an important step in improving preventive practices of stroke.

%B Stroke %V 37 %P 1975-9 %8 2006 Aug %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/16794205?dopt=Abstract %R 10.1161/01.STR.0000231453.98473.67 %0 Journal Article %J J Neurol Neurosurg Psychiatry %D 2006 %T Neuropsychological characteristics of mild cognitive impairment subgroups. %A Lopez, O L %A Becker, J T %A Jagust, W J %A Fitzpatrick, A %A Carlson, M C %A DeKosky, S T %A Breitner, J %A Lyketsos, C G %A Jones, B %A Kawas, C %A Kuller, L H %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Amnesia %K Cognition Disorders %K Female %K Humans %K Male %K Neuropsychological Tests %K Psychometrics %K Reference Values %X

OBJECTIVE: To describe the neuropsychological characteristics of mild cognitive impairment (MCI) subgroups identified in the Cardiovascular Health Study (CHS) cognition study.

METHODS: MCI was classified as MCI-amnestic type (MCI-AT): patients with documented memory deficits but otherwise normal cognitive function; and MCI-multiple cognitive deficits type (MCI-MCDT): impairment of at least one cognitive domain (not including memory), or one abnormal test in at least two other domains, but who had not crossed the dementia threshold. The MCI subjects did not have systemic, neurological, or psychiatric disorders likely to affect cognition.

RESULTS: MCI-AT (n = 10) had worse verbal and non-verbal memory performance than MCI-MCDT (n = 28) or normal controls (n = 374). By contrast, MCI-MCDT had worse language, psychomotor speed, fine motor control, and visuoconstructional function than MCI-AT or normal controls. MCI-MCDT subjects had memory deficits, though they were less pronounced than in MCI-AT. Of the MCI-MCDT cases, 22 (78.5%) had memory deficits, and 6 (21.5%) did not. MCI-MCDT with memory disorders had more language deficits than MCI-MCDT without memory disorders. By contrast, MCI-MCDT without memory deficits had more fine motor control deficits than MCI-MCDT with memory deficits.

CONCLUSIONS: The most frequent form of MCI was the MCI-MCDT with memory deficits. However, the identification of memory impaired MCI groups did not reflect the true prevalence of MCI in a population, as 16% of all MCI cases and 21.5% of the MCI-MCDT cases did not have memory impairment. Study of idiopathic amnestic and non-amnestic forms of MCI is essential for an understanding of the aetiology of MCI.

%B J Neurol Neurosurg Psychiatry %V 77 %P 159-65 %8 2006 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/16103044?dopt=Abstract %R 10.1136/jnnp.2004.045567 %0 Journal Article %J Diabetes Care %D 2006 %T New-onset diabetes and risk of all-cause and cardiovascular mortality: the Cardiovascular Health Study. %A Smith, Nicholas L %A Barzilay, Joshua I %A Kronmal, Richard %A Lumley, Thomas %A Enquobahrie, Daniel %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Atherosclerosis %K Blood Glucose %K Cardiovascular Diseases %K Diabetes Complications %K Diabetes Mellitus %K Follow-Up Studies %K Humans %K Kaplan-Meier Estimate %K Risk Factors %K Survival Rate %K Time Factors %X

OBJECTIVE: Cardiovascular risk associated with new-onset diabetes is not well characterized. We hypothesized that risk of all-cause and cardiovascular mortality would be similar among participants with and without new-onset diabetes in the first years of follow-up and rise over time for new-onset diabetes.

RESEARCH DESIGN AND METHODS: The Cardiovascular Health Study (CHS) is a longitudinal study of cardiovascular risk factors in adults aged > or =65 years. We used CHS participants to define a cohort (n = 282) with new-onset diabetes during 11 years of follow-up. New-onset diabetes was defined by initiation of antidiabetes medication or by fasting plasma glucose >125 mg/dl among CHS participants without diabetes at study entry. Three CHS participants without diabetes were matched for age, sex, and race to each participant with new-onset diabetes at the time of diabetes identification (n = 837). Survival analysis provided adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality.

RESULTS: During a median of 5.9 years of follow-up, there were 352 deaths, of which 41% were cardiovascular. In adjusted analyses, new-onset diabetes was associated with an HR of 1.9 (95% CI 1.4-2.5) for all-cause and 2.2 (1.4-3.4) for cardiovascular mortality compared with no diabetes. Mortality risks were elevated within 2 years of onset, especially cardiovascular risk (4.3 [95% CI 1.7-10.8]), and did not increase over time.

CONCLUSIONS: Our findings indicate that there may be a mortality differential soon after diabetes onset in older adults and suggest that long-term macrovascular damage from atherosclerosis may not be primarily responsible for increased risk.

%B Diabetes Care %V 29 %P 2012-7 %8 2006 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16936145?dopt=Abstract %R 10.2337/dc06-0574 %0 Journal Article %J Sleep %D 2006 %T Obstructive sleep apnea and plasma natriuretic peptide levels in a community-based sample. %A Patwardhan, Anjali A %A Larson, Martin G %A Levy, Daniel %A Benjamin, Emelia J %A Leip, Eric P %A Keyes, Michelle J %A Wang, Thomas J %A Gottlieb, Daniel J %A Vasan, Ramachandran S %K Atrial Fibrillation %K Body Mass Index %K Cohort Studies %K Female %K Humans %K Hypertension %K Male %K Middle Aged %K Myocardial Infarction %K Natriuretic Peptides %K Obesity %K Polysomnography %K Prevalence %K Residence Characteristics %K Severity of Illness Index %K Sleep Apnea, Obstructive %X

STUDY OBJECTIVES: We hypothesized that alterations in cardiac hemodynamics associated with obstructive sleep apnea-hypopnea (OSAH) would be reflected in higher natriuretic peptide levels. We examined the association of OSAH with natriuretic peptides in a community-based sample.

DESIGN: Cross-sectional, retrospective, observational study.

SETTING: Framingham Heart Study Offspring Cohort and Sleep Heart Health Study.

PARTICIPANTS: Community-based sample of 623 individuals.

MEASUREMENTS: Full-montage home polysomnography was used to determine apnea-hypopnea index (AHI) and percentage of time with an oxyhemoglobin saturation < 90% (PctLt90). Sensitive immunoradiometric assays were used to measure plasma B-type (BNP) and N-terminal pro-atrial natriuretic peptide (NT-ANP). Multivariable regression was used to examine the relations between natriuretic peptides and indicators of OSAH, adjusting for age, sex, body mass index, and clinical covariates.

RESULTS: No statistically significant relations between OSAH indices and BNP were observed in the multivariable model. Compared with an AHI < 5, relative levels of 1.20, 0.88, and 0.91 were observed forAHI categories 5-15, 15-30, >30 events per hour, respectively. For NT-ANP, no significant relations were seen with AHI in the multivariable model (relative levels of 0.98, 0.91, and 0.90). An inverse association was observed between NT-ANP and PctLt90 in age- and sex-adjusted models (relative levels of 0.93, 0.87, and 0.80), although this association became statistically nonsignificant after adjusting for body mass index.

CONCLUSION: Lack of association of natriuretic peptides with OSAH indices suggests that undiagnosed OSAH may not be associated with major alterations in left ventricular function, as reflected in morning natriuretic peptide levels.

%B Sleep %V 29 %P 1301-6 %8 2006 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/17068983?dopt=Abstract %R 10.1093/sleep/29.10.1301 %0 Journal Article %J Circulation %D 2006 %T Plasma phospholipid trans fatty acids, fatal ischemic heart disease, and sudden cardiac death in older adults: the cardiovascular health study. %A Lemaitre, Rozenn N %A King, Irena B %A Mozaffarian, Dariush %A Sotoodehnia, Nona %A Rea, Thomas D %A Kuller, Lewis H %A Tracy, Russel P %A Siscovick, David S %K Aged %K Aged, 80 and over %K Biomarkers %K Case-Control Studies %K Coronary Disease %K Death, Sudden, Cardiac %K Female %K Humans %K Male %K Myocardial Ischemia %K Phospholipids %K Trans Fatty Acids %K United States %X

BACKGROUND: Intake of trans fatty acids is associated with increased risk of coronary heart disease. Whether different classes of trans fatty acids show similar associations is unclear. We previously reported an association of sudden cardiac death with red cell membrane trans-18:2 but not trans-18:1 fatty acids. To extend these findings, we investigated the associations of plasma phospholipid trans fatty acids with fatal ischemic heart disease (IHD) and sudden cardiac death.

METHODS AND RESULTS: We conducted a case-control study nested in the Cardiovascular Health Study. We identified 214 cases of fatal IHD (fatal myocardial infarction and coronary heart disease death) between 1992 and 1998. We randomly selected 214 controls, matched to cases on demographics, prevalent cardiovascular disease, and timing of blood draw. Plasma phospholipid fatty acids were assessed in blood samples collected earlier. Higher levels of plasma phospholipid trans-18:2 fatty acids were associated with higher risk of fatal IHD (odds ratio [OR] for interquintile range 1.68, 95% confidence interval [CI] 1.21 to 2.33) after adjustment for risk factors and trans-18:1 levels. Trans-18:1 levels above the 20th percentile were associated with lower risk (OR 0.34, 95% CI 0.18 to 0.63). In analyses limited to cases of sudden cardiac death (n=95), higher levels of trans-18:2 fatty acids were associated with higher risk (OR 2.34, 95% CI 1.27 to 4.31) and higher trans-18:1 with lower risk (OR 0.18, 95% CI 0.06 to 0.54).

CONCLUSIONS: Higher levels of trans-18:2 and lower levels of trans-18:1 fatty acids are associated with higher risks of fatal IHD and sudden cardiac death. If confirmed, these findings suggest that current efforts at decreasing trans fatty acid intake in foods should take into consideration the trans-18:2 content.

%B Circulation %V 114 %P 209-15 %8 2006 Jul 18 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16818809?dopt=Abstract %R 10.1161/CIRCULATIONAHA.106.620336 %0 Journal Article %J Neuroepidemiology %D 2006 %T Quantitative measures of gait characteristics indicate prevalence of underlying subclinical structural brain abnormalities in high-functioning older adults. %A Rosano, Caterina %A Brach, Jennifer %A Longstreth, William T %A Newman, Anne B %K Aged %K Brain %K Cerebral Infarction %K Cerebral Ventricles %K Cerebrovascular Disorders %K Cohort Studies %K Dementia %K Female %K Gait %K Gait Disorders, Neurologic %K Humans %K Hypertension %K Magnetic Resonance Imaging %K Male %K Neuropsychological Tests %K Stroke %K United States %X

Abnormal gait in high-functioning older adults may indicate underlying subtle structural brain abnormalities. We tested the hypothesis that temporal and spatial parameters of gait, including speed, stride length and double support time, are cross-sectionally associated with white matter hyperintensity, subcortical infarcts or brain atrophy on brain MRI. We examined 321 men and women (mean age = 78.3) participating to the Cardiovascular Health Study who were free of dementia or stroke at the time of the gait assessment. Analyses were set with gait as independent variable and brain MRIs as dependent variables. Gait measures were determined from the footfalls recorded on a 4-meter-long instrumented walking surface, the GaitMat II. Brain MRIs were examined for the presence of white matter hyperintensity (WMG, graded from 0 to 9), brain infarcts (predominantly subcortical) and ventricular enlargement (graded from 0 to 9). Slower gait, shorter stride length and longer double support times were associated with greater prevalence of white matter grade > or =3 (p = 0.02), and at least 1 brain infarct (p = 0.04) independent of age. In multivariate logistic regression models adjusted for demographics and clinical cardiovascular diseases, those with gait speed <1.02 m/s were more likely to have WMG > or =3 and at least 1 brain infarct, compared with those with faster gait - odds ratio (OR): 2.85, 95% confidence interval (95% CI): 1.35, 6.02, and OR: 2.09, 95% CI: 1.04, 4.19. Shorter stride length was also associated with greater probability of having at least 1 brain infarct (gait stride <0.88 vs. >1.10 m: OR: 3.20, 95% CI: 1.49, 6.88), while longer double support times were associated with a greater probability of having WMG > or =3 (double support time >0.19 vs. <0.14 s: OR: 2.3, 95% CI: 1.1, 4.7) independent of demographics and clinical cardiovascular diseases. Gait parameters were not significantly associated with ventricular grade. In summary, in this group of high-functioning older adults, poorer gait speed, shorter stride and longer double support time are associated with high white matter disease and subclinical strokes.

%B Neuroepidemiology %V 26 %P 52-60 %8 2006 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/16254454?dopt=Abstract %R 10.1159/000089240 %0 Journal Article %J Int J Epidemiol %D 2006 %T Regression dilution methods for meta-analysis: assessing long-term variability in plasma fibrinogen among 27,247 adults in 15 prospective studies. %A Wood, Angela M %A White, Ian %A Thompson, Simon G %A Lewington, Sarah %A Danesh, John %K Adult %K Age Factors %K Bias %K Cardiovascular Diseases %K Female %K Fibrinogen %K Humans %K Male %K Meta-Analysis as Topic %K Prospective Studies %K Regression Analysis %K Risk Factors %K Sex Factors %K Smoking %K Time Factors %X

BACKGROUND: Within-person variability in measured values of a risk factor can bias its association with disease. The extent of this regression dilution bias for plasma fibrinogen was investigated using repeat measurement data collected at varying time intervals on 27 247 adults in 15 prospective studies.

METHODS: Regression dilution ratios (RDRs) were estimated from a linear regression of repeat measurements on baseline values in each study and for each time interval, and pooled allowing for within- and between-study heterogeneity. RDRs were estimated both without and with adjustment for confounders, and factors were investigated that might influence the RDRs.

RESULTS: The unadjusted overall RDR was 0.51 (95% CI: 0.47, 0.55), which decreased to 0.46 (95% CI: 0.42, 0.49) after adjustment for age, sex and measured values of other established vascular risk factors. The RDR did not vary materially by assay method, age, sex or smoking status, but decreased at higher levels of baseline fibrinogen.

CONCLUSION: It is appropriate to use an RDR of 0.5 to correct approximately for regression dilution bias in plasma fibrinogen values; however, this correction factor may produce somewhat conservative hazard ratios in adjusted analyses, at higher fibrinogen concentrations and in follow-up beyond a decade. More generally, the methods described in this report have widespread applicability to quantifying regression dilution bias in repeatability data from multiple prospective studies.

%B Int J Epidemiol %V 35 %P 1570-8 %8 2006 Dec %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/17148467?dopt=Abstract %R 10.1093/ije/dyl233 %0 Journal Article %J Biostatistics %D 2006 %T The sensitivity and specificity of markers for event times. %A Cai, Tianxi %A Pepe, Margaret Sullivan %A Zheng, Yingye %A Lumley, Thomas %A Jenny, Nancy Swords %K Aged %K Aged, 80 and over %K Biomarkers %K Biometry %K Cardiovascular Diseases %K Female %K Humans %K Male %K Models, Statistical %K Risk Factors %K ROC Curve %K Sensitivity and Specificity %K Time Factors %X

The statistical literature on assessing the accuracy of risk factors or disease markers as diagnostic tests deals almost exclusively with settings where the test, Y, is measured concurrently with disease status D. In practice, however, disease status may vary over time and there is often a time lag between when the marker is measured and the occurrence of disease. One example concerns the Framingham risk score (FR-score) as a marker for the future risk of cardiovascular events, events that occur after the score is ascertained. To evaluate such a marker, one needs to take the time lag into account since the predictive accuracy may be higher when the marker is measured closer to the time of disease occurrence. We therefore consider inference for sensitivity and specificity functions that are defined as functions of time. Semiparametric regression models are proposed. Data from a cohort study are used to estimate model parameters. One issue that arises in practice is that event times may be censored. In this research, we extend in several respects the work by Leisenring et al. (1997) that dealt only with parametric models for binary tests and uncensored data. We propose semiparametric models that accommodate continuous tests and censoring. Asymptotic distribution theory for parameter estimates is developed and procedures for making statistical inference are evaluated with simulation studies. We illustrate our methods with data from the Cardiovascular Health Study, relating the FR-score measured at enrollment to subsequent risk of cardiovascular events.

%B Biostatistics %V 7 %P 182-97 %8 2006 Apr %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/16079162?dopt=Abstract %R 10.1093/biostatistics/kxi047 %0 Journal Article %J JAMA %D 2006 %T Thyroid status, cardiovascular risk, and mortality in older adults. %A Cappola, Anne R %A Fried, Linda P %A Arnold, Alice M %A Danese, Mark D %A Kuller, Lewis H %A Burke, Gregory L %A Tracy, Russell P %A Ladenson, Paul W %K Aged %K Atrial Fibrillation %K Cardiovascular Diseases %K Female %K Humans %K Hyperthyroidism %K Hypothyroidism %K Male %K Proportional Hazards Models %K Risk Factors %K Thyroid Gland %K Thyrotropin %X

CONTEXT: Previous studies have suggested that subclinical abnormalities in thyroid-stimulating hormone levels are associated with detrimental effects on the cardiovascular system.

OBJECTIVE: To determine the relationship between baseline thyroid status and incident atrial fibrillation, incident cardiovascular disease, and mortality in older men and women not taking thyroid medication.

DESIGN, SETTING, AND PARTICIPANTS: A total of 3233 US community-dwelling individuals aged 65 years or older with baseline serum thyroid-stimulating hormone levels were enrolled in 1989-1990 in the Cardiovascular Health Study, a large, prospective cohort study.

MAIN OUTCOME MEASURES: Incident atrial fibrillation, coronary heart disease, cerebrovascular disease, cardiovascular death, and all-cause death assessed through June 2002. Analyses are reported for 4 groups defined according to thyroid function test results: subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism.

RESULTS: Individuals with overt thyrotoxicosis (n = 4) were excluded because of small numbers. Eighty-two percent of participants (n = 2639) had normal thyroid function, 15% (n = 496) had subclinical hypothyroidism, 1.6% (n = 51) had overt hypothyroidism, and 1.5% (n = 47) had subclinical hyperthyroidism. After exclusion of those with prevalent atrial fibrillation, individuals with subclinical hyperthyroidism had a greater incidence of atrial fibrillation compared with those with normal thyroid function (67 events vs 31 events per 1000 person-years; adjusted hazard ratio, 1.98; 95% confidence interval, 1.29-3.03). No differences were seen between the subclinical hyperthyroidism group and euthyroidism group for incident coronary heart disease, cerebrovascular disease, cardiovascular death, or all-cause death. Likewise, there were no differences between the subclinical hypothyroidism or overt hypothyroidism groups and the euthyroidism group for cardiovascular outcomes or mortality. Specifically, individuals with subclinical hypothyroidism had an adjusted hazard ratio of 1.07 (95% confidence interval, 0.90-1.28) for incident coronary heart disease.

CONCLUSION: Our data show an association between subclinical hyperthyroidism and development of atrial fibrillation but do not support the hypothesis that unrecognized subclinical hyperthyroidism or subclinical hypothyroidism is associated with other cardiovascular disorders or mortality.

%B JAMA %V 295 %P 1033-41 %8 2006 Mar 01 %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16507804?dopt=Abstract %R 10.1001/jama.295.9.1033 %0 Journal Article %J J Am Coll Cardiol %D 2006 %T Transthyretin V122I in African Americans with congestive heart failure. %A Buxbaum, Joel %A Jacobson, Daniel R %A Tagoe, Clement %A Alexander, Alice %A Kitzman, Dalane W %A Greenberg, Barry %A Thaneemit-Chen, Surai %A Lavori, Philip %K African Americans %K Gene Frequency %K Heart Failure %K Heterozygote %K Humans %K Isoleucine %K Mutation %K Prealbumin %K Valine %B J Am Coll Cardiol %V 47 %P 1724-5 %8 2006 Apr 18 %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/16631014?dopt=Abstract %R 10.1016/j.jacc.2006.01.042 %0 Journal Article %J Neurobiol Aging %D 2007 %T Acceleration of cerebral ventricular expansion in the Cardiovascular Health Study. %A Carmichael, Owen T %A Kuller, L H %A Lopez, O L %A Thompson, P M %A Dutton, R A %A Lu, A %A Lee, S E %A Lee, J Y %A Aizenstein, H J %A Meltzer, C C %A Liu, Y %A Toga, A W %A Becker, J T %K Aged %K Analysis of Variance %K Cardiovascular Diseases %K Cerebral Ventricles %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Reference Values %K Retrospective Studies %K Sex Factors %K Time Factors %X

Interactions between prevalent late-life medical conditions and expansion of the cerebral ventricles are not well understood. Thirty elderly subjects received three magnetic resonance (MR) scans each, in 1997-1999, 2002-2004, and 2003-2005. A linear expansion model of MR-measured lateral ventricle volume was estimated for each subject by fitting a line to a plot of their 1997-1999 and 2002-2004 volumes as a function of time. Acceleration in ventricular expansion was defined as the deviation between the 2003-2005 volumes measured from MR and the 2003-2005 volumes predicted by the linear expansion model. Ventricular acceleration was analyzed in a multivariate model with age, race, history of heart disease, diabetes, and hypertension as fixed effects. Ventricular acceleration was significantly higher in non-whites, diabetics, and those without heart disease (p<0.05). Ventricular acceleration was higher in subjects with a history of hypertension, but the difference was not statistically significant (p=0.08). Acceleration of ventricular expansion in the elderly may be related to demographic and cardiovascular factors.

%B Neurobiol Aging %V 28 %P 1316-21 %8 2007 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16875759?dopt=Abstract %R 10.1016/j.neurobiolaging.2006.06.016 %0 Journal Article %J Arch Ophthalmol %D 2007 %T Apolipoprotein e gene and age-related maculopathy in older individuals: the cardiovascular health study. %A Tikellis, Gabriella %A Sun, Cong %A Gorin, Michael B %A Klein, Ronald %A Klein, Barbara E K %A Larsen, Emily K Marino %A Siscovick, David S %A Hubbard, Larry D %A Wong, Tien Y %K African Americans %K Aged %K Aged, 80 and over %K Alleles %K Apolipoprotein E2 %K Apolipoprotein E3 %K Apolipoprotein E4 %K Cardiovascular Diseases %K European Continental Ancestry Group %K Female %K Genotype %K Humans %K Macular Degeneration %K Male %K Odds Ratio %K Polymorphism, Genetic %K Risk Factors %X

OBJECTIVE: To examine the association between the apolipoprotein E (APOE) gene and age-related maculopathy (ARM) in an older population.

METHODS: Two thousand one hundred seventy persons 65 years and older sampled from 4 US communities had ARM signs assessed from retinal photographs using a modified Wisconsin Age-Related Maculopathy Grading System. DNA extracted from blood samples was analyzed for common APOE alleles.

RESULTS: After controlling for age, sex, cigarette smoking, and other factors, white participants carrying the epsilon2 allele had an increased risk of late ARM (odds ratio, 2.53 [95% confidence interval, 1.08-5.90]) while carriers of the epsilon4 allele had a lower risk of late ARM (odds ratio, 0.69 [95% confidence interval, 0.19-2.50]). There were too few late ARM cases in African American individuals for analysis.

CONCLUSION: APOE polymorphism is associated with late ARM in older white persons 65 years and older. Consistent with previous studies, the APOE epsilon2 allele is associated with a significant increased risk of late ARM development, whereas the epsilon4 allele may confer some protection.

%B Arch Ophthalmol %V 125 %P 68-73 %8 2007 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/17210854?dopt=Abstract %R 10.1001/archopht.125.1.68 %0 Journal Article %J Mol Vis %D 2007 %T Apolipoprotein E gene and retinal microvascular signs in older people: the Cardiovascular Health Study. %A Sun, Cong %A Tikellis, Gabriella %A Liew, Gerald %A Klein, Ronald %A Larsen, Emily K Marino %A Wong, Tien Y %K Aged %K Aged, 80 and over %K Apolipoprotein E2 %K Apolipoprotein E4 %K Apolipoproteins E %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genotype %K Heterozygote %K Homozygote %K Humans %K Male %K Microcirculation %K Polymorphism, Genetic %K Retinal Diseases %K Retinal Vessels %X

PURPOSE: To examine the association between apolipoprotein E (APOE) gene polymorphism and retinal microvascular signs in an older population.

METHODS: Retinal photographs were taken of 2,152 participants (1,831 whites, and 321 African-Americans), aged 69-96 years, who were participating in a population-based study of four United States communities. We used standardized protocols to assess photographs for the presence of retinal microvascular signs (retinopathy, arterio-venous nicking, and focal arteriolar narrowing) and a computer-assisted method to measure retinal vessel diameters. We analyzed DNA extracted from blood samples of participants for common allelic variants of the APOE gene.

RESULTS: After adjusting for age, gender, systolic blood pressure, smoking, total serum cholesterol, and other risk factors, we found white participants carrying the epsilon2 and epsilon4 alleles were more likely to have arterio-venous nicking than the epsilon3/epsilon3 homozygotes, with odds ratio (OR) of 1.70 and confidence interval (CI) 95% (1.03-2.83) for the epsilon2 carriers and OR 1.74 (95% CI 1.06-2.84) for the epsilon4 carriers. Among white participants without hypertension, the associations remained significant for the epsilon4 carriers (OR 2.32, 95% CI 1.18-4.57). Whites, normotensive carriers of the epsilon2 allele had significantly narrower retinal arteriolar diameters (adjusted mean arteriolar diameter of 163.5 mum, 95% CI 160.1-167.0, p=0.03) compared to the epsilon3/epsilon3 homozygotes (167.8 mum, 95% CI 166.0-169.6). APOE gene polymorphism was not associated with retinopathy, focal narrowing, or retinal venular diameters in white participants. There were insufficient numbers of African-Americans for separate multivariate analysis.

CONCLUSIONS: This study provides little evidence that the APOE gene polymorphism plays a significant role in the pathogenesis of retinal microvascular changes in the general population. In the older white population, APOE epsilon2 and epsilon4 allele carriers were more likely to have arterio-venous nicking. Other retinal signs, however, were not related to APOE gene polymorphism.

%B Mol Vis %V 13 %P 2105-11 %8 2007 Nov 12 %G eng %1 https://www.ncbi.nlm.nih.gov/pubmed/18079687?dopt=Abstract %0 Journal Article %J Am J Geriatr Psychiatry %D 2007 %T Are microvascular abnormalities in the retina associated with depression symptoms? The Cardiovascular Health Study. %A Sun, Cong %A Tikellis, Gabriella %A Klein, Ronald %A Steffens, David C %A Larsen, Emily K Marino %A Siscovick, David S %A Klein, Barbara E K %A Wong, Tien Y %K Aged %K Aged, 80 and over %K Body Mass Index %K Cardiovascular Diseases %K Cohort Studies %K Comorbidity %K Cross-Sectional Studies %K Depression %K Female %K Fluorescein Angiography %K Humans %K Male %K Microcirculation %K Personality Inventory %K Retinal Artery Occlusion %K Retinal Diseases %K Retinal Vein Occlusion %K Risk Factors %K Statistics as Topic %K United States %X

OBJECTIVE: Depression has been linked with vascular risk factors and stroke. The authors examined the relationship between retinal microvascular abnormalities and depression symptoms in an elderly population.

METHODS: The Cardiovascular Health Study is a population-based study conducted in four U.S. communities initiated in 1989-1990. A total of 2,420 persons aged 65 years and older were included in the current analyses. During the 1997-1998 examination, retinal photographs were performed and assessed for retinal microvascular abnormalities (retinopathy, focal arteriolar narrowing, arteriovenous nicking, generalized retinal arteriolar narrowing, and generalized retinal venular dilation) according to standardized methods. Depression symptoms were assessed by a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale annually from 1989 through 1997-1998 and was defined as a CES-D score of >9.

RESULTS: Participants with retinal microvascular abnormalities were not more likely to have depression symptoms, with adjusted odds ratio (OR) (95% confidence intervals) of 1.08 (0.71-1.65) for retinopathy, OR 1.09 (0.71-1.68) for focal arteriolar narrowing, OR 0.85 (0.52-1.40) for arteriovenous nicking, OR 0.97 (0.70-1.34) for generalized arteriolar narrowing, and OR 0.79 (0.56-1.12) for generalized venular dilation. Retinal microvascular abnormalities were not related to depression symptoms in multinomial logistic regression comparing the three top quartiles of the depression CES-D scores with the lowest quartile.

CONCLUSIONS: Our study did not find an association between retinal microvascular abnormalities and depression symptoms in older people.

%B Am J Geriatr Psychiatry %V 15 %P 335-43 %8 2007 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/17384316?dopt=Abstract %R 10.1097/01.JGP.0000247161.98311.0f %0 Journal Article %J Am J Epidemiol %D 2007 %T Associations between findings on cranial magnetic resonance imaging and retinal photography in the elderly: the Cardiovascular Health Study. %A Longstreth, Wt %A Larsen, Emily K Marino %A Klein, Ronald %A Wong, Tien Yin %A Sharrett, A Richey %A Lefkowitz, David %A Manolio, Teri A %K Age Factors %K Aged %K Aged, 80 and over %K Arteriosclerosis %K Cerebral Infarction %K Female %K Humans %K Leukoaraiosis %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Microcirculation %K Photography %K Retina %K Retinal Diseases %K Retinal Vessels %K Risk Assessment %K Risk Factors %X

Associations between findings on cranial magnetic resonance imaging (MRI) and retinal photographs have been described mostly in middle-aged people. In the Cardiovascular Health Study, 1,717 elderly participants underwent MRI and retinal photography between 1991 and 1999. Associations were sought between MRI findings and four findings of retinal microvascular disease: retinopathy, focal arteriolar narrowing, arteriovenous nicking, and the arteriovenous ratio--the last based upon semiautomated measurements of arterioles and venules. After controlling for age and gender, the authors found associations between MRI findings and the smaller arteriovenous ratio (per standard deviation decrease): prevalent infarcts (odds ratio = 1.18, 95% confidence interval: 1.05, 1.34; p = 0.007), white matter grade (regression coefficient, 0.093; p = 0.011), incident infarct (odds ratio = 1.26, 95% confidence interval: 1.09, 1.46; p = 0.002), and worsening white matter grade (odds ratio = 1.12, 95% confidence interval: 0.98, 1.29; p = 0.09). Arteriovenous nicking was also associated with prevalent (odds ratio = 1.84, 95% confidence interval: 1.23, 2.76; p = 0.003) and incident (odds ratio = 1.84, 95% confidence interval: 1.15, 2.94; p = 0.011) infarcts. Adjustment for hypertension and diabetes had minimal effect. Evidence of small vessel disease in the retina increases the likelihood of finding it in the brain. Associations were less prominent in this elderly population than have been described in middle-aged people.

%B Am J Epidemiol %V 165 %P 78-84 %8 2007 Jan 01 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/17041135?dopt=Abstract %R 10.1093/aje/kwj350 %0 Journal Article %J Am J Epidemiol %D 2007 %T Associations of plasma fibrinogen levels with established cardiovascular disease risk factors, inflammatory markers, and other characteristics: individual participant meta-analysis of 154,211 adults in 31 prospective studies: the fibrinogen studies collab %A Kaptoge, S %A White, I R %A Thompson, S G %A Wood, A M %A Lewington, S %A Lowe, G D O %A Danesh, J %K Adult %K African Americans %K Age Factors %K Biomarkers %K Body Mass Index %K C-Reactive Protein %K Cardiovascular Diseases %K Cohort Studies %K Female %K Fibrinogen %K Humans %K Linear Models %K Male %K Prospective Studies %K Risk Factors %K Sex Factors %K Smoking %K Social Class %K United States %X

Long-term increases in plasma fibrinogen levels of 1 g/liter are associated with an approximate doubling of risk of major cardiovascular disease outcomes, but causality remains uncertain. To quantify cross-sectional associations of fibrinogen levels with established risk factors and other characteristics, the investigators combined individual data on 154,211 apparently healthy adults from 31 prospective studies conducted between 1967 and 2003, using a linear mixed model that included random effects at the cohort level. Fibrinogen levels increased with age and showed continuous, approximately linear relations with several risk markers and slightly curvilinear associations with log triglycerides, albumin, and tobacco and alcohol consumption. Female sex, Black ethnicity, lower socioeconomic status, and alcohol abstinence were each associated with modestly higher fibrinogen levels. Approximately one third of the variation in fibrinogen levels was explained by cohort, age, and sex. An additional 7% was explained by established risk factors (notably, positive associations with smoking and body mass index and an inverse association with high density lipoprotein cholesterol), and a further 10% was explained by inflammatory markers (notably, a positive association with C-reactive protein). The association with body mass index was twice as strong in women as in men, whereas the association with smoking was much stronger in men. These findings substantially advance understanding of the correlates and possible determinants of fibrinogen levels.

%B Am J Epidemiol %V 166 %P 867-79 %8 2007 Oct 15 %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/17785713?dopt=Abstract %R 10.1093/aje/kwm191 %0 Journal Article %J Alzheimer Dis Assoc Disord %D 2007 %T Cerebral ventricular changes associated with transitions between normal cognitive function, mild cognitive impairment, and dementia. %A Carmichael, Owen T %A Kuller, Lewis H %A Lopez, Oscar L %A Thompson, Paul M %A Dutton, Rebecca A %A Lu, Allen %A Lee, Sharon E %A Lee, Jessica Y %A Aizenstein, Howard J %A Meltzer, Carolyn C %A Liu, Yanxi %A Toga, Arthur W %A Becker, James T %K Aged %K Aged, 80 and over %K Case-Control Studies %K Cerebral Ventricles %K Cognition Disorders %K Dementia %K Disease Progression %K Female %K Humans %K Image Processing, Computer-Assisted %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Risk Factors %K Severity of Illness Index %K Time Factors %X

Expansion of the cerebral ventricles may occur at an accelerated rate in subjects with dementia, but the time course of expansion during transitions between normal cognitive function, mild cognitive impairment (MCI), and dementia is not well understood. Furthermore, the effects of cardiovascular risk factors on rate of ventricular expansion are unclear. We used a fully automated segmentation technique to measure change rate in lateral ventricle-to-brain ratio (VBR) on 145 longitudinal pairs of magnetic resonance images of subjects in the Cardiovascular Health Study Cognition Study from the Pittsburgh Center. A multivariate model analyzed VBR change rate, accounting for dementia statuses at both imaging times (normal, MCI, or dementia), age, sex, education, race, magnetic resonance-defined infarcts, Center for Epidemiology Studies Depression Scale, baseline ventricular volume, and cardiovascular risk factors. VBR change was faster in subjects who were demented or transitioned from MCI to dementia, compared with subjects normal at both images and subjects who transitioned from normal to MCI or dementia. Patients with diabetes had faster VBR change. Ventricular expansion may accelerate late in the progression from normal cognitive function to dementia, and may be modulated by diabetes.

%B Alzheimer Dis Assoc Disord %V 21 %P 14-24 %8 2007 Jan-Mar %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/17334268?dopt=Abstract %R 10.1097/WAD.0b013e318032d2b1 %0 Journal Article %J Eur J Cardiovasc Prev Rehabil %D 2007 %T Collaborative meta-analysis of individual participant data from observational studies of Lp-PLA2 and cardiovascular diseases. %A Ballantyne, C %A Cushman, M %A Psaty, B %A Furberg, C %A Khaw, K T %A Sandhu, M %A Oldgren, J %A Rossi, G P %A Maiolino, G %A Cesari, M %A Lenzini, L %A James, S K %A Rimm, E %A Collins, R %A Anderson, J %A Koenig, W %A Brenner, H %A Rothenbacher, D %A Berglund, G %A Persson, M %A Berger, P %A Brilakis, E %A McConnell, J P %A Koenig, W %A Sacco, R %A Elkind, M %A Talmud, P %A Rimm, E %A Cannon, C P %A Packard, C %A Barrett-Connor, E %A Hofman, A %A Kardys, I %A Witteman, J C M %A Criqui, M %A Corsetti, J P %A Rainwater, D L %A Moss, A J %A Robins, S %A Bloomfield, H %A Collins, D %A Packard, C %A Wassertheil-Smoller, S %A Ridker, P %A Ballantyne, C %A Cannon, C P %A Cushman, M %A Danesh, J %A Gu, D %A Hofman, A %A Nelson, J J %A Thompson, S %A Zalewski, A %A Zariffa, N %A Di Angelantonio, E %A Kaptoge, S %A Thompson, A %A Thompson, S %A Walker, M %A Watson, S %A Wood, A %K 1-Alkyl-2-acetylglycerophosphocholine Esterase %K Cardiovascular Diseases %K Humans %K Phospholipases A2 %X

BACKGROUND: A large number of observational epidemiological studies have reported generally positive associations between circulating mass and activity levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular diseases. Few studies have been large enough to provide reliable estimates in different circumstances, such as in different subgroups (e.g., by age group, sex, or smoking status) or at different Lp-PLA2 levels. Moreover, most published studies have related disease risk only to baseline values of Lp-PLA2 markers (which can lead to substantial underestimation of any risk relationships because of within-person variability over time) and have used different approaches to adjustment for possible confounding factors.

OBJECTIVES: By combination of data from individual participants from all relevant observational studies in a systematic 'meta-analysis', with correction for regression dilution (using available data on serial measurements of Lp-PLA2), the Lp-PLA2 Studies Collaboration will aim to characterize more precisely than has previously been possible the strength and shape of the age and sex-specific associations of plasma Lp-PLA2 with coronary heart disease (and, where data are sufficient, with other vascular diseases, such as ischaemic stroke). It will also help to determine to what extent such associations are independent of possible confounding factors and to explore potential sources of heterogeneity among studies, such as those related to assay methods and study design. It is anticipated that the present collaboration will serve as a framework to investigate related questions on Lp-PLA2 and cardiovascular outcomes.

METHODS: A central database is being established containing data on circulating Lp-PLA2 values, sex and other potential confounding factors, age at baseline Lp-PLA2 measurement, age at event or at last follow-up, major vascular morbidity and cause-specific mortality. Information about any repeat measurements of Lp-PLA2 and potential confounding factors has been sought to allow adjustment for possible confounding and correction for regression dilution. The analyses will involve age-specific regression models. Synthesis of the available observational studies of Lp-PLA2 will yield information on a total of about 15 000 cardiovascular disease endpoints.

%B Eur J Cardiovasc Prev Rehabil %V 14 %P 3-11 %8 2007 Feb %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/17301621?dopt=Abstract %R 10.1097/01.hjr.0000239464.18509.f1 %0 Journal Article %J Ophthalmic Epidemiol %D 2007 %T Depressive symptoms and age-related macular degeneration in older people: the cardiovascular health study. %A Sun, Cong %A Tikellis, Gabriella %A Klein, Ronald %A Steffens, David C %A Larsen, Emily K Marino %A Wong, Tien Y %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cross-Sectional Studies %K Depressive Disorder %K Female %K Health Surveys %K Humans %K Intelligence Tests %K Macular Degeneration %K Male %K Photography %K United States %X

PURPOSE: To examine the association between age-related macular degeneration (AMD) and depressive symptoms.

METHODS: Population-based, cross-sectional study. A total of 2,194 persons aged 69-97 years were included in the current analyses. During the 1997-1998 examination, retinal photography from one randomly selected eye was graded for presence of early and late AMD using a modified Wisconsin AMD by Grading System. Depressive symptoms were assessed via a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale annually from 1989 through 1997-1998. Depressive symptoms were defined as a CES-D score of >9 (top quartile of CES-D score) at the 1997-1998 examination.

RESULTS: There were 338 (15.6%) individuals with early AMD and 29 (1.3%) with late AMD. Among them, 368 (16.8%) persons had depressive symptoms at the 1997-1998 examination. Depressive symptoms were not associated with early AMD (multivariable adjusted odds ratio [OR]: 0.97; 95% confidence intervals [CI]: 0.69-1.36) or late AMD (OR: 1.15; 95% CI: 0.38-3.46). Including persons using anti-depressive medications did not alter these associations (OR: 0.98; 95% CI: 0.74-1.32 for early AMD and OR: 0.97; 95% CI: 0.35-2.67 for late AMD). There was no association in multinomial logistic regression models of increasing quartiles of the CES-D scores with early or late AMD status.

CONCLUSIONS: Our study did not find an association between early AMD and depressive symptoms in older people.

%B Ophthalmic Epidemiol %V 14 %P 127-33 %8 2007 May-Jun %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/17613847?dopt=Abstract %R 10.1080/09286580601186742 %0 Journal Article %J Eur J Epidemiol %D 2007 %T The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. %A Danesh, J %A Erqou, S %A Walker, M %A Thompson, S G %A Tipping, R %A Ford, C %A Pressel, S %A Walldius, G %A Jungner, I %A Folsom, A R %A Chambless, L E %A Knuiman, M %A Whincup, P H %A Wannamethee, S G %A Morris, R W %A Willeit, J %A Kiechl, S %A Santer, P %A Mayr, A %A Wald, N %A Ebrahim, S %A Lawlor, D A %A Yarnell, J W G %A Gallacher, J %A Casiglia, E %A Tikhonoff, V %A Nietert, P J %A Sutherland, S E %A Bachman, D L %A Keil, J E %A Cushman, M %A Psaty, B M %A Tracy, R P %A Tybjaerg-Hansen, A %A Nordestgaard, B G %A Frikke-Schmidt, R %A Giampaoli, S %A Palmieri, L %A Panico, S %A Vanuzzo, D %A Pilotto, L %A Simons, L %A McCallum, J %A Friedlander, Y %A Fowkes, F G R %A Lee, A J %A Smith, F B %A Taylor, J %A Guralnik, J %A Phillips, C %A Wallace, R %A Blazer, D %A Khaw, K T %A Jansson, J H %A Donfrancesco, C %A Salomaa, V %A Harald, K %A Jousilahti, P %A Vartiainen, E %A Woodward, M %A D'Agostino, R B %A Wolf, P A %A Vasan, R S %A Pencina, M J %A Bladbjerg, E M %A Jorgensen, T %A Moller, L %A Jespersen, J %A Dankner, R %A Chetrit, A %A Lubin, F %A Rosengren, A %A Wilhelmsen, L %A Lappas, G %A Eriksson, H %A Bjorkelund, C %A Cremer, P %A Nagel, D %A Tilvis, R %A Strandberg, T %A Rodriguez, B %A Bouter, L M %A Heine, R J %A Dekker, J M %A Nijpels, G %A Stehouwer, C D A %A Rimm, E %A Pai, J %A Sato, S %A Iso, H %A Kitamura, A %A Noda, H %A Goldbourt, U %A Salomaa, V %A Salonen, J T %A Nyyssönen, K %A Tuomainen, T-P %A Deeg, D %A Poppelaars, J L %A Meade, T %A Cooper, J %A Hedblad, B %A Berglund, G %A Engstrom, G %A Döring, A %A Koenig, W %A Meisinger, C %A Mraz, W %A Kuller, L %A Selmer, R %A Tverdal, A %A Nystad, W %A Gillum, R %A Mussolino, M %A Hankinson, S %A Manson, J %A De Stavola, B %A Knottenbelt, C %A Cooper, J A %A Bauer, K A %A Rosenberg, R D %A Sato, S %A Naito, Y %A Holme, I %A Nakagawa, H %A Miura, H %A Ducimetiere, P %A Jouven, X %A Crespo, C %A Garcia-Palmieri, M %A Amouyel, P %A Arveiler, D %A Evans, A %A Ferrieres, J %A Schulte, H %A Assmann, G %A Shepherd, J %A Packard, C %A Sattar, N %A Cantin, B %A Lamarche, B %A Després, J-P %A Dagenais, G R %A Barrett-Connor, E %A Wingard, D %A Bettencourt, R %A Gudnason, V %A Aspelund, T %A Sigurdsson, G %A Thorsson, B %A Trevisan, M %A Witteman, J %A Kardys, I %A Breteler, M %A Hofman, A %A Tunstall-Pedoe, H %A Tavendale, R %A Lowe, G D O %A Ben-Shlomo, Y %A Howard, B V %A Zhang, Y %A Best, L %A Umans, J %A Onat, A %A Meade, T W %A Njolstad, I %A Mathiesen, E %A Lochen, M L %A Wilsgaard, T %A Gaziano, J M %A Stampfer, M %A Ridker, P %A Ulmer, H %A Diem, G %A Concin, H %A Rodeghiero, F %A Tosetto, A %A Brunner, E %A Shipley, M %A Buring, J %A Cobbe, S M %A Ford, I %A Robertson, M %A He, Y %A Ibanez, A M %A Feskens, E J M %A Kromhout, D %A Collins, R %A Di Angelantonio, E %A Kaptoge, S %A Lewington, S %A Orfei, L %A Pennells, L %A Perry, P %A Ray, K %A Sarwar, N %A Scherman, M %A Thompson, A %A Watson, S %A Wensley, F %A White, I R %A Wood, A M %K Albumins %K Biomarkers %K Cardiovascular Diseases %K Databases, Factual %K Far East %K Humans %K Inflammation %K Leukocyte Count %K Lipids %K Lipoproteins, HDL %K Prospective Studies %K Risk Factors %K Triglycerides %X

Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.

%B Eur J Epidemiol %V 22 %P 839-69 %8 2007 %G eng %N 12 %1 https://www.ncbi.nlm.nih.gov/pubmed/17876711?dopt=Abstract %R 10.1007/s10654-007-9165-7 %0 Journal Article %J Am J Prev Med %D 2007 %T Ethnic-specific prevalence of peripheral arterial disease in the United States. %A Allison, Matthew A %A Ho, Elena %A Denenberg, Julie O %A Langer, Robert D %A Newman, Anne B %A Fabsitz, Richard R %A Criqui, Michael H %K Adult %K Aged %K Aged, 80 and over %K Databases as Topic %K Female %K Humans %K Male %K Middle Aged %K Peripheral Vascular Diseases %K United States %X

BACKGROUND: Individuals diagnosed with peripheral arterial disease (PAD) are at increased risk for future functional limitations as well as cardiovascular morbidity and mortality. The aim of this study was to estimate the age-, gender-, and ethnic-specific burden of PAD in the United States for the year 2000.

METHODS: Data were collected from seven community-based studies that assessed subjects for the presence of PAD using the ankle-brachial index (ABI). Using standardized weighting criteria, age-, gender-, and ethnic-specific prevalence rates were computed and then multiplied by the corresponding 2000 Census population totals to estimate the burden of PAD in the United States for that year. Evidence-based adjustments for studies which did not consider possible subclavian stenosis, prior revascularization for PAD, or both were employed.

RESULTS: In 2000, it is conservatively estimated that at least 6.8 million (5.8%) individuals aged 40 years or older had PAD based on an ABI of less than 0.9 or previous revascularization for PAD, and that that there are an additional 1.7 million Americans with PAD but "normal" ABIs. Including this group gives a total of 8.5 million (7.2%) individuals with PAD.

CONCLUSIONS: Roughly one in 16 individuals residing in the United States in 2000 who were aged 40 years and older had PAD. Clinicians are encouraged to screen for the presence of PAD using the ABI.

%B Am J Prev Med %V 32 %P 328-33 %8 2007 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/17383564?dopt=Abstract %R 10.1016/j.amepre.2006.12.010 %0 Journal Article %J J Neuroimaging %D 2007 %T Focal atrophy and cerebrovascular disease increase dementia risk among cognitively normal older adults. %A Rosano, Caterina %A Aizenstein, Howard J %A Wu, Minjie %A Newman, Anne B %A Becker, James T %A Lopez, Oscar L %A Kuller, Lewis H %K Aged %K Alzheimer Disease %K Analysis of Variance %K Atrophy %K Cerebrovascular Disorders %K Cognition %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Risk Factors %K Temporal Lobe %K United States %X

BACKGROUND AND PURPOSE: This study investigated the association of medial temporal lobe (MTL) atrophy and cerebrovascular disease (white matter hyperintensities [WMH], subclinical infarcts) with the risk of developing Alzheimer's disease (AD) among cognitively normal older adults.

METHODS: Risk of developing AD was examined for 155 cognitively normal older adults (77.4 years, 60% women, 81% white). The MTL volumes and the presence of WMH and of subclinical infarcts were determined from brain magnetic resonance imaging (MRI) at the beginning of the study. Follow-up cognitive evaluations (average 4.3 years) identified those who developed AD.

RESULTS: The presence of either MTL atrophy or subclinical infarcts was independently and significantly associated with a greater risk to develop AD (OR [95% CI]: 4.4 [1.5, 12.3] and 2.7 [1.0, 7.1], respectively). In addition, those participants with both MTL atrophy and at least one brain infarct had a 7-fold increase in the risk of developing AD (OR [95% CI]: 7.0 [1.5, 33.1]), compared to those who had neither of these conditions.

CONCLUSIONS: In cognitively normal older adults, markers of neurodegeneration (as reflected by MTL atrophy) and of cerebrovascular disease (as reflected by infarcts on MRI) independently contribute to the risk to develop AD.

%B J Neuroimaging %V 17 %P 148-55 %8 2007 Apr %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/17441836?dopt=Abstract %R 10.1111/j.1552-6569.2007.00093.x %0 Journal Article %J Neuroepidemiology %D 2007 %T Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults. %A Rosano, Caterina %A Brach, Jennifer %A Studenski, Stephanie %A Longstreth, W T %A Newman, Anne B %K Accidental Falls %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Basal Ganglia Cerebrovascular Disease %K Brain %K Cerebral Infarction %K Comorbidity %K Female %K Gait Disorders, Neurologic %K Geriatric Assessment %K Health Surveys %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Mobility Limitation %K Neurodegenerative Diseases %K Neurologic Examination %K Risk Factors %K United States %X

BACKGROUND: Gait variability is an index of how much gait parameters, such as step length, change from one step to the next. Gait variability increases with age and in individuals affected by cortical and subcortical neurodegenerative conditions, and it is associated with falls and incident mobility disability. The brain anatomical correlates of gait variability have not been studied in high-functioning community-dwelling older adults.

METHODS: Gait variability and brain MRIs were assessed in a cohort of 331 men and women (mean age = 78.3 years) free from stroke, dementia or Parkinson's disease. Gait variability was computed for spatial parameters (step length and step width) and for temporal parameters (stance time). Subclinical brain vascular abnormalities were measured on brain MRIs as infarcts and white matter hyperintensities.

RESULTS: Greater variability of step length was associated with greater prevalence of infarcts, including infarcts in the basal ganglia, and with greater white matter hyperintensities severity, independent of age, gender, cognitive function and cardiovascular disease. Weaker associations were found between the other variability measures and the MRI measures.

CONCLUSION: In this group of older adults free from neurodegenerative diseases, a greater variability of step length was associated with greater burden of subclinical brain vascular abnormalities as defined by MRI.

%B Neuroepidemiology %V 29 %P 193-200 %8 2007 %G eng %N 3-4 %1 https://www.ncbi.nlm.nih.gov/pubmed/18043004?dopt=Abstract %R 10.1159/000111582 %0 Journal Article %J Hum Genet %D 2007 %T IL-6 gene variation is associated with IL-6 and C-reactive protein levels but not cardiovascular outcomes in the Cardiovascular Health Study. %A Walston, Jeremy D %A Fallin, M Daniele %A Cushman, Mary %A Lange, Leslie %A Psaty, Bruce %A Jenny, Nancy %A Browner, Warren %A Tracy, Russell %A Durda, Peter %A Reiner, Alex %K African Americans %K Aged %K Alleles %K C-Reactive Protein %K Cardiovascular Diseases %K Cohort Studies %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Predisposition to Disease %K Genetic Variation %K Humans %K Interleukin-6 %K Introns %K Longitudinal Studies %K Male %K Polymorphism, Single Nucleotide %K Promoter Regions, Genetic %X

Interleukin-6 (IL-6) and C-reactive protein (CRP) levels increase with age and likely play a role in adverse health outcomes in older adults. The relationship between IL-6 gene tag single nucleotide polymorphisms (SNPs) and circulating IL-6 and CRP levels, cardiovascular disease (CVD) outcomes, and mortality in Caucasian (CA) and African American (AA) participants of the Cardiovascular Health Study (CHS) was evaluated using ANCOVA and Cox proportional hazards models. The minor allele of the promoter SNP 1510 and intronic SNP 3572 associates with significantly higher serum IL-6 and CRP levels in CA but not AA. The CRP association persisted after CA and AA populations were combined and after accounting for multiple comparisons. These associations did not carry through to cardiovascular disease outcomes. Decreased risk of stroke was identified in CA, with the minor allele of SNP 1111 (HRR 0.71, 95% CI 0.52, 0.95), P = 0.02, and increased risk of CVD and all-cause mortality (HRR 1.31, 95% CI 1.05-1.64) in AAs heterozygote for SNP 2989. While genetic variation in the IL-6 gene was associated with circulating IL-6 and especially with CRP concentrations in this study, there is little evidence for association between common IL-6 gene variation and adverse health outcomes in this population of older adults.

%B Hum Genet %V 122 %P 485-94 %8 2007 Dec %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/17851695?dopt=Abstract %R 10.1007/s00439-007-0428-x %0 Journal Article %J Arch Neurol %D 2007 %T Incidence of dementia in mild cognitive impairment in the cardiovascular health study cognition study. %A Lopez, Oscar L %A Kuller, Lewis H %A Becker, James T %A Dulberg, Corinne %A Sweet, Robert A %A Gach, H Michael %A DeKosky, Steven T %K Aged %K Aged, 80 and over %K Cardiovascular System %K Cognition Disorders %K Dementia %K Disease Progression %K Female %K Humans %K Incidence %K Male %K Retrospective Studies %X

OBJECTIVES: To examine the incidence of dementia in subjects with mild cognitive impairment (MCI) in the Cardiovascular Health Study Cognition Study.

DESIGN: Prospective epidemiological study.

SETTING: The Cardiovascular Health Study Cognition Study of Pittsburgh, Pa, was conducted from 2002 through 2003 to determine the incidence of dementia in participants classified as having MCI in 1998 and 1999. Subjects There were 136 subjects with MCI. Mild cognitive impairment was subclassified as MCI amnestic type and MCI multiple cognitive deficits type (MCI-MCDT); subjects with MCI-MCDT were also grouped based on the presence of a memory impairment. Subjects with MCI were classified as possible when there were comorbidities that could explain the subjects' cognitive deficits and as probable when there were none. Main Outcome Measure Dementia.

RESULTS: The incidence of all dementias in the subjects with MCI was 147 per 1000 person-years (mean follow-up overall, 4.3 years). Of the 136 subjects with MCI, 69 (51%) in 1998 through 1999 progressed to dementia (57 [83%] to Alzheimer disease [AD]), but 25 (18%) returned to normal. Of the 10 subjects with probable MCI amnestic type, 7 (70%) progressed to dementia (all of them to AD) and none returned to normal, whereas 7 (41%) of the 17 subjects with possible MCI amnestic type became demented (6 [86%] to AD) and 3 (18%) returned to normal. Of the 40 subjects with probable MCI-MCDT, 21 (52%) progressed to dementia (17 [81%] to AD) and 2 (5%) returned to normal. Of the 69 subjects with possible MCI-MCDT, 34 (49%) progressed to dementia (28 [82%] to AD) and 20 (29%) returned to normal. Among the subjects with probable MCI-MCDT, 15 (54%) of 28 with and 6 (50%) of 12 without memory deficits progressed to dementia.

CONCLUSIONS: Subjects with MCI are at high risk for dementia. The probable MCI diagnosis identified individuals in the earliest stages of dementia, usually AD, whereas the possible MCI diagnosis identified a more heterogeneous group. However, this latter group had only a slightly lower rate of conversion to dementia than the group with probable MCI, suggesting that even with comorbid conditions, there is a high likelihood of the presence of a progressive dementing disorder.

%B Arch Neurol %V 64 %P 416-20 %8 2007 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/17353386?dopt=Abstract %R 10.1001/archneur.64.3.416 %0 Journal Article %J Am Heart J %D 2007 %T Long-term costs and resource use in elderly participants with congestive heart failure in the Cardiovascular Health Study. %A Liao, Lawrence %A Anstrom, Kevin J %A Gottdiener, John S %A Pappas, Paul A %A Whellan, David J %A Kitzman, Dalane W %A Aurigemma, Gerard P %A Mark, Daniel B %A Schulman, Kevin A %A Jollis, James G %K Aged %K Costs and Cost Analysis %K Female %K Health Resources %K Heart Failure %K Humans %K Male %K Medicare %K Prospective Studies %K Time Factors %X

BACKGROUND: Although heart failure (HF) afflicts nearly 5 million Americans, the long-term cost of HF care has not been described previously. In a prospective, longitudinal cohort of community-dwelling elderly from 4 regions, we examined the long-term costs and resource use of elderly patients with HF.

METHODS: We linked 4860 elderly participants in the National Heart, Lung, and Blood Institute Cardiovascular Health Study to Medicare part A and part B claims from 1992 to 2003. Costs were calculated from Medicare payments and discounted at 3% annually. We applied nonparametric estimators to calculate mean costs and resource use per patient for a 10-year period. To describe the relationship between patient characteristics and long-term costs, we constructed censoring-adjusted regression models.

RESULTS: There were 343 participants (84.8% white; 50.1% men; mean age, 78.2 years) with prevalent HF and 4517 participants without HF at study entry. Mean follow-up was 6.7 years (median, 6.4 years). The 10-year survival rates were 33% and 63% for the prevalent HF and nonprevalent HF groups (P < .001), respectively. The mean 10-year medical costs were significantly higher for the prevalent HF cohort (54,704 dollars vs 41 dollars,780, P < .001). The higher costs associated with HF were also reflected in greater resource use with more hospitalizations (P < .05) and more intensive care unit days (P < .05). Participants with HF had more physician visits (P < .05), with most of these encounters involving noncardiology physicians. However, in multivariate models, prevalent HF was not an independent predictor of higher costs.

CONCLUSION: Patients with HF consume substantially more health care resources than their elderly peers, and these higher costs persist through 10 years of follow-up. Many of these costs may be related to other comorbid conditions.

%B Am Heart J %V 153 %P 245-52 %8 2007 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/17239685?dopt=Abstract %R 10.1016/j.ahj.2006.11.010 %0 Journal Article %J Neurology %D 2007 %T Physical activity and white matter lesion progression: assessment using MRI. %A Podewils, L J %A Guallar, E %A Beauchamp, N %A Lyketsos, C G %A Kuller, L H %A Scheltens, P %K Activities of Daily Living %K Aged %K Alzheimer Disease %K Cognition Disorders %K Cohort Studies %K Demyelinating Diseases %K Disease Progression %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Motor Activity %K United States %X

We evaluated the association between physical activity and changes in white matter lesions (WMLs) on MRI in a sample of 179 older adults comprising 59 incident cases of Alzheimer disease, 60 persons with mild cognitive impairment, and 60 persons who remained cognitively stable over a median 5-year follow-up. Physical activity was not significantly associated with a decreased rate of periventricular or deep WML progression.

%B Neurology %V 68 %P 1223-6 %8 2007 Apr 10 %G eng %N 15 %1 https://www.ncbi.nlm.nih.gov/pubmed/17420407?dopt=Abstract %R 10.1212/01.wnl.0000259063.50219.3e %0 Journal Article %J Ann Pharmacother %D 2007 %T Potential interactions between complementary/alternative products and conventional medicines in a Medicare population. %A Elmer, Gary W %A Lafferty, William E %A Tyree, Patrick T %A Lind, Bonnie K %K Aged %K Complementary Therapies %K Drug Interactions %K Drug-Related Side Effects and Adverse Reactions %K Female %K Hemorrhage %K Herb-Drug Interactions %K Humans %K Male %K Medicare %K Pharmaceutical Preparations %K Phytotherapy %K Plant Extracts %K Plant Preparations %K Retrospective Studies %K Risk Factors %K Washington %X

BACKGROUND: Despite the high prevalence of complementary and alternative medicine (CAM) product use among the elderly, little is known about the extent of concurrent CAM-conventional medicine use and the potential for adverse reactions.

OBJECTIVE: To determine the prevalence of CAM product use concurrent with conventional medications, prescription and nonprescription, in a Medicare population and assess the risk for adverse interactions.

METHODS: Retrospective analysis was performed on Cardiovascular Health Study interview data from 1994, 1995, 1997, and 1999. The prevalence of concurrent combinations of CAM products and conventional drugs was tabulated. The adverse interaction risks were categorized as unknown, theoretical, and significant.

RESULTS: Of 5052 participants, the median age was 75, 60.2% were female, 16.6% were African American, and 83.4% were white. The percent using CAM products during the 4 time periods was 6.3%, 6.7%, 12.8%, and 15.1%. The percent using both CAM products and conventional drugs was 6.0%, 6.2%, 11.7%, and 14.4%. Of these, 294 (5.8%) individuals took combinations considered to have a significant risk for an adverse interaction. Combinations with risk were observed on 393 separate interviews. Most (379) involved a risk of bleeding due to use of ginkgo, garlic, or ginseng together with aspirin, warfarin, ticlopidine, or pentoxifylline. An additional 786 observations of combinations were considered to have some, albeit theoretical or uncertain, risk for an adverse interaction.

CONCLUSIONS: Concurrent use of CAM products and conventional medicines in a Medicare population was found to be common. Research to define the risks of combining ginkgo and garlic supplements with aspirin should be of high priority.

%B Ann Pharmacother %V 41 %P 1617-24 %8 2007 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/17785609?dopt=Abstract %R 10.1345/aph.1K221 %0 Journal Article %J Stroke %D 2007 %T Retinal microvascular signs, cognitive function, and dementia in older persons: the Cardiovascular Health Study. %A Baker, Michelle L %A Marino Larsen, Emily K %A Kuller, Lewis H %A Klein, Ronald %A Klein, Barbara E K %A Siscovick, David S %A Bernick, Charles %A Manolio, Teri A %A Wong, Tien Yin %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cognition %K Cross-Sectional Studies %K Dementia %K Female %K Humans %K Longitudinal Studies %K Male %K Microcirculation %K Neuropsychological Tests %K Retinal Vessels %K Risk Factors %X

BACKGROUND AND PURPOSE: Cerebral microvascular disease may be a risk factor for the development of dementia in elderly persons. We describe the association of retinal microvascular signs with cognitive function and dementia among older individuals.

METHODS: In the population-based Cardiovascular Health Study, 2211 persons aged 69 to 97 years at recruitment had retinal photography. Photographs were evaluated for retinopathy (eg, microaneurysms, retinal hemorrhages), focal arteriolar narrowing, arteriovenous nicking, and retinal arteriolar and venular caliber. Cognitive status was determined from the Digit-Symbol Substitution Test and Modified Mini-Mental State Examination. Participants were also further evaluated for the presence of dementia with detailed neuropsychological testing. Persons with a prior stroke or taking antipsychotic or antidepressant medications were excluded.

RESULTS: After adjusting for age, gender, race, field center, education level, internal carotid intima-media thickness, body mass index, hypertension, diabetes, and cigarette smoking status, persons with retinopathy had lower mean Digit-Symbol Substitution Test scores but not Modified Mini-Mental State Examination than those without retinopathy (39 versus 41, P=0.002). In hypertensive persons, retinopathy (multivariable-adjusted OR, 2.10; 95% CI, 1.04 to 4.24) and focal arteriolar narrowing (OR, 3.02; 95% CI, 1.51 to 6.02) were associated with dementia. These associations were not present in individuals without hypertension.

CONCLUSIONS: In older persons, our study shows a modest cross-sectional association between retinopathy signs with poorer cognitive function and, in persons with hypertension, with dementia. These data support a possible role of cerebral microvascular disease in the pathogenesis of impaired cognitive function and dementia in older hypertensive persons.

%B Stroke %V 38 %P 2041-7 %8 2007 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/17525385?dopt=Abstract %R 10.1161/STROKEAHA.107.483586 %0 Journal Article %J Stroke %D 2007 %T Risk factors for intracerebral hemorrhage in a pooled prospective study. %A Sturgeon, Jared D %A Folsom, Aaron R %A Longstreth, W T %A Shahar, Eyal %A Rosamond, Wayne D %A Cushman, Mary %K African Americans %K Age Distribution %K Cerebral Hemorrhage %K Cholesterol, LDL %K Female %K Follow-Up Studies %K Humans %K Hypertension %K Incidence %K Male %K Middle Aged %K Multivariate Analysis %K Predictive Value of Tests %K Prevalence %K Prospective Studies %K Risk Factors %K Stroke %K Triglycerides %X

BACKGROUND AND PURPOSE: Few prospective studies have reported risk factors for intracerebral hemorrhage (ICH), and results are inconsistent. We studied risk factors for ICH in a pooled cohort of the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS).

METHODS: The ARIC cohort was recruited in 1987 to 1989 and involves 15 792 men and women, aged 45 to 64 years at baseline, sampled from 4 US communities. The CHS cohort was recruited in 1989 to 1993 and involves 5888 men and women, aged 65 or over at baseline, sampled from 4 US communities. Baseline measurements included many potential vascular risk factors. The cohorts were followed for incident stroke events.

RESULTS: Over 263 489 person-years of follow-up, 135 incident ICH events occurred. In a multivariable model, age, African-American ethnicity (versus Whites), and hypertension were positively associated with incident ICH, whereas low-density lipoprotein cholesterol and triglycerides were inversely related to incident ICH. Participants with systolic blood pressure >or=160 mm Hg or diastolic blood pressure >/=110 mm Hg had 5.55 (95% CI 3.07 to 10.0) times the rate of ICH as nonhypertensives. Sex, smoking, alcohol intake, body mass index, waist-to-hip ratio, waist circumference, and diabetes were not related to ICH.

CONCLUSIONS: In this pooled cohort the risk factors for ICH were older age, African-American ethnicity, hypertension, lower LDL-C, and lower triglycerides.

%B Stroke %V 38 %P 2718-25 %8 2007 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/17761915?dopt=Abstract %R 10.1161/STROKEAHA.107.487090 %0 Journal Article %J Neurobiol Aging %D 2007 %T Ventricular volume and dementia progression in the Cardiovascular Health Study. %A Carmichael, Owen T %A Kuller, Lewis H %A Lopez, Oscar L %A Thompson, Paul M %A Dutton, Rebecca A %A Lu, Allen %A Lee, Sharon E %A Lee, Jessica Y %A Aizenstein, Howard J %A Meltzer, Carolyn Cidis %A Liu, Yanxi %A Toga, Arthur W %A Becker, James T %K Aged %K Aged, 80 and over %K Aging %K Cognition Disorders %K Cross-Sectional Studies %K Dementia %K Disease Progression %K Female %K Follow-Up Studies %K Humans %K Lateral Ventricles %K Linear Models %K Magnetic Resonance Imaging %K Male %K Predictive Value of Tests %K Prospective Studies %K Retrospective Studies %K Time Factors %X

Elevated cerebral ventricular volume may be associated with dementia risk and progression. A fully-automated technique that agreed highly with radiological readings was used to estimate lateral ventricle volume on MR scans done at baseline in 1997-99 of 377 subjects in the Cardiovascular Health Study (CHS) from the Pittsburgh Center. 327 subjects were normal or diagnosed with mild cognitive impairment (MCI) at baseline and were evaluated 4 years later. Baseline ventricular volume was analyzed in multivariate models with age, gender, education level, presence and incidence of cerebral infarcts, and dementia category (normal, MCI, or dementia) at baseline and follow-up as fixed effects. Ventricular volume at baseline was significantly higher among subjects normal at baseline and demented 4 years later. Age, gender, education level, and dementia progression were significant factors affecting ventricular volume. Ventricular volume was higher in dementia compared to MCI, higher in MCI compared to controls, and higher in Possible-Alzheimer's-disease (AD) dementia compared to Probable-AD. Larger ventricles in healthy subjects may indicate susceptibility to, or progression of, dementia-related pathology.

%B Neurobiol Aging %V 28 %P 389-97 %8 2007 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/16504345?dopt=Abstract %R 10.1016/j.neurobiolaging.2006.01.006 %0 Journal Article %J Neurobiol Aging %D 2007 %T White matter grade and ventricular volume on brain MRI as markers of longevity in the cardiovascular health study. %A Kuller, Lewis H %A Arnold, Alice M %A Longstreth, W T %A Manolio, Teri A %A O'Leary, Daniel H %A Burke, Gregory L %A Fried, Linda P %A Newman, Anne B %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Biomarkers %K Brain %K Cardiovascular Diseases %K Cerebral Ventricles %K European Continental Ancestry Group %K Female %K Geriatric Assessment %K Health Status %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Retrospective Studies %K Risk Factors %K Sex Factors %X

High white matter grade (WMG) on magnetic resonance imaging (MRI) is a risk factor for dementia, stroke and disability. Higher ventricular size is a marker of brain "atrophy." In the Cardiovascular Health Study (CHS) (n=3245) mean age 75 years, 50% black and 40% men, we evaluated WM and ventricular grade (VG), total, cardiovascular and noncardiovascular mortality and longevity before and after adjusting for numerous determinants of longevity over an approximate 10-12 years of follow-up. A low WMG and VG was a marker for low total, cardiovascular and noncardiovascular mortality and for increased longevity over 10+ years of follow-up. We estimated that a 75-year-old with WMG below median would have about a 5-6 years greater longevity and for VG about 3 years, than above the median even after adjustment for numerous risk factors. Low WMG and VG on MRI is a powerful determinant of long-term survival among older individuals.

%B Neurobiol Aging %V 28 %P 1307-15 %8 2007 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16857296?dopt=Abstract %R 10.1016/j.neurobiolaging.2006.06.010 %0 Journal Article %J Stroke %D 2008 %T Abnormal regional cerebral blood flow in cognitively normal elderly subjects with hypertension. %A Dai, Weiying %A Lopez, Oscar L %A Carmichael, Owen T %A Becker, James T %A Kuller, Lewis H %A Gach, H Michael %K Aged %K Aged, 80 and over %K Cerebral Cortex %K Cerebrovascular Circulation %K Cognition %K Cognition Disorders %K Female %K Globus Pallidus %K Gyrus Cinguli %K Humans %K Hypertension %K Magnetic Resonance Imaging %K Male %K Putamen %K Spin Labels %X

BACKGROUND AND PURPOSE: The purpose of this study was to examine regional cerebral blood flow (rCBF) in normal cognitive-performing subjects with hypertension (HTN) using continuous arterial spin-labeled MRI. The most common explanation for the effect of blood pressure on cognition is that HTN increases the risk of cerebrovascular disease, and it may increase the risk for Alzheimer disease possibly through small vessel disease, ischemia, oxidative stress, and inflammation. However, few studies to date have examined the rCBF of cognitively normal subjects with HTN in population-based cohorts, and none have used continuous arterial spin-labeled MRI. This is a noninvasive technique that does not require either injections or ionizing radiation and can measure absolute rCBF rates over the entire brain.

METHODS: rCBF was measured at 1.5 T using continuous arterial spin-labeled MRI in 41 cognitively normal subjects who were participating in the Cardiovascular Health Study Cognition Study. A deformable atrophy-corrected registration method was used to warp the rCBF maps to the standard colin27 brain space. Image and cluster-based statistical analyses were performed between subject groups.

RESULTS: Cognitively normal subjects with HTN (n=19) had decreased rCBF in the putamen, globus pallidus, bilaterally, and in the left hippocampus compared with normotensives (n=22). In addition, decreased rCBF was observed in the right and left anterior cingulate gyrus with extension to the subcallosal region, left posterior cingulate gyrus and medial precuneus, left lateral inferior and superior frontal, and inferior parietal, left orbitofrontal, and left superior temporal cortices.

CONCLUSIONS: rCBF is affected in normal subjects with HTN, not only in the subcortical regions, but also in limbic and paralimbic structures. We hypothesize that the HTN creates a vulnerability state for the development of neurodegenerative disorders, especially Alzheimer disease.

%B Stroke %V 39 %P 349-54 %8 2008 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/18174483?dopt=Abstract %R 10.1161/STROKEAHA.107.495457 %0 Journal Article %J Am J Kidney Dis %D 2008 %T Albuminuria and dementia in the elderly: a community study. %A Barzilay, Joshua I %A Fitzpatrick, Annette L %A Luchsinger, Jose %A Yasar, Sevil %A Bernick, Charles %A Jenny, Nancy S %A Kuller, Lewis H %K Age Factors %K Aged %K Aged, 80 and over %K Albuminuria %K Brain %K Cognition %K Cross-Sectional Studies %K Dementia %K Female %K Humans %K Incidence %K Magnetic Resonance Imaging %K Male %K Odds Ratio %K Population Surveillance %K Prognosis %K Retrospective Studies %K Risk Factors %X

BACKGROUND: Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney.

STUDY DESIGN: Cross-sectional analysis.

SETTING & PARTICIPANTS: 2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria.

PREDICTOR: Doubling of albuminuria.

OUTCOME: Dementia defined according to neuropsychological and clinical evaluation.

MEASUREMENTS: Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition.

RESULTS: 283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors.

LIMITATIONS: Results are cross-sectional; causality cannot be imputed.

CONCLUSIONS: The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.

%B Am J Kidney Dis %V 52 %P 216-26 %8 2008 Aug %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/18468749?dopt=Abstract %R 10.1053/j.ajkd.2007.12.044 %0 Journal Article %J J Am Geriatr Soc %D 2008 %T Anemia is associated with the progression of white matter disease in older adults with high blood pressure: the cardiovascular health study. %A Inzitari, Marco %A Studenski, Stephanie %A Rosano, Caterina %A Zakai, Neil A %A Longstreth, William T %A Cushman, Mary %A Newman, Anne B %K Aged %K Anemia %K Brain %K Cardiovascular Diseases %K Disease Progression %K Female %K Humans %K Hypertension %K Leukoaraiosis %K Magnetic Resonance Imaging %K Male %X

OBJECTIVES: To investigate whether anemia predicts worsening white matter hyperintensities (WMHs) in older community-dwellers.

DESIGN: Prospective cohort study.

SETTING: Older community-dwellers.

PARTICIPANTS: One thousand eight hundred forty-six Cardiovascular Health Study (CHS) participants (mean age 73.7 +/- 4.4, 41% male, 15.6% African American).

MEASUREMENTS: Participants had hemoglobin measured and brain magnetic resonance imaging (MRI) in 1992/93 and a second brain MRI in 1997/98. Anemia was defined according to World Health Organization criteria (hemoglobin <12 g/dL in women and <13 g/dL in men). Worsening WMHs were determined according to standardized side-by-side readings.

RESULTS: After 5 years, WMHs worsened in 517 participants (28%). Progression was not associated with anemia in the whole sample, in sex or race strata, or in other prespecified subgroups (participants with renal dysfunction or diabetes mellitus), except in participants with high blood pressure (>or=140/90 mmHg). Of the 678 participants with high blood pressure, those with anemia (10.5%) had a 1.79 times greater risk of WMHs worsening (95% confidence interval=1.06-2.98; P for interaction between anemia and high blood pressure=.01) independent of demographics, baseline WMHs, cardiovascular risk factors and comorbidities, medications, renal function, inflammation, and incident stroke (logistic regression models). There was no greater risk in participants with anemia with normal blood pressure.

CONCLUSION: Anemia may contribute to worsening of WMHs in older adults with high blood pressure.

%B J Am Geriatr Soc %V 56 %P 1867-72 %8 2008 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/18811608?dopt=Abstract %R 10.1111/j.1532-5415.2008.01950.x %0 Journal Article %J JAMA %D 2008 %T Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. %A Fowkes, F G R %A Murray, G D %A Butcher, I %A Heald, C L %A Lee, R J %A Chambless, L E %A Folsom, A R %A Hirsch, A T %A Dramaix, M %A deBacker, G %A Wautrecht, J-C %A Kornitzer, M %A Newman, A B %A Cushman, M %A Sutton-Tyrrell, K %A Fowkes, F G R %A Lee, A J %A Price, J F %A D'Agostino, R B %A Murabito, J M %A Norman, P E %A Jamrozik, K %A Curb, J D %A Masaki, K H %A Rodríguez, B L %A Dekker, J M %A Bouter, L M %A Heine, R J %A Nijpels, G %A Stehouwer, C D A %A Ferrucci, L %A McDermott, M M %A Stoffers, H E %A Hooi, J D %A Knottnerus, J A %A Ogren, M %A Hedblad, B %A Witteman, J C %A Breteler, M M B %A Hunink, M G M %A Hofman, A %A Criqui, M H %A Langer, R D %A Fronek, A %A Hiatt, W R %A Hamman, R %A Resnick, H E %A Guralnik, J %A McDermott, M M %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Ankle %K Atherosclerosis %K Blood Pressure %K Brachial Artery %K Cardiovascular Diseases %K Cohort Studies %K Confidence Intervals %K Female %K Global Health %K Humans %K Male %K Middle Aged %K Odds Ratio %K Predictive Value of Tests %K Risk Assessment %K Risk Factors %K Severity of Illness Index %X

CONTEXT: Prediction models to identify healthy individuals at high risk of cardiovascular disease have limited accuracy. A low ankle brachial index (ABI) is an indicator of atherosclerosis and has the potential to improve prediction.

OBJECTIVE: To determine if the ABI provides information on the risk of cardiovascular events and mortality independently of the Framingham risk score (FRS) and can improve risk prediction.

DATA SOURCES: Relevant studies were identified. A search of MEDLINE (1950 to February 2008) and EMBASE (1980 to February 2008) was conducted using common text words for the term ankle brachial index combined with text words and Medical Subject Headings to capture prospective cohort designs. Review of reference lists and conference proceedings, and correspondence with experts was conducted to identify additional published and unpublished studies.

STUDY SELECTION: Studies were included if participants were derived from a general population, ABI was measured at baseline, and individuals were followed up to detect total and cardiovascular mortality.

DATA EXTRACTION: Prespecified data on individuals in each selected study were extracted into a combined data set and an individual participant data meta-analysis was conducted on individuals who had no previous history of coronary heart disease.

RESULTS: Sixteen population cohort studies fulfilling the inclusion criteria were included. During 480,325 person-years of follow-up of 24,955 men and 23,339 women, the risk of death by ABI had a reverse J-shaped distribution with a normal (low risk) ABI of 1.11 to 1.40. The 10-year cardiovascular mortality in men with a low ABI (< or = 0.90) was 18.7% (95% confidence interval [CI], 13.3%-24.1%) and with normal ABI (1.11-1.40) was 4.4% (95% CI, 3.2%-5.7%) (hazard ratio [HR], 4.2; 95% CI, 3.3-5.4). Corresponding mortalities in women were 12.6% (95% CI, 6.2%-19.0%) and 4.1% (95% CI, 2.2%-6.1%) (HR, 3.5; 95% CI, 2.4-5.1). The HRs remained elevated after adjusting for FRS (2.9 [95% CI, 2.3-3.7] for men vs 3.0 [95% CI, 2.0-4.4] for women). A low ABI (< or = 0.90) was associated with approximately twice the 10-year total mortality, cardiovascular mortality, and major coronary event rate compared with the overall rate in each FRS category. Inclusion of the ABI in cardiovascular risk stratification using the FRS would result in reclassification of the risk category and modification of treatment recommendations in approximately 19% of men and 36% of women.

CONCLUSION: Measurement of the ABI may improve the accuracy of cardiovascular risk prediction beyond the FRS.

%B JAMA %V 300 %P 197-208 %8 2008 Jul 09 %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/18612117?dopt=Abstract %R 10.1001/jama.300.2.197 %0 Journal Article %J Stroke %D 2008 %T Antidepressant treatment and worsening white matter on serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. %A Steffens, David C %A Chung, Hyoju %A Krishnan, K Ranga R %A Longstreth, W T %A Carlson, Michelle %A Burke, Gregory L %K Aged %K Antidepressive Agents %K Antidepressive Agents, Tricyclic %K Cohort Studies %K Disease Progression %K Female %K Follow-Up Studies %K Humans %K Leukoaraiosis %K Magnetic Resonance Imaging %K Male %K Multivariate Analysis %K Risk Assessment %K Serotonin Uptake Inhibitors %X

BACKGROUND AND PURPOSE: In some studies, late life depression is associated with white matter lesions on MRI. The effect of different classes of antidepressants on progression of white matter lesions is unknown. Selective serotonergic reuptake inhibitors (SSRIs) may decrease platelet aggregation. We hypothesized that Cardiovascular Health Study participants taking SSRIs would less often have worsening white matter on serial MRI than participants not on antidepressants.

METHODS: Among 1826 participants who were not using an antidepressant at initial MRI scan, we examined the association of worsening in white matter grade from initial to follow-up MRI scans, 5 years apart on average, and antidepressant use between the scans. Logistic regression models were used, controlling for a variety of potential confounding variables.

RESULTS: Use of any antidepressant during the period of study was associated with worsening white matter. In a multivariable model, risk was slightly increased, not reduced, with use of serotonergic agents (OR 1.36, 95% CI 0.87 to 2.12) and was significantly increased with the use of tricyclic antidepressants (OR 1.77, 95% CI 1.07 to 2.94).

CONCLUSIONS: The association between worsening white matter and use of tricyclic antidepressants was an unexpected finding that may relate to indications for use other than depression or to side effects such as hypotension. Protection against worsening was not seen with use of serotonergic agents.

%B Stroke %V 39 %P 857-62 %8 2008 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/18239166?dopt=Abstract %R 10.1161/STROKEAHA.107.498097 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2008 %T Association of gene variants with incident myocardial infarction in the Cardiovascular Health Study. %A Shiffman, Dov %A O'Meara, Ellen S %A Bare, Lance A %A Rowland, Charles M %A Louie, Judy Z %A Arellano, Andre R %A Lumley, Thomas %A Rice, Kenneth %A Iakoubova, Olga %A Luke, May M %A Young, Bradford A %A Malloy, Mary J %A Kane, John P %A Ellis, Stephen G %A Tracy, Russell P %A Devlin, James J %A Psaty, Bruce M %K African Americans %K Aged %K Aged, 80 and over %K Coronary Disease %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Humans %K Longitudinal Studies %K Male %K Myocardial Infarction %K National Heart, Lung, and Blood Institute (U.S.) %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K United States %X

OBJECTIVE: We asked whether single nucleotide polymorphisms (SNPs) that had been nominally associated with cardiovascular disease in antecedent studies were also associated with cardiovascular disease in a population-based prospective study of 4522 individuals aged 65 or older.

METHODS AND RESULTS: Based on antecedent studies, we prespecified a risk allele and an inheritance model for each of 74 SNPs. We then tested the association of these SNPs with myocardial infarction (MI) in the Cardiovascular Health Study (CHS). The prespecified risk alleles of 8 SNPs were nominally associated (1-sided P<0.05) with increased risk of MI in White CHS participants. The false discovery rate for these 8 was 0.43, suggesting that about 4 of these 8 are likely to be true positives. The 4 of these 8 SNPs that had the strongest evidence for association with cardiovascular disease before testing in CHS (association in 3 antecedent studies) were in KIF6 (CHS HR=1.29; 90%CI 1.1 to 1.52), VAMP8 (HR=1.2; 90%CI 1.02 to 1.41), TAS2R50 (HR=1.13; 90%CI 1 to 1.27), and LPA (HR=1.62; 90%CI 1.09 to 2.42).

CONCLUSIONS: Although most of the SNPs investigated were not associated with MI in CHS, evidence from this investigation combined with previous studies suggests that 4 of these SNPs are likely associated with MI.

%B Arterioscler Thromb Vasc Biol %V 28 %P 173-9 %8 2008 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/17975119?dopt=Abstract %R 10.1161/ATVBAHA.107.153981 %0 Journal Article %J Thromb Haemost %D 2008 %T Associations between common fibrinogen gene polymorphisms and cardiovascular disease in older adults. The Cardiovascular Health Study. %A Carty, Cara L %A Cushman, Mary %A Jones, Daniel %A Lange, Leslie A %A Hindorff, Lucia A %A Rice, Kenneth %A Jenny, Nancy S %A Durda, J Peter %A Walston, Jeremy %A Carlson, Christopher S %A Nickerson, Debbie %A Tracy, Russell P %A Reiner, Alex P %K African Americans %K Age Factors %K Aged %K Brain Ischemia %K Cardiovascular Diseases %K Carotid Artery Diseases %K European Continental Ancestry Group %K Female %K Fibrinogen %K Gene Frequency %K Genetic Predisposition to Disease %K Haplotypes %K Humans %K Male %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Population Surveillance %K Proportional Hazards Models %K Prospective Studies %K Reproducibility of Results %K Risk Assessment %K Risk Factors %K Sex Factors %K Stroke %K United States %X

Elevated plasma fibrinogen is a risk factor for cardiovascular disease (CVD), but associations between fibrinogen single nucleotide polymorphisms (SNPs) and disease risk are inconsistent. We investigated whether common (> or = 5% minor allele frequency) variation in the fibrinogen genes (FGA, FGB, FGG) is associated with fibrinogen concentration, carotid artery intima-medial thickness (IMT) and risk of incident myocardial infarction (MI), ischemic stroke and CVD mortality in European- (EA) and African-descent (AA) adults (> or = 65 years) from the Cardiovascular Health Study. TagSNPs were genotyped in 3,969 EA and 719 AA free of MI or stroke at baseline. Race-specific models included multiple testing correction and adjustment for sex, age and site. Among EA, minor alleles of FGA3807, FGB1437 and FGG902 were associated with higher fibrinogen levels; whereas FGA251, FGA2224, FGA6534 and FGG10034 were associated with lower levels, p<0.004 for each. Strongest associations were seen for FGB1437; each additional copy of the minor allele was associated with 13 mg/dl (95%CI: 9-16) higher fibrinogen level. Similar trends in AA were not significant. Fibrinogen haplotypes were not significantly associated with internal or common carotid IMT. No associations with MI or CVD mortality were seen in EA, though FGB1038 and FGG902 were significantly associated with increased and decreased risk of stroke in men, respectively, as were related haplotypes. FGB1038 was also associated with CVD mortality in AA, HR = 1.9 (95%CI: 1.3-2.7). In conclusion, while fibrinogen genetic variation was strongly associated with fibrinogen levels, there was less evidence of association with the more complex outcomes of IMT and CVD events.

%B Thromb Haemost %V 99 %P 388-95 %8 2008 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/18278190?dopt=Abstract %R 10.1160/TH07-08-0523 %0 Journal Article %J Stroke %D 2008 %T Biomarkers of Inflammation and MRI-Defined Small Vessel Disease of the Brain: The Cardiovascular Health Study. %A Fornage, Myriam %A Chiang, Y Aron %A O'Meara, Ellen S %A Psaty, Bruce M %A Reiner, Alexander P %A Siscovick, David S %A Tracy, Russell P %A Longstreth, W T %K African Continental Ancestry Group %K Aged %K Biomarkers %K Brain Infarction %K C-Reactive Protein %K Cohort Studies %K European Continental Ancestry Group %K Female %K Haplotypes %K Humans %K Inflammation %K Interleukin-6 %K Magnetic Resonance Imaging %K Male %K Polymorphism, Single Nucleotide %X

BACKGROUND AND PURPOSE: To clarify the role of inflammation in the pathogenesis of small vessel disease of the brain, we investigated the association between common variation in the C-reactive protein (CRP) and interleukin (IL)-6 genes, plasma CRP and IL6 levels, and presence of MRI-defined white matter lesions (WML) and brain infarcts (BI) in elderly participants of the Cardiovascular Health Study.

METHODS: Tag single nucleotide polymorphisms (SNPs) in the CRP and IL6 genes were selected from the SeattleSNPs database. In cross-sectional analyses, logistic regression models adjusting for known cardiovascular disease risk factors were constructed to assess the associations of plasma CRP and IL6 levels and common CRP and IL6 gene haplotypes with presence of WML or BI in Blacks (n=532) and Whites (n=2905).

RESULTS: Plasma IL6 and CRP levels were associated with presence of WML and BI in both races. In Whites, common haplotypes of the IL6 gene were significantly associated with WML and BI. The common haplotype tagged by the -174G/C promoter polymorphism was associated with an increased risk of WML (OR=1.14; 95% CI: [1.02; 1.28]). The common haplotype tagged by the -572G/C promoter polymorphism was associated with an increased risk of BI (OR=1.57; 95% CI: [1.15; 2.14]). Significant associations were lacking for WML or BI with IL6 gene variation in Blacks, or with CRP gene variation in either race.

CONCLUSIONS: This study provides evidence of a genetic basis underlying the relationship between plasma biomarkers of inflammation and small vessel disease of the brain. Further studies to elucidate the specific role of IL6 in disease pathogenesis are warranted.

%B Stroke %V 39 %P 1952-9 %8 2008 Jul %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/18436879?dopt=Abstract %R 10.1161/STROKEAHA.107.508135 %0 Journal Article %J J Thromb Haemost %D 2008 %T Common genetic variants associated with plasma fibrin D-dimer concentration in older European- and African-American adults. %A Lange, L A %A Reiner, A P %A Carty, C L %A Jenny, N S %A Cushman, M %A Lange, E M %K Africa %K African Americans %K Aged %K Aged, 80 and over %K Blood Coagulation %K Europe %K European Continental Ancestry Group %K Female %K Fibrin Fibrinogen Degradation Products %K Fibrinogen %K Fibrinolysis %K Genotype %K Humans %K Male %K Middle Aged %K Plasminogen Activator Inhibitor 1 %K Polymorphism, Single Nucleotide %K Prospective Studies %K United States %K Urokinase-Type Plasminogen Activator %X

BACKGROUND AND OBJECTIVES: D-dimer is a hemostasis marker that reflects ongoing fibrin formation and degradation. There is significant inter-individual and inter-population variability in D-dimer concentration, but whether genetic factors underlie these differences is largely unknown. We hypothesized that common coagulation gene variants contribute to differences in circulating D-dimer concentration.

METHODS: The setting was European-American (EA; n = 1858) and African-American (AA; n = 327) unrelated older adults from the Cardiovascular Health Study (CHS), in which we genotyped SNPs in 42 genes related to blood coagulation and fibrinolysis.

RESULTS: Several fibrinogen gene polymorphisms, including the Thr312Ala Aalpha chain variant and the FGG-10034 C/T variant, were associated with approximately 20% higher plasma D-dimer levels in EA (false discovery rate < 5% for covariate-adjusted model). There was also some evidence that a Pro41Leu variant of the PLAU gene encoding urinary plasminogen activator and non-coding polymorphism of the plasminogen activator inhibitor type 1 gene (SERPINE1) were associated with higher plasma D-dimer in EA. There were no significant associations between the studied coagulation or fibrinolysis gene SNPs and plasma D-dimer levels in the smaller AA sample. However, each standard deviation increase in European ancestry assessed by ancestry-informative gene markers was associated with approximately 10% lower mean D-dimer levels in AA.

CONCLUSIONS: Together, common coagulation/fibrinolysis gene SNPs explained only approximately 2% of the variance in plasma D-dimer levels in EA. These findings suggest that the association of D-dimer with risk of vascular outcomes may be mediated largely by environmental factors, other genes, and/or genetic interactions.

%B J Thromb Haemost %V 6 %P 654-9 %8 2008 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/18208536?dopt=Abstract %R 10.1111/j.1538-7836.2008.02906.x %0 Journal Article %J Atherosclerosis %D 2008 %T Common variants in the CRP gene in relation to longevity and cause-specific mortality in older adults: the Cardiovascular Health Study. %A Hindorff, Lucia A %A Rice, Kenneth M %A Lange, Leslie A %A Diehr, Paula %A Halder, Indrani %A Walston, Jeremy %A Kwok, Pui %A Ziv, Elad %A Nievergelt, Caroline %A Cummings, Steven R %A Newman, Anne B %A Tracy, Russell P %A Psaty, Bruce M %A Reiner, Alexander P %K African Americans %K Aged %K C-Reactive Protein %K Cardiovascular Diseases %K Cause of Death %K Cohort Studies %K Female %K Genetic Predisposition to Disease %K Haplotypes %K Humans %K Linear Models %K Longevity %K Male %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K United States %X

Common polymorphisms in the CRP gene are associated with plasma CRP levels in population-based studies, but associations with age-related events are uncertain. A previous study of CRP haplotypes in older adults was broadened to include longevity and cause-specific mortality (all-cause, noncardiovascular (non-CV), and cardiovascular (CV)). Common haplotypes were inferred from four tagSNPs in 4512 whites and five tagSNPs in 812 blacks from the Cardiovascular Health Study, a longitudinal cohort of adults over age 65. Exploratory analyses addressed early versus late mortality. CRP haplotypes were not associated with all-cause mortality or longevity overall in either population, but associations with all-cause mortality differed during early and late periods. In blacks, the haplotype tagged by 3872A (rs1205) was associated with increased risk of non-CV mortality, relative to other haplotypes (adjusted hazard ratio for each additional copy: 1.42, 95% CI: 1.07, 1.87). Relative to other haplotypes, this haplotype was associated with decreased risk of early but not decreased risk of late CV mortality in blacks; among whites, a haplotype tagged by 2667C (rs1800947) gave similar but nonsignificant findings. If confirmed, CRP genetic variants may be weakly associated with CV and non-CV mortality in older adults, particularly in self-identified blacks.

%B Atherosclerosis %V 197 %P 922-30 %8 2008 Apr %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/17888441?dopt=Abstract %R 10.1016/j.atherosclerosis.2007.08.012 %0 Journal Article %J Arch Neurol %D 2008 %T Enhanced risk for Alzheimer disease in persons with type 2 diabetes and APOE epsilon4: the Cardiovascular Health Study Cognition Study. %A Irie, Fumiko %A Fitzpatrick, Annette L %A Lopez, Oscar L %A Kuller, Lewis H %A Peila, Rita %A Newman, Anne B %A Launer, Lenore J %K African Americans %K Age Factors %K Aged %K Alzheimer Disease %K Apolipoprotein E4 %K Cognition %K Cohort Studies %K Confidence Intervals %K Dementia, Vascular %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Female %K Genotype %K Humans %K Longitudinal Studies %K Male %K Neuropsychological Tests %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Sex Factors %X

BACKGROUND: Diabetes and the apolipoprotein E epsilon4 allele (APOE epsilon4) increase the risk for Alzheimer disease (AD). We hypothesize that APOE epsilon4 may modify the risk for AD in individuals with diabetes.

OBJECTIVE: To examine the joint effect of type 2 diabetes and APOE epsilon4 on the risk of AD, AD with vascular dementia (mixed AD), and vascular dementia without AD.

DESIGN: The Cardiovascular Health Study (CHS) Cognition Study (1992-2000) is a prospective study designed to identify all existing and new cases of dementia among study participants. Diagnoses were made according to international criteria for dementia and subtypes. There were 2547 dementia-free participants in the CHS Cognition Study cohort with complete information on APOE epsilon4 and type 2 diabetes status; among these, 411 new cases of dementia developed. Risk of dementia was estimated with a Cox proportional hazard model adjusted for age and other demographic and cardiovascular risk factors.

RESULTS: Compared with those who had neither type 2 diabetes nor APOE epsilon4, those with both factors had a significantly higher risk of AD (hazard ratio, 4.58; 95% confidence interval, 2.18-9.65) and mixed AD (hazard ratio, 3.89; 95% confidence interval, 1.46-10.40).

CONCLUSION: These data suggest that having both diabetes and APOE epsilon4 increases the risk of dementia, especially for AD and mixed AD.

%B Arch Neurol %V 65 %P 89-93 %8 2008 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/18195144?dopt=Abstract %R 10.1001/archneurol.2007.29 %0 Journal Article %J Stat Med %D 2008 %T Evaluation of a method for fitting a semi-Markov process model in the presence of left-censored spells using the Cardiovascular Health Study. %A Cai, Liming %A Schenker, Nathaniel %A Lubitz, James %A Diehr, Paula %A Arnold, Alice %A Fried, Linda P %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cardiovascular System %K Data Interpretation, Statistical %K Disease Progression %K Female %K Humans %K Longitudinal Studies %K Male %K Markov Chains %K Models, Statistical %K Stochastic Processes %K Time Factors %X

We used a longitudinal data set covering 13 years from the Cardiovascular Health Study to evaluate the properties of a recently developed approach to deal with left censoring that fits a semi-Markov process (SMP) model by using an analog to the stochastic EM algorithm--the SMP-EM approach. It appears that the SMP-EM approach gives estimates of duration-dependent probabilities of health changes similar to those obtained by using SMP models that have the advantage of actual duration data. SMP-EM estimates of duration-dependent transition probabilities also appear more accurate and less variable than multi-state life table estimates.

%B Stat Med %V 27 %P 5509-24 %8 2008 Nov 20 %G eng %N 26 %1 https://www.ncbi.nlm.nih.gov/pubmed/18712777?dopt=Abstract %R 10.1002/sim.3382 %0 Journal Article %J Neurology %D 2008 %T Fish consumption and risk of subclinical brain abnormalities on MRI in older adults. %A Virtanen, J K %A Siscovick, D S %A Longstreth, W T %A Kuller, L H %A Mozaffarian, D %K Aged %K Animals %K Brain %K Brain Infarction %K Cooking %K Cross-Sectional Studies %K Diet %K Female %K Fish Products %K Fishes %K Humans %K Magnetic Resonance Imaging %K Male %K Prospective Studies %K Risk %X

OBJECTIVE: To investigate the association between fish consumption and subclinical brain abnormalities.

METHODS: In the population-based Cardiovascular Health Study, 3,660 participants age > or =65 underwent an MRI scan in 1992-1994. Five years later, 2,313 were scanned. Neuroradiologists assessed MRI scans in a standardized and blinded manner. Food frequency questionnaires were used to assess dietary intakes. Participants with known cerebrovascular disease were excluded from the analyses.

RESULTS: After adjustment for multiple risk factors, the risk of having one or more prevalent subclinical infarcts was lower among those consuming tuna/other fish > or =3 times/week, compared to <1/month (relative risk 0.74, 95% CI = 0.54-1.01, p = 0.06, p trend = 0.03). Tuna/other fish consumption was also associated with trends toward lower incidence of subclinical infarcts. Additionally, tuna/other fish intake was associated with better white matter grade, but not with sulcal and ventricular grades, markers of brain atrophy. No significant associations were found between fried fish consumption and any subclinical brain abnormalities.

CONCLUSIONS: Among older adults, modest consumption of tuna/other fish, but not fried fish, was associated with lower prevalence of subclinical infarcts and white matter abnormalities on MRI examinations. Our results add to prior evidence that suggest that dietary intake of fish with higher eicosapentaenoic acid and docosahexaenoic acid content, and not fried fish intake, may have clinically important health benefits.

%B Neurology %V 71 %P 439-46 %8 2008 Aug 05 %G eng %N 6 %1 https://www.ncbi.nlm.nih.gov/pubmed/18678827?dopt=Abstract %R 10.1212/01.wnl.0000324414.12665.b0 %0 Journal Article %J Stroke %D 2008 %T Hemostatic and inflammatory risk factors for intracerebral hemorrhage in a pooled cohort. %A Sturgeon, Jared D %A Folsom, Aaron R %A Longstreth, W T %A Shahar, Eyal %A Rosamond, Wayne D %A Cushman, Mary %K Age Distribution %K Aged %K Biomarkers %K C-Reactive Protein %K Cerebral Hemorrhage %K Cohort Studies %K Factor VIII %K Female %K Fibrinogen %K Follow-Up Studies %K Humans %K Leukocyte Count %K Lipoprotein(a) %K Male %K Middle Aged %K Multivariate Analysis %K Prevalence %K Risk Factors %K Stroke %K United States %K Vasculitis %K von Willebrand Factor %X

BACKGROUND AND PURPOSE: The purpose of this study was to identify novel risk factors for intracerebral hemorrhagic stroke (ICH).

METHODS: Risk factors were assessed at baseline in a pooled cohort of the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS) involving 21,680 adults aged 45 or over. Over 263,489 person-years of follow-up, we identified 135 incident ICH events.

RESULTS: In multivariable models, for each SD higher baseline level of fibrinogen, the relative rate of incident ICH increased 35% (95% CI, 17% to 55%). Fibrinogen was more strongly related to ICH in ARIC than in CHS. In multivariable models, those with von Willebrand factor levels above the median were 1.72 (95% CI, 0.97 to 3.03) times more likely to have an incident ICH as those below the median. Factor VIII was significantly positively related to ICH in ARIC (relative rate per standard deviation of 1.31; 95% CI, 1.07 to 1.62), but not in CHS. There was no relation in multivariable models between lipoprotein (a), Factor VII, white blood cell count, or C-reactive protein and ICH.

CONCLUSIONS: Greater plasma fibrinogen and, to some degree, von Willebrand factor were associated with increased rates of ICH in these prospective studies, whereas Factor VIII was related to ICH in younger ARIC study participants only.

%B Stroke %V 39 %P 2268-73 %8 2008 Aug %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/18535282?dopt=Abstract %R 10.1161/STROKEAHA.107.505800 %0 Journal Article %J Ann Intern Med %D 2008 %T Insulin-like growth factors, their binding proteins, and prostate cancer risk: analysis of individual patient data from 12 prospective studies. %A Roddam, Andrew W %A Allen, Naomi E %A Appleby, Paul %A Key, Timothy J %A Ferrucci, Luigi %A Carter, H Ballentine %A Metter, E Jeffrey %A Chen, Chu %A Weiss, Noel S %A Fitzpatrick, Annette %A Hsing, Ann W %A Lacey, James V %A Helzlsouer, Kathy %A Rinaldi, Sabina %A Riboli, Elio %A Kaaks, Rudolf %A Janssen, Joop A M J L %A Wildhagen, Mark F %A Schröder, Fritz H %A Platz, Elizabeth A %A Pollak, Michael %A Giovannucci, Edward %A Schaefer, Catherine %A Quesenberry, Charles P %A Vogelman, Joseph H %A Severi, Gianluca %A English, Dallas R %A Giles, Graham G %A Stattin, Pär %A Hallmans, Göran %A Johansson, Mattias %A Chan, June M %A Gann, Peter %A Oliver, Steven E %A Holly, Jeff M %A Donovan, Jenny %A Meyer, François %A Bairati, Isabelle %A Galan, Pilar %K Aged %K Humans %K Insulin-Like Growth Factor Binding Protein 2 %K Insulin-Like Growth Factor Binding Protein 3 %K Insulin-Like Growth Factor Binding Proteins %K Insulin-Like Growth Factor I %K Insulin-Like Growth Factor II %K Male %K Middle Aged %K Prospective Studies %K Prostatic Neoplasms %K Risk Factors %K Somatomedins %X

BACKGROUND: Some, but not all, published results have shown an association between circulating blood levels of some insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) and the subsequent risk for prostate cancer.

PURPOSE: To assess the association between levels of IGFs and IGFBPs and the subsequent risk for prostate cancer.

DATA SOURCES: Studies identified in PubMed, Web of Science, and CancerLit.

STUDY SELECTION: The principal investigators of all studies that published data on circulating concentrations of sex steroids, IGFs, or IGFBPs and prostate cancer risk using prospectively collected blood samples were invited to collaborate.

DATA EXTRACTION: Investigators provided individual participant data on circulating concentrations of IGF-I, IGF-II, IGFBP-II, and IGFBP-III and participant characteristics to a central data set in Oxford, United Kingdom.

DATA SYNTHESIS: The study included data on 3700 men with prostate cancer and 5200 control participants. On average, case patients were 61.5 years of age at blood collection and received a diagnosis of prostate cancer 5 years after blood collection. The greater the serum IGF-I concentration, the greater the subsequent risk for prostate cancer (odds ratio [OR] in the highest vs. lowest quintile, 1.38 [95% CI, 1.19 to 1.60]; P < 0.001 for trend). Neither IGF-II nor IGFBP-II concentrations were associated with prostate cancer risk, but statistical power was limited. Insulin-like growth factor I and IGFBP-III were correlated (r = 0.58), and although IGFBP-III concentration seemed to be associated with prostate cancer risk, this was secondary to its association with IGF-I levels. Insulin-like growth factor I concentrations seemed to be more positively associated with low-grade than high-grade disease; otherwise, the association between IGFs and IGFBPs and prostate cancer risk had no statistically significant heterogeneity related to stage or grade of disease, time between blood collection and diagnosis, age and year of diagnosis, prostate-specific antigen level at recruitment, body mass index, smoking, or alcohol intake.

LIMITATIONS: Insulin-like growth factor concentrations were measured in only 1 sample for each participant, and the laboratory methods to measure IGFs differed in each study. Not all patients had disease stage or grade information, and the diagnosis of prostate cancer may differ among the studies.

CONCLUSION: High circulating IGF-I concentrations are associated with a moderately increased risk for prostate cancer.

%B Ann Intern Med %V 149 %P 461-71, W83-8 %8 2008 Oct 07 %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/18838726?dopt=Abstract %R 10.7326/0003-4819-149-7-200810070-00006 %0 Journal Article %J J Clin Epidemiol %D 2008 %T Item response theory facilitated cocalibrating cognitive tests and reduced bias in estimated rates of decline. %A Crane, Paul K %A Narasimhalu, Kaavya %A Gibbons, Laura E %A Mungas, Dan M %A Haneuse, Sebastien %A Larson, Eric B %A Kuller, Lewis %A Hall, Kathleen %A van Belle, Gerald %K Aged %K Aged, 80 and over %K Cognition Disorders %K Dementia %K Disease Progression %K Epidemiologic Methods %K Female %K Humans %K Male %K Neuropsychological Tests %K Psychometrics %X

OBJECTIVE: To cocalibrate the Mini-Mental State Examination, the Modified Mini-Mental State, the Cognitive Abilities Screening Instrument, and the Community Screening Instrument for Dementia using item response theory (IRT) to compare screening cut points used to identify cases of dementia from different studies, to compare measurement properties of the tests, and to explore the implications of these measurement properties on longitudinal studies of cognitive functioning over time.

STUDY DESIGN AND SETTING: We used cross-sectional data from three large (n>1000) community-based studies of cognitive functioning in the elderly. We used IRT to cocalibrate the scales and performed simulations of longitudinal studies.

RESULTS: Screening cut points varied quite widely across studies. The four tests have curvilinear scaling and varied levels of measurement precision, with more measurement error at higher levels of cognitive functioning. In longitudinal simulations, IRT scores always performed better than standard scoring, whereas a strategy to account for varying measurement precision had mixed results.

CONCLUSION: Cocalibration allows direct comparison of cognitive functioning in studies using any of these four tests. Standard scoring appears to be a poor choice for analysis of longitudinal cognitive testing data. More research is needed into the implications of varying levels of measurement precision.

%B J Clin Epidemiol %V 61 %P 1018-27.e9 %8 2008 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/18455909?dopt=Abstract %R 10.1016/j.jclinepi.2007.11.011 %0 Journal Article %J Curr Med Res Opin %D 2008 %T Pancreatic beta-cell function as a predictor of cardiovascular outcomes and costs: findings from the Cardiovascular Health Study. %A Curtis, Lesley H %A Hammill, Bradley G %A Bethel, M Angelyn %A Anstrom, Kevin J %A Liao, Lawrence %A Gottdiener, John S %A Schulman, Kevin A %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cohort Studies %K Coronary Disease %K Female %K Follow-Up Studies %K Health Care Costs %K Heart Failure %K Humans %K Insulin-Secreting Cells %K Male %K Myocardial Infarction %K Outcome Assessment, Health Care %K Prognosis %K Prospective Studies %K Stroke %X

OBJECTIVE: To explore relationships between beta-cell function and incident cardiovascular events, death, and medical costs among elderly individuals.

RESEARCH DESIGN AND METHODS: In a prospective, population-based cohort of 4555 elderly individuals, we examined the effect of beta-cell function on incident cardiovascular events and mortality. We also examined costs for 3715 of these individuals. We used the computer-based homeostasis model assessment (HOMA) to calculate indices of beta-cell function (HOMA-%B) and insulin sensitivity (HOMA-%S) using baseline fasting glucose and insulin levels. All subjects were followed from 1992/1993 for 6 years or until death.

MAIN OUTCOME MEASURES: Discrete-time survival model of the effects of beta-cell function on incident cardiovascular events and all-cause mortality; and semiparametric estimators for calculations of mean 6-year costs.

RESULTS: Controlling for HOMA-%S, a 20% decrease in HOMA-%B was associated with increased odds of incident cardiovascular events (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.05-1.14) and death (OR, 1.10; 95% CI, 1.07-1.14). The relationships persisted after controlling for clinical and sociodemographic confounders. A 20% decrease in HOMA-%B was also associated with increased costs (cost ratio, 1.03; 95% CI, 1.01-1.05). The significant association did not persist after controlling for confounders.

LIMITATIONS: The sample comprises relatively healthy elderly individuals and is based on data from 1992 through 1999, which may not reflect current experience. The measure of beta-cell function is an estimate generated from single measures of glucose and insulin.

CONCLUSIONS: Beta-cell function as measured by HOMA-%B is a significant predictor of incident cardiovascular events and mortality but not of costs, controlling for HOMA-%S and sociodemographic and clinical confounders.

%B Curr Med Res Opin %V 24 %P 41-50 %8 2008 Jan %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/18021490?dopt=Abstract %R 10.1185/030079908x253573 %0 Journal Article %J Neurology %D 2008 %T Plasma amyloid levels and the risk of AD in normal subjects in the Cardiovascular Health Study. %A Lopez, O L %A Kuller, L H %A Mehta, P D %A Becker, J T %A Gach, H M %A Sweet, R A %A Chang, Y F %A Tracy, R %A DeKosky, S T %K Age Factors %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Amyloid beta-Peptides %K Apolipoprotein E4 %K Biomarkers %K Brain %K Cerebrovascular Disorders %K Comorbidity %K Cross-Sectional Studies %K Cystatin C %K Cystatins %K Female %K Humans %K Incidence %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Models, Statistical %K Neuropsychological Tests %K Peptide Fragments %K Predictive Value of Tests %K Prospective Studies %K Reference Values %K Risk Factors %X

OBJECTIVES: To examine the association between incident Alzheimer disease (AD), and plasma A beta 1-40 and A beta 1-42 levels in normal and mild cognitive impairment (MCI) subjects in a subgroup of participants of the Cardiovascular Health Study Cognition Study.

METHODS: We determined the plasma A beta 1-40 and A beta 1-42 levels of 274 nondemented subjects (232 normals and 42 with MCI) in 1998-1999 and repeated the measurements in 2002-2003. The mean age of the subjects at baseline was 79.3 +/- 3.6 years. We examined the association between A beta levels and incident AD over the ensuing 4.5 years, controlling for age, cystatin C level (marker of glomerular function), apolipoprotein E-4 allele, Modified-Mini-Mental State Examination scores, and MRI-identified infarcts.

RESULTS: In an unadjusted prospective model in normal subjects, both A beta 1-40 and A beta 1-42 levels in 1998-1999 were associated with incident AD (n = 55) in 2002-2003 (longitudinal analysis). In the fully adjusted multivariate model, neither A beta 1-42 nor A beta 1-40 nor their ratio was associated with incident AD. However, adjustment had a very small effect on point estimates for A beta 1-42, from an odds ratio (OR) of 1.61 (p = 0.007) in the unadjusted model to an OR of 1.46 (p = 0.08) in the fully adjusted model. In 2002-2003 (cross-sectional analysis), only the unadjusted models showed that both peptides were associated with AD.

CONCLUSIONS: Plasma A beta levels are affected by age and by systemic and CNS vascular risk factors. After controlling for these conditions, A beta-40 and A beta 1-42 are weak predictors of conversion to Alzheimer disease (AD) in normal subjects and are only weakly associated with AD in cross-sectional analysis. Consequently, plasma levels of A beta do not seem to be useful biomarkers for AD.

%B Neurology %V 70 %P 1664-71 %8 2008 May 06 %G eng %N 19 %1 https://www.ncbi.nlm.nih.gov/pubmed/18401021?dopt=Abstract %R 10.1212/01.wnl.0000306696.82017.66 %0 Journal Article %J Am J Hum Genet %D 2008 %T Polymorphisms of the HNF1A gene encoding hepatocyte nuclear factor-1 alpha are associated with C-reactive protein. %A Reiner, Alexander P %A Barber, Mathew J %A Guan, Yongtao %A Ridker, Paul M %A Lange, Leslie A %A Chasman, Daniel I %A Walston, Jeremy D %A Cooper, Gregory M %A Jenny, Nancy S %A Rieder, Mark J %A Durda, J Peter %A Smith, Joshua D %A Novembre, John %A Tracy, Russell P %A Rotter, Jerome I %A Stephens, Matthew %A Nickerson, Deborah A %A Krauss, Ronald M %K Aged %K Bayes Theorem %K C-Reactive Protein %K Female %K Hepatocyte Nuclear Factor 1-alpha %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Pravastatin %K Simvastatin %X

Data from the Pharmacogenomics and Risk of Cardiovascular Disease (PARC) study and the Cardiovascular Health Study (CHS) provide independent and confirmatory evidence for association between common polymorphisms of the HNF1A gene encoding hepatocyte nuclear factor-1 alpha and plasma C-reactive protein (CRP) concentration. Analyses with the use of imputation-based methods to combine genotype data from both studies and to test untyped SNPs from the HapMap database identified several SNPs within a 5 kb region of HNF1A intron 1 with the strongest evidence of association with CRP phenotype.

%B Am J Hum Genet %V 82 %P 1193-201 %8 2008 May %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/18439552?dopt=Abstract %R 10.1016/j.ajhg.2008.03.017 %0 Journal Article %J Circulation %D 2008 %T Prevalence, prognosis, and implications of isolated minor nonspecific ST-segment and T-wave abnormalities in older adults: Cardiovascular Health Study. %A Kumar, Anita %A Prineas, Ronald J %A Arnold, Alice M %A Psaty, Bruce M %A Furberg, Curt D %A Robbins, John %A Lloyd-Jones, Donald M %K Age Factors %K Aged %K Arrhythmias, Cardiac %K Cardiovascular Diseases %K Cohort Studies %K Electrocardiography %K Female %K Health Status %K Humans %K Male %K Middle Aged %K Prevalence %K Prognosis %K Prospective Studies %X

BACKGROUND: The prevalence and prognostic significance of isolated minor nonspecific ST-segment and T-wave abnormalities (NSSTTAs) in older adults are poorly understood.

METHODS AND RESULTS: Cardiovascular Health Study participants free of both clinical cardiovascular disease and major ECG abnormalities were included. We examined the prospective association of isolated minor NSSTTAs (defined by Minnesota Codes 4-3, 4-4, 5-3, and 5-4) with total, cardiovascular, and coronary mortality and incident nonfatal myocardial infarction. Among 3224 participants (61.9% women; mean age, 72 years), 233 (7.2%) had isolated NSSTTAs at baseline. Covariates associated with isolated NSSTTAs included older age, nonwhite race (20.5% of blacks versus 4.8% of whites; P<0.001), diabetes, and higher blood pressure and body mass index but not the presence of subclinical cardiovascular disease. After 39 518 person-years of follow-up, the presence of isolated NSSTTAs was associated with significantly increased risk for coronary heart disease mortality (multivariable-adjusted hazards ratio, 1.76; 95% CI, 1.18 to 2.61) but not with incident nonfatal myocardial infarction (multivariable-adjusted hazards ratio, 0.71; 95% CI, 0.43 to 1.17). The association of isolated NSSTTAs with coronary death was independent of subclinical atherosclerosis and left ventricular mass measures. In secondary analyses, among those with cardiac death, there was a significantly higher rate of primary arrhythmic death (32.3% versus 15.4%; P=0.02) in participants with isolated NSSTTAs versus those without NSSTTAs.

CONCLUSIONS: Isolated NSSTTAs are common in older Americans and are associated with significantly increased risk for coronary death. However, isolated NSSTTAs are not associated with incident nonfatal myocardial infarction, suggesting that they are associated particularly with increased risk for primary arrhythmic death.

%B Circulation %V 118 %P 2790-6 %8 2008 Dec 16 %G eng %N 25 %1 https://www.ncbi.nlm.nih.gov/pubmed/19064684?dopt=Abstract %R 10.1161/CIRCULATIONAHA.108.772541 %0 Journal Article %J J Thromb Haemost %D 2008 %T PROC, PROCR and PROS1 polymorphisms, plasma anticoagulant phenotypes, and risk of cardiovascular disease and mortality in older adults: the Cardiovascular Health Study. %A Reiner, A P %A Carty, C L %A Jenny, N S %A Nievergelt, C %A Cushman, M %A Stearns-Kurosawa, D J %A Kurosawa, S %A Kuller, L H %A Lange, L A %K Aged %K Aged, 80 and over %K Aging %K Antigens, CD %K Blood Coagulation Factor Inhibitors %K Cardiovascular Diseases %K Coronary Disease %K Endothelial Protein C Receptor %K Female %K Humans %K Inflammation %K Male %K Middle Aged %K Mortality %K Polymorphism, Genetic %K Protein C %K Protein S %K Receptors, Cell Surface %K Risk %K Stroke %K Thrombosis %X

BACKGROUND AND OBJECTIVES: Genes encoding protein C anticoagulant pathways are candidates for atherothrombotic and other aging-related disorders.

METHODS: Using a tagSNP approach, and data from the Cardiovascular Health Study (CHS), we assessed associations of common polymorphisms of PROC, PROS1 and PROCR with: (i) plasma protein C, soluble protein C endothelial receptor (sEPCR) and protein S levels measured in a subsample of 336 participants at study entry; and (ii) risk of incident clinical outcomes [coronary heart disease (CHD), stroke, and mortality] in 4547 participants during follow-up. Secondarily, we explored associations between plasma protein C, protein S and sEPCR levels and other candidate genes involved in thrombosis, inflammation, and aging.

RESULTS: The PROCR Ser219Gly polymorphism (rs867186) was strongly associated with higher sEPCR levels, explaining 75% of the phenotypic variation. The PROCR Ser219Gly variant was also associated with higher levels of circulating protein C antigen. An IL10 polymorphism was associated with higher free protein S levels. The minor alleles of PROC rs2069901 and PROS1 rs4857343 were weakly associated with lower protein C and free protein S levels, respectively. There was no association between PROCR Ser219Gly and risk of CHD, stroke, or mortality. The minor allele of another common PROCR tagSNP, rs2069948, was associated with lymphoid PROCR mRNA expression and with increased risk of incident stroke and all-cause mortality, and decreased healthy survival during follow-up.

CONCLUSIONS: A common PROCR variant may be associated with decreased healthy survival in older adults. Additional studies are warranted to establish the role of PROCR variants in ischemic and aging-related disorders.

%B J Thromb Haemost %V 6 %P 1625-32 %8 2008 Oct %G eng %N 10 %1 https://www.ncbi.nlm.nih.gov/pubmed/18680534?dopt=Abstract %R 10.1111/j.1538-7836.2008.03118.x %0 Journal Article %J J Am Geriatr Soc %D 2008 %T The relationship between exercise and risk of venous thrombosis in elderly people. %A van Stralen, Karlijn J %A Doggen, Carine J M %A Lumley, Thomas %A Cushman, Mary %A Folsom, Aaron R %A Psaty, Bruce M %A Siscovick, David %A Rosendaal, Frits R %A Heckbert, Susan R %K Aged %K Aged, 80 and over %K Case-Control Studies %K Cohort Studies %K Energy Metabolism %K Exercise %K Female %K Humans %K Male %K Prevalence %K Risk Factors %K United States %K Venous Thrombosis %X

OBJECTIVES: To study whether exercise is associated with the risk of venous thrombosis in elderly people.

DESIGN: Observational study with a median follow-up of 11.6 years.

SETTING: The Cardiovascular Health Study in four U.S. communities.

PARTICIPANTS: People aged 65 and older without prior venous thrombosis (deep venous thrombosis or pulmonary embolism).

MEASUREMENTS: Self-reported exercise was measured two or three times during follow-up and was defined as expending more than 500 kcal/wk on exercise, including walking for exercise. Venous thrombosis cases were verified using medical record review.

RESULTS: Of 5,534 participants, 171 developed a first venous thrombosis. Self-reported exercise at baseline was not related to the risk of venous thrombosis after adjustment for sex, age, race, self-reported health, and body mass index (adjusted hazard ratio (HR(adj))=1.16, 95% confidence interval (CI)=0.84-1.61), although with exercise modeled as a time-varying exposure, overall results were in the direction of greater risk of venous thrombosis (HR(adj)=1.38, 95% CI=0.99-1.91). For mild-intensity exercise, such as walking, there was a nonsignificant finding in the direction of benefit (HR(adj)=0.75, 95% CI=0.49-1.16), but strenuous exercise, such as jogging, was associated with greater risk of venous thrombosis (HR(adj)=1.75, 95% CI=1.08-2.83) than no exercise at all.

CONCLUSION: In elderly people, strenuous exercise was associated with a higher risk of venous thrombosis than no exercise at all. Future studies are needed to explain this unexpected higher risk.

%B J Am Geriatr Soc %V 56 %P 517-22 %8 2008 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/18179500?dopt=Abstract %R 10.1111/j.1532-5415.2007.01588.x %0 Journal Article %J J Am Coll Cardiol %D 2008 %T Subclinical thyroid dysfunction, cardiac function, and the risk of heart failure. The Cardiovascular Health study. %A Rodondi, Nicolas %A Bauer, Douglas C %A Cappola, Anne R %A Cornuz, Jacques %A Robbins, John %A Fried, Linda P %A Ladenson, Paul W %A Vittinghoff, Eric %A Gottdiener, John S %A Newman, Anne B %K Aged %K Aged, 80 and over %K Cohort Studies %K Echocardiography %K Female %K Heart %K Heart Failure %K Heart Function Tests %K Humans %K Hyperthyroidism %K Hypertrophy, Left Ventricular %K Hypothyroidism %K Male %K Risk Factors %K Time Factors %X

OBJECTIVES: The goal of this study was to determine whether subclinical thyroid dysfunction was associated with incident heart failure (HF) and echocardiogram abnormalities.

BACKGROUND: Subclinical hypothyroidism and hyperthyroidism have been associated with cardiac dysfunction. However, long-term data on the risk of HF are limited.

METHODS: We studied 3,044 adults>or=65 years of age who initially were free of HF in the Cardiovascular Health Study. We compared adjudicated HF events over a mean 12-year follow-up and changes in cardiac function over the course of 5 years among euthyroid participants, those with subclinical hypothyroidism (subdivided by thyroid-stimulating hormone [TSH] levels: 4.5 to 9.9, >or=10.0 mU/l), and those with subclinical hyperthyroidism.

RESULTS: Over the course of 12 years, 736 participants developed HF events. Participants with TSH>or=10.0 mU/l had a greater incidence of HF compared with euthyroid participants (41.7 vs. 22.9 per 1,000 person years, p=0.01; adjusted hazard ratio: 1.88; 95% confidence interval: 1.05 to 3.34). Baseline peak E velocity, which is an echocardiographic measurement of diastolic function associated with incident HF in the CHS cohort, was greater in those patients with TSH>or=10.0 mU/l compared with euthyroid participants (0.80 m/s vs. 0.72 m/s, p=0.002). Over the course of 5 years, left ventricular mass increased among those with TSH>or=10.0 mU/l, but other echocardiographic measurements were unchanged. Those patients with TSH 4.5 to 9.9 mU/l or with subclinical hyperthyroidism had no increase in risk of HF.

CONCLUSIONS: Compared with euthyroid older adults, those adults with TSH>or=10.0 mU/l have a moderately increased risk of HF and alterations in cardiac function but not older adults with TSH<10.0 mU/l. Clinical trials should assess whether the risk of HF might be ameliorated by thyroxine replacement in individuals with TSH>or=10.0 mU/l.

%B J Am Coll Cardiol %V 52 %P 1152-9 %8 2008 Sep 30 %G eng %N 14 %1 https://www.ncbi.nlm.nih.gov/pubmed/18804743?dopt=Abstract %R 10.1016/j.jacc.2008.07.009 %0 Journal Article %J Neurology %D 2009 %T Age, Alzheimer disease, and brain structure. %A Raji, C A %A Lopez, O L %A Kuller, L H %A Carmichael, O T %A Becker, J T %K Aged %K Aged, 80 and over %K Aging %K Alzheimer Disease %K Brain %K Brain Mapping %K Cognition Disorders %K Female %K Humans %K Image Processing, Computer-Assisted %K Linear Models %K Magnetic Resonance Imaging %K Male %K Neuropsychological Tests %K Retrospective Studies %X

BACKGROUND: Lack of clear understanding remains on the overlapping atrophy patterns of aging and early Alzheimer disease (AD) pathology in gray matter (GM) of the brain in vivo.

OBJECTIVE: To evaluate the independent and overlapping patterns of GM atrophy in normal aging and AD.

METHODS: A total of 169 cognitively normal subjects and 33 persons with probable AD enrolled in the longitudinal Cardiovascular Health Study-Cognition Study underwent 3-dimensional volumetric MRI scans. Controls remained cognitively normal for at least 5 years after their MRI scans and the probable AD subjects were relatively early in their clinical course with an average modified Mini-Mental State Examination score of 76/100. The scans were analyzed using voxel-based morphometry adjusting for total intracranial volume, gender, education, and race.

RESULTS: With older age, GM volume was lower in the sensorimotor and heteromodal association areas in frontal, temporal, occipital, and parietal lobes, as well as in the cerebellum (false discovery rate p = 0.05). Additional atrophy was observed in the posterior hippocampus, thalamus, and middle cingulate gyrus. By contrast, atrophy was seen in subjects with AD in the anterior hippocampal/parahippocampal regions and the precuneus. Normal aging and AD overlapped in the hippocampal body and the entorhinal cortex.

CONCLUSION: Brain atrophy with aging was observed in supratentorial and infratentorial areas, as well in primary motor, sensory, and heteromodal association regions. Age and Alzheimer disease exert independent gray matter atrophy patterns but these effects overlapped substantially in the hippocampus and entorhinal cortex.

%B Neurology %V 73 %P 1899-905 %8 2009 Dec 01 %G eng %N 22 %1 http://www.ncbi.nlm.nih.gov/pubmed/19846828?dopt=Abstract %R 10.1212/WNL.0b013e3181c3f293 %0 Journal Article %J Arch Intern Med %D 2009 %T Angiotensin-converting enzyme inhibitors and cognitive decline in older adults with hypertension: results from the Cardiovascular Health Study. %A Sink, Kaycee M %A Leng, Xiaoyan %A Williamson, Jeff %A Kritchevsky, Stephen B %A Yaffe, Kristine %A Kuller, Lewis %A Yasar, Sevil %A Atkinson, Hal %A Robbins, Mike %A Psaty, Bruce %A Goff, David C %K Aged %K Angiotensin-Converting Enzyme Inhibitors %K Blood-Brain Barrier %K Cognition %K Dementia %K Female %K Follow-Up Studies %K Humans %K Hypertension %K Incidence %K Male %K Prospective Studies %K Risk Factors %X

BACKGROUND: Hypertension (HTN) is a risk factor for dementia, and animal studies suggest that centrally active angiotensin-converting enzyme (ACE) inhibitors (those that cross the blood-brain barrier) may protect against dementia beyond HTN control.

METHODS: Participants in the Cardiovascular Health Study Cognition Substudy with treated HTN and no diagnosis of congestive heart failure (n = 1054; mean age, 75 years) were followed up for a median of 6 years to determine whether cumulative exposure to ACE inhibitors (as a class and by central activity), compared with other anti-HTN agents, was associated with a lower risk of incident dementia, cognitive decline (by Modified Mini-Mental State Examination [3MSE]), or incident disability in instrumental activities of daily living (IADLs).

RESULTS: Among 414 participants who were exposed to ACE inhibitors and 640 who were not, there were 158 cases of incident dementia. Compared with other anti-HTN drugs, there was no association between exposure to all ACE inhibitors and risk of dementia (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.88-1.15), difference in 3MSE scores (-0.32 points per year; P = .15), or odds of disability in IADLs (odds ratio [OR], 1.06; 95% CI, 0.99-1.14). Adjusted results were similar. However, centrally active ACE inhibitors were associated with 65% less decline in 3MSE scores per year of exposure (P = .01), and noncentrally active ACE inhibitors were associated with a greater risk of incident dementia (adjusted HR, 1.20; 95% CI, 1.00-1.43 per year of exposure) and greater odds of disability in IADLs (adjusted OR, 1.16; 95% CI, 1.03-1.30 per year of exposure) compared with other anti-HTN drugs.

CONCLUSIONS: While ACE inhibitors as a class do not appear to be independently associated with dementia risk or cognitive decline in older hypertensive adults, there may be within-class differences in regard to these outcomes. These results should be confirmed with a randomized clinical trial of a centrally active ACE inhibitor in the prevention of cognitive decline and dementia.

%B Arch Intern Med %V 169 %P 1195-202 %8 2009 Jul 13 %G eng %N 13 %1 http://www.ncbi.nlm.nih.gov/pubmed/19597068?dopt=Abstract %R 10.1001/archinternmed.2009.175 %0 Journal Article %J Circ Cardiovasc Genet %D 2009 %T Association of novel genetic Loci with circulating fibrinogen levels: a genome-wide association study in 6 population-based cohorts. %A Dehghan, Abbas %A Yang, Qiong %A Peters, Annette %A Basu, Saonli %A Bis, Joshua C %A Rudnicka, Alicja R %A Kavousi, Maryam %A Chen, Ming-Huei %A Baumert, Jens %A Lowe, Gordon D O %A McKnight, Barbara %A Tang, Weihong %A de Maat, Moniek %A Larson, Martin G %A Eyhermendy, Susana %A McArdle, Wendy L %A Lumley, Thomas %A Pankow, James S %A Hofman, Albert %A Massaro, Joseph M %A Rivadeneira, Fernando %A Kolz, Melanie %A Taylor, Kent D %A van Duijn, Cornelia M %A Kathiresan, Sekar %A Illig, Thomas %A Aulchenko, Yurii S %A Volcik, Kelly A %A Johnson, Andrew D %A Uitterlinden, André G %A Tofler, Geoffrey H %A Gieger, Christian %A Psaty, Bruce M %A Couper, David J %A Boerwinkle, Eric %A Koenig, Wolfgang %A O'Donnell, Christopher J %A Witteman, Jacqueline C %A Strachan, David P %A Smith, Nicholas L %A Folsom, Aaron R %K Adult %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cohort Studies %K European Continental Ancestry Group %K Female %K Fibrinogen %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Pedigree %K Polymorphism, Single Nucleotide %K Young Adult %X

BACKGROUND: Fibrinogen is both central to blood coagulation and an acute-phase reactant. We aimed to identify common variants influencing circulation fibrinogen levels.

METHODS AND RESULTS: We conducted a genome-wide association analysis on 6 population-based studies, the Rotterdam Study, the Framingham Heart Study, the Cardiovascular Health Study, the Atherosclerosis Risk in Communities Study, the Monitoring of Trends and Determinants in Cardiovascular Disease/KORA Augsburg Study, and the British 1958 Birth Cohort Study, including 22 096 participants of European ancestry. Four loci were marked by 1 or more single-nucleotide polymorphisms that demonstrated genome-wide significance (P<5.0 x 10(-8)). These included a single-nucleotide polymorphism located in the fibrinogen beta chain (FGB) gene and 3 single-nucleotide polymorphisms representing newly identified loci. The high-signal single-nucleotide polymorphisms were rs1800789 in exon 7 of FGB (P=1.8 x 10(-30)), rs2522056 downstream from the interferon regulatory factor 1 (IRF1) gene (P=1.3 x 10(-15)), rs511154 within intron 1 of the propionyl coenzyme A carboxylase (PCCB) gene (P=5.9 x 10(-10)), and rs1539019 on the NLR family pyrin domain containing 3 isoforms (NLRP3) gene (P=1.04 x 10(-8)).

CONCLUSIONS: Our findings highlight biological pathways that may be important in regulation of inflammation underlying cardiovascular disease.

%B Circ Cardiovasc Genet %V 2 %P 125-33 %8 2009 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20031576?dopt=Abstract %R 10.1161/CIRCGENETICS.108.825224 %0 Journal Article %J Vasc Med %D 2009 %T Brachial artery diameter, blood flow and flow-mediated dilation in sleep-disordered breathing. %A Chami, Hassan A %A Keyes, Michelle J %A Vita, Joseph A %A Mitchell, Gary F %A Larson, Martin G %A Fan, Shuxia %A Vasan, Ramachandran S %A O'Connor, George T %A Benjamin, Emelia J %A Gottlieb, Daniel J %K Adult %K Aged %K Aged, 80 and over %K Blood Flow Velocity %K Brachial Artery %K Cross-Sectional Studies %K Female %K Humans %K Hyperemia %K Hypoxia %K Laser-Doppler Flowmetry %K Male %K Middle Aged %K Polysomnography %K Regional Blood Flow %K Severity of Illness Index %K Sleep Apnea Syndromes %K Ultrasonography %K Vasodilation %X

Clinic-based, case-control studies linked sleep-disordered breathing (SDB) to markers of endothelial dysfunction. We attempted to validate this association in a large community-based sample, and evaluate the relation of SDB to arterial diameter and peripheral blood flow. This community-based, cross-sectional observational study included 327 men and 355 women, aged 42-83 years, from the Framingham Heart Study site of the Sleep Heart Health Study. The polysomnographically derived apnea-hypopnea index and the hypoxemia index (percent sleep time with oxyhemoglobin saturation below 90%) were used to quantify the severity of SDB. Brachial artery ultrasound measurements included baseline diameter, percent flow-mediated dilation, and baseline and hyperemic flow velocity and volume. The baseline brachial artery diameter was significantly associated with both the apnea-hypopnea index and the hypoxemia index. The association was diminished by adjustment for body mass index, but remained significant for the apnea-hypopnea index. Age-, sex-, race- and body mass index-adjusted mean diameters were 4.32, 4.33, 4.33, 4.56, 4.53 mm for those with apnea-hypopnea index < 1.5, 1.5-4.9, 5-14.9, 15-29.9, >/= 30, respectively; p = 0.03. Baseline flow measures were associated with the apnea-hypopnea index but this association was non-significant after adjusting for body mass index. No significant association was observed between measures of SDB and percent flow-mediated dilation or hyperemic flow in any model. In conclusion, this study supports a moderate association of SDB and larger baseline brachial artery diameter, which may reflect SDB-induced vascular remodeling. This study does not support a link between SDB and endothelial dysfunction as measured by brachial artery flow-mediated dilation.

%B Vasc Med %V 14 %P 351-60 %8 2009 Nov %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/19808720?dopt=Abstract %R 10.1177/1358863X09105132 %0 Journal Article %J Circ Cardiovasc Genet %D 2009 %T Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium: Design of prospective meta-analyses of genome-wide association studies from 5 cohorts. %A Psaty, Bruce M %A O'Donnell, Christopher J %A Gudnason, Vilmundur %A Lunetta, Kathryn L %A Folsom, Aaron R %A Rotter, Jerome I %A Uitterlinden, André G %A Harris, Tamara B %A Witteman, Jacqueline C M %A Boerwinkle, Eric %K Adult %K Aged %K Aging %K Cohort Studies %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Heart Diseases %K Humans %K Male %K Meta-Analysis as Topic %K Middle Aged %K Phenotype %K Research Design %K Risk Factors %X

BACKGROUND: The primary aim of genome-wide association studies is to identify novel genetic loci associated with interindividual variation in the levels of risk factors, the degree of subclinical disease, or the risk of clinical disease. The requirement for large sample sizes and the importance of replication have served as powerful incentives for scientific collaboration. Methods- The Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium was formed to facilitate genome-wide association studies meta-analyses and replication opportunities among multiple large population-based cohort studies, which collect data in a standardized fashion and represent the preferred method for estimating disease incidence. The design of the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium includes 5 prospective cohort studies from the United States and Europe: the Age, Gene/Environment Susceptibility-Reykjavik Study, the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study. With genome-wide data on a total of about 38 000 individuals, these cohort studies have a large number of health-related phenotypes measured in similar ways. For each harmonized trait, within-cohort genome-wide association study analyses are combined by meta-analysis. A prospective meta-analysis of data from all 5 cohorts, with a properly selected level of genome-wide statistical significance, is a powerful approach to finding genuine phenotypic associations with novel genetic loci.

CONCLUSIONS: The Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium and collaborating non-member studies or consortia provide an excellent framework for the identification of the genetic determinants of risk factors, subclinical-disease measures, and clinical events.

%B Circ Cardiovasc Genet %V 2 %P 73-80 %8 2009 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20031568?dopt=Abstract %R 10.1161/CIRCGENETICS.108.829747 %0 Journal Article %J Circ Cardiovasc Genet %D 2009 %T Common coding variants of the HNF1A gene are associated with multiple cardiovascular risk phenotypes in community-based samples of younger and older European-American adults: the Coronary Artery Risk Development in Young Adults Study and The Cardiovascula %A Reiner, Alexander P %A Gross, Myron D %A Carlson, Christopher S %A Bielinski, Suzette J %A Lange, Leslie A %A Fornage, Myriam %A Jenny, Nancy S %A Walston, Jeremy %A Tracy, Russell P %A Williams, O Dale %A Jacobs, David R %A Nickerson, Deborah A %K Adolescent %K Adult %K African Americans %K Aged %K Aged, 80 and over %K C-Reactive Protein %K Cardiovascular Diseases %K Cholesterol, LDL %K Cohort Studies %K European Continental Ancestry Group %K Female %K Fibrinogen %K gamma-Glutamyltransferase %K Genetic Predisposition to Disease %K Genotype %K Hepatocyte Nuclear Factor 1-alpha %K Humans %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Risk Factors %X

BACKGROUND: The transcription factor hepatocyte nuclear factor (HNF)-1 alpha regulates the activity of a number of genes involved in innate immunity, blood coagulation, lipid and glucose transport and metabolism, and cellular detoxification. Common polymorphisms of the HNF-1 alpha gene (HNF1A) were recently associated with plasma C-reactive protein and gamma-glutamyl transferase concentration in middle-aged to older European Americans (EA).

METHODS AND RESULTS: We assessed whether common variants of HNF1A are associated with C-reactive protein, gamma-glutamyl transferase, and other atherosclerotic and metabolic risk factors, in the large, population-based Coronary Artery Risk Development in Young Adults Study of healthy young EA (n=2154) and African American (AA; n=2083) adults. The minor alleles of Ile27Leu (rs1169288) and Ser486Asn (rs2464196) were associated with 0.10 to 0.15 standard deviation units lower C-reactive protein and gamma-glutamyl transferase levels in EA. The same HNF1A coding variants were associated with higher low-density lipoprotein cholesterol, apolipoprotein B, creatinine, and fibrinogen in EA. We replicated the associations between HNF1A coding variants and C-reactive protein, fibrinogen, low-density lipoprotein cholesterol, and renal function in a second population-based sample of EA adults 65 years and older from the Cardiovascular Health Study. The HNF1A Ser486Asn and/or Ile27Leu variants were also associated with increased risk of subclinical coronary atherosclerosis in Coronary Artery Risk Development in Young Adults and with incident coronary heart disease in Cardiovascular Health Study. The Ile27Leu and Ser486Asn variants were 3-fold less common in AA than in EA. There was little evidence of association between HNF1A genotype and atherosclerosis-related phenotypes in AA.

CONCLUSIONS: Common polymorphisms of HNF1A seem to influence multiple phenotypes related to cardiovascular risk in the general population of younger and older EA adults.

%B Circ Cardiovasc Genet %V 2 %P 244-54 %8 2009 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20031592?dopt=Abstract %R 10.1161/CIRCGENETICS.108.839506 %0 Journal Article %J J Thromb Haemost %D 2009 %T Common hemostasis and inflammation gene variants and venous thrombosis in older adults from the Cardiovascular Health Study. %A Reiner, A P %A Lange, L A %A Smith, N L %A Zakai, N A %A Cushman, M %A Folsom, A R %K Aged %K Alleles %K Factor V %K Factor VIII %K Female %K Hemostasis %K Humans %K Inflammation %K Male %K Middle Aged %K Models, Genetic %K Plasminogen %K Prothrombin %K Risk %K Serine Endopeptidases %K Venous Thrombosis %X

BACKGROUND/OBJECTIVES: Age-related changes in blood coagulation and fibrinolysis are associated with increased risk of thrombotic events. Inherited deficiencies of coagulation proteins, such as factor V (FV) Leiden and prothrombin G20210A, explain a small fraction of venous thromboembolic disease (VTE). Additional genetic factors are likely to underlie the etiology of VTE, some of which may become manifest at older ages.

METHODS: We tested 290 common SNPs within 51 thrombosis and inflammation genes for association with VTE in the Cardiovascular Health Study, a large, prospective cohort of older adults followed for up to 12 years.

RESULTS: There were 184 VTE events that occurred at mean age of 78 years. TagSNPs within four genes encoding FXIII subunit A (F13A), FVII activating protease (HABP2), protease activated receptor-1 (F2R) and the urokinase receptor (PLAUR) showed the strongest evidence for association with VTE, with each gene having a global P-value < 0.05 and at least one tagSNP false discovery rate (FDR) q-value < 0.05. The rs3024409 variant allele of F13A1 was associated with 1.66-fold increased risk of VTE, while the minor alleles of HABP2 rs6585234 and rs3862019, F2R rs253061 and rs153311, and PLAUR rs344782 were each associated with lower risk of VTE (hazard ratios in the range of 0.49-0.66). Consistent with the observed protective association for VTE risk, the HABP2 rs3862019 variant allele was also associated with lower activity levels of coagulation factors FVIII, FIX, FX and plasminogen. We also confirm previously reported associations between common variants of the coagulation FII, FV, FVIII, FXI, alpha-fibrinogen and protein C genes and risk of VTE.

CONCLUSIONS: These findings suggest that several novel common coagulation gene variants may be related to risk of VTE in older adults. Further studies in older adults are needed to validate these findings and assess functional molecular mechanisms.

%B J Thromb Haemost %V 7 %P 1499-505 %8 2009 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/19552680?dopt=Abstract %R 10.1111/j.1538-7836.2009.03522.x %0 Journal Article %J Nat Genet %D 2009 %T Common variants at ten loci influence QT interval duration in the QTGEN Study. %A Newton-Cheh, Christopher %A Eijgelsheim, Mark %A Rice, Kenneth M %A de Bakker, Paul I W %A Yin, Xiaoyan %A Estrada, Karol %A Bis, Joshua C %A Marciante, Kristin %A Rivadeneira, Fernando %A Noseworthy, Peter A %A Sotoodehnia, Nona %A Smith, Nicholas L %A Rotter, Jerome I %A Kors, Jan A %A Witteman, Jacqueline C M %A Hofman, Albert %A Heckbert, Susan R %A O'Donnell, Christopher J %A Uitterlinden, André G %A Psaty, Bruce M %A Lumley, Thomas %A Larson, Martin G %A Stricker, Bruno H Ch %K Adaptor Proteins, Signal Transducing %K Adult %K Aged %K Arrhythmias, Cardiac %K Chromosome Mapping %K Death, Sudden, Cardiac %K Electroencephalography %K ERG1 Potassium Channel %K Ether-A-Go-Go Potassium Channels %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genetic Variation %K Genome, Human %K Humans %K KCNQ1 Potassium Channel %K Meta-Analysis as Topic %K Muscle Proteins %K NAV1.5 Voltage-Gated Sodium Channel %K Polymorphism, Single Nucleotide %K Potassium Channels, Voltage-Gated %K Risk Factors %K Sodium Channels %X

QT interval duration, reflecting myocardial repolarization on the electrocardiogram, is a heritable risk factor for sudden cardiac death and drug-induced arrhythmias. We conducted a meta-analysis of three genome-wide association studies in 13,685 individuals of European ancestry from the Framingham Heart Study, the Rotterdam Study and the Cardiovascular Health Study, as part of the QTGEN consortium. We observed associations at P < 5 x 10(-8) with variants in NOS1AP, KCNQ1, KCNE1, KCNH2 and SCN5A, known to be involved in myocardial repolarization and mendelian long-QT syndromes. Associations were found at five newly identified loci, including 16q21 near NDRG4 and GINS3, 6q22 near PLN, 1p36 near RNF207, 16p13 near LITAF and 17q12 near LIG3 and RFFL. Collectively, the 14 independent variants at these 10 loci explain 5.4-6.5% of the variation in QT interval. These results, together with an accompanying paper, offer insights into myocardial repolarization and suggest candidate genes that could predispose to sudden cardiac death and drug-induced arrhythmias.

%B Nat Genet %V 41 %P 399-406 %8 2009 Apr %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/19305408?dopt=Abstract %R 10.1038/ng.364 %0 Journal Article %J Cancer Causes Control %D 2009 %T C-reactive protein, interleukin-6, and prostate cancer risk in men aged 65 years and older. %A Pierce, Brandon L %A Biggs, Mary L %A DeCambre, Marvalyn %A Reiner, Alexander P %A Li, Christopher %A Fitzpatrick, Annette %A Carlson, Christopher S %A Stanford, Janet L %A Austin, Melissa A %K African Americans %K Aged %K Aged, 80 and over %K Biomarkers %K C-Reactive Protein %K European Continental Ancestry Group %K Humans %K Inflammation %K Interleukin-6 %K Male %K Polymorphism, Single Nucleotide %K Prospective Studies %K Prostatic Neoplasms %K Risk Factors %X

Inflammation is believed to play a role in prostate cancer (PCa) etiology, but it is unclear whether inflammatory markers C-reactive protein (CRP) and interleukin-6 (IL-6) associate with PCa risk in older men. Using Cox regression, we assessed the relationship between baseline concentrations of CRP and IL-6 and the subsequent PCa risk in the Cardiovascular Health Study, a population-based cohort study of mostly European American men of ages >64 years (n = 2,234; mean follow-up = 8.7 years; 215 incident PCa cases). We also tested associations between CRP and IL-6 tagSNPs and PCa risk, focusing on SNPs that are known to associate with circulating CRP and/or IL-6. Neither CRP nor IL-6 blood concentrations was associated with PCa risk. The C allele of IL-6 SNP rs1800795 (-174), a known functional variant, was associated with increased risk in a dominant model (HR = 1.44; 95% CI = 1.03-2.01; p = 0.03), but was not statistically significant after accounting for multiple tests (permutation p = 0.21). Our results suggest that circulating CRP and IL-6 do not influence PCa risk. SNPs at the CRP locus are not associated with PCa risk in this cohort, while the association between rs1800795 and PCa risk warrants further investigation.

%B Cancer Causes Control %V 20 %P 1193-203 %8 2009 Sep %G eng %N 7 %1 https://www.ncbi.nlm.nih.gov/pubmed/19267250?dopt=Abstract %R 10.1007/s10552-009-9320-4 %0 Journal Article %J Am J Geriatr Psychiatry %D 2009 %T Depressed mood is not a risk factor for incident dementia in a community-based cohort. %A Becker, James T %A Chang, Yue-Fang %A Lopez, Oscar L %A Dew, Mary Amanda %A Sweet, Robert A %A Barnes, Deborah %A Yaffe, Kristine %A Young, Jeffrey %A Kuller, Lewis %A Reynolds, Charles F %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Cognition Disorders %K Dementia %K Depression %K Female %K Follow-Up Studies %K Humans %K Incidence %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Mental Status Schedule %K Prospective Studies %K Psychiatric Status Rating Scales %K Residence Characteristics %K Risk Factors %X

OBJECTIVES: To determine the relationship between depressed mood and the development of Alzheimer disease in cognitively normal individuals.

DESIGN: Longitudinal and observational.

SETTING: Community-based cohort study.

PARTICIPANTS: A total of 288 participants in the Cardiovascular Health Study-Cognition Study (mean age: 77.52, SD =3.65, range: 70-89). All of the participants were adjudicated as cognitively normal in 1998/1999, and all had at least three visits before 1998/1999 with measures of cognition and mood state. The mean length of follow-up from 1998-1999 to 2007 was 7.1 years (range: 1-9 years, median =9 years).

MEASUREMENTS: The Center for Epidemiological Studies-Depression Scale (CESD) was used to index mood state, and the Modified Mini-Mental State Examination (3MSE) was the index of cognitive function among participants before 1998/1999. These measures were considered in two ways: participants were classified according to: 1) whether they showed a high-negative correlation between their CESD and 3MSE scores (i.e., indicating that greater depression was linked to poorer cognition) and 2) whether they showed persistently elevated CESD scores. The study outcome, development of dementia (N = 48), was based on consensus classifications, which was based on detailed neuropsychological and neurological exams.

RESULTS: The authors could find no consistent relationship between mood state, either alone or in relation to cognitive status, and the subsequent development of dementia. Those individuals whose cognitive functions were highly correlated with their mood state were no more likely to develop dementia than other participants. Those who had persistently depressed mood were also no more likely to develop dementia than those without persistently depressed mood.

CONCLUSION: Within the confines of this prospective, community-based study of elderly adults, the authors could not find strong evidence to support the hypothesis that mood disturbance was linked with the development of dementia.

%B Am J Geriatr Psychiatry %V 17 %P 653-63 %8 2009 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/19634208?dopt=Abstract %0 Journal Article %J Arch Ophthalmol %D 2009 %T Early age-related macular degeneration, cognitive function, and dementia: the Cardiovascular Health Study. %A Baker, Michelle L %A Wang, Jie Jin %A Rogers, Sophie %A Klein, Ronald %A Kuller, Lewis H %A Larsen, Emily K %A Wong, Tien Yin %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cognition Disorders %K Dementia %K Female %K Humans %K Intelligence Tests %K Macular Degeneration %K Male %K Neuropsychological Tests %K Odds Ratio %K Prospective Studies %K Risk Factors %K United States %X

OBJECTIVE: To describe the association of cognitive function and dementia with early age-related macular degeneration (AMD) in older individuals.

METHODS: This population-based study included 2,088 persons aged 69 to 97 years who participated in the Cardiovascular Health Study. The AMD was assessed from retinal photographs based on a modified Wisconsin AMD grading system. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST) and the Modified Mini-Mental State Examination. Participants were also evaluated for dementia using detailed neuropsychological testing.

RESULTS: After controlling for age, sex, race, and study center, persons with low DSST scores (lowest quartile of scores, < or =30) were more likely to have early AMD (odds ratio, 1.38; 95% confidence interval, 1.03-1.85) than were persons with higher DSST scores. In analyses further controlling for education, systolic blood pressure, total cholesterol level, diabetes mellitus, smoking status, and apolipoprotein E genotype, this association was stronger (odds ratio, 2.00; 95% confidence interval, 1.29-3.10). There was no association of low Modified Mini-Mental State Examination scores, dementia, or Alzheimer disease with early AMD.

CONCLUSIONS: In this older population, cognitive impairment may share common age-related pathogenesis and risk factors with early AMD.

%B Arch Ophthalmol %V 127 %P 667-73 %8 2009 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/19433718?dopt=Abstract %R 10.1001/archophthalmol.2009.30 %0 Journal Article %J Stroke %D 2009 %T Gene variants associated with ischemic stroke: the cardiovascular health study. %A Luke, May M %A O'Meara, Ellen S %A Rowland, Charles M %A Shiffman, Dov %A Bare, Lance A %A Arellano, Andre R %A Longstreth, W T %A Lumley, Thomas %A Rice, Kenneth %A Tracy, Russell P %A Devlin, James J %A Psaty, Bruce M %K African Continental Ancestry Group %K Aged %K Alleles %K Brain Ischemia %K Cardiovascular Diseases %K Coronary Disease %K Ethnic Groups %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Variation %K Humans %K Kaplan-Meier Estimate %K Male %K Polymorphism, Single Nucleotide %K Prospective Studies %K Risk Factors %K Stroke %K United States %X

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether 74 single nucleotide polymorphisms (SNPs), which had been associated with coronary heart disease, are associated with incident ischemic stroke.

METHODS: Based on antecedent studies of coronary heart disease, we prespecified the risk allele for each of the 74 SNPs. We used Cox proportional hazards models that adjusted for traditional risk factors to estimate the associations of these SNPs with incident ischemic stroke during 14 years of follow-up in a population-based study of older adults: the Cardiovascular Health Study (CHS).

RESULTS: In white CHS participants, the prespecified risk alleles of 7 of the 74 SNPs (in HPS1, ITGAE, ABCG2, MYH15, FSTL4, CALM1, and BAT2) were nominally associated with increased risk of stroke (one-sided P<0.05, false discovery rate=0.42). In black participants, the prespecified risk alleles of 5 SNPs (in KRT4, LY6G5B, EDG1, DMXL2, and ABCG2) were nominally associated with stroke (one-sided P<0.05, false discovery rate=0.55). The Val12Met SNP in ABCG2 was associated with stroke in both white (hazard ratio, 1.46; 90% CI, 1.05 to 2.03) and black (hazard ratio, 3.59; 90% CI, 1.11 to 11.6) participants of CHS. Kaplan-Meier estimates of the 10-year cumulative incidence of stroke were greater among Val allele homozygotes than among Met allele carriers in both white (10% versus 6%) and black (12% versus 3%) participants of CHS.

CONCLUSIONS: The Val12Met SNP in ABCG2 (encoding a transporter of sterols and xenobiotics) was associated with incident ischemic stroke in white and black participants of CHS.

%B Stroke %V 40 %P 363-8 %8 2009 Feb %G eng %N 2 %1 https://www.ncbi.nlm.nih.gov/pubmed/19023099?dopt=Abstract %R 10.1161/STROKEAHA.108.521328 %0 Journal Article %J JAMA %D 2009 %T Genetic variants associated with cardiac structure and function: a meta-analysis and replication of genome-wide association data. %A Vasan, Ramachandran S %A Glazer, Nicole L %A Felix, Janine F %A Lieb, Wolfgang %A Wild, Philipp S %A Felix, Stephan B %A Watzinger, Norbert %A Larson, Martin G %A Smith, Nicholas L %A Dehghan, Abbas %A Grosshennig, Anika %A Schillert, Arne %A Teumer, Alexander %A Schmidt, Reinhold %A Kathiresan, Sekar %A Lumley, Thomas %A Aulchenko, Yurii S %A König, Inke R %A Zeller, Tanja %A Homuth, Georg %A Struchalin, Maksim %A Aragam, Jayashri %A Bis, Joshua C %A Rivadeneira, Fernando %A Erdmann, Jeanette %A Schnabel, Renate B %A Dörr, Marcus %A Zweiker, Robert %A Lind, Lars %A Rodeheffer, Richard J %A Greiser, Karin Halina %A Levy, Daniel %A Haritunians, Talin %A Deckers, Jaap W %A Stritzke, Jan %A Lackner, Karl J %A Völker, Uwe %A Ingelsson, Erik %A Kullo, Iftikhar %A Haerting, Johannes %A O'Donnell, Christopher J %A Heckbert, Susan R %A Stricker, Bruno H %A Ziegler, Andreas %A Reffelmann, Thorsten %A Redfield, Margaret M %A Werdan, Karl %A Mitchell, Gary F %A Rice, Kenneth %A Arnett, Donna K %A Hofman, Albert %A Gottdiener, John S %A Uitterlinden, André G %A Meitinger, Thomas %A Blettner, Maria %A Friedrich, Nele %A Wang, Thomas J %A Psaty, Bruce M %A van Duijn, Cornelia M %A Wichmann, H-Erich %A Munzel, Thomas F %A Kroemer, Heyo K %A Benjamin, Emelia J %A Rotter, Jerome I %A Witteman, Jacqueline C %A Schunkert, Heribert %A Schmidt, Helena %A Völzke, Henry %A Blankenberg, Stefan %K Adult %K Aged %K Aged, 80 and over %K Aorta %K Cardiovascular Diseases %K Echocardiography %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Genotype %K Heart Atria %K Heart Ventricles %K Humans %K Male %K Middle Aged %K Organ Size %K Phenotype %K Polymorphism, Single Nucleotide %K Risk Factors %K Ventricular Dysfunction, Left %K Ventricular Function, Left %X

CONTEXT: Echocardiographic measures of left ventricular (LV) structure and function are heritable phenotypes of cardiovascular disease.

OBJECTIVE: To identify common genetic variants associated with cardiac structure and function by conducting a meta-analysis of genome-wide association data in 5 population-based cohort studies (stage 1) with replication (stage 2) in 2 other community-based samples.

DESIGN, SETTING, AND PARTICIPANTS: Within each of 5 community-based cohorts comprising the EchoGen consortium (stage 1; n = 12 612 individuals of European ancestry; 55% women, aged 26-95 years; examinations between 1978-2008), we estimated the association between approximately 2.5 million single-nucleotide polymorphisms (SNPs; imputed to the HapMap CEU panel) and echocardiographic traits. In stage 2, SNPs significantly associated with traits in stage 1 were tested for association in 2 other cohorts (n = 4094 people of European ancestry). Using a prespecified P value threshold of 5 x 10(-7) to indicate genome-wide significance, we performed an inverse variance-weighted fixed-effects meta-analysis of genome-wide association data from each cohort.

MAIN OUTCOME MEASURES: Echocardiographic traits: LV mass, internal dimensions, wall thickness, systolic dysfunction, aortic root, and left atrial size.

RESULTS: In stage 1, 16 genetic loci were associated with 5 echocardiographic traits: 1 each with LV internal dimensions and systolic dysfunction, 3 each with LV mass and wall thickness, and 8 with aortic root size. In stage 2, 5 loci replicated (6q22 locus associated with LV diastolic dimensions, explaining <1% of trait variance; 5q23, 12p12, 12q14, and 17p13 associated with aortic root size, explaining 1%-3% of trait variance).

CONCLUSIONS: We identified 5 genetic loci harboring common variants that were associated with variation in LV diastolic dimensions and aortic root size, but such findings explained a very small proportion of variance. Further studies are required to replicate these findings, identify the causal variants at or near these loci, characterize their functional significance, and determine whether they are related to overt cardiovascular disease.

%B JAMA %V 302 %P 168-78 %8 2009 Jul 08 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/19584346?dopt=Abstract %R 10.1001/jama.2009.978-a %0 Journal Article %J N Engl J Med %D 2009 %T Genomewide association studies of stroke. %A Ikram, M Arfan %A Seshadri, Sudha %A Bis, Joshua C %A Fornage, Myriam %A DeStefano, Anita L %A Aulchenko, Yurii S %A Debette, Stephanie %A Lumley, Thomas %A Folsom, Aaron R %A van den Herik, Evita G %A Bos, Michiel J %A Beiser, Alexa %A Cushman, Mary %A Launer, Lenore J %A Shahar, Eyal %A Struchalin, Maksim %A Du, Yangchun %A Glazer, Nicole L %A Rosamond, Wayne D %A Rivadeneira, Fernando %A Kelly-Hayes, Margaret %A Lopez, Oscar L %A Coresh, Josef %A Hofman, Albert %A DeCarli, Charles %A Heckbert, Susan R %A Koudstaal, Peter J %A Yang, Qiong %A Smith, Nicholas L %A Kase, Carlos S %A Rice, Kenneth %A Haritunians, Talin %A Roks, Gerwin %A de Kort, Paul L M %A Taylor, Kent D %A de Lau, Lonneke M %A Oostra, Ben A %A Uitterlinden, André G %A Rotter, Jerome I %A Boerwinkle, Eric %A Psaty, Bruce M %A Mosley, Thomas H %A van Duijn, Cornelia M %A Breteler, Monique M B %A Longstreth, W T %A Wolf, Philip A %K African Continental Ancestry Group %K Aged %K Chromosomes, Human, Pair 12 %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Markers %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K Risk Factors %K Stroke %X

BACKGROUND: The genes underlying the risk of stroke in the general population remain undetermined.

METHODS: We carried out an analysis of genomewide association data generated from four large cohorts composing the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, including 19,602 white persons (mean [+/-SD] age, 63+/-8 years) in whom 1544 incident strokes (1164 ischemic strokes) developed over an average follow-up of 11 years. We tested the markers most strongly associated with stroke in a replication cohort of 2430 black persons with 215 incident strokes (191 ischemic strokes), another cohort of 574 black persons with 85 incident strokes (68 ischemic strokes), and 652 Dutch persons with ischemic stroke and 3613 unaffected persons.

RESULTS: Two intergenic single-nucleotide polymorphisms on chromosome 12p13 and within 11 kb of the gene NINJ2 were associated with stroke (P<5x10(-8)). NINJ2 encodes an adhesion molecule expressed in glia and shows increased expression after nerve injury. Direct genotyping showed that rs12425791 was associated with an increased risk of total (i.e., all types) and ischemic stroke, with hazard ratios of 1.30 (95% confidence interval [CI], 1.19 to 1.42) and 1.33 (95% CI, 1.21 to 1.47), respectively, yielding population attributable risks of 11% and 12% in the discovery cohorts. Corresponding hazard ratios were 1.35 (95% CI, 1.01 to 1.79; P=0.04) and 1.42 (95% CI, 1.06 to 1.91; P=0.02) in the large cohort of black persons and 1.17 (95% CI, 1.01 to 1.37; P=0.03) and 1.19 (95% CI, 1.01 to 1.41; P=0.04) in the Dutch sample; the results of an underpowered analysis of the smaller black cohort were nonsignificant.

CONCLUSIONS: A genetic locus on chromosome 12p13 is associated with an increased risk of stroke.

%B N Engl J Med %V 360 %P 1718-28 %8 2009 Apr 23 %G eng %N 17 %1 https://www.ncbi.nlm.nih.gov/pubmed/19369658?dopt=Abstract %R 10.1056/NEJMoa0900094 %0 Journal Article %J Nat Genet %D 2009 %T Genome-wide association study of blood pressure and hypertension. %A Levy, Daniel %A Ehret, Georg B %A Rice, Kenneth %A Verwoert, Germaine C %A Launer, Lenore J %A Dehghan, Abbas %A Glazer, Nicole L %A Morrison, Alanna C %A Johnson, Andrew D %A Aspelund, Thor %A Aulchenko, Yurii %A Lumley, Thomas %A Köttgen, Anna %A Vasan, Ramachandran S %A Rivadeneira, Fernando %A Eiriksdottir, Gudny %A Guo, Xiuqing %A Arking, Dan E %A Mitchell, Gary F %A Mattace-Raso, Francesco U S %A Smith, Albert V %A Taylor, Kent %A Scharpf, Robert B %A Hwang, Shih-Jen %A Sijbrands, Eric J G %A Bis, Joshua %A Harris, Tamara B %A Ganesh, Santhi K %A O'Donnell, Christopher J %A Hofman, Albert %A Rotter, Jerome I %A Coresh, Josef %A Benjamin, Emelia J %A Uitterlinden, André G %A Heiss, Gerardo %A Fox, Caroline S %A Witteman, Jacqueline C M %A Boerwinkle, Eric %A Wang, Thomas J %A Gudnason, Vilmundur %A Larson, Martin G %A Chakravarti, Aravinda %A Psaty, Bruce M %A van Duijn, Cornelia M %K Blood Pressure %K Cell Line %K Chromosome Mapping %K Chromosomes, Human %K Diastole %K Gene Expression Regulation %K Genetic Association Studies %K Genome-Wide Association Study %K Humans %K Hypertension %K Liver %K Lymphocytes %K Meta-Analysis as Topic %K Odds Ratio %K Phenotype %K Prevalence %K Risk Assessment %K Systole %X

Blood pressure is a major cardiovascular disease risk factor. To date, few variants associated with interindividual blood pressure variation have been identified and replicated. Here we report results of a genome-wide association study of systolic (SBP) and diastolic (DBP) blood pressure and hypertension in the CHARGE Consortium (n = 29,136), identifying 13 SNPs for SBP, 20 for DBP and 10 for hypertension at P < 4 × 10(-7). The top ten loci for SBP and DBP were incorporated into a risk score; mean BP and prevalence of hypertension increased in relation to the number of risk alleles carried. When ten CHARGE SNPs for each trait were included in a joint meta-analysis with the Global BPgen Consortium (n = 34,433), four CHARGE loci attained genome-wide significance (P < 5 × 10(-8)) for SBP (ATP2B1, CYP17A1, PLEKHA7, SH2B3), six for DBP (ATP2B1, CACNB2, CSK-ULK3, SH2B3, TBX3-TBX5, ULK4) and one for hypertension (ATP2B1). Identifying genes associated with blood pressure advances our understanding of blood pressure regulation and highlights potential drug targets for the prevention or treatment of hypertension.

%B Nat Genet %V 41 %P 677-87 %8 2009 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19430479?dopt=Abstract %R 10.1038/ng.384 %0 Journal Article %J J Neuroimaging %D 2009 %T Imaging cerebral blood flow in the cognitively normal aging brain with arterial spin labeling: implications for imaging of neurodegenerative disease. %A Lee, Charles %A Lopez, Oscar L %A Becker, James T %A Raji, Cyrus %A Dai, Weiying %A Kuller, Lewis H %A Gach, H Michael %K Aged, 80 and over %K Aging %K Brain %K Brain Mapping %K Cerebrovascular Circulation %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Neurodegenerative Diseases %K Signal Processing, Computer-Assisted %K Spin Labels %X

INTRODUCTION: Arterial spin labeling (ASL) is a safe, noninvasive imaging method for evaluating cerebral blood flow (rCBF). The purpose of this article is to present ASL imaging features of 38 elderly cognitively normals (CN) with their rCBF values and an averaged profile of targeted anatomic regions rCBF values.

METHODS: Thirty-eight CN underwent MR imaging especially ASL with voxel morphometric techniques fusing the MR anatomical and ASL images to a standard reference brain (colin27). The ASL images were fused to echo planar images, which were then coregistered to high-resolution anatomical SPGR images. rCBF was calculated per region of interest using a modified continuous arterial spin labeling (CASL) convolutional method. Anatomical regions were selected and identified by the Talairach atlas in SPM2.

RESULTS: We identified areas of decreased and increased perfusion (compared to the averaged rCBF of all 38 CN) corresponding to decreased and increased quantified rCBF. The most common sites for decreased perfusion were precuneus (53%), superior temporal (48%), and orbitofrontal (37%), and for increased perfusion the caudate (39%), posterior cingulate (34%), anterior cingulate (32%), and amygdala (32%).

CONCLUSION: There are regional variations in rCBF both increased and decreased with the posterior cingulate and precuneus cortex showing the highest averaged values and signal intensity (bright spots). These variations represent the normal profile of a CN elderly brain, with higher perfusion in areas associated with cognition, memory, and behavior. It is necessary to understand these normal variations in order to determine if there are perfusion changes in ASL detected in neurodegenerative disorders such as Alzheimer's disease.

%B J Neuroimaging %V 19 %P 344-52 %8 2009 Oct %G eng %N 4 %1 https://www.ncbi.nlm.nih.gov/pubmed/19292827?dopt=Abstract %R 10.1111/j.1552-6569.2008.00277.x %0 Journal Article %J Exp Gerontol %D 2009 %T Inflammation and stress-related candidate genes, plasma interleukin-6 levels, and longevity in older adults. %A Walston, Jeremy D %A Matteini, Amy M %A Nievergelt, Caroline %A Lange, Leslie A %A Fallin, Dani M %A Barzilai, Nir %A Ziv, Elad %A Pawlikowska, Ludmila %A Kwok, Pui %A Cummings, Steve R %A Kooperberg, Charles %A LaCroix, Andrea %A Tracy, Russell P %A Atzmon, Gil %A Lange, Ethan M %A Reiner, Alex P %K Aged %K Aged, 80 and over %K Aging %K Cardiovascular Diseases %K Case-Control Studies %K Female %K Genetic Variation %K Genotype %K Humans %K Inflammation %K Interleukin-6 %K Longevity %K Male %K Phenotype %K Poly (ADP-Ribose) Polymerase-1 %K Poly(ADP-ribose) Polymerases %K Risk Factors %X

Interleukin-6 (IL-6) is an inflammatory cytokine that influences the development of inflammatory and aging-related disorders and ultimately longevity. In order to study the influence of variants in genes that regulate inflammatory response on IL-6 levels and longevity, we screened a panel of 477 tag SNPs across 87 candidate genes in >5000 older participants from the population-based Cardiovascular Health Study (CHS). Baseline plasma IL-6 concentration was first confirmed as a strong predictor of all-cause mortality. Functional alleles of the IL6R and PARP1 genes were significantly associated with 15%-20% higher baseline IL-6 concentration per copy among CHS European-American (EA) participants (all p<10(-4)). In a case/control analysis nested within this EA cohort, the minor allele of PARP1 rs1805415 was nominally associated with decreased longevity (p=0.001), but there was no evidence of association between IL6R genotype and longevity. The PARP1 rs1805415--longevity association was subsequently replicated in one of two independent case/control studies. In a pooled analysis of all three studies, the "risk" of longevity associated with the minor allele of PARP1 rs1805415 was 0.79 (95%CI 0.62-1.02; p=0.07). These findings warrant further study of the potential role of PARP1 genotype in inflammatory and aging-related phenotypes.

%B Exp Gerontol %V 44 %P 350-5 %8 2009 May %G eng %N 5 %1 https://www.ncbi.nlm.nih.gov/pubmed/19249341?dopt=Abstract %R 10.1016/j.exger.2009.02.004 %0 Journal Article %J Ann Intern Med %D 2009 %T Meta-analysis: retinal vessel caliber and risk for coronary heart disease. %A McGeechan, Kevin %A Liew, Gerald %A Macaskill, Petra %A Irwig, Les %A Klein, Ronald %A Klein, Barbara E K %A Wang, Jie Jin %A Mitchell, Paul %A Vingerling, Johannes R %A Dejong, Paulus T V M %A Witteman, Jacqueline C M %A Breteler, Monique M B %A Shaw, Jonathan %A Zimmet, Paul %A Wong, Tien Y %K Adult %K Aged %K Arterioles %K Biomarkers %K Coronary Disease %K Female %K Humans %K Male %K Middle Aged %K Proportional Hazards Models %K Retinal Vessels %K Risk Factors %K Sex Factors %K Venules %X

BACKGROUND: Retinal vessel caliber may be a novel marker of coronary heart disease (CHD) risk. However, the sex-specific effect, magnitude of association, and effect independent of traditional CHD disease risk factors remain unclear.

PURPOSE: To determine the association between retinal vessel caliber and risk for CHD.

DATA SOURCES: Relevant studies in any language identified through MEDLINE (1950 to June 2009) and EMBASE (1950 to June 2009) databases.

STUDY SELECTION: Studies were included if they examined a general population, measured retinal vessel caliber from retinal photographs, and documented CHD risk factors and incident CHD events.

DATA EXTRACTION: 6 population-based prospective cohort studies provided data for individual participant meta-analysis.

DATA SYNTHESIS: Proportional hazards models, adjusted for traditional CHD risk factors, were constructed for retinal vessel caliber and incident CHD in women and men. Among 22,159 participants who were free of CHD and followed for 5 to 14 years, 2219 (10.0%) incident CHD events occurred. Retinal vessel caliber changes (wider venules and narrower arterioles) were each associated with an increased risk for CHD in women (pooled multivariable-adjusted hazard ratios, 1.16 [95% CI, 1.06 to 1.26] per 20-microm increase in venular caliber and 1.17 [CI, 1.07 to 1.28] per 20-microm decrease in arteriolar caliber) but not in men (1.02 [CI, 0.94 to 1.10] per 20-microm increase in venular caliber and 1.02 [CI, 0.95 to 1.10] per 20-microm decrease in arteriolar caliber). Women without hypertension or diabetes had higher hazard ratios.

LIMITATION: Error in the measurement of retinal vessel caliber and Framingham variables was not taken into account.

CONCLUSION: Retinal vessel caliber changes were independently associated with an increased risk for CHD events in women.

%B Ann Intern Med %V 151 %P 404-13 %8 2009 Sep 15 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19755365?dopt=Abstract %0 Journal Article %J Arch Neurol %D 2009 %T Midlife and late-life obesity and the risk of dementia: cardiovascular health study. %A Fitzpatrick, Annette L %A Kuller, Lewis H %A Lopez, Oscar L %A Diehr, Paula %A O'Meara, Ellen S %A Longstreth, W T %A Luchsinger, José A %K Aged %K Aged, 80 and over %K Aging %K Alzheimer Disease %K Anthropometry %K Body Mass Index %K Dementia, Vascular %K Evaluation Studies as Topic %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Obesity %K Prospective Studies %K Risk %K Survival Analysis %X

BACKGROUND: While high adiposity in middle age appears to be related to greater dementia risk, studies exploring this association in the elderly are conflicting.

OBJECTIVE: To evaluate associations between midlife and late-life obesity and risk of dementia.

DESIGN: Prospective study with mean follow-up of 5.4 years (1992-1994 through 1999).

SETTING: Community-dwelling sample in 4 US sites recruited from Medicare eligibility files.

PARTICIPANTS: A total of 2798 adults without dementia (mean age, 74.7 years; 59.1% women) participating in the Cardiovascular Health Study who underwent magnetic resonance imaging were measured for height and weight at baseline at age 65 years or older (late life), and self-reported weight at age 50 years (midlife). Body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) was calculated at both times.

MAIN OUTCOME MEASURES: Dementia, Alzheimer disease, and vascular dementia classified by a multidisciplinary committee using standardized criteria.

RESULTS: Classification resulted in 480 persons with incident dementia, 245 with Alzheimer disease (no vascular dementia), and 213 with vascular dementia (with or without Alzheimer disease). In evaluations of midlife obesity, an increased risk of dementia was found for obese (BMI >30) vs normal-weight (BMI 20-25) persons, adjusted for demographics (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.03-1.87) and for cardiovascular risk factors (1.36; 0.94-1.95). The risk estimates were reversed in assessments of late-life BMI. Underweight persons (BMI <20) had an increased risk of dementia (1.62; 1.02-2.64), whereas being overweight (BMI >25-30) was not associated (0.92; 0.72-1.18) and being obese reduced the risk of dementia (0.63; 0.44-0.91) compared with those with normal BMI.

CONCLUSION: These results help explain the "obesity paradox" as differences in dementia risk across time are consistent with physical changes in the trajectory toward disability.

%B Arch Neurol %V 66 %P 336-42 %8 2009 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/19273752?dopt=Abstract %R 10.1001/archneurol.2008.582 %0 Journal Article %J Radiology %D 2009 %T Mild cognitive impairment and alzheimer disease: patterns of altered cerebral blood flow at MR imaging. %A Dai, Weiying %A Lopez, Oscar L %A Carmichael, Owen T %A Becker, James T %A Kuller, Lewis H %A Gach, H Michael %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Brain %K Cerebrovascular Circulation %K Cognition Disorders %K Female %K Humans %K Magnetic Resonance Imaging %K Male %X

PURPOSE: To examine regional cerebral blood flow (rCBF) in incident mild cognitive impairment (MCI) and Alzheimer disease (AD) by using continuous arterial spin-labeling (CASL) magnetic resonance (MR) imaging.

MATERIALS AND METHODS: This study was approved by the local institutional review board and was compliant with HIPAA regulations. Informed consent was obtained. rCBF was measured in 38 control subjects, 29 MCI patients, and 37 AD patients who were participating in a longitudinal epidemiologic study. Multisection CASL MR imaging with alternating single and double adiabatic inversion pulses and ramp-sampled echo-planar imaging were performed to acquire 19 contiguous axial sections. Voxel-level rCBF was compared among groups by using an analysis of variance design; clusters of voxels with significant group differences were identified. Multiple regression models controlled for age, sex, and presence of hypertension and related the mean rCBF in those clusters to the presence of MCI and AD.

RESULTS: MCI and AD patients had decreased rCBF in the posterior cingulate gyrus (P = .01) with extension to the medial precuneus compared with that in control subjects. MCI patients had increased rCBF in the left hippocampus (P < .001), right amygdala (P = .007), and rostral head of the right caudate nucleus and ventral putamen and globus pallidus (P = .003) compared with that in control subjects. AD patients had decreased rCBF relative to that in control subjects and MCI patients in the left inferior parietal (P = .005), left lateral frontal (P < .001), left superior temporal (P = .001), and left orbitofrontal (P = .003) cortices. AD patients had increased rCBF in the right anterior cingulate gyrus (P = .02) compared with that in control subjects.

CONCLUSION: The transition from normal cognition to AD is associated with dynamic pathologic processes in the brain, and this is reflected by both decreases and increases in rCBF. Increases in rCBF suggest a cellular and vascular compensatory process associated with incipient AD.

SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2503080751/DC1.

%B Radiology %V 250 %P 856-66 %8 2009 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/19164119?dopt=Abstract %R 10.1148/radiol.2503080751 %0 Journal Article %J Nat Genet %D 2009 %T Multiple loci associated with indices of renal function and chronic kidney disease. %A Köttgen, Anna %A Glazer, Nicole L %A Dehghan, Abbas %A Hwang, Shih-Jen %A Katz, Ronit %A Li, Man %A Yang, Qiong %A Gudnason, Vilmundur %A Launer, Lenore J %A Harris, Tamara B %A Smith, Albert V %A Arking, Dan E %A Astor, Brad C %A Boerwinkle, Eric %A Ehret, Georg B %A Ruczinski, Ingo %A Scharpf, Robert B %A Chen, Yii-Der Ida %A de Boer, Ian H %A Haritunians, Talin %A Lumley, Thomas %A Sarnak, Mark %A Siscovick, David %A Benjamin, Emelia J %A Levy, Daniel %A Upadhyay, Ashish %A Aulchenko, Yurii S %A Hofman, Albert %A Rivadeneira, Fernando %A Uitterlinden, André G %A van Duijn, Cornelia M %A Chasman, Daniel I %A Paré, Guillaume %A Ridker, Paul M %A Kao, W H Linda %A Witteman, Jacqueline C %A Coresh, Josef %A Shlipak, Michael G %A Fox, Caroline S %K Chromosome Mapping %K Cohort Studies %K Genetic Variation %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K Kidney %K Kidney Failure, Chronic %K Meta-Analysis as Topic %K Mucoproteins %K Netherlands %K Polymorphism, Single Nucleotide %K Prevalence %K Uromodulin %X

Chronic kidney disease (CKD) has a heritable component and is an important global public health problem because of its high prevalence and morbidity. We conducted genome-wide association studies (GWAS) to identify susceptibility loci for glomerular filtration rate, estimated by serum creatinine (eGFRcrea) and cystatin C (eGFRcys), and CKD (eGFRcrea < 60 ml/min/1.73 m(2)) in European-ancestry participants of four population-based cohorts (ARIC, CHS, FHS, RS; n = 19,877; 2,388 CKD cases), and tested for replication in 21,466 participants (1,932 CKD cases). We identified significant SNP associations (P < 5 × 10(-8)) with CKD at the UMOD locus, with eGFRcrea at UMOD, SHROOM3 and GATM-SPATA5L1, and with eGFRcys at CST and STC1. UMOD encodes the most common protein in human urine, Tamm-Horsfall protein, and rare mutations in UMOD cause mendelian forms of kidney disease. Our findings provide new insights into CKD pathogenesis and underscore the importance of common genetic variants influencing renal function and disease.

%B Nat Genet %V 41 %P 712-7 %8 2009 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19430482?dopt=Abstract %R 10.1038/ng.377 %0 Journal Article %J Nat Genet %D 2009 %T Multiple loci influence erythrocyte phenotypes in the CHARGE Consortium. %A Ganesh, Santhi K %A Zakai, Neil A %A van Rooij, Frank J A %A Soranzo, Nicole %A Smith, Albert V %A Nalls, Michael A %A Chen, Ming-Huei %A Köttgen, Anna %A Glazer, Nicole L %A Dehghan, Abbas %A Kuhnel, Brigitte %A Aspelund, Thor %A Yang, Qiong %A Tanaka, Toshiko %A Jaffe, Andrew %A Bis, Joshua C M %A Verwoert, Germaine C %A Teumer, Alexander %A Fox, Caroline S %A Guralnik, Jack M %A Ehret, Georg B %A Rice, Kenneth %A Felix, Janine F %A Rendon, Augusto %A Eiriksdottir, Gudny %A Levy, Daniel %A Patel, Kushang V %A Boerwinkle, Eric %A Rotter, Jerome I %A Hofman, Albert %A Sambrook, Jennifer G %A Hernandez, Dena G %A Zheng, Gang %A Bandinelli, Stefania %A Singleton, Andrew B %A Coresh, Josef %A Lumley, Thomas %A Uitterlinden, André G %A Vangils, Janine M %A Launer, Lenore J %A Cupples, L Adrienne %A Oostra, Ben A %A Zwaginga, Jaap-Jan %A Ouwehand, Willem H %A Thein, Swee-Lay %A Meisinger, Christa %A Deloukas, Panos %A Nauck, Matthias %A Spector, Tim D %A Gieger, Christian %A Gudnason, Vilmundur %A van Duijn, Cornelia M %A Psaty, Bruce M %A Ferrucci, Luigi %A Chakravarti, Aravinda %A Greinacher, Andreas %A O'Donnell, Christopher J %A Witteman, Jacqueline C M %A Furth, Susan %A Cushman, Mary %A Harris, Tamara B %A Lin, Jing-Ping %K Blood Pressure %K Cell Line %K Cohort Studies %K Endothelial Cells %K Erythrocytes %K Gene Expression %K Genome, Human %K Genome-Wide Association Study %K Humans %K Hypertension %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

Measurements of erythrocytes within the blood are important clinical traits and can indicate various hematological disorders. We report here genome-wide association studies (GWAS) for six erythrocyte traits, including hemoglobin concentration (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and red blood cell count (RBC). We performed an initial GWAS in cohorts of the CHARGE Consortium totaling 24,167 individuals of European ancestry and replication in additional independent cohorts of the HaemGen Consortium totaling 9,456 individuals. We identified 23 loci significantly associated with these traits in a meta-analysis of the discovery and replication cohorts (combined P values ranging from 5 x 10(-8) to 7 x 10(-86)). Our findings include loci previously associated with these traits (HBS1L-MYB, HFE, TMPRSS6, TFR2, SPTA1) as well as new associations (EPO, TFRC, SH2B3 and 15 other loci). This study has identified new determinants of erythrocyte traits, offering insight into common variants underlying variation in erythrocyte measures.

%B Nat Genet %V 41 %P 1191-8 %8 2009 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/19862010?dopt=Abstract %R 10.1038/ng.466 %0 Journal Article %J PLoS Genet %D 2009 %T NRXN3 is a novel locus for waist circumference: a genome-wide association study from the CHARGE Consortium. %A Heard-Costa, Nancy L %A Zillikens, M Carola %A Monda, Keri L %A Johansson, Asa %A Harris, Tamara B %A Fu, Mao %A Haritunians, Talin %A Feitosa, Mary F %A Aspelund, Thor %A Eiriksdottir, Gudny %A Garcia, Melissa %A Launer, Lenore J %A Smith, Albert V %A Mitchell, Braxton D %A McArdle, Patrick F %A Shuldiner, Alan R %A Bielinski, Suzette J %A Boerwinkle, Eric %A Brancati, Fred %A Demerath, Ellen W %A Pankow, James S %A Arnold, Alice M %A Chen, Yii-Der Ida %A Glazer, Nicole L %A McKnight, Barbara %A Psaty, Bruce M %A Rotter, Jerome I %A Amin, Najaf %A Campbell, Harry %A Gyllensten, Ulf %A Pattaro, Cristian %A Pramstaller, Peter P %A Rudan, Igor %A Struchalin, Maksim %A Vitart, Veronique %A Gao, Xiaoyi %A Kraja, Aldi %A Province, Michael A %A Zhang, Qunyuan %A Atwood, Larry D %A Dupuis, Josée %A Hirschhorn, Joel N %A Jaquish, Cashell E %A O'Donnell, Christopher J %A Vasan, Ramachandran S %A White, Charles C %A Aulchenko, Yurii S %A Estrada, Karol %A Hofman, Albert %A Rivadeneira, Fernando %A Uitterlinden, André G %A Witteman, Jacqueline C M %A Oostra, Ben A %A Kaplan, Robert C %A Gudnason, Vilmundur %A O'Connell, Jeffrey R %A Borecki, Ingrid B %A van Duijn, Cornelia M %A Cupples, L Adrienne %A Fox, Caroline S %A North, Kari E %K Aged %K Body Mass Index %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Nerve Tissue Proteins %K Obesity %K Polymorphism, Single Nucleotide %K Waist Circumference %X

Central abdominal fat is a strong risk factor for diabetes and cardiovascular disease. To identify common variants influencing central abdominal fat, we conducted a two-stage genome-wide association analysis for waist circumference (WC). In total, three loci reached genome-wide significance. In stage 1, 31,373 individuals of Caucasian descent from eight cohort studies confirmed the role of FTO and MC4R and identified one novel locus associated with WC in the neurexin 3 gene [NRXN3 (rs10146997, p = 6.4x10(-7))]. The association with NRXN3 was confirmed in stage 2 by combining stage 1 results with those from 38,641 participants in the GIANT consortium (p = 0.009 in GIANT only, p = 5.3x10(-8) for combined analysis, n = 70,014). Mean WC increase per copy of the G allele was 0.0498 z-score units (0.65 cm). This SNP was also associated with body mass index (BMI) [p = 7.4x10(-6), 0.024 z-score units (0.10 kg/m(2)) per copy of the G allele] and the risk of obesity (odds ratio 1.13, 95% CI 1.07-1.19; p = 3.2x10(-5) per copy of the G allele). The NRXN3 gene has been previously implicated in addiction and reward behavior, lending further evidence that common forms of obesity may be a central nervous system-mediated disorder. Our findings establish that common variants in NRXN3 are associated with WC, BMI, and obesity.

%B PLoS Genet %V 5 %P e1000539 %8 2009 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19557197?dopt=Abstract %R 10.1371/journal.pgen.1000539 %0 Journal Article %J Am J Kidney Dis %D 2009 %T Obesity and change in estimated GFR among older adults. %A de Boer, Ian H %A Katz, Ronit %A Fried, Linda F %A Ix, Joachim H %A Luchsinger, Jose %A Sarnak, Mark J %A Shlipak, Michael G %A Siscovick, David S %A Kestenbaum, Bryan %K Aged %K Aging %K Body Composition %K Body Mass Index %K Chronic Disease %K Cohort Studies %K Creatinine %K Cystatin C %K Female %K Glomerular Filtration Rate %K Humans %K Kidney %K Kidney Diseases %K Longitudinal Studies %K Male %K Obesity %K Risk Factors %X

BACKGROUND: The prevalence of chronic kidney disease is growing most rapidly among older adults; however, determinants of impaired kidney function in this population are not well understood. Obesity assessed in midlife has been associated with chronic kidney disease.

STUDY DESIGN: Cohort study.

SETTING & PARTICIPANTS: 4,295 participants in the community-based Cardiovascular Health Study, aged >or= 65 years.

PREDICTORS: Body mass index, waist circumference, and fat mass measured using bioelectrical impedance.

OUTCOME: Change in glomerular filtration rate (GFR) during 7 years of follow-up.

MEASUREMENTS: Longitudinal estimates of GFR calculated using the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation.

RESULTS: Estimated GFR decreased by an average of 0.4 +/- 3.6 mL/min/1.73 m(2)/y, and rapid GFR loss (>3 mL/min/1.73 m(2)/y) occurred in 693 participants (16%). Baseline body mass index, waist circumference, and fat mass were each associated with increased risk of rapid GFR loss: ORs, 1.19 (95% CI, 1.09-1.30) per 5 kg/m(2), 1.25 (95% CI, 1.16-1.36) per 12 cm, and 1.14 (95% CI, 1.05-1.24) per 10 kg after adjustment for age, sex, race, and smoking. The magnitude of increased risk was larger for participants with estimated GFR < 60 mL/min/1.73 m(2) at baseline (P for interaction < 0.05). Associations were substantially attenuated by further adjustment for diabetes, hypertension, and C-reactive protein level. Obesity measurements were not associated with change in GFR estimated using serum cystatin C level.

LIMITATIONS: Few participants with advanced chronic kidney disease at baseline, no direct GFR measurements.

CONCLUSION: Obesity may be a modifiable risk factor for the development and progression of kidney disease in older adults.

%B Am J Kidney Dis %V 54 %P 1043-51 %8 2009 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/19782454?dopt=Abstract %R 10.1053/j.ajkd.2009.07.018 %0 Journal Article %J J Thromb Haemost %D 2009 %T Peak thrombin generation and subsequent venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE) study. %A Lutsey, P L %A Folsom, A R %A Heckbert, S R %A Cushman, M %K Adult %K Aged %K Biomarkers %K Blood Coagulation Factors %K Case-Control Studies %K Ethnic Groups %K Factor VIII %K Female %K Fibrin Fibrinogen Degradation Products %K Humans %K Male %K Middle Aged %K Partial Thromboplastin Time %K Prospective Studies %K Risk Factors %K Thrombin %K United States %K Venous Thromboembolism %X

BACKGROUND: Thrombin is an enzyme that is essential for the acceleration of the coagulation cascade and the conversion of fibrinogen to clottable fibrin.

OBJECTIVES: We evaluated the relationship of basal peak thrombin generation with the risk of future venous thromboembolism (VTE), and determined whether associations were independent of other coagulation markers.

METHODS: The Longitudinal Investigation of Thromboembolism Etiology (LITE) study investigated VTE in two prospective population-based cohorts: the Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS). Peak thrombin generation was measured on stored plasma in a nested case-control sample (434 cases and 1004 controls). Logistic regression was used to estimate the relationship of peak thrombin generation with VTE, adjusted for age, sex, race, center, and body mass index. Mediation was evaluated by additionally adjusting for factor VIII and D-dimer.

RESULTS: Relative to the first quartile of peak thrombin generation, the odds ratio (OR) of VTE for those above the median was 1.74 [95% confidence interval (CI) 1.28-2.37]. The association was modestly attenuated by adjustment for FVIII and D-dimer (OR 1.47, 95% CI 1.05-2.05). Associations appeared to be stronger for idiopathic than for secondary VTE. Elevated peak thrombin generation more than added to the VTE risk associated with FV Leiden or low activated partial thromboplastin time.

CONCLUSIONS: In this prospective study of two independent cohorts, elevated basal peak thrombin generation was associated with subsequent risk of VTE, independently of established VTE risk factors.

%B J Thromb Haemost %V 7 %P 1639-48 %8 2009 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/19656279?dopt=Abstract %R 10.1111/j.1538-7836.2009.03561.x %0 Journal Article %J J Thromb Haemost %D 2009 %T Platelet count and the risk for thrombosis and death in the elderly. %A van der Bom, J G %A Heckbert, S R %A Lumley, T %A Holmes, C E %A Cushman, M %A Folsom, A R %A Rosendaal, F R %A Psaty, B M %K Aged %K Aged, 80 and over %K Cause of Death %K Cerebral Hemorrhage %K Female %K Humans %K Male %K Myocardial Infarction %K Platelet Count %K Risk %K Stroke %K Survival Analysis %K Thrombosis %K Venous Thrombosis %X

AIM: Our aim was to examine the association between platelet count and the incidence of myocardial infarction, ischemic stroke, hemorrhagic stroke, venous thrombosis, and mortality.

METHODS AND RESULTS: Platelet count was measured at baseline in 1989-1990 and at 3 years follow-up, or at baseline (for a newly recruited group) in 1992-1993 in 5766 community-dwelling individuals aged 65 years and older (mean age at baseline, 73 years). During 12-15 years of follow-up, there were 821 incident myocardial infarctions, 807 ischemic strokes, 161 hemorrhagic strokes, 159 venous thrombotic events, and 3413 participants died. Platelet count was not associated with the occurrence of myocardial infarction, ischemic or hemorrhagic stroke, venous thrombosis, or cardiovascular mortality. Non-cardiovascular mortality was higher among both participants with low and with high platelet count. Adjusted non-cardiovascular mortality rates for platelet counts below 100, 100-199, 300-399, and above 400 x 10(9) L(-1) relative to the reference mortality rate in participants with platelet count values between 200 and 299 x 10(9) L(-1) were 1.89 (1.21-2.96), 1.08 (0.98-1.20), 1.20 (1.06-1.37), and 1.47 (1.14-1.90), respectively.

CONCLUSION: Platelet counts were not associated with vascular outcomes but low and high platelet counts were associated with non-cardiovascular mortality, including cancer mortality.

%B J Thromb Haemost %V 7 %P 399-405 %8 2009 Mar %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/19143922?dopt=Abstract %R 10.1111/j.1538-7836.2008.03267.x %0 Journal Article %J Neurology %D 2009 %T Predicting risk of dementia in older adults: The late-life dementia risk index. %A Barnes, D E %A Covinsky, K E %A Whitmer, R A %A Kuller, L H %A Lopez, O L %A Yaffe, K %K Age Factors %K Aged %K Aged, 80 and over %K Alcohol Drinking %K Apolipoprotein E4 %K Body Mass Index %K Carotid Stenosis %K Cerebrum %K Cognition Disorders %K Cohort Studies %K Coronary Artery Bypass %K Dementia %K Female %K Genetic Markers %K Health Status Indicators %K Humans %K Logistic Models %K Male %K Predictive Value of Tests %K Risk Assessment %K Risk Factors %K Risk Reduction Behavior %X

OBJECTIVE: To develop a late-life dementia risk index that can accurately stratify older adults into those with a low, moderate, or high risk of developing dementia within 6 years.

METHODS: Subjects were 3,375 participants in the Cardiovascular Health Cognition Study without evidence of dementia at baseline. We used logistic regression to identify those factors most predictive of developing incident dementia within 6 years and developed a point system based on the logistic regression coefficients.

RESULTS: Subjects had a mean age of 76 years at baseline; 59% were women and 15% were African American. Fourteen percent (n = 480) developed dementia within 6 years. The final late-life dementia risk index included older age (1-2 points), poor cognitive test performance (2-4 points), body mass index <18.5 (2 points), > or =1 apolipoprotein E epsilon4 alleles (1 point), cerebral MRI findings of white matter disease (1 point) or ventricular enlargement (1 point), internal carotid artery thickening on ultrasound (1 point), history of bypass surgery (1 point), slow physical performance (1 point), and lack of alcohol consumption (1 point) (c statistic, 0.81; 95% confidence interval, 0.79-0.83). Four percent of subjects with low scores developed dementia over 6 years compared with 23% of subjects with moderate scores and 56% of subjects with high scores.

CONCLUSIONS: The late-life dementia risk index accurately stratified older adults into those with low, moderate, and high risk of developing dementia. This tool could be used in clinical or research settings to target prevention and intervention strategies toward high-risk individuals.

%B Neurology %V 73 %P 173-9 %8 2009 Jul 21 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/19439724?dopt=Abstract %R 10.1212/WNL.0b013e3181a81636 %0 Journal Article %J Am J Epidemiol %D 2009 %T Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis. %A McGeechan, Kevin %A Liew, Gerald %A Macaskill, Petra %A Irwig, Les %A Klein, Ronald %A Klein, Barbara E K %A Wang, Jie Jin %A Mitchell, Paul %A Vingerling, Johannes R %A de Jong, Paulus T V M %A Witteman, Jacqueline C M %A Breteler, Monique M B %A Shaw, Jonathan %A Zimmet, Paul %A Wong, Tien Y %K Aged %K Fluorescein Angiography %K Humans %K Middle Aged %K Predictive Value of Tests %K Proportional Hazards Models %K Retinal Artery %K Retinal Vein %K Retinal Vessels %K Risk Factors %K Stroke %X

The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio = 1.15, 95% confidence interval: 1.05, 1.25 per 20-micron increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio = 1.00, 95% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1% of people at intermediate risk into different, mostly lower, risk categories.

%B Am J Epidemiol %V 170 %P 1323-32 %8 2009 Dec 01 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/19884126?dopt=Abstract %R 10.1093/aje/kwp306 %0 Journal Article %J J Thromb Haemost %D 2009 %T Replication of findings on the association of genetic variation in 24 hemostasis genes and risk of incident venous thrombosis. %A Smith, N L %A Wiggins, K L %A Reiner, A P %A Lange, L A %A Cushman, M %A Heckbert, S R %A Lumley, T %A Rice, K M %A Folsom, A R %A Psaty, B M %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Case-Control Studies %K Cohort Studies %K Female %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genetic Variation %K Haplotypes %K Hemostasis %K Humans %K Incidence %K Male %K Menopause %K Middle Aged %K Polymorphism, Single Nucleotide %K Reproducibility of Results %K Risk %K Thrombophilia %K Venous Thrombosis %K Young Adult %B J Thromb Haemost %V 7 %P 1743-6 %8 2009 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/19682239?dopt=Abstract %R 10.1111/j.1538-7836.2009.03567.x %0 Journal Article %J Stat Med %D 2009 %T Systematically missing confounders in individual participant data meta-analysis of observational cohort studies. %A Jackson, Dan %A White, Ian %A Kostis, J B %A Wilson, A C %A Folsom, A R %A Wu, K %A Chambless, L %A Benderly, M %A Goldbourt, U %A Willeit, J %A Kiechl, S %A Yarnell, J W G %A Sweetnam, P M %A Elwood, P C %A Cushman, M %A Psaty, B M %A Tracy, R P %A Tybjaerg-Hansen, A %A Haverkate, F %A de Maat, M P M %A Thompson, S G %A Fowkes, F G R %A Lee, A J %A Smith, F B %A Salomaa, V %A Harald, K %A Rasi, V %A Vahtera, E %A Jousilahti, P %A D'Agostino, R %A Kannel, W B %A Wilson, P W F %A Tofler, G %A Levy, D %A Marchioli, R %A Valagussa, F %A Rosengren, A %A Wilhelmsen, L %A Lappas, G %A Eriksson, H %A Cremer, P %A Nagel, D %A Curb, J D %A Rodriguez, B %A Yano, K %A Salonen, J T %A Nyyssönen, K %A Tuomainen, T-P %A Hedblad, B %A Engstrom, G %A Berglund, G %A Loewel, H %A Koenig, W %A Hense, H W %A Meade, T W %A Cooper, J A %A De Stavola, B %A Knottenbelt, C %A Miller, G J %A Cooper, J A %A Bauer, K A %A Rosenberg, R D %A Sato, S %A Kitamura, A %A Naito, Y %A Iso, H %A Salomaa, V %A Harald, K %A Rasi, V %A Vahtera, E %A Jousilahti, P %A Palosuo, T %A Ducimetiere, P %A Amouyel, P %A Arveiler, D %A Evans, A E %A Ferrieres, J %A Juhan-Vague, I %A Bingham, A %A Schulte, H %A Assmann, G %A Cantin, B %A Lamarche, B %A Després, J-P %A Dagenais, G R %A Tunstall-Pedoe, H %A Lowe, G D O %A Woodward, M %A Ben-Shlomo, Y %A Davey Smith, G %A Palmieri, V %A Yeh, J L %A Meade, T W %A Rudnicka, A %A Brennan, P %A Knottenbelt, C %A Cooper, J A %A Ridker, P %A Rodeghiero, F %A Tosetto, A %A Shepherd, J %A Lowe, G D O %A Ford, I %A Robertson, M %A Brunner, E %A Shipley, M %A Feskens, E J M %A Di Angelantonio, E %A Kaptoge, S %A Lewington, S %A Lowe, G D O %A Sarwar, N %A Thompson, S G %A Walker, M %A Watson, S %A White, I R %A Wood, A M %A Danesh, J %K Cohort Studies %K Computer Simulation %K Coronary Disease %K Data Interpretation, Statistical %K Female %K Fibrinogen %K Humans %K Male %K Meta-Analysis as Topic %K Models, Statistical %X

One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154,012 participants in 31 cohorts

%B Stat Med %V 28 %P 1218-37 %8 2009 Apr 15 %G eng %N 8 %1 https://www.ncbi.nlm.nih.gov/pubmed/19222087?dopt=Abstract %R 10.1002/sim.3540 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2009 %T Total and cause-specific mortality in the cardiovascular health study. %A Newman, Anne B %A Sachs, Michael C %A Arnold, Alice M %A Fried, Linda P %A Kronmal, Richard %A Cushman, Mary %A Psaty, Bruce M %A Harris, Tamara B %A Robbins, John A %A Burke, Gregory L %A Kuller, Lewis H %A Lumley, Thomas %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Cardiovascular Diseases %K Cause of Death %K Chronic Disease %K Cohort Studies %K Female %K Geriatric Assessment %K Health Surveys %K Humans %K Kaplan-Meier Estimate %K Male %K Probability %K Proportional Hazards Models %K Retrospective Studies %K Risk Assessment %K Severity of Illness Index %K Sex Factors %K Survival Analysis %K United States %X

BACKGROUND: Few cohort studies have adequate numbers of carefully reviewed deaths to allow an analysis of unique and shared risk factors for cause-specific mortality. Shared risk factors could be targeted for prevention of premature death and the study of longevity.

METHODS: A total of 5,888 community-dwelling persons aged 65 years or older living in four communities in the United States participated in the Cardiovascular Health Study cohort. Participants were initially recruited from 1989 to 1990; an additional 687 black participants were recruited in 1992-1993. The average length of follow-up was 16 years. Total and cause-specific mortality, including cardiovascular disease, stroke, cancer, dementia, pulmonary disease, infection, and other cause, were examined as outcomes. Variables previously associated with total mortality were examined for each cause of death using Cox proportional hazard models.

RESULTS: Multiple risk factors were related to total mortality. When examining specific causes, many factors were related to cardiovascular death, whereas fewer were related to other causes. For most causes, risk factors were specific for that cause. For example, apolipoprotein E epsilon4 was strongly associated for dementia death and forced vital capacity with pulmonary death. Age, male sex, markers of inflammation, and cognitive function were related to multiple causes of death.

CONCLUSIONS: In these older adults, associations of risk factors with a given cause of death were related to specific deficits in that same organ system. Inflammation may represent a common pathway to all causes of death.

%B J Gerontol A Biol Sci Med Sci %V 64 %P 1251-61 %8 2009 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/19723772?dopt=Abstract %R 10.1093/gerona/glp127 %0 Journal Article %J Nat Genet %D 2009 %T Variants in ZFHX3 are associated with atrial fibrillation in individuals of European ancestry. %A Benjamin, Emelia J %A Rice, Kenneth M %A Arking, Dan E %A Pfeufer, Arne %A van Noord, Charlotte %A Smith, Albert V %A Schnabel, Renate B %A Bis, Joshua C %A Boerwinkle, Eric %A Sinner, Moritz F %A Dehghan, Abbas %A Lubitz, Steven A %A D'Agostino, Ralph B %A Lumley, Thomas %A Ehret, Georg B %A Heeringa, Jan %A Aspelund, Thor %A Newton-Cheh, Christopher %A Larson, Martin G %A Marciante, Kristin D %A Soliman, Elsayed Z %A Rivadeneira, Fernando %A Wang, Thomas J %A Eiriksdottir, Gudny %A Levy, Daniel %A Psaty, Bruce M %A Li, Man %A Chamberlain, Alanna M %A Hofman, Albert %A Vasan, Ramachandran S %A Harris, Tamara B %A Rotter, Jerome I %A Kao, W H Linda %A Agarwal, Sunil K %A Stricker, Bruno H Ch %A Wang, Ke %A Launer, Lenore J %A Smith, Nicholas L %A Chakravarti, Aravinda %A Uitterlinden, André G %A Wolf, Philip A %A Sotoodehnia, Nona %A Köttgen, Anna %A van Duijn, Cornelia M %A Meitinger, Thomas %A Mueller, Martina %A Perz, Siegfried %A Steinbeck, Gerhard %A Wichmann, H-Erich %A Lunetta, Kathryn L %A Heckbert, Susan R %A Gudnason, Vilmundur %A Alonso, Alvaro %A Kääb, Stefan %A Ellinor, Patrick T %A Witteman, Jacqueline C M %K Atrial Fibrillation %K Chromosomes, Human, Pair 16 %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Homeodomain Proteins %K Humans %K Meta-Analysis as Topic %K Mutation %K Polymorphism, Single Nucleotide %K Reproducibility of Results %X

We conducted meta-analyses of genome-wide association studies for atrial fibrillation (AF) in participants from five community-based cohorts. Meta-analyses of 896 prevalent (15,768 referents) and 2,517 incident (21,337 referents) AF cases identified a new locus for AF (ZFHX3, rs2106261, risk ratio RR = 1.19; P = 2.3 x 10(-7)). We replicated this association in an independent cohort from the German AF Network (odds ratio = 1.44; P = 1.6 x 10(-11); combined RR = 1.25; combined P = 1.8 x 10(-15)).

%B Nat Genet %V 41 %P 879-81 %8 2009 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/19597492?dopt=Abstract %R 10.1038/ng.416 %0 Journal Article %J J Med Genet %D 2010 %T Admixture mapping of ankle-arm index: identification of a candidate locus associated with peripheral arterial disease. %A Scherer, M L %A Nalls, M A %A Pawlikowska, L %A Ziv, E %A Mitchell, G %A Huntsman, S %A Hu, D %A Sutton-Tyrrell, K %A Lakatta, E G %A Hsueh, W-C %A Newman, A B %A Tandon, A %A Kim, L %A Kwok, P-Y %A Sung, A %A Li, R %A Psaty, B %A Reiner, A P %A Harris, T %K African Americans %K Aged %K Ankle Brachial Index %K Chromosome Mapping %K Chromosomes, Human, Pair 11 %K Female %K Genetic Loci %K Genotype %K Humans %K Male %K Odds Ratio %K Peripheral Vascular Diseases %K Polymorphism, Single Nucleotide %X

BACKGROUND: Peripheral arterial disease (PAD) is associated with significant morbidity and mortality, and has a higher prevalence in African Americans than Caucasians. Ankle-arm index (AAI) is the ratio of systolic blood pressure in the leg to that in the arm, and, when low, is a marker of PAD.

METHODS: The authors used an admixture mapping approach to search for genetic loci associated with low AAI. Using data from 1040 African American participants in the observational, population based Health, Aging, and Body Composition Study who were genotyped at 1322 single nucleotide polymorphisms (SNPs) that are informative for African versus European ancestry and span the entire genome, we estimated genetic ancestry in each chromosomal region and then tested the association between AAI and genetic ancestry at each locus.

RESULTS: The authors found a region of chromosome 11 that reaches its peak between 80 and 82 Mb associated with low AAI (p<0.001 for rs12289502 and rs9665943, both within this region). 753 African American participants in the observational, population based Cardiovascular Health Study were genotyped at rs9665943 to test the reproducibility of this association, and this association was also statistically significant (odds ratio (OR) for homozygous African genotype 1.59, 95% confidence interval (CI) 1.12 to 2.27). Another candidate SNP (rs1042602) in the same genomic region was tested in both populations, and was also found to be significantly associated with low AAI in both populations (OR for homozygous African genotype 1.89, 95% CI 1.29 to 2.76).

CONCLUSION: This study identifies a novel region of chromosome 11 representing an area with a potential candidate gene associated with PAD in African Americans.

%B J Med Genet %V 47 %P 1-7 %8 2010 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/19586928?dopt=Abstract %R 10.1136/jmg.2008.064808 %0 Journal Article %J Neurology %D 2010 %T Albuminuria and the risk of incident stroke and stroke types in older adults. %A Aguilar, M I %A O'Meara, E S %A Seliger, S %A Longstreth, W T %A Hart, R G %A Pergola, P E %A Shlipak, M G %A Katz, R %A Sarnak, M J %A Rifkin, D E %K Aged %K Aged, 80 and over %K Albuminuria %K Community Health Services %K Confidence Intervals %K Female %K Geriatric Assessment %K Glomerular Filtration Rate %K Humans %K Incidence %K Longitudinal Studies %K Male %K Proportional Hazards Models %K Retrospective Studies %K Risk Factors %K Stroke %X

BACKGROUND: The kidney biomarker that best reflects risk of stroke is unknown. We sought to evaluate the association of stroke with 3 kidney biomarkers: albuminuria, cystatin C, and glomerular filtration rate.

METHODS: These 3 biomarkers were determined in 3,287 participants without history of stroke from the Cardiovascular Health Study, a longitudinal cohort study of men and women age 65 years and older from 4 US communities. The biomarkers were albuminuria ascertained using urinary albumin-to-creatinine ratio (UACR) from morning spot urine, creatinine-based estimated glomerular filtration rate (eGFR), and cystatin C. Outcomes were incident stroke (any, ischemic, or hemorrhagic) during follow-up between 1996 and 2006.

RESULTS: A total of 390 participants had an incident stroke: 81% ischemic, 12% hemorrhagic, and 7% unclassified. In adjusted Cox regression models, UACR was more strongly related to any stroke, ischemic stroke, and hemorrhagic stroke than eGFR and cystatin C. The hazard ratio (HR) of any stroke comparing the top to bottom quintile of UACR was 2.10 (95% confidence interval [CI] 1.47-3.00), while HR for eGFR was 1.29 (95% CI 0.91-1.84) and for cystatin C was 1.22 (95% CI 0.85-1.74). When considering clinically relevant categories, elevated UACR was associated with increased hazard of any stroke and ischemic stroke regardless of eGFR or cystatin C categories.

CONCLUSIONS: UACR was the kidney biomarker most strongly associated with risk of incident stroke. Results in this elderly cohort may not be applicable to younger populations. These findings suggest that measures of glomerular filtration and permeability have differential effects on stroke risk.

%B Neurology %V 75 %P 1343-50 %8 2010 Oct 12 %G eng %N 15 %1 http://www.ncbi.nlm.nih.gov/pubmed/20810996?dopt=Abstract %R 10.1212/WNL.0b013e3181f73638 %0 Journal Article %J Nat Genet %D 2010 %T Association analyses of 249,796 individuals reveal 18 new loci associated with body mass index. %A Speliotes, Elizabeth K %A Willer, Cristen J %A Berndt, Sonja I %A Monda, Keri L %A Thorleifsson, Gudmar %A Jackson, Anne U %A Lango Allen, Hana %A Lindgren, Cecilia M %A Luan, Jian'an %A Mägi, Reedik %A Randall, Joshua C %A Vedantam, Sailaja %A Winkler, Thomas W %A Qi, Lu %A Workalemahu, Tsegaselassie %A Heid, Iris M %A Steinthorsdottir, Valgerdur %A Stringham, Heather M %A Weedon, Michael N %A Wheeler, Eleanor %A Wood, Andrew R %A Ferreira, Teresa %A Weyant, Robert J %A Segrè, Ayellet V %A Estrada, Karol %A Liang, Liming %A Nemesh, James %A Park, Ju-Hyun %A Gustafsson, Stefan %A Kilpeläinen, Tuomas O %A Yang, Jian %A Bouatia-Naji, Nabila %A Esko, Tõnu %A Feitosa, Mary F %A Kutalik, Zoltán %A Mangino, Massimo %A Raychaudhuri, Soumya %A Scherag, Andre %A Smith, Albert Vernon %A Welch, Ryan %A Zhao, Jing Hua %A Aben, Katja K %A Absher, Devin M %A Amin, Najaf %A Dixon, Anna L %A Fisher, Eva %A Glazer, Nicole L %A Goddard, Michael E %A Heard-Costa, Nancy L %A Hoesel, Volker %A Hottenga, Jouke-Jan %A Johansson, Asa %A Johnson, Toby %A Ketkar, Shamika %A Lamina, Claudia %A Li, Shengxu %A Moffatt, Miriam F %A Myers, Richard H %A Narisu, Narisu %A Perry, John R B %A Peters, Marjolein J %A Preuss, Michael %A Ripatti, Samuli %A Rivadeneira, Fernando %A Sandholt, Camilla %A Scott, Laura J %A Timpson, Nicholas J %A Tyrer, Jonathan P %A van Wingerden, Sophie %A Watanabe, Richard M %A White, Charles C %A Wiklund, Fredrik %A Barlassina, Christina %A Chasman, Daniel I %A Cooper, Matthew N %A Jansson, John-Olov %A Lawrence, Robert W %A Pellikka, Niina %A Prokopenko, Inga %A Shi, Jianxin %A Thiering, Elisabeth %A Alavere, Helene %A Alibrandi, Maria T S %A Almgren, Peter %A Arnold, Alice M %A Aspelund, Thor %A Atwood, Larry D %A Balkau, Beverley %A Balmforth, Anthony J %A Bennett, Amanda J %A Ben-Shlomo, Yoav %A Bergman, Richard N %A Bergmann, Sven %A Biebermann, Heike %A Blakemore, Alexandra I F %A Boes, Tanja %A Bonnycastle, Lori L %A Bornstein, Stefan R %A Brown, Morris J %A Buchanan, Thomas A %A Busonero, Fabio %A Campbell, Harry %A Cappuccio, Francesco P %A Cavalcanti-Proença, Christine %A Chen, Yii-Der Ida %A Chen, Chih-Mei %A Chines, Peter S %A Clarke, Robert %A Coin, Lachlan %A Connell, John %A Day, Ian N M %A den Heijer, Martin %A Duan, Jubao %A Ebrahim, Shah %A Elliott, Paul %A Elosua, Roberto %A Eiriksdottir, Gudny %A Erdos, Michael R %A Eriksson, Johan G %A Facheris, Maurizio F %A Felix, Stephan B %A Fischer-Posovszky, Pamela %A Folsom, Aaron R %A Friedrich, Nele %A Freimer, Nelson B %A Fu, Mao %A Gaget, Stefan %A Gejman, Pablo V %A Geus, Eco J C %A Gieger, Christian %A Gjesing, Anette P %A Goel, Anuj %A Goyette, Philippe %A Grallert, Harald %A Grässler, Jürgen %A Greenawalt, Danielle M %A Groves, Christopher J %A Gudnason, Vilmundur %A Guiducci, Candace %A Hartikainen, Anna-Liisa %A Hassanali, Neelam %A Hall, Alistair S %A Havulinna, Aki S %A Hayward, Caroline %A Heath, Andrew C %A Hengstenberg, Christian %A Hicks, Andrew A %A Hinney, Anke %A Hofman, Albert %A Homuth, Georg %A Hui, Jennie %A Igl, Wilmar %A Iribarren, Carlos %A Isomaa, Bo %A Jacobs, Kevin B %A Jarick, Ivonne %A Jewell, Elizabeth %A John, Ulrich %A Jørgensen, Torben %A Jousilahti, Pekka %A Jula, Antti %A Kaakinen, Marika %A Kajantie, Eero %A Kaplan, Lee M %A Kathiresan, Sekar %A Kettunen, Johannes %A Kinnunen, Leena %A Knowles, Joshua W %A Kolcic, Ivana %A König, Inke R %A Koskinen, Seppo %A Kovacs, Peter %A Kuusisto, Johanna %A Kraft, Peter %A Kvaløy, Kirsti %A Laitinen, Jaana %A Lantieri, Olivier %A Lanzani, Chiara %A Launer, Lenore J %A Lecoeur, Cécile %A Lehtimäki, Terho %A Lettre, Guillaume %A Liu, Jianjun %A Lokki, Marja-Liisa %A Lorentzon, Mattias %A Luben, Robert N %A Ludwig, Barbara %A Manunta, Paolo %A Marek, Diana %A Marre, Michel %A Martin, Nicholas G %A McArdle, Wendy L %A McCarthy, Anne %A McKnight, Barbara %A Meitinger, Thomas %A Melander, Olle %A Meyre, David %A Midthjell, Kristian %A Montgomery, Grant W %A Morken, Mario A %A Morris, Andrew P %A Mulic, Rosanda %A Ngwa, Julius S %A Nelis, Mari %A Neville, Matt J %A Nyholt, Dale R %A O'Donnell, Christopher J %A O'Rahilly, Stephen %A Ong, Ken K %A Oostra, Ben %A Paré, Guillaume %A Parker, Alex N %A Perola, Markus %A Pichler, Irene %A Pietiläinen, Kirsi H %A Platou, Carl G P %A Polasek, Ozren %A Pouta, Anneli %A Rafelt, Suzanne %A Raitakari, Olli %A Rayner, Nigel W %A Ridderstråle, Martin %A Rief, Winfried %A Ruokonen, Aimo %A Robertson, Neil R %A Rzehak, Peter %A Salomaa, Veikko %A Sanders, Alan R %A Sandhu, Manjinder S %A Sanna, Serena %A Saramies, Jouko %A Savolainen, Markku J %A Scherag, Susann %A Schipf, Sabine %A Schreiber, Stefan %A Schunkert, Heribert %A Silander, Kaisa %A Sinisalo, Juha %A Siscovick, David S %A Smit, Jan H %A Soranzo, Nicole %A Sovio, Ulla %A Stephens, Jonathan %A Surakka, Ida %A Swift, Amy J %A Tammesoo, Mari-Liis %A Tardif, Jean-Claude %A Teder-Laving, Maris %A Teslovich, Tanya M %A Thompson, John R %A Thomson, Brian %A Tönjes, Anke %A Tuomi, Tiinamaija %A van Meurs, Joyce B J %A van Ommen, Gert-Jan %A Vatin, Vincent %A Viikari, Jorma %A Visvikis-Siest, Sophie %A Vitart, Veronique %A Vogel, Carla I G %A Voight, Benjamin F %A Waite, Lindsay L %A Wallaschofski, Henri %A Walters, G Bragi %A Widen, Elisabeth %A Wiegand, Susanna %A Wild, Sarah H %A Willemsen, Gonneke %A Witte, Daniel R %A Witteman, Jacqueline C %A Xu, Jianfeng %A Zhang, Qunyuan %A Zgaga, Lina %A Ziegler, Andreas %A Zitting, Paavo %A Beilby, John P %A Farooqi, I Sadaf %A Hebebrand, Johannes %A Huikuri, Heikki V %A James, Alan L %A Kähönen, Mika %A Levinson, Douglas F %A Macciardi, Fabio %A Nieminen, Markku S %A Ohlsson, Claes %A Palmer, Lyle J %A Ridker, Paul M %A Stumvoll, Michael %A Beckmann, Jacques S %A Boeing, Heiner %A Boerwinkle, Eric %A Boomsma, Dorret I %A Caulfield, Mark J %A Chanock, Stephen J %A Collins, Francis S %A Cupples, L Adrienne %A Smith, George Davey %A Erdmann, Jeanette %A Froguel, Philippe %A Grönberg, Henrik %A Gyllensten, Ulf %A Hall, Per %A Hansen, Torben %A Harris, Tamara B %A Hattersley, Andrew T %A Hayes, Richard B %A Heinrich, Joachim %A Hu, Frank B %A Hveem, Kristian %A Illig, Thomas %A Jarvelin, Marjo-Riitta %A Kaprio, Jaakko %A Karpe, Fredrik %A Khaw, Kay-Tee %A Kiemeney, Lambertus A %A Krude, Heiko %A Laakso, Markku %A Lawlor, Debbie A %A Metspalu, Andres %A Munroe, Patricia B %A Ouwehand, Willem H %A Pedersen, Oluf %A Penninx, Brenda W %A Peters, Annette %A Pramstaller, Peter P %A Quertermous, Thomas %A Reinehr, Thomas %A Rissanen, Aila %A Rudan, Igor %A Samani, Nilesh J %A Schwarz, Peter E H %A Shuldiner, Alan R %A Spector, Timothy D %A Tuomilehto, Jaakko %A Uda, Manuela %A Uitterlinden, Andre %A Valle, Timo T %A Wabitsch, Martin %A Waeber, Gérard %A Wareham, Nicholas J %A Watkins, Hugh %A Wilson, James F %A Wright, Alan F %A Zillikens, M Carola %A Chatterjee, Nilanjan %A McCarroll, Steven A %A Purcell, Shaun %A Schadt, Eric E %A Visscher, Peter M %A Assimes, Themistocles L %A Borecki, Ingrid B %A Deloukas, Panos %A Fox, Caroline S %A Groop, Leif C %A Haritunians, Talin %A Hunter, David J %A Kaplan, Robert C %A Mohlke, Karen L %A O'Connell, Jeffrey R %A Peltonen, Leena %A Schlessinger, David %A Strachan, David P %A van Duijn, Cornelia M %A Wichmann, H-Erich %A Frayling, Timothy M %A Thorsteinsdottir, Unnur %A Abecasis, Goncalo R %A Barroso, Inês %A Boehnke, Michael %A Stefansson, Kari %A North, Kari E %A McCarthy, Mark I %A Hirschhorn, Joel N %A Ingelsson, Erik %A Loos, Ruth J F %K Body Height %K Body Mass Index %K Body Size %K Body Weight %K Chromosome Mapping %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Obesity %K Polymorphism, Single Nucleotide %X

Obesity is globally prevalent and highly heritable, but its underlying genetic factors remain largely elusive. To identify genetic loci for obesity susceptibility, we examined associations between body mass index and ∼ 2.8 million SNPs in up to 123,865 individuals with targeted follow up of 42 SNPs in up to 125,931 additional individuals. We confirmed 14 known obesity susceptibility loci and identified 18 new loci associated with body mass index (P < 5 × 10⁻⁸), one of which includes a copy number variant near GPRC5B. Some loci (at MC4R, POMC, SH2B1 and BDNF) map near key hypothalamic regulators of energy balance, and one of these loci is near GIPR, an incretin receptor. Furthermore, genes in other newly associated loci may provide new insights into human body weight regulation.

%B Nat Genet %V 42 %P 937-48 %8 2010 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/20935630?dopt=Abstract %R 10.1038/ng.686 %0 Journal Article %J JAMA %D 2010 %T Association between adiposity in midlife and older age and risk of diabetes in older adults. %A Biggs, Mary L %A Mukamal, Kenneth J %A Luchsinger, José A %A Ix, Joachim H %A Carnethon, Mercedes R %A Newman, Anne B %A de Boer, Ian H %A Strotmeyer, Elsa S %A Mozaffarian, Dariush %A Siscovick, David S %K Adiposity %K Age Factors %K Aged %K Body Mass Index %K Diabetes Mellitus, Type 2 %K Female %K Humans %K Incidence %K Male %K Prospective Studies %K Risk Factors %K United States %K Weight Gain %X

CONTEXT: Adiposity is a well-recognized risk factor for type 2 diabetes among young and middle-aged adults, but the relationship between body composition and type 2 diabetes is not well described among older adults.

OBJECTIVE: To examine the relationship between adiposity, changes in adiposity, and risk of incident type 2 diabetes in adults 65 years of age and older.

DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study (1989-2007) of 4193 men and women 65 years of age and older in the Cardiovascular Health Study. Measures of adiposity were derived from anthropometry and bioelectrical impedance data at baseline and anthropometry repeated 3 years later.

MAIN OUTCOME MEASURE: Incident diabetes was ascertained based on use of antidiabetic medication or a fasting glucose level of 126 mg/dL or greater.

RESULTS: Over median follow-up of 12.4 years (range, 0.9-17.8 years), 339 cases of incident diabetes were ascertained (7.1/1000 person-years). The adjusted hazard ratio (HR) (95% confidence interval [CI]) of type 2 diabetes for participants in the highest quintile of baseline measures compared with those in the lowest was 4.3 (95% CI, 2.9-6.5) for body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]), 3.0 (95% CI, 2.0-4.3) for BMI at 50 years of age, 4.2 (95% CI, 2.8-6.4) for weight, 4.0 (95% CI, 2.6-6.0) for fat mass, 4.2 (95% CI, 2.8-6.2) for waist circumference, 2.4 (95% CI, 1.6-3.5) for waist-hip ratio, and 3.8 (95% CI, 2.6-5.5) for waist-height ratio. However, when stratified by age, participants 75 years of age and older had HRs approximately half as large as those 65 to 74 years of age. Compared with weight-stable participants (+/-2 kg), those who gained the most weight from 50 years of age to baseline (> or = 9 kg), and from baseline to the third follow-up visit (> or = 6 kg), had HRs for type 2 diabetes of 2.8 (95% CI, 1.9-4.3) and 2.0 (95% CI, 1.1-3.7), respectively. Participants with a greater than 10-cm increase in waist size from baseline to the third follow-up visit had an HR of type 2 diabetes of 1.7 (95% CI, 1.1-2.8) compared with those who gained or lost 2 cm or less.

CONCLUSION: Among older adults, overall and central adiposity, and weight gain during middle age and after the age of 65 years are associated with risk of diabetes.

%B JAMA %V 303 %P 2504-12 %8 2010 Jun 23 %G eng %N 24 %1 http://www.ncbi.nlm.nih.gov/pubmed/20571017?dopt=Abstract %R 10.1001/jama.2010.843 %0 Journal Article %J Circ Cardiovasc Genet %D 2010 %T Association of genome-wide variation with the risk of incident heart failure in adults of European and African ancestry: a prospective meta-analysis from the cohorts for heart and aging research in genomic epidemiology (CHARGE) consortium. %A Smith, Nicholas L %A Felix, Janine F %A Morrison, Alanna C %A Demissie, Serkalem %A Glazer, Nicole L %A Loehr, Laura R %A Cupples, L Adrienne %A Dehghan, Abbas %A Lumley, Thomas %A Rosamond, Wayne D %A Lieb, Wolfgang %A Rivadeneira, Fernando %A Bis, Joshua C %A Folsom, Aaron R %A Benjamin, Emelia %A Aulchenko, Yurii S %A Haritunians, Talin %A Couper, David %A Murabito, Joanne %A Wang, Ying A %A Stricker, Bruno H %A Gottdiener, John S %A Chang, Patricia P %A Wang, Thomas J %A Rice, Kenneth M %A Hofman, Albert %A Heckbert, Susan R %A Fox, Ervin R %A O'Donnell, Christopher J %A Uitterlinden, André G %A Rotter, Jerome I %A Willerson, James T %A Levy, Daniel %A van Duijn, Cornelia M %A Psaty, Bruce M %A Witteman, Jacqueline C M %A Boerwinkle, Eric %A Vasan, Ramachandran S %K African Americans %K Aged %K Aged, 80 and over %K Cohort Studies %K Endopeptidases %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Heart Failure %K Humans %K Incidence %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk %K Ubiquitin-Specific Proteases %X

BACKGROUND: Although genetic factors contribute to the onset of heart failure (HF), no large-scale genome-wide investigation of HF risk has been published to date. We have investigated the association of 2,478,304 single-nucleotide polymorphisms with incident HF by meta-analyzing data from 4 community-based prospective cohorts: the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study.

METHODS AND RESULTS: Eligible participants for these analyses were of European or African ancestry and free of clinical HF at baseline. Each study independently conducted genome-wide scans and imputed data to the approximately 2.5 million single-nucleotide polymorphisms in HapMap. Within each study, Cox proportional hazards regression models provided age- and sex-adjusted estimates of the association between each variant and time to incident HF. Fixed-effect meta-analyses combined results for each single-nucleotide polymorphism from the 4 cohorts to produce an overall association estimate and P value. A genome-wide significance P value threshold was set a priori at 5.0x10(-7). During a mean follow-up of 11.5 years, 2526 incident HF events (12%) occurred in 20 926 European-ancestry participants. The meta-analysis identified a genome-wide significant locus at chromosomal position 15q22 (1.4x10(-8)), which was 58.8 kb from USP3. Among 2895 African-ancestry participants, 466 incident HF events (16%) occurred during a mean follow-up of 13.7 years. One genome-wide significant locus was identified at 12q14 (6.7x10(-8)), which was 6.3 kb from LRIG3.

CONCLUSIONS: We identified 2 loci that were associated with incident HF and exceeded genome-wide significance. The findings merit replication in other community-based settings of incident HF.

%B Circ Cardiovasc Genet %V 3 %P 256-66 %8 2010 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20445134?dopt=Abstract %R 10.1161/CIRCGENETICS.109.895763 %0 Journal Article %J Am J Respir Crit Care Med %D 2010 %T Associations of PM10 with sleep and sleep-disordered breathing in adults from seven U.S. urban areas. %A Zanobetti, Antonella %A Redline, Susan %A Schwartz, Joel %A Rosen, Dennis %A Patel, Sanjay %A O'Connor, George T %A Lebowitz, Michael %A Coull, Brent A %A Gold, Diane R %K Adult %K Aged %K Aged, 80 and over %K Air Pollutants %K Air Pollution %K Cities %K Cohort Studies %K Female %K Humans %K Male %K Middle Aged %K Multicenter Studies as Topic %K Particle Size %K Particulate Matter %K Polysomnography %K Seasons %K Severity of Illness Index %K Sleep %K Sleep Apnea Syndromes %K Temperature %K United States %K Urban Health %X

RATIONALE: Sleep-disordered breathing (SDB), the recurrent episodic disruption of normal breathing during sleep, affects as much as 17% of U.S. adults, and may be more prevalent in poor urban environments. SDB and air pollution have been linked to increased cardiovascular diseases and mortality, but the association between pollution and SDB is poorly understood.

OBJECTIVES: We used data from the Sleep Heart Health Study (SHHS), a U.S. multicenter cohort study assessing cardiovascular and other consequences of SDB, to examine whether particulate air matter less than 10 μm in aerodynamic diameter (PM(10)) was associated with SDB among persons 39 years of age and older.

METHODS: Using baseline data from SHHS urban sites, outcomes included the following: the respiratory disturbance index (RDI); percentage of sleep time at less than 90% O(2) saturation; and sleep efficiency, measured by overnight in-home polysomnography. We applied a fixed-effect model containing a city effect, controlling for potential predictors. In all models we included both the 365-day moving averages of PM(10) and temperature (long-term effects) and the differences between the daily measures of these two predictors and their 365-day average (short-term effects).

MEASUREMENTS AND MAIN RESULTS: In summer, increases in RDI or percentage of sleep time at less than 90% O(2) saturation, and decreases in sleep efficiency, were all associated with increases in short-term variation in PM(10). Over all seasons, we found that increased RDI was associated with an 11.5% (95% confidence interval: 1.96, 22.01) increase per interquartile range increase (25.5°F) in temperature.

CONCLUSIONS: Reduction in air pollution exposure may decrease the severity of SDB and nocturnal hypoxemia and may improve cardiac risk.

%B Am J Respir Crit Care Med %V 182 %P 819-25 %8 2010 Sep 15 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/20508218?dopt=Abstract %R 10.1164/rccm.200912-1797OC %0 Journal Article %J Stat Med %D 2010 %T Bayesian methods for meta-analysis of causal relationships estimated using genetic instrumental variables. %A Burgess, Stephen %A Thompson, Simon G %A Burgess, S %A Thompson, S G %A Andrews, G %A Samani, N J %A Hall, A %A Whincup, P %A Morris, R %A Lawlor, D A %A Davey Smith, G %A Timpson, N %A Ebrahim, S %A Ben-Shlomo, Y %A Davey Smith, G %A Timpson, N %A Brown, M %A Ricketts, S %A Sandhu, M %A Reiner, A %A Psaty, B %A Lange, L %A Cushman, M %A Hung, J %A Thompson, P %A Beilby, J %A Warrington, N %A Palmer, L J %A Nordestgaard, B G %A Tybjaerg-Hansen, A %A Zacho, J %A Wu, C %A Lowe, G %A Tzoulaki, I %A Kumari, M %A Sandhu, M %A Yamamoto, J F %A Chiodini, B %A Franzosi, M %A Hankey, G J %A Jamrozik, K %A Palmer, L %A Rimm, E %A Pai, J %A Psaty, B %A Heckbert, S %A Bis, J %A Anand, S %A Engert, J %A Collins, R %A Clarke, R %A Melander, O %A Berglund, G %A Ladenvall, P %A Johansson, L %A Jansson, J-H %A Hallmans, G %A Hingorani, A %A Humphries, S %A Rimm, E %A Manson, J %A Pai, J %A Watkins, H %A Clarke, R %A Hopewell, J %A Saleheen, D %A Frossard, R %A Danesh, J %A Sattar, N %A Robertson, M %A Shepherd, J %A Schaefer, E %A Hofman, A %A Witteman, J C M %A Kardys, I %A Ben-Shlomo, Y %A Davey Smith, G %A Timpson, N %A de Faire, U %A Bennet, A %A Sattar, N %A Ford, I %A Packard, C %A Kumari, M %A Manson, J %A Lawlor, Debbie A %A Davey Smith, George %A Anand, S %A Collins, R %A Casas, J P %A Danesh, J %A Davey Smith, G %A Franzosi, M %A Hingorani, A %A Lawlor, D A %A Manson, J %A Nordestgaard, B G %A Samani, N J %A Sandhu, M %A Smeeth, L %A Wensley, F %A Anand, S %A Bowden, J %A Burgess, S %A Casas, J P %A Di Angelantonio, E %A Engert, J %A Gao, P %A Shah, T %A Smeeth, L %A Thompson, S G %A Verzilli, C %A Walker, M %A Whittaker, J %A Hingorani, A %A Danesh, J %K Bayes Theorem %K Biostatistics %K C-Reactive Protein %K Fibrinogen %K Genetic Markers %K Humans %K Meta-Analysis as Topic %K Models, Statistical %K Phenotype %K Polymorphism, Single Nucleotide %X

Genetic markers can be used as instrumental variables, in an analogous way to randomization in a clinical trial, to estimate the causal relationship between a phenotype and an outcome variable. Our purpose is to extend the existing methods for such Mendelian randomization studies to the context of multiple genetic markers measured in multiple studies, based on the analysis of individual participant data. First, for a single genetic marker in one study, we show that the usual ratio of coefficients approach can be reformulated as a regression with heterogeneous error in the explanatory variable. This can be implemented using a Bayesian approach, which is next extended to include multiple genetic markers. We then propose a hierarchical model for undertaking a meta-analysis of multiple studies, in which it is not necessary that the same genetic markers are measured in each study. This provides an overall estimate of the causal relationship between the phenotype and the outcome, and an assessment of its heterogeneity across studies. As an example, we estimate the causal relationship of blood concentrations of C-reactive protein on fibrinogen levels using data from 11 studies. These methods provide a flexible framework for efficient estimation of causal relationships derived from multiple studies. Issues discussed include weak instrument bias, analysis of binary outcome data such as disease risk, missing genetic data, and the use of haplotypes.

%B Stat Med %V 29 %P 1298-311 %8 2010 May 30 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/20209660?dopt=Abstract %R 10.1002/sim.3843 %0 Journal Article %J Nature %D 2010 %T Biological, clinical and population relevance of 95 loci for blood lipids. %A Teslovich, Tanya M %A Musunuru, Kiran %A Smith, Albert V %A Edmondson, Andrew C %A Stylianou, Ioannis M %A Koseki, Masahiro %A Pirruccello, James P %A Ripatti, Samuli %A Chasman, Daniel I %A Willer, Cristen J %A Johansen, Christopher T %A Fouchier, Sigrid W %A Isaacs, Aaron %A Peloso, Gina M %A Barbalic, Maja %A Ricketts, Sally L %A Bis, Joshua C %A Aulchenko, Yurii S %A Thorleifsson, Gudmar %A Feitosa, Mary F %A Chambers, John %A Orho-Melander, Marju %A Melander, Olle %A Johnson, Toby %A Li, Xiaohui %A Guo, Xiuqing %A Li, Mingyao %A Shin Cho, Yoon %A Jin Go, Min %A Jin Kim, Young %A Lee, Jong-Young %A Park, Taesung %A Kim, Kyunga %A Sim, Xueling %A Twee-Hee Ong, Rick %A Croteau-Chonka, Damien C %A Lange, Leslie A %A Smith, Joshua D %A Song, Kijoung %A Hua Zhao, Jing %A Yuan, Xin %A Luan, Jian'an %A Lamina, Claudia %A Ziegler, Andreas %A Zhang, Weihua %A Zee, Robert Y L %A Wright, Alan F %A Witteman, Jacqueline C M %A Wilson, James F %A Willemsen, Gonneke %A Wichmann, H-Erich %A Whitfield, John B %A Waterworth, Dawn M %A Wareham, Nicholas J %A Waeber, Gérard %A Vollenweider, Peter %A Voight, Benjamin F %A Vitart, Veronique %A Uitterlinden, André G %A Uda, Manuela %A Tuomilehto, Jaakko %A Thompson, John R %A Tanaka, Toshiko %A Surakka, Ida %A Stringham, Heather M %A Spector, Tim D %A Soranzo, Nicole %A Smit, Johannes H %A Sinisalo, Juha %A Silander, Kaisa %A Sijbrands, Eric J G %A Scuteri, Angelo %A Scott, James %A Schlessinger, David %A Sanna, Serena %A Salomaa, Veikko %A Saharinen, Juha %A Sabatti, Chiara %A Ruokonen, Aimo %A Rudan, Igor %A Rose, Lynda M %A Roberts, Robert %A Rieder, Mark %A Psaty, Bruce M %A Pramstaller, Peter P %A Pichler, Irene %A Perola, Markus %A Penninx, Brenda W J H %A Pedersen, Nancy L %A Pattaro, Cristian %A Parker, Alex N %A Paré, Guillaume %A Oostra, Ben A %A O'Donnell, Christopher J %A Nieminen, Markku S %A Nickerson, Deborah A %A Montgomery, Grant W %A Meitinger, Thomas %A McPherson, Ruth %A McCarthy, Mark I %A McArdle, Wendy %A Masson, David %A Martin, Nicholas G %A Marroni, Fabio %A Mangino, Massimo %A Magnusson, Patrik K E %A Lucas, Gavin %A Luben, Robert %A Loos, Ruth J F %A Lokki, Marja-Liisa %A Lettre, Guillaume %A Langenberg, Claudia %A Launer, Lenore J %A Lakatta, Edward G %A Laaksonen, Reijo %A Kyvik, Kirsten O %A Kronenberg, Florian %A König, Inke R %A Khaw, Kay-Tee %A Kaprio, Jaakko %A Kaplan, Lee M %A Johansson, Asa %A Jarvelin, Marjo-Riitta %A Janssens, A Cecile J W %A Ingelsson, Erik %A Igl, Wilmar %A Kees Hovingh, G %A Hottenga, Jouke-Jan %A Hofman, Albert %A Hicks, Andrew A %A Hengstenberg, Christian %A Heid, Iris M %A Hayward, Caroline %A Havulinna, Aki S %A Hastie, Nicholas D %A Harris, Tamara B %A Haritunians, Talin %A Hall, Alistair S %A Gyllensten, Ulf %A Guiducci, Candace %A Groop, Leif C %A Gonzalez, Elena %A Gieger, Christian %A Freimer, Nelson B %A Ferrucci, Luigi %A Erdmann, Jeanette %A Elliott, Paul %A Ejebe, Kenechi G %A Döring, Angela %A Dominiczak, Anna F %A Demissie, Serkalem %A Deloukas, Panagiotis %A de Geus, Eco J C %A de Faire, Ulf %A Crawford, Gabriel %A Collins, Francis S %A Chen, Yii-der I %A Caulfield, Mark J %A Campbell, Harry %A Burtt, Noel P %A Bonnycastle, Lori L %A Boomsma, Dorret I %A Boekholdt, S Matthijs %A Bergman, Richard N %A Barroso, Inês %A Bandinelli, Stefania %A Ballantyne, Christie M %A Assimes, Themistocles L %A Quertermous, Thomas %A Altshuler, David %A Seielstad, Mark %A Wong, Tien Y %A Tai, E-Shyong %A Feranil, Alan B %A Kuzawa, Christopher W %A Adair, Linda S %A Taylor, Herman A %A Borecki, Ingrid B %A Gabriel, Stacey B %A Wilson, James G %A Holm, Hilma %A Thorsteinsdottir, Unnur %A Gudnason, Vilmundur %A Krauss, Ronald M %A Mohlke, Karen L %A Ordovas, Jose M %A Munroe, Patricia B %A Kooner, Jaspal S %A Tall, Alan R %A Hegele, Robert A %A Kastelein, John J P %A Schadt, Eric E %A Rotter, Jerome I %A Boerwinkle, Eric %A Strachan, David P %A Mooser, Vincent %A Stefansson, Kari %A Reilly, Muredach P %A Samani, Nilesh J %A Schunkert, Heribert %A Cupples, L Adrienne %A Sandhu, Manjinder S %A Ridker, Paul M %A Rader, Daniel J %A van Duijn, Cornelia M %A Peltonen, Leena %A Abecasis, Goncalo R %A Boehnke, Michael %A Kathiresan, Sekar %K African Americans %K Animals %K Asian Continental Ancestry Group %K Cholesterol, HDL %K Cholesterol, LDL %K Coronary Artery Disease %K Europe %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Humans %K Lipid Metabolism %K Lipids %K Liver %K Male %K Mice %K N-Acetylgalactosaminyltransferases %K Phenotype %K Polymorphism, Single Nucleotide %K Protein Phosphatase 1 %K Reproducibility of Results %K Triglycerides %X

Plasma concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides are among the most important risk factors for coronary artery disease (CAD) and are targets for therapeutic intervention. We screened the genome for common variants associated with plasma lipids in >100,000 individuals of European ancestry. Here we report 95 significantly associated loci (P < 5 x 10(-8)), with 59 showing genome-wide significant association with lipid traits for the first time. The newly reported associations include single nucleotide polymorphisms (SNPs) near known lipid regulators (for example, CYP7A1, NPC1L1 and SCARB1) as well as in scores of loci not previously implicated in lipoprotein metabolism. The 95 loci contribute not only to normal variation in lipid traits but also to extreme lipid phenotypes and have an impact on lipid traits in three non-European populations (East Asians, South Asians and African Americans). Our results identify several novel loci associated with plasma lipids that are also associated with CAD. Finally, we validated three of the novel genes-GALNT2, PPP1R3B and TTC39B-with experiments in mouse models. Taken together, our findings provide the foundation to develop a broader biological understanding of lipoprotein metabolism and to identify new therapeutic opportunities for the prevention of CAD.

%B Nature %V 466 %P 707-13 %8 2010 Aug 05 %G eng %N 7307 %1 http://www.ncbi.nlm.nih.gov/pubmed/20686565?dopt=Abstract %R 10.1038/nature09270 %0 Journal Article %J Hum Brain Mapp %D 2010 %T Brain structure and obesity. %A Raji, Cyrus A %A Ho, April J %A Parikshak, Neelroop N %A Becker, James T %A Lopez, Oscar L %A Kuller, Lewis H %A Hua, Xue %A Leow, Alex D %A Toga, Arthur W %A Thompson, Paul M %K Age Factors %K Aged %K Analysis of Variance %K Body Mass Index %K Brain %K Continental Population Groups %K Diabetes Mellitus, Type 2 %K Fasting %K Female %K Humans %K Insulin %K Magnetic Resonance Imaging %K Male %K Nerve Fibers, Myelinated %K Nerve Fibers, Unmyelinated %K Obesity %K Organ Size %K Regression Analysis %K Sex Factors %X

Obesity is associated with increased risk for cardiovascular health problems including diabetes, hypertension, and stroke. These cardiovascular afflictions increase risk for cognitive decline and dementia, but it is unknown whether these factors, specifically obesity and Type II diabetes, are associated with specific patterns of brain atrophy. We used tensor-based morphometry (TBM) to examine gray matter (GM) and white matter (WM) volume differences in 94 elderly subjects who remained cognitively normal for at least 5 years after their scan. Bivariate analyses with corrections for multiple comparisons strongly linked body mass index (BMI), fasting plasma insulin (FPI) levels, and Type II Diabetes Mellitus (DM2) with atrophy in frontal, temporal, and subcortical brain regions. A multiple regression model, also correcting for multiple comparisons, revealed that BMI was still negatively correlated with brain atrophy (FDR <5%), while DM2 and FPI were no longer associated with any volume differences. In an Analysis of Covariance (ANCOVA) model controlling for age, gender, and race, obese subjects with a high BMI (BMI > 30) showed atrophy in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus compared with individuals with a normal BMI (18.5-25). Overweight subjects (BMI: 25-30) had atrophy in the basal ganglia and corona radiata of the WM. Overall brain volume did not differ between overweight and obese persons. Higher BMI was associated with lower brain volumes in overweight and obese elderly subjects. Obesity is therefore associated with detectable brain volume deficits in cognitively normal elderly subjects.

%B Hum Brain Mapp %V 31 %P 353-64 %8 2010 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/19662657?dopt=Abstract %R 10.1002/hbm.20870 %0 Journal Article %J Circ Cardiovasc Genet %D 2010 %T Candidate gene association resource (CARe): design, methods, and proof of concept. %A Musunuru, Kiran %A Lettre, Guillaume %A Young, Taylor %A Farlow, Deborah N %A Pirruccello, James P %A Ejebe, Kenechi G %A Keating, Brendan J %A Yang, Qiong %A Chen, Ming-Huei %A Lapchyk, Nina %A Crenshaw, Andrew %A Ziaugra, Liuda %A Rachupka, Anthony %A Benjamin, Emelia J %A Cupples, L Adrienne %A Fornage, Myriam %A Fox, Ervin R %A Heckbert, Susan R %A Hirschhorn, Joel N %A Newton-Cheh, Christopher %A Nizzari, Marcia M %A Paltoo, Dina N %A Papanicolaou, George J %A Patel, Sanjay R %A Psaty, Bruce M %A Rader, Daniel J %A Redline, Susan %A Rich, Stephen S %A Rotter, Jerome I %A Taylor, Herman A %A Tracy, Russell P %A Vasan, Ramachandran S %A Wilson, James G %A Kathiresan, Sekar %A Fabsitz, Richard R %A Boerwinkle, Eric %A Gabriel, Stacey B %K African Americans %K Cholesterol, HDL %K Cholesterol, LDL %K Cohort Studies %K Databases, Genetic %K European Continental Ancestry Group %K Genetic Association Studies %K Genotype %K Humans %K Phenotype %K Pilot Projects %K Polymorphism, Single Nucleotide %K Research Design %K Triglycerides %X

BACKGROUND: The National Heart, Lung, and Blood Institute's Candidate Gene Association Resource (CARe), a planned cross-cohort analysis of genetic variation in cardiovascular, pulmonary, hematologic, and sleep-related traits, comprises >40,000 participants representing 4 ethnic groups in 9 community-based cohorts. The goals of CARe include the discovery of new variants associated with traits using a candidate gene approach and the discovery of new variants using the genome-wide association mapping approach specifically in African Americans.

METHODS AND RESULTS: CARe has assembled DNA samples for >40,000 individuals self-identified as European American, African American, Hispanic, or Chinese American, with accompanying data on hundreds of phenotypes that have been standardized and deposited in the CARe Phenotype Database. All participants were genotyped for 7 single-nucleotide polymorphisms (SNPs) selected based on prior association evidence. We performed association analyses relating each of these SNPs to lipid traits, stratified by sex and ethnicity, and adjusted for age and age squared. In at least 2 of the ethnic groups, SNPs near CETP, LIPC, and LPL strongly replicated for association with high-density lipoprotein cholesterol concentrations, PCSK9 with low-density lipoprotein cholesterol levels, and LPL and APOA5 with serum triglycerides. Notably, some SNPs showed varying effect sizes and significance of association in different ethnic groups.

CONCLUSIONS: The CARe Pilot Study validates the operational framework for phenotype collection, SNP genotyping, and analytic pipeline of the CARe project and validates the planned candidate gene study of approximately 2000 biological candidate loci in all participants and genome-wide association study in approximately 8000 African American participants. CARe will serve as a valuable resource for the scientific community.

%B Circ Cardiovasc Genet %V 3 %P 267-75 %8 2010 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20400780?dopt=Abstract %R 10.1161/CIRCGENETICS.109.882696 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2010 %T Chronic medical conditions and the sex-based disparity in disability: the Cardiovascular Health Study. %A Whitson, Heather E %A Landerman, Lawrence R %A Newman, Anne B %A Fried, Linda P %A Pieper, Carl F %A Cohen, Harvey Jay %K Aged %K Arthritis %K Cardiovascular Diseases %K Chronic Disease %K Cohort Studies %K Comorbidity %K Cross-Sectional Studies %K Disabled Persons %K Emphysema %K Female %K Hearing Disorders %K Humans %K Male %K Obesity %K Prevalence %K Sex Distribution %X

BACKGROUND: Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women.

METHODS: We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review.

RESULTS: Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, hearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p < .001).

CONCLUSIONS: Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process.

%B J Gerontol A Biol Sci Med Sci %V 65 %P 1325-31 %8 2010 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/20675619?dopt=Abstract %R 10.1093/gerona/glq139 %0 Journal Article %J Am J Clin Nutr %D 2010 %T Circulating palmitoleic acid and risk of metabolic abnormalities and new-onset diabetes. %A Mozaffarian, Dariush %A Cao, Haiming %A King, Irena B %A Lemaitre, Rozenn N %A Song, Xiaoling %A Siscovick, David S %A Hotamisligil, Gökhan S %K Aged %K Aged, 80 and over %K Alcohol Drinking %K Body Mass Index %K Cholesterol %K Cholesterol, HDL %K Diabetes Mellitus %K Diet %K Dietary Carbohydrates %K Fatty Acids, Monounsaturated %K Female %K Fibrinogen %K Humans %K Insulin Resistance %K Life Style %K Lipids %K Male %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Sex Factors %K Triglycerides %X

BACKGROUND: Animal experiments suggest that circulating palmitoleic acid (cis-16:1n-7) from adipocyte de novo fatty acid synthesis may directly regulate insulin resistance and metabolic dysregulation.

OBJECTIVE: We investigated the independent determinants of circulating palmitoleate in free-living humans and whether palmitoleate is related to lower metabolic risk and the incidence of diabetes.

DESIGN: In a prospective cohort of 3630 US men and women in the Cardiovascular Health Study, plasma phospholipid fatty acids, anthropometric variables, blood lipids, inflammatory markers, and glucose and insulin concentrations were measured between 1992 and 2006 by using standardized methods. Independent determinants of plasma phospholipid palmitoleate and relations of palmitoleate with metabolic risk factors were investigated by using multivariable-adjusted linear regression. Relations with incident diabetes (296 incident cases) were investigated by using Cox proportional hazards.

RESULTS: The mean (± SD) palmitoleate value was 0.49 ± 0.20% (range: 0.11-2.55%) of total fatty acids. Greater body mass index, carbohydrate intake, protein intake, and alcohol use were each independent lifestyle correlates of higher palmitoleate concentrations. In multivariable analyses that adjusted for these factors and other potential confounders, higher palmitoleate concentrations were independently associated with lower LDL cholesterol (P < 0.001), higher HDL cholesterol (P < 0.001), lower total:HDL-cholesterol ratio (P = 0.04), and lower fibrinogen (P < 0.001). However, palmitoleate was also associated with higher triglycerides (P < 0.001) and (in men only) with greater insulin resistance (P < 0.001). Palmitoleate was not significantly associated with incident diabetes.

CONCLUSIONS: Adiposity (energy imbalance), carbohydrate consumption, and alcohol use-even within typical ranges-are associated with higher circulating palmitoleate concentrations. Circulating palmitoleate is robustly associated with multiple metabolic risk factors but in mixed directions, perhaps related to divergent lifestyle determinants or endogenous sources (liver, adipose tissue) of fatty acid synthesis.

%B Am J Clin Nutr %V 92 %P 1350-8 %8 2010 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/20943795?dopt=Abstract %R 10.3945/ajcn.110.003970 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2010 %T Cognition and the risk of hospitalization for serious falls in the elderly: results from the Cardiovascular Health Study. %A Welmerink, Diana B %A Longstreth, W T %A Lyles, Mary F %A Fitzpatrick, Annette L %K Accidental Falls %K Aged %K Aged, 80 and over %K Chi-Square Distribution %K Cognition Disorders %K Female %K Follow-Up Studies %K Geriatric Assessment %K Hospitalization %K Humans %K Male %K Mental Status Schedule %K Physical Examination %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Surveys and Questionnaires %X

BACKGROUND: Many elderly adults fall every year, sometimes resulting in serious injury and hospitalization. Although impaired cognition is a risk factor for injurious falls, little is known about cognitive decline above the threshold of impairment and risk of serious falls in community-dwelling seniors.

METHODS: In total, 702 of 5,356 older adults participating in the Cardiovascular Health Study experienced an injurious fall between 1990 and 2005, as indicated by hospitalization records. General cognition was measured annually with the Modified Mini-Mental State Examination and processing speed with the Digit Symbol Substitution Test. The Cox regression model was used to calculate hazard ratio and 95% confidence interval with and without time-dependent covariates and adjusted for known risk factors.

RESULTS: Participants with slightly decreased Digit Symbol Substitution Test scores were at increased risk for a serious fall (hazard ratio = 1.58, 95% confidence interval = 1.15-2.17). The risk continued to increase with each quartile decrease in Digit Symbol Substitution Test score. Participants without prevalent cardiovascular disease at baseline and decreased Modified Mini-Mental State Examination scores (80-89) had a 45% increased risk for a serious fall and those at high risk for dementia (<80) were at twice the risk as participants scoring above 90 (hazard ratio = 2.16, 95% confidence interval = 1.60-2.91).

CONCLUSIONS: Both decreased general cognition and decreased processing speed appear to be potential risk factors for serious falls in the elderly. When assessing the risk of serious falls in elderly patients, clinicians should consider usual factors like gait instability and sensory impairment as well as less obvious ones such as cardiovascular disease and cognitive function in nondemented adults.

%B J Gerontol A Biol Sci Med Sci %V 65 %P 1242-9 %8 2010 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/20584769?dopt=Abstract %R 10.1093/gerona/glq115 %0 Journal Article %J Am J Hypertens %D 2010 %T Combined association of lipids and blood pressure in relation to incident cardiovascular disease in the elderly: the cardiovascular health study. %A Wong, Nathan D %A Lopez, Victor A %A Roberts, Craig S %A Solomon, Henry A %A Burke, Gregory L %A Kuller, Lewis %A Tracy, Russell %A Yanez, David %A Psaty, Bruce M %K Age Factors %K Aged %K Aged, 80 and over %K Blood Pressure %K Cardiovascular Diseases %K Cholesterol, HDL %K Cholesterol, LDL %K Diabetes Mellitus %K Female %K Health Surveys %K Humans %K Likelihood Functions %K Lipids %K Male %K Proportional Hazards Models %K Sex Factors %K Smoking %K Socioeconomic Factors %K United States %X

BACKGROUND: Hypertension and dyslipidemia are highly prevalent in the elderly. We studied the combined impact of both conditions on cardiovascular disease (CVD) events.

METHODS: We studied 4,311 participants aged 65-98 (61.2% female) from the Cardiovascular Health Study (CHS), a longitudinal epidemiologic study, with no prior CVD. We evaluated the relation of low-density lipoprotein (LDL), high-density lipoprotein (HDL), or non-HDL-cholesterol combined with blood pressure (BP) categories to incident CVD-including coronary heart disease (CHD) (angina, myocardial infarction (MI), angioplasty, coronary bypass surgery, or CHD death), stroke, claudication, and CVD death over 15 years.

RESULTS: CVD incidence (per 1,000 person years) ranged from 38.4 when BP <120/80 mm Hg and LDL-C <100 mg/dl to 94.8 when BP >or=160/100 mm Hg and LDL-C >or=160 mg/dl, and from 28.9 when BP <120/80 mm Hg and HDL >60 mg/dl to 87.1 for a BP >or=160/100 and HDL-C <40 mg/dl. Compared with those with BP <120/80 mm Hg with either LDL-C <100 mg/dl or HDL-C >60 mg/dl, hazard ratios (HRs) for CVD events were 2.1 when BP >or=160/100 mm Hg and LDL-C >or=160 mg/dl and 2.1 when BP >or=160/100 and HDL-C <40 mg/dl (all P < 0.01), with similar results for non-HDL-C. Elevated BP was associated with increased risk across all lipid levels. Increased LDL-C added risk mainly when BP <140/90 mm Hg, but lower HDL-C also predicted CVD in those with higher BP.

CONCLUSION: Increased BP confers increased risks for CVD in elderly persons across all lipid levels. Although increased LDL-C added risk mainly when BP <140/90 mm Hg, low HDL-C added risk also in those with hypertension. These results document the importance of combined hypertension and dyslipidemia.

%B Am J Hypertens %V 23 %P 161-7 %8 2010 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/19927131?dopt=Abstract %R 10.1038/ajh.2009.216 %0 Journal Article %J Alzheimers Dement %D 2010 %T Commentary on "Developing a national strategy to prevent dementia: Leon Thal Symposium 2009." Dementia risk indices: A framework for identifying individuals with a high dementia risk. %A Barnes, Deborah E %A Covinsky, Kenneth E %A Whitmer, Rachel A %A Kuller, Lewis H %A Lopez, Oscar L %A Yaffe, Kristine %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Dementia %K Diagnosis, Differential %K Disability Evaluation %K Early Diagnosis %K Humans %K National Health Programs %K Predictive Value of Tests %K Prognosis %K Risk Assessment %K Risk Factors %K United States %B Alzheimers Dement %V 6 %P 138-41 %8 2010 Mar %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20298975?dopt=Abstract %R 10.1016/j.jalz.2010.01.005 %0 Journal Article %J Lancet %D 2010 %T Common genetic determinants of vitamin D insufficiency: a genome-wide association study. %A Wang, Thomas J %A Zhang, Feng %A Richards, J Brent %A Kestenbaum, Bryan %A van Meurs, Joyce B %A Berry, Diane %A Kiel, Douglas P %A Streeten, Elizabeth A %A Ohlsson, Claes %A Koller, Daniel L %A Peltonen, Leena %A Cooper, Jason D %A O'Reilly, Paul F %A Houston, Denise K %A Glazer, Nicole L %A Vandenput, Liesbeth %A Peacock, Munro %A Shi, Julia %A Rivadeneira, Fernando %A McCarthy, Mark I %A Anneli, Pouta %A de Boer, Ian H %A Mangino, Massimo %A Kato, Bernet %A Smyth, Deborah J %A Booth, Sarah L %A Jacques, Paul F %A Burke, Greg L %A Goodarzi, Mark %A Cheung, Ching-Lung %A Wolf, Myles %A Rice, Kenneth %A Goltzman, David %A Hidiroglou, Nick %A Ladouceur, Martin %A Wareham, Nicholas J %A Hocking, Lynne J %A Hart, Deborah %A Arden, Nigel K %A Cooper, Cyrus %A Malik, Suneil %A Fraser, William D %A Hartikainen, Anna-Liisa %A Zhai, Guangju %A Macdonald, Helen M %A Forouhi, Nita G %A Loos, Ruth J F %A Reid, David M %A Hakim, Alan %A Dennison, Elaine %A Liu, Yongmei %A Power, Chris %A Stevens, Helen E %A Jaana, Laitinen %A Vasan, Ramachandran S %A Soranzo, Nicole %A Bojunga, Jörg %A Psaty, Bruce M %A Lorentzon, Mattias %A Foroud, Tatiana %A Harris, Tamara B %A Hofman, Albert %A Jansson, John-Olov %A Cauley, Jane A %A Uitterlinden, André G %A Gibson, Quince %A Jarvelin, Marjo-Riitta %A Karasik, David %A Siscovick, David S %A Econs, Michael J %A Kritchevsky, Stephen B %A Florez, Jose C %A Todd, John A %A Dupuis, Josée %A Hyppönen, Elina %A Spector, Timothy D %K Canada %K Chromosomes, Human, Pair 11 %K Chromosomes, Human, Pair 4 %K Cohort Studies %K Dietary Supplements %K Europe %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Heterozygote %K Homozygote %K Humans %K Immunoassay %K International Cooperation %K Linkage Disequilibrium %K Polymorphism, Single Nucleotide %K Seasons %K United States %K Vitamin D %K Vitamin D Deficiency %X

BACKGROUND: Vitamin D is crucial for maintenance of musculoskeletal health, and might also have a role in extraskeletal tissues. Determinants of circulating 25-hydroxyvitamin D concentrations include sun exposure and diet, but high heritability suggests that genetic factors could also play a part. We aimed to identify common genetic variants affecting vitamin D concentrations and risk of insufficiency.

METHODS: We undertook a genome-wide association study of 25-hydroxyvitamin D concentrations in 33 996 individuals of European descent from 15 cohorts. Five epidemiological cohorts were designated as discovery cohorts (n=16 125), five as in-silico replication cohorts (n=9367), and five as de-novo replication cohorts (n=8504). 25-hydroxyvitamin D concentrations were measured by radioimmunoassay, chemiluminescent assay, ELISA, or mass spectrometry. Vitamin D insufficiency was defined as concentrations lower than 75 nmol/L or 50 nmol/L. We combined results of genome-wide analyses across cohorts using Z-score-weighted meta-analysis. Genotype scores were constructed for confirmed variants.

FINDINGS: Variants at three loci reached genome-wide significance in discovery cohorts for association with 25-hydroxyvitamin D concentrations, and were confirmed in replication cohorts: 4p12 (overall p=1.9x10(-109) for rs2282679, in GC); 11q12 (p=2.1x10(-27) for rs12785878, near DHCR7); and 11p15 (p=3.3x10(-20) for rs10741657, near CYP2R1). Variants at an additional locus (20q13, CYP24A1) were genome-wide significant in the pooled sample (p=6.0x10(-10) for rs6013897). Participants with a genotype score (combining the three confirmed variants) in the highest quartile were at increased risk of having 25-hydroxyvitamin D concentrations lower than 75 nmol/L (OR 2.47, 95% CI 2.20-2.78, p=2.3x10(-48)) or lower than 50 nmol/L (1.92, 1.70-2.16, p=1.0x10(-26)) compared with those in the lowest quartile.

INTERPRETATION: Variants near genes involved in cholesterol synthesis, hydroxylation, and vitamin D transport affect vitamin D status. Genetic variation at these loci identifies individuals who have substantially raised risk of vitamin D insufficiency.

FUNDING: Full funding sources listed at end of paper (see Acknowledgments).

%B Lancet %V 376 %P 180-8 %8 2010 Jul 17 %G eng %N 9736 %1 http://www.ncbi.nlm.nih.gov/pubmed/20541252?dopt=Abstract %R 10.1016/S0140-6736(10)60588-0 %0 Journal Article %J J Am Soc Nephrol %D 2010 %T Common genetic variants associate with serum phosphorus concentration. %A Kestenbaum, Bryan %A Glazer, Nicole L %A Köttgen, Anna %A Felix, Janine F %A Hwang, Shih-Jen %A Liu, Yongmei %A Lohman, Kurt %A Kritchevsky, Stephen B %A Hausman, Dorothy B %A Petersen, Ann-Kristin %A Gieger, Christian %A Ried, Janina S %A Meitinger, Thomas %A Strom, Tim M %A Wichmann, H Erich %A Campbell, Harry %A Hayward, Caroline %A Rudan, Igor %A de Boer, Ian H %A Psaty, Bruce M %A Rice, Kenneth M %A Chen, Yii-Der Ida %A Li, Man %A Arking, Dan E %A Boerwinkle, Eric %A Coresh, Josef %A Yang, Qiong %A Levy, Daniel %A van Rooij, Frank J A %A Dehghan, Abbas %A Rivadeneira, Fernando %A Uitterlinden, André G %A Hofman, Albert %A van Duijn, Cornelia M %A Shlipak, Michael G %A Kao, W H Linda %A Witteman, Jacqueline C M %A Siscovick, David S %A Fox, Caroline S %K Adult %K Aged %K European Continental Ancestry Group %K Female %K Fibroblast Growth Factors %K Gene Frequency %K Genetic Loci %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Kidney %K Male %K Middle Aged %K Phosphorus %K Polymorphism, Single Nucleotide %K Receptors, Calcium-Sensing %K Sex Factors %K Sodium-Phosphate Cotransporter Proteins, Type IIa %X

Phosphorus is an essential mineral that maintains cellular energy and mineralizes the skeleton. Because complex actions of ion transporters and regulatory hormones regulate serum phosphorus concentrations, genetic variation may determine interindividual variation in phosphorus metabolism. Here, we report a comprehensive genome-wide association study of serum phosphorus concentration. We evaluated 16,264 participants of European ancestry from the Cardiovascular Heath Study, Atherosclerosis Risk in Communities Study, Framingham Offspring Study, and the Rotterdam Study. We excluded participants with an estimated GFR <45 ml/min per 1.73 m(2) to focus on phosphorus metabolism under normal conditions. We imputed genotypes to approximately 2.5 million single-nucleotide polymorphisms in the HapMap and combined study-specific findings using meta-analysis. We tested top polymorphisms from discovery cohorts in a 5444-person replication sample. Polymorphisms in seven loci with minor allele frequencies 0.08 to 0.49 associate with serum phosphorus concentration (P = 3.5 x 10(-16) to 3.6 x 10(-7)). Three loci were near genes encoding the kidney-specific type IIa sodium phosphate co-transporter (SLC34A1), the calcium-sensing receptor (CASR), and fibroblast growth factor 23 (FGF23), proteins that contribute to phosphorus metabolism. We also identified genes encoding phosphatases, kinases, and phosphodiesterases that have yet-undetermined roles in phosphorus homeostasis. In the replication sample, five of seven top polymorphisms associate with serum phosphorous concentrations (P < 0.05 for each). In conclusion, common genetic variants associate with serum phosphorus in the general population. Further study of the loci identified in this study may help elucidate mechanisms of phosphorus regulation.

%B J Am Soc Nephrol %V 21 %P 1223-32 %8 2010 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/20558539?dopt=Abstract %R 10.1681/ASN.2009111104 %0 Journal Article %J Nat Genet %D 2010 %T Common variants in 22 loci are associated with QRS duration and cardiac ventricular conduction. %A Sotoodehnia, Nona %A Isaacs, Aaron %A de Bakker, Paul I W %A Dörr, Marcus %A Newton-Cheh, Christopher %A Nolte, Ilja M %A van der Harst, Pim %A Müller, Martina %A Eijgelsheim, Mark %A Alonso, Alvaro %A Hicks, Andrew A %A Padmanabhan, Sandosh %A Hayward, Caroline %A Smith, Albert Vernon %A Polasek, Ozren %A Giovannone, Steven %A Fu, Jingyuan %A Magnani, Jared W %A Marciante, Kristin D %A Pfeufer, Arne %A Gharib, Sina A %A Teumer, Alexander %A Li, Man %A Bis, Joshua C %A Rivadeneira, Fernando %A Aspelund, Thor %A Köttgen, Anna %A Johnson, Toby %A Rice, Kenneth %A Sie, Mark P S %A Wang, Ying A %A Klopp, Norman %A Fuchsberger, Christian %A Wild, Sarah H %A Mateo Leach, Irene %A Estrada, Karol %A Völker, Uwe %A Wright, Alan F %A Asselbergs, Folkert W %A Qu, Jiaxiang %A Chakravarti, Aravinda %A Sinner, Moritz F %A Kors, Jan A %A Petersmann, Astrid %A Harris, Tamara B %A Soliman, Elsayed Z %A Munroe, Patricia B %A Psaty, Bruce M %A Oostra, Ben A %A Cupples, L Adrienne %A Perz, Siegfried %A de Boer, Rudolf A %A Uitterlinden, André G %A Völzke, Henry %A Spector, Timothy D %A Liu, Fang-Yu %A Boerwinkle, Eric %A Dominiczak, Anna F %A Rotter, Jerome I %A van Herpen, Gé %A Levy, Daniel %A Wichmann, H-Erich %A van Gilst, Wiek H %A Witteman, Jacqueline C M %A Kroemer, Heyo K %A Kao, W H Linda %A Heckbert, Susan R %A Meitinger, Thomas %A Hofman, Albert %A Campbell, Harry %A Folsom, Aaron R %A van Veldhuisen, Dirk J %A Schwienbacher, Christine %A O'Donnell, Christopher J %A Volpato, Claudia Beu %A Caulfield, Mark J %A Connell, John M %A Launer, Lenore %A Lu, Xiaowen %A Franke, Lude %A Fehrmann, Rudolf S N %A te Meerman, Gerard %A Groen, Harry J M %A Weersma, Rinse K %A van den Berg, Leonard H %A Wijmenga, Cisca %A Ophoff, Roel A %A Navis, Gerjan %A Rudan, Igor %A Snieder, Harold %A Wilson, James F %A Pramstaller, Peter P %A Siscovick, David S %A Wang, Thomas J %A Gudnason, Vilmundur %A van Duijn, Cornelia M %A Felix, Stephan B %A Fishman, Glenn I %A Jamshidi, Yalda %A Stricker, Bruno H Ch %A Samani, Nilesh J %A Kääb, Stefan %A Arking, Dan E %K Animals %K Animals, Newborn %K Chromosomes, Human %K Computational Biology %K Electrocardiography %K Genetic Loci %K Genome-Wide Association Study %K Heart Conduction System %K Humans %K Mice %K Mice, Transgenic %K Models, Animal %K Myocytes, Cardiac %K NAV1.8 Voltage-Gated Sodium Channel %K Polymorphism, Single Nucleotide %K Sodium Channels %X

The QRS interval, from the beginning of the Q wave to the end of the S wave on an electrocardiogram, reflects ventricular depolarization and conduction time and is a risk factor for mortality, sudden death and heart failure. We performed a genome-wide association meta-analysis in 40,407 individuals of European descent from 14 studies, with further genotyping in 7,170 additional Europeans, and we identified 22 loci associated with QRS duration (P < 5 × 10(-8)). These loci map in or near genes in pathways with established roles in ventricular conduction such as sodium channels, transcription factors and calcium-handling proteins, but also point to previously unidentified biologic processes, such as kinase inhibitors and genes related to tumorigenesis. We demonstrate that SCN10A, a candidate gene at the most significantly associated locus in this study, is expressed in the mouse ventricular conduction system, and treatment with a selective SCN10A blocker prolongs QRS duration. These findings extend our current knowledge of ventricular depolarization and conduction.

%B Nat Genet %V 42 %P 1068-76 %8 2010 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21076409?dopt=Abstract %R 10.1038/ng.716 %0 Journal Article %J Nat Genet %D 2010 %T Common variants in KCNN3 are associated with lone atrial fibrillation. %A Ellinor, Patrick T %A Lunetta, Kathryn L %A Glazer, Nicole L %A Pfeufer, Arne %A Alonso, Alvaro %A Chung, Mina K %A Sinner, Moritz F %A de Bakker, Paul I W %A Mueller, Martina %A Lubitz, Steven A %A Fox, Ervin %A Darbar, Dawood %A Smith, Nicholas L %A Smith, Jonathan D %A Schnabel, Renate B %A Soliman, Elsayed Z %A Rice, Kenneth M %A Van Wagoner, David R %A Beckmann, Britt-M %A van Noord, Charlotte %A Wang, Ke %A Ehret, Georg B %A Rotter, Jerome I %A Hazen, Stanley L %A Steinbeck, Gerhard %A Smith, Albert V %A Launer, Lenore J %A Harris, Tamara B %A Makino, Seiko %A Nelis, Mari %A Milan, David J %A Perz, Siegfried %A Esko, Tõnu %A Köttgen, Anna %A Moebus, Susanne %A Newton-Cheh, Christopher %A Li, Man %A Möhlenkamp, Stefan %A Wang, Thomas J %A Kao, W H Linda %A Vasan, Ramachandran S %A Nöthen, Markus M %A MacRae, Calum A %A Stricker, Bruno H Ch %A Hofman, Albert %A Uitterlinden, André G %A Levy, Daniel %A Boerwinkle, Eric %A Metspalu, Andres %A Topol, Eric J %A Chakravarti, Aravinda %A Gudnason, Vilmundur %A Psaty, Bruce M %A Roden, Dan M %A Meitinger, Thomas %A Wichmann, H-Erich %A Witteman, Jacqueline C M %A Barnard, John %A Arking, Dan E %A Benjamin, Emelia J %A Heckbert, Susan R %A Kääb, Stefan %K Adolescent %K Adult %K Aged %K Atrial Fibrillation %K Case-Control Studies %K Cohort Studies %K Female %K Genome-Wide Association Study %K Humans %K Introns %K Male %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %K Small-Conductance Calcium-Activated Potassium Channels %K Young Adult %X

Atrial fibrillation (AF) is the most common sustained arrhythmia. Previous studies have identified several genetic loci associated with typical AF. We sought to identify common genetic variants underlying lone AF. This condition affects a subset of individuals without overt heart disease and with an increased heritability of AF. We report a meta-analysis of genome-wide association studies conducted using 1,335 individuals with lone AF (cases) and 12,844 unaffected individuals (referents). Cases were obtained from the German AF Network, Heart and Vascular Health Study, the Atherosclerosis Risk in Communities Study, the Cleveland Clinic and Massachusetts General Hospital. We identified an association on chromosome 1q21 to lone AF (rs13376333, adjusted odds ratio = 1.56; P = 6.3 x 10(-12)), and we replicated this association in two independent cohorts with lone AF (overall combined odds ratio = 1.52, 95% CI 1.40-1.64; P = 1.83 x 10(-21)). rs13376333 is intronic to KCNN3, which encodes a potassium channel protein involved in atrial repolarization.

%B Nat Genet %V 42 %P 240-4 %8 2010 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20173747?dopt=Abstract %R 10.1038/ng.537 %0 Journal Article %J Hum Mol Genet %D 2010 %T Common variants in the calcium-sensing receptor gene are associated with total serum calcium levels. %A O'Seaghdha, Conall M %A Yang, Qiong %A Glazer, Nicole L %A Leak, Tennille S %A Dehghan, Abbas %A Smith, Albert V %A Kao, W H Linda %A Lohman, Kurt %A Hwang, Shih-Jen %A Johnson, Andrew D %A Hofman, Albert %A Uitterlinden, André G %A Chen, Yii-Der Ida %A Brown, Edward M %A Siscovick, David S %A Harris, Tamara B %A Psaty, Bruce M %A Coresh, Josef %A Gudnason, Vilmundur %A Witteman, Jacqueline C %A Liu, Yong Mei %A Kestenbaum, Bryan R %A Fox, Caroline S %A Köttgen, Anna %K Adult %K Calcium %K Female %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Receptors, Calcium-Sensing %X

Serum calcium levels are tightly regulated. We performed genome-wide association studies (GWAS) in population-based studies participating in the CHARGE Consortium to uncover common genetic variations associated with total serum calcium levels. GWAS of serum calcium concentrations was performed in 20 611 individuals of European ancestry for ∼2.5 million genotyped and imputed single-nucleotide polymorphisms (SNPs). The SNP with the lowest P-value was rs17251221 (P = 2.4 * 10(-22), minor allele frequency 14%) in the calcium-sensing receptor gene (CASR). This lead SNP was associated with higher serum calcium levels [0.06 mg/dl (0.015 mmol/l) per copy of the minor G allele] and accounted for 0.54% of the variance in serum calcium concentrations. The identification of variation in CASR that influences serum calcium concentration confirms the results of earlier candidate gene studies. The G allele of rs17251221 was also associated with higher serum magnesium levels (P = 1.2 * 10(-3)), lower serum phosphate levels (P = 2.8 * 10(-7)) and lower bone mineral density at the lumbar spine (P = 0.038), but not the femoral neck. No additional genomic loci contained SNPs associated at genome-wide significance (P < 5 * 10(-8)). These associations resemble clinical characteristics of patients with familial hypocalciuric hypercalcemia, an autosomal-dominant disease arising from rare inactivating mutations in the CASR gene. We conclude that common genetic variation in the CASR gene is associated with similar but milder features in the general population.

%B Hum Mol Genet %V 19 %P 4296-303 %8 2010 Nov 01 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/20705733?dopt=Abstract %R 10.1093/hmg/ddq342 %0 Journal Article %J Lancet %D 2010 %T C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. %A Kaptoge, Stephen %A Di Angelantonio, Emanuele %A Lowe, Gordon %A Pepys, Mark B %A Thompson, Simon G %A Collins, Rory %A Danesh, John %K Alcohol Drinking %K Biomarkers %K Blood Pressure %K Body Mass Index %K C-Reactive Protein %K Cholesterol %K Coronary Disease %K Databases, Factual %K Diabetes Mellitus %K Female %K Fibrinogen %K Humans %K Interleukin-6 %K Leukocyte Count %K Lung Diseases %K Male %K Middle Aged %K Motor Activity %K Neoplasms %K Regression Analysis %K Risk Assessment %K Risk Factors %K Serum Albumin %K Sex Factors %K Smoking %K Stroke %K Triglycerides %X

BACKGROUND: Associations of C-reactive protein (CRP) concentration with risk of major diseases can best be assessed by long-term prospective follow-up of large numbers of people. We assessed the associations of CRP concentration with risk of vascular and non-vascular outcomes under different circumstances.

METHODS: We meta-analysed individual records of 160 309 people without a history of vascular disease (ie, 1.31 million person-years at risk, 27 769 fatal or non-fatal disease outcomes) from 54 long-term prospective studies. Within-study regression analyses were adjusted for within-person variation in risk factor levels.

RESULTS: Log(e) CRP concentration was linearly associated with several conventional risk factors and inflammatory markers, and nearly log-linearly with the risk of ischaemic vascular disease and non-vascular mortality. Risk ratios (RRs) for coronary heart disease per 1-SD higher log(e) CRP concentration (three-fold higher) were 1.63 (95% CI 1.51-1.76) when initially adjusted for age and sex only, and 1.37 (1.27-1.48) when adjusted further for conventional risk factors; 1.44 (1.32-1.57) and 1.27 (1.15-1.40) for ischaemic stroke; 1.71 (1.53-1.91) and 1.55 (1.37-1.76) for vascular mortality; and 1.55 (1.41-1.69) and 1.54 (1.40-1.68) for non-vascular mortality. RRs were largely unchanged after exclusion of smokers or initial follow-up. After further adjustment for fibrinogen, the corresponding RRs were 1.23 (1.07-1.42) for coronary heart disease; 1.32 (1.18-1.49) for ischaemic stroke; 1.34 (1.18-1.52) for vascular mortality; and 1.34 (1.20-1.50) for non-vascular mortality.

INTERPRETATION: CRP concentration has continuous associations with the risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease that are each of broadly similar size. The relevance of CRP to such a range of disorders is unclear. Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation.

FUNDING: British Heart Foundation, UK Medical Research Council, BUPA Foundation, and GlaxoSmithKline.

%B Lancet %V 375 %P 132-40 %8 2010 Jan 09 %G eng %N 9709 %1 http://www.ncbi.nlm.nih.gov/pubmed/20031199?dopt=Abstract %R 10.1016/S0140-6736(09)61717-7 %0 Journal Article %J Lancet %D 2010 %T Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. %A Sarwar, N %A Gao, P %A Seshasai, S R Kondapally %A Gobin, R %A Kaptoge, S %A Di Angelantonio, E %A Ingelsson, E %A Lawlor, D A %A Selvin, E %A Stampfer, M %A Stehouwer, C D A %A Lewington, S %A Pennells, L %A Thompson, A %A Sattar, N %A White, I R %A Ray, K K %A Danesh, J %K Adult %K Aged %K Blood Glucose %K Coronary Disease %K Diabetes Complications %K Diabetes Mellitus %K Fasting %K Female %K Humans %K Male %K Middle Aged %K Risk Factors %K Stroke %X

BACKGROUND: Uncertainties persist about the magnitude of associations of diabetes mellitus and fasting glucose concentration with risk of coronary heart disease and major stroke subtypes. We aimed to quantify these associations for a wide range of circumstances.

METHODS: We undertook a meta-analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body-mass index to calculate hazard ratios (HRs) for vascular disease.

FINDINGS: Analyses included data for 698 782 people (52 765 non-fatal or fatal vascular outcomes; 8.49 million person-years at risk) from 102 prospective studies. Adjusted HRs with diabetes were: 2.00 (95% CI 1.83-2.19) for coronary heart disease; 2.27 (1.95-2.65) for ischaemic stroke; 1.56 (1.19-2.05) for haemorrhagic stroke; 1.84 (1.59-2.13) for unclassified stroke; and 1.73 (1.51-1.98) for the aggregate of other vascular deaths. HRs did not change appreciably after further adjustment for lipid, inflammatory, or renal markers. HRs for coronary heart disease were higher in women than in men, at 40-59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10-12%) of vascular deaths. Fasting blood glucose concentration was non-linearly related to vascular risk, with no significant associations between 3.90 mmol/L and 5.59 mmol/L. Compared with fasting blood glucose concentrations of 3.90-5.59 mmol/L, HRs for coronary heart disease were: 1.07 (0.97-1.18) for lower than 3.90 mmol/L; 1.11 (1.04-1.18) for 5.60-6.09 mmol/L; and 1.17 (1.08-1.26) for 6.10-6.99 mmol/L. In people without a history of diabetes, information about fasting blood glucose concentration or impaired fasting glucose status did not significantly improve metrics of vascular disease prediction when added to information about several conventional risk factors.

INTERPRETATION: Diabetes confers about a two-fold excess risk for a wide range of vascular diseases, independently from other conventional risk factors. In people without diabetes, fasting blood glucose concentration is modestly and non-linearly associated with risk of vascular disease.

FUNDING: British Heart Foundation, UK Medical Research Council, and Pfizer.

%B Lancet %V 375 %P 2215-22 %8 2010 Jun 26 %G eng %N 9733 %1 http://www.ncbi.nlm.nih.gov/pubmed/20609967?dopt=Abstract %R 10.1016/S0140-6736(10)60484-9 %0 Journal Article %J PLoS One %D 2010 %T Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. %A Gkrania-Klotsas, Effrossyni %A Ye, Zheng %A Cooper, Andrew J %A Sharp, Stephen J %A Luben, Robert %A Biggs, Mary L %A Chen, Liang-Kung %A Gokulakrishnan, Kuppan %A Hanefeld, Markolf %A Ingelsson, Erik %A Lai, Wen-An %A Lin, Shih-Yi %A Lind, Lars %A Lohsoonthorn, Vitool %A Mohan, Viswanathan %A Muscari, Antonio %A Nilsson, Goran %A Ohrvik, John %A Chao Qiang, Jiang %A Jenny, Nancy Swords %A Tamakoshi, Koji %A Temelkova-Kurktschiev, Theodora %A Wang, Ya-Yu %A Yajnik, Chittaranjan Sakerlal %A Zoli, Marco %A Khaw, Kay-Tee %A Forouhi, Nita G %A Wareham, Nicholas J %A Langenberg, Claudia %K Adult %K Aged %K Cross-Sectional Studies %K Diabetes Mellitus, Type 2 %K Female %K Humans %K Leukocyte Count %K Male %K Middle Aged %K Prospective Studies %X

OBJECTIVE: Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated.

RESEARCH DESIGN AND METHODS: Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 non-cases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored.

RESULTS: The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p = 1.5*10(-18)). Substantial heterogeneity was present (I(2) = 83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p = 1.5*10(-4)), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p = 0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p = 0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p = 7.7*10(-13)), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p = 7.7*10(-5)). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference.

CONCLUSIONS: A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.

%B PLoS One %V 5 %P e13405 %8 2010 Oct 18 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/20976133?dopt=Abstract %R 10.1371/journal.pone.0013405 %0 Journal Article %J Circulation %D 2010 %T European ancestry as a risk factor for atrial fibrillation in African Americans. %A Marcus, Gregory M %A Alonso, Alvaro %A Peralta, Carmen A %A Lettre, Guillaume %A Vittinghoff, Eric %A Lubitz, Steven A %A Fox, Ervin R %A Levitzky, Yamini S %A Mehra, Reena %A Kerr, Kathleen F %A Deo, Rajat %A Sotoodehnia, Nona %A Akylbekova, Meggie %A Ellinor, Patrick T %A Paltoo, Dina N %A Soliman, Elsayed Z %A Benjamin, Emelia J %A Heckbert, Susan R %K African Americans %K Aged %K Atrial Fibrillation %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Risk Factors %X

BACKGROUND: Despite a higher burden of standard atrial fibrillation (AF) risk factors, African Americans have a lower risk of AF than whites. It is unknown whether the higher risk is due to genetic or environmental factors. Because African Americans have varying degrees of European ancestry, we sought to test the hypothesis that European ancestry is an independent risk factor for AF.

METHODS AND RESULTS: We studied whites (n=4543) and African Americans (n=822) in the Cardiovascular Health Study (CHS) and whites (n=10 902) and African Americans (n=3517) in the Atherosclerosis Risk in Communities (ARIC) Study (n=3517). Percent European ancestry in African Americans was estimated with 1747 ancestry informative markers from the Illumina custom ITMAT-Broad-CARe array. Among African Americans without baseline AF, 120 of 804 CHS participants and 181 of 3517 ARIC participants developed incident AF. A meta-analysis from the 2 studies revealed that every 10% increase in European ancestry increased the risk of AF by 13% (hazard ratio, 1.13; 95% confidence interval, 1.03 to 1.23; P=0.007). After adjustment for potential confounders, European ancestry remained a predictor of incident AF in each cohort alone, with a combined estimated hazard ratio for each 10% increase in European ancestry of 1.17 (95% confidence interval, 1.07 to 1.29; P=0.001). A second analysis using 3192 ancestry informative markers from a genome-wide Affymetrix 6.0 array in ARIC African Americans yielded similar results.

CONCLUSIONS: European ancestry predicted risk of incident AF. Our study suggests that investigating genetic variants contributing to differential AF risk in individuals of African versus European ancestry will be informative.

%B Circulation %V 122 %P 2009-15 %8 2010 Nov 16 %G eng %N 20 %1 http://www.ncbi.nlm.nih.gov/pubmed/21098467?dopt=Abstract %R 10.1161/CIRCULATIONAHA.110.958306 %0 Journal Article %J Am J Clin Nutr %D 2010 %T Food sources of individual plasma phospholipid trans fatty acid isomers: the Cardiovascular Health Study. %A Micha, Renata %A King, Irena B %A Lemaitre, Rozenn N %A Rimm, Eric B %A Sacks, Frank %A Song, Xiaoling %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Cardiovascular System %K Diet %K Diet Surveys %K Dietary Fats %K Female %K Food Analysis %K Health %K Humans %K Hydrogenation %K Isomerism %K Male %K Phospholipids %K Plant Oils %K Regression Analysis %K Surveys and Questionnaires %K Trans Fatty Acids %X

BACKGROUND: The overall consumption of trans fatty acids (TFAs) increases the risk of coronary artery disease. However, multiple TFA isomers exist, each with potentially different health effects. Different food sources of these specific TFA isomers are not well established.

OBJECTIVE: Our objective was to determine the major independent food sources of specific TFA isomers.

DESIGN: We investigated relations of major potential food sources of TFAs, as assessed by serial food-frequency questionnaires, with 10 plasma phospholipid TFA isomers [5 trans (t-) 18:1, 3 t-18:2, and 2 t-16:1] in 3330 older adults in the Cardiovascular Health Study, a community-based multicenter cohort. Stepwise regression was used to identify independent major food sources of individual plasma phospholipid TFA isomers, which were adjusted for demographic, lifestyle, and dietary factors.

RESULTS: All 5 t-18:1 isomers were similarly associated with foods commonly made with partially hydrogenated vegetable oils (PHVOs), including biscuits (0.51 higher SD of total 18:1 fatty acid concentrations per serving/d, P < 0.01), chips and/or popcorn (0.33 higher SD per serving/d, P = 0.02), margarine (0.32 higher SD per serving/d, P < 0.001), fried foods (0.32 higher SD per serving/d, P = 0.04), and bakery foods (0.23 higher SD per serving/d, P = 0.02). Each of the t-18:2 isomers were associated only with bakery foods (0.50 higher SD of total 18:2 fatty acid concentrations per serving/d, P < 0.001). Ruminant foods were major correlates of t-16:1n-7, including red meats (0.72 higher SD per serving/d, P < 0.001), butter (0.43 higher SD per serving/d, P < 0.001), and higher-fat dairy (0.37 higher SD per serving/d, P < 0.001). In contrast, t-16:1n-9 were derived mainly from margarine (0.31 higher SD per serving/d, P < 0.001).

CONCLUSIONS: t-18:1 Isomers are similarly derived from multiple PHVO-containing foods. In contrast, t-18:2 and t-16:1n-9 isomers are derived from more-specific types of PHVO-containing foods. Ruminant foods are major sources of t-16:1n-7. Different TFA isomers and dietary sources should be considered when investigating health effects and interventions to lower TFAs.

%B Am J Clin Nutr %V 91 %P 883-93 %8 2010 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/20219966?dopt=Abstract %R 10.3945/ajcn.2009.28877 %0 Journal Article %J PLoS Genet %D 2010 %T Four novel Loci (19q13, 6q24, 12q24, and 5q14) influence the microcirculation in vivo. %A Ikram, M Kamran %A Sim, Xueling %A Xueling, Sim %A Jensen, Richard A %A Cotch, Mary Frances %A Hewitt, Alex W %A Ikram, M Arfan %A Wang, Jie Jin %A Klein, Ronald %A Klein, Barbara E K %A Breteler, Monique M B %A Cheung, Ning %A Liew, Gerald %A Mitchell, Paul %A Uitterlinden, André G %A Rivadeneira, Fernando %A Hofman, Albert %A de Jong, Paulus T V M %A van Duijn, Cornelia M %A Kao, Linda %A Cheng, Ching-Yu %A Smith, Albert Vernon %A Glazer, Nicole L %A Lumley, Thomas %A McKnight, Barbara %A Psaty, Bruce M %A Jonasson, Fridbert %A Eiriksdottir, Gudny %A Aspelund, Thor %A Harris, Tamara B %A Launer, Lenore J %A Taylor, Kent D %A Li, Xiaohui %A Iyengar, Sudha K %A Xi, Quansheng %A Sivakumaran, Theru A %A Mackey, David A %A Macgregor, Stuart %A Martin, Nicholas G %A Young, Terri L %A Bis, Josh C %A Wiggins, Kerri L %A Heckbert, Susan R %A Hammond, Christopher J %A Andrew, Toby %A Fahy, Samantha %A Attia, John %A Holliday, Elizabeth G %A Scott, Rodney J %A Islam, F M Amirul %A Rotter, Jerome I %A McAuley, Annie K %A Boerwinkle, Eric %A Tai, E Shyong %A Gudnason, Vilmundur %A Siscovick, David S %A Vingerling, Johannes R %A Wong, Tien Y %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Child %K Child, Preschool %K Chromosomes, Human, Pair 12 %K Chromosomes, Human, Pair 19 %K Chromosomes, Human, Pair 5 %K Chromosomes, Human, Pair 6 %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Microcirculation %K Middle Aged %K Polymorphism, Single Nucleotide %K Retinal Vessels %K Young Adult %X

There is increasing evidence that the microcirculation plays an important role in the pathogenesis of cardiovascular diseases. Changes in retinal vascular caliber reflect early microvascular disease and predict incident cardiovascular events. We performed a genome-wide association study to identify genetic variants associated with retinal vascular caliber. We analyzed data from four population-based discovery cohorts with 15,358 unrelated Caucasian individuals, who are members of the Cohort for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and replicated findings in four independent Caucasian cohorts (n  =  6,652). All participants had retinal photography and retinal arteriolar and venular caliber measured from computer software. In the discovery cohorts, 179 single nucleotide polymorphisms (SNP) spread across five loci were significantly associated (p<5.0×10(-8)) with retinal venular caliber, but none showed association with arteriolar caliber. Collectively, these five loci explain 1.0%-3.2% of the variation in retinal venular caliber. Four out of these five loci were confirmed in independent replication samples. In the combined analyses, the top SNPs at each locus were: rs2287921 (19q13; p  =  1.61×10(-25), within the RASIP1 locus), rs225717 (6q24; p = 1.25×10(-16), adjacent to the VTA1 and NMBR loci), rs10774625 (12q24; p  =  2.15×10(-13), in the region of ATXN2,SH2B3 and PTPN11 loci), and rs17421627 (5q14; p = 7.32×10(-16), adjacent to the MEF2C locus). In two independent samples, locus 12q24 was also associated with coronary heart disease and hypertension. Our population-based genome-wide association study demonstrates four novel loci associated with retinal venular caliber, an endophenotype of the microcirculation associated with clinical cardiovascular disease. These data provide further insights into the contribution and biological mechanisms of microcirculatory changes that underlie cardiovascular disease.

%B PLoS Genet %V 6 %P e1001184 %8 2010 Oct 28 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21060863?dopt=Abstract %R 10.1371/journal.pgen.1001184 %0 Journal Article %J N Engl J Med %D 2010 %T Genetic ancestry in lung-function predictions. %A Kumar, Rajesh %A Seibold, Max A %A Aldrich, Melinda C %A Williams, L Keoki %A Reiner, Alex P %A Colangelo, Laura %A Galanter, Joshua %A Gignoux, Christopher %A Hu, Donglei %A Sen, Saunak %A Choudhry, Shweta %A Peterson, Edward L %A Rodriguez-Santana, Jose %A Rodriguez-Cintron, William %A Nalls, Michael A %A Leak, Tennille S %A O'Meara, Ellen %A Meibohm, Bernd %A Kritchevsky, Stephen B %A Li, Rongling %A Harris, Tamara B %A Nickerson, Deborah A %A Fornage, Myriam %A Enright, Paul %A Ziv, Elad %A Smith, Lewis J %A Liu, Kiang %A Burchard, Esteban González %K Adolescent %K Adult %K African Americans %K Aged %K Aged, 80 and over %K Female %K Forced Expiratory Volume %K Genetic Markers %K Genotype %K Humans %K Linear Models %K Male %K Middle Aged %K Oligonucleotide Array Sequence Analysis %K Reference Values %K Respiratory Function Tests %K Vital Capacity %K Young Adult %X

BACKGROUND: Self-identified race or ethnic group is used to determine normal reference standards in the prediction of pulmonary function. We conducted a study to determine whether the genetically determined percentage of African ancestry is associated with lung function and whether its use could improve predictions of lung function among persons who identified themselves as African American.

METHODS: We assessed the ancestry of 777 participants self-identified as African American in the Coronary Artery Risk Development in Young Adults (CARDIA) study and evaluated the relation between pulmonary function and ancestry by means of linear regression. We performed similar analyses of data for two independent cohorts of subjects identifying themselves as African American: 813 participants in the Health, Aging, and Body Composition (HABC) study and 579 participants in the Cardiovascular Health Study (CHS). We compared the fit of two types of models to lung-function measurements: models based on the covariates used in standard prediction equations and models incorporating ancestry. We also evaluated the effect of the ancestry-based models on the classification of disease severity in two asthma-study populations.

RESULTS: African ancestry was inversely related to forced expiratory volume in 1 second (FEV(1)) and forced vital capacity in the CARDIA cohort. These relations were also seen in the HABC and CHS cohorts. In predicting lung function, the ancestry-based model fit the data better than standard models. Ancestry-based models resulted in the reclassification of asthma severity (based on the percentage of the predicted FEV(1)) in 4 to 5% of participants.

CONCLUSIONS: Current predictive equations, which rely on self-identified race alone, may misestimate lung function among subjects who identify themselves as African American. Incorporating ancestry into normative equations may improve lung-function estimates and more accurately categorize disease severity. (Funded by the National Institutes of Health and others.)

%B N Engl J Med %V 363 %P 321-30 %8 2010 Jul 22 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/20647190?dopt=Abstract %R 10.1056/NEJMoa0907897 %0 Journal Article %J JAMA %D 2010 %T Genome-wide analysis of genetic loci associated with Alzheimer disease. %A Seshadri, Sudha %A Fitzpatrick, Annette L %A Ikram, M Arfan %A DeStefano, Anita L %A Gudnason, Vilmundur %A Boada, Merce %A Bis, Joshua C %A Smith, Albert V %A Carassquillo, Minerva M %A Lambert, Jean Charles %A Harold, Denise %A Schrijvers, Elisabeth M C %A Ramirez-Lorca, Reposo %A Debette, Stephanie %A Longstreth, W T %A Janssens, A Cecile J W %A Pankratz, V Shane %A Dartigues, Jean François %A Hollingworth, Paul %A Aspelund, Thor %A Hernandez, Isabel %A Beiser, Alexa %A Kuller, Lewis H %A Koudstaal, Peter J %A Dickson, Dennis W %A Tzourio, Christophe %A Abraham, Richard %A Antunez, Carmen %A Du, Yangchun %A Rotter, Jerome I %A Aulchenko, Yurii S %A Harris, Tamara B %A Petersen, Ronald C %A Berr, Claudine %A Owen, Michael J %A Lopez-Arrieta, Jesus %A Varadarajan, Badri N %A Becker, James T %A Rivadeneira, Fernando %A Nalls, Michael A %A Graff-Radford, Neill R %A Campion, Dominique %A Auerbach, Sanford %A Rice, Kenneth %A Hofman, Albert %A Jonsson, Palmi V %A Schmidt, Helena %A Lathrop, Mark %A Mosley, Thomas H %A Au, Rhoda %A Psaty, Bruce M %A Uitterlinden, André G %A Farrer, Lindsay A %A Lumley, Thomas %A Ruiz, Agustin %A Williams, Julie %A Amouyel, Philippe %A Younkin, Steve G %A Wolf, Philip A %A Launer, Lenore J %A Lopez, Oscar L %A van Duijn, Cornelia M %A Breteler, Monique M B %K Age of Onset %K Aged %K Alzheimer Disease %K Case-Control Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Odds Ratio %K Polymorphism, Single Nucleotide %X

CONTEXT: Genome-wide association studies (GWAS) have recently identified CLU, PICALM, and CR1 as novel genes for late-onset Alzheimer disease (AD).

OBJECTIVES: To identify and strengthen additional loci associated with AD and confirm these in an independent sample and to examine the contribution of recently identified genes to AD risk prediction in a 3-stage analysis of new and previously published GWAS on more than 35,000 persons (8371 AD cases).

DESIGN, SETTING, AND PARTICIPANTS: In stage 1, we identified strong genetic associations (P < 10(-3)) in a sample of 3006 AD cases and 14,642 controls by combining new data from the population-based Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (1367 AD cases [973 incident]) with previously reported results from the Translational Genomics Research Institute and the Mayo AD GWAS. We identified 2708 single-nucleotide polymorphisms (SNPs) with P < 10(-3). In stage 2, we pooled results for these SNPs with the European AD Initiative (2032 cases and 5328 controls) to identify 38 SNPs (10 loci) with P < 10(-5). In stage 3, we combined data for these 10 loci with data from the Genetic and Environmental Risk in AD consortium (3333 cases and 6995 controls) to identify 4 SNPs with P < 1.7x10(-8). These 4 SNPs were replicated in an independent Spanish sample (1140 AD cases and 1209 controls). Genome-wide association analyses were completed in 2007-2008 and the meta-analyses and replication in 2009.

MAIN OUTCOME MEASURE: Presence of Alzheimer disease.

RESULTS: Two loci were identified to have genome-wide significance for the first time: rs744373 near BIN1 (odds ratio [OR],1.13; 95% confidence interval [CI],1.06-1.21 per copy of the minor allele; P = 1.59x10(-11)) and rs597668 near EXOC3L2/BLOC1S3/MARK4 (OR, 1.18; 95% CI, 1.07-1.29; P = 6.45x10(-9)). Associations of these 2 loci plus the previously identified loci CLU and PICALM with AD were confirmed in the Spanish sample (P < .05). However, although CLU and PICALM were confirmed to be associated with AD in this independent sample, they did not improve the ability of a model that included age, sex, and APOE to predict incident AD (improvement in area under the receiver operating characteristic curve from 0.847 to 0.849 in the Rotterdam Study and 0.702 to 0.705 in the Cardiovascular Health Study).

CONCLUSIONS: Two genetic loci for AD were found for the first time to reach genome-wide statistical significance. These findings were replicated in an independent population. Two recently reported associations were also confirmed. These loci did not improve AD risk prediction. While not clinically useful, they may implicate biological pathways useful for future research.

%B JAMA %V 303 %P 1832-40 %8 2010 May 12 %G eng %N 18 %1 http://www.ncbi.nlm.nih.gov/pubmed/20460622?dopt=Abstract %R 10.1001/jama.2010.574 %0 Journal Article %J Hum Mol Genet %D 2010 %T Genome-wide association analysis identifies multiple loci related to resting heart rate. %A Eijgelsheim, Mark %A Newton-Cheh, Christopher %A Sotoodehnia, Nona %A de Bakker, Paul I W %A Müller, Martina %A Morrison, Alanna C %A Smith, Albert V %A Isaacs, Aaron %A Sanna, Serena %A Dörr, Marcus %A Navarro, Pau %A Fuchsberger, Christian %A Nolte, Ilja M %A de Geus, Eco J C %A Estrada, Karol %A Hwang, Shih-Jen %A Bis, Joshua C %A Rückert, Ina-Maria %A Alonso, Alvaro %A Launer, Lenore J %A Hottenga, Jouke Jan %A Rivadeneira, Fernando %A Noseworthy, Peter A %A Rice, Kenneth M %A Perz, Siegfried %A Arking, Dan E %A Spector, Tim D %A Kors, Jan A %A Aulchenko, Yurii S %A Tarasov, Kirill V %A Homuth, Georg %A Wild, Sarah H %A Marroni, Fabio %A Gieger, Christian %A Licht, Carmilla M %A Prineas, Ronald J %A Hofman, Albert %A Rotter, Jerome I %A Hicks, Andrew A %A Ernst, Florian %A Najjar, Samer S %A Wright, Alan F %A Peters, Annette %A Fox, Ervin R %A Oostra, Ben A %A Kroemer, Heyo K %A Couper, David %A Völzke, Henry %A Campbell, Harry %A Meitinger, Thomas %A Uda, Manuela %A Witteman, Jacqueline C M %A Psaty, Bruce M %A Wichmann, H-Erich %A Harris, Tamara B %A Kääb, Stefan %A Siscovick, David S %A Jamshidi, Yalda %A Uitterlinden, André G %A Folsom, Aaron R %A Larson, Martin G %A Wilson, James F %A Penninx, Brenda W %A Snieder, Harold %A Pramstaller, Peter P %A van Duijn, Cornelia M %A Lakatta, Edward G %A Felix, Stephan B %A Gudnason, Vilmundur %A Pfeufer, Arne %A Heckbert, Susan R %A Stricker, Bruno H Ch %A Boerwinkle, Eric %A O'Donnell, Christopher J %K Adult %K Aged %K Base Pairing %K Cohort Studies %K Female %K Genetic Loci %K Genome, Human %K Genome-Wide Association Study %K Heart Rate %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Rest %X

Higher resting heart rate is associated with increased cardiovascular disease and mortality risk. Though heritable factors play a substantial role in population variation, little is known about specific genetic determinants. This knowledge can impact clinical care by identifying novel factors that influence pathologic heart rate states, modulate heart rate through cardiac structure and function or by improving our understanding of the physiology of heart rate regulation. To identify common genetic variants associated with heart rate, we performed a meta-analysis of 15 genome-wide association studies (GWAS), including 38,991 subjects of European ancestry, estimating the association between age-, sex- and body mass-adjusted RR interval (inverse heart rate) and approximately 2.5 million markers. Results with P < 5 × 10(-8) were considered genome-wide significant. We constructed regression models with multiple markers to assess whether results at less stringent thresholds were likely to be truly associated with RR interval. We identified six novel associations with resting heart rate at six loci: 6q22 near GJA1; 14q12 near MYH7; 12p12 near SOX5, c12orf67, BCAT1, LRMP and CASC1; 6q22 near SLC35F1, PLN and c6orf204; 7q22 near SLC12A9 and UfSp1; and 11q12 near FADS1. Associations at 6q22 400 kb away from GJA1, at 14q12 MYH6 and at 1q32 near CD34 identified in previously published GWAS were confirmed. In aggregate, these variants explain approximately 0.7% of RR interval variance. A multivariant regression model including 20 variants with P < 10(-5) increased the explained variance to 1.6%, suggesting that some loci falling short of genome-wide significance are likely truly associated. Future research is warranted to elucidate underlying mechanisms that may impact clinical care.

%B Hum Mol Genet %V 19 %P 3885-94 %8 2010 Oct 01 %G eng %N 19 %1 http://www.ncbi.nlm.nih.gov/pubmed/20639392?dopt=Abstract %R 10.1093/hmg/ddq303 %0 Journal Article %J Nat Genet %D 2010 %T Genome-wide association identifies multiple ulcerative colitis susceptibility loci. %A McGovern, Dermot P B %A Gardet, Agnès %A Törkvist, Leif %A Goyette, Philippe %A Essers, Jonah %A Taylor, Kent D %A Neale, Benjamin M %A Ong, Rick T H %A Lagacé, Caroline %A Li, Chun %A Green, Todd %A Stevens, Christine R %A Beauchamp, Claudine %A Fleshner, Phillip R %A Carlson, Marie %A D'Amato, Mauro %A Halfvarson, Jonas %A Hibberd, Martin L %A Lördal, Mikael %A Padyukov, Leonid %A Andriulli, Angelo %A Colombo, Elisabetta %A Latiano, Anna %A Palmieri, Orazio %A Bernard, Edmond-Jean %A Deslandres, Colette %A Hommes, Daan W %A de Jong, Dirk J %A Stokkers, Pieter C %A Weersma, Rinse K %A Sharma, Yashoda %A Silverberg, Mark S %A Cho, Judy H %A Wu, Jing %A Roeder, Kathryn %A Brant, Steven R %A Schumm, L Phillip %A Duerr, Richard H %A Dubinsky, Marla C %A Glazer, Nicole L %A Haritunians, Talin %A Ippoliti, Andy %A Melmed, Gil Y %A Siscovick, David S %A Vasiliauskas, Eric A %A Targan, Stephan R %A Annese, Vito %A Wijmenga, Cisca %A Pettersson, Sven %A Rotter, Jerome I %A Xavier, Ramnik J %A Daly, Mark J %A Rioux, John D %A Seielstad, Mark %K Colitis, Ulcerative %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Membrane Proteins %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Receptors, IgG %X

Ulcerative colitis is a chronic, relapsing inflammatory condition of the gastrointestinal tract with a complex genetic and environmental etiology. In an effort to identify genetic variation underlying ulcerative colitis risk, we present two distinct genome-wide association studies of ulcerative colitis and their joint analysis with a previously published scan, comprising, in aggregate, 2,693 individuals with ulcerative colitis and 6,791 control subjects. Fifty-nine SNPs from 14 independent loci attained an association significance of P < 10(-5). Seven of these loci exceeded genome-wide significance (P < 5 x 10(-8)). After testing an independent cohort of 2,009 cases of ulcerative colitis and 1,580 controls, we identified 13 loci that were significantly associated with ulcerative colitis (P < 5 x 10(-8)), including the immunoglobulin receptor gene FCGR2A, 5p15, 2p16 and ORMDL3 (orosomucoid1-like 3). We confirmed association with 14 previously identified ulcerative colitis susceptibility loci, and an analysis of acknowledged Crohn's disease loci showed that roughly half of the known Crohn's disease associations are shared with ulcerative colitis. These data implicate approximately 30 loci in ulcerative colitis, thereby providing insight into disease pathogenesis.

%B Nat Genet %V 42 %P 332-7 %8 2010 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/20228799?dopt=Abstract %R 10.1038/ng.549 %0 Journal Article %J Proc Natl Acad Sci U S A %D 2010 %T Genome-wide association identifies OBFC1 as a locus involved in human leukocyte telomere biology. %A Levy, Daniel %A Neuhausen, Susan L %A Hunt, Steven C %A Kimura, Masayuki %A Hwang, Shih-Jen %A Chen, Wei %A Bis, Joshua C %A Fitzpatrick, Annette L %A Smith, Erin %A Johnson, Andrew D %A Gardner, Jeffrey P %A Srinivasan, Sathanur R %A Schork, Nicholas %A Rotter, Jerome I %A Herbig, Utz %A Psaty, Bruce M %A Sastrasinh, Malinee %A Murray, Sarah S %A Vasan, Ramachandran S %A Province, Michael A %A Glazer, Nicole L %A Lu, Xiaobin %A Cao, Xiaojian %A Kronmal, Richard %A Mangino, Massimo %A Soranzo, Nicole %A Spector, Tim D %A Berenson, Gerald S %A Aviv, Abraham %K Cohort Studies %K Genome-Wide Association Study %K Genotype %K Humans %K Leukocytes %K Polymorphism, Single Nucleotide %K Receptors, CXCR4 %K Telomere %K Telomere-Binding Proteins %X

Telomeres are engaged in a host of cellular functions, and their length is regulated by multiple genes. Telomere shortening, in the course of somatic cell replication, ultimately leads to replicative senescence. In humans, rare mutations in genes that regulate telomere length have been identified in monogenic diseases such as dyskeratosis congenita and idiopathic pulmonary fibrosis, which are associated with shortened leukocyte telomere length (LTL) and increased risk for aplastic anemia. Shortened LTL is observed in a host of aging-related complex genetic diseases and is associated with diminished survival in the elderly. We report results of a genome-wide association study of LTL in a consortium of four observational studies (n = 3,417 participants with LTL and genome-wide genotyping). SNPs in the regions of the oligonucleotide/oligosaccharide-binding folds containing one gene (OBFC1; rs4387287; P = 3.9 x 10(-9)) and chemokine (C-X-C motif) receptor 4 gene (CXCR4; rs4452212; P = 2.9 x 10(-8)) were associated with LTL at a genome-wide significance level (P < 5 x 10(-8)). We attempted replication of the top SNPs at these loci through de novo genotyping of 1,893 additional individuals and in silico lookup in another observational study (n = 2,876), and we confirmed the association findings for OBFC1 but not CXCR4. In addition, we confirmed the telomerase RNA component (TERC) as a gene associated with LTL (P = 1.1 x 10(-5)). The identification of OBFC1 through genome-wide association as a locus for interindividual variation in LTL in the general population advances the understanding of telomere biology in humans and may provide insights into aging-related disorders linked to altered LTL dynamics.

%B Proc Natl Acad Sci U S A %V 107 %P 9293-8 %8 2010 May 18 %G eng %N 20 %1 http://www.ncbi.nlm.nih.gov/pubmed/20421499?dopt=Abstract %R 10.1073/pnas.0911494107 %0 Journal Article %J Stroke %D 2010 %T Genome-wide association studies of MRI-defined brain infarcts: meta-analysis from the CHARGE Consortium. %A Debette, Stephanie %A Bis, Joshua C %A Fornage, Myriam %A Schmidt, Helena %A Ikram, M Arfan %A Sigurdsson, Sigurdur %A Heiss, Gerardo %A Struchalin, Maksim %A Smith, Albert V %A van der Lugt, Aad %A DeCarli, Charles %A Lumley, Thomas %A Knopman, David S %A Enzinger, Christian %A Eiriksdottir, Gudny %A Koudstaal, Peter J %A DeStefano, Anita L %A Psaty, Bruce M %A Dufouil, Carole %A Catellier, Diane J %A Fazekas, Franz %A Aspelund, Thor %A Aulchenko, Yurii S %A Beiser, Alexa %A Rotter, Jerome I %A Tzourio, Christophe %A Shibata, Dean K %A Tscherner, Maria %A Harris, Tamara B %A Rivadeneira, Fernando %A Atwood, Larry D %A Rice, Kenneth %A Gottesman, Rebecca F %A van Buchem, Mark A %A Uitterlinden, André G %A Kelly-Hayes, Margaret %A Cushman, Mary %A Zhu, Yicheng %A Boerwinkle, Eric %A Gudnason, Vilmundur %A Hofman, Albert %A Romero, Jose R %A Lopez, Oscar %A van Duijn, Cornelia M %A Au, Rhoda %A Heckbert, Susan R %A Wolf, Philip A %A Mosley, Thomas H %A Seshadri, Sudha %A Breteler, Monique M B %A Schmidt, Reinhold %A Launer, Lenore J %A Longstreth, W T %K African Americans %K Aged %K Brain %K Brain Infarction %K Cohort Studies %K DNA Mutational Analysis %K Female %K Gene Frequency %K Genetic Markers %K Genetic Predisposition to Disease %K Genetic Testing %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Prospective Studies %X

BACKGROUND AND PURPOSE: Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI infarct in persons without histories of transient ischemic attack or stroke. We performed meta-analysis of genome-wide association studies of white participants in 6 studies comprising the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium.

METHODS: Using 2.2 million genotyped and imputed single nucleotide polymorphisms, each study performed cross-sectional genome-wide association analysis of MRI infarct using age- and sex-adjusted logistic regression models. Study-specific findings were combined in an inverse-variance-weighted meta-analysis, including 9401 participants with mean age 69.7 (19.4% of whom had >or=1 MRI infarct).

RESULTS: The most significant association was found with rs2208454 (minor allele frequency, 20%), located in intron 3 of MACRO domain containing 2 gene and in the downstream region of fibronectin leucine-rich transmembrane protein 3 gene. Each copy of the minor allele was associated with lower risk of MRI infarcts (odds ratio, 0.76; 95% confidence interval, 0.68-0.84; P=4.64x10(-7)). Highly suggestive associations (P<1.0x10(-5)) were also found for 22 other single nucleotide polymorphisms in linkage disequilibrium (r(2)>0.64) with rs2208454. The association with rs2208454 did not replicate in independent samples of 1822 white and 644 black participants, although 4 single nucleotide polymorphisms within 200 kb from rs2208454 were associated with MRI infarcts in the black population sample.

CONCLUSIONS: This first community-based, genome-wide association study on covert MRI infarcts uncovered novel associations. Although replication of the association with top single nucleotide polymorphisms failed, possibly because of insufficient power, results in the black population sample are encouraging, and further efforts at replication are needed.

%B Stroke %V 41 %P 210-7 %8 2010 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20044523?dopt=Abstract %R 10.1161/STROKEAHA.109.569194 %0 Journal Article %J PLoS Genet %D 2010 %T Genome-wide association studies of serum magnesium, potassium, and sodium concentrations identify six Loci influencing serum magnesium levels. %A Meyer, Tamra E %A Verwoert, Germaine C %A Hwang, Shih-Jen %A Glazer, Nicole L %A Smith, Albert V %A van Rooij, Frank J A %A Ehret, Georg B %A Boerwinkle, Eric %A Felix, Janine F %A Leak, Tennille S %A Harris, Tamara B %A Yang, Qiong %A Dehghan, Abbas %A Aspelund, Thor %A Katz, Ronit %A Homuth, Georg %A Kocher, Thomas %A Rettig, Rainer %A Ried, Janina S %A Gieger, Christian %A Prucha, Hanna %A Pfeufer, Arne %A Meitinger, Thomas %A Coresh, Josef %A Hofman, Albert %A Sarnak, Mark J %A Chen, Yii-Der Ida %A Uitterlinden, André G %A Chakravarti, Aravinda %A Psaty, Bruce M %A van Duijn, Cornelia M %A Kao, W H Linda %A Witteman, Jacqueline C M %A Gudnason, Vilmundur %A Siscovick, David S %A Fox, Caroline S %A Köttgen, Anna %K Adult %K Aged %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Magnesium %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Potassium %K Sodium %X

Magnesium, potassium, and sodium, cations commonly measured in serum, are involved in many physiological processes including energy metabolism, nerve and muscle function, signal transduction, and fluid and blood pressure regulation. To evaluate the contribution of common genetic variation to normal physiologic variation in serum concentrations of these cations, we conducted genome-wide association studies of serum magnesium, potassium, and sodium concentrations using approximately 2.5 million genotyped and imputed common single nucleotide polymorphisms (SNPs) in 15,366 participants of European descent from the international CHARGE Consortium. Study-specific results were combined using fixed-effects inverse-variance weighted meta-analysis. SNPs demonstrating genome-wide significant (p<5 x 10(-8)) or suggestive associations (p<4 x 10(-7)) were evaluated for replication in an additional 8,463 subjects of European descent. The association of common variants at six genomic regions (in or near MUC1, ATP2B1, DCDC5, TRPM6, SHROOM3, and MDS1) with serum magnesium levels was genome-wide significant when meta-analyzed with the replication dataset. All initially significant SNPs from the CHARGE Consortium showed nominal association with clinically defined hypomagnesemia, two showed association with kidney function, two with bone mineral density, and one of these also associated with fasting glucose levels. Common variants in CNNM2, a magnesium transporter studied only in model systems to date, as well as in CNNM3 and CNNM4, were also associated with magnesium concentrations in this study. We observed no associations with serum sodium or potassium levels exceeding p<4 x 10(-7). Follow-up studies of newly implicated genomic loci may provide additional insights into the regulation and homeostasis of human serum magnesium levels.

%B PLoS Genet %V 6 %8 2010 Aug 05 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/20700443?dopt=Abstract %R 10.1371/journal.pgen.1001045 %0 Journal Article %J Nat Genet %D 2010 %T Genome-wide association study of PR interval. %A Pfeufer, Arne %A van Noord, Charlotte %A Marciante, Kristin D %A Arking, Dan E %A Larson, Martin G %A Smith, Albert Vernon %A Tarasov, Kirill V %A Müller, Martina %A Sotoodehnia, Nona %A Sinner, Moritz F %A Verwoert, Germaine C %A Li, Man %A Kao, W H Linda %A Köttgen, Anna %A Coresh, Josef %A Bis, Joshua C %A Psaty, Bruce M %A Rice, Kenneth %A Rotter, Jerome I %A Rivadeneira, Fernando %A Hofman, Albert %A Kors, Jan A %A Stricker, Bruno H C %A Uitterlinden, André G %A van Duijn, Cornelia M %A Beckmann, Britt M %A Sauter, Wiebke %A Gieger, Christian %A Lubitz, Steven A %A Newton-Cheh, Christopher %A Wang, Thomas J %A Magnani, Jared W %A Schnabel, Renate B %A Chung, Mina K %A Barnard, John %A Smith, Jonathan D %A Van Wagoner, David R %A Vasan, Ramachandran S %A Aspelund, Thor %A Eiriksdottir, Gudny %A Harris, Tamara B %A Launer, Lenore J %A Najjar, Samer S %A Lakatta, Edward %A Schlessinger, David %A Uda, Manuela %A Abecasis, Goncalo R %A Müller-Myhsok, Bertram %A Ehret, Georg B %A Boerwinkle, Eric %A Chakravarti, Aravinda %A Soliman, Elsayed Z %A Lunetta, Kathryn L %A Perz, Siegfried %A Wichmann, H-Erich %A Meitinger, Thomas %A Levy, Daniel %A Gudnason, Vilmundur %A Ellinor, Patrick T %A Sanna, Serena %A Kääb, Stefan %A Witteman, Jacqueline C M %A Alonso, Alvaro %A Benjamin, Emelia J %A Heckbert, Susan R %K Aged %K Atrial Fibrillation %K Cohort Studies %K Electrocardiography %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Heart Conduction System %K Humans %K Male %K Meta-Analysis as Topic %X

The electrocardiographic PR interval (or PQ interval) reflects atrial and atrioventricular nodal conduction, disturbances of which increase risk of atrial fibrillation. We report a meta-analysis of genome-wide association studies for PR interval from seven population-based European studies in the CHARGE Consortium: AGES, ARIC, CHS, FHS, KORA, Rotterdam Study, and SardiNIA (N = 28,517). We identified nine loci associated with PR interval at P < 5 x 10(-8). At the 3p22.2 locus, we observed two independent associations in voltage-gated sodium channel genes, SCN10A and SCN5A. Six of the loci were near cardiac developmental genes, including CAV1-CAV2, NKX2-5 (CSX1), SOX5, WNT11, MEIS1, and TBX5-TBX3, providing pathophysiologically interesting candidate genes. Five of the loci, SCN5A, SCN10A, NKX2-5, CAV1-CAV2, and SOX5, were also associated with atrial fibrillation (N = 5,741 cases, P < 0.0056). This suggests a role for common variation in ion channel and developmental genes in atrial and atrioventricular conduction as well as in susceptibility to atrial fibrillation.

%B Nat Genet %V 42 %P 153-9 %8 2010 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20062060?dopt=Abstract %R 10.1038/ng.517 %0 Journal Article %J Nat Genet %D 2010 %T Genome-wide meta-analysis increases to 71 the number of confirmed Crohn's disease susceptibility loci. %A Franke, Andre %A McGovern, Dermot P B %A Barrett, Jeffrey C %A Wang, Kai %A Radford-Smith, Graham L %A Ahmad, Tariq %A Lees, Charlie W %A Balschun, Tobias %A Lee, James %A Roberts, Rebecca %A Anderson, Carl A %A Bis, Joshua C %A Bumpstead, Suzanne %A Ellinghaus, David %A Festen, Eleonora M %A Georges, Michel %A Green, Todd %A Haritunians, Talin %A Jostins, Luke %A Latiano, Anna %A Mathew, Christopher G %A Montgomery, Grant W %A Prescott, Natalie J %A Raychaudhuri, Soumya %A Rotter, Jerome I %A Schumm, Philip %A Sharma, Yashoda %A Simms, Lisa A %A Taylor, Kent D %A Whiteman, David %A Wijmenga, Cisca %A Baldassano, Robert N %A Barclay, Murray %A Bayless, Theodore M %A Brand, Stephan %A Büning, Carsten %A Cohen, Albert %A Colombel, Jean-Frederick %A Cottone, Mario %A Stronati, Laura %A Denson, Ted %A De Vos, Martine %A D'Inca, Renata %A Dubinsky, Marla %A Edwards, Cathryn %A Florin, Tim %A Franchimont, Denis %A Gearry, Richard %A Glas, Jürgen %A Van Gossum, Andre %A Guthery, Stephen L %A Halfvarson, Jonas %A Verspaget, Hein W %A Hugot, Jean-Pierre %A Karban, Amir %A Laukens, Debby %A Lawrance, Ian %A Lemann, Marc %A Levine, Arie %A Libioulle, Cecile %A Louis, Edouard %A Mowat, Craig %A Newman, William %A Panés, Julián %A Phillips, Anne %A Proctor, Deborah D %A Regueiro, Miguel %A Russell, Richard %A Rutgeerts, Paul %A Sanderson, Jeremy %A Sans, Miquel %A Seibold, Frank %A Steinhart, A Hillary %A Stokkers, Pieter C F %A Törkvist, Leif %A Kullak-Ublick, Gerd %A Wilson, David %A Walters, Thomas %A Targan, Stephan R %A Brant, Steven R %A Rioux, John D %A D'Amato, Mauro %A Weersma, Rinse K %A Kugathasan, Subra %A Griffiths, Anne M %A Mansfield, John C %A Vermeire, Severine %A Duerr, Richard H %A Silverberg, Mark S %A Satsangi, Jack %A Schreiber, Stefan %A Cho, Judy H %A Annese, Vito %A Hakonarson, Hakon %A Daly, Mark J %A Parkes, Miles %K Computational Biology %K Crohn Disease %K Genetic Linkage %K Genetic Loci %K Genetic Predisposition to Disease %K Genetic Variation %K Genome, Human %K Genome-Wide Association Study %K Humans %K Reproducibility of Results %X

We undertook a meta-analysis of six Crohn's disease genome-wide association studies (GWAS) comprising 6,333 affected individuals (cases) and 15,056 controls and followed up the top association signals in 15,694 cases, 14,026 controls and 414 parent-offspring trios. We identified 30 new susceptibility loci meeting genome-wide significance (P < 5 × 10⁻⁸). A series of in silico analyses highlighted particular genes within these loci and, together with manual curation, implicated functionally interesting candidate genes including SMAD3, ERAP2, IL10, IL2RA, TYK2, FUT2, DNMT3A, DENND1B, BACH2 and TAGAP. Combined with previously confirmed loci, these results identify 71 distinct loci with genome-wide significant evidence for association with Crohn's disease.

%B Nat Genet %V 42 %P 1118-25 %8 2010 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21102463?dopt=Abstract %R 10.1038/ng.717 %0 Journal Article %J Circ Cardiovasc Genet %D 2010 %T Genomic variation associated with mortality among adults of European and African ancestry with heart failure: the cohorts for heart and aging research in genomic epidemiology consortium. %A Morrison, Alanna C %A Felix, Janine F %A Cupples, L Adrienne %A Glazer, Nicole L %A Loehr, Laura R %A Dehghan, Abbas %A Demissie, Serkalem %A Bis, Joshua C %A Rosamond, Wayne D %A Aulchenko, Yurii S %A Wang, Ying A %A Haritunians, Talin %A Folsom, Aaron R %A Rivadeneira, Fernando %A Benjamin, Emelia J %A Lumley, Thomas %A Couper, David %A Stricker, Bruno H %A O'Donnell, Christopher J %A Rice, Kenneth M %A Chang, Patricia P %A Hofman, Albert %A Levy, Daniel %A Rotter, Jerome I %A Fox, Ervin R %A Uitterlinden, André G %A Wang, Thomas J %A Psaty, Bruce M %A Willerson, James T %A van Duijn, Cornelia M %A Boerwinkle, Eric %A Witteman, Jacqueline C M %A Vasan, Ramachandran S %A Smith, Nicholas L %K African Americans %K Aged %K Aged, 80 and over %K Chemokines %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Genotype %K Heart Failure %K Humans %K Introns %K Male %K MARVEL Domain-Containing Proteins %K Membrane Proteins %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %X

BACKGROUND: Prognosis and survival are significant concerns for individuals with heart failure (HF). To better understand the pathophysiology of HF prognosis, the association between 2,366,858 single-nucleotide polymorphisms (SNPs) and all-cause mortality was evaluated among individuals with incident HF from 4 community-based prospective cohorts: the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study.

METHODS AND RESULTS: Participants were 2526 individuals of European ancestry and 466 individuals of African ancestry who experienced an incident HF event during follow-up in the respective cohorts. Within each study, the association between genetic variants and time to mortality among individuals with HF was assessed by Cox proportional hazards models that included adjustment for sex and age at the time of the HF event. Prospective fixed-effect meta-analyses were conducted for the 4 study populations of European ancestry (N=1645 deaths) and for the 2 populations of African ancestry (N=281 deaths). Genome-wide significance was set at P=5.0x10(-7). Meta-analytic findings among individuals of European ancestry revealed 1 genome-wide significant locus on chromosome 3p22 in an intron of CKLF-like MARVEL transmembrane domain containing 7 (CMTM7, P=3.2x10(-7)). Eight additional loci in individuals of European ancestry and 4 loci in individuals of African ancestry were identified by high-signal SNPs (P<1.0x10(-5)) but did not meet genome-wide significance.

CONCLUSIONS: This study identified a novel locus associated with all-cause mortality among individuals of European ancestry with HF. This finding warrants additional investigation, including replication, in other studies of HF.

%B Circ Cardiovasc Genet %V 3 %P 248-55 %8 2010 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20400778?dopt=Abstract %R 10.1161/CIRCGENETICS.109.895995 %0 Journal Article %J Eur Heart J %D 2010 %T Hip fractures and heart failure: findings from the Cardiovascular Health Study. %A Carbone, Laura %A Bůzková, Petra %A Fink, Howard A %A Lee, Jennifer S %A Chen, Zhao %A Ahmed, Ali %A Parashar, Susmita %A Robbins, John R %K Aged %K Female %K Heart Failure %K Hip Fractures %K Humans %K Incidence %K Male %K Risk Factors %K United States %X

AIMS: The aim of the study was to find the epidemiology of hip fractures in heart failure. The increasing survival rate for patients with heart failure places them at risk for other diseases of ageing, including osteoporosis.

METHODS AND RESULTS: We included 5613 persons from the Cardiovascular Health Study (CHS) with an average of 11.5 year follow-up. We determined incidence rates and hazard ratios (HRs) in persons with heart failure compared with persons without heart failure and mortality hazards following these fractures. Annualized incidence rates for hip fractures were 14 per 1000 person-years in heart failure and 6.8 per 1000 person-years without heart failure. Unadjusted and multivariable adjusted HRs for hip fracture associated with heart failure in men were 1.87 (95% CI 1.2-2.93) and 1.59 (95% CI 0.93-2.72), respectively. Respective HRs for women were 1.75 (95% CI 1.27-2.4) and 1.41 (95% CI 0.98-2.03). Mortality hazard was approximately 2-fold greater in patients with heart failure and hip fracture compared with those having heart failure alone.

CONCLUSION: Persons with heart failure are at high risk for hip fractures. However, much of the association between hip fractures and heart failure is explained by shared risk factors. Hip fractures are a substantial contributor to mortality in men and women with heart failure.

%B Eur Heart J %V 31 %P 77-84 %8 2010 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/19892715?dopt=Abstract %R 10.1093/eurheartj/ehp483 %0 Journal Article %J Nature %D 2010 %T Hundreds of variants clustered in genomic loci and biological pathways affect human height. %A Lango Allen, Hana %A Estrada, Karol %A Lettre, Guillaume %A Berndt, Sonja I %A Weedon, Michael N %A Rivadeneira, Fernando %A Willer, Cristen J %A Jackson, Anne U %A Vedantam, Sailaja %A Raychaudhuri, Soumya %A Ferreira, Teresa %A Wood, Andrew R %A Weyant, Robert J %A Segrè, Ayellet V %A Speliotes, Elizabeth K %A Wheeler, Eleanor %A Soranzo, Nicole %A Park, Ju-Hyun %A Yang, Jian %A Gudbjartsson, Daniel %A Heard-Costa, Nancy L %A Randall, Joshua C %A Qi, Lu %A Vernon Smith, Albert %A Mägi, Reedik %A Pastinen, Tomi %A Liang, Liming %A Heid, Iris M %A Luan, Jian'an %A Thorleifsson, Gudmar %A Winkler, Thomas W %A Goddard, Michael E %A Sin Lo, Ken %A Palmer, Cameron %A Workalemahu, Tsegaselassie %A Aulchenko, Yurii S %A Johansson, Asa %A Zillikens, M Carola %A Feitosa, Mary F %A Esko, Tõnu %A Johnson, Toby %A Ketkar, Shamika %A Kraft, Peter %A Mangino, Massimo %A Prokopenko, Inga %A Absher, Devin %A Albrecht, Eva %A Ernst, Florian %A Glazer, Nicole L %A Hayward, Caroline %A Hottenga, Jouke-Jan %A Jacobs, Kevin B %A Knowles, Joshua W %A Kutalik, Zoltán %A Monda, Keri L %A Polasek, Ozren %A Preuss, Michael %A Rayner, Nigel W %A Robertson, Neil R %A Steinthorsdottir, Valgerdur %A Tyrer, Jonathan P %A Voight, Benjamin F %A Wiklund, Fredrik %A Xu, Jianfeng %A Zhao, Jing Hua %A Nyholt, Dale R %A Pellikka, Niina %A Perola, Markus %A Perry, John R B %A Surakka, Ida %A Tammesoo, Mari-Liis %A Altmaier, Elizabeth L %A Amin, Najaf %A Aspelund, Thor %A Bhangale, Tushar %A Boucher, Gabrielle %A Chasman, Daniel I %A Chen, Constance %A Coin, Lachlan %A Cooper, Matthew N %A Dixon, Anna L %A Gibson, Quince %A Grundberg, Elin %A Hao, Ke %A Juhani Junttila, M %A Kaplan, Lee M %A Kettunen, Johannes %A König, Inke R %A Kwan, Tony %A Lawrence, Robert W %A Levinson, Douglas F %A Lorentzon, Mattias %A McKnight, Barbara %A Morris, Andrew P %A Müller, Martina %A Suh Ngwa, Julius %A Purcell, Shaun %A Rafelt, Suzanne %A Salem, Rany M %A Salvi, Erika %A Sanna, Serena %A Shi, Jianxin %A Sovio, Ulla %A Thompson, John R %A Turchin, Michael C %A Vandenput, Liesbeth %A Verlaan, Dominique J %A Vitart, Veronique %A White, Charles C %A Ziegler, Andreas %A Almgren, Peter %A Balmforth, Anthony J %A Campbell, Harry %A Citterio, Lorena %A De Grandi, Alessandro %A Dominiczak, Anna %A Duan, Jubao %A Elliott, Paul %A Elosua, Roberto %A Eriksson, Johan G %A Freimer, Nelson B %A Geus, Eco J C %A Glorioso, Nicola %A Haiqing, Shen %A Hartikainen, Anna-Liisa %A Havulinna, Aki S %A Hicks, Andrew A %A Hui, Jennie %A Igl, Wilmar %A Illig, Thomas %A Jula, Antti %A Kajantie, Eero %A Kilpeläinen, Tuomas O %A Koiranen, Markku %A Kolcic, Ivana %A Koskinen, Seppo %A Kovacs, Peter %A Laitinen, Jaana %A Liu, Jianjun %A Lokki, Marja-Liisa %A Marusic, Ana %A Maschio, Andrea %A Meitinger, Thomas %A Mulas, Antonella %A Paré, Guillaume %A Parker, Alex N %A Peden, John F %A Petersmann, Astrid %A Pichler, Irene %A Pietiläinen, Kirsi H %A Pouta, Anneli %A Ridderstråle, Martin %A Rotter, Jerome I %A Sambrook, Jennifer G %A Sanders, Alan R %A Schmidt, Carsten Oliver %A Sinisalo, Juha %A Smit, Jan H %A Stringham, Heather M %A Bragi Walters, G %A Widen, Elisabeth %A Wild, Sarah H %A Willemsen, Gonneke %A Zagato, Laura %A Zgaga, Lina %A Zitting, Paavo %A Alavere, Helene %A Farrall, Martin %A McArdle, Wendy L %A Nelis, Mari %A Peters, Marjolein J %A Ripatti, Samuli %A van Meurs, Joyce B J %A Aben, Katja K %A Ardlie, Kristin G %A Beckmann, Jacques S %A Beilby, John P %A Bergman, Richard N %A Bergmann, Sven %A Collins, Francis S %A Cusi, Daniele %A den Heijer, Martin %A Eiriksdottir, Gudny %A Gejman, Pablo V %A Hall, Alistair S %A Hamsten, Anders %A Huikuri, Heikki V %A Iribarren, Carlos %A Kähönen, Mika %A Kaprio, Jaakko %A Kathiresan, Sekar %A Kiemeney, Lambertus %A Kocher, Thomas %A Launer, Lenore J %A Lehtimäki, Terho %A Melander, Olle %A Mosley, Tom H %A Musk, Arthur W %A Nieminen, Markku S %A O'Donnell, Christopher J %A Ohlsson, Claes %A Oostra, Ben %A Palmer, Lyle J %A Raitakari, Olli %A Ridker, Paul M %A Rioux, John D %A Rissanen, Aila %A Rivolta, Carlo %A Schunkert, Heribert %A Shuldiner, Alan R %A Siscovick, David S %A Stumvoll, Michael %A Tönjes, Anke %A Tuomilehto, Jaakko %A van Ommen, Gert-Jan %A Viikari, Jorma %A Heath, Andrew C %A Martin, Nicholas G %A Montgomery, Grant W %A Province, Michael A %A Kayser, Manfred %A Arnold, Alice M %A Atwood, Larry D %A Boerwinkle, Eric %A Chanock, Stephen J %A Deloukas, Panos %A Gieger, Christian %A Grönberg, Henrik %A Hall, Per %A Hattersley, Andrew T %A Hengstenberg, Christian %A Hoffman, Wolfgang %A Lathrop, G Mark %A Salomaa, Veikko %A Schreiber, Stefan %A Uda, Manuela %A Waterworth, Dawn %A Wright, Alan F %A Assimes, Themistocles L %A Barroso, Inês %A Hofman, Albert %A Mohlke, Karen L %A Boomsma, Dorret I %A Caulfield, Mark J %A Cupples, L Adrienne %A Erdmann, Jeanette %A Fox, Caroline S %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Harris, Tamara B %A Hayes, Richard B %A Jarvelin, Marjo-Riitta %A Mooser, Vincent %A Munroe, Patricia B %A Ouwehand, Willem H %A Penninx, Brenda W %A Pramstaller, Peter P %A Quertermous, Thomas %A Rudan, Igor %A Samani, Nilesh J %A Spector, Timothy D %A Völzke, Henry %A Watkins, Hugh %A Wilson, James F %A Groop, Leif C %A Haritunians, Talin %A Hu, Frank B %A Kaplan, Robert C %A Metspalu, Andres %A North, Kari E %A Schlessinger, David %A Wareham, Nicholas J %A Hunter, David J %A O'Connell, Jeffrey R %A Strachan, David P %A Wichmann, H-Erich %A Borecki, Ingrid B %A van Duijn, Cornelia M %A Schadt, Eric E %A Thorsteinsdottir, Unnur %A Peltonen, Leena %A Uitterlinden, André G %A Visscher, Peter M %A Chatterjee, Nilanjan %A Loos, Ruth J F %A Boehnke, Michael %A McCarthy, Mark I %A Ingelsson, Erik %A Lindgren, Cecilia M %A Abecasis, Goncalo R %A Stefansson, Kari %A Frayling, Timothy M %A Hirschhorn, Joel N %K Body Height %K Chromosomes, Human, Pair 3 %K Genetic Loci %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Metabolic Networks and Pathways %K Multifactorial Inheritance %K Phenotype %K Polymorphism, Single Nucleotide %X

Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.

%B Nature %V 467 %P 832-8 %8 2010 Oct 14 %G eng %N 7317 %1 http://www.ncbi.nlm.nih.gov/pubmed/20881960?dopt=Abstract %R 10.1038/nature09410 %0 Journal Article %J Circulation %D 2010 %T Independent susceptibility markers for atrial fibrillation on chromosome 4q25. %A Lubitz, Steven A %A Sinner, Moritz F %A Lunetta, Kathryn L %A Makino, Seiko %A Pfeufer, Arne %A Rahman, Rosanna %A Veltman, Caroline E %A Barnard, John %A Bis, Joshua C %A Danik, Stephan P %A Sonni, Akshata %A Shea, Marisa A %A Del Monte, Federica %A Perz, Siegfried %A Müller, Martina %A Peters, Annette %A Greenberg, Steven M %A Furie, Karen L %A van Noord, Charlotte %A Boerwinkle, Eric %A Stricker, Bruno H C %A Witteman, Jacqueline %A Smith, Jonathan D %A Chung, Mina K %A Heckbert, Susan R %A Benjamin, Emelia J %A Rosand, Jonathan %A Arking, Dan E %A Alonso, Alvaro %A Kääb, Stefan %A Ellinor, Patrick T %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Chromosome Mapping %K Chromosomes, Human, Pair 4 %K European Continental Ancestry Group %K Female %K Genetic Markers %K Genetic Predisposition to Disease %K Haplotypes %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %X

BACKGROUND: Genetic variants on chromosome 4q25 are associated with atrial fibrillation (AF). We sought to determine whether there is more than 1 susceptibility signal at this locus.

METHODS AND RESULTS: Thirty-four haplotype-tagging single-nucleotide polymorphisms (SNPs) at the 4q25 locus were genotyped in 790 case and 1177 control subjects from Massachusetts General Hospital and tested for association with AF. We replicated SNPs associated with AF after adjustment for the most significantly associated SNP in 5066 case and 30 661 referent subjects from the German Competence Network for Atrial Fibrillation, Atherosclerosis Risk In Communities Study, Cleveland Clinic Lone AF Study, Cardiovascular Health Study, and Rotterdam Study. All subjects were of European ancestry. A multimarker risk score composed of SNPs that tagged distinct AF susceptibility signals was constructed and tested for association with AF, and all results were subjected to meta-analysis. The previously reported SNP, rs2200733, was most significantly associated with AF (minor allele odds ratio 1.80, 95% confidence interval 1.50 to 2.15, P=1.2 x 10(-20)) in the discovery sample. Adjustment for rs2200733 genotype revealed 2 additional susceptibility signals marked by rs17570669 and rs3853445. A graded risk of AF was observed with an increasing number of AF risk alleles at SNPs that tagged these 3 susceptibility signals.

CONCLUSIONS: We identified 2 novel AF susceptibility signals on chromosome 4q25. Consideration of multiple susceptibility signals at chromosome 4q25 identifies individuals with an increased risk of AF and may localize regulatory elements at the locus with biological relevance in the pathogenesis of AF.

%B Circulation %V 122 %P 976-84 %8 2010 Sep 07 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/20733104?dopt=Abstract %R 10.1161/CIRCULATIONAHA.109.886440 %0 Journal Article %J Ann Hum Genet %D 2010 %T Interaction between fibrinogen and IL-6 genetic variants and associations with cardiovascular disease risk in the Cardiovascular Health Study. %A Carty, Cara L %A Heagerty, Patrick %A Heckbert, Susan R %A Jarvik, Gail P %A Lange, Leslie A %A Cushman, Mary %A Tracy, Russell P %A Reiner, Alexander P %K Aged %K Cardiovascular Diseases %K Carotid Arteries %K Female %K Fibrinogen %K Genetic Predisposition to Disease %K Genetic Variation %K Humans %K Interleukin-6 %K Male %K Models, Biological %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Risk %K Stroke %X

The inflammatory cytokine interleukin-6 (IL-6) is a main regulator of fibrinogen synthesis, though its interaction with fibrinogen genes (FGA, FGB, FGG) and subsequent impact on cardiovascular disease (CVD) risk is not well-studied. We investigated joint associations of fibrinogen and IL6 tagSNPs with fibrinogen concentrations, carotid intima-media thickness, and myocardial infarction or ischemic stroke in 3900 European-American Cardiovascular Health Study participants. To identify combinations of genetic main effects and interactions associated with outcomes, we used logic regression. We also evaluated whether the relationship between fibrinogen SNPs and fibrinogen level varied by IL-6 level using linear regression models with multiplicative interaction terms. Combinations of fibrinogen and IL6 SNPs were significantly associated with fibrinogen level (p < 0.005), but not with other outcomes. Fibrinogen levels were higher in individuals having FGB1437 (rs1800790) and lacking FGA6534 (rs6050) minor alleles; these SNPs interacted with IL6 rs1800796 to influence fibrinogen level. Marginally significant (p= 0.03) interactions between IL-6 level and FGA and FGG promoter SNPs associated with fibrinogen levels were detected. We identified potential gene-gene interactions influencing fibrinogen levels. Although IL-6 responsive binding sites are present in fibrinogen gene promoter regions, we did not find strong evidence of interaction between fibrinogen SNPs and IL6 SNPs or levels influencing CVD.

%B Ann Hum Genet %V 74 %P 1-10 %8 2010 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20059469?dopt=Abstract %R 10.1111/j.1469-1809.2009.00551.x %0 Journal Article %J Diabetes Care %D 2010 %T Interactions of dietary whole-grain intake with fasting glucose- and insulin-related genetic loci in individuals of European descent: a meta-analysis of 14 cohort studies. %A Nettleton, Jennifer A %A McKeown, Nicola M %A Kanoni, Stavroula %A Lemaitre, Rozenn N %A Hivert, Marie-France %A Ngwa, Julius %A van Rooij, Frank J A %A Sonestedt, Emily %A Wojczynski, Mary K %A Ye, Zheng %A Tanaka, Tosh %A Garcia, Melissa %A Anderson, Jennifer S %A Follis, Jack L %A Djoussé, Luc %A Mukamal, Kenneth %A Papoutsakis, Constantina %A Mozaffarian, Dariush %A Zillikens, M Carola %A Bandinelli, Stefania %A Bennett, Amanda J %A Borecki, Ingrid B %A Feitosa, Mary F %A Ferrucci, Luigi %A Forouhi, Nita G %A Groves, Christopher J %A Hallmans, Göran %A Harris, Tamara %A Hofman, Albert %A Houston, Denise K %A Hu, Frank B %A Johansson, Ingegerd %A Kritchevsky, Stephen B %A Langenberg, Claudia %A Launer, Lenore %A Liu, Yongmei %A Loos, Ruth J %A Nalls, Michael %A Orho-Melander, Marju %A Renstrom, Frida %A Rice, Kenneth %A Riserus, Ulf %A Rolandsson, Olov %A Rotter, Jerome I %A Saylor, Georgia %A Sijbrands, Eric J G %A Sjogren, Per %A Smith, Albert %A Steingrímsdóttir, Laufey %A Uitterlinden, André G %A Wareham, Nicholas J %A Prokopenko, Inga %A Pankow, James S %A van Duijn, Cornelia M %A Florez, Jose C %A Witteman, Jacqueline C M %A Dupuis, Josée %A Dedoussis, George V %A Ordovas, Jose M %A Ingelsson, Erik %A Cupples, L Adrienne %A Siscovick, David S %A Franks, Paul W %A Meigs, James B %K Adult %K Aged %K Blood Glucose %K Edible Grain %K European Continental Ancestry Group %K Fasting %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Humans %K Insulin %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

OBJECTIVE: Whole-grain foods are touted for multiple health benefits, including enhancing insulin sensitivity and reducing type 2 diabetes risk. Recent genome-wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs) associated with fasting glucose and insulin concentrations in individuals free of diabetes. We tested the hypothesis that whole-grain food intake and genetic variation interact to influence concentrations of fasting glucose and insulin.

RESEARCH DESIGN AND METHODS: Via meta-analysis of data from 14 cohorts comprising ∼ 48,000 participants of European descent, we studied interactions of whole-grain intake with loci previously associated in GWAS with fasting glucose (16 loci) and/or insulin (2 loci) concentrations. For tests of interaction, we considered a P value <0.0028 (0.05 of 18 tests) as statistically significant.

RESULTS: Greater whole-grain food intake was associated with lower fasting glucose and insulin concentrations independent of demographics, other dietary and lifestyle factors, and BMI (β [95% CI] per 1-serving-greater whole-grain intake: -0.009 mmol/l glucose [-0.013 to -0.005], P < 0.0001 and -0.011 pmol/l [ln] insulin [-0.015 to -0.007], P = 0.0003). No interactions met our multiple testing-adjusted statistical significance threshold. The strongest SNP interaction with whole-grain intake was rs780094 (GCKR) for fasting insulin (P = 0.006), where greater whole-grain intake was associated with a smaller reduction in fasting insulin concentrations in those with the insulin-raising allele.

CONCLUSIONS: Our results support the favorable association of whole-grain intake with fasting glucose and insulin and suggest a potential interaction between variation in GCKR and whole-grain intake in influencing fasting insulin concentrations.

%B Diabetes Care %V 33 %P 2684-91 %8 2010 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/20693352?dopt=Abstract %R 10.2337/dc10-1150 %0 Journal Article %J Am J Emerg Med %D 2010 %T Intravenous tissue plasminogen activator and stroke in the elderly. %A Longstreth, W T %A Katz, Ronit %A Tirschwell, David L %A Cushman, Mary %A Psaty, Bruce M %K Aged, 80 and over %K Female %K Fibrinolytic Agents %K Humans %K Longitudinal Studies %K Male %K Placebos %K Randomized Controlled Trials as Topic %K Stroke %K Tissue Plasminogen Activator %K Treatment Outcome %K United States %X

OBJECTIVE: Since publication in 1995 of the National Institute of Neurological Disorders and Stroke (NINDS) trial of intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke, the benefit and frequency of use of IV tPA in the elderly have remained uncertain.

METHODS: We obtained data from the NINDS trial to summarize outcomes for randomized subjects older than 80 years. We used data from the Cardiovascular Health Study, a cohort study of 5888 elderly participants from 4 US communities followed longitudinally for stroke since 1989 to estimate the use of and hospital outcome after IV tPA in older adults following publication of the trial in 1995.

RESULTS: In the NINDS trial, 44 subjects older than 80 years were randomized, and their 3-month functional outcomes were not significantly improved with IV tPA. Of 25 randomized to IV tPA, 4 experienced symptomatic intracranial hemorrhages within 36 hours of treatment. Compared with younger patients, older patients were 2.87 times more likely to experience a symptomatic intracranial hemorrhage within 36 hours of IV tPA (95% confidence interval, 1.04-7.93). Of 227 Cardiovascular Health Study participants hospitalized for ischemic stroke between 1995 and 2002, seven, whose mean age was 84 years, were treated with IV tPA (3.1%; 95% confidence interval 1.2-6.2). Two had symptomatic intracranial hemorrhages, 3 failed to improve, and 2 of the 7 had good outcomes.

CONCLUSIONS: These data highlight the need to clarify the risk-benefit profile of IV tPA in ischemic stroke victims who are older than 80 years.

%B Am J Emerg Med %V 28 %P 359-63 %8 2010 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20223397?dopt=Abstract %R 10.1016/j.ajem.2009.01.025 %0 Journal Article %J Hum Mol Genet %D 2010 %T Large-scale genomic studies reveal central role of ABO in sP-selectin and sICAM-1 levels. %A Barbalic, Maja %A Dupuis, Josée %A Dehghan, Abbas %A Bis, Joshua C %A Hoogeveen, Ron C %A Schnabel, Renate B %A Nambi, Vijay %A Bretler, Monique %A Smith, Nicholas L %A Peters, Annette %A Lu, Chen %A Tracy, Russell P %A Aleksic, Nena %A Heeriga, Jan %A Keaney, John F %A Rice, Kenneth %A Lip, Gregory Y H %A Vasan, Ramachandran S %A Glazer, Nicole L %A Larson, Martin G %A Uitterlinden, André G %A Yamamoto, Jennifer %A Durda, Peter %A Haritunians, Talin %A Psaty, Bruce M %A Boerwinkle, Eric %A Hofman, Albert %A Koenig, Wolfgang %A Jenny, Nancy S %A Witteman, Jacqueline C %A Ballantyne, Christie %A Benjamin, Emelia J %K ABO Blood-Group System %K Blood Platelets %K Enzyme-Linked Immunosorbent Assay %K European Continental Ancestry Group %K Fluorescence %K Genome-Wide Association Study %K Humans %K Intercellular Adhesion Molecule-1 %K P-Selectin %X

P-selectin and intercellular adhesion molecule-1 (ICAM-1) participate in inflammatory processes by promoting adhesion of leukocytes to vascular wall endothelium. Their soluble levels have been associated with adverse cardiovascular events. To identify loci affecting soluble levels of P-selectin (sP-selectin) and ICAM-1 (sICAM-1), we performed a genome-wide association study in a sample of 4115 (sP-selectin) and 9813 (sICAM-1) individuals of European ancestry as a part of The Cohorts for Heart and Aging Research in Genome Epidemiology consortium. The most significant SNP association for sP-selectin was within the SELP gene (rs6136, P = 4.05 x 10(-61)) and for sICAM-1 levels within the ICAM-1 gene (rs3093030, P = 3.53 x 10(-23)). Both sP-selectin and sICAM-1 were associated with ABO gene variants (rs579459, P = 1.86 x 10(-41) and rs649129, P = 1.22 x 10(-15), respectively) and in both cases the observed associations could be accounted for by the A1 allele of the ABO blood group. The absence of an association between ABO blood group and platelet-bound P-selectin levels in an independent subsample (N = 1088) from the ARIC study, suggests that the ABO blood group may influence cleavage of the P-selectin protein from the cell surface or clearance from the circulation, rather than its production and cellular presentation. These results provide new insights into adhesion molecule biology.

%B Hum Mol Genet %V 19 %P 1863-72 %8 2010 May 01 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/20167578?dopt=Abstract %R 10.1093/hmg/ddq061 %0 Journal Article %J Lancet %D 2010 %T Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. %A Thompson, Alexander %A Gao, Pei %A Orfei, Lia %A Watson, Sarah %A Di Angelantonio, Emanuele %A Kaptoge, Stephen %A Ballantyne, Christie %A Cannon, Christopher P %A Criqui, Michael %A Cushman, Mary %A Hofman, Albert %A Packard, Chris %A Thompson, Simon G %A Collins, Rory %A Danesh, John %K 1-Alkyl-2-acetylglycerophosphocholine Esterase %K Blood Pressure %K Coronary Disease %K Female %K Humans %K Linear Models %K Lipids %K Male %K Middle Aged %K Prospective Studies %K Risk Assessment %K Risk Factors %K Stroke %K Systole %X

BACKGROUND: Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), an inflammatory enzyme expressed in atherosclerotic plaques, is a therapeutic target being assessed in trials of vascular disease prevention. We investigated associations of circulating Lp-PLA(2) mass and activity with risk of coronary heart disease, stroke, and mortality under different circumstances.

METHODS: With use of individual records from 79 036 participants in 32 prospective studies (yielding 17 722 incident fatal or non-fatal outcomes during 474 976 person-years at risk), we did a meta-analysis of within-study regressions to calculate risk ratios (RRs) per 1 SD higher value of Lp-PLA(2) or other risk factor. The primary outcome was coronary heart disease.

FINDINGS: Lp-PLA(2) activity and mass were associated with each other (r=0.51, 95% CI 0.47-0.56) and proatherogenic lipids. We noted roughly log-linear associations of Lp-PLA(2) activity and mass with risk of coronary heart disease and vascular death. RRs, adjusted for conventional risk factors, were: 1.10 (95% CI 1.05-1.16) with Lp-PLA(2) activity and 1.11 (1.07-1.16) with Lp-PLA(2) mass for coronary heart disease; 1.08 (0.97-1.20) and 1.14 (1.02-1.27) for ischaemic stroke; 1.16 (1.09-1.24) and 1.13 (1.05-1.22) for vascular mortality; and 1.10 (1.04-1.17) and 1.10 (1.03-1.18) for non-vascular mortality, respectively. RRs with Lp-PLA(2) did not differ significantly in people with and without initial stable vascular disease, apart from for vascular death with Lp-PLA(2) mass. Adjusted RRs for coronary heart disease were 1.10 (1.02-1.18) with non-HDL cholesterol and 1.10 (1.00-1.21) with systolic blood pressure.

INTERPRETATION: Lp-PLA(2) activity and mass each show continuous associations with risk of coronary heart disease, similar in magnitude to that with non-HDL cholesterol or systolic blood pressure in this population. Associations of Lp-PLA(2) mass and activity are not exclusive to vascular outcomes, and the vascular associations depend at least partly on lipids.

FUNDING: UK Medical Research Council, GlaxoSmithKline, and British Heart Foundation.

%B Lancet %V 375 %P 1536-44 %8 2010 May 01 %G eng %N 9725 %1 https://www.ncbi.nlm.nih.gov/pubmed/20435228?dopt=Abstract %R 10.1016/S0140-6736(10)60319-4 %0 Journal Article %J Nat Genet %D 2010 %T Meta-analyses of genome-wide association studies identify multiple loci associated with pulmonary function. %A Hancock, Dana B %A Eijgelsheim, Mark %A Wilk, Jemma B %A Gharib, Sina A %A Loehr, Laura R %A Marciante, Kristin D %A Franceschini, Nora %A van Durme, Yannick M T A %A Chen, Ting-Hsu %A Barr, R Graham %A Schabath, Matthew B %A Couper, David J %A Brusselle, Guy G %A Psaty, Bruce M %A van Duijn, Cornelia M %A Rotter, Jerome I %A Uitterlinden, André G %A Hofman, Albert %A Punjabi, Naresh M %A Rivadeneira, Fernando %A Morrison, Alanna C %A Enright, Paul L %A North, Kari E %A Heckbert, Susan R %A Lumley, Thomas %A Stricker, Bruno H C %A O'Connor, George T %A London, Stephanie J %K Databases, Genetic %K Female %K Forced Expiratory Volume %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Lung %K Lung Diseases %K Male %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Spirometry %K Vital Capacity %X

Spirometric measures of lung function are heritable traits that reflect respiratory health and predict morbidity and mortality. We meta-analyzed genome-wide association studies for two clinically important lung-function measures: forced expiratory volume in the first second (FEV(1)) and its ratio to forced vital capacity (FEV(1)/FVC), an indicator of airflow obstruction. This meta-analysis included 20,890 participants of European ancestry from four CHARGE Consortium studies: Atherosclerosis Risk in Communities, Cardiovascular Health Study, Framingham Heart Study and Rotterdam Study. We identified eight loci associated with FEV(1)/FVC (HHIP, GPR126, ADAM19, AGER-PPT2, FAM13A, PTCH1, PID1 and HTR4) and one locus associated with FEV(1) (INTS12-GSTCD-NPNT) at or near genome-wide significance (P < 5 x 10(-8)) in the CHARGE Consortium dataset. Our findings may offer insights into pulmonary function and pathogenesis of chronic lung disease.

%B Nat Genet %V 42 %P 45-52 %8 2010 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20010835?dopt=Abstract %R 10.1038/ng.500 %0 Journal Article %J Nat Genet %D 2010 %T Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution. %A Heid, Iris M %A Jackson, Anne U %A Randall, Joshua C %A Winkler, Thomas W %A Qi, Lu %A Steinthorsdottir, Valgerdur %A Thorleifsson, Gudmar %A Zillikens, M Carola %A Speliotes, Elizabeth K %A Mägi, Reedik %A Workalemahu, Tsegaselassie %A White, Charles C %A Bouatia-Naji, Nabila %A Harris, Tamara B %A Berndt, Sonja I %A Ingelsson, Erik %A Willer, Cristen J %A Weedon, Michael N %A Luan, Jian'an %A Vedantam, Sailaja %A Esko, Tõnu %A Kilpeläinen, Tuomas O %A Kutalik, Zoltán %A Li, Shengxu %A Monda, Keri L %A Dixon, Anna L %A Holmes, Christopher C %A Kaplan, Lee M %A Liang, Liming %A Min, Josine L %A Moffatt, Miriam F %A Molony, Cliona %A Nicholson, George %A Schadt, Eric E %A Zondervan, Krina T %A Feitosa, Mary F %A Ferreira, Teresa %A Lango Allen, Hana %A Weyant, Robert J %A Wheeler, Eleanor %A Wood, Andrew R %A Estrada, Karol %A Goddard, Michael E %A Lettre, Guillaume %A Mangino, Massimo %A Nyholt, Dale R %A Purcell, Shaun %A Smith, Albert Vernon %A Visscher, Peter M %A Yang, Jian %A McCarroll, Steven A %A Nemesh, James %A Voight, Benjamin F %A Absher, Devin %A Amin, Najaf %A Aspelund, Thor %A Coin, Lachlan %A Glazer, Nicole L %A Hayward, Caroline %A Heard-Costa, Nancy L %A Hottenga, Jouke-Jan %A Johansson, Asa %A Johnson, Toby %A Kaakinen, Marika %A Kapur, Karen %A Ketkar, Shamika %A Knowles, Joshua W %A Kraft, Peter %A Kraja, Aldi T %A Lamina, Claudia %A Leitzmann, Michael F %A McKnight, Barbara %A Morris, Andrew P %A Ong, Ken K %A Perry, John R B %A Peters, Marjolein J %A Polasek, Ozren %A Prokopenko, Inga %A Rayner, Nigel W %A Ripatti, Samuli %A Rivadeneira, Fernando %A Robertson, Neil R %A Sanna, Serena %A Sovio, Ulla %A Surakka, Ida %A Teumer, Alexander %A van Wingerden, Sophie %A Vitart, Veronique %A Zhao, Jing Hua %A Cavalcanti-Proença, Christine %A Chines, Peter S %A Fisher, Eva %A Kulzer, Jennifer R %A Lecoeur, Cécile %A Narisu, Narisu %A Sandholt, Camilla %A Scott, Laura J %A Silander, Kaisa %A Stark, Klaus %A Tammesoo, Mari-Liis %A Teslovich, Tanya M %A Timpson, Nicholas John %A Watanabe, Richard M %A Welch, Ryan %A Chasman, Daniel I %A Cooper, Matthew N %A Jansson, John-Olov %A Kettunen, Johannes %A Lawrence, Robert W %A Pellikka, Niina %A Perola, Markus %A Vandenput, Liesbeth %A Alavere, Helene %A Almgren, Peter %A Atwood, Larry D %A Bennett, Amanda J %A Biffar, Reiner %A Bonnycastle, Lori L %A Bornstein, Stefan R %A Buchanan, Thomas A %A Campbell, Harry %A Day, Ian N M %A Dei, Mariano %A Dörr, Marcus %A Elliott, Paul %A Erdos, Michael R %A Eriksson, Johan G %A Freimer, Nelson B %A Fu, Mao %A Gaget, Stefan %A Geus, Eco J C %A Gjesing, Anette P %A Grallert, Harald %A Grässler, Jürgen %A Groves, Christopher J %A Guiducci, Candace %A Hartikainen, Anna-Liisa %A Hassanali, Neelam %A Havulinna, Aki S %A Herzig, Karl-Heinz %A Hicks, Andrew A %A Hui, Jennie %A Igl, Wilmar %A Jousilahti, Pekka %A Jula, Antti %A Kajantie, Eero %A Kinnunen, Leena %A Kolcic, Ivana %A Koskinen, Seppo %A Kovacs, Peter %A Kroemer, Heyo K %A Krzelj, Vjekoslav %A Kuusisto, Johanna %A Kvaloy, Kirsti %A Laitinen, Jaana %A Lantieri, Olivier %A Lathrop, G Mark %A Lokki, Marja-Liisa %A Luben, Robert N %A Ludwig, Barbara %A McArdle, Wendy L %A McCarthy, Anne %A Morken, Mario A %A Nelis, Mari %A Neville, Matt J %A Paré, Guillaume %A Parker, Alex N %A Peden, John F %A Pichler, Irene %A Pietiläinen, Kirsi H %A Platou, Carl G P %A Pouta, Anneli %A Ridderstråle, Martin %A Samani, Nilesh J %A Saramies, Jouko %A Sinisalo, Juha %A Smit, Jan H %A Strawbridge, Rona J %A Stringham, Heather M %A Swift, Amy J %A Teder-Laving, Maris %A Thomson, Brian %A Usala, Gianluca %A van Meurs, Joyce B J %A van Ommen, Gert-Jan %A Vatin, Vincent %A Volpato, Claudia B %A Wallaschofski, Henri %A Walters, G Bragi %A Widen, Elisabeth %A Wild, Sarah H %A Willemsen, Gonneke %A Witte, Daniel R %A Zgaga, Lina %A Zitting, Paavo %A Beilby, John P %A James, Alan L %A Kähönen, Mika %A Lehtimäki, Terho %A Nieminen, Markku S %A Ohlsson, Claes %A Palmer, Lyle J %A Raitakari, Olli %A Ridker, Paul M %A Stumvoll, Michael %A Tönjes, Anke %A Viikari, Jorma %A Balkau, Beverley %A Ben-Shlomo, Yoav %A Bergman, Richard N %A Boeing, Heiner %A Smith, George Davey %A Ebrahim, Shah %A Froguel, Philippe %A Hansen, Torben %A Hengstenberg, Christian %A Hveem, Kristian %A Isomaa, Bo %A Jørgensen, Torben %A Karpe, Fredrik %A Khaw, Kay-Tee %A Laakso, Markku %A Lawlor, Debbie A %A Marre, Michel %A Meitinger, Thomas %A Metspalu, Andres %A Midthjell, Kristian %A Pedersen, Oluf %A Salomaa, Veikko %A Schwarz, Peter E H %A Tuomi, Tiinamaija %A Tuomilehto, Jaakko %A Valle, Timo T %A Wareham, Nicholas J %A Arnold, Alice M %A Beckmann, Jacques S %A Bergmann, Sven %A Boerwinkle, Eric %A Boomsma, Dorret I %A Caulfield, Mark J %A Collins, Francis S %A Eiriksdottir, Gudny %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Hamsten, Anders %A Hattersley, Andrew T %A Hofman, Albert %A Hu, Frank B %A Illig, Thomas %A Iribarren, Carlos %A Jarvelin, Marjo-Riitta %A Kao, W H Linda %A Kaprio, Jaakko %A Launer, Lenore J %A Munroe, Patricia B %A Oostra, Ben %A Penninx, Brenda W %A Pramstaller, Peter P %A Psaty, Bruce M %A Quertermous, Thomas %A Rissanen, Aila %A Rudan, Igor %A Shuldiner, Alan R %A Soranzo, Nicole %A Spector, Timothy D %A Syvänen, Ann-Christine %A Uda, Manuela %A Uitterlinden, Andre %A Völzke, Henry %A Vollenweider, Peter %A Wilson, James F %A Witteman, Jacqueline C %A Wright, Alan F %A Abecasis, Goncalo R %A Boehnke, Michael %A Borecki, Ingrid B %A Deloukas, Panos %A Frayling, Timothy M %A Groop, Leif C %A Haritunians, Talin %A Hunter, David J %A Kaplan, Robert C %A North, Kari E %A O'Connell, Jeffrey R %A Peltonen, Leena %A Schlessinger, David %A Strachan, David P %A Hirschhorn, Joel N %A Assimes, Themistocles L %A Wichmann, H-Erich %A Thorsteinsdottir, Unnur %A van Duijn, Cornelia M %A Stefansson, Kari %A Cupples, L Adrienne %A Loos, Ruth J F %A Barroso, Inês %A McCarthy, Mark I %A Fox, Caroline S %A Mohlke, Karen L %A Lindgren, Cecilia M %K Adipose Tissue %K Age Factors %K Chromosome Mapping %K Female %K Genome, Human %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Sex Characteristics %K Waist-Hip Ratio %X

Waist-hip ratio (WHR) is a measure of body fat distribution and a predictor of metabolic consequences independent of overall adiposity. WHR is heritable, but few genetic variants influencing this trait have been identified. We conducted a meta-analysis of 32 genome-wide association studies for WHR adjusted for body mass index (comprising up to 77,167 participants), following up 16 loci in an additional 29 studies (comprising up to 113,636 subjects). We identified 13 new loci in or near RSPO3, VEGFA, TBX15-WARS2, NFE2L3, GRB14, DNM3-PIGC, ITPR2-SSPN, LY86, HOXC13, ADAMTS9, ZNRF3-KREMEN1, NISCH-STAB1 and CPEB4 (P = 1.9 × 10⁻⁹ to P = 1.8 × 10⁻⁴⁰) and the known signal at LYPLAL1. Seven of these loci exhibited marked sexual dimorphism, all with a stronger effect on WHR in women than men (P for sex difference = 1.9 × 10⁻³ to P = 1.2 × 10⁻¹³). These findings provide evidence for multiple loci that modulate body fat distribution independent of overall adiposity and reveal strong gene-by-sex interactions.

%B Nat Genet %V 42 %P 949-60 %8 2010 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/20935629?dopt=Abstract %R 10.1038/ng.685 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2010 %T A meta-analysis of four genome-wide association studies of survival to age 90 years or older: the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. %A Newman, Anne B %A Walter, Stefan %A Lunetta, Kathryn L %A Garcia, Melissa E %A Slagboom, P Eline %A Christensen, Kaare %A Arnold, Alice M %A Aspelund, Thor %A Aulchenko, Yurii S %A Benjamin, Emelia J %A Christiansen, Lene %A D'Agostino, Ralph B %A Fitzpatrick, Annette L %A Franceschini, Nora %A Glazer, Nicole L %A Gudnason, Vilmundur %A Hofman, Albert %A Kaplan, Robert %A Karasik, David %A Kelly-Hayes, Margaret %A Kiel, Douglas P %A Launer, Lenore J %A Marciante, Kristin D %A Massaro, Joseph M %A Miljkovic, Iva %A Nalls, Michael A %A Hernandez, Dena %A Psaty, Bruce M %A Rivadeneira, Fernando %A Rotter, Jerome %A Seshadri, Sudha %A Smith, Albert V %A Taylor, Kent D %A Tiemeier, Henning %A Uh, Hae-Won %A Uitterlinden, André G %A Vaupel, James W %A Walston, Jeremy %A Westendorp, Rudi G J %A Harris, Tamara B %A Lumley, Thomas %A van Duijn, Cornelia M %A Murabito, Joanne M %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Alleles %K Cohort Studies %K Confidence Intervals %K Female %K Genome-Wide Association Study %K Genotype %K Humans %K Longevity %K Male %K Middle Aged %K Odds Ratio %K Polymorphism, Single Nucleotide %X

BACKGROUND: Genome-wide association studies (GWAS) may yield insights into longevity.

METHODS: We performed a meta-analysis of GWAS in Caucasians from four prospective cohort studies: the Age, Gene/Environment Susceptibility-Reykjavik Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Longevity was defined as survival to age 90 years or older (n = 1,836); the comparison group comprised cohort members who died between the ages of 55 and 80 years (n = 1,955). In a second discovery stage, additional genotyping was conducted in the Leiden Longevity Study cohort and the Danish 1905 cohort.

RESULTS: There were 273 single-nucleotide polymorphism (SNP) associations with p < .0001, but none reached the prespecified significance level of 5 x 10(-8). Of the most significant SNPs, 24 were independent signals, and 16 of these SNPs were successfully genotyped in the second discovery stage, with one association for rs9664222, reaching 6.77 x 10(-7) for the combined meta-analysis of CHARGE and the stage 2 cohorts. The SNP lies in a region near MINPP1 (chromosome 10), a well-conserved gene involved in regulation of cellular proliferation. The minor allele was associated with lower odds of survival past age 90 (odds ratio = 0.82). Associations of interest in a homologue of the longevity assurance gene (LASS3) and PAPPA2 were not strengthened in the second stage.

CONCLUSION: Survival studies of larger size or more extreme or specific phenotypes may support or refine these initial findings.

%B J Gerontol A Biol Sci Med Sci %V 65 %P 478-87 %8 2010 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/20304771?dopt=Abstract %R 10.1093/gerona/glq028 %0 Journal Article %J Circ Cardiovasc Genet %D 2010 %T Multiple genetic loci influence serum urate levels and their relationship with gout and cardiovascular disease risk factors. %A Yang, Qiong %A Köttgen, Anna %A Dehghan, Abbas %A Smith, Albert V %A Glazer, Nicole L %A Chen, Ming-Huei %A Chasman, Daniel I %A Aspelund, Thor %A Eiriksdottir, Gudny %A Harris, Tamara B %A Launer, Lenore %A Nalls, Michael %A Hernandez, Dena %A Arking, Dan E %A Boerwinkle, Eric %A Grove, Megan L %A Li, Man %A Linda Kao, W H %A Chonchol, Michel %A Haritunians, Talin %A Li, Guo %A Lumley, Thomas %A Psaty, Bruce M %A Shlipak, Michael %A Hwang, Shih-Jen %A Larson, Martin G %A O'Donnell, Christopher J %A Upadhyay, Ashish %A van Duijn, Cornelia M %A Hofman, Albert %A Rivadeneira, Fernando %A Stricker, Bruno %A Uitterlinden, André G %A Paré, Guillaume %A Parker, Alex N %A Ridker, Paul M %A Siscovick, David S %A Gudnason, Vilmundur %A Witteman, Jacqueline C %A Fox, Caroline S %A Coresh, Josef %K Cardiovascular Diseases %K Coronary Disease %K Female %K Genetic Loci %K Genome-Wide Association Study %K Gout %K Humans %K Male %K Risk Factors %K Uric Acid %X

BACKGROUND: Elevated serum urate levels can lead to gout and are associated with cardiovascular risk factors. We performed a genome-wide association study to search for genetic susceptibility loci for serum urate and gout and investigated the causal nature of the associations of serum urate with gout and selected cardiovascular risk factors and coronary heart disease (CHD).

METHODS AND RESULTS: Meta-analyses of genome-wide association studies (GWAS) were performed in 5 population-based cohorts of the Cohorts for Heart and Aging Research in Genome Epidemiology consortium for serum urate and gout in 28 283 white participants. The effect of the most significant single-nucleotide polymorphism at all genome-wide significant loci on serum urate was added to create a genetic urate score. Findings were replicated in the Women's Genome Health Study (n=22 054). Single-nucleotide polymorphisms at 8 genetic loci achieved genome-wide significance with serum urate levels (P=4×10(-8) to 2×10(-242) in SLC22A11, GCKR, R3HDM2-INHBC region, RREB1, PDZK1, SLC2A9, ABCG2, and SLC17A1). Only 2 loci (SLC2A9, ABCG2) showed genome-wide significant association with gout. The genetic urate score was strongly associated with serum urate and gout (odds ratio, 12.4 per 100 μmol/L; P=3×10(-39)) but not with blood pressure, glucose, estimated glomerular filtration rate, chronic kidney disease, or CHD. The lack of association between the genetic score and the latter phenotypes also was observed in the Women's Genome Health Study.

CONCLUSIONS: The genetic urate score analysis suggested a causal relationship between serum urate and gout but did not provide evidence for one between serum urate and cardiovascular risk factors and CHD.

%B Circ Cardiovasc Genet %V 3 %P 523-30 %8 2010 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/20884846?dopt=Abstract %R 10.1161/CIRCGENETICS.109.934455 %0 Journal Article %J Nat Genet %D 2010 %T New genetic loci implicated in fasting glucose homeostasis and their impact on type 2 diabetes risk. %A Dupuis, Josée %A Langenberg, Claudia %A Prokopenko, Inga %A Saxena, Richa %A Soranzo, Nicole %A Jackson, Anne U %A Wheeler, Eleanor %A Glazer, Nicole L %A Bouatia-Naji, Nabila %A Gloyn, Anna L %A Lindgren, Cecilia M %A Mägi, Reedik %A Morris, Andrew P %A Randall, Joshua %A Johnson, Toby %A Elliott, Paul %A Rybin, Denis %A Thorleifsson, Gudmar %A Steinthorsdottir, Valgerdur %A Henneman, Peter %A Grallert, Harald %A Dehghan, Abbas %A Hottenga, Jouke Jan %A Franklin, Christopher S %A Navarro, Pau %A Song, Kijoung %A Goel, Anuj %A Perry, John R B %A Egan, Josephine M %A Lajunen, Taina %A Grarup, Niels %A Sparsø, Thomas %A Doney, Alex %A Voight, Benjamin F %A Stringham, Heather M %A Li, Man %A Kanoni, Stavroula %A Shrader, Peter %A Cavalcanti-Proença, Christine %A Kumari, Meena %A Qi, Lu %A Timpson, Nicholas J %A Gieger, Christian %A Zabena, Carina %A Rocheleau, Ghislain %A Ingelsson, Erik %A An, Ping %A O'Connell, Jeffrey %A Luan, Jian'an %A Elliott, Amanda %A McCarroll, Steven A %A Payne, Felicity %A Roccasecca, Rosa Maria %A Pattou, François %A Sethupathy, Praveen %A Ardlie, Kristin %A Ariyurek, Yavuz %A Balkau, Beverley %A Barter, Philip %A Beilby, John P %A Ben-Shlomo, Yoav %A Benediktsson, Rafn %A Bennett, Amanda J %A Bergmann, Sven %A Bochud, Murielle %A Boerwinkle, Eric %A Bonnefond, Amélie %A Bonnycastle, Lori L %A Borch-Johnsen, Knut %A Böttcher, Yvonne %A Brunner, Eric %A Bumpstead, Suzannah J %A Charpentier, Guillaume %A Chen, Yii-Der Ida %A Chines, Peter %A Clarke, Robert %A Coin, Lachlan J M %A Cooper, Matthew N %A Cornelis, Marilyn %A Crawford, Gabe %A Crisponi, Laura %A Day, Ian N M %A de Geus, Eco J C %A Delplanque, Jerome %A Dina, Christian %A Erdos, Michael R %A Fedson, Annette C %A Fischer-Rosinsky, Antje %A Forouhi, Nita G %A Fox, Caroline S %A Frants, Rune %A Franzosi, Maria Grazia %A Galan, Pilar %A Goodarzi, Mark O %A Graessler, Jürgen %A Groves, Christopher J %A Grundy, Scott %A Gwilliam, Rhian %A Gyllensten, Ulf %A Hadjadj, Samy %A Hallmans, Göran %A Hammond, Naomi %A Han, Xijing %A Hartikainen, Anna-Liisa %A Hassanali, Neelam %A Hayward, Caroline %A Heath, Simon C %A Hercberg, Serge %A Herder, Christian %A Hicks, Andrew A %A Hillman, David R %A Hingorani, Aroon D %A Hofman, Albert %A Hui, Jennie %A Hung, Joe %A Isomaa, Bo %A Johnson, Paul R V %A Jørgensen, Torben %A Jula, Antti %A Kaakinen, Marika %A Kaprio, Jaakko %A Kesaniemi, Y Antero %A Kivimaki, Mika %A Knight, Beatrice %A Koskinen, Seppo %A Kovacs, Peter %A Kyvik, Kirsten Ohm %A Lathrop, G Mark %A Lawlor, Debbie A %A Le Bacquer, Olivier %A Lecoeur, Cécile %A Li, Yun %A Lyssenko, Valeriya %A Mahley, Robert %A Mangino, Massimo %A Manning, Alisa K %A Martínez-Larrad, María Teresa %A McAteer, Jarred B %A McCulloch, Laura J %A McPherson, Ruth %A Meisinger, Christa %A Melzer, David %A Meyre, David %A Mitchell, Braxton D %A Morken, Mario A %A Mukherjee, Sutapa %A Naitza, Silvia %A Narisu, Narisu %A Neville, Matthew J %A Oostra, Ben A %A Orrù, Marco %A Pakyz, Ruth %A Palmer, Colin N A %A Paolisso, Giuseppe %A Pattaro, Cristian %A Pearson, Daniel %A Peden, John F %A Pedersen, Nancy L %A Perola, Markus %A Pfeiffer, Andreas F H %A Pichler, Irene %A Polasek, Ozren %A Posthuma, Danielle %A Potter, Simon C %A Pouta, Anneli %A Province, Michael A %A Psaty, Bruce M %A Rathmann, Wolfgang %A Rayner, Nigel W %A Rice, Kenneth %A Ripatti, Samuli %A Rivadeneira, Fernando %A Roden, Michael %A Rolandsson, Olov %A Sandbaek, Annelli %A Sandhu, Manjinder %A Sanna, Serena %A Sayer, Avan Aihie %A Scheet, Paul %A Scott, Laura J %A Seedorf, Udo %A Sharp, Stephen J %A Shields, Beverley %A Sigurethsson, Gunnar %A Sijbrands, Eric J G %A Silveira, Angela %A Simpson, Laila %A Singleton, Andrew %A Smith, Nicholas L %A Sovio, Ulla %A Swift, Amy %A Syddall, Holly %A Syvänen, Ann-Christine %A Tanaka, Toshiko %A Thorand, Barbara %A Tichet, Jean %A Tönjes, Anke %A Tuomi, Tiinamaija %A Uitterlinden, André G %A van Dijk, Ko Willems %A van Hoek, Mandy %A Varma, Dhiraj %A Visvikis-Siest, Sophie %A Vitart, Veronique %A Vogelzangs, Nicole %A Waeber, Gérard %A Wagner, Peter J %A Walley, Andrew %A Walters, G Bragi %A Ward, Kim L %A Watkins, Hugh %A Weedon, Michael N %A Wild, Sarah H %A Willemsen, Gonneke %A Witteman, Jaqueline C M %A Yarnell, John W G %A Zeggini, Eleftheria %A Zelenika, Diana %A Zethelius, Björn %A Zhai, Guangju %A Zhao, Jing Hua %A Zillikens, M Carola %A Borecki, Ingrid B %A Loos, Ruth J F %A Meneton, Pierre %A Magnusson, Patrik K E %A Nathan, David M %A Williams, Gordon H %A Hattersley, Andrew T %A Silander, Kaisa %A Salomaa, Veikko %A Smith, George Davey %A Bornstein, Stefan R %A Schwarz, Peter %A Spranger, Joachim %A Karpe, Fredrik %A Shuldiner, Alan R %A Cooper, Cyrus %A Dedoussis, George V %A Serrano-Ríos, Manuel %A Morris, Andrew D %A Lind, Lars %A Palmer, Lyle J %A Hu, Frank B %A Franks, Paul W %A Ebrahim, Shah %A Marmot, Michael %A Kao, W H Linda %A Pankow, James S %A Sampson, Michael J %A Kuusisto, Johanna %A Laakso, Markku %A Hansen, Torben %A Pedersen, Oluf %A Pramstaller, Peter Paul %A Wichmann, H Erich %A Illig, Thomas %A Rudan, Igor %A Wright, Alan F %A Stumvoll, Michael %A Campbell, Harry %A Wilson, James F %A Bergman, Richard N %A Buchanan, Thomas A %A Collins, Francis S %A Mohlke, Karen L %A Tuomilehto, Jaakko %A Valle, Timo T %A Altshuler, David %A Rotter, Jerome I %A Siscovick, David S %A Penninx, Brenda W J H %A Boomsma, Dorret I %A Deloukas, Panos %A Spector, Timothy D %A Frayling, Timothy M %A Ferrucci, Luigi %A Kong, Augustine %A Thorsteinsdottir, Unnur %A Stefansson, Kari %A van Duijn, Cornelia M %A Aulchenko, Yurii S %A Cao, Antonio %A Scuteri, Angelo %A Schlessinger, David %A Uda, Manuela %A Ruokonen, Aimo %A Jarvelin, Marjo-Riitta %A Waterworth, Dawn M %A Vollenweider, Peter %A Peltonen, Leena %A Mooser, Vincent %A Abecasis, Goncalo R %A Wareham, Nicholas J %A Sladek, Robert %A Froguel, Philippe %A Watanabe, Richard M %A Meigs, James B %A Groop, Leif %A Boehnke, Michael %A McCarthy, Mark I %A Florez, Jose C %A Barroso, Inês %K Adolescent %K Adult %K Alleles %K Blood Glucose %K Child %K Databases, Genetic %K Diabetes Mellitus, Type 2 %K DNA Copy Number Variations %K Fasting %K Gene Expression Regulation %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Homeostasis %K Humans %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Quantitative Trait, Heritable %K Reproducibility of Results %X

Levels of circulating glucose are tightly regulated. To identify new loci influencing glycemic traits, we performed meta-analyses of 21 genome-wide association studies informative for fasting glucose, fasting insulin and indices of beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) in up to 46,186 nondiabetic participants. Follow-up of 25 loci in up to 76,558 additional subjects identified 16 loci associated with fasting glucose and HOMA-B and two loci associated with fasting insulin and HOMA-IR. These include nine loci newly associated with fasting glucose (in or near ADCY5, MADD, ADRA2A, CRY2, FADS1, GLIS3, SLC2A2, PROX1 and C2CD4B) and one influencing fasting insulin and HOMA-IR (near IGF1). We also demonstrated association of ADCY5, PROX1, GCK, GCKR and DGKB-TMEM195 with type 2 diabetes. Within these loci, likely biological candidate genes influence signal transduction, cell proliferation, development, glucose-sensing and circadian regulation. Our results demonstrate that genetic studies of glycemic traits can identify type 2 diabetes risk loci, as well as loci containing gene variants that are associated with a modest elevation in glucose levels but are not associated with overt diabetes.

%B Nat Genet %V 42 %P 105-16 %8 2010 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20081858?dopt=Abstract %R 10.1038/ng.520 %0 Journal Article %J Nat Genet %D 2010 %T New loci associated with kidney function and chronic kidney disease. %A Köttgen, Anna %A Pattaro, Cristian %A Böger, Carsten A %A Fuchsberger, Christian %A Olden, Matthias %A Glazer, Nicole L %A Parsa, Afshin %A Gao, Xiaoyi %A Yang, Qiong %A Smith, Albert V %A O'Connell, Jeffrey R %A Li, Man %A Schmidt, Helena %A Tanaka, Toshiko %A Isaacs, Aaron %A Ketkar, Shamika %A Hwang, Shih-Jen %A Johnson, Andrew D %A Dehghan, Abbas %A Teumer, Alexander %A Paré, Guillaume %A Atkinson, Elizabeth J %A Zeller, Tanja %A Lohman, Kurt %A Cornelis, Marilyn C %A Probst-Hensch, Nicole M %A Kronenberg, Florian %A Tönjes, Anke %A Hayward, Caroline %A Aspelund, Thor %A Eiriksdottir, Gudny %A Launer, Lenore J %A Harris, Tamara B %A Rampersaud, Evadnie %A Mitchell, Braxton D %A Arking, Dan E %A Boerwinkle, Eric %A Struchalin, Maksim %A Cavalieri, Margherita %A Singleton, Andrew %A Giallauria, Francesco %A Metter, Jeffrey %A de Boer, Ian H %A Haritunians, Talin %A Lumley, Thomas %A Siscovick, David %A Psaty, Bruce M %A Zillikens, M Carola %A Oostra, Ben A %A Feitosa, Mary %A Province, Michael %A de Andrade, Mariza %A Turner, Stephen T %A Schillert, Arne %A Ziegler, Andreas %A Wild, Philipp S %A Schnabel, Renate B %A Wilde, Sandra %A Munzel, Thomas F %A Leak, Tennille S %A Illig, Thomas %A Klopp, Norman %A Meisinger, Christa %A Wichmann, H-Erich %A Koenig, Wolfgang %A Zgaga, Lina %A Zemunik, Tatijana %A Kolcic, Ivana %A Minelli, Cosetta %A Hu, Frank B %A Johansson, Asa %A Igl, Wilmar %A Zaboli, Ghazal %A Wild, Sarah H %A Wright, Alan F %A Campbell, Harry %A Ellinghaus, David %A Schreiber, Stefan %A Aulchenko, Yurii S %A Felix, Janine F %A Rivadeneira, Fernando %A Uitterlinden, André G %A Hofman, Albert %A Imboden, Medea %A Nitsch, Dorothea %A Brandstätter, Anita %A Kollerits, Barbara %A Kedenko, Lyudmyla %A Mägi, Reedik %A Stumvoll, Michael %A Kovacs, Peter %A Boban, Mladen %A Campbell, Susan %A Endlich, Karlhans %A Völzke, Henry %A Kroemer, Heyo K %A Nauck, Matthias %A Völker, Uwe %A Polasek, Ozren %A Vitart, Veronique %A Badola, Sunita %A Parker, Alexander N %A Ridker, Paul M %A Kardia, Sharon L R %A Blankenberg, Stefan %A Liu, Yongmei %A Curhan, Gary C %A Franke, Andre %A Rochat, Thierry %A Paulweber, Bernhard %A Prokopenko, Inga %A Wang, Wei %A Gudnason, Vilmundur %A Shuldiner, Alan R %A Coresh, Josef %A Schmidt, Reinhold %A Ferrucci, Luigi %A Shlipak, Michael G %A van Duijn, Cornelia M %A Borecki, Ingrid %A Krämer, Bernhard K %A Rudan, Igor %A Gyllensten, Ulf %A Wilson, James F %A Witteman, Jacqueline C %A Pramstaller, Peter P %A Rettig, Rainer %A Hastie, Nick %A Chasman, Daniel I %A Kao, W H %A Heid, Iris M %A Fox, Caroline S %K Cohort Studies %K Creatinine %K Cystatin C %K Diet %K Europe %K Genetic Markers %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K Kidney %K Kidney Failure, Chronic %K Models, Genetic %K Risk Factors %X

Chronic kidney disease (CKD) is a significant public health problem, and recent genetic studies have identified common CKD susceptibility variants. The CKDGen consortium performed a meta-analysis of genome-wide association data in 67,093 individuals of European ancestry from 20 predominantly population-based studies in order to identify new susceptibility loci for reduced renal function as estimated by serum creatinine (eGFRcrea), serum cystatin c (eGFRcys) and CKD (eGFRcrea < 60 ml/min/1.73 m(2); n = 5,807 individuals with CKD (cases)). Follow-up of the 23 new genome-wide-significant loci (P < 5 x 10(-8)) in 22,982 replication samples identified 13 new loci affecting renal function and CKD (in or near LASS2, GCKR, ALMS1, TFDP2, DAB2, SLC34A1, VEGFA, PRKAG2, PIP5K1B, ATXN2, DACH1, UBE2Q2 and SLC7A9) and 7 loci suspected to affect creatinine production and secretion (CPS1, SLC22A2, TMEM60, WDR37, SLC6A13, WDR72 and BCAS3). These results further our understanding of the biologic mechanisms of kidney function by identifying loci that potentially influence nephrogenesis, podocyte function, angiogenesis, solute transport and metabolic functions of the kidney.

%B Nat Genet %V 42 %P 376-84 %8 2010 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/20383146?dopt=Abstract %R 10.1038/ng.568 %0 Journal Article %J Circulation %D 2010 %T Novel associations of multiple genetic loci with plasma levels of factor VII, factor VIII, and von Willebrand factor: The CHARGE (Cohorts for Heart and Aging Research in Genome Epidemiology) Consortium. %A Smith, Nicholas L %A Chen, Ming-Huei %A Dehghan, Abbas %A Strachan, David P %A Basu, Saonli %A Soranzo, Nicole %A Hayward, Caroline %A Rudan, Igor %A Sabater-Lleal, Maria %A Bis, Joshua C %A de Maat, Moniek P M %A Rumley, Ann %A Kong, Xiaoxiao %A Yang, Qiong %A Williams, Frances M K %A Vitart, Veronique %A Campbell, Harry %A Mälarstig, Anders %A Wiggins, Kerri L %A van Duijn, Cornelia M %A McArdle, Wendy L %A Pankow, James S %A Johnson, Andrew D %A Silveira, Angela %A McKnight, Barbara %A Uitterlinden, André G %A Aleksic, Nena %A Meigs, James B %A Peters, Annette %A Koenig, Wolfgang %A Cushman, Mary %A Kathiresan, Sekar %A Rotter, Jerome I %A Bovill, Edwin G %A Hofman, Albert %A Boerwinkle, Eric %A Tofler, Geoffrey H %A Peden, John F %A Psaty, Bruce M %A Leebeek, Frank %A Folsom, Aaron R %A Larson, Martin G %A Spector, Timothy D %A Wright, Alan F %A Wilson, James F %A Hamsten, Anders %A Lumley, Thomas %A Witteman, Jacqueline C M %A Tang, Weihong %A O'Donnell, Christopher J %K Adult %K Factor VII %K Factor VIII %K Female %K Genome-Wide Association Study %K Hemostasis %K Humans %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Thrombosis %K von Willebrand Factor %X

BACKGROUND: Plasma levels of coagulation factors VII (FVII), VIII (FVIII), and von Willebrand factor (vWF) influence risk of hemorrhage and thrombosis. We conducted genome-wide association studies to identify new loci associated with plasma levels.

METHODS AND RESULTS: The setting of the study included 5 community-based studies for discovery comprising 23 608 European-ancestry participants: Atherosclerosis Risk In Communities Study, Cardiovascular Health Study, British 1958 Birth Cohort, Framingham Heart Study, and Rotterdam Study. All subjects had genome-wide single-nucleotide polymorphism (SNP) scans and at least 1 phenotype measured: FVII activity/antigen, FVIII activity, and vWF antigen. Each study used its genotype data to impute to HapMap SNPs and independently conducted association analyses of hemostasis measures using an additive genetic model. Study findings were combined by meta-analysis. Replication was conducted in 7604 participants not in the discovery cohort. For FVII, 305 SNPs exceeded the genome-wide significance threshold of 5.0x10(-8) and comprised 5 loci on 5 chromosomes: 2p23 (smallest P value 6.2x10(-24)), 4q25 (3.6x10(-12)), 11q12 (2.0x10(-10)), 13q34 (9.0x10(-259)), and 20q11.2 (5.7x10(-37)). Loci were within or near genes, including 4 new candidate genes and F7 (13q34). For vWF, 400 SNPs exceeded the threshold and marked 8 loci on 6 chromosomes: 6q24 (1.2x10(-22)), 8p21 (1.3x10(-16)), 9q34 (<5.0x10(-324)), 12p13 (1.7x10(-32)), 12q23 (7.3x10(-10)), 12q24.3 (3.8x10(-11)), 14q32 (2.3x10(-10)), and 19p13.2 (1.3x10(-9)). All loci were within genes, including 6 new candidate genes, as well as ABO (9q34) and VWF (12p13). For FVIII, 5 loci were identified and overlapped vWF findings. Nine of the 10 new findings were replicated.

CONCLUSIONS: New genetic associations were discovered outside previously known biological pathways and may point to novel prevention and treatment targets of hemostasis disorders.

%B Circulation %V 121 %P 1382-92 %8 2010 Mar 30 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/20231535?dopt=Abstract %R 10.1161/CIRCULATIONAHA.109.869156 %0 Journal Article %J Neurobiol Aging %D 2010 %T Obesity is linked with lower brain volume in 700 AD and MCI patients. %A Ho, April J %A Raji, Cyrus A %A Becker, James T %A Lopez, Oscar L %A Kuller, Lewis H %A Hua, Xue %A Lee, Suh %A Hibar, Derrek %A Dinov, Ivo D %A Stein, Jason L %A Jack, Clifford R %A Weiner, Michael W %A Toga, Arthur W %A Thompson, Paul M %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Atrophy %K Body Mass Index %K Brain %K Cognition Disorders %K Cohort Studies %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Obesity %K Organ Size %K Prospective Studies %K Risk Factors %X

Obesity is associated with lower brain volumes in cognitively normal elderly subjects, but no study has yet investigated the effects of obesity on brain structure in patients with mild cognitive impairment (MCI) or Alzheimer's disease (AD). To determine if higher body mass index (BMI) is associated with brain volume deficits in cognitively impaired elderly subjects, we analyzed brain magnetic resonance imaging (MRI) scans of 700 MCI or AD patients from 2 different cohorts: the Alzheimer's Disease Neuroimaging Initiative (ADNI) and the Cardiovascular Health Study-Cognition Study (CHS-CS). Tensor-based morphometry (TBM) was used to create 3-dimensional maps of regional tissue excess or deficits in subjects with MCI (ADNI, n = 399; CHS-CS, n = 77) and AD (ADNI, n = 188; CHS, n = 36). In both AD and MCI groups, higher body mass index was associated with brain volume deficits in frontal, temporal, parietal, and occipital lobes; the atrophic pattern was consistent in both ADNI and CHS populations. Cardiovascular risk factors, especially obesity, should be considered as influencing brain structure in those already afflicted by cognitive impairment and dementia.

%B Neurobiol Aging %V 31 %P 1326-39 %8 2010 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/20570405?dopt=Abstract %R 10.1016/j.neurobiolaging.2010.04.006 %0 Journal Article %J Am J Respir Crit Care Med %D 2010 %T Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. %A Redline, Susan %A Yenokyan, Gayane %A Gottlieb, Daniel J %A Shahar, Eyal %A O'Connor, George T %A Resnick, Helaine E %A Diener-West, Marie %A Sanders, Mark H %A Wolf, Philip A %A Geraghty, Estella M %A Ali, Tauqeer %A Lebowitz, Michael %A Punjabi, Naresh M %K Aged %K Female %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Polysomnography %K Proportional Hazards Models %K Prospective Studies %K Severity of Illness Index %K Sex Factors %K Sleep Apnea, Obstructive %K Stroke %X

RATIONALE: Although obstructive sleep apnea is associated with physiological perturbations that increase risk of hypertension and are proatherogenic, it is uncertain whether sleep apnea is associated with increased stroke risk in the general population.

OBJECTIVES: To quantify the incidence of ischemic stroke with sleep apnea in a community-based sample of men and women across a wide range of sleep apnea.

METHODS: Baseline polysomnography was performed between 1995 and 1998 in a longitudinal cohort study. The primary exposure was the obstructive apnea-hypopnea index (OAHI) and outcome was incident ischemic stroke.

MEASUREMENTS AND MAIN RESULTS: A total of 5,422 participants without a history of stroke at the baseline examination and untreated for sleep apnea were followed for a median of 8.7 years. One hundred ninety-three ischemic strokes were observed. In covariate-adjusted Cox proportional hazard models, a significant positive association between ischemic stroke and OAHI was observed in men (P value for linear trend: P = 0.016). Men in the highest OAHI quartile (>19) had an adjusted hazard ratio of 2.86 (95% confidence interval, 1.1-7.4). In the mild to moderate range (OAHI, 5-25), each one-unit increase in OAHI in men was estimated to increase stroke risk by 6% (95% confidence interval, 2-10%). In women, stroke was not significantly associated with OAHI quartiles, but increased risk was observed at an OAHI greater than 25.

CONCLUSIONS: The strong adjusted association between ischemic stroke and OAHI in community-dwelling men with mild to moderate sleep apnea suggests that this is an appropriate target for future stroke prevention trials.

%B Am J Respir Crit Care Med %V 182 %P 269-77 %8 2010 Jul 15 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20339144?dopt=Abstract %R 10.1164/rccm.200911-1746OC %0 Journal Article %J J Aging Phys Act %D 2010 %T Physical activity and years of healthy life in older adults: results from the cardiovascular health study. %A Hirsch, Calvin H %A Diehr, Paula %A Newman, Anne B %A Gerrior, Shirley A %A Pratt, Charlotte %A Lebowitz, Michael D %A Jackson, Sharon A %K Activities of Daily Living %K Age Factors %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cohort Studies %K Exercise %K Female %K Health Behavior %K Health Status %K Humans %K Leisure Activities %K Life Style %K Male %K Quality-Adjusted Life Years %K Sex Factors %X

Little is known about how many years of life and disability-free years seniors can gain through exercise. Using data from the Cardiovascular Health Study, the authors estimated the extra years of life and self-reported healthy life (over 11 years) and years without impairment in activities of daily living (over 6 years) associated with quintiles of physical activity (PA) in older adults from different age groups. They estimated PA from the Minnesota Leisure Time Activities Questionnaire. Multivariable linear regression adjusted for health-related covariates. The relative gains in survival and years of healthy life (YHL) generally were proportionate to the amount of PA, greater among those 75+, and higher in men. Compared with being sedentary, the most active men 75+ had 1.49 more YHL (95% CI: 0.79, 2.19), and the most active women 75+ had 1.06 more YHL (95% CI: 0.44, 1.68). Seniors over age 74 experience the largest relative gains in survival and healthy life from physical activity.

%B J Aging Phys Act %V 18 %P 313-34 %8 2010 Jul %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20651417?dopt=Abstract %0 Journal Article %J Neurology %D 2010 %T Physical activity predicts gray matter volume in late adulthood: the Cardiovascular Health Study. %A Erickson, K I %A Raji, C A %A Lopez, O L %A Becker, J T %A Rosano, C %A Newman, A B %A Gach, H M %A Thompson, P M %A Ho, A J %A Kuller, L H %K Aged %K Aged, 80 and over %K Brain %K Brain Mapping %K Cardiovascular Diseases %K Cognition Disorders %K Female %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Mental Status Schedule %K Motor Activity %K Neuropsychological Tests %K Odds Ratio %K Predictive Value of Tests %K Surveys and Questionnaires %X

OBJECTIVES: Physical activity (PA) has been hypothesized to spare gray matter volume in late adulthood, but longitudinal data testing an association has been lacking. Here we tested whether PA would be associated with greater gray matter volume after a 9-year follow-up, a threshold could be identified for the amount of walking necessary to spare gray matter volume, and greater gray matter volume associated with PA would be associated with a reduced risk for cognitive impairment 13 years after the PA evaluation.

METHODS: In 299 adults (mean age 78 years) from the Cardiovascular Health Cognition Study, we examined the association between gray matter volume, PA, and cognitive impairment. Physical activity was quantified as the number of blocks walked over 1 week. High-resolution brain scans were acquired 9 years after the PA assessment on cognitively normal adults. White matter hyperintensities, ventricular grade, and other health variables at baseline were used as covariates. Clinical adjudication for cognitive impairment occurred 13 years after baseline.

RESULTS: Walking amounts ranged from 0 to 300 blocks (mean 56.3; SD 69.7). Greater PA predicted greater volumes of frontal, occipital, entorhinal, and hippocampal regions 9 years later. Walking 72 blocks was necessary to detect increased gray matter volume but walking more than 72 blocks did not spare additional volume. Greater gray matter volume with PA reduced the risk for cognitive impairment 2-fold.

CONCLUSION: Greater amounts of walking are associated with greater gray matter volume, which is in turn associated with a reduced risk of cognitive impairment.

%B Neurology %V 75 %P 1415-22 %8 2010 Oct 19 %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/20944075?dopt=Abstract %R 10.1212/WNL.0b013e3181f88359 %0 Journal Article %J Neuroepidemiology %D 2010 %T Post hoc Parkinson's disease: identifying an uncommon disease in the Cardiovascular Health Study. %A Ton, T G %A Jain, S %A Boudreau, R %A Thacker, E L %A Strotmeyer, E S %A Newman, A B %A Longstreth, W T %A Checkoway, H %K Aged %K Aged, 80 and over %K Cardiovascular System %K Cohort Studies %K Female %K Health Status %K Humans %K Incidence %K Male %K Odds Ratio %K Parkinson Disease %K Prevalence %K Prospective Studies %K Risk Factors %K Smoking %K Surveys and Questionnaires %K United States %X

BACKGROUND: Although ongoing cohort studies offer a unique opportunity to apply existing information collected prospectively to further the scientific understanding of Parkinson's disease (PD), they typically have limited information for clinical diagnosis.

METHODS: We used combinations of self-report, International Classification of Diseases - 9th edition codes and antiparkinsonian medications to identify PD in the Cardiovascular Health Study. To determine whether the expected inverse association between smoking and PD is evident using our outcome definitions, we assessed baseline smoking characteristics for various definitions of PD.

RESULTS: We identified 60 cases with prevalent PD (1.0%; 95% confidence interval, CI = 0.8-1.3%) and 154 with incident PD by year 14. Clear associations were observed for current smokers (odds ratio, OR = 0.50; 95% CI = 0.26-0.95) and for those who smoked ≥50 pack-years (OR = 0.53; 95% CI = 0.29-0.96). Estimates for smoking were similar when ≥2 data sources were required. Estimates for self-report alone were attenuated towards null.

CONCLUSIONS: Using multiple data sources to identify PD represents an alternative method of outcome identification in a cohort that would otherwise not be possible for PD research. Ongoing cohort studies can provide settings in which rapid replication and explorations of new hypotheses for PD are possible.

%B Neuroepidemiology %V 35 %P 241-9 %8 2010 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/20881426?dopt=Abstract %R 10.1159/000319895 %0 Journal Article %J Stroke %D 2010 %T Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis. %A de Weerd, Marjolein %A Greving, Jacoba P %A Hedblad, Bo %A Lorenz, Matthias W %A Mathiesen, Ellisiv B %A O'Leary, Daniel H %A Rosvall, Maria %A Sitzer, Matthias %A Buskens, Erik %A Bots, Michiel L %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Carotid Stenosis %K Female %K Humans %K Male %K Mass Screening %K Middle Aged %K Prevalence %K Severity of Illness Index %K Sex Factors %X

BACKGROUND AND PURPOSE: In the discussion on the cost-effectiveness of screening, precise estimates of severe asymptomatic carotid stenosis are vital. Accordingly, we assessed the prevalence of moderate and severe asymptomatic carotid stenosis by age and sex using pooled cohort data.

METHODS: We performed an individual participant data meta-analysis (23 706 participants) of 4 population-based studies (Malmö Diet and Cancer Study, Tromsø, Carotid Atherosclerosis Progression Study, and Cardiovascular Health Study). Outcomes of interest were asymptomatic moderate (> or =50%) and severe carotid stenosis (> or =70%).

RESULTS: Prevalence of moderate asymptomatic carotid stenosis ranged from 0.2% (95% CI, 0.0% to 0.4%) in men aged <50 years to 7.5% (5.2% to 10.5%) in men aged > or =80 years. For women, this prevalence increased from 0% (0% to 0.2%) to 5.0% (3.1% to 7.5%). Prevalence of severe asymptomatic carotid stenosis ranged from 0.1% (0.0% to 0.3%) in men aged <50 years to 3.1% (1.7% to 5.3%) in men aged > or =80. For women, this prevalence increased from 0% (0.0% to 0.2%) to 0.9% (0.3% to 2.4%).

CONCLUSIONS: The prevalence of severe asymptomatic carotid stenosis in the general population ranges from 0% to 3.1%, which is useful information in the discussion on the cost-effectiveness of screening.

%B Stroke %V 41 %P 1294-7 %8 2010 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/20431077?dopt=Abstract %R 10.1161/STROKEAHA.110.581058 %0 Journal Article %J Thromb Haemost %D 2010 %T Serum albumin and risk of venous thromboembolism. %A Folsom, Aaron R %A Lutsey, Pamela L %A Heckbert, Susan R %A Cushman, Mary %K Aged %K Biomarkers %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Middle Aged %K Risk Factors %K Serum Albumin %K United States %K Venous Thromboembolism %X

The incidence of venous thromboembolism (VTE) is increased in patients with albuminuria. However, whether a low serum albumin concentration is associated with increased risk of VTE has been a matter of controversy. We determined the association of serum albumin with VTE incidence in two large, prospective, population-based cohorts: the Atherosclerosis Risk in Communities (ARIC) Study (n = 15,300) and the Cardiovascular Health Study (CHS) (n = 5,400). Validated VTE occurrence (n = 462 in ARIC and n = 174 in CHS) was ascertained during follow-up. In both studies, after adjustment for age, sex, race, use of hormone replacement therapy, estimated glomerular filtration rate, history of cancer, and diabetes, serum albumin tended to be associated inversely with VTE. The adjusted hazard ratio per standard deviation lower albumin was 1.18 (95% confidence interval [CI] = 1.08, 1.31) in ARIC and 1.10 (95% CI = 0.94, 1.29) in CHS. The hazard ratio for albumin below (vs. above) the fifth percentile was 1.28 (95% CI = 0.90, 1.84) in ARIC and 1.80 (95% CI = 1.11, 2.93) in CHS. In conclusion, low serum albumin was a modest marker of increased VTE risk. The observed association likely does not reflect cause and effect, but rather that low serum albumin reflects a hyperinflammatory or hypercoagulable state. Whether this association has clinical relevance warrants further study.

%B Thromb Haemost %V 104 %P 100-4 %8 2010 Jul %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20390234?dopt=Abstract %R 10.1160/TH09-12-0856 %0 Journal Article %J Clin Transl Sci %D 2010 %T Study of the relationship between the interleukin-6 gene and obstructive sleep apnea. %A Larkin, Emma K %A Patel, Sanjay R %A Zhu, Xiaofeng %A Tracy, Russell P %A Jenny, Nancy S %A Reiner, Alex P %A Walston, Jeremy %A Redline, Susan %K Adult %K African Americans %K Alleles %K Female %K Humans %K Interleukin-6 %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Sleep Apnea, Obstructive %B Clin Transl Sci %V 3 %P 337-9 %8 2010 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21207764?dopt=Abstract %0 Journal Article %J Arch Intern Med %D 2010 %T Subclinical thyroid dysfunction and incident hip fracture in older adults. %A Lee, Jennifer S %A Bůzková, Petra %A Fink, Howard A %A Vu, Joseph %A Carbone, Laura %A Chen, Zhao %A Cauley, Jane %A Bauer, Doug C %A Cappola, Anne R %A Robbins, John %K Aged %K Female %K Follow-Up Studies %K Hip Fractures %K Humans %K Hyperthyroidism %K Hypothyroidism %K Incidence %K Male %K Multivariate Analysis %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Sex Distribution %K Thyrotropin %K United States %X

BACKGROUND: Subclinical thyroid dysfunction is common in older adults and affects bone metabolism, but its effects on fracture risk have not been reported. We sought to determine prospectively whether older men and women with subclinical hyperthyroidism or hypothyroidism have an increased risk of hip fracture.

METHODS: Prospective cohort of 3567 US community-dwelling adults, 65 years or older, with biochemically defined subclinical thyroid dysfunction or euthyroidism was enrolled from June 10, 1989, through May 30, 1990, and followed up through 2004. Main outcome measures included incidence and hazard ratios (HRs), with 95% confidence intervals (CIs), of confirmed incident hip fractures for groups with subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroidism as defined at baseline.

RESULTS: During 39 952 person-years (median follow-up, 13 years), hip fracture incidence (per 1000 men-years) was 13.65 in men with subclinical hyperthyroidism (n = 29) and 10.27 in men with subclinical hypothyroidism (n = 184), both greater than 5.0 in men with euthyroidism (n = 1159). Men with subclinical hypothyroidism had a multivariable-adjusted HR of 2.31 (95% CI, 1.25-4.27); those with subclinical hyperthyroidism, 3.27 (0.99-11.30). After excluding those with baseline use of thyroid-altering medications, men with endogenous subclinical hyperthyroidism had a higher HR of 4.91 (95% CI, 1.13-21.27), as did men with endogenous subclinical hypothyroidism (2.45, 1.27-4.73). Hip fracture incidence (per 1000 women-years) was 8.93 in women with subclinical hypothyroidism (n = 359) and 10.90 in women with subclinical hyperthyroidism (n = 142) compared with 10.18 in women with euthyroidism (n = 1694). No clear association between subclinical dysfunction and fracture was observed in women.

CONCLUSIONS: Older men with subclinical hyperthyroidism or hypothyroidism are at increased risk for hip fracture. Whether treatment of the subclinical syndrome reduces this risk is unknown.

%B Arch Intern Med %V 170 %P 1876-83 %8 2010 Nov 22 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/21098345?dopt=Abstract %R 10.1001/archinternmed.2010.424 %0 Journal Article %J Ann Intern Med %D 2010 %T Trans-palmitoleic acid, metabolic risk factors, and new-onset diabetes in U.S. adults: a cohort study. %A Mozaffarian, Dariush %A Cao, Haiming %A King, Irena B %A Lemaitre, Rozenn N %A Song, Xiaoling %A Siscovick, David S %A Hotamisligil, Gökhan S %K Adiposity %K Aged %K C-Reactive Protein %K Cholesterol %K Cholesterol, HDL %K Dairy Products %K Diabetes Mellitus, Type 2 %K Fatty Acids, Monounsaturated %K Feeding Behavior %K Female %K Humans %K Incidence %K Insulin Resistance %K Male %K Prospective Studies %K Risk Factors %K Triglycerides %K United States %X

BACKGROUND: Palmitoleic acid (cis-16:1n-7), which is produced by endogenous fat synthesis, has been linked to both beneficial and deleterious metabolic effects, potentially confounded by diverse determinants and tissue sources of endogenous production. Trans-palmitoleate (trans-16:1n-7) represents a distinctly exogenous source of 16:1n-7, unconfounded by endogenous synthesis or its determinants, that may be uniquely informative.

OBJECTIVE: To investigate whether circulating trans-palmitoleate is independently related to lower metabolic risk and incident type 2 diabetes.

DESIGN: Prospective cohort study from 1992 to 2006.

SETTING: Four U.S. communities.

PATIENTS: 3736 adults in the Cardiovascular Health Study.

MEASUREMENTS: Anthropometric characteristics and levels of plasma phospholipid fatty acids, blood lipids, inflammatory markers, and glucose-insulin measured at baseline in 1992 and dietary habits measured 3 years earlier. Multivariate-adjusted models were used to investigate how demographic, clinical, and lifestyle factors independently related to plasma phospholipid trans-palmitoleate; how trans-palmitoleate related to major metabolic risk factors; and how trans-palmitoleate related to new-onset diabetes (304 incident cases). Findings were validated for metabolic risk factors in an independent cohort of 327 women.

RESULTS: In multivariate analyses, whole-fat dairy consumption was most strongly associated with higher trans-palmitoleate levels. Higher trans-palmitoleate levels were associated with slightly lower adiposity and, independently, with higher high-density lipoprotein cholesterol levels (1.9% across quintiles; P = 0.040), lower triglyceride levels (-19.0%; P < 0.001), a lower total cholesterol-HDL cholesterol ratio (-4.7%; P < 0.001), lower C-reactive protein levels (-13.8%; P = 0.05), and lower insulin resistance (-16.7%, P < 0.001). Trans-palmitoleate was also associated with a substantially lower incidence of diabetes, with multivariate hazard ratios of 0.41 (95% CI, 0.27 to 0.64) and 0.38 (CI, 0.24 to 0.62) in quintiles 4 and 5 versus quintile 1 (P for trend < 0.001). Findings were independent of estimated dairy consumption or other fatty acid dairy biomarkers. Protective associations with metabolic risk factors were confirmed in the validation cohort.

LIMITATION: Results could be affected by measurement error or residual confounding.

CONCLUSION: Circulating trans-palmitoleate is associated with lower insulin resistance, presence of atherogenic dyslipidemia, and incident diabetes. Our findings may explain previously observed metabolic benefits of dairy consumption and support the need for detailed further experimental and clinical investigation.

PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

%B Ann Intern Med %V 153 %P 790-9 %8 2010 Dec 21 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21173413?dopt=Abstract %R 10.7326/0003-4819-153-12-201012210-00005 %0 Journal Article %J Lancet %D 2010 %T Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. %A Sarwar, Nadeem %A Sandhu, Manjinder S %A Ricketts, Sally L %A Butterworth, Adam S %A Di Angelantonio, Emanuele %A Boekholdt, S Matthijs %A Ouwehand, Willem %A Watkins, Hugh %A Samani, Nilesh J %A Saleheen, Danish %A Lawlor, Debbie %A Reilly, Muredach P %A Hingorani, Aroon D %A Talmud, Philippa J %A Danesh, John %K Apolipoprotein A-V %K Apolipoproteins %K Apolipoproteins A %K Coronary Disease %K Gene Frequency %K Genotype %K Humans %K Lipids %K Lipoproteins, HDL %K Lipoproteins, LDL %K Lipoproteins, VLDL %K Mendelian Randomization Analysis %K Particle Size %K Polymorphism, Single Nucleotide %K Promoter Regions, Genetic %K Risk Factors %K Triglycerides %X

BACKGROUND: Whether triglyceride-mediated pathways are causally relevant to coronary heart disease is uncertain. We studied a genetic variant that regulates triglyceride concentration to help judge likelihood of causality.

METHODS: We assessed the -1131T>C (rs662799) promoter polymorphism of the apolipoprotein A5 (APOA5) gene in relation to triglyceride concentration, several other risk factors, and risk of coronary heart disease. We compared disease risk for genetically-raised triglyceride concentration (20,842 patients with coronary heart disease, 35,206 controls) with that recorded for equivalent differences in circulating triglyceride concentration in prospective studies (302 430 participants with no history of cardiovascular disease; 12,785 incident cases of coronary heart disease during 2.79 million person-years at risk). We analysed -1131T>C in 1795 people without a history of cardiovascular disease who had information about lipoprotein concentration and diameter obtained by nuclear magnetic resonance spectroscopy.

FINDINGS: The minor allele frequency of -1131T>C was 8% (95% CI 7-9). -1131T>C was not significantly associated with several non-lipid risk factors or LDL cholesterol, and it was modestly associated with lower HDL cholesterol (mean difference per C allele 3.5% [95% CI 2.6-4.6]; 0.053 mmol/L [0.039-0.068]), lower apolipoprotein AI (1.3% [0.3-2.3]; 0.023 g/L [0.005-0.041]), and higher apolipoprotein B (3.2% [1.3-5.1]; 0.027 g/L [0.011-0.043]). By contrast, for every C allele inherited, mean triglyceride concentration was 16.0% (95% CI 12.9-18.7), or 0.25 mmol/L (0.20-0.29), higher (p=4.4x10(-24)). The odds ratio for coronary heart disease was 1.18 (95% CI 1.11-1.26; p=2.6x10(-7)) per C allele, which was concordant with the hazard ratio of 1.10 (95% CI 1.08-1.12) per 16% higher triglyceride concentration recorded in prospective studies. -1131T>C was significantly associated with higher VLDL particle concentration (mean difference per C allele 12.2 nmol/L [95% CI 7.7-16.7]; p=9.3x10(-8)) and smaller HDL particle size (0.14 nm [0.08-0.20]; p=7.0x10(-5)), factors that could mediate the effects of triglyceride.

INTERPRETATION: These data are consistent with a causal association between triglyceride-mediated pathways and coronary heart disease.

FUNDING: British Heart Foundation, UK Medical Research Council, Novartis.

%B Lancet %V 375 %P 1634-9 %8 2010 May 08 %G eng %N 9726 %1 http://www.ncbi.nlm.nih.gov/pubmed/20452521?dopt=Abstract %R 10.1016/S0140-6736(10)60545-4 %0 Journal Article %J Sleep %D 2010 %T Utility of sleep stage transitions in assessing sleep continuity. %A Laffan, Alison %A Caffo, Brian %A Swihart, Bruce J %A Punjabi, Naresh M %K Age Factors %K Aged %K Arousal %K Body Mass Index %K Cohort Studies %K Female %K Humans %K Male %K Middle Aged %K Polysomnography %K Predictive Value of Tests %K Risk Factors %K Sex Factors %K Sleep Stages %K Sleep Wake Disorders %X

STUDY OBJECTIVES: Sleep continuity is commonly assessed with polysomnographic measures such as sleep efficiency, sleep stage percentages, and the arousal index. The aim of this study was to examine whether the transition rate between different sleep stages could be used as an index of sleep continuity to predict self-reported sleep quality independent of other commonly used metrics.

DESIGN AND SETTING: Analysis of the Sleep Heart Health Study polysomnographic data.

PARTICIPANTS: A community cohort.

MEASUREMENTS AND RESULTS: Sleep recordings on 5,684 participants were deemed to be of sufficient quality to allow visual scoring of NREM and REM sleep. For each participant, we tabulated the frequency of transitions between wake, NREM sleep, and REM sleep. An overall transition rate was determined as the number of all transitions per hour sleep. Stage-specific transition rates between wake, NREM sleep, and REM sleep were also determined. A 5-point Likert scale was used to assess the subjective experience of restless and light sleep the morning after the sleep study. Multivariable regression models showed that a high overall sleep stage transition rate was associated with restless and light sleep independent of several covariates including total sleep time, percentages of sleep stages, wake time after sleep onset, and the arousal index. Compared to the lowest quartile of the overall transition rate (<7.76 events/h), the odds ratios for restless sleep were 1.27, 1.42, and 1.38, for the second (7.77-10.10 events/h), third (10.11-13.34 events/h), and fourth (≥13.35 events/h) quartiles, respectively. Analysis of stage-specific transition rates showed that transitions between wake and NREM sleep were also independently associated with restless and light sleep.

CONCLUSIONS: Assessing overall and stage-specific transition rates provides a complementary approach for assessing sleep continuity. Incorporating such measures, along with conventional metrics, could yield useful insights into the significance of sleep continuity for clinical outcomes.

%B Sleep %V 33 %P 1681-6 %8 2010 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21120130?dopt=Abstract %0 Journal Article %J Arch Intern Med %D 2010 %T Validation of an atrial fibrillation risk algorithm in whites and African Americans. %A Schnabel, Renate B %A Aspelund, Thor %A Li, Guo %A Sullivan, Lisa M %A Suchy-Dicey, Astrid %A Harris, Tamara B %A Pencina, Michael J %A D'Agostino, Ralph B %A Levy, Daniel %A Kannel, William B %A Wang, Thomas J %A Kronmal, Richard A %A Wolf, Philip A %A Burke, Gregory L %A Launer, Lenore J %A Vasan, Ramachandran S %A Psaty, Bruce M %A Benjamin, Emelia J %A Gudnason, Vilmundur %A Heckbert, Susan R %K African Continental Ancestry Group %K Age Factors %K Aged %K Aged, 80 and over %K Algorithms %K Atrial Fibrillation %K Blood Pressure %K Body Mass Index %K Cohort Studies %K Electrocardiography %K Europe %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Hypertension %K Incidence %K Kaplan-Meier Estimate %K Male %K Middle Aged %K Proportional Hazards Models %K Risk Factors %K Sex Factors %K Systole %K United States %X

BACKGROUND: We sought to validate a recently published risk algorithm for incident atrial fibrillation (AF) in independent cohorts and other racial groups.

METHODS: We evaluated the performance of a Framingham Heart Study (FHS)-derived risk algorithm modified for 5-year incidence of AF in the FHS (n = 4764 participants) and 2 geographically and racially diverse cohorts in the age range 45 to 95 years: AGES (the Age, Gene/Environment Susceptibility-Reykjavik Study) (n = 4238) and CHS (the Cardiovascular Health Study) (n = 5410, of whom 874 [16.2%] were African Americans). The risk algorithm included age, sex, body mass index, systolic blood pressure, electrocardiographic PR interval, hypertension treatment, and heart failure.

RESULTS: We found 1359 incident AF events in 100 074 person-years of follow-up. Unadjusted 5-year event rates differed by cohort (AGES, 12.8 cases/1000 person-years; CHS whites, 22.7 cases/1000 person-years; and FHS, 4.5 cases/1000 person-years) and by race (CHS African Americans, 18.4 cases/1000 person-years). The strongest risk factors in all samples were age and heart failure. The relative risks for incident AF associated with risk factors were comparable across cohorts and race groups. After recalibration for baseline incidence and risk factor distribution, the Framingham algorithm, reported in C statistic, performed reasonably well in all samples: AGES, 0.67 (95% confidence interval [CI], 0.64-0.71); CHS whites, 0.68 (95% CI, 0.66-0.70); and CHS African Americans, 0.66 (95% CI, 0.61-0.71). Risk factors combined in the algorithm explained between 47.0% (AGES) and 63.6% (FHS) of the population-attributable risk.

CONCLUSIONS: Risk of incident AF in community-dwelling whites and African Americans can be assessed reliably by routinely available and potentially modifiable clinical variables. Seven risk factors accounted for up to 64% of risk.

%B Arch Intern Med %V 170 %P 1909-17 %8 2010 Nov 22 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/21098350?dopt=Abstract %R 10.1001/archinternmed.2010.434 %0 Journal Article %J J Am Coll Cardiol %D 2011 %T Association of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults: the cardiovascular health study. %A Rodriguez, Carlos J %A Bartz, Traci M %A Longstreth, W T %A Kizer, Jorge R %A Barasch, Eddy %A Lloyd-Jones, Donald M %A Gottdiener, John S %K Aged %K Aortic Valve Stenosis %K Brain %K Brain Infarction %K Calcinosis %K Cohort Studies %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Mitral Valve Stenosis %K Retrospective Studies %X

OBJECTIVES: The objective of this study was to investigate the associations of mitral annular calcification, aortic annular calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)-defined brain infarcts.

BACKGROUND: Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular calcifications are suspected as risk factors for clinical ischemic stroke.

METHODS: A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995).

RESULTS: The mean age of the participants was 74.5 ± 4.8 years, and 39.3% were men. The presence of any annular or valvular calcification (mitral annular calcification, aortic annular calcification, or aortic valve sclerosis), mitral annular calcification alone, or aortic annular calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p < 0.01 for all). In models adjusted for age, sex, race, body mass index, physical activity, creatinine, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, diabetes, coronary heart disease, and congestive heart failure, the presence of any annular or valve calcification remained associated with covert brain infarcts (risk ratio: 1.24; 95% confidence interval: 1.05 to 1.47). The degree of annular or valvular calcification severity showed a direct relation with the presence of covert MRI findings.

CONCLUSIONS: Left-sided cardiac annular and valvular calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke.

%B J Am Coll Cardiol %V 57 %P 2172-80 %8 2011 May 24 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/21596233?dopt=Abstract %R 10.1016/j.jacc.2011.01.034 %0 Journal Article %J J Thromb Haemost %D 2011 %T Association of coagulation-related and inflammation-related genes and factor VIIc levels with stroke: the Cardiovascular Health Study. %A Zakai, N A %A Lange, L %A Longstreth, W T %A O'Meara, E S %A Kelley, J L %A Fornage, M %A Nikerson, D %A Cushman, M %A Reiner, A P %K Blood Coagulation Factors %K Cardiovascular Diseases %K Cohort Studies %K Factor VII %K Female %K Humans %K Inflammation %K Male %K Polymorphism, Single Nucleotide %K Prospective Studies %K Risk Factors %K Stroke %X

BACKGROUND: Thrombosis and inflammation are critical in stroke etiology, but associations of coagulation and inflammation gene variants with stroke, and particularly factor VII levels, are inconclusive.

OBJECTIVES: To test the associations between 736 single-nucleotide polymorphisms (SNPs) between tagging haplotype patterns of 130 coagulation and inflammation genes, and stroke events, in the 5888 participants aged ≥ 65 years of the observational Cardiovascular Health Study cohort.

PATIENTS/METHODS: With 16 years of follow-up, age-adjusted and sex-adjusted Cox models were used to estimate associations of SNPs and FVIIc levels with future stroke.

RESULTS: Eight hundred and fifteen strokes occurred in 5255 genotyped participants without baseline stroke (748 ischemic strokes; 586 among whites). Among whites, six SNPs were associated with stroke, with a nominal P-value of < 0.01: rs6046 and rs3093261 (F7); rs4918851 and rs3781387 (HABP2); and rs3138055 (NFKB1A) and rs4648004 (NFKB1). Two of these SNPs were associated with FVIIc levels (units of percentage activity): rs6046 (β = -18.5, P = 2.38 × 10(-83)) and rs3093261 (β = 2.99, P = 3.93 × 10(-6)). After adjustment for age, sex, race, and cardiovascular risk factors, the association of FVIIc quintiles (Q) with stroke were as follows (hazard ratio; 95% confidence interval): Q1, reference; Q2, 1.4, 1.1-1.9); Q3, 1.1, 0.8-1.5); Q4, 1.5, 1.1-2.0); and Q5, 1.6, 1.2-2.2). Associations between SNPs and stroke were independent of FVIIc levels.

CONCLUSIONS: Variations in FVII-related genes and FVIIc levels were associated with risk of incident ischemic stroke in this elderly cohort, suggesting a potential causal role for FVII in stroke etiology.

%B J Thromb Haemost %V 9 %P 267-74 %8 2011 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/21114618?dopt=Abstract %R 10.1111/j.1538-7836.2010.04149.x %0 Journal Article %J PLoS Genet %D 2011 %T Association of eGFR-Related Loci Identified by GWAS with Incident CKD and ESRD. %A Böger, Carsten A %A Gorski, Mathias %A Li, Man %A Hoffmann, Michael M %A Huang, Chunmei %A Yang, Qiong %A Teumer, Alexander %A Krane, Vera %A O'Seaghdha, Conall M %A Kutalik, Zoltán %A Wichmann, H-Erich %A Haak, Thomas %A Boes, Eva %A Coassin, Stefan %A Coresh, Josef %A Kollerits, Barbara %A Haun, Margot %A Paulweber, Bernhard %A Köttgen, Anna %A Li, Guo %A Shlipak, Michael G %A Powe, Neil %A Hwang, Shih-Jen %A Dehghan, Abbas %A Rivadeneira, Fernando %A Uitterlinden, Andre %A Hofman, Albert %A Beckmann, Jacques S %A Krämer, Bernhard K %A Witteman, Jacqueline %A Bochud, Murielle %A Siscovick, David %A Rettig, Rainer %A Kronenberg, Florian %A Wanner, Christoph %A Thadhani, Ravi I %A Heid, Iris M %A Fox, Caroline S %A Kao, W H %K Adaptor Proteins, Signal Transducing %K Adult %K Aged %K Chronic Disease %K Creatinine %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Genetic Association Studies %K Humans %K Kidney Diseases %K Kidney Failure, Chronic %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Receptor, Epidermal Growth Factor %K Uromodulin %X

Family studies suggest a genetic component to the etiology of chronic kidney disease (CKD) and end stage renal disease (ESRD). Previously, we identified 16 loci for eGFR in genome-wide association studies, but the associations of these single nucleotide polymorphisms (SNPs) for incident CKD or ESRD are unknown. We thus investigated the association of these loci with incident CKD in 26,308 individuals of European ancestry free of CKD at baseline drawn from eight population-based cohorts followed for a median of 7.2 years (including 2,122 incident CKD cases defined as eGFR <60ml/min/1.73m(2) at follow-up) and with ESRD in four case-control studies in subjects of European ancestry (3,775 cases, 4,577 controls). SNPs at 11 of the 16 loci (UMOD, PRKAG2, ANXA9, DAB2, SHROOM3, DACH1, STC1, SLC34A1, ALMS1/NAT8, UBE2Q2, and GCKR) were associated with incident CKD; p-values ranged from p = 4.1e-9 in UMOD to p = 0.03 in GCKR. After adjusting for baseline eGFR, six of these loci remained significantly associated with incident CKD (UMOD, PRKAG2, ANXA9, DAB2, DACH1, and STC1). SNPs in UMOD (OR = 0.92, p = 0.04) and GCKR (OR = 0.93, p = 0.03) were nominally associated with ESRD. In summary, the majority of eGFR-related loci are either associated or show a strong trend towards association with incident CKD, but have modest associations with ESRD in individuals of European descent. Additional work is required to characterize the association of genetic determinants of CKD and ESRD at different stages of disease progression.

%B PLoS Genet %V 7 %P e1002292 %8 2011 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/21980298?dopt=Abstract %R 10.1371/journal.pgen.1002292 %0 Journal Article %J Circ Cardiovasc Genet %D 2011 %T Association of genetic variants and incident coronary heart disease in multiethnic cohorts: the PAGE study. %A Franceschini, Nora %A Carty, Cara %A Bůzková, Petra %A Reiner, Alex P %A Garrett, Tiana %A Lin, Yi %A Vöckler, Jens-S %A Hindorff, Lucia A %A Cole, Shelley A %A Boerwinkle, Eric %A Lin, Dan-Yu %A Bookman, Ebony %A Best, Lyle G %A Bella, Jonathan N %A Eaton, Charles %A Greenland, Philip %A Jenny, Nancy %A North, Kari E %A Taverna, Darin %A Young, Alicia M %A Deelman, Ewa %A Kooperberg, Charles %A Psaty, Bruce %A Heiss, Gerardo %K Aged %K Aged, 80 and over %K Continental Population Groups %K Coronary Disease %K Female %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Prospective Studies %X

BACKGROUND: Genome-wide association studies identified several single nucleotide polymorphisms (SNP) associated with prevalent coronary heart disease (CHD), but less is known of associations with incident CHD. The association of 13 published CHD SNPs was examined in 5 ancestry groups of 4 large US prospective cohorts.

METHODS AND RESULTS: The analyses included incident coronary events over an average 9.1 to 15.7 follow-up person-years in up to 26 617 white individuals (6626 events), 8018 black individuals (914 events), 1903 Hispanic individuals (113 events), 3669 American Indian individuals (595 events), and 885 Asian/Pacific Islander individuals (66 events). We used Cox proportional hazards models (with additive mode of inheritance) adjusted for age, sex, and ancestry (as needed). Nine loci were statistically associated with incident CHD events in white participants: 9p21 (rs10757278; P=4.7 × 10(-41)), 16q23.1 (rs2549513; P=0.0004), 6p24.1 (rs499818; P=0.0002), 2q36.3 (rs2943634; P=6.7 × 10(-6)), MTHFD1L (rs6922269, P=5.1 × 10(-10)), APOE (rs429358; P=2.7×10(-18)), ZNF627 (rs4804611; P=5.0 × 10(-8)), CXCL12 (rs501120; P=1.4 × 10(-6)) and LPL (rs268; P=2.7 × 10(-17)). The 9p21 region showed significant between-study heterogeneity, with larger effects in individuals age 55 years or younger and in women. Inclusion of coronary revascularization procedures among the incident CHD events introduced heterogeneity. The SNPs were not associated with CHD in black participants, and associations varied in other US minorities.

CONCLUSIONS: Prospective analyses of white participants replicated several reported cross-sectional CHD-SNP associations.

%B Circ Cardiovasc Genet %V 4 %P 661-72 %8 2011 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22042884?dopt=Abstract %R 10.1161/CIRCGENETICS.111.960096 %0 Journal Article %J Hum Mol Genet %D 2011 %T Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study. %A Fox, Ervin R %A Young, J Hunter %A Li, Yali %A Dreisbach, Albert W %A Keating, Brendan J %A Musani, Solomon K %A Liu, Kiang %A Morrison, Alanna C %A Ganesh, Santhi %A Kutlar, Abdullah %A Ramachandran, Vasan S %A Polak, Josef F %A Fabsitz, Richard R %A Dries, Daniel L %A Farlow, Deborah N %A Redline, Susan %A Adeyemo, Adebowale %A Hirschorn, Joel N %A Sun, Yan V %A Wyatt, Sharon B %A Penman, Alan D %A Palmas, Walter %A Rotter, Jerome I %A Townsend, Raymond R %A Doumatey, Ayo P %A Tayo, Bamidele O %A Mosley, Thomas H %A Lyon, Helen N %A Kang, Sun J %A Rotimi, Charles N %A Cooper, Richard S %A Franceschini, Nora %A Curb, J David %A Martin, Lisa W %A Eaton, Charles B %A Kardia, Sharon L R %A Taylor, Herman A %A Caulfield, Mark J %A Ehret, Georg B %A Johnson, Toby %A Chakravarti, Aravinda %A Zhu, Xiaofeng %A Levy, Daniel %K Adult %K African Americans %K Aged %K Blood Pressure %K Cohort Studies %K Diastole %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Humans %K Hypertension %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Systole %X

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10(-8)) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10(-8)). The top IBC association for SBP was rs2012318 (P= 6.4 × 10(-6)) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10(-6)) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity.

%B Hum Mol Genet %V 20 %P 2273-84 %8 2011 Jun 01 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/21378095?dopt=Abstract %R 10.1093/hmg/ddr092 %0 Journal Article %J Blood %D 2011 %T Association of genomic loci from a cardiovascular gene SNP array with fibrinogen levels in European Americans and African-Americans from six cohort studies: the Candidate Gene Association Resource (CARe). %A Wassel, Christina L %A Lange, Leslie A %A Keating, Brendan J %A Taylor, Kira C %A Johnson, Andrew D %A Palmer, Cameron %A Ho, Lindsey A %A Smith, Nicholas L %A Lange, Ethan M %A Li, Yun %A Yang, Qiong %A Delaney, Joseph A %A Tang, Weihong %A Tofler, Geoffrey %A Redline, Susan %A Taylor, Herman A %A Wilson, James G %A Tracy, Russell P %A Jacobs, David R %A Folsom, Aaron R %A Green, David %A O'Donnell, Christopher J %A Reiner, Alexander P %K Adult %K African Americans %K Aged %K Cardiovascular Diseases %K Cohort Studies %K European Continental Ancestry Group %K Female %K Fibrinogen %K Genetic Predisposition to Disease %K Haplotypes %K Humans %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Risk Factors %X

Several common genomic loci, involving various immunity- and metabolism-related genes, have been associated with plasma fibrinogen in European Americans (EAs). The genetic determinants of fibrinogen in African Americans (AAs) are poorly characterized. Using a vascular gene-centric array in 23,634 EA and 6657 AA participants from 6 studies comprising the Candidate Gene Association Resource project, we examined the association of 47,539 common and lower frequency variants with fibrinogen concentration. We identified a rare Pro265Leu variant in FGB (rs6054) associated with lower fibrinogen. Common fibrinogen gene single nucleotide polymorphisms (FGB rs1800787 and FGG rs2066861) significantly associated with fibrinogen in EAs were prevalent in AAs and showed consistent associations. Several fibrinogen locus single nucleotide polymorphism associated with lower fibrinogen were exclusive to AAs; these include a newly reported association with FGA rs10050257. For IL6R, IL1RN, and NLRP3 inflammatory gene loci, associations with fibrinogen were concordant between EAs and AAs, but not at other loci (CPS1, PCCB, and SCL22A5-IRF1). The association of FGG rs2066861 with fibrinogen differed according to assay type used to measure fibrinogen. Further characterization of common and lower-frequency genetic variants that contribute to interpopulation differences in fibrinogen phenotype may help refine our understanding of the contribution of hemostasis and inflammation to atherothrombotic risk.

%B Blood %V 117 %P 268-75 %8 2011 Jan 06 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20978265?dopt=Abstract %R 10.1182/blood-2010-06-289546 %0 Journal Article %J J Alzheimers Dis %D 2011 %T Association of HSP70 and its co-chaperones with Alzheimer's disease. %A Broer, Linda %A Ikram, Mohammad Arfan %A Schuur, Maaike %A DeStefano, Anita L %A Bis, Joshua C %A Liu, Fan %A Rivadeneira, Fernando %A Uitterlinden, André G %A Beiser, Alexa S %A Longstreth, William T %A Hofman, Albert %A Aulchenko, Yurii %A Seshadri, Sudha %A Fitzpatrick, Annette L %A Oostra, Ben A %A Breteler, Monique M B %A van Duijn, Cornelia M %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Cohort Studies %K Genetic Association Studies %K Genetic Variation %K HSP70 Heat-Shock Proteins %K Humans %K Middle Aged %K Molecular Chaperones %K Polymorphism, Single Nucleotide %X

The heat shock protein (HSP) 70 family has been implicated in the pathology of Alzheimer's disease (AD). In this study, we examined common genetic variations in the 80 genes encoding HSP70 and its co-chaperones. We conducted a study in a series of 462 patients and 5238 unaffected participants derived from the Rotterdam Study, a population-based study including 7983 persons aged 55 years and older. We genotyped a total of 12,053 Single Nucleotide Polymorphisms (SNPs) using the HumanHap550K Genotyping BeadChip from Illumina. Replication was performed in two independent cohort studies, the Framingham Heart study (FHS; n = 806) and Cardiovascular Health Study (CHS; n = 2150). When adjusting for multiple testing, we found a small but consistent, though not significant effect of rs12118313 located 32 kb from PFDN2, with an OR of 1.19 (p-value from meta-analysis = 0.003). However this SNP was in the intron of another gene, suggesting it is unlikely this SNP reflects the effect of PFDN2. In a formal pathway analysis we found nominally significant evidence for an association of BAG, DNAJA and prefoldin with AD. These findings corroborate with those of a study of 2032 AD patients and 5328 controls, in which several members of the prefoldin family showed evidence for association to AD. Our study did not reveal evidence for a genetic variant if the HSP70 family with a major effect on AD. However, our findings of the single SNP analysis and pathway analysis suggest that multiple genetic variants in prefoldin are associated with AD.

%B J Alzheimers Dis %V 25 %P 93-102 %8 2011 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21403392?dopt=Abstract %R 10.3233/JAD-2011-101560 %0 Journal Article %J Hypertension %D 2011 %T Association of hypertension drug target genes with blood pressure and hypertension in 86,588 individuals. %A Johnson, Andrew D %A Newton-Cheh, Christopher %A Chasman, Daniel I %A Ehret, Georg B %A Johnson, Toby %A Rose, Lynda %A Rice, Kenneth %A Verwoert, Germaine C %A Launer, Lenore J %A Gudnason, Vilmundur %A Larson, Martin G %A Chakravarti, Aravinda %A Psaty, Bruce M %A Caulfield, Mark %A van Duijn, Cornelia M %A Ridker, Paul M %A Munroe, Patricia B %A Levy, Daniel %K Alleles %K Angiotensinogen %K Antihypertensive Agents %K Blood Pressure %K Female %K Genetic Predisposition to Disease %K Genotype %K Humans %K Hypertension %K Male %K Pharmacogenetics %K Polymorphism, Single Nucleotide %K Receptors, Adrenergic, beta-1 %X

We previously conducted genome-wide association meta-analysis of systolic blood pressure, diastolic blood pressure, and hypertension in 29,136 people from 6 cohort studies in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Here we examine associations of these traits with 30 gene regions encoding known antihypertensive drug targets. We find nominal evidence of association of ADRB1, ADRB2, AGT, CACNA1A, CACNA1C, and SLC12A3 polymorphisms with 1 or more BP traits in the Cohorts for Heart and Aging Research in Genomic Epidemiology genome-wide association meta-analysis. We attempted replication of the top meta-analysis single nucleotide polymorphisms for these genes in the Global BPgen Consortium (n=34,433) and the Women's Genome Health Study (n=23,019) and found significant results for rs1801253 in ADRB1 (Arg389Gly), with the Gly allele associated with a lower mean systolic blood pressure (β: 0.57 mm Hg; SE: 0.09 mm Hg; meta-analysis: P=4.7×10(-10)), diastolic blood pressure (β: 0.36 mm Hg; SE: 0.06 mm Hg; meta-analysis: P=9.5×10(-10)), and prevalence of hypertension (β: 0.06 mm Hg; SE: 0.02 mm Hg; meta-analysis: P=3.3×10(-4)). Variation in AGT (rs2004776) was associated with systolic blood pressure (β: 0.42 mm Hg; SE: 0.09 mm Hg; meta-analysis: P=3.8×10(-6)), as well as diastolic blood pressure (P=5.0×10(-8)) and hypertension (P=3.7×10(-7)). A polymorphism in ACE (rs4305) showed modest replication of association with increased hypertension (β: 0.06 mm Hg; SE: 0.01 mm Hg; meta-analysis: P=3.0×10(-5)). Two loci, ADRB1 and AGT, contain single nucleotide polymorphisms that reached a genome-wide significance threshold in meta-analysis for the first time. Our findings suggest that these genes warrant further studies of their genetic effects on blood pressure, including pharmacogenetic interactions.

%B Hypertension %V 57 %P 903-10 %8 2011 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/21444836?dopt=Abstract %R 10.1161/HYPERTENSIONAHA.110.158667 %0 Journal Article %J Invest Ophthalmol Vis Sci %D 2011 %T Association of polymorphisms in the hepatocyte growth factor gene promoter with keratoconus. %A Burdon, Kathryn P %A Macgregor, Stuart %A Bykhovskaya, Yelena %A Javadiyan, Sharhbanou %A Li, Xiaohui %A Laurie, Kate J %A Muszynska, Dorota %A Lindsay, Richard %A Lechner, Judith %A Haritunians, Talin %A Henders, Anjali K %A Dash, Durga %A Siscovick, David %A Anand, Seema %A Aldave, Anthony %A Coster, Douglas J %A Szczotka-Flynn, Loretta %A Mills, Richard A %A Iyengar, Sudha K %A Taylor, Kent D %A Phillips, Tony %A Montgomery, Grant W %A Rotter, Jerome I %A Hewitt, Alex W %A Sharma, Shiwani %A Rabinowitz, Yaron S %A Willoughby, Colin %A Craig, Jamie E %K Adult %K Aged %K Chromosomes, Human, Pair 7 %K Corneal Topography %K Enzyme-Linked Immunosorbent Assay %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Hepatocyte Growth Factor %K Humans %K Keratoconus %K Middle Aged %K Nucleic Acid Hybridization %K Polymorphism, Single Nucleotide %K Promoter Regions, Genetic %K Sequence Tagged Sites %X

PURPOSE: Keratoconus is a progressive disorder of the cornea that can lead to severe visual impairment or blindness. Although several genomic regions have been linked to rare familial forms of keratoconus, no genes have yet been definitively identified for common forms of the disease.

METHODS: Two genome-wide association scans were undertaken in parallel. The first used pooled DNA from an Australian cohort, followed by typing of top-ranked single-nucleotide polymorphisms (SNPs) in individual DNA samples. The second was conducted in individually genotyped patients, and controls from the USA. Tag SNPs around the hepatocyte growth factor (HGF) gene were typed in three additional replication cohorts. Serum levels of HGF protein in normal individuals were assessed with ELISA and correlated with genotype.

RESULTS: The only SNP observed to be associated in both the pooled discovery and primary replication cohort was rs1014091, located upstream of the HGF gene. The nearby SNP rs3735520 was found to be associated in the individually typed discovery cohort (P = 6.1 × 10(-7)). Genotyping of tag SNPs around HGF revealed association at rs3735520 and rs17501108/rs1014091 in four of the five cohorts. Meta-analysis of all five datasets together yielded suggestive P values for rs3735520 (P = 9.9 × 10(-7)) and rs17501108 (P = 9.9 × 10(-5)). In addition, SNP rs3735520 was found to be associated with serum HGF level in normal individuals (P = 0.036).

CONCLUSIONS: Taken together, these results implicate genetic variation at the HGF locus with keratoconus susceptibility.

%B Invest Ophthalmol Vis Sci %V 52 %P 8514-9 %8 2011 Oct 31 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/22003120?dopt=Abstract %R 10.1167/iovs.11-8261 %0 Journal Article %J J Am Coll Cardiol %D 2011 %T Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study. %A Linefsky, Jason P %A O'Brien, Kevin D %A Katz, Ronit %A de Boer, Ian H %A Barasch, Eddy %A Jenny, Nancy S %A Siscovick, David S %A Kestenbaum, Bryan %K Aged %K Aortic Valve %K Calcinosis %K Calcium %K Female %K Heart Valve Diseases %K Humans %K Male %K Mitral Valve %K Parathyroid Hormone %K Phosphates %K Risk Factors %K Sclerosis %K Vitamin D %X

OBJECTIVES: This study was conducted to evaluate mineral metabolism markers as potential risk factors for calcific aortic valve disease.

BACKGROUND: Mineral metabolism disturbances are common among older people and may contribute to cardiac valvular calcification. Associations of serum mineral metabolism markers with cardiac valvular calcification have not been evaluated in a well-characterized general population of older adults.

METHODS: We measured serum levels of phosphate, calcium, parathyroid hormone, and 25-hydroxyvitamin D in 1,938 Cardiovascular Health Study participants who were free of clinical cardiovascular disease and who underwent echocardiographic measurements of aortic valve sclerosis (AVS), mitral annular calcification (MAC), and aortic annular calcification (AAC). We used logistic regression models to estimate associations of mineral metabolism markers with AVS, MAC, and AAC after adjustment for relevant confounding variables, including kidney function.

RESULTS: The respective prevalences of AVS, MAC, and AAC were 54%, 39%, and 44%. Each 0.5 mg/dl higher serum phosphate concentration was associated with greater adjusted odds of AVS (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.04 to 1.31, p = 0.01), MAC (OR: 1.12, 95% CI: 1.00 to 1.26, p = 0.05), and AAC (OR: 1.12, 95% CI: 0.99 to 1.25, p = 0.05). In contrast, serum calcium, parathyroid hormone, and 25-hydroxyvitamin D concentrations were not associated with aortic or mitral calcification.

CONCLUSIONS: Higher serum phosphate levels within the normal range were associated with valvular and annular calcification in a community-based cohort of older adults. Phosphate may be a novel risk factor for calcific aortic valve disease and warrants further study.

%B J Am Coll Cardiol %V 58 %P 291-7 %8 2011 Jul 12 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21737022?dopt=Abstract %R 10.1016/j.jacc.2010.11.073 %0 Journal Article %J Diabetes %D 2011 %T A bivariate genome-wide approach to metabolic syndrome: STAMPEED consortium. %A Kraja, Aldi T %A Vaidya, Dhananjay %A Pankow, James S %A Goodarzi, Mark O %A Assimes, Themistocles L %A Kullo, Iftikhar J %A Sovio, Ulla %A Mathias, Rasika A %A Sun, Yan V %A Franceschini, Nora %A Absher, Devin %A Li, Guo %A Zhang, Qunyuan %A Feitosa, Mary F %A Glazer, Nicole L %A Haritunians, Talin %A Hartikainen, Anna-Liisa %A Knowles, Joshua W %A North, Kari E %A Iribarren, Carlos %A Kral, Brian %A Yanek, Lisa %A O'Reilly, Paul F %A McCarthy, Mark I %A Jaquish, Cashell %A Couper, David J %A Chakravarti, Aravinda %A Psaty, Bruce M %A Becker, Lewis C %A Province, Michael A %A Boerwinkle, Eric %A Quertermous, Thomas %A Palotie, Leena %A Jarvelin, Marjo-Riitta %A Becker, Diane M %A Kardia, Sharon L R %A Rotter, Jerome I %A Chen, Yii-Der Ida %A Borecki, Ingrid B %K Adult %K Aged %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Meta-Analysis as Topic %K Metabolic Syndrome %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %X

OBJECTIVE The metabolic syndrome (MetS) is defined as concomitant disorders of lipid and glucose metabolism, central obesity, and high blood pressure, with an increased risk of type 2 diabetes and cardiovascular disease. This study tests whether common genetic variants with pleiotropic effects account for some of the correlated architecture among five metabolic phenotypes that define MetS. RESEARCH DESIGN AND METHODS Seven studies of the STAMPEED consortium, comprising 22,161 participants of European ancestry, underwent genome-wide association analyses of metabolic traits using a panel of ∼2.5 million imputed single nucleotide polymorphisms (SNPs). Phenotypes were defined by the National Cholesterol Education Program (NCEP) criteria for MetS in pairwise combinations. Individuals exceeding the NCEP thresholds for both traits of a pair were considered affected. RESULTS Twenty-nine common variants were associated with MetS or a pair of traits. Variants in the genes LPL, CETP, APOA5 (and its cluster), GCKR (and its cluster), LIPC, TRIB1, LOC100128354/MTNR1B, ABCB11, and LOC100129150 were further tested for their association with individual qualitative and quantitative traits. None of the 16 top SNPs (one per gene) associated simultaneously with more than two individual traits. Of them 11 variants showed nominal associations with MetS per se. The effects of 16 top SNPs on the quantitative traits were relatively small, together explaining from ∼9% of the variance in triglycerides, 5.8% of high-density lipoprotein cholesterol, 3.6% of fasting glucose, and 1.4% of systolic blood pressure. CONCLUSIONS Qualitative and quantitative pleiotropic tests on pairs of traits indicate that a small portion of the covariation in these traits can be explained by the reported common genetic variants.

%B Diabetes %V 60 %P 1329-39 %8 2011 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21386085?dopt=Abstract %R 10.2337/db10-1011 %0 Journal Article %J Invest Ophthalmol Vis Sci %D 2011 %T Candidate gene association study for diabetic retinopathy in persons with type 2 diabetes: the Candidate gene Association Resource (CARe). %A Sobrin, Lucia %A Green, Todd %A Sim, Xueling %A Jensen, Richard A %A Tai, E Shyong %A Tay, Wan Ting %A Wang, Jie Jin %A Mitchell, Paul %A Sandholm, Niina %A Liu, Yiyuan %A Hietala, Kustaa %A Iyengar, Sudha K %A Brooks, Matthew %A Buraczynska, Monika %A Van Zuydam, Natalie %A Smith, Albert V %A Gudnason, Vilmundur %A Doney, Alex S F %A Morris, Andrew D %A Leese, Graham P %A Palmer, Colin N A %A Swaroop, Anand %A Taylor, Herman A %A Wilson, James G %A Penman, Alan %A Chen, Ching J %A Groop, Per-Henrik %A Saw, Seang-Mei %A Aung, Tin %A Klein, Barbara E %A Rotter, Jerome I %A Siscovick, David S %A Cotch, Mary Frances %A Klein, Ronald %A Daly, Mark J %A Wong, Tien Y %K Cardiovascular Diseases %K Diabetes Mellitus, Type 2 %K Diabetic Nephropathies %K Diabetic Retinopathy %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Iduronidase %K Odds Ratio %K P-Selectin %K Polymorphism, Single Nucleotide %K Risk Factors %X

PURPOSE: To investigate whether variants in cardiovascular candidate genes, some of which have been previously associated with type 2 diabetes (T2D), diabetic retinopathy (DR), and diabetic nephropathy (DN), are associated with DR in the Candidate gene Association Resource (CARe).

METHODS: Persons with T2D who were enrolled in the study (n = 2691) had fundus photography and genotyping of single nucleotide polymorphisms (SNPs) in 2000 candidate genes. Two case definitions were investigated: Early Treatment Diabetic Retinopathy Study (ETDRS) grades ≥ 14 and ≥ 30. The χ² analyses for each CARe cohort were combined by Cochran-Mantel-Haenszel (CMH) pooling of odds ratios (ORs) and corrected for multiple hypothesis testing. Logistic regression was performed with adjustment for other DR risk factors. Results from replication in independent cohorts were analyzed with CMH meta-analysis methods.

RESULTS: Among 39 genes previously associated with DR, DN, or T2D, three SNPs in P-selectin (SELP) were associated with DR. The strongest association was to rs6128 (OR = 0.43, P = 0.0001, after Bonferroni correction). These associations remained significant after adjustment for DR risk factors. Among other genes examined, several variants were associated with DR with significant P values, including rs6856425 tagging α-l-iduronidase (IDUA) (P = 2.1 × 10(-5), after Bonferroni correction). However, replication in independent cohorts did not reveal study-wide significant effects. The P values after replication were 0.55 and 0.10 for rs6128 and rs6856425, respectively.

CONCLUSIONS: Genes associated with DN, T2D, and vascular diseases do not appear to be consistently associated with DR. A few genetic variants associated with DR, particularly those in SELP and near IDUA, should be investigated in additional DR cohorts.

%B Invest Ophthalmol Vis Sci %V 52 %P 7593-602 %8 2011 Sep 29 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21873659?dopt=Abstract %R 10.1167/iovs.11-7510 %0 Journal Article %J Stroke %D 2011 %T Carotid intima-media thickness, electrocardiographic left ventricular hypertrophy, and incidence of intracerebral hemorrhage. %A Folsom, Aaron R %A Yatsuya, Hiroshi %A Psaty, Bruce M %A Shahar, Eyal %A Longstreth, W T %K Carotid Intima-Media Thickness %K Cerebral Hemorrhage %K Cohort Studies %K Electrocardiography %K Female %K Follow-Up Studies %K Humans %K Hypertrophy, Left Ventricular %K Incidence %K Male %K Middle Aged %K Prospective Studies %K Risk Factors %X

BACKGROUND AND PURPOSE: Carotid intima-media thickness and electrocardiographic left ventricular hypertrophy are 2 subclinical cardiovascular disease measures associated with increased risk of total and ischemic strokes. Increased intima-media thickness and electrocardiographic left ventricular hypertrophy also may reflect end-organ hypertensive effects. Information is scant on the associations of these subclinical measures with intracerebral hemorrhage (ICH). We hypothesized that greater carotid intima-media thickness and the presence of electrocardiographic left ventricular hypertrophy would be independently associated with increased ICH incidence.

METHODS: Among 18,155 participants initially free of stroke in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS), we assessed carotid intima-media thickness, carotid plaque, and electrocardiographic left ventricular hypertrophy. Over a median of 18 years of follow-up, 162 incident ICH events occurred.

RESULTS: After adjustment for other ICH risk factors, carotid intima-media thickness was associated positively with incidence of ICH in both ARIC and CHS. The risk was lowest in study-specific Quartile 1, elevated 1.6- to 2.6-fold in Quartiles 2 to 3, and elevated 2.5 to 3.7-fold in Quartile 4 (P<0.05 for both studies). In CHS, having a carotid plaque was associated with a 2-fold (95% CI, 1.1-3.4) greater ICH risk than having no plaque, but only 1.2-fold (95% CI, 0.76-2.0) greater ICH risk in ARIC. Electrocardiographic left ventricular hypertrophy carried a hazard ratio of ICH of 1.7 (95% CI, 0.77-3.7) in CHS and 2.8 (95% CI, 1.2-6.4) in ARIC.

CONCLUSIONS: Our data suggest that people with carotid atherosclerosis and possibly left ventricular hypertrophy are at increased risk not only of ischemic stroke, but also of ICH.

%B Stroke %V 42 %P 3075-9 %8 2011 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/21940954?dopt=Abstract %R 10.1161/STROKEAHA.111.623157 %0 Journal Article %J Pharmacogenet Genomics %D 2011 %T Cerivastatin, genetic variants, and the risk of rhabdomyolysis. %A Marciante, Kristin D %A Durda, Jon P %A Heckbert, Susan R %A Lumley, Thomas %A Rice, Ken %A McKnight, Barbara %A Totah, Rheem A %A Tamraz, Bani %A Kroetz, Deanna L %A Fukushima, Hisayo %A Kaspera, Rüdiger %A Bis, Joshua C %A Glazer, Nicole L %A Li, Guo %A Austin, Thomas R %A Taylor, Kent D %A Rotter, Jerome I %A Jaquish, Cashell E %A Kwok, Pui-Yan %A Tracy, Russell P %A Psaty, Bruce M %K Adult %K Aged %K Aged, 80 and over %K Aryl Hydrocarbon Hydroxylases %K Case-Control Studies %K Cytochrome P-450 CYP2C8 %K Female %K Genetic Variation %K Genome-Wide Association Study %K Glucuronosyltransferase %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Male %K Middle Aged %K Organic Anion Transporters %K Polymorphism, Single Nucleotide %K Pyridines %K Rhabdomyolysis %K Risk %K Ryanodine Receptor Calcium Release Channel %K Solute Carrier Organic Anion Transporter Family Member 1b1 %X

OBJECTIVE: The withdrawal of cerivastatin involved an uncommon but serious adverse reaction, rhabdomyolysis. The bimodal response, rhabdomyolysis in a small proportion of users, points to genetic factors as a potential cause. We conducted a case-control study to evaluate genetic markers for cerivastatin-associated rhabdomyolysis.

METHODS: This study had two components: a candidate gene study to evaluate variants in CYP2C8, UGT1A1, UGT1A3, and SLCO1B1; and a genome-wide association study to identify risk factors in other regions of the genome. A total of 185 rhabdomyolysis cases were frequency matched to statin-using controls from the Cardiovascular Health Study (n=374) and the Heart and Vascular Health Study (n=358). Validation relied on functional studies.

RESULTS: Permutation test results suggested an association between cerivastatin-associated rhabdomyolysis and variants in SLCO1B1 (P=0.002), but not variants in CYP2C8 (P=0.073) or UGTs (P=0.523). An additional copy of the minor allele of SLCO1B1 rs4149056 (p.Val174Ala) was associated with the risk of rhabdomyolysis (odds ratio: 1.89; 95% confidence interval: 1.40-2.56). In transfected cells, this variant reduced cerivastatin transport by 40% compared with the reference transporter (P<0.001). The genome-wide association study identified an intronic variant (rs2819742) in the ryanodine receptor 2 gene (RYR2) as significant (P=1.74E-07). An additional copy of the minor allele of the RYR2 variant was associated with a reduced risk of rhabdomyolysis (odds ratio: 0.48; 95% confidence interval: 0.36-0.63).

CONCLUSION: We identified modest genetic risk factors for an extreme response to cerivastatin. Disabling genetic variants in the candidate genes were not responsible for the bimodal response to cerivastatin.

%B Pharmacogenet Genomics %V 21 %P 280-8 %8 2011 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/21386754?dopt=Abstract %R 10.1097/FPC.0b013e328343dd7d %0 Journal Article %J Ann Intern Med %D 2011 %T Circulating long-chain ω-3 fatty acids and incidence of congestive heart failure in older adults: the cardiovascular health study: a cohort study. %A Mozaffarian, Dariush %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Spiegelman, Donna %A Sacks, Frank M %A Rimm, Eric B %A Siscovick, David S %K Aged %K Biomarkers %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Fatty Acids, Omega-3 %K Fatty Acids, Unsaturated %K Feeding Behavior %K Heart Failure %K Humans %K Incidence %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %X

BACKGROUND: Few previous studies have evaluated associations between long-chain ω-3 fatty acids and incidence of congestive heart failure (CHF), and those that have are typically based on diet questionnaires and yield conflicting results. Circulating fatty acid concentrations provide objective biomarkers of exposure.

OBJECTIVE: To determine whether plasma phospholipid concentrations of long-chain ω-3 fatty acids, including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), were associated with incident CHF.

DESIGN: Prospective cohort study.

SETTING: 4 U.S. communities.

PATIENTS: 2735 U.S. adults without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006.

MEASUREMENTS: Plasma phospholipid fatty acid concentrations and other cardiovascular risk factors were measured in 1992 by using standardized methods. Relationships with incident CHF (555 cases during 26 490 person-years, adjudicated by using medical records) were assessed by using Cox proportional hazards models.

RESULTS: After multivariate adjustment, plasma phospholipid EPA concentration was inversely associated with incident CHF; risk was approximately 50% lower in the highest versus the lowest quartile (hazard ratio [HR], 0.52 [95% CI, 0.38 to 0.72]; P for trend = 0.001). In similar analyses, trends toward lower risk were seen for DPA (HR, 0.76 [CI, 0.56 to 1.04]; P for trend = 0.057) and total long-chain ω-3 fatty acids (HR, 0.70 [CI, 0.49 to 0.99]; P for trend = 0.062) but not for DHA (HR, 0.84 [CI, 0.58 to 1.21]; P for trend = 0.38). In analyses censored to the middle of follow-up (7 years) to minimize exposure misclassification over time, multivariate-adjusted HRs were 0.48 for EPA (CI, 0.32 to 0.71; P for trend = 0.005), 0.61 for DPA (CI, 0.39 to 0.95; P for trend = 0.033), 0.64 for DHA (CI, 0.40 to 1.04; P for trend = 0.057), and 0.51 for total ω-3 fatty acids (CI, 0.32 to 0.80; P for trend = 0.003).

LIMITATIONS: Temporal changes in fatty acid concentrations over time may have caused underestimation of associations. Unmeasured or imperfectly measured covariates may have caused residual confounding.

CONCLUSION: Circulating individual and total ω-3 fatty acid concentrations are associated with lower incidence of CHF in older adults.

PRIMARY FUNDING SOURCE: National Institutes of Health.

%B Ann Intern Med %V 155 %P 160-70 %8 2011 Aug 02 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21810709?dopt=Abstract %R 10.7326/0003-4819-155-3-201108020-00006 %0 Journal Article %J Biostatistics %D 2011 %T Comparing costs associated with risk stratification rules for t-year survival. %A Cai, Tianxi %A Tian, Lu %A Lloyd-Jones, Donald M %K Biostatistics %K Coronary Disease %K Cost-Benefit Analysis %K Costs and Cost Analysis %K Humans %K Models, Statistical %K Risk Assessment %K Risk Factors %K Time Factors %X

Accurate risk prediction is an important step in developing optimal strategies for disease prevention and treatment. Based on the predicted risks, patients can be stratified to different risk categories where each category corresponds to a particular clinical intervention. Incorrect or suboptimal interventions are likely to result in unnecessary financial and medical consequences. It is thus essential to account for the costs associated with the clinical interventions when developing and evaluating risk stratification (RS) rules for clinical use. In this article, we propose to quantify the value of an RS rule based on the total expected cost attributed to incorrect assignment of risk groups due to the rule. We have established the relationship between cost parameters and optimal threshold values used in the stratification rule that minimizes the total expected cost over the entire population of interest. Statistical inference procedures are developed for evaluating and comparing given RS rules and examined through simulation studies. The proposed procedures are illustrated with an example from the Cardiovascular Health Study.

%B Biostatistics %V 12 %P 597-609 %8 2011 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21415016?dopt=Abstract %R 10.1093/biostatistics/kxr001 %0 Journal Article %J BMC Cardiovasc Disord %D 2011 %T The contribution of a 9p21.3 variant, a KIF6 variant, and C-reactive protein to predicting risk of myocardial infarction in a prospective study. %A Shiffman, Dov %A O'Meara, Ellen S %A Rowland, Charles M %A Louie, Judy Z %A Cushman, Mary %A Tracy, Russell P %A Devlin, James J %A Psaty, Bruce M %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K C-Reactive Protein %K Case-Control Studies %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Genetic Variation %K Humans %K Kinesin %K Male %K Myocardial Infarction %K Predictive Value of Tests %K Prospective Studies %K Risk Factors %X

BACKGROUND: Genetic risk factors might improve prediction of coronary events. Several variants at chromosome 9p21.3 have been widely reported to be associated with coronary heart disease (CHD) in prospective and case-control studies. A variant of KIF6 (719Arg) has also been reported to be associated with increased risk of CHD in large prospective studies, but not in case-control studies. We asked whether the addition of genetic information (the 9p21.3 or KIF6 variants) or a well-established non-genetic risk factor (C-reactive protein [CRP]) can improve risk prediction by the Framingham Risk Score (FRS) in the Cardiovascular Health Study (CHS)--a prospective observational study of risk factors for cardiovascular disease among > 5,000 participants aged 65 or older.

METHODS: Improvement of risk prediction was assessed by change in the area under the receiver-operator characteristic curve (AUC) and by net reclassification improvement (NRI).

RESULTS: Among white participants the FRS was improved by addition of KIF6 719Arg carrier status among men as assessed by the AUC (from 0.581 to 0.596, P = 0.03) but not by NRI (NRI = 0.027, P = 0.32). Adding both CRP and 719Arg carrier status to the FRS improved risk prediction by the AUC (0.608, P = 0.02) and NRI (0.093, P = 0.008) in men, but not women (P ≥ 0.24).

CONCLUSIONS: While none of these risk markers individually or in combination improved risk prediction among women, a combination of KIF6 719Arg carrier status and CRP levels modestly improved risk prediction among white men; although this improvement is not significant after multiple-testing correction. These observations should be investigated in other prospective studies.

%B BMC Cardiovasc Disord %V 11 %P 10 %8 2011 Mar 15 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/21406102?dopt=Abstract %R 10.1186/1471-2261-11-10 %0 Journal Article %J J Am Soc Nephrol %D 2011 %T CUBN is a gene locus for albuminuria. %A Böger, Carsten A %A Chen, Ming-Huei %A Tin, Adrienne %A Olden, Matthias %A Köttgen, Anna %A de Boer, Ian H %A Fuchsberger, Christian %A O'Seaghdha, Conall M %A Pattaro, Cristian %A Teumer, Alexander %A Liu, Ching-Ti %A Glazer, Nicole L %A Li, Man %A O'Connell, Jeffrey R %A Tanaka, Toshiko %A Peralta, Carmen A %A Kutalik, Zoltán %A Luan, Jian'an %A Zhao, Jing Hua %A Hwang, Shih-Jen %A Akylbekova, Ermeg %A Kramer, Holly %A van der Harst, Pim %A Smith, Albert V %A Lohman, Kurt %A de Andrade, Mariza %A Hayward, Caroline %A Kollerits, Barbara %A Tönjes, Anke %A Aspelund, Thor %A Ingelsson, Erik %A Eiriksdottir, Gudny %A Launer, Lenore J %A Harris, Tamara B %A Shuldiner, Alan R %A Mitchell, Braxton D %A Arking, Dan E %A Franceschini, Nora %A Boerwinkle, Eric %A Egan, Josephine %A Hernandez, Dena %A Reilly, Muredach %A Townsend, Raymond R %A Lumley, Thomas %A Siscovick, David S %A Psaty, Bruce M %A Kestenbaum, Bryan %A Haritunians, Talin %A Bergmann, Sven %A Vollenweider, Peter %A Waeber, Gérard %A Mooser, Vincent %A Waterworth, Dawn %A Johnson, Andrew D %A Florez, Jose C %A Meigs, James B %A Lu, Xiaoning %A Turner, Stephen T %A Atkinson, Elizabeth J %A Leak, Tennille S %A Aasarød, Knut %A Skorpen, Frank %A Syvänen, Ann-Christine %A Illig, Thomas %A Baumert, Jens %A Koenig, Wolfgang %A Krämer, Bernhard K %A Devuyst, Olivier %A Mychaleckyj, Josyf C %A Minelli, Cosetta %A Bakker, Stephan J L %A Kedenko, Lyudmyla %A Paulweber, Bernhard %A Coassin, Stefan %A Endlich, Karlhans %A Kroemer, Heyo K %A Biffar, Reiner %A Stracke, Sylvia %A Völzke, Henry %A Stumvoll, Michael %A Mägi, Reedik %A Campbell, Harry %A Vitart, Veronique %A Hastie, Nicholas D %A Gudnason, Vilmundur %A Kardia, Sharon L R %A Liu, Yongmei %A Polasek, Ozren %A Curhan, Gary %A Kronenberg, Florian %A Prokopenko, Inga %A Rudan, Igor %A Arnlöv, Johan %A Hallan, Stein %A Navis, Gerjan %A Parsa, Afshin %A Ferrucci, Luigi %A Coresh, Josef %A Shlipak, Michael G %A Bull, Shelley B %A Paterson, Nicholas J %A Wichmann, H-Erich %A Wareham, Nicholas J %A Loos, Ruth J F %A Rotter, Jerome I %A Pramstaller, Peter P %A Cupples, L Adrienne %A Beckmann, Jacques S %A Yang, Qiong %A Heid, Iris M %A Rettig, Rainer %A Dreisbach, Albert W %A Bochud, Murielle %A Fox, Caroline S %A Kao, W H L %K African Continental Ancestry Group %K Albuminuria %K European Continental Ancestry Group %K Genetic Loci %K Genetic Predisposition to Disease %K Humans %K Mutation, Missense %K Receptors, Cell Surface %X

Identification of genetic risk factors for albuminuria may alter strategies for early prevention of CKD progression, particularly among patients with diabetes. Little is known about the influence of common genetic variants on albuminuria in both general and diabetic populations. We performed a meta-analysis of data from 63,153 individuals of European ancestry with genotype information from genome-wide association studies (CKDGen Consortium) and from a large candidate gene study (CARe Consortium) to identify susceptibility loci for the quantitative trait urinary albumin-to-creatinine ratio (UACR) and the clinical diagnosis microalbuminuria. We identified an association between a missense variant (I2984V) in the CUBN gene, which encodes cubilin, and both UACR (P = 1.1 × 10(-11)) and microalbuminuria (P = 0.001). We observed similar associations among 6981 African Americans in the CARe Consortium. The associations between this variant and both UACR and microalbuminuria were significant in individuals of European ancestry regardless of diabetes status. Finally, this variant associated with a 41% increased risk for the development of persistent microalbuminuria during 20 years of follow-up among 1304 participants with type 1 diabetes in the prospective DCCT/EDIC Study. In summary, we identified a missense CUBN variant that associates with levels of albuminuria in both the general population and in individuals with diabetes.

%B J Am Soc Nephrol %V 22 %P 555-70 %8 2011 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21355061?dopt=Abstract %R 10.1681/ASN.2010060598 %0 Journal Article %J J Am Soc Nephrol %D 2011 %T Cystatin C identifies chronic kidney disease patients at higher risk for complications. %A Peralta, Carmen A %A Katz, Ronit %A Sarnak, Mark J %A Ix, Joachim %A Fried, Linda F %A de Boer, Ian %A Palmas, Walter %A Siscovick, David %A Levey, Andrew S %A Shlipak, Michael G %K Aged %K Aged, 80 and over %K Biomarkers %K Cardiovascular Diseases %K Chronic Disease %K Creatinine %K Cystatin C %K Disease Progression %K Female %K Glomerular Filtration Rate %K Heart Failure %K Humans %K Kidney Diseases %K Kidney Failure, Chronic %K Male %K Middle Aged %K Predictive Value of Tests %K Retrospective Studies %K Risk Factors %X

Although cystatin C is a stronger predictor of clinical outcomes associated with CKD than creatinine, the clinical role for cystatin C is unclear. We included 11,909 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS) and assessed risks for death, cardiovascular events, heart failure, and ESRD among persons categorized into mutually exclusive groups on the basis of the biomarkers that supported a diagnosis of CKD (eGFR <60 ml/min per 1.73 m(2)): creatinine only, cystatin C only, both, or neither. We used CKD-EPI equations to estimate GFR from these biomarkers. In MESA, 9% had CKD by the creatinine-based equation only, 2% had CKD by the cystatin C-based equation only, and 4% had CKD by both equations; in CHS, these percentages were 12, 4, and 13%, respectively. Compared with those without CKD, the adjusted hazard ratios (HR) for mortality in MESA were: 0.80 (95% CI 0.50 to 1.26) for CKD by creatinine only; 3.23 (95% CI 1.84 to 5.67) for CKD by cystatin C only; and 1.93 (95% CI 1.27 to 2.92) for CKD by both; in CHS, the adjusted HR were 1.09 (95% CI 0.98 to 1.21), 1.78 (95% CI 1.53 to 2.08), and 1.74 (95% CI 1.58 to 1.93), respectively. The pattern was similar for cardiovascular disease (CVD), heart failure, and kidney failure outcomes. In conclusion, among adults diagnosed with CKD using the creatinine-based CKD-EPI equation, the adverse prognosis is limited to the subset who also have CKD according to the cystatin C-based equation. Cystatin C may have a role in identifying persons with CKD who have the highest risk for complications.

%B J Am Soc Nephrol %V 22 %P 147-55 %8 2011 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21164029?dopt=Abstract %R 10.1681/ASN.2010050483 %0 Journal Article %J N Engl J Med %D 2011 %T Diabetes mellitus, fasting glucose, and risk of cause-specific death. %A Rao Kondapally Seshasai, Sreenivasa %A Kaptoge, Stephen %A Thompson, Alexander %A Di Angelantonio, Emanuele %A Gao, Pei %A Sarwar, Nadeem %A Whincup, Peter H %A Mukamal, Kenneth J %A Gillum, Richard F %A Holme, Ingar %A Njølstad, Inger %A Fletcher, Astrid %A Nilsson, Peter %A Lewington, Sarah %A Collins, Rory %A Gudnason, Vilmundur %A Thompson, Simon G %A Sattar, Naveed %A Selvin, Elizabeth %A Hu, Frank B %A Danesh, John %K Blood Glucose %K Cause of Death %K Diabetes Mellitus %K Female %K Humans %K Hyperglycemia %K Life Expectancy %K Male %K Middle Aged %K Risk %K Survival Analysis %X

BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain.

METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies.

RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths.

CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.).

%B N Engl J Med %V 364 %P 829-841 %8 2011 Mar 03 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/21366474?dopt=Abstract %R 10.1056/NEJMoa1008862 %0 Journal Article %J Hum Brain Mapp %D 2011 %T The effects of physical activity, education, and body mass index on the aging brain. %A Ho, April J %A Raji, Cyrus A %A Becker, James T %A Lopez, Oscar L %A Kuller, Lewis H %A Hua, Xue %A Dinov, Ivo D %A Stein, Jason L %A Rosano, Caterina %A Toga, Arthur W %A Thompson, Paul M %K Aged %K Aged, 80 and over %K Aging %K Analysis of Variance %K Body Mass Index %K Brain %K Brain Mapping %K Educational Status %K Female %K Humans %K Image Processing, Computer-Assisted %K Magnetic Resonance Imaging %K Male %K Motor Activity %K Neuropsychological Tests %K Statistics as Topic %X

Normal human aging is accompanied by progressive brain tissue loss and cognitive decline; however, several factors are thought to influence brain aging. We applied tensor-based morphometry to high-resolution brain MRI scans to determine whether educational level or physical activity was associated with brain tissue volumes in the elderly, particularly in regions susceptible to age-related atrophy. We mapped the 3D profile of brain volume differences in 226 healthy elderly subjects (130F/96M; 77.9 ± 3.6 SD years) from the Cardiovascular Health Study-Cognition Study. Statistical maps revealed the 3D profile of brain regions whose volumes were associated with educational level and physical activity (based on leisure-time energy expenditure). After controlling for age, sex, and physical activity, higher educational levels were associated with ~2-3% greater tissue volumes, on average, in the temporal lobe gray matter. After controlling for age, sex, and education, greater physical activity was associated with ~2-2.5% greater average tissue volumes in the white matter of the corona radiata extending into the parietal-occipital junction. Body mass index (BMI) was highly correlated with both education and physical activity, so we examined BMI as a contributing factor by including physical activity, education, and BMI in the same model; only BMI effects remained significant. This is one of the largest MRI studies of factors influencing structural brain aging, and BMI may be a key factor explaining the observed relationship between education, physical activity, and brain structure. Independent contributions to brain structure could not be teased apart as all these factors were highly correlated with one another.

%B Hum Brain Mapp %V 32 %P 1371-82 %8 2011 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/20715081?dopt=Abstract %R 10.1002/hbm.21113 %0 Journal Article %J PLoS Genet %D 2011 %T Enhanced statistical tests for GWAS in admixed populations: assessment using African Americans from CARe and a Breast Cancer Consortium. %A Pasaniuc, Bogdan %A Zaitlen, Noah %A Lettre, Guillaume %A Chen, Gary K %A Tandon, Arti %A Kao, W H Linda %A Ruczinski, Ingo %A Fornage, Myriam %A Siscovick, David S %A Zhu, Xiaofeng %A Larkin, Emma %A Lange, Leslie A %A Cupples, L Adrienne %A Yang, Qiong %A Akylbekova, Ermeg L %A Musani, Solomon K %A Divers, Jasmin %A Mychaleckyj, Joe %A Li, Mingyao %A Papanicolaou, George J %A Millikan, Robert C %A Ambrosone, Christine B %A John, Esther M %A Bernstein, Leslie %A Zheng, Wei %A Hu, Jennifer J %A Ziegler, Regina G %A Nyante, Sarah J %A Bandera, Elisa V %A Ingles, Sue A %A Press, Michael F %A Chanock, Stephen J %A Deming, Sandra L %A Rodriguez-Gil, Jorge L %A Palmer, Cameron D %A Buxbaum, Sarah %A Ekunwe, Lynette %A Hirschhorn, Joel N %A Henderson, Brian E %A Myers, Simon %A Haiman, Christopher A %A Reich, David %A Patterson, Nick %A Wilson, James G %A Price, Alkes L %K African Americans %K Algorithms %K Breast Neoplasms %K Chromosome Mapping %K Coronary Disease %K Diabetes Mellitus, Type 2 %K Female %K Gene Frequency %K Genetic Variation %K Genetics, Population %K Genome, Human %K Genome-Wide Association Study %K Genotype %K Humans %K Linkage Disequilibrium %K Male %K Odds Ratio %K Phenotype %K Polymorphism, Single Nucleotide %K Principal Component Analysis %K Receptor, Fibroblast Growth Factor, Type 2 %K Software %X

While genome-wide association studies (GWAS) have primarily examined populations of European ancestry, more recent studies often involve additional populations, including admixed populations such as African Americans and Latinos. In admixed populations, linkage disequilibrium (LD) exists both at a fine scale in ancestral populations and at a coarse scale (admixture-LD) due to chromosomal segments of distinct ancestry. Disease association statistics in admixed populations have previously considered SNP association (LD mapping) or admixture association (mapping by admixture-LD), but not both. Here, we introduce a new statistical framework for combining SNP and admixture association in case-control studies, as well as methods for local ancestry-aware imputation. We illustrate the gain in statistical power achieved by these methods by analyzing data of 6,209 unrelated African Americans from the CARe project genotyped on the Affymetrix 6.0 chip, in conjunction with both simulated and real phenotypes, as well as by analyzing the FGFR2 locus using breast cancer GWAS data from 5,761 African-American women. We show that, at typed SNPs, our method yields an 8% increase in statistical power for finding disease risk loci compared to the power achieved by standard methods in case-control studies. At imputed SNPs, we observe an 11% increase in statistical power for mapping disease loci when our local ancestry-aware imputation framework and the new scoring statistic are jointly employed. Finally, we show that our method increases statistical power in regions harboring the causal SNP in the case when the causal SNP is untyped and cannot be imputed. Our methods and our publicly available software are broadly applicable to GWAS in admixed populations.

%B PLoS Genet %V 7 %P e1001371 %8 2011 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21541012?dopt=Abstract %R 10.1371/journal.pgen.1001371 %0 Journal Article %J Stroke %D 2011 %T Fasting and post-glucose load measures of insulin resistance and risk of ischemic stroke in older adults. %A Thacker, Evan L %A Psaty, Bruce M %A McKnight, Barbara %A Heckbert, Susan R %A Longstreth, W T %A Mukamal, Kenneth J %A Meigs, James B %A de Boer, Ian H %A Boyko, Edward J %A Carnethon, Mercedes R %A Kizer, Jorge R %A Tracy, Russell P %A Smith, Nicholas L %A Siscovick, David S %K Aged %K Aged, 80 and over %K Blood Glucose %K Body Mass Index %K Brain Ischemia %K Fasting %K Female %K Humans %K Incidence %K Insulin Resistance %K Male %K Risk %K Stroke %X

BACKGROUND AND PURPOSE: Few studies have assessed post-glucose load measures of insulin resistance and ischemic stroke risk, and data are sparse for older adults. We investigated whether fasting and post-glucose load measures of insulin resistance were related to incident ischemic stroke in nondiabetic, older adults.

METHODS: Participants were men and women in the Cardiovascular Health Study, age 65+ years and without prevalent diabetes or stroke at baseline, followed for 17 years for incident ischemic stroke. The Gutt insulin sensitivity index was calculated from baseline body weight and from fasting and 2-hour postload insulin and glucose; a lower Gutt index indicates higher insulin resistance.

RESULTS: Analyses included 3442 participants (42% men) with a mean age of 73 years. Incidence of ischemic stroke was 9.8 strokes per 1000 person-years. The relative risk (RR) for lowest quartile versus highest quartile of Gutt index was 1.64 (95% CI, 1.24-2.16), adjusted for demographics and prevalent cardiovascular and kidney disease. Similarly, the adjusted RR for highest quartile versus lowest quartile of 2-hour glucose was 1.84 (95% CI, 1.39-2.42). In contrast, the adjusted RR for highest quartile versus lowest quartile of fasting insulin was 1.10 (95% CI, 0.84-1.46).

CONCLUSIONS: In nondiabetic, older adults, insulin resistance measured by Gutt index or 2-hour glucose, but not by fasting insulin, was associated with risk of incident ischemic stroke.

%B Stroke %V 42 %P 3347-51 %8 2011 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21998054?dopt=Abstract %R 10.1161/STROKEAHA.111.620773 %0 Journal Article %J Am J Clin Nutr %D 2011 %T Fatty acids in the de novo lipogenesis pathway and risk of coronary heart disease: the Cardiovascular Health Study. %A Wu, Jason H Y %A Lemaitre, Rozenn N %A Imamura, Fumiaki %A King, Irena B %A Song, Xiaoling %A Spiegelman, Donna %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Cohort Studies %K Coronary Disease %K Death, Sudden, Cardiac %K Diet %K Fatty Acids %K Female %K Humans %K Lipogenesis %K Male %K Phospholipids %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %X

BACKGROUND: De novo lipogenesis (DNL) is an endogenous pathway whereby carbohydrates and proteins are converted to fatty acids. DNL could affect coronary heart disease (CHD) or sudden cardiac arrest (SCA) via generation of specific fatty acids. Whether these fatty acids are prospectively associated with SCA or other CHD events is unknown.

OBJECTIVE: The objective was to investigate the relations of 4 fatty acids in the DNL pathway-palmitic acid (16:0), palmitoleic acid (16:1n-7), 7-hexadecenoic acid (16:1n-9), and cis-vaccenic acid (18:1n-7)-with incident CHD, including fatal CHD, nonfatal myocardial infarction (NFMI), and SCA.

DESIGN: A community-based prospective study was conducted in 2890 men and women aged ≥65 y, who were free of known CHD at baseline and who were followed from 1992 to 2006. Cardiovascular disease risk factors and plasma phospholipid fatty acids were measured at baseline by using standardized methods. Incident CHD was ascertained prospectively and was centrally adjudicated by using medical records. Risk was assessed by using multivariable-adjusted Cox proportional hazards.

RESULTS: During 29,835 person-years of follow-up, 631 CHD and 71 SCA events occurred. Both 18:1n-7 and 16:1n-9 were associated with a higher risk of SCA [multivariable-adjusted hazard ratio (95% CI) for the interquintile range: 7.63 (2.58, 22.6) for 18:1n-7 and 2.30 (1.16, 4.55) for 16:1n-9] but not of total CHD, fatal CHD, or NFMI. In secondary analyses censored to mid-follow-up (7 y) to minimize the effects of changes in concentrations over time, 16:1n-9 was also associated with a significantly higher risk of total CHD (2.11; 1.76, 2.54), including a higher risk of CHD death, NFMI, and SCA; 16:0 and 16:1n-7 were not associated with clinical CHD outcomes.

CONCLUSION: Higher plasma phospholipid 18:1n-7 and 16:1n-9 concentrations were prospectively associated with an elevated risk of SCA but not of other CHD events, except in secondary analyses.

%B Am J Clin Nutr %V 94 %P 431-8 %8 2011 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/21697077?dopt=Abstract %R 10.3945/ajcn.111.012054 %0 Journal Article %J J Alzheimers Dis %D 2011 %T Gender differences in tea, coffee, and cognitive decline in the elderly: the Cardiovascular Health Study. %A Arab, Lenore %A Biggs, Mary L %A O'Meara, Ellen S %A Longstreth, W T %A Crane, Paul K %A Fitzpatrick, Annette L %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Coffee %K Cognition Disorders %K Cohort Studies %K Female %K Follow-Up Studies %K Humans %K Longitudinal Studies %K Male %K Prospective Studies %K Sex Characteristics %K Tea %X

Although caffeine can enhance cognitive function acutely, long-term effects of consumption of caffeine-containing beverages such as tea and coffee are uncertain. Data on 4,809 participants aged 65 and older from the Cardiovascular Health Study (CHS) were used to examine the relationship of consumption of tea and coffee, assessed by food frequency questionnaire, on change in cognitive function by gender. Cognitive performance was assessed using serial Modified Mini-Mental State (3MS) examinations, which were administered annually up to 9 times. Linear mixed models were used to estimate rates of change in standard 3MS scores and scores modeled using item response theory (IRT). Models were adjusted for age, education, smoking status, clinic site, diabetes, hypertension, stroke, coronary heart disease, depression score, and APOE genotype. Over the median 7.9 years of follow-up, participants who did not consume tea or coffee declined annually an average of 1.30 points (women) and 1.11 points (men) on standard 3MS scores. In fully adjusted models using either standard or IRT 3MS scores, we found modestly reduced rates of cognitive decline for some, but not all, levels of coffee and tea consumption for women, with no consistent effect for men. Caffeine consumption was also associated with attenuation in cognitive decline in women. Dose-response relationships were not linear. These longitudinal analyses suggest a somewhat attenuated rate of cognitive decline among tea and coffee consumers compared to non-consumers in women but not in men. Whether this association is causal or due to unmeasured confounding requires further study.

%B J Alzheimers Dis %V 27 %P 553-66 %8 2011 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21841254?dopt=Abstract %R 10.3233/JAD-2011-110431 %0 Journal Article %J Hum Mol Genet %D 2011 %T A gene-centric association scan for Coagulation Factor VII levels in European and African Americans: the Candidate Gene Association Resource (CARe) Consortium. %A Taylor, Kira C %A Lange, Leslie A %A Zabaneh, Delilah %A Lange, Ethan %A Keating, Brendan J %A Tang, Weihong %A Smith, Nicholas L %A Delaney, Joseph A %A Kumari, Meena %A Hingorani, Aroon %A North, Kari E %A Kivimaki, Mika %A Tracy, Russell P %A O'Donnell, Christopher J %A Folsom, Aaron R %A Green, David %A Humphries, Steve E %A Reiner, Alexander P %K Adult %K African Americans %K Aged %K Cardiovascular Diseases %K European Continental Ancestry Group %K Factor VII %K Female %K Genetic Predisposition to Disease %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

Polymorphisms in several distinct genomic regions, including the F7 gene, were recently associated with factor VII (FVII) levels in European Americans (EAs). The genetic determinants of FVII in African Americans (AAs) are unknown. We used a 50,000 single nucleotide polymorphism (SNP) gene-centric array having dense coverage of over 2,000 candidate genes for cardiovascular disease (CVD) pathways in a community-based sample of 16,324 EA and 3898 AA participants from the Candidate Gene Association Resource (CARe) consortium. Our aim was the discovery of new genomic loci and more detailed characterization of existing loci associated with FVII levels. In EAs, we identified three new loci associated with FVII, of which APOA5 on chromosome 11q23 and HNF4A on chromosome 20q12-13 were replicated in a sample of 4289 participants from the Whitehall II study. We confirmed four previously reported FVII-associated loci (GCKR, MS4A6A, F7 and PROCR) in CARe EA samples. In AAs, the F7 and PROCR regions were significantly associated with FVII. Several of the FVII-associated regions are known to be associated with lipids and other cardiovascular-related traits. At the F7 locus, there was evidence of at least five independently associated SNPs in EAs and three independent signals in AAs. Though the variance in FVII explained by the existing loci is substantial (20% in EA and 10% in AA), larger sample sizes and investigation of lower frequency variants may be required to identify additional FVII-associated loci in EAs and AAs and further clarify the relationship between FVII and other CVD risk factors.

%B Hum Mol Genet %V 20 %P 3525-34 %8 2011 Sep 01 %G eng %N 17 %1 http://www.ncbi.nlm.nih.gov/pubmed/21676895?dopt=Abstract %R 10.1093/hmg/ddr264 %0 Journal Article %J PLoS Genet %D 2011 %T Genetic association for renal traits among participants of African ancestry reveals new loci for renal function. %A Liu, Ching-Ti %A Garnaas, Maija K %A Tin, Adrienne %A Köttgen, Anna %A Franceschini, Nora %A Peralta, Carmen A %A de Boer, Ian H %A Lu, Xiaoning %A Atkinson, Elizabeth %A Ding, Jingzhong %A Nalls, Michael %A Shriner, Daniel %A Coresh, Josef %A Kutlar, Abdullah %A Bibbins-Domingo, Kirsten %A Siscovick, David %A Akylbekova, Ermeg %A Wyatt, Sharon %A Astor, Brad %A Mychaleckjy, Josef %A Li, Man %A Reilly, Muredach P %A Townsend, Raymond R %A Adeyemo, Adebowale %A Zonderman, Alan B %A de Andrade, Mariza %A Turner, Stephen T %A Mosley, Thomas H %A Harris, Tamara B %A Rotimi, Charles N %A Liu, Yongmei %A Kardia, Sharon L R %A Evans, Michele K %A Shlipak, Michael G %A Kramer, Holly %A Flessner, Michael F %A Dreisbach, Albert W %A Goessling, Wolfram %A Cupples, L Adrienne %A Kao, W Linda %A Fox, Caroline S %K Adaptor Proteins, Vesicular Transport %K Adult %K African Continental Ancestry Group %K Aged %K Animals %K Female %K Gene Knockdown Techniques %K Genetic Association Studies %K Genetic Loci %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K KCNQ1 Potassium Channel %K Kidney %K Kidney Failure, Chronic %K Male %K Middle Aged %K Neoplasm Proteins %K Phenotype %K Polymorphism, Single Nucleotide %K Zebrafish %X

Chronic kidney disease (CKD) is an increasing global public health concern, particularly among populations of African ancestry. We performed an interrogation of known renal loci, genome-wide association (GWA), and IBC candidate-gene SNP association analyses in African Americans from the CARe Renal Consortium. In up to 8,110 participants, we performed meta-analyses of GWA and IBC array data for estimated glomerular filtration rate (eGFR), CKD (eGFR <60 mL/min/1.73 m(2)), urinary albumin-to-creatinine ratio (UACR), and microalbuminuria (UACR >30 mg/g) and interrogated the 250 kb flanking region around 24 SNPs previously identified in European Ancestry renal GWAS analyses. Findings were replicated in up to 4,358 African Americans. To assess function, individually identified genes were knocked down in zebrafish embryos by morpholino antisense oligonucleotides. Expression of kidney-specific genes was assessed by in situ hybridization, and glomerular filtration was evaluated by dextran clearance. Overall, 23 of 24 previously identified SNPs had direction-consistent associations with eGFR in African Americans, 2 of which achieved nominal significance (UMOD, PIP5K1B). Interrogation of the flanking regions uncovered 24 new index SNPs in African Americans, 12 of which were replicated (UMOD, ANXA9, GCKR, TFDP2, DAB2, VEGFA, ATXN2, GATM, SLC22A2, TMEM60, SLC6A13, and BCAS3). In addition, we identified 3 suggestive loci at DOK6 (p-value = 5.3×10(-7)) and FNDC1 (p-value = 3.0×10(-7)) for UACR, and KCNQ1 with eGFR (p = 3.6×10(-6)). Morpholino knockdown of kcnq1 in the zebrafish resulted in abnormal kidney development and filtration capacity. We identified several SNPs in association with eGFR in African Ancestry individuals, as well as 3 suggestive loci for UACR and eGFR. Functional genetic studies support a role for kcnq1 in glomerular development in zebrafish.

%B PLoS Genet %V 7 %P e1002264 %8 2011 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/21931561?dopt=Abstract %R 10.1371/journal.pgen.1002264 %0 Journal Article %J PLoS Genet %D 2011 %T Genetic determinants of lipid traits in diverse populations from the population architecture using genomics and epidemiology (PAGE) study. %A Dumitrescu, Logan %A Carty, Cara L %A Taylor, Kira %A Schumacher, Fredrick R %A Hindorff, Lucia A %A Ambite, José L %A Anderson, Garnet %A Best, Lyle G %A Brown-Gentry, Kristin %A Bůzková, Petra %A Carlson, Christopher S %A Cochran, Barbara %A Cole, Shelley A %A Devereux, Richard B %A Duggan, Dave %A Eaton, Charles B %A Fornage, Myriam %A Franceschini, Nora %A Haessler, Jeff %A Howard, Barbara V %A Johnson, Karen C %A Laston, Sandra %A Kolonel, Laurence N %A Lee, Elisa T %A MacCluer, Jean W %A Manolio, Teri A %A Pendergrass, Sarah A %A Quibrera, Miguel %A Shohet, Ralph V %A Wilkens, Lynne R %A Haiman, Christopher A %A Le Marchand, Loïc %A Buyske, Steven %A Kooperberg, Charles %A North, Kari E %A Crawford, Dana C %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Continental Population Groups %K Female %K Gene Frequency %K Genetics, Population %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Lipid Metabolism %K Lipoproteins, HDL %K Lipoproteins, LDL %K Male %K Middle Aged %K Molecular Epidemiology %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Risk Factors %K Triglycerides %K Young Adult %X

For the past five years, genome-wide association studies (GWAS) have identified hundreds of common variants associated with human diseases and traits, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels. Approximately 95 loci associated with lipid levels have been identified primarily among populations of European ancestry. The Population Architecture using Genomics and Epidemiology (PAGE) study was established in 2008 to characterize GWAS-identified variants in diverse population-based studies. We genotyped 49 GWAS-identified SNPs associated with one or more lipid traits in at least two PAGE studies and across six racial/ethnic groups. We performed a meta-analysis testing for SNP associations with fasting HDL-C, LDL-C, and ln(TG) levels in self-identified European American (~20,000), African American (~9,000), American Indian (~6,000), Mexican American/Hispanic (~2,500), Japanese/East Asian (~690), and Pacific Islander/Native Hawaiian (~175) adults, regardless of lipid-lowering medication use. We replicated 55 of 60 (92%) SNP associations tested in European Americans at p<0.05. Despite sufficient power, we were unable to replicate ABCA1 rs4149268 and rs1883025, CETP rs1864163, and TTC39B rs471364 previously associated with HDL-C and MAFB rs6102059 previously associated with LDL-C. Based on significance (p<0.05) and consistent direction of effect, a majority of replicated genotype-phentoype associations for HDL-C, LDL-C, and ln(TG) in European Americans generalized to African Americans (48%, 61%, and 57%), American Indians (45%, 64%, and 77%), and Mexican Americans/Hispanics (57%, 56%, and 86%). Overall, 16 associations generalized across all three populations. For the associations that did not generalize, differences in effect sizes, allele frequencies, and linkage disequilibrium offer clues to the next generation of association studies for these traits.

%B PLoS Genet %V 7 %P e1002138 %8 2011 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21738485?dopt=Abstract %R 10.1371/journal.pgen.1002138 %0 Journal Article %J PLoS Genet %D 2011 %T Genetic loci associated with plasma phospholipid n-3 fatty acids: a meta-analysis of genome-wide association studies from the CHARGE Consortium. %A Lemaitre, Rozenn N %A Tanaka, Toshiko %A Tang, Weihong %A Manichaikul, Ani %A Foy, Millennia %A Kabagambe, Edmond K %A Nettleton, Jennifer A %A King, Irena B %A Weng, Lu-Chen %A Bhattacharya, Sayanti %A Bandinelli, Stefania %A Bis, Joshua C %A Rich, Stephen S %A Jacobs, David R %A Cherubini, Antonio %A McKnight, Barbara %A Liang, Shuang %A Gu, Xiangjun %A Rice, Kenneth %A Laurie, Cathy C %A Lumley, Thomas %A Browning, Brian L %A Psaty, Bruce M %A Chen, Yii-der I %A Friedlander, Yechiel %A Djoussé, Luc %A Wu, Jason H Y %A Siscovick, David S %A Uitterlinden, André G %A Arnett, Donna K %A Ferrucci, Luigi %A Fornage, Myriam %A Tsai, Michael Y %A Mozaffarian, Dariush %A Steffen, Lyn M %K Alleles %K Continental Population Groups %K Fatty Acids, Omega-3 %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Metabolic Networks and Pathways %K Polymorphism, Single Nucleotide %X

Long-chain n-3 polyunsaturated fatty acids (PUFAs) can derive from diet or from α-linolenic acid (ALA) by elongation and desaturation. We investigated the association of common genetic variation with plasma phospholipid levels of the four major n-3 PUFAs by performing genome-wide association studies in five population-based cohorts comprising 8,866 subjects of European ancestry. Minor alleles of SNPs in FADS1 and FADS2 (desaturases) were associated with higher levels of ALA (p = 3 x 10⁻⁶⁴) and lower levels of eicosapentaenoic acid (EPA, p = 5 x 10⁻⁵⁸) and docosapentaenoic acid (DPA, p = 4 x 10⁻¹⁵⁴). Minor alleles of SNPs in ELOVL2 (elongase) were associated with higher EPA (p = 2 x 10⁻¹²) and DPA (p = 1 x 10⁻⁴³) and lower docosahexaenoic acid (DHA, p = 1 x 10⁻¹⁵). In addition to genes in the n-3 pathway, we identified a novel association of DPA with several SNPs in GCKR (glucokinase regulator, p = 1 x 10⁻⁸). We observed a weaker association between ALA and EPA among carriers of the minor allele of a representative SNP in FADS2 (rs1535), suggesting a lower rate of ALA-to-EPA conversion in these subjects. In samples of African, Chinese, and Hispanic ancestry, associations of n-3 PUFAs were similar with a representative SNP in FADS1 but less consistent with a representative SNP in ELOVL2. Our findings show that common variation in n-3 metabolic pathway genes and in GCKR influences plasma phospholipid levels of n-3 PUFAs in populations of European ancestry and, for FADS1, in other ancestries.

%B PLoS Genet %V 7 %P e1002193 %8 2011 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/21829377?dopt=Abstract %R 10.1371/journal.pgen.1002193 %0 Journal Article %J Circulation %D 2011 %T Genetic predictors of fibrin D-dimer levels in healthy adults. %A Smith, Nicholas L %A Huffman, Jennifer E %A Strachan, David P %A Huang, Jie %A Dehghan, Abbas %A Trompet, Stella %A Lopez, Lorna M %A Shin, So-Youn %A Baumert, Jens %A Vitart, Veronique %A Bis, Joshua C %A Wild, Sarah H %A Rumley, Ann %A Yang, Qiong %A Uitterlinden, André G %A Stott, David J %A Davies, Gail %A Carter, Angela M %A Thorand, Barbara %A Polasek, Ozren %A McKnight, Barbara %A Campbell, Harry %A Rudnicka, Alicja R %A Chen, Ming-Huei %A Buckley, Brendan M %A Harris, Sarah E %A Peters, Annette %A Pulanic, Drazen %A Lumley, Thomas %A de Craen, Anton J M %A Liewald, David C %A Gieger, Christian %A Campbell, Susan %A Ford, Ian %A Gow, Alan J %A Luciano, Michelle %A Porteous, David J %A Guo, Xiuqing %A Sattar, Naveed %A Tenesa, Albert %A Cushman, Mary %A Slagboom, P Eline %A Visscher, Peter M %A Spector, Tim D %A Illig, Thomas %A Rudan, Igor %A Bovill, Edwin G %A Wright, Alan F %A McArdle, Wendy L %A Tofler, Geoffrey %A Hofman, Albert %A Westendorp, Rudi G J %A Starr, John M %A Grant, Peter J %A Karakas, Mahir %A Hastie, Nicholas D %A Psaty, Bruce M %A Wilson, James F %A Lowe, Gordon D O %A O'Donnell, Christopher J %A Witteman, Jacqueline C M %A Jukema, J Wouter %A Deary, Ian J %A Soranzo, Nicole %A Koenig, Wolfgang %A Hayward, Caroline %K Adult %K Aged %K Blood Coagulation %K European Continental Ancestry Group %K Factor V %K Female %K Fibrin Fibrinogen Degradation Products %K Fibrinogen %K Genetic Testing %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Reference Values %K Thromboplastin %X

BACKGROUND: Fibrin fragment D-dimer, one of several peptides produced when crosslinked fibrin is degraded by plasmin, is the most widely used clinical marker of activated blood coagulation. To identity genetic loci influencing D-dimer levels, we performed the first large-scale, genome-wide association search.

METHODS AND RESULTS: A genome-wide investigation of the genomic correlates of plasma D-dimer levels was conducted among 21 052 European-ancestry adults. Plasma levels of D-dimer were measured independently in each of 13 cohorts. Each study analyzed the association between ≈2.6 million genotyped and imputed variants across the 22 autosomal chromosomes and natural-log–transformed D-dimer levels using linear regression in additive genetic models adjusted for age and sex. Among all variants, 74 exceeded the genome-wide significance threshold and marked 3 regions. At 1p22, rs12029080 (P=6.4×10(-52)) was 46.0 kb upstream from F3, coagulation factor III (tissue factor). At 1q24, rs6687813 (P=2.4×10(-14)) was 79.7 kb downstream of F5, coagulation factor V. At 4q32, rs13109457 (P=2.9×10(-18)) was located between 2 fibrinogen genes: 10.4 kb downstream from FGG and 3.0 kb upstream from FGA. Variants were associated with a 0.099-, 0.096-, and 0.061-unit difference, respectively, in natural-log–transformed D-dimer and together accounted for 1.8% of the total variance. When adjusted for nonsynonymous substitutions in F5 and FGA loci known to be associated with D-dimer levels, there was no evidence of an additional association at either locus.

CONCLUSIONS: Three genes were associated with fibrin D-dimer levels. Of these 3, the F3 association was the strongest, and has not been previously reported.

%B Circulation %V 123 %P 1864-72 %8 2011 May 03 %G eng %N 17 %1 http://www.ncbi.nlm.nih.gov/pubmed/21502573?dopt=Abstract %R 10.1161/CIRCULATIONAHA.110.009480 %0 Journal Article %J Nature %D 2011 %T Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. %A Ehret, Georg B %A Munroe, Patricia B %A Rice, Kenneth M %A Bochud, Murielle %A Johnson, Andrew D %A Chasman, Daniel I %A Smith, Albert V %A Tobin, Martin D %A Verwoert, Germaine C %A Hwang, Shih-Jen %A Pihur, Vasyl %A Vollenweider, Peter %A O'Reilly, Paul F %A Amin, Najaf %A Bragg-Gresham, Jennifer L %A Teumer, Alexander %A Glazer, Nicole L %A Launer, Lenore %A Zhao, Jing Hua %A Aulchenko, Yurii %A Heath, Simon %A Sõber, Siim %A Parsa, Afshin %A Luan, Jian'an %A Arora, Pankaj %A Dehghan, Abbas %A Zhang, Feng %A Lucas, Gavin %A Hicks, Andrew A %A Jackson, Anne U %A Peden, John F %A Tanaka, Toshiko %A Wild, Sarah H %A Rudan, Igor %A Igl, Wilmar %A Milaneschi, Yuri %A Parker, Alex N %A Fava, Cristiano %A Chambers, John C %A Fox, Ervin R %A Kumari, Meena %A Go, Min Jin %A van der Harst, Pim %A Kao, Wen Hong Linda %A Sjögren, Marketa %A Vinay, D G %A Alexander, Myriam %A Tabara, Yasuharu %A Shaw-Hawkins, Sue %A Whincup, Peter H %A Liu, Yongmei %A Shi, Gang %A Kuusisto, Johanna %A Tayo, Bamidele %A Seielstad, Mark %A Sim, Xueling %A Nguyen, Khanh-Dung Hoang %A Lehtimäki, Terho %A Matullo, Giuseppe %A Wu, Ying %A Gaunt, Tom R %A Onland-Moret, N Charlotte %A Cooper, Matthew N %A Platou, Carl G P %A Org, Elin %A Hardy, Rebecca %A Dahgam, Santosh %A Palmen, Jutta %A Vitart, Veronique %A Braund, Peter S %A Kuznetsova, Tatiana %A Uiterwaal, Cuno S P M %A Adeyemo, Adebowale %A Palmas, Walter %A Campbell, Harry %A Ludwig, Barbara %A Tomaszewski, Maciej %A Tzoulaki, Ioanna %A Palmer, Nicholette D %A Aspelund, Thor %A Garcia, Melissa %A Chang, Yen-Pei C %A O'Connell, Jeffrey R %A Steinle, Nanette I %A Grobbee, Diederick E %A Arking, Dan E %A Kardia, Sharon L %A Morrison, Alanna C %A Hernandez, Dena %A Najjar, Samer %A McArdle, Wendy L %A Hadley, David %A Brown, Morris J %A Connell, John M %A Hingorani, Aroon D %A Day, Ian N M %A Lawlor, Debbie A %A Beilby, John P %A Lawrence, Robert W %A Clarke, Robert %A Hopewell, Jemma C %A Ongen, Halit %A Dreisbach, Albert W %A Li, Yali %A Young, J Hunter %A Bis, Joshua C %A Kähönen, Mika %A Viikari, Jorma %A Adair, Linda S %A Lee, Nanette R %A Chen, Ming-Huei %A Olden, Matthias %A Pattaro, Cristian %A Bolton, Judith A Hoffman %A Köttgen, Anna %A Bergmann, Sven %A Mooser, Vincent %A Chaturvedi, Nish %A Frayling, Timothy M %A Islam, Muhammad %A Jafar, Tazeen H %A Erdmann, Jeanette %A Kulkarni, Smita R %A Bornstein, Stefan R %A Grässler, Jürgen %A Groop, Leif %A Voight, Benjamin F %A Kettunen, Johannes %A Howard, Philip %A Taylor, Andrew %A Guarrera, Simonetta %A Ricceri, Fulvio %A Emilsson, Valur %A Plump, Andrew %A Barroso, Inês %A Khaw, Kay-Tee %A Weder, Alan B %A Hunt, Steven C %A Sun, Yan V %A Bergman, Richard N %A Collins, Francis S %A Bonnycastle, Lori L %A Scott, Laura J %A Stringham, Heather M %A Peltonen, Leena %A Perola, Markus %A Vartiainen, Erkki %A Brand, Stefan-Martin %A Staessen, Jan A %A Wang, Thomas J %A Burton, Paul R %A Soler Artigas, Maria %A Dong, Yanbin %A Snieder, Harold %A Wang, Xiaoling %A Zhu, Haidong %A Lohman, Kurt K %A Rudock, Megan E %A Heckbert, Susan R %A Smith, Nicholas L %A Wiggins, Kerri L %A Doumatey, Ayo %A Shriner, Daniel %A Veldre, Gudrun %A Viigimaa, Margus %A Kinra, Sanjay %A Prabhakaran, Dorairaj %A Tripathy, Vikal %A Langefeld, Carl D %A Rosengren, Annika %A Thelle, Dag S %A Corsi, Anna Maria %A Singleton, Andrew %A Forrester, Terrence %A Hilton, Gina %A McKenzie, Colin A %A Salako, Tunde %A Iwai, Naoharu %A Kita, Yoshikuni %A Ogihara, Toshio %A Ohkubo, Takayoshi %A Okamura, Tomonori %A Ueshima, Hirotsugu %A Umemura, Satoshi %A Eyheramendy, Susana %A Meitinger, Thomas %A Wichmann, H-Erich %A Cho, Yoon Shin %A Kim, Hyung-Lae %A Lee, Jong-Young %A Scott, James %A Sehmi, Joban S %A Zhang, Weihua %A Hedblad, Bo %A Nilsson, Peter %A Smith, George Davey %A Wong, Andrew %A Narisu, Narisu %A Stančáková, Alena %A Raffel, Leslie J %A Yao, Jie %A Kathiresan, Sekar %A O'Donnell, Christopher J %A Schwartz, Stephen M %A Ikram, M Arfan %A Longstreth, W T %A Mosley, Thomas H %A Seshadri, Sudha %A Shrine, Nick R G %A Wain, Louise V %A Morken, Mario A %A Swift, Amy J %A Laitinen, Jaana %A Prokopenko, Inga %A Zitting, Paavo %A Cooper, Jackie A %A Humphries, Steve E %A Danesh, John %A Rasheed, Asif %A Goel, Anuj %A Hamsten, Anders %A Watkins, Hugh %A Bakker, Stephan J L %A van Gilst, Wiek H %A Janipalli, Charles S %A Mani, K Radha %A Yajnik, Chittaranjan S %A Hofman, Albert %A Mattace-Raso, Francesco U S %A Oostra, Ben A %A Demirkan, Ayse %A Isaacs, Aaron %A Rivadeneira, Fernando %A Lakatta, Edward G %A Orrù, Marco %A Scuteri, Angelo %A Ala-Korpela, Mika %A Kangas, Antti J %A Lyytikäinen, Leo-Pekka %A Soininen, Pasi %A Tukiainen, Taru %A Würtz, Peter %A Ong, Rick Twee-Hee %A Dörr, Marcus %A Kroemer, Heyo K %A Völker, Uwe %A Völzke, Henry %A Galan, Pilar %A Hercberg, Serge %A Lathrop, Mark %A Zelenika, Diana %A Deloukas, Panos %A Mangino, Massimo %A Spector, Tim D %A Zhai, Guangju %A Meschia, James F %A Nalls, Michael A %A Sharma, Pankaj %A Terzic, Janos %A Kumar, M V Kranthi %A Denniff, Matthew %A Zukowska-Szczechowska, Ewa %A Wagenknecht, Lynne E %A Fowkes, F Gerald R %A Charchar, Fadi J %A Schwarz, Peter E H %A Hayward, Caroline %A Guo, Xiuqing %A Rotimi, Charles %A Bots, Michiel L %A Brand, Eva %A Samani, Nilesh J %A Polasek, Ozren %A Talmud, Philippa J %A Nyberg, Fredrik %A Kuh, Diana %A Laan, Maris %A Hveem, Kristian %A Palmer, Lyle J %A van der Schouw, Yvonne T %A Casas, Juan P %A Mohlke, Karen L %A Vineis, Paolo %A Raitakari, Olli %A Ganesh, Santhi K %A Wong, Tien Y %A Tai, E Shyong %A Cooper, Richard S %A Laakso, Markku %A Rao, Dabeeru C %A Harris, Tamara B %A Morris, Richard W %A Dominiczak, Anna F %A Kivimaki, Mika %A Marmot, Michael G %A Miki, Tetsuro %A Saleheen, Danish %A Chandak, Giriraj R %A Coresh, Josef %A Navis, Gerjan %A Salomaa, Veikko %A Han, Bok-Ghee %A Zhu, Xiaofeng %A Kooner, Jaspal S %A Melander, Olle %A Ridker, Paul M %A Bandinelli, Stefania %A Gyllensten, Ulf B %A Wright, Alan F %A Wilson, James F %A Ferrucci, Luigi %A Farrall, Martin %A Tuomilehto, Jaakko %A Pramstaller, Peter P %A Elosua, Roberto %A Soranzo, Nicole %A Sijbrands, Eric J G %A Altshuler, David %A Loos, Ruth J F %A Shuldiner, Alan R %A Gieger, Christian %A Meneton, Pierre %A Uitterlinden, André G %A Wareham, Nicholas J %A Gudnason, Vilmundur %A Rotter, Jerome I %A Rettig, Rainer %A Uda, Manuela %A Strachan, David P %A Witteman, Jacqueline C M %A Hartikainen, Anna-Liisa %A Beckmann, Jacques S %A Boerwinkle, Eric %A Vasan, Ramachandran S %A Boehnke, Michael %A Larson, Martin G %A Jarvelin, Marjo-Riitta %A Psaty, Bruce M %A Abecasis, Goncalo R %A Chakravarti, Aravinda %A Elliott, Paul %A van Duijn, Cornelia M %A Newton-Cheh, Christopher %A Levy, Daniel %A Caulfield, Mark J %A Johnson, Toby %K Africa %K Asia %K Blood Pressure %K Cardiovascular Diseases %K Coronary Artery Disease %K Europe %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Hypertension %K Kidney Diseases %K Polymorphism, Single Nucleotide %K Stroke %X

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or  ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure (GUCY1A3-GUCY1B3, NPR3-C5orf23, ADM, FURIN-FES, GOSR2, GNAS-EDN3); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention.

%B Nature %V 478 %P 103-9 %8 2011 Sep 11 %G eng %N 7367 %1 http://www.ncbi.nlm.nih.gov/pubmed/21909115?dopt=Abstract %R 10.1038/nature10405 %0 Journal Article %J Brain %D 2011 %T Genetic variants of the NOTCH3 gene in the elderly and magnetic resonance imaging correlates of age-related cerebral small vessel disease. %A Schmidt, Helena %A Zeginigg, Marion %A Wiltgen, Marco %A Freudenberger, Paul %A Petrovic, Katja %A Cavalieri, Margherita %A Gider, Pierre %A Enzinger, Christian %A Fornage, Myriam %A Debette, Stephanie %A Rotter, Jerome I %A Ikram, Mohammad A %A Launer, Lenore J %A Schmidt, Reinhold %K Aged %K Aged, 80 and over %K Alleles %K Brain %K Cerebral Small Vessel Diseases %K Exons %K Female %K Follow-Up Studies %K Genetic Association Studies %K Genotype %K Humans %K Hypertension %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Phenotype %K Promoter Regions, Genetic %K Prospective Studies %K Receptor, Notch3 %K Receptors, Notch %X

Cerebral small vessel disease-related brain lesions such as white matter lesions and lacunes are common findings of magnetic resonance imaging in the elderly. These lesions are thought to be major contributors to disability in old age, and risk factors that include age and hypertension have been established. The radiological, histopathologic and clinical phenotypes of age-related cerebral small vessel disease remarkably resemble autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy, which is caused by mutations in NOTCH3. We hypothesized that genetic variations in NOTCH3 also play a role in age-related cerebral small vessel disease. We directly sequenced all 33 exons, the promoter and 3'-untranslated region of NOTCH3 in 195 participants with either coalescent white matter lesions or lacunes and compared the results to 82 randomly selected participants with no focal changes on magnetic resonance images in the Austrian Stroke Prevention Study. We detected nine common and 33 rare single nucleotide polymorphisms, of which 20 were novel. All common single nucleotide polymorphisms were genotyped in the entire cohort (n = 888), and four of them, rs1043994, rs10404382, rs10423702 and rs1043997, were associated significantly with both the presence and progression of white matter lesions. The association was confined to hypertensives, a result which we replicated in the Cohorts for Heart and Ageing Research in Genomic Epidemiology Consortium on an independent sample of 4773 stroke-free hypertensive elderly individuals of European descent (P = 0.04). The 33 rare single nucleotide polymorphisms were scattered over the NOTCH3 gene with three being located in the promoter region, 24 in exons (18 non-synonymous), three in introns and three in the 3'-untranslated region. None of the single nucleotide polymorphisms affected a cysteine residue. Sorting Intolerant From Tolerant, PolyPhen2 analyses and protein structure simulation consistently predicted six of the non-synonymous single nucleotide polymorphisms (H170R, P496L, V1183M, L1518M, D1823N and V1952M) to be functional, with four being exclusively or mainly detected in subjects with severe white matter lesions. In four individuals with rare non-synonymous single nucleotide polymorphisms, we noted anterior temporal lobe hyperintensity, hyperintensity in the external capsule, lacunar infarcts or subcortical lacunar lesions. None of the observed abnormalities were specific to cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy. This is the first comprehensive study investigating (i) the frequency of NOTCH3 variations in community-dwelling elderly and (ii) their effect on cerebral small vessel disease related magnetic resonance imaging phenotypes. We show that the NOTCH3 gene is highly variable with both common and rare single nucleotide polymorphisms spreading across the gene, and that common variants at the NOTCH3 gene increase the risk of age-related white matter lesions in hypertensives. Additional investigations are required to explore the biological mechanisms underlying the observed association.

%B Brain %V 134 %P 3384-97 %8 2011 Nov %G eng %N Pt 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/22006983?dopt=Abstract %R 10.1093/brain/awr252 %0 Journal Article %J Nat Genet %D 2011 %T Genetic variation near IRS1 associates with reduced adiposity and an impaired metabolic profile. %A Kilpeläinen, Tuomas O %A Zillikens, M Carola %A Stančáková, Alena %A Finucane, Francis M %A Ried, Janina S %A Langenberg, Claudia %A Zhang, Weihua %A Beckmann, Jacques S %A Luan, Jian'an %A Vandenput, Liesbeth %A Styrkarsdottir, Unnur %A Zhou, Yanhua %A Smith, Albert Vernon %A Zhao, Jing-Hua %A Amin, Najaf %A Vedantam, Sailaja %A Shin, So-Youn %A Haritunians, Talin %A Fu, Mao %A Feitosa, Mary F %A Kumari, Meena %A Halldorsson, Bjarni V %A Tikkanen, Emmi %A Mangino, Massimo %A Hayward, Caroline %A Song, Ci %A Arnold, Alice M %A Aulchenko, Yurii S %A Oostra, Ben A %A Campbell, Harry %A Cupples, L Adrienne %A Davis, Kathryn E %A Döring, Angela %A Eiriksdottir, Gudny %A Estrada, Karol %A Fernández-Real, José Manuel %A Garcia, Melissa %A Gieger, Christian %A Glazer, Nicole L %A Guiducci, Candace %A Hofman, Albert %A Humphries, Steve E %A Isomaa, Bo %A Jacobs, Leonie C %A Jula, Antti %A Karasik, David %A Karlsson, Magnus K %A Khaw, Kay-Tee %A Kim, Lauren J %A Kivimaki, Mika %A Klopp, Norman %A Kuhnel, Brigitte %A Kuusisto, Johanna %A Liu, Yongmei %A Ljunggren, Osten %A Lorentzon, Mattias %A Luben, Robert N %A McKnight, Barbara %A Mellström, Dan %A Mitchell, Braxton D %A Mooser, Vincent %A Moreno, José Maria %A Männistö, Satu %A O'Connell, Jeffery R %A Pascoe, Laura %A Peltonen, Leena %A Peral, Belén %A Perola, Markus %A Psaty, Bruce M %A Salomaa, Veikko %A Savage, David B %A Semple, Robert K %A Skaric-Juric, Tatjana %A Sigurdsson, Gunnar %A Song, Kijoung S %A Spector, Timothy D %A Syvänen, Ann-Christine %A Talmud, Philippa J %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Uitterlinden, André G %A van Duijn, Cornelia M %A Vidal-Puig, Antonio %A Wild, Sarah H %A Wright, Alan F %A Clegg, Deborah J %A Schadt, Eric %A Wilson, James F %A Rudan, Igor %A Ripatti, Samuli %A Borecki, Ingrid B %A Shuldiner, Alan R %A Ingelsson, Erik %A Jansson, John-Olov %A Kaplan, Robert C %A Gudnason, Vilmundur %A Harris, Tamara B %A Groop, Leif %A Kiel, Douglas P %A Rivadeneira, Fernando %A Walker, Mark %A Barroso, Inês %A Vollenweider, Peter %A Waeber, Gérard %A Chambers, John C %A Kooner, Jaspal S %A Soranzo, Nicole %A Hirschhorn, Joel N %A Stefansson, Kari %A Wichmann, H-Erich %A Ohlsson, Claes %A O'Rahilly, Stephen %A Wareham, Nicholas J %A Speliotes, Elizabeth K %A Fox, Caroline S %A Laakso, Markku %A Loos, Ruth J F %K Adiponectin %K Adiposity %K Alleles %K Body Fat Distribution %K Body Mass Index %K Body Weight %K Female %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Insulin Receptor Substrate Proteins %K Intracellular Signaling Peptides and Proteins %K Male %K Membrane Proteins %K Meta-Analysis as Topic %K Metabolome %K Obesity %K Polymorphism, Single Nucleotide %K Subcutaneous Fat %X

Genome-wide association studies have identified 32 loci influencing body mass index, but this measure does not distinguish lean from fat mass. To identify adiposity loci, we meta-analyzed associations between ∼2.5 million SNPs and body fat percentage from 36,626 individuals and followed up the 14 most significant (P < 10(-6)) independent loci in 39,576 individuals. We confirmed a previously established adiposity locus in FTO (P = 3 × 10(-26)) and identified two new loci associated with body fat percentage, one near IRS1 (P = 4 × 10(-11)) and one near SPRY2 (P = 3 × 10(-8)). Both loci contain genes with potential links to adipocyte physiology. Notably, the body-fat-decreasing allele near IRS1 is associated with decreased IRS1 expression and with an impaired metabolic profile, including an increased visceral to subcutaneous fat ratio, insulin resistance, dyslipidemia, risk of diabetes and coronary artery disease and decreased adiponectin levels. Our findings provide new insights into adiposity and insulin resistance.

%B Nat Genet %V 43 %P 753-60 %8 2011 Jun 26 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/21706003?dopt=Abstract %R 10.1038/ng.866 %0 Journal Article %J Nat Genet %D 2011 %T Genome-wide association and large-scale follow up identifies 16 new loci influencing lung function. %A Soler Artigas, Maria %A Loth, Daan W %A Wain, Louise V %A Gharib, Sina A %A Obeidat, Ma'en %A Tang, Wenbo %A Zhai, Guangju %A Zhao, Jing Hua %A Smith, Albert Vernon %A Huffman, Jennifer E %A Albrecht, Eva %A Jackson, Catherine M %A Evans, David M %A Cadby, Gemma %A Fornage, Myriam %A Manichaikul, Ani %A Lopez, Lorna M %A Johnson, Toby %A Aldrich, Melinda C %A Aspelund, Thor %A Barroso, Inês %A Campbell, Harry %A Cassano, Patricia A %A Couper, David J %A Eiriksdottir, Gudny %A Franceschini, Nora %A Garcia, Melissa %A Gieger, Christian %A Gislason, Gauti Kjartan %A Grkovic, Ivica %A Hammond, Christopher J %A Hancock, Dana B %A Harris, Tamara B %A Ramasamy, Adaikalavan %A Heckbert, Susan R %A Heliövaara, Markku %A Homuth, Georg %A Hysi, Pirro G %A James, Alan L %A Jankovic, Stipan %A Joubert, Bonnie R %A Karrasch, Stefan %A Klopp, Norman %A Koch, Beate %A Kritchevsky, Stephen B %A Launer, Lenore J %A Liu, Yongmei %A Loehr, Laura R %A Lohman, Kurt %A Loos, Ruth J F %A Lumley, Thomas %A Al Balushi, Khalid A %A Ang, Wei Q %A Barr, R Graham %A Beilby, John %A Blakey, John D %A Boban, Mladen %A Boraska, Vesna %A Brisman, Jonas %A Britton, John R %A Brusselle, Guy G %A Cooper, Cyrus %A Curjuric, Ivan %A Dahgam, Santosh %A Deary, Ian J %A Ebrahim, Shah %A Eijgelsheim, Mark %A Francks, Clyde %A Gaysina, Darya %A Granell, Raquel %A Gu, Xiangjun %A Hankinson, John L %A Hardy, Rebecca %A Harris, Sarah E %A Henderson, John %A Henry, Amanda %A Hingorani, Aroon D %A Hofman, Albert %A Holt, Patrick G %A Hui, Jennie %A Hunter, Michael L %A Imboden, Medea %A Jameson, Karen A %A Kerr, Shona M %A Kolcic, Ivana %A Kronenberg, Florian %A Liu, Jason Z %A Marchini, Jonathan %A McKeever, Tricia %A Morris, Andrew D %A Olin, Anna-Carin %A Porteous, David J %A Postma, Dirkje S %A Rich, Stephen S %A Ring, Susan M %A Rivadeneira, Fernando %A Rochat, Thierry %A Sayer, Avan Aihie %A Sayers, Ian %A Sly, Peter D %A Smith, George Davey %A Sood, Akshay %A Starr, John M %A Uitterlinden, André G %A Vonk, Judith M %A Wannamethee, S Goya %A Whincup, Peter H %A Wijmenga, Cisca %A Williams, O Dale %A Wong, Andrew %A Mangino, Massimo %A Marciante, Kristin D %A McArdle, Wendy L %A Meibohm, Bernd %A Morrison, Alanna C %A North, Kari E %A Omenaas, Ernst %A Palmer, Lyle J %A Pietiläinen, Kirsi H %A Pin, Isabelle %A Pola Sbreve Ek, Ozren %A Pouta, Anneli %A Psaty, Bruce M %A Hartikainen, Anna-Liisa %A Rantanen, Taina %A Ripatti, Samuli %A Rotter, Jerome I %A Rudan, Igor %A Rudnicka, Alicja R %A Schulz, Holger %A Shin, So-Youn %A Spector, Tim D %A Surakka, Ida %A Vitart, Veronique %A Völzke, Henry %A Wareham, Nicholas J %A Warrington, Nicole M %A Wichmann, H-Erich %A Wild, Sarah H %A Wilk, Jemma B %A Wjst, Matthias %A Wright, Alan F %A Zgaga, Lina %A Zemunik, Tatijana %A Pennell, Craig E %A Nyberg, Fredrik %A Kuh, Diana %A Holloway, John W %A Boezen, H Marike %A Lawlor, Debbie A %A Morris, Richard W %A Probst-Hensch, Nicole %A Kaprio, Jaakko %A Wilson, James F %A Hayward, Caroline %A Kähönen, Mika %A Heinrich, Joachim %A Musk, Arthur W %A Jarvis, Deborah L %A Gläser, Sven %A Jarvelin, Marjo-Riitta %A Ch Stricker, Bruno H %A Elliott, Paul %A O'Connor, George T %A Strachan, David P %A London, Stephanie J %A Hall, Ian P %A Gudnason, Vilmundur %A Tobin, Martin D %K Child %K European Continental Ancestry Group %K Genome-Wide Association Study %K Humans %K Pulmonary Disease, Chronic Obstructive %K Respiratory Function Tests %X

Pulmonary function measures reflect respiratory health and are used in the diagnosis of chronic obstructive pulmonary disease. We tested genome-wide association with forced expiratory volume in 1 second and the ratio of forced expiratory volume in 1 second to forced vital capacity in 48,201 individuals of European ancestry with follow up of the top associations in up to an additional 46,411 individuals. We identified new regions showing association (combined P < 5 × 10(-8)) with pulmonary function in or near MFAP2, TGFB2, HDAC4, RARB, MECOM (also known as EVI1), SPATA9, ARMC2, NCR3, ZKSCAN3, CDC123, C10orf11, LRP1, CCDC38, MMP15, CFDP1 and KCNE2. Identification of these 16 new loci may provide insight into the molecular mechanisms regulating pulmonary function and into molecular targets for future therapy to alleviate reduced lung function.

%B Nat Genet %V 43 %P 1082-90 %8 2011 Sep 25 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/21946350?dopt=Abstract %R 10.1038/ng.941 %0 Journal Article %J Ann Neurol %D 2011 %T Genome-wide association studies of cerebral white matter lesion burden: the CHARGE consortium. %A Fornage, Myriam %A Debette, Stephanie %A Bis, Joshua C %A Schmidt, Helena %A Ikram, M Arfan %A Dufouil, Carole %A Sigurdsson, Sigurdur %A Lumley, Thomas %A DeStefano, Anita L %A Fazekas, Franz %A Vrooman, Henri A %A Shibata, Dean K %A Maillard, Pauline %A Zijdenbos, Alex %A Smith, Albert V %A Gudnason, Haukur %A de Boer, Renske %A Cushman, Mary %A Mazoyer, Bernard %A Heiss, Gerardo %A Vernooij, Meike W %A Enzinger, Christian %A Glazer, Nicole L %A Beiser, Alexa %A Knopman, David S %A Cavalieri, Margherita %A Niessen, Wiro J %A Harris, Tamara B %A Petrovic, Katja %A Lopez, Oscar L %A Au, Rhoda %A Lambert, Jean-Charles %A Hofman, Albert %A Gottesman, Rebecca F %A Garcia, Melissa %A Heckbert, Susan R %A Atwood, Larry D %A Catellier, Diane J %A Uitterlinden, André G %A Yang, Qiong %A Smith, Nicholas L %A Aspelund, Thor %A Romero, Jose R %A Rice, Kenneth %A Taylor, Kent D %A Nalls, Michael A %A Rotter, Jerome I %A Sharrett, Richey %A van Duijn, Cornelia M %A Amouyel, Philippe %A Wolf, Philip A %A Gudnason, Vilmundur %A van der Lugt, Aad %A Boerwinkle, Eric %A Psaty, Bruce M %A Seshadri, Sudha %A Tzourio, Christophe %A Breteler, Monique M B %A Mosley, Thomas H %A Schmidt, Reinhold %A Longstreth, W T %A DeCarli, Charles %A Launer, Lenore J %K Aged %K Aged, 80 and over %K Cerebral Cortex %K Chromosomes, Human, Pair 17 %K Cognition Disorders %K Cohort Studies %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Leukoencephalopathies %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Movement Disorders %K Nerve Fibers, Myelinated %K Polymorphism, Single Nucleotide %K Residence Characteristics %K RNA, Messenger %X

OBJECTIVE: White matter hyperintensities (WMHs) detectable by magnetic resonance imaging are part of the spectrum of vascular injury associated with aging of the brain and are thought to reflect ischemic damage to the small deep cerebral vessels. WMHs are associated with an increased risk of cognitive and motor dysfunction, dementia, depression, and stroke. Despite a significant heritability, few genetic loci influencing WMH burden have been identified.

METHODS: We performed a meta-analysis of genome-wide association studies (GWASs) for WMH burden in 9,361 stroke-free individuals of European descent from 7 community-based cohorts. Significant findings were tested for replication in 3,024 individuals from 2 additional cohorts.

RESULTS: We identified 6 novel risk-associated single nucleotide polymorphisms (SNPs) in 1 locus on chromosome 17q25 encompassing 6 known genes including WBP2, TRIM65, TRIM47, MRPL38, FBF1, and ACOX1. The most significant association was for rs3744028 (p(discovery) = 4.0 × 10(-9) ; p(replication) = 1.3 × 10(-7) ; p(combined) = 4.0 × 10(-15) ). Other SNPs in this region also reaching genome-wide significance were rs9894383 (p = 5.3 × 10(-9) ), rs11869977 (p = 5.7 × 10(-9) ), rs936393 (p = 6.8 × 10(-9) ), rs3744017 (p = 7.3 × 10(-9) ), and rs1055129 (p = 4.1 × 10(-8) ). Variant alleles at these loci conferred a small increase in WMH burden (4-8% of the overall mean WMH burden in the sample).

INTERPRETATION: This large GWAS of WMH burden in community-based cohorts of individuals of European descent identifies a novel locus on chromosome 17. Further characterization of this locus may provide novel insights into the pathogenesis of cerebral WMH.

%B Ann Neurol %V 69 %P 928-39 %8 2011 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21681796?dopt=Abstract %R 10.1002/ana.22403 %0 Journal Article %J Hum Mol Genet %D 2011 %T Genome-wide association study for serum urate concentrations and gout among African Americans identifies genomic risk loci and a novel URAT1 loss-of-function allele. %A Tin, Adrienne %A Woodward, Owen M %A Kao, Wen Hong Linda %A Liu, Ching-Ti %A Lu, Xiaoning %A Nalls, Michael A %A Shriner, Daniel %A Semmo, Mariam %A Akylbekova, Ermeg L %A Wyatt, Sharon B %A Hwang, Shih-Jen %A Yang, Qiong %A Zonderman, Alan B %A Adeyemo, Adebowale A %A Palmer, Cameron %A Meng, Yan %A Reilly, Muredach %A Shlipak, Michael G %A Siscovick, David %A Evans, Michele K %A Rotimi, Charles N %A Flessner, Michael F %A Köttgen, Michael %A Cupples, L Adrienne %A Fox, Caroline S %A Köttgen, Anna %K Adult %K African Americans %K Aged %K Animals %K CHO Cells %K Cricetinae %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Gout %K Humans %K Loss of Heterozygosity %K Male %K Middle Aged %K Organic Anion Transporters %K Organic Cation Transport Proteins %K Polymorphism, Single Nucleotide %K Uric Acid %K Young Adult %X

Serum urate concentrations are highly heritable and elevated serum urate is a key risk factor for gout. Genome-wide association studies (GWAS) of serum urate in African American (AA) populations are lacking. We conducted a meta-analysis of GWAS of serum urate levels and gout among 5820 AA and a large candidate gene study among 6890 AA and 21 708 participants of European ancestry (EA) within the Candidate Gene Association Resource Consortium. Findings were tested for replication among 1996 independent AA individuals, and evaluated for their association among 28 283 EA participants of the CHARGE Consortium. Functional studies were conducted using (14)C-urate transport assays in mammalian Chinese hamster ovary cells. In the discovery GWAS of serum urate, three loci achieved genome-wide significance (P< 5.0 × 10(-8)): a novel locus near SGK1/SLC2A12 on chromosome 6 (rs9321453, P= 1.0 × 10(-9)), and two loci previously identified in EA participants, SLC2A9 (P= 3.8 × 10(-32)) and SLC22A12 (P= 2.1 × 10(-10)). A novel rare non-synonymous variant of large effect size in SLC22A12, rs12800450 (minor allele frequency 0.01, G65W), was identified and replicated (beta -1.19 mg/dl, P= 2.7 × 10(-16)). (14)C-urate transport assays showed reduced urate transport for the G65W URAT1 mutant. Finally, in analyses of 11 loci previously associated with serum urate in EA individuals, 10 of 11 lead single-nucleotide polymorphisms showed direction-consistent association with urate among AA. In summary, we identified and replicated one novel locus in association with serum urate levels and experimentally characterize the novel G65W variant in URAT1 as a functional allele. Our data support the importance of multi-ethnic GWAS in the identification of novel risk loci as well as functional variants.

%B Hum Mol Genet %V 20 %P 4056-68 %8 2011 Oct 15 %G eng %N 20 %1 http://www.ncbi.nlm.nih.gov/pubmed/21768215?dopt=Abstract %R 10.1093/hmg/ddr307 %0 Journal Article %J Hum Mol Genet %D 2011 %T A genome-wide association study identifies novel loci associated with circulating IGF-I and IGFBP-3. %A Kaplan, Robert C %A Petersen, Ann-Kristin %A Chen, Ming-Huei %A Teumer, Alexander %A Glazer, Nicole L %A Döring, Angela %A Lam, Carolyn S P %A Friedrich, Nele %A Newman, Anne %A Müller, Martina %A Yang, Qiong %A Homuth, Georg %A Cappola, Anne %A Klopp, Norman %A Smith, Holly %A Ernst, Florian %A Psaty, Bruce M %A Wichmann, H-Erich %A Sawyer, Douglas B %A Biffar, Reiner %A Rotter, Jerome I %A Gieger, Christian %A Sullivan, Lisa S %A Völzke, Henry %A Rice, Kenneth %A Spyroglou, Ariadni %A Kroemer, Heyo K %A Ida Chen, Y-D %A Manolopoulou, Jenny %A Nauck, Matthias %A Strickler, Howard D %A Goodarzi, Mark O %A Reincke, Martin %A Pollak, Michael N %A Bidlingmaier, Martin %A Vasan, Ramachandran S %A Wallaschofski, Henri %K Aged %K Chromosomes, Human, Pair 7 %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Insulin-Like Growth Factor Binding Protein 3 %K Insulin-Like Growth Factor I %K Male %K Polymorphism, Single Nucleotide %X

Insulin-like growth factor-I (IGF-I) and insulin-like growth factor-binding protein-3 (IGFBP-3) are involved in cell replication, proliferation, differentiation, protein synthesis, carbohydrate homeostasis and bone metabolism. Circulating IGF-I and IGFBP-3 concentrations predict anthropometric traits and risk of cancer and cardiovascular disease. In a genome-wide association study of 10 280 middle-aged and older men and women from four community-based cohort studies, we confirmed a known association of single nucleotide polymorphisms in the IGFBP3 gene region on chromosome 7p12.3 with IGFBP-3 concentrations using a significance threshold of P < 5 × 10(-8) (P = 3.3 × 10(-101)). Furthermore, the same IGFBP3 gene locus (e.g. rs11977526) that was associated with IGFBP-3 concentrations was also associated with the opposite direction of effect, with IGF-I concentration after adjustment for IGFBP-3 concentration (P = 1.9 × 10(-26)). A novel and independent locus on chromosome 7p12.3 (rs700752) had genome-wide significant associations with higher IGFBP-3 (P = 4.4 × 10(-21)) and higher IGF-I (P = 4.9 × 10(-9)) concentrations; when the two measurements were adjusted for one another, the IGF-I association was attenuated but the IGFBP-3 association was not. Two additional loci demonstrated genome-wide significant associations with IGFBP-3 concentration (rs1065656, chromosome 16p13.3, P = 1.2 × 10(-11), IGFALS, a confirmatory finding; and rs4234798, chromosome 4p16.1, P = 4.5 × 10(-10), SORCS2, a novel finding). Together, the four genome-wide significant loci explained 6.5% of the population variation in IGFBP-3 concentration. Furthermore, we observed a borderline statistically significant association between IGF-I concentration and FOXO3 (rs2153960, chromosome 6q21, P = 5.1 × 10(-7)), a locus associated with longevity. These genetic loci deserve further investigation to elucidate the biological basis for the observed associations and clarify their possible role in IGF-mediated regulation of cell growth and metabolism.

%B Hum Mol Genet %V 20 %P 1241-51 %8 2011 Mar 15 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21216879?dopt=Abstract %R 10.1093/hmg/ddq560 %0 Journal Article %J Nat Genet %D 2011 %T Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure. %A Wain, Louise V %A Verwoert, Germaine C %A O'Reilly, Paul F %A Shi, Gang %A Johnson, Toby %A Johnson, Andrew D %A Bochud, Murielle %A Rice, Kenneth M %A Henneman, Peter %A Smith, Albert V %A Ehret, Georg B %A Amin, Najaf %A Larson, Martin G %A Mooser, Vincent %A Hadley, David %A Dörr, Marcus %A Bis, Joshua C %A Aspelund, Thor %A Esko, Tõnu %A Janssens, A Cecile J W %A Zhao, Jing Hua %A Heath, Simon %A Laan, Maris %A Fu, Jingyuan %A Pistis, Giorgio %A Luan, Jian'an %A Arora, Pankaj %A Lucas, Gavin %A Pirastu, Nicola %A Pichler, Irene %A Jackson, Anne U %A Webster, Rebecca J %A Zhang, Feng %A Peden, John F %A Schmidt, Helena %A Tanaka, Toshiko %A Campbell, Harry %A Igl, Wilmar %A Milaneschi, Yuri %A Hottenga, Jouke-Jan %A Vitart, Veronique %A Chasman, Daniel I %A Trompet, Stella %A Bragg-Gresham, Jennifer L %A Alizadeh, Behrooz Z %A Chambers, John C %A Guo, Xiuqing %A Lehtimäki, Terho %A Kuhnel, Brigitte %A Lopez, Lorna M %A Polasek, Ozren %A Boban, Mladen %A Nelson, Christopher P %A Morrison, Alanna C %A Pihur, Vasyl %A Ganesh, Santhi K %A Hofman, Albert %A Kundu, Suman %A Mattace-Raso, Francesco U S %A Rivadeneira, Fernando %A Sijbrands, Eric J G %A Uitterlinden, André G %A Hwang, Shih-Jen %A Vasan, Ramachandran S %A Wang, Thomas J %A Bergmann, Sven %A Vollenweider, Peter %A Waeber, Gérard %A Laitinen, Jaana %A Pouta, Anneli %A Zitting, Paavo %A McArdle, Wendy L %A Kroemer, Heyo K %A Völker, Uwe %A Völzke, Henry %A Glazer, Nicole L %A Taylor, Kent D %A Harris, Tamara B %A Alavere, Helene %A Haller, Toomas %A Keis, Aime %A Tammesoo, Mari-Liis %A Aulchenko, Yurii %A Barroso, Inês %A Khaw, Kay-Tee %A Galan, Pilar %A Hercberg, Serge %A Lathrop, Mark %A Eyheramendy, Susana %A Org, Elin %A Sõber, Siim %A Lu, Xiaowen %A Nolte, Ilja M %A Penninx, Brenda W %A Corre, Tanguy %A Masciullo, Corrado %A Sala, Cinzia %A Groop, Leif %A Voight, Benjamin F %A Melander, Olle %A O'Donnell, Christopher J %A Salomaa, Veikko %A d'Adamo, Adamo Pio %A Fabretto, Antonella %A Faletra, Flavio %A Ulivi, Sheila %A Del Greco, Fabiola M %A Facheris, Maurizio %A Collins, Francis S %A Bergman, Richard N %A Beilby, John P %A Hung, Joseph %A Musk, A William %A Mangino, Massimo %A Shin, So-Youn %A Soranzo, Nicole %A Watkins, Hugh %A Goel, Anuj %A Hamsten, Anders %A Gider, Pierre %A Loitfelder, Marisa %A Zeginigg, Marion %A Hernandez, Dena %A Najjar, Samer S %A Navarro, Pau %A Wild, Sarah H %A Corsi, Anna Maria %A Singleton, Andrew %A de Geus, Eco J C %A Willemsen, Gonneke %A Parker, Alex N %A Rose, Lynda M %A Buckley, Brendan %A Stott, David %A Orrù, Marco %A Uda, Manuela %A van der Klauw, Melanie M %A Zhang, Weihua %A Li, Xinzhong %A Scott, James %A Chen, Yii-Der Ida %A Burke, Gregory L %A Kähönen, Mika %A Viikari, Jorma %A Döring, Angela %A Meitinger, Thomas %A Davies, Gail %A Starr, John M %A Emilsson, Valur %A Plump, Andrew %A Lindeman, Jan H %A Hoen, Peter A C 't %A König, Inke R %A Felix, Janine F %A Clarke, Robert %A Hopewell, Jemma C %A Ongen, Halit %A Breteler, Monique %A Debette, Stephanie %A DeStefano, Anita L %A Fornage, Myriam %A Mitchell, Gary F %A Smith, Nicholas L %A Holm, Hilma %A Stefansson, Kari %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Samani, Nilesh J %A Preuss, Michael %A Rudan, Igor %A Hayward, Caroline %A Deary, Ian J %A Wichmann, H-Erich %A Raitakari, Olli T %A Palmas, Walter %A Kooner, Jaspal S %A Stolk, Ronald P %A Jukema, J Wouter %A Wright, Alan F %A Boomsma, Dorret I %A Bandinelli, Stefania %A Gyllensten, Ulf B %A Wilson, James F %A Ferrucci, Luigi %A Schmidt, Reinhold %A Farrall, Martin %A Spector, Tim D %A Palmer, Lyle J %A Tuomilehto, Jaakko %A Pfeufer, Arne %A Gasparini, Paolo %A Siscovick, David %A Altshuler, David %A Loos, Ruth J F %A Toniolo, Daniela %A Snieder, Harold %A Gieger, Christian %A Meneton, Pierre %A Wareham, Nicholas J %A Oostra, Ben A %A Metspalu, Andres %A Launer, Lenore %A Rettig, Rainer %A Strachan, David P %A Beckmann, Jacques S %A Witteman, Jacqueline C M %A Erdmann, Jeanette %A van Dijk, Ko Willems %A Boerwinkle, Eric %A Boehnke, Michael %A Ridker, Paul M %A Jarvelin, Marjo-Riitta %A Chakravarti, Aravinda %A Abecasis, Goncalo R %A Gudnason, Vilmundur %A Newton-Cheh, Christopher %A Levy, Daniel %A Munroe, Patricia B %A Psaty, Bruce M %A Caulfield, Mark J %A Rao, Dabeeru C %A Tobin, Martin D %A Elliott, Paul %A van Duijn, Cornelia M %K Arteries %K Blood Pressure %K Case-Control Studies %K Follow-Up Studies %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Hypertension %K Linkage Disequilibrium %K Polymorphism, Single Nucleotide %X

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP.

%B Nat Genet %V 43 %P 1005-11 %8 2011 Sep 11 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21909110?dopt=Abstract %R 10.1038/ng.922 %0 Journal Article %J Neurobiol Aging %D 2011 %T A genome-wide association study of aging. %A Walter, Stefan %A Atzmon, Gil %A Demerath, Ellen W %A Garcia, Melissa E %A Kaplan, Robert C %A Kumari, Meena %A Lunetta, Kathryn L %A Milaneschi, Yuri %A Tanaka, Toshiko %A Tranah, Gregory J %A Völker, Uwe %A Yu, Lei %A Arnold, Alice %A Benjamin, Emelia J %A Biffar, Reiner %A Buchman, Aron S %A Boerwinkle, Eric %A Couper, David %A De Jager, Philip L %A Evans, Denis A %A Harris, Tamara B %A Hoffmann, Wolfgang %A Hofman, Albert %A Karasik, David %A Kiel, Douglas P %A Kocher, Thomas %A Kuningas, Maris %A Launer, Lenore J %A Lohman, Kurt K %A Lutsey, Pamela L %A Mackenbach, Johan %A Marciante, Kristin %A Psaty, Bruce M %A Reiman, Eric M %A Rotter, Jerome I %A Seshadri, Sudha %A Shardell, Michelle D %A Smith, Albert V %A van Duijn, Cornelia %A Walston, Jeremy %A Zillikens, M Carola %A Bandinelli, Stefania %A Baumeister, Sebastian E %A Bennett, David A %A Ferrucci, Luigi %A Gudnason, Vilmundur %A Kivimaki, Mika %A Liu, Yongmei %A Murabito, Joanne M %A Newman, Anne B %A Tiemeier, Henning %A Franceschini, Nora %K Aging %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Longevity %X

Human longevity and healthy aging show moderate heritability (20%-50%). We conducted a meta-analysis of genome-wide association studies from 9 studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium for 2 outcomes: (1) all-cause mortality, and (2) survival free of major disease or death. No single nucleotide polymorphism (SNP) was a genome-wide significant predictor of either outcome (p < 5 × 10(-8)). We found 14 independent SNPs that predicted risk of death, and 8 SNPs that predicted event-free survival (p < 10(-5)). These SNPs are in or near genes that are highly expressed in the brain (HECW2, HIP1, BIN2, GRIA1), genes involved in neural development and function (KCNQ4, LMO4, GRIA1, NETO1) and autophagy (ATG4C), and genes that are associated with risk of various diseases including cancer and Alzheimer's disease. In addition to considerable overlap between the traits, pathway and network analysis corroborated these findings. These findings indicate that variation in genes involved in neurological processes may be an important factor in regulating aging free of major disease and achieving longevity.

%B Neurobiol Aging %V 32 %P 2109.e15-28 %8 2011 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/21782286?dopt=Abstract %R 10.1016/j.neurobiolaging.2011.05.026 %0 Journal Article %J Aging (Albany NY) %D 2011 %T Health and function of participants in the Long Life Family Study: A comparison with other cohorts. %A Newman, Anne B %A Glynn, Nancy W %A Taylor, Christopher A %A Sebastiani, Paola %A Perls, Thomas T %A Mayeux, Richard %A Christensen, Kaare %A Zmuda, Joseph M %A Barral, Sandra %A Lee, Joseph H %A Simonsick, Eleanor M %A Walston, Jeremy D %A Yashin, Anatoli I %A Hadley, Evan %K Aged %K Aged, 80 and over %K Aging %K Blood Pressure %K Cardiovascular Diseases %K Cohort Studies %K Female %K Gait %K Humans %K Longevity %K Male %K Middle Aged %K Psychomotor Performance %K Research Design %X

Individuals from families recruited for the Long Life Family Study (LLFS) (n= 4559) were examined and compared to individuals from other cohorts to determine whether the recruitment targeting longevity resulted in a cohort of individuals with better health and function. Other cohorts with similar data included the Cardiovascular Health Study, the Framingham Heart Study, and the New England Centenarian Study. Diabetes, chronic pulmonary disease and peripheral artery disease tended to be less common in LLFS probands and offspring compared to similar aged persons in the other cohorts. Pulse pressure and triglycerides were lower, high density lipids were higher, and a perceptual speed task and gait speed were better in LLFS. Age-specific comparisons showed differences that would be consistent with a higher peak, later onset of decline or slower rate of change across age in LLFS participants. These findings suggest several priority phenotypes for inclusion in future genetic analysis to identify loci contributing to exceptional survival.

%B Aging (Albany NY) %V 3 %P 63-76 %8 2011 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21258136?dopt=Abstract %R 10.18632/aging.100242 %0 Journal Article %J J Am Geriatr Soc %D 2011 %T High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up. %A Rosano, Caterina %A Longstreth, William T %A Boudreau, Robert %A Taylor, Christopher A %A Du, Yan %A Kuller, Lewis H %A Newman, Anne B %K Aged %K Antihypertensive Agents %K Comorbidity %K Female %K Follow-Up Studies %K Gait %K Geriatric Assessment %K Humans %K Hypertension %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Risk Factors %K Statistics, Nonparametric %X

OBJECTIVES: To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it.

DESIGN: Longitudinal cohort study.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Of 2,733 potential participants with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included.

MEASUREMENTS: Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors.

RESULTS: Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results.

CONCLUSION: High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted.

%B J Am Geriatr Soc %V 59 %P 390-7 %8 2011 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21391929?dopt=Abstract %R 10.1111/j.1532-5415.2010.03282.x %0 Journal Article %J Stroke %D 2011 %T Hospitalization for infection and risk of acute ischemic stroke: the Cardiovascular Health Study. %A Elkind, Mitchell S V %A Carty, Cara L %A O'Meara, Ellen S %A Lumley, Thomas %A Lefkowitz, David %A Kronmal, Richard A %A Longstreth, W T %K Bacterial Infections %K Brain Ischemia %K Cardiology %K Cohort Studies %K Cross-Over Studies %K Female %K Follow-Up Studies %K Hospitalization %K Humans %K Male %K Odds Ratio %K Proportional Hazards Models %K Regression Analysis %K Risk %K Stroke %K Time Factors %X

BACKGROUND AND PURPOSE: Little is known about the acute precipitants of ischemic stroke, although evidence suggests infections contribute to risk. We hypothesized that acute hospitalization for infection is associated with the short-term risk of stroke.

METHODS: The case-crossover design was used to compare hospitalization for infection during case periods (90, 30, or 14 days before an incident ischemic stroke) and control periods (equivalent time periods exactly 1 or 2 years before stroke) in the Cardiovascular Health Study, a population-based cohort of 5888 elderly participants from 4 US sites. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by conditional logistic regression. Confirmatory analyses assessed hazard ratios of stroke from Cox regression models, with hospitalization for infection as a time-varying exposure.

RESULTS: During a median follow-up of 12.2 years, 669 incident ischemic strokes were observed in participants without a baseline history of stroke. Hospitalization for infection was more likely during case than control time periods; for 90 days before stroke, OR=3.4 (95% CI, 1.8 to 6.5). The point estimates of risks were higher when we examined shorter intervals: for 30 days, OR=7.3 (95% CI, 1.9 to 40.9), and for 14 days, OR=8.0 (95% CI, 1.7 to 77.3). In survival analyses, risk of stroke was associated with hospitalization for infection in the preceding 90 days, adjusted hazard ratio=2.4 (95% CI, 1.6 to 3.4).

CONCLUSIONS: Hospitalization for infection is associated with a short-term increased risk of stroke, with higher risks observed for shorter intervals preceding stroke.

%B Stroke %V 42 %P 1851-6 %8 2011 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/21546476?dopt=Abstract %R 10.1161/STROKEAHA.110.608588 %0 Journal Article %J Circulation %D 2011 %T Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: the Cardiovascular Health Study. %A Hajjar, Ihab %A Quach, Lien %A Yang, Frances %A Chaves, Paulo H M %A Newman, Anne B %A Mukamal, Kenneth %A Longstreth, Will %A Inzitari, Marco %A Lipsitz, Lewis A %K Aged %K Aged, 80 and over %K Brain %K Cognition Disorders %K Female %K Humans %K Hypertension %K Kaplan-Meier Estimate %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Microcirculation %K Mobility Limitation %K Mood Disorders %K Nerve Fibers, Myelinated %K Retrospective Studies %K Risk Factors %X

BACKGROUND: Our objective was to investigate the association between hypertension and concurrent impairments in mobility, cognition, and mood; the role of brain white matter hyperintensities in mediating this association; and the impact of these impairments on disability and mortality in elderly hypertensive individuals.

METHODS AND RESULTS: -Blood pressure, gait speed, digit symbol substitution test, and the Center for Epidemiological Studies Depression Scale were measured yearly (1992-1999) on 4700 participants in the Cardiovascular Health Study (age: 74.7, 58% women, 17% blacks, 68% hypertension, 3600 had brain magnetic resonance imaging in 1992-1993, survival data 1992-2005). Using latent profile analysis at baseline, we found that 498 (11%) subjects had concurrent impairments and 3086 (66%) were intact on all 3 measures. Between 1992 and 1999, 651 (21%) became impaired in all 3 domains. Hypertensive individuals were more likely to be impaired at baseline (odds ratio 1.23, 95% confidence interval 1.04 to 1.42, P=0.01) and become impaired during the follow-up (hazard ratio=1.3, 95% confidence interval 1.02 to 1.66, P=0.037). A greater degree of white matter hyperintensities was associated with impairments in the 3 domains (P=0.007) and mediated the association with hypertension (P=0.19 for hypertension after adjusting for white matter hyperintensities in the model, 21% hazard ratio change). Impairments in the 3 domains increased subsequent disability with hypertension (P<0.0001). Hypertension mortality also was increased in those impaired (compared with unimpaired hypertensive individuals: HR=1.10, 95% confidence interval 1.04 to 1.17, P=0.004).

CONCLUSIONS: Hypertension increases the risk of concurrent impairments in mobility, cognition, and mood, which increases disability and mortality. This association is mediated in part by microvascular brain injury.

%B Circulation %V 123 %P 858-65 %8 2011 Mar 01 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/21321150?dopt=Abstract %R 10.1161/CIRCULATIONAHA.110.978114 %0 Journal Article %J PLoS Genet %D 2011 %T Identification of a sudden cardiac death susceptibility locus at 2q24.2 through genome-wide association in European ancestry individuals. %A Arking, Dan E %A Junttila, M Juhani %A Goyette, Philippe %A Huertas-Vazquez, Adriana %A Eijgelsheim, Mark %A Blom, Marieke T %A Newton-Cheh, Christopher %A Reinier, Kyndaron %A Teodorescu, Carmen %A Uy-Evanado, Audrey %A Carter-Monroe, Naima %A Kaikkonen, Kari S %A Kortelainen, Marja-Leena %A Boucher, Gabrielle %A Lagacé, Caroline %A Moes, Anna %A Zhao, XiaoQing %A Kolodgie, Frank %A Rivadeneira, Fernando %A Hofman, Albert %A Witteman, Jacqueline C M %A Uitterlinden, André G %A Marsman, Roos F %A Pazoki, Raha %A Bardai, Abdennasser %A Koster, Rudolph W %A Dehghan, Abbas %A Hwang, Shih-Jen %A Bhatnagar, Pallav %A Post, Wendy %A Hilton, Gina %A Prineas, Ronald J %A Li, Man %A Köttgen, Anna %A Ehret, Georg %A Boerwinkle, Eric %A Coresh, Josef %A Kao, W H Linda %A Psaty, Bruce M %A Tomaselli, Gordon F %A Sotoodehnia, Nona %A Siscovick, David S %A Burke, Greg L %A Marbán, Eduardo %A Spooner, Peter M %A Cupples, L Adrienne %A Jui, Jonathan %A Gunson, Karen %A Kesaniemi, Y Antero %A Wilde, Arthur A M %A Tardif, Jean-Claude %A O'Donnell, Christopher J %A Bezzina, Connie R %A Virmani, Renu %A Stricker, Bruno H C H %A Tan, Hanno L %A Albert, Christine M %A Chakravarti, Aravinda %A Rioux, John D %A Huikuri, Heikki V %A Chugh, Sumeet S %K Adult %K Aged %K Alleles %K Chromosomes, Human, Pair 2 %K Death, Sudden, Cardiac %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Myocardial Contraction %K Polymorphism, Single Nucleotide %X

Sudden cardiac death (SCD) continues to be one of the leading causes of mortality worldwide, with an annual incidence estimated at 250,000-300,000 in the United States and with the vast majority occurring in the setting of coronary disease. We performed a genome-wide association meta-analysis in 1,283 SCD cases and >20,000 control individuals of European ancestry from 5 studies, with follow-up genotyping in up to 3,119 SCD cases and 11,146 controls from 11 European ancestry studies, and identify the BAZ2B locus as associated with SCD (P = 1.8×10(-10)). The risk allele, while ancestral, has a frequency of ~1.4%, suggesting strong negative selection and increases risk for SCD by 1.92-fold per allele (95% CI 1.57-2.34). We also tested the role of 49 SNPs previously implicated in modulating electrocardiographic traits (QRS, QT, and RR intervals). Consistent with epidemiological studies showing increased risk of SCD with prolonged QRS/QT intervals, the interval-prolonging alleles are in aggregate associated with increased risk for SCD (P = 0.006).

%B PLoS Genet %V 7 %P e1002158 %8 2011 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21738491?dopt=Abstract %R 10.1371/journal.pgen.1002158 %0 Journal Article %J Circ Cardiovasc Genet %D 2011 %T Large-scale candidate gene analysis in whites and African Americans identifies IL6R polymorphism in relation to atrial fibrillation: the National Heart, Lung, and Blood Institute's Candidate Gene Association Resource (CARe) project. %A Schnabel, Renate B %A Kerr, Kathleen F %A Lubitz, Steven A %A Alkylbekova, Ermeg L %A Marcus, Gregory M %A Sinner, Moritz F %A Magnani, Jared W %A Wolf, Philip A %A Deo, Rajat %A Lloyd-Jones, Donald M %A Lunetta, Kathryn L %A Mehra, Reena %A Levy, Daniel %A Fox, Ervin R %A Arking, Dan E %A Mosley, Thomas H %A Müller-Nurasyid, Martina %A Young, Taylor R %A Wichmann, H-Erich %A Seshadri, Sudha %A Farlow, Deborah N %A Rotter, Jerome I %A Soliman, Elsayed Z %A Glazer, Nicole L %A Wilson, James G %A Breteler, Monique M B %A Sotoodehnia, Nona %A Newton-Cheh, Christopher %A Kääb, Stefan %A Ellinor, Patrick T %A Alonso, Alvaro %A Benjamin, Emelia J %A Heckbert, Susan R %K African Americans %K Aged %K Alleles %K Atrial Fibrillation %K Chromosomes, Human, Pair 4 %K Cohort Studies %K European Continental Ancestry Group %K Female %K Humans %K Male %K Middle Aged %K National Heart, Lung, and Blood Institute (U.S.) %K Polymorphism, Single Nucleotide %K Receptors, Interleukin-6 %K Risk Factors %K Stroke %K United States %X

BACKGROUND: The genetic background of atrial fibrillation (AF) in whites and African Americans is largely unknown. Genes in cardiovascular pathways have not been systematically investigated.

METHODS AND RESULTS: We examined a panel of approximately 50,000 common single-nucleotide polymorphisms (SNPs) in 2095 cardiovascular candidate genes and AF in 3 cohorts with participants of European (n=18,524; 2260 cases) or African American descent (n=3662; 263 cases) in the National Heart, Lung, and Blood Institute's Candidate Gene Association Resource. Results in whites were followed up in the German Competence Network for AF (n=906, 468 cases). The top result was assessed in relation to incident ischemic stroke in the Cohorts for Heart and Aging Research in Genomic Epidemiology Stroke Consortium (n=19,602 whites, 1544 incident strokes). SNP rs4845625 in the IL6R gene was associated with AF (relative risk [RR] C allele, 0.90; 95% confidence interval [CI], 0.85-0.95; P=0.0005) in whites but did not reach statistical significance in African Americans (RR, 0.86; 95% CI, 0.72-1.03; P=0.09). The results were comparable in the German AF Network replication, (RR, 0.71; 95% CI, 0.57-0.89; P=0.003). No association between rs4845625 and stroke was observed in whites. The known chromosome 4 locus near PITX2 in whites also was associated with AF in African Americans (rs4611994; hazard ratio, 1.40; 95% CI, 1.16-1.69; P=0.0005).

CONCLUSIONS: In a community-based cohort meta-analysis, we identified genetic association in IL6R with AF in whites. Additionally, we demonstrated that the chromosome 4 locus known from recent genome-wide association studies in whites is associated with AF in African Americans.

%B Circ Cardiovasc Genet %V 4 %P 557-64 %8 2011 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/21846873?dopt=Abstract %R 10.1161/CIRCGENETICS.110.959197 %0 Journal Article %J Thromb Haemost %D 2011 %T Longer legs are associated with greater risk of incident venous thromboembolism independent of total body height. The Longitudinal Study of Thromboembolism Etiology (LITE). %A Lutsey, Pamela L %A Cushman, Mary %A Heckbert, Susan R %A Tang, Weihong %A Folsom, Aaron R %K Adult %K Aged %K Anthropometry %K Body Height %K Female %K Follow-Up Studies %K Humans %K Leg %K Male %K Middle Aged %K Population Groups %K Prospective Studies %K Risk Factors %K United States %K Venous Thromboembolism %X

Several studies have reported that taller individuals are at greater risk of venous thromboembolism (VTE). We hypothesised that longer leg length would be positively associated with incident VTE, and would explain the height association. LITE ascertained VTE in a prospective population-based sample of 21,860 individuals aged 45 and older. Leg length was measured as standing height minus torso length. Cox regression models were adjusted for age, race, sex, waist circumference, diabetes, and factor VIII. To evaluate whether leg length was associated with VTE risk independent of height, we standardised leg length and height per 1 standard deviation (SD), and then included them simultaneously in Cox regression models. A total of 641 incident VTE cases accrued over a median follow-up of 16 years. Participants in the highest quintile of leg length were at 59% (95% CI: 22%-108%) greater risk of VTE, relative to the lowest quintile. For height, risk was 45% (12%-88%) greater for those in the highest quintile, compared to the lowest. When leg length and height were modelled simultaneously leg length remained associated with VTE risk (HR per 1 SD: 1.21 (1.04-1.40) while height was unrelated (HR per 1 SD: 1.00 (0.86-1.16). To conclude, participants with longer legs were at greater risk of incident VTE, and leg length explained the relation of height to VTE. It remains to be established whether this finding is due to greater venous surface area, a larger number of venous valves, or greater hydrostatic pressure among individuals with longer legs.

%B Thromb Haemost %V 106 %P 113-20 %8 2011 Jul %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21655679?dopt=Abstract %R 10.1160/TH11-02-0100 %0 Journal Article %J Kidney Int %D 2011 %T Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes. A collaborative meta-analysis of general and high-risk population cohorts. %A Gansevoort, Ron T %A Matsushita, Kunihiro %A van der Velde, Marije %A Astor, Brad C %A Woodward, Mark %A Levey, Andrew S %A de Jong, Paul E %A Coresh, Josef %K Aged %K Albuminuria %K Cohort Studies %K Creatinine %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Prognosis %K Proportional Hazards Models %K Risk Factors %X

Both a low estimated glomerular filtration rate (eGFR) and albuminuria are known risk factors for end-stage renal disease (ESRD). To determine their joint contribution to ESRD and other kidney outcomes, we performed a meta-analysis of nine general population cohorts with 845,125 participants and an additional eight cohorts with 173,892 patients, the latter selected because of their high risk for chronic kidney disease (CKD). In the general population, the risk for ESRD was unrelated to eGFR at values between 75 and 105 ml/min per 1.73 m(2) but increased exponentially at lower levels. Hazard ratios for eGFRs averaging 60, 45, and 15 were 4, 29, and 454, respectively, compared with an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log ESRD risk without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 30, 300, and 1000 mg/g were 5, 13, and 28, respectively, compared with an albumin-to-creatinine ratio of 5. Albuminuria and eGFR were associated with ESRD, without evidence for multiplicative interaction. Similar associations were found for acute kidney injury and progressive CKD. In high-risk cohorts, the findings were generally comparable. Thus, lower eGFR and higher albuminuria are risk factors for ESRD, acute kidney injury and progressive CKD in both general and high-risk populations, independent of each other and of cardiovascular risk factors.

%B Kidney Int %V 80 %P 93-104 %8 2011 Jul %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21289597?dopt=Abstract %R 10.1038/ki.2010.531 %0 Journal Article %J Am J Epidemiol %D 2011 %T Measures of adiposity and future risk of ischemic stroke and coronary heart disease in older men and women. %A Kizer, Jorge R %A Biggs, Mary L %A Ix, Joachim H %A Mukamal, Kenneth J %A Zieman, Susan J %A de Boer, Ian H %A Mozaffarian, Dariush %A Barzilay, Joshua I %A Strotmeyer, Elsa S %A Luchsinger, José A %A Elkind, Mitchell S V %A Longstreth, W T %A Kuller, Lewis H %A Siscovick, David S %K Adiposity %K Age Factors %K Aged %K Aged, 80 and over %K Brain Ischemia %K Coronary Disease %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Obesity %K Prevalence %K Retrospective Studies %K Risk Factors %K Sex Factors %K United States %X

The relation between measures of general and central adiposity and individual cardiovascular endpoints remains understudied in older adults. This study investigated the association of measures of body size and composition with incident ischemic stroke or coronary heart disease (1989-2007) in 3,754 community-dwelling US adults aged 65-100 years. Standardized anthropometry and bioelectric impedance measurements were obtained at baseline. Body mass index at age 50 years (BMI50) was calculated on the basis of recalled weight. Although only waist/hip ratio was significantly associated with ischemic stroke in quintile analysis in women, dichotomized body mass index (BMI) (≥ 30 kg/m²) was the only significant predictor in men. For coronary heart disease, there were significant positive adjusted associations for all adiposity measures, without interaction by sex. This was true for both quintiles and conventional cutpoints for obesity, although BMI-defined overweight (25-29.9 kg/m² was significant at midlife but not at baseline. Strengths of association for extreme quintiles (quintile 5 vs. quintile 1) were broadly comparable, but the highest effect estimates were for waist/hip ratio (hazard ratio = 1.56, 95% confidence interval: 1.25, 1.94) and BMI50 (hazard ratio = 1.71, 95% confidence interval: 1.37, 2.14), both of which remained significant after adjustment for mediators, BMI, or each other. Whether these differences translate to better risk prediction will require meta-analytical approaches, as will determination of prognostic cutpoints.

%B Am J Epidemiol %V 173 %P 10-25 %8 2011 Jan 01 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21123850?dopt=Abstract %R 10.1093/aje/kwq311 %0 Journal Article %J Genet Epidemiol %D 2011 %T Meta-analysis of gene-environment interaction: joint estimation of SNP and SNP × environment regression coefficients. %A Manning, Alisa K %A LaValley, Michael %A Liu, Ching-Ti %A Rice, Kenneth %A An, Ping %A Liu, Yongmei %A Miljkovic, Iva %A Rasmussen-Torvik, Laura %A Harris, Tamara B %A Province, Michael A %A Borecki, Ingrid B %A Florez, Jose C %A Meigs, James B %A Cupples, L Adrienne %A Dupuis, Josée %K Adult %K Aged %K Body Mass Index %K Confidence Intervals %K Diabetes Mellitus, Type 2 %K Environment %K Fasting %K Female %K Genome, Human %K Genome-Wide Association Study %K Genotype %K Humans %K Insulin %K Least-Squares Analysis %K Male %K Mathematical Computing %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %K PPAR gamma %X

INTRODUCTION: Genetic discoveries are validated through the meta-analysis of genome-wide association scans in large international consortia. Because environmental variables may interact with genetic factors, investigation of differing genetic effects for distinct levels of an environmental exposure in these large consortia may yield additional susceptibility loci undetected by main effects analysis. We describe a method of joint meta-analysis (JMA) of SNP and SNP by Environment (SNP × E) regression coefficients for use in gene-environment interaction studies.

METHODS: In testing SNP × E interactions, one approach uses a two degree of freedom test to identify genetic variants that influence the trait of interest. This approach detects both main and interaction effects between the trait and the SNP. We propose a method to jointly meta-analyze the SNP and SNP × E coefficients using multivariate generalized least squares. This approach provides confidence intervals of the two estimates, a joint significance test for SNP and SNP × E terms, and a test of homogeneity across samples.

RESULTS: We present a simulation study comparing this method to four other methods of meta-analysis and demonstrate that the JMA performs better than the others when both main and interaction effects are present. Additionally, we implemented our methods in a meta-analysis of the association between SNPs from the type 2 diabetes-associated gene PPARG and log-transformed fasting insulin levels and interaction by body mass index in a combined sample of 19,466 individuals from five cohorts.

%B Genet Epidemiol %V 35 %P 11-8 %8 2011 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21181894?dopt=Abstract %R 10.1002/gepi.20546 %0 Journal Article %J Nat Genet %D 2011 %T Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque. %A Bis, Joshua C %A Kavousi, Maryam %A Franceschini, Nora %A Isaacs, Aaron %A Abecasis, Goncalo R %A Schminke, Ulf %A Post, Wendy S %A Smith, Albert V %A Cupples, L Adrienne %A Markus, Hugh S %A Schmidt, Reinhold %A Huffman, Jennifer E %A Lehtimäki, Terho %A Baumert, Jens %A Münzel, Thomas %A Heckbert, Susan R %A Dehghan, Abbas %A North, Kari %A Oostra, Ben %A Bevan, Steve %A Stoegerer, Eva-Maria %A Hayward, Caroline %A Raitakari, Olli %A Meisinger, Christa %A Schillert, Arne %A Sanna, Serena %A Völzke, Henry %A Cheng, Yu-Ching %A Thorsson, Bolli %A Fox, Caroline S %A Rice, Kenneth %A Rivadeneira, Fernando %A Nambi, Vijay %A Halperin, Eran %A Petrovic, Katja E %A Peltonen, Leena %A Wichmann, H Erich %A Schnabel, Renate B %A Dörr, Marcus %A Parsa, Afshin %A Aspelund, Thor %A Demissie, Serkalem %A Kathiresan, Sekar %A Reilly, Muredach P %A Taylor, Kent %A Uitterlinden, Andre %A Couper, David J %A Sitzer, Matthias %A Kähönen, Mika %A Illig, Thomas %A Wild, Philipp S %A Orrù, Marco %A Lüdemann, Jan %A Shuldiner, Alan R %A Eiriksdottir, Gudny %A White, Charles C %A Rotter, Jerome I %A Hofman, Albert %A Seissler, Jochen %A Zeller, Tanja %A Usala, Gianluca %A Ernst, Florian %A Launer, Lenore J %A D'Agostino, Ralph B %A O'Leary, Daniel H %A Ballantyne, Christie %A Thiery, Joachim %A Ziegler, Andreas %A Lakatta, Edward G %A Chilukoti, Ravi Kumar %A Harris, Tamara B %A Wolf, Philip A %A Psaty, Bruce M %A Polak, Joseph F %A Li, Xia %A Rathmann, Wolfgang %A Uda, Manuela %A Boerwinkle, Eric %A Klopp, Norman %A Schmidt, Helena %A Wilson, James F %A Viikari, Jorma %A Koenig, Wolfgang %A Blankenberg, Stefan %A Newman, Anne B %A Witteman, Jacqueline %A Heiss, Gerardo %A Duijn, Cornelia van %A Scuteri, Angelo %A Homuth, Georg %A Mitchell, Braxton D %A Gudnason, Vilmundur %A O'Donnell, Christopher J %K Adult %K Aged %K Aging %K Atherosclerosis %K Carotid Intima-Media Thickness %K Cohort Studies %K Coronary Artery Disease %K European Continental Ancestry Group %K Genetic Loci %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Genotype %K Heart %K Humans %K Middle Aged %K Phenotype %K Plaque, Atherosclerotic %K Polymorphism, Single Nucleotide %K Risk Factors %X

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10(-8)). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events.

%B Nat Genet %V 43 %P 940-7 %8 2011 Sep 11 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21909108?dopt=Abstract %R 10.1038/ng.920 %0 Journal Article %J Circulation %D 2011 %T Meta-analysis of genome-wide association studies in >80 000 subjects identifies multiple loci for C-reactive protein levels. %A Dehghan, Abbas %A Dupuis, Josée %A Barbalic, Maja %A Bis, Joshua C %A Eiriksdottir, Gudny %A Lu, Chen %A Pellikka, Niina %A Wallaschofski, Henri %A Kettunen, Johannes %A Henneman, Peter %A Baumert, Jens %A Strachan, David P %A Fuchsberger, Christian %A Vitart, Veronique %A Wilson, James F %A Paré, Guillaume %A Naitza, Silvia %A Rudock, Megan E %A Surakka, Ida %A de Geus, Eco J C %A Alizadeh, Behrooz Z %A Guralnik, Jack %A Shuldiner, Alan %A Tanaka, Toshiko %A Zee, Robert Y L %A Schnabel, Renate B %A Nambi, Vijay %A Kavousi, Maryam %A Ripatti, Samuli %A Nauck, Matthias %A Smith, Nicholas L %A Smith, Albert V %A Sundvall, Jouko %A Scheet, Paul %A Liu, Yongmei %A Ruokonen, Aimo %A Rose, Lynda M %A Larson, Martin G %A Hoogeveen, Ron C %A Freimer, Nelson B %A Teumer, Alexander %A Tracy, Russell P %A Launer, Lenore J %A Buring, Julie E %A Yamamoto, Jennifer F %A Folsom, Aaron R %A Sijbrands, Eric J G %A Pankow, James %A Elliott, Paul %A Keaney, John F %A Sun, Wei %A Sarin, Antti-Pekka %A Fontes, João D %A Badola, Sunita %A Astor, Brad C %A Hofman, Albert %A Pouta, Anneli %A Werdan, Karl %A Greiser, Karin H %A Kuss, Oliver %A Meyer zu Schwabedissen, Henriette E %A Thiery, Joachim %A Jamshidi, Yalda %A Nolte, Ilja M %A Soranzo, Nicole %A Spector, Timothy D %A Völzke, Henry %A Parker, Alexander N %A Aspelund, Thor %A Bates, David %A Young, Lauren %A Tsui, Kim %A Siscovick, David S %A Guo, Xiuqing %A Rotter, Jerome I %A Uda, Manuela %A Schlessinger, David %A Rudan, Igor %A Hicks, Andrew A %A Penninx, Brenda W %A Thorand, Barbara %A Gieger, Christian %A Coresh, Joe %A Willemsen, Gonneke %A Harris, Tamara B %A Uitterlinden, André G %A Jarvelin, Marjo-Riitta %A Rice, Kenneth %A Radke, Dörte %A Salomaa, Veikko %A Willems van Dijk, Ko %A Boerwinkle, Eric %A Vasan, Ramachandran S %A Ferrucci, Luigi %A Gibson, Quince D %A Bandinelli, Stefania %A Snieder, Harold %A Boomsma, Dorret I %A Xiao, Xiangjun %A Campbell, Harry %A Hayward, Caroline %A Pramstaller, Peter P %A van Duijn, Cornelia M %A Peltonen, Leena %A Psaty, Bruce M %A Gudnason, Vilmundur %A Ridker, Paul M %A Homuth, Georg %A Koenig, Wolfgang %A Ballantyne, Christie M %A Witteman, Jacqueline C M %A Benjamin, Emelia J %A Perola, Markus %A Chasman, Daniel I %K Biomarkers %K C-Reactive Protein %K Cardiovascular Diseases %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Risk Factors %K Vasculitis %X

BACKGROUND: C-reactive protein (CRP) is a heritable marker of chronic inflammation that is strongly associated with cardiovascular disease. We sought to identify genetic variants that are associated with CRP levels.

METHODS AND RESULTS: We performed a genome-wide association analysis of CRP in 66 185 participants from 15 population-based studies. We sought replication for the genome-wide significant and suggestive loci in a replication panel comprising 16 540 individuals from 10 independent studies. We found 18 genome-wide significant loci, and we provided evidence of replication for 8 of them. Our results confirm 7 previously known loci and introduce 11 novel loci that are implicated in pathways related to the metabolic syndrome (APOC1, HNF1A, LEPR, GCKR, HNF4A, and PTPN2) or the immune system (CRP, IL6R, NLRP3, IL1F10, and IRF1) or that reside in regions previously not known to play a role in chronic inflammation (PPP1R3B, SALL1, PABPC4, ASCL1, RORA, and BCL7B). We found a significant interaction of body mass index with LEPR (P<2.9×10(-6)). A weighted genetic risk score that was developed to summarize the effect of risk alleles was strongly associated with CRP levels and explained ≈5% of the trait variance; however, there was no evidence for these genetic variants explaining the association of CRP with coronary heart disease.

CONCLUSIONS: We identified 18 loci that were associated with CRP levels. Our study highlights immune response and metabolic regulatory pathways involved in the regulation of chronic inflammation.

%B Circulation %V 123 %P 731-8 %8 2011 Feb 22 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/21300955?dopt=Abstract %R 10.1161/CIRCULATIONAHA.110.948570 %0 Journal Article %J Stroke %D 2011 %T Neighborhood disadvantage and ischemic stroke: the Cardiovascular Health Study (CHS). %A Brown, Arleen F %A Liang, Li-Jung %A Vassar, Stefanie D %A Stein-Merkin, Sharon %A Longstreth, W T %A Ovbiagele, Bruce %A Yan, Tingjian %A Escarce, José J %K Aged %K Aged, 80 and over %K Brain Ischemia %K Female %K Health Status Disparities %K Humans %K Incidence %K Longitudinal Studies %K Male %K Poverty %K Residence Characteristics %K Risk %K Risk Factors %K Social Class %K Social Environment %K Socioeconomic Factors %K Stroke %K Urban Population %X

BACKGROUND AND PURPOSE: Neighborhood characteristics may influence the risk of stroke and contribute to socioeconomic disparities in stroke incidence. The objectives of this study were to examine the relationship between neighborhood socioeconomic status and incident ischemic stroke and examine potential mediators of these associations.

METHODS: We analyzed data from 3834 whites and 785 blacks enrolled in the Cardiovascular Health Study, a multicenter, population-based, longitudinal study of adults ages≥65 years from 4 US counties. The primary outcome was adjudicated incident ischemic stroke. Neighborhood socioeconomic status was measured using a composite of 6 census tract variables. Race-stratified multilevel Cox proportional hazard models were constructed adjusted for sociodemographic, behavioral, and biological risk factors.

RESULTS: Among whites, in models adjusted for sociodemographic characteristics, stroke hazard was significantly higher among residents of neighborhoods in the lowest compared with the highest neighborhood socioeconomic status quartile (hazard ratio, 1.32; 95% CI, 1.01-1.72) with greater attenuation of the hazard ratio after adjustment for biological risk factors (hazard ratio, 1.16; 0.88-1.52) than for behavioral risk factors (hazard ratio, 1.30; 0.99-1.70). Among blacks, we found no significant associations between neighborhood socioeconomic status and ischemic stroke.

CONCLUSIONS: Higher risk of incident ischemic stroke was observed in the most disadvantaged neighborhoods among whites, but not among blacks. The relationship between neighborhood socioeconomic status and stroke among whites appears to be mediated more strongly by biological than behavioral risk factors.

%B Stroke %V 42 %P 3363-8 %8 2011 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21940966?dopt=Abstract %R 10.1161/STROKEAHA.111.622134 %0 Journal Article %J Nature %D 2011 %T New gene functions in megakaryopoiesis and platelet formation. %A Gieger, Christian %A Radhakrishnan, Aparna %A Cvejic, Ana %A Tang, Weihong %A Porcu, Eleonora %A Pistis, Giorgio %A Serbanovic-Canic, Jovana %A Elling, Ulrich %A Goodall, Alison H %A Labrune, Yann %A Lopez, Lorna M %A Mägi, Reedik %A Meacham, Stuart %A Okada, Yukinori %A Pirastu, Nicola %A Sorice, Rossella %A Teumer, Alexander %A Voss, Katrin %A Zhang, Weihua %A Ramirez-Solis, Ramiro %A Bis, Joshua C %A Ellinghaus, David %A Gögele, Martin %A Hottenga, Jouke-Jan %A Langenberg, Claudia %A Kovacs, Peter %A O'Reilly, Paul F %A Shin, So-Youn %A Esko, Tõnu %A Hartiala, Jaana %A Kanoni, Stavroula %A Murgia, Federico %A Parsa, Afshin %A Stephens, Jonathan %A van der Harst, Pim %A Ellen van der Schoot, C %A Allayee, Hooman %A Attwood, Antony %A Balkau, Beverley %A Bastardot, François %A Basu, Saonli %A Baumeister, Sebastian E %A Biino, Ginevra %A Bomba, Lorenzo %A Bonnefond, Amélie %A Cambien, Francois %A Chambers, John C %A Cucca, Francesco %A D'Adamo, Pio %A Davies, Gail %A de Boer, Rudolf A %A de Geus, Eco J C %A Döring, Angela %A Elliott, Paul %A Erdmann, Jeanette %A Evans, David M %A Falchi, Mario %A Feng, Wei %A Folsom, Aaron R %A Frazer, Ian H %A Gibson, Quince D %A Glazer, Nicole L %A Hammond, Chris %A Hartikainen, Anna-Liisa %A Heckbert, Susan R %A Hengstenberg, Christian %A Hersch, Micha %A Illig, Thomas %A Loos, Ruth J F %A Jolley, Jennifer %A Khaw, Kay Tee %A Kuhnel, Brigitte %A Kyrtsonis, Marie-Christine %A Lagou, Vasiliki %A Lloyd-Jones, Heather %A Lumley, Thomas %A Mangino, Massimo %A Maschio, Andrea %A Mateo Leach, Irene %A McKnight, Barbara %A Memari, Yasin %A Mitchell, Braxton D %A Montgomery, Grant W %A Nakamura, Yusuke %A Nauck, Matthias %A Navis, Gerjan %A Nöthlings, Ute %A Nolte, Ilja M %A Porteous, David J %A Pouta, Anneli %A Pramstaller, Peter P %A Pullat, Janne %A Ring, Susan M %A Rotter, Jerome I %A Ruggiero, Daniela %A Ruokonen, Aimo %A Sala, Cinzia %A Samani, Nilesh J %A Sambrook, Jennifer %A Schlessinger, David %A Schreiber, Stefan %A Schunkert, Heribert %A Scott, James %A Smith, Nicholas L %A Snieder, Harold %A Starr, John M %A Stumvoll, Michael %A Takahashi, Atsushi %A Tang, W H Wilson %A Taylor, Kent %A Tenesa, Albert %A Lay Thein, Swee %A Tönjes, Anke %A Uda, Manuela %A Ulivi, Sheila %A van Veldhuisen, Dirk J %A Visscher, Peter M %A Völker, Uwe %A Wichmann, H-Erich %A Wiggins, Kerri L %A Willemsen, Gonneke %A Yang, Tsun-Po %A Hua Zhao, Jing %A Zitting, Paavo %A Bradley, John R %A Dedoussis, George V %A Gasparini, Paolo %A Hazen, Stanley L %A Metspalu, Andres %A Pirastu, Mario %A Shuldiner, Alan R %A Joost van Pelt, L %A Zwaginga, Jaap-Jan %A Boomsma, Dorret I %A Deary, Ian J %A Franke, Andre %A Froguel, Philippe %A Ganesh, Santhi K %A Jarvelin, Marjo-Riitta %A Martin, Nicholas G %A Meisinger, Christa %A Psaty, Bruce M %A Spector, Timothy D %A Wareham, Nicholas J %A Akkerman, Jan-Willem N %A Ciullo, Marina %A Deloukas, Panos %A Greinacher, Andreas %A Jupe, Steve %A Kamatani, Naoyuki %A Khadake, Jyoti %A Kooner, Jaspal S %A Penninger, Josef %A Prokopenko, Inga %A Stemple, Derek %A Toniolo, Daniela %A Wernisch, Lorenz %A Sanna, Serena %A Hicks, Andrew A %A Rendon, Augusto %A Ferreira, Manuel A %A Ouwehand, Willem H %A Soranzo, Nicole %K Animals %K Blood Platelets %K Cell Size %K Drosophila melanogaster %K Drosophila Proteins %K Europe %K Gene Expression Profiling %K Gene Silencing %K Genome, Human %K Genome-Wide Association Study %K Hematopoiesis %K Humans %K Megakaryocytes %K Platelet Count %K Protein Interaction Maps %K Transcription, Genetic %K Zebrafish %K Zebrafish Proteins %X

Platelets are the second most abundant cell type in blood and are essential for maintaining haemostasis. Their count and volume are tightly controlled within narrow physiological ranges, but there is only limited understanding of the molecular processes controlling both traits. Here we carried out a high-powered meta-analysis of genome-wide association studies (GWAS) in up to 66,867 individuals of European ancestry, followed by extensive biological and functional assessment. We identified 68 genomic loci reliably associated with platelet count and volume mapping to established and putative novel regulators of megakaryopoiesis and platelet formation. These genes show megakaryocyte-specific gene expression patterns and extensive network connectivity. Using gene silencing in Danio rerio and Drosophila melanogaster, we identified 11 of the genes as novel regulators of blood cell formation. Taken together, our findings advance understanding of novel gene functions controlling fate-determining events during megakaryopoiesis and platelet formation, providing a new example of successful translation of GWAS to function.

%B Nature %V 480 %P 201-8 %8 2011 Nov 30 %G eng %N 7376 %1 http://www.ncbi.nlm.nih.gov/pubmed/22139419?dopt=Abstract %R 10.1038/nature10659 %0 Journal Article %J Am J Epidemiol %D 2011 %T The Next PAGE in understanding complex traits: design for the analysis of Population Architecture Using Genetics and Epidemiology (PAGE) Study. %A Matise, Tara C %A Ambite, Jose Luis %A Buyske, Steven %A Carlson, Christopher S %A Cole, Shelley A %A Crawford, Dana C %A Haiman, Christopher A %A Heiss, Gerardo %A Kooperberg, Charles %A Marchand, Loic Le %A Manolio, Teri A %A North, Kari E %A Peters, Ulrike %A Ritchie, Marylyn D %A Hindorff, Lucia A %A Haines, Jonathan L %K Epidemiologic Methods %K Epidemiologic Research Design %K Ethnic Groups %K Genetic Association Studies %K Genetics, Population %K Genome-Wide Association Study %K Humans %K Interinstitutional Relations %K Multifactorial Inheritance %K National Human Genome Research Institute (U.S.) %K Phenotype %K Pilot Projects %K Research Design %K Risk Factors %K United States %X

Genetic studies have identified thousands of variants associated with complex traits. However, most association studies are limited to populations of European descent and a single phenotype. The Population Architecture using Genomics and Epidemiology (PAGE) Study was initiated in 2008 by the National Human Genome Research Institute to investigate the epidemiologic architecture of well-replicated genetic variants associated with complex diseases in several large, ethnically diverse population-based studies. Combining DNA samples and hundreds of phenotypes from multiple cohorts, PAGE is well-suited to address generalization of associations and variability of effects in diverse populations; identify genetic and environmental modifiers; evaluate disease subtypes, intermediate phenotypes, and biomarkers; and investigate associations with novel phenotypes. PAGE investigators harmonize phenotypes across studies where possible and perform coordinated cohort-specific analyses and meta-analyses. PAGE researchers are genotyping thousands of genetic variants in up to 121,000 DNA samples from African-American, white, Hispanic/Latino, Asian/Pacific Islander, and American Indian participants. Initial analyses will focus on single nucleotide polymorphisms (SNPs) associated with obesity, lipids, cardiovascular disease, type 2 diabetes, inflammation, various cancers, and related biomarkers. PAGE SNPs are also assessed for pleiotropy using the "phenome-wide association study" approach, testing each SNP for associations with hundreds of phenotypes. PAGE data will be deposited into the National Center for Biotechnology Information's Database of Genotypes and Phenotypes and made available via a custom browser.

%B Am J Epidemiol %V 174 %P 849-59 %8 2011 Oct 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/21836165?dopt=Abstract %R 10.1093/aje/kwr160 %0 Journal Article %J PLoS Genet %D 2011 %T A phenomics-based strategy identifies loci on APOC1, BRAP, and PLCG1 associated with metabolic syndrome phenotype domains. %A Avery, Christy L %A He, Qianchuan %A North, Kari E %A Ambite, José L %A Boerwinkle, Eric %A Fornage, Myriam %A Hindorff, Lucia A %A Kooperberg, Charles %A Meigs, James B %A Pankow, James S %A Pendergrass, Sarah A %A Psaty, Bruce M %A Ritchie, Marylyn D %A Rotter, Jerome I %A Taylor, Kent D %A Wilkens, Lynne R %A Heiss, Gerardo %A Lin, Dan Yu %K African Americans %K Apolipoprotein C-I %K Blood Glucose %K Dyslipidemias %K European Continental Ancestry Group %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genome, Human %K Humans %K Metabolic Syndrome %K Obesity, Abdominal %K Phenotype %K Phospholipase C gamma %K Polymorphism, Single Nucleotide %K Quantitative Trait, Heritable %K Ubiquitin-Protein Ligases %K Vascular Diseases %X

Despite evidence of the clustering of metabolic syndrome components, current approaches for identifying unifying genetic mechanisms typically evaluate clinical categories that do not provide adequate etiological information. Here, we used data from 19,486 European American and 6,287 African American Candidate Gene Association Resource Consortium participants to identify loci associated with the clustering of metabolic phenotypes. Six phenotype domains (atherogenic dyslipidemia, vascular dysfunction, vascular inflammation, pro-thrombotic state, central obesity, and elevated plasma glucose) encompassing 19 quantitative traits were examined. Principal components analysis was used to reduce the dimension of each domain such that >55% of the trait variance was represented within each domain. We then applied a statistically efficient and computational feasible multivariate approach that related eight principal components from the six domains to 250,000 imputed SNPs using an additive genetic model and including demographic covariates. In European Americans, we identified 606 genome-wide significant SNPs representing 19 loci. Many of these loci were associated with only one trait domain, were consistent with results in African Americans, and overlapped with published findings, for instance central obesity and FTO. However, our approach, which is applicable to any set of interval scale traits that is heritable and exhibits evidence of phenotypic clustering, identified three new loci in or near APOC1, BRAP, and PLCG1, which were associated with multiple phenotype domains. These pleiotropic loci may help characterize metabolic dysregulation and identify targets for intervention.

%B PLoS Genet %V 7 %P e1002322 %8 2011 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/22022282?dopt=Abstract %R 10.1371/journal.pgen.1002322 %0 Journal Article %J Am J Clin Nutr %D 2011 %T Plasma omega-3 fatty acids and incident diabetes in older adults. %A Djoussé, Luc %A Biggs, Mary L %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Ix, Joachim H %A Mukamal, Kenneth J %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K alpha-Linolenic Acid %K Diabetes Mellitus %K Fatty Acids, Omega-3 %K Female %K Humans %K Male %K Phospholipids %K Proportional Hazards Models %K Prospective Studies %X

BACKGROUND: Although long-chain omega-3 fatty acid (n-3 FA) consumption estimated via food-frequency questionnaires has been associated with a higher incidence of diabetes, limited prospective data on diabetes risk are available that use objective biomarkers of n-3 FAs.

OBJECTIVE: We sought to examine the relation between plasma phospholipid n-3 FAs and incident diabetes.

DESIGN: We prospectively analyzed data in 3088 older men and women (mean age: 75 y) from the Cardiovascular Health Study (1992-2007). Plasma phospholipid n-3 FAs were measured by using gas chromatography, and incident diabetes was ascertained by using information on hypoglycemic agents and serum glucose. We used Cox proportional hazards models to estimate multivariable-adjusted relative risks.

RESULTS: During a median follow-up of 10.6 y, 204 new cases of diabetes occurred. In a multivariable model that controlled for age, sex, race, clinic site, body mass index, alcohol intake, smoking, physical activity, LDL cholesterol, and linoleic acid, relative risks (95% CIs) for diabetes were 1.0 (reference), 0.96 (0.65, 1.43), 1.03 (0.69, 1.54), and 0.64 (0.41, 1.01) across consecutive quartiles of phospholipid eicosapentaenoic acid and docosahexaenoic acid (P for trend = 0.05). Corresponding relative risks (95% CIs) for phospholipid α-linolenic acid (ALA) were 1.0 (reference), 0.93 (0.65, 1.34), 0.99 (0.68, 1.44), and 0.57 (0.36, 0.90) (P for trend = 0.03).

CONCLUSIONS: With the use of objective biomarkers, long-chain n-3 FAs and ALA were not associated with a higher incidence of diabetes. Individuals with the highest concentrations of both types of FAs had lower risk of diabetes.

%B Am J Clin Nutr %V 94 %P 527-33 %8 2011 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/21593500?dopt=Abstract %R 10.3945/ajcn.111.013334 %0 Journal Article %J Stroke %D 2011 %T Progression of magnetic resonance imaging-defined brain vascular disease predicts vascular events in elderly: the Cardiovascular Health Study. %A Longstreth, W T %A Arnold, Alice M %A Kuller, Lewis H %A Bernick, Charles %A Lefkowitz, David S %A Beauchamp, Norman J %A Manolio, Teri A %K Aged %K Brain %K Disease Progression %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Nerve Fibers, Myelinated %K Predictive Value of Tests %K Prognosis %K Stroke %X

BACKGROUND AND PURPOSE: To determine whether progression of MRI-defined vascular disease predicts subsequent vascular events in the elderly.

METHODS: The Cardiovascular Health Study, a longitudinal cohort study of vascular disease in the elderly, allows us to address this question because its participants had 2 MRI scans≈5 years apart and have been followed for ≈9 years since the follow-up scan for incident vascular events.

RESULTS: Both MRI-defined incident infarcts and worsened white matter grade were significantly associated with heart failure, stroke, and death, but not transient ischemic attacks, angina, or myocardial infarction. Strongest associations occurred when both incident infarcts and worsened white matter grade were present for heart failure (hazard ratio, 1.79; 95% confidence interval, 1.18-2.73), stroke (hazard ratio, 2.58; 95% confidence interval, 1.53-4.36), death (hazard ratio, 1.69; 95% confidence interval, 1.28-2.24), and cardiovascular death (hazard ratio, 1.97; 95% confidence interval, 1.24-3.14).

CONCLUSIONS: Progression of MRI-defined vascular disease identifies elderly people at increased risk for subsequent heart failure, stroke, and death. Whether aggressive risk factor management would reduce risk is unknown.

%B Stroke %V 42 %P 2970-2 %8 2011 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21817135?dopt=Abstract %R 10.1161/STROKEAHA.111.622977 %0 Journal Article %J Stroke %D 2011 %T Retinal microvascular signs and functional loss in older persons: the cardiovascular health study. %A Kim, Dae Hyun %A Newman, Anne B %A Hajjar, Ihab %A Strotmeyer, Elsa S %A Klein, Ronald %A Newton, Elizabeth %A Sarnak, Mark J %A Burke, Gregory L %A Lipsitz, Lewis A %K Aged %K Cardiovascular Diseases %K Depressive Disorder %K Frontal Lobe %K Humans %K Microcirculation %K Neuropsychological Tests %K Retinal Diseases %K Retinal Vessels %K Risk Factors %X

BACKGROUND AND PURPOSE: We hypothesized that retinal microvascular signs are associated with executive dysfunction, slow gait, and depressive mood, which are characteristic features of microvascular disease affecting frontal subcortical regions of the brain.

METHODS: In the Cardiovascular Health Study, 1744 participants (mean age, 78) free of stroke had retinal photographs and carotid ultrasound during the 1997 to 1998 visit. We examined the cross-sectional association of retinal signs with the digit-symbol substitution test (DSST) score, gait speed, the Center for Epidemiologic Studies-Depression score, and depressive mood, defined as Center for Epidemiologic Studies-Depression score >9 or antidepressant use.

RESULTS: After adjusting for potential confounders, retinal signs were associated with lower DSST score (generalized arteriolar narrowing and arteriovenous nicking), slower gait (retinopathy), and depressive mood (generalized arteriolar narrowing). A higher number of retinal signs was associated with lower DSST score (-0.76 and -2.79 points for 1 sign and ≥2 signs versus none; P<0.001) and slower gait (-0.009 and -0.083 m/s; P=0.047), but not with the square root of Center for Epidemiologic Studies-Depression score (0.079 and -0.208; P=0.072). In addition, coexistence of retinal signs (generalized arteriolar narrowing and arteriovenous nicking) and carotid atherosclerosis was associated with lower DSST score compared with either process alone (P for interaction <0.01). Notably, further adjustment for ventricular size, white matter disease, and infarcts on MRI did not attenuate the association.

CONCLUSIONS: Retinal signs are associated with executive dysfunction and slow gait, and possibly with depressive mood, suggesting a common process involving small vessels.

%B Stroke %V 42 %P 1589-95 %8 2011 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/21493913?dopt=Abstract %R 10.1161/STROKEAHA.110.605261 %0 Journal Article %J Neuroepidemiology %D 2011 %T The risk of Parkinson disease associated with urate in a community-based cohort of older adults. %A Jain, S %A Ton, T G %A Boudreau, R M %A Yang, M %A Thacker, E L %A Studenski, S %A Longstreth, W T %A Strotmeyer, E S %A Newman, A B %K Aged %K California %K Cohort Studies %K Female %K Humans %K Male %K Maryland %K North Carolina %K Parkinson Disease %K Pennsylvania %K Prospective Studies %K Risk Factors %K Sex Distribution %K Sex Factors %K Uric Acid %X

BACKGROUND/AIMS: Studies suggest an inverse association between urate concentration and the risk of Parkinson disease (PD). We investigated this in the Cardiovascular Health Study in an elderly community-based cohort of adults.

METHODS: The association of baseline urate (µmol/l) and incident PD over 14 years was assessed with locally weighted scatterplot smoothing (LOESS) regression from which categories of low (<300 µmol/l), middle (300-500 µmol/l), and high (>500 µmol/l) urate ranges were derived. Multivariate logistic regression models assessed the risk of PD for each urate range. Linear and quadratic terms were tested when modeling the association between urate and the risk of PD.

RESULTS: Women had significantly lower urate concentrations than did men [316.8 µmol/l (SD 88.0) vs. 367.4 µmol/l (SD 87.7), p < 0.0001] and in women no associations between urate and PD risk were observed. In men, LOESS curves suggested a U-shaped or threshold effect between urate and PD risk. With the middle range as reference, the risk of developing PD was significantly increased for urate <300 µmol/l (OR 1.69, 95% CI 1.03-2.78) but not for urate >500 µmol/l (OR 1.55, 95% CI 0.72-3.32) in men. A negative linear term was significant for urate <500 µmol/l, and across the entire range a convex quadratic term was significant.

CONCLUSIONS: Results suggest a more complex relationship than previously reported between urate levels and the risk of PD in men. Low urate concentrations were associated with a higher PD risk and high urate concentrations were not associated with a further decrease in PD risk.

%B Neuroepidemiology %V 36 %P 223-9 %8 2011 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21677446?dopt=Abstract %R 10.1159/000327748 %0 Journal Article %J Am J Epidemiol %D 2011 %T Seasonal variation in 25-hydroxyvitamin D concentrations in the cardiovascular health study. %A Shoben, Abigail B %A Kestenbaum, Bryan %A Levin, Gregory %A Hoofnagle, Andrew N %A Psaty, Bruce M %A Siscovick, David S %A de Boer, Ian H %K Aged %K Biomarkers %K Continental Population Groups %K Exercise %K Female %K Humans %K Male %K Residence Characteristics %K Seasons %K Sex Factors %K Vitamin D %X

Low circulating concentrations of 25-hydroxyvitamin D (25(OH)D) are associated with adverse health outcomes in diverse populations. However, 25(OH)D concentrations vary seasonally with varying exposure to sunlight, so single measurements may poorly reflect long-term 25(OH)D exposure. The authors investigated cyclical trends in average serum 25(OH)D concentrations among 2,298 individuals enrolled in the Cardiovascular Health Study of community-based older adults (1992-1993). A sinusoidal model closely approximated observed 25(OH)D concentrations and fit the data significantly better than did a mean model (P < 0.0001). The mean annual 25(OH)D concentration was 25.1 ng/mL (95% confidence interval: 24.7, 25.5), and the mean peak-trough difference was 9.6 ng/mL (95% confidence interval: 8.5, 10.7). Male sex, higher latitude of study site, and greater physical activity levels were associated with larger peak-trough difference in 25(OH)D concentration (each P < 0.05). Serum concentrations of intact parathyroid hormone and bone-specific alkaline phosphatase also varied in a sinusoidal fashion (P < 0.0001), inversely to 25(OH)D. In conclusion, serum 25(OH)D varies in a sinusoidal manner, with large seasonal differences relative to mean concentration and laboratory evidence of biologic sequelae. Single 25(OH)D measurements might not capture overall vitamin D status, and the extent of misclassification could vary by demographic and behavioral factors. Accounting for collection time may reduce bias in research studies and improve decision-making in clinical care.

%B Am J Epidemiol %V 174 %P 1363-72 %8 2011 Dec 15 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/22112344?dopt=Abstract %R 10.1093/aje/kwr258 %0 Journal Article %J Lancet %D 2011 %T Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. %A Wormser, David %A Kaptoge, Stephen %A Di Angelantonio, Emanuele %A Wood, Angela M %A Pennells, Lisa %A Thompson, Alex %A Sarwar, Nadeem %A Kizer, Jorge R %A Lawlor, Debbie A %A Nordestgaard, Børge G %A Ridker, Paul %A Salomaa, Veikko %A Stevens, June %A Woodward, Mark %A Sattar, Naveed %A Collins, Rory %A Thompson, Simon G %A Whitlock, Gary %A Danesh, John %K Age Factors %K Blood Pressure %K Body Mass Index %K Cardiovascular Diseases %K Cholesterol %K Cholesterol, HDL %K Diabetes Mellitus %K Female %K Humans %K Male %K Middle Aged %K Obesity, Abdominal %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Sex Factors %K Smoking %K Systole %K Waist Circumference %K Waist-Hip Ratio %X

BACKGROUND: Guidelines differ about the value of assessment of adiposity measures for cardiovascular disease risk prediction when information is available for other risk factors. We studied the separate and combined associations of body-mass index (BMI), waist circumference, and waist-to-hip ratio with risk of first-onset cardiovascular disease.

METHODS: We used individual records from 58 cohorts to calculate hazard ratios (HRs) per 1 SD higher baseline values (4.56 kg/m(2) higher BMI, 12.6 cm higher waist circumference, and 0.083 higher waist-to-hip ratio) and measures of risk discrimination and reclassification. Serial adiposity assessments were used to calculate regression dilution ratios.

RESULTS: Individual records were available for 221,934 people in 17 countries (14,297 incident cardiovascular disease outcomes; 1.87 million person-years at risk). Serial adiposity assessments were made in up to 63,821 people (mean interval 5.7 years [SD 3.9]). In people with BMI of 20 kg/m(2) or higher, HRs for cardiovascular disease were 1.23 (95% CI 1.17-1.29) with BMI, 1.27 (1.20-1.33) with waist circumference, and 1.25 (1.19-1.31) with waist-to-hip ratio, after adjustment for age, sex, and smoking status. After further adjustment for baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, corresponding HRs were 1.07 (1.03-1.11) with BMI, 1.10 (1.05-1.14) with waist circumference, and 1.12 (1.08-1.15) with waist-to-hip ratio. Addition of information on BMI, waist circumference, or waist-to-hip ratio to a cardiovascular disease risk prediction model containing conventional risk factors did not importantly improve risk discrimination (C-index changes of -0.0001, -0.0001, and 0.0008, respectively), nor classification of participants to categories of predicted 10-year risk (net reclassification improvement -0.19%, -0.05%, and -0.05%, respectively). Findings were similar when adiposity measures were considered in combination. Reproducibility was greater for BMI (regression dilution ratio 0.95, 95% CI 0.93-0.97) than for waist circumference (0.86, 0.83-0.89) or waist-to-hip ratio (0.63, 0.57-0.70).

INTERPRETATION: BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

FUNDING: British Heart Foundation and UK Medical Research Council.

%B Lancet %V 377 %P 1085-95 %8 2011 Mar 26 %G eng %N 9771 %1 http://www.ncbi.nlm.nih.gov/pubmed/21397319?dopt=Abstract %R 10.1016/S0140-6736(11)60105-0 %0 Journal Article %J Aging Clin Exp Res %D 2011 %T Surrogate screening models for the low physical activity criterion of frailty. %A Eckel, Sandrah P %A Bandeen-Roche, Karen %A Chaves, Paulo H M %A Fried, Linda P %A Louis, Thomas A %K Activities of Daily Living %K Aged %K Cohort Studies %K Exercise %K Female %K Follow-Up Studies %K Frail Elderly %K Geriatric Assessment %K Humans %K Leisure Activities %K Logistic Models %K Male %K Motor Activity %K Prospective Studies %K Surveys and Questionnaires %K Women's Health %X

BACKGROUND AND AIMS: Low physical activity, one of five criteria in a validated clinical phenotype of frailty, is assessed by a standardized, semiquantitative questionnaire on up to 20 leisure time activities. Because of the time demanded to collect the interview data, it has been challenging to translate to studies other than the Cardiovascular Health Study (CHS), for which it was developed. Considering subsets of activities, we identified and evaluated streamlined surrogate assessment methods and compared them to one implemented in the Women's Health and Aging Study (WHAS).

METHODS: Using data on men and women ages 65 and older from the CHS, we applied logistic regression models to rank activities by "relative influence" in predicting low physical activity.We considered subsets of the most influential activities as inputs to potential surrogate models (logistic regressions). We evaluated predictive accuracy and predictive validity using the area under receiver operating characteristic curves and assessed criterion validity using proportional hazards models relating frailty status (defined using the surrogate) to mortality.

RESULTS: Walking for exercise and moderately strenuous household chores were highly influential for both genders. Women required fewer activities than men for accurate classification. The WHAS model (8 CHS activities) was an effective surrogate, but a surrogate using 6 activities (walking, chores, gardening, general exercise, mowing and golfing) was also highly predictive.

CONCLUSIONS: We recommend a 6 activity questionnaire to assess physical activity for men and women. If efficiency is essential and the study involves only women, fewer activities can be included.

%B Aging Clin Exp Res %V 23 %P 209-16 %8 2011 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21993168?dopt=Abstract %0 Journal Article %J Heart %D 2011 %T Systolic blood pressure and incident heart failure in the elderly. The Cardiovascular Health Study and the Health, Ageing and Body Composition Study. %A Butler, Javed %A Kalogeropoulos, Andreas P %A Georgiopoulou, Vasiliki V %A Bibbins-Domingo, Kirsten %A Najjar, Samer S %A Sutton-Tyrrell, Kim C %A Harris, Tamara B %A Kritchevsky, Stephen B %A Lloyd-Jones, Donald M %A Newman, Anne B %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Aging %K Blood Pressure %K Body Composition %K Epidemiologic Methods %K Female %K Heart Failure %K Humans %K Hypertension %K Male %K Myocardial Infarction %K Sex Factors %K Stroke %K Stroke Volume %X

BACKGROUND: The exact form of the association between systolic blood pressure (SBP) and heart failure (HF) risk in the elderly remains incompletely defined, especially in individuals not receiving antihypertensive drugs.

OBJECTIVE: To examine the association between SBP and HF risk in the elderly.

DESIGN: Competing-risks proportional hazards modelling of incident HF risk, using 10-year follow-up data from two NIH-sponsored cohort studies: the Cardiovascular Health Study (inception: 1989-90 and 1992-3) and the Health ABC Study (inception: 1997-8).

SETTING: Community-based cohorts.

PARTICIPANTS: 4408 participants (age, 72.8 (4.9) years; 53.1% women, 81.7% white; 18.3% black) without prevalent HF and not receiving antihypertensive drugs at baseline.

MAIN OUTCOME MEASURES: Incident HF, defined as first adjudicated hospitalisation for HF.

RESULTS: Over 10 years, 493 (11.2%) participants developed HF. Prehypertension (120-139 mm Hg), stage 1 (140-159 mm Hg), and stage 2 (≥160 mm Hg) hypertension were associated with escalating HF risk; HRs versus optimal SBP (<120 mm Hg) in competing-risks models controlling for clinical characteristics were 1.63 (95% CI 1.23 to 2.16; p=0.001), 2.21 (95% CI 1.65 to 2.96; p<0.001) and 2.60 (95% CI 1.85 to 3.64; p<0.001), respectively. Overall 255/493 (51.7%) HF events occurred in participants with SBP <140 mm Hg at baseline. Increasing SBP was associated with higher HF risk in women than in men; no race-SBP interaction was seen. In analyses with continuous SBP, HF risk had a continuous positive association with SBP to levels as low as 113 mm Hg in men and 112 mm Hg in women.

CONCLUSIONS: There is a continuous positive association between SBP and HF risk in the elderly for levels of SBP as low as <115 mm Hg; over half of incident HF events occur in individuals with SBP <140 mm Hg.

%B Heart %V 97 %P 1304-11 %8 2011 Aug %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/21636845?dopt=Abstract %R 10.1136/hrt.2011.225482 %0 Journal Article %J Diabetes %D 2011 %T Total zinc intake may modify the glucose-raising effect of a zinc transporter (SLC30A8) variant: a 14-cohort meta-analysis. %A Kanoni, Stavroula %A Nettleton, Jennifer A %A Hivert, Marie-France %A Ye, Zheng %A van Rooij, Frank J A %A Shungin, Dmitry %A Sonestedt, Emily %A Ngwa, Julius S %A Wojczynski, Mary K %A Lemaitre, Rozenn N %A Gustafsson, Stefan %A Anderson, Jennifer S %A Tanaka, Toshiko %A Hindy, George %A Saylor, Georgia %A Renstrom, Frida %A Bennett, Amanda J %A van Duijn, Cornelia M %A Florez, Jose C %A Fox, Caroline S %A Hofman, Albert %A Hoogeveen, Ron C %A Houston, Denise K %A Hu, Frank B %A Jacques, Paul F %A Johansson, Ingegerd %A Lind, Lars %A Liu, Yongmei %A McKeown, Nicola %A Ordovas, Jose %A Pankow, James S %A Sijbrands, Eric J G %A Syvänen, Ann-Christine %A Uitterlinden, André G %A Yannakoulia, Mary %A Zillikens, M Carola %A Wareham, Nick J %A Prokopenko, Inga %A Bandinelli, Stefania %A Forouhi, Nita G %A Cupples, L Adrienne %A Loos, Ruth J %A Hallmans, Göran %A Dupuis, Josée %A Langenberg, Claudia %A Ferrucci, Luigi %A Kritchevsky, Stephen B %A McCarthy, Mark I %A Ingelsson, Erik %A Borecki, Ingrid B %A Witteman, Jacqueline C M %A Orho-Melander, Marju %A Siscovick, David S %A Meigs, James B %A Franks, Paul W %A Dedoussis, George V %K Blood Glucose %K Cation Transport Proteins %K Cohort Studies %K Humans %K Polymorphism, Single Nucleotide %K Zinc %K Zinc Transporter 8 %X

OBJECTIVE: Many genetic variants have been associated with glucose homeostasis and type 2 diabetes in genome-wide association studies. Zinc is an essential micronutrient that is important for β-cell function and glucose homeostasis. We tested the hypothesis that zinc intake could influence the glucose-raising effect of specific variants.

RESEARCH DESIGN AND METHODS: We conducted a 14-cohort meta-analysis to assess the interaction of 20 genetic variants known to be related to glycemic traits and zinc metabolism with dietary zinc intake (food sources) and a 5-cohort meta-analysis to assess the interaction with total zinc intake (food sources and supplements) on fasting glucose levels among individuals of European ancestry without diabetes.

RESULTS: We observed a significant association of total zinc intake with lower fasting glucose levels (β-coefficient ± SE per 1 mg/day of zinc intake: -0.0012 ± 0.0003 mmol/L, summary P value = 0.0003), while the association of dietary zinc intake was not significant. We identified a nominally significant interaction between total zinc intake and the SLC30A8 rs11558471 variant on fasting glucose levels (β-coefficient ± SE per A allele for 1 mg/day of greater total zinc intake: -0.0017 ± 0.0006 mmol/L, summary interaction P value = 0.005); this result suggests a stronger inverse association between total zinc intake and fasting glucose in individuals carrying the glucose-raising A allele compared with individuals who do not carry it. None of the other interaction tests were statistically significant.

CONCLUSIONS: Our results suggest that higher total zinc intake may attenuate the glucose-raising effect of the rs11558471 SLC30A8 (zinc transporter) variant. Our findings also support evidence for the association of higher total zinc intake with lower fasting glucose levels.

%B Diabetes %V 60 %P 2407-16 %8 2011 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/21810599?dopt=Abstract %R 10.2337/db11-0176 %0 Journal Article %J Am J Geriatr Psychiatry %D 2011 %T Trajectory of cognitive decline as a predictor of psychosis in early Alzheimer disease in the cardiovascular health study. %A Emanuel, James E %A Lopez, Oscar L %A Houck, Patricia R %A Becker, James T %A Weamer, Elise A %A Demichele-Sweet, Mary Ann A %A Kuller, Lewis %A Sweet, Robert A %K Aged %K Alzheimer Disease %K Chi-Square Distribution %K Female %K Follow-Up Studies %K Humans %K Longitudinal Studies %K Male %K Neuropsychological Tests %K Psychiatric Status Rating Scales %K Psychotic Disorders %K Time Factors %X

OBJECTIVE: To compare the trajectories of cognitive decline between groups with, and without, the later development of psychotic symptoms during Alzheimer disease (AD) or mild cognitive impairment (MCI).

DESIGN: : The authors examined cognitive function in a new analysis of an existing data set, the Cardiovascular Health Study, an epidemiologic, longitudinal follow-up study. Our analyses examined 9 years of follow-up data.

SETTING: Community.

PARTICIPANTS: The authors examined subjects who were without dementia at study entry, received a diagnosis of AD or MCI during follow-up, and had been rated on the Neuropsychiatric Inventory for the presence of psychosis; 362 participants for the modified Mini-Mental State Examination (3MS) analysis and 350 participants for the digit symbol substitution test (DSST) analysis had sufficient follow-up data and apolipoprotein-∊ (APOE) genotyping.

MEASUREMENTS: The 3MS and DSST were administered annually and analyzed using mixed-effects models including APOE4 status.

RESULTS: : Mean 3MS and DSST scores did not differ between AD with psychosis (AD + P) and without psychosis groups at baseline. The 3MS and DSST scores decreased more rapidly in subjects who ultimately developed psychosis.

CONCLUSIONS: Individuals who ultimately develop psychosis have more rapid cognitive deterioration during the earliest phases of AD than individuals with AD not developing psychosis. The genetic and other neurobiologic factors leading to the expression of AD + P may exert their effects by acceleration of the neurodegenerative process.

%B Am J Geriatr Psychiatry %V 19 %P 160-8 %8 2011 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/20808116?dopt=Abstract %R 10.1097/JGP.0b013e3181e446c8 %0 Journal Article %J JAMA %D 2012 %T Age and association of kidney measures with mortality and end-stage renal disease. %A Hallan, Stein I %A Matsushita, Kunihiro %A Sang, Yingying %A Mahmoodi, Bakhtawar K %A Black, Corri %A Ishani, Areef %A Kleefstra, Nanne %A Naimark, David %A Roderick, Paul %A Tonelli, Marcello %A Wetzels, Jack F M %A Astor, Brad C %A Gansevoort, Ron T %A Levin, Adeera %A Wen, Chi-Pang %A Coresh, Josef %K Adolescent %K Adult %K Age Factors %K Aged %K Albuminuria %K Cohort Studies %K Female %K Glomerular Filtration Rate %K Humans %K Kidney %K Kidney Failure, Chronic %K Male %K Middle Aged %K Risk %K Young Adult %X

CONTEXT: Chronic kidney disease (CKD) is prevalent in older individuals, but the risk implications of low estimated glomerular filtration rate (eGFR) and high albuminuria across the full age range are controversial.

OBJECTIVE: To evaluate possible effect modification (interaction) by age of the association of eGFR and albuminuria with clinical risk, examining both relative and absolute risks.

DESIGN, SETTING, AND PARTICIPANTS: Individual-level meta-analysis including 2,051,244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD cohorts from Asia, Australasia, Europe, and North/South America, conducted in 1972-2011 with a mean follow-up time of 5.8 years (range, 0-31 years).

MAIN OUTCOME MEASURES: Hazard ratios (HRs) of mortality and end-stage renal disease (ESRD) according to eGFR and albuminuria were meta-analyzed across age categories after adjusting for sex, race, cardiovascular disease, diabetes, systolic blood pressure, cholesterol, body mass index, and smoking. Absolute risks were estimated using HRs and average incidence rates.

RESULTS: Mortality (112,325 deaths) and ESRD (8411 events) risks were higher at lower eGFR and higher albuminuria in every age category. In general and high-risk cohorts, relative mortality risk for reduced eGFR decreased with increasing age; eg, adjusted HRs at an eGFR of 45 mL/min/1.73 m2 vs 80 mL/min/1.73 m2 were 3.50 (95% CI, 2.55-4.81), 2.21 (95% CI, 2.02-2.41), 1.59 (95% CI, 1.42-1.77), and 1.35 (95% CI, 1.23-1.48) in age categories 18-54, 55-64, 65-74, and ≥75 years, respectively (P <.05 for age interaction). Absolute risk differences for the same comparisons were higher at older age (9.0 [95% CI, 6.0-12.8], 12.2 [95% CI, 10.3-14.3], 13.3 [95% CI, 9.0-18.6], and 27.2 [95% CI, 13.5-45.5] excess deaths per 1000 person-years, respectively). For increased albuminuria, reduction of relative risk with increasing age was less evident, while differences in absolute risk were higher in older age categories (7.5 [95% CI, 4.3-11.9], 12.2 [95% CI, 7.9-17.6], 22.7 [95% CI, 15.3-31.6], and 34.3 [95% CI, 19.5-52.4] excess deaths per 1000 person-years, respectively by age category, at an albumin-creatinine ratio of 300 mg/g vs 10 mg/g). In CKD cohorts, adjusted relative hazards of mortality did not decrease with age. In all cohorts, ESRD relative risks and absolute risk differences at lower eGFR or higher albuminuria were comparable across age categories.

CONCLUSIONS: Both low eGFR and high albuminuria were independently associated with mortality and ESRD regardless of age across a wide range of populations. Mortality showed lower relative risk but higher absolute risk differences at older age.

%B JAMA %V 308 %P 2349-60 %8 2012 Dec 12 %G eng %N 22 %R 10.1001/jama.2012.16817 %0 Journal Article %J J Bone Miner Res %D 2012 %T Assessment of gene-by-sex interaction effect on bone mineral density. %A Liu, Ching-Ti %A Estrada, Karol %A Yerges-Armstrong, Laura M %A Amin, Najaf %A Evangelou, Evangelos %A Li, Guo %A Minster, Ryan L %A Carless, Melanie A %A Kammerer, Candace M %A Oei, Ling %A Zhou, Yanhua %A Alonso, Nerea %A Dailiana, Zoe %A Eriksson, Joel %A García-Giralt, Natalia %A Giroux, Sylvie %A Husted, Lise Bjerre %A Khusainova, Rita I %A Koromila, Theodora %A Kung, Annie Waichee %A Lewis, Joshua R %A Masi, Laura %A Mencej-Bedrac, Simona %A Nogues, Xavier %A Patel, Millan S %A Prezelj, Janez %A Richards, J Brent %A Sham, Pak Chung %A Spector, Timothy %A Vandenput, Liesbeth %A Xiao, Su-Mei %A Zheng, Hou-Feng %A Zhu, Kun %A Balcells, Susana %A Brandi, Maria Luisa %A Frost, Morten %A Goltzman, David %A González-Macías, Jesús %A Karlsson, Magnus %A Khusnutdinova, Elza K %A Kollia, Panagoula %A Langdahl, Bente Lomholt %A Ljunggren, Osten %A Lorentzon, Mattias %A Marc, Janja %A Mellström, Dan %A Ohlsson, Claes %A Olmos, José M %A Ralston, Stuart H %A Riancho, José A %A Rousseau, François %A Urreizti, Roser %A Van Hul, Wim %A Zarrabeitia, María T %A Castano-Betancourt, Martha %A Demissie, Serkalem %A Grundberg, Elin %A Herrera, Lizbeth %A Kwan, Tony %A Medina-Gómez, Carolina %A Pastinen, Tomi %A Sigurdsson, Gunnar %A Thorleifsson, Gudmar %A Vanmeurs, Joyce Bj %A Blangero, John %A Hofman, Albert %A Liu, Yongmei %A Mitchell, Braxton D %A O'Connell, Jeffrey R %A Oostra, Ben A %A Rotter, Jerome I %A Stefansson, Kari %A Streeten, Elizabeth A %A Styrkarsdottir, Unnur %A Thorsteinsdottir, Unnur %A Tylavsky, Frances A %A Uitterlinden, Andre %A Cauley, Jane A %A Harris, Tamara B %A Ioannidis, John Pa %A Psaty, Bruce M %A Robbins, John A %A Zillikens, M Carola %A Vanduijn, Cornelia M %A Prince, Richard L %A Karasik, David %A Rivadeneira, Fernando %A Kiel, Douglas P %A Cupples, L Adrienne %A Hsu, Yi-Hsiang %K Bone Density %K Cohort Studies %K Female %K Genes %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Reproducibility of Results %K Sex Characteristics %X

Sexual dimorphism in various bone phenotypes, including bone mineral density (BMD), is widely observed; however, the extent to which genes explain these sex differences is unclear. To identify variants with different effects by sex, we examined gene-by-sex autosomal interactions genome-wide, and performed expression quantitative trait loci (eQTL) analysis and bioinformatics network analysis. We conducted an autosomal genome-wide meta-analysis of gene-by-sex interaction on lumbar spine (LS) and femoral neck (FN) BMD in 25,353 individuals from 8 cohorts. In a second stage, we followed up the 12 top single-nucleotide polymorphisms (SNPs; p < 1 × 10(-5) ) in an additional set of 24,763 individuals. Gene-by-sex interaction and sex-specific effects were examined in these 12 SNPs. We detected one novel genome-wide significant interaction associated with LS-BMD at the Chr3p26.1-p25.1 locus, near the GRM7 gene (male effect = 0.02 and p = 3.0 × 10(-5) ; female effect = -0.007 and p = 3.3 × 10(-2) ), and 11 suggestive loci associated with either FN- or LS-BMD in discovery cohorts. However, there was no evidence for genome-wide significant (p < 5 × 10(-8) ) gene-by-sex interaction in the joint analysis of discovery and replication cohorts. Despite the large collaborative effort, no genome-wide significant evidence for gene-by-sex interaction was found to influence BMD variation in this screen of autosomal markers. If they exist, gene-by-sex interactions for BMD probably have weak effects, accounting for less than 0.08% of the variation in these traits per implicated SNP. © 2012 American Society for Bone and Mineral Research.

%B J Bone Miner Res %V 27 %P 2051-64 %8 2012 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/22692763?dopt=Abstract %R 10.1002/jbmr.1679 %0 Journal Article %J Circ Cardiovasc Genet %D 2012 %T Association between chromosome 9p21 variants and the ankle-brachial index identified by a meta-analysis of 21 genome-wide association studies. %A Murabito, Joanne M %A White, Charles C %A Kavousi, Maryam %A Sun, Yan V %A Feitosa, Mary F %A Nambi, Vijay %A Lamina, Claudia %A Schillert, Arne %A Coassin, Stefan %A Bis, Joshua C %A Broer, Linda %A Crawford, Dana C %A Franceschini, Nora %A Frikke-Schmidt, Ruth %A Haun, Margot %A Holewijn, Suzanne %A Huffman, Jennifer E %A Hwang, Shih-Jen %A Kiechl, Stefan %A Kollerits, Barbara %A Montasser, May E %A Nolte, Ilja M %A Rudock, Megan E %A Senft, Andrea %A Teumer, Alexander %A van der Harst, Pim %A Vitart, Veronique %A Waite, Lindsay L %A Wood, Andrew R %A Wassel, Christina L %A Absher, Devin M %A Allison, Matthew A %A Amin, Najaf %A Arnold, Alice %A Asselbergs, Folkert W %A Aulchenko, Yurii %A Bandinelli, Stefania %A Barbalic, Maja %A Boban, Mladen %A Brown-Gentry, Kristin %A Couper, David J %A Criqui, Michael H %A Dehghan, Abbas %A den Heijer, Martin %A Dieplinger, Benjamin %A Ding, Jingzhong %A Dörr, Marcus %A Espinola-Klein, Christine %A Felix, Stephan B %A Ferrucci, Luigi %A Folsom, Aaron R %A Fraedrich, Gustav %A Gibson, Quince %A Goodloe, Robert %A Gunjaca, Grgo %A Haltmayer, Meinhard %A Heiss, Gerardo %A Hofman, Albert %A Kieback, Arne %A Kiemeney, Lambertus A %A Kolcic, Ivana %A Kullo, Iftikhar J %A Kritchevsky, Stephen B %A Lackner, Karl J %A Li, Xiaohui %A Lieb, Wolfgang %A Lohman, Kurt %A Meisinger, Christa %A Melzer, David %A Mohler, Emile R %A Mudnic, Ivana %A Mueller, Thomas %A Navis, Gerjan %A Oberhollenzer, Friedrich %A Olin, Jeffrey W %A O'Connell, Jeff %A O'Donnell, Christopher J %A Palmas, Walter %A Penninx, Brenda W %A Petersmann, Astrid %A Polasek, Ozren %A Psaty, Bruce M %A Rantner, Barbara %A Rice, Ken %A Rivadeneira, Fernando %A Rotter, Jerome I %A Seldenrijk, Adrie %A Stadler, Marietta %A Summerer, Monika %A Tanaka, Toshiko %A Tybjaerg-Hansen, Anne %A Uitterlinden, André G %A van Gilst, Wiek H %A Vermeulen, Sita H %A Wild, Sarah H %A Wild, Philipp S %A Willeit, Johann %A Zeller, Tanja %A Zemunik, Tatijana %A Zgaga, Lina %A Assimes, Themistocles L %A Blankenberg, Stefan %A Boerwinkle, Eric %A Campbell, Harry %A Cooke, John P %A de Graaf, Jacqueline %A Herrington, David %A Kardia, Sharon L R %A Mitchell, Braxton D %A Murray, Anna %A Münzel, Thomas %A Newman, Anne B %A Oostra, Ben A %A Rudan, Igor %A Shuldiner, Alan R %A Snieder, Harold %A van Duijn, Cornelia M %A Völker, Uwe %A Wright, Alan F %A Wichmann, H-Erich %A Wilson, James F %A Witteman, Jacqueline C M %A Liu, Yongmei %A Hayward, Caroline %A Borecki, Ingrid B %A Ziegler, Andreas %A North, Kari E %A Cupples, L Adrienne %A Kronenberg, Florian %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Alleles %K Ankle Brachial Index %K Chromosomes, Human, Pair 9 %K Cohort Studies %K Cyclin-Dependent Kinase Inhibitor p15 %K Female %K Genome-Wide Association Study %K Genotype %K HapMap Project %K Humans %K Logistic Models %K Male %K Middle Aged %K Peripheral Vascular Diseases %K Phenotype %K Polymorphism, Single Nucleotide %K Risk Factors %K Sex Factors %X

BACKGROUND: Genetic determinants of peripheral arterial disease (PAD) remain largely unknown. To identify genetic variants associated with the ankle-brachial index (ABI), a noninvasive measure of PAD, we conducted a meta-analysis of genome-wide association study data from 21 population-based cohorts.

METHODS AND RESULTS: Continuous ABI and PAD (ABI ≤0.9) phenotypes adjusted for age and sex were examined. Each study conducted genotyping and imputed data to the ≈2.5 million single nucleotide polymorphisms (SNPs) in HapMap. Linear and logistic regression models were used to test each SNP for association with ABI and PAD using additive genetic models. Study-specific data were combined using fixed effects inverse variance weighted meta-analyses. There were a total of 41 692 participants of European ancestry (≈60% women, mean ABI 1.02 to 1.19), including 3409 participants with PAD and with genome-wide association study data available. In the discovery meta-analysis, rs10757269 on chromosome 9 near CDKN2B had the strongest association with ABI (β=-0.006, P=2.46×10(-8)). We sought replication of the 6 strongest SNP associations in 5 population-based studies and 3 clinical samples (n=16 717). The association for rs10757269 strengthened in the combined discovery and replication analysis (P=2.65×10(-9)). No other SNP associations for ABI or PAD achieved genome-wide significance. However, 2 previously reported candidate genes for PAD and 1 SNP associated with coronary artery disease were associated with ABI: DAB21P (rs13290547, P=3.6×10(-5)), CYBA (rs3794624, P=6.3×10(-5)), and rs1122608 (LDLR, P=0.0026).

CONCLUSIONS: Genome-wide association studies in more than 40 000 individuals identified 1 genome wide significant association on chromosome 9p21 with ABI. Two candidate genes for PAD and 1 SNP for coronary artery disease are associated with ABI.

%B Circ Cardiovasc Genet %V 5 %P 100-12 %8 2012 Feb 01 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22199011?dopt=Abstract %R 10.1161/CIRCGENETICS.111.961292 %0 Journal Article %J Int J Epidemiol %D 2012 %T The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: a meta-analysis of 29 cohorts involving more than 58 000 elderly persons. %A de Hollander, Ellen L %A Bemelmans, Wanda Je %A Boshuizen, Hendriek C %A Friedrich, Nele %A Wallaschofski, Henri %A Guallar-Castillón, Pilar %A Walter, Stefan %A Zillikens, M Carola %A Rosengren, Annika %A Lissner, Lauren %A Bassett, Julie K %A Giles, Graham G %A Orsini, Nicola %A Heim, Noor %A Visser, Marjolein %A de Groot, Lisette Cpgm %K Aged %K Body Mass Index %K Body Weight %K Cardiovascular Diseases %K Female %K Humans %K Male %K Mortality %K Neoplasms %K Overweight %K Respiratory Tract Diseases %K Risk Assessment %K Waist Circumference %X

BACKGROUND: For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined.

METHODS: Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC(2)) were calculated by the investigators and pooled by means of random-effects models.

RESULTS: During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: ≥102 cm, women: ≥88 cm) was associated with increased all-cause mortality RRs for those in the 'healthy' weight {1.7 [95% confidence interval (CI): 1.2-2.2], 1.7 (95% CI: 1.3-2.3)}, overweight [1.1(95% CI: 1.0-1.3), 1.4 (95%: 1.1-1.7)] and obese [1.1 (95% CI: 1.0-1.3), 1.6 (95% CI: 1.3-1.9)] BMI category compared with the 'healthy' weight (20-24.9 kg/m(2)) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95% CI: 1.8-2.8)] and women [2.3 (95% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women.

CONCLUSIONS: Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations.

%B Int J Epidemiol %V 41 %P 805-17 %8 2012 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22467292?dopt=Abstract %R 10.1093/ije/dys008 %0 Journal Article %J PLoS One %D 2012 %T Association of genetic loci with sleep apnea in European Americans and African-Americans: the Candidate Gene Association Resource (CARe). %A Patel, Sanjay R %A Goodloe, Robert %A De, Gourab %A Kowgier, Matthew %A Weng, Jia %A Buxbaum, Sarah G %A Cade, Brian %A Fulop, Tibor %A Gharib, Sina A %A Gottlieb, Daniel J %A Hillman, David %A Larkin, Emma K %A Lauderdale, Diane S %A Li, Li %A Mukherjee, Sutapa %A Palmer, Lyle %A Zee, Phyllis %A Zhu, Xiaofeng %A Redline, Susan %K Adult %K African Americans %K Aged %K Alleles %K European Continental Ancestry Group %K Female %K Genetic Association Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genotype %K Humans %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Polysomnography %K Sleep Apnea, Obstructive %X

Although obstructive sleep apnea (OSA) is known to have a strong familial basis, no genetic polymorphisms influencing apnea risk have been identified in cross-cohort analyses. We utilized the National Heart, Lung, and Blood Institute (NHLBI) Candidate Gene Association Resource (CARe) to identify sleep apnea susceptibility loci. Using a panel of 46,449 polymorphisms from roughly 2,100 candidate genes on a customized Illumina iSelect chip, we tested for association with the apnea hypopnea index (AHI) as well as moderate to severe OSA (AHI≥15) in 3,551 participants of the Cleveland Family Study and two cohorts participating in the Sleep Heart Health Study.Among 647 African-Americans, rs11126184 in the pleckstrin (PLEK) gene was associated with OSA while rs7030789 in the lysophosphatidic acid receptor 1 (LPAR1) gene was associated with AHI using a chip-wide significance threshold of p-value<2×10(-6). Among 2,904 individuals of European ancestry, rs1409986 in the prostaglandin E2 receptor (PTGER3) gene was significantly associated with OSA. Consistency of effects between rs7030789 and rs1409986 in LPAR1 and PTGER3 and apnea phenotypes were observed in independent clinic-based cohorts.Novel genetic loci for apnea phenotypes were identified through the use of customized gene chips and meta-analyses of cohort data with replication in clinic-based samples. The identified SNPs all lie in genes associated with inflammation suggesting inflammation may play a role in OSA pathogenesis.

%B PLoS One %V 7 %P e48836 %8 2012 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/23155414?dopt=Abstract %R 10.1371/journal.pone.0048836 %0 Journal Article %J Circulation %D 2012 %T Association of mild to moderate chronic kidney disease with venous thromboembolism: pooled analysis of five prospective general population cohorts. %A Mahmoodi, Bakhtawar K %A Gansevoort, Ron T %A Næss, Inger Anne %A Lutsey, Pamela L %A Brækkan, Sigrid K %A Veeger, Nic J G M %A Brodin, Ellen E %A Meijer, Karina %A Sang, Yingying %A Matsushita, Kunihiro %A Hallan, Stein I %A Hammerstrøm, Jens %A Cannegieter, Suzanne C %A Astor, Brad C %A Coresh, Josef %A Folsom, Aaron R %A Hansen, John-Bjarne %A Cushman, Mary %K Aged %K Cohort Studies %K Europe %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Prevalence %K Renal Insufficiency, Chronic %K Risk Factors %K Severity of Illness Index %K Venous Thromboembolism %X

BACKGROUND: Recent findings suggest that chronic kidney disease (CKD) may be associated with an increased risk of venous thromboembolism (VTE). Given the high prevalence of mild-to-moderate CKD in the general population, in depth analysis of this association is warranted.

METHODS AND RESULTS: We pooled individual participant data from 5 community-based cohorts from Europe (second Nord-Trøndelag Health Study [HUNT2], Prevention of Renal and Vascular End-stage Disease [PREVEND], and the Tromsø study) and the United States (Atherosclerosis Risks in Communities [ARIC] and Cardiovascular Health Study [CHS]) to assess the association of estimated glomerular filtration rate (eGFR), albuminuria, and CKD with objectively verified VTE. To estimate adjusted hazard ratios for VTE, categorical and continuous spline models were fit by using Cox regression with shared-frailty or random-effect meta-analysis. A total of 1178 VTE events occurred over 599 453 person-years follow-up. Relative to eGFR 100 mL/min per 1.73 m(2), hazard ratios for VTE were 1.29 (95% confidence interval, 1.04-1.59) for eGFR 75, 1.31 (1.00-1.71) for eGFR 60, 1.82 (1.27-2.60) for eGFR 45, and 1.95 (1.26-3.01) for eGFR 30 mL/min per 1.73 m(2). In comparison with an albumin-to-creatinine ratio (ACR) of 5.0 mg/g, the hazard ratios for VTE were 1.34 (1.04-1.72) for ACR 30 mg/g, 1.60 (1.08-2.36) for ACR 300 mg/g, and 1.92 (1.19-3.09) for ACR 1000 mg/g. There was no interaction between clinical categories of eGFR and ACR (P=0.20). The adjusted hazard ratio for CKD, defined as eGFR <60 mL/min per 1.73 m(2) or albuminuria ≥30 mg/g, (versus no CKD) was 1.54 (95% confidence interval, 1.15-2.06). Associations were consistent in subgroups according to age, sex, and comorbidities, and for unprovoked versus provoked VTE, as well.

CONCLUSIONS: Both eGFR and ACR are independently associated with increased risk of VTE in the general population, even across the normal eGFR and ACR ranges.

%B Circulation %V 126 %P 1964-71 %8 2012 Oct 16 %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/22977129?dopt=Abstract %R 10.1161/CIRCULATIONAHA.112.113944 %0 Journal Article %J Circulation %D 2012 %T Association of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study. %A Wu, Jason H Y %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Sacks, Frank M %A Rimm, Eric B %A Heckbert, Susan R %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Atrial Fibrillation %K Biomarkers %K Dietary Fats %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Fatty Acids, Omega-3 %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Proportional Hazards Models %K Risk Factors %K Seafood %X

BACKGROUND: Experimental studies suggest that long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) may reduce the risk of atrial fibrillation (AF). Prior studies evaluating fish or n-3 PUFA consumption from dietary questionnaires and incident AF have been conflicting. Circulating levels of n-3 PUFAs provide an objective measurement of exposure.

METHODS AND RESULTS: Among 3326 US men and women ≥65 years of age and free of AF or heart failure at baseline, plasma phospholipid levels of eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid were measured at baseline by use of standardized methods. Incident AF (789 cases) was identified prospectively from hospital discharge records and study visit ECGs during 31 169 person-years of follow-up (1992-2006). In multivariable Cox models adjusted for other risk factors, the relative risk in the top versus lowest quartile of total n-3 PUFAs (eicosapentaenoic acid+docosapentaenoic acid+docosahexaenoic acid) levels was 0.71 (95% confidence interval, 0.57-0.89; P for trend=0.004) and of DHA levels was 0.77 (95% confidence interval, 0.62-0.96; P for trend=0.01). Eicosapentaenoic acid and docosapentaenoic acid levels were not significantly associated with incident AF. Evaluated nonparametrically, both total n-3 PUFAs and docosahexaenoic acid showed graded and linear inverse associations with incidence of AF. Adjustment for intervening events such as heart failure or myocardial infarction during follow-up did not appreciably alter results.

CONCLUSIONS: In older adults, higher circulating total long-chain n-3 PUFA and docosahexaenoic acid levels were associated with lower risk of incident AF. These results highlight the need to evaluate whether increased dietary intake of these fatty acids could be effective for the primary prevention of AF.

%B Circulation %V 125 %P 1084-93 %8 2012 Mar 06 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22282329?dopt=Abstract %R 10.1161/CIRCULATIONAHA.111.062653 %0 Journal Article %J JAMA %D 2012 %T Association of weight status with mortality in adults with incident diabetes. %A Carnethon, Mercedes R %A De Chavez, Peter John D %A Biggs, Mary L %A Lewis, Cora E %A Pankow, James S %A Bertoni, Alain G %A Golden, Sherita H %A Liu, Kiang %A Mukamal, Kenneth J %A Campbell-Jenkins, Brenda %A Dyer, Alan R %K Adult %K Aged %K Aged, 80 and over %K Body Mass Index %K Body Weight %K Cardiovascular Diseases %K Cause of Death %K Diabetes Mellitus, Type 2 %K Female %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Obesity %K Overweight %K United States %X

CONTEXT: Type 2 diabetes in normal-weight adults (body mass index [BMI] <25) is a representation of the metabolically obese normal-weight phenotype with unknown mortality consequences.

OBJECTIVE: To test the association of weight status with mortality in adults with new-onset diabetes in order to minimize the influence of diabetes duration and voluntary weight loss on mortality.

DESIGN, SETTING, AND PARTICIPANTS: Pooled analysis of 5 longitudinal cohort studies: Atherosclerosis Risk in Communities study, 1990-2006; Cardiovascular Health Study, 1992-2008; Coronary Artery Risk Development in Young Adults, 1987-2011; Framingham Offspring Study, 1979-2007; and Multi-Ethnic Study of Atherosclerosis, 2002-2011. A total of 2625 participants with incident diabetes contributed 27,125 person-years of follow-up. Included were men and women (age >40 years) who developed incident diabetes based on fasting glucose 126 mg/dL or greater or newly initiated diabetes medication and who had concurrent measurements of BMI. Participants were classified as normal weight if their BMI was 18.5 to 24.99 or overweight/obese if BMI was 25 or greater.

MAIN OUTCOME MEASURES: Total, cardiovascular, and noncardiovascular mortality.

RESULTS: The proportion of adults who were normal weight at the time of incident diabetes ranged from 9% to 21% (overall 12%). During follow-up, 449 participants died: 178 from cardiovascular causes and 253 from noncardiovascular causes (18 were not classified). The rates of total, cardiovascular, and noncardiovascular mortality were higher in normal-weight participants (284.8, 99.8, and 198.1 per 10,000 person-years, respectively) than in overweight/obese participants (152.1, 67.8, and 87.9 per 10,000 person-years, respectively). After adjustment for demographic characteristics and blood pressure, lipid levels, waist circumference, and smoking status, hazard ratios comparing normal-weight participants with overweight/obese participants for total, cardiovascular, and noncardiovascular mortality were 2.08 (95% CI, 1.52-2.85), 1.52 (95% CI, 0.89-2.58), and 2.32 (95% CI, 1.55-3.48), respectively.

CONCLUSION: Adults who were normal weight at the time of incident diabetes had higher mortality than adults who are overweight or obese.

%B JAMA %V 308 %P 581-90 %8 2012 Aug 08 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22871870?dopt=Abstract %R 10.1001/jama.2012.9282 %0 Journal Article %J Lancet %D 2012 %T Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. %A Fox, Caroline S %A Matsushita, Kunihiro %A Woodward, Mark %A Bilo, Henk J G %A Chalmers, John %A Heerspink, Hiddo J Lambers %A Lee, Brian J %A Perkins, Robert M %A Rossing, Peter %A Sairenchi, Toshimi %A Tonelli, Marcello %A Vassalotti, Joseph A %A Yamagishi, Kazumasa %A Coresh, Josef %A de Jong, Paul E %A Wen, Chi-Pang %A Nelson, Robert G %K Aged %K Albuminuria %K Cardiovascular Diseases %K Cause of Death %K Diabetic Nephropathies %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Risk Factors %X

BACKGROUND: Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes is unknown.

METHODS: We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes.

FINDINGS: We analysed data for 1,024,977 participants (128,505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75,306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21,237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2-1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m(2) [vs 95 mL/min per 1·73 m(2)], HR 1·35; 95% CI 1·18-1·55; vs 1·33; 1·19-1·48 and at ACR 30 mg/g [vs 5 mg/g], 1·50; 1·35-1·65 vs 1·52; 1·38-1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts.

INTERPRETATION: Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes.

FUNDING: US National Kidney Foundation.

%B Lancet %V 380 %P 1662-73 %8 2012 Nov 10 %G eng %N 9854 %1 http://www.ncbi.nlm.nih.gov/pubmed/23013602?dopt=Abstract %R 10.1016/S0140-6736(12)61350-6 %0 Journal Article %J Mov Disord %D 2012 %T Cardiovascular physiology in premotor Parkinson's disease: a neuroepidemiologic study. %A Jain, Samay %A Ton, Thanh G %A Perera, Subashan %A Zheng, Yan %A Stein, Phyllis K %A Thacker, Evan %A Strotmeyer, Elsa S %A Newman, Anne B %A Longstreth, Will T %K Aged %K Antiparkinson Agents %K Cardiovascular Physiological Phenomena %K Carotid Stenosis %K Cohort Studies %K Data Interpretation, Statistical %K Dizziness %K Electrocardiography %K Female %K Heart Rate %K Hospitalization %K Humans %K Longitudinal Studies %K Male %K Movement Disorders %K Neurologic Examination %K Parkinson Disease %K Risk %K Ultrasonography %X

Changes in cardiovascular physiology in Parkinson's disease (PD) are common and may occur prior to diagnostic parkinsonian motor signs. We investigated associations of electrocardiographic (ECG) abnormalities, orthostasis, heart rate variability, and carotid stenosis with the risk of PD diagnosis in the Cardiovascular Health Study, a community-based cohort of older adults. ECG abnormality, orthostasis (symptomatic or asymptomatic), heart rate variability (24-hour Holter monitoring), and any carotid stenosis (≥1%) by ultrasound were modeled as primary predictors of incident PD diagnosis using multivariable logistic regression. Incident PD cases were identified by at least 1 of the following: self-report, antiparkinsonian medication use, and ICD-9. If unadjusted models were significant, they were adjusted or stratified by age, sex, and smoking status, and those in which predictors were still significant (P ≤ .05) were also adjusted for race, diabetes, total cholesterol, low-density lipoprotein, blood pressure, body mass index, physical activity, education level, stroke, and C-reactive protein. Of 5888 participants, 154 incident PD cases were identified over 14 years of follow-up. After adjusting models with all covariates, those with any ECG abnormality (odds ratio [OR], 1.45; 95% CI, 1.02-2.07; P = .04) or any carotid stenosis (OR, 2.40; 95% CI, 1.40-4.09; P = .001) at baseline had a higher risk of incident PD diagnosis. Orthostasis and heart rate variability were not significant predictors. This exploratory study suggests that carotid stenosis and ECG abnormalities occur prior to motor signs in PD, thus serving as potential premotor features or risk factors for PD diagnosis. Replication is needed in a population with more thorough ascertainment of PD onset.

%B Mov Disord %V 27 %P 988-95 %8 2012 Jul %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/22700356?dopt=Abstract %R 10.1002/mds.24979 %0 Journal Article %J Lancet %D 2012 %T Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. %A Lorenz, Matthias W %A Polak, Joseph F %A Kavousi, Maryam %A Mathiesen, Ellisiv B %A Völzke, Henry %A Tuomainen, Tomi-Pekka %A Sander, Dirk %A Plichart, Matthieu %A Catapano, Alberico L %A Robertson, Christine M %A Kiechl, Stefan %A Rundek, Tatjana %A Desvarieux, Moïse %A Lind, Lars %A Schmid, Caroline %A DasMahapatra, Pronabesh %A Gao, Lu %A Ziegelbauer, Kathrin %A Bots, Michiel L %A Thompson, Simon G %K Cardiovascular Diseases %K Carotid Intima-Media Thickness %K Disease Progression %K Follow-Up Studies %K Humans %K Myocardial Infarction %K Prognosis %K Risk Assessment %K Stroke %X

BACKGROUND: Carotid intima-media thickness (cIMT) is related to the risk of cardiovascular events in the general population. An association between changes in cIMT and cardiovascular risk is frequently assumed but has rarely been reported. Our aim was to test this association.

METHODS: We identified general population studies that assessed cIMT at least twice and followed up participants for myocardial infarction, stroke, or death. The study teams collaborated in an individual participant data meta-analysis. Excluding individuals with previous myocardial infarction or stroke, we assessed the association between cIMT progression and the risk of cardiovascular events (myocardial infarction, stroke, vascular death, or a combination of these) for each study with Cox regression. The log hazard ratios (HRs) per SD difference were pooled by random effects meta-analysis.

FINDINGS: Of 21 eligible studies, 16 with 36,984 participants were included. During a mean follow-up of 7·0 years, 1519 myocardial infarctions, 1339 strokes, and 2028 combined endpoints (myocardial infarction, stroke, vascular death) occurred. Yearly cIMT progression was derived from two ultrasound visits 2-7 years (median 4 years) apart. For mean common carotid artery intima-media thickness progression, the overall HR of the combined endpoint was 0·97 (95% CI 0·94-1·00) when adjusted for age, sex, and mean common carotid artery intima-media thickness, and 0·98 (0·95-1·01) when also adjusted for vascular risk factors. Although we detected no associations with cIMT progression in sensitivity analyses, the mean cIMT of the two ultrasound scans was positively and robustly associated with cardiovascular risk (HR for the combined endpoint 1·16, 95% CI 1·10-1·22, adjusted for age, sex, mean common carotid artery intima-media thickness progression, and vascular risk factors). In three studies including 3439 participants who had four ultrasound scans, cIMT progression did not correlate between occassions (reproducibility correlations between r=-0·06 and r=-0·02).

INTERPRETATION: The association between cIMT progression assessed from two ultrasound scans and cardiovascular risk in the general population remains unproven. No conclusion can be derived for the use of cIMT progression as a surrogate in clinical trials.

FUNDING: Deutsche Forschungsgemeinschaft.

%B Lancet %V 379 %P 2053-62 %8 2012 Jun 02 %G eng %N 9831 %1 http://www.ncbi.nlm.nih.gov/pubmed/22541275?dopt=Abstract %R 10.1016/S0140-6736(12)60441-3 %0 Journal Article %J Am J Clin Nutr %D 2012 %T Circulating and dietary α-linolenic acid and incidence of congestive heart failure in older adults: the Cardiovascular Health Study. %A Lemaitre, Rozenn N %A Sitlani, Colleen %A Song, Xiaoling %A King, Irena B %A McKnight, Barbara %A Spiegelman, Donna %A Sacks, Frank M %A Djoussé, Luc %A Rimm, Eric B %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Alcohol Drinking %K alpha-Linolenic Acid %K Biomarkers %K Body Mass Index %K Cardiovascular Diseases %K Diet %K Fatty Acid Desaturases %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Incidence %K Male %K Polymorphism, Single Nucleotide %K Prevalence %K Prospective Studies %K Risk Factors %K Smoking %K Surveys and Questionnaires %K United States %X

BACKGROUND: Few studies have evaluated the association between the n-3 fatty acid α-linolenic acid (ALA) and the incidence of congestive heart failure (CHF).

OBJECTIVE: We investigated whether plasma phospholipid concentrations and estimated dietary consumption of ALA are associated with incident CHF.

DESIGN: We used data from the Cardiovascular Health Study, a prospective cohort study of cardiovascular diseases among adults aged ≥65 y, from 4 US communities. A total of 2957 participants free of prevalent heart disease and with available fatty acid measurements were included in biomarker analyses (30,722 person-years and 686 incident CHF events). A total of 4432 participants free of prevalent heart disease were included in dietary analyses (52,609 person-years and 1072 events). We investigated the association of ALA with incident CHF by using Cox regression.

RESULTS: After adjustment for age, sex, race, education, smoking status, BMI, waist circumference, and alcohol consumption, plasma phospholipid ALA was not associated with incident CHF (HR for the highest compared with the lowest quartile: 0.97; 95% CI: 0.79, 1.21; P-trend = 0.85). Likewise, dietary ALA was not associated with incident CHF (adjusted HR for the highest compared with the lowest quartile: 0.96; 95% CI: 0.82, 1.20; P-trend = 0.97). We observed no association of biomarker or dietary ALA with nonvalvular CHF subtype. We also found little evidence of an association between ALA and CHF in subgroups based on age, sex, diabetes, fish consumption, BMI, or FADS2 genotype (rs1535).

CONCLUSION: ALA intake is not associated with incident CHF in older adults. This trial was registered at clinicaltrials.gov as NCT00005133.

%B Am J Clin Nutr %V 96 %P 269-74 %8 2012 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/22743310?dopt=Abstract %R 10.3945/ajcn.112.037960 %0 Journal Article %J Neuroimage Clin %D 2012 %T Common folate gene variant, MTHFR C677T, is associated with brain structure in two independent cohorts of people with mild cognitive impairment. %A Rajagopalan, Priya %A Jahanshad, Neda %A Stein, Jason L %A Hua, Xue %A Madsen, Sarah K %A Kohannim, Omid %A Hibar, Derrek P %A Toga, Arthur W %A Jack, Clifford R %A Saykin, Andrew J %A Green, Robert C %A Weiner, Michael W %A Bis, Joshua C %A Kuller, Lewis H %A Riverol, Mario %A Becker, James T %A Lopez, Oscar L %A Thompson, Paul M %X

A commonly carried C677T polymorphism in a folate-related gene, MTHFR, is associated with higher plasma homocysteine, a well-known mediator of neuronal damage and brain atrophy. As homocysteine promotes brain atrophy, we set out to discover whether people carrying the C677T MTHFR polymorphism which increases homocysteine, might also show systematic differences in brain structure. Using tensor-based morphometry, we tested this association in 359 elderly Caucasian subjects with mild cognitive impairment (MCI) (mean age: 75 ± 7.1 years) scanned with brain MRI and genotyped as part of Alzheimer's Disease Neuroimaging Initiative. We carried out a replication study in an independent, non-overlapping sample of 51 elderly Caucasian subjects with MCI (mean age: 76 ± 5.5 years), scanned with brain MRI and genotyped for MTHFR, as part of the Cardiovascular Health Study. At each voxel in the brain, we tested to see where regional volume differences were associated with carrying one or more MTHFR 'T' alleles. In ADNI subjects, carriers of the MTHFR risk allele had detectable brain volume deficits, in the white matter, of up to 2-8% per risk T allele locally at baseline and showed accelerated brain atrophy of 0.5-1.5% per T allele at 1 year follow-up, after adjusting for age and sex. We replicated these brain volume deficits of up to 5-12% per MTHFR T allele in the independent cohort of CHS subjects. As expected, the associations weakened after controlling for homocysteine levels, which the risk gene affects. The MTHFR risk variant may thus promote brain atrophy by elevating homocysteine levels. This study aims to investigate the spatially detailed effects of this MTHFR polymorphism on brain structure in 3D, pointing to a causal pathway that may promote homocysteine-mediated brain atrophy in elderly people with MCI.

%B Neuroimage Clin %V 1 %P 179-87 %8 2012 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24179750?dopt=Abstract %R 10.1016/j.nicl.2012.09.012 %0 Journal Article %J JAMA %D 2012 %T Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. %A Matsushita, Kunihiro %A Mahmoodi, Bakhtawar K %A Woodward, Mark %A Emberson, Jonathan R %A Jafar, Tazeen H %A Jee, Sun Ha %A Polkinghorne, Kevan R %A Shankar, Anoop %A Smith, David H %A Tonelli, Marcello %A Warnock, David G %A Wen, Chi-Pang %A Coresh, Josef %A Gansevoort, Ron T %A Hemmelgarn, Brenda R %A Levey, Andrew S %K African Continental Ancestry Group %K Aged %K Algorithms %K Asian Continental Ancestry Group %K Cardiovascular Diseases %K Cohort Studies %K Decision Support Techniques %K European Continental Ancestry Group %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Models, Theoretical %K Risk Assessment %K Sex Factors %X

CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking.

OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics.

DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged ≥ 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012.

MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years).

RESULTS: Estimated GFR was classified into 6 categories (≥90, 60-89, 45-59, 30-44, 15-29, and <15 mL/min/1.73 m(2)) by both equations. Compared with the MDRD Study equation, 24.4% and 0.6% of participants from general population cohorts were reclassified to a higher and lower estimated GFR category, respectively, by the CKD-EPI equation, and the prevalence of CKD stages 3 to 5 (estimated GFR <60 mL/min/1.73 m(2)) was reduced from 8.7% to 6.3%. In estimated GFR of 45 to 59 mL/min/1.73 m(2) by the MDRD Study equation, 34.7% of participants were reclassified to estimated GFR of 60 to 89 mL/min/1.73 m(2) by the CKD-EPI equation and had lower incidence rates (per 1000 person-years) for the outcomes of interest (9.9 vs 34.5 for all-cause mortality, 2.7 vs 13.0 for cardiovascular mortality, and 0.5 vs 0.8 for ESRD) compared with those not reclassified. The corresponding adjusted hazard ratios were 0.80 (95% CI, 0.74-0.86) for all-cause mortality, 0.73 (95% CI, 0.65-0.82) for cardiovascular mortality, and 0.49 (95% CI, 0.27-0.88) for ESRD. Similar findings were observed in other estimated GFR categories by the MDRD Study equation. Net reclassification improvement based on estimated GFR categories was significantly positive for all outcomes (range, 0.06-0.13; all P < .001). Net reclassification improvement was similarly positive in most subgroups defined by age (<65 years and ≥65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts.

CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.

%B JAMA %V 307 %P 1941-51 %8 2012 May 09 %G eng %N 18 %1 http://www.ncbi.nlm.nih.gov/pubmed/22570462?dopt=Abstract %R 10.1001/jama.2012.3954 %0 Journal Article %J Diabetes %D 2012 %T Consistent directions of effect for established type 2 diabetes risk variants across populations: the population architecture using Genomics and Epidemiology (PAGE) Consortium. %A Haiman, Christopher A %A Fesinmeyer, Megan D %A Spencer, Kylee L %A Bůzková, Petra %A Voruganti, V Saroja %A Wan, Peggy %A Haessler, Jeff %A Franceschini, Nora %A Monroe, Kristine R %A Howard, Barbara V %A Jackson, Rebecca D %A Florez, Jose C %A Kolonel, Laurence N %A Buyske, Steven %A Goodloe, Robert J %A Liu, Simin %A Manson, JoAnn E %A Meigs, James B %A Waters, Kevin %A Mukamal, Kenneth J %A Pendergrass, Sarah A %A Shrader, Peter %A Wilkens, Lynne R %A Hindorff, Lucia A %A Ambite, Jose Luis %A North, Kari E %A Peters, Ulrike %A Crawford, Dana C %A Le Marchand, Loïc %A Pankow, James S %K Adult %K Aged %K Aged, 80 and over %K Alleles %K Diabetes Mellitus, Type 2 %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Metagenomics %K Middle Aged %K Population Groups %K Risk %K Risk Factors %X

Common genetic risk variants for type 2 diabetes (T2D) have primarily been identified in populations of European and Asian ancestry. We tested whether the direction of association with 20 T2D risk variants generalizes across six major racial/ethnic groups in the U.S. as part of the Population Architecture using Genomics and Epidemiology Consortium (16,235 diabetes case and 46,122 control subjects of European American, African American, Hispanic, East Asian, American Indian, and Native Hawaiian ancestry). The percentage of positive (odds ratio [OR] >1 for putative risk allele) associations ranged from 69% in American Indians to 100% in European Americans. Of the nine variants where we observed significant heterogeneity of effect by racial/ethnic group (P(heterogeneity) < 0.05), eight were positively associated with risk (OR >1) in at least five groups. The marked directional consistency of association observed for most genetic variants across populations implies a shared functional common variant in each region. Fine-mapping of all loci will be required to reveal markers of risk that are important within and across populations.

%B Diabetes %V 61 %P 1642-7 %8 2012 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22474029?dopt=Abstract %R 10.2337/db11-1296 %0 Journal Article %J Ann Intern Med %D 2012 %T Development and validation of a coronary risk prediction model for older U.S. and European persons in the Cardiovascular Health Study and the Rotterdam Study. %A Koller, Michael T %A Leening, Maarten J G %A Wolbers, Marcel %A Steyerberg, Ewout W %A Hunink, M G Myriam %A Schoop, Rotraut %A Hofman, Albert %A Bucher, Heiner C %A Psaty, Bruce M %A Lloyd-Jones, Donald M %A Witteman, Jacqueline C M %K Aged %K Aged, 80 and over %K Algorithms %K Cause of Death %K Coronary Disease %K European Continental Ancestry Group %K Female %K Humans %K Incidence %K Male %K Models, Statistical %K Multivariate Analysis %K Netherlands %K Prospective Studies %K Risk Assessment %K Risk Factors %K United States %X

BACKGROUND: Risk scores for prediction of coronary heart disease (CHD) in older adults are needed.

OBJECTIVE: To develop a sex-specific CHD risk prediction model for older adults that accounts for competing risks for death.

DESIGN: 2 observational cohort studies, using data from 4946 participants in the Cardiovascular Health Study (CHS) and 4303 participants in the Rotterdam Study (RS).

SETTING: Community settings in the United States (CHS) and Rotterdam, the Netherlands (RS).

PARTICIPANTS: Persons aged 65 years or older who were free of cardiovascular disease.

MEASUREMENTS: A composite of nonfatal myocardial infarction and coronary death.

RESULTS: During a median follow-up of 16.5 and 14.9 years, 1166 CHS and 698 RS participants had CHD events, respectively. Deaths from noncoronary causes largely exceeded the number of CHD events, complicating accurate CHD risk predictions. The prediction model had moderate ability to discriminate between events and nonevents (c-statistic, 0.63 in both U.S. and European men and 0.67 and 0.68 in U.S. and European women). The model was well-calibrated; predicted risks were in good agreement with observed risks. Compared with the Framingham point scores, the prediction model classified elderly U.S. persons into higher risk categories but elderly European persons into lower risk categories. Differences in classification accuracy were not consistent and depended on cohort and sex. Adding newer cardiovascular risk markers to the model did not substantially improve performance.

LIMITATION: The model may be less applicable in nonwhite populations, and the comparison Framingham model was not designed for adults older than 79 years.

CONCLUSION: A CHD risk prediction model that accounts for deaths from noncoronary causes among older adults provided well-calibrated risk estimates but was not substantially more accurate than Framingham point scores. Moreover, adding newer risk markers did not improve accuracy. These findings emphasize the difficulties of predicting CHD risk in elderly persons and the need to improve these predictions.

PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute; National Institute of Neurological Disorders and Stroke; The Netherlands Organisation for Scientific Research; and the Netherlands Organisation for Health Research and Development.

%B Ann Intern Med %V 157 %P 389-97 %8 2012 Sep 18 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22986376?dopt=Abstract %R 10.7326/0003-4819-157-6-201209180-00002 %0 Journal Article %J Am J Psychiatry %D 2012 %T Effect of Alzheimer's disease risk genes on trajectories of cognitive function in the Cardiovascular Health Study. %A Sweet, Robert A %A Seltman, Howard %A Emanuel, James E %A Lopez, Oscar L %A Becker, James T %A Bis, Joshua C %A Weamer, Elise A %A Demichele-Sweet, Mary Ann A %A Kuller, Lewis H %K Age of Onset %K Aged %K Alleles %K Alzheimer Disease %K Apolipoprotein E4 %K Bayes Theorem %K Clusterin %K Cohort Studies %K Dementia %K Disease Progression %K Female %K Genetic Predisposition to Disease %K Humans %K Male %K Models, Psychological %K Monomeric Clathrin Assembly Proteins %K Polymorphism, Single Nucleotide %K Receptors, Complement 3b %K Risk Factors %X

OBJECTIVE: The trajectory of cognitive decline in patients with late-onset Alzheimer's disease varies widely. Genetic variations in CLU, PICALM, and CR1 are associated with Alzheimer's disease, but it is unknown whether they exert their effects by altering cognitive trajectory in elderly individuals at risk for the disease.

METHOD: The authors developed a Bayesian model to fit cognitive trajectories in a cohort of elderly subjects and test for genetic effects. They first validated the model's ability to detect the previously established effects of APOE ε4 alleles on age at cognitive decline and of psychosis on the rate of cognitive decline in 802 subjects from the Cardiovascular Health Cognition Study who did not have dementia at study entry and developed incident dementia during follow-up. The authors then evaluated the effects of CLU, PICALM, and CR1 on age and rate of decline in 1,831 subjects who did not have dementia at study entry and then did or did not develop incident dementia by study's end.

RESULTS: The model generated robust fits to the observed cognitive trajectory data, and validation analysis supported the model's utility. CLU and CR1 were associated with more rapid cognitive decline. PICALM was associated with an earlier age at midpoint of cognitive decline. Associations remained after accounting for the effects of APOE and demographic factors.

CONCLUSIONS: Evaluation of cognitive trajectories provides a powerful approach to dissecting genetic effects on the processes leading to cognitive deterioration and Alzheimer's disease.

%B Am J Psychiatry %V 169 %P 954-62 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22952074?dopt=Abstract %R 10.1176/appi.ajp.2012.11121815 %0 Journal Article %J Eur Heart J %D 2012 %T Eight genetic loci associated with variation in lipoprotein-associated phospholipase A2 mass and activity and coronary heart disease: meta-analysis of genome-wide association studies from five community-based studies. %A Grallert, Harald %A Dupuis, Josée %A Bis, Joshua C %A Dehghan, Abbas %A Barbalic, Maja %A Baumert, Jens %A Lu, Chen %A Smith, Nicholas L %A Uitterlinden, André G %A Roberts, Robert %A Khuseyinova, Natalie %A Schnabel, Renate B %A Rice, Kenneth M %A Rivadeneira, Fernando %A Hoogeveen, Ron C %A Fontes, João Daniel %A Meisinger, Christa %A Keaney, John F %A Lemaitre, Rozenn %A Aulchenko, Yurii S %A Vasan, Ramachandran S %A Ellis, Stephen %A Hazen, Stanley L %A van Duijn, Cornelia M %A Nelson, Jeanenne J %A März, Winfried %A Schunkert, Heribert %A McPherson, Ruth M %A Stirnadel-Farrant, Heide A %A Psaty, Bruce M %A Gieger, Christian %A Siscovick, David %A Hofman, Albert %A Illig, Thomas %A Cushman, Mary %A Yamamoto, Jennifer F %A Rotter, Jerome I %A Larson, Martin G %A Stewart, Alexandre F R %A Boerwinkle, Eric %A Witteman, Jacqueline C M %A Tracy, Russell P %A Koenig, Wolfgang %A Benjamin, Emelia J %A Ballantyne, Christie M %K 1-Alkyl-2-acetylglycerophosphocholine Esterase %K Aged %K Coronary Artery Disease %K Coronary Disease %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Phospholipases A2 %K Polymorphism, Single Nucleotide %X

AIMS: Lipoprotein-associated phospholipase A2 (Lp-PLA2) generates proinflammatory and proatherogenic compounds in the arterial vascular wall and is a potential therapeutic target in coronary heart disease (CHD). We searched for genetic loci related to Lp-PLA2 mass or activity by a genome-wide association study as part of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.

METHODS AND RESULTS: In meta-analyses of findings from five population-based studies, comprising 13 664 subjects, variants at two loci (PLA2G7, CETP) were associated with Lp-PLA2 mass. The strongest signal was at rs1805017 in PLA2G7 [P = 2.4 × 10(-23), log Lp-PLA2 difference per allele (beta): 0.043]. Variants at six loci were associated with Lp-PLA2 activity (PLA2G7, APOC1, CELSR2, LDL, ZNF259, SCARB1), among which the strongest signals were at rs4420638, near the APOE-APOC1-APOC4-APOC2 cluster [P = 4.9 × 10(-30); log Lp-PLA2 difference per allele (beta): -0.054]. There were no significant gene-environment interactions between these eight polymorphisms associated with Lp-PLA2 mass or activity and age, sex, body mass index, or smoking status. Four of the polymorphisms (in APOC1, CELSR2, SCARB1, ZNF259), but not PLA2G7, were significantly associated with CHD in a second study.

CONCLUSION: Levels of Lp-PLA2 mass and activity were associated with PLA2G7, the gene coding for this protein. Lipoprotein-associated phospholipase A2 activity was also strongly associated with genetic variants related to low-density lipoprotein cholesterol levels.

%B Eur Heart J %V 33 %P 238-51 %8 2012 Jan %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/22003152?dopt=Abstract %R 10.1093/eurheartj/ehr372 %0 Journal Article %J PLoS One %D 2012 %T Evaluation of the metabochip genotyping array in African Americans and implications for fine mapping of GWAS-identified loci: the PAGE study. %A Buyske, Steven %A Wu, Ying %A Carty, Cara L %A Cheng, Iona %A Assimes, Themistocles L %A Dumitrescu, Logan %A Hindorff, Lucia A %A Mitchell, Sabrina %A Ambite, Jose Luis %A Boerwinkle, Eric %A Bůzková, Petra %A Carlson, Chris S %A Cochran, Barbara %A Duggan, David %A Eaton, Charles B %A Fesinmeyer, Megan D %A Franceschini, Nora %A Haessler, Jeffrey %A Jenny, Nancy %A Kang, Hyun Min %A Kooperberg, Charles %A Lin, Yi %A Le Marchand, Loïc %A Matise, Tara C %A Robinson, Jennifer G %A Rodriguez, Carlos %A Schumacher, Fredrick R %A Voight, Benjamin F %A Young, Alicia %A Manolio, Teri A %A Mohlke, Karen L %A Haiman, Christopher A %A Peters, Ulrike %A Crawford, Dana C %A North, Kari E %K African Americans %K Cardiovascular Diseases %K Cholesterol Ester Transfer Proteins %K Cholesterol, HDL %K Cholesterol, LDL %K Chromosomes, Human %K Cohort Studies %K Gene Frequency %K Genome-Wide Association Study %K Genotype %K Humans %K Metabolic Diseases %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

The Metabochip is a custom genotyping array designed for replication and fine mapping of metabolic, cardiovascular, and anthropometric trait loci and includes low frequency variation content identified from the 1000 Genomes Project. It has 196,725 SNPs concentrated in 257 genomic regions. We evaluated the Metabochip in 5,863 African Americans; 89% of all SNPs passed rigorous quality control with a call rate of 99.9%. Two examples illustrate the value of fine mapping with the Metabochip in African-ancestry populations. At CELSR2/PSRC1/SORT1, we found the strongest associated SNP for LDL-C to be rs12740374 (p = 3.5 × 10(-11)), a SNP indistinguishable from multiple SNPs in European ancestry samples due to high correlation. Its distinct signal supports functional studies elsewhere suggesting a causal role in LDL-C. At CETP we found rs17231520, with risk allele frequency 0.07 in African Americans, to be associated with HDL-C (p = 7.2 × 10(-36)). This variant is very rare in Europeans and not tagged in common GWAS arrays, but was identified as associated with HDL-C in African Americans in a single-gene study. Our results, one narrowing the risk interval and the other revealing an associated variant not found in Europeans, demonstrate the advantages of high-density genotyping of common and rare variation for fine mapping of trait loci in African American samples.

%B PLoS One %V 7 %P e35651 %8 2012 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22539988?dopt=Abstract %R 10.1371/journal.pone.0035651 %0 Journal Article %J Science %D 2012 %T Evolution and functional impact of rare coding variation from deep sequencing of human exomes. %A Tennessen, Jacob A %A Bigham, Abigail W %A O'Connor, Timothy D %A Fu, Wenqing %A Kenny, Eimear E %A Gravel, Simon %A McGee, Sean %A Do, Ron %A Liu, Xiaoming %A Jun, Goo %A Kang, Hyun Min %A Jordan, Daniel %A Leal, Suzanne M %A Gabriel, Stacey %A Rieder, Mark J %A Abecasis, Goncalo %A Altshuler, David %A Nickerson, Deborah A %A Boerwinkle, Eric %A Sunyaev, Shamil %A Bustamante, Carlos D %A Bamshad, Michael J %A Akey, Joshua M %K African Americans %K Disease %K European Continental Ancestry Group %K Evolution, Molecular %K Exome %K Female %K Gene Frequency %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genetic Variation %K Genome, Human %K High-Throughput Nucleotide Sequencing %K Humans %K Male %K Polymorphism, Single Nucleotide %K Population Growth %K Selection, Genetic %X

As a first step toward understanding how rare variants contribute to risk for complex diseases, we sequenced 15,585 human protein-coding genes to an average median depth of 111× in 2440 individuals of European (n = 1351) and African (n = 1088) ancestry. We identified over 500,000 single-nucleotide variants (SNVs), the majority of which were rare (86% with a minor allele frequency less than 0.5%), previously unknown (82%), and population-specific (82%). On average, 2.3% of the 13,595 SNVs each person carried were predicted to affect protein function of ~313 genes per genome, and ~95.7% of SNVs predicted to be functionally important were rare. This excess of rare functional variants is due to the combined effects of explosive, recent accelerated population growth and weak purifying selection. Furthermore, we show that large sample sizes will be required to associate rare variants with complex traits.

%B Science %V 337 %P 64-9 %8 2012 Jul 06 %G eng %N 6090 %1 http://www.ncbi.nlm.nih.gov/pubmed/22604720?dopt=Abstract %R 10.1126/science.1219240 %0 Journal Article %J PLoS Genet %D 2012 %T Fine-mapping and initial characterization of QT interval loci in African Americans. %A Avery, Christy L %A Sethupathy, Praveen %A Buyske, Steven %A He, Qianchuan %A Lin, Dan-Yu %A Arking, Dan E %A Carty, Cara L %A Duggan, David %A Fesinmeyer, Megan D %A Hindorff, Lucia A %A Jeff, Janina M %A Klein, Liviu %A Patton, Kristen K %A Peters, Ulrike %A Shohet, Ralph V %A Sotoodehnia, Nona %A Young, Alicia M %A Kooperberg, Charles %A Haiman, Christopher A %A Mohlke, Karen L %A Whitsel, Eric A %A North, Kari E %K African Americans %K Aged %K Computational Biology %K Electrocardiography %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Male %K Metagenomics %K Middle Aged %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Quantitative Trait, Heritable %K Risk Factors %K Tachycardia %K United States %X

The QT interval (QT) is heritable and its prolongation is a risk factor for ventricular tachyarrhythmias and sudden death. Most genetic studies of QT have examined European ancestral populations; however, the increased genetic diversity in African Americans provides opportunities to narrow association signals and identify population-specific variants. We therefore evaluated 6,670 SNPs spanning eleven previously identified QT loci in 8,644 African American participants from two Population Architecture using Genomics and Epidemiology (PAGE) studies: the Atherosclerosis Risk in Communities study and Women's Health Initiative Clinical Trial. Of the fifteen known independent QT variants at the eleven previously identified loci, six were significantly associated with QT in African American populations (P≤1.20×10(-4)): ATP1B1, PLN1, KCNQ1, NDRG4, and two NOS1AP independent signals. We also identified three population-specific signals significantly associated with QT in African Americans (P≤1.37×10(-5)): one at NOS1AP and two at ATP1B1. Linkage disequilibrium (LD) patterns in African Americans assisted in narrowing the region likely to contain the functional variants for several loci. For example, African American LD patterns showed that 0 SNPs were in LD with NOS1AP signal rs12143842, compared with European LD patterns that indicated 87 SNPs, which spanned 114.2 Kb, were in LD with rs12143842. Finally, bioinformatic-based characterization of the nine African American signals pointed to functional candidates located exclusively within non-coding regions, including predicted binding sites for transcription factors such as TBX5, which has been implicated in cardiac structure and conductance. In this detailed evaluation of QT loci, we identified several African Americans SNPs that better define the association with QT and successfully narrowed intervals surrounding established loci. These results demonstrate that the same loci influence variation in QT across multiple populations, that novel signals exist in African Americans, and that the SNPs identified as strong candidates for functional evaluation implicate gene regulatory dysfunction in QT prolongation.

%B PLoS Genet %V 8 %P e1002870 %8 2012 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/22912591?dopt=Abstract %R 10.1371/journal.pgen.1002870 %0 Journal Article %J Nature %D 2012 %T FTO genotype is associated with phenotypic variability of body mass index. %A Yang, Jian %A Loos, Ruth J F %A Powell, Joseph E %A Medland, Sarah E %A Speliotes, Elizabeth K %A Chasman, Daniel I %A Rose, Lynda M %A Thorleifsson, Gudmar %A Steinthorsdottir, Valgerdur %A Mägi, Reedik %A Waite, Lindsay %A Smith, Albert Vernon %A Yerges-Armstrong, Laura M %A Monda, Keri L %A Hadley, David %A Mahajan, Anubha %A Li, Guo %A Kapur, Karen %A Vitart, Veronique %A Huffman, Jennifer E %A Wang, Sophie R %A Palmer, Cameron %A Esko, Tõnu %A Fischer, Krista %A Zhao, Jing Hua %A Demirkan, Ayse %A Isaacs, Aaron %A Feitosa, Mary F %A Luan, Jian'an %A Heard-Costa, Nancy L %A White, Charles %A Jackson, Anne U %A Preuss, Michael %A Ziegler, Andreas %A Eriksson, Joel %A Kutalik, Zoltán %A Frau, Francesca %A Nolte, Ilja M %A van Vliet-Ostaptchouk, Jana V %A Hottenga, Jouke-Jan %A Jacobs, Kevin B %A Verweij, Niek %A Goel, Anuj %A Medina-Gómez, Carolina %A Estrada, Karol %A Bragg-Gresham, Jennifer Lynn %A Sanna, Serena %A Sidore, Carlo %A Tyrer, Jonathan %A Teumer, Alexander %A Prokopenko, Inga %A Mangino, Massimo %A Lindgren, Cecilia M %A Assimes, Themistocles L %A Shuldiner, Alan R %A Hui, Jennie %A Beilby, John P %A McArdle, Wendy L %A Hall, Per %A Haritunians, Talin %A Zgaga, Lina %A Kolcic, Ivana %A Polasek, Ozren %A Zemunik, Tatijana %A Oostra, Ben A %A Junttila, M Juhani %A Grönberg, Henrik %A Schreiber, Stefan %A Peters, Annette %A Hicks, Andrew A %A Stephens, Jonathan %A Foad, Nicola S %A Laitinen, Jaana %A Pouta, Anneli %A Kaakinen, Marika %A Willemsen, Gonneke %A Vink, Jacqueline M %A Wild, Sarah H %A Navis, Gerjan %A Asselbergs, Folkert W %A Homuth, Georg %A John, Ulrich %A Iribarren, Carlos %A Harris, Tamara %A Launer, Lenore %A Gudnason, Vilmundur %A O'Connell, Jeffrey R %A Boerwinkle, Eric %A Cadby, Gemma %A Palmer, Lyle J %A James, Alan L %A Musk, Arthur W %A Ingelsson, Erik %A Psaty, Bruce M %A Beckmann, Jacques S %A Waeber, Gérard %A Vollenweider, Peter %A Hayward, Caroline %A Wright, Alan F %A Rudan, Igor %A Groop, Leif C %A Metspalu, Andres %A Khaw, Kay Tee %A van Duijn, Cornelia M %A Borecki, Ingrid B %A Province, Michael A %A Wareham, Nicholas J %A Tardif, Jean-Claude %A Huikuri, Heikki V %A Cupples, L Adrienne %A Atwood, Larry D %A Fox, Caroline S %A Boehnke, Michael %A Collins, Francis S %A Mohlke, Karen L %A Erdmann, Jeanette %A Schunkert, Heribert %A Hengstenberg, Christian %A Stark, Klaus %A Lorentzon, Mattias %A Ohlsson, Claes %A Cusi, Daniele %A Staessen, Jan A %A van der Klauw, Melanie M %A Pramstaller, Peter P %A Kathiresan, Sekar %A Jolley, Jennifer D %A Ripatti, Samuli %A Jarvelin, Marjo-Riitta %A de Geus, Eco J C %A Boomsma, Dorret I %A Penninx, Brenda %A Wilson, James F %A Campbell, Harry %A Chanock, Stephen J %A van der Harst, Pim %A Hamsten, Anders %A Watkins, Hugh %A Hofman, Albert %A Witteman, Jacqueline C %A Zillikens, M Carola %A Uitterlinden, André G %A Rivadeneira, Fernando %A Zillikens, M Carola %A Kiemeney, Lambertus A %A Vermeulen, Sita H %A Abecasis, Goncalo R %A Schlessinger, David %A Schipf, Sabine %A Stumvoll, Michael %A Tönjes, Anke %A Spector, Tim D %A North, Kari E %A Lettre, Guillaume %A McCarthy, Mark I %A Berndt, Sonja I %A Heath, Andrew C %A Madden, Pamela A F %A Nyholt, Dale R %A Montgomery, Grant W %A Martin, Nicholas G %A McKnight, Barbara %A Strachan, David P %A Hill, William G %A Snieder, Harold %A Ridker, Paul M %A Thorsteinsdottir, Unnur %A Stefansson, Kari %A Frayling, Timothy M %A Hirschhorn, Joel N %A Goddard, Michael E %A Visscher, Peter M %K Alpha-Ketoglutarate-Dependent Dioxygenase FTO %K Body Height %K Body Mass Index %K Co-Repressor Proteins %K Female %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Male %K Nerve Tissue Proteins %K Phenotype %K Polymorphism, Single Nucleotide %K Proteins %K Repressor Proteins %X

There is evidence across several species for genetic control of phenotypic variation of complex traits, such that the variance among phenotypes is genotype dependent. Understanding genetic control of variability is important in evolutionary biology, agricultural selection programmes and human medicine, yet for complex traits, no individual genetic variants associated with variance, as opposed to the mean, have been identified. Here we perform a meta-analysis of genome-wide association studies of phenotypic variation using ∼170,000 samples on height and body mass index (BMI) in human populations. We report evidence that the single nucleotide polymorphism (SNP) rs7202116 at the FTO gene locus, which is known to be associated with obesity (as measured by mean BMI for each rs7202116 genotype), is also associated with phenotypic variability. We show that the results are not due to scale effects or other artefacts, and find no other experiment-wise significant evidence for effects on variability, either at loci other than FTO for BMI or at any locus for height. The difference in variance for BMI among individuals with opposite homozygous genotypes at the FTO locus is approximately 7%, corresponding to a difference of ∼0.5 kilograms in the standard deviation of weight. Our results indicate that genetic variants can be discovered that are associated with variability, and that between-person variability in obesity can partly be explained by the genotype at the FTO locus. The results are consistent with reported FTO by environment interactions for BMI, possibly mediated by DNA methylation. Our BMI results for other SNPs and our height results for all SNPs suggest that most genetic variants, including those that influence mean height or mean BMI, are not associated with phenotypic variance, or that their effects on variability are too small to detect even with samples sizes greater than 100,000.

%B Nature %V 490 %P 267-72 %8 2012 Oct 11 %G eng %N 7419 %1 http://www.ncbi.nlm.nih.gov/pubmed/22982992?dopt=Abstract %R 10.1038/nature11401 %0 Journal Article %J Atherosclerosis %D 2012 %T Genetic determinants of the ankle-brachial index: a meta-analysis of a cardiovascular candidate gene 50K SNP panel in the candidate gene association resource (CARe) consortium. %A Wassel, Christina L %A Lamina, Claudia %A Nambi, Vijay %A Coassin, Stefan %A Mukamal, Kenneth J %A Ganesh, Santhi K %A Jacobs, David R %A Franceschini, Nora %A Papanicolaou, George J %A Gibson, Quince %A Yanek, Lisa R %A van der Harst, Pim %A Ferguson, Jane F %A Crawford, Dana C %A Waite, Lindsay L %A Allison, Matthew A %A Criqui, Michael H %A McDermott, Mary M %A Mehra, Reena %A Cupples, L Adrienne %A Hwang, Shih-Jen %A Redline, Susan %A Kaplan, Robert C %A Heiss, Gerardo %A Rotter, Jerome I %A Boerwinkle, Eric %A Taylor, Herman A %A Eraso, Luis H %A Haun, Margot %A Li, Mingyao %A Meisinger, Christa %A O'Connell, Jeffrey R %A Shuldiner, Alan R %A Tybjærg-Hansen, Anne %A Frikke-Schmidt, Ruth %A Kollerits, Barbara %A Rantner, Barbara %A Dieplinger, Benjamin %A Stadler, Marietta %A Mueller, Thomas %A Haltmayer, Meinhard %A Klein-Weigel, Peter %A Summerer, Monika %A Wichmann, H-Erich %A Asselbergs, Folkert W %A Navis, Gerjan %A Mateo Leach, Irene %A Brown-Gentry, Kristin %A Goodloe, Robert %A Assimes, Themistocles L %A Becker, Diane M %A Cooke, John P %A Absher, Devin M %A Olin, Jeffrey W %A Mitchell, Braxton D %A Reilly, Muredach P %A Mohler, Emile R %A North, Kari E %A Reiner, Alexander P %A Kronenberg, Florian %A Murabito, Joanne M %K Adult %K African Americans %K Aged %K Ankle Brachial Index %K Aryl Hydrocarbon Hydroxylases %K Cytochrome P-450 CYP2B6 %K European Continental Ancestry Group %K Female %K Humans %K Male %K Middle Aged %K Oxidoreductases, N-Demethylating %K Peripheral Arterial Disease %K Polymorphism, Single Nucleotide %K Risk Factors %K Transcription Factor 7-Like 2 Protein %X

BACKGROUND: Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to identify genetic variants for ABI.

METHODS AND RESULTS: We studied subjects of European ancestry from 8 studies (n=21,547, 55% women, mean age 44-73 years) and African American ancestry from 5 studies (n=7267, 60% women, mean age 41-73 years) involved in the candidate gene association resource (CARe) consortium. In each ethnic group, additive genetic models were used (with each additional copy of the minor allele corresponding to the given beta) to test each SNP for association with continuous ABI (excluding ABI>1.40) and PAD (defined as ABI<0.90) using linear or logistic regression with adjustment for known PAD risk factors and population stratification. We then conducted a fixed-effects inverse-variance weighted meta-analyses considering a p<2×10(-6) to denote statistical significance.

RESULTS: In the European ancestry discovery meta-analyses, rs2171209 in SYTL3 (β=-0.007, p=6.02×10(-7)) and rs290481 in TCF7L2 (β=-0.008, p=7.01×10(-7)) were significantly associated with ABI. None of the SNP associations for PAD were significant, though a SNP in CYP2B6 (p=4.99×10(-5)) was among the strongest associations. These 3 genes are linked to key PAD risk factors (lipoprotein(a), type 2 diabetes, and smoking behavior, respectively). We sought replication in 6 population-based and 3 clinical samples (n=15,440) for rs290481 and rs2171209. However, in the replication stage (rs2171209, p=0.75; rs290481, p=0.19) and in the combined discovery and replication analysis the SNP-ABI associations were no longer significant (rs2171209, p=1.14×10(-3); rs290481, p=8.88×10(-5)). In African Americans, none of the SNP associations for ABI or PAD achieved an experiment-wide level of significance.

CONCLUSIONS: Genetic determinants of ABI and PAD remain elusive. Follow-up of these preliminary findings may uncover important biology given the known gene-risk factor associations. New and more powerful approaches to PAD gene discovery are warranted.

%B Atherosclerosis %V 222 %P 138-47 %8 2012 May %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22361517?dopt=Abstract %R 10.1016/j.atherosclerosis.2012.01.039 %0 Journal Article %J Lancet Neurol %D 2012 %T Genetic risk factors for ischaemic stroke and its subtypes (the METASTROKE collaboration): a meta-analysis of genome-wide association studies. %A Traylor, Matthew %A Farrall, Martin %A Holliday, Elizabeth G %A Sudlow, Cathie %A Hopewell, Jemma C %A Cheng, Yu-Ching %A Fornage, Myriam %A Ikram, M Arfan %A Malik, Rainer %A Bevan, Steve %A Thorsteinsdottir, Unnur %A Nalls, Mike A %A Longstreth, Wt %A Wiggins, Kerri L %A Yadav, Sunaina %A Parati, Eugenio A %A DeStefano, Anita L %A Worrall, Bradford B %A Kittner, Steven J %A Khan, Muhammad Saleem %A Reiner, Alex P %A Helgadottir, Anna %A Achterberg, Sefanja %A Fernandez-Cadenas, Israel %A Abboud, Sherine %A Schmidt, Reinhold %A Walters, Matthew %A Chen, Wei-Min %A Ringelstein, E Bernd %A O'Donnell, Martin %A Ho, Weang Kee %A Pera, Joanna %A Lemmens, Robin %A Norrving, Bo %A Higgins, Peter %A Benn, Marianne %A Sale, Michele %A Kuhlenbäumer, Gregor %A Doney, Alexander S F %A Vicente, Astrid M %A Delavaran, Hossein %A Algra, Ale %A Davies, Gail %A Oliveira, Sofia A %A Palmer, Colin N A %A Deary, Ian %A Schmidt, Helena %A Pandolfo, Massimo %A Montaner, Joan %A Carty, Cara %A de Bakker, Paul I W %A Kostulas, Konstantinos %A Ferro, Jose M %A van Zuydam, Natalie R %A Valdimarsson, Einar %A Nordestgaard, Børge G %A Lindgren, Arne %A Thijs, Vincent %A Slowik, Agnieszka %A Saleheen, Danish %A Paré, Guillaume %A Berger, Klaus %A Thorleifsson, Gudmar %A Hofman, Albert %A Mosley, Thomas H %A Mitchell, Braxton D %A Furie, Karen %A Clarke, Robert %A Levi, Christopher %A Seshadri, Sudha %A Gschwendtner, Andreas %A Boncoraglio, Giorgio B %A Sharma, Pankaj %A Bis, Joshua C %A Gretarsdottir, Solveig %A Psaty, Bruce M %A Rothwell, Peter M %A Rosand, Jonathan %A Meschia, James F %A Stefansson, Kari %A Dichgans, Martin %A Markus, Hugh S %K Brain Ischemia %K Databases, Genetic %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Risk Factors %K Stroke %X

BACKGROUND: Various genome-wide association studies (GWAS) have been done in ischaemic stroke, identifying a few loci associated with the disease, but sample sizes have been 3500 cases or less. We established the METASTROKE collaboration with the aim of validating associations from previous GWAS and identifying novel genetic associations through meta-analysis of GWAS datasets for ischaemic stroke and its subtypes.

METHODS: We meta-analysed data from 15 ischaemic stroke cohorts with a total of 12 389 individuals with ischaemic stroke and 62 004 controls, all of European ancestry. For the associations reaching genome-wide significance in METASTROKE, we did a further analysis, conditioning on the lead single nucleotide polymorphism in every associated region. Replication of novel suggestive signals was done in 13 347 cases and 29 083 controls.

FINDINGS: We verified previous associations for cardioembolic stroke near PITX2 (p=2·8×10(-16)) and ZFHX3 (p=2·28×10(-8)), and for large-vessel stroke at a 9p21 locus (p=3·32×10(-5)) and HDAC9 (p=2·03×10(-12)). Additionally, we verified that all associations were subtype specific. Conditional analysis in the three regions for which the associations reached genome-wide significance (PITX2, ZFHX3, and HDAC9) indicated that all the signal in each region could be attributed to one risk haplotype. We also identified 12 potentially novel loci at p<5×10(-6). However, we were unable to replicate any of these novel associations in the replication cohort.

INTERPRETATION: Our results show that, although genetic variants can be detected in patients with ischaemic stroke when compared with controls, all associations we were able to confirm are specific to a stroke subtype. This finding has two implications. First, to maximise success of genetic studies in ischaemic stroke, detailed stroke subtyping is required. Second, different genetic pathophysiological mechanisms seem to be associated with different stroke subtypes.

FUNDING: Wellcome Trust, UK Medical Research Council (MRC), Australian National and Medical Health Research Council, National Institutes of Health (NIH) including National Heart, Lung and Blood Institute (NHLBI), the National Institute on Aging (NIA), the National Human Genome Research Institute (NHGRI), and the National Institute of Neurological Disorders and Stroke (NINDS).

%B Lancet Neurol %V 11 %P 951-62 %8 2012 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/23041239?dopt=Abstract %R 10.1016/S1474-4422(12)70234-X %0 Journal Article %J JAMA %D 2012 %T Genetic variants and associations of 25-hydroxyvitamin D concentrations with major clinical outcomes. %A Levin, Gregory P %A Robinson-Cohen, Cassianne %A de Boer, Ian H %A Houston, Denise K %A Lohman, Kurt %A Liu, Yongmei %A Kritchevsky, Stephen B %A Cauley, Jane A %A Tanaka, Toshiko %A Ferrucci, Luigi %A Bandinelli, Stefania %A Patel, Kushang V %A Hagström, Emil %A Michaëlsson, Karl %A Melhus, Håkan %A Wang, Thomas %A Wolf, Myles %A Psaty, Bruce M %A Siscovick, David %A Kestenbaum, Bryan %K 25-Hydroxyvitamin D3 1-alpha-Hydroxylase %K Aged %K Chronic Disease %K Cohort Studies %K Female %K Genetic Variation %K Genotype %K Hip Fractures %K Humans %K Low Density Lipoprotein Receptor-Related Protein-2 %K Male %K Meta-Analysis as Topic %K Myocardial Infarction %K Neoplasms %K Polymorphism, Single Nucleotide %K Receptors, Calcitriol %K Receptors, Cell Surface %K Risk %K Steroid Hydroxylases %K Vitamin D %K Vitamin D3 24-Hydroxylase %X

CONTEXT: Lower serum 25-hydroxyvitamin D concentrations are associated with greater risks of many chronic diseases across large, prospective community-based studies. Substrate 25-hydroxyvitamin D must be converted to 1,25-dihydroxyvitamin D for full biological activity, and complex metabolic pathways suggest that interindividual variability in vitamin D metabolism may alter the clinical consequences of measured serum 25-hydroxyvitamin D.

OBJECTIVE: To investigate whether common variation within genes encoding the vitamin D-binding protein, megalin, cubilin, CYP27B1, CYP24A1, and the vitamin D receptor (VDR) modify associations of low 25-hydroxyvitamin D with major clinical outcomes.

DESIGN, SETTING, AND PARTICIPANTS: Examination of 141 single-nucleotide polymorphisms in a discovery cohort of 1514 white participants (who were recruited from 4 US regions) from the community-based Cardiovascular Health Study. Participants had serum 25-hydroxyvitamin D measurements in 1992-1993 and were followed up for a median of 11 years (through 2006). Replication meta-analyses were conducted across the independent, community-based US Health, Aging, and Body Composition (n = 922; follow-up: 1998-1999 through 2005), Italian Invecchiare in Chianti (n = 835; follow-up: 1998-2000 through 2006), and Swedish Uppsala Longitudinal Study of Adult Men (n = 970; follow-up: 1991-1995 through 2008) cohort studies.

MAIN OUTCOME MEASURE: Composite outcome of incident hip facture, myocardial infarction, cancer, and mortality over long-term follow-up.

RESULTS: Interactions between 5 single-nucleotide polymorphisms and low 25-hydroxyvitamin D concentration were identified in the discovery phase and 1 involving a variant in the VDR gene replicated in independent meta-analysis. Among Cardiovascular Health Study participants, low 25-hydroxyvitamin D concentration was associated with hazard ratios for risk of the composite outcome of 1.40 (95% CI, 1.12-1.74) for those who had 1 minor allele at rs7968585 and 1.82 (95% CI, 1.31-2.54) for those with 2 minor alleles at rs7968585. In contrast, there was no evidence of an association (estimated hazard ratio, 0.93 [95% CI, 0.70-1.24]) among participants who had 0 minor alleles at this single-nucleotide polymorphism.

CONCLUSION: Known associations of low 25-hydroxyvitamin D with major health outcomes may vary according to common genetic differences in the vitamin D receptor.

%B JAMA %V 308 %P 1898-905 %8 2012 Nov 14 %G eng %N 18 %1 http://www.ncbi.nlm.nih.gov/pubmed/23150009?dopt=Abstract %R 10.1001/jama.2012.17304 %0 Journal Article %J PLoS Genet %D 2012 %T Genome-wide association and functional follow-up reveals new loci for kidney function. %A Pattaro, Cristian %A Köttgen, Anna %A Teumer, Alexander %A Garnaas, Maija %A Böger, Carsten A %A Fuchsberger, Christian %A Olden, Matthias %A Chen, Ming-Huei %A Tin, Adrienne %A Taliun, Daniel %A Li, Man %A Gao, Xiaoyi %A Gorski, Mathias %A Yang, Qiong %A Hundertmark, Claudia %A Foster, Meredith C %A O'Seaghdha, Conall M %A Glazer, Nicole %A Isaacs, Aaron %A Liu, Ching-Ti %A Smith, Albert V %A O'Connell, Jeffrey R %A Struchalin, Maksim %A Tanaka, Toshiko %A Li, Guo %A Johnson, Andrew D %A Gierman, Hinco J %A Feitosa, Mary %A Hwang, Shih-Jen %A Atkinson, Elizabeth J %A Lohman, Kurt %A Cornelis, Marilyn C %A Johansson, Asa %A Tönjes, Anke %A Dehghan, Abbas %A Chouraki, Vincent %A Holliday, Elizabeth G %A Sorice, Rossella %A Kutalik, Zoltán %A Lehtimäki, Terho %A Esko, Tõnu %A Deshmukh, Harshal %A Ulivi, Sheila %A Chu, Audrey Y %A Murgia, Federico %A Trompet, Stella %A Imboden, Medea %A Kollerits, Barbara %A Pistis, Giorgio %A Harris, Tamara B %A Launer, Lenore J %A Aspelund, Thor %A Eiriksdottir, Gudny %A Mitchell, Braxton D %A Boerwinkle, Eric %A Schmidt, Helena %A Cavalieri, Margherita %A Rao, Madhumathi %A Hu, Frank B %A Demirkan, Ayse %A Oostra, Ben A %A de Andrade, Mariza %A Turner, Stephen T %A Ding, Jingzhong %A Andrews, Jeanette S %A Freedman, Barry I %A Koenig, Wolfgang %A Illig, Thomas %A Döring, Angela %A Wichmann, H-Erich %A Kolcic, Ivana %A Zemunik, Tatijana %A Boban, Mladen %A Minelli, Cosetta %A Wheeler, Heather E %A Igl, Wilmar %A Zaboli, Ghazal %A Wild, Sarah H %A Wright, Alan F %A Campbell, Harry %A Ellinghaus, David %A Nöthlings, Ute %A Jacobs, Gunnar %A Biffar, Reiner %A Endlich, Karlhans %A Ernst, Florian %A Homuth, Georg %A Kroemer, Heyo K %A Nauck, Matthias %A Stracke, Sylvia %A Völker, Uwe %A Völzke, Henry %A Kovacs, Peter %A Stumvoll, Michael %A Mägi, Reedik %A Hofman, Albert %A Uitterlinden, André G %A Rivadeneira, Fernando %A Aulchenko, Yurii S %A Polasek, Ozren %A Hastie, Nick %A Vitart, Veronique %A Helmer, Catherine %A Wang, Jie Jin %A Ruggiero, Daniela %A Bergmann, Sven %A Kähönen, Mika %A Viikari, Jorma %A Nikopensius, Tiit %A Province, Michael %A Ketkar, Shamika %A Colhoun, Helen %A Doney, Alex %A Robino, Antonietta %A Giulianini, Franco %A Krämer, Bernhard K %A Portas, Laura %A Ford, Ian %A Buckley, Brendan M %A Adam, Martin %A Thun, Gian-Andri %A Paulweber, Bernhard %A Haun, Margot %A Sala, Cinzia %A Metzger, Marie %A Mitchell, Paul %A Ciullo, Marina %A Kim, Stuart K %A Vollenweider, Peter %A Raitakari, Olli %A Metspalu, Andres %A Palmer, Colin %A Gasparini, Paolo %A Pirastu, Mario %A Jukema, J Wouter %A Probst-Hensch, Nicole M %A Kronenberg, Florian %A Toniolo, Daniela %A Gudnason, Vilmundur %A Shuldiner, Alan R %A Coresh, Josef %A Schmidt, Reinhold %A Ferrucci, Luigi %A Siscovick, David S %A van Duijn, Cornelia M %A Borecki, Ingrid %A Kardia, Sharon L R %A Liu, Yongmei %A Curhan, Gary C %A Rudan, Igor %A Gyllensten, Ulf %A Wilson, James F %A Franke, Andre %A Pramstaller, Peter P %A Rettig, Rainer %A Prokopenko, Inga %A Witteman, Jacqueline C M %A Hayward, Caroline %A Ridker, Paul %A Parsa, Afshin %A Bochud, Murielle %A Heid, Iris M %A Goessling, Wolfram %A Chasman, Daniel I %A Kao, W H Linda %A Fox, Caroline S %K African Americans %K Aged %K Animals %K Caspase 9 %K Cyclin-Dependent Kinases %K DEAD-box RNA Helicases %K DNA Helicases %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Gene Knockdown Techniques %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K Kidney %K Kidney Failure, Chronic %K Male %K Middle Aged %K Phosphoric Diester Hydrolases %K Zebrafish %X

Chronic kidney disease (CKD) is an important public health problem with a genetic component. We performed genome-wide association studies in up to 130,600 European ancestry participants overall, and stratified for key CKD risk factors. We uncovered 6 new loci in association with estimated glomerular filtration rate (eGFR), the primary clinical measure of CKD, in or near MPPED2, DDX1, SLC47A1, CDK12, CASP9, and INO80. Morpholino knockdown of mpped2 and casp9 in zebrafish embryos revealed podocyte and tubular abnormalities with altered dextran clearance, suggesting a role for these genes in renal function. By providing new insights into genes that regulate renal function, these results could further our understanding of the pathogenesis of CKD.

%B PLoS Genet %V 8 %P e1002584 %8 2012 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22479191?dopt=Abstract %R 10.1371/journal.pgen.1002584 %0 Journal Article %J Am J Respir Crit Care Med %D 2012 %T Genome-wide association studies identify CHRNA5/3 and HTR4 in the development of airflow obstruction. %A Wilk, Jemma B %A Shrine, Nick R G %A Loehr, Laura R %A Zhao, Jing Hua %A Manichaikul, Ani %A Lopez, Lorna M %A Smith, Albert Vernon %A Heckbert, Susan R %A Smolonska, Joanna %A Tang, Wenbo %A Loth, Daan W %A Curjuric, Ivan %A Hui, Jennie %A Cho, Michael H %A Latourelle, Jeanne C %A Henry, Amanda P %A Aldrich, Melinda %A Bakke, Per %A Beaty, Terri H %A Bentley, Amy R %A Borecki, Ingrid B %A Brusselle, Guy G %A Burkart, Kristin M %A Chen, Ting-Hsu %A Couper, David %A Crapo, James D %A Davies, Gail %A Dupuis, Josée %A Franceschini, Nora %A Gulsvik, Amund %A Hancock, Dana B %A Harris, Tamara B %A Hofman, Albert %A Imboden, Medea %A James, Alan L %A Khaw, Kay-Tee %A Lahousse, Lies %A Launer, Lenore J %A Litonjua, Augusto %A Liu, Yongmei %A Lohman, Kurt K %A Lomas, David A %A Lumley, Thomas %A Marciante, Kristin D %A McArdle, Wendy L %A Meibohm, Bernd %A Morrison, Alanna C %A Musk, Arthur W %A Myers, Richard H %A North, Kari E %A Postma, Dirkje S %A Psaty, Bruce M %A Rich, Stephen S %A Rivadeneira, Fernando %A Rochat, Thierry %A Rotter, Jerome I %A Soler Artigas, Maria %A Starr, John M %A Uitterlinden, André G %A Wareham, Nicholas J %A Wijmenga, Cisca %A Zanen, Pieter %A Province, Michael A %A Silverman, Edwin K %A Deary, Ian J %A Palmer, Lyle J %A Cassano, Patricia A %A Gudnason, Vilmundur %A Barr, R Graham %A Loos, Ruth J F %A Strachan, David P %A London, Stephanie J %A Boezen, H Marike %A Probst-Hensch, Nicole %A Gharib, Sina A %A Hall, Ian P %A O'Connor, George T %A Tobin, Martin D %A Stricker, Bruno H %K Aged %K Female %K Forced Expiratory Volume %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Nerve Tissue Proteins %K Polymorphism, Single Nucleotide %K Pulmonary Disease, Chronic Obstructive %K Receptors, Nicotinic %K Receptors, Serotonin, 5-HT4 %K Smoking %K Vital Capacity %X

RATIONALE: Genome-wide association studies (GWAS) have identified loci influencing lung function, but fewer genes influencing chronic obstructive pulmonary disease (COPD) are known.

OBJECTIVES: Perform meta-analyses of GWAS for airflow obstruction, a key pathophysiologic characteristic of COPD assessed by spirometry, in population-based cohorts examining all participants, ever smokers, never smokers, asthma-free participants, and more severe cases.

METHODS: Fifteen cohorts were studied for discovery (3,368 affected; 29,507 unaffected), and a population-based family study and a meta-analysis of case-control studies were used for replication and regional follow-up (3,837 cases; 4,479 control subjects). Airflow obstruction was defined as FEV(1) and its ratio to FVC (FEV(1)/FVC) both less than their respective lower limits of normal as determined by published reference equations.

MEASUREMENTS AND MAIN RESULTS: The discovery meta-analyses identified one region on chromosome 15q25.1 meeting genome-wide significance in ever smokers that includes AGPHD1, IREB2, and CHRNA5/CHRNA3 genes. The region was also modestly associated among never smokers. Gene expression studies confirmed the presence of CHRNA5/3 in lung, airway smooth muscle, and bronchial epithelial cells. A single-nucleotide polymorphism in HTR4, a gene previously related to FEV(1)/FVC, achieved genome-wide statistical significance in combined meta-analysis. Top single-nucleotide polymorphisms in ADAM19, RARB, PPAP2B, and ADAMTS19 were nominally replicated in the COPD meta-analysis.

CONCLUSIONS: These results suggest an important role for the CHRNA5/3 region as a genetic risk factor for airflow obstruction that may be independent of smoking and implicate the HTR4 gene in the etiology of airflow obstruction.

%B Am J Respir Crit Care Med %V 186 %P 622-32 %8 2012 Oct 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/22837378?dopt=Abstract %R 10.1164/rccm.201202-0366OC %0 Journal Article %J Blood %D 2012 %T Genome-wide association study for circulating levels of PAI-1 provides novel insights into its regulation. %A Huang, Jie %A Sabater-Lleal, Maria %A Asselbergs, Folkert W %A Tregouet, David %A Shin, So-Youn %A Ding, Jingzhong %A Baumert, Jens %A Oudot-Mellakh, Tiphaine %A Folkersen, Lasse %A Johnson, Andrew D %A Smith, Nicholas L %A Williams, Scott M %A Ikram, Mohammad A %A Kleber, Marcus E %A Becker, Diane M %A Truong, Vinh %A Mychaleckyj, Josyf C %A Tang, Weihong %A Yang, Qiong %A Sennblad, Bengt %A Moore, Jason H %A Williams, Frances M K %A Dehghan, Abbas %A Silbernagel, Günther %A Schrijvers, Elisabeth M C %A Smith, Shelly %A Karakas, Mahir %A Tofler, Geoffrey H %A Silveira, Angela %A Navis, Gerjan J %A Lohman, Kurt %A Chen, Ming-Huei %A Peters, Annette %A Goel, Anuj %A Hopewell, Jemma C %A Chambers, John C %A Saleheen, Danish %A Lundmark, Per %A Psaty, Bruce M %A Strawbridge, Rona J %A Boehm, Bernhard O %A Carter, Angela M %A Meisinger, Christa %A Peden, John F %A Bis, Joshua C %A McKnight, Barbara %A Ohrvik, John %A Taylor, Kent %A Franzosi, Maria Grazia %A Seedorf, Udo %A Collins, Rory %A Franco-Cereceda, Anders %A Syvänen, Ann-Christine %A Goodall, Alison H %A Yanek, Lisa R %A Cushman, Mary %A Müller-Nurasyid, Martina %A Folsom, Aaron R %A Basu, Saonli %A Matijevic, Nena %A van Gilst, Wiek H %A Kooner, Jaspal S %A Hofman, Albert %A Danesh, John %A Clarke, Robert %A Meigs, James B %A Kathiresan, Sekar %A Reilly, Muredach P %A Klopp, Norman %A Harris, Tamara B %A Winkelmann, Bernhard R %A Grant, Peter J %A Hillege, Hans L %A Watkins, Hugh %A Spector, Timothy D %A Becker, Lewis C %A Tracy, Russell P %A März, Winfried %A Uitterlinden, André G %A Eriksson, Per %A Cambien, Francois %A Morange, Pierre-Emmanuel %A Koenig, Wolfgang %A Soranzo, Nicole %A van der Harst, Pim %A Liu, Yongmei %A O'Donnell, Christopher J %A Hamsten, Anders %K Adaptor Proteins, Signal Transducing %K ARNTL Transcription Factors %K ATPases Associated with Diverse Cellular Activities %K Cell Line %K Cell Line, Tumor %K Cohort Studies %K Coronary Artery Disease %K Diabetes Mellitus, Type 2 %K Gene Expression Profiling %K Gene Expression Regulation %K Gene Frequency %K Genome-Wide Association Study %K Genotype %K Humans %K LIM Domain Proteins %K Meta-Analysis as Topic %K Monocytes %K Mucin-3 %K Plasminogen Activator Inhibitor 1 %K Polymorphism, Single Nucleotide %K PPAR gamma %K Proteasome Endopeptidase Complex %K RNA Interference %K Transcription Factors %X

We conducted a genome-wide association study to identify novel associations between genetic variants and circulating plasminogen activator inhibitor-1 (PAI-1) concentration, and examined functional implications of variants and genes that were discovered. A discovery meta-analysis was performed in 19 599 subjects, followed by replication analysis of genome-wide significant (P < 5 × 10(-8)) single nucleotide polymorphisms (SNPs) in 10 796 independent samples. We further examined associations with type 2 diabetes and coronary artery disease, assessed the functional significance of the SNPs for gene expression in human tissues, and conducted RNA-silencing experiments for one novel association. We confirmed the association of the 4G/5G proxy SNP rs2227631 in the promoter region of SERPINE1 (7q22.1) and discovered genome-wide significant associations at 3 additional loci: chromosome 7q22.1 close to SERPINE1 (rs6976053, discovery P = 3.4 × 10(-10)); chromosome 11p15.2 within ARNTL (rs6486122, discovery P = 3.0 × 10(-8)); and chromosome 3p25.2 within PPARG (rs11128603, discovery P = 2.9 × 10(-8)). Replication was achieved for the 7q22.1 and 11p15.2 loci. There was nominal association with type 2 diabetes and coronary artery disease at ARNTL (P < .05). Functional studies identified MUC3 as a candidate gene for the second association signal on 7q22.1. In summary, SNPs in SERPINE1 and ARNTL and an SNP associated with the expression of MUC3 were robustly associated with circulating levels of PAI-1.

%B Blood %V 120 %P 4873-81 %8 2012 Dec 06 %G eng %N 24 %1 http://www.ncbi.nlm.nih.gov/pubmed/22990020?dopt=Abstract %R 10.1182/blood-2012-06-436188 %0 Journal Article %J Hum Mol Genet %D 2012 %T A genome-wide association study identifies a potential novel gene locus for keratoconus, one of the commonest causes for corneal transplantation in developed countries. %A Li, Xiaohui %A Bykhovskaya, Yelena %A Haritunians, Talin %A Siscovick, David %A Aldave, Anthony %A Szczotka-Flynn, Loretta %A Iyengar, Sudha K %A Rotter, Jerome I %A Taylor, Kent D %A Rabinowitz, Yaron S %K Case-Control Studies %K Chromosomes, Human, Pair 2 %K Cohort Studies %K Corneal Transplantation %K Developed Countries %K Genome-Wide Association Study %K Humans %K Keratoconus %K Polymorphism, Single Nucleotide %X

Keratoconus is a condition in which the cornea progressively thins over time, and is a major cause for cornea transplantation. To identify keratoconus susceptibility regions, we performed a comprehensive genome-wide association study (GWAS) using a discovery and replication design. A discovery panel of 222 keratoconus Caucasian patients and 3324 Caucasian controls was genotyped using Illumina 370K beadchips. Further associated and fine-mapping single nucleotide polymorphisms (SNPs) (n= 4905) were genotyped in an independent replication case-control panel of 304 cases and 518 controls and a family panel of 307 subjects in 70 families. Logistic regression models implemented in PLINK were performed to test associations in case-control samples with and without principal component (PC) adjustments. Generalized estimation equation models accounting for familial correlations implemented in GWAF were used for association testing in families. No genome-wide associations were identified in the discovery GWAS panel. From the initial testing without adjustments for PCs, the top three SNPs located at 3p26 (rs6442925), 2q21.3 (rs4954218) and 19q13.3 (rs1428642) were identified with unadjusted P-values of 6.5 × 10(-8), 2.4 × 10(-7) and 3.1 × 10(-7), respectively. After adjustments for PCs, rs1428642 became the most significant through the genome with a P-value of 1.4 × 10(-6), while rs6442925 and rs4954218 were less significant (P= 1.9 × 10(-5) and 2.6 × 10(-4)). SNP rs4954218 was confirmed in two independent replication panels with P-values of 0.004 and 0.009, respectively. Meta-analysis revealed a highest association at rs4954218 with adjusted P= 1.6 × 10(-7) (unadjusted P= 1.2 × 10(-9)). These findings suggest SNP rs4954218, located near the RAB3GAP1 gene, previously reported to be associated with corneal malformation, is a potential susceptibility locus for keratoconus.

%B Hum Mol Genet %V 21 %P 421-9 %8 2012 Jan 15 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/21979947?dopt=Abstract %R 10.1093/hmg/ddr460 %0 Journal Article %J PLoS Genet %D 2012 %T Genome-wide joint meta-analysis of SNP and SNP-by-smoking interaction identifies novel loci for pulmonary function. %A Hancock, Dana B %A Soler Artigas, Maria %A Gharib, Sina A %A Henry, Amanda %A Manichaikul, Ani %A Ramasamy, Adaikalavan %A Loth, Daan W %A Imboden, Medea %A Koch, Beate %A McArdle, Wendy L %A Smith, Albert V %A Smolonska, Joanna %A Sood, Akshay %A Tang, Wenbo %A Wilk, Jemma B %A Zhai, Guangju %A Zhao, Jing Hua %A Aschard, Hugues %A Burkart, Kristin M %A Curjuric, Ivan %A Eijgelsheim, Mark %A Elliott, Paul %A Gu, Xiangjun %A Harris, Tamara B %A Janson, Christer %A Homuth, Georg %A Hysi, Pirro G %A Liu, Jason Z %A Loehr, Laura R %A Lohman, Kurt %A Loos, Ruth J F %A Manning, Alisa K %A Marciante, Kristin D %A Obeidat, Ma'en %A Postma, Dirkje S %A Aldrich, Melinda C %A Brusselle, Guy G %A Chen, Ting-Hsu %A Eiriksdottir, Gudny %A Franceschini, Nora %A Heinrich, Joachim %A Rotter, Jerome I %A Wijmenga, Cisca %A Williams, O Dale %A Bentley, Amy R %A Hofman, Albert %A Laurie, Cathy C %A Lumley, Thomas %A Morrison, Alanna C %A Joubert, Bonnie R %A Rivadeneira, Fernando %A Couper, David J %A Kritchevsky, Stephen B %A Liu, Yongmei %A Wjst, Matthias %A Wain, Louise V %A Vonk, Judith M %A Uitterlinden, André G %A Rochat, Thierry %A Rich, Stephen S %A Psaty, Bruce M %A O'Connor, George T %A North, Kari E %A Mirel, Daniel B %A Meibohm, Bernd %A Launer, Lenore J %A Khaw, Kay-Tee %A Hartikainen, Anna-Liisa %A Hammond, Christopher J %A Gläser, Sven %A Marchini, Jonathan %A Kraft, Peter %A Wareham, Nicholas J %A Völzke, Henry %A Stricker, Bruno H C %A Spector, Timothy D %A Probst-Hensch, Nicole M %A Jarvis, Deborah %A Jarvelin, Marjo-Riitta %A Heckbert, Susan R %A Gudnason, Vilmundur %A Boezen, H Marike %A Barr, R Graham %A Cassano, Patricia A %A Strachan, David P %A Fornage, Myriam %A Hall, Ian P %A Dupuis, Josée %A Tobin, Martin D %A London, Stephanie J %K Forced Expiratory Volume %K Gene Expression %K Genome, Human %K Genome-Wide Association Study %K HLA-DQ Antigens %K HLA-DQ beta-Chains %K Humans %K Lung %K Nerve Tissue Proteins %K Polymorphism, Single Nucleotide %K Potassium Channels, Inwardly Rectifying %K Pulmonary Disease, Chronic Obstructive %K Receptors, Cell Surface %K Smoking %K SOX9 Transcription Factor %K Vital Capacity %X

Genome-wide association studies have identified numerous genetic loci for spirometic measures of pulmonary function, forced expiratory volume in one second (FEV(1)), and its ratio to forced vital capacity (FEV(1)/FVC). Given that cigarette smoking adversely affects pulmonary function, we conducted genome-wide joint meta-analyses (JMA) of single nucleotide polymorphism (SNP) and SNP-by-smoking (ever-smoking or pack-years) associations on FEV(1) and FEV(1)/FVC across 19 studies (total N = 50,047). We identified three novel loci not previously associated with pulmonary function. SNPs in or near DNER (smallest P(JMA = )5.00×10(-11)), HLA-DQB1 and HLA-DQA2 (smallest P(JMA = )4.35×10(-9)), and KCNJ2 and SOX9 (smallest P(JMA = )1.28×10(-8)) were associated with FEV(1)/FVC or FEV(1) in meta-analysis models including SNP main effects, smoking main effects, and SNP-by-smoking (ever-smoking or pack-years) interaction. The HLA region has been widely implicated for autoimmune and lung phenotypes, unlike the other novel loci, which have not been widely implicated. We evaluated DNER, KCNJ2, and SOX9 and found them to be expressed in human lung tissue. DNER and SOX9 further showed evidence of differential expression in human airway epithelium in smokers compared to non-smokers. Our findings demonstrated that joint testing of SNP and SNP-by-environment interaction identified novel loci associated with complex traits that are missed when considering only the genetic main effects.

%B PLoS Genet %V 8 %P e1003098 %8 2012 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/23284291?dopt=Abstract %R 10.1371/journal.pgen.1003098 %0 Journal Article %J Transl Psychiatry %D 2012 %T Genome-wide meta-analyses of smoking behaviors in African Americans. %A David, S P %A Hamidovic, A %A Chen, G K %A Bergen, A W %A Wessel, J %A Kasberger, J L %A Brown, W M %A Petruzella, S %A Thacker, E L %A Kim, Y %A Nalls, M A %A Tranah, G J %A Sung, Y J %A Ambrosone, C B %A Arnett, D %A Bandera, E V %A Becker, D M %A Becker, L %A Berndt, S I %A Bernstein, L %A Blot, W J %A Broeckel, U %A Buxbaum, S G %A Caporaso, N %A Casey, G %A Chanock, S J %A Deming, S L %A Diver, W R %A Eaton, C B %A Evans, D S %A Evans, M K %A Fornage, M %A Franceschini, N %A Harris, T B %A Henderson, B E %A Hernandez, D G %A Hitsman, B %A Hu, J J %A Hunt, S C %A Ingles, S A %A John, E M %A Kittles, R %A Kolb, S %A Kolonel, L N %A Le Marchand, L %A Liu, Y %A Lohman, K K %A McKnight, B %A Millikan, R C %A Murphy, A %A Neslund-Dudas, C %A Nyante, S %A Press, M %A Psaty, B M %A Rao, D C %A Redline, S %A Rodriguez-Gil, J L %A Rybicki, B A %A Signorello, L B %A Singleton, A B %A Smoller, J %A Snively, B %A Spring, B %A Stanford, J L %A Strom, S S %A Swan, G E %A Taylor, K D %A Thun, M J %A Wilson, A F %A Witte, J S %A Yamamura, Y %A Yanek, L R %A Yu, K %A Zheng, W %A Ziegler, R G %A Zonderman, A B %A Jorgenson, E %A Haiman, C A %A Furberg, H %K Adult %K African Americans %K Aged %K Chromosomes, Human, Pair 10 %K Chromosomes, Human, Pair 15 %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Middle Aged %K Nerve Tissue Proteins %K Phenotype %K Polymorphism, Single Nucleotide %K Proteoglycans %K Receptors, Nicotinic %K Smoking %K Statistics as Topic %X

The identification and exploration of genetic loci that influence smoking behaviors have been conducted primarily in populations of the European ancestry. Here we report results of the first genome-wide association study meta-analysis of smoking behavior in African Americans in the Study of Tobacco in Minority Populations Genetics Consortium (n = 32,389). We identified one non-coding single-nucleotide polymorphism (SNP; rs2036527[A]) on chromosome 15q25.1 associated with smoking quantity (cigarettes per day), which exceeded genome-wide significance (β = 0.040, s.e. = 0.007, P = 1.84 × 10(-8)). This variant is present in the 5'-distal enhancer region of the CHRNA5 gene and defines the primary index signal reported in studies of the European ancestry. No other SNP reached genome-wide significance for smoking initiation (SI, ever vs never smoking), age of SI, or smoking cessation (SC, former vs current smoking). Informative associations that approached genome-wide significance included three modestly correlated variants, at 15q25.1 within PSMA4, CHRNA5 and CHRNA3 for smoking quantity, which are associated with a second signal previously reported in studies in European ancestry populations, and a signal represented by three SNPs in the SPOCK2 gene on chr10q22.1. The association at 15q25.1 confirms this region as an important susceptibility locus for smoking quantity in men and women of African ancestry. Larger studies will be needed to validate the suggestive loci that did not reach genome-wide significance and further elucidate the contribution of genetic variation to disparities in cigarette consumption, SC and smoking-attributable disease between African Americans and European Americans.

%B Transl Psychiatry %V 2 %P e119 %8 2012 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/22832964?dopt=Abstract %R 10.1038/tp.2012.41 %0 Journal Article %J Nat Genet %D 2012 %T Genome-wide meta-analysis identifies 56 bone mineral density loci and reveals 14 loci associated with risk of fracture. %A Estrada, Karol %A Styrkarsdottir, Unnur %A Evangelou, Evangelos %A Hsu, Yi-Hsiang %A Duncan, Emma L %A Ntzani, Evangelia E %A Oei, Ling %A Albagha, Omar M E %A Amin, Najaf %A Kemp, John P %A Koller, Daniel L %A Li, Guo %A Liu, Ching-Ti %A Minster, Ryan L %A Moayyeri, Alireza %A Vandenput, Liesbeth %A Willner, Dana %A Xiao, Su-Mei %A Yerges-Armstrong, Laura M %A Zheng, Hou-Feng %A Alonso, Nerea %A Eriksson, Joel %A Kammerer, Candace M %A Kaptoge, Stephen K %A Leo, Paul J %A Thorleifsson, Gudmar %A Wilson, Scott G %A Wilson, James F %A Aalto, Ville %A Alen, Markku %A Aragaki, Aaron K %A Aspelund, Thor %A Center, Jacqueline R %A Dailiana, Zoe %A Duggan, David J %A Garcia, Melissa %A García-Giralt, Natalia %A Giroux, Sylvie %A Hallmans, Göran %A Hocking, Lynne J %A Husted, Lise Bjerre %A Jameson, Karen A %A Khusainova, Rita %A Kim, Ghi Su %A Kooperberg, Charles %A Koromila, Theodora %A Kruk, Marcin %A Laaksonen, Marika %A LaCroix, Andrea Z %A Lee, Seung Hun %A Leung, Ping C %A Lewis, Joshua R %A Masi, Laura %A Mencej-Bedrac, Simona %A Nguyen, Tuan V %A Nogues, Xavier %A Patel, Millan S %A Prezelj, Janez %A Rose, Lynda M %A Scollen, Serena %A Siggeirsdottir, Kristin %A Smith, Albert V %A Svensson, Olle %A Trompet, Stella %A Trummer, Olivia %A van Schoor, Natasja M %A Woo, Jean %A Zhu, Kun %A Balcells, Susana %A Brandi, Maria Luisa %A Buckley, Brendan M %A Cheng, Sulin %A Christiansen, Claus %A Cooper, Cyrus %A Dedoussis, George %A Ford, Ian %A Frost, Morten %A Goltzman, David %A González-Macías, Jesús %A Kähönen, Mika %A Karlsson, Magnus %A Khusnutdinova, Elza %A Koh, Jung-Min %A Kollia, Panagoula %A Langdahl, Bente Lomholt %A Leslie, William D %A Lips, Paul %A Ljunggren, Osten %A Lorenc, Roman S %A Marc, Janja %A Mellström, Dan %A Obermayer-Pietsch, Barbara %A Olmos, José M %A Pettersson-Kymmer, Ulrika %A Reid, David M %A Riancho, José A %A Ridker, Paul M %A Rousseau, François %A Slagboom, P Eline %A Tang, Nelson L S %A Urreizti, Roser %A Van Hul, Wim %A Viikari, Jorma %A Zarrabeitia, María T %A Aulchenko, Yurii S %A Castano-Betancourt, Martha %A Grundberg, Elin %A Herrera, Lizbeth %A Ingvarsson, Thorvaldur %A Johannsdottir, Hrefna %A Kwan, Tony %A Li, Rui %A Luben, Robert %A Medina-Gómez, Carolina %A Palsson, Stefan Th %A Reppe, Sjur %A Rotter, Jerome I %A Sigurdsson, Gunnar %A van Meurs, Joyce B J %A Verlaan, Dominique %A Williams, Frances M K %A Wood, Andrew R %A Zhou, Yanhua %A Gautvik, Kaare M %A Pastinen, Tomi %A Raychaudhuri, Soumya %A Cauley, Jane A %A Chasman, Daniel I %A Clark, Graeme R %A Cummings, Steven R %A Danoy, Patrick %A Dennison, Elaine M %A Eastell, Richard %A Eisman, John A %A Gudnason, Vilmundur %A Hofman, Albert %A Jackson, Rebecca D %A Jones, Graeme %A Jukema, J Wouter %A Khaw, Kay-Tee %A Lehtimäki, Terho %A Liu, Yongmei %A Lorentzon, Mattias %A McCloskey, Eugene %A Mitchell, Braxton D %A Nandakumar, Kannabiran %A Nicholson, Geoffrey C %A Oostra, Ben A %A Peacock, Munro %A Pols, Huibert A P %A Prince, Richard L %A Raitakari, Olli %A Reid, Ian R %A Robbins, John %A Sambrook, Philip N %A Sham, Pak Chung %A Shuldiner, Alan R %A Tylavsky, Frances A %A van Duijn, Cornelia M %A Wareham, Nick J %A Cupples, L Adrienne %A Econs, Michael J %A Evans, David M %A Harris, Tamara B %A Kung, Annie Wai Chee %A Psaty, Bruce M %A Reeve, Jonathan %A Spector, Timothy D %A Streeten, Elizabeth A %A Zillikens, M Carola %A Thorsteinsdottir, Unnur %A Ohlsson, Claes %A Karasik, David %A Richards, J Brent %A Brown, Matthew A %A Stefansson, Kari %A Uitterlinden, André G %A Ralston, Stuart H %A Ioannidis, John P A %A Kiel, Douglas P %A Rivadeneira, Fernando %K Bone Density %K Computational Biology %K European Continental Ancestry Group %K Extracellular Matrix Proteins %K Female %K Femur Neck %K Fractures, Bone %K Gene Expression Profiling %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Glycoproteins %K Humans %K Intercellular Signaling Peptides and Proteins %K Low Density Lipoprotein Receptor-Related Protein-5 %K Lumbar Vertebrae %K Male %K Mitochondrial Membrane Transport Proteins %K Osteoporosis %K Phosphoproteins %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Risk Factors %K Spectrin %X

Bone mineral density (BMD) is the most widely used predictor of fracture risk. We performed the largest meta-analysis to date on lumbar spine and femoral neck BMD, including 17 genome-wide association studies and 32,961 individuals of European and east Asian ancestry. We tested the top BMD-associated markers for replication in 50,933 independent subjects and for association with risk of low-trauma fracture in 31,016 individuals with a history of fracture (cases) and 102,444 controls. We identified 56 loci (32 new) associated with BMD at genome-wide significance (P < 5 × 10(-8)). Several of these factors cluster within the RANK-RANKL-OPG, mesenchymal stem cell differentiation, endochondral ossification and Wnt signaling pathways. However, we also discovered loci that were localized to genes not known to have a role in bone biology. Fourteen BMD-associated loci were also associated with fracture risk (P < 5 × 10(-4), Bonferroni corrected), of which six reached P < 5 × 10(-8), including at 18p11.21 (FAM210A), 7q21.3 (SLC25A13), 11q13.2 (LRP5), 4q22.1 (MEPE), 2p16.2 (SPTBN1) and 10q21.1 (DKK1). These findings shed light on the genetic architecture and pathophysiological mechanisms underlying BMD variation and fracture susceptibility.

%B Nat Genet %V 44 %P 491-501 %8 2012 Apr 15 %G eng %N 5 %R 10.1038/ng.2249 %0 Journal Article %J Hum Mol Genet %D 2012 %T Genome-wide meta-analysis points to CTC1 and ZNF676 as genes regulating telomere homeostasis in humans. %A Mangino, Massimo %A Hwang, Shih-Jen %A Spector, Timothy D %A Hunt, Steven C %A Kimura, Masayuki %A Fitzpatrick, Annette L %A Christiansen, Lene %A Petersen, Inge %A Elbers, Clara C %A Harris, Tamara %A Chen, Wei %A Srinivasan, Sathanur R %A Kark, Jeremy D %A Benetos, Athanase %A El Shamieh, Said %A Visvikis-Siest, Sophie %A Christensen, Kaare %A Berenson, Gerald S %A Valdes, Ana M %A Viñuela, Ana %A Garcia, Melissa %A Arnett, Donna K %A Broeckel, Ulrich %A Province, Michael A %A Pankow, James S %A Kammerer, Candace %A Liu, Yongmei %A Nalls, Michael %A Tishkoff, Sarah %A Thomas, Fridtjof %A Ziv, Elad %A Psaty, Bruce M %A Bis, Joshua C %A Rotter, Jerome I %A Taylor, Kent D %A Smith, Erin %A Schork, Nicholas J %A Levy, Daniel %A Aviv, Abraham %K Genome-Wide Association Study %K Humans %K Kruppel-Like Transcription Factors %K Telomere %K Telomere Homeostasis %K Telomere-Binding Proteins %X

Leukocyte telomere length (LTL) is associated with a number of common age-related diseases and is a heritable trait. Previous genome-wide association studies (GWASs) identified two loci on chromosomes 3q26.2 (TERC) and 10q24.33 (OBFC1) that are associated with the inter-individual LTL variation. We performed a meta-analysis of 9190 individuals from six independent GWAS and validated our findings in 2226 individuals from four additional studies. We confirmed previously reported associations with OBFC1 (rs9419958 P = 9.1 × 10(-11)) and with the telomerase RNA component TERC (rs1317082, P = 1.1 × 10(-8)). We also identified two novel genomic regions associated with LTL variation that map near a conserved telomere maintenance complex component 1 (CTC1; rs3027234, P = 3.6 × 10(-8)) on chromosome17p13.1 and zinc finger protein 676 (ZNF676; rs412658, P = 3.3 × 10(-8)) on 19p12. The minor allele of rs3027234 was associated with both shorter LTL and lower expression of CTC1. Our findings are consistent with the recent observations that point mutations in CTC1 cause short telomeres in both Arabidopsis and humans affected by a rare Mendelian syndrome. Overall, our results provide novel insights into the genetic architecture of inter-individual LTL variation in the general population.

%B Hum Mol Genet %V 21 %P 5385-94 %8 2012 Dec 15 %G eng %N 24 %1 http://www.ncbi.nlm.nih.gov/pubmed/23001564?dopt=Abstract %R 10.1093/hmg/dds382 %0 Journal Article %J Circ Cardiovasc Genet %D 2012 %T Impact of ancestry and common genetic variants on QT interval in African Americans. %A Smith, J Gustav %A Avery, Christy L %A Evans, Daniel S %A Nalls, Michael A %A Meng, Yan A %A Smith, Erin N %A Palmer, Cameron %A Tanaka, Toshiko %A Mehra, Reena %A Butler, Anne M %A Young, Taylor %A Buxbaum, Sarah G %A Kerr, Kathleen F %A Berenson, Gerald S %A Schnabel, Renate B %A Li, Guo %A Ellinor, Patrick T %A Magnani, Jared W %A Chen, Wei %A Bis, Joshua C %A Curb, J David %A Hsueh, Wen-Chi %A Rotter, Jerome I %A Liu, Yongmei %A Newman, Anne B %A Limacher, Marian C %A North, Kari E %A Reiner, Alexander P %A Quibrera, P Miguel %A Schork, Nicholas J %A Singleton, Andrew B %A Psaty, Bruce M %A Soliman, Elsayed Z %A Solomon, Allen J %A Srinivasan, Sathanur R %A Alonso, Alvaro %A Wallace, Robert %A Redline, Susan %A Zhang, Zhu-Ming %A Post, Wendy S %A Zonderman, Alan B %A Taylor, Herman A %A Murray, Sarah S %A Ferrucci, Luigi %A Arking, Dan E %A Evans, Michele K %A Fox, Ervin R %A Sotoodehnia, Nona %A Heckbert, Susan R %A Whitsel, Eric A %A Newton-Cheh, Christopher %K Adult %K African Americans %K Aged %K Electrocardiography %K European Continental Ancestry Group %K Female %K Genealogy and Heraldry %K Genetic Variation %K Genome, Human %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

BACKGROUND: Ethnic differences in cardiac arrhythmia incidence have been reported, with a particularly high incidence of sudden cardiac death and low incidence of atrial fibrillation in individuals of African ancestry. We tested the hypotheses that African ancestry and common genetic variants are associated with prolonged duration of cardiac repolarization, a central pathophysiological determinant of arrhythmia, as measured by the electrocardiographic QT interval.

METHODS AND RESULTS: First, individual estimates of African and European ancestry were inferred from genome-wide single-nucleotide polymorphism (SNP) data in 7 population-based cohorts of African Americans (n=12,097) and regressed on measured QT interval from ECGs. Second, imputation was performed for 2.8 million SNPs, and a genome-wide association study of QT interval was performed in 10 cohorts (n=13,105). There was no evidence of association between genetic ancestry and QT interval (P=0.94). Genome-wide significant associations (P<2.5 × 10(-8)) were identified with SNPs at 2 loci, upstream of the genes NOS1AP (rs12143842, P=2 × 10(-15)) and ATP1B1 (rs1320976, P=2 × 10(-10)). The most significant SNP in NOS1AP was the same as the strongest SNP previously associated with QT interval in individuals of European ancestry. Low probability values (P<10(-5)) were observed for SNPs at several other loci previously identified in genome-wide association studies in individuals of European ancestry, including KCNQ1, KCNH2, LITAF, and PLN.

CONCLUSIONS: We observed no difference in duration of cardiac repolarization with global genetic indices of African American ancestry. In addition, our genome-wide association study extends the association of polymorphisms at several loci associated with repolarization in individuals of European ancestry to include individuals of African ancestry.

%B Circ Cardiovasc Genet %V 5 %P 647-55 %8 2012 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23166209?dopt=Abstract %R 10.1161/CIRCGENETICS.112.962787 %0 Journal Article %J Circulation %D 2012 %T Impact of blood pressure and blood pressure change during middle age on the remaining lifetime risk for cardiovascular disease: the cardiovascular lifetime risk pooling project. %A Allen, Norrina %A Berry, Jarett D %A Ning, Hongyan %A Van Horn, Linda %A Dyer, Alan %A Lloyd-Jones, Donald M %K Aged %K Aged, 80 and over %K Blood Pressure %K Cardiovascular Diseases %K Cohort Studies %K Female %K Follow-Up Studies %K Humans %K Hypertension %K Life Tables %K Longitudinal Studies %K Male %K Middle Aged %K Risk Factors %X

BACKGROUND: Prior estimates of lifetime risk (LTR) for cardiovascular disease (CVD) examined the impact of blood pressure (BP) at the index age and did not account for changes in BP over time. We examined how changes in BP during middle age affect LTR for CVD, coronary heart disease, and stroke.

METHODS AND RESULTS: Data from 7 diverse US cohort studies were pooled. Remaining LTRs for CVD, coronary heart disease, and stroke were estimated for white and black men and women with death free of CVD as a competing event. LTRs for CVD by BP strata and by changes in BP over an average of 14 years were estimated. Starting at 55 years of age, we followed up 61 585 men and women for 700 000 person-years. LTR for CVD was 52.5% (95% confidence interval, 51.3-53.7) for men and 39.9% (95% confidence interval, 38.7-41.0) for women. LTR for CVD was higher for blacks and increased with increasing BP at index age. Individuals who maintained or decreased their BP to normal levels had the lowest remaining LTR for CVD, 22% to 41%, compared with individuals who had or developed hypertension by 55 years of age, 42% to 69%, suggesting a dose-response effect for the length of time at high BP levels.

CONCLUSIONS: Individuals who experience increases or decreases in BP in middle age have associated higher and lower remaining LTR for CVD. Prevention efforts should continue to emphasize the importance of lowering BP and avoiding or delaying the incidence of hypertension to reduce the LTR for CVD.

%B Circulation %V 125 %P 37-44 %8 2012 Jan 03 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22184621?dopt=Abstract %R 10.1161/CIRCULATIONAHA.110.002774 %0 Journal Article %J Neurology %D 2012 %T Incidence of mild cognitive impairment in the Pittsburgh Cardiovascular Health Study-Cognition Study. %A Lopez, Oscar L %A Becker, James T %A Chang, Yue-Fang %A Sweet, Robert A %A DeKosky, Steven T %A Gach, Michael H %A Carmichael, Owen T %A McDade, Eric %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Cognitive Dysfunction %K Dementia %K Disease Progression %K Female %K Health Surveys %K Humans %K Incidence %K Male %K Risk Factors %K Severity of Illness Index %X

OBJECTIVES AND METHODS: The purpose of this study was to examine the incidence of mild cognitive impairment (MCI) and patterns of progression from incident MCI to dementia in 285 cognitively normal subjects (mean age, 78.9 years) in the Cardiovascular Health Study-Cognition Study from 1998-1999 to 2010-2011.

RESULTS: Two hundred (70%) of the participants progressed to MCI; the age-adjusted incidence of MCI was 111.09 (95% confidence interval, 88.13-142.95) per 1,000 person-years. A total of 107 (53.5%) of the incident MCI subjects progressed to dementia. The mean time from MCI to dementia was 2.8 ± 1.8 years. Forty (20%) of the incident MCI cases had an "unstable" course: 19 (9.5%) converted to MCI and later returned to normal; 10 (5%) converted to MCI, to normal, and later back to MCI; 7 (3.5%) converted to MCI, to normal, to MCI, and later to dementia; and 4 (2%) converted to MCI, to normal, and later to dementia. There was an increased mortality rate among the cognitively normal group (110.10 per 1,000 person-years) compared to those with incident MCI who converted to dementia (41.32 per 1,000 person-years).

CONCLUSIONS: The majority of the subjects aged >80 years developed an MCI syndrome, and half of them progressed to dementia. Once the MCI syndrome was present, the symptoms of dementia appeared within 2 to 3 years. Progression from normal to MCI or from normal to MCI to dementia is not always linear; subjects who developed MCI and later returned to normal can subsequently progress to dementia. Competing mortality and morbidity influence the study of incident MCI and dementia in population cohorts.

%B Neurology %V 79 %P 1599-606 %8 2012 Oct 09 %G eng %N 15 %1 http://www.ncbi.nlm.nih.gov/pubmed/23019262?dopt=Abstract %R 10.1212/WNL.0b013e31826e25f0 %0 Journal Article %J Nat Genet %D 2012 %T Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways. %A Scott, Robert A %A Lagou, Vasiliki %A Welch, Ryan P %A Wheeler, Eleanor %A Montasser, May E %A Luan, Jian'an %A Mägi, Reedik %A Strawbridge, Rona J %A Rehnberg, Emil %A Gustafsson, Stefan %A Kanoni, Stavroula %A Rasmussen-Torvik, Laura J %A Yengo, Loic %A Lecoeur, Cécile %A Shungin, Dmitry %A Sanna, Serena %A Sidore, Carlo %A Johnson, Paul C D %A Jukema, J Wouter %A Johnson, Toby %A Mahajan, Anubha %A Verweij, Niek %A Thorleifsson, Gudmar %A Hottenga, Jouke-Jan %A Shah, Sonia %A Smith, Albert V %A Sennblad, Bengt %A Gieger, Christian %A Salo, Perttu %A Perola, Markus %A Timpson, Nicholas J %A Evans, David M %A Pourcain, Beate St %A Wu, Ying %A Andrews, Jeanette S %A Hui, Jennie %A Bielak, Lawrence F %A Zhao, Wei %A Horikoshi, Momoko %A Navarro, Pau %A Isaacs, Aaron %A O'Connell, Jeffrey R %A Stirrups, Kathleen %A Vitart, Veronique %A Hayward, Caroline %A Esko, Tõnu %A Mihailov, Evelin %A Fraser, Ross M %A Fall, Tove %A Voight, Benjamin F %A Raychaudhuri, Soumya %A Chen, Han %A Lindgren, Cecilia M %A Morris, Andrew P %A Rayner, Nigel W %A Robertson, Neil %A Rybin, Denis %A Liu, Ching-Ti %A Beckmann, Jacques S %A Willems, Sara M %A Chines, Peter S %A Jackson, Anne U %A Kang, Hyun Min %A Stringham, Heather M %A Song, Kijoung %A Tanaka, Toshiko %A Peden, John F %A Goel, Anuj %A Hicks, Andrew A %A An, Ping %A Müller-Nurasyid, Martina %A Franco-Cereceda, Anders %A Folkersen, Lasse %A Marullo, Letizia %A Jansen, Hanneke %A Oldehinkel, Albertine J %A Bruinenberg, Marcel %A Pankow, James S %A North, Kari E %A Forouhi, Nita G %A Loos, Ruth J F %A Edkins, Sarah %A Varga, Tibor V %A Hallmans, Göran %A Oksa, Heikki %A Antonella, Mulas %A Nagaraja, Ramaiah %A Trompet, Stella %A Ford, Ian %A Bakker, Stephan J L %A Kong, Augustine %A Kumari, Meena %A Gigante, Bruna %A Herder, Christian %A Munroe, Patricia B %A Caulfield, Mark %A Antti, Jula %A Mangino, Massimo %A Small, Kerrin %A Miljkovic, Iva %A Liu, Yongmei %A Atalay, Mustafa %A Kiess, Wieland %A James, Alan L %A Rivadeneira, Fernando %A Uitterlinden, André G %A Palmer, Colin N A %A Doney, Alex S F %A Willemsen, Gonneke %A Smit, Johannes H %A Campbell, Susan %A Polasek, Ozren %A Bonnycastle, Lori L %A Hercberg, Serge %A Dimitriou, Maria %A Bolton, Jennifer L %A Fowkes, Gerard R %A Kovacs, Peter %A Lindström, Jaana %A Zemunik, Tatijana %A Bandinelli, Stefania %A Wild, Sarah H %A Basart, Hanneke V %A Rathmann, Wolfgang %A Grallert, Harald %A Maerz, Winfried %A Kleber, Marcus E %A Boehm, Bernhard O %A Peters, Annette %A Pramstaller, Peter P %A Province, Michael A %A Borecki, Ingrid B %A Hastie, Nicholas D %A Rudan, Igor %A Campbell, Harry %A Watkins, Hugh %A Farrall, Martin %A Stumvoll, Michael %A Ferrucci, Luigi %A Waterworth, Dawn M %A Bergman, Richard N %A Collins, Francis S %A Tuomilehto, Jaakko %A Watanabe, Richard M %A de Geus, Eco J C %A Penninx, Brenda W %A Hofman, Albert %A Oostra, Ben A %A Psaty, Bruce M %A Vollenweider, Peter %A Wilson, James F %A Wright, Alan F %A Hovingh, G Kees %A Metspalu, Andres %A Uusitupa, Matti %A Magnusson, Patrik K E %A Kyvik, Kirsten O %A Kaprio, Jaakko %A Price, Jackie F %A Dedoussis, George V %A Deloukas, Panos %A Meneton, Pierre %A Lind, Lars %A Boehnke, Michael %A Shuldiner, Alan R %A van Duijn, Cornelia M %A Morris, Andrew D %A Toenjes, Anke %A Peyser, Patricia A %A Beilby, John P %A Körner, Antje %A Kuusisto, Johanna %A Laakso, Markku %A Bornstein, Stefan R %A Schwarz, Peter E H %A Lakka, Timo A %A Rauramaa, Rainer %A Adair, Linda S %A Smith, George Davey %A Spector, Tim D %A Illig, Thomas %A de Faire, Ulf %A Hamsten, Anders %A Gudnason, Vilmundur %A Kivimaki, Mika %A Hingorani, Aroon %A Keinanen-Kiukaanniemi, Sirkka M %A Saaristo, Timo E %A Boomsma, Dorret I %A Stefansson, Kari %A van der Harst, Pim %A Dupuis, Josée %A Pedersen, Nancy L %A Sattar, Naveed %A Harris, Tamara B %A Cucca, Francesco %A Ripatti, Samuli %A Salomaa, Veikko %A Mohlke, Karen L %A Balkau, Beverley %A Froguel, Philippe %A Pouta, Anneli %A Jarvelin, Marjo-Riitta %A Wareham, Nicholas J %A Bouatia-Naji, Nabila %A McCarthy, Mark I %A Franks, Paul W %A Meigs, James B %A Teslovich, Tanya M %A Florez, Jose C %A Langenberg, Claudia %A Ingelsson, Erik %A Prokopenko, Inga %A Barroso, Inês %K Adult %K Animals %K Blood Glucose %K Fasting %K Female %K Gene Frequency %K Genome-Wide Association Study %K Humans %K Insulin %K Male %K Metabolic Networks and Pathways %K Mice %K Osmolar Concentration %K Quantitative Trait Loci %X

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.

%B Nat Genet %V 44 %P 991-1005 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22885924?dopt=Abstract %R 10.1038/ng.2385 %0 Journal Article %J BMJ Open %D 2012 %T Large-scale international validation of the ADO index in subjects with COPD: an individual subject data analysis of 10 cohorts. %A Puhan, Milo A %A Hansel, Nadia N %A Sobradillo, Patricia %A Enright, Paul %A Lange, Peter %A Hickson, Demarc %A Menezes, Ana M %A ter Riet, Gerben %A Held, Ulrike %A Domingo-Salvany, Antonia %A Mosenifar, Zab %A Antó, Josep M %A Moons, Karel G M %A Kessels, Alphons %A Garcia-Aymerich, Judith %X

BACKGROUND: Little evidence on the validity of simple and widely applicable tools to predict mortality in patients with chronic obstructive pulmonary disease (COPD) exists.

OBJECTIVE: To conduct a large international study to validate the ADO index that uses age, dyspnoea and FEV(1) to predict 3-year mortality and to update it in order to make prediction of mortality in COPD patients as generalisable as possible.

DESIGN: Individual subject data analysis of 10 European and American cohorts (n=13 914).

SETTING: Population-based, primary, secondary and tertiary care.

PATIENTS: COPD GOLD stages I-IV.

MEASUREMENTS: We validated the original ADO index. We then obtained an updated ADO index in half of our cohorts to improve its predictive accuracy, which in turn was validated comprehensively in the remaining cohorts using discrimination, calibration and decision curve analysis and a number of sensitivity analyses.

RESULTS: 1350 (9.7%) of all subjects with COPD (60% male, mean age 61 years, mean FEV(1) 66% predicted) had died at 3 years. The original ADO index showed high discrimination but poor calibration (p<0.001 for difference between predicted and observed risk). The updated ADO index (scores from 0 to 14) preserved excellent discrimination (area under curve 0.81, 95% CI 0.80 to 0.82) but showed much improved calibration with predicted 3-year risks from 0.7% (95% CI 0.6% to 0.9%, score of 0) to 64.5% (61.2% to 67.7%, score of 14). The ADO index showed higher net benefit in subjects at low-to-moderate risk of 3-year mortality than FEV(1) alone.

INTERPRETATION: The updated 15-point ADO index accurately predicts 3-year mortality across the COPD severity spectrum and can be used to inform patients about their prognosis, clinical trial study design or benefit harm assessment of medical interventions.

%B BMJ Open %V 2 %8 2012 %G eng %N 6 %R 10.1136/bmjopen-2012-002152 %0 Journal Article %J JAMA %D 2012 %T Lifetime risk and years lived free of total cardiovascular disease. %A Wilkins, John T %A Ning, Hongyan %A Berry, Jarett %A Zhao, Lihui %A Dyer, Alan R %A Lloyd-Jones, Donald M %K Adult %K Aged %K Blood Pressure %K Cardiovascular Diseases %K Cohort Studies %K Diabetes Mellitus %K Female %K Forecasting %K Humans %K Kaplan-Meier Estimate %K Male %K Middle Aged %K Morbidity %K Risk %K Risk Factors %K Smoking %X

CONTEXT: Estimates of lifetime risk for total cardiovascular disease (CVD) may provide projections of the future population burden of CVD and may assist in clinician-patient risk communication. To date, no lifetime risk estimates of total CVD have been reported.

OBJECTIVES: To calculate lifetime risk estimates of total CVD by index age (45, 55, 65, 75 years) and risk factor strata and to estimate years lived free of CVD across risk factor strata.

DESIGN, SETTING, AND PARTICIPANTS: Pooled survival analysis of as many as 905,115 person-years of data from 1964 through 2008 from 5 National Heart, Lung, and Blood Institute-funded community-based cohorts: Framingham Heart Study, Framingham Offspring Study, Atherosclerosis Risk in Communities Study, Chicago Heart Association Detection Project in Industry Study, and Cardiovascular Health Study. All participants were free of CVD at baseline with risk factor data (blood pressure [BP], total cholesterol [TC], diabetes, and smoking status) and total CVD outcome data.

MAIN OUTCOME MEASURES: Any total CVD event (including fatal and nonfatal coronary heart disease, all forms of stroke, congestive heart failure, and other CVD deaths).

RESULTS: At an index age of 45 years, overall lifetime risk for total CVD was 60.3% (95% CI, 59.3%-61.2%) for men and 55.6% (95% CI, 54.5%-56.7%) for women. Men had higher lifetime risk estimates than women across all index ages. At index ages 55 and 65 years, men and women with at least 1 elevated risk factor (BP, 140-149/90-99 mm Hg; or TC, 200-239 mg/dL; but no diabetes or smoking), 1 major risk factor, or at least 2 major risk factors (BP, ≥160/100 mm Hg or receiving treatment; TC, ≥240 mg/dL or receiving treatment; diabetes mellitus; or current smoking) had lifetime risk estimates to age 95 years that exceeded 50%. Despite an optimal risk factor profile (BP, <120/80 mm Hg; TC, <180 mg/dL; and no smoking or diabetes), men and women at the index age of 55 years had lifetime risks (through 85 years of age) for total CVD of greater than 40% and 30%, respectively. Compared with participants with at least 2 major risk factors, those with an optimal risk factor profile lived up to 14 years longer free of total CVD.

CONCLUSIONS: Lifetime risk estimates for total CVD were high (>30%) for all individuals, even those with optimal risk factors in middle age. However, maintenance of optimal risk factor levels in middle age was associated with substantially longer morbidity-free survival.

%B JAMA %V 308 %P 1795-801 %8 2012 Nov 07 %G eng %N 17 %1 http://www.ncbi.nlm.nih.gov/pubmed/23117780?dopt=Abstract %R 10.1001/jama.2012.14312 %0 Journal Article %J N Engl J Med %D 2012 %T Lifetime risks of cardiovascular disease. %A Berry, Jarett D %A Dyer, Alan %A Cai, Xuan %A Garside, Daniel B %A Ning, Hongyan %A Thomas, Avis %A Greenland, Philip %A Van Horn, Linda %A Tracy, Russell P %A Lloyd-Jones, Donald M %K Adult %K African Americans %K Aged %K Cardiovascular Diseases %K Cohort Effect %K European Continental Ancestry Group %K Female %K Humans %K Male %K Middle Aged %K Risk %K Risk Assessment %K Risk Factors %K United States %X

BACKGROUND: The lifetime risks of cardiovascular disease have not been reported across the age spectrum in black adults and white adults.

METHODS: We conducted a meta-analysis at the individual level using data from 18 cohort studies involving a total of 257,384 black men and women and white men and women whose risk factors for cardiovascular disease were measured at the ages of 45, 55, 65, and 75 years. Blood pressure, cholesterol level, smoking status, and diabetes status were used to stratify participants according to risk factors into five mutually exclusive categories. The remaining lifetime risks of cardiovascular events were estimated for participants in each category at each age, with death free of cardiovascular disease treated as a competing event.

RESULTS: We observed marked differences in the lifetime risks of cardiovascular disease across risk-factor strata. Among participants who were 55 years of age, those with an optimal risk-factor profile (total cholesterol level, <180 mg per deciliter [4.7 mmol per liter]; blood pressure, <120 mm Hg systolic and 80 mm Hg diastolic; nonsmoking status; and nondiabetic status) had substantially lower risks of death from cardiovascular disease through the age of 80 years than participants with two or more major risk factors (4.7% vs. 29.6% among men, 6.4% vs. 20.5% among women). Those with an optimal risk-factor profile also had lower lifetime risks of fatal coronary heart disease or nonfatal myocardial infarction (3.6% vs. 37.5% among men, <1% vs. 18.3% among women) and fatal or nonfatal stroke (2.3% vs. 8.3% among men, 5.3% vs. 10.7% among women). Similar trends within risk-factor strata were observed among blacks and whites and across diverse birth cohorts.

CONCLUSIONS: Differences in risk-factor burden translate into marked differences in the lifetime risk of cardiovascular disease, and these differences are consistent across race and birth cohorts. (Funded by the National Heart, Lung, and Blood Institute.).

%B N Engl J Med %V 366 %P 321-9 %8 2012 Jan 26 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22276822?dopt=Abstract %R 10.1056/NEJMoa1012848 %0 Journal Article %J J Alzheimers Dis %D 2012 %T Markers of cholesterol metabolism in the brain show stronger associations with cerebrovascular disease than Alzheimer's disease. %A Hughes, Timothy M %A Kuller, Lewis H %A Lopez, Oscar L %A Becker, James T %A Evans, Rhobert W %A Sutton-Tyrrell, Kim %A Rosano, Caterina %K Age Factors %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Apolipoprotein E4 %K Brain %K Cerebrovascular Disorders %K Cognition Disorders %K Cohort Studies %K Female %K Humans %K Hydroxycholesterols %K Magnetic Resonance Imaging %K Male %K Retrospective Studies %X

Cholesterol metabolism is believed to play a role in the development of Alzheimer's disease (AD). Oxysterol metabolites of cholesterol, 24S-hydroxycholesterol (24-OHC, a brain-derived oxysterol) and 27-hydroxycholesterol (27-OHC, a peripherally derived oxysterol) cross the blood brain barrier and have been associated with AD. We investigated whether oxysterols were associated with markers of cerebrovascular disease prior to the onset of cognitive impairment. Oxysterols were quantified in 105 participants (average age: 80 ± 4 years) from the Pittsburgh Cardiovascular Health Study Cognition Study who remained cognitively normal at blood draw in 2002, had MRI in 1992 and 1998, and annual cognitive assessment for incident AD and mild cognitive impairment made by consensus conference between 1998 and 2010. Higher plasma levels of 24-OHC were associated with age, gender, the presence of high grade white matter hyperintensities, and brain infarcts on prior MRI. Participants with higher plasma 24-OHC and a greater ratio of 24-OHC/27-OHC were also more likely to develop incident cognitive impairment over 8 years of follow-up. Higher levels of 24-OHC suggest increased cholesterol metabolism occurring in the brains of participants with cerebrovascular disease prior to the onset of cognitive impairment. Measurement of oxysterols may provide information about cholesterol metabolism and brain disease over the cognitive impairment process.

%B J Alzheimers Dis %V 30 %P 53-61 %8 2012 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22377780?dopt=Abstract %R 10.3233/JAD-2012-111460 %0 Journal Article %J Parkinsonism Relat Disord %D 2012 %T Markers of inflammation in prevalent and incident Parkinson's disease in the Cardiovascular Health Study. %A Ton, Thanh G N %A Jain, Samay %A Biggs, Mary L %A Thacker, Evan L %A Strotmeyer, Elsa S %A Boudreau, Robert %A Newman, Anne B %A Longstreth, W T %A Checkoway, Harvey %K Aged %K Aged, 80 and over %K Albumins %K Biomarkers %K C-Reactive Protein %K Enzyme-Linked Immunosorbent Assay %K Female %K Fibrinogen %K Humans %K Incidence %K Inflammation %K Interleukin-6 %K Leukocyte Count %K Male %K Parkinson Disease %K Prevalence %K Risk Factors %K Tumor Necrosis Factor-alpha %X

BACKGROUND: Studies demonstrate existence of inflammation in prevalent Parkinson's disease (PD). We assessed associations of baseline levels of inflammatory markers with prevalent PD at baseline (1989) and incident PD identified over 13 years of follow-up of the Cardiovascular Health Study.

METHODS: Blood samples at baseline were measured for fibrinogen, interleukin-6, tumor necrosis factor-α, C-reactive protein, albumin, and white blood cells. The analysis included 60 prevalent and 154 incident PD cases.

RESULTS: Risk of prevalent PD was significantly higher per doubling of IL-6 among women (odds ratio [OR]=1.5, 95% confidence interval [CI]: 1.0, 2.4) and WBC among men (OR: 2.4, 95% CI: 1.2, 4.9) in multivariate models. Risk of incident PD was not associated with higher levels of any biomarker after adjusting for age, smoking, African American race, and history of diabetes. Inverse associations with incident PD were observed per doubling of C-reactive protein (OR=0.9; 95% CI: 0.8, 1.0) and of fibrinogen among women (OR=0.4; 95% CI: 0.2, 0.8).

CONCLUSIONS: Although inflammation exists in PD, it may not represent an etiologic factor. Our findings suggest the need for larger studies that measure inflammatory markers before PD onset.

%B Parkinsonism Relat Disord %V 18 %P 274-8 %8 2012 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22119505?dopt=Abstract %R 10.1016/j.parkreldis.2011.11.003 %0 Journal Article %J Nat Genet %D 2012 %T Meta-analyses identify 13 loci associated with age at menopause and highlight DNA repair and immune pathways. %A Stolk, Lisette %A Perry, John R B %A Chasman, Daniel I %A He, Chunyan %A Mangino, Massimo %A Sulem, Patrick %A Barbalic, Maja %A Broer, Linda %A Byrne, Enda M %A Ernst, Florian %A Esko, Tõnu %A Franceschini, Nora %A Gudbjartsson, Daniel F %A Hottenga, Jouke-Jan %A Kraft, Peter %A McArdle, Patrick F %A Porcu, Eleonora %A Shin, So-Youn %A Smith, Albert V %A van Wingerden, Sophie %A Zhai, Guangju %A Zhuang, Wei V %A Albrecht, Eva %A Alizadeh, Behrooz Z %A Aspelund, Thor %A Bandinelli, Stefania %A Lauc, Lovorka Barac %A Beckmann, Jacques S %A Boban, Mladen %A Boerwinkle, Eric %A Broekmans, Frank J %A Burri, Andrea %A Campbell, Harry %A Chanock, Stephen J %A Chen, Constance %A Cornelis, Marilyn C %A Corre, Tanguy %A Coviello, Andrea D %A D'Adamo, Pio %A Davies, Gail %A de Faire, Ulf %A de Geus, Eco J C %A Deary, Ian J %A Dedoussis, George V Z %A Deloukas, Panagiotis %A Ebrahim, Shah %A Eiriksdottir, Gudny %A Emilsson, Valur %A Eriksson, Johan G %A Fauser, Bart C J M %A Ferreli, Liana %A Ferrucci, Luigi %A Fischer, Krista %A Folsom, Aaron R %A Garcia, Melissa E %A Gasparini, Paolo %A Gieger, Christian %A Glazer, Nicole %A Grobbee, Diederick E %A Hall, Per %A Haller, Toomas %A Hankinson, Susan E %A Hass, Merli %A Hayward, Caroline %A Heath, Andrew C %A Hofman, Albert %A Ingelsson, Erik %A Janssens, A Cecile J W %A Johnson, Andrew D %A Karasik, David %A Kardia, Sharon L R %A Keyzer, Jules %A Kiel, Douglas P %A Kolcic, Ivana %A Kutalik, Zoltán %A Lahti, Jari %A Lai, Sandra %A Laisk, Triin %A Laven, Joop S E %A Lawlor, Debbie A %A Liu, Jianjun %A Lopez, Lorna M %A Louwers, Yvonne V %A Magnusson, Patrik K E %A Marongiu, Mara %A Martin, Nicholas G %A Klaric, Irena Martinovic %A Masciullo, Corrado %A McKnight, Barbara %A Medland, Sarah E %A Melzer, David %A Mooser, Vincent %A Navarro, Pau %A Newman, Anne B %A Nyholt, Dale R %A Onland-Moret, N Charlotte %A Palotie, Aarno %A Paré, Guillaume %A Parker, Alex N %A Pedersen, Nancy L %A Peeters, Petra H M %A Pistis, Giorgio %A Plump, Andrew S %A Polasek, Ozren %A Pop, Victor J M %A Psaty, Bruce M %A Räikkönen, Katri %A Rehnberg, Emil %A Rotter, Jerome I %A Rudan, Igor %A Sala, Cinzia %A Salumets, Andres %A Scuteri, Angelo %A Singleton, Andrew %A Smith, Jennifer A %A Snieder, Harold %A Soranzo, Nicole %A Stacey, Simon N %A Starr, John M %A Stathopoulou, Maria G %A Stirrups, Kathleen %A Stolk, Ronald P %A Styrkarsdottir, Unnur %A Sun, Yan V %A Tenesa, Albert %A Thorand, Barbara %A Toniolo, Daniela %A Tryggvadottir, Laufey %A Tsui, Kim %A Ulivi, Sheila %A van Dam, Rob M %A van der Schouw, Yvonne T %A van Gils, Carla H %A van Nierop, Peter %A Vink, Jacqueline M %A Visscher, Peter M %A Voorhuis, Marlies %A Waeber, Gérard %A Wallaschofski, Henri %A Wichmann, H Erich %A Widen, Elisabeth %A Wijnands-van Gent, Colette J M %A Willemsen, Gonneke %A Wilson, James F %A Wolffenbuttel, Bruce H R %A Wright, Alan F %A Yerges-Armstrong, Laura M %A Zemunik, Tatijana %A Zgaga, Lina %A Zillikens, M Carola %A Zygmunt, Marek %A Arnold, Alice M %A Boomsma, Dorret I %A Buring, Julie E %A Crisponi, Laura %A Demerath, Ellen W %A Gudnason, Vilmundur %A Harris, Tamara B %A Hu, Frank B %A Hunter, David J %A Launer, Lenore J %A Metspalu, Andres %A Montgomery, Grant W %A Oostra, Ben A %A Ridker, Paul M %A Sanna, Serena %A Schlessinger, David %A Spector, Tim D %A Stefansson, Kari %A Streeten, Elizabeth A %A Thorsteinsdottir, Unnur %A Uda, Manuela %A Uitterlinden, André G %A van Duijn, Cornelia M %A Völzke, Henry %A Murray, Anna %A Murabito, Joanne M %A Visser, Jenny A %A Lunetta, Kathryn L %K Age Factors %K DNA Helicases %K DNA Polymerase gamma %K DNA Primase %K DNA Repair %K DNA Repair Enzymes %K DNA-Directed DNA Polymerase %K European Continental Ancestry Group %K Exodeoxyribonucleases %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Immunity %K Menopause %K Polymorphism, Single Nucleotide %K Proteins %X

To newly identify loci for age at natural menopause, we carried out a meta-analysis of 22 genome-wide association studies (GWAS) in 38,968 women of European descent, with replication in up to 14,435 women. In addition to four known loci, we identified 13 loci newly associated with age at natural menopause (at P < 5 × 10(-8)). Candidate genes located at these newly associated loci include genes implicated in DNA repair (EXO1, HELQ, UIMC1, FAM175A, FANCI, TLK1, POLG and PRIM1) and immune function (IL11, NLRP11 and PRRC2A (also known as BAT2)). Gene-set enrichment pathway analyses using the full GWAS data set identified exoDNase, NF-κB signaling and mitochondrial dysfunction as biological processes related to timing of menopause.

%B Nat Genet %V 44 %P 260-8 %8 2012 Jan 22 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22267201?dopt=Abstract %R 10.1038/ng.1051 %0 Journal Article %J Nat Genet %D 2012 %T Meta-analysis identifies six new susceptibility loci for atrial fibrillation. %A Ellinor, Patrick T %A Lunetta, Kathryn L %A Albert, Christine M %A Glazer, Nicole L %A Ritchie, Marylyn D %A Smith, Albert V %A Arking, Dan E %A Müller-Nurasyid, Martina %A Krijthe, Bouwe P %A Lubitz, Steven A %A Bis, Joshua C %A Chung, Mina K %A Dörr, Marcus %A Ozaki, Kouichi %A Roberts, Jason D %A Smith, J Gustav %A Pfeufer, Arne %A Sinner, Moritz F %A Lohman, Kurt %A Ding, Jingzhong %A Smith, Nicholas L %A Smith, Jonathan D %A Rienstra, Michiel %A Rice, Kenneth M %A Van Wagoner, David R %A Magnani, Jared W %A Wakili, Reza %A Clauss, Sebastian %A Rotter, Jerome I %A Steinbeck, Gerhard %A Launer, Lenore J %A Davies, Robert W %A Borkovich, Matthew %A Harris, Tamara B %A Lin, Honghuang %A Völker, Uwe %A Völzke, Henry %A Milan, David J %A Hofman, Albert %A Boerwinkle, Eric %A Chen, Lin Y %A Soliman, Elsayed Z %A Voight, Benjamin F %A Li, Guo %A Chakravarti, Aravinda %A Kubo, Michiaki %A Tedrow, Usha B %A Rose, Lynda M %A Ridker, Paul M %A Conen, David %A Tsunoda, Tatsuhiko %A Furukawa, Tetsushi %A Sotoodehnia, Nona %A Xu, Siyan %A Kamatani, Naoyuki %A Levy, Daniel %A Nakamura, Yusuke %A Parvez, Babar %A Mahida, Saagar %A Furie, Karen L %A Rosand, Jonathan %A Muhammad, Raafia %A Psaty, Bruce M %A Meitinger, Thomas %A Perz, Siegfried %A Wichmann, H-Erich %A Witteman, Jacqueline C M %A Kao, W H Linda %A Kathiresan, Sekar %A Roden, Dan M %A Uitterlinden, André G %A Rivadeneira, Fernando %A McKnight, Barbara %A Sjögren, Marketa %A Newman, Anne B %A Liu, Yongmei %A Gollob, Michael H %A Melander, Olle %A Tanaka, Toshihiro %A Stricker, Bruno H Ch %A Felix, Stephan B %A Alonso, Alvaro %A Darbar, Dawood %A Barnard, John %A Chasman, Daniel I %A Heckbert, Susan R %A Benjamin, Emelia J %A Gudnason, Vilmundur %A Kääb, Stefan %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Asian Continental Ancestry Group %K Atrial Fibrillation %K Child %K Child, Preschool %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Infant %K Infant, Newborn %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %K Young Adult %X

Atrial fibrillation is a highly prevalent arrhythmia and a major risk factor for stroke, heart failure and death. We conducted a genome-wide association study (GWAS) in individuals of European ancestry, including 6,707 with and 52,426 without atrial fibrillation. Six new atrial fibrillation susceptibility loci were identified and replicated in an additional sample of individuals of European ancestry, including 5,381 subjects with and 10,030 subjects without atrial fibrillation (P < 5 × 10(-8)). Four of the loci identified in Europeans were further replicated in silico in a GWAS of Japanese individuals, including 843 individuals with and 3,350 individuals without atrial fibrillation. The identified loci implicate candidate genes that encode transcription factors related to cardiopulmonary development, cardiac-expressed ion channels and cell signaling molecules.

%B Nat Genet %V 44 %P 670-5 %8 2012 Apr 29 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22544366?dopt=Abstract %R 10.1038/ng.2261 %0 Journal Article %J Am J Epidemiol %D 2012 %T Modification of the association between ambient air pollution and lung function by frailty status among older adults in the Cardiovascular Health Study. %A Eckel, Sandrah P %A Louis, Thomas A %A Chaves, Paulo H M %A Fried, Linda P %A Margolis, And Helene G %K Aged %K Air Pollution %K Cardiovascular Diseases %K Female %K Forced Expiratory Volume %K Frail Elderly %K Geriatric Assessment %K Humans %K Male %K Prospective Studies %K Respiratory Function Tests %K Sex Factors %K Smoking %K Time Factors %K United States %K Vital Capacity %X

The susceptibility of older adults to the health effects of air pollution is well-recognized. Advanced age may act as a partial surrogate for conditions associated with aging. The authors investigated whether gerontologic frailty (a clinical health status metric) modified the association between ambient level of ozone or particulate matter with an aerodynamic diameter less than 10 µm and lung function in 3,382 older adults using 7 years of follow-up data (1990-1997) from the Cardiovascular Health Study and its Environmental Factors Ancillary Study. Monthly average pollution and annual frailty assessments were related to up to 3 repeated measurements of lung function using cumulative summaries of pollution and frailty histories that accounted for duration as well as concentration. Frailty history was found to modify long-term associations of pollutants with forced vital capacity. For example, the decrease in forced vital capacity associated with a 70-ppb/month greater cumulative sum of monthly average ozone exposure was 12.3 mL (95% confidence interval: 10.4, 14.2) for a woman who had spent the prior 7 years prefrail or frail as compared with 4.7 mL (95% confidence interval: 3.8, 5.6) for a similar woman who was robust during all 7 years (interaction P < 0.001).

%B Am J Epidemiol %V 176 %P 214-23 %8 2012 Aug 01 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22811494?dopt=Abstract %R 10.1093/aje/kws001 %0 Journal Article %J PLoS One %D 2012 %T Multi-ethnic analysis of lipid-associated loci: the NHLBI CARe project. %A Musunuru, Kiran %A Romaine, Simon P R %A Lettre, Guillaume %A Wilson, James G %A Volcik, Kelly A %A Tsai, Michael Y %A Taylor, Herman A %A Schreiner, Pamela J %A Rotter, Jerome I %A Rich, Stephen S %A Redline, Susan %A Psaty, Bruce M %A Papanicolaou, George J %A Ordovas, Jose M %A Liu, Kiang %A Krauss, Ronald M %A Glazer, Nicole L %A Gabriel, Stacey B %A Fornage, Myriam %A Cupples, L Adrienne %A Buxbaum, Sarah G %A Boerwinkle, Eric %A Ballantyne, Christie M %A Kathiresan, Sekar %A Rader, Daniel J %K African Americans %K Cholesterol, HDL %K Cholesterol, LDL %K European Continental Ancestry Group %K Genetic Association Studies %K Genetic Loci %K Humans %K Polymorphism, Single Nucleotide %K Triglycerides %X

BACKGROUND: Whereas it is well established that plasma lipid levels have substantial heritability within populations, it remains unclear how many of the genetic determinants reported in previous studies (largely performed in European American cohorts) are relevant in different ethnicities.

METHODOLOGY/PRINCIPAL FINDINGS: We tested a set of ∼50,000 polymorphisms from ∼2,000 candidate genes and genetic loci from genome-wide association studies (GWAS) for association with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in 25,000 European Americans and 9,000 African Americans in the National Heart, Lung, and Blood Institute (NHLBI) Candidate Gene Association Resource (CARe). We replicated associations for a number of genes in one or both ethnicities and identified a novel lipid-associated variant in a locus harboring ICAM1. We compared the architecture of genetic loci associated with lipids in both African Americans and European Americans and found that the same genes were relevant across ethnic groups but the specific associated variants at each gene often differed.

CONCLUSIONS/SIGNIFICANCE: We identify or provide further evidence for a number of genetic determinants of plasma lipid levels through population association studies. In many loci the determinants appear to differ substantially between African Americans and European Americans.

%B PLoS One %V 7 %P e36473 %8 2012 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/22629316?dopt=Abstract %R 10.1371/journal.pone.0036473 %0 Journal Article %J Circ Arrhythm Electrophysiol %D 2012 %T Nonesterified fatty acids and risk of sudden cardiac death in older adults. %A Djoussé, Luc %A Biggs, Mary L %A Ix, Joachim H %A Kizer, Jorge R %A Lemaitre, Rozenn N %A Sotoodehnia, Nona %A Zieman, Susan J %A Mozaffarian, Dariush %A Tracy, Russell P %A Mukamal, Kenneth J %A Siscovick, David S %K Aged %K Aged, 80 and over %K Biomarkers %K Death, Sudden, Cardiac %K Fatty Acids, Nonesterified %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Proportional Hazards Models %K Prospective Studies %K Retrospective Studies %K Risk Factors %X

BACKGROUND: Although nonesterified fatty acids (NEFA) have been positively associated with coronary heart disease risk factors, limited and inconsistent data are available on the relation between NEFA and sudden cardiac death.

METHODS AND RESULTS: Using a prospective design, we studied 4657 older men and women (mean age, 75 years) from the Cardiovascular Health Study (1992-2006) to evaluate the association between plasma NEFA and the risk of sudden cardiac death in older adults. Plasma concentrations of NEFA were measured using established enzymatic methods, and sudden death was adjudicated using medical records, death certificates, proxy interview, and autopsy reports. We used Cox proportional hazard models to estimate multivariable-adjusted relative risks. During a median follow-up of 10.0 years, 221 new cases of sudden cardiac death occurred. In a multivariable model adjusting for age, sex, race, clinic site, alcohol intake, smoking, prevalent coronary heart disease and heart failure, and self-reported health status, relative risks (95% confidence interval) for sudden cardiac death were 1.0 (ref), 1.15 (0.81-1.64), 1.06 (0.72-1.55), and 0.91 (0.60-1.38) across consecutive quartiles of NEFA concentration. In secondary analyses restricted to the first 5 years of follow-up, we also did not observe a statistically significant association between plasma NEFA and sudden cardiac death.

CONCLUSIONS: Our data do not provide evidence for an association between plasma NEFA measured late in life and the risk of sudden cardiac death in older adults.

%B Circ Arrhythm Electrophysiol %V 5 %P 273-8 %8 2012 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/22281952?dopt=Abstract %R 10.1161/CIRCEP.111.967661 %0 Journal Article %J Am J Clin Nutr %D 2012 %T Novel circulating fatty acid patterns and risk of cardiovascular disease: the Cardiovascular Health Study. %A Imamura, Fumiaki %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Lichtenstein, Alice H %A Matthan, Nirupa R %A Herrington, David M %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Biomarkers %K Cardiovascular Diseases %K Cohort Studies %K Coronary Artery Disease %K Disease Progression %K Female %K Follow-Up Studies %K Humans %K Incidence %K Longitudinal Studies %K Male %K Middle Aged %K Myocardial Ischemia %K Principal Component Analysis %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stroke %K Trans Fatty Acids %K United States %X

BACKGROUND: Complex interplays of diet and metabolism influence circulating fatty acids (FAs), possibly constituting FA patterns related to cardiovascular disease (CVD) risk.

OBJECTIVES: We aimed to derive FA patterns from circulating FAs, relate the patterns to CVD incidence, and extend the derived patterns to atherosclerosis progression in another independent cohort.

DESIGN: We used principal component analysis (PCA) to derive FA patterns from 38 plasma phospholipid FAs in 2972 older adults in the Cardiovascular Health Study (CHS). Identified patterns were evaluated for prospective associations with 14-y incidence of CVD [ischemic heart disease (IHD) or stroke]. In another independent cohort of postmenopausal women with IHD, we evaluated associations of the CHS-derived patterns with 3.2-y progression of angiographically defined coronary atherosclerosis.

RESULTS: Three distinct patterns were identified, characterized by higher proportions of trans FAs, de novo lipogenesis (DNL) FAs, and long-chain MUFAs (LCMUFAs). During 32,265 person-years, 780 incident CVD events occurred. The trans FA pattern was associated with higher CVD risk (multivariable-adjusted HR for the highest compared with the lowest quintiles = 1.58; 95% CI: 1.17, 2.12; P-trend = 0.006), primarily attributable to higher risk of stroke (HR: 2.46; 95% CI: 1.54, 3.92; P-trend = 0.005). The DNL and LCMUFA patterns were not associated with CVD incidence or with IHD or stroke (P-trend > 0.11 each). In the second cohort, the trans FA pattern, but not the other 2 patterns, was positively associated with progression of coronary atherosclerosis (P-trend < 0.05).

CONCLUSIONS: PCA appears to provide informative circulating FA patterns. A pattern driven mainly by trans FA levels related to greater CVD risk in older adults and coronary atherosclerosis progression in women with IHD.

%B Am J Clin Nutr %V 96 %P 1252-61 %8 2012 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23097270?dopt=Abstract %R 10.3945/ajcn.112.039990 %0 Journal Article %J Circ Cardiovasc Genet %D 2012 %T Novel loci associated with PR interval in a genome-wide association study of 10 African American cohorts. %A Butler, Anne M %A Yin, Xiaoyan %A Evans, Daniel S %A Nalls, Michael A %A Smith, Erin N %A Tanaka, Toshiko %A Li, Guo %A Buxbaum, Sarah G %A Whitsel, Eric A %A Alonso, Alvaro %A Arking, Dan E %A Benjamin, Emelia J %A Berenson, Gerald S %A Bis, Josh C %A Chen, Wei %A Deo, Rajat %A Ellinor, Patrick T %A Heckbert, Susan R %A Heiss, Gerardo %A Hsueh, Wen-Chi %A Keating, Brendan J %A Kerr, Kathleen F %A Li, Yun %A Limacher, Marian C %A Liu, Yongmei %A Lubitz, Steven A %A Marciante, Kristin D %A Mehra, Reena %A Meng, Yan A %A Newman, Anne B %A Newton-Cheh, Christopher %A North, Kari E %A Palmer, Cameron D %A Psaty, Bruce M %A Quibrera, P Miguel %A Redline, Susan %A Reiner, Alex P %A Rotter, Jerome I %A Schnabel, Renate B %A Schork, Nicholas J %A Singleton, Andrew B %A Smith, J Gustav %A Soliman, Elsayed Z %A Srinivasan, Sathanur R %A Zhang, Zhu-Ming %A Zonderman, Alan B %A Ferrucci, Luigi %A Murray, Sarah S %A Evans, Michele K %A Sotoodehnia, Nona %A Magnani, Jared W %A Avery, Christy L %K Adult %K African Americans %K Cohort Studies %K Electrocardiography %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %X

BACKGROUND: The PR interval, as measured by the resting, standard 12-lead ECG, reflects the duration of atrial/atrioventricular nodal depolarization. Substantial evidence exists for a genetic contribution to PR, including genome-wide association studies that have identified common genetic variants at 9 loci influencing PR in populations of European and Asian descent. However, few studies have examined loci associated with PR in African Americans.

METHODS AND RESULTS: We present results from the largest genome-wide association study to date of PR in 13 415 adults of African descent from 10 cohorts. We tested for association between PR (ms) and ≈2.8 million genotyped and imputed single-nucleotide polymorphisms. Imputation was performed using HapMap 2 YRI and CEU panels. Study-specific results, adjusted for global ancestry and clinical correlates of PR, were meta-analyzed using the inverse variance method. Variation in genome-wide test statistic distributions was noted within studies (λ range: 0.9-1.1), although not after genomic control correction was applied to the overall meta-analysis (λ: 1.008). In addition to generalizing previously reported associations with MEIS1, SCN5A, ARHGAP24, CAV1, and TBX5 to African American populations at the genome-wide significance level (P<5.0 × 10(-8)), we also identified a novel locus: ITGA9, located in a region previously implicated in SCN5A expression. The 3p21 region harboring SCN5A also contained 2 additional independent secondary signals influencing PR (P<5.0 × 10(-8)).

CONCLUSIONS: This study demonstrates the ability to map novel loci in African Americans as well as the generalizability of loci associated with PR across populations of African, European, and Asian descent.

%B Circ Cardiovasc Genet %V 5 %P 639-46 %8 2012 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23139255?dopt=Abstract %R 10.1161/CIRCGENETICS.112.963991 %0 Journal Article %J PLoS Genet %D 2012 %T Novel loci for adiponectin levels and their influence on type 2 diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals. %A Dastani, Zari %A Hivert, Marie-France %A Timpson, Nicholas %A Perry, John R B %A Yuan, Xin %A Scott, Robert A %A Henneman, Peter %A Heid, Iris M %A Kizer, Jorge R %A Lyytikäinen, Leo-Pekka %A Fuchsberger, Christian %A Tanaka, Toshiko %A Morris, Andrew P %A Small, Kerrin %A Isaacs, Aaron %A Beekman, Marian %A Coassin, Stefan %A Lohman, Kurt %A Qi, Lu %A Kanoni, Stavroula %A Pankow, James S %A Uh, Hae-Won %A Wu, Ying %A Bidulescu, Aurelian %A Rasmussen-Torvik, Laura J %A Greenwood, Celia M T %A Ladouceur, Martin %A Grimsby, Jonna %A Manning, Alisa K %A Liu, Ching-Ti %A Kooner, Jaspal %A Mooser, Vincent E %A Vollenweider, Peter %A Kapur, Karen A %A Chambers, John %A Wareham, Nicholas J %A Langenberg, Claudia %A Frants, Rune %A Willems-Vandijk, Ko %A Oostra, Ben A %A Willems, Sara M %A Lamina, Claudia %A Winkler, Thomas W %A Psaty, Bruce M %A Tracy, Russell P %A Brody, Jennifer %A Chen, Ida %A Viikari, Jorma %A Kähönen, Mika %A Pramstaller, Peter P %A Evans, David M %A St Pourcain, Beate %A Sattar, Naveed %A Wood, Andrew R %A Bandinelli, Stefania %A Carlson, Olga D %A Egan, Josephine M %A Böhringer, Stefan %A van Heemst, Diana %A Kedenko, Lyudmyla %A Kristiansson, Kati %A Nuotio, Marja-Liisa %A Loo, Britt-Marie %A Harris, Tamara %A Garcia, Melissa %A Kanaya, Alka %A Haun, Margot %A Klopp, Norman %A Wichmann, H-Erich %A Deloukas, Panos %A Katsareli, Efi %A Couper, David J %A Duncan, Bruce B %A Kloppenburg, Margreet %A Adair, Linda S %A Borja, Judith B %A Wilson, James G %A Musani, Solomon %A Guo, Xiuqing %A Johnson, Toby %A Semple, Robert %A Teslovich, Tanya M %A Allison, Matthew A %A Redline, Susan %A Buxbaum, Sarah G %A Mohlke, Karen L %A Meulenbelt, Ingrid %A Ballantyne, Christie M %A Dedoussis, George V %A Hu, Frank B %A Liu, Yongmei %A Paulweber, Bernhard %A Spector, Timothy D %A Slagboom, P Eline %A Ferrucci, Luigi %A Jula, Antti %A Perola, Markus %A Raitakari, Olli %A Florez, Jose C %A Salomaa, Veikko %A Eriksson, Johan G %A Frayling, Timothy M %A Hicks, Andrew A %A Lehtimäki, Terho %A Smith, George Davey %A Siscovick, David S %A Kronenberg, Florian %A van Duijn, Cornelia %A Loos, Ruth J F %A Waterworth, Dawn M %A Meigs, James B %A Dupuis, Josée %A Richards, J Brent %A Voight, Benjamin F %A Scott, Laura J %A Steinthorsdottir, Valgerdur %A Dina, Christian %A Welch, Ryan P %A Zeggini, Eleftheria %A Huth, Cornelia %A Aulchenko, Yurii S %A Thorleifsson, Gudmar %A McCulloch, Laura J %A Ferreira, Teresa %A Grallert, Harald %A Amin, Najaf %A Wu, Guanming %A Willer, Cristen J %A Raychaudhuri, Soumya %A McCarroll, Steve A %A Hofmann, Oliver M %A Segrè, Ayellet V %A van Hoek, Mandy %A Navarro, Pau %A Ardlie, Kristin %A Balkau, Beverley %A Benediktsson, Rafn %A Bennett, Amanda J %A Blagieva, Roza %A Boerwinkle, Eric %A Bonnycastle, Lori L %A Boström, Kristina Bengtsson %A Bravenboer, Bert %A Bumpstead, Suzannah %A Burtt, Noel P %A Charpentier, Guillaume %A Chines, Peter S %A Cornelis, Marilyn %A Crawford, Gabe %A Doney, Alex S F %A Elliott, Katherine S %A Elliott, Amanda L %A Erdos, Michael R %A Fox, Caroline S %A Franklin, Christopher S %A Ganser, Martha %A Gieger, Christian %A Grarup, Niels %A Green, Todd %A Griffin, Simon %A Groves, Christopher J %A Guiducci, Candace %A Hadjadj, Samy %A Hassanali, Neelam %A Herder, Christian %A Isomaa, Bo %A Jackson, Anne U %A Johnson, Paul R V %A Jørgensen, Torben %A Kao, Wen H L %A Kong, Augustine %A Kraft, Peter %A Kuusisto, Johanna %A Lauritzen, Torsten %A Li, Man %A Lieverse, Aloysius %A Lindgren, Cecilia M %A Lyssenko, Valeriya %A Marre, Michel %A Meitinger, Thomas %A Midthjell, Kristian %A Morken, Mario A %A Narisu, Narisu %A Nilsson, Peter %A Owen, Katharine R %A Payne, Felicity %A Petersen, Ann-Kristin %A Platou, Carl %A Proença, Christine %A Prokopenko, Inga %A Rathmann, Wolfgang %A Rayner, N William %A Robertson, Neil R %A Rocheleau, Ghislain %A Roden, Michael %A Sampson, Michael J %A Saxena, Richa %A Shields, Beverley M %A Shrader, Peter %A Sigurdsson, Gunnar %A Sparsø, Thomas %A Strassburger, Klaus %A Stringham, Heather M %A Sun, Qi %A Swift, Amy J %A Thorand, Barbara %A Tichet, Jean %A Tuomi, Tiinamaija %A van Dam, Rob M %A van Haeften, Timon W %A van Herpt, Thijs %A van Vliet-Ostaptchouk, Jana V %A Walters, G Bragi %A Weedon, Michael N %A Wijmenga, Cisca %A Witteman, Jacqueline %A Bergman, Richard N %A Cauchi, Stephane %A Collins, Francis S %A Gloyn, Anna L %A Gyllensten, Ulf %A Hansen, Torben %A Hide, Winston A %A Hitman, Graham A %A Hofman, Albert %A Hunter, David J %A Hveem, Kristian %A Laakso, Markku %A Morris, Andrew D %A Palmer, Colin N A %A Rudan, Igor %A Sijbrands, Eric %A Stein, Lincoln D %A Tuomilehto, Jaakko %A Uitterlinden, Andre %A Walker, Mark %A Watanabe, Richard M %A Abecasis, Goncalo R %A Boehm, Bernhard O %A Campbell, Harry %A Daly, Mark J %A Hattersley, Andrew T %A Pedersen, Oluf %A Barroso, Inês %A Groop, Leif %A Sladek, Rob %A Thorsteinsdottir, Unnur %A Wilson, James F %A Illig, Thomas %A Froguel, Philippe %A van Duijn, Cornelia M %A Stefansson, Kari %A Altshuler, David %A Boehnke, Michael %A McCarthy, Mark I %A Soranzo, Nicole %A Wheeler, Eleanor %A Glazer, Nicole L %A Bouatia-Naji, Nabila %A Mägi, Reedik %A Randall, Joshua %A Elliott, Paul %A Rybin, Denis %A Dehghan, Abbas %A Hottenga, Jouke Jan %A Song, Kijoung %A Goel, Anuj %A Lajunen, Taina %A Doney, Alex %A Cavalcanti-Proença, Christine %A Kumari, Meena %A Timpson, Nicholas J %A Zabena, Carina %A Ingelsson, Erik %A An, Ping %A O'Connell, Jeffrey %A Luan, Jian'an %A Elliott, Amanda %A McCarroll, Steven A %A Roccasecca, Rosa Maria %A Pattou, François %A Sethupathy, Praveen %A Ariyurek, Yavuz %A Barter, Philip %A Beilby, John P %A Ben-Shlomo, Yoav %A Bergmann, Sven %A Bochud, Murielle %A Bonnefond, Amélie %A Borch-Johnsen, Knut %A Böttcher, Yvonne %A Brunner, Eric %A Bumpstead, Suzannah J %A Chen, Yii-Der Ida %A Chines, Peter %A Clarke, Robert %A Coin, Lachlan J M %A Cooper, Matthew N %A Crisponi, Laura %A Day, Ian N M %A de Geus, Eco J C %A Delplanque, Jerome %A Fedson, Annette C %A Fischer-Rosinsky, Antje %A Forouhi, Nita G %A Franzosi, Maria Grazia %A Galan, Pilar %A Goodarzi, Mark O %A Graessler, Jürgen %A Grundy, Scott %A Gwilliam, Rhian %A Hallmans, Göran %A Hammond, Naomi %A Han, Xijing %A Hartikainen, Anna-Liisa %A Hayward, Caroline %A Heath, Simon C %A Hercberg, Serge %A Hillman, David R %A Hingorani, Aroon D %A Hui, Jennie %A Hung, Joe %A Kaakinen, Marika %A Kaprio, Jaakko %A Kesaniemi, Y Antero %A Kivimaki, Mika %A Knight, Beatrice %A Koskinen, Seppo %A Kovacs, Peter %A Kyvik, Kirsten Ohm %A Lathrop, G Mark %A Lawlor, Debbie A %A Le Bacquer, Olivier %A Lecoeur, Cécile %A Li, Yun %A Mahley, Robert %A Mangino, Massimo %A Martínez-Larrad, María Teresa %A McAteer, Jarred B %A McPherson, Ruth %A Meisinger, Christa %A Melzer, David %A Meyre, David %A Mitchell, Braxton D %A Mukherjee, Sutapa %A Naitza, Silvia %A Neville, Matthew J %A Orrù, Marco %A Pakyz, Ruth %A Paolisso, Giuseppe %A Pattaro, Cristian %A Pearson, Daniel %A Peden, John F %A Pedersen, Nancy L %A Pfeiffer, Andreas F H %A Pichler, Irene %A Polasek, Ozren %A Posthuma, Danielle %A Potter, Simon C %A Pouta, Anneli %A Province, Michael A %A Rayner, Nigel W %A Rice, Kenneth %A Ripatti, Samuli %A Rivadeneira, Fernando %A Rolandsson, Olov %A Sandbaek, Annelli %A Sandhu, Manjinder %A Sanna, Serena %A Sayer, Avan Aihie %A Scheet, Paul %A Seedorf, Udo %A Sharp, Stephen J %A Shields, Beverley %A Sigurðsson, Gunnar %A Sijbrands, Eric J G %A Silveira, Angela %A Simpson, Laila %A Singleton, Andrew %A Smith, Nicholas L %A Sovio, Ulla %A Swift, Amy %A Syddall, Holly %A Syvänen, Ann-Christine %A Tönjes, Anke %A Uitterlinden, André G %A van Dijk, Ko Willems %A Varma, Dhiraj %A Visvikis-Siest, Sophie %A Vitart, Veronique %A Vogelzangs, Nicole %A Waeber, Gérard %A Wagner, Peter J %A Walley, Andrew %A Ward, Kim L %A Watkins, Hugh %A Wild, Sarah H %A Willemsen, Gonneke %A Witteman, Jaqueline C M %A Yarnell, John W G %A Zelenika, Diana %A Zethelius, Björn %A Zhai, Guangju %A Zhao, Jing Hua %A Zillikens, M Carola %A Borecki, Ingrid B %A Meneton, Pierre %A Magnusson, Patrik K E %A Nathan, David M %A Williams, Gordon H %A Silander, Kaisa %A Bornstein, Stefan R %A Schwarz, Peter %A Spranger, Joachim %A Karpe, Fredrik %A Shuldiner, Alan R %A Cooper, Cyrus %A Serrano-Ríos, Manuel %A Lind, Lars %A Palmer, Lyle J %A Hu, Frank B %A Franks, Paul W %A Ebrahim, Shah %A Marmot, Michael %A Kao, W H Linda %A Pramstaller, Peter Paul %A Wright, Alan F %A Stumvoll, Michael %A Hamsten, Anders %A Buchanan, Thomas A %A Valle, Timo T %A Rotter, Jerome I %A Penninx, Brenda W J H %A Boomsma, Dorret I %A Cao, Antonio %A Scuteri, Angelo %A Schlessinger, David %A Uda, Manuela %A Ruokonen, Aimo %A Jarvelin, Marjo-Riitta %A Peltonen, Leena %A Mooser, Vincent %A Sladek, Robert %A Musunuru, Kiran %A Smith, Albert V %A Edmondson, Andrew C %A Stylianou, Ioannis M %A Koseki, Masahiro %A Pirruccello, James P %A Chasman, Daniel I %A Johansen, Christopher T %A Fouchier, Sigrid W %A Peloso, Gina M %A Barbalic, Maja %A Ricketts, Sally L %A Bis, Joshua C %A Feitosa, Mary F %A Orho-Melander, Marju %A Melander, Olle %A Li, Xiaohui %A Li, Mingyao %A Cho, Yoon Shin %A Go, Min Jin %A Kim, Young Jin %A Lee, Jong-Young %A Park, Taesung %A Kim, Kyunga %A Sim, Xueling %A Ong, Rick Twee-Hee %A Croteau-Chonka, Damien C %A Lange, Leslie A %A Smith, Joshua D %A Ziegler, Andreas %A Zhang, Weihua %A Zee, Robert Y L %A Whitfield, John B %A Thompson, John R %A Surakka, Ida %A Spector, Tim D %A Smit, Johannes H %A Sinisalo, Juha %A Scott, James %A Saharinen, Juha %A Sabatti, Chiara %A Rose, Lynda M %A Roberts, Robert %A Rieder, Mark %A Parker, Alex N %A Paré, Guillaume %A O'Donnell, Christopher J %A Nieminen, Markku S %A Nickerson, Deborah A %A Montgomery, Grant W %A McArdle, Wendy %A Masson, David %A Martin, Nicholas G %A Marroni, Fabio %A Lucas, Gavin %A Luben, Robert %A Lokki, Marja-Liisa %A Lettre, Guillaume %A Launer, Lenore J %A Lakatta, Edward G %A Laaksonen, Reijo %A Kyvik, Kirsten O %A König, Inke R %A Khaw, Kay-Tee %A Kaplan, Lee M %A Johansson, Asa %A Janssens, A Cecile J W %A Igl, Wilmar %A Hovingh, G Kees %A Hengstenberg, Christian %A Havulinna, Aki S %A Hastie, Nicholas D %A Harris, Tamara B %A Haritunians, Talin %A Hall, Alistair S %A Groop, Leif C %A Gonzalez, Elena %A Freimer, Nelson B %A Erdmann, Jeanette %A Ejebe, Kenechi G %A Döring, Angela %A Dominiczak, Anna F %A Demissie, Serkalem %A Deloukas, Panagiotis %A de Faire, Ulf %A Crawford, Gabriel %A Chen, Yii-der I %A Caulfield, Mark J %A Boekholdt, S Matthijs %A Assimes, Themistocles L %A Quertermous, Thomas %A Seielstad, Mark %A Wong, Tien Y %A Tai, E-Shyong %A Feranil, Alan B %A Kuzawa, Christopher W %A Taylor, Herman A %A Gabriel, Stacey B %A Holm, Hilma %A Gudnason, Vilmundur %A Krauss, Ronald M %A Ordovas, Jose M %A Munroe, Patricia B %A Kooner, Jaspal S %A Tall, Alan R %A Hegele, Robert A %A Kastelein, John J P %A Schadt, Eric E %A Strachan, David P %A Reilly, Muredach P %A Samani, Nilesh J %A Schunkert, Heribert %A Cupples, L Adrienne %A Sandhu, Manjinder S %A Ridker, Paul M %A Rader, Daniel J %A Kathiresan, Sekar %K Adiponectin %K African Americans %K Asian Continental Ancestry Group %K Cholesterol, HDL %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Female %K Gene Expression %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Glucose Tolerance Test %K Humans %K Insulin Resistance %K Male %K Metabolic Networks and Pathways %K Polymorphism, Single Nucleotide %K Waist-Hip Ratio %X

Circulating levels of adiponectin, a hormone produced predominantly by adipocytes, are highly heritable and are inversely associated with type 2 diabetes mellitus (T2D) and other metabolic traits. We conducted a meta-analysis of genome-wide association studies in 39,883 individuals of European ancestry to identify genes associated with metabolic disease. We identified 8 novel loci associated with adiponectin levels and confirmed 2 previously reported loci (P = 4.5×10(-8)-1.2×10(-43)). Using a novel method to combine data across ethnicities (N = 4,232 African Americans, N = 1,776 Asians, and N = 29,347 Europeans), we identified two additional novel loci. Expression analyses of 436 human adipocyte samples revealed that mRNA levels of 18 genes at candidate regions were associated with adiponectin concentrations after accounting for multiple testing (p<3×10(-4)). We next developed a multi-SNP genotypic risk score to test the association of adiponectin decreasing risk alleles on metabolic traits and diseases using consortia-level meta-analytic data. This risk score was associated with increased risk of T2D (p = 4.3×10(-3), n = 22,044), increased triglycerides (p = 2.6×10(-14), n = 93,440), increased waist-to-hip ratio (p = 1.8×10(-5), n = 77,167), increased glucose two hours post oral glucose tolerance testing (p = 4.4×10(-3), n = 15,234), increased fasting insulin (p = 0.015, n = 48,238), but with lower in HDL-cholesterol concentrations (p = 4.5×10(-13), n = 96,748) and decreased BMI (p = 1.4×10(-4), n = 121,335). These findings identify novel genetic determinants of adiponectin levels, which, taken together, influence risk of T2D and markers of insulin resistance.

%B PLoS Genet %V 8 %P e1002607 %8 2012 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22479202?dopt=Abstract %R 10.1371/journal.pgen.1002607 %0 Journal Article %J Circulation %D 2012 %T Racial differences in risks for first cardiovascular events and noncardiovascular death: the Atherosclerosis Risk in Communities study, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis. %A Feinstein, Matthew %A Ning, Hongyan %A Kang, Joseph %A Bertoni, Alain %A Carnethon, Mercedes %A Lloyd-Jones, Donald M %K African Continental Ancestry Group %K Age Factors %K Aged %K Aged, 80 and over %K Atherosclerosis %K Cardiovascular Diseases %K Cohort Studies %K Continental Population Groups %K Ethnic Groups %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Residence Characteristics %K Risk Factors %X

BACKGROUND: No studies have compared first cardiovascular disease (CVD) events and non-CVD death between races in a competing risks framework, which examines risks for numerous events simultaneously.

METHODS AND RESULTS: We used competing Cox models to estimate hazards for first CVD events and non-CVD death within and between races in 3 multicenter, National Heart, Lung, and Blood Institute-sponsored cohorts. Of 14 569 Atherosclerosis Risk in Communities (ARIC) study participants aged 45 to 64 years with mean follow-up of 10.5 years, 11.6% had CVD and 5.0% had non-CVD death as first events; among 4237 Cardiovascular Health Study (CHS) study participants aged 65 to 84 years and followed for 8.5 years, these figures were 43.2% and 15.7%, respectively. Middle-aged blacks were significantly more likely than whites to experience any CVD as a first event; this disparity disappeared by older adulthood and after adjustment for CVD risk factors. The pattern of results was similar for Multi-Ethnic Study of Atherosclerosis (MESA) participants. Traditional Cox and competing risks models yielded different results for coronary heart disease risk. Black men appeared somewhat more likely than white men to experience coronary heart disease with use of a standard Cox model (hazard ratio 1.06; 95% CI 0.90, 1.26), whereas they appeared less likely than white men to have a first coronary heart disease event with use of a competing risks model (hazard ratio, 0.77; 95% CI, 0.60, 1.00).

CONCLUSIONS: CVD affects blacks at an earlier age than whites; this may be attributable in part to elevated CVD risk factor levels among blacks. Racial disparities in first CVD incidence disappear by older adulthood. Competing risks analyses may yield somewhat different results than traditional Cox models and provide a complementary approach to examining risks for first CVD events.

%B Circulation %V 126 %P 50-9 %8 2012 Jul 03 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22693351?dopt=Abstract %R 10.1161/CIRCULATIONAHA.111.057232 %0 Journal Article %J Arch Ophthalmol %D 2012 %T Retinal microvascular signs and disability in the Cardiovascular Health Study. %A Kim, Dae Hyun %A Chaves, Paulo H M %A Newman, Anne B %A Klein, Ronald %A Sarnak, Mark J %A Newton, Elizabeth %A Strotmeyer, Elsa S %A Burke, Gregory L %A Lipsitz, Lewis A %K Activities of Daily Living %K Aged %K Carotid Artery Diseases %K Cognition Disorders %K Diagnostic Techniques, Ophthalmological %K Disability Evaluation %K Follow-Up Studies %K Humans %K Hypertension %K Incidence %K Kaplan-Meier Estimate %K Microcirculation %K Predictive Value of Tests %K Prevalence %K Prognosis %K Prospective Studies %K Retinal Diseases %K Risk Factors %K Smoking %X

OBJECTIVE: To study the associations of retinal microvascular changes, which are associated with systemic conditions and cognitive decline, with disability in performing activities of daily living (ADL).

DESIGN: Prospective cohort study of 1487 community-dwelling participants in the Cardiovascular Health Study (mean age, 78 years) who were free of ADL disability and had available data on retinal signs and carotid intima-media thickness at the 1998-1999 visit. Main outcome measures were incident ADL disability, defined as self-reported difficulty in performing any ADL, by the presence of retinal signs and advanced carotid atherosclerosis, defined by carotid intima-media thickness in the 80th percentile or more or 25% or more stenosis, and potential mediation by cerebral microvascular disease on brain imaging or by executive dysfunction, slow gait, and depressive mood, which are symptoms of frontal subcortical dysfunction.

RESULTS: During the median follow-up of 3.1 years (maximum, 7.8 years), participants with 2 or more retinal signs had a higher rate of disability than those with fewer than 2 retinal signs (10.1% vs 7.1%; adjusted hazard ratio, 1.45; 95% confidence interval, 1.24-1.69; P < .001). There was no evidence of interaction by advanced carotid atherosclerosis (P > .10). The association seemed to be partially mediated by executive dysfunction, slow gait, and depressive symptoms but not by cerebral microvascular disease on brain imaging.

CONCLUSIONS: These results provide further support for the pathophysiologic and prognostic significance of microvascular disease in age-related disability. However, it remains to be determined how to best use retinal photography in clinical risk prediction.

%B Arch Ophthalmol %V 130 %P 350-6 %8 2012 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22084159?dopt=Abstract %R 10.1001/archophthalmol.2011.360 %0 Journal Article %J Ann Neurol %D 2012 %T Risk of intraparenchymal hemorrhage with magnetic resonance imaging-defined leukoaraiosis and brain infarcts. %A Folsom, Aaron R %A Yatsuya, Hiroshi %A Mosley, Thomas H %A Psaty, Bruce M %A Longstreth, W T %K Cerebral Infarction %K Cohort Studies %K Female %K Humans %K Incidence %K Intracranial Hemorrhages %K Leukoaraiosis %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Risk Factors %X

OBJECTIVE: To determine whether the burden of leukoaraiosis and the number of brain infarcts, defined by magnetic resonance imaging (MRI), are prospectively and independently associated with intraparenchymal hemorrhage (IPH) incidence in a pooled population-based study.

METHODS: Among 4,872 participants initially free of clinical stroke in the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study, we assessed white matter grade (range, 0-9), reflecting increasing leukoaraiosis, and brain infarcts using MRI. Over a median of 13 years of follow-up, 71 incident, spontaneous IPH events occurred.

RESULTS: After adjustment for other IPH risk factors, the hazard ratios (95% confidence intervals) across white matter grades 0 to 1, 2, 3, and 4 to 9 were 1.00, 1.68 (0.86-3.30), 3.52 (1.80-6.89), and 3.96 (1.90-8.27), respectively (p for trend <0.0001). These hazard ratios were weakened only modestly (p for trend = 0.0003) with adjustment for MRI-defined brain infarcts. The IPH hazard ratios for 0, 1, 2, or ≥3 MRI-defined brain infarcts were 1.00, 1.97 (1.10-3.54), 2.00 (0.83-4.78), and 3.12 (1.31-7.43) (p for trend = 0.002), but these were substantially attenuated when adjusted for white matter grade (p for trend = 0.049).

INTERPRETATION: Greater MRI-defined burden of leukoaraiosis is a risk factor for spontaneous IPH. Spontaneous IPH should be added to the growing list of potential poor outcomes in people with leukoaraiosis.

%B Ann Neurol %V 71 %P 552-9 %8 2012 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22522444?dopt=Abstract %R 10.1002/ana.22690 %0 Journal Article %J Clin Pharmacol Ther %D 2012 %T A screening study of drug-drug interactions in cerivastatin users: an adverse effect of clopidogrel. %A Floyd, J S %A Kaspera, R %A Marciante, K D %A Weiss, N S %A Heckbert, S R %A Lumley, T %A Wiggins, K L %A Tamraz, B %A Kwok, P-Y %A Totah, R A %A Psaty, B M %K Adverse Drug Reaction Reporting Systems %K Aged %K Aged, 80 and over %K Aryl Hydrocarbon Hydroxylases %K Case-Control Studies %K Cytochrome P-450 CYP2C8 %K Cytochrome P-450 CYP3A %K Cytochrome P-450 CYP3A Inhibitors %K Drug Interactions %K Female %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Male %K Platelet Aggregation Inhibitors %K Pyridines %K Rhabdomyolysis %K Ticlopidine %X

An analysis of a case-control study of rhabdomyolysis was conducted to screen for previously unrecognized cytochrome P450 enzyme (CYP) 2C8 inhibitors that may cause other clinically important drug-drug interactions. Medication use in cases of rhabdomyolysis using cerivastatin (n = 72) was compared with that in controls using atorvastatin (n = 287) for the period 1998-2001. The use of clopidogrel was strongly associated with rhabdomyolysis (odds ratio (OR) 29.6; 95% confidence interval (CI), 6.1-143). In a replication effort that used the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS), it was found that clopidogrel was used more commonly in patients with rhabdomyolysis receiving cerivastatin (17%) than in those receiving atorvastatin (0%, OR infinity; 95% CI = 5.2-infinity). Several medications were tested in vitro for their potential to cause drug-drug interactions. Clopidogrel, rosiglitazone, and montelukast were the most potent inhibitors of cerivastatin metabolism. Clopidogrel and its metabolites also inhibited cerivastatin metabolism in human hepatocytes. These epidemiological and in vitro findings suggest that clopidogrel may cause clinically important, dose-dependent drug-drug interactions with other medications metabolized by CYP2C8.

%B Clin Pharmacol Ther %V 91 %P 896-904 %8 2012 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/22419147?dopt=Abstract %R 10.1038/clpt.2011.295 %0 Journal Article %J Ann Intern Med %D 2012 %T Serum 25-hydroxyvitamin D concentration and risk for major clinical disease events in a community-based population of older adults: a cohort study. %A de Boer, Ian H %A Levin, Gregory %A Robinson-Cohen, Cassianne %A Biggs, Mary L %A Hoofnagle, Andy N %A Siscovick, David S %A Kestenbaum, Bryan %K Aged %K Cause of Death %K Female %K Follow-Up Studies %K Hip Fractures %K Humans %K Male %K Myocardial Infarction %K Neoplasms %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Seasons %K United States %K Vitamin D %K Vitamin D Deficiency %X

BACKGROUND: Circulating concentrations of 25-hydroxyvitamin D [25-(OH)D] are used to define vitamin D deficiency. Current clinical 25-(OH)D targets based on associations with intermediate markers of bone metabolism may not reflect optimal levels for other chronic diseases and do not account for known seasonal variation in 25-(OH)D concentration.

OBJECTIVE: To evaluate the relationship of 25-(OH)D concentration with the incidence of major clinical disease events that are pathophysiologically relevant to vitamin D.

DESIGN: Cohort study.

SETTING: The Cardiovascular Health Study conducted in 4 U.S. communities. Data from 1992 to 2006 were included in this analysis.

PARTICIPANTS: 1621 white older adults.

MEASUREMENTS: Serum 25-(OH)D concentration (using a high-performance liquid chromatography-tandem mass spectrometry assay that conforms to National Institute of Standards and Technology reference standards) and associations with time to a composite outcome of incident hip fracture, myocardial infarction, cancer, or death.

RESULTS: Over a median 11-year follow-up, the composite outcome occurred in 1018 participants (63%). Defining events included 137 hip fractures, 186 myocardial infarctions, 335 incidences of cancer, and 360 deaths. The association of low 25-(OH)D concentration with risk for the composite outcome varied by season (P = 0.057). A concentration lower than a season-specific Z score of -0.54 best discriminated risk for the composite outcome and was associated with a 24% higher risk in adjusted analyses (95% CI, 9% to 42%). Corresponding season-specific 25-(OH)D concentrations were 43, 50, 61, and 55 nmol/L (17, 20, 24, and 22 ng/mL) in winter, spring, summer, and autumn, respectively.

LIMITATION: The observational study was restricted to white participants.

CONCLUSION: Threshold concentrations of 25-(OH)D associated with increased risk for relevant clinical disease events center near 50 nmol/L (20 ng/mL). Season-specific targets for 25-(OH)D concentration may be more appropriate than static targets when evaluating health risk.

PRIMARY FUNDING SOURCE: National Institutes of Health.

%B Ann Intern Med %V 156 %P 627-34 %8 2012 May 01 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22547472?dopt=Abstract %R 10.7326/0003-4819-156-9-201205010-00004 %0 Journal Article %J Age Ageing %D 2012 %T Slower gait, slower information processing and smaller prefrontal area in older adults. %A Rosano, Caterina %A Studenski, Stephanie A %A Aizenstein, Howard J %A Boudreau, Robert M %A Longstreth, William T %A Newman, Anne B %K Affect %K Aged %K Aged, 80 and over %K Aging %K Attention %K Body Mass Index %K Cross-Sectional Studies %K Female %K Gait Disorders, Neurologic %K Geriatric Assessment %K Humans %K Male %K Memory %K Mental Disorders %K Mental Processes %K Muscle Strength %K Neuroimaging %K Neuropsychological Tests %K Prefrontal Cortex %K Prevalence %K Walking %X

BACKGROUND: Slower gait in older adults is related to smaller volume of the prefrontal area (PFAv). The pathways underlying this association have not yet been explored. Understanding slowing gait could help improve function in older age. We examine whether the association between smaller PFAv and slower gait is explained by lower performance on numerous neuropsychological tests.

HYPOTHESIS: We hypothesise that slower information processing explains this association, while tests of language or memory will not.

METHODS: Data on brain imaging, neuropsychological tests (information processing speed, visuospatial attention, memory, language, mood) and time to walk 15 feet were obtained in 214 adults (73.3 years, 62% women) free from stroke and dementia. Covariates included central (white matter hyperintensities, vision) and peripheral contributors of gait (vibration sense, muscle strength, arthritis, body mass index), demographics (age, race, gender, education), as well as markers of prevalent vascular diseases (cardiovascular disease, diabetes and ankle arm index).

RESULTS: In linear regression models, smaller PFAv was associated with slower time to walk independent of covariates. This association was no longer significant after adding information processing speed to the model. None of the other neuropsychological tests significantly attenuated this association.

CONCLUSIONS: We conclude that smaller PFAv may contribute to slower gait through slower information processing. Future longitudinal studies are warranted to examine the casual relationship between focal brain atrophy with slowing in information processing and gait.

%B Age Ageing %V 41 %P 58-64 %8 2012 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21965414?dopt=Abstract %R 10.1093/ageing/afr113 %0 Journal Article %J Arch Intern Med %D 2012 %T Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. %A Collet, Tinh-Hai %A Gussekloo, Jacobijn %A Bauer, Douglas C %A den Elzen, Wendy P J %A Cappola, Anne R %A Balmer, Philippe %A Iervasi, Giorgio %A Asvold, Bjørn O %A Sgarbi, José A %A Völzke, Henry %A Gencer, Bariş %A Maciel, Rui M B %A Molinaro, Sabrina %A Bremner, Alexandra %A Luben, Robert N %A Maisonneuve, Patrick %A Cornuz, Jacques %A Newman, Anne B %A Khaw, Kay-Tee %A Westendorp, Rudi G J %A Franklyn, Jayne A %A Vittinghoff, Eric %A Walsh, John P %A Rodondi, Nicolas %K Adolescent %K Adult %K Age Distribution %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Cause of Death %K Cohort Studies %K Coronary Artery Disease %K Female %K Humans %K Hyperthyroidism %K Male %K Middle Aged %K Prognosis %K Prospective Studies %K Risk Assessment %K Severity of Illness Index %K Sex Distribution %K Survival Analysis %K Switzerland %K Thyroid Function Tests %K Thyrotropin %K Young Adult %X

BACKGROUND: Data from prospective cohort studies regarding the association between subclinical hyperthyroidism and cardiovascular outcomes are conflicting.We aimed to assess the risks of total and coronary heart disease (CHD) mortality, CHD events, and atrial fibrillation (AF) associated with endogenous subclinical hyperthyroidism among all available large prospective cohorts.

METHODS: Individual data on 52 674 participants were pooled from 10 cohorts. Coronary heart disease events were analyzed in 22 437 participants from 6 cohorts with available data, and incident AF was analyzed in 8711 participants from 5 cohorts. Euthyroidism was defined as thyrotropin level between 0.45 and 4.49 mIU/L and endogenous subclinical hyperthyroidism as thyrotropin level lower than 0.45 mIU/L with normal free thyroxine levels, after excluding those receiving thyroid-altering medications.

RESULTS: Of 52 674 participants, 2188 (4.2%) had subclinical hyperthyroidism. During follow-up, 8527 participants died (including 1896 from CHD), 3653 of 22 437 had CHD events, and 785 of 8711 developed AF. In age- and sex-adjusted analyses, subclinical hyperthyroidism was associated with increased total mortality (hazard ratio[HR], 1.24, 95% CI, 1.06-1.46), CHD mortality (HR,1.29; 95% CI, 1.02-1.62), CHD events (HR, 1.21; 95%CI, 0.99-1.46), and AF (HR, 1.68; 95% CI, 1.16-2.43).Risks did not differ significantly by age, sex, or preexisting cardiovascular disease and were similar after further adjustment for cardiovascular risk factors, with attributable risk of 14.5% for total mortality to 41.5% forAF in those with subclinical hyperthyroidism. Risks for CHD mortality and AF (but not other outcomes) were higher for thyrotropin level lower than 0.10 mIU/L compared with thyrotropin level between 0.10 and 0.44 mIU/L(for both, P value for trend, .03).

CONCLUSION: Endogenous subclinical hyperthyroidism is associated with increased risks of total, CHD mortality, and incident AF, with highest risks of CHD mortality and AF when thyrotropin level is lower than 0.10 mIU/L.

%B Arch Intern Med %V 172 %P 799-809 %8 2012 May 28 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/22529182?dopt=Abstract %R 10.1001/archinternmed.2012.402 %0 Journal Article %J Circulation %D 2012 %T Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. %A Gencer, Bariş %A Collet, Tinh-Hai %A Virgini, Vanessa %A Bauer, Douglas C %A Gussekloo, Jacobijn %A Cappola, Anne R %A Nanchen, David %A den Elzen, Wendy P J %A Balmer, Philippe %A Luben, Robert N %A Iacoviello, Massimo %A Triggiani, Vincenzo %A Cornuz, Jacques %A Newman, Anne B %A Khaw, Kay-Tee %A Jukema, J Wouter %A Westendorp, Rudi G J %A Vittinghoff, Eric %A Aujesky, Drahomir %A Rodondi, Nicolas %K Adult %K Aged %K Aged, 80 and over %K Comorbidity %K Female %K Follow-Up Studies %K Heart Failure %K Humans %K Hypothyroidism %K Male %K Middle Aged %K Prospective Studies %K Risk %K Risk Factors %K Sensitivity and Specificity %K Thyrotropin %K Thyroxine %X

BACKGROUND: American College of Cardiology/American Heart Association guidelines for the diagnosis and management of heart failure recommend investigating exacerbating conditions such as thyroid dysfunction, but without specifying the impact of different thyroid-stimulation hormone (TSH) levels. Limited prospective data exist on the association between subclinical thyroid dysfunction and heart failure events.

METHODS AND RESULTS: We performed a pooled analysis of individual participant data using all available prospective cohorts with thyroid function tests and subsequent follow-up of heart failure events. Individual data on 25 390 participants with 216 248 person-years of follow-up were supplied from 6 prospective cohorts in the United States and Europe. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L, subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L, and subclinical hyperthyroidism as TSH <0.45 mIU/L, the last two with normal free thyroxine levels. Among 25 390 participants, 2068 (8.1%) had subclinical hypothyroidism and 648 (2.6%) had subclinical hyperthyroidism. In age- and sex-adjusted analyses, risks of heart failure events were increased with both higher and lower TSH levels (P for quadratic pattern <0.01); the hazard ratio was 1.01 (95% confidence interval, 0.81-1.26) for TSH of 4.5 to 6.9 mIU/L, 1.65 (95% confidence interval, 0.84-3.23) for TSH of 7.0 to 9.9 mIU/L, 1.86 (95% confidence interval, 1.27-2.72) for TSH of 10.0 to 19.9 mIU/L (P for trend <0.01) and 1.31 (95% confidence interval, 0.88-1.95) for TSH of 0.10 to 0.44 mIU/L and 1.94 (95% confidence interval, 1.01-3.72) for TSH <0.10 mIU/L (P for trend=0.047). Risks remained similar after adjustment for cardiovascular risk factors.

CONCLUSION: Risks of heart failure events were increased with both higher and lower TSH levels, particularly for TSH ≥10 and <0.10 mIU/L.

%B Circulation %V 126 %P 1040-9 %8 2012 Aug 28 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22821943?dopt=Abstract %R 10.1161/CIRCULATIONAHA.112.096024 %0 Journal Article %J Circ Arrhythm Electrophysiol %D 2012 %T Trans-fatty acid consumption and heart rate variability in 2 separate cohorts of older and younger adults. %A Soares-Miranda, Luisa %A Stein, Phyllis K %A Imamura, Fumiaki %A Sattelmair, Jacob %A Lemaitre, Rozenn N %A Siscovick, David S %A Mota, Jorge %A Mozaffarian, Dariush %K Adolescent %K Age Factors %K Aged %K Aging %K Arrhythmias, Cardiac %K Cohort Studies %K Cross-Sectional Studies %K Dietary Fats %K Electrocardiography, Ambulatory %K Feeding Behavior %K Female %K Heart Rate %K Humans %K Linear Models %K Longitudinal Studies %K Male %K Multivariate Analysis %K Portugal %K Predictive Value of Tests %K Prospective Studies %K Risk Assessment %K Risk Factors %K Surveys and Questionnaires %K Trans Fatty Acids %K United States %K Young Adult %X

BACKGROUND: Trans-fatty acid (TFA) consumption is associated with risk of coronary heart disease, and trans-18:2, but not trans-18:1, in red blood cell membranes has been associated with sudden cardiac arrest. Abnormal heart rate variability (HRV) reflects autonomic dysfunction and predicts cardiac death. Relationships between TFA consumption and HRV remain understudied. We determined whether total TFA consumption, as well as trans-18:1 and trans-18:2 TFA consumption, was independently associated with HRV in 2 independent cohorts in the United States and Portugal.

METHODS AND RESULTS: In 2 independent cohorts of older US adults (Cardiovascular Health Study [CHS], age 72±5 years, 1989/1995) and young Portuguese adults (Porto, age 19±2 years, 2008/2010), we assessed habitual TFA intake by food frequency questionnaires in CHS (separately estimating trans-18:1 and trans-18:2) and multiple 24-hour recalls in Porto (estimating total TFA only, which in a subset correlated with circulating trans-18:2 but not trans-18:1, suggesting that we captured the former). HRV was assessed using 24-hour Holters in CHS (n=1076) and repeated short-term (5-minute) ECGs in Porto (n=160). We used multivariate-adjusted linear regression to relate TFA consumption to HRV cross-sectionally (CHS, Porto) and longitudinally (CHS). In CHS, higher trans-18:2 consumption was associated with lower 24-hour SD of all normal-to-normal intervals both cross-sectionally (-12%; 95% CI, -19% to -6%; P=0.001) and longitudinally (-15%; 95% CI, -25% to -4%; P= 0.009) and lower 24-hour SD of 5-minute average N-N intervals and mean of the 5-minute SD of N-N intervals calculated over 24 hours (P<0.05 each). Higher trans-18:1 consumption in CHS was associated with more favorable 24-hour HRV in particular time-domain indices (24-hour SD of all normal-to-normal intervals, SD of 5-minute average N-N intervals, mean of the 5-minute SD of N-N intervals calculated over 24 hours; P<0.05 each). In Porto, each higher SD TFA consumption was associated with 4% lower 5-minute 24-hour SD of all normal-to-normal intervals (95% CI, -8% to -1%; P=0.04) and 7% lower 5-minute square root of the mean of the squares of successive N-N differences (95% CI, -13% to -1%; P=0.04).

CONCLUSIONS: Trans-18:2 consumption is associated with specific, less favorable indices of HRV in both older and young adults. Trans-18:1 consumption is associated with more favorable HRV indices in older adults. Our results support the need to investigate potential HRV-related mechanisms, whereby trans-18:2 may increase arrhythmic risk.

%B Circ Arrhythm Electrophysiol %V 5 %P 728-38 %8 2012 Aug 01 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22772898?dopt=Abstract %R 10.1161/CIRCEP.111.966259 %0 Journal Article %J Cytokine %D 2012 %T Transforming growth factor beta-1 and incidence of heart failure in older adults: the Cardiovascular Health Study. %A Glazer, Nicole L %A Macy, Elizabeth M %A Lumley, Thomas %A Smith, Nicholas L %A Reiner, Alex P %A Psaty, Bruce M %A King, George L %A Tracy, Russell P %A Siscovick, David S %K Aged %K Case-Control Studies %K Health %K Heart Failure %K Humans %K Incidence %K Transforming Growth Factor beta1 %K United States %X

CONTEXT: Transforming growth factor-beta1 (TGF-B1) is a highly pleiotropic cytokine whose functions include a central role in the induction of fibrosis.

OBJECTIVE: To investigate the hypothesis that elevated plasma levels of TGF-B1 are positively associated with incident heart failure (HF).

PARTICIPANTS AND METHODS: The hypotheses were tested using a two-phase case-control study design, ancillary to the Cardiovascular Health Study - a longitudinal, population-based cohort study. Cases were defined as having an incident HF event after their 1992-1993 exam and controls were free of HF at follow-up. TGF-B1 was measured using plasma collected in 1992-1993 and data from 89 cases and 128 controls were used for analysis. The association between TGF-B1 and risk of HF was evaluated using the weighted likelihood method, and odds ratios (OR) for risk of HF were calculated for TGF-B1 as a continuous linear variable and across quartiles of TGF-B1.

RESULTS: The OR for HF was 1.88 (95% confidence intervals [CI] 1.26-2.81) for each nanogram increase in TGF-B1, and the OR for the highest quartile (compared to the lowest) of TGF-B1 was 5.79 (95% CI 1.65-20.34), after adjustment for age, sex, C-reactive protein, platelet count and digoxin use. Further adjustment with other covariates did not change the results.

CONCLUSIONS: Higher levels of plasma TGF-B1 were associated with an increased risk of incident heart failure among older adults. However, further study is needed in larger samples to confirm these findings.

%B Cytokine %V 60 %P 341-5 %8 2012 Nov %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/22878343?dopt=Abstract %R 10.1016/j.cyto.2012.07.013 %0 Journal Article %J Genetics %D 2012 %T Ultraconserved elements in the human genome: association and transmission analyses of highly constrained single-nucleotide polymorphisms. %A Chiang, Charleston W K %A Liu, Ching-Ti %A Lettre, Guillaume %A Lange, Leslie A %A Jorgensen, Neal W %A Keating, Brendan J %A Vedantam, Sailaja %A Nock, Nora L %A Franceschini, Nora %A Reiner, Alex P %A Demerath, Ellen W %A Boerwinkle, Eric %A Rotter, Jerome I %A Wilson, James G %A North, Kari E %A Papanicolaou, George J %A Cupples, L Adrienne %A Murabito, Joanne M %A Hirschhorn, Joel N %K Alleles %K Animals %K Body Height %K Body Mass Index %K Child %K Conserved Sequence %K Dogs %K Evolution, Molecular %K Female %K Genetic Fitness %K Genetic Variation %K Genome, Human %K Genotype %K Humans %K Inheritance Patterns %K Male %K Mice %K Pedigree %K Phenotype %K Polymorphism, Single Nucleotide %K Rats %K Reproduction %K Young Adult %X

Ultraconserved elements in the human genome likely harbor important biological functions as they are dosage sensitive and are able to direct tissue-specific expression. Because they are under purifying selection, variants in these elements may have a lower frequency in the population but a higher likelihood of association with complex traits. We tested a set of highly constrained SNPs (hcSNPs) distributed genome-wide among ultraconserved and nearly ultraconserved elements for association with seven traits related to reproductive (age at natural menopause, number of children, age at first child, and age at last child) and overall [longevity, body mass index (BMI), and height] fitness. Using up to 24,047 European-American samples from the National Heart, Lung, and Blood Institute Candidate Gene Association Resource (CARe), we observed an excess of associations with BMI and height. In an independent replication panel the most strongly associated SNPs showed an 8.4-fold enrichment of associations at the nominal level, including three variants in previously identified loci and one in a locus (DENND1A) previously shown to be associated with polycystic ovary syndrome. Finally, using 1430 family trios, we showed that the transmissions from heterozygous parents to offspring of the derived alleles of rare (frequency ≤ 0.5%) hcSNPs are not biased, particularly after adjusting for the rates of genotype missingness and error in the data. The lack of transmission bias ruled out an immediately and strongly deleterious effect due to the rare derived alleles, consistent with the observation that mice homozygous for the deletion of ultraconserved elements showed no overt phenotype. Our study also illustrated the importance of carefully modeling potential technical confounders when analyzing genotype data of rare variants.

%B Genetics %V 192 %P 253-66 %8 2012 Sep %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22714408?dopt=Abstract %R 10.1534/genetics.112.141945 %0 Journal Article %J Invest Ophthalmol Vis Sci %D 2012 %T Variation in the lysyl oxidase (LOX) gene is associated with keratoconus in family-based and case-control studies. %A Bykhovskaya, Yelena %A Li, Xiaohui %A Epifantseva, Irina %A Haritunians, Talin %A Siscovick, David %A Aldave, Anthony %A Szczotka-Flynn, Loretta %A Iyengar, Sudha K %A Taylor, Kent D %A Rotter, Jerome I %A Rabinowitz, Yaron S %K Case-Control Studies %K Cornea %K Corneal Topography %K DNA %K Family %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Keratoconus %K Polymorphism, Genetic %K Protein-Lysine 6-Oxidase %X

PURPOSE: Keratoconus is a bilateral noninflammatory progressive corneal disorder with complex genetic inheritance and a common cause for cornea transplantation in young adults. A genomewide linkage scan in keratoconus families identified a locus at 5q23.2, overlapping the gene coding for the lysyl oxidase (LOX). LOX encodes an enzyme responsible for collagen cross-linking in a variety of tissues including the cornea. Corneal collagen cross-linking with long-wave ultraviolet light and riboflavin is a promising new treatment for keratoconus. To determine whether LOX is a genetic determinant of the pathogenesis of keratoconus, we analyzed association results of LOX polymorphisms in two independent case-control samples and in keratoconus families.

METHODS: Association results were analyzed of single-nucleotide polymorphisms (SNPs) in the LOX gene from a Genome-Wide Association Study (GWAS) investigation in two independent panels of patients with keratoconus and controls and in keratoconus families.

RESULTS: Evidence of association was found at SNPs rs10519694 and rs2956540 located in intron 4 of LOX in the GWAS discovery case-control panel with P values of 2.3×10(-3) and 7×10(-3), respectively. The same two SNPs were found to be associated with keratoconus by family-based association testing with P values of 2.7×10(-3) and 7.7×10(-4), respectively. Meta P values of 4.0×10(-5) and 4.0×10(-7) were calculated for SNPs rs10519694 and rs2956540 by analyzing case-control and family samples simultaneously. Sequencing of LOX exons in a subset of keratoconus patients identified two polymorphisms, rs1800449 and rs2288393, located in LOX transcripts I and II, associated with keratoconus in case-control and family samples with a meta P value of 0.02.

CONCLUSIONS: Results provided strong genetic evidence that LOX variants lead to increased susceptibility to developing of keratoconus.

%B Invest Ophthalmol Vis Sci %V 53 %P 4152-7 %8 2012 Jun 28 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/22661479?dopt=Abstract %R 10.1167/iovs.11-9268 %0 Journal Article %J Neurobiol Aging %D 2012 %T White matter lesions and brain gray matter volume in cognitively normal elders. %A Raji, Cyrus A %A Lopez, Oscar L %A Kuller, Lewis H %A Carmichael, Owen T %A Longstreth, William T %A Gach, H Michael %A Boardman, John %A Bernick, Charles B %A Thompson, Paul M %A Becker, James T %K Aged %K Aged, 80 and over %K Aging %K Apolipoprotein E4 %K Brain %K Cognition Disorders %K Female %K Humans %K Imaging, Three-Dimensional %K Leukoaraiosis %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Memory Disorders %K Mental Status Schedule %K Neuropsychological Tests %K Regression Analysis %K Retrospective Studies %X

Cerebral white matter lesions (WMLs) reflect small vessel disease, are common in elderly individuals, and are associated with cognitive impairment. We sought to determine the relationships between WMLs, age, gray matter (GM) volume, and cognition in the Cardiovascular Health Study (CHS). From the Cardiovascular Health Study we selected 740 cognitively normal controls with a 1.5 T magnetic resonance imaging (MRI) scan of the brain and a detailed diagnostic evaluation. WML severity was determined using a standardized visual rating system. GM volumes were analyzed using voxel-based morphometry implemented in the Statistical Parametric Mapping software. WMLs were inversely correlated with GM volume, with the greatest volume loss in the frontal cortex. Age-related atrophy was observed in the hippocampus and posterior cingulate cortex. Regression analyses revealed links among age, APOE*4 allele, hypertension, WMLs, GM volume, and digit symbol substitution test scores. Both advancing age and hypertension predict higher WML load, which is itself associated with GM atrophy. Longitudinal data are needed to confirm the temporal sequence of events leading to a decline in cognitive function.

%B Neurobiol Aging %V 33 %P 834.e7-16 %8 2012 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21943959?dopt=Abstract %R 10.1016/j.neurobiolaging.2011.08.010 %0 Journal Article %J Biomarkers %D 2013 %T Adhesion molecules, endothelin-1 and lung function in seven population-based cohorts. %A Oelsner, E C %A Pottinger, T D %A Burkart, K M %A Allison, M %A Buxbaum, S G %A Hansel, N N %A Kumar, R %A Larkin, E K %A Lange, L A %A Loehr, L R %A London, S J %A O'Connor, G T %A Papanicolaou, G %A Petrini, M F %A Rabinowitz, D %A Raghavan, S %A Redline, S %A Thyagarajan, B %A Tracy, R P %A Wilk, J B %A White, W B %A Rich, S S %A Barr, R G %K African Continental Ancestry Group %K Biomarkers %K Cohort Studies %K E-Selectin %K Endothelin-1 %K Endothelium, Vascular %K European Continental Ancestry Group %K Female %K Gene Expression %K Humans %K Intercellular Adhesion Molecule-1 %K Lung %K Male %K Middle Aged %K P-Selectin %K Pulmonary Disease, Chronic Obstructive %K Respiratory Function Tests %K Spirometry %X

CONTEXT: Endothelial function is abnormal in chronic obstructive pulmonary disease (COPD); whether endothelial dysfunction causes COPD is unknown.

OBJECTIVE: Test associations of endothelial biomarkers with FEV1 using instrumental variables.

METHODS: Among 26 907 participants with spirometry, ICAM-1, P-selectin, E-selectin and endothelin-1 were measured in subsets.

RESULTS: ICAM-1 and P-selectin were inversely associated with FEV1 among European-Americans (-29 mL and -34 mL per standard deviation of log-transformed biomarker, p < 0.001), as was endothelin-1 among African-Americans (-22 mL, p = 0.008). Genetically-estimated ICAM-1 and P-selectin were not significantly associated with FEV1. The instrumental variable for endothelin-1 was non-informative.

CONCLUSION: Although ICAM-1, P-selectin and endothelin-1 were inversely associated with FEV1, associations for ICAM-1 and P-selectin do not appear causal.

%B Biomarkers %V 18 %P 196-203 %8 2013 May %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23557128?dopt=Abstract %R 10.3109/1354750X.2012.762805 %0 Journal Article %J Neuroepidemiology %D 2013 %T Adiposity and cognitive decline in the cardiovascular health study. %A Luchsinger, José A %A Biggs, Mary L %A Kizer, Jorge R %A Barzilay, Joshua %A Fitzpatrick, Annette %A Newman, Anne %A Longstreth, William T %A Lopez, Oscar %A Siscovick, David %A Kuller, Lewis %K Adiposity %K Aged %K Aged, 80 and over %K Body Mass Index %K Cardiovascular Diseases %K Cognition Disorders %K Electric Impedance %K Female %K Humans %K Male %K Risk Factors %K Waist Circumference %K Waist-Hip Ratio %X

BACKGROUND: Studies relating adiposity to cognition in the elderly show conflicting results, which may be explained by the choice of adiposity measures. Thus, we studied the longitudinal associations of different adiposity measures, fat mass by bioelectrical impedance analysis, body mass index (BMI) and waist circumference (WC), with cognitive performance in the Cardiovascular Health Study.

METHODS: Cognitive performance was assessed with the modified Mini-Mental State Examination, the Digit Symbol Substitution Test, and a composite of both. We used linear mixed models to estimate rates of change in cognitive function scores associated with adiposity measured at baseline.

RESULTS: The final sample was comprised of 2,681 women (57.9%) and 1,949 men (42.1%) aged 73 ± 5.2 and 73.9 ± 5.6 years, respectively. Adiposity was associated with slower cognitive decline in most analyses. Results were similar for fat mass, BMI and WC. Higher fat-free mass was also related to slower cognitive decline. Results were similar in analyses excluding persons with cancer, smokers, and persons with short follow-up, poor self-reported health, or persons with cardiovascular disease.

CONCLUSIONS: Higher adiposity and higher fat-free mass in the elderly was related to better cognitive performance. This finding was not explained by confounding by preexisting conditions.

%B Neuroepidemiology %V 40 %P 274-81 %8 2013 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/23445925?dopt=Abstract %R 10.1159/000345136 %0 Journal Article %J Am J Epidemiol %D 2013 %T Association of functional polymorphism rs2231142 (Q141K) in the ABCG2 gene with serum uric acid and gout in 4 US populations: the PAGE Study. %A Zhang, Lili %A Spencer, Kylee L %A Voruganti, V Saroja %A Jorgensen, Neal W %A Fornage, Myriam %A Best, Lyle G %A Brown-Gentry, Kristin D %A Cole, Shelley A %A Crawford, Dana C %A Deelman, Ewa %A Franceschini, Nora %A Gaffo, Angelo L %A Glenn, Kimberly R %A Heiss, Gerardo %A Jenny, Nancy S %A Köttgen, Anna %A Li, Qiong %A Liu, Kiang %A Matise, Tara C %A North, Kari E %A Umans, Jason G %A Kao, W H Linda %K Adult %K African Americans %K Age Distribution %K ATP-Binding Cassette Transporters %K Comorbidity %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genetics, Population %K Genome-Wide Association Study %K Gout %K Hormone Replacement Therapy %K Humans %K Indians, North American %K Male %K Mexican Americans %K Middle Aged %K Neoplasm Proteins %K Polymorphism, Genetic %K Postmenopause %K Sex Distribution %K United States %K Uric Acid %X

A loss-of-function mutation (Q141K, rs2231142) in the ATP-binding cassette, subfamily G, member 2 gene (ABCG2) has been shown to be associated with serum uric acid levels and gout in Asians, Europeans, and European and African Americans; however, less is known about these associations in other populations. Rs2231142 was genotyped in 22,734 European Americans, 9,720 African Americans, 3,849 Mexican Americans, and 3,550 American Indians in the Population Architecture using Genomics and Epidemiology (PAGE) Study (2008-2012). Rs2231142 was significantly associated with serum uric acid levels (P = 2.37 × 10(-67), P = 3.98 × 10(-5), P = 6.97 × 10(-9), and P = 5.33 × 10(-4) in European Americans, African Americans, Mexican Americans, and American Indians, respectively) and gout (P = 2.83 × 10(-10), P = 0.01, and P = 0.01 in European Americans, African Americans, and Mexican Americans, respectively). Overall, the T allele was associated with a 0.24-mg/dL increase in serum uric acid level (P = 1.37 × 10(-80)) and a 1.75-fold increase in the odds of gout (P = 1.09 × 10(-12)). The association between rs2231142 and serum uric acid was significantly stronger in men, postmenopausal women, and hormone therapy users compared with their counterparts. The association with gout was also significantly stronger in men than in women. These results highlight a possible role of sex hormones in the regulation of ABCG2 urate transporter and its potential implications for the prevention, diagnosis, and treatment of hyperuricemia and gout.

%B Am J Epidemiol %V 177 %P 923-32 %8 2013 May 1 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/23552988?dopt=Abstract %R 10.1093/aje/kws330 %0 Journal Article %J Age (Dordr) %D 2013 %T Association of heat shock proteins with all-cause mortality. %A Broer, L %A Demerath, E W %A Garcia, M E %A Homuth, G %A Kaplan, R C %A Lunetta, K L %A Tanaka, T %A Tranah, G J %A Walter, S %A Arnold, A M %A Atzmon, G %A Harris, T B %A Hoffmann, W %A Karasik, D %A Kiel, D P %A Kocher, T %A Launer, L J %A Lohman, K K %A Rotter, J I %A Tiemeier, H %A Uitterlinden, A G %A Wallaschofski, H %A Bandinelli, S %A Dörr, M %A Ferrucci, L %A Franceschini, N %A Gudnason, V %A Hofman, A %A Liu, Y %A Murabito, J M %A Newman, A B %A Oostra, B A %A Psaty, B M %A Smith, A V %A van Duijn, C M %K Aged, 80 and over %K Aging %K Cause of Death %K Forecasting %K Genotype %K Heat-Shock Proteins %K Humans %K Longevity %K Promoter Regions, Genetic %K Retrospective Studies %K Transcription, Genetic %K United States %X

Experimental mild heat shock is widely known as an intervention that results in extended longevity in various models along the evolutionary lineage. Heat shock proteins (HSPs) are highly upregulated immediately after a heat shock. The elevation in HSP levels was shown to inhibit stress-mediated cell death, and recent experiments indicate a highly versatile role for these proteins as inhibitors of programmed cell death. In this study, we examined common genetic variations in 31 genes encoding all members of the HSP70, small HSP, and heat shock factor (HSF) families for their association with all-cause mortality. Our discovery cohort was the Rotterdam study (RS1) containing 5,974 participants aged 55 years and older (3,174 deaths). We assessed 4,430 single nucleotide polymorphisms (SNPs) using the HumanHap550K Genotyping BeadChip from Illumina. After adjusting for multiple testing by permutation analysis, three SNPs showed evidence for association with all-cause mortality in RS1. These findings were followed in eight independent population-based cohorts, leading to a total of 25,007 participants (8,444 deaths). In the replication phase, only HSF2 (rs1416733) remained significantly associated with all-cause mortality. Rs1416733 is a known cis-eQTL for HSF2. Our findings suggest a role of HSF2 in all-cause mortality.

%B Age (Dordr) %V 35 %P 1367-76 %8 2013 Aug %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22555621?dopt=Abstract %R 10.1007/s11357-012-9417-7 %0 Journal Article %J J Am Heart Assoc %D 2013 %T Associations of plasma phospholipid and dietary alpha linolenic acid with incident atrial fibrillation in older adults: the Cardiovascular Health Study. %A Fretts, Amanda M %A Mozaffarian, Dariush %A Siscovick, David S %A Heckbert, Susan R %A McKnight, Barbara %A King, Irena B %A Rimm, Eric B %A Psaty, Bruce M %A Sacks, Frank M %A Song, Xiaoling %A Spiegelman, Donna %A Lemaitre, Rozenn N %K Age Factors %K Aged %K Aged, 80 and over %K alpha-Linolenic Acid %K Atrial Fibrillation %K Biomarkers %K Diet %K Female %K Humans %K Incidence %K Linear Models %K Longitudinal Studies %K Male %K Nutritional Status %K Phospholipids %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Risk Factors %K Time Factors %K United States %X

BACKGROUND: Few studies have examined the relationship of α-linolenic acid (ALA 18:3n-3), an intermediate-chain essential n-3 polyunsaturated fatty acid derived from plants and vegetable oils, with incident atrial fibrillation (AF).

METHODS AND RESULTS: The study population included participants from the Cardiovascular Health Study, a community-based longitudinal cohort of adults aged 65 or older, free of prevalent coronary heart disease and atrial fibrillation. We assessed the associations of plasma phospholipid and dietary ALA with incident AF using Cox regression. The biomarker analysis comprised a total of 2899 participants, and the dietary analysis comprised 4337 participants. We found no association of plasma phospholipid ALA and incident AF. Comparing each of the second, third, and fourth quartiles to the lowest quartile, the hazard ratios for AF were 1.11 (95% CI, 0.90 to 1.37), 1.09 (95% CI, 0.88 to 1.35), and 0.92 (95% CI, 0.74 to 1.15), after adjustment for age, sex, race, clinic, education, smoking, alcohol, body mass index, waist circumference, diabetes, heart failure, stroke, treated hypertension, and physical activity (P trend=0.48). When dietary ALA was considered the exposure of interest, results were similar.

CONCLUSIONS: Results from this prospective cohort study of older adults indicate no association of plasma phospholipid or dietary ALA and incident AF.

%B J Am Heart Assoc %V 2 %P e003814 %8 2013 Jan 31 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23525429?dopt=Abstract %R 10.1161/JAHA.112.003814 %0 Journal Article %J Neurology %D 2013 %T Atrial fibrillation and cognitive decline: a longitudinal cohort study. %A Thacker, Evan L %A McKnight, Barbara %A Psaty, Bruce M %A Longstreth, W T %A Sitlani, Colleen M %A Dublin, Sascha %A Arnold, Alice M %A Fitzpatrick, Annette L %A Gottesman, Rebecca F %A Heckbert, Susan R %K Age Factors %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Cognition Disorders %K Comorbidity %K Female %K Humans %K Incidence %K Longitudinal Studies %K Luria-Nebraska Neuropsychological Battery %K Male %K Predictive Value of Tests %X

OBJECTIVE: We sought to determine whether in the absence of clinical stroke, people with atrial fibrillation experience faster cognitive decline than people without atrial fibrillation.

METHODS: We conducted a longitudinal analysis in the Cardiovascular Health Study, a community-based study of 5,888 men and women aged 65 years and older, enrolled in 1989/1990 or 1992/1993. Participants did not have atrial fibrillation or a history of stroke at baseline. Participants were censored when they experienced incident clinical stroke. Incident atrial fibrillation was identified by hospital discharge diagnosis codes and annual study ECGs. The main outcome was rate of decline in mean scores on the 100-point Modified Mini-Mental State Examination (3MSE), administered annually up to 9 times.

RESULTS: Analyses included 5,150 participants, of whom 552 (10.7%) developed incident atrial fibrillation during a mean of 7 years of follow-up. Mean 3MSE scores declined faster after incident atrial fibrillation compared with no prior atrial fibrillation. For example, the predicted 5-year decline in mean 3MSE score from age 80 to age 85 was -6.4 points (95% confidence interval [CI]: -7.0, -5.9) for participants without a history of atrial fibrillation, but was -10.3 points (95% CI: -11.8, -8.9) for participants experiencing incident atrial fibrillation at age 80, a 5-year difference of -3.9 points (95% CI: -5.3, -2.5).

CONCLUSIONS: In the absence of clinical stroke, people with incident atrial fibrillation are likely to reach thresholds of cognitive impairment or dementia at earlier ages than people with no history of atrial fibrillation.

%B Neurology %V 81 %P 119-25 %8 2013 Jul 09 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23739229?dopt=Abstract %R 10.1212/WNL.0b013e31829a33d1 %0 Journal Article %J JAMA Intern Med %D 2013 %T Atrial fibrillation and the risk of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study. %A Chen, Lin Y %A Sotoodehnia, Nona %A Bůzková, Petra %A Lopez, Faye L %A Yee, Laura M %A Heckbert, Susan R %A Prineas, Ronald %A Soliman, Elsayed Z %A Adabag, Selcuk %A Konety, Suma %A Folsom, Aaron R %A Siscovick, David %A Alonso, Alvaro %K Aged %K Atrial Fibrillation %K Cardiovascular Diseases %K Death, Sudden, Cardiac %K Demography %K Ethnic Groups %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Sex Factors %K United States %X

BACKGROUND: It is unknown whether atrial fibrillation (AF) is associated with an increased risk of sudden cardiac death (SCD) in the general population. This association was examined in 2 population-based cohorts.

METHODS: In the Atherosclerosis Risk in Communities (ARIC) Study, we analyzed data from 15 439 participants (baseline age, 45-64 years; 55.2% women; and 26.6% black) from baseline (1987-1989) through December 31, 2001. In the Cardiovascular Health Study (CHS), we analyzed data from 5479 participants (baseline age, ≥65 years; 58.2% women; and 15.4% black) from baseline (first cohort, 1989-1990; second cohort, 1992-1993) through December 31, 2006. The main outcome was physician-adjudicated SCD, defined as death from a sudden, pulseless condition presumed to be due to a ventricular tachyarrhythmia. The secondary outcome was non-SCD (NSCD), defined as coronary heart disease death not meeting SCD criteria. We used Cox proportional hazards models to assess the association between AF and SCD/NSCD, adjusting for baseline demographic and cardiovascular risk factors.

RESULTS: In the ARIC Study, 894 AF, 269 SCD, and 233 NSCD events occurred during follow-up (median, 13.1 years). The crude incidence rates of SCD were 2.89 per 1000 person-years (with AF) and 1.30 per 1000 person-years (without AF). The multivariable hazard ratios (HRs) (95% CIs) of AF for SCD and NSCD were 3.26 (2.17-4.91) and 2.43 (1.60-3.71), respectively. In the CHS, 1458 AF, 292 SCD, and 581 NSCD events occurred during follow-up (median, 13.1 years). The crude incidence rates of SCD were 12.00 per 1000 person-years (with AF) and 3.82 per 1000 person-years (without AF). The multivariable HRs (95% CIs) of AF for SCD and NSCD were 2.14 (1.60-2.87) and 3.10 (2.58-3.72), respectively. The meta-analyzed HRs (95% CIs) of AF for SCD and NSCD were 2.47 (1.95-3.13) and 2.98 (2.52-3.53), respectively.

CONCLUSIONS: Incident AF is associated with an increased risk of SCD and NSCD in the general population. Additional research to identify predictors of SCD in patients with AF is warranted.

%B JAMA Intern Med %V 173 %P 29-35 %8 2013 Jan 14 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23404043?dopt=Abstract %R 10.1001/2013.jamainternmed.744 %0 Journal Article %J PLoS One %D 2013 %T Best practices and joint calling of the HumanExome BeadChip: the CHARGE Consortium. %A Grove, Megan L %A Yu, Bing %A Cochran, Barbara J %A Haritunians, Talin %A Bis, Joshua C %A Taylor, Kent D %A Hansen, Mark %A Borecki, Ingrid B %A Cupples, L Adrienne %A Fornage, Myriam %A Gudnason, Vilmundur %A Harris, Tamara B %A Kathiresan, Sekar %A Kraaij, Robert %A Launer, Lenore J %A Levy, Daniel %A Liu, Yongmei %A Mosley, Thomas %A Peloso, Gina M %A Psaty, Bruce M %A Rich, Stephen S %A Rivadeneira, Fernando %A Siscovick, David S %A Smith, Albert V %A Uitterlinden, Andre %A van Duijn, Cornelia M %A Wilson, James G %A O'Donnell, Christopher J %A Rotter, Jerome I %A Boerwinkle, Eric %K Aging %K Alleles %K Cluster Analysis %K Cohort Studies %K Continental Population Groups %K Exome %K Female %K Gene Frequency %K Genomics %K Genotype %K Heart %K Humans %K Male %K Oligonucleotide Array Sequence Analysis %K Polymorphism, Single Nucleotide %K Sample Size %K Self Report %K Sequence Analysis, DNA %X

Genotyping arrays are a cost effective approach when typing previously-identified genetic polymorphisms in large numbers of samples. One limitation of genotyping arrays with rare variants (e.g., minor allele frequency [MAF] <0.01) is the difficulty that automated clustering algorithms have to accurately detect and assign genotype calls. Combining intensity data from large numbers of samples may increase the ability to accurately call the genotypes of rare variants. Approximately 62,000 ethnically diverse samples from eleven Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium cohorts were genotyped with the Illumina HumanExome BeadChip across seven genotyping centers. The raw data files for the samples were assembled into a single project for joint calling. To assess the quality of the joint calling, concordance of genotypes in a subset of individuals having both exome chip and exome sequence data was analyzed. After exclusion of low performing SNPs on the exome chip and non-overlap of SNPs derived from sequence data, genotypes of 185,119 variants (11,356 were monomorphic) were compared in 530 individuals that had whole exome sequence data. A total of 98,113,070 pairs of genotypes were tested and 99.77% were concordant, 0.14% had missing data, and 0.09% were discordant. We report that joint calling allows the ability to accurately genotype rare variation using array technology when large sample sizes are available and best practices are followed. The cluster file from this experiment is available at www.chargeconsortium.com/main/exomechip.

%B PLoS One %V 8 %P e68095 %8 2013 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23874508?dopt=Abstract %R 10.1371/journal.pone.0068095 %0 Journal Article %J Am J Respir Crit Care Med %D 2013 %T Bidirectional relationship between cognitive function and pneumonia. %A Shah, Faraaz Ali %A Pike, Francis %A Alvarez, Karina %A Angus, Derek %A Newman, Anne B %A Lopez, Oscar %A Tate, Judith %A Kapur, Vishesh %A Wilsdon, Anthony %A Krishnan, Jerry A %A Hansel, Nadia %A Au, David %A Avdalovic, Mark %A Fan, Vincent S %A Barr, R Graham %A Yende, Sachin %K Aged %K Cognition Disorders %K Dementia %K Female %K Hospitalization %K Humans %K Longitudinal Studies %K Male %K Neuropsychological Tests %K Pneumonia %K Proportional Hazards Models %K Risk Factors %X

RATIONALE: Relationships between chronic health conditions and acute infections remain poorly understood. Preclinical studies suggest crosstalk between nervous and immune systems.

OBJECTIVES: To determine bidirectional relationships between cognition and pneumonia.

METHODS: We conducted longitudinal analyses of a population-based cohort over 10 years. We determined whether changes in cognition increase risk of pneumonia hospitalization by trajectory analyses and joint modeling. We then determined whether pneumonia hospitalization increased risk of subsequent dementia using a Cox model with pneumonia as a time-varying covariate.

MEASUREMENTS AND MAIN RESULTS: Of the 5,888 participants, 639 (10.9%) were hospitalized with pneumonia at least once. Most participants had normal cognition before pneumonia. Three cognition trajectories were identified: no, minimal, and severe rapid decline. A greater proportion of participants hospitalized with pneumonia were on trajectories of minimal or severe decline before occurrence of pneumonia compared with those never hospitalized with pneumonia (proportion with no, minimal, and severe decline were 67.1%, 22.8%, and 10.0% vs. 76.0%, 19.3%, and 4.6% for participants with and without pneumonia, respectively; P < 0.001). Small subclinical changes in cognition increased risk of pneumonia, even in those with normal cognition and physical function before pneumonia (β = -0.02; P < 0.001). Participants with pneumonia were subsequently at an increased risk of dementia (hazard ratio, 2.24 [95% confidence interval, 1.62-3.11]; P = 0.01). Associations were independent of demographics, health behaviors, other chronic conditions, and physical function. Bidirectional relationship did not vary based on severity of disease, and similar associations were noted for those with severe sepsis and other infections.

CONCLUSIONS: A bidirectional relationship exists between pneumonia and cognition and may explain how a single episode of infection in well-appearing older individuals accelerates decline in chronic health conditions and loss of functional independence.

%B Am J Respir Crit Care Med %V 188 %P 586-92 %8 2013 Sep 01 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23848267?dopt=Abstract %R 10.1164/rccm.201212-2154OC %0 Journal Article %J Am J Hypertens %D 2013 %T Blood pressure variability and the risk of all-cause mortality, incident myocardial infarction, and incident stroke in the cardiovascular health study. %A Suchy-Dicey, Astrid M %A Wallace, Erin R %A Mitchell, S V Elkind %A Aguilar, Maria %A Gottesman, Rebecca F %A Rice, Kenneth %A Kronmal, Richard %A Psaty, Bruce M %A Longstreth, W T %K Aged %K Blood Pressure %K Cohort Studies %K Female %K Humans %K Incidence %K Longitudinal Studies %K Male %K Mortality %K Myocardial Infarction %K Risk %K Stroke %K United States %X

BACKGROUND: Recent reports have linked variability in visit-to-visit systolic blood pressure (SBP) to risk of mortality and stroke, independent of the effect of mean SBP level. This study aimed to evaluate whether variability in SBP is associated with all-cause mortality, incident myocardial infarction (MI), and incident stroke, independent of mean SBP or trends in SBP levels over time.

METHODS: The Cardiovascular Health Study is a longitudinal cohort study of vascular risk factors and disease in the elderly. Participants who attended their first 5 annual clinic visits and experienced no event before the 5th visit were eligible (n = 3,852). Primary analyses were restricted to participants not using antihypertensive medications throughout the first 5 clinic visits (n = 1,642). Intraindividual SBP variables were defined using each participant's 5-visit blood pressure measures. Cox proportional hazards models estimated adjusted hazard ratios (HRs) per SD increase in intraindividual SBP variability, adjusted for intraindividual SBP mean and change over time.

RESULTS: Over a mean follow-up of 9.9 years, there were 844 deaths, 203 MIs, and 195 strokes. Intraindividual SBP variability was significantly associated with increased risk of mortality (HR = 1.13; 95% confidence interval (CI) = 1.05-1.21) and of incident MI (HR = 1.20; 95%CI = 1.06-1.36), independent of the effect from adjustment factors. Intraindividual SBP variability was not associated with risk of stroke (HR = 1.03; 95% CI = 0.89-1.21).

CONCLUSIONS: Long-term visit-to-visit SBP variability was independently associated with a higher risk of subsequent mortality and MI but not stroke. More research is needed to determine the relationship of BP variability with cardiovascular risk and the clinical implications.

%B Am J Hypertens %V 26 %P 1210-7 %8 2013 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/23744496?dopt=Abstract %R 10.1093/ajh/hpt092 %0 Journal Article %J J Am Coll Cardiol %D 2013 %T Cardiomyocyte injury assessed by a highly sensitive troponin assay and sudden cardiac death in the community: the Cardiovascular Health Study. %A Hussein, Ayman A %A Gottdiener, John S %A Bartz, Traci M %A Sotoodehnia, Nona %A DeFilippi, Christopher %A Dickfeld, Timm %A Deo, Rajat %A Siscovick, David %A Stein, Phyllis K %A Lloyd-Jones, Donald %K Aged %K Ambulatory Care %K Biomarkers %K Death, Sudden, Cardiac %K Female %K Heart Arrest %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Myocardium %K Myocytes, Cardiac %K Proportional Hazards Models %K Risk Assessment %K Troponin T %X

OBJECTIVES: This study sought to determine the association between markers of cardiomyocyte injury in ambulatory subjects and sudden cardiac death (SCD).

BACKGROUND: The pathophysiology of SCD is complex but is believed to be associated with an abnormal cardiac substrate in most cases. The association between biomarkers of cardiomyocyte injury in ambulatory subjects and SCD has not been investigated.

METHODS: Levels of cardiac troponin T, a biomarker of cardiomyocyte injury, were measured by a highly sensitive assay (hsTnT) in 4,431 ambulatory participants in the Cardiovascular Health Study, a longitudinal community-based prospective cohort study. Serial measures were obtained in 3,089 subjects. All deaths, including SCD, were adjudicated by a central events committee.

RESULTS: Over a median follow-up of 13.1 years, 246 participants had SCD. Baseline levels of hsTnT were significantly associated with SCD (hazard ratio [HR] for +1 log(hsTnT): 2.04, 95% confidence interval [CI]: 1.78 to 2.34]. This association persisted in covariate-adjusted Cox analyses accounting for baseline risk factors (HR: 1.30, 95% CI: 1.05 to 1.62), as well as for incident heart failure and myocardial infarction (HR: 1.26, 95% CI: 1.01 to 1.57). The population was also categorized into 3 groups based on baseline hsTnT levels and SCD risk [fully adjusted HR: 1.89 vs. 1.55 vs. 1 (reference group) for hsTnT ≥12.10 vs. 5.01 to 12.09 vs. ≤ 5.00 pg/ml, respectively; p trend = 0.005]. On serial measurements, change in hsTnT levels was also associated with SCD risk (fully adjusted HR for +1 pg/ml per year increase from baseline: 1.03, 95% CI: 1.01 to 1.06).

CONCLUSIONS: The findings suggest an association between cardiomyocyte injury in ambulatory subjects and SCD risk beyond that of traditional risk factors.

%B J Am Coll Cardiol %V 62 %P 2112-20 %8 2013 Dec 03 %G eng %N 22 %1 http://www.ncbi.nlm.nih.gov/pubmed/23973690?dopt=Abstract %R 10.1016/j.jacc.2013.07.049 %0 Journal Article %J J Am Heart Assoc %D 2013 %T Circulating omega-3 polyunsaturated fatty acids and subclinical brain abnormalities on MRI in older adults: the Cardiovascular Health Study. %A Virtanen, Jyrki K %A Siscovick, David S %A Lemaitre, Rozenn N %A Longstreth, William T %A Spiegelman, Donna %A Rimm, Eric B %A King, Irena B %A Mozaffarian, Dariush %K Aged %K Animals %K Biomarkers %K Brain %K Cross-Sectional Studies %K Fatty Acids, Omega-3 %K Female %K Fishes %K Humans %K Magnetic Resonance Imaging %K Male %K Prospective Studies %X

BACKGROUND: Consumption of tuna or other broiled or baked fish, but not fried fish, is associated with fewer subclinical brain abnormalities on magnetic resonance imaging (MRI). We investigated the association between plasma phospholipid omega-3 polyunsaturated fatty acids (PUFAs), objective biomarkers of exposure, and subclinical brain abnormalities on MRI.

METHODS AND RESULTS: In the community-based Cardiovascular Health Study, 3660 participants aged ≥ 65 underwent brain MRI in 1992-1994, and 2313 were rescanned 5 years later. MRIs were centrally read by neuroradiologists in a standardized, blinded manner. Participants with recognized transient ischemic attacks or stroke were excluded. Phospholipid PUFAs were measured in stored plasma collected in 1992-1993 and related to cross-sectional and longitudinal MRI findings. After multivariable adjustment, the odds ratio for having a prevalent subclinical infarct was 0.60 (95% CI, 0.44 to 0.82; P for trend = 0.001) in the highest versus lowest long-chain omega-3 PUFA quartile. Higher long-chain omega-3 PUFA content was also associated with better white matter grade, but not with sulcal or ventricular grades, markers of brain atrophy, or with incident subclinical infarcts. The phospholipid intermediate-chain omega-3 PUFA alpha-linolenic acid was associated only with modestly better sulcal and ventricular grades. However, this finding was not supported in the analyses with alpha-linolenic acid intake.

CONCLUSIONS: Among older adults, higher phospholipid long-chain omega-3 PUFA content was associated with lower prevalence of subclinical infarcts and better white matter grade on MRI. Our results support the beneficial effects of fish consumption, the major source of long-chain omega-3 PUFAs, on brain health in later life. The role of plant-derived alpha-linolenic acid in brain health requires further investigation.

%B J Am Heart Assoc %V 2 %P e000305 %8 2013 Oct 10 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/24113325?dopt=Abstract %R 10.1161/JAHA.113.000305 %0 Journal Article %J Diabetologia %D 2013 %T Common carotid intima-media thickness does not add to Framingham risk score in individuals with diabetes mellitus: the USE-IMT initiative. %A den Ruijter, H M %A Peters, S A E %A Groenewegen, K A %A Anderson, T J %A Britton, A R %A Dekker, J M %A Engstrom, G %A Eijkemans, M J %A Evans, G W %A de Graaf, J %A Grobbee, D E %A Hedblad, B %A Hofman, A %A Holewijn, S %A Ikeda, A %A Kavousi, M %A Kitagawa, K %A Kitamura, A %A Koffijberg, H %A Ikram, M A %A Lonn, E M %A Lorenz, M W %A Mathiesen, E B %A Nijpels, G %A Okazaki, S %A O'Leary, D H %A Polak, J F %A Price, J F %A Robertson, C %A Rembold, C M %A Rosvall, M %A Rundek, T %A Salonen, J T %A Sitzer, M %A Stehouwer, C D A %A Witteman, J C %A Moons, K G %A Bots, M L %K Cardiovascular Diseases %K Carotid Intima-Media Thickness %K Diabetes Mellitus %K Humans %K Myocardial Infarction %K Risk Factors %K Stroke %X

AIMS/HYPOTHESIS: The aim of this work was to investigate whether measurement of the mean common carotid intima-media thickness (CIMT) improves cardiovascular risk prediction in individuals with diabetes.

METHODS: We performed a subanalysis among 4,220 individuals with diabetes in a large ongoing individual participant data meta-analysis involving 56,194 subjects from 17 population-based cohorts worldwide. We first refitted the risk factors of the Framingham heart risk score on the individuals without previous cardiovascular disease (baseline model) and then expanded this model with the mean common CIMT (CIMT model). The absolute 10 year risk for developing a myocardial infarction or stroke was estimated from both models. In individuals with diabetes we compared discrimination and calibration of the two models. Reclassification of individuals with diabetes was based on allocation to another cardiovascular risk category when mean common CIMT was added.

RESULTS: During a median follow-up of 8.7 years, 684 first-time cardiovascular events occurred among the population with diabetes. The C statistic was 0.67 for the Framingham model and 0.68 for the CIMT model. The absolute 10 year risk for developing a myocardial infarction or stroke was 16% in both models. There was no net reclassification improvement with the addition of mean common CIMT (1.7%; 95% CI -1.8, 3.8). There were no differences in the results between men and women.

CONCLUSIONS/INTERPRETATION: There is no improvement in risk prediction in individuals with diabetes when measurement of the mean common CIMT is added to the Framingham risk score. Therefore, this measurement is not recommended for improving individual cardiovascular risk stratification in individuals with diabetes.

%B Diabetologia %V 56 %P 1494-502 %8 2013 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23568273?dopt=Abstract %R 10.1007/s00125-013-2898-9 %0 Journal Article %J Am J Clin Nutr %D 2013 %T Common genetic loci influencing plasma homocysteine concentrations and their effect on risk of coronary artery disease. %A van Meurs, Joyce B J %A Paré, Guillaume %A Schwartz, Stephen M %A Hazra, Aditi %A Tanaka, Toshiko %A Vermeulen, Sita H %A Cotlarciuc, Ioana %A Yuan, Xin %A Mälarstig, Anders %A Bandinelli, Stefania %A Bis, Joshua C %A Blom, Henk %A Brown, Morris J %A Chen, Constance %A Chen, Yii-Der %A Clarke, Robert J %A Dehghan, Abbas %A Erdmann, Jeanette %A Ferrucci, Luigi %A Hamsten, Anders %A Hofman, Albert %A Hunter, David J %A Goel, Anuj %A Johnson, Andrew D %A Kathiresan, Sekar %A Kampman, Ellen %A Kiel, Douglas P %A Kiemeney, Lambertus A L M %A Chambers, John C %A Kraft, Peter %A Lindemans, Jan %A McKnight, Barbara %A Nelson, Christopher P %A O'Donnell, Christopher J %A Psaty, Bruce M %A Ridker, Paul M %A Rivadeneira, Fernando %A Rose, Lynda M %A Seedorf, Udo %A Siscovick, David S %A Schunkert, Heribert %A Selhub, Jacob %A Ueland, Per M %A Vollenweider, Peter %A Waeber, Gérard %A Waterworth, Dawn M %A Watkins, Hugh %A Witteman, Jacqueline C M %A den Heijer, Martin %A Jacques, Paul %A Uitterlinden, André G %A Kooner, Jaspal S %A Rader, Dan J %A Reilly, Muredach P %A Mooser, Vincent %A Chasman, Daniel I %A Samani, Nilesh J %A Ahmadi, Kourosh R %K Coronary Artery Disease %K Genes %K Genetic Loci %K Genetic Predisposition to Disease %K Genotype %K Homocysteine %K Humans %K Polymorphism, Genetic %K Risk Factors %X

BACKGROUND: The strong observational association between total homocysteine (tHcy) concentrations and risk of coronary artery disease (CAD) and the null associations in the homocysteine-lowering trials have prompted the need to identify genetic variants associated with homocysteine concentrations and risk of CAD.

OBJECTIVE: We tested whether common genetic polymorphisms associated with variation in tHcy are also associated with CAD.

DESIGN: We conducted a meta-analysis of genome-wide association studies (GWAS) on tHcy concentrations in 44,147 individuals of European descent. Polymorphisms associated with tHcy (P < 10(⁻⁸) were tested for association with CAD in 31,400 cases and 92,927 controls.

RESULTS: Common variants at 13 loci, explaining 5.9% of the variation in tHcy, were associated with tHcy concentrations, including 6 novel loci in or near MMACHC (2.1 × 10⁻⁹), SLC17A3 (1.0 × 10⁻⁸), GTPB10 (1.7 × 10⁻⁸), CUBN (7.5 × 10⁻¹⁰), HNF1A (1.2 × 10⁻¹²)), and FUT2 (6.6 × 10⁻⁹), and variants previously reported at or near the MTHFR, MTR, CPS1, MUT, NOX4, DPEP1, and CBS genes. Individuals within the highest 10% of the genotype risk score (GRS) had 3-μmol/L higher mean tHcy concentrations than did those within the lowest 10% of the GRS (P = 1 × 10⁻³⁶). The GRS was not associated with risk of CAD (OR: 1.01; 95% CI: 0.98, 1.04; P = 0.49).

CONCLUSIONS: We identified several novel loci that influence plasma tHcy concentrations. Overall, common genetic variants that influence plasma tHcy concentrations are not associated with risk of CAD in white populations, which further refutes the causal relevance of moderately elevated tHcy concentrations and tHcy-related pathways for CAD.

%B Am J Clin Nutr %V 98 %P 668-76 %8 2013 Sep %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23824729?dopt=Abstract %R 10.3945/ajcn.112.044545 %0 Journal Article %J Heart Rhythm %D 2013 %T Common genetic variation near the connexin-43 gene is associated with resting heart rate in African Americans: a genome-wide association study of 13,372 participants. %A Deo, R %A Nalls, M A %A Avery, C L %A Smith, J G %A Evans, D S %A Keller, M F %A Butler, A M %A Buxbaum, S G %A Li, G %A Miguel Quibrera, P %A Smith, E N %A Tanaka, T %A Akylbekova, E L %A Alonso, A %A Arking, D E %A Benjamin, E J %A Berenson, G S %A Bis, J C %A Chen, L Y %A Chen, W %A Cummings, S R %A Ellinor, P T %A Evans, M K %A Ferrucci, L %A Fox, E R %A Heckbert, S R %A Heiss, G %A Hsueh, W C %A Kerr, K F %A Limacher, M C %A Liu, Y %A Lubitz, S A %A Magnani, J W %A Mehra, R %A Marcus, G M %A Murray, S S %A Newman, A B %A Njajou, O %A North, K E %A Paltoo, D N %A Psaty, B M %A Redline, S S %A Reiner, A P %A Robinson, J G %A Rotter, J I %A Samdarshi, T E %A Schnabel, R B %A Schork, N J %A Singleton, A B %A Siscovick, D %A Soliman, E Z %A Sotoodehnia, N %A Srinivasan, S R %A Taylor, H A %A Trevisan, M %A Zhang, Z %A Zonderman, A B %A Newton-Cheh, C %A Whitsel, E A %K Adult %K African Americans %K Aged %K Arrhythmias, Cardiac %K Connexin 43 %K Electrocardiography %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genotype %K Heart Rate %K Humans %K Male %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %K Rest %K United States %X

BACKGROUND: Genome-wide association studies have identified several genetic loci associated with variation in resting heart rate in European and Asian populations. No study has evaluated genetic variants associated with heart rate in African Americans.

OBJECTIVE: To identify novel genetic variants associated with resting heart rate in African Americans.

METHODS: Ten cohort studies participating in the Candidate-gene Association Resource and Continental Origins and Genetic Epidemiology Network consortia performed genome-wide genotyping of single nucleotide polymorphisms (SNPs) and imputed 2,954,965 SNPs using HapMap YRI and CEU panels in 13,372 participants of African ancestry. Each study measured the RR interval (ms) from 10-second resting 12-lead electrocardiograms and estimated RR-SNP associations using covariate-adjusted linear regression. Random-effects meta-analysis was used to combine cohort-specific measures of association and identify genome-wide significant loci (P≤2.5×10(-8)).

RESULTS: Fourteen SNPs on chromosome 6q22 exceeded the genome-wide significance threshold. The most significant association was for rs9320841 (+13 ms per minor allele; P = 4.98×10(-15)). This SNP was approximately 350 kb downstream of GJA1, a locus previously identified as harboring SNPs associated with heart rate in Europeans. Adjustment for rs9320841 also attenuated the association between the remaining 13 SNPs in this region and heart rate. In addition, SNPs in MYH6, which have been identified in European genome-wide association study, were associated with similar changes in the resting heart rate as this population of African Americans.

CONCLUSIONS: An intergenic region downstream of GJA1 (the gene encoding connexin 43, the major protein of the human myocardial gap junction) and an intragenic region within MYH6 are associated with variation in resting heart rate in African Americans as well as in populations of European and Asian origin.

%B Heart Rhythm %V 10 %P 401-8 %8 2013 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23183192?dopt=Abstract %R 10.1016/j.hrthm.2012.11.014 %0 Journal Article %J Nat Genet %D 2013 %T Common variants associated with plasma triglycerides and risk for coronary artery disease. %A Do, Ron %A Willer, Cristen J %A Schmidt, Ellen M %A Sengupta, Sebanti %A Gao, Chi %A Peloso, Gina M %A Gustafsson, Stefan %A Kanoni, Stavroula %A Ganna, Andrea %A Chen, Jin %A Buchkovich, Martin L %A Mora, Samia %A Beckmann, Jacques S %A Bragg-Gresham, Jennifer L %A Chang, Hsing-Yi %A Demirkan, Ayse %A Den Hertog, Heleen M %A Donnelly, Louise A %A Ehret, Georg B %A Esko, Tõnu %A Feitosa, Mary F %A Ferreira, Teresa %A Fischer, Krista %A Fontanillas, Pierre %A Fraser, Ross M %A Freitag, Daniel F %A Gurdasani, Deepti %A Heikkilä, Kauko %A Hyppönen, Elina %A Isaacs, Aaron %A Jackson, Anne U %A Johansson, Asa %A Johnson, Toby %A Kaakinen, Marika %A Kettunen, Johannes %A Kleber, Marcus E %A Li, Xiaohui %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Magnusson, Patrik K E %A Mangino, Massimo %A Mihailov, Evelin %A Montasser, May E %A Müller-Nurasyid, Martina %A Nolte, Ilja M %A O'Connell, Jeffrey R %A Palmer, Cameron D %A Perola, Markus %A Petersen, Ann-Kristin %A Sanna, Serena %A Saxena, Richa %A Service, Susan K %A Shah, Sonia %A Shungin, Dmitry %A Sidore, Carlo %A Song, Ci %A Strawbridge, Rona J %A Surakka, Ida %A Tanaka, Toshiko %A Teslovich, Tanya M %A Thorleifsson, Gudmar %A van den Herik, Evita G %A Voight, Benjamin F %A Volcik, Kelly A %A Waite, Lindsay L %A Wong, Andrew %A Wu, Ying %A Zhang, Weihua %A Absher, Devin %A Asiki, Gershim %A Barroso, Inês %A Been, Latonya F %A Bolton, Jennifer L %A Bonnycastle, Lori L %A Brambilla, Paolo %A Burnett, Mary S %A Cesana, Giancarlo %A Dimitriou, Maria %A Doney, Alex S F %A Döring, Angela %A Elliott, Paul %A Epstein, Stephen E %A Eyjolfsson, Gudmundur Ingi %A Gigante, Bruna %A Goodarzi, Mark O %A Grallert, Harald %A Gravito, Martha L %A Groves, Christopher J %A Hallmans, Göran %A Hartikainen, Anna-Liisa %A Hayward, Caroline %A Hernandez, Dena %A Hicks, Andrew A %A Holm, Hilma %A Hung, Yi-Jen %A Illig, Thomas %A Jones, Michelle R %A Kaleebu, Pontiano %A Kastelein, John J P %A Khaw, Kay-Tee %A Kim, Eric %A Klopp, Norman %A Komulainen, Pirjo %A Kumari, Meena %A Langenberg, Claudia %A Lehtimäki, Terho %A Lin, Shih-Yi %A Lindström, Jaana %A Loos, Ruth J F %A Mach, François %A McArdle, Wendy L %A Meisinger, Christa %A Mitchell, Braxton D %A Müller, Gabrielle %A Nagaraja, Ramaiah %A Narisu, Narisu %A Nieminen, Tuomo V M %A Nsubuga, Rebecca N %A Olafsson, Isleifur %A Ong, Ken K %A Palotie, Aarno %A Papamarkou, Theodore %A Pomilla, Cristina %A Pouta, Anneli %A Rader, Daniel J %A Reilly, Muredach P %A Ridker, Paul M %A Rivadeneira, Fernando %A Rudan, Igor %A Ruokonen, Aimo %A Samani, Nilesh %A Scharnagl, Hubert %A Seeley, Janet %A Silander, Kaisa %A Stančáková, Alena %A Stirrups, Kathleen %A Swift, Amy J %A Tiret, Laurence %A Uitterlinden, André G %A van Pelt, L Joost %A Vedantam, Sailaja %A Wainwright, Nicholas %A Wijmenga, Cisca %A Wild, Sarah H %A Willemsen, Gonneke %A Wilsgaard, Tom %A Wilson, James F %A Young, Elizabeth H %A Zhao, Jing Hua %A Adair, Linda S %A Arveiler, Dominique %A Assimes, Themistocles L %A Bandinelli, Stefania %A Bennett, Franklyn %A Bochud, Murielle %A Boehm, Bernhard O %A Boomsma, Dorret I %A Borecki, Ingrid B %A Bornstein, Stefan R %A Bovet, Pascal %A Burnier, Michel %A Campbell, Harry %A Chakravarti, Aravinda %A Chambers, John C %A Chen, Yii-Der Ida %A Collins, Francis S %A Cooper, Richard S %A Danesh, John %A Dedoussis, George %A de Faire, Ulf %A Feranil, Alan B %A Ferrieres, Jean %A Ferrucci, Luigi %A Freimer, Nelson B %A Gieger, Christian %A Groop, Leif C %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Hamsten, Anders %A Harris, Tamara B %A Hingorani, Aroon %A Hirschhorn, Joel N %A Hofman, Albert %A Hovingh, G Kees %A Hsiung, Chao Agnes %A Humphries, Steve E %A Hunt, Steven C %A Hveem, Kristian %A Iribarren, Carlos %A Jarvelin, Marjo-Riitta %A Jula, Antti %A Kähönen, Mika %A Kaprio, Jaakko %A Kesäniemi, Antero %A Kivimaki, Mika %A Kooner, Jaspal S %A Koudstaal, Peter J %A Krauss, Ronald M %A Kuh, Diana %A Kuusisto, Johanna %A Kyvik, Kirsten O %A Laakso, Markku %A Lakka, Timo A %A Lind, Lars %A Lindgren, Cecilia M %A Martin, Nicholas G %A März, Winfried %A McCarthy, Mark I %A McKenzie, Colin A %A Meneton, Pierre %A Metspalu, Andres %A Moilanen, Leena %A Morris, Andrew D %A Munroe, Patricia B %A Njølstad, Inger %A Pedersen, Nancy L %A Power, Chris %A Pramstaller, Peter P %A Price, Jackie F %A Psaty, Bruce M %A Quertermous, Thomas %A Rauramaa, Rainer %A Saleheen, Danish %A Salomaa, Veikko %A Sanghera, Dharambir K %A Saramies, Jouko %A Schwarz, Peter E H %A Sheu, Wayne H-H %A Shuldiner, Alan R %A Siegbahn, Agneta %A Spector, Tim D %A Stefansson, Kari %A Strachan, David P %A Tayo, Bamidele O %A Tremoli, Elena %A Tuomilehto, Jaakko %A Uusitupa, Matti %A van Duijn, Cornelia M %A Vollenweider, Peter %A Wallentin, Lars %A Wareham, Nicholas J %A Whitfield, John B %A Wolffenbuttel, Bruce H R %A Altshuler, David %A Ordovas, Jose M %A Boerwinkle, Eric %A Palmer, Colin N A %A Thorsteinsdottir, Unnur %A Chasman, Daniel I %A Rotter, Jerome I %A Franks, Paul W %A Ripatti, Samuli %A Cupples, L Adrienne %A Sandhu, Manjinder S %A Rich, Stephen S %A Boehnke, Michael %A Deloukas, Panos %A Mohlke, Karen L %A Ingelsson, Erik %A Abecasis, Goncalo R %A Daly, Mark J %A Neale, Benjamin M %A Kathiresan, Sekar %K Biological Transport %K Cholesterol, HDL %K Cholesterol, LDL %K Coronary Artery Disease %K Humans %K Polymorphism, Single Nucleotide %K Risk Factors %K Triglycerides %X

Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P < 5 × 10(-8) for each) to examine the role of triglycerides in risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and we show that the direction and magnitude of the associations with both traits are factors in determining CAD risk. Second, we consider loci with only a strong association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol (HDL-C) levels, the strength of a polymorphism's effect on triglyceride levels is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD.

%B Nat Genet %V 45 %P 1345-52 %8 2013 Nov %G eng %N 11 %R 10.1038/ng.2795 %0 Journal Article %J J Am Soc Nephrol %D 2013 %T Common variants in Mendelian kidney disease genes and their association with renal function. %A Parsa, Afshin %A Fuchsberger, Christian %A Köttgen, Anna %A O'Seaghdha, Conall M %A Pattaro, Cristian %A de Andrade, Mariza %A Chasman, Daniel I %A Teumer, Alexander %A Endlich, Karlhans %A Olden, Matthias %A Chen, Ming-Huei %A Tin, Adrienne %A Kim, Young J %A Taliun, Daniel %A Li, Man %A Feitosa, Mary %A Gorski, Mathias %A Yang, Qiong %A Hundertmark, Claudia %A Foster, Meredith C %A Glazer, Nicole %A Isaacs, Aaron %A Rao, Madhumathi %A Smith, Albert V %A O'Connell, Jeffrey R %A Struchalin, Maksim %A Tanaka, Toshiko %A Li, Guo %A Hwang, Shih-Jen %A Atkinson, Elizabeth J %A Lohman, Kurt %A Cornelis, Marilyn C %A Johansson, Asa %A Tönjes, Anke %A Dehghan, Abbas %A Couraki, Vincent %A Holliday, Elizabeth G %A Sorice, Rossella %A Kutalik, Zoltán %A Lehtimäki, Terho %A Esko, Tõnu %A Deshmukh, Harshal %A Ulivi, Sheila %A Chu, Audrey Y %A Murgia, Federico %A Trompet, Stella %A Imboden, Medea %A Kollerits, Barbara %A Pistis, Giorgio %A Harris, Tamara B %A Launer, Lenore J %A Aspelund, Thor %A Eiriksdottir, Gudny %A Mitchell, Braxton D %A Boerwinkle, Eric %A Schmidt, Helena %A Hofer, Edith %A Hu, Frank %A Demirkan, Ayse %A Oostra, Ben A %A Turner, Stephen T %A Ding, Jingzhong %A Andrews, Jeanette S %A Freedman, Barry I %A Giulianini, Franco %A Koenig, Wolfgang %A Illig, Thomas %A Döring, Angela %A Wichmann, H-Erich %A Zgaga, Lina %A Zemunik, Tatijana %A Boban, Mladen %A Minelli, Cosetta %A Wheeler, Heather E %A Igl, Wilmar %A Zaboli, Ghazal %A Wild, Sarah H %A Wright, Alan F %A Campbell, Harry %A Ellinghaus, David %A Nöthlings, Ute %A Jacobs, Gunnar %A Biffar, Reiner %A Ernst, Florian %A Homuth, Georg %A Kroemer, Heyo K %A Nauck, Matthias %A Stracke, Sylvia %A Völker, Uwe %A Völzke, Henry %A Kovacs, Peter %A Stumvoll, Michael %A Mägi, Reedik %A Hofman, Albert %A Uitterlinden, André G %A Rivadeneira, Fernando %A Aulchenko, Yurii S %A Polasek, Ozren %A Hastie, Nick %A Vitart, Veronique %A Helmer, Catherine %A Wang, Jie Jin %A Stengel, Bénédicte %A Ruggiero, Daniela %A Bergmann, Sven %A Kähönen, Mika %A Viikari, Jorma %A Nikopensius, Tiit %A Province, Michael %A Colhoun, Helen %A Doney, Alex %A Robino, Antonietta %A Krämer, Bernhard K %A Portas, Laura %A Ford, Ian %A Buckley, Brendan M %A Adam, Martin %A Thun, Gian-Andri %A Paulweber, Bernhard %A Haun, Margot %A Sala, Cinzia %A Mitchell, Paul %A Ciullo, Marina %A Vollenweider, Peter %A Raitakari, Olli %A Metspalu, Andres %A Palmer, Colin %A Gasparini, Paolo %A Pirastu, Mario %A Jukema, J Wouter %A Probst-Hensch, Nicole M %A Kronenberg, Florian %A Toniolo, Daniela %A Gudnason, Vilmundur %A Shuldiner, Alan R %A Coresh, Josef %A Schmidt, Reinhold %A Ferrucci, Luigi %A van Duijn, Cornelia M %A Borecki, Ingrid %A Kardia, Sharon L R %A Liu, Yongmei %A Curhan, Gary C %A Rudan, Igor %A Gyllensten, Ulf %A Wilson, James F %A Franke, Andre %A Pramstaller, Peter P %A Rettig, Rainer %A Prokopenko, Inga %A Witteman, Jacqueline %A Hayward, Caroline %A Ridker, Paul M %A Bochud, Murielle %A Heid, Iris M %A Siscovick, David S %A Fox, Caroline S %A Kao, W Linda %A Böger, Carsten A %K Databases, Genetic %K European Continental Ancestry Group %K Gene Frequency %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Kidney %K Mendelian Randomization Analysis %K Phenotype %K Polymorphism, Single Nucleotide %K Renal Insufficiency, Chronic %X

Many common genetic variants identified by genome-wide association studies for complex traits map to genes previously linked to rare inherited Mendelian disorders. A systematic analysis of common single-nucleotide polymorphisms (SNPs) in genes responsible for Mendelian diseases with kidney phenotypes has not been performed. We thus developed a comprehensive database of genes for Mendelian kidney conditions and evaluated the association between common genetic variants within these genes and kidney function in the general population. Using the Online Mendelian Inheritance in Man database, we identified 731 unique disease entries related to specific renal search terms and confirmed a kidney phenotype in 218 of these entries, corresponding to mutations in 258 genes. We interrogated common SNPs (minor allele frequency >5%) within these genes for association with the estimated GFR in 74,354 European-ancestry participants from the CKDGen Consortium. However, the top four candidate SNPs (rs6433115 at LRP2, rs1050700 at TSC1, rs249942 at PALB2, and rs9827843 at ROBO2) did not achieve significance in a stage 2 meta-analysis performed in 56,246 additional independent individuals, indicating that these common SNPs are not associated with estimated GFR. The effect of less common or rare variants in these genes on kidney function in the general population and disease-specific cohorts requires further research.

%B J Am Soc Nephrol %V 24 %P 2105-17 %8 2013 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24029420?dopt=Abstract %R 10.1681/ASN.2012100983 %0 Journal Article %J N Engl J Med %D 2013 %T Cystatin C versus creatinine in determining risk based on kidney function. %A Shlipak, Michael G %A Matsushita, Kunihiro %A Arnlöv, Johan %A Inker, Lesley A %A Katz, Ronit %A Polkinghorne, Kevan R %A Rothenbacher, Dietrich %A Sarnak, Mark J %A Astor, Brad C %A Coresh, Josef %A Levey, Andrew S %A Gansevoort, Ron T %K Creatinine %K Cystatin C %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Kidney Function Tests %K Reference Standards %K Renal Insufficiency, Chronic %K Risk %K Risk Assessment %X

BACKGROUND: Adding the measurement of cystatin C to that of serum creatinine to determine the estimated glomerular filtration rate (eGFR) improves accuracy, but the effect on detection, staging, and risk classification of chronic kidney disease across diverse populations has not been determined.

METHODS: We performed a meta-analysis of 11 general-population studies (with 90,750 participants) and 5 studies of cohorts with chronic kidney disease (2960 participants) for whom standardized measurements of serum creatinine and cystatin C were available. We compared the association of the eGFR, as calculated by the measurement of creatinine or cystatin C alone or in combination with creatinine, with the rates of death (13,202 deaths in 15 cohorts), death from cardiovascular causes (3471 in 12 cohorts), and end-stage renal disease (1654 cases in 7 cohorts) and assessed improvement in reclassification with the use of cystatin C.

RESULTS: In the general-population cohorts, the prevalence of an eGFR of less than 60 ml per minute per 1.73 m(2) of body-surface area was higher with the cystatin C-based eGFR than with the creatinine-based eGFR (13.7% vs. 9.7%). Across all eGFR categories, the reclassification of the eGFR to a higher value with the measurement of cystatin C, as compared with creatinine, was associated with a reduced risk of all three study outcomes, and reclassification to a lower eGFR was associated with an increased risk. The net reclassification improvement with the measurement of cystatin C, as compared with creatinine, was 0.23 (95% confidence interval [CI], 0.18 to 0.28) for death and 0.10 (95% CI, 0.00 to 0.21) for end-stage renal disease. Results were generally similar for the five cohorts with chronic kidney disease and when both creatinine and cystatin C were used to calculate the eGFR.

CONCLUSIONS: The use of cystatin C alone or in combination with creatinine strengthens the association between the eGFR and the risks of death and end-stage renal disease across diverse populations. (Funded by the National Kidney Foundation and others.).

%B N Engl J Med %V 369 %P 932-43 %8 2013 Sep 05 %G eng %N 10 %R 10.1056/NEJMoa1214234 %0 Journal Article %J Nat Genet %D 2013 %T Discovery and refinement of loci associated with lipid levels. %A Willer, Cristen J %A Schmidt, Ellen M %A Sengupta, Sebanti %A Peloso, Gina M %A Gustafsson, Stefan %A Kanoni, Stavroula %A Ganna, Andrea %A Chen, Jin %A Buchkovich, Martin L %A Mora, Samia %A Beckmann, Jacques S %A Bragg-Gresham, Jennifer L %A Chang, Hsing-Yi %A Demirkan, Ayse %A Den Hertog, Heleen M %A Do, Ron %A Donnelly, Louise A %A Ehret, Georg B %A Esko, Tõnu %A Feitosa, Mary F %A Ferreira, Teresa %A Fischer, Krista %A Fontanillas, Pierre %A Fraser, Ross M %A Freitag, Daniel F %A Gurdasani, Deepti %A Heikkilä, Kauko %A Hyppönen, Elina %A Isaacs, Aaron %A Jackson, Anne U %A Johansson, Asa %A Johnson, Toby %A Kaakinen, Marika %A Kettunen, Johannes %A Kleber, Marcus E %A Li, Xiaohui %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Magnusson, Patrik K E %A Mangino, Massimo %A Mihailov, Evelin %A Montasser, May E %A Müller-Nurasyid, Martina %A Nolte, Ilja M %A O'Connell, Jeffrey R %A Palmer, Cameron D %A Perola, Markus %A Petersen, Ann-Kristin %A Sanna, Serena %A Saxena, Richa %A Service, Susan K %A Shah, Sonia %A Shungin, Dmitry %A Sidore, Carlo %A Song, Ci %A Strawbridge, Rona J %A Surakka, Ida %A Tanaka, Toshiko %A Teslovich, Tanya M %A Thorleifsson, Gudmar %A van den Herik, Evita G %A Voight, Benjamin F %A Volcik, Kelly A %A Waite, Lindsay L %A Wong, Andrew %A Wu, Ying %A Zhang, Weihua %A Absher, Devin %A Asiki, Gershim %A Barroso, Inês %A Been, Latonya F %A Bolton, Jennifer L %A Bonnycastle, Lori L %A Brambilla, Paolo %A Burnett, Mary S %A Cesana, Giancarlo %A Dimitriou, Maria %A Doney, Alex S F %A Döring, Angela %A Elliott, Paul %A Epstein, Stephen E %A Ingi Eyjolfsson, Gudmundur %A Gigante, Bruna %A Goodarzi, Mark O %A Grallert, Harald %A Gravito, Martha L %A Groves, Christopher J %A Hallmans, Göran %A Hartikainen, Anna-Liisa %A Hayward, Caroline %A Hernandez, Dena %A Hicks, Andrew A %A Holm, Hilma %A Hung, Yi-Jen %A Illig, Thomas %A Jones, Michelle R %A Kaleebu, Pontiano %A Kastelein, John J P %A Khaw, Kay-Tee %A Kim, Eric %A Klopp, Norman %A Komulainen, Pirjo %A Kumari, Meena %A Langenberg, Claudia %A Lehtimäki, Terho %A Lin, Shih-Yi %A Lindström, Jaana %A Loos, Ruth J F %A Mach, François %A McArdle, Wendy L %A Meisinger, Christa %A Mitchell, Braxton D %A Müller, Gabrielle %A Nagaraja, Ramaiah %A Narisu, Narisu %A Nieminen, Tuomo V M %A Nsubuga, Rebecca N %A Olafsson, Isleifur %A Ong, Ken K %A Palotie, Aarno %A Papamarkou, Theodore %A Pomilla, Cristina %A Pouta, Anneli %A Rader, Daniel J %A Reilly, Muredach P %A Ridker, Paul M %A Rivadeneira, Fernando %A Rudan, Igor %A Ruokonen, Aimo %A Samani, Nilesh %A Scharnagl, Hubert %A Seeley, Janet %A Silander, Kaisa %A Stančáková, Alena %A Stirrups, Kathleen %A Swift, Amy J %A Tiret, Laurence %A Uitterlinden, André G %A van Pelt, L Joost %A Vedantam, Sailaja %A Wainwright, Nicholas %A Wijmenga, Cisca %A Wild, Sarah H %A Willemsen, Gonneke %A Wilsgaard, Tom %A Wilson, James F %A Young, Elizabeth H %A Zhao, Jing Hua %A Adair, Linda S %A Arveiler, Dominique %A Assimes, Themistocles L %A Bandinelli, Stefania %A Bennett, Franklyn %A Bochud, Murielle %A Boehm, Bernhard O %A Boomsma, Dorret I %A Borecki, Ingrid B %A Bornstein, Stefan R %A Bovet, Pascal %A Burnier, Michel %A Campbell, Harry %A Chakravarti, Aravinda %A Chambers, John C %A Chen, Yii-Der Ida %A Collins, Francis S %A Cooper, Richard S %A Danesh, John %A Dedoussis, George %A de Faire, Ulf %A Feranil, Alan B %A Ferrieres, Jean %A Ferrucci, Luigi %A Freimer, Nelson B %A Gieger, Christian %A Groop, Leif C %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Hamsten, Anders %A Harris, Tamara B %A Hingorani, Aroon %A Hirschhorn, Joel N %A Hofman, Albert %A Hovingh, G Kees %A Hsiung, Chao Agnes %A Humphries, Steve E %A Hunt, Steven C %A Hveem, Kristian %A Iribarren, Carlos %A Jarvelin, Marjo-Riitta %A Jula, Antti %A Kähönen, Mika %A Kaprio, Jaakko %A Kesäniemi, Antero %A Kivimaki, Mika %A Kooner, Jaspal S %A Koudstaal, Peter J %A Krauss, Ronald M %A Kuh, Diana %A Kuusisto, Johanna %A Kyvik, Kirsten O %A Laakso, Markku %A Lakka, Timo A %A Lind, Lars %A Lindgren, Cecilia M %A Martin, Nicholas G %A März, Winfried %A McCarthy, Mark I %A McKenzie, Colin A %A Meneton, Pierre %A Metspalu, Andres %A Moilanen, Leena %A Morris, Andrew D %A Munroe, Patricia B %A Njølstad, Inger %A Pedersen, Nancy L %A Power, Chris %A Pramstaller, Peter P %A Price, Jackie F %A Psaty, Bruce M %A Quertermous, Thomas %A Rauramaa, Rainer %A Saleheen, Danish %A Salomaa, Veikko %A Sanghera, Dharambir K %A Saramies, Jouko %A Schwarz, Peter E H %A Sheu, Wayne H-H %A Shuldiner, Alan R %A Siegbahn, Agneta %A Spector, Tim D %A Stefansson, Kari %A Strachan, David P %A Tayo, Bamidele O %A Tremoli, Elena %A Tuomilehto, Jaakko %A Uusitupa, Matti %A van Duijn, Cornelia M %A Vollenweider, Peter %A Wallentin, Lars %A Wareham, Nicholas J %A Whitfield, John B %A Wolffenbuttel, Bruce H R %A Ordovas, Jose M %A Boerwinkle, Eric %A Palmer, Colin N A %A Thorsteinsdottir, Unnur %A Chasman, Daniel I %A Rotter, Jerome I %A Franks, Paul W %A Ripatti, Samuli %A Cupples, L Adrienne %A Sandhu, Manjinder S %A Rich, Stephen S %A Boehnke, Michael %A Deloukas, Panos %A Kathiresan, Sekar %A Mohlke, Karen L %A Ingelsson, Erik %A Abecasis, Goncalo R %K African Continental Ancestry Group %K Asian Continental Ancestry Group %K Cholesterol, HDL %K Cholesterol, LDL %K Coronary Artery Disease %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Lipids %K Triglycerides %X

Levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol are heritable, modifiable risk factors for coronary artery disease. To identify new loci and refine known loci influencing these lipids, we examined 188,577 individuals using genome-wide and custom genotyping arrays. We identify and annotate 157 loci associated with lipid levels at P < 5 × 10(-8), including 62 loci not previously associated with lipid levels in humans. Using dense genotyping in individuals of European, East Asian, South Asian and African ancestry, we narrow association signals in 12 loci. We find that loci associated with blood lipid levels are often associated with cardiovascular and metabolic traits, including coronary artery disease, type 2 diabetes, blood pressure, waist-hip ratio and body mass index. Our results demonstrate the value of using genetic data from individuals of diverse ancestry and provide insights into the biological mechanisms regulating blood lipids to guide future genetic, biological and therapeutic research.

%B Nat Genet %V 45 %P 1274-1283 %8 2013 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/24097068?dopt=Abstract %R 10.1038/ng.2797 %0 Journal Article %J COPD %D 2013 %T Effects of respiratory and non-respiratory factors on disability among older adults with airway obstruction: the Cardiovascular Health Study. %A Locke, Emily %A Thielke, Stephen %A Diehr, Paula %A Wilsdon, Anthony G %A Barr, R Graham %A Hansel, Nadia %A Kapur, Vishesh K %A Krishnan, Jerry %A Enright, Paul %A Heckbert, Susan R %A Kronmal, Richard A %A Fan, Vincent S %K Activities of Daily Living %K Aged %K Cognition Disorders %K Cohort Studies %K Comorbidity %K Depression %K Diabetes Mellitus %K Disease Progression %K Dyspnea %K Female %K Heart Failure %K Humans %K Linear Models %K Longitudinal Studies %K Male %K Muscle Weakness %K Myocardial Ischemia %K Osteoporosis %K Pulmonary Disease, Chronic Obstructive %K Severity of Illness Index %K Spirometry %X

BACKGROUND: High rates of disability associated with chronic airway obstruction may be caused by impaired pulmonary function, pulmonary symptoms, other chronic diseases, or systemic inflammation.

METHODS: We analyzed data from the Cardiovascular Health Study, a longitudinal cohort of 5888 older adults. Categories of lung function (normal; restricted; borderline, mild-moderate, and severe obstruction) were delineated by baseline spirometry (without bronchodilator). Disability-free years were calculated as total years alive and without self-report of difficulty performing &γτ;1 Instrumental Activities of Daily Living over 6 years of follow-up. Using linear regression, we compared disability-free years by lung disease category, adjusting for demographic factors, body mass index, smoking, cognition, and other chronic co-morbidities. Among participants with airflow obstruction, we examined the association of respiratory factors (FEV1 and dyspnea) and non-respiratory factors (ischemic heart disease, congestive heart failure, diabetes, muscle weakness, osteoporosis, depression and cognitive impairment) on disability-free years.

RESULTS: The average disability free years were 4.0 out of a possible 6 years. Severe obstruction was associated with 1 fewer disability-free year compared to normal spirometry in the adjusted model. For the 1,048 participants with airway obstruction, both respiratory factors (FEV1 and dyspnea) and non-respiratory factors (heart disease, coronary artery disease, diabetes, depression, osteoporosis, cognitive function, and weakness) were associated with decreased disability-free years.

CONCLUSIONS: Severe obstruction is associated with greater disability compared to patients with normal spirometery. Both respiratory and non-respiratory factors contribute to disability in older adults with abnormal spirometry.

%B COPD %V 10 %P 588-96 %8 2013 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23819728?dopt=Abstract %R 10.3109/15412555.2013.781148 %0 Journal Article %J BMC Med Genet %D 2013 %T Effects of smoking on the genetic risk of obesity: the population architecture using genomics and epidemiology study. %A Fesinmeyer, Megan D %A North, Kari E %A Lim, Unhee %A Bůzková, Petra %A Crawford, Dana C %A Haessler, Jeffrey %A Gross, Myron D %A Fowke, Jay H %A Goodloe, Robert %A Love, Shelley-Ann %A Graff, Misa %A Carlson, Christopher S %A Kuller, Lewis H %A Matise, Tara C %A Hong, Ching-Ping %A Henderson, Brian E %A Allen, Melissa %A Rohde, Rebecca R %A Mayo, Ping %A Schnetz-Boutaud, Nathalie %A Monroe, Kristine R %A Ritchie, Marylyn D %A Prentice, Ross L %A Kolonel, Lawrence N %A Manson, JoAnn E %A Pankow, James %A Hindorff, Lucia A %A Franceschini, Nora %A Wilkens, Lynne R %A Haiman, Christopher A %A Le Marchand, Loïc %A Peters, Ulrike %K Adolescent %K Adult %K African Americans %K Aged %K Alpha-Ketoglutarate-Dependent Dioxygenase FTO %K Body Mass Index %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Humans %K Male %K Membrane Proteins %K Middle Aged %K Obesity %K Polymorphism, Single Nucleotide %K Proteins %K Risk Factors %K Smoking %K Young Adult %X

BACKGROUND: Although smoking behavior is known to affect body mass index (BMI), the potential for smoking to influence genetic associations with BMI is largely unexplored.

METHODS: As part of the 'Population Architecture using Genomics and Epidemiology (PAGE)' Consortium, we investigated interaction between genetic risk factors associated with BMI and smoking for 10 single nucleotide polymorphisms (SNPs) previously identified in genome-wide association studies. We included 6 studies with a total of 56,466 subjects (16,750 African Americans (AA) and 39,716 European Americans (EA)). We assessed effect modification by testing an interaction term for each SNP and smoking (current vs. former/never) in the linear regression and by stratified analyses.

RESULTS: We did not observe strong evidence for interactions and only observed two interactions with p-values <0.1: for rs6548238/TMEM18, the risk allele (C) was associated with BMI only among AA females who were former/never smokers (β = 0.018, p = 0.002), vs. current smokers (β = 0.001, p = 0.95, p(interaction) = 0.10). For rs9939609/FTO, the A allele was more strongly associated with BMI among current smoker EA females (β = 0.017, p = 3.5 x 10(-5)), vs. former/never smokers (β = 0.006, p = 0.05, p(interaction) = 0.08).

CONCLUSIONS: These analyses provide limited evidence that smoking status may modify genetic effects of previously identified genetic risk factors for BMI. Larger studies are needed to follow up our results.

CLINICAL TRIAL REGISTRATION: NCT00000611.

%B BMC Med Genet %V 14 %P 6 %8 2013 Jan 11 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/23311614?dopt=Abstract %R 10.1186/1471-2350-14-6 %0 Journal Article %J Chest %D 2013 %T Epidemiology and long-term clinical and biologic risk factors for pneumonia in community-dwelling older Americans: analysis of three cohorts. %A Yende, Sachin %A Alvarez, Karina %A Loehr, Laura %A Folsom, Aaron R %A Newman, Anne B %A Weissfeld, Lisa A %A Wunderink, Richard G %A Kritchevsky, Stephen B %A Mukamal, Kenneth J %A London, Stephanie J %A Harris, Tamara B %A Bauer, Doug C %A Angus, Derek C %K Age Factors %K Aged %K Aged, 80 and over %K Community-Acquired Infections %K Comorbidity %K Female %K Follow-Up Studies %K Hospitalization %K Humans %K Incidence %K Male %K Middle Aged %K Pneumonia %K Prognosis %K Prospective Studies %K Risk Assessment %K Risk Factors %K Survival Rate %K Time Factors %X

BACKGROUND: Preventing pneumonia requires better understanding of incidence, mortality, and long-term clinical and biologic risk factors, particularly in younger individuals.

METHODS: This was a cohort study in three population-based cohorts of community-dwelling individuals. A derivation cohort (n = 16,260) was used to determine incidence and survival and develop a risk prediction model. The prediction model was validated in two cohorts (n = 8,495). The primary outcome was 10-year risk of pneumonia hospitalization.

RESULTS: The crude and age-adjusted incidences of pneumonia were 6.71 and 9.43 cases/1,000 person-years (10-year risk was 6.15%). The 30-day and 1-year mortality were 16.5% and 31.5%. Although age was the most important risk factor (range of crude incidence rates, 1.69-39.13 cases/1,000 person-years for each 5-year increment from 45-85 years), 38% of pneumonia cases occurred in adults < 65 years of age. The 30-day and 1-year mortality were 12.5% and 25.7% in those < 65 years of age. Although most comorbidities were associated with higher risk of pneumonia, reduced lung function was the most important risk factor (relative risk = 6.61 for severe reduction based on FEV1 by spirometry). A clinical risk prediction model based on age, smoking, and lung function predicted 10-year risk (area under curve [AUC] = 0.77 and Hosmer-Lemeshow [HL] C statistic = 0.12). Model discrimination and calibration were similar in the internal validation cohort (AUC = 0.77; HL C statistic, 0.65) but lower in the external validation cohort (AUC = 0.62; HL C statistic, 0.45). The model also calibrated well in blacks and younger adults. C-reactive protein and IL-6 were associated with higher pneumonia risk but did not improve model performance.

CONCLUSIONS: Pneumonia hospitalization is common and associated with high mortality, even in younger healthy adults. Long-term risk of pneumonia can be predicted in community-dwelling adults with a simple clinical risk prediction model.

%B Chest %V 144 %P 1008-1017 %8 2013 Sep %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23744106?dopt=Abstract %R 10.1378/chest.12-2818 %0 Journal Article %J Lifetime Data Anal %D 2013 %T Evaluating subject-level incremental values of new markers for risk classification rule. %A Cai, T %A Tian, L %A Lloyd-Jones, D %A Wei, L J %K Aged %K Antihypertensive Agents %K Biomarkers %K Biostatistics %K C-Reactive Protein %K Confidence Intervals %K Coronary Disease %K Female %K Humans %K Risk %K Risk Factors %K Statistics, Nonparametric %K United States %X

Suppose that we need to classify a population of subjects into several well-defined ordered risk categories for disease prevention or management with their "baseline" risk factors/markers. In this article, we present a systematic approach to identify subjects using their conventional risk factors/markers who would benefit from a new set of risk markers for more accurate classification. Specifically for each subgroup of individuals with the same conventional risk estimate, we present inference procedures for the reclassification and the corresponding correct re-categorization rates with the new markers. We then apply these new tools to analyze the data from the Cardiovascular Health Study sponsored by the US National Heart, Lung, and Blood Institute. We used Framingham risk factors plus the information of baseline anti-hypertensive drug usage to identify adult American women who may benefit from the measurement of a new blood biomarker, CRP, for better risk classification in order to intensify prevention of coronary heart disease for the subsequent 10 years.

%B Lifetime Data Anal %V 19 %P 547-67 %8 2013 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/23807696?dopt=Abstract %R 10.1007/s10985-013-9272-6 %0 Journal Article %J Circ Cardiovasc Genet %D 2013 %T Exome sequencing and genome-wide linkage analysis in 17 families illustrate the complex contribution of TTN truncating variants to dilated cardiomyopathy. %A Norton, Nadine %A Li, Duanxiang %A Rampersaud, Evadnie %A Morales, Ana %A Martin, Eden R %A Zuchner, Stephan %A Guo, Shengru %A Gonzalez, Michael %A Hedges, Dale J %A Robertson, Peggy D %A Krumm, Niklas %A Nickerson, Deborah A %A Hershberger, Ray E %K Adolescent %K Adult %K Aged %K Cardiomyopathy, Dilated %K Chromosomes, Human, Pair 9 %K Connectin %K Exome %K Female %K Genetic Heterogeneity %K Genetic Linkage %K Genetic Loci %K Genome, Human %K Humans %K Male %K Middle Aged %K Muscle Proteins %K Mutation, Missense %K Odds Ratio %K Pedigree %K Protein Kinases %K Sequence Analysis, DNA %K Young Adult %X

BACKGROUND- Familial dilated cardiomyopathy (DCM) is a genetically heterogeneous disease with >30 known genes. TTN truncating variants were recently implicated in a candidate gene study to cause 25% of familial and 18% of sporadic DCM cases. METHODS AND RESULTS- We used an unbiased genome-wide approach using both linkage analysis and variant filtering across the exome sequences of 48 individuals affected with DCM from 17 families to identify genetic cause. Linkage analysis ranked the TTN region as falling under the second highest genome-wide multipoint linkage peak, multipoint logarithm of odds, 1.59. We identified 6 TTN truncating variants carried by individuals affected with DCM in 7 of 17 DCM families (logarithm of odds, 2.99); 2 of these 7 families also had novel missense variants that segregated with disease. Two additional novel truncating TTN variants did not segregate with DCM. Nucleotide diversity at the TTN locus, including missense variants, was comparable with 5 other known DCM genes. The average number of missense variants in the exome sequences from the DCM cases or the ≈5400 cases from the Exome Sequencing Project was ≈23 per individual. The average number of TTN truncating variants in the Exome Sequencing Project was 0.014 per individual. We also identified a region (chr9q21.11-q22.31) with no known DCM genes with a maximum heterogeneity logarithm of odds score of 1.74. CONCLUSIONS- These data suggest that TTN truncating variants contribute to DCM cause. However, the lack of segregation of all identified TTN truncating variants illustrates the challenge of determining variant pathogenicity even with full exome sequencing.

%B Circ Cardiovasc Genet %V 6 %P 144-53 %8 2013 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23418287?dopt=Abstract %R 10.1161/CIRCGENETICS.111.000062 %0 Journal Article %J Age Ageing %D 2013 %T Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study. %A Yan, Tingjian %A Escarce, José J %A Liang, Li-Jung %A Longstreth, W T %A Merkin, Sharon Stein %A Ovbiagele, Bruce %A Vassar, Stefanie D %A Seeman, Teresa %A Sarkisian, Catherine %A Brown, Arleen F %K African Americans %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Brain Ischemia %K Depression %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Humans %K Incidence %K Linear Models %K Logistic Models %K Male %K Middle Aged %K Proportional Hazards Models %K Prospective Studies %K Residence Characteristics %K Risk Assessment %K Risk Factors %K Social Support %K Socioeconomic Factors %K Stroke %K Time Factors %K United States %K Vulnerable Populations %X

OBJECTIVES: to investigate whether psychosocial pathways mediate the association between neighbourhood socioeconomic disadvantage and stroke.

METHODS: prospective cohort study with a follow-up of 11.5 years.

SETTING: the Cardiovascular Health Study, a longitudinal population-based cohort study of older adults ≥65 years.

MEASUREMENTS: the primary outcome was adjudicated incident ischaemic stroke. Neighbourhood socioeconomic status (NSES) was measured using a composite of six census-tract variables. Psychosocial factors were assessed with standard measures for depression, social support and social networks.

RESULTS: of the 3,834 white participants with no prior stroke, 548 had an incident ischaemic stroke over the 11.5-year follow-up. Among whites, the incident stroke hazard ratio (HR) associated with living in the lowest relative to highest NSES quartile was 1.32 (95% CI = 1.01-1.73), in models adjusted for individual SES. Additional adjustment for psychosocial factors had a minimal effect on hazard of incident stroke (HR = 1.31, CI = 1.00-1.71). Associations between NSES and stroke incidence were not found among African-Americans (n = 785) in either partially or fully adjusted models.

CONCLUSIONS: psychosocial factors played a minimal role in mediating the effect of NSES on stroke incidence among white older adults.

%B Age Ageing %V 42 %P 391-7 %8 2013 May %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23264005?dopt=Abstract %R 10.1093/ageing/afs179 %0 Journal Article %J J Clin Endocrinol Metab %D 2013 %T Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults: the cardiovascular health study. %A Jovanovich, Anna %A Bůzková, Petra %A Chonchol, Michel %A Robbins, John %A Fink, Howard A %A de Boer, Ian H %A Kestenbaum, Bryan %A Katz, Ronit %A Carbone, Laura %A Lee, Jennifer %A Laughlin, Gail A %A Mukamal, Kenneth J %A Fried, Linda F %A Shlipak, Michael G %A Ix, Joachim H %K Aged %K Aged, 80 and over %K Bone Density %K Female %K Fibroblast Growth Factors %K Hip Fractures %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Risk %K Spinal Fractures %X

CONTEXT: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that also inhibits calcitriol synthesis.

OBJECTIVE: Our objective was to evaluate the relationships of plasma FGF23 concentrations with bone mineral density (BMD) and hip fracture in community-dwelling older adults.

DESIGN AND SETTING: Linear regression and Cox proportional hazard models were used to examine the associations of plasma FGF23 concentrations with BMD and incident hip fracture, respectively. Analyses were also stratified by chronic kidney disease.

PARTICIPANTS: Participants included 2008 women and 1329 men ≥65 years from the 1996 to 1997 Cardiovascular Health Study visit.

MAIN OUTCOME MEASURES: Dual x-ray absorptiometry measured total hip (TH) and lumbar spine (LS) BMD in 1291 participants. Hip fracture incidence was assessed prospectively through June 30, 2008 by hospitalization records in all participants.

RESULTS: Women had higher plasma FGF23 concentrations than men (75 [56-107] vs 66 [interquartile range = 52-92] relative units/mL; P < .001). After adjustment, higher FGF23 concentrations were associated with greater total hip and lumbar spine BMD in men only (β per doubling of FGF23 = 0.02, with 95% confidence interval [CI] = 0.001-0.04 g/cm(2), and 0.03 with 95% CI = 0.01-0.06 g/cm(2)). During 9.6 ± 5.1-11.0 years of follow-up, 328 hip fractures occurred. Higher FGF23 concentrations were not associated with hip fracture risk in women or men (adjusted hazard ratio = 0.95, with 95% CI = 0.78-1.15, and 1.09 with 95% CI = 0.82-1.46 per doubling of FGF23). Results did not differ by chronic kidney disease status (P > .4 for interactions).

CONCLUSIONS: In this large prospective cohort of community-dwelling older adults, higher FGF23 concentrations were weakly associated with greater lumbar spine and total hip BMD but not with hip fracture risk.

%B J Clin Endocrinol Metab %V 98 %P 3323-31 %8 2013 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/23771921?dopt=Abstract %R 10.1210/jc.2013-1152 %0 Journal Article %J Am J Hum Genet %D 2013 %T Fine Mapping and Identification of BMI Loci in African Americans. %A Gong, Jian %A Schumacher, Fredrick %A Lim, Unhee %A Hindorff, Lucia A %A Haessler, Jeff %A Buyske, Steven %A Carlson, Christopher S %A Rosse, Stephanie %A Bůzková, Petra %A Fornage, Myriam %A Gross, Myron %A Pankratz, Nathan %A Pankow, James S %A Schreiner, Pamela J %A Cooper, Richard %A Ehret, Georg %A Gu, C Charles %A Houston, Denise %A Irvin, Marguerite R %A Jackson, Rebecca %A Kuller, Lew %A Henderson, Brian %A Cheng, Iona %A Wilkens, Lynne %A Leppert, Mark %A Lewis, Cora E %A Li, Rongling %A Nguyen, Khanh-Dung H %A Goodloe, Robert %A Farber-Eger, Eric %A Boston, Jonathan %A Dilks, Holli H %A Ritchie, Marylyn D %A Fowke, Jay %A Pooler, Loreall %A Graff, Misa %A Fernandez-Rhodes, Lindsay %A Cochrane, Barbara %A Boerwinkle, Eric %A Kooperberg, Charles %A Matise, Tara C %A Le Marchand, Loïc %A Crawford, Dana C %A Haiman, Christopher A %A North, Kari E %A Peters, Ulrike %K Adult %K African Americans %K Aged %K Aged, 80 and over %K Body Mass Index %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Genotype %K Humans %K Linkage Disequilibrium %K Male %K Middle Aged %K Obesity %K Polymorphism, Single Nucleotide %K Young Adult %X

Genome-wide association studies (GWASs) primarily performed in European-ancestry (EA) populations have identified numerous loci associated with body mass index (BMI). However, it is still unclear whether these GWAS loci can be generalized to other ethnic groups, such as African Americans (AAs). Furthermore, the putative functional variant or variants in these loci mostly remain under investigation. The overall lower linkage disequilibrium in AA compared to EA populations provides the opportunity to narrow in or fine-map these BMI-related loci. Therefore, we used the Metabochip to densely genotype and evaluate 21 BMI GWAS loci identified in EA studies in 29,151 AAs from the Population Architecture using Genomics and Epidemiology (PAGE) study. Eight of the 21 loci (SEC16B, TMEM18, ETV5, GNPDA2, TFAP2B, BDNF, FTO, and MC4R) were found to be associated with BMI in AAs at 5.8 × 10(-5). Within seven out of these eight loci, we found that, on average, a substantially smaller number of variants was correlated (r(2) > 0.5) with the most significant SNP in AA than in EA populations (16 versus 55). Conditional analyses revealed GNPDA2 harboring a potential additional independent signal. Moreover, Metabochip-wide discovery analyses revealed two BMI-related loci, BRE (rs116612809, p = 3.6 × 10(-8)) and DHX34 (rs4802349, p = 1.2 × 10(-7)), which were significant when adjustment was made for the total number of SNPs tested across the chip. These results demonstrate that fine mapping in AAs is a powerful approach for both narrowing in on the underlying causal variants in known loci and discovering BMI-related loci.

%B Am J Hum Genet %V 93 %P 661-71 %8 2013 Oct 3 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/24094743?dopt=Abstract %R 10.1016/j.ajhg.2013.08.012 %0 Journal Article %J Hum Mol Genet %D 2013 %T Gene-centric meta-analyses of 108 912 individuals confirm known body mass index loci and reveal three novel signals. %A Guo, Yiran %A Lanktree, Matthew B %A Taylor, Kira C %A Hakonarson, Hakon %A Lange, Leslie A %A Keating, Brendan J %K Body Mass Index %K Cohort Studies %K Ethnic Groups %K Humans %K Polymorphism, Single Nucleotide %X

Recent genetic association studies have made progress in uncovering components of the genetic architecture of the body mass index (BMI). We used the ITMAT-Broad-Candidate Gene Association Resource (CARe) (IBC) array comprising up to 49 320 single nucleotide polymorphisms (SNPs) across ~2100 metabolic and cardiovascular-related loci to genotype up to 108 912 individuals of European ancestry (EA), African-Americans, Hispanics and East Asians, from 46 studies, to provide additional insight into SNPs underpinning BMI. We used a five-phase study design: Phase I focused on meta-analysis of EA studies providing individual level genotype data; Phase II performed a replication of cohorts providing summary level EA data; Phase III meta-analyzed results from the first two phases; associated SNPs from Phase III were used for replication in Phase IV; finally in Phase V, a multi-ethnic meta-analysis of all samples from four ethnicities was performed. At an array-wide significance (P < 2.40E-06), we identify novel BMI associations in loci translocase of outer mitochondrial membrane 40 homolog (yeast) - apolipoprotein E - apolipoprotein C-I (TOMM40-APOE-APOC1) (rs2075650, P = 2.95E-10), sterol regulatory element binding transcription factor 2 (SREBF2, rs5996074, P = 9.43E-07) and neurotrophic tyrosine kinase, receptor, type 2 [NTRK2, a brain-derived neurotrophic factor (BDNF) receptor gene, rs1211166, P = 1.04E-06] in the Phase IV meta-analysis. Of 10 loci with previous evidence for BMI association represented on the IBC array, eight were replicated, with the remaining two showing nominal significance. Conditional analyses revealed two independent BMI-associated signals in BDNF and melanocortin 4 receptor (MC4R) regions. Of the 11 array-wide significant SNPs, three are associated with gene expression levels in both primary B-cells and monocytes; with rs4788099 in SH2B adaptor protein 1 (SH2B1) notably being associated with the expression of multiple genes in cis. These multi-ethnic meta-analyses expand our knowledge of BMI genetics.

%B Hum Mol Genet %V 22 %P 184-201 %8 2013 Jan 01 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23001569?dopt=Abstract %R 10.1093/hmg/dds396 %0 Journal Article %J PLoS Biol %D 2013 %T Generalization and dilution of association results from European GWAS in populations of non-European ancestry: the PAGE study. %A Carlson, Christopher S %A Matise, Tara C %A North, Kari E %A Haiman, Christopher A %A Fesinmeyer, Megan D %A Buyske, Steven %A Schumacher, Fredrick R %A Peters, Ulrike %A Franceschini, Nora %A Ritchie, Marylyn D %A Duggan, David J %A Spencer, Kylee L %A Dumitrescu, Logan %A Eaton, Charles B %A Thomas, Fridtjof %A Young, Alicia %A Carty, Cara %A Heiss, Gerardo %A Le Marchand, Loïc %A Crawford, Dana C %A Hindorff, Lucia A %A Kooperberg, Charles L %K African Americans %K Asian Americans %K Body Mass Index %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Gene Frequency %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Hispanic Americans %K Humans %K Indians, North American %K Lipids %K Metagenomics %K Oceanic Ancestry Group %K Polymorphism, Single Nucleotide %X

The vast majority of genome-wide association study (GWAS) findings reported to date are from populations with European Ancestry (EA), and it is not yet clear how broadly the genetic associations described will generalize to populations of diverse ancestry. The Population Architecture Using Genomics and Epidemiology (PAGE) study is a consortium of multi-ancestry, population-based studies formed with the objective of refining our understanding of the genetic architecture of common traits emerging from GWAS. In the present analysis of five common diseases and traits, including body mass index, type 2 diabetes, and lipid levels, we compare direction and magnitude of effects for GWAS-identified variants in multiple non-EA populations against EA findings. We demonstrate that, in all populations analyzed, a significant majority of GWAS-identified variants have allelic associations in the same direction as in EA, with none showing a statistically significant effect in the opposite direction, after adjustment for multiple testing. However, 25% of tagSNPs identified in EA GWAS have significantly different effect sizes in at least one non-EA population, and these differential effects were most frequent in African Americans where all differential effects were diluted toward the null. We demonstrate that differential LD between tagSNPs and functional variants within populations contributes significantly to dilute effect sizes in this population. Although most variants identified from GWAS in EA populations generalize to all non-EA populations assessed, genetic models derived from GWAS findings in EA may generate spurious results in non-EA populations due to differential effect sizes. Regardless of the origin of the differential effects, caution should be exercised in applying any genetic risk prediction model based on tagSNPs outside of the ancestry group in which it was derived. Models based directly on functional variation may generalize more robustly, but the identification of functional variants remains challenging.

%B PLoS Biol %V 11 %P e1001661 %8 2013 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/24068893?dopt=Abstract %R 10.1371/journal.pbio.1001661 %0 Journal Article %J J Clin Psychopharmacol %D 2013 %T Genetic analysis of a population heavy drinking phenotype identifies risk variants in whites. %A Hamidovic, Ajna %A Goodloe, Robert J %A Young, Taylor R %A Styn, Mindi A %A Mukamal, Kenneth J %A Choquet, Helene %A Kasberger, Jay L %A Buxbaum, Sarah G %A Papanicolaou, George J %A White, Wendy %A Volcik, Kelly %A Spring, Bonnie %A Hitsman, Brian %A Levy, Daniel %A Jorgenson, Eric %K Aged %K Alcohol Drinking %K Alcoholism %K Case-Control Studies %K European Continental Ancestry Group %K Feasibility Studies %K Genetic Association Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genetic Variation %K Humans %K Incidence %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Risk %X

Genetic association studies thus far have used detailed diagnoses of alcoholism to identify loci associated with risk. This proof-of-concept analysis examined whether population data of lifetime heaviest alcohol consumption may be used to identify genetic loci that modulate risk. We conducted a genetic association study in European Americans between variants in approximately 2100 genes and alcohol consumption as part of the Candidate gene Association Resource project. We defined cases as individuals with a history of drinking 5 or more drinks per day almost every day of the week and controls as current light drinkers (1-5 drinks per week). We cross-validated identified single nucleotide polymorphisms in a meta-analysis of 2 cohorts of unrelated individuals--Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health Study (CHS)--and in a separate cohort of related individuals--Framingham Heart Study (FHS). The most significant variant in the meta-analysis of ARIC and CHS was rs6933598 in methylenetetrahydrofolate dehydrogenase (P = 7.46 × 10(-05)) with a P value in FHS of 0.042. The top variants in FHS were rs12249562 in cubulin (P = 3.03 × 10(-05)) and rs9839267 near cholecystokinin (P = 3.05 × 10(-05)) with a P value of 0.019 for rs9839267 in CHS. We have here shown feasibility in evaluating lifetime incidence of heavy alcohol drinking from population-based studies for the purpose of conducting genetic association analyses.

%B J Clin Psychopharmacol %V 33 %P 206-10 %8 2013 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23422394?dopt=Abstract %& 206 %R 10.1097/JCP.0b013e318287009a %0 Journal Article %J Invest Ophthalmol Vis Sci %D 2013 %T Genetic association of COL5A1 variants in keratoconus patients suggests a complex connection between corneal thinning and keratoconus. %A Li, Xiaohui %A Bykhovskaya, Yelena %A Canedo, Ana Laura Caiado %A Haritunians, Talin %A Siscovick, David %A Aldave, Anthony J %A Szczotka-Flynn, Loretta %A Iyengar, Sudha K %A Rotter, Jerome I %A Taylor, Kent D %A Rabinowitz, Yaron S %K Adult %K Aged %K Collagen Type V %K Cornea %K Corneal Topography %K DNA %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Keratoconus %K Male %K Microscopy, Acoustic %K Middle Aged %K Polymorphism, Single Nucleotide %K Tomography, Optical Coherence %X

PURPOSE: Single nucleotide polymorphisms (SNPs) located near or within the COL5A1 gene, at 9q34.2-q34.3 chromosomal region have been reported in association with central corneal thickness (CCT). Using family linkage analysis, we identified a keratoconus susceptibility locus at 9q34. These findings led us to perform an association study between COL5A1 variation and keratoconus susceptibility.

METHODS: A Caucasian case-control cohort of 222 keratoconus patients and 3324 controls was selected as the discovery panel. An independent case-control panel of 304 cases and 518 controls and a family panel of 186 subjects were replicated for genotyping and association. Forty-four SNPs (21 for discovery and 23 for fine-mapping) spanning 300 kilobases in and around COL5A1 were genotyped and tested for genetic association. Logistic regression models implemented in PLINK were used to test for association in case controls. Generalized estimating equation models accounting for familial correlations implemented in genome-wide interaction analyses with family data were used for association testing in families.

RESULTS: Two CCT associated SNPs (rs1536482 and rs7044529 near and within COL5A1) were identified in the keratoconus discovery cohort (P values of 6.5 × 10(-3) and 7.4 × 10(-3)). SNP rs1536482 was replicated in the second case-control sample (P = 0.02), and SNP rs7044529 was replicated in a keratoconus family panel (P = 0.03). Meta P values of rs1536482 and rs7044529 in the keratoconus cohorts were 1.5 × 10(-4) (odds ratio [OR] = 1.30) and 2.9 × 10(-3) (OR = 1.39). After Bonferroni correction, the association of SNP rs1536482 remained significant (P = 6.5 × 10(-3)).

CONCLUSIONS: SNPs in the COL5A1 region, which regulate normal variation in CCT, may play a role in the thinning associated with keratoconus.

%B Invest Ophthalmol Vis Sci %V 54 %P 2696-704 %8 2013 Apr 12 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/23513063?dopt=Abstract %R 10.1167/iovs.13-11601 %0 Journal Article %J PLoS One %D 2013 %T Genetic loci for retinal arteriolar microcirculation. %A Sim, Xueling %A Jensen, Richard A %A Ikram, M Kamran %A Cotch, Mary Frances %A Li, Xiaohui %A Macgregor, Stuart %A Xie, Jing %A Smith, Albert Vernon %A Boerwinkle, Eric %A Mitchell, Paul %A Klein, Ronald %A Klein, Barbara E K %A Glazer, Nicole L %A Lumley, Thomas %A McKnight, Barbara %A Psaty, Bruce M %A de Jong, Paulus T V M %A Hofman, Albert %A Rivadeneira, Fernando %A Uitterlinden, André G %A van Duijn, Cornelia M %A Aspelund, Thor %A Eiriksdottir, Gudny %A Harris, Tamara B %A Jonasson, Fridbert %A Launer, Lenore J %A Attia, John %A Baird, Paul N %A Harrap, Stephen %A Holliday, Elizabeth G %A Inouye, Michael %A Rochtchina, Elena %A Scott, Rodney J %A Viswanathan, Ananth %A Li, Guo %A Smith, Nicholas L %A Wiggins, Kerri L %A Kuo, Jane Z %A Taylor, Kent D %A Hewitt, Alex W %A Martin, Nicholas G %A Montgomery, Grant W %A Sun, Cong %A Young, Terri L %A Mackey, David A %A van Zuydam, Natalie R %A Doney, Alex S F %A Palmer, Colin N A %A Morris, Andrew D %A Rotter, Jerome I %A Tai, E Shyong %A Gudnason, Vilmundur %A Vingerling, Johannes R %A Siscovick, David S %A Wang, Jie Jin %A Wong, Tien Y %K Aged %K Aged, 80 and over %K Arterioles %K Chromosomes, Human, Pair 5 %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K MEF2 Transcription Factors %K Microcirculation %K Middle Aged %K Models, Genetic %K Retinal Vessels %X

Narrow arterioles in the retina have been shown to predict hypertension as well as other vascular diseases, likely through an increase in the peripheral resistance of the microcirculatory flow. In this study, we performed a genome-wide association study in 18,722 unrelated individuals of European ancestry from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium and the Blue Mountain Eye Study, to identify genetic determinants associated with variations in retinal arteriolar caliber. Retinal vascular calibers were measured on digitized retinal photographs using a standardized protocol. One variant (rs2194025 on chromosome 5q14 near the myocyte enhancer factor 2C MEF2C gene) was associated with retinal arteriolar caliber in the meta-analysis of the discovery cohorts at genome-wide significance of P-value <5×10(-8). This variant was replicated in an additional 3,939 individuals of European ancestry from the Australian Twins Study and Multi-Ethnic Study of Atherosclerosis (rs2194025, P-value = 2.11×10(-12) in combined meta-analysis of discovery and replication cohorts). In independent studies of modest sample sizes, no significant association was found between this variant and clinical outcomes including coronary artery disease, stroke, myocardial infarction or hypertension. In conclusion, we found one novel loci which underlie genetic variation in microvasculature which may be relevant to vascular disease. The relevance of these findings to clinical outcomes remains to be determined.

%B PLoS One %V 8 %P e65804 %8 2013 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23776548?dopt=Abstract %R 10.1371/journal.pone.0065804 %0 Journal Article %J Obesity (Silver Spring) %D 2013 %T Genetic risk factors for BMI and obesity in an ethnically diverse population: results from the population architecture using genomics and epidemiology (PAGE) study. %A Fesinmeyer, Megan D %A North, Kari E %A Ritchie, Marylyn D %A Lim, Unhee %A Franceschini, Nora %A Wilkens, Lynne R %A Gross, Myron D %A Bůzková, Petra %A Glenn, Kimberly %A Quibrera, P Miguel %A Fernandez-Rhodes, Lindsay %A Li, Qiong %A Fowke, Jay H %A Li, Rongling %A Carlson, Christopher S %A Prentice, Ross L %A Kuller, Lewis H %A Manson, JoAnn E %A Matise, Tara C %A Cole, Shelley A %A Chen, Christina T L %A Howard, Barbara V %A Kolonel, Laurence N %A Henderson, Brian E %A Monroe, Kristine R %A Crawford, Dana C %A Hindorff, Lucia A %A Buyske, Steven %A Haiman, Christopher A %A Le Marchand, Loïc %A Peters, Ulrike %K Alleles %K Body Mass Index %K Ethnic Groups %K Gene Frequency %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Metagenomics %K Obesity %K Phenotype %K Polymorphism, Single Nucleotide %K Risk Factors %X

OBJECTIVE: Several genome-wide association studies (GWAS) have demonstrated that common genetic variants contribute to obesity. However, studies of this complex trait have focused on ancestrally European populations, despite the high prevalence of obesity in some minority groups.

DESIGN AND METHODS: As part of the "Population Architecture using Genomics and Epidemiology (PAGE)" Consortium, we investigated the association between 13 GWAS-identified single-nucleotide polymorphisms (SNPs) and BMI and obesity in 69,775 subjects, including 6,149 American Indians, 15,415 African-Americans, 2,438 East Asians, 7,346 Hispanics, 604 Pacific Islanders, and 37,823 European Americans. For the BMI-increasing allele of each SNP, we calculated β coefficients using linear regression (for BMI) and risk estimates using logistic regression (for obesity defined as BMI ≥ 30) followed by fixed-effects meta-analysis to combine results across PAGE sites. Analyses stratified by racial/ethnic group assumed an additive genetic model and were adjusted for age, sex, and current smoking. We defined "replicating SNPs" (in European Americans) and "generalizing SNPs" (in other racial/ethnic groups) as those associated with an allele frequency-specific increase in BMI.

RESULTS: By this definition, we replicated 9/13 SNP associations (5 out of 8 loci) in European Americans. We also generalized 8/13 SNP associations (5/8 loci) in East Asians, 7/13 (5/8 loci) in African Americans, 6/13 (4/8 loci) in Hispanics, 5/8 in Pacific Islanders (5/8 loci), and 5/9 (4/8 loci) in American Indians.

CONCLUSION: Linkage disequilibrium patterns suggest that tagSNPs selected for European Americans may not adequately tag causal variants in other ancestry groups. Accordingly, fine-mapping in large samples is needed to comprehensively explore these loci in diverse populations.

%B Obesity (Silver Spring) %V 21 %P 835-46 %8 2013 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/23712987?dopt=Abstract %R 10.1002/oby.20268 %0 Journal Article %J BMC Med Genet %D 2013 %T Genetic variants associated with fasting glucose and insulin concentrations in an ethnically diverse population: results from the Population Architecture using Genomics and Epidemiology (PAGE) study. %A Fesinmeyer, Megan D %A Meigs, James B %A North, Kari E %A Schumacher, Fredrick R %A Bůzková, Petra %A Franceschini, Nora %A Haessler, Jeffrey %A Goodloe, Robert %A Spencer, Kylee L %A Voruganti, Venkata Saroja %A Howard, Barbara V %A Jackson, Rebecca %A Kolonel, Laurence N %A Liu, Simin %A Manson, JoAnn E %A Monroe, Kristine R %A Mukamal, Kenneth %A Dilks, Holli H %A Pendergrass, Sarah A %A Nato, Andrew %A Wan, Peggy %A Wilkens, Lynne R %A Le Marchand, Loïc %A Ambite, Jose Luis %A Buyske, Steven %A Florez, Jose C %A Crawford, Dana C %A Hindorff, Lucia A %A Haiman, Christopher A %A Peters, Ulrike %A Pankow, James S %K Adaptor Proteins, Signal Transducing %K Adult %K African Americans %K Aged %K Alleles %K Asian Continental Ancestry Group %K Blood Glucose %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Loci %K Genome-Wide Association Study %K Genomics %K Hispanic Americans %K Humans %K Indians, North American %K Insulin %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Transcription Factor 7-Like 2 Protein %X

BACKGROUND: Multiple genome-wide association studies (GWAS) within European populations have implicated common genetic variants associated with insulin and glucose concentrations. In contrast, few studies have been conducted within minority groups, which carry the highest burden of impaired glucose homeostasis and type 2 diabetes in the U.S.

METHODS: As part of the 'Population Architecture using Genomics and Epidemiology (PAGE) Consortium, we investigated the association of up to 10 GWAS-identified single nucleotide polymorphisms (SNPs) in 8 genetic regions with glucose or insulin concentrations in up to 36,579 non-diabetic subjects including 23,323 European Americans (EA) and 7,526 African Americans (AA), 3,140 Hispanics, 1,779 American Indians (AI), and 811 Asians. We estimated the association between each SNP and fasting glucose or log-transformed fasting insulin, followed by meta-analysis to combine results across PAGE sites.

RESULTS: Overall, our results show that 9/9 GWAS SNPs are associated with glucose in EA (p = 0.04 to 9 × 10-15), versus 3/9 in AA (p= 0.03 to 6 × 10-5), 3/4 SNPs in Hispanics, 2/4 SNPs in AI, and 1/2 SNPs in Asians. For insulin we observed a significant association with rs780094/GCKR in EA, Hispanics and AI only.

CONCLUSIONS: Generalization of results across multiple racial/ethnic groups helps confirm the relevance of some of these loci for glucose and insulin metabolism. Lack of association in non-EA groups may be due to insufficient power, or to unique patterns of linkage disequilibrium.

%B BMC Med Genet %V 14 %P 98 %8 2013 Sep 25 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24063630?dopt=Abstract %R 10.1186/1471-2350-14-98 %0 Journal Article %J Hum Mol Genet %D 2013 %T Genome-wide and gene-centric analyses of circulating myeloperoxidase levels in the charge and care consortia. %A Reiner, Alexander P %A Hartiala, Jaana %A Zeller, Tanja %A Bis, Joshua C %A Dupuis, Josée %A Fornage, Myriam %A Baumert, Jens %A Kleber, Marcus E %A Wild, Philipp S %A Baldus, Stephan %A Bielinski, Suzette J %A Fontes, João D %A Illig, Thomas %A Keating, Brendan J %A Lange, Leslie A %A Ojeda, Francisco %A Müller-Nurasyid, Martina %A Munzel, Thomas F %A Psaty, Bruce M %A Rice, Kenneth %A Rotter, Jerome I %A Schnabel, Renate B %A Tang, W H Wilson %A Thorand, Barbara %A Erdmann, Jeanette %A Jacobs, David R %A Wilson, James G %A Koenig, Wolfgang %A Tracy, Russell P %A Blankenberg, Stefan %A März, Winfried %A Gross, Myron D %A Benjamin, Emelia J %A Hazen, Stanley L %A Allayee, Hooman %K Adult %K African Americans %K Aged %K Case-Control Studies %K Complement Factor H %K Coronary Artery Disease %K European Continental Ancestry Group %K Female %K Gene Expression Regulation, Enzymologic %K Genetic Association Studies %K Genetic Variation %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Middle Aged %K Peroxidase %K Polymorphism, Single Nucleotide %K Young Adult %X

Increased systemic levels of myeloperoxidase (MPO) are associated with the risk of coronary artery disease (CAD). To identify the genetic factors that are associated with circulating MPO levels, we carried out a genome-wide association study (GWAS) and a gene-centric analysis in subjects of European ancestry and African Americans (AAs). A locus on chromosome 1q31.1 containing the complement factor H (CFH) gene was strongly associated with serum MPO levels in 9305 subjects of European ancestry (lead SNP rs800292; P = 4.89 × 10(-41)) and in 1690 AA subjects (rs505102; P = 1.05 × 10(-8)). Gene-centric analyses in 8335 subjects of European ancestry additionally identified two rare MPO coding sequence variants that were associated with serum MPO levels (rs28730837, P = 5.21 × 10(-12); rs35897051, P = 3.32 × 10(-8)). A GWAS for plasma MPO levels in 9260 European ancestry subjects identified a chromosome 17q22 region near MPO that was significantly associated (lead SNP rs6503905; P = 2.94 × 10(-12)), but the CFH locus did not exhibit evidence of association with plasma MPO levels. Functional analyses revealed that rs800292 was associated with levels of complement proteins in serum. Variants at chromosome 17q22 also had pleiotropic cis effects on gene expression. In a case-control analysis of ∼80 000 subjects from CARDIoGRAM, none of the identified single-nucleotide polymorphisms (SNPs) were associated with CAD. These results suggest that distinct genetic factors regulate serum and plasma MPO levels, which may have relevance for various acute and chronic inflammatory disorders. The clinical implications for CAD and a better understanding of the functional basis for the association of CFH and MPO variants with circulating MPO levels require further study.

%B Hum Mol Genet %V 22 %P 3381-93 %8 2013 Aug 15 %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/23620142?dopt=Abstract %R 10.1093/hmg/ddt189 %0 Journal Article %J Nat Genet %D 2013 %T Genome-wide association analyses identify 18 new loci associated with serum urate concentrations. %A Köttgen, Anna %A Albrecht, Eva %A Teumer, Alexander %A Vitart, Veronique %A Krumsiek, Jan %A Hundertmark, Claudia %A Pistis, Giorgio %A Ruggiero, Daniela %A O'Seaghdha, Conall M %A Haller, Toomas %A Yang, Qiong %A Tanaka, Toshiko %A Johnson, Andrew D %A Kutalik, Zoltán %A Smith, Albert V %A Shi, Julia %A Struchalin, Maksim %A Middelberg, Rita P S %A Brown, Morris J %A Gaffo, Angelo L %A Pirastu, Nicola %A Li, Guo %A Hayward, Caroline %A Zemunik, Tatijana %A Huffman, Jennifer %A Yengo, Loic %A Zhao, Jing Hua %A Demirkan, Ayse %A Feitosa, Mary F %A Liu, Xuan %A Malerba, Giovanni %A Lopez, Lorna M %A van der Harst, Pim %A Li, Xinzhong %A Kleber, Marcus E %A Hicks, Andrew A %A Nolte, Ilja M %A Johansson, Asa %A Murgia, Federico %A Wild, Sarah H %A Bakker, Stephan J L %A Peden, John F %A Dehghan, Abbas %A Steri, Maristella %A Tenesa, Albert %A Lagou, Vasiliki %A Salo, Perttu %A Mangino, Massimo %A Rose, Lynda M %A Lehtimäki, Terho %A Woodward, Owen M %A Okada, Yukinori %A Tin, Adrienne %A Müller, Christian %A Oldmeadow, Christopher %A Putku, Margus %A Czamara, Darina %A Kraft, Peter %A Frogheri, Laura %A Thun, Gian Andri %A Grotevendt, Anne %A Gislason, Gauti Kjartan %A Harris, Tamara B %A Launer, Lenore J %A McArdle, Patrick %A Shuldiner, Alan R %A Boerwinkle, Eric %A Coresh, Josef %A Schmidt, Helena %A Schallert, Michael %A Martin, Nicholas G %A Montgomery, Grant W %A Kubo, Michiaki %A Nakamura, Yusuke %A Tanaka, Toshihiro %A Munroe, Patricia B %A Samani, Nilesh J %A Jacobs, David R %A Liu, Kiang %A D'Adamo, Pio %A Ulivi, Sheila %A Rotter, Jerome I %A Psaty, Bruce M %A Vollenweider, Peter %A Waeber, Gérard %A Campbell, Susan %A Devuyst, Olivier %A Navarro, Pau %A Kolcic, Ivana %A Hastie, Nicholas %A Balkau, Beverley %A Froguel, Philippe %A Esko, Tõnu %A Salumets, Andres %A Khaw, Kay Tee %A Langenberg, Claudia %A Wareham, Nicholas J %A Isaacs, Aaron %A Kraja, Aldi %A Zhang, Qunyuan %A Wild, Philipp S %A Scott, Rodney J %A Holliday, Elizabeth G %A Org, Elin %A Viigimaa, Margus %A Bandinelli, Stefania %A Metter, Jeffrey E %A Lupo, Antonio %A Trabetti, Elisabetta %A Sorice, Rossella %A Döring, Angela %A Lattka, Eva %A Strauch, Konstantin %A Theis, Fabian %A Waldenberger, Melanie %A Wichmann, H-Erich %A Davies, Gail %A Gow, Alan J %A Bruinenberg, Marcel %A Stolk, Ronald P %A Kooner, Jaspal S %A Zhang, Weihua %A Winkelmann, Bernhard R %A Boehm, Bernhard O %A Lucae, Susanne %A Penninx, Brenda W %A Smit, Johannes H %A Curhan, Gary %A Mudgal, Poorva %A Plenge, Robert M %A Portas, Laura %A Persico, Ivana %A Kirin, Mirna %A Wilson, James F %A Mateo Leach, Irene %A van Gilst, Wiek H %A Goel, Anuj %A Ongen, Halit %A Hofman, Albert %A Rivadeneira, Fernando %A Uitterlinden, André G %A Imboden, Medea %A von Eckardstein, Arnold %A Cucca, Francesco %A Nagaraja, Ramaiah %A Piras, Maria Grazia %A Nauck, Matthias %A Schurmann, Claudia %A Budde, Kathrin %A Ernst, Florian %A Farrington, Susan M %A Theodoratou, Evropi %A Prokopenko, Inga %A Stumvoll, Michael %A Jula, Antti %A Perola, Markus %A Salomaa, Veikko %A Shin, So-Youn %A Spector, Tim D %A Sala, Cinzia %A Ridker, Paul M %A Kähönen, Mika %A Viikari, Jorma %A Hengstenberg, Christian %A Nelson, Christopher P %A Meschia, James F %A Nalls, Michael A %A Sharma, Pankaj %A Singleton, Andrew B %A Kamatani, Naoyuki %A Zeller, Tanja %A Burnier, Michel %A Attia, John %A Laan, Maris %A Klopp, Norman %A Hillege, Hans L %A Kloiber, Stefan %A Choi, Hyon %A Pirastu, Mario %A Tore, Silvia %A Probst-Hensch, Nicole M %A Völzke, Henry %A Gudnason, Vilmundur %A Parsa, Afshin %A Schmidt, Reinhold %A Whitfield, John B %A Fornage, Myriam %A Gasparini, Paolo %A Siscovick, David S %A Polasek, Ozren %A Campbell, Harry %A Rudan, Igor %A Bouatia-Naji, Nabila %A Metspalu, Andres %A Loos, Ruth J F %A van Duijn, Cornelia M %A Borecki, Ingrid B %A Ferrucci, Luigi %A Gambaro, Giovanni %A Deary, Ian J %A Wolffenbuttel, Bruce H R %A Chambers, John C %A März, Winfried %A Pramstaller, Peter P %A Snieder, Harold %A Gyllensten, Ulf %A Wright, Alan F %A Navis, Gerjan %A Watkins, Hugh %A Witteman, Jacqueline C M %A Sanna, Serena %A Schipf, Sabine %A Dunlop, Malcolm G %A Tönjes, Anke %A Ripatti, Samuli %A Soranzo, Nicole %A Toniolo, Daniela %A Chasman, Daniel I %A Raitakari, Olli %A Kao, W H Linda %A Ciullo, Marina %A Fox, Caroline S %A Caulfield, Mark %A Bochud, Murielle %A Gieger, Christian %K Analysis of Variance %K European Continental Ancestry Group %K Gene Frequency %K Genetic Loci %K Genome-Wide Association Study %K Glucose %K Gout %K Humans %K Inhibins %K Polymorphism, Single Nucleotide %K Signal Transduction %K Uric Acid %X

Elevated serum urate concentrations can cause gout, a prevalent and painful inflammatory arthritis. By combining data from >140,000 individuals of European ancestry within the Global Urate Genetics Consortium (GUGC), we identified and replicated 28 genome-wide significant loci in association with serum urate concentrations (18 new regions in or near TRIM46, INHBB, SFMBT1, TMEM171, VEGFA, BAZ1B, PRKAG2, STC1, HNF4G, A1CF, ATXN2, UBE2Q2, IGF1R, NFAT5, MAF, HLF, ACVR1B-ACVRL1 and B3GNT4). Associations for many of the loci were of similar magnitude in individuals of non-European ancestry. We further characterized these loci for associations with gout, transcript expression and the fractional excretion of urate. Network analyses implicate the inhibins-activins signaling pathways and glucose metabolism in systemic urate control. New candidate genes for serum urate concentration highlight the importance of metabolic control of urate production and excretion, which may have implications for the treatment and prevention of gout.

%B Nat Genet %V 45 %P 145-54 %8 2013 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23263486?dopt=Abstract %R 10.1038/ng.2500 %0 Journal Article %J PLoS Genet %D 2013 %T Genome-wide association of body fat distribution in African ancestry populations suggests new loci. %A Liu, Ching-Ti %A Monda, Keri L %A Taylor, Kira C %A Lange, Leslie %A Demerath, Ellen W %A Palmas, Walter %A Wojczynski, Mary K %A Ellis, Jaclyn C %A Vitolins, Mara Z %A Liu, Simin %A Papanicolaou, George J %A Irvin, Marguerite R %A Xue, Luting %A Griffin, Paula J %A Nalls, Michael A %A Adeyemo, Adebowale %A Liu, Jiankang %A Li, Guo %A Ruiz-Narvaez, Edward A %A Chen, Wei-Min %A Chen, Fang %A Henderson, Brian E %A Millikan, Robert C %A Ambrosone, Christine B %A Strom, Sara S %A Guo, Xiuqing %A Andrews, Jeanette S %A Sun, Yan V %A Mosley, Thomas H %A Yanek, Lisa R %A Shriner, Daniel %A Haritunians, Talin %A Rotter, Jerome I %A Speliotes, Elizabeth K %A Smith, Megan %A Rosenberg, Lynn %A Mychaleckyj, Josyf %A Nayak, Uma %A Spruill, Ida %A Garvey, W Timothy %A Pettaway, Curtis %A Nyante, Sarah %A Bandera, Elisa V %A Britton, Angela F %A Zonderman, Alan B %A Rasmussen-Torvik, Laura J %A Chen, Yii-Der Ida %A Ding, Jingzhong %A Lohman, Kurt %A Kritchevsky, Stephen B %A Zhao, Wei %A Peyser, Patricia A %A Kardia, Sharon L R %A Kabagambe, Edmond %A Broeckel, Ulrich %A Chen, Guanjie %A Zhou, Jie %A Wassertheil-Smoller, Sylvia %A Neuhouser, Marian L %A Rampersaud, Evadnie %A Psaty, Bruce %A Kooperberg, Charles %A Manson, JoAnn E %A Kuller, Lewis H %A Ochs-Balcom, Heather M %A Johnson, Karen C %A Sucheston, Lara %A Ordovas, Jose M %A Palmer, Julie R %A Haiman, Christopher A %A McKnight, Barbara %A Howard, Barbara V %A Becker, Diane M %A Bielak, Lawrence F %A Liu, Yongmei %A Allison, Matthew A %A Grant, Struan F A %A Burke, Gregory L %A Patel, Sanjay R %A Schreiner, Pamela J %A Borecki, Ingrid B %A Evans, Michele K %A Taylor, Herman %A Sale, Michèle M %A Howard, Virginia %A Carlson, Christopher S %A Rotimi, Charles N %A Cushman, Mary %A Harris, Tamara B %A Reiner, Alexander P %A Cupples, L Adrienne %A North, Kari E %A Fox, Caroline S %K Adiposity %K African Continental Ancestry Group %K Body Fat Distribution %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Obesity %K Polymorphism, Single Nucleotide %K Waist-Hip Ratio %X

Central obesity, measured by waist circumference (WC) or waist-hip ratio (WHR), is a marker of body fat distribution. Although obesity disproportionately affects minority populations, few studies have conducted genome-wide association study (GWAS) of fat distribution among those of predominantly African ancestry (AA). We performed GWAS of WC and WHR, adjusted and unadjusted for BMI, in up to 33,591 and 27,350 AA individuals, respectively. We identified loci associated with fat distribution in AA individuals using meta-analyses of GWA results for WC and WHR (stage 1). Overall, 25 SNPs with single genomic control (GC)-corrected p-values<5.0 × 10(-6) were followed-up (stage 2) in AA with WC and with WHR. Additionally, we interrogated genomic regions of previously identified European ancestry (EA) WHR loci among AA. In joint analysis of association results including both Stage 1 and 2 cohorts, 2 SNPs demonstrated association, rs2075064 at LHX2, p = 2.24×10(-8) for WC-adjusted-for-BMI, and rs6931262 at RREB1, p = 2.48×10(-8) for WHR-adjusted-for-BMI. However, neither signal was genome-wide significant after double GC-correction (LHX2: p = 6.5 × 10(-8); RREB1: p = 5.7 × 10(-8)). Six of fourteen previously reported loci for waist in EA populations were significant (p<0.05 divided by the number of independent SNPs within the region) in AA studied here (TBX15-WARS2, GRB14, ADAMTS9, LY86, RSPO3, ITPR2-SSPN). Further, we observed associations with metabolic traits: rs13389219 at GRB14 associated with HDL-cholesterol, triglycerides, and fasting insulin, and rs13060013 at ADAMTS9 with HDL-cholesterol and fasting insulin. Finally, we observed nominal evidence for sexual dimorphism, with stronger results in AA women at the GRB14 locus (p for interaction = 0.02). In conclusion, we identified two suggestive loci associated with fat distribution in AA populations in addition to confirming 6 loci previously identified in populations of EA. These findings reinforce the concept that there are fat distribution loci that are independent of generalized adiposity.

%B PLoS Genet %V 9 %P e1003681 %8 2013 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/23966867?dopt=Abstract %R 10.1371/journal.pgen.1003681 %0 Journal Article %J Genet Epidemiol %D 2013 %T A genome-wide association study for venous thromboembolism: the extended cohorts for heart and aging research in genomic epidemiology (CHARGE) consortium. %A Tang, Weihong %A Teichert, Martina %A Chasman, Daniel I %A Heit, John A %A Morange, Pierre-Emmanuel %A Li, Guo %A Pankratz, Nathan %A Leebeek, Frank W %A Paré, Guillaume %A de Andrade, Mariza %A Tzourio, Christophe %A Psaty, Bruce M %A Basu, Saonli %A Ruiter, Rikje %A Rose, Lynda %A Armasu, Sebastian M %A Lumley, Thomas %A Heckbert, Susan R %A Uitterlinden, André G %A Lathrop, Mark %A Rice, Kenneth M %A Cushman, Mary %A Hofman, Albert %A Lambert, Jean-Charles %A Glazer, Nicole L %A Pankow, James S %A Witteman, Jacqueline C %A Amouyel, Philippe %A Bis, Joshua C %A Bovill, Edwin G %A Kong, Xiaoxiao %A Tracy, Russell P %A Boerwinkle, Eric %A Rotter, Jerome I %A Trégouët, David-Alexandre %A Loth, Daan W %A Stricker, Bruno H Ch %A Ridker, Paul M %A Folsom, Aaron R %A Smith, Nicholas L %K Aged %K Aging %K Case-Control Studies %K Cohort Studies %K Female %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %K Regression Analysis %K Risk Factors %K Venous Thromboembolism %X

Venous thromboembolism (VTE) is a common, heritable disease resulting in high rates of hospitalization and mortality. Yet few associations between VTE and genetic variants, all in the coagulation pathway, have been established. To identify additional genetic determinants of VTE, we conducted a two-stage genome-wide association study (GWAS) among individuals of European ancestry in the extended cohorts for heart and aging research in genomic epidemiology (CHARGE) VTE consortium. The discovery GWAS comprised 1,618 incident VTE cases out of 44,499 participants from six community-based studies. Genotypes for genome-wide single-nucleotide polymorphisms (SNPs) were imputed to approximately 2.5 million SNPs in HapMap and association with VTE assessed using study-design appropriate regression methods. Meta-analysis of these results identified two known loci, in F5 and ABO. Top 1,047 tag SNPs (P ≤ 0.0016) from the discovery GWAS were tested for association in an additional 3,231 cases and 3,536 controls from three case-control studies. In the combined data from these two stages, additional genome-wide significant associations were observed on 4q35 at F11 (top SNP rs4253399, intronic to F11) and on 4q28 at FGG (rs6536024, 9.7 kb from FGG; P < 5.0 × 10(-13) for both). The associations at the FGG locus were not completely explained by previously reported variants. Loci at or near SUSD1 and OTUD7A showed borderline yet novel associations (P < 5.0 × 10(-6) ) and constitute new candidate genes. In conclusion, this large GWAS replicated key genetic associations in F5 and ABO, and confirmed the importance of F11 and FGG loci for VTE. Future studies are warranted to better characterize the associations with F11 and FGG and to replicate the new candidate associations.

%B Genet Epidemiol %V 37 %P 512-521 %8 2013 Jul %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23650146?dopt=Abstract %R 10.1002/gepi.21731 %0 Journal Article %J Circ Cardiovasc Genet %D 2013 %T Genome-wide association study identifies novel loci associated with concentrations of four plasma phospholipid fatty acids in the de novo lipogenesis pathway: results from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortiu %A Wu, Jason H Y %A Lemaitre, Rozenn N %A Manichaikul, Ani %A Guan, Weihua %A Tanaka, Toshiko %A Foy, Millennia %A Kabagambe, Edmond K %A Djoussé, Luc %A Siscovick, David %A Fretts, Amanda M %A Johnson, Catherine %A King, Irena B %A Psaty, Bruce M %A McKnight, Barbara %A Rich, Stephen S %A Chen, Yii-der I %A Nettleton, Jennifer A %A Tang, Weihong %A Bandinelli, Stefania %A Jacobs, David R %A Browning, Brian L %A Laurie, Cathy C %A Gu, Xiangjun %A Tsai, Michael Y %A Steffen, Lyn M %A Ferrucci, Luigi %A Fornage, Myriam %A Mozaffarian, Dariush %K Adult %K Aged %K Chromosomes, Human, Pair 2 %K Cohort Studies %K Coronary Disease %K Diabetes Mellitus, Type 2 %K Fatty Acids, Monounsaturated %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Humans %K Linkage Disequilibrium %K Lipogenesis %K Male %K Middle Aged %K Oleic Acid %K Palmitic Acid %K Polymorphism, Single Nucleotide %K Stearic Acids %X

BACKGROUND- Palmitic acid (16:0), stearic acid (18:0), palmitoleic acid (16:1n-7), and oleic acid (18:1n-9) are major saturated and monounsaturated fatty acids that affect cellular signaling and metabolic pathways. They are synthesized via de novo lipogenesis and are the main saturated and monounsaturated fatty acids in the diet. Levels of these fatty acids have been linked to diseases including type 2 diabetes mellitus and coronary heart disease. METHODS AND RESULTS- Genome-wide association studies were conducted in 5 population-based cohorts comprising 8961 participants of European ancestry to investigate the association of common genetic variation with plasma levels of these 4 fatty acids. We identified polymorphisms in 7 novel loci associated with circulating levels of ≥1 of these fatty acids. ALG14 (asparagine-linked glycosylation 14 homolog) polymorphisms were associated with higher 16:0 (P=2.7×10(-11)) and lower 18:0 (P=2.2×10(-18)). FADS1 and FADS2 (desaturases) polymorphisms were associated with higher 16:1n-7 (P=6.6×10(-13)) and 18:1n-9 (P=2.2×10(-32)) and lower 18:0 (P=1.3×10(-20)). LPGAT1 (lysophosphatidylglycerol acyltransferase) polymorphisms were associated with lower 18:0 (P=2.8×10(-9)). GCKR (glucokinase regulator; P=9.8×10(-10)) and HIF1AN (factor inhibiting hypoxia-inducible factor-1; P=5.7×10(-9)) polymorphisms were associated with higher 16:1n-7, whereas PKD2L1 (polycystic kidney disease 2-like 1; P=5.7×10(-15)) and a locus on chromosome 2 (not near known genes) were associated with lower 16:1n-7 (P=4.1×10(-8)). CONCLUSIONS- Our findings provide novel evidence that common variations in genes with diverse functions, including protein-glycosylation, polyunsaturated fatty acid metabolism, phospholipid modeling, and glucose- and oxygen-sensing pathways, are associated with circulating levels of 4 fatty acids in the de novo lipogenesis pathway. These results expand our knowledge of genetic factors relevant to de novo lipogenesis and fatty acid biology.

%B Circ Cardiovasc Genet %V 6 %P 171-83 %8 2013 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23362303?dopt=Abstract %R 10.1161/CIRCGENETICS.112.964619 %0 Journal Article %J Circ Cardiovasc Genet %D 2013 %T Genome-wide association study of cardiac structure and systolic function in African Americans: the Candidate Gene Association Resource (CARe) study. %A Fox, Ervin R %A Musani, Solomon K %A Barbalic, Maja %A Lin, Honghuang %A Yu, Bing %A Ogunyankin, Kofo O %A Smith, Nicholas L %A Kutlar, Abdullah %A Glazer, Nicole L %A Post, Wendy S %A Paltoo, Dina N %A Dries, Daniel L %A Farlow, Deborah N %A Duarte, Christine W %A Kardia, Sharon L %A Meyers, Kristin J %A Sun, Yan V %A Arnett, Donna K %A Patki, Amit A %A Sha, Jin %A Cui, Xiangqui %A Samdarshi, Tandaw E %A Penman, Alan D %A Bibbins-Domingo, Kirsten %A Bůzková, Petra %A Benjamin, Emelia J %A Bluemke, David A %A Morrison, Alanna C %A Heiss, Gerardo %A Carr, J Jeffrey %A Tracy, Russell P %A Mosley, Thomas H %A Taylor, Herman A %A Psaty, Bruce M %A Heckbert, Susan R %A Cappola, Thomas P %A Vasan, Ramachandran S %K African Americans %K Aged %K Cohort Studies %K Diastole %K Echocardiography %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Genotype %K Heart %K Humans %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Systole %X

BACKGROUND: Using data from 4 community-based cohorts of African Americans, we tested the association between genome-wide markers (single-nucleotide polymorphisms) and cardiac phenotypes in the Candidate-gene Association Resource study.

METHODS AND RESULTS: Among 6765 African Americans, we related age, sex, height, and weight-adjusted residuals for 9 cardiac phenotypes (assessed by echocardiogram or magnetic resonance imaging) to 2.5 million single-nucleotide polymorphisms genotyped using Genome-wide Affymetrix Human SNP Array 6.0 (Affy6.0) and the remainder imputed. Within the cohort, genome-wide association analysis was conducted, followed by meta-analysis across cohorts using inverse variance weights (genome-wide significance threshold=4.0 ×10(-7)). Supplementary pathway analysis was performed. We attempted replication in 3 smaller cohorts of African ancestry and tested lookups in 1 consortium of European ancestry (EchoGEN). Across the 9 phenotypes, variants in 4 genetic loci reached genome-wide significance: rs4552931 in UBE2V2 (P=1.43×10(-7)) for left ventricular mass, rs7213314 in WIPI1 (P=1.68×10(-7)) for left ventricular internal diastolic diameter, rs1571099 in PPAPDC1A (P=2.57×10(-8)) for interventricular septal wall thickness, and rs9530176 in KLF5 (P=4.02×10(-7)) for ejection fraction. Associated variants were enriched in 3 signaling pathways involved in cardiac remodeling. None of the 4 loci replicated in cohorts of African ancestry was confirmed in lookups in EchoGEN.

CONCLUSIONS: In the largest genome-wide association study of cardiac structure and function to date in African Americans, we identified 4 genetic loci related to left ventricular mass, interventricular septal wall thickness, left ventricular internal diastolic diameter, and ejection fraction, which reached genome-wide significance. Replication results suggest that these loci may be unique to individuals of African ancestry. Additional large-scale studies are warranted for these complex phenotypes.

%B Circ Cardiovasc Genet %V 6 %P 37-46 %8 2013 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23275298?dopt=Abstract %R 10.1161/CIRCGENETICS.111.962365 %0 Journal Article %J Biol Psychiatry %D 2013 %T A genome-wide association study of depressive symptoms. %A Hek, Karin %A Demirkan, Ayse %A Lahti, Jari %A Terracciano, Antonio %A Teumer, Alexander %A Cornelis, Marilyn C %A Amin, Najaf %A Bakshis, Erin %A Baumert, Jens %A Ding, Jingzhong %A Liu, Yongmei %A Marciante, Kristin %A Meirelles, Osorio %A Nalls, Michael A %A Sun, Yan V %A Vogelzangs, Nicole %A Yu, Lei %A Bandinelli, Stefania %A Benjamin, Emelia J %A Bennett, David A %A Boomsma, Dorret %A Cannas, Alessandra %A Coker, Laura H %A de Geus, Eco %A De Jager, Philip L %A Diez-Roux, Ana V %A Purcell, Shaun %A Hu, Frank B %A Rimma, Eric B %A Hunter, David J %A Jensen, Majken K %A Curhan, Gary %A Rice, Kenneth %A Penman, Alan D %A Rotter, Jerome I %A Sotoodehnia, Nona %A Emeny, Rebecca %A Eriksson, Johan G %A Evans, Denis A %A Ferrucci, Luigi %A Fornage, Myriam %A Gudnason, Vilmundur %A Hofman, Albert %A Illig, Thomas %A Kardia, Sharon %A Kelly-Hayes, Margaret %A Koenen, Karestan %A Kraft, Peter %A Kuningas, Maris %A Massaro, Joseph M %A Melzer, David %A Mulas, Antonella %A Mulder, Cornelis L %A Murray, Anna %A Oostra, Ben A %A Palotie, Aarno %A Penninx, Brenda %A Petersmann, Astrid %A Pilling, Luke C %A Psaty, Bruce %A Rawal, Rajesh %A Reiman, Eric M %A Schulz, Andrea %A Shulman, Joshua M %A Singleton, Andrew B %A Smith, Albert V %A Sutin, Angelina R %A Uitterlinden, André G %A Völzke, Henry %A Widen, Elisabeth %A Yaffe, Kristine %A Zonderman, Alan B %A Cucca, Francesco %A Harris, Tamara %A Ladwig, Karl-Heinz %A Llewellyn, David J %A Räikkönen, Katri %A Tanaka, Toshiko %A van Duijn, Cornelia M %A Grabe, Hans J %A Launer, Lenore J %A Lunetta, Kathryn L %A Mosley, Thomas H %A Newman, Anne B %A Tiemeier, Henning %A Murabito, Joanne %K Aged %K Aged, 80 and over %K Chromosomes, Human, Pair 5 %K Depression %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

BACKGROUND: Depression is a heritable trait that exists on a continuum of varying severity and duration. Yet, the search for genetic variants associated with depression has had few successes. We exploit the entire continuum of depression to find common variants for depressive symptoms.

METHODS: In this genome-wide association study, we combined the results of 17 population-based studies assessing depressive symptoms with the Center for Epidemiological Studies Depression Scale. Replication of the independent top hits (p<1×10(-5)) was performed in five studies assessing depressive symptoms with other instruments. In addition, we performed a combined meta-analysis of all 22 discovery and replication studies.

RESULTS: The discovery sample comprised 34,549 individuals (mean age of 66.5) and no loci reached genome-wide significance (lowest p = 1.05×10(-7)). Seven independent single nucleotide polymorphisms were considered for replication. In the replication set (n = 16,709), we found suggestive association of one single nucleotide polymorphism with depressive symptoms (rs161645, 5q21, p = 9.19×10(-3)). This 5q21 region reached genome-wide significance (p = 4.78×10(-8)) in the overall meta-analysis combining discovery and replication studies (n = 51,258).

CONCLUSIONS: The results suggest that only a large sample comprising more than 50,000 subjects may be sufficiently powered to detect genes for depressive symptoms.

%B Biol Psychiatry %V 73 %P 667-78 %8 2013 Apr 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23290196?dopt=Abstract %R 10.1016/j.biopsych.2012.09.033 %0 Journal Article %J Hum Mol Genet %D 2013 %T A genome-wide association study of early menopause and the combined impact of identified variants. %A Perry, John R B %A Corre, Tanguy %A Esko, Tõnu %A Chasman, Daniel I %A Fischer, Krista %A Franceschini, Nora %A He, Chunyan %A Kutalik, Zoltán %A Mangino, Massimo %A Rose, Lynda M %A Vernon Smith, Albert %A Stolk, Lisette %A Sulem, Patrick %A Weedon, Michael N %A Zhuang, Wei V %A Arnold, Alice %A Ashworth, Alan %A Bergmann, Sven %A Buring, Julie E %A Burri, Andrea %A Chen, Constance %A Cornelis, Marilyn C %A Couper, David J %A Goodarzi, Mark O %A Gudnason, Vilmundur %A Harris, Tamara %A Hofman, Albert %A Jones, Michael %A Kraft, Peter %A Launer, Lenore %A Laven, Joop S E %A Li, Guo %A McKnight, Barbara %A Masciullo, Corrado %A Milani, Lili %A Orr, Nicholas %A Psaty, Bruce M %A Ridker, Paul M %A Rivadeneira, Fernando %A Sala, Cinzia %A Salumets, Andres %A Schoemaker, Minouk %A Traglia, Michela %A Waeber, Gérard %A Chanock, Stephen J %A Demerath, Ellen W %A Garcia, Melissa %A Hankinson, Susan E %A Hu, Frank B %A Hunter, David J %A Lunetta, Kathryn L %A Metspalu, Andres %A Montgomery, Grant W %A Murabito, Joanne M %A Newman, Anne B %A Ong, Ken K %A Spector, Tim D %A Stefansson, Kari %A Swerdlow, Anthony J %A Thorsteinsdottir, Unnur %A van Dam, Rob M %A Uitterlinden, André G %A Visser, Jenny A %A Vollenweider, Peter %A Toniolo, Daniela %A Murray, Anna %K Case-Control Studies %K Female %K Gene Frequency %K Genome-Wide Association Study %K Humans %K Menopause, Premature %K Polymorphism, Single Nucleotide %K Primary Ovarian Insufficiency %K Quantitative Trait Loci %K Risk %X

Early menopause (EM) affects up to 10% of the female population, reducing reproductive lifespan considerably. Currently, it constitutes the leading cause of infertility in the western world, affecting mainly those women who postpone their first pregnancy beyond the age of 30 years. The genetic aetiology of EM is largely unknown in the majority of cases. We have undertaken a meta-analysis of genome-wide association studies (GWASs) in 3493 EM cases and 13 598 controls from 10 independent studies. No novel genetic variants were discovered, but the 17 variants previously associated with normal age at natural menopause as a quantitative trait (QT) were also associated with EM and primary ovarian insufficiency (POI). Thus, EM has a genetic aetiology which overlaps variation in normal age at menopause and is at least partly explained by the additive effects of the same polygenic variants. The combined effect of the common variants captured by the single nucleotide polymorphism arrays was estimated to account for ∼30% of the variance in EM. The association between the combined 17 variants and the risk of EM was greater than the best validated non-genetic risk factor, smoking.

%B Hum Mol Genet %V 22 %P 1465-72 %8 2013 Apr 01 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23307926?dopt=Abstract %R 10.1093/hmg/dds551 %0 Journal Article %J PLoS One %D 2013 %T Genome-wide association study of retinopathy in individuals without diabetes. %A Jensen, Richard A %A Sim, Xueling %A Li, Xiaohui %A Cotch, Mary Frances %A Ikram, M Kamran %A Holliday, Elizabeth G %A Eiriksdottir, Gudny %A Harris, Tamara B %A Jonasson, Fridbert %A Klein, Barbara E K %A Launer, Lenore J %A Smith, Albert Vernon %A Boerwinkle, Eric %A Cheung, Ning %A Hewitt, Alex W %A Liew, Gerald %A Mitchell, Paul %A Wang, Jie Jin %A Attia, John %A Scott, Rodney %A Glazer, Nicole L %A Lumley, Thomas %A McKnight, Barbara %A Psaty, Bruce M %A Taylor, Kent %A Hofman, Albert %A de Jong, Paulus T V M %A Rivadeneira, Fernando %A Uitterlinden, André G %A Tay, Wan-Ting %A Teo, Yik Ying %A Seielstad, Mark %A Liu, Jianjun %A Cheng, Ching-Yu %A Saw, Seang-Mei %A Aung, Tin %A Ganesh, Santhi K %A O'Donnell, Christopher J %A Nalls, Mike A %A Wiggins, Kerri L %A Kuo, Jane Z %A van Duijn, Cornelia M %A Gudnason, Vilmundur %A Klein, Ronald %A Siscovick, David S %A Rotter, Jerome I %A Tai, E Shong %A Vingerling, Johannes %A Wong, Tien Y %K Aged %K Aged, 80 and over %K Female %K Genome-Wide Association Study %K Genotype %K Histone Deacetylases %K Humans %K Hypertension %K Male %K Polymorphism, Single Nucleotide %K Repressor Proteins %K Retinal Diseases %X

BACKGROUND: Mild retinopathy (microaneurysms or dot-blot hemorrhages) is observed in persons without diabetes or hypertension and may reflect microvascular disease in other organs. We conducted a genome-wide association study (GWAS) of mild retinopathy in persons without diabetes.

METHODS: A working group agreed on phenotype harmonization, covariate selection and analytic plans for within-cohort GWAS. An inverse-variance weighted fixed effects meta-analysis was performed with GWAS results from six cohorts of 19,411 Caucasians. The primary analysis included individuals without diabetes and secondary analyses were stratified by hypertension status. We also singled out the results from single nucleotide polymorphisms (SNPs) previously shown to be associated with diabetes and hypertension, the two most common causes of retinopathy.

RESULTS: No SNPs reached genome-wide significance in the primary analysis or the secondary analysis of participants with hypertension. SNP, rs12155400, in the histone deacetylase 9 gene (HDAC9) on chromosome 7, was associated with retinopathy in analysis of participants without hypertension, -1.3±0.23 (beta ± standard error), p = 6.6×10(-9). Evidence suggests this was a false positive finding. The minor allele frequency was low (∼2%), the quality of the imputation was moderate (r(2) ∼0.7), and no other common variants in the HDAC9 gene were associated with the outcome. SNPs found to be associated with diabetes and hypertension in other GWAS were not associated with retinopathy in persons without diabetes or in subgroups with or without hypertension.

CONCLUSIONS: This GWAS of retinopathy in individuals without diabetes showed little evidence of genetic associations. Further studies are needed to identify genes associated with these signs in order to help unravel novel pathways and determinants of microvascular diseases.

%B PLoS One %V 8 %P e54232 %8 2013 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23393555?dopt=Abstract %R 10.1371/journal.pone.0054232 %0 Journal Article %J Nat Genet %D 2013 %T Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture. %A Berndt, Sonja I %A Gustafsson, Stefan %A Mägi, Reedik %A Ganna, Andrea %A Wheeler, Eleanor %A Feitosa, Mary F %A Justice, Anne E %A Monda, Keri L %A Croteau-Chonka, Damien C %A Day, Felix R %A Esko, Tõnu %A Fall, Tove %A Ferreira, Teresa %A Gentilini, Davide %A Jackson, Anne U %A Luan, Jian'an %A Randall, Joshua C %A Vedantam, Sailaja %A Willer, Cristen J %A Winkler, Thomas W %A Wood, Andrew R %A Workalemahu, Tsegaselassie %A Hu, Yi-Juan %A Lee, Sang Hong %A Liang, Liming %A Lin, Dan-Yu %A Min, Josine L %A Neale, Benjamin M %A Thorleifsson, Gudmar %A Yang, Jian %A Albrecht, Eva %A Amin, Najaf %A Bragg-Gresham, Jennifer L %A Cadby, Gemma %A den Heijer, Martin %A Eklund, Niina %A Fischer, Krista %A Goel, Anuj %A Hottenga, Jouke-Jan %A Huffman, Jennifer E %A Jarick, Ivonne %A Johansson, Asa %A Johnson, Toby %A Kanoni, Stavroula %A Kleber, Marcus E %A König, Inke R %A Kristiansson, Kati %A Kutalik, Zoltán %A Lamina, Claudia %A Lecoeur, Cécile %A Li, Guo %A Mangino, Massimo %A McArdle, Wendy L %A Medina-Gómez, Carolina %A Müller-Nurasyid, Martina %A Ngwa, Julius S %A Nolte, Ilja M %A Paternoster, Lavinia %A Pechlivanis, Sonali %A Perola, Markus %A Peters, Marjolein J %A Preuss, Michael %A Rose, Lynda M %A Shi, Jianxin %A Shungin, Dmitry %A Smith, Albert Vernon %A Strawbridge, Rona J %A Surakka, Ida %A Teumer, Alexander %A Trip, Mieke D %A Tyrer, Jonathan %A van Vliet-Ostaptchouk, Jana V %A Vandenput, Liesbeth %A Waite, Lindsay L %A Zhao, Jing Hua %A Absher, Devin %A Asselbergs, Folkert W %A Atalay, Mustafa %A Attwood, Antony P %A Balmforth, Anthony J %A Basart, Hanneke %A Beilby, John %A Bonnycastle, Lori L %A Brambilla, Paolo %A Bruinenberg, Marcel %A Campbell, Harry %A Chasman, Daniel I %A Chines, Peter S %A Collins, Francis S %A Connell, John M %A Cookson, William O %A de Faire, Ulf %A de Vegt, Femmie %A Dei, Mariano %A Dimitriou, Maria %A Edkins, Sarah %A Estrada, Karol %A Evans, David M %A Farrall, Martin %A Ferrario, Marco M %A Ferrieres, Jean %A Franke, Lude %A Frau, Francesca %A Gejman, Pablo V %A Grallert, Harald %A Grönberg, Henrik %A Gudnason, Vilmundur %A Hall, Alistair S %A Hall, Per %A Hartikainen, Anna-Liisa %A Hayward, Caroline %A Heard-Costa, Nancy L %A Heath, Andrew C %A Hebebrand, Johannes %A Homuth, Georg %A Hu, Frank B %A Hunt, Sarah E %A Hyppönen, Elina %A Iribarren, Carlos %A Jacobs, Kevin B %A Jansson, John-Olov %A Jula, Antti %A Kähönen, Mika %A Kathiresan, Sekar %A Kee, Frank %A Khaw, Kay-Tee %A Kivimaki, Mika %A Koenig, Wolfgang %A Kraja, Aldi T %A Kumari, Meena %A Kuulasmaa, Kari %A Kuusisto, Johanna %A Laitinen, Jaana H %A Lakka, Timo A %A Langenberg, Claudia %A Launer, Lenore J %A Lind, Lars %A Lindström, Jaana %A Liu, Jianjun %A Liuzzi, Antonio %A Lokki, Marja-Liisa %A Lorentzon, Mattias %A Madden, Pamela A %A Magnusson, Patrik K %A Manunta, Paolo %A Marek, Diana %A März, Winfried %A Mateo Leach, Irene %A McKnight, Barbara %A Medland, Sarah E %A Mihailov, Evelin %A Milani, Lili %A Montgomery, Grant W %A Mooser, Vincent %A Mühleisen, Thomas W %A Munroe, Patricia B %A Musk, Arthur W %A Narisu, Narisu %A Navis, Gerjan %A Nicholson, George %A Nohr, Ellen A %A Ong, Ken K %A Oostra, Ben A %A Palmer, Colin N A %A Palotie, Aarno %A Peden, John F %A Pedersen, Nancy %A Peters, Annette %A Polasek, Ozren %A Pouta, Anneli %A Pramstaller, Peter P %A Prokopenko, Inga %A Pütter, Carolin %A Radhakrishnan, Aparna %A Raitakari, Olli %A Rendon, Augusto %A Rivadeneira, Fernando %A Rudan, Igor %A Saaristo, Timo E %A Sambrook, Jennifer G %A Sanders, Alan R %A Sanna, Serena %A Saramies, Jouko %A Schipf, Sabine %A Schreiber, Stefan %A Schunkert, Heribert %A Shin, So-Youn %A Signorini, Stefano %A Sinisalo, Juha %A Skrobek, Boris %A Soranzo, Nicole %A Stančáková, Alena %A Stark, Klaus %A Stephens, Jonathan C %A Stirrups, Kathleen %A Stolk, Ronald P %A Stumvoll, Michael %A Swift, Amy J %A Theodoraki, Eirini V %A Thorand, Barbara %A Trégouët, David-Alexandre %A Tremoli, Elena %A van der Klauw, Melanie M %A van Meurs, Joyce B J %A Vermeulen, Sita H %A Viikari, Jorma %A Virtamo, Jarmo %A Vitart, Veronique %A Waeber, Gérard %A Wang, Zhaoming %A Widen, Elisabeth %A Wild, Sarah H %A Willemsen, Gonneke %A Winkelmann, Bernhard R %A Witteman, Jacqueline C M %A Wolffenbuttel, Bruce H R %A Wong, Andrew %A Wright, Alan F %A Zillikens, M Carola %A Amouyel, Philippe %A Boehm, Bernhard O %A Boerwinkle, Eric %A Boomsma, Dorret I %A Caulfield, Mark J %A Chanock, Stephen J %A Cupples, L Adrienne %A Cusi, Daniele %A Dedoussis, George V %A Erdmann, Jeanette %A Eriksson, Johan G %A Franks, Paul W %A Froguel, Philippe %A Gieger, Christian %A Gyllensten, Ulf %A Hamsten, Anders %A Harris, Tamara B %A Hengstenberg, Christian %A Hicks, Andrew A %A Hingorani, Aroon %A Hinney, Anke %A Hofman, Albert %A Hovingh, Kees G %A Hveem, Kristian %A Illig, Thomas %A Jarvelin, Marjo-Riitta %A Jöckel, Karl-Heinz %A Keinanen-Kiukaanniemi, Sirkka M %A Kiemeney, Lambertus A %A Kuh, Diana %A Laakso, Markku %A Lehtimäki, Terho %A Levinson, Douglas F %A Martin, Nicholas G %A Metspalu, Andres %A Morris, Andrew D %A Nieminen, Markku S %A Njølstad, Inger %A Ohlsson, Claes %A Oldehinkel, Albertine J %A Ouwehand, Willem H %A Palmer, Lyle J %A Penninx, Brenda %A Power, Chris %A Province, Michael A %A Psaty, Bruce M %A Qi, Lu %A Rauramaa, Rainer %A Ridker, Paul M %A Ripatti, Samuli %A Salomaa, Veikko %A Samani, Nilesh J %A Snieder, Harold %A Sørensen, Thorkild I A %A Spector, Timothy D %A Stefansson, Kari %A Tönjes, Anke %A Tuomilehto, Jaakko %A Uitterlinden, André G %A Uusitupa, Matti %A van der Harst, Pim %A Vollenweider, Peter %A Wallaschofski, Henri %A Wareham, Nicholas J %A Watkins, Hugh %A Wichmann, H-Erich %A Wilson, James F %A Abecasis, Goncalo R %A Assimes, Themistocles L %A Barroso, Inês %A Boehnke, Michael %A Borecki, Ingrid B %A Deloukas, Panos %A Fox, Caroline S %A Frayling, Timothy %A Groop, Leif C %A Haritunian, Talin %A Heid, Iris M %A Hunter, David %A Kaplan, Robert C %A Karpe, Fredrik %A Moffatt, Miriam F %A Mohlke, Karen L %A O'Connell, Jeffrey R %A Pawitan, Yudi %A Schadt, Eric E %A Schlessinger, David %A Steinthorsdottir, Valgerdur %A Strachan, David P %A Thorsteinsdottir, Unnur %A van Duijn, Cornelia M %A Visscher, Peter M %A Di Blasio, Anna Maria %A Hirschhorn, Joel N %A Lindgren, Cecilia M %A Morris, Andrew P %A Meyre, David %A Scherag, Andre %A McCarthy, Mark I %A Speliotes, Elizabeth K %A North, Kari E %A Loos, Ruth J F %A Ingelsson, Erik %K Anthropometry %K Body Height %K Body Mass Index %K Case-Control Studies %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Meta-Analysis as Topic %K Obesity %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Waist-Hip Ratio %X

Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.

%B Nat Genet %V 45 %P 501-12 %8 2013 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23563607?dopt=Abstract %R 10.1038/ng.2606 %0 Journal Article %J Am J Clin Nutr %D 2013 %T Genome-wide meta-analysis of observational studies shows common genetic variants associated with macronutrient intake. %A Tanaka, Toshiko %A Ngwa, Julius S %A van Rooij, Frank J A %A Zillikens, M Carola %A Wojczynski, Mary K %A Frazier-Wood, Alexis C %A Houston, Denise K %A Kanoni, Stavroula %A Lemaitre, Rozenn N %A Luan, Jian'an %A Mikkilä, Vera %A Renstrom, Frida %A Sonestedt, Emily %A Zhao, Jing Hua %A Chu, Audrey Y %A Qi, Lu %A Chasman, Daniel I %A de Oliveira Otto, Marcia C %A Dhurandhar, Emily J %A Feitosa, Mary F %A Johansson, Ingegerd %A Khaw, Kay-Tee %A Lohman, Kurt K %A Manichaikul, Ani %A McKeown, Nicola M %A Mozaffarian, Dariush %A Singleton, Andrew %A Stirrups, Kathleen %A Viikari, Jorma %A Ye, Zheng %A Bandinelli, Stefania %A Barroso, Inês %A Deloukas, Panos %A Forouhi, Nita G %A Hofman, Albert %A Liu, Yongmei %A Lyytikäinen, Leo-Pekka %A North, Kari E %A Dimitriou, Maria %A Hallmans, Göran %A Kähönen, Mika %A Langenberg, Claudia %A Ordovas, Jose M %A Uitterlinden, André G %A Hu, Frank B %A Kalafati, Ioanna-Panagiota %A Raitakari, Olli %A Franco, Oscar H %A Johnson, Andrew %A Emilsson, Valur %A Schrack, Jennifer A %A Semba, Richard D %A Siscovick, David S %A Arnett, Donna K %A Borecki, Ingrid B %A Franks, Paul W %A Kritchevsky, Stephen B %A Lehtimäki, Terho %A Loos, Ruth J F %A Orho-Melander, Marju %A Rotter, Jerome I %A Wareham, Nicholas J %A Witteman, Jacqueline C M %A Ferrucci, Luigi %A Dedoussis, George %A Cupples, L Adrienne %A Nettleton, Jennifer A %K Alleles %K Atherosclerosis %K Body Mass Index %K Dietary Carbohydrates %K Dietary Fats %K Dietary Proteins %K Energy Intake %K European Continental Ancestry Group %K Fibroblast Growth Factors %K Follow-Up Studies %K Gene-Environment Interaction %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Life Style %K Obesity %K Polymorphism, Single Nucleotide %K Prospective Studies %K Quantitative Trait Loci %K Surveys and Questionnaires %X

BACKGROUND: Macronutrient intake varies substantially between individuals, and there is evidence that this variation is partly accounted for by genetic variants.

OBJECTIVE: The objective of the study was to identify common genetic variants that are associated with macronutrient intake.

DESIGN: We performed 2-stage genome-wide association (GWA) meta-analysis of macronutrient intake in populations of European descent. Macronutrients were assessed by using food-frequency questionnaires and analyzed as percentages of total energy consumption from total fat, protein, and carbohydrate. From the discovery GWA (n = 38,360), 35 independent loci associated with macronutrient intake at P < 5 × 10(-6) were identified and taken forward to replication in 3 additional cohorts (n = 33,533) from the DietGen Consortium. For one locus, fat mass obesity-associated protein (FTO), cohorts with Illumina MetaboChip genotype data (n = 7724) provided additional replication data.

RESULTS: A variant in the chromosome 19 locus (rs838145) was associated with higher carbohydrate (β ± SE: 0.25 ± 0.04%; P = 1.68 × 10(-8)) and lower fat (β ± SE: -0.21 ± 0.04%; P = 1.57 × 10(-9)) consumption. A candidate gene in this region, fibroblast growth factor 21 (FGF21), encodes a fibroblast growth factor involved in glucose and lipid metabolism. The variants in this locus were associated with circulating FGF21 protein concentrations (P < 0.05) but not mRNA concentrations in blood or brain. The body mass index (BMI)-increasing allele of the FTO variant (rs1421085) was associated with higher protein intake (β ± SE: 0.10 ± 0.02%; P = 9.96 × 10(-10)), independent of BMI (after adjustment for BMI, β ± SE: 0.08 ± 0.02%; P = 3.15 × 10(-7)).

CONCLUSION: Our results indicate that variants in genes involved in nutrient metabolism and obesity are associated with macronutrient consumption in humans. Trials related to this study were registered at clinicaltrials.gov as NCT00005131 (Atherosclerosis Risk in Communities), NCT00005133 (Cardiovascular Health Study), NCT00005136 (Family Heart Study), NCT00005121 (Framingham Heart Study), NCT00083369 (Genetic and Environmental Determinants of Triglycerides), NCT01331512 (InCHIANTI Study), and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).

%B Am J Clin Nutr %V 97 %P 1395-402 %8 2013 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23636237?dopt=Abstract %R 10.3945/ajcn.112.052183 %0 Journal Article %J Hum Genet %D 2013 %T Genome-wide study identifies two loci associated with lung function decline in mild to moderate COPD. %A Hansel, Nadia N %A Ruczinski, Ingo %A Rafaels, Nicholas %A Sin, Don D %A Daley, Denise %A Malinina, Alla %A Huang, Lili %A Sandford, Andrew %A Murray, Tanda %A Kim, Yoonhee %A Vergara, Candelaria %A Heckbert, Susan R %A Psaty, Bruce M %A Li, Guo %A Elliott, W Mark %A Aminuddin, Farzian %A Dupuis, Josée %A O'Connor, George T %A Doheny, Kimberly %A Scott, Alan F %A Boezen, H Marike %A Postma, Dirkje S %A Smolonska, Joanna %A Zanen, Pieter %A Mohamed Hoesein, Firdaus A %A de Koning, Harry J %A Crystal, Ronald G %A Tanaka, Toshiko %A Ferrucci, Luigi %A Silverman, Edwin %A Wan, Emily %A Vestbo, Jorgen %A Lomas, David A %A Connett, John %A Wise, Robert A %A Neptune, Enid R %A Mathias, Rasika A %A Paré, Peter D %A Beaty, Terri H %A Barnes, Kathleen C %K Adult %K Ankyrins %K Chromosomes, Human, Pair 10 %K Chromosomes, Human, Pair 14 %K Cohort Studies %K Female %K Genome-Wide Association Study %K Hepatocyte Nuclear Factor 3-alpha %K Humans %K Linkage Disequilibrium %K Lung %K Male %K Membrane Proteins %K Middle Aged %K Polymorphism, Single Nucleotide %K Pulmonary Disease, Chronic Obstructive %X

Accelerated lung function decline is a key COPD phenotype; however, its genetic control remains largely unknown. We performed a genome-wide association study using the Illumina Human660W-Quad v.1_A BeadChip. Generalized estimation equations were used to assess genetic contributions to lung function decline over a 5-year period in 4,048 European American Lung Health Study participants with largely mild COPD. Genotype imputation was performed using reference HapMap II data. To validate regions meeting genome-wide significance, replication of top SNPs was attempted in independent cohorts. Three genes (TMEM26, ANK3 and FOXA1) within the regions of interest were selected for tissue expression studies using immunohistochemistry. Two intergenic SNPs (rs10761570, rs7911302) on chromosome 10 and one SNP on chromosome 14 (rs177852) met genome-wide significance after Bonferroni. Further support for the chromosome 10 region was obtained by imputation, the most significantly associated imputed SNPs (rs10761571, rs7896712) being flanked by observed markers rs10761570 and rs7911302. Results were not replicated in four general population cohorts or a smaller cohort of subjects with moderate to severe COPD; however, we show novel expression of genes near regions of significantly associated SNPS, including TMEM26 and FOXA1 in airway epithelium and lung parenchyma, and ANK3 in alveolar macrophages. Levels of expression were associated with lung function and COPD status. We identified two novel regions associated with lung function decline in mild COPD. Genes within these regions were expressed in relevant lung cells and their expression related to airflow limitation suggesting they may represent novel candidate genes for COPD susceptibility.

%B Hum Genet %V 132 %P 79-90 %8 2013 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22986903?dopt=Abstract %R 10.1007/s00439-012-1219-6 %0 Journal Article %J J Stroke Cerebrovasc Dis %D 2013 %T Height and risk of incident intraparenchymal hemorrhage: Atherosclerosis Risk in Communities and Cardiovascular Health study cohorts. %A Smith, Lindsay G %A Yatsuya, Hiroshi %A Psaty, Bruce M %A Longstreth, W T %A Folsom, Aaron R %K African Americans %K Aged %K Body Height %K Cerebral Hemorrhage %K European Continental Ancestry Group %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Multivariate Analysis %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Risk Factors %K Sex Factors %K Time Factors %K United States %X

BACKGROUND: Height is inversely associated with incident coronary disease and total stroke, but few studies have examined the association between height and intraparenchymal hemorrhage (IPH). We hypothesized that height would be inversely associated with incident IPH in the combined cohorts of the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study.

METHODS: Data on Caucasian and African American participants were used to estimate the association of height at baseline with incident IPH verified by clinician review of medical records and imaging reports. Sex-specific Cox proportional hazards regression models were used to calculate hazard ratios.

RESULTS: A total of 20,983 participants initially free of stroke (11,788 women and 9195 men) were followed for an average of 15.9 years (standard deviation [SD] 5.1 years). Incident IPH occurred in 115 women and 73 men. Sex, but not age, race, study, or blood pressure, modified the association (P = .03). After adjustment for risk factors (age, systolic blood pressure, triglycerides, low-density lipoprotein cholesterol, fibrinogen, and race), among women, height was significantly inversely associated with incident IPH (hazard ratio [HR] per SD [6.3 cm] was 0.81; 95% confidence interval [CI] 0.66-0.99; P = .04). The HR for tertile 3 vs 1 in women was 0.63 (95% CI 0.37-1.08). Among men, height was not linearly associated with incident IPH (HR per SD [6.7 cm] was 1.09; 95% CI 0.84-1.40; P = .52).

CONCLUSIONS: This large prospective study provides evidence that shorter height may be a risk factor for incident IPH in women.

%B J Stroke Cerebrovasc Dis %V 22 %P 323-8 %8 2013 May %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/22177930?dopt=Abstract %R 10.1016/j.jstrokecerebrovasdis.2011.09.004 %0 Journal Article %J J Nutr %D 2013 %T Higher magnesium intake is associated with lower fasting glucose and insulin, with no evidence of interaction with select genetic loci, in a meta-analysis of 15 CHARGE Consortium Studies. %A Hruby, Adela %A Ngwa, Julius S %A Renstrom, Frida %A Wojczynski, Mary K %A Ganna, Andrea %A Hallmans, Göran %A Houston, Denise K %A Jacques, Paul F %A Kanoni, Stavroula %A Lehtimäki, Terho %A Lemaitre, Rozenn N %A Manichaikul, Ani %A North, Kari E %A Ntalla, Ioanna %A Sonestedt, Emily %A Tanaka, Toshiko %A van Rooij, Frank J A %A Bandinelli, Stefania %A Djoussé, Luc %A Grigoriou, Efi %A Johansson, Ingegerd %A Lohman, Kurt K %A Pankow, James S %A Raitakari, Olli T %A Riserus, Ulf %A Yannakoulia, Mary %A Zillikens, M Carola %A Hassanali, Neelam %A Liu, Yongmei %A Mozaffarian, Dariush %A Papoutsakis, Constantina %A Syvänen, Ann-Christine %A Uitterlinden, André G %A Viikari, Jorma %A Groves, Christopher J %A Hofman, Albert %A Lind, Lars %A McCarthy, Mark I %A Mikkilä, Vera %A Mukamal, Kenneth %A Franco, Oscar H %A Borecki, Ingrid B %A Cupples, L Adrienne %A Dedoussis, George V %A Ferrucci, Luigi %A Hu, Frank B %A Ingelsson, Erik %A Kähönen, Mika %A Kao, W H Linda %A Kritchevsky, Stephen B %A Orho-Melander, Marju %A Prokopenko, Inga %A Rotter, Jerome I %A Siscovick, David S %A Witteman, Jacqueline C M %A Franks, Paul W %A Meigs, James B %A McKeown, Nicola M %A Nettleton, Jennifer A %K Blood Glucose %K Female %K Genetic Loci %K Humans %K Insulin %K Magnesium %K Male %K Polymorphism, Single Nucleotide %K Trace Elements %K TRPM Cation Channels %X

Favorable associations between magnesium intake and glycemic traits, such as fasting glucose and insulin, are observed in observational and clinical studies, but whether genetic variation affects these associations is largely unknown. We hypothesized that single nucleotide polymorphisms (SNPs) associated with either glycemic traits or magnesium metabolism affect the association between magnesium intake and fasting glucose and insulin. Fifteen studies from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided data from up to 52,684 participants of European descent without known diabetes. In fixed-effects meta-analyses, we quantified 1) cross-sectional associations of dietary magnesium intake with fasting glucose (mmol/L) and insulin (ln-pmol/L) and 2) interactions between magnesium intake and SNPs related to fasting glucose (16 SNPs), insulin (2 SNPs), or magnesium (8 SNPs) on fasting glucose and insulin. After adjustment for age, sex, energy intake, BMI, and behavioral risk factors, magnesium (per 50-mg/d increment) was inversely associated with fasting glucose [β = -0.009 mmol/L (95% CI: -0.013, -0.005), P < 0.0001] and insulin [-0.020 ln-pmol/L (95% CI: -0.024, -0.017), P < 0.0001]. No magnesium-related SNP or interaction between any SNP and magnesium reached significance after correction for multiple testing. However, rs2274924 in magnesium transporter-encoding TRPM6 showed a nominal association (uncorrected P = 0.03) with glucose, and rs11558471 in SLC30A8 and rs3740393 near CNNM2 showed a nominal interaction (uncorrected, both P = 0.02) with magnesium on glucose. Consistent with other studies, a higher magnesium intake was associated with lower fasting glucose and insulin. Nominal evidence of TRPM6 influence and magnesium interaction with select loci suggests that further investigation is warranted.

%B J Nutr %V 143 %P 345-53 %8 2013 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23343670?dopt=Abstract %R 10.3945/jn.112.172049 %0 Journal Article %J Nat Genet %D 2013 %T Identification of heart rate-associated loci and their effects on cardiac conduction and rhythm disorders. %A den Hoed, Marcel %A Eijgelsheim, Mark %A Esko, Tõnu %A Brundel, Bianca J J M %A Peal, David S %A Evans, David M %A Nolte, Ilja M %A Segrè, Ayellet V %A Holm, Hilma %A Handsaker, Robert E %A Westra, Harm-Jan %A Johnson, Toby %A Isaacs, Aaron %A Yang, Jian %A Lundby, Alicia %A Zhao, Jing Hua %A Kim, Young Jin %A Go, Min Jin %A Almgren, Peter %A Bochud, Murielle %A Boucher, Gabrielle %A Cornelis, Marilyn C %A Gudbjartsson, Daniel %A Hadley, David %A van der Harst, Pim %A Hayward, Caroline %A den Heijer, Martin %A Igl, Wilmar %A Jackson, Anne U %A Kutalik, Zoltán %A Luan, Jian'an %A Kemp, John P %A Kristiansson, Kati %A Ladenvall, Claes %A Lorentzon, Mattias %A Montasser, May E %A Njajou, Omer T %A O'Reilly, Paul F %A Padmanabhan, Sandosh %A St Pourcain, Beate %A Rankinen, Tuomo %A Salo, Perttu %A Tanaka, Toshiko %A Timpson, Nicholas J %A Vitart, Veronique %A Waite, Lindsay %A Wheeler, William %A Zhang, Weihua %A Draisma, Harmen H M %A Feitosa, Mary F %A Kerr, Kathleen F %A Lind, Penelope A %A Mihailov, Evelin %A Onland-Moret, N Charlotte %A Song, Ci %A Weedon, Michael N %A Xie, Weijia %A Yengo, Loic %A Absher, Devin %A Albert, Christine M %A Alonso, Alvaro %A Arking, Dan E %A de Bakker, Paul I W %A Balkau, Beverley %A Barlassina, Cristina %A Benaglio, Paola %A Bis, Joshua C %A Bouatia-Naji, Nabila %A Brage, Søren %A Chanock, Stephen J %A Chines, Peter S %A Chung, Mina %A Darbar, Dawood %A Dina, Christian %A Dörr, Marcus %A Elliott, Paul %A Felix, Stephan B %A Fischer, Krista %A Fuchsberger, Christian %A de Geus, Eco J C %A Goyette, Philippe %A Gudnason, Vilmundur %A Harris, Tamara B %A Hartikainen, Anna-Liisa %A Havulinna, Aki S %A Heckbert, Susan R %A Hicks, Andrew A %A Hofman, Albert %A Holewijn, Suzanne %A Hoogstra-Berends, Femke %A Hottenga, Jouke-Jan %A Jensen, Majken K %A Johansson, Asa %A Junttila, Juhani %A Kääb, Stefan %A Kanon, Bart %A Ketkar, Shamika %A Khaw, Kay-Tee %A Knowles, Joshua W %A Kooner, Angrad S %A Kors, Jan A %A Kumari, Meena %A Milani, Lili %A Laiho, Päivi %A Lakatta, Edward G %A Langenberg, Claudia %A Leusink, Maarten %A Liu, Yongmei %A Luben, Robert N %A Lunetta, Kathryn L %A Lynch, Stacey N %A Markus, Marcello R P %A Marques-Vidal, Pedro %A Mateo Leach, Irene %A McArdle, Wendy L %A McCarroll, Steven A %A Medland, Sarah E %A Miller, Kathryn A %A Montgomery, Grant W %A Morrison, Alanna C %A Müller-Nurasyid, Martina %A Navarro, Pau %A Nelis, Mari %A O'Connell, Jeffrey R %A O'Donnell, Christopher J %A Ong, Ken K %A Newman, Anne B %A Peters, Annette %A Polasek, Ozren %A Pouta, Anneli %A Pramstaller, Peter P %A Psaty, Bruce M %A Rao, Dabeeru C %A Ring, Susan M %A Rossin, Elizabeth J %A Rudan, Diana %A Sanna, Serena %A Scott, Robert A %A Sehmi, Jaban S %A Sharp, Stephen %A Shin, Jordan T %A Singleton, Andrew B %A Smith, Albert V %A Soranzo, Nicole %A Spector, Tim D %A Stewart, Chip %A Stringham, Heather M %A Tarasov, Kirill V %A Uitterlinden, André G %A Vandenput, Liesbeth %A Hwang, Shih-Jen %A Whitfield, John B %A Wijmenga, Cisca %A Wild, Sarah H %A Willemsen, Gonneke %A Wilson, James F %A Witteman, Jacqueline C M %A Wong, Andrew %A Wong, Quenna %A Jamshidi, Yalda %A Zitting, Paavo %A Boer, Jolanda M A %A Boomsma, Dorret I %A Borecki, Ingrid B %A van Duijn, Cornelia M %A Ekelund, Ulf %A Forouhi, Nita G %A Froguel, Philippe %A Hingorani, Aroon %A Ingelsson, Erik %A Kivimaki, Mika %A Kronmal, Richard A %A Kuh, Diana %A Lind, Lars %A Martin, Nicholas G %A Oostra, Ben A %A Pedersen, Nancy L %A Quertermous, Thomas %A Rotter, Jerome I %A van der Schouw, Yvonne T %A Verschuren, W M Monique %A Walker, Mark %A Albanes, Demetrius %A Arnar, David O %A Assimes, Themistocles L %A Bandinelli, Stefania %A Boehnke, Michael %A de Boer, Rudolf A %A Bouchard, Claude %A Caulfield, W L Mark %A Chambers, John C %A Curhan, Gary %A Cusi, Daniele %A Eriksson, Johan %A Ferrucci, Luigi %A van Gilst, Wiek H %A Glorioso, Nicola %A de Graaf, Jacqueline %A Groop, Leif %A Gyllensten, Ulf %A Hsueh, Wen-Chi %A Hu, Frank B %A Huikuri, Heikki V %A Hunter, David J %A Iribarren, Carlos %A Isomaa, Bo %A Jarvelin, Marjo-Riitta %A Jula, Antti %A Kähönen, Mika %A Kiemeney, Lambertus A %A van der Klauw, Melanie M %A Kooner, Jaspal S %A Kraft, Peter %A Iacoviello, Licia %A Lehtimäki, Terho %A Lokki, Marja-Liisa L %A Mitchell, Braxton D %A Navis, Gerjan %A Nieminen, Markku S %A Ohlsson, Claes %A Poulter, Neil R %A Qi, Lu %A Raitakari, Olli T %A Rimm, Eric B %A Rioux, John D %A Rizzi, Federica %A Rudan, Igor %A Salomaa, Veikko %A Sever, Peter S %A Shields, Denis C %A Shuldiner, Alan R %A Sinisalo, Juha %A Stanton, Alice V %A Stolk, Ronald P %A Strachan, David P %A Tardif, Jean-Claude %A Thorsteinsdottir, Unnur %A Tuomilehto, Jaako %A van Veldhuisen, Dirk J %A Virtamo, Jarmo %A Viikari, Jorma %A Vollenweider, Peter %A Waeber, Gérard %A Widen, Elisabeth %A Cho, Yoon Shin %A Olsen, Jesper V %A Visscher, Peter M %A Willer, Cristen %A Franke, Lude %A Erdmann, Jeanette %A Thompson, John R %A Pfeufer, Arne %A Sotoodehnia, Nona %A Newton-Cheh, Christopher %A Ellinor, Patrick T %A Stricker, Bruno H Ch %A Metspalu, Andres %A Perola, Markus %A Beckmann, Jacques S %A Smith, George Davey %A Stefansson, Kari %A Wareham, Nicholas J %A Munroe, Patricia B %A Sibon, Ody C M %A Milan, David J %A Snieder, Harold %A Samani, Nilesh J %A Loos, Ruth J F %K Animals %K Arrhythmias, Cardiac %K Gene Frequency %K Genetic Loci %K Genome-Wide Association Study %K Heart Conduction System %K Heart Rate %K Humans %K Metabolic Networks and Pathways %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci. Experimental downregulation of gene expression in Drosophila melanogaster and Danio rerio identified 20 genes at 11 loci that are relevant for heart rate regulation and highlight a role for genes involved in signal transmission, embryonic cardiac development and the pathophysiology of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate-increasing and heart rate-decreasing variants associate with risk of atrial fibrillation. Our findings provide fresh insights into the mechanisms regulating heart rate and identify new therapeutic targets.

%B Nat Genet %V 45 %P 621-31 %8 2013 Jun %G eng %N 6 %R 10.1038/ng.2610 %0 Journal Article %J Atherosclerosis %D 2013 %T Impact of inflammatory biomarkers on relation of high density lipoprotein-cholesterol with incident coronary heart disease: cardiovascular Health Study. %A Tehrani, David M %A Gardin, Julius M %A Yanez, David %A Hirsch, Calvin H %A Lloyd-Jones, Donald M %A Stein, Phyllis K %A Wong, Nathan D %K 1-Alkyl-2-acetylglycerophosphocholine Esterase %K African Americans %K Aged %K Biomarkers %K C-Reactive Protein %K Cardiovascular Diseases %K Cholesterol, HDL %K Coronary Disease %K European Continental Ancestry Group %K Female %K Humans %K Incidence %K Inflammation %K Interleukin-6 %K Male %K Middle Aged %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %X

BACKGROUND: Inflammatory factors and low HDL-C relate to CHD risk, but whether inflammation attenuates any protective association of high HDL-C is unknown.

OBJECTIVE: Investigate inflammatory markers' individual and collective impact on the association of HDL-C with incident coronary heart disease (CHD).

METHODS: In 3888 older adults without known cardiovascular disease (CVD), we examined if the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA₂) modify the relation of HDL-C with CHD. HDL-C, CRP, IL-6, and Lp-PLA₂ values were grouped as using gender-specific tertiles. Also, an inflammation index of z-score sums for CRP, IL-6, and Lp-PLA₂ was categorized into tertiles. We calculated CHD incidence for each HDL-C/inflammation group and performed Cox regression, adjusted for standard CVD risk factors and triglycerides to examine the relationship of combined HDL-C-inflammation groups with incident events.

RESULTS: CHD incidence (per 1000 person years) was higher for higher levels of CRP, IL-6, and the index, and lower for higher levels of HDL-C. Compared to high HDL-C/low-inflammation categories (referent), adjusted HRs for incident CHD were increased for those with high HDL-C and high CRP (HR = 1.50, p < 0.01) or highest IL-6 tertile (HR = 1.40, p < 0.05), but not with highest Lp-PLA₂ tertile. Higher CHD incidence was similarly seen for those with intermediate or low HDL-C accompanied by high CRP, high IL-6, or a high inflammatory index.

CONCLUSION: The protective relation of high HDL-C for incident CHD appears to be attenuated by greater inflammation.

%B Atherosclerosis %V 231 %P 246-51 %8 2013 Dec %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24267235?dopt=Abstract %R 10.1016/j.atherosclerosis.2013.08.036 %0 Journal Article %J Heart Rhythm %D 2013 %T Inflammation and sudden cardiac death in a community-based population of older adults: the Cardiovascular Health Study. %A Hussein, Ayman A %A Gottdiener, John S %A Bartz, Traci M %A Sotoodehnia, Nona %A DeFilippi, Christopher %A See, Vincent %A Deo, Rajat %A Siscovick, David %A Stein, Phyllis K %A Lloyd-Jones, Donald %K Age Factors %K Aged %K Aged, 80 and over %K Biomarkers %K C-Reactive Protein %K Case-Control Studies %K Cohort Studies %K Death, Sudden, Cardiac %K Female %K Humans %K Inflammation %K Interleukin-6 %K Male %K Risk Factors %X

BACKGROUND: Inflammation is linked to adverse cardiovascular events, but its association with sudden cardiac death (SCD) has been controversial. Older subjects, who are at particular risk for SCD, were underrepresented in previous studies addressing this issue.

OBJECTIVE: The purpose of this study was to study the association between inflammation and SCD in a community-based population of older adults.

METHODS: In the Cardiovascular Health Study, 5806 and 5382 participants had measurements of C-reactive protein (CRP) and interleukin-6 (IL6), respectively, and were followed for up to 17 years. SCD risk as a function of baseline IL-6 and CRP was assessed in the overall population and in a group of participants without known prevalent cardiac disease.

RESULTS: In univariate analyses, both IL-6 (hazard ratio [HR] 1.79 for 1+ log IL-6, 95% confidence interval [CI] 1.50-2.13; 5th vs 1st quintile HR 3.36, 95% CI 2.24-5.05) and CRP (HR 1.31 for 1+ log CRP, 95% CI 1.18-1.45; 5th vs 1st quintile HR 2.00, 95% CI 1.40-2.87) were associated with SCD risk. In covariate-adjusted analyses, accounting for baseline risk factors, incident myocardial infarction, and heart failure, the association with SCD risk persisted for IL-6 (HR 1.26 for 1+ log IL-6, 95% CI 1.02-1.56; 5th vs 1st quintile HR 1.63, 95% CI 1.03-2.56) but was significantly attenuated for CRP (HR 1.13 for 1+ log CRP, 95% CI 1.00-1.28; 5th vs 1st quintile HR 1.34, 95% CI 0.88-2.05). Similar findings were observed in participants without prevalent cardiac disease.

CONCLUSION: Greater burden of inflammation, assessed by IL-6 levels, is associated with SCD risk beyond traditional risk factors, incident myocardial infarction, and heart failure.

%B Heart Rhythm %V 10 %P 1425-32 %8 2013 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/23906927?dopt=Abstract %R 10.1016/j.hrthm.2013.07.004 %0 Journal Article %J Diabetes %D 2013 %T The influence of obesity-related single nucleotide polymorphisms on BMI across the life course: the PAGE study. %A Graff, Mariaelisa %A Gordon-Larsen, Penny %A Lim, Unhee %A Fowke, Jay H %A Love, Shelly-Ann %A Fesinmeyer, Megan %A Wilkens, Lynne R %A Vertilus, Shawyntee %A Ritchie, Marilyn D %A Prentice, Ross L %A Pankow, Jim %A Monroe, Kristine %A Manson, JoAnn E %A Le Marchand, Loïc %A Kuller, Lewis H %A Kolonel, Laurence N %A Hong, Ching P %A Henderson, Brian E %A Haessler, Jeff %A Gross, Myron D %A Goodloe, Robert %A Franceschini, Nora %A Carlson, Christopher S %A Buyske, Steven %A Bůzková, Petra %A Hindorff, Lucia A %A Matise, Tara C %A Crawford, Dana C %A Haiman, Christopher A %A Peters, Ulrike %A North, Kari E %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Aging %K Body Mass Index %K Cohort Studies %K Cross-Sectional Studies %K European Continental Ancestry Group %K Female %K Genetic Association Studies %K Health Surveys %K Humans %K Male %K Middle Aged %K Obesity %K Polymorphism, Single Nucleotide %K Proteins %K United States %K Young Adult %X

Evidence is limited as to whether heritable risk of obesity varies throughout adulthood. Among >34,000 European Americans, aged 18-100 years, from multiple U.S. studies in the Population Architecture using Genomics and Epidemiology (PAGE) Consortium, we examined evidence for heterogeneity in the associations of five established obesity risk variants (near FTO, GNPDA2, MTCH2, TMEM18, and NEGR1) with BMI across four distinct epochs of adulthood: 1) young adulthood (ages 18-25 years), adulthood (ages 26-49 years), middle-age adulthood (ages 50-69 years), and older adulthood (ages ≥70 years); or 2) by menopausal status in women and stratification by age 50 years in men. Summary-effect estimates from each meta-analysis were compared for heterogeneity across the life epochs. We found heterogeneity in the association of the FTO (rs8050136) variant with BMI across the four adulthood epochs (P = 0.0006), with larger effects in young adults relative to older adults (β [SE] = 1.17 [0.45] vs. 0.09 [0.09] kg/m², respectively, per A allele) and smaller intermediate effects. We found no evidence for heterogeneity in the association of GNPDA2, MTCH2, TMEM18, and NEGR1 with BMI across adulthood. Genetic predisposition to obesity may have greater effects on body weight in young compared with older adulthood for FTO, suggesting changes by age, generation, or secular trends. Future research should compare and contrast our findings with results using longitudinal data.

%B Diabetes %V 62 %P 1763-7 %8 2013 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23300277?dopt=Abstract %R 10.2337/db12-0863 %0 Journal Article %J PLoS One %D 2013 %T Insights into the genetic architecture of early stage age-related macular degeneration: a genome-wide association study meta-analysis. %A Holliday, Elizabeth G %A Smith, Albert V %A Cornes, Belinda K %A Buitendijk, Gabriëlle H S %A Jensen, Richard A %A Sim, Xueling %A Aspelund, Thor %A Aung, Tin %A Baird, Paul N %A Boerwinkle, Eric %A Cheng, Ching Yu %A van Duijn, Cornelia M %A Eiriksdottir, Gudny %A Gudnason, Vilmundur %A Harris, Tamara %A Hewitt, Alex W %A Inouye, Michael %A Jonasson, Fridbert %A Klein, Barbara E K %A Launer, Lenore %A Li, Xiaohui %A Liew, Gerald %A Lumley, Thomas %A McElduff, Patrick %A McKnight, Barbara %A Mitchell, Paul %A Psaty, Bruce M %A Rochtchina, Elena %A Rotter, Jerome I %A Scott, Rodney J %A Tay, Wanting %A Taylor, Kent %A Teo, Yik Ying %A Uitterlinden, André G %A Viswanathan, Ananth %A Xie, Sophia %A Vingerling, Johannes R %A Klaver, Caroline C W %A Tai, E Shyong %A Siscovick, David %A Klein, Ronald %A Cotch, Mary Frances %A Wong, Tien Y %A Attia, John %A Wang, Jie Jin %K Apolipoproteins E %K Complement Factor H %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Kruppel-Like Transcription Factors %K Macular Degeneration %K Nerve Tissue Proteins %K Polymorphism, Single Nucleotide %K Proteins %K Risk Factors %K Zinc Finger Protein Gli3 %X

Genetic factors explain a majority of risk variance for age-related macular degeneration (AMD). While genome-wide association studies (GWAS) for late AMD implicate genes in complement, inflammatory and lipid pathways, the genetic architecture of early AMD has been relatively under studied. We conducted a GWAS meta-analysis of early AMD, including 4,089 individuals with prevalent signs of early AMD (soft drusen and/or retinal pigment epithelial changes) and 20,453 individuals without these signs. For various published late AMD risk loci, we also compared effect sizes between early and late AMD using an additional 484 individuals with prevalent late AMD. GWAS meta-analysis confirmed previously reported association of variants at the complement factor H (CFH) (peak P = 1.5×10(-31)) and age-related maculopathy susceptibility 2 (ARMS2) (P = 4.3×10(-24)) loci, and suggested Apolipoprotein E (ApoE) polymorphisms (rs2075650; P = 1.1×10(-6)) associated with early AMD. Other possible loci that did not reach GWAS significance included variants in the zinc finger protein gene GLI3 (rs2049622; P = 8.9×10(-6)) and upstream of GLI2 (rs6721654; P = 6.5×10(-6)), encoding retinal Sonic hedgehog signalling regulators, and in the tyrosinase (TYR) gene (rs621313; P = 3.5×10(-6)), involved in melanin biosynthesis. For a range of published, late AMD risk loci, estimated effect sizes were significantly lower for early than late AMD. This study confirms the involvement of multiple established AMD risk variants in early AMD, but suggests weaker genetic effects on the risk of early AMD relative to late AMD. Several biological processes were suggested to be potentially specific for early AMD, including pathways regulating RPE cell melanin content and signalling pathways potentially involved in retinal regeneration, generating hypotheses for further investigation.

%B PLoS One %V 8 %P e53830 %8 2013 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23326517?dopt=Abstract %R 10.1371/journal.pone.0053830 %0 Journal Article %J Circ Heart Fail %D 2013 %T Insulin resistance and risk of incident heart failure: Cardiovascular Health Study. %A Banerjee, Dipanjan %A Biggs, Mary L %A Mercer, Laina %A Mukamal, Kenneth %A Kaplan, Robert %A Barzilay, Joshua %A Kuller, Lewis %A Kizer, Jorge R %A Djoussé, Luc %A Tracy, Russell %A Zieman, Susan %A Lloyd-Jones, Donald %A Siscovick, David %A Carnethon, Mercedes %K Aged %K Female %K Heart Atria %K Heart Failure %K Heart Ventricles %K Humans %K Incidence %K Insulin %K Insulin Resistance %K Male %K Middle Aged %K Myocardial Infarction %K Organ Size %K Proportional Hazards Models %K Prospective Studies %X

BACKGROUND: Patients with heart failure (HF) have higher fasting insulin levels and a higher prevalence of insulin resistance as compared with matched controls. Insulin resistance leads to structural abnormalities in the heart, such as increased left atrial size, left ventricular mass, and alterations in transmitral velocity that can precede the diagnosis of HF. It is not known whether insulin resistance precedes the development of HF or whether the relationship between insulin resistance and HF is present among adults with HF caused by nonischemic heart disease.

METHODS AND RESULTS: We examined 4425 participants (60% women) from the Cardiovascular Health Study after excluding those with HF, myocardial infarction, or treated diabetes mellitus at baseline. We used Cox proportional hazards models to estimate the relative risk of incident HF associated with fasting insulin measured at study entry. There were 1216 cases of incident HF (1103 without antecedent myocardial infarction) during a median follow-up of 12 years (maximum, 19 years). Fasting insulin levels were positively associated with the risk of incident HF (hazard ratio, 1.10; 95% confidence interval, 1.05-1.15, per SD change) when adjusted for age, sex, race, field center, physical activity, smoking, alcohol intake, high-density lipoprotein-cholesterol, total cholesterol, systolic blood pressure, and waist circumference. The association between fasting insulin levels and incident HF was similar for HF without antecedent myocardial infarction (hazard ratio, 1.10; 95% confidence interval, 1.05-1.15). Measures of left atrial size, left ventricular mass, and peak A velocity at baseline were associated both with fasting insulin levels and with HF; however, additional statistical adjustment for these parameters did not completely attenuate the insulin-HF estimate (hazard ratio, 1.08; 95% confidence interval, 1.03-1.14 per 1-SD increase in fasting insulin).

CONCLUSIONS: Fasting insulin was positively associated with adverse echocardiographic features and risk of subsequent HF in Cardiovascular Health Study participants, including those without an antecedent myocardial infarction.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005133.

%B Circ Heart Fail %V 6 %P 364-70 %8 2013 May %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23575256?dopt=Abstract %R 10.1161/CIRCHEARTFAILURE.112.000022 %0 Journal Article %J BMC Genet %D 2013 %T Investigation of gene-by-sex interactions for lipid traits in diverse populations from the population architecture using genomics and epidemiology study. %A Taylor, Kira C %A Carty, Cara L %A Dumitrescu, Logan %A Bůzková, Petra %A Cole, Shelley A %A Hindorff, Lucia %A Schumacher, Fred R %A Wilkens, Lynne R %A Shohet, Ralph V %A Quibrera, P Miguel %A Johnson, Karen C %A Henderson, Brian E %A Haessler, Jeff %A Franceschini, Nora %A Eaton, Charles B %A Duggan, David J %A Cochran, Barbara %A Cheng, Iona %A Carlson, Chris S %A Brown-Gentry, Kristin %A Anderson, Garnet %A Ambite, Jose Luis %A Haiman, Christopher %A Le Marchand, Loïc %A Kooperberg, Charles %A Crawford, Dana C %A Buyske, Steven %A North, Kari E %A Fornage, Myriam %K Female %K Genetic Heterogeneity %K Genome, Human %K Genome-Wide Association Study %K Humans %K Lipids %K Male %K Polymorphism, Single Nucleotide %K Population Groups %X

BACKGROUND: High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels are influenced by both genes and the environment. Genome-wide association studies (GWAS) have identified ~100 common genetic variants associated with HDL-C, LDL-C, and/or TG levels, mostly in populations of European descent, but little is known about the modifiers of these associations. Here, we investigated whether GWAS-identified SNPs for lipid traits exhibited heterogeneity by sex in the Population Architecture using Genomics and Epidemiology (PAGE) study.

RESULTS: A sex-stratified meta-analysis was performed for 49 GWAS-identified SNPs for fasting HDL-C, LDL-C, and ln(TG) levels among adults self-identified as European American (25,013). Heterogeneity by sex was established when phet < 0.001. There was evidence for heterogeneity by sex for two SNPs for ln(TG) in the APOA1/C3/A4/A5/BUD13 gene cluster: rs28927680 (p(het) = 7.4 x 10(-7)) and rs3135506 (p(het) = 4.3 x 10(-4)one SNP in PLTP for HDL levels (rs7679; p(het) = 9.9 x 10(-4)), and one in HMGCR for LDL levels (rs12654264; p(het) = 3.1 x 10(-5)). We replicated heterogeneity by sex in five of seventeen loci previously reported by genome-wide studies (binomial p = 0.0009). We also present results for other racial/ethnic groups in the supplementary materials, to provide a resource for future meta-analyses.

CONCLUSIONS: We provide further evidence for sex-specific effects of SNPs in the APOA1/C3/A4/A5/BUD13 gene cluster, PLTP, and HMGCR on fasting triglyceride levels in European Americans from the PAGE study. Our findings emphasize the need for considering context-specific effects when interpreting genetic associations emerging from GWAS, and also highlight the difficulties in replicating interaction effects across studies and across racial/ethnic groups.

%B BMC Genet %V 14 %P 33 %8 2013 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/23634756?dopt=Abstract %R 10.1186/1471-2156-14-33 %0 Journal Article %J Ann Neurol %D 2013 %T Ischemic stroke is associated with the ABO locus: the EuroCLOT study. %A Williams, Frances M K %A Carter, Angela M %A Hysi, Pirro G %A Surdulescu, Gabriela %A Hodgkiss, Dylan %A Soranzo, Nicole %A Traylor, Matthew %A Bevan, Steve %A Dichgans, Martin %A Rothwell, Peter M W %A Sudlow, Cathie %A Farrall, Martin %A Silander, Kaisa %A Kaunisto, Mari %A Wagner, Peter %A Saarela, Olli %A Kuulasmaa, Kari %A Virtamo, Jarmo %A Salomaa, Veikko %A Amouyel, Philippe %A Arveiler, Dominique %A Ferrieres, Jean %A Wiklund, Per-Gunnar %A Ikram, M Arfan %A Hofman, Albert %A Boncoraglio, Giorgio B %A Parati, Eugenio A %A Helgadottir, Anna %A Gretarsdottir, Solveig %A Thorsteinsdottir, Unnur %A Thorleifsson, Gudmar %A Stefansson, Kari %A Seshadri, Sudha %A DeStefano, Anita %A Gschwendtner, Andreas %A Psaty, Bruce %A Longstreth, Will %A Mitchell, Braxton D %A Cheng, Yu-Ching %A Clarke, Robert %A Ferrario, Marco %A Bis, Joshua C %A Levi, Christopher %A Attia, John %A Holliday, Elizabeth G %A Scott, Rodney J %A Fornage, Myriam %A Sharma, Pankaj %A Furie, Karen L %A Rosand, Jonathan %A Nalls, Mike %A Meschia, James %A Mosely, Thomas H %A Evans, Alun %A Palotie, Aarno %A Markus, Hugh S %A Grant, Peter J %A Spector, Tim D %K ABO Blood-Group System %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Blood Coagulation %K Brain Ischemia %K Cohort Studies %K Europe %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Stroke %K Young Adult %X

OBJECTIVE: End-stage coagulation and the structure/function of fibrin are implicated in the pathogenesis of ischemic stroke. We explored whether genetic variants associated with end-stage coagulation in healthy volunteers account for the genetic predisposition to ischemic stroke and examined their influence on stroke subtype.

METHODS: Common genetic variants identified through genome-wide association studies of coagulation factors and fibrin structure/function in healthy twins (n = 2,100, Stage 1) were examined in ischemic stroke (n = 4,200 cases) using 2 independent samples of European ancestry (Stage 2). A third clinical collection having stroke subtyping (total 8,900 cases, 55,000 controls) was used for replication (Stage 3).

RESULTS: Stage 1 identified 524 single nucleotide polymorphisms (SNPs) from 23 linkage disequilibrium blocks having significant association (p < 5 × 10(-8)) with 1 or more coagulation/fibrin phenotypes. The most striking associations included SNP rs5985 with factor XIII activity (p = 2.6 × 10(-186)), rs10665 with FVII (p = 2.4 × 10(-47)), and rs505922 in the ABO gene with both von Willebrand factor (p = 4.7 × 10(-57)) and factor VIII (p = 1.2 × 10(-36)). In Stage 2, the 23 independent SNPs were examined in stroke cases/noncases using MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Wellcome Trust Case Control Consortium 2 collections. SNP rs505922 was nominally associated with ischemic stroke (odds ratio = 0.94, 95% confidence interval = 0.88-0.99, p = 0.023). Independent replication in Meta-Stroke confirmed the rs505922 association with stroke, beta (standard error, SE) = 0.066 (0.02), p = 0.001, a finding specific to large-vessel and cardioembolic stroke (p = 0.001 and p = < 0.001, respectively) but not seen with small-vessel stroke (p = 0.811).

INTERPRETATION: ABO gene variants are associated with large-vessel and cardioembolic stroke but not small-vessel disease. This work sheds light on the different pathogenic mechanisms underpinning stroke subtype.

%B Ann Neurol %V 73 %P 16-31 %8 2013 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23381943?dopt=Abstract %R 10.1002/ana.23838 %0 Journal Article %J J Am Coll Cardiol %D 2013 %T Lifetime risk for heart failure among white and black Americans: cardiovascular lifetime risk pooling project. %A Huffman, Mark D %A Berry, Jarett D %A Ning, Hongyan %A Dyer, Alan R %A Garside, Daniel B %A Cai, Xuan %A Daviglus, Martha L %A Lloyd-Jones, Donald M %K Adolescent %K Adult %K African Americans %K Age Factors %K Aged %K Anthropometry %K Body Mass Index %K Cardiovascular Diseases %K Cohort Studies %K European Continental Ancestry Group %K Female %K Health Surveys %K Heart Failure %K Humans %K Kaplan-Meier Estimate %K Male %K Middle Aged %K Predictive Value of Tests %K Prognosis %K Risk Assessment %K Severity of Illness Index %K Sex Factors %K Survival Analysis %K Time Factors %K United States %K Young Adult %X

OBJECTIVES: This study sought to estimate lifetime risk for heart failure (HF) by sex and race.

BACKGROUND: Prior estimates of lifetime risk for developing HF range from 20% to 33% in predominantly white cohorts. Short-term risks for HF appear higher for blacks than whites, but only limited comparisons of lifetime risk for HF have been made.

METHODS: Using public-release and internal datasets from National Heart, Lung, and Blood Institute-sponsored cohorts, we estimated lifetime risks for developing HF to age 95 years, with death free of HF as the competing event, among participants in the CHA (Chicago Heart Association Detection Project in Industry), ARIC (Atherosclerosis Risk in Communities), and CHS (Cardiovascular Health Study) cohorts.

RESULTS: There were 39,578 participants (33,652 [85%] white; 5,926 [15%] black) followed for 716,976 person-years; 5,983 participants developed HF. At age 45 years, lifetime risks for HF through age 95 years in CHA and CHS were 30% to 42% in white men, 20% to 29% in black men, 32% to 39% in white women, and 24% to 46% in black women. Results for ARIC demonstrated similar lifetime risks for HF in blacks and whites through age 75 years (limit of follow-up). Lifetime risk for HF was higher with higher blood pressure and body mass index at all ages in both blacks and whites, and did not diminish substantially with advancing index age.

CONCLUSIONS: These are among the first data to compare lifetime risks for HF between blacks and whites. Lifetime risks for HF are high and appear similar for black and white women, yet are somewhat lower for black compared with white men due to competing risks.

%B J Am Coll Cardiol %V 61 %P 1510-7 %8 2013 Apr 09 %G eng %N 14 %1 http://www.ncbi.nlm.nih.gov/pubmed/23500287?dopt=Abstract %& 1510 %R 10.1016/j.jacc.2013.01.022 %0 Journal Article %J Int J Obes (Lond) %D 2013 %T Lipoprotein receptor-related protein 1 variants and dietary fatty acids: meta-analysis of European origin and African American studies. %A Smith, C E %A Ngwa, J %A Tanaka, T %A Qi, Q %A Wojczynski, M K %A Lemaitre, R N %A Anderson, J S %A Manichaikul, A %A Mikkilä, V %A van Rooij, F J A %A Ye, Z %A Bandinelli, S %A Frazier-Wood, A C %A Houston, D K %A Hu, F %A Langenberg, C %A McKeown, N M %A Mozaffarian, D %A North, K E %A Viikari, J %A Zillikens, M C %A Djoussé, L %A Hofman, A %A Kähönen, M %A Kabagambe, E K %A Loos, R J F %A Saylor, G B %A Forouhi, N G %A Liu, Y %A Mukamal, K J %A Chen, Y-D I %A Tsai, M Y %A Uitterlinden, A G %A Raitakari, O %A van Duijn, C M %A Arnett, D K %A Borecki, I B %A Cupples, L A %A Ferrucci, L %A Kritchevsky, S B %A Lehtimäki, T %A Qi, Lu %A Rotter, J I %A Siscovick, D S %A Wareham, N J %A Witteman, J C M %A Ordovás, J M %A Nettleton, J A %K Adipose Tissue %K Adult %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Body Mass Index %K Europe %K European Continental Ancestry Group %K Fatty Acids %K Female %K Gene Frequency %K Gene-Environment Interaction %K Genetic Predisposition to Disease %K Genotype %K Humans %K Low Density Lipoprotein Receptor-Related Protein-1 %K Male %K Middle Aged %K Obesity %K Phenotype %K Polymorphism, Single Nucleotide %K Prevalence %K United States %X

OBJECTIVE: Low-density lipoprotein-related receptor protein 1 (LRP1) is a multi-functional endocytic receptor and signaling molecule that is expressed in adipose and the hypothalamus. Evidence for a role of LRP1 in adiposity is accumulating from animal and in vitro models, but data from human studies are limited. The study objectives were to evaluate (i) relationships between LRP1 genotype and anthropometric traits, and (ii) whether these relationships were modified by dietary fatty acids.

DESIGN AND METHODS: We conducted race/ethnic-specific meta-analyses using data from 14 studies of US and European whites and 4 of African Americans to evaluate associations of dietary fatty acids and LRP1 genotypes with body mass index (BMI), waist circumference and hip circumference, as well as interactions between dietary fatty acids and LRP1 genotypes. Seven single-nucleotide polymorphisms (SNPs) of LRP1 were evaluated in whites (N up to 42 000) and twelve SNPs in African Americans (N up to 5800).

RESULTS: After adjustment for age, sex and population substructure if relevant, for each one unit greater intake of percentage of energy from saturated fat (SFA), BMI was 0.104 kg m(-2) greater, waist was 0.305 cm larger and hip was 0.168 cm larger (all P<0.0001). Other fatty acids were not associated with outcomes. The association of SFA with outcomes varied by genotype at rs2306692 (genotyped in four studies of whites), where the magnitude of the association of SFA intake with each outcome was greater per additional copy of the T allele: 0.107 kg m(-2) greater for BMI (interaction P=0.0001), 0.267 cm for waist (interaction P=0.001) and 0.21 cm for hip (interaction P=0.001). No other significant interactions were observed.

CONCLUSION: Dietary SFA and LRP1 genotype may interactively influence anthropometric traits. Further exploration of this, and other diet x genotype interactions, may improve understanding of interindividual variability in the relationships of dietary factors with anthropometric traits.

%B Int J Obes (Lond) %V 37 %P 1211-20 %8 2013 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/23357958?dopt=Abstract %R 10.1038/ijo.2012.215 %0 Journal Article %J Circulation %D 2013 %T Long-chain monounsaturated Fatty acids and incidence of congestive heart failure in 2 prospective cohorts. %A Imamura, Fumiaki %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Steffen, Lyn M %A Folsom, Aaron R %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Cross-Sectional Studies %K Dietary Fats %K Fatty Acids, Monounsaturated %K Feeding Behavior %K Female %K Heart Failure %K Humans %K Incidence %K Longitudinal Studies %K Male %K Middle Aged %K Nutrition Surveys %K Prospective Studies %K Risk Factors %K Stroke %X

BACKGROUND: Decades-old animal experiments suggested that dietary long-chain monounsaturated fatty acids (LCMUFAs) caused cardiotoxicity, leading, for example, development of Canola oil (Canadian oil low in erucic acid) from rapeseed. However, potential cardiotoxicity in humans and contemporary dietary sources of LCMUFAs are unknown.

METHODS AND RESULTS: We prospectively investigated the associations of plasma phospholipid LCMUFAs (20:1, 22:1, and 24:1), assessed as objective biomarkers of exposure, with incidence congestive heart failure in 2 independent cohorts: 3694 older adults (mean age, 75.2±5.2 years) in the Cardiovascular Health Study (CHS; 1992-2006) and 3577 middle-aged adults (mean age, 54.1±5.8 years) in the Atherosclerosis Risk in Communities Study, Minnesota subcohort (ARIC; 1987-2008). We further examined dietary correlates of circulating LCMUFAs in CHS and ARIC and US dietary sources of LCMUFAs in the 2003-2010 National Health and Nutrition Examination Survey (NHANES). In CHS, 997 congestive heart failure events occurred during 39 238 person-years; in ARIC, 330 events congestive heart failure events occurred during 64 438 person-years. After multivariable adjustment, higher levels of 22:1 and 24:1 were positively associated with greater incident congestive heart failure in both CHS and ARIC; hazard ratios were 1.34 (95% confidence interval, 1.02-1.76) and 1.57 (95% confidence interval, 1.11-2.23) for highest versus lowest quintiles of 22:1, respectively, and 1.75 (95% confidence interval, 1.23-2.50) and 1.92 (95% confidence interval, 1.22-3.03) for 24:1, respectively (P for trend ≤0.03 each). A variety of foods were related to circulating LCMUFAs in CHS and ARIC, consistent with food sources of LCMUFAs in NHANES, including fish, poultry, meats, whole grains, and mustard.

CONCLUSIONS: Higher circulating levels of 22:1 and 24:1, with apparently diverse dietary sources, were associated with incident congestive heart failure in 2 independent cohorts, suggesting possible cardiotoxicity of LCMUFAs in humans.

%B Circulation %V 127 %P 1512-21, 1521e1-18 %8 2013 Apr 09 %G eng %N 14 %1 http://www.ncbi.nlm.nih.gov/pubmed/23487436?dopt=Abstract %& 1512 %R 10.1161/CIRCULATIONAHA.112.001197 %0 Journal Article %J Psychosom Med %D 2013 %T Long-term survival in adults 65 years and older with white matter hyperintensity: association with performance on the digit symbol substitution test. %A Rosano, Caterina %A Chang, Yue-Fang %A Kuller, Lewis H %A Guralnik, Jack M %A Studenski, Stephanie A %A Aizenstein, Howard J %A Gianaros, Peter J %A Lopez, Oscar L %A Longstreth, William T %A Newman, Anne B %K Aged %K Apolipoprotein E4 %K Biomarkers %K Brain %K Cardiovascular Diseases %K Epidemiologic Methods %K Female %K Humans %K Life Style %K Magnetic Resonance Imaging %K Male %K Neuroimaging %K Neuropsychological Tests %K Reaction Time %K Sex Factors %K Stroke %K Survivors %X

OBJECTIVE: White matter hyperintensity (WMH) confers increased mortality risk in patients with cardiovascular diseases. However, little is known about differences in survival times among adults 65 years and older who have WMH and live in the community. To characterize the factors that may reduce mortality risk in the presence of WMH, measures of race, sex, apolipoprotein E4, neuroimaging, and cardiometabolic, physiological, and psychosocial characteristics were examined, with a particular focus on information processing as measured by the Digit Symbol Substitution Test (DSST).

METHODS: Cox proportional models were used to estimate mortality risks in a cohort of 3513 adults (74.8 years, 58% women, 84% white) with WMH (0-9 points), DSST (0-90 points), risk factor assessment in 1992 to 1994, and data on mortality and incident stroke in 2009 (median follow-up [range] = 14.2 [0.5-18.1] years).

RESULTS: WMH predicted a 48% greater mortality risk (age-adjusted hazard ratio [HR; 95% confidence interval {CI}] for WMH >3 points = 1.48 [1.35-1.62]). This association was attenuated after adjustment for DSST (HR [CI] = 1.38 [1.27-1.51]) or lacunar infarcts (HR [CI] = 1.37 [1.25,1.50]) but not after adjustment for other factors. The interaction between DSST and WMH was significant (p = .011). In fully adjusted models stratified by WMH of 3 or higher, participants with DSST greater than or equal to median had a 34% lower mortality risk among those with WMH of 3 or higher (n = 532/1217) and a 28% lower mortality risk among those with WMH lower than 3 (n = 1364/2296), compared with participants with DSST less than median (HR [95% CI] = 0.66 [0.55-0.81] and 0.72 [0.62-0.83], respectively).

CONCLUSIONS: WMH is associated with increased long-term mortality risk in community-dwelling adults 65 years and older. The increased risk is attenuated for those with higher DSST. Assessment of cognitive function with DSST may improve risk stratification of individuals with WMH.

%B Psychosom Med %V 75 %P 624-31 %8 2013 Sep %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23886735?dopt=Abstract %R 10.1097/PSY.0b013e31829c1df2 %0 Journal Article %J Nat Genet %D 2013 %T A meta-analysis identifies new loci associated with body mass index in individuals of African ancestry. %A Monda, Keri L %A Chen, Gary K %A Taylor, Kira C %A Palmer, Cameron %A Edwards, Todd L %A Lange, Leslie A %A Ng, Maggie C Y %A Adeyemo, Adebowale A %A Allison, Matthew A %A Bielak, Lawrence F %A Chen, Guanjie %A Graff, Mariaelisa %A Irvin, Marguerite R %A Rhie, Suhn K %A Li, Guo %A Liu, Yongmei %A Liu, Youfang %A Lu, Yingchang %A Nalls, Michael A %A Sun, Yan V %A Wojczynski, Mary K %A Yanek, Lisa R %A Aldrich, Melinda C %A Ademola, Adeyinka %A Amos, Christopher I %A Bandera, Elisa V %A Bock, Cathryn H %A Britton, Angela %A Broeckel, Ulrich %A Cai, Quiyin %A Caporaso, Neil E %A Carlson, Chris S %A Carpten, John %A Casey, Graham %A Chen, Wei-Min %A Chen, Fang %A Chen, Yii-der I %A Chiang, Charleston W K %A Coetzee, Gerhard A %A Demerath, Ellen %A Deming-Halverson, Sandra L %A Driver, Ryan W %A Dubbert, Patricia %A Feitosa, Mary F %A Feng, Ye %A Freedman, Barry I %A Gillanders, Elizabeth M %A Gottesman, Omri %A Guo, Xiuqing %A Haritunians, Talin %A Harris, Tamara %A Harris, Curtis C %A Hennis, Anselm J M %A Hernandez, Dena G %A McNeill, Lorna H %A Howard, Timothy D %A Howard, Barbara V %A Howard, Virginia J %A Johnson, Karen C %A Kang, Sun J %A Keating, Brendan J %A Kolb, Suzanne %A Kuller, Lewis H %A Kutlar, Abdullah %A Langefeld, Carl D %A Lettre, Guillaume %A Lohman, Kurt %A Lotay, Vaneet %A Lyon, Helen %A Manson, JoAnn E %A Maixner, William %A Meng, Yan A %A Monroe, Kristine R %A Morhason-Bello, Imran %A Murphy, Adam B %A Mychaleckyj, Josyf C %A Nadukuru, Rajiv %A Nathanson, Katherine L %A Nayak, Uma %A N'diaye, Amidou %A Nemesure, Barbara %A Wu, Suh-Yuh %A Leske, M Cristina %A Neslund-Dudas, Christine %A Neuhouser, Marian %A Nyante, Sarah %A Ochs-Balcom, Heather %A Ogunniyi, Adesola %A Ogundiran, Temidayo O %A Ojengbede, Oladosu %A Olopade, Olufunmilayo I %A Palmer, Julie R %A Ruiz-Narvaez, Edward A %A Palmer, Nicholette D %A Press, Michael F %A Rampersaud, Evandine %A Rasmussen-Torvik, Laura J %A Rodriguez-Gil, Jorge L %A Salako, Babatunde %A Schadt, Eric E %A Schwartz, Ann G %A Shriner, Daniel A %A Siscovick, David %A Smith, Shad B %A Wassertheil-Smoller, Sylvia %A Speliotes, Elizabeth K %A Spitz, Margaret R %A Sucheston, Lara %A Taylor, Herman %A Tayo, Bamidele O %A Tucker, Margaret A %A Van Den Berg, David J %A Edwards, Digna R Velez %A Wang, Zhaoming %A Wiencke, John K %A Winkler, Thomas W %A Witte, John S %A Wrensch, Margaret %A Wu, Xifeng %A Yang, James J %A Levin, Albert M %A Young, Taylor R %A Zakai, Neil A %A Cushman, Mary %A Zanetti, Krista A %A Zhao, Jing Hua %A Zhao, Wei %A Zheng, Yonglan %A Zhou, Jie %A Ziegler, Regina G %A Zmuda, Joseph M %A Fernandes, Jyotika K %A Gilkeson, Gary S %A Kamen, Diane L %A Hunt, Kelly J %A Spruill, Ida J %A Ambrosone, Christine B %A Ambs, Stefan %A Arnett, Donna K %A Atwood, Larry %A Becker, Diane M %A Berndt, Sonja I %A Bernstein, Leslie %A Blot, William J %A Borecki, Ingrid B %A Bottinger, Erwin P %A Bowden, Donald W %A Burke, Gregory %A Chanock, Stephen J %A Cooper, Richard S %A Ding, Jingzhong %A Duggan, David %A Evans, Michele K %A Fox, Caroline %A Garvey, W Timothy %A Bradfield, Jonathan P %A Hakonarson, Hakon %A Grant, Struan F A %A Hsing, Ann %A Chu, Lisa %A Hu, Jennifer J %A Huo, Dezheng %A Ingles, Sue A %A John, Esther M %A Jordan, Joanne M %A Kabagambe, Edmond K %A Kardia, Sharon L R %A Kittles, Rick A %A Goodman, Phyllis J %A Klein, Eric A %A Kolonel, Laurence N %A Le Marchand, Loïc %A Liu, Simin %A McKnight, Barbara %A Millikan, Robert C %A Mosley, Thomas H %A Padhukasahasram, Badri %A Williams, L Keoki %A Patel, Sanjay R %A Peters, Ulrike %A Pettaway, Curtis A %A Peyser, Patricia A %A Psaty, Bruce M %A Redline, Susan %A Rotimi, Charles N %A Rybicki, Benjamin A %A Sale, Michèle M %A Schreiner, Pamela J %A Signorello, Lisa B %A Singleton, Andrew B %A Stanford, Janet L %A Strom, Sara S %A Thun, Michael J %A Vitolins, Mara %A Zheng, Wei %A Moore, Jason H %A Williams, Scott M %A Ketkar, Shamika %A Zhu, Xiaofeng %A Zonderman, Alan B %A Kooperberg, Charles %A Papanicolaou, George J %A Henderson, Brian E %A Reiner, Alex P %A Hirschhorn, Joel N %A Loos, Ruth J F %A North, Kari E %A Haiman, Christopher A %K African Americans %K Body Mass Index %K Case-Control Studies %K Gene Frequency %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Obesity %K Polymorphism, Single Nucleotide %X

Genome-wide association studies (GWAS) have identified 36 loci associated with body mass index (BMI), predominantly in populations of European ancestry. We conducted a meta-analysis to examine the association of >3.2 million SNPs with BMI in 39,144 men and women of African ancestry and followed up the most significant associations in an additional 32,268 individuals of African ancestry. We identified one new locus at 5q33 (GALNT10, rs7708584, P = 3.4 × 10(-11)) and another at 7p15 when we included data from the GIANT consortium (MIR148A-NFE2L3, rs10261878, P = 1.2 × 10(-10)). We also found suggestive evidence of an association at a third locus at 6q16 in the African-ancestry sample (KLHL32, rs974417, P = 6.9 × 10(-8)). Thirty-two of the 36 previously established BMI variants showed directionally consistent effect estimates in our GWAS (binomial P = 9.7 × 10(-7)), five of which reached genome-wide significance. These findings provide strong support for shared BMI loci across populations, as well as for the utility of studying ancestrally diverse populations.

%B Nat Genet %V 45 %P 690-6 %8 2013 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23583978?dopt=Abstract %R 10.1038/ng.2608 %0 Journal Article %J Nat Genet %D 2013 %T Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease. %A Lambert, J C %A Ibrahim-Verbaas, C A %A Harold, D %A Naj, A C %A Sims, R %A Bellenguez, C %A DeStafano, A L %A Bis, J C %A Beecham, G W %A Grenier-Boley, B %A Russo, G %A Thorton-Wells, T A %A Jones, N %A Smith, A V %A Chouraki, V %A Thomas, C %A Ikram, M A %A Zelenika, D %A Vardarajan, B N %A Kamatani, Y %A Lin, C F %A Gerrish, A %A Schmidt, H %A Kunkle, B %A Dunstan, M L %A Ruiz, A %A Bihoreau, M T %A Choi, S H %A Reitz, C %A Pasquier, F %A Cruchaga, C %A Craig, D %A Amin, N %A Berr, C %A Lopez, O L %A De Jager, P L %A Deramecourt, V %A Johnston, J A %A Evans, D %A Lovestone, S %A Letenneur, L %A Morón, F J %A Rubinsztein, D C %A Eiriksdottir, G %A Sleegers, K %A Goate, A M %A Fiévet, N %A Huentelman, M W %A Gill, M %A Brown, K %A Kamboh, M I %A Keller, L %A Barberger-Gateau, P %A McGuiness, B %A Larson, E B %A Green, R %A Myers, A J %A Dufouil, C %A Todd, S %A Wallon, D %A Love, S %A Rogaeva, E %A Gallacher, J %A St George-Hyslop, P %A Clarimon, J %A Lleo, A %A Bayer, A %A Tsuang, D W %A Yu, L %A Tsolaki, M %A Bossù, P %A Spalletta, G %A Proitsi, P %A Collinge, J %A Sorbi, S %A Sanchez-Garcia, F %A Fox, N C %A Hardy, J %A Deniz Naranjo, M C %A Bosco, P %A Clarke, R %A Brayne, C %A Galimberti, D %A Mancuso, M %A Matthews, F %A Moebus, S %A Mecocci, P %A Del Zompo, M %A Maier, W %A Hampel, H %A Pilotto, A %A Bullido, M %A Panza, F %A Caffarra, P %A Nacmias, B %A Gilbert, J R %A Mayhaus, M %A Lannefelt, L %A Hakonarson, H %A Pichler, S %A Carrasquillo, M M %A Ingelsson, M %A Beekly, D %A Alvarez, V %A Zou, F %A Valladares, O %A Younkin, S G %A Coto, E %A Hamilton-Nelson, K L %A Gu, W %A Razquin, C %A Pastor, P %A Mateo, I %A Owen, M J %A Faber, K M %A Jonsson, P V %A Combarros, O %A O'Donovan, M C %A Cantwell, L B %A Soininen, H %A Blacker, D %A Mead, S %A Mosley, T H %A Bennett, D A %A Harris, T B %A Fratiglioni, L %A Holmes, C %A de Bruijn, R F %A Passmore, P %A Montine, T J %A Bettens, K %A Rotter, J I %A Brice, A %A Morgan, K %A Foroud, T M %A Kukull, W A %A Hannequin, D %A Powell, J F %A Nalls, M A %A Ritchie, K %A Lunetta, K L %A Kauwe, J S %A Boerwinkle, E %A Riemenschneider, M %A Boada, M %A Hiltuenen, M %A Martin, E R %A Schmidt, R %A Rujescu, D %A Wang, L S %A Dartigues, J F %A Mayeux, R %A Tzourio, C %A Hofman, A %A Nöthen, M M %A Graff, C %A Psaty, B M %A Jones, L %A Haines, J L %A Holmans, P A %A Lathrop, M %A Pericak-Vance, M A %A Launer, L J %A Farrer, L A %A van Duijn, C M %A Van Broeckhoven, C %A Moskvina, V %A Seshadri, S %A Williams, J %A Schellenberg, G D %A Amouyel, P %K Age of Onset %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Case-Control Studies %K Cohort Studies %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

Eleven susceptibility loci for late-onset Alzheimer's disease (LOAD) were identified by previous studies; however, a large portion of the genetic risk for this disease remains unexplained. We conducted a large, two-stage meta-analysis of genome-wide association studies (GWAS) in individuals of European ancestry. In stage 1, we used genotyped and imputed data (7,055,881 SNPs) to perform meta-analysis on 4 previously published GWAS data sets consisting of 17,008 Alzheimer's disease cases and 37,154 controls. In stage 2, 11,632 SNPs were genotyped and tested for association in an independent set of 8,572 Alzheimer's disease cases and 11,312 controls. In addition to the APOE locus (encoding apolipoprotein E), 19 loci reached genome-wide significance (P < 5 × 10(-8)) in the combined stage 1 and stage 2 analysis, of which 11 are newly associated with Alzheimer's disease.

%B Nat Genet %V 45 %P 1452-8 %8 2013 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24162737?dopt=Abstract %R 10.1038/ng.2802 %0 Journal Article %J PLoS Genet %D 2013 %T Meta-analysis of genome-wide association studies identifies six new Loci for serum calcium concentrations. %A O'Seaghdha, Conall M %A Wu, Hongsheng %A Yang, Qiong %A Kapur, Karen %A Guessous, Idris %A Zuber, Annie Mercier %A Köttgen, Anna %A Stoudmann, Candice %A Teumer, Alexander %A Kutalik, Zoltán %A Mangino, Massimo %A Dehghan, Abbas %A Zhang, Weihua %A Eiriksdottir, Gudny %A Li, Guo %A Tanaka, Toshiko %A Portas, Laura %A Lopez, Lorna M %A Hayward, Caroline %A Lohman, Kurt %A Matsuda, Koichi %A Padmanabhan, Sandosh %A Firsov, Dmitri %A Sorice, Rossella %A Ulivi, Sheila %A Brockhaus, A Catharina %A Kleber, Marcus E %A Mahajan, Anubha %A Ernst, Florian D %A Gudnason, Vilmundur %A Launer, Lenore J %A Mace, Aurelien %A Boerwinckle, Eric %A Arking, Dan E %A Tanikawa, Chizu %A Nakamura, Yusuke %A Brown, Morris J %A Gaspoz, Jean-Michel %A Theler, Jean-Marc %A Siscovick, David S %A Psaty, Bruce M %A Bergmann, Sven %A Vollenweider, Peter %A Vitart, Veronique %A Wright, Alan F %A Zemunik, Tatijana %A Boban, Mladen %A Kolcic, Ivana %A Navarro, Pau %A Brown, Edward M %A Estrada, Karol %A Ding, Jingzhong %A Harris, Tamara B %A Bandinelli, Stefania %A Hernandez, Dena %A Singleton, Andrew B %A Girotto, Giorgia %A Ruggiero, Daniela %A d'Adamo, Adamo Pio %A Robino, Antonietta %A Meitinger, Thomas %A Meisinger, Christa %A Davies, Gail %A Starr, John M %A Chambers, John C %A Boehm, Bernhard O %A Winkelmann, Bernhard R %A Huang, Jie %A Murgia, Federico %A Wild, Sarah H %A Campbell, Harry %A Morris, Andrew P %A Franco, Oscar H %A Hofman, Albert %A Uitterlinden, André G %A Rivadeneira, Fernando %A Völker, Uwe %A Hannemann, Anke %A Biffar, Reiner %A Hoffmann, Wolfgang %A Shin, So-Youn %A Lescuyer, Pierre %A Henry, Hughes %A Schurmann, Claudia %A Munroe, Patricia B %A Gasparini, Paolo %A Pirastu, Nicola %A Ciullo, Marina %A Gieger, Christian %A März, Winfried %A Lind, Lars %A Spector, Tim D %A Smith, Albert V %A Rudan, Igor %A Wilson, James F %A Polasek, Ozren %A Deary, Ian J %A Pirastu, Mario %A Ferrucci, Luigi %A Liu, Yongmei %A Kestenbaum, Bryan %A Kooner, Jaspal S %A Witteman, Jacqueline C M %A Nauck, Matthias %A Kao, W H Linda %A Wallaschofski, Henri %A Bonny, Olivier %A Fox, Caroline S %A Bochud, Murielle %K Animals %K Bone and Bones %K Bone Density %K Calcium %K European Continental Ancestry Group %K Gene Expression Regulation %K Genome-Wide Association Study %K Homeostasis %K Humans %K Kidney %K Mice %K Polymorphism, Single Nucleotide %X

Calcium is vital to the normal functioning of multiple organ systems and its serum concentration is tightly regulated. Apart from CASR, the genes associated with serum calcium are largely unknown. We conducted a genome-wide association meta-analysis of 39,400 individuals from 17 population-based cohorts and investigated the 14 most strongly associated loci in ≤ 21,679 additional individuals. Seven loci (six new regions) in association with serum calcium were identified and replicated. Rs1570669 near CYP24A1 (P = 9.1E-12), rs10491003 upstream of GATA3 (P = 4.8E-09) and rs7481584 in CARS (P = 1.2E-10) implicate regions involved in Mendelian calcemic disorders: Rs1550532 in DGKD (P = 8.2E-11), also associated with bone density, and rs7336933 near DGKH/KIAA0564 (P = 9.1E-10) are near genes that encode distinct isoforms of diacylglycerol kinase. Rs780094 is in GCKR. We characterized the expression of these genes in gut, kidney, and bone, and demonstrate modulation of gene expression in bone in response to dietary calcium in mice. Our results shed new light on the genetics of calcium homeostasis.

%B PLoS Genet %V 9 %P e1003796 %8 2013 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/24068962?dopt=Abstract %R 10.1371/journal.pgen.1003796 %0 Journal Article %J PLoS Genet %D 2013 %T A meta-analysis of thyroid-related traits reveals novel loci and gender-specific differences in the regulation of thyroid function. %A Porcu, Eleonora %A Medici, Marco %A Pistis, Giorgio %A Volpato, Claudia B %A Wilson, Scott G %A Cappola, Anne R %A Bos, Steffan D %A Deelen, Joris %A den Heijer, Martin %A Freathy, Rachel M %A Lahti, Jari %A Liu, Chunyu %A Lopez, Lorna M %A Nolte, Ilja M %A O'Connell, Jeffrey R %A Tanaka, Toshiko %A Trompet, Stella %A Arnold, Alice %A Bandinelli, Stefania %A Beekman, Marian %A Böhringer, Stefan %A Brown, Suzanne J %A Buckley, Brendan M %A Camaschella, Clara %A de Craen, Anton J M %A Davies, Gail %A de Visser, Marieke C H %A Ford, Ian %A Forsen, Tom %A Frayling, Timothy M %A Fugazzola, Laura %A Gögele, Martin %A Hattersley, Andrew T %A Hermus, Ad R %A Hofman, Albert %A Houwing-Duistermaat, Jeanine J %A Jensen, Richard A %A Kajantie, Eero %A Kloppenburg, Margreet %A Lim, Ee M %A Masciullo, Corrado %A Mariotti, Stefano %A Minelli, Cosetta %A Mitchell, Braxton D %A Nagaraja, Ramaiah %A Netea-Maier, Romana T %A Palotie, Aarno %A Persani, Luca %A Piras, Maria G %A Psaty, Bruce M %A Räikkönen, Katri %A Richards, J Brent %A Rivadeneira, Fernando %A Sala, Cinzia %A Sabra, Mona M %A Sattar, Naveed %A Shields, Beverley M %A Soranzo, Nicole %A Starr, John M %A Stott, David J %A Sweep, Fred C G J %A Usala, Gianluca %A van der Klauw, Melanie M %A van Heemst, Diana %A van Mullem, Alies %A Vermeulen, Sita H %A Visser, W Edward %A Walsh, John P %A Westendorp, Rudi G J %A Widen, Elisabeth %A Zhai, Guangju %A Cucca, Francesco %A Deary, Ian J %A Eriksson, Johan G %A Ferrucci, Luigi %A Fox, Caroline S %A Jukema, J Wouter %A Kiemeney, Lambertus A %A Pramstaller, Peter P %A Schlessinger, David %A Shuldiner, Alan R %A Slagboom, Eline P %A Uitterlinden, André G %A Vaidya, Bijay %A Visser, Theo J %A Wolffenbuttel, Bruce H R %A Meulenbelt, Ingrid %A Rotter, Jerome I %A Spector, Tim D %A Hicks, Andrew A %A Toniolo, Daniela %A Sanna, Serena %A Peeters, Robin P %A Naitza, Silvia %K Female %K Genome-Wide Association Study %K Humans %K Hyperthyroidism %K Hypothyroidism %K Male %K Phenotype %K Polymorphism, Genetic %K Polymorphism, Single Nucleotide %K Sex Characteristics %K Signal Transduction %K Thyroid Gland %K Thyrotropin %K Thyroxine %X

Thyroid hormone is essential for normal metabolism and development, and overt abnormalities in thyroid function lead to common endocrine disorders affecting approximately 10% of individuals over their life span. In addition, even mild alterations in thyroid function are associated with weight changes, atrial fibrillation, osteoporosis, and psychiatric disorders. To identify novel variants underlying thyroid function, we performed a large meta-analysis of genome-wide association studies for serum levels of the highly heritable thyroid function markers TSH and FT4, in up to 26,420 and 17,520 euthyroid subjects, respectively. Here we report 26 independent associations, including several novel loci for TSH (PDE10A, VEGFA, IGFBP5, NFIA, SOX9, PRDM11, FGF7, INSR, ABO, MIR1179, NRG1, MBIP, ITPK1, SASH1, GLIS3) and FT4 (LHX3, FOXE1, AADAT, NETO1/FBXO15, LPCAT2/CAPNS2). Notably, only limited overlap was detected between TSH and FT4 associated signals, in spite of the feedback regulation of their circulating levels by the hypothalamic-pituitary-thyroid axis. Five of the reported loci (PDE8B, PDE10A, MAF/LOC440389, NETO1/FBXO15, and LPCAT2/CAPNS2) show strong gender-specific differences, which offer clues for the known sexual dimorphism in thyroid function and related pathologies. Importantly, the TSH-associated loci contribute not only to variation within the normal range, but also to TSH values outside the reference range, suggesting that they may be involved in thyroid dysfunction. Overall, our findings explain, respectively, 5.64% and 2.30% of total TSH and FT4 trait variance, and they improve the current knowledge of the regulation of hypothalamic-pituitary-thyroid axis function and the consequences of genetic variation for hypo- or hyperthyroidism.

%B PLoS Genet %V 9 %P e1003266 %8 2013 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23408906?dopt=Abstract %R 10.1371/journal.pgen.1003266 %0 Journal Article %J Circulation %D 2013 %T Multiethnic meta-analysis of genome-wide association studies in >100 000 subjects identifies 23 fibrinogen-associated Loci but no strong evidence of a causal association between circulating fibrinogen and cardiovascular disease. %A Sabater-Lleal, Maria %A Huang, Jie %A Chasman, Daniel %A Naitza, Silvia %A Dehghan, Abbas %A Johnson, Andrew D %A Teumer, Alexander %A Reiner, Alex P %A Folkersen, Lasse %A Basu, Saonli %A Rudnicka, Alicja R %A Trompet, Stella %A Mälarstig, Anders %A Baumert, Jens %A Bis, Joshua C %A Guo, Xiuqing %A Hottenga, Jouke J %A Shin, So-Youn %A Lopez, Lorna M %A Lahti, Jari %A Tanaka, Toshiko %A Yanek, Lisa R %A Oudot-Mellakh, Tiphaine %A Wilson, James F %A Navarro, Pau %A Huffman, Jennifer E %A Zemunik, Tatijana %A Redline, Susan %A Mehra, Reena %A Pulanic, Drazen %A Rudan, Igor %A Wright, Alan F %A Kolcic, Ivana %A Polasek, Ozren %A Wild, Sarah H %A Campbell, Harry %A Curb, J David %A Wallace, Robert %A Liu, Simin %A Eaton, Charles B %A Becker, Diane M %A Becker, Lewis C %A Bandinelli, Stefania %A Räikkönen, Katri %A Widen, Elisabeth %A Palotie, Aarno %A Fornage, Myriam %A Green, David %A Gross, Myron %A Davies, Gail %A Harris, Sarah E %A Liewald, David C %A Starr, John M %A Williams, Frances M K %A Grant, Peter J %A Spector, Timothy D %A Strawbridge, Rona J %A Silveira, Angela %A Sennblad, Bengt %A Rivadeneira, Fernando %A Uitterlinden, André G %A Franco, Oscar H %A Hofman, Albert %A van Dongen, Jenny %A Willemsen, Gonneke %A Boomsma, Dorret I %A Yao, Jie %A Swords Jenny, Nancy %A Haritunians, Talin %A McKnight, Barbara %A Lumley, Thomas %A Taylor, Kent D %A Rotter, Jerome I %A Psaty, Bruce M %A Peters, Annette %A Gieger, Christian %A Illig, Thomas %A Grotevendt, Anne %A Homuth, Georg %A Völzke, Henry %A Kocher, Thomas %A Goel, Anuj %A Franzosi, Maria Grazia %A Seedorf, Udo %A Clarke, Robert %A Steri, Maristella %A Tarasov, Kirill V %A Sanna, Serena %A Schlessinger, David %A Stott, David J %A Sattar, Naveed %A Buckley, Brendan M %A Rumley, Ann %A Lowe, Gordon D %A McArdle, Wendy L %A Chen, Ming-Huei %A Tofler, Geoffrey H %A Song, Jaejoon %A Boerwinkle, Eric %A Folsom, Aaron R %A Rose, Lynda M %A Franco-Cereceda, Anders %A Teichert, Martina %A Ikram, M Arfan %A Mosley, Thomas H %A Bevan, Steve %A Dichgans, Martin %A Rothwell, Peter M %A Sudlow, Cathie L M %A Hopewell, Jemma C %A Chambers, John C %A Saleheen, Danish %A Kooner, Jaspal S %A Danesh, John %A Nelson, Christopher P %A Erdmann, Jeanette %A Reilly, Muredach P %A Kathiresan, Sekar %A Schunkert, Heribert %A Morange, Pierre-Emmanuel %A Ferrucci, Luigi %A Eriksson, Johan G %A Jacobs, David %A Deary, Ian J %A Soranzo, Nicole %A Witteman, Jacqueline C M %A de Geus, Eco J C %A Tracy, Russell P %A Hayward, Caroline %A Koenig, Wolfgang %A Cucca, Francesco %A Jukema, J Wouter %A Eriksson, Per %A Seshadri, Sudha %A Markus, Hugh S %A Watkins, Hugh %A Samani, Nilesh J %A Wallaschofski, Henri %A Smith, Nicholas L %A Tregouet, David %A Ridker, Paul M %A Tang, Weihong %A Strachan, David P %A Hamsten, Anders %A O'Donnell, Christopher J %K Adolescent %K Adult %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Coronary Artery Disease %K European Continental Ancestry Group %K Female %K Fibrinogen %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Hispanic Americans %K Humans %K Male %K Middle Aged %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Risk Factors %K Stroke %K Venous Thromboembolism %K Young Adult %X

BACKGROUND: Estimates of the heritability of plasma fibrinogen concentration, an established predictor of cardiovascular disease, range from 34% to 50%. Genetic variants so far identified by genome-wide association studies explain only a small proportion (<2%) of its variation.

METHODS AND RESULTS: We conducted a meta-analysis of 28 genome-wide association studies including >90 000 subjects of European ancestry, the first genome-wide association meta-analysis of fibrinogen levels in 7 studies in blacks totaling 8289 samples, and a genome-wide association study in Hispanics totaling 1366 samples. Evaluation for association of single-nucleotide polymorphisms with clinical outcomes included a total of 40 695 cases and 85 582 controls for coronary artery disease, 4752 cases and 24 030 controls for stroke, and 3208 cases and 46 167 controls for venous thromboembolism. Overall, we identified 24 genome-wide significant (P<5×10(-8)) independent signals in 23 loci, including 15 novel associations, together accounting for 3.7% of plasma fibrinogen variation. Gene-set enrichment analysis highlighted key roles in fibrinogen regulation for the 3 structural fibrinogen genes and pathways related to inflammation, adipocytokines, and thyrotrophin-releasing hormone signaling. Whereas lead single-nucleotide polymorphisms in a few loci were significantly associated with coronary artery disease, the combined effect of all 24 fibrinogen-associated lead single-nucleotide polymorphisms was not significant for coronary artery disease, stroke, or venous thromboembolism.

CONCLUSIONS: We identify 23 robustly associated fibrinogen loci, 15 of which are new. Clinical outcome analysis of these loci does not support a causal relationship between circulating levels of fibrinogen and coronary artery disease, stroke, or venous thromboembolism.

%B Circulation %V 128 %P 1310-24 %8 2013 Sep 17 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/23969696?dopt=Abstract %R 10.1161/CIRCULATIONAHA.113.002251 %0 Journal Article %J Neurology %D 2013 %T Neighborhood socioeconomic disadvantage and mortality after stroke. %A Brown, Arleen F %A Liang, Li-Jung %A Vassar, Stefanie D %A Merkin, Sharon Stein %A Longstreth, W T %A Ovbiagele, Bruce %A Yan, Tingjian %A Escarce, José J %K Aged %K Female %K Humans %K Incidence %K Kaplan-Meier Estimate %K Male %K Proportional Hazards Models %K Residence Characteristics %K Risk Factors %K Socioeconomic Factors %K Stroke %K Vulnerable Populations %X

OBJECTIVE: Residence in a socioeconomically disadvantaged community is associated with mortality, but the mechanisms are not well understood. We examined whether socioeconomic features of the residential neighborhood contribute to poststroke mortality and whether neighborhood influences are mediated by traditional behavioral and biologic risk factors.

METHODS: We used data from the Cardiovascular Health Study, a multicenter, population-based, longitudinal study of adults ≥65 years. Residential neighborhood disadvantage was measured using neighborhood socioeconomic status (NSES), a composite of 6 census tract variables representing income, education, employment, and wealth. Multilevel Cox proportional hazard models were constructed to determine the association of NSES to mortality after an incident stroke, adjusted for sociodemographic characteristics, stroke type, and behavioral and biologic risk factors.

RESULTS: Among the 3,834 participants with no prior stroke at baseline, 806 had a stroke over a mean 11.5 years of follow-up, with 168 (20%) deaths 30 days after stroke and 276 (34%) deaths at 1 year. In models adjusted for demographic characteristics, stroke type, and behavioral and biologic risk factors, mortality hazard 1 year after stroke was significantly higher among residents of neighborhoods with the lowest NSES than those in the highest NSES neighborhoods (hazard ratio 1.77, 95% confidence interval 1.17-2.68).

CONCLUSION: Living in a socioeconomically disadvantaged neighborhood is associated with higher mortality hazard at 1 year following an incident stroke. Further work is needed to understand the structural and social characteristics of neighborhoods that may contribute to mortality in the year after a stroke and the pathways through which these characteristics operate.

%B Neurology %V 80 %P 520-7 %8 2013 Feb 05 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23284071?dopt=Abstract %& 520 %R 10.1212/WNL.0b013e31828154ae %0 Journal Article %J Hum Genet %D 2013 %T No evidence of interaction between known lipid-associated genetic variants and smoking in the multi-ethnic PAGE population. %A Dumitrescu, Logan %A Carty, Cara L %A Franceschini, Nora %A Hindorff, Lucia A %A Cole, Shelley A %A Bůzková, Petra %A Schumacher, Fredrick R %A Eaton, Charles B %A Goodloe, Robert J %A Duggan, David J %A Haessler, Jeff %A Cochran, Barbara %A Henderson, Brian E %A Cheng, Iona %A Johnson, Karen C %A Carlson, Chris S %A Love, Shelly-Anne %A Brown-Gentry, Kristin %A Nato, Alejandro Q %A Quibrera, Miguel %A Shohet, Ralph V %A Ambite, Jose Luis %A Wilkens, Lynne R %A Le Marchand, Loïc %A Haiman, Christopher A %A Buyske, Steven %A Kooperberg, Charles %A North, Kari E %A Fornage, Myriam %A Crawford, Dana C %K Cholesterol, HDL %K Cholesterol, LDL %K Cohort Studies %K Ethnic Groups %K Female %K Gene Frequency %K Gene-Environment Interaction %K Genetics, Population %K Genome-Wide Association Study %K Humans %K Lipid Metabolism %K Male %K Polymorphism, Single Nucleotide %K Prevalence %K Smoking %K Triglycerides %K Young Adult %X

Genome-wide association studies (GWAS) have identified many variants that influence high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and/or triglycerides. However, environmental modifiers, such as smoking, of these known genotype-phenotype associations are just recently emerging in the literature. We have tested for interactions between smoking and 49 GWAS-identified variants in over 41,000 racially/ethnically diverse samples with lipid levels from the Population Architecture Using Genomics and Epidemiology (PAGE) study. Despite their biological plausibility, we were unable to detect significant SNP × smoking interactions.

%B Hum Genet %V 132 %P 1427-31 %8 2013 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24100633?dopt=Abstract %R 10.1007/s00439-013-1375-3 %0 Journal Article %J J Clin Endocrinol Metab %D 2013 %T Persistent subclinical hypothyroidism and cardiovascular risk in the elderly: the cardiovascular health study. %A Hyland, Kristen A %A Arnold, Alice M %A Lee, Jennifer S %A Cappola, Anne R %K Aged %K Aged, 80 and over %K Coronary Disease %K Female %K Heart Failure %K Humans %K Hypothyroidism %K Incidence %K Longitudinal Studies %K Male %K Risk %K Thyroid Function Tests %X

CONTEXT: Use of a single set of thyroid function tests to define subclinical hypothyroidism may lead to misclassification over time and could influence findings from longitudinal studies.

OBJECTIVE: We assessed the risks of coronary heart disease (CHD), heart failure (HF), and cardiovascular (CV) death in older adults with persistent subclinical hypothyroidism.

DESIGN, SETTING, AND PARTICIPANTS: The study included 679 subclinically hypothyroid and 4184 euthyroid U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study and not taking thyroid preparations.

MAIN OUTCOME MEASURE: We measured the 10-yr risk of incident CHD, HF, and CV death from persistent subclinical hypothyroidism, overall and stratified by degree of TSH elevation (4.5-6.9, 7.0-9.9, and 10.0-19.9 mU/liter).

RESULTS: There was no association between persistent subclinical hypothyroidism and incident CHD [hazard ratio (HR), 1.12; 95% confidence interval (CI), 0.93-1.36], HF (HR, 1.05; 95% CI, 0.97-1.27), or CV death (HR, 1.07; 95% CI, 0.87-1.31) in adjusted analyses in which subclinical hypothyroidism was modeled as a time-varying exposure using up to four serial thyroid function tests. When subclinical hypothyroidism was stratified by degree of TSH elevation, no significant associations were found in any stratum. Findings were similar in fixed exposure analyses in which only participants with testing 2 yr apart were considered, with no association between persistent or transient subclinical hypothyroidism and incident CHD, HF, or CV death.

CONCLUSIONS: Our data do not support increased risk of CHD, HF, or CV death in older adults with persistent subclinical hypothyroidism.

%B J Clin Endocrinol Metab %V 98 %P 533-40 %8 2013 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23162099?dopt=Abstract %R 10.1210/jc.2012-2180 %0 Journal Article %J Cardiol Res Pract %D 2013 %T Plasma Fatty Acid binding protein 4 and risk of sudden cardiac death in older adults. %A Djoussé, Luc %A Maziarz, Marlena %A Biggs, Mary L %A Ix, Joachim H %A Zieman, Susan J %A Kizer, Jorge R %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %A Tracy, Russell P %A Mukamal, Kenneth J %A Siscovick, David S %A Sotoodehnia, Nona %X

Although fatty acid binding protein 4 (FABP4) may increase risk of diabetes and exert negative cardiac inotropy, it is unknown whether plasma concentrations of FABP4 are associated with incidence of sudden cardiac death (SCD). We prospectively analyzed data on 4,560 participants of the Cardiovascular Health Study. FABP4 was measured at baseline using ELISA, and SCD events were adjudicated through review of medical records. We used Cox proportional hazards to estimate effect measures. During a median followup of 11.8 years, 146 SCD cases occurred. In a multivariable model adjusting for demographic, lifestyle, and metabolic factors, relative risk of SCD associated with each higher standard deviation (SD) of plasma FABP4 was 1.15 (95% CI: 0.95-1.38), P = 0.15. In a secondary analysis stratified by prevalent diabetes status, FABP4 was associated with higher risk of SCD in nondiabetic participants, (RR per SD higher FABP4: 1.33 (95% CI: 1.07-1.65), P = 0.009) but not in diabetic participants (RR per SD higher FABP4: 0.88 (95% CI: 0.62-1.27), P = 0.50), P for diabetes-FABP4 interaction 0.049. In summary, a single measure of plasma FABP4 obtained later in life was not associated with the risk of SCD in older adults overall. Confirmation of our post-hoc results in nondiabetic people in other studies is warranted.

%B Cardiol Res Pract %V 2013 %P 181054 %8 2013 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24455402?dopt=Abstract %R 10.1155/2013/181054 %0 Journal Article %J Circ Heart Fail %D 2013 %T Plasma free fatty acids and risk of heart failure: the Cardiovascular Health Study. %A Djoussé, Luc %A Benkeser, David %A Arnold, Alice %A Kizer, Jorge R %A Zieman, Susan J %A Lemaitre, Rozenn N %A Tracy, Russell P %A Gottdiener, John S %A Mozaffarian, Dariush %A Siscovick, David S %A Mukamal, Kenneth J %A Ix, Joachim H %K Aged %K Aged, 80 and over %K Biomarkers %K Comorbidity %K Fatty Acids, Nonesterified %K Female %K Heart Failure %K Humans %K Incidence %K Kaplan-Meier Estimate %K Linear Models %K Male %K Multivariate Analysis %K Prognosis %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Time Factors %K United States %X

BACKGROUND: Although plasma free fatty acid (FFA) concentrations have been associated with lipotoxicity, apoptosis, and risk of diabetes mellitus and coronary heart disease, it is unclear whether FFA levels are associated with heart failure (HF).

METHODS AND RESULTS: To test the hypothesis that plasma concentration of FFAs is positively associated with incident HF, we prospectively analyzed data on 4248 men and women free of HF at baseline and >65 years old from the Cardiovascular Health Study. FFA concentration was measured in duplicate by the Wako enzymatic method. Incident HF was validated by a centralized Events Committee. We used Cox proportional hazards to estimate the hazard ratio of HF per SD of FFAs. During a median follow-up of 10.5 years, a total of 1286 new cases of HF occurred. In a multivariable model adjusting for clinic site, comorbidity, demographic, anthropometric, and lifestyle factors, each SD (0.2 mEq/L) higher plasma FFA was associated with 12% (95% confidence interval, 6%-19%) higher risk of HF. Controlling for time-varying diabetes mellitus and coronary heart disease did not change the results (hazard ratio per SD, 1.16 [95% confidence interval, 1.09-1.23]).

CONCLUSIONS: A single measure of plasma FFA obtained later in life is associated with a higher risk of HF in older adults. Additional studies are needed to explore biological mechanisms by which FFAs may influence the risk of HF and determine whether FFAs could serve as a novel pharmacological target for HF prevention.

%B Circ Heart Fail %V 6 %P 964-9 %8 2013 Sep 01 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23926204?dopt=Abstract %R 10.1161/CIRCHEARTFAILURE.113.000521 %0 Journal Article %J Ann Intern Med %D 2013 %T Plasma phospholipid long-chain ω-3 fatty acids and total and cause-specific mortality in older adults: a cohort study. %A Mozaffarian, Dariush %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Huang, Hongyan %A Sacks, Frank M %A Rimm, Eric B %A Wang, Molin %A Siscovick, David S %K Aged %K Biomarkers %K Cause of Death %K Coronary Disease %K Diet Records %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Fatty Acids, Omega-3 %K Fatty Acids, Unsaturated %K Feeding Behavior %K Female %K Humans %K Male %K Prospective Studies %K Risk Assessment %K Stroke %X

BACKGROUND: Long-chain ω-3 polyunsaturated fatty acids (ω3-PUFAs), including eicosapentaenoic acid (EPA) (20:5ω-3), docosapentaenoic acid (DPA) (22:5ω-3), and docosahexaenoic acid (DHA) (22:6ω-3), have been shown to reduce cardiovascular risk, but effects on cause-specific and total mortality and potential dose-responses remain controversial. Most observational studies have assessed self-reported dietary intake and most randomized trials have tested effects of adding supplements to dietary intake and evaluated secondary prevention, thus limiting inference for dietary ω3-PUFAs or primary prevention.

OBJECTIVE: To investigate associations of plasma phospholipid EPA, DPA, DHA, and total ω3-PUFA levels with total and cause-specific mortality among healthy older adults not receiving supplements.

DESIGN: Prospective cohort study.

SETTING: 4 U.S. communities.

PARTICIPANTS: 2692 U.S. adults aged 74 years (±5 years) without prevalent coronary heart disease (CHD), stroke, or heart failure at baseline.

MEASUREMENTS: Phospholipid fatty acid levels and cardiovascular risk factors were measured in 1992. Relationships with total and cause-specific mortality and incident fatal or nonfatal CHD and stroke through 2008 were assessed.

RESULTS: During 30 829 person-years, 1625 deaths (including 570 cardiovascular deaths), 359 fatal and 371 nonfatal CHD events, and 130 fatal and 276 nonfatal strokes occurred. After adjustment, higher plasma levels of ω3-PUFA biomarkers were associated with lower total mortality, with extreme-quintile hazard ratios of 0.83 for EPA (95% CI, 0.71 to 0.98; P for trend = 0.005), 0.77 for DPA (CI, 0.66 to 0.90; P for trend = 0.008), 0.80 for DHA (CI, 0.67 to 0.94; P for trend = 0.006), and 0.73 for total ω3-PUFAs (CI, 0.61 to 0.86; P for trend < 0.001). Lower risk was largely attributable to fewer cardiovascular than noncardiovascular deaths. Individuals in the highest quintile of phospholipid ω3-PUFA level lived an average of 2.22 more years (CI, 0.75 to 3.13 years) after age 65 years than did those in the lowest quintile.

LIMITATION: Temporal changes in fatty acid levels and misclassification of causes of death may have resulted in underestimated associations, and unmeasured or imperfectly measured covariates may have caused residual confounding.

CONCLUSION: Higher circulating individual and total ω3-PUFA levels are associated with lower total mortality, especially CHD death, in older adults.

PRIMARY FUNDING SOURCE: National Institutes of Health.

%B Ann Intern Med %V 158 %P 515-25 %8 2013 Apr 02 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23546563?dopt=Abstract %R 10.7326/0003-4819-158-7-201304020-00003 %0 Journal Article %J Ann Hum Genet %D 2013 %T Post-genome-wide association study challenges for lipid traits: describing age as a modifier of gene-lipid associations in the Population Architecture using Genomics and Epidemiology (PAGE) study. %A Dumitrescu, Logan %A Carty, Cara L %A Franceschini, Nora %A Hindorff, Lucia A %A Cole, Shelley A %A Bůzková, Petra %A Schumacher, Fredrick R %A Eaton, Charles B %A Goodloe, Robert J %A Duggan, David J %A Haessler, Jeff %A Cochran, Barbara %A Henderson, Brian E %A Cheng, Iona %A Johnson, Karen C %A Carlson, Chris S %A Love, Shelly-Ann %A Brown-Gentry, Kristin %A Nato, Alejandro Q %A Quibrera, Miguel %A Anderson, Garnet %A Shohet, Ralph V %A Ambite, Jose Luis %A Wilkens, Lynne R %A Marchand, Loic Le %A Haiman, Christopher A %A Buyske, Steven %A Kooperberg, Charles %A North, Kari E %A Fornage, Myriam %A Crawford, Dana C %K Adult %K Aged %K European Continental Ancestry Group %K Female %K Genetic Association Studies %K Genome-Wide Association Study %K Humans %K Lipids %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Quantitative Trait, Heritable %K Risk Factors %X

Numerous common genetic variants that influence plasma high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride distributions have been identified via genome-wide association studies (GWAS). However, whether or not these associations are age-dependent has largely been overlooked. We conducted an association study and meta-analysis in more than 22,000 European Americans between 49 previously identified GWAS variants and the three lipid traits, stratified by age (males: <50 or ≥50 years of age; females: pre- or postmenopausal). For each variant, a test of heterogeneity was performed between the two age strata and significant Phet values were used as evidence of age-specific genetic effects. We identified seven associations in females and eight in males that displayed suggestive heterogeneity by age (Phet < 0.05). The association between rs174547 (FADS1) and LDL-C in males displayed the most evidence for heterogeneity between age groups (Phet = 1.74E-03, I(2) = 89.8), with a significant association in older males (P = 1.39E-06) but not younger males (P = 0.99). However, none of the suggestive modifying effects survived adjustment for multiple testing, highlighting the challenges of identifying modifiers of modest SNP-trait associations despite large sample sizes.

%B Ann Hum Genet %V 77 %P 416-25 %8 2013 Sep %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23808484?dopt=Abstract %R 10.1111/ahg.12027 %0 Journal Article %J Heart Rhythm %D 2013 %T The QT interval and risk of incident atrial fibrillation. %A Mandyam, Mala C %A Soliman, Elsayed Z %A Alonso, Alvaro %A Dewland, Thomas A %A Heckbert, Susan R %A Vittinghoff, Eric %A Cummings, Steven R %A Ellinor, Patrick T %A Chaitman, Bernard R %A Stocke, Karen %A Applegate, William B %A Arking, Dan E %A Butler, Javed %A Loehr, Laura R %A Magnani, Jared W %A Murphy, Rachel A %A Satterfield, Suzanne %A Newman, Anne B %A Marcus, Gregory M %K Aged %K Atrial Fibrillation %K Cohort Studies %K Electrocardiography %K Female %K Humans %K Incidence %K Long QT Syndrome %K Male %K Middle Aged %K Risk Factors %X

BACKGROUND: Abnormal atrial repolarization is important in the development of atrial fibrillation (AF), but no direct measurement is available in clinical medicine.

OBJECTIVE: To determine whether the QT interval, a marker of ventricular repolarization, could be used to predict incident AF.

METHODS: We examined a prolonged QT interval corrected by using the Framingham formula (QT(Fram)) as a predictor of incident AF in the Atherosclerosis Risk in Communities (ARIC) study. The Cardiovascular Health Study (CHS) and Health, Aging, and Body Composition (ABC) study were used for validation. Secondary predictors included QT duration as a continuous variable, a short QT interval, and QT intervals corrected by using other formulas.

RESULTS: Among 14,538 ARIC study participants, a prolonged QT(Fram) predicted a roughly 2-fold increased risk of AF (hazard ratio [HR] 2.05; 95% confidence interval [CI] 1.42-2.96; P < .001). No substantive attenuation was observed after adjustment for age, race, sex, study center, body mass index, hypertension, diabetes, coronary disease, and heart failure. The findings were validated in Cardiovascular Health Study and Health, Aging, and Body Composition study and were similar across various QT correction methods. Also in the ARIC study, each 10-ms increase in QT(Fram) was associated with an increased unadjusted (HR 1.14; 95% CI 1.10-1.17; P < .001) and adjusted (HR 1.11; 95% CI 1.07-1.14; P < .001) risk of AF. Findings regarding a short QT interval were inconsistent across cohorts.

CONCLUSIONS: A prolonged QT interval is associated with an increased risk of incident AF.

%B Heart Rhythm %V 10 %P 1562-8 %8 2013 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/23872693?dopt=Abstract %R 10.1016/j.hrthm.2013.07.023 %0 Journal Article %J Hum Reprod %D 2013 %T Replication of genetic loci for ages at menarche and menopause in the multi-ethnic Population Architecture using Genomics and Epidemiology (PAGE) study. %A Carty, C L %A Spencer, K L %A Setiawan, V W %A Fernandez-Rhodes, L %A Malinowski, J %A Buyske, S %A Young, A %A Jorgensen, N W %A Cheng, I %A Carlson, C S %A Brown-Gentry, K %A Goodloe, R %A Park, A %A Parikh, N I %A Henderson, B %A Le Marchand, L %A Wactawski-Wende, J %A Fornage, M %A Matise, T C %A Hindorff, L A %A Arnold, A M %A Haiman, C A %A Franceschini, N %A Peters, U %A Crawford, D C %K Age Factors %K Cross-Sectional Studies %K Female %K Genome-Wide Association Study %K Genotype %K Humans %K Menarche %K Menopause %K Polymorphism, Single Nucleotide %X

STUDY QUESTION: Do genetic associations identified in genome-wide association studies (GWAS) of age at menarche (AM) and age at natural menopause (ANM) replicate in women of diverse race/ancestry from the Population Architecture using Genomics and Epidemiology (PAGE) Study?

SUMMARY ANSWER: We replicated GWAS reproductive trait single nucleotide polymorphisms (SNPs) in our European descent population and found that many SNPs were also associated with AM and ANM in populations of diverse ancestry.

WHAT IS KNOWN ALREADY: Menarche and menopause mark the reproductive lifespan in women and are important risk factors for chronic diseases including obesity, cardiovascular disease and cancer. Both events are believed to be influenced by environmental and genetic factors, and vary in populations differing by genetic ancestry and geography. Most genetic variants associated with these traits have been identified in GWAS of European-descent populations.

STUDY DESIGN, SIZE, DURATION: A total of 42 251 women of diverse ancestry from PAGE were included in cross-sectional analyses of AM and ANM.

MATERIALS, SETTING, METHODS: SNPs previously associated with ANM (n = 5 SNPs) and AM (n = 3 SNPs) in GWAS were genotyped in American Indians, African Americans, Asians, European Americans, Hispanics and Native Hawaiians. To test SNP associations with ANM or AM, we used linear regression models stratified by race/ethnicity and PAGE sub-study. Results were then combined in race-specific fixed effect meta-analyses for each outcome. For replication and generalization analyses, significance was defined at P < 0.01 for ANM analyses and P < 0.017 for AM analyses.

MAIN RESULTS AND THE ROLE OF CHANCE: We replicated findings for AM SNPs in the LIN28B locus and an intergenic region on 9q31 in European Americans. The LIN28B SNPs (rs314277 and rs314280) were also significantly associated with AM in Asians, but not in other race/ethnicity groups. Linkage disequilibrium (LD) patterns at this locus varied widely among the ancestral groups. With the exception of an intergenic SNP at 13q34, all ANM SNPs replicated in European Americans. Three were significantly associated with ANM in other race/ethnicity populations: rs2153157 (6p24.2/SYCP2L), rs365132 (5q35/UIMC1) and rs16991615 (20p12.3/MCM8). While rs1172822 (19q13/BRSK1) was not significant in the populations of non-European descent, effect sizes showed similar trends.

LIMITATIONS, REASONS FOR CAUTION: Lack of association for the GWAS SNPs in the non-European American groups may be due to differences in locus LD patterns between these groups and the European-descent populations included in the GWAS discovery studies; and in some cases, lower power may also contribute to non-significant findings.

WIDER IMPLICATIONS OF THE FINDINGS: The discovery of genetic variants associated with the reproductive traits provides an important opportunity to elucidate the biological mechanisms involved with normal variation and disorders of menarche and menopause. In this study we replicated most, but not all reported SNPs in European descent populations and examined the epidemiologic architecture of these early reported variants, describing their generalizability and effect size across differing ancestral populations. Such data will be increasingly important for prioritizing GWAS SNPs for follow-up in fine-mapping and resequencing studies, as well as in translational research.

%B Hum Reprod %V 28 %P 1695-706 %8 2013 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23508249?dopt=Abstract %R 10.1093/humrep/det071 %0 Journal Article %J Am J Epidemiol %D 2013 %T Risk factors for type 2 diabetes mellitus preceded by β-cell dysfunction, insulin resistance, or both in older adults: the Cardiovascular Health Study. %A Imamura, Fumiaki %A Mukamal, Kenneth J %A Meigs, James B %A Luchsinger, José A %A Ix, Joachim H %A Siscovick, David S %A Mozaffarian, Dariush %K Adiposity %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Alcohol Drinking %K Blood Pressure %K Cross-Sectional Studies %K Diabetes Mellitus, Type 2 %K Female %K Humans %K Incidence %K Insulin Resistance %K Insulin-Secreting Cells %K Lipids %K Male %K Prospective Studies %K Risk Factors %K Socioeconomic Factors %K United States %X

Insulin resistance (IR) and pancreatic β-cell dysfunction lead to type 2 diabetes mellitus (DM). We tested whether risk factors would differ for DM that was preceded predominantly by IR, β-cell dysfunction, or both among 4,384 older adults (mean age, 72.7 (standard deviation, 5.6) years) in the Cardiovascular Health Study, which was conducted in North Carolina, California, Maryland, and Pennsylvania (1989-2007). When evaluating established risk factors, we found older age, greater adiposity, higher systolic blood pressure, a lower high-density lipoprotein cholesterol level, a higher triglyceride level, and a lower alcohol intake to be independently associated with greater IR but, conversely, with better β-cell function (P < 0.001). The prospective associations between some risk factors and incident DM varied significantly depending on whether DM was preceded predominantly by IR, β-cell dysfunction, or both. For example, obesity and lower high-density lipoprotein cholesterol levels were positively associated with DM preceded predominantly by IR (hazard ratio (HR) = 5.02, 95% confidence interval (CI): 2.81, 9.00; and HR = 1.97, 95% CI: 1.32, 2.93, respectively), with a significant association with and an insignificant trend toward a lower risk of DM preceded predominantly by β-cell dysfunction (HR = 0.33, 95% CI: 0.14, 0.80; and HR = 0.78, 95% CI: 0.43, 1.39, respectively). In conclusion, among older adults, DM risk factors were differentially associated with DM preceded predominantly by IR or β-cell dysfunction. Biologic and clinical implications of putative subtypes of DM require further investigation.

%B Am J Epidemiol %V 177 %P 1418-29 %8 2013 Jun 15 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/23707958?dopt=Abstract %& 1418 %R 10.1093/aje/kws440 %0 Journal Article %J Eur J Epidemiol %D 2013 %T Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T: a meta-analysis involving over 11,000 cases and 21,000 controls. %A Simone, Benedetto %A De Stefano, Valerio %A Leoncini, Emanuele %A Zacho, Jeppe %A Martinelli, Ida %A Emmerich, Joseph %A Rossi, Elena %A Folsom, Aaron R %A Almawi, Wassim Y %A Scarabin, Pierre Y %A den Heijer, Martin %A Cushman, Mary %A Penco, Silvana %A Vaya, Amparo %A Angchaisuksiri, Pantep %A Okumus, Gulfer %A Gemmati, Donato %A Cima, Simona %A Akar, Nejat %A Oguzulgen, Kivilcim I %A Ducros, Véronique %A Lichy, Christoph %A Fernandez-Miranda, Consuelo %A Szczeklik, Andrzej %A Nieto, José A %A Torres, Jose Domingo %A Le Cam-Duchez, Véronique %A Ivanov, Petar %A Cantu-Brito, Carlos %A Shmeleva, Veronika M %A Stegnar, Mojka %A Ogunyemi, Dotun %A Eid, Suhair S %A Nicolotti, Nicola %A De Feo, Emma %A Ricciardi, Walter %A Boccia, Stefania %K Case-Control Studies %K Factor V %K Genetic Predisposition to Disease %K Humans %K Methylenetetrahydrofolate Reductase (NADPH2) %K Prothrombin %K Risk Factors %K Venous Thromboembolism %X

Genetic and environmental factors interact in determining the risk of venous thromboembolism (VTE). The risk associated with the polymorphic variants G1691A of factor V (Factor V Leiden, FVL), G20210A of prothrombin (PT20210A) and C677T of methylentetrahydrofolate reductase (C677T MTHFR) genes has been investigated in many studies. We performed a pooled analysis of case-control and cohort studies investigating in adults the association between each variant and VTE, published on Pubmed, Embase or Google through January 2010. Authors of eligible papers, were invited to provide all available individual data for the pooling. The Odds Ratio (OR) for first VTE associated with each variant, individually and combined with the others, were calculated with a random effect model, in heterozygotes and homozygotes (dominant model for FVL and PT20210A; recessive for C677T MTHFR). We analysed 31 databases, including 11,239 cases and 21,521 controls. No significant association with VTE was found for homozygous C677T MTHFR (OR: 1.38; 95 % confidence intervals [CI]: 0.98-1.93), whereas the risk was increased in carriers of either heterozygous FVL or PT20210 (OR = 4.22; 95 % CI: 3.35-5.32; and OR = 2.79;95 % CI: 2.25-3.46, respectively), in double heterozygotes (OR = 3.42; 95 %CI 1.64-7.13), and in homozygous FVL or PT20210A (OR = 11.45; 95 %CI: 6.79-19.29; and OR: 6.74 (CI 95 % 2.19-20.72), respectively). The stratified analyses showed a stronger effect of FVL on individuals ≤ 45 years (p value for interaction = 0.036) and of PT20210A in women using oral contraceptives (p-value for interaction = 0.045). In this large pooled analysis, inclusive of large studies like MEGA, no effect was found for C677T MTHFR on VTE; FVL and PT20210A were confirmed to be moderate risk factors. Notably, double carriers of the two genetic variants produced an impact on VTE risk significantly increased but weaker than previously thought.

%B Eur J Epidemiol %V 28 %P 621-47 %8 2013 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/23900608?dopt=Abstract %R 10.1007/s10654-013-9825-8 %0 Journal Article %J PLoS Genet %D 2013 %T Sex-stratified genome-wide association studies including 270,000 individuals show sexual dimorphism in genetic loci for anthropometric traits. %A Randall, Joshua C %A Winkler, Thomas W %A Kutalik, Zoltán %A Berndt, Sonja I %A Jackson, Anne U %A Monda, Keri L %A Kilpeläinen, Tuomas O %A Esko, Tõnu %A Mägi, Reedik %A Li, Shengxu %A Workalemahu, Tsegaselassie %A Feitosa, Mary F %A Croteau-Chonka, Damien C %A Day, Felix R %A Fall, Tove %A Ferreira, Teresa %A Gustafsson, Stefan %A Locke, Adam E %A Mathieson, Iain %A Scherag, Andre %A Vedantam, Sailaja %A Wood, Andrew R %A Liang, Liming %A Steinthorsdottir, Valgerdur %A Thorleifsson, Gudmar %A Dermitzakis, Emmanouil T %A Dimas, Antigone S %A Karpe, Fredrik %A Min, Josine L %A Nicholson, George %A Clegg, Deborah J %A Person, Thomas %A Krohn, Jon P %A Bauer, Sabrina %A Buechler, Christa %A Eisinger, Kristina %A Bonnefond, Amélie %A Froguel, Philippe %A Hottenga, Jouke-Jan %A Prokopenko, Inga %A Waite, Lindsay L %A Harris, Tamara B %A Smith, Albert Vernon %A Shuldiner, Alan R %A McArdle, Wendy L %A Caulfield, Mark J %A Munroe, Patricia B %A Grönberg, Henrik %A Chen, Yii-Der Ida %A Li, Guo %A Beckmann, Jacques S %A Johnson, Toby %A Thorsteinsdottir, Unnur %A Teder-Laving, Maris %A Khaw, Kay-Tee %A Wareham, Nicholas J %A Zhao, Jing Hua %A Amin, Najaf %A Oostra, Ben A %A Kraja, Aldi T %A Province, Michael A %A Cupples, L Adrienne %A Heard-Costa, Nancy L %A Kaprio, Jaakko %A Ripatti, Samuli %A Surakka, Ida %A Collins, Francis S %A Saramies, Jouko %A Tuomilehto, Jaakko %A Jula, Antti %A Salomaa, Veikko %A Erdmann, Jeanette %A Hengstenberg, Christian %A Loley, Christina %A Schunkert, Heribert %A Lamina, Claudia %A Wichmann, H Erich %A Albrecht, Eva %A Gieger, Christian %A Hicks, Andrew A %A Johansson, Asa %A Pramstaller, Peter P %A Kathiresan, Sekar %A Speliotes, Elizabeth K %A Penninx, Brenda %A Hartikainen, Anna-Liisa %A Jarvelin, Marjo-Riitta %A Gyllensten, Ulf %A Boomsma, Dorret I %A Campbell, Harry %A Wilson, James F %A Chanock, Stephen J %A Farrall, Martin %A Goel, Anuj %A Medina-Gómez, Carolina %A Rivadeneira, Fernando %A Estrada, Karol %A Uitterlinden, André G %A Hofman, Albert %A Zillikens, M Carola %A den Heijer, Martin %A Kiemeney, Lambertus A %A Maschio, Andrea %A Hall, Per %A Tyrer, Jonathan %A Teumer, Alexander %A Völzke, Henry %A Kovacs, Peter %A Tönjes, Anke %A Mangino, Massimo %A Spector, Tim D %A Hayward, Caroline %A Rudan, Igor %A Hall, Alistair S %A Samani, Nilesh J %A Attwood, Antony Paul %A Sambrook, Jennifer G %A Hung, Joseph %A Palmer, Lyle J %A Lokki, Marja-Liisa %A Sinisalo, Juha %A Boucher, Gabrielle %A Huikuri, Heikki %A Lorentzon, Mattias %A Ohlsson, Claes %A Eklund, Niina %A Eriksson, Johan G %A Barlassina, Cristina %A Rivolta, Carlo %A Nolte, Ilja M %A Snieder, Harold %A van der Klauw, Melanie M %A van Vliet-Ostaptchouk, Jana V %A Gejman, Pablo V %A Shi, Jianxin %A Jacobs, Kevin B %A Wang, Zhaoming %A Bakker, Stephan J L %A Mateo Leach, Irene %A Navis, Gerjan %A van der Harst, Pim %A Martin, Nicholas G %A Medland, Sarah E %A Montgomery, Grant W %A Yang, Jian %A Chasman, Daniel I %A Ridker, Paul M %A Rose, Lynda M %A Lehtimäki, Terho %A Raitakari, Olli %A Absher, Devin %A Iribarren, Carlos %A Basart, Hanneke %A Hovingh, Kees G %A Hyppönen, Elina %A Power, Chris %A Anderson, Denise %A Beilby, John P %A Hui, Jennie %A Jolley, Jennifer %A Sager, Hendrik %A Bornstein, Stefan R %A Schwarz, Peter E H %A Kristiansson, Kati %A Perola, Markus %A Lindström, Jaana %A Swift, Amy J %A Uusitupa, Matti %A Atalay, Mustafa %A Lakka, Timo A %A Rauramaa, Rainer %A Bolton, Jennifer L %A Fowkes, Gerry %A Fraser, Ross M %A Price, Jackie F %A Fischer, Krista %A Krjutå Kov, Kaarel %A Metspalu, Andres %A Mihailov, Evelin %A Langenberg, Claudia %A Luan, Jian'an %A Ong, Ken K %A Chines, Peter S %A Keinanen-Kiukaanniemi, Sirkka M %A Saaristo, Timo E %A Edkins, Sarah %A Franks, Paul W %A Hallmans, Göran %A Shungin, Dmitry %A Morris, Andrew David %A Palmer, Colin N A %A Erbel, Raimund %A Moebus, Susanne %A Nöthen, Markus M %A Pechlivanis, Sonali %A Hveem, Kristian %A Narisu, Narisu %A Hamsten, Anders %A Humphries, Steve E %A Strawbridge, Rona J %A Tremoli, Elena %A Grallert, Harald %A Thorand, Barbara %A Illig, Thomas %A Koenig, Wolfgang %A Müller-Nurasyid, Martina %A Peters, Annette %A Boehm, Bernhard O %A Kleber, Marcus E %A März, Winfried %A Winkelmann, Bernhard R %A Kuusisto, Johanna %A Laakso, Markku %A Arveiler, Dominique %A Cesana, Giancarlo %A Kuulasmaa, Kari %A Virtamo, Jarmo %A Yarnell, John W G %A Kuh, Diana %A Wong, Andrew %A Lind, Lars %A de Faire, Ulf %A Gigante, Bruna %A Magnusson, Patrik K E %A Pedersen, Nancy L %A Dedoussis, George %A Dimitriou, Maria %A Kolovou, Genovefa %A Kanoni, Stavroula %A Stirrups, Kathleen %A Bonnycastle, Lori L %A Njølstad, Inger %A Wilsgaard, Tom %A Ganna, Andrea %A Rehnberg, Emil %A Hingorani, Aroon %A Kivimaki, Mika %A Kumari, Meena %A Assimes, Themistocles L %A Barroso, Inês %A Boehnke, Michael %A Borecki, Ingrid B %A Deloukas, Panos %A Fox, Caroline S %A Frayling, Timothy %A Groop, Leif C %A Haritunians, Talin %A Hunter, David %A Ingelsson, Erik %A Kaplan, Robert %A Mohlke, Karen L %A O'Connell, Jeffrey R %A Schlessinger, David %A Strachan, David P %A Stefansson, Kari %A van Duijn, Cornelia M %A Abecasis, Goncalo R %A McCarthy, Mark I %A Hirschhorn, Joel N %A Qi, Lu %A Loos, Ruth J F %A Lindgren, Cecilia M %A North, Kari E %A Heid, Iris M %K Anthropometry %K Body Height %K Body Mass Index %K Body Weight %K Body Weights and Measures %K Female %K Genetic Loci %K Genome, Human %K Genome-Wide Association Study %K Humans %K Male %K Polymorphism, Single Nucleotide %K Sex Characteristics %K Waist Circumference %K Waist-Hip Ratio %X

Given the anthropometric differences between men and women and previous evidence of sex-difference in genetic effects, we conducted a genome-wide search for sexually dimorphic associations with height, weight, body mass index, waist circumference, hip circumference, and waist-to-hip-ratio (133,723 individuals) and took forward 348 SNPs into follow-up (additional 137,052 individuals) in a total of 94 studies. Seven loci displayed significant sex-difference (FDR<5%), including four previously established (near GRB14/COBLL1, LYPLAL1/SLC30A10, VEGFA, ADAMTS9) and three novel anthropometric trait loci (near MAP3K1, HSD17B4, PPARG), all of which were genome-wide significant in women (P<5×10(-8)), but not in men. Sex-differences were apparent only for waist phenotypes, not for height, weight, BMI, or hip circumference. Moreover, we found no evidence for genetic effects with opposite directions in men versus women. The PPARG locus is of specific interest due to its role in diabetes genetics and therapy. Our results demonstrate the value of sex-specific GWAS to unravel the sexually dimorphic genetic underpinning of complex traits.

%B PLoS Genet %V 9 %P e1003500 %8 2013 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/23754948?dopt=Abstract %R 10.1371/journal.pgen.1003500 %0 Journal Article %J J Am Heart Assoc %D 2013 %T Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium. %A Alonso, Alvaro %A Krijthe, Bouwe P %A Aspelund, Thor %A Stepas, Katherine A %A Pencina, Michael J %A Moser, Carlee B %A Sinner, Moritz F %A Sotoodehnia, Nona %A Fontes, João D %A Janssens, A Cecile J W %A Kronmal, Richard A %A Magnani, Jared W %A Witteman, Jacqueline C %A Chamberlain, Alanna M %A Lubitz, Steven A %A Schnabel, Renate B %A Agarwal, Sunil K %A McManus, David D %A Ellinor, Patrick T %A Larson, Martin G %A Burke, Gregory L %A Launer, Lenore J %A Hofman, Albert %A Levy, Daniel %A Gottdiener, John S %A Kääb, Stefan %A Couper, David %A Harris, Tamara B %A Soliman, Elsayed Z %A Stricker, Bruno H C %A Gudnason, Vilmundur %A Heckbert, Susan R %A Benjamin, Emelia J %K African Americans %K Age Factors %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Cohort Studies %K Diabetes Mellitus %K European Continental Ancestry Group %K Female %K Heart Failure %K Humans %K Hypertension %K Iceland %K Incidence %K Male %K Middle Aged %K Myocardial Infarction %K Netherlands %K Proportional Hazards Models %K Risk Assessment %K Smoking %K United States %X

BACKGROUND: Tools for the prediction of atrial fibrillation (AF) may identify high-risk individuals more likely to benefit from preventive interventions and serve as a benchmark to test novel putative risk factors.

METHODS AND RESULTS: Individual-level data from 3 large cohorts in the United States (Atherosclerosis Risk in Communities [ARIC] study, the Cardiovascular Health Study [CHS], and the Framingham Heart Study [FHS]), including 18 556 men and women aged 46 to 94 years (19% African Americans, 81% whites) were pooled to derive predictive models for AF using clinical variables. Validation of the derived models was performed in 7672 participants from the Age, Gene and Environment-Reykjavik study (AGES) and the Rotterdam Study (RS). The analysis included 1186 incident AF cases in the derivation cohorts and 585 in the validation cohorts. A simple 5-year predictive model including the variables age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes, and history of myocardial infarction and heart failure had good discrimination (C-statistic, 0.765; 95% CI, 0.748 to 0.781). Addition of variables from the electrocardiogram did not improve the overall model discrimination (C-statistic, 0.767; 95% CI, 0.750 to 0.783; categorical net reclassification improvement, -0.0032; 95% CI, -0.0178 to 0.0113). In the validation cohorts, discrimination was acceptable (AGES C-statistic, 0.664; 95% CI, 0.632 to 0.697 and RS C-statistic, 0.705; 95% CI, 0.664 to 0.747) and calibration was adequate.

CONCLUSION: A risk model including variables readily available in primary care settings adequately predicted AF in diverse populations from the United States and Europe.

%B J Am Heart Assoc %V 2 %P e000102 %8 2013 Mar 18 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23537808?dopt=Abstract %R 10.1161/JAHA.112.000102 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2013 %T Soluble CD14: genomewide association analysis and relationship to cardiovascular risk and mortality in older adults. %A Reiner, Alex P %A Lange, Ethan M %A Jenny, Nancy S %A Chaves, Paulo H M %A Ellis, Jaclyn %A Li, Jin %A Walston, Jeremy %A Lange, Leslie A %A Cushman, Mary %A Tracy, Russell P %K African Americans %K Age Factors %K Aged %K Biomarkers %K Cardiovascular Diseases %K Chromosomes, Human, Pair 5 %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Haplotypes %K Hexosyltransferases %K Humans %K Incidence %K Inflammation Mediators %K Linear Models %K Lipopolysaccharide Receptors %K Logistic Models %K Male %K Membrane Proteins %K Multivariate Analysis %K Phenotype %K Polymorphism, Single Nucleotide %K Principal Component Analysis %K Prognosis %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Risk Factors %K Time Factors %K United States %X

OBJECTIVE: CD14 is a glycosylphosphotidylinositol-anchored membrane glycoprotein expressed on neutrophils and monocytes/macrophages that also circulates as a soluble form (sCD14). Despite the well-recognized role of CD14 in inflammation, relatively little is known about the genetic determinants of sCD14 or the relationship of sCD14 to vascular- and aging-related phenotypes.

METHODS AND RESULTS: We measured baseline levels of sCD14 in >5000 European-American and black adults aged 65 years and older from the Cardiovascular Health Study, who were well characterized at baseline for atherosclerotic risk factors and subclinical cardiovascular disease, and who have been followed for clinical cardiovascular disease and mortality outcomes up to 20 years. At baseline, sCD14 generally showed strong positive correlations with traditional cardio-metabolic risk factors and with subclinical measures of vascular disease such as carotid wall thickness and ankle-brachial index (independently of traditional cardiovascular disease risk factors), and was also inversely correlated with body mass index. In genomewide association analyses of sCD14, we (1) confirmed the importance of the CD14 locus on chromosome 5q21 in European-American; (2) identified a novel African ancestry-specific allele of CD14 associated with lower sCD14 in blacks; and (3) identified a putative novel association in European-American of a nonsynonymous variant of PIGC, which encodes an enzyme required for the first step in glycosylphosphotidylinositol anchor biosynthesis. Finally, we show that, like other acute phase inflammatory biomarkers, sCD14 predicts incident cardiovascular disease, and strongly and independently predicts all-cause mortality in older adults.

CONCLUSIONS: CD14 independently predicts risk mortality in older adults.

%B Arterioscler Thromb Vasc Biol %V 33 %P 158-64 %8 2013 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23162014?dopt=Abstract %R 10.1161/ATVBAHA.112.300421 %0 Journal Article %J PLoS Genet %D 2013 %T A systematic mapping approach of 16q12.2/FTO and BMI in more than 20,000 African Americans narrows in on the underlying functional variation: results from the Population Architecture using Genomics and Epidemiology (PAGE) study. %A Peters, Ulrike %A North, Kari E %A Sethupathy, Praveen %A Buyske, Steve %A Haessler, Jeff %A Jiao, Shuo %A Fesinmeyer, Megan D %A Jackson, Rebecca D %A Kuller, Lew H %A Rajkovic, Aleksandar %A Lim, Unhee %A Cheng, Iona %A Schumacher, Fred %A Wilkens, Lynne %A Li, Rongling %A Monda, Keri %A Ehret, Georg %A Nguyen, Khanh-Dung H %A Cooper, Richard %A Lewis, Cora E %A Leppert, Mark %A Irvin, Marguerite R %A Gu, C Charles %A Houston, Denise %A Bůzková, Petra %A Ritchie, Marylyn %A Matise, Tara C %A Le Marchand, Loïc %A Hindorff, Lucia A %A Crawford, Dana C %A Haiman, Christopher A %A Kooperberg, Charles %K Adaptor Proteins, Signal Transducing %K Adult %K African Americans %K Aged %K Aged, 80 and over %K Alleles %K Body Mass Index %K Chromosome Mapping %K Continental Population Groups %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Male %K Metagenomics %K Middle Aged %K Obesity %K Proteins %X

Genetic variants in intron 1 of the fat mass- and obesity-associated (FTO) gene have been consistently associated with body mass index (BMI) in Europeans. However, follow-up studies in African Americans (AA) have shown no support for some of the most consistently BMI-associated FTO index single nucleotide polymorphisms (SNPs). This is most likely explained by different race-specific linkage disequilibrium (LD) patterns and lower correlation overall in AA, which provides the opportunity to fine-map this region and narrow in on the functional variant. To comprehensively explore the 16q12.2/FTO locus and to search for second independent signals in the broader region, we fine-mapped a 646-kb region, encompassing the large FTO gene and the flanking gene RPGRIP1L by investigating a total of 3,756 variants (1,529 genotyped and 2,227 imputed variants) in 20,488 AAs across five studies. We observed associations between BMI and variants in the known FTO intron 1 locus: the SNP with the most significant p-value, rs56137030 (8.3 × 10(-6)) had not been highlighted in previous studies. While rs56137030was correlated at r(2)>0.5 with 103 SNPs in Europeans (including the GWAS index SNPs), this number was reduced to 28 SNPs in AA. Among rs56137030 and the 28 correlated SNPs, six were located within candidate intronic regulatory elements, including rs1421085, for which we predicted allele-specific binding affinity for the transcription factor CUX1, which has recently been implicated in the regulation of FTO. We did not find strong evidence for a second independent signal in the broader region. In summary, this large fine-mapping study in AA has substantially reduced the number of common alleles that are likely to be functional candidates of the known FTO locus. Importantly our study demonstrated that comprehensive fine-mapping in AA provides a powerful approach to narrow in on the functional candidate(s) underlying the initial GWAS findings in European populations.

%B PLoS Genet %V 9 %P e1003171 %8 2013 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23341774?dopt=Abstract %R 10.1371/journal.pgen.1003171 %0 Journal Article %J PLoS Genet %D 2013 %T Trans-ethnic fine-mapping of lipid loci identifies population-specific signals and allelic heterogeneity that increases the trait variance explained. %A Wu, Ying %A Waite, Lindsay L %A Jackson, Anne U %A Sheu, Wayne H-H %A Buyske, Steven %A Absher, Devin %A Arnett, Donna K %A Boerwinkle, Eric %A Bonnycastle, Lori L %A Carty, Cara L %A Cheng, Iona %A Cochran, Barbara %A Croteau-Chonka, Damien C %A Dumitrescu, Logan %A Eaton, Charles B %A Franceschini, Nora %A Guo, Xiuqing %A Henderson, Brian E %A Hindorff, Lucia A %A Kim, Eric %A Kinnunen, Leena %A Komulainen, Pirjo %A Lee, Wen-Jane %A Le Marchand, Loïc %A Lin, Yi %A Lindström, Jaana %A Lingaas-Holmen, Oddgeir %A Mitchell, Sabrina L %A Narisu, Narisu %A Robinson, Jennifer G %A Schumacher, Fred %A Stančáková, Alena %A Sundvall, Jouko %A Sung, Yun-Ju %A Swift, Amy J %A Wang, Wen-Chang %A Wilkens, Lynne %A Wilsgaard, Tom %A Young, Alicia M %A Adair, Linda S %A Ballantyne, Christie M %A Bůzková, Petra %A Chakravarti, Aravinda %A Collins, Francis S %A Duggan, David %A Feranil, Alan B %A Ho, Low-Tone %A Hung, Yi-Jen %A Hunt, Steven C %A Hveem, Kristian %A Juang, Jyh-Ming J %A Kesäniemi, Antero Y %A Kuusisto, Johanna %A Laakso, Markku %A Lakka, Timo A %A Lee, I-Te %A Leppert, Mark F %A Matise, Tara C %A Moilanen, Leena %A Njølstad, Inger %A Peters, Ulrike %A Quertermous, Thomas %A Rauramaa, Rainer %A Rotter, Jerome I %A Saramies, Jouko %A Tuomilehto, Jaakko %A Uusitupa, Matti %A Wang, Tzung-Dau %A Boehnke, Michael %A Haiman, Christopher A %A Chen, Yii-der I %A Kooperberg, Charles %A Assimes, Themistocles L %A Crawford, Dana C %A Hsiung, Chao A %A North, Kari E %A Mohlke, Karen L %K African Americans %K Apolipoproteins A %K Cholesterol, HDL %K Cholesterol, LDL %K European Continental Ancestry Group %K Genome-Wide Association Study %K Humans %K Lipoproteins, HDL %K Lipoproteins, LDL %K Proprotein Convertases %K Serine Endopeptidases %K Triglycerides %X

Genome-wide association studies (GWAS) have identified ~100 loci associated with blood lipid levels, but much of the trait heritability remains unexplained, and at most loci the identities of the trait-influencing variants remain unknown. We conducted a trans-ethnic fine-mapping study at 18, 22, and 18 GWAS loci on the Metabochip for their association with triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), respectively, in individuals of African American (n = 6,832), East Asian (n = 9,449), and European (n = 10,829) ancestry. We aimed to identify the variants with strongest association at each locus, identify additional and population-specific signals, refine association signals, and assess the relative significance of previously described functional variants. Among the 58 loci, 33 exhibited evidence of association at P<1 × 10(-4) in at least one ancestry group. Sequential conditional analyses revealed that ten, nine, and four loci in African Americans, Europeans, and East Asians, respectively, exhibited two or more signals. At these loci, accounting for all signals led to a 1.3- to 1.8-fold increase in the explained phenotypic variance compared to the strongest signals. Distinct signals across ancestry groups were identified at PCSK9 and APOA5. Trans-ethnic analyses narrowed the signals to smaller sets of variants at GCKR, PPP1R3B, ABO, LCAT, and ABCA1. Of 27 variants reported previously to have functional effects, 74% exhibited the strongest association at the respective signal. In conclusion, trans-ethnic high-density genotyping and analysis confirm the presence of allelic heterogeneity, allow the identification of population-specific variants, and limit the number of candidate SNPs for functional studies.

%B PLoS Genet %V 9 %P e1003379 %8 2013 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23555291?dopt=Abstract %R 10.1371/journal.pgen.1003379 %0 Journal Article %J Cancer Causes Control %D 2013 %T Use of antihypertensive medications and breast cancer risk. %A Saltzman, Babette S %A Weiss, Noel S %A Sieh, Weiva %A Fitzpatrick, Annette L %A McTiernan, Anne %A Daling, Janet R %A Li, Christopher I %K Aged %K Aged, 80 and over %K Antihypertensive Agents %K Breast Neoplasms %K Cohort Studies %K Female %K Humans %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K United States %X

PURPOSE: Use of specific antihypertensive medications (AHTs) has been hypothesized to increase breast cancer risk, but results across published studies are inconsistent.

METHODS: We re-evaluated the relationship between AHT use and breast cancer risk in a prospective cohort of 3,201 women ≥65 years of age at recruitment now with more than double the length of follow-up (12 vs. 5 years) and substantially more breast cancer diagnoses (188 compared with 75 cases). We estimated the association between AHT use overall as well as use of specific formulations (based on data collected annually) and breast cancer risk using multivariate-adjusted Cox regression.

RESULTS: Compared with women who reported no use of AHTs, women who had used calcium channel blockers (CCB) within the past two years had a 1.6-fold increased risk of breast cancer (95 % confidence interval (CI): 1.0-2.5), and in particular, recent users of immediate-release CCBs had a 2.4-fold increased risk (95 % CI: 1.3-4.5). Neither ever nor recent use of any other type of AHT was associated with breast cancer risk.

CONCLUSIONS: While the observed association between immediate-release CCBs and breast cancer risk is based on a small sample size and needs to be interpreted cautiously, this result is consistent with others in the literature. However, given declines in use of these preparations in favor of sustained-release CCBs, which was not related to risk, the potential clinical and public health impact of this association is limited. This study also adds to the evidence that other commonly used AHTs are not strongly related to breast cancer risk.

%B Cancer Causes Control %V 24 %P 365-71 %8 2013 Feb %G eng %N 2 %R 10.1007/s10552-012-0122-8 %0 Journal Article %J Nat Genet %D 2013 %T Whole-genome sequence-based analysis of high-density lipoprotein cholesterol. %A Morrison, Alanna C %A Voorman, Arend %A Johnson, Andrew D %A Liu, Xiaoming %A Yu, Jin %A Li, Alexander %A Muzny, Donna %A Yu, Fuli %A Rice, Kenneth %A Zhu, Chengsong %A Bis, Joshua %A Heiss, Gerardo %A O'Donnell, Christopher J %A Psaty, Bruce M %A Cupples, L Adrienne %A Gibbs, Richard %A Boerwinkle, Eric %K Cholesterol, HDL %K Computational Biology %K Databases, Genetic %K Genetic Variation %K Genome, Human %K Genome-Wide Association Study %K Genomics %K Heterozygote %K Humans %K Open Reading Frames %X

We describe initial steps for interrogating whole-genome sequence data to characterize the genetic architecture of a complex trait, levels of high-density lipoprotein cholesterol (HDL-C). We report whole-genome sequencing and analysis of 962 individuals from the Cohorts for Heart and Aging Research in Genetic Epidemiology (CHARGE) studies. From this analysis, we estimate that common variation contributes more to heritability of HDL-C levels than rare variation, and screening for mendelian variants for dyslipidemia identified individuals with extreme HDL-C levels. Whole-genome sequencing analyses highlight the value of regulatory and non-protein-coding regions of the genome in addition to protein-coding regions.

%B Nat Genet %V 45 %P 899-901 %8 2013 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/23770607?dopt=Abstract %R 10.1038/ng.2671 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T ADAM19 and HTR4 variants and pulmonary function: Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study. %A London, Stephanie J %A Gao, Wei %A Gharib, Sina A %A Hancock, Dana B %A Wilk, Jemma B %A House, John S %A Gibbs, Richard A %A Muzny, Donna M %A Lumley, Thomas %A Franceschini, Nora %A North, Kari E %A Psaty, Bruce M %A Kovar, Christie L %A Coresh, Josef %A Zhou, Yanhua %A Heckbert, Susan R %A Brody, Jennifer A %A Morrison, Alanna C %A Dupuis, Josée %K ADAM Proteins %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Heart Diseases %K Humans %K Lung %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Sequence Analysis, DNA %X

BACKGROUND: The pulmonary function measures of forced expiratory volume in 1 second (FEV1) and its ratio to forced vital capacity (FVC) are used in the diagnosis and monitoring of lung diseases and predict cardiovascular mortality in the general population. Genome-wide association studies (GWASs) have identified numerous loci associated with FEV1 and FEV1/FVC, but the causal variants remain uncertain. We hypothesized that novel or rare variants poorly tagged by GWASs may explain the significant associations between FEV1/FVC and 2 genes: ADAM19 and HTR4.

METHODS AND RESULTS: We sequenced ADAM19 and its promoter region along with the ≈21-kb portion of HTR4 harboring GWAS single-nucleotide polymorphisms for pulmonary function and analyzed associations with FEV1/FVC among 3983 participants of European ancestry from Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Meta-analysis of common variants in each region identified statistically significant associations (316 tests; P<1.58×10(-4)) with FEV1/FVC for 14 ADAM19 single-nucleotide polymorphisms and 24 HTR4 single-nucleotide polymorphisms. After conditioning on the sentinel GWASs hit in each gene (ADAM19 rs1422795, minor allele frequency=0.33 and HTR4 rs11168048, minor allele frequency=0.40], 1 single-nucleotide polymorphism remained statistically significant (ADAM19 rs13155908, minor allele frequency=0.12; P=1.56×10(-4)). Analysis of rare variants (minor allele frequency <1%) using sequence kernel association test did not identify associations with either region.

CONCLUSIONS: Sequencing identified 1 common variant associated with FEV1/FVC independent of the sentinel ADAM19 GWAS hit and supports the original HTR4 GWAS findings. Rare variants do not seem to underlie GWAS associations with pulmonary function for common variants in ADAM19 and HTR4.

%B Circ Cardiovasc Genet %V 7 %P 350-8 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951661?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000066 %0 Journal Article %J BMJ %D 2014 %T Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. %A Holmes, Michael V %A Dale, Caroline E %A Zuccolo, Luisa %A Silverwood, Richard J %A Guo, Yiran %A Ye, Zheng %A Prieto-Merino, David %A Dehghan, Abbas %A Trompet, Stella %A Wong, Andrew %A Cavadino, Alana %A Drogan, Dagmar %A Padmanabhan, Sandosh %A Li, Shanshan %A Yesupriya, Ajay %A Leusink, Maarten %A Sundström, Johan %A Hubacek, Jaroslav A %A Pikhart, Hynek %A Swerdlow, Daniel I %A Panayiotou, Andrie G %A Borinskaya, Svetlana A %A Finan, Chris %A Shah, Sonia %A Kuchenbaecker, Karoline B %A Shah, Tina %A Engmann, Jorgen %A Folkersen, Lasse %A Eriksson, Per %A Ricceri, Fulvio %A Melander, Olle %A Sacerdote, Carlotta %A Gamble, Dale M %A Rayaprolu, Sruti %A Ross, Owen A %A McLachlan, Stela %A Vikhireva, Olga %A Sluijs, Ivonne %A Scott, Robert A %A Adamkova, Vera %A Flicker, Leon %A Bockxmeer, Frank M van %A Power, Christine %A Marques-Vidal, Pedro %A Meade, Tom %A Marmot, Michael G %A Ferro, Jose M %A Paulos-Pinheiro, Sofia %A Humphries, Steve E %A Talmud, Philippa J %A Mateo Leach, Irene %A Verweij, Niek %A Linneberg, Allan %A Skaaby, Tea %A Doevendans, Pieter A %A Cramer, Maarten J %A van der Harst, Pim %A Klungel, Olaf H %A Dowling, Nicole F %A Dominiczak, Anna F %A Kumari, Meena %A Nicolaides, Andrew N %A Weikert, Cornelia %A Boeing, Heiner %A Ebrahim, Shah %A Gaunt, Tom R %A Price, Jackie F %A Lannfelt, Lars %A Peasey, Anne %A Kubinova, Ruzena %A Pajak, Andrzej %A Malyutina, Sofia %A Voevoda, Mikhail I %A Tamosiunas, Abdonas %A Maitland-van der Zee, Anke H %A Norman, Paul E %A Hankey, Graeme J %A Bergmann, Manuela M %A Hofman, Albert %A Franco, Oscar H %A Cooper, Jackie %A Palmen, Jutta %A Spiering, Wilko %A de Jong, Pim A %A Kuh, Diana %A Hardy, Rebecca %A Uitterlinden, André G %A Ikram, M Arfan %A Ford, Ian %A Hyppönen, Elina %A Almeida, Osvaldo P %A Wareham, Nicholas J %A Khaw, Kay-Tee %A Hamsten, Anders %A Husemoen, Lise Lotte N %A Tjønneland, Anne %A Tolstrup, Janne S %A Rimm, Eric %A Beulens, Joline W J %A Verschuren, W M Monique %A Onland-Moret, N Charlotte %A Hofker, Marten H %A Wannamethee, S Goya %A Whincup, Peter H %A Morris, Richard %A Vicente, Astrid M %A Watkins, Hugh %A Farrall, Martin %A Jukema, J Wouter %A Meschia, James %A Cupples, L Adrienne %A Sharp, Stephen J %A Fornage, Myriam %A Kooperberg, Charles %A LaCroix, Andrea Z %A Dai, James Y %A Lanktree, Matthew B %A Siscovick, David S %A Jorgenson, Eric %A Spring, Bonnie %A Coresh, Josef %A Li, Yun R %A Buxbaum, Sarah G %A Schreiner, Pamela J %A Ellison, R Curtis %A Tsai, Michael Y %A Patel, Sanjay R %A Redline, Susan %A Johnson, Andrew D %A Hoogeveen, Ron C %A Hakonarson, Hakon %A Rotter, Jerome I %A Boerwinkle, Eric %A de Bakker, Paul I W %A Kivimaki, Mika %A Asselbergs, Folkert W %A Sattar, Naveed %A Lawlor, Debbie A %A Whittaker, John %A Davey Smith, George %A Mukamal, Kenneth %A Psaty, Bruce M %A Wilson, James G %A Lange, Leslie A %A Hamidovic, Ajna %A Hingorani, Aroon D %A Nordestgaard, Børge G %A Bobak, Martin %A Leon, David A %A Langenberg, Claudia %A Palmer, Tom M %A Reiner, Alex P %A Keating, Brendan J %A Dudbridge, Frank %A Casas, Juan P %K Adult %K Aged %K Alcohol Dehydrogenase %K Alcohol Drinking %K Biomarkers %K Coronary Disease %K Female %K Genetic Markers %K Genotype %K Humans %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Models, Statistical %K Polymorphism, Single Nucleotide %K Stroke %X

OBJECTIVE: To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease.

DESIGN: Mendelian randomisation meta-analysis of 56 epidemiological studies.

PARTICIPANTS: 261 991 individuals of European descent, including 20 259 coronary heart disease cases and 10 164 stroke events. Data were available on ADH1B rs1229984 variant, alcohol phenotypes, and cardiovascular biomarkers.

MAIN OUTCOME MEASURES: Odds ratio for coronary heart disease and stroke associated with the ADH1B variant in all individuals and by categories of alcohol consumption.

RESULTS: Carriers of the A-allele of ADH1B rs1229984 consumed 17.2% fewer units of alcohol per week (95% confidence interval 15.6% to 18.9%), had a lower prevalence of binge drinking (odds ratio 0.78 (95% CI 0.73 to 0.84)), and had higher abstention (odds ratio 1.27 (1.21 to 1.34)) than non-carriers. Rs1229984 A-allele carriers had lower systolic blood pressure (-0.88 (-1.19 to -0.56) mm Hg), interleukin-6 levels (-5.2% (-7.8 to -2.4%)), waist circumference (-0.3 (-0.6 to -0.1) cm), and body mass index (-0.17 (-0.24 to -0.10) kg/m(2)). Rs1229984 A-allele carriers had lower odds of coronary heart disease (odds ratio 0.90 (0.84 to 0.96)). The protective association of the ADH1B rs1229984 A-allele variant remained the same across all categories of alcohol consumption (P=0.83 for heterogeneity). Although no association of rs1229984 was identified with the combined subtypes of stroke, carriers of the A-allele had lower odds of ischaemic stroke (odds ratio 0.83 (0.72 to 0.95)).

CONCLUSIONS: Individuals with a genetic variant associated with non-drinking and lower alcohol consumption had a more favourable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant. This suggests that reduction of alcohol consumption, even for light to moderate drinkers, is beneficial for cardiovascular health.

%B BMJ %V 349 %P g4164 %8 2014 Jul 10 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25011450?dopt=Abstract %R 10.1136/bmj.g4164 %0 Journal Article %J Am J Kidney Dis %D 2014 %T Association of a cystatin C gene variant with cystatin C levels, CKD, and risk of incident cardiovascular disease and mortality. %A O'Seaghdha, Conall M %A Tin, Adrienne %A Yang, Qiong %A Katz, Ronit %A Liu, Yongmei %A Harris, Tamara %A Astor, Brad %A Coresh, Josef %A Fox, Caroline S %A Kao, W H Linda %A Shlipak, Michael G %K Aged %K Bias %K Biomarkers %K Cardiovascular Diseases %K Creatinine %K Cystatin C %K Female %K Genetic Variation %K Glomerular Filtration Rate %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Renal Insufficiency, Chronic %K Risk Assessment %K Risk Factors %K Severity of Illness Index %K Statistics as Topic %K Survival Rate %X

BACKGROUND: Carriers of the T allele of the single-nucleotide polymorphism rs13038305 tend to have lower cystatin C levels and higher cystatin C-based estimated glomerular filtration rate (eGFRcys). Adjusting for this genetic effect on cystatin C concentrations may improve GFR estimation, reclassify cases of chronic kidney disease (CKD), and strengthen risk estimates for cardiovascular disease (CVD) and mortality.

STUDY DESIGN: Observational.

SETTING & POPULATION: 4 population-based cohorts: Atherosclerosis Risk in Communities (ARIC), Cardiovascular Health (CHS), Framingham Heart (FHS), and Health, Aging, and Body Composition (Health ABC) studies.

PREDICTORS: We estimated the association of rs13038305 with eGFRcys and serum creatinine-based eGFR (eGFRcr) and performed longitudinal analyses of the associations of eGFRcys with mortality and cardiovascular events following adjustment for rs13038305.

OUTCOMES: We assessed reclassification by genotype-adjusted eGFRcys across CKD categories: <45, 45-59, 60-89, and ≥ 90 mL/min/1.73 m(2). We compared mortality and CVD outcomes in those reclassified to a worse eGFRcys category with those unaffected. Results were combined using fixed-effect inverse-variance meta-analysis.

RESULTS: In 14,645 participants, each copy of the T allele of rs13038305 (frequency, 21%) was associated with a 6.4% lower cystatin C concentration, 5.5-mL/min/1.73 m(2) higher eGFRcys, and 36% [95% CI, 29%-41%] lower odds of CKD. Associations with CVD (HR, 1.17; 95% CI, 1.14-1.20) and mortality (HR, 1.22; 95% CI, 1.19-1.24) per 10-mL/min/1.73 m(2) lower eGFRcys were similar with or without rs13038305 adjustment. 1,134 (7.7%) participants were reclassified to a worse CKD category following rs13038305 adjustment, and rates of CVD and mortality were higher in individuals who were reclassified. However, the overall net reclassification index was not significant for either outcome, at 0.009 (95% CI, -0.003 to 0.022) for mortality and 0.014 (95% CI, 0.0 to 0.028) for CVD.

LIMITATIONS: rs13038305 explains only a small proportion of cystatin C variation.

CONCLUSIONS: Statistical adjustment can correct a genetic bias in GFR estimates based on cystatin C in carriers of the T allele of rs13038305 and result in changes in disease classification. However, on a population level, the effects on overall reclassification of CKD status are modest.

%B Am J Kidney Dis %V 63 %P 16-22 %8 2014 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23932088?dopt=Abstract %R 10.1053/j.ajkd.2013.06.015 %0 Journal Article %J Stroke %D 2014 %T Association of kidney disease measures with ischemic versus hemorrhagic strokes: pooled analyses of 4 prospective community-based cohorts. %A Mahmoodi, Bakhtawar K %A Yatsuya, Hiroshi %A Matsushita, Kunihiro %A Sang, Yinying %A Gottesman, Rebecca F %A Astor, Brad C %A Woodward, Mark %A Longstreth, W T %A Psaty, Bruce M %A Shlipak, Michael G %A Folsom, Aaron R %A Gansevoort, Ron T %A Coresh, Josef %K Aged %K Albuminuria %K Brain Ischemia %K Comorbidity %K Female %K Glomerular Filtration Rate %K Humans %K Intracranial Hemorrhages %K Kidney Diseases %K Male %K Middle Aged %K Netherlands %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stroke %K United States %X

BACKGROUND AND PURPOSE: Although low glomerular filtration rate (GFR) and albuminuria are associated with increased risk of stroke, few studies compared their contribution to risk of ischemic versus hemorrhagic stroke separately. We contrasted the association of these kidney measures with ischemic versus hemorrhagic stroke.

METHODS: We pooled individual participant data from 4 community-based cohorts: 3 from the United States and 1 from The Netherlands. GFR was estimated using both creatinine and cystatin C, and albuminuria was quantified by urinary albumin-to-creatinine ratio (ACR). Associations of estimated GFR and ACR were compared for each stroke type (ischemic versus intraparenchymal hemorrhagic) using study-stratified Cox regression.

RESULTS: Among 29,595 participants (mean age, 61 [SD 12.5] years; 46% men; 17% black), 1261 developed stroke (12% hemorrhagic) during 280,549 person-years. Low estimated GFR was significantly associated with increased risk of ischemic stroke, but not hemorrhagic stroke, whereas high ACR was associated with both stroke types. Adjusted hazard ratios for ischemic and hemorrhagic stroke at estimated GFR of 45 (versus 95) mL/min per 1.73 m2 were 1.30 (95% confidence interval, 1.01-1.68) and 0.92 (0.47-1.81), respectively. In contrast, the corresponding hazard ratios for ACR of 300 (versus 5) mg/g were 1.62 (1.27-2.07) for ischemic and 2.57 (1.37-4.83) for hemorrhagic stroke, with significantly stronger association with hemorrhagic stroke (P=0.04). For hemorrhagic stroke, the association of elevated ACR was of similar magnitude as that of elevated systolic blood pressure.

CONCLUSIONS: Whereas albuminuria showed significant association with both stroke types, the association of decreased estimated GFR was only significant for ischemic stroke. The strong association of albuminuria with both stroke types warrants clinical attention and further investigations.

%B Stroke %V 45 %P 1925-31 %8 2014 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/24876078?dopt=Abstract %R 10.1161/STROKEAHA.114.004900 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Association of levels of fasting glucose and insulin with rare variants at the chromosome 11p11.2-MADD locus: Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study. %A Cornes, Belinda K %A Brody, Jennifer A %A Nikpoor, Naghmeh %A Morrison, Alanna C %A Chu, Huan %A Ahn, Byung Soo %A Wang, Shuai %A Dauriz, Marco %A Barzilay, Joshua I %A Dupuis, Josée %A Florez, Jose C %A Coresh, Josef %A Gibbs, Richard A %A Kao, W H Linda %A Liu, Ching-Ti %A McKnight, Barbara %A Muzny, Donna %A Pankow, James S %A Reid, Jeffrey G %A White, Charles C %A Johnson, Andrew D %A Wong, Tien Y %A Psaty, Bruce M %A Boerwinkle, Eric %A Rotter, Jerome I %A Siscovick, David S %A Sladek, Robert %A Meigs, James B %K Aged %K Aged, 80 and over %K Aging %K Blood Glucose %K Chromosomes, Human, Pair 11 %K Cohort Studies %K Death Domain Receptor Signaling Adaptor Proteins %K Diabetes Mellitus, Type 2 %K Fasting %K Female %K Gene Frequency %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Guanine Nucleotide Exchange Factors %K Heart Diseases %K Humans %K Insulin %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Sequence Analysis, DNA %X

BACKGROUND: Common variation at the 11p11.2 locus, encompassing MADD, ACP2, NR1H3, MYBPC3, and SPI1, has been associated in genome-wide association studies with fasting glucose and insulin (FI). In the Cohorts for Heart and Aging Research in Genomic Epidemiology Targeted Sequencing Study, we sequenced 5 gene regions at 11p11.2 to identify rare, potentially functional variants influencing fasting glucose or FI levels.

METHODS AND RESULTS: Sequencing (mean depth, 38×) across 16.1 kb in 3566 individuals without diabetes mellitus identified 653 variants, 79.9% of which were rare (minor allele frequency <1%) and novel. We analyzed rare variants in 5 gene regions with FI or fasting glucose using the sequence kernel association test. At NR1H3, 53 rare variants were jointly associated with FI (P=2.73×10(-3)); of these, 7 were predicted to have regulatory function and showed association with FI (P=1.28×10(-3)). Conditioning on 2 previously associated variants at MADD (rs7944584, rs10838687) did not attenuate this association, suggesting that there are >2 independent signals at 11p11.2. One predicted regulatory variant, chr11:47227430 (hg18; minor allele frequency=0.00068), contributed 20.6% to the overall sequence kernel association test score at NR1H3, lies in intron 2 of NR1H3, and is a predicted binding site for forkhead box A1 (FOXA1), a transcription factor associated with insulin regulation. In human HepG2 hepatoma cells, the rare chr11:47227430 A allele disrupted FOXA1 binding and reduced FOXA1-dependent transcriptional activity.

CONCLUSIONS: Sequencing at 11p11.2-NR1H3 identified rare variation associated with FI. One variant, chr11:47227430, seems to be functional, with the rare A allele reducing transcription factor FOXA1 binding and FOXA1-dependent transcriptional activity.

%B Circ Cardiovasc Genet %V 7 %P 374-382 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951664?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000169 %0 Journal Article %J Am J Hum Genet %D 2014 %T Association of low-frequency and rare coding-sequence variants with blood lipids and coronary heart disease in 56,000 whites and blacks. %A Peloso, Gina M %A Auer, Paul L %A Bis, Joshua C %A Voorman, Arend %A Morrison, Alanna C %A Stitziel, Nathan O %A Brody, Jennifer A %A Khetarpal, Sumeet A %A Crosby, Jacy R %A Fornage, Myriam %A Isaacs, Aaron %A Jakobsdottir, Johanna %A Feitosa, Mary F %A Davies, Gail %A Huffman, Jennifer E %A Manichaikul, Ani %A Davis, Brian %A Lohman, Kurt %A Joon, Aron Y %A Smith, Albert V %A Grove, Megan L %A Zanoni, Paolo %A Redon, Valeska %A Demissie, Serkalem %A Lawson, Kim %A Peters, Ulrike %A Carlson, Christopher %A Jackson, Rebecca D %A Ryckman, Kelli K %A Mackey, Rachel H %A Robinson, Jennifer G %A Siscovick, David S %A Schreiner, Pamela J %A Mychaleckyj, Josyf C %A Pankow, James S %A Hofman, Albert %A Uitterlinden, André G %A Harris, Tamara B %A Taylor, Kent D %A Stafford, Jeanette M %A Reynolds, Lindsay M %A Marioni, Riccardo E %A Dehghan, Abbas %A Franco, Oscar H %A Patel, Aniruddh P %A Lu, Yingchang %A Hindy, George %A Gottesman, Omri %A Bottinger, Erwin P %A Melander, Olle %A Orho-Melander, Marju %A Loos, Ruth J F %A Duga, Stefano %A Merlini, Piera Angelica %A Farrall, Martin %A Goel, Anuj %A Asselta, Rosanna %A Girelli, Domenico %A Martinelli, Nicola %A Shah, Svati H %A Kraus, William E %A Li, Mingyao %A Rader, Daniel J %A Reilly, Muredach P %A McPherson, Ruth %A Watkins, Hugh %A Ardissino, Diego %A Zhang, Qunyuan %A Wang, Judy %A Tsai, Michael Y %A Taylor, Herman A %A Correa, Adolfo %A Griswold, Michael E %A Lange, Leslie A %A Starr, John M %A Rudan, Igor %A Eiriksdottir, Gudny %A Launer, Lenore J %A Ordovas, Jose M %A Levy, Daniel %A Chen, Y-D Ida %A Reiner, Alexander P %A Hayward, Caroline %A Polasek, Ozren %A Deary, Ian J %A Borecki, Ingrid B %A Liu, Yongmei %A Gudnason, Vilmundur %A Wilson, James G %A van Duijn, Cornelia M %A Kooperberg, Charles %A Rich, Stephen S %A Psaty, Bruce M %A Rotter, Jerome I %A O'Donnell, Christopher J %A Rice, Kenneth %A Boerwinkle, Eric %A Kathiresan, Sekar %A Cupples, L Adrienne %K 1-Alkyl-2-acetylglycerophosphocholine Esterase %K Adult %K African Continental Ancestry Group %K Aged %K Alleles %K Animals %K Cholesterol, HDL %K Cholesterol, LDL %K Cohort Studies %K Coronary Disease %K European Continental Ancestry Group %K Female %K Gene Frequency %K Genetic Association Studies %K Genetic Code %K Genetic Variation %K Humans %K Linear Models %K Male %K Mice %K Mice, Inbred C57BL %K Microtubule-Associated Proteins %K Middle Aged %K Phenotype %K Sequence Analysis, DNA %K Subtilisins %K Triglycerides %X

Low-frequency coding DNA sequence variants in the proprotein convertase subtilisin/kexin type 9 gene (PCSK9) lower plasma low-density lipoprotein cholesterol (LDL-C), protect against risk of coronary heart disease (CHD), and have prompted the development of a new class of therapeutics. It is uncertain whether the PCSK9 example represents a paradigm or an isolated exception. We used the "Exome Array" to genotype >200,000 low-frequency and rare coding sequence variants across the genome in 56,538 individuals (42,208 European ancestry [EA] and 14,330 African ancestry [AA]) and tested these variants for association with LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides. Although we did not identify new genes associated with LDL-C, we did identify four low-frequency (frequencies between 0.1% and 2%) variants (ANGPTL8 rs145464906 [c.361C>T; p.Gln121*], PAFAH1B2 rs186808413 [c.482C>T; p.Ser161Leu], COL18A1 rs114139997 [c.331G>A; p.Gly111Arg], and PCSK7 rs142953140 [c.1511G>A; p.Arg504His]) with large effects on HDL-C and/or triglycerides. None of these four variants was associated with risk for CHD, suggesting that examples of low-frequency coding variants with robust effects on both lipids and CHD will be limited.

%B Am J Hum Genet %V 94 %P 223-32 %8 2014 Feb 06 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24507774?dopt=Abstract %R 10.1016/j.ajhg.2014.01.009 %0 Journal Article %J PLoS One %D 2014 %T Association of sick sinus syndrome with incident cardiovascular disease and mortality: the Atherosclerosis Risk in Communities study and Cardiovascular Health Study. %A Alonso, Alvaro %A Jensen, Paul N %A Lopez, Faye L %A Chen, Lin Y %A Psaty, Bruce M %A Folsom, Aaron R %A Heckbert, Susan R %K Age Distribution %K Atherosclerosis %K Cohort Studies %K Continental Population Groups %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Residence Characteristics %K Risk %K Sex Distribution %K Sick Sinus Syndrome %X

BACKGROUND: Sick sinus syndrome (SSS) is a common indication for pacemaker implantation. Limited information exists on the association of sick sinus syndrome (SSS) with mortality and cardiovascular disease (CVD) in the general population.

METHODS: We studied 19,893 men and women age 45 and older in the Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS), two community-based cohorts, who were without a pacemaker or atrial fibrillation (AF) at baseline. Incident SSS cases were validated by review of medical charts. Incident CVD and mortality were ascertained using standardized protocols. Multivariable Cox models were used to estimate the association of incident SSS with selected outcomes.

RESULTS: During a mean follow-up of 17 years, 213 incident SSS events were identified and validated (incidence, 0.6 events per 1,000 person-years). After adjustment for confounders, SSS incidence was associated with increased mortality (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.14-1.70), coronary heart disease (HR 1.72, 95%CI 1.11-2.66), heart failure (HR 2.87, 95%CI 2.17-3.80), stroke (HR 1.56, 95%CI 0.99-2.46), AF (HR 5.75, 95%CI 4.43-7.46), and pacemaker implantation (HR 53.7, 95%CI 42.9-67.2). After additional adjustment for other incident CVD during follow-up, SSS was no longer associated with increased mortality, coronary heart disease, or stroke, but remained associated with higher risk of heart failure (HR 2.00, 95%CI 1.51-2.66), AF (HR 4.25, 95%CI 3.28-5.51), and pacemaker implantation (HR 25.2, 95%CI 19.8-32.1).

CONCLUSION: Individuals who develop SSS are at increased risk of death and CVD. The mechanisms underlying these associations warrant further investigation.

%B PLoS One %V 9 %P e109662 %8 2014 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25285853?dopt=Abstract %R 10.1371/journal.pone.0109662 %0 Journal Article %J PLoS One %D 2014 %T Associations of NINJ2 sequence variants with incident ischemic stroke in the Cohorts for Heart and Aging in Genomic Epidemiology (CHARGE) consortium. %A Bis, Joshua C %A DeStefano, Anita %A Liu, Xiaoming %A Brody, Jennifer A %A Choi, Seung Hoan %A Verhaaren, Benjamin F J %A Debette, Stephanie %A Ikram, M Arfan %A Shahar, Eyal %A Butler, Kenneth R %A Gottesman, Rebecca F %A Muzny, Donna %A Kovar, Christie L %A Psaty, Bruce M %A Hofman, Albert %A Lumley, Thomas %A Gupta, Mayetri %A Wolf, Philip A %A van Duijn, Cornelia %A Gibbs, Richard A %A Mosley, Thomas H %A Longstreth, W T %A Boerwinkle, Eric %A Seshadri, Sudha %A Fornage, Myriam %K Cell Adhesion Molecules, Neuronal %K European Continental Ancestry Group %K Female %K Genetic Association Studies %K Genetic Heterogeneity %K Humans %K Introns %K Ischemia %K Male %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Prospective Studies %K Sequence Analysis, DNA %X

BACKGROUND: Stroke, the leading neurologic cause of death and disability, has a substantial genetic component. We previously conducted a genome-wide association study (GWAS) in four prospective studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium and demonstrated that sequence variants near the NINJ2 gene are associated with incident ischemic stroke. Here, we sought to fine-map functional variants in the region and evaluate the contribution of rare variants to ischemic stroke risk.

METHODS AND RESULTS: We sequenced 196 kb around NINJ2 on chromosome 12p13 among 3,986 European ancestry participants, including 475 ischemic stroke cases, from the Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, and Framingham Heart Study. Meta-analyses of single-variant tests for 425 common variants (minor allele frequency [MAF] ≥ 1%) confirmed the original GWAS results and identified an independent intronic variant, rs34166160 (MAF = 0.012), most significantly associated with incident ischemic stroke (HR = 1.80, p = 0.0003). Aggregating 278 putatively-functional variants with MAF≤ 1% using count statistics, we observed a nominally statistically significant association, with the burden of rare NINJ2 variants contributing to decreased ischemic stroke incidence (HR = 0.81; p = 0.026).

CONCLUSION: Common and rare variants in the NINJ2 region were nominally associated with incident ischemic stroke among a subset of CHARGE participants. Allelic heterogeneity at this locus, caused by multiple rare, low frequency, and common variants with disparate effects on risk, may explain the difficulties in replicating the original GWAS results. Additional studies that take into account the complex allelic architecture at this locus are needed to confirm these findings.

%B PLoS One %V 9 %P e99798 %8 2014 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/24959832?dopt=Abstract %R 10.1371/journal.pone.0099798 %0 Journal Article %J J Am Geriatr Soc %D 2014 %T Brain imaging findings in elderly adults and years of life, healthy life, and able life over the ensuing 16 years: the Cardiovascular Health Study. %A Longstreth, W T %A Diehr, Paula H %A Yee, Laura M %A Newman, Anne B %A Beauchamp, Norman J %K Activities of Daily Living %K Aged %K Atrophy %K Brain %K Brain Infarction %K Cohort Studies %K Disability Evaluation %K Female %K Health Status %K Humans %K Leukoaraiosis %K Longevity %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Prognosis %K Regression Analysis %K United States %X

OBJECTIVES: To determine whether elderly people with different patterns of magnetic resonance imaging (MRI) findings have different long-term outcomes.

DESIGN: Longitudinal cohort study.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Individuals aged 65 and older were recruited (N = 5,888); 3,660 of these underwent MRI, and 3,230 without a stroke before MRI were included in these analyses.

MEASUREMENTS: Cluster analysis of brain MRI findings was previously used to define five clusters: normal, atrophy, simple infarct, leukoaraiosis, and complex infarct. Participants were subsequently classified as healthy if they rated their health as excellent, very good, or good and as able if they did not report any limitations in activities of daily living (ADLs). Mean years of life (YoL), years of healthy life (YHL), and years of able life (YAL) were calculated over 16 years after the MRI and compared between clusters using unadjusted and adjusted regression analyses.

RESULTS: Mean age of participants was 75.0. With 16 years of follow-up, mean YoL was 11.3; YHL, 8.0; and YAL, 8.4. Outcomes differed significantly between clusters. With or without adjustments, outcomes were all significantly better in the normal than complex infarct cluster. The three remaining clusters had intermediate results, significantly different from the normal and complex infarct clusters but not usually from one another. Over 16 years of follow-up, participants in the complex infarct cluster (n = 368) spent the largest percentage of their 8.4 years alive being sick (38%) and not able (38%).

CONCLUSION: Findings on MRI scans in elderly adults are associated not only with long-term survival, but also with long-term self-rated health and limitation in ADLs. The combination of infarcts and leukoaraiosis carried the worst prognosis, presumably reflecting small vessel disease.

%B J Am Geriatr Soc %V 62 %P 1838-43 %8 2014 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25333525?dopt=Abstract %R 10.1111/jgs.13068 %0 Journal Article %J Europace %D 2014 %T B-type natriuretic peptide and C-reactive protein in the prediction of atrial fibrillation risk: the CHARGE-AF Consortium of community-based cohort studies. %A Sinner, Moritz F %A Stepas, Katherine A %A Moser, Carlee B %A Krijthe, Bouwe P %A Aspelund, Thor %A Sotoodehnia, Nona %A Fontes, João D %A Janssens, A Cecile J W %A Kronmal, Richard A %A Magnani, Jared W %A Witteman, Jacqueline C %A Chamberlain, Alanna M %A Lubitz, Steven A %A Schnabel, Renate B %A Vasan, Ramachandran S %A Wang, Thomas J %A Agarwal, Sunil K %A McManus, David D %A Franco, Oscar H %A Yin, Xiaoyan %A Larson, Martin G %A Burke, Gregory L %A Launer, Lenore J %A Hofman, Albert %A Levy, Daniel %A Gottdiener, John S %A Kääb, Stefan %A Couper, David %A Harris, Tamara B %A Astor, Brad C %A Ballantyne, Christie M %A Hoogeveen, Ron C %A Arai, Andrew E %A Soliman, Elsayed Z %A Ellinor, Patrick T %A Stricker, Bruno H C %A Gudnason, Vilmundur %A Heckbert, Susan R %A Pencina, Michael J %A Benjamin, Emelia J %A Alonso, Alvaro %K Aged %K Atrial Fibrillation %K Biomarkers %K C-Reactive Protein %K Europe %K Female %K Humans %K Incidence %K Male %K Natriuretic Peptide, Brain %K Peptide Fragments %K Predictive Value of Tests %K Risk Assessment %K Risk Factors %K United States %X

AIMS: B-type natriuretic peptide (BNP) and C-reactive protein (CRP) predict atrial fibrillation (AF) risk. However, their risk stratification abilities in the broad community remain uncertain. We sought to improve risk stratification for AF using biomarker information.

METHODS AND RESULTS: We ascertained AF incidence in 18 556 Whites and African Americans from the Atherosclerosis Risk in Communities Study (ARIC, n=10 675), Cardiovascular Health Study (CHS, n = 5043), and Framingham Heart Study (FHS, n = 2838), followed for 5 years (prediction horizon). We added BNP (ARIC/CHS: N-terminal pro-B-type natriuretic peptide; FHS: BNP), CRP, or both to a previously reported AF risk score, and assessed model calibration and predictive ability [C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI)]. We replicated models in two independent European cohorts: Age, Gene/Environment Susceptibility Reykjavik Study (AGES), n = 4467; Rotterdam Study (RS), n = 3203. B-type natriuretic peptide and CRP were significantly associated with AF incidence (n = 1186): hazard ratio per 1-SD ln-transformed biomarker 1.66 [95% confidence interval (CI), 1.56-1.76], P < 0.0001 and 1.18 (95% CI, 1.11-1.25), P < 0.0001, respectively. Model calibration was sufficient (BNP, χ(2) = 17.0; CRP, χ(2) = 10.5; BNP and CRP, χ(2) = 13.1). B-type natriuretic peptide improved the C-statistic from 0.765 to 0.790, yielded an IDI of 0.027 (95% CI, 0.022-0.032), a relative IDI of 41.5%, and a continuous NRI of 0.389 (95% CI, 0.322-0.455). The predictive ability of CRP was limited (C-statistic increment 0.003). B-type natriuretic peptide consistently improved prediction in AGES and RS.

CONCLUSION: B-type natriuretic peptide, not CRP, substantially improved AF risk prediction beyond clinical factors in an independently replicated, heterogeneous population. B-type natriuretic peptide may serve as a benchmark to evaluate novel putative AF risk biomarkers.

%B Europace %V 16 %P 1426-33 %8 2014 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25037055?dopt=Abstract %R 10.1093/europace/euu175 %0 Journal Article %J PLoS One %D 2014 %T The challenges of genome-wide interaction studies: lessons to learn from the analysis of HDL blood levels. %A van Leeuwen, Elisabeth M %A Smouter, Françoise A S %A Kam-Thong, Tony %A Karbalai, Nazanin %A Smith, Albert V %A Harris, Tamara B %A Launer, Lenore J %A Sitlani, Colleen M %A Li, Guo %A Brody, Jennifer A %A Bis, Joshua C %A White, Charles C %A Jaiswal, Alok %A Oostra, Ben A %A Hofman, Albert %A Rivadeneira, Fernando %A Uitterlinden, André G %A Boerwinkle, Eric %A Ballantyne, Christie M %A Gudnason, Vilmundur %A Psaty, Bruce M %A Cupples, L Adrienne %A Jarvelin, Marjo-Riitta %A Ripatti, Samuli %A Isaacs, Aaron %A Müller-Myhsok, Bertram %A Karssen, Lennart C %A van Duijn, Cornelia M %K Cholesterol, HDL %K Female %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

Genome-wide association studies (GWAS) have revealed 74 single nucleotide polymorphisms (SNPs) associated with high-density lipoprotein cholesterol (HDL) blood levels. This study is, to our knowledge, the first genome-wide interaction study (GWIS) to identify SNP×SNP interactions associated with HDL levels. We performed a GWIS in the Rotterdam Study (RS) cohort I (RS-I) using the GLIDE tool which leverages the massively parallel computing power of Graphics Processing Units (GPUs) to perform linear regression on all genome-wide pairs of SNPs. By performing a meta-analysis together with Rotterdam Study cohorts II and III (RS-II and RS-III), we were able to filter 181 interaction terms with a p-value<1 · 10-8 that replicated in the two independent cohorts. We were not able to replicate any of these interaction term in the AGES, ARIC, CHS, ERF, FHS and NFBC-66 cohorts (Ntotal = 30,011) when adjusting for multiple testing. Our GWIS resulted in the consistent finding of a possible interaction between rs774801 in ARMC8 (ENSG00000114098) and rs12442098 in SPATA8 (ENSG00000185594) being associated with HDL levels. However, p-values do not reach the preset Bonferroni correction of the p-values. Our study suggest that even for highly genetically determined traits such as HDL the sample sizes needed to detect SNP×SNP interactions are large and the 2-step filtering approaches do not yield a solution. Here we present our analysis plan and our reservations concerning GWIS.

%B PLoS One %V 9 %P e109290 %8 2014 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25329471?dopt=Abstract %R 10.1371/journal.pone.0109290 %0 Journal Article %J Circulation %D 2014 %T Circulating omega-6 polyunsaturated fatty acids and total and cause-specific mortality: the Cardiovascular Health Study. %A Wu, Jason H Y %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Psaty, Bruce M %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Arachidonic Acid %K Biomarkers %K Cohort Studies %K Coronary Disease %K Fatty Acids, Omega-3 %K Fatty Acids, Omega-6 %K Fatty Acids, Unsaturated %K Female %K Follow-Up Studies %K Humans %K Linoleic Acid %K Male %K Prospective Studies %K Regression Analysis %K Risk Factors %K Stroke %K Survival Rate %K United States %X

BACKGROUND: Although omega-6 polyunsaturated fatty acids (n-6 PUFA) have been recommended to reduce coronary heart disease (CHD), controversy remains about benefits versus harms, including concerns over theorized proinflammatory effects of n-6 PUFA. We investigated associations of circulating n-6 PUFA including linoleic acid (the major dietary PUFA), γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid, with total and cause-specific mortality in the Cardiovascular Health Study, a community-based U.S. cohort.

METHODS AND RESULTS: Among 2792 participants(aged ≥65 years) free of cardiovascular disease at baseline, plasma phospholipid n-6 PUFA were measured at baseline using standardized methods. All-cause and cause-specific mortality, and total incident CHD and stroke, were assessed and adjudicated centrally. Associations of PUFA with risk were assessed by Cox regression. During 34 291 person-years of follow-up (1992-2010), 1994 deaths occurred (678 cardiovascular deaths), with 427 fatal and 418 nonfatal CHD, and 154 fatal and 399 nonfatal strokes. In multivariable models, higher linoleic acid was associated with lower total mortality, with extreme-quintile hazard ratio =0.87 (P trend=0.005). Lower death was largely attributable to cardiovascular disease causes, especially nonarrhythmic CHD mortality (hazard ratio, 0.51; 95% confidence interval, 0.32-0.82; P trend=0.001). Circulating γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid were not significantly associated with total or cause-specific mortality (eg, for arachidonic acid and CHD death, the extreme-quintile hazard ratio was 0.97; 95% confidence interval, 0.70-1.34; P trend=0.87). Evaluated semiparametrically, linoleic acid showed graded inverse associations with total mortality (P=0.005). There was little evidence that associations of n-6 PUFA with total mortality varied by age, sex, race, or plasma n-3 PUFA. Evaluating both n-6 and n-3 PUFA, lowest risk was evident with highest levels of both.

CONCLUSIONS: High circulating linoleic acid, but not other n-6 PUFA, was inversely associated with total and CHD mortality in older adults.

%B Circulation %V 130 %P 1245-53 %8 2014 Oct 7 %G eng %N 15 %1 http://www.ncbi.nlm.nih.gov/pubmed/25124495?dopt=Abstract %R 10.1161/CIRCULATIONAHA.114.011590 %0 Journal Article %J Hypertension %D 2014 %T Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration. %A Bots, Michiel L %A Groenewegen, Karlijn A %A Anderson, Todd J %A Britton, Annie R %A Dekker, Jacqueline M %A Engström, Gunnar %A Evans, Greg W %A de Graaf, Jacqueline %A Grobbee, Diederick E %A Hedblad, Bo %A Hofman, Albert %A Holewijn, Suzanne %A Ikeda, Ai %A Kavousi, Maryam %A Kitagawa, Kazuo %A Kitamura, Akihiko %A Ikram, M Arfan %A Lonn, Eva M %A Lorenz, Matthias W %A Mathiesen, Ellisiv B %A Nijpels, Giel %A Okazaki, Shuhei %A O'Leary, Daniel H %A Polak, Joseph F %A Price, Jacqueline F %A Robertson, Christine %A Rembold, Christopher M %A Rosvall, Maria %A Rundek, Tatjana %A Salonen, Jukka T %A Sitzer, Matthias %A Stehouwer, Coen D A %A Franco, Oscar H %A Peters, Sanne A E %A den Ruijter, Hester M %K Adult %K Aged %K Antihypertensive Agents %K Blood Pressure %K Cardiovascular Diseases %K Carotid Artery, Common %K Carotid Intima-Media Thickness %K Cohort Studies %K Female %K Humans %K Hypertension %K Male %K Meta-Analysis as Topic %K Middle Aged %K Risk Assessment %K Risk Factors %X

Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (i.e., a systolic blood pressure ≥140 mm Hg and a diastolic blood pressure ≥ 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.

%B Hypertension %V 63 %P 1173-81 %8 2014 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/24614213?dopt=Abstract %R 10.1161/HYPERTENSIONAHA.113.02683 %0 Journal Article %J J Cardiovasc Electrophysiol %D 2014 %T A common SCN5A variant is associated with PR interval and atrial fibrillation among African Americans. %A Ilkhanoff, Leonard %A Arking, Dan E %A Lemaitre, Rozenn N %A Alonso, Alvaro %A Chen, Lin Y %A Durda, Peter %A Hesselson, Stephanie E %A Kerr, Kathleen F %A Magnani, Jared W %A Marcus, Gregory M %A Schnabel, Renate B %A Smith, J Gustav %A Soliman, Elsayed Z %A Reiner, Alexander P %A Sotoodehnia, Nona %K Adult %K African Americans %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Case-Control Studies %K Cohort Studies %K Death, Sudden, Cardiac %K Female %K Genetic Variation %K Humans %K Male %K Middle Aged %K NAV1.5 Voltage-Gated Sodium Channel %K Prospective Studies %K Risk Factors %K Single-Blind Method %X

OBJECTIVE: We examined the association of rs7626962 (S1103Y) or rs7629265, a variant in high linkage disequilibrium with S1103Y (r(2) = 0.87 - 1), with sudden cardiac death (SCD) and atrial fibrillation (AF) among African Americans.

BACKGROUND: The SCN5A missense variant S1103Y has been associated with SCD among African Americans in small case-control studies, but larger population-based studies are needed to validate these findings. The association of this variant with AF has not been fully explored.

METHODS: Using genotyping data on over 7,000 African Americans from 5 cohorts (Atherosclerosis Risk in Communities [ARIC], Cleveland Family Study [CFS], Jackson Heart Study [JHS], Multi-Ethnic Study of Atherosclerosis [MESA], Cardiovascular Health Study [CHS]), we examined the association of rs7629265 with electrocardiographic PR, QRS, and QT intervals, and with incident AF and SCD. We examined association of S1103Y (rs7626962) with SCD using a population-based case-control study of SCD Cardiac Arrest Blood Study (CABS).

RESULTS: Meta-analyses across 5 cohorts demonstrated that rs7629265 was significantly associated with PR duration (β = -4.1 milliseconds; P = 2.2×10(-6) ), but not significantly associated with QRS or QT intervals. In meta-analyses of prospectively followed ARIC and CHS participants (n = 3,656), rs7629265 was associated with increased AF risk (n = 299 AF cases; HR = 1.74, P = 1.9 × 10(-4) ). By contrast, rs7629265 was not significantly associated with SCD risk in ARIC (n = 83 SCD cases; P = 0.30) or CHS (n = 54 SCD cases; P = 0.47). Similarly, S1103Y was not significantly associated with SCD risk in CABS (n = 225 SCD cases; P = 0.29).

CONCLUSION: The common SCN5A variant, rs7629265, is associated with increased AF risk and shorter PR interval among African Americans. In contrast to prior reports, we found no evidence of association of rs7629265 or rs7626962 (S1103Y) with SCD risk in the general population.

%B J Cardiovasc Electrophysiol %V 25 %P 1150-7 %8 2014 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/25065297?dopt=Abstract %R 10.1111/jce.12483 %0 Journal Article %J Heart Rhythm %D 2014 %T Common variation in fatty acid metabolic genes and risk of incident sudden cardiac arrest. %A Lemaitre, Rozenn N %A Johnson, Catherine O %A Hesselson, Stephanie %A Sotoodehnia, Nona %A Sotoodhenia, Nona %A McKnight, Barbara %A Sitlani, Colleen M %A Rea, Thomas D %A King, Irena B %A Kwok, Pui-Yan %A Mak, Angel %A Li, Guo %A Brody, Jennifer %A Larson, Eric %A Mozaffarian, Dariush %A Psaty, Bruce M %A Huertas-Vazquez, Adriana %A Tardif, Jean-Claude %A Albert, Christine M %A Lyytikäinen, Leo-Pekka %A Arking, Dan E %A Kääb, Stefan %A Huikuri, Heikki V %A Krijthe, Bouwe P %A Eijgelsheim, Mark %A Wang, Ying A %A Reinier, Kyndaron %A Lehtimäki, Terho %A Pulit, Sara L %A Brugada, Ramon %A Müller-Nurasyid, Martina %A Newton-Cheh, Chris H %A Karhunen, Pekka J %A Stricker, Bruno H %A Goyette, Philippe %A Rotter, Jerome I %A Chugh, Sumeet S %A Chakravarti, Aravinda %A Jouven, Xavier %A Siscovick, David S %K 1-Acylglycerophosphocholine O-Acyltransferase %K Aged %K Algorithms %K Alleles %K Case-Control Studies %K Death, Sudden, Cardiac %K Fatty Acids %K Female %K Genetic Predisposition to Disease %K Genetic Variation %K Genotype %K Humans %K Male %K Polymorphism, Single Nucleotide %K Risk Factors %X

BACKGROUND: There is limited information on genetic factors associated with sudden cardiac arrest (SCA).

OBJECTIVE: To assess the association of common variation in genes in fatty acid pathways with SCA risk.

METHODS: We selected 85 candidate genes and 1155 single nucleotide polymorphisms (SNPs) tagging common variation in each gene. We investigated the SNP associations with SCA in a population-based case-control study. Cases (n = 2160) were from a repository of SCA in the greater Seattle area. Controls (n = 2615), frequency-matched on age and sex, were from the same area. We used linear logistic regression to examine SNP associations with SCA. We performed permutation-based p-min tests to account for multiple comparisons within each gene. The SNP associations with a corrected P value of <.05 were then examined in a meta-analysis of these SNP associations in 9 replication studies totaling 2129 SCA cases and 23,833 noncases.

RESULTS: Eight SNPs in or near 8 genes were associated with SCA risk in the discovery study, one of which was nominally significant in the replication phase (rs7737692, minor allele frequency 36%, near the LPCAT1 gene). For each copy of the minor allele, rs7737692 was associated with 13% lower SCA risk (95% confidence interval -21% to -5%) in the discovery phase and 9% lower SCA risk (95% confidence interval -16% to -1%) in the replication phase.

CONCLUSIONS: While none of the associations reached significance with Bonferroni correction, a common genetic variant near LPCAT1, a gene involved in the remodeling of phospholipids, was nominally associated with incident SCA risk. Further study is needed to validate this observation.

%B Heart Rhythm %V 11 %P 471-7 %8 2014 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24418166?dopt=Abstract %R 10.1016/j.hrthm.2014.01.008 %0 Journal Article %J J Am Heart Assoc %D 2014 %T Coronary heart disease risks associated with high levels of HDL cholesterol. %A Wilkins, John T %A Ning, Hongyan %A Stone, Neil J %A Criqui, Michael H %A Zhao, Lihui %A Greenland, Philip %A Lloyd-Jones, Donald M %K Aged %K Biomarkers %K Cholesterol, HDL %K Coronary Disease %K Female %K Humans %K Linear Models %K Male %K Middle Aged %K Multivariate Analysis %K Prognosis %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Time Factors %K United States %K Up-Regulation %X

BACKGROUND: The association between high-density lipoprotein cholesterol (HDL-C) and coronary heart disease (CHD) events is not well described in individuals with very high levels of HDL-C (>80 mg/dL).

METHODS AND RESULTS: Using pooled data from 6 community-based cohorts we examined CHD and total mortality risks across a broad range of HDL-C, including values in excess of 80 mg/dL. We used Cox proportional hazards models with penalized splines to assess multivariable, adjusted, sex-stratified associations of HDL-C with the hazard for CHD events and total mortality, using HDL-C 45 mg/dL and 55 mg/dL as the referent in men and women, respectively. Analyses included 11 515 men and 12 925 women yielding 307 245 person-years of follow-up. In men, the association between HDL-C and CHD events was inverse and linear across most HDL-C values; however at HDL-C values >90 mg/dL there was a plateau effect in the pattern of association. In women, the association between HDL-C and CHD events was inverse and linear across lower values of HDL-C, however at HDL-C values >75 mg/dL there were no further reductions in the hazard ratio point estimates for CHD. In unadjusted models there were increased total mortality risks in men with very high HDL-C, however mortality risks observed in participants with very high HDL-C were attenuated after adjustment for traditional risk factors.

CONCLUSIONS: We did not observe further reductions in CHD risk with HDL-C values higher than 90 mg/dL in men and 75 mg/dL in women.

%B J Am Heart Assoc %V 3 %P e000519 %8 2014 Mar 13 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24627418?dopt=Abstract %R 10.1161/JAHA.113.000519 %0 Journal Article %J JAMA %D 2014 %T Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. %A Coresh, Josef %A Turin, Tanvir Chowdhury %A Matsushita, Kunihiro %A Sang, Yingying %A Ballew, Shoshana H %A Appel, Lawrence J %A Arima, Hisatomi %A Chadban, Steven J %A Cirillo, Massimo %A Djurdjev, Ognjenka %A Green, Jamie A %A Heine, Gunnar H %A Inker, Lesley A %A Irie, Fujiko %A Ishani, Areef %A Ix, Joachim H %A Kovesdy, Csaba P %A Marks, Angharad %A Ohkubo, Takayoshi %A Shalev, Varda %A Shankar, Anoop %A Wen, Chi Pang %A de Jong, Paul E %A Iseki, Kunitoshi %A Stengel, Bénédicte %A Gansevoort, Ron T %A Levey, Andrew S %K Adult %K Aged %K Aged, 80 and over %K Cohort Studies %K Creatinine %K Disease Progression %K Endpoint Determination %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Reference Values %K Risk %X

IMPORTANCE: The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of −57% or greater) is a late event.

OBJECTIVE: To characterize the association of decline in estimated GFR with subsequent progression to ESRD with implications for using lesser declines in estimated GFR as potential alternative end points for CKD progression. Because most people with CKD die before reaching ESRD, mortality risk also was investigated.

DATA SOURCES AND STUDY SELECTION: Individual meta-analysis of 1.7 million participants with 12,344 ESRD events and 223,944 deaths from 35 cohorts in the CKD Prognosis Consortium with a repeated measure of serum creatinine concentration over 1 to 3 years and outcome data.

DATA EXTRACTION AND SYNTHESIS: Transfer of individual participant data or standardized analysis of outputs for random-effects meta-analysis conducted between July 2012 and September 2013, with baseline estimated GFR values collected from 1975 through 2012.

MAIN OUTCOMES AND MEASURES: End-stage renal disease (initiation of dialysis or transplantation) or all-cause mortality risk related to percentage change in estimated GFR over 2 years, adjusted for potential confounders and first estimated GFR.

RESULTS: The adjusted hazard ratios (HRs) of ESRD and mortality were higher with larger estimated GFR decline. Among participants with baseline estimated GFR of less than 60 mL/min/1.73 m2, the adjusted HRs for ESRD were 32.1 (95% CI, 22.3-46.3) for changes of −57% in estimated GFR and 5.4 (95% CI, 4.5-6.4) for changes of −30%. However, changes of −30% or greater (6.9% [95% CI, 6.4%-7.4%] of the entire consortium) were more common than changes of −57% (0.79% [95% CI, 0.52%-1.06%]). This association was strong and consistent across the length of the baseline period (1 to 3 years), baseline estimated GFR, age, diabetes status, or albuminuria. Average adjusted 10-year risk of ESRD (in patients with a baseline estimated GFR of 35 mL/min/1.73 m2) was 99% (95% CI, 95%-100%) for estimated GFR change of −57%, was 83% (95% CI, 71%-93%) for estimated GFR change of −40%, and was 64% (95% CI, 52%-77%) for estimated GFR change of −30% vs 18% (95% CI, 15%-22%) for estimated GFR change of 0%. Corresponding mortality risks were 77% (95% CI, 71%-82%), 60% (95% CI, 56%-63%), and 50% (95% CI, 47%-52%) vs 32% (95% CI, 31%-33%), showing a similar but weaker pattern.

CONCLUSIONS AND RELEVANCE: Declines in estimated GFR smaller than a doubling of serum creatinine concentration occurred more commonly and were strongly and consistently associated with the risk of ESRD and mortality, supporting consideration of lesser declines in estimated GFR (such as a 30% reduction over 2 years) as an alternative end point for CKD progression.

%B JAMA %V 311 %P 2518-2531 %8 2014 Jun 25 %G eng %N 24 %1 http://www.ncbi.nlm.nih.gov/pubmed/24892770?dopt=Abstract %R 10.1001/jama.2014.6634 %0 Journal Article %J Alzheimers Dement %D 2014 %T Development and validation of a brief dementia screening indicator for primary care. %A Barnes, Deborah E %A Beiser, Alexa S %A Lee, Anne %A Langa, Kenneth M %A Koyama, Alain %A Preis, Sarah R %A Neuhaus, John %A McCammon, Ryan J %A Yaffe, Kristine %A Seshadri, Sudha %A Haan, Mary N %A Weir, David R %K Aged %K Cohort Studies %K Dementia %K Female %K Humans %K Male %K Mass Screening %K Predictive Value of Tests %K Primary Health Care %K Proportional Hazards Models %K Risk Assessment %X

BACKGROUND: Detection of "any cognitive impairment" is mandated as part of the Medicare annual wellness visit, but screening all patients may result in excessive false positives.

METHODS: We developed and validated a brief Dementia Screening Indicator using data from four large, ongoing cohort studies (the Cardiovascular Health Study [CHS]; the Framingham Heart Study [FHS]; the Health and Retirement Study [HRS]; the Sacramento Area Latino Study on Aging [SALSA]) to help clinicians identify a subgroup of high-risk patients to target for cognitive screening.

RESULTS: The final Dementia Screening Indicator included age (1 point/year; ages, 65-79 years), less than 12 years of education (9 points), stroke (6 points), diabetes mellitus (3 points), body mass index less than 18.5 kg/m(2) (8 points), requiring assistance with money or medications (10 points), and depressive symptoms (6 points). Accuracy was good across the cohorts (Harrell's C statistic: CHS, 0.68; FHS, 0.77; HRS, 0.76; SALSA, 0.78).

CONCLUSIONS: The Dementia Screening Indicator is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.

%B Alzheimers Dement %V 10 %P 656-665.e1 %8 2014 Nov %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/24491321?dopt=Abstract %R 10.1016/j.jalz.2013.11.006 %0 Journal Article %J Eur J Prev Cardiol %D 2014 %T Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events. %A Fowkes, F G R %A Murray, G D %A Butcher, I %A Folsom, A R %A Hirsch, A T %A Couper, D J %A deBacker, G %A Kornitzer, M %A Newman, A B %A Sutton-Tyrrell, K C %A Cushman, M %A Lee, A J %A Price, J F %A D'Agostino, R B %A Murabito, J M %A Norman, Pe %A Masaki, K H %A Bouter, L M %A Heine, R J %A Stehouwer, C D A %A McDermott, M M %A Stoffers, H E J H %A Knottnerus, J A %A Ogren, M %A Hedblad, B %A Koenig, W %A Meisinger, C %A Cauley, J A %A Franco, Oh %A Hunink, M G M %A Hofman, A %A Witteman, J C %A Criqui, M H %A Langer, R D %A Hiatt, W R %A Hamman, R F %K Adult %K Aged %K Aged, 80 and over %K Ankle Brachial Index %K Cardiovascular Diseases %K Europe %K European Continental Ancestry Group %K Female %K Humans %K Male %K Middle Aged %K Models, Statistical %K Predictive Value of Tests %K Prognosis %K Reproducibility of Results %K Risk Assessment %K Risk Factors %K Sex Factors %K Time Factors %K United States %K Young Adult %X

BACKGROUND: The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS.

DESIGN: An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events.

METHODS: Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events.

RESULTS: In predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p = 0.050) and 9.6% (95% CI 6.1 to 16.4%, p < 0.001), respectively. Restricting the FRS + ABI model to those with FRS intermediate 10-year risk of 10 to 19% resulted in higher NRI of 15.9% (95% CI 6.1 to 20.6%, p < 0.001) in men and 23.3% (95% CI 13.8 to 62.5%, p = 0.002) in women. However, incorporating ABI in an improved newly fitted risk factor model had a nonsignificant effect: NRI 2.0% (95% CI 2.3 to 4.2%, p = 0.567) in men and 1.1% (95% CI 1.9 to 4.0%, p = 0.483) in women.

CONCLUSIONS: An ABI risk model may improve prediction especially in individuals at intermediate risk and when performance of the base risk factor model is modest.

%B Eur J Prev Cardiol %V 21 %P 310-20 %8 2014 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24367001?dopt=Abstract %R 10.1177/2047487313516564 %0 Journal Article %J Respiration %D 2014 %T Disability and recovery of independent function in obstructive lung disease: the cardiovascular health study. %A Fan, Vincent S %A Locke, Emily R %A Diehr, Paula %A Wilsdon, Anthony %A Enright, Paul %A Yende, Sachin %A Avdalovic, Mark %A Barr, Graham %A Kapur, Vishesh K %A Thomas, Rachel %A Krishnan, Jerry A %A Lovasi, Gina %A Thielke, Stephen %K Activities of Daily Living %K Aged %K Cardiac Rehabilitation %K Cardiovascular Diseases %K Disability Evaluation %K Exercise Test %K Female %K Humans %K Independent Living %K Longitudinal Studies %K Male %K Motor Activity %K Muscle Strength %K Outcome Assessment (Health Care) %K Pulmonary Disease, Chronic Obstructive %K Recovery of Function %K Risk Assessment %K Severity of Illness Index %K Spirometry %K United States %X

BACKGROUND: Chronic obstructive lung disease frequently leads to disability. Older patients may experience transitions between states of disability and independence over time.

OBJECTIVE: To identify factors associated with transition between states of disability and independent function in obstructive lung disease.

METHODS: We analyzed data on 4,394 participants in the Cardiovascular Health Study who completed prebronchodilator spirometry. We calculated the 1-year probability of developing and resolving impairment in ≥1 instrumental activity of daily living (IADL) or ≥1 activity of daily living (ADL) using transition probability analysis. We identified factors associated with resolving disability using relative risk (RR) regression.

RESULTS: The prevalence of IADL impairment was higher with moderate (23.9%) and severe (36.9%) airflow obstruction compared to normal spirometry (22.5%; p < 0.001). Among participants with severe airflow obstruction, 23.5% recovered independence in IADLs and 40.5% recovered independence in ADLs. In the adjusted analyses, airflow obstruction predicted the development of IADL, but not ADL impairment. Participants with severe airflow obstruction were less likely to resolve IADL impairment [RR 0.67 and 95% confidence interval (CI) 0.49-0.94]. Compared to the most active individuals (i.e. who walked ≥28 blocks per week), walking less was associated with a decreased likelihood of resolving IADL impairment (7-27 blocks: RR 0.81 and 95% CI 0.69-0.86 and <7 blocks: RR 0.73 and 95% CI 0.61-0.86). Increased strength (RR 1.16 and 95% CI 1.05-1.29) was associated with resolving IADL impairment.

CONCLUSIONS: Disability is common in older people, especially in those with severe airflow obstruction. Increased physical activity and muscle strength are associated with recovery. Research is needed on interventions to improve these factors among patients with obstructive lung disease and disability.

%B Respiration %V 88 %P 329-38 %8 2014 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25228204?dopt=Abstract %R 10.1159/000363772 %0 Journal Article %J Pharmacogenomics J %D 2014 %T Drug-gene interactions and the search for missing heritability: a cross-sectional pharmacogenomics study of the QT interval. %A Avery, C L %A Sitlani, C M %A Arking, D E %A Arnett, D K %A Bis, J C %A Boerwinkle, E %A Buckley, B M %A Ida Chen, Y-D %A de Craen, A J M %A Eijgelsheim, M %A Enquobahrie, D %A Evans, D S %A Ford, I %A Garcia, M E %A Gudnason, V %A Harris, T B %A Heckbert, S R %A Hochner, H %A Hofman, A %A Hsueh, W-C %A Isaacs, A %A Jukema, J W %A Knekt, P %A Kors, J A %A Krijthe, B P %A Kristiansson, K %A Laaksonen, M %A Liu, Y %A Li, X %A Macfarlane, P W %A Newton-Cheh, C %A Nieminen, M S %A Oostra, B A %A Peloso, G M %A Porthan, K %A Rice, K %A Rivadeneira, F F %A Rotter, J I %A Salomaa, V %A Sattar, N %A Siscovick, D S %A Slagboom, P E %A Smith, A V %A Sotoodehnia, N %A Stott, D J %A Stricker, B H %A Stürmer, T %A Trompet, S %A Uitterlinden, A G %A van Duijn, C %A Westendorp, R G J %A Witteman, J C %A Whitsel, E A %A Psaty, B M %K Computer Simulation %K Cross-Sectional Studies %K Drug-Related Side Effects and Adverse Reactions %K Electrocardiography %K European Continental Ancestry Group %K Gene-Environment Interaction %K Genome-Wide Association Study %K Humans %K Linear Models %K Long QT Syndrome %K Markov Chains %K Pharmacogenetics %K Polymorphism, Single Nucleotide %K Quantitative Trait, Heritable %X

Variability in response to drug use is common and heritable, suggesting that genome-wide pharmacogenomics studies may help explain the 'missing heritability' of complex traits. Here, we describe four independent analyses in 33 781 participants of European ancestry from 10 cohorts that were designed to identify genetic variants modifying the effects of drugs on QT interval duration (QT). Each analysis cross-sectionally examined four therapeutic classes: thiazide diuretics (prevalence of use=13.0%), tri/tetracyclic antidepressants (2.6%), sulfonylurea hypoglycemic agents (2.9%) and QT-prolonging drugs as classified by the University of Arizona Center for Education and Research on Therapeutics (4.4%). Drug-gene interactions were estimated using covariable-adjusted linear regression and results were combined with fixed-effects meta-analysis. Although drug-single-nucleotide polymorphism (SNP) interactions were biologically plausible and variables were well-measured, findings from the four cross-sectional meta-analyses were null (Pinteraction>5.0 × 10(-8)). Simulations suggested that additional efforts, including longitudinal modeling to increase statistical power, are likely needed to identify potentially important pharmacogenomic effects.

%B Pharmacogenomics J %V 14 %P 6-13 %8 2014 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/23459443?dopt=Abstract %R 10.1038/tpj.2013.4 %0 Journal Article %J J Aging Res %D 2014 %T Effect of dementia on the use of drugs for secondary prevention of ischemic heart disease. %A Fowler, Nicole R %A Barnato, Amber E %A Degenholtz, Howard B %A Curcio, Angela M %A Becker, James T %A Kuller, Lewis H %A Lopez, Oscar L %X

Background. Dementia and cardiovascular disease (CVD) are frequently comorbid. The presence of dementia may have an effect on how CVD is treated. Objective. To examine the effect of dementia on the use of four medications recommended for secondary prevention of ischemic heart disease (IHD): angiotensin-converting enzyme inhibitors, beta-blockers, lipid-lowering medications, and antiplatelet medications. Design. Retrospective analysis of data from the Cardiovascular Health Study: Cognition Study. Setting and Subjects. 1,087 older adults in four US states who had or developed IHD between 1989 and 1998. Methods. Generalized estimating equations to explore the association between dementia and the use of guideline-recommended medications for the secondary prevention of IHD. Results. The length of follow-up for the cohort was 8.7 years and 265 (24%) had or developed dementia during the study. Use of medications for the secondary prevention of IHD for patients with and without dementia increased during the study period. In models, subjects with dementia were not less likely to use any one particular class of medication but were less likely to use two or more classes of medications as a group (OR, 0.60; 95% CI, 0.36-0.99). Conclusions. Subjects with dementia used fewer guideline-recommended medications for the secondary prevention of IHD than those without dementia.

%B J Aging Res %V 2014 %P 897671 %8 2014 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24719764?dopt=Abstract %R 10.1155/2014/897671 %0 Journal Article %J Am J Hum Genet %D 2014 %T Effects of long-term averaging of quantitative blood pressure traits on the detection of genetic associations. %A Ganesh, Santhi K %A Chasman, Daniel I %A Larson, Martin G %A Guo, Xiuqing %A Verwoert, Germain %A Bis, Joshua C %A Gu, Xiangjun %A Smith, Albert V %A Yang, Min-Lee %A Zhang, Yan %A Ehret, Georg %A Rose, Lynda M %A Hwang, Shih-Jen %A Papanicolau, George J %A Sijbrands, Eric J %A Rice, Kenneth %A Eiriksdottir, Gudny %A Pihur, Vasyl %A Ridker, Paul M %A Vasan, Ramachandran S %A Newton-Cheh, Christopher %A Raffel, Leslie J %A Amin, Najaf %A Rotter, Jerome I %A Liu, Kiang %A Launer, Lenore J %A Xu, Ming %A Caulfield, Mark %A Morrison, Alanna C %A Johnson, Andrew D %A Vaidya, Dhananjay %A Dehghan, Abbas %A Li, Guo %A Bouchard, Claude %A Harris, Tamara B %A Zhang, He %A Boerwinkle, Eric %A Siscovick, David S %A Gao, Wei %A Uitterlinden, André G %A Rivadeneira, Fernando %A Hofman, Albert %A Willer, Cristen J %A Franco, Oscar H %A Huo, Yong %A Witteman, Jacqueline C M %A Munroe, Patricia B %A Gudnason, Vilmundur %A Palmas, Walter %A van Duijn, Cornelia %A Fornage, Myriam %A Levy, Daniel %A Psaty, Bruce M %A Chakravarti, Aravinda %K Blood Pressure %K Genome-Wide Association Study %K Humans %K Longitudinal Studies %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

Blood pressure (BP) is a heritable, quantitative trait with intraindividual variability and susceptibility to measurement error. Genetic studies of BP generally use single-visit measurements and thus cannot remove variability occurring over months or years. We leveraged the idea that averaging BP measured across time would improve phenotypic accuracy and thereby increase statistical power to detect genetic associations. We studied systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) averaged over multiple years in 46,629 individuals of European ancestry. We identified 39 trait-variant associations across 19 independent loci (p < 5 × 10(-8)); five associations (in four loci) uniquely identified by our LTA analyses included those of SBP and MAP at 2p23 (rs1275988, near KCNK3), DBP at 2q11.2 (rs7599598, in FER1L5), and PP at 6p21 (rs10948071, near CRIP3) and 7p13 (rs2949837, near IGFBP3). Replication analyses conducted in cohorts with single-visit BP data showed positive replication of associations and a nominal association (p < 0.05). We estimated a 20% gain in statistical power with long-term average (LTA) as compared to single-visit BP association studies. Using LTA analysis, we identified genetic loci influencing BP. LTA might be one way of increasing the power of genetic associations for continuous traits in extant samples for other phenotypes that are measured serially over time.

%B Am J Hum Genet %V 95 %P 49-65 %8 2014 Jul 03 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24975945?dopt=Abstract %R 10.1016/j.ajhg.2014.06.002 %0 Journal Article %J Pharmacoepidemiol Drug Saf %D 2014 %T Enhancing case ascertainment of Parkinson's disease using Medicare claims data in a population-based cohort: the Cardiovascular Health Study. %A Ton, Thanh G N %A Biggs, Mary Lou %A Comer, Diane %A Curtis, Lesley %A Hu, Shu-Ching %A Thacker, Evan L %A Searles Nielsen, Susan %A Delaney, Joseph A %A Landsittel, Douglas %A Longstreth, William T %A Checkoway, Harvey %A Jain, Samay %K Aged %K Aged, 80 and over %K Algorithms %K Antiparkinson Agents %K Cohort Studies %K Databases, Factual %K Female %K Hospitalization %K Humans %K Incidence %K Logistic Models %K Male %K Medicare %K Parkinson Disease %K Prevalence %K Prospective Studies %K Smoking %K Time Factors %K United States %X

PURPOSE: We sought to improve a previous algorithm to ascertain Parkinson's disease (PD) in the Cardiovascular Health Study by incorporating additional data from Medicare outpatient claims. We compared our results to the previous algorithm in terms of baseline prevalence and incidence of PD, as well as associations with baseline smoking characteristics.

METHODS: Our original case ascertainment used self-reported diagnosis, antiparkinsonian medication, and hospitalization discharge International Classification of Diseases-Ninth version code. In this study, we incorporated additional data from fee-for-service Medicare claims, extended follow-up time, review of hospitalization records, and adjudicated cause of death. Two movement disorders specialists adjudicated final PD status. We used logistic regression models and controlled for age, sex, African American race, and education.

RESULTS: We identified 75 additional cases but reclassified 80 previously identified cases as not having PD. We observed significant inverse association with smoking status (odds ratio = 0.42; 95% confidence interval (CI) = 0.22, 0.79), and inverse linear trends with pack-years (p = 0.005), and cigarettes per day (p = 0.019) with incident PD. All estimates were stronger than those from the previous algorithm.

CONCLUSIONS: Our enhanced method did not alter prevalence and incidence estimates compared with our previous algorithm. However, our enhanced method provided stronger estimates of association, potentially due to reduced level of disease misclassification.

%B Pharmacoepidemiol Drug Saf %V 23 %P 119-27 %8 2014 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24357102?dopt=Abstract %R 10.1002/pds.3552 %0 Journal Article %J Am J Kidney Dis %D 2014 %T Estimated GFR and circulating 24,25-dihydroxyvitamin D3 concentration: a participant-level analysis of 5 cohort studies and clinical trials. %A de Boer, Ian H %A Sachs, Michael C %A Chonchol, Michel %A Himmelfarb, Jonathan %A Hoofnagle, Andrew N %A Ix, Joachim H %A Kremsdorf, Robin A %A Lin, Yvonne S %A Mehrotra, Rajnish %A Robinson-Cohen, Cassianne %A Siscovick, David S %A Steffes, Michael W %A Thummel, Kenneth E %A Tracy, Russell P %A Wang, Zhican %A Kestenbaum, Bryan %K 24,25-Dihydroxyvitamin D 3 %K Adult %K Aged %K Aged, 80 and over %K Biomarkers %K Cohort Studies %K Cross-Sectional Studies %K Diabetes Mellitus %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Observational Studies as Topic %K Randomized Controlled Trials as Topic %K Young Adult %X

BACKGROUND: Decreased glomerular filtration rate (GFR) leads to reduced production of 1,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3 (25[OH]D3). Effects of low GFR on vitamin D catabolism are less well understood. We tested associations of estimated GFR (eGFR) with the circulating concentration of 24,25-dihydroxyvitamin D3 (24,25[OH]2D3), the most abundant product of 25(OH)D3 catabolism, across populations with a wide range of GFRs.

STUDY DESIGN: Cross-sectional study.

SETTING & PARTICIPANTS: 9,596 participants in 5 cohort studies and clinical trials: the Diabetes Control and Complications Trial (N=1,193), Multi-Ethnic Study of Atherosclerosis (N=6,470), Cardiovascular Health Study (N=932), Seattle Kidney Study (N=289), and Hemodialysis Study (N=712).

PREDICTOR: eGFR.

OUTCOME: Circulating 24,25(OH)2D3 concentration.

MEASUREMENTS: GFR was estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration equation. Vitamin D metabolites were measured by mass spectrometry.

RESULTS: Circulating 24,25(OH)2D3 concentration was correlated with circulating 25(OH)D3 concentration (Pearson r range, 0.64-0.88). This correlation was weaker with lower eGFRs. Moreover, the increment in 24,25(OH)2D3 concentration associated with higher 25(OH)D3 concentration (slope) was lower with lower eGFRs: 2.06 (95% CI, 2.01-2.10), 1.77 (95% CI, 1.74-1.81), 1.55 (95% CI, 1.48-1.62), 1.17 (95% CI, 1.05-1.29), 0.92 (95% CI, 0.74-1.10), 0.61 (95% CI, 0.22-1.00), and 0.37 (95% CI, 0.35-0.39) ng/mL of 24,25(OH)2D3 per 10 ng/mL of 25(OH)D3 for eGFRs≥90, 60-89, 45-59, 30-44, 15-29, and <15 mL/min/1.73 m2 and end-stage renal disease treated with hemodialysis, respectively. As a result, at a 25(OH)D3 concentration of 20 ng/mL, mean 24,25(OH)2D3 concentrations were 2.92 (95% CI, 2.87-2.96), 2.68 (95% CI, 2.64-2.72), 2.35 (95% CI, 2.26-2.45), 1.92 (95% CI, 1.74-2.10), 1.69 (95% CI, 1.43-1.95), 1.14 (95% CI, 0.62-1.66), and 1.04 (95% CI,1.02-1.07) ng/mL for each category, respectively. This interaction was independent of other relevant clinical characteristics. Race, diabetes, urine albumin excretion, and circulating parathyroid hormone and fibroblast growth factor 23 concentrations more modestly modified the association of 24,25(OH)2D3 with 25(OH)D3.

LIMITATIONS: Lack of direct pharmacokinetic measurements of vitamin D catabolism.

CONCLUSIONS: Lower eGFR is associated strongly with reduced vitamin D catabolism, as measured by circulating 24,25(OH)2D3 concentration.

%B Am J Kidney Dis %V 64 %P 187-97 %8 2014 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24703961?dopt=Abstract %R 10.1053/j.ajkd.2014.02.015 %0 Journal Article %J Epidemiology %D 2014 %T Evidence of heterogeneity by race/ethnicity in genetic determinants of QT interval. %A Seyerle, Amanda A %A Young, Alicia M %A Jeff, Janina M %A Melton, Phillip E %A Jorgensen, Neal W %A Lin, Yi %A Carty, Cara L %A Deelman, Ewa %A Heckbert, Susan R %A Hindorff, Lucia A %A Jackson, Rebecca D %A Martin, Lisa W %A Okin, Peter M %A Perez, Marco V %A Psaty, Bruce M %A Soliman, Elsayed Z %A Whitsel, Eric A %A North, Kari E %A Laston, Sandra %A Kooperberg, Charles %A Avery, Christy L %K Aged %K Continental Population Groups %K Electrocardiography %K Female %K Genetic Predisposition to Disease %K Haplotypes %K Humans %K Long QT Syndrome %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Quantitative Trait, Heritable %K Risk Factors %X

BACKGROUND: QT interval (QT) prolongation is an established risk factor for ventricular tachyarrhythmia and sudden cardiac death. Previous genome-wide association studies in populations of the European descent have identified multiple genetic loci that influence QT, but few have examined these loci in ethnically diverse populations.

METHODS: Here, we examine the direction, magnitude, and precision of effect sizes for 21 previously reported SNPs from 12 QT loci, in populations of European (n = 16,398), African (n = 5,437), American Indian (n = 5,032), Hispanic (n = 1,143), and Asian (n = 932) descent as part of the Population Architecture using Genomics and Epidemiology (PAGE) study. Estimates obtained from linear regression models stratified by race/ethnicity were combined using inverse-variance weighted meta-analysis. Heterogeneity was evaluated using Cochran's Q test.

RESULTS: Of 21 SNPs, 7 showed consistent direction of effect across all 5 populations, and an additional 9 had estimated effects that were consistent across 4 populations. Despite consistent direction of effect, 9 of 16 SNPs had evidence (P < 0.05) of heterogeneity by race/ethnicity. For these 9 SNPs, linkage disequilibrium plots often indicated substantial variation in linkage disequilibrium patterns among the various racial/ethnic groups, as well as possible allelic heterogeneity.

CONCLUSIONS: These results emphasize the importance of analyzing racial/ethnic groups separately in genetic studies. Furthermore, they underscore the possible utility of trans-ethnic studies to pinpoint underlying casual variants influencing heritable traits such as QT.

%B Epidemiology %V 25 %P 790-8 %8 2014 Nov %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25166880?dopt=Abstract %R 10.1097/EDE.0000000000000168 %0 Journal Article %J Hum Mol Genet %D 2014 %T FTO genetic variants, dietary intake and body mass index: insights from 177,330 individuals. %A Qi, Qibin %A Kilpeläinen, Tuomas O %A Downer, Mary K %A Tanaka, Toshiko %A Smith, Caren E %A Sluijs, Ivonne %A Sonestedt, Emily %A Chu, Audrey Y %A Renstrom, Frida %A Lin, Xiaochen %A Ängquist, Lars H %A Huang, Jinyan %A Liu, Zhonghua %A Li, Yanping %A Asif Ali, Muhammad %A Xu, Min %A Ahluwalia, Tarunveer Singh %A Boer, Jolanda M A %A Chen, Peng %A Daimon, Makoto %A Eriksson, Johan %A Perola, Markus %A Friedlander, Yechiel %A Gao, Yu-Tang %A Heppe, Denise H M %A Holloway, John W %A Houston, Denise K %A Kanoni, Stavroula %A Kim, Yu-Mi %A Laaksonen, Maarit A %A Jääskeläinen, Tiina %A Lee, Nanette R %A Lehtimäki, Terho %A Lemaitre, Rozenn N %A Lu, Wei %A Luben, Robert N %A Manichaikul, Ani %A Männistö, Satu %A Marques-Vidal, Pedro %A Monda, Keri L %A Ngwa, Julius S %A Perusse, Louis %A van Rooij, Frank J A %A Xiang, Yong-Bing %A Wen, Wanqing %A Wojczynski, Mary K %A Zhu, Jingwen %A Borecki, Ingrid B %A Bouchard, Claude %A Cai, Qiuyin %A Cooper, Cyrus %A Dedoussis, George V %A Deloukas, Panos %A Ferrucci, Luigi %A Forouhi, Nita G %A Hansen, Torben %A Christiansen, Lene %A Hofman, Albert %A Johansson, Ingegerd %A Jørgensen, Torben %A Karasawa, Shigeru %A Khaw, Kay-Tee %A Kim, Mi-Kyung %A Kristiansson, Kati %A Li, Huaixing %A Lin, Xu %A Liu, Yongmei %A Lohman, Kurt K %A Long, Jirong %A Mikkilä, Vera %A Mozaffarian, Dariush %A North, Kari %A Pedersen, Oluf %A Raitakari, Olli %A Rissanen, Harri %A Tuomilehto, Jaakko %A van der Schouw, Yvonne T %A Uitterlinden, André G %A Zillikens, M Carola %A Franco, Oscar H %A Shyong Tai, E %A Ou Shu, Xiao %A Siscovick, David S %A Toft, Ulla %A Verschuren, W M Monique %A Vollenweider, Peter %A Wareham, Nicholas J %A Witteman, Jacqueline C M %A Zheng, Wei %A Ridker, Paul M %A Kang, Jae H %A Liang, Liming %A Jensen, Majken K %A Curhan, Gary C %A Pasquale, Louis R %A Hunter, David J %A Mohlke, Karen L %A Uusitupa, Matti %A Cupples, L Adrienne %A Rankinen, Tuomo %A Orho-Melander, Marju %A Wang, Tao %A Chasman, Daniel I %A Franks, Paul W %A Sørensen, Thorkild I A %A Hu, Frank B %A Loos, Ruth J F %A Nettleton, Jennifer A %A Qi, Lu %K Adult %K African Americans %K Aged %K Alleles %K Asian Continental Ancestry Group %K Body Mass Index %K Dietary Carbohydrates %K Dietary Fats %K Dietary Proteins %K Energy Intake %K European Continental Ancestry Group %K Female %K Gene Frequency %K Humans %K Male %K Middle Aged %K Obesity %K Polymorphism, Single Nucleotide %K Proteins %X

FTO is the strongest known genetic susceptibility locus for obesity. Experimental studies in animals suggest the potential roles of FTO in regulating food intake. The interactive relation among FTO variants, dietary intake and body mass index (BMI) is complex and results from previous often small-scale studies in humans are highly inconsistent. We performed large-scale analyses based on data from 177,330 adults (154 439 Whites, 5776 African Americans and 17 115 Asians) from 40 studies to examine: (i) the association between the FTO-rs9939609 variant (or a proxy single-nucleotide polymorphism) and total energy and macronutrient intake and (ii) the interaction between the FTO variant and dietary intake on BMI. The minor allele (A-allele) of the FTO-rs9939609 variant was associated with higher BMI in Whites (effect per allele = 0.34 [0.31, 0.37] kg/m(2), P = 1.9 × 10(-105)), and all participants (0.30 [0.30, 0.35] kg/m(2), P = 3.6 × 10(-107)). The BMI-increasing allele of the FTO variant showed a significant association with higher dietary protein intake (effect per allele = 0.08 [0.06, 0.10] %, P = 2.4 × 10(-16)), and relative weak associations with lower total energy intake (-6.4 [-10.1, -2.6] kcal/day, P = 0.001) and lower dietary carbohydrate intake (-0.07 [-0.11, -0.02] %, P = 0.004). The associations with protein (P = 7.5 × 10(-9)) and total energy (P = 0.002) were attenuated but remained significant after adjustment for BMI. We did not find significant interactions between the FTO variant and dietary intake of total energy, protein, carbohydrate or fat on BMI. Our findings suggest a positive association between the BMI-increasing allele of FTO variant and higher dietary protein intake and offer insight into potential link between FTO, dietary protein intake and adiposity.

%B Hum Mol Genet %V 23 %P 6961-72 %8 2014 Dec 20 %G eng %N 25 %1 http://www.ncbi.nlm.nih.gov/pubmed/25104851?dopt=Abstract %R 10.1093/hmg/ddu411 %0 Journal Article %J Exp Gerontol %D 2014 %T Gender and telomere length: systematic review and meta-analysis. %A Gardner, Michael %A Bann, David %A Wiley, Laura %A Cooper, Rachel %A Hardy, Rebecca %A Nitsch, Dorothea %A Martin-Ruiz, Carmen %A Shiels, Paul %A Sayer, Avan Aihie %A Barbieri, Michelangela %A Bekaert, Sofie %A Bischoff, Claus %A Brooks-Wilson, Angela %A Chen, Wei %A Cooper, Cyrus %A Christensen, Kaare %A De Meyer, Tim %A Deary, Ian %A Der, Geoff %A Diez Roux, Ana %A Fitzpatrick, Annette %A Hajat, Anjum %A Halaschek-Wiener, Julius %A Harris, Sarah %A Hunt, Steven C %A Jagger, Carol %A Jeon, Hyo-Sung %A Kaplan, Robert %A Kimura, Masayuki %A Lansdorp, Peter %A Li, Changyong %A Maeda, Toyoki %A Mangino, Massimo %A Nawrot, Tim S %A Nilsson, Peter %A Nordfjall, Katarina %A Paolisso, Giuseppe %A Ren, Fu %A Riabowol, Karl %A Robertson, Tony %A Roos, Goran %A Staessen, Jan A %A Spector, Tim %A Tang, Nelson %A Unryn, Brad %A van der Harst, Pim %A Woo, Jean %A Xing, Chao %A Yadegarfar, Mohammad E %A Park, Jae Yong %A Young, Neal %A Kuh, Diana %A von Zglinicki, Thomas %A Ben-Shlomo, Yoav %K Adult %K Aged %K Aged, 80 and over %K Aging %K Female %K Humans %K Male %K Middle Aged %K Sex Factors %K Telomere %X

BACKGROUND: It is widely believed that females have longer telomeres than males, although results from studies have been contradictory.

METHODS: We carried out a systematic review and meta-analyses to test the hypothesis that in humans, females have longer telomeres than males and that this association becomes stronger with increasing age. Searches were conducted in EMBASE and MEDLINE (by November 2009) and additional datasets were obtained from study investigators. Eligible observational studies measured telomeres for both females and males of any age, had a minimum sample size of 100 and included participants not part of a diseased group. We calculated summary estimates using random-effects meta-analyses. Heterogeneity between studies was investigated using sub-group analysis and meta-regression.

RESULTS: Meta-analyses from 36 cohorts (36,230 participants) showed that on average females had longer telomeres than males (standardised difference in telomere length between females and males 0.090, 95% CI 0.015, 0.166; age-adjusted). There was little evidence that these associations varied by age group (p=1.00) or cell type (p=0.29). However, the size of this difference did vary by measurement methods, with only Southern blot but neither real-time PCR nor Flow-FISH showing a significant difference. This difference was not associated with random measurement error.

CONCLUSIONS: Telomere length is longer in females than males, although this difference was not universally found in studies that did not use Southern blot methods. Further research on explanations for the methodological differences is required.

%B Exp Gerontol %V 51 %P 15-27 %8 2014 Mar %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24365661?dopt=Abstract %R 10.1016/j.exger.2013.12.004 %0 Journal Article %J Am J Hum Genet %D 2014 %T Gene-age interactions in blood pressure regulation: a large-scale investigation with the CHARGE, Global BPgen, and ICBP Consortia. %A Simino, Jeannette %A Shi, Gang %A Bis, Joshua C %A Chasman, Daniel I %A Ehret, Georg B %A Gu, Xiangjun %A Guo, Xiuqing %A Hwang, Shih-Jen %A Sijbrands, Eric %A Smith, Albert V %A Verwoert, Germaine C %A Bragg-Gresham, Jennifer L %A Cadby, Gemma %A Chen, Peng %A Cheng, Ching-Yu %A Corre, Tanguy %A de Boer, Rudolf A %A Goel, Anuj %A Johnson, Toby %A Khor, Chiea-Chuen %A Lluís-Ganella, Carla %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Nolte, Ilja M %A Sim, Xueling %A Sõber, Siim %A van der Most, Peter J %A Verweij, Niek %A Zhao, Jing Hua %A Amin, Najaf %A Boerwinkle, Eric %A Bouchard, Claude %A Dehghan, Abbas %A Eiriksdottir, Gudny %A Elosua, Roberto %A Franco, Oscar H %A Gieger, Christian %A Harris, Tamara B %A Hercberg, Serge %A Hofman, Albert %A James, Alan L %A Johnson, Andrew D %A Kähönen, Mika %A Khaw, Kay-Tee %A Kutalik, Zoltán %A Larson, Martin G %A Launer, Lenore J %A Li, Guo %A Liu, Jianjun %A Liu, Kiang %A Morrison, Alanna C %A Navis, Gerjan %A Ong, Rick Twee-Hee %A Papanicolau, George J %A Penninx, Brenda W %A Psaty, Bruce M %A Raffel, Leslie J %A Raitakari, Olli T %A Rice, Kenneth %A Rivadeneira, Fernando %A Rose, Lynda M %A Sanna, Serena %A Scott, Robert A %A Siscovick, David S %A Stolk, Ronald P %A Uitterlinden, André G %A Vaidya, Dhananjay %A van der Klauw, Melanie M %A Vasan, Ramachandran S %A Vithana, Eranga Nishanthie %A Völker, Uwe %A Völzke, Henry %A Watkins, Hugh %A Young, Terri L %A Aung, Tin %A Bochud, Murielle %A Farrall, Martin %A Hartman, Catharina A %A Laan, Maris %A Lakatta, Edward G %A Lehtimäki, Terho %A Loos, Ruth J F %A Lucas, Gavin %A Meneton, Pierre %A Palmer, Lyle J %A Rettig, Rainer %A Snieder, Harold %A Tai, E Shyong %A Teo, Yik-Ying %A van der Harst, Pim %A Wareham, Nicholas J %A Wijmenga, Cisca %A Wong, Tien Yin %A Fornage, Myriam %A Gudnason, Vilmundur %A Levy, Daniel %A Palmas, Walter %A Ridker, Paul M %A Rotter, Jerome I %A van Duijn, Cornelia M %A Witteman, Jacqueline C M %A Chakravarti, Aravinda %A Rao, Dabeeru C %K Adolescent %K Adult %K Age Factors %K Aged %K Blood Pressure %K Cohort Studies %K Humans %K Middle Aged %K Young Adult %X

Although age-dependent effects on blood pressure (BP) have been reported, they have not been systematically investigated in large-scale genome-wide association studies (GWASs). We leveraged the infrastructure of three well-established consortia (CHARGE, GBPgen, and ICBP) and a nonstandard approach (age stratification and metaregression) to conduct a genome-wide search of common variants with age-dependent effects on systolic (SBP), diastolic (DBP), mean arterial (MAP), and pulse (PP) pressure. In a two-staged design using 99,241 individuals of European ancestry, we identified 20 genome-wide significant (p ≤ 5 × 10(-8)) loci by using joint tests of the SNP main effect and SNP-age interaction. Nine of the significant loci demonstrated nominal evidence of age-dependent effects on BP by tests of the interactions alone. Index SNPs in the EHBP1L1 (DBP and MAP), CASZ1 (SBP and MAP), and GOSR2 (PP) loci exhibited the largest age interactions, with opposite directions of effect in the young versus the old. The changes in the genetic effects over time were small but nonnegligible (up to 1.58 mm Hg over 60 years). The EHBP1L1 locus was discovered through gene-age interactions only in whites but had DBP main effects replicated (p = 8.3 × 10(-4)) in 8,682 Asians from Singapore, indicating potential interethnic heterogeneity. A secondary analysis revealed 22 loci with evidence of age-specific effects (e.g., only in 20 to 29-year-olds). Age can be used to select samples with larger genetic effect sizes and more homogenous phenotypes, which may increase statistical power. Age-dependent effects identified through novel statistical approaches can provide insight into the biology and temporal regulation underlying BP associations.

%B Am J Hum Genet %V 95 %P 24-38 %8 2014 Jul 03 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24954895?dopt=Abstract %R 10.1016/j.ajhg.2014.05.010 %0 Journal Article %J Hum Mol Genet %D 2014 %T Gene-centric meta-analyses for central adiposity traits in up to 57 412 individuals of European descent confirm known loci and reveal several novel associations. %A Yoneyama, Sachiko %A Guo, Yiran %A Lanktree, Matthew B %A Barnes, Michael R %A Elbers, Clara C %A Karczewski, Konrad J %A Padmanabhan, Sandosh %A Bauer, Florianne %A Baumert, Jens %A Beitelshees, Amber %A Berenson, Gerald S %A Boer, Jolanda M A %A Burke, Gregory %A Cade, Brian %A Chen, Wei %A Cooper-Dehoff, Rhonda M %A Gaunt, Tom R %A Gieger, Christian %A Gong, Yan %A Gorski, Mathias %A Heard-Costa, Nancy %A Johnson, Toby %A Lamonte, Michael J %A McDonough, Caitrin %A Monda, Keri L %A Onland-Moret, N Charlotte %A Nelson, Christopher P %A O'Connell, Jeffrey R %A Ordovas, Jose %A Peter, Inga %A Peters, Annette %A Shaffer, Jonathan %A Shen, Haiqinq %A Smith, Erin %A Speilotes, Liz %A Thomas, Fridtjof %A Thorand, Barbara %A Monique Verschuren, W M %A Anand, Sonia S %A Dominiczak, Anna %A Davidson, Karina W %A Hegele, Robert A %A Heid, Iris %A Hofker, Marten H %A Huggins, Gordon S %A Illig, Thomas %A Johnson, Julie A %A Kirkland, Susan %A König, Wolfgang %A Langaee, Taimour Y %A McCaffery, Jeanne %A Melander, Olle %A Mitchell, Braxton D %A Munroe, Patricia %A Murray, Sarah S %A Papanicolaou, George %A Redline, Susan %A Reilly, Muredach %A Samani, Nilesh J %A Schork, Nicholas J %A van der Schouw, Yvonne T %A Shimbo, Daichi %A Shuldiner, Alan R %A Tobin, Martin D %A Wijmenga, Cisca %A Yusuf, Salim %A Hakonarson, Hakon %A Lange, Leslie A %A Demerath, Ellen W %A Fox, Caroline S %A North, Kari E %A Reiner, Alex P %A Keating, Brendan %A Taylor, Kira C %K Adiposity %K Adult %K Aged %K Aged, 80 and over %K Body Mass Index %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Waist Circumference %K Waist-Hip Ratio %K Young Adult %X

Waist circumference (WC) and waist-to-hip ratio (WHR) are surrogate measures of central adiposity that are associated with adverse cardiovascular events, type 2 diabetes and cancer independent of body mass index (BMI). WC and WHR are highly heritable with multiple susceptibility loci identified to date. We assessed the association between SNPs and BMI-adjusted WC and WHR and unadjusted WC in up to 57 412 individuals of European descent from 22 cohorts collaborating with the NHLBI's Candidate Gene Association Resource (CARe) project. The study population consisted of women and men aged 20-80 years. Study participants were genotyped using the ITMAT/Broad/CARE array, which includes ∼50 000 cosmopolitan tagged SNPs across ∼2100 cardiovascular-related genes. Each trait was modeled as a function of age, study site and principal components to control for population stratification, and we conducted a fixed-effects meta-analysis. No new loci for WC were observed. For WHR analyses, three novel loci were significantly associated (P < 2.4 × 10(-6)). Previously unreported rs2811337-G near TMCC1 was associated with increased WHR (β ± SE, 0.048 ± 0.008, P = 7.7 × 10(-9)) as was rs7302703-G in HOXC10 (β = 0.044 ± 0.008, P = 2.9 × 10(-7)) and rs936108-C in PEMT (β = 0.035 ± 0.007, P = 1.9 × 10(-6)). Sex-stratified analyses revealed two additional novel signals among females only, rs12076073-A in SHC1 (β = 0.10 ± 0.02, P = 1.9 × 10(-6)) and rs1037575-A in ATBDB4 (β = 0.046 ± 0.01, P = 2.2 × 10(-6)), supporting an already established sexual dimorphism of central adiposity-related genetic variants. Functional analysis using ENCODE and eQTL databases revealed that several of these loci are in regulatory regions or regions with differential expression in adipose tissue.

%B Hum Mol Genet %V 23 %P 2498-510 %8 2014 May 01 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/24345515?dopt=Abstract %R 10.1093/hmg/ddt626 %0 Journal Article %J Nat Genet %D 2014 %T Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization. %A Arking, Dan E %A Pulit, Sara L %A Crotti, Lia %A van der Harst, Pim %A Munroe, Patricia B %A Koopmann, Tamara T %A Sotoodehnia, Nona %A Rossin, Elizabeth J %A Morley, Michael %A Wang, Xinchen %A Johnson, Andrew D %A Lundby, Alicia %A Gudbjartsson, Daniel F %A Noseworthy, Peter A %A Eijgelsheim, Mark %A Bradford, Yuki %A Tarasov, Kirill V %A Dörr, Marcus %A Müller-Nurasyid, Martina %A Lahtinen, Annukka M %A Nolte, Ilja M %A Smith, Albert Vernon %A Bis, Joshua C %A Isaacs, Aaron %A Newhouse, Stephen J %A Evans, Daniel S %A Post, Wendy S %A Waggott, Daryl %A Lyytikäinen, Leo-Pekka %A Hicks, Andrew A %A Eisele, Lewin %A Ellinghaus, David %A Hayward, Caroline %A Navarro, Pau %A Ulivi, Sheila %A Tanaka, Toshiko %A Tester, David J %A Chatel, Stéphanie %A Gustafsson, Stefan %A Kumari, Meena %A Morris, Richard W %A Naluai, Åsa T %A Padmanabhan, Sandosh %A Kluttig, Alexander %A Strohmer, Bernhard %A Panayiotou, Andrie G %A Torres, Maria %A Knoflach, Michael %A Hubacek, Jaroslav A %A Slowikowski, Kamil %A Raychaudhuri, Soumya %A Kumar, Runjun D %A Harris, Tamara B %A Launer, Lenore J %A Shuldiner, Alan R %A Alonso, Alvaro %A Bader, Joel S %A Ehret, Georg %A Huang, Hailiang %A Kao, W H Linda %A Strait, James B %A Macfarlane, Peter W %A Brown, Morris %A Caulfield, Mark J %A Samani, Nilesh J %A Kronenberg, Florian %A Willeit, Johann %A Smith, J Gustav %A Greiser, Karin H %A Meyer Zu Schwabedissen, Henriette %A Werdan, Karl %A Carella, Massimo %A Zelante, Leopoldo %A Heckbert, Susan R %A Psaty, Bruce M %A Rotter, Jerome I %A Kolcic, Ivana %A Polasek, Ozren %A Wright, Alan F %A Griffin, Maura %A Daly, Mark J %A Arnar, David O %A Holm, Hilma %A Thorsteinsdottir, Unnur %A Denny, Joshua C %A Roden, Dan M %A Zuvich, Rebecca L %A Emilsson, Valur %A Plump, Andrew S %A Larson, Martin G %A O'Donnell, Christopher J %A Yin, Xiaoyan %A Bobbo, Marco %A D'Adamo, Adamo P %A Iorio, Annamaria %A Sinagra, Gianfranco %A Carracedo, Angel %A Cummings, Steven R %A Nalls, Michael A %A Jula, Antti %A Kontula, Kimmo K %A Marjamaa, Annukka %A Oikarinen, Lasse %A Perola, Markus %A Porthan, Kimmo %A Erbel, Raimund %A Hoffmann, Per %A Jöckel, Karl-Heinz %A Kälsch, Hagen %A Nöthen, Markus M %A den Hoed, Marcel %A Loos, Ruth J F %A Thelle, Dag S %A Gieger, Christian %A Meitinger, Thomas %A Perz, Siegfried %A Peters, Annette %A Prucha, Hanna %A Sinner, Moritz F %A Waldenberger, Melanie %A de Boer, Rudolf A %A Franke, Lude %A van der Vleuten, Pieter A %A Beckmann, Britt Maria %A Martens, Eimo %A Bardai, Abdennasser %A Hofman, Nynke %A Wilde, Arthur A M %A Behr, Elijah R %A Dalageorgou, Chrysoula %A Giudicessi, John R %A Medeiros-Domingo, Argelia %A Barc, Julien %A Kyndt, Florence %A Probst, Vincent %A Ghidoni, Alice %A Insolia, Roberto %A Hamilton, Robert M %A Scherer, Stephen W %A Brandimarto, Jeffrey %A Margulies, Kenneth %A Moravec, Christine E %A del Greco M, Fabiola %A Fuchsberger, Christian %A O'Connell, Jeffrey R %A Lee, Wai K %A Watt, Graham C M %A Campbell, Harry %A Wild, Sarah H %A El Mokhtari, Nour E %A Frey, Norbert %A Asselbergs, Folkert W %A Mateo Leach, Irene %A Navis, Gerjan %A van den Berg, Maarten P %A van Veldhuisen, Dirk J %A Kellis, Manolis %A Krijthe, Bouwe P %A Franco, Oscar H %A Hofman, Albert %A Kors, Jan A %A Uitterlinden, André G %A Witteman, Jacqueline C M %A Kedenko, Lyudmyla %A Lamina, Claudia %A Oostra, Ben A %A Abecasis, Goncalo R %A Lakatta, Edward G %A Mulas, Antonella %A Orrù, Marco %A Schlessinger, David %A Uda, Manuela %A Markus, Marcello R P %A Völker, Uwe %A Snieder, Harold %A Spector, Timothy D %A Arnlöv, Johan %A Lind, Lars %A Sundström, Johan %A Syvänen, Ann-Christine %A Kivimaki, Mika %A Kähönen, Mika %A Mononen, Nina %A Raitakari, Olli T %A Viikari, Jorma S %A Adamkova, Vera %A Kiechl, Stefan %A Brion, Maria %A Nicolaides, Andrew N %A Paulweber, Bernhard %A Haerting, Johannes %A Dominiczak, Anna F %A Nyberg, Fredrik %A Whincup, Peter H %A Hingorani, Aroon D %A Schott, Jean-Jacques %A Bezzina, Connie R %A Ingelsson, Erik %A Ferrucci, Luigi %A Gasparini, Paolo %A Wilson, James F %A Rudan, Igor %A Franke, Andre %A Mühleisen, Thomas W %A Pramstaller, Peter P %A Lehtimäki, Terho J %A Paterson, Andrew D %A Parsa, Afshin %A Liu, Yongmei %A van Duijn, Cornelia M %A Siscovick, David S %A Gudnason, Vilmundur %A Jamshidi, Yalda %A Salomaa, Veikko %A Felix, Stephan B %A Sanna, Serena %A Ritchie, Marylyn D %A Stricker, Bruno H %A Stefansson, Kari %A Boyer, Laurie A %A Cappola, Thomas P %A Olsen, Jesper V %A Lage, Kasper %A Schwartz, Peter J %A Kääb, Stefan %A Chakravarti, Aravinda %A Ackerman, Michael J %A Pfeufer, Arne %A de Bakker, Paul I W %A Newton-Cheh, Christopher %K Adult %K Aged %K Arrhythmias, Cardiac %K Calcium Signaling %K Death, Sudden, Cardiac %K Electrocardiography %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Heart Ventricles %K Humans %K Long QT Syndrome %K Male %K Middle Aged %K Myocardium %K Polymorphism, Single Nucleotide %X

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.

%B Nat Genet %V 46 %P 826-36 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/24952745?dopt=Abstract %R 10.1038/ng.3014 %0 Journal Article %J BMC Genet %D 2014 %T Genetic diversity is a predictor of mortality in humans. %A Bihlmeyer, Nathan A %A Brody, Jennifer A %A Smith, Albert Vernon %A Lunetta, Kathryn L %A Nalls, Mike %A Smith, Jennifer A %A Tanaka, Toshiko %A Davies, Gail %A Yu, Lei %A Mirza, Saira Saeed %A Teumer, Alexander %A Coresh, Josef %A Pankow, James S %A Franceschini, Nora %A Scaria, Anish %A Oshima, Junko %A Psaty, Bruce M %A Gudnason, Vilmundur %A Eiriksdottir, Gudny %A Harris, Tamara B %A Li, Hanyue %A Karasik, David %A Kiel, Douglas P %A Garcia, Melissa %A Liu, Yongmei %A Faul, Jessica D %A Kardia, Sharon Lr %A Zhao, Wei %A Ferrucci, Luigi %A Allerhand, Michael %A Liewald, David C %A Redmond, Paul %A Starr, John M %A De Jager, Philip L %A Evans, Denis A %A Direk, Nese %A Ikram, Mohammed Arfan %A Uitterlinden, Andre %A Homuth, Georg %A Lorbeer, Roberto %A Grabe, Hans J %A Launer, Lenore %A Murabito, Joanne M %A Singleton, Andrew B %A Weir, David R %A Bandinelli, Stefania %A Deary, Ian J %A Bennett, David A %A Tiemeier, Henning %A Kocher, Thomas %A Lumley, Thomas %A Arking, Dan E %K Genome-Wide Association Study %K Heterozygote %K Humans %K Mortality %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %X

BACKGROUND: It has been well-established, both by population genetics theory and direct observation in many organisms, that increased genetic diversity provides a survival advantage. However, given the limitations of both sample size and genome-wide metrics, this hypothesis has not been comprehensively tested in human populations. Moreover, the presence of numerous segregating small effect alleles that influence traits that directly impact health directly raises the question as to whether global measures of genomic variation are themselves associated with human health and disease.

RESULTS: We performed a meta-analysis of 17 cohorts followed prospectively, with a combined sample size of 46,716 individuals, including a total of 15,234 deaths. We find a significant association between increased heterozygosity and survival (P = 0.03). We estimate that within a single population, every standard deviation of heterozygosity an individual has over the mean decreases that person's risk of death by 1.57%.

CONCLUSIONS: This effect was consistent between European and African ancestry cohorts, men and women, and major causes of death (cancer and cardiovascular disease), demonstrating the broad positive impact of genomic diversity on human survival.

%B BMC Genet %V 15 %P 159 %8 2014 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25543667?dopt=Abstract %R 10.1186/s12863-014-0159-7 %0 Journal Article %J PLoS One %D 2014 %T Gene-wide analysis detects two new susceptibility genes for Alzheimer's disease. %A Escott-Price, Valentina %A Bellenguez, Céline %A Wang, Li-San %A Choi, Seung-Hoan %A Harold, Denise %A Jones, Lesley %A Holmans, Peter %A Gerrish, Amy %A Vedernikov, Alexey %A Richards, Alexander %A DeStefano, Anita L %A Lambert, Jean-Charles %A Ibrahim-Verbaas, Carla A %A Naj, Adam C %A Sims, Rebecca %A Jun, Gyungah %A Bis, Joshua C %A Beecham, Gary W %A Grenier-Boley, Benjamin %A Russo, Giancarlo %A Thornton-Wells, Tricia A %A Denning, Nicola %A Smith, Albert V %A Chouraki, Vincent %A Thomas, Charlene %A Ikram, M Arfan %A Zelenika, Diana %A Vardarajan, Badri N %A Kamatani, Yoichiro %A Lin, Chiao-Feng %A Schmidt, Helena %A Kunkle, Brian %A Dunstan, Melanie L %A Vronskaya, Maria %A Johnson, Andrew D %A Ruiz, Agustin %A Bihoreau, Marie-Thérèse %A Reitz, Christiane %A Pasquier, Florence %A Hollingworth, Paul %A Hanon, Olivier %A Fitzpatrick, Annette L %A Buxbaum, Joseph D %A Campion, Dominique %A Crane, Paul K %A Baldwin, Clinton %A Becker, Tim %A Gudnason, Vilmundur %A Cruchaga, Carlos %A Craig, David %A Amin, Najaf %A Berr, Claudine %A Lopez, Oscar L %A De Jager, Philip L %A Deramecourt, Vincent %A Johnston, Janet A %A Evans, Denis %A Lovestone, Simon %A Letenneur, Luc %A Hernandez, Isabel %A Rubinsztein, David C %A Eiriksdottir, Gudny %A Sleegers, Kristel %A Goate, Alison M %A Fiévet, Nathalie %A Huentelman, Matthew J %A Gill, Michael %A Brown, Kristelle %A Kamboh, M Ilyas %A Keller, Lina %A Barberger-Gateau, Pascale %A McGuinness, Bernadette %A Larson, Eric B %A Myers, Amanda J %A Dufouil, Carole %A Todd, Stephen %A Wallon, David %A Love, Seth %A Rogaeva, Ekaterina %A Gallacher, John %A George-Hyslop, Peter St %A Clarimon, Jordi %A Lleo, Alberto %A Bayer, Anthony %A Tsuang, Debby W %A Yu, Lei %A Tsolaki, Magda %A Bossù, Paola %A Spalletta, Gianfranco %A Proitsi, Petra %A Collinge, John %A Sorbi, Sandro %A Garcia, Florentino Sanchez %A Fox, Nick C %A Hardy, John %A Naranjo, Maria Candida Deniz %A Bosco, Paolo %A Clarke, Robert %A Brayne, Carol %A Galimberti, Daniela %A Scarpini, Elio %A Bonuccelli, Ubaldo %A Mancuso, Michelangelo %A Siciliano, Gabriele %A Moebus, Susanne %A Mecocci, Patrizia %A Zompo, Maria Del %A Maier, Wolfgang %A Hampel, Harald %A Pilotto, Alberto %A Frank-García, Ana %A Panza, Francesco %A Solfrizzi, Vincenzo %A Caffarra, Paolo %A Nacmias, Benedetta %A Perry, William %A Mayhaus, Manuel %A Lannfelt, Lars %A Hakonarson, Hakon %A Pichler, Sabrina %A Carrasquillo, Minerva M %A Ingelsson, Martin %A Beekly, Duane %A Alvarez, Victoria %A Zou, Fanggeng %A Valladares, Otto %A Younkin, Steven G %A Coto, Eliecer %A Hamilton-Nelson, Kara L %A Gu, Wei %A Razquin, Cristina %A Pastor, Pau %A Mateo, Ignacio %A Owen, Michael J %A Faber, Kelley M %A Jonsson, Palmi V %A Combarros, Onofre %A O'Donovan, Michael C %A Cantwell, Laura B %A Soininen, Hilkka %A Blacker, Deborah %A Mead, Simon %A Mosley, Thomas H %A Bennett, David A %A Harris, Tamara B %A Fratiglioni, Laura %A Holmes, Clive %A de Bruijn, Renee F A G %A Passmore, Peter %A Montine, Thomas J %A Bettens, Karolien %A Rotter, Jerome I %A Brice, Alexis %A Morgan, Kevin %A Foroud, Tatiana M %A Kukull, Walter A %A Hannequin, Didier %A Powell, John F %A Nalls, Michael A %A Ritchie, Karen %A Lunetta, Kathryn L %A Kauwe, John S K %A Boerwinkle, Eric %A Riemenschneider, Matthias %A Boada, Merce %A Hiltunen, Mikko %A Martin, Eden R %A Schmidt, Reinhold %A Rujescu, Dan %A Dartigues, Jean-François %A Mayeux, Richard %A Tzourio, Christophe %A Hofman, Albert %A Nöthen, Markus M %A Graff, Caroline %A Psaty, Bruce M %A Haines, Jonathan L %A Lathrop, Mark %A Pericak-Vance, Margaret A %A Launer, Lenore J %A Van Broeckhoven, Christine %A Farrer, Lindsay A %A van Duijn, Cornelia M %A Ramirez, Alfredo %A Seshadri, Sudha %A Schellenberg, Gerard D %A Amouyel, Philippe %A Williams, Julie %K Alzheimer Disease %K Carrier Proteins %K Case-Control Studies %K Genome-Wide Association Study %K Heat-Shock Proteins %K Humans %K Polymorphism, Single Nucleotide %K Receptors, Antigen, B-Cell %X

BACKGROUND: Alzheimer's disease is a common debilitating dementia with known heritability, for which 20 late onset susceptibility loci have been identified, but more remain to be discovered. This study sought to identify new susceptibility genes, using an alternative gene-wide analytical approach which tests for patterns of association within genes, in the powerful genome-wide association dataset of the International Genomics of Alzheimer's Project Consortium, comprising over 7 m genotypes from 25,580 Alzheimer's cases and 48,466 controls.

PRINCIPAL FINDINGS: In addition to earlier reported genes, we detected genome-wide significant loci on chromosomes 8 (TP53INP1, p = 1.4×10-6) and 14 (IGHV1-67 p = 7.9×10-8) which indexed novel susceptibility loci.

SIGNIFICANCE: The additional genes identified in this study, have an array of functions previously implicated in Alzheimer's disease, including aspects of energy metabolism, protein degradation and the immune system and add further weight to these pathways as potential therapeutic targets in Alzheimer's disease.

%B PLoS One %V 9 %P e94661 %8 2014 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/24922517?dopt=Abstract %R 10.1371/journal.pone.0094661 %0 Journal Article %J Nat Genet %D 2014 %T Genome-wide association analysis identifies six new loci associated with forced vital capacity. %A Loth, Daan W %A Soler Artigas, Maria %A Gharib, Sina A %A Wain, Louise V %A Franceschini, Nora %A Koch, Beate %A Pottinger, Tess D %A Smith, Albert Vernon %A Duan, Qing %A Oldmeadow, Chris %A Lee, Mi Kyeong %A Strachan, David P %A James, Alan L %A Huffman, Jennifer E %A Vitart, Veronique %A Ramasamy, Adaikalavan %A Wareham, Nicholas J %A Kaprio, Jaakko %A Wang, Xin-Qun %A Trochet, Holly %A Kähönen, Mika %A Flexeder, Claudia %A Albrecht, Eva %A Lopez, Lorna M %A de Jong, Kim %A Thyagarajan, Bharat %A Alves, Alexessander Couto %A Enroth, Stefan %A Omenaas, Ernst %A Joshi, Peter K %A Fall, Tove %A Viñuela, Ana %A Launer, Lenore J %A Loehr, Laura R %A Fornage, Myriam %A Li, Guo %A Wilk, Jemma B %A Tang, Wenbo %A Manichaikul, Ani %A Lahousse, Lies %A Harris, Tamara B %A North, Kari E %A Rudnicka, Alicja R %A Hui, Jennie %A Gu, Xiangjun %A Lumley, Thomas %A Wright, Alan F %A Hastie, Nicholas D %A Campbell, Susan %A Kumar, Rajesh %A Pin, Isabelle %A Scott, Robert A %A Pietiläinen, Kirsi H %A Surakka, Ida %A Liu, Yongmei %A Holliday, Elizabeth G %A Schulz, Holger %A Heinrich, Joachim %A Davies, Gail %A Vonk, Judith M %A Wojczynski, Mary %A Pouta, Anneli %A Johansson, Asa %A Wild, Sarah H %A Ingelsson, Erik %A Rivadeneira, Fernando %A Völzke, Henry %A Hysi, Pirro G %A Eiriksdottir, Gudny %A Morrison, Alanna C %A Rotter, Jerome I %A Gao, Wei %A Postma, Dirkje S %A White, Wendy B %A Rich, Stephen S %A Hofman, Albert %A Aspelund, Thor %A Couper, David %A Smith, Lewis J %A Psaty, Bruce M %A Lohman, Kurt %A Burchard, Esteban G %A Uitterlinden, André G %A Garcia, Melissa %A Joubert, Bonnie R %A McArdle, Wendy L %A Musk, A Bill %A Hansel, Nadia %A Heckbert, Susan R %A Zgaga, Lina %A van Meurs, Joyce B J %A Navarro, Pau %A Rudan, Igor %A Oh, Yeon-Mok %A Redline, Susan %A Jarvis, Deborah L %A Zhao, Jing Hua %A Rantanen, Taina %A O'Connor, George T %A Ripatti, Samuli %A Scott, Rodney J %A Karrasch, Stefan %A Grallert, Harald %A Gaddis, Nathan C %A Starr, John M %A Wijmenga, Cisca %A Minster, Ryan L %A Lederer, David J %A Pekkanen, Juha %A Gyllensten, Ulf %A Campbell, Harry %A Morris, Andrew P %A Gläser, Sven %A Hammond, Christopher J %A Burkart, Kristin M %A Beilby, John %A Kritchevsky, Stephen B %A Gudnason, Vilmundur %A Hancock, Dana B %A Williams, O Dale %A Polasek, Ozren %A Zemunik, Tatijana %A Kolcic, Ivana %A Petrini, Marcy F %A Wjst, Matthias %A Kim, Woo Jin %A Porteous, David J %A Scotland, Generation %A Smith, Blair H %A Viljanen, Anne %A Heliövaara, Markku %A Attia, John R %A Sayers, Ian %A Hampel, Regina %A Gieger, Christian %A Deary, Ian J %A Boezen, H Marike %A Newman, Anne %A Jarvelin, Marjo-Riitta %A Wilson, James F %A Lind, Lars %A Stricker, Bruno H %A Teumer, Alexander %A Spector, Timothy D %A Melén, Erik %A Peters, Marjolein J %A Lange, Leslie A %A Barr, R Graham %A Bracke, Ken R %A Verhamme, Fien M %A Sung, Joohon %A Hiemstra, Pieter S %A Cassano, Patricia A %A Sood, Akshay %A Hayward, Caroline %A Dupuis, Josée %A Hall, Ian P %A Brusselle, Guy G %A Tobin, Martin D %A London, Stephanie J %K Cohort Studies %K Databases, Genetic %K Follow-Up Studies %K Forced Expiratory Volume %K Genetic Loci %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Lung Diseases %K Meta-Analysis as Topic %K Polymorphism, Single Nucleotide %K Prognosis %K Quantitative Trait Loci %K Respiratory Function Tests %K Spirometry %K Vital Capacity %X

Forced vital capacity (FVC), a spirometric measure of pulmonary function, reflects lung volume and is used to diagnose and monitor lung diseases. We performed genome-wide association study meta-analysis of FVC in 52,253 individuals from 26 studies and followed up the top associations in 32,917 additional individuals of European ancestry. We found six new regions associated at genome-wide significance (P < 5 × 10(-8)) with FVC in or near EFEMP1, BMP6, MIR129-2-HSD17B12, PRDM11, WWOX and KCNJ2. Two loci previously associated with spirometric measures (GSTCD and PTCH1) were related to FVC. Newly implicated regions were followed up in samples from African-American, Korean, Chinese and Hispanic individuals. We detected transcripts for all six newly implicated genes in human lung tissue. The new loci may inform mechanisms involved in lung development and the pathogenesis of restrictive lung disease.

%B Nat Genet %V 46 %P 669-77 %8 2014 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/24929828?dopt=Abstract %R 10.1038/ng.3011 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2014 %T Genome-wide association study for circulating tissue plasminogen activator levels and functional follow-up implicates endothelial STXBP5 and STX2. %A Huang, Jie %A Huffman, Jennifer E %A Yamakuchi, Munekazu %A Yamkauchi, Munekazu %A Trompet, Stella %A Asselbergs, Folkert W %A Sabater-Lleal, Maria %A Trégouët, David-Alexandre %A Chen, Wei-Min %A Smith, Nicholas L %A Kleber, Marcus E %A Shin, So-Youn %A Becker, Diane M %A Tang, Weihong %A Dehghan, Abbas %A Johnson, Andrew D %A Truong, Vinh %A Folkersen, Lasse %A Yang, Qiong %A Oudot-Mellkah, Tiphaine %A Buckley, Brendan M %A Moore, Jason H %A Williams, Frances M K %A Campbell, Harry %A Silbernagel, Günther %A Vitart, Veronique %A Rudan, Igor %A Tofler, Geoffrey H %A Navis, Gerjan J %A DeStefano, Anita %A Wright, Alan F %A Chen, Ming-Huei %A de Craen, Anton J M %A Worrall, Bradford B %A Rudnicka, Alicja R %A Rumley, Ann %A Bookman, Ebony B %A Psaty, Bruce M %A Chen, Fang %A Keene, Keith L %A Franco, Oscar H %A Böhm, Bernhard O %A Uitterlinden, André G %A Carter, Angela M %A Jukema, J Wouter %A Sattar, Naveed %A Bis, Joshua C %A Ikram, Mohammad A %A Sale, Michèle M %A McKnight, Barbara %A Fornage, Myriam %A Ford, Ian %A Taylor, Kent %A Slagboom, P Eline %A McArdle, Wendy L %A Hsu, Fang-Chi %A Franco-Cereceda, Anders %A Goodall, Alison H %A Yanek, Lisa R %A Furie, Karen L %A Cushman, Mary %A Hofman, Albert %A Witteman, Jacqueline C M %A Folsom, Aaron R %A Basu, Saonli %A Matijevic, Nena %A van Gilst, Wiek H %A Wilson, James F %A Westendorp, Rudi G J %A Kathiresan, Sekar %A Reilly, Muredach P %A Tracy, Russell P %A Polasek, Ozren %A Winkelmann, Bernhard R %A Grant, Peter J %A Hillege, Hans L %A Cambien, Francois %A Stott, David J %A Lowe, Gordon D %A Spector, Timothy D %A Meigs, James B %A März, Winfried %A Eriksson, Per %A Becker, Lewis C %A Morange, Pierre-Emmanuel %A Soranzo, Nicole %A Williams, Scott M %A Hayward, Caroline %A van der Harst, Pim %A Hamsten, Anders %A Lowenstein, Charles J %A Strachan, David P %A O'Donnell, Christopher J %K Aged %K Cells, Cultured %K Coronary Artery Disease %K Endothelial Cells %K Europe %K Female %K Gene Expression Regulation %K Gene Silencing %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Nerve Tissue Proteins %K Phenotype %K Polymorphism, Single Nucleotide %K R-SNARE Proteins %K Risk Factors %K Stroke %K Syntaxin 1 %K Tissue Plasminogen Activator %K Transfection %K United States %K Up-Regulation %X

OBJECTIVE: Tissue plasminogen activator (tPA), a serine protease, catalyzes the conversion of plasminogen to plasmin, the major enzyme responsible for endogenous fibrinolysis. In some populations, elevated plasma levels of tPA have been associated with myocardial infarction and other cardiovascular diseases. We conducted a meta-analysis of genome-wide association studies to identify novel correlates of circulating levels of tPA.

APPROACH AND RESULTS: Fourteen cohort studies with tPA measures (N=26 929) contributed to the meta-analysis. Three loci were significantly associated with circulating tPA levels (P<5.0×10(-8)). The first locus is on 6q24.3, with the lead single nucleotide polymorphism (SNP; rs9399599; P=2.9×10(-14)) within STXBP5. The second locus is on 8p11.21. The lead SNP (rs3136739; P=1.3×10(-9)) is intronic to POLB and <200 kb away from the tPA encoding the gene PLAT. We identified a nonsynonymous SNP (rs2020921) in modest linkage disequilibrium with rs3136739 (r(2)=0.50) within exon 5 of PLAT (P=2.0×10(-8)). The third locus is on 12q24.33, with the lead SNP (rs7301826; P=1.0×10(-9)) within intron 7 of STX2. We further found evidence for the association of lead SNPs in STXBP5 and STX2 with expression levels of the respective transcripts. In in vitro cell studies, silencing STXBP5 decreased the release of tPA from vascular endothelial cells, whereas silencing STX2 increased the tPA release. Through an in silico lookup, we found no associations of the 3 lead SNPs with coronary artery disease or stroke.

CONCLUSIONS: We identified 3 loci associated with circulating tPA levels, the PLAT region, STXBP5, and STX2. Our functional studies implicate a novel role for STXBP5 and STX2 in regulating tPA release.

%B Arterioscler Thromb Vasc Biol %V 34 %P 1093-101 %8 2014 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/24578379?dopt=Abstract %R 10.1161/ATVBAHA.113.302088 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Genome-wide association study of L-arginine and dimethylarginines reveals novel metabolic pathway for symmetric dimethylarginine. %A Lüneburg, Nicole %A Lieb, Wolfgang %A Zeller, Tanja %A Chen, Ming-Huei %A Maas, Renke %A Carter, Angela M %A Xanthakis, Vanessa %A Glazer, Nicole L %A Schwedhelm, Edzard %A Seshadri, Sudha %A Ikram, Mohammad Arfan %A Longstreth, William T %A Fornage, Myriam %A König, Inke R %A Loley, Christina %A Ojeda, Francisco M %A Schillert, Arne %A Wang, Thomas J %A Sticht, Heinrich %A Kittel, Anja %A König, Jörg %A Benjamin, Emelia J %A Sullivan, Lisa M %A Bernges, Isabel %A Anderssohn, Maike %A Ziegler, Andreas %A Gieger, Christian %A Illig, Thomas %A Meisinger, Christa %A Wichmann, H-Erich %A Wild, Philipp S %A Schunkert, Heribert %A Psaty, Bruce M %A Wiggins, Kerri L %A Heckbert, Susan R %A Smith, Nicholas %A Lackner, Karl %A Lunetta, Kathryn L %A Blankenberg, Stefan %A Erdmann, Jeanette %A Münzel, Thomas %A Grant, Peter J %A Vasan, Ramachandran S %A Böger, Rainer H %K Adult %K Aged %K Amidohydrolases %K Arginine %K Binding Sites %K Cohort Studies %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K HEK293 Cells %K Humans %K Male %K Mediator Complex %K Middle Aged %K Polymorphism, Single Nucleotide %K Protein Structure, Tertiary %K Risk Factors %K Stroke %K Substrate Specificity %K Transaminases %X

BACKGROUND: Dimethylarginines (DMA) interfere with nitric oxide formation by inhibiting nitric oxide synthase (asymmetrical DMA [ADMA]) and l-arginine uptake into the cell (ADMA and symmetrical DMA [SDMA]). In prospective clinical studies, ADMA has been characterized as a cardiovascular risk marker, whereas SDMA is a novel marker for renal function and associated with all-cause mortality after ischemic stroke. The aim of the current study was to characterize the environmental and genetic contributions to interindividual variability of these biomarkers.

METHODS AND RESULTS: This study comprised a genome-wide association analysis of 3 well-characterized population-based cohorts (Framingham Heart Study [FHS; n=2992], Gutenberg Health Study [GHS; n=4354], and Multinational Monitoring of Trends and Determinants in Cardiovascular Disease Study [MONICA]/Cooperative Health Research in the Augsburg Area, Augsburg, Bavaria, Germany [KORA] F3 [n=581]) and identified replicated loci (DDAH1, MED23, Arg1, and AGXT2) associated with the interindividual variability in ADMA, l-arginine, and SDMA. Experimental in silico and in vitro studies confirmed functional significance of the identified AGXT2 variants. Clinical outcome analysis in 384 patients of the Leeds stroke study demonstrated an association between increased plasma levels of SDMA, AGXT2 variants, and various cardiometabolic risk factors. AGXT2 variants were not associated with poststroke survival in the Leeds study or were they associated with incident stroke in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium.

CONCLUSIONS: These genome-wide association study support the importance of DDAH1 and MED23/Arg1 in regulating ADMA and l-arginine metabolism, respectively, and identify a novel regulatory renal pathway for SDMA by AGXT2. AGXT2 variants might explain part of the pathogenic link between SDMA, renal function, and outcome. An association between AGXT2 variants and stroke is unclear and warrants further investigation.

%B Circ Cardiovasc Genet %V 7 %P 864-72 %8 2014 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25245031?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000264 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Genome-wide association study of plasma N6 polyunsaturated fatty acids within the cohorts for heart and aging research in genomic epidemiology consortium. %A Guan, Weihua %A Steffen, Brian T %A Lemaitre, Rozenn N %A Wu, Jason H Y %A Tanaka, Toshiko %A Manichaikul, Ani %A Foy, Millennia %A Rich, Stephen S %A Wang, Lu %A Nettleton, Jennifer A %A Tang, Weihong %A Gu, Xiangjun %A Bandinelli, Stafania %A King, Irena B %A McKnight, Barbara %A Psaty, Bruce M %A Siscovick, David %A Djoussé, Luc %A Chen, Yii-Der Ida %A Ferrucci, Luigi %A Fornage, Myriam %A Mozafarrian, Dariush %A Tsai, Michael Y %A Steffen, Lyn M %K Adult %K Aged %K Aged, 80 and over %K Aging %K Chromosomes, Human, Pair 10 %K Chromosomes, Human, Pair 16 %K Chromosomes, Human, Pair 6 %K Fatty Acid Desaturases %K Fatty Acids, Omega-6 %K Female %K Genome-Wide Association Study %K Genomics %K Heart Diseases %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Prospective Studies %K Sequence Analysis, DNA %X

BACKGROUND: Omega6 (n6) polyunsaturated fatty acids (PUFAs) and their metabolites are involved in cell signaling, inflammation, clot formation, and other crucial biological processes. Genetic components, such as variants of fatty acid desaturase (FADS) genes, determine the composition of n6 PUFAs.

METHODS AND RESULTS: To elucidate undiscovered biological pathways that may influence n6 PUFA composition, we conducted genome-wide association studies and meta-analyses of associations of common genetic variants with 6 plasma n6 PUFAs in 8631 white adults (55% women) across 5 prospective studies. Plasma phospholipid or total plasma fatty acids were analyzed by similar gas chromatography techniques. The n6 fatty acids linoleic acid (LA), γ-linolenic acid (GLA), dihomo-GLA, arachidonic acid, and adrenic acid were expressed as percentage of total fatty acids. We performed linear regression with robust SEs to test for single-nucleotide polymorphism-fatty acid associations, with pooling using inverse-variance-weighted meta-analysis. Novel regions were identified on chromosome 10 associated with LA (rs10740118; P=8.1×10(-9); near NRBF2), on chromosome 16 with LA, GLA, dihomo-GLA, and arachidonic acid (rs16966952; P=1.2×10(-15), 5.0×10(-11), 7.6×10(-65), and 2.4×10(-10), respectively; NTAN1), and on chromosome 6 with adrenic acid after adjustment for arachidonic acid (rs3134950; P=2.1×10(-10); AGPAT1). We confirmed previous findings of the FADS cluster on chromosome 11 with LA and arachidonic acid, and further observed novel genome-wide significant association of this cluster with GLA, dihomo-GLA, and adrenic acid (P=2.3×10(-72), 2.6×10(-151), and 6.3×10(-140), respectively).

CONCLUSIONS: Our findings suggest that along with the FADS gene cluster, additional genes may influence n6 PUFA composition.

%B Circ Cardiovasc Genet %V 7 %P 321-331 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24823311?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000208 %0 Journal Article %J JAMA %D 2014 %T Glycated hemoglobin measurement and prediction of cardiovascular disease. %A Di Angelantonio, Emanuele %A Gao, Pei %A Khan, Hassan %A Butterworth, Adam S %A Wormser, David %A Kaptoge, Stephen %A Kondapally Seshasai, Sreenivasa Rao %A Thompson, Alex %A Sarwar, Nadeem %A Willeit, Peter %A Ridker, Paul M %A Barr, Elizabeth L M %A Khaw, Kay-Tee %A Psaty, Bruce M %A Brenner, Hermann %A Balkau, Beverley %A Dekker, Jacqueline M %A Lawlor, Debbie A %A Daimon, Makoto %A Willeit, Johann %A Njølstad, Inger %A Nissinen, Aulikki %A Brunner, Eric J %A Kuller, Lewis H %A Price, Jackie F %A Sundström, Johan %A Knuiman, Matthew W %A Feskens, Edith J M %A Verschuren, W M M %A Wald, Nicholas %A Bakker, Stephan J L %A Whincup, Peter H %A Ford, Ian %A Goldbourt, Uri %A Gómez-de-la-Cámara, Agustín %A Gallacher, John %A Simons, Leon A %A Rosengren, Annika %A Sutherland, Susan E %A Björkelund, Cecilia %A Blazer, Dan G %A Wassertheil-Smoller, Sylvia %A Onat, Altan %A Marín Ibañez, Alejandro %A Casiglia, Edoardo %A Jukema, J Wouter %A Simpson, Lara M %A Giampaoli, Simona %A Nordestgaard, Børge G %A Selmer, Randi %A Wennberg, Patrik %A Kauhanen, Jussi %A Salonen, Jukka T %A Dankner, Rachel %A Barrett-Connor, Elizabeth %A Kavousi, Maryam %A Gudnason, Vilmundur %A Evans, Denis %A Wallace, Robert B %A Cushman, Mary %A D'Agostino, Ralph B %A Umans, Jason G %A Kiyohara, Yutaka %A Nakagawa, Hidaeki %A Sato, Shinichi %A Gillum, Richard F %A Folsom, Aaron R %A van der Schouw, Yvonne T %A Moons, Karel G %A Griffin, Simon J %A Sattar, Naveed %A Wareham, Nicholas J %A Selvin, Elizabeth %A Thompson, Simon G %A Danesh, John %K Aged %K C-Reactive Protein %K Cholesterol, HDL %K Coronary Disease %K Diabetes Mellitus %K Female %K Glycated Hemoglobin A %K Humans %K Male %K Middle Aged %K Predictive Value of Tests %K Prospective Studies %K Risk Assessment %K Stroke %X

IMPORTANCE: The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain.

OBJECTIVE: To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk.

DESIGN, SETTING, AND PARTICIPANTS: Analysis of individual-participant data available from 73 prospective studies involving 294,998 participants without a known history of diabetes mellitus or CVD at the baseline assessment.

MAIN OUTCOMES AND MEASURES: Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5% to <7.5%), and high (≥ 7.5%) risk.

RESULTS: During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20,840 incident fatal and nonfatal CVD outcomes (13,237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (-0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for measurement of fasting, random, or postload plasma glucose levels.

CONCLUSIONS AND RELEVANCE: In a study of individuals without known CVD or diabetes, additional assessment of HbA1c values in the context of CVD risk assessment provided little incremental benefit for prediction of CVD risk.

%B JAMA %V 311 %P 1225-33 %8 2014 Mar 26 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24668104?dopt=Abstract %R 10.1001/jama.2014.1873 %0 Journal Article %J Ann Epidemiol %D 2014 %T Height and risk of sudden cardiac death: the Atherosclerosis Risk in Communities and Cardiovascular Health studies. %A Rosenberg, Michael A %A Lopez, Faye L %A Bůzková, Petra %A Adabag, Selcuk %A Chen, Lin Y %A Sotoodehnia, Nona %A Kronmal, Richard A %A Siscovick, David S %A Alonso, Alvaro %A Buxton, Alfred %A Folsom, Aaron R %A Mukamal, Kenneth J %K Adult %K Aged %K Atherosclerosis %K Body Height %K Coronary Disease %K Death, Sudden, Cardiac %K Female %K Humans %K Hypertension %K Incidence %K Male %K Middle Aged %K Population Surveillance %K Prospective Studies %K Risk Factors %X

PURPOSE: Sudden cardiac death (SCD) is an important cause of mortality in the adult population. Height has been associated with cardiac hypertrophy and an increased risk of arrhythmias but also with decreased risk of coronary heart disease, suggesting a complex association with SCD.

METHODS: We examined the association of adult height with the risk of physician-adjudicated SCD in two large population-based cohorts: the Cardiovascular Health Study and the Atherosclerosis Risk in Communities study.

RESULTS: Over an average follow-up time of 11.7 years in Cardiovascular Health Study, there were 199 (3.6%) cases of SCD among 5556 participants. In Atherosclerosis Risk in Communities study, over 12.6 years, there were 227 (1.5%) cases of SCD among 15,633 participants. In both cohorts, there was a trend toward decreased SCD with taller height. In fixed effects meta-analysis, the pooled hazard ratio per 10 cm of height was 0.84; 95% confidence interval, 0.73-0.98; P = .03. The association of increased height with lower risk of SCD was slightly attenuated after inclusion of risk factors associated with height, such as hypertension and left ventricular hypertrophy. The association appeared stronger among men than women in both cohorts.

CONCLUSIONS: In two population-based prospective cohorts of different ages, greater height was associated with lower risk of SCD.

%B Ann Epidemiol %V 24 %P 174-179.e2 %8 2014 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24360853?dopt=Abstract %R 10.1016/j.annepidem.2013.11.008 %0 Journal Article %J PLoS Genet %D 2014 %T Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease. %A Medici, Marco %A Porcu, Eleonora %A Pistis, Giorgio %A Teumer, Alexander %A Brown, Suzanne J %A Jensen, Richard A %A Rawal, Rajesh %A Roef, Greet L %A Plantinga, Theo S %A Vermeulen, Sita H %A Lahti, Jari %A Simmonds, Matthew J %A Husemoen, Lise Lotte N %A Freathy, Rachel M %A Shields, Beverley M %A Pietzner, Diana %A Nagy, Rebecca %A Broer, Linda %A Chaker, Layal %A Korevaar, Tim I M %A Plia, Maria Grazia %A Sala, Cinzia %A Völker, Uwe %A Richards, J Brent %A Sweep, Fred C %A Gieger, Christian %A Corre, Tanguy %A Kajantie, Eero %A Thuesen, Betina %A Taes, Youri E %A Visser, W Edward %A Hattersley, Andrew T %A Kratzsch, Jürgen %A Hamilton, Alexander %A Li, Wei %A Homuth, Georg %A Lobina, Monia %A Mariotti, Stefano %A Soranzo, Nicole %A Cocca, Massimiliano %A Nauck, Matthias %A Spielhagen, Christin %A Ross, Alec %A Arnold, Alice %A van de Bunt, Martijn %A Liyanarachchi, Sandya %A Heier, Margit %A Grabe, Hans Jörgen %A Masciullo, Corrado %A Galesloot, Tessel E %A Lim, Ee M %A Reischl, Eva %A Leedman, Peter J %A Lai, Sandra %A Delitala, Alessandro %A Bremner, Alexandra P %A Philips, David I W %A Beilby, John P %A Mulas, Antonella %A Vocale, Matteo %A Abecasis, Goncalo %A Forsen, Tom %A James, Alan %A Widen, Elisabeth %A Hui, Jennie %A Prokisch, Holger %A Rietzschel, Ernst E %A Palotie, Aarno %A Feddema, Peter %A Fletcher, Stephen J %A Schramm, Katharina %A Rotter, Jerome I %A Kluttig, Alexander %A Radke, Dörte %A Traglia, Michela %A Surdulescu, Gabriela L %A He, Huiling %A Franklyn, Jayne A %A Tiller, Daniel %A Vaidya, Bijay %A De Meyer, Tim %A Jørgensen, Torben %A Eriksson, Johan G %A O'Leary, Peter C %A Wichmann, Eric %A Hermus, Ad R %A Psaty, Bruce M %A Ittermann, Till %A Hofman, Albert %A Bosi, Emanuele %A Schlessinger, David %A Wallaschofski, Henri %A Pirastu, Nicola %A Aulchenko, Yurii S %A de la Chapelle, Albert %A Netea-Maier, Romana T %A Gough, Stephen C L %A Meyer Zu Schwabedissen, Henriette %A Frayling, Timothy M %A Kaufman, Jean-Marc %A Linneberg, Allan %A Räikkönen, Katri %A Smit, Johannes W A %A Kiemeney, Lambertus A %A Rivadeneira, Fernando %A Uitterlinden, André G %A Walsh, John P %A Meisinger, Christa %A den Heijer, Martin %A Visser, Theo J %A Spector, Timothy D %A Wilson, Scott G %A Völzke, Henry %A Cappola, Anne %A Toniolo, Daniela %A Sanna, Serena %A Naitza, Silvia %A Peeters, Robin P %K Autoantibodies %K Genetic Loci %K Genome-Wide Association Study %K Graves Disease %K Hashimoto Disease %K Humans %K Iodide Peroxidase %K Risk Factors %K Thyroiditis, Autoimmune %K Thyrotropin %X

Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the possible causative genes of TPOAbs and AITD remain largely unknown, we performed GWAS meta-analyses in 18,297 individuals for TPOAb-positivity (1769 TPOAb-positives and 16,528 TPOAb-negatives) and in 12,353 individuals for TPOAb serum levels, with replication in 8,990 individuals. Significant associations (P<5×10(-8)) were detected at TPO-rs11675434, ATXN2-rs653178, and BACH2-rs10944479 for TPOAb-positivity, and at TPO-rs11675434, MAGI3-rs1230666, and KALRN-rs2010099 for TPOAb levels. Individual and combined effects (genetic risk scores) of these variants on (subclinical) hypo- and hyperthyroidism, goiter and thyroid cancer were studied. Individuals with a high genetic risk score had, besides an increased risk of TPOAb-positivity (OR: 2.18, 95% CI 1.68-2.81, P = 8.1×10(-8)), a higher risk of increased thyroid-stimulating hormone levels (OR: 1.51, 95% CI 1.26-1.82, P = 2.9×10(-6)), as well as a decreased risk of goiter (OR: 0.77, 95% CI 0.66-0.89, P = 6.5×10(-4)). The MAGI3 and BACH2 variants were associated with an increased risk of hyperthyroidism, which was replicated in an independent cohort of patients with Graves' disease (OR: 1.37, 95% CI 1.22-1.54, P = 1.2×10(-7) and OR: 1.25, 95% CI 1.12-1.39, P = 6.2×10(-5)). The MAGI3 variant was also associated with an increased risk of hypothyroidism (OR: 1.57, 95% CI 1.18-2.10, P = 1.9×10(-3)). This first GWAS meta-analysis for TPOAbs identified five newly associated loci, three of which were also associated with clinical thyroid disease. With these markers we identified a large subgroup in the general population with a substantially increased risk of TPOAbs. The results provide insight into why individuals with thyroid autoimmunity do or do not eventually develop thyroid disease, and these markers may therefore predict which TPOAb-positives are particularly at risk of developing clinical thyroid dysfunction.

%B PLoS Genet %V 10 %P e1004123 %8 2014 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24586183?dopt=Abstract %R 10.1371/journal.pgen.1004123 %0 Journal Article %J Circulation %D 2014 %T Integrating genetic, transcriptional, and functional analyses to identify 5 novel genes for atrial fibrillation. %A Sinner, Moritz F %A Tucker, Nathan R %A Lunetta, Kathryn L %A Ozaki, Kouichi %A Smith, J Gustav %A Trompet, Stella %A Bis, Joshua C %A Lin, Honghuang %A Chung, Mina K %A Nielsen, Jonas B %A Lubitz, Steven A %A Krijthe, Bouwe P %A Magnani, Jared W %A Ye, Jiangchuan %A Gollob, Michael H %A Tsunoda, Tatsuhiko %A Müller-Nurasyid, Martina %A Lichtner, Peter %A Peters, Annette %A Dolmatova, Elena %A Kubo, Michiaki %A Smith, Jonathan D %A Psaty, Bruce M %A Smith, Nicholas L %A Jukema, J Wouter %A Chasman, Daniel I %A Albert, Christine M %A Ebana, Yusuke %A Furukawa, Tetsushi %A Macfarlane, Peter W %A Harris, Tamara B %A Darbar, Dawood %A Dörr, Marcus %A Holst, Anders G %A Svendsen, Jesper H %A Hofman, Albert %A Uitterlinden, André G %A Gudnason, Vilmundur %A Isobe, Mitsuaki %A Malik, Rainer %A Dichgans, Martin %A Rosand, Jonathan %A Van Wagoner, David R %A Benjamin, Emelia J %A Milan, David J %A Melander, Olle %A Heckbert, Susan R %A Ford, Ian %A Liu, Yongmei %A Barnard, John %A Olesen, Morten S %A Stricker, Bruno H C %A Tanaka, Toshihiro %A Kääb, Stefan %A Ellinor, Patrick T %K Aged %K Animals %K Atrial Fibrillation %K Chromosome Mapping %K Connexin 43 %K Europe %K Female %K Gene Knockdown Techniques %K Genetic Loci %K Genetic Predisposition to Disease %K Genotype %K Homeodomain Proteins %K Humans %K Japan %K Male %K Middle Aged %K Muscle Proteins %K Nuclear Proteins %K Quantitative Trait Loci %K Repressor Proteins %K T-Box Domain Proteins %K Transcription Factors %K Ubiquitin-Protein Ligases %K Zebrafish %K Zebrafish Proteins %X

BACKGROUND: Atrial fibrillation (AF) affects >30 million individuals worldwide and is associated with an increased risk of stroke, heart failure, and death. AF is highly heritable, yet the genetic basis for the arrhythmia remains incompletely understood.

METHODS AND RESULTS: To identify new AF-related genes, we used a multifaceted approach, combining large-scale genotyping in 2 ethnically distinct populations, cis-eQTL (expression quantitative trait loci) mapping, and functional validation. Four novel loci were identified in individuals of European descent near the genes NEURL (rs12415501; relative risk [RR]=1.18; 95% confidence interval [CI], 1.13-1.23; P=6.5×10(-16)), GJA1 (rs13216675; RR=1.10; 95% CI, 1.06-1.14; P=2.2×10(-8)), TBX5 (rs10507248; RR=1.12; 95% CI, 1.08-1.16; P=5.7×10(-11)), and CAND2 (rs4642101; RR=1.10; 95% CI, 1.06-1.14; P=9.8×10(-9)). In Japanese, novel loci were identified near NEURL (rs6584555; RR=1.32; 95% CI, 1.26-1.39; P=2.0×10(-25)) and CUX2 (rs6490029; RR=1.12; 95% CI, 1.08-1.16; P=3.9×10(-9)). The top single-nucleotide polymorphisms or their proxies were identified as cis-eQTLs for the genes CAND2 (P=2.6×10(-19)), GJA1 (P=2.66×10(-6)), and TBX5 (P=1.36×10(-5)). Knockdown of the zebrafish orthologs of NEURL and CAND2 resulted in prolongation of the atrial action potential duration (17% and 45%, respectively).

CONCLUSIONS: We have identified 5 novel loci for AF. Our results expand the diversity of genetic pathways implicated in AF and provide novel molecular targets for future biological and pharmacological investigation.

%B Circulation %V 130 %P 1225-35 %8 2014 Oct 7 %G eng %N 15 %1 http://www.ncbi.nlm.nih.gov/pubmed/25124494?dopt=Abstract %R 10.1161/CIRCULATIONAHA.114.009892 %0 Journal Article %J Hum Genet %D 2014 %T Large multiethnic Candidate Gene Study for C-reactive protein levels: identification of a novel association at CD36 in African Americans. %A Ellis, Jaclyn %A Lange, Ethan M %A Li, Jin %A Dupuis, Josée %A Baumert, Jens %A Walston, Jeremy D %A Keating, Brendan J %A Durda, Peter %A Fox, Ervin R %A Palmer, Cameron D %A Meng, Yan A %A Young, Taylor %A Farlow, Deborah N %A Schnabel, Renate B %A Marzi, Carola S %A Larkin, Emma %A Martin, Lisa W %A Bis, Joshua C %A Auer, Paul %A Ramachandran, Vasan S %A Gabriel, Stacey B %A Willis, Monte S %A Pankow, James S %A Papanicolaou, George J %A Rotter, Jerome I %A Ballantyne, Christie M %A Gross, Myron D %A Lettre, Guillaume %A Wilson, James G %A Peters, Ulrike %A Koenig, Wolfgang %A Tracy, Russell P %A Redline, Susan %A Reiner, Alex P %A Benjamin, Emelia J %A Lange, Leslie A %K Adult %K African Americans %K Aged %K Biomarkers %K C-Reactive Protein %K Cardiovascular Diseases %K CD36 Antigens %K Female %K Genetic Loci %K Genetic Predisposition to Disease %K Genetics, Population %K Genome-Wide Association Study %K Humans %K Meta-Analysis as Topic %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %X

C-reactive protein (CRP) is a heritable biomarker of systemic inflammation and a predictor of cardiovascular disease (CVD). Large-scale genetic association studies for CRP have largely focused on individuals of European descent. We sought to uncover novel genetic variants for CRP in a multiethnic sample using the ITMAT Broad-CARe (IBC) array, a custom 50,000 SNP gene-centric array having dense coverage of over 2,000 candidate CVD genes. We performed analyses on 7,570 African Americans (AA) from the Candidate gene Association Resource (CARe) study and race-combined meta-analyses that included 29,939 additional individuals of European descent from CARe, the Women's Health Initiative (WHI) and KORA studies. We observed array-wide significance (p < 2.2 × 10(-6)) for four loci in AA, three of which have been reported previously in individuals of European descent (IL6R, p = 2.0 × 10(-6); CRP, p = 4.2 × 10(-71); APOE, p = 1.6 × 10(-6)). The fourth significant locus, CD36 (p = 1.6 × 10(-6)), was observed at a functional variant (rs3211938) that is extremely rare in individuals of European descent. We replicated the CD36 finding (p = 1.8 × 10(-5)) in an independent sample of 8,041 AA women from WHI; a meta-analysis combining the CARe and WHI AA results at rs3211938 reached genome-wide significance (p = 1.5 × 10(-10)). In the race-combined meta-analyses, 13 loci reached significance, including ten (CRP, TOMM40/APOE/APOC1, HNF1A, LEPR, GCKR, IL6R, IL1RN, NLRP3, HNF4A and BAZ1B/BCL7B) previously associated with CRP, and one (ARNTL) previously reported to be nominally associated with CRP. Two novel loci were also detected (RPS6KB1, p = 2.0 × 10(-6); CD36, p = 1.4 × 10(-6)). These results highlight both shared and unique genetic risk factors for CRP in AA compared to populations of European descent.

%B Hum Genet %V 133 %P 985-95 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/24643644?dopt=Abstract %R 10.1007/s00439-014-1439-z %0 Journal Article %J PLoS One %D 2014 %T Large-scale genome-wide association studies and meta-analyses of longitudinal change in adult lung function. %A Tang, Wenbo %A Kowgier, Matthew %A Loth, Daan W %A Soler Artigas, Maria %A Joubert, Bonnie R %A Hodge, Emily %A Gharib, Sina A %A Smith, Albert V %A Ruczinski, Ingo %A Gudnason, Vilmundur %A Mathias, Rasika A %A Harris, Tamara B %A Hansel, Nadia N %A Launer, Lenore J %A Barnes, Kathleen C %A Hansen, Joyanna G %A Albrecht, Eva %A Aldrich, Melinda C %A Allerhand, Michael %A Barr, R Graham %A Brusselle, Guy G %A Couper, David J %A Curjuric, Ivan %A Davies, Gail %A Deary, Ian J %A Dupuis, Josée %A Fall, Tove %A Foy, Millennia %A Franceschini, Nora %A Gao, Wei %A Gläser, Sven %A Gu, Xiangjun %A Hancock, Dana B %A Heinrich, Joachim %A Hofman, Albert %A Imboden, Medea %A Ingelsson, Erik %A James, Alan %A Karrasch, Stefan %A Koch, Beate %A Kritchevsky, Stephen B %A Kumar, Ashish %A Lahousse, Lies %A Li, Guo %A Lind, Lars %A Lindgren, Cecilia %A Liu, Yongmei %A Lohman, Kurt %A Lumley, Thomas %A McArdle, Wendy L %A Meibohm, Bernd %A Morris, Andrew P %A Morrison, Alanna C %A Musk, Bill %A North, Kari E %A Palmer, Lyle J %A Probst-Hensch, Nicole M %A Psaty, Bruce M %A Rivadeneira, Fernando %A Rotter, Jerome I %A Schulz, Holger %A Smith, Lewis J %A Sood, Akshay %A Starr, John M %A Strachan, David P %A Teumer, Alexander %A Uitterlinden, André G %A Völzke, Henry %A Voorman, Arend %A Wain, Louise V %A Wells, Martin T %A Wilk, Jemma B %A Williams, O Dale %A Heckbert, Susan R %A Stricker, Bruno H %A London, Stephanie J %A Fornage, Myriam %A Tobin, Martin D %A O'Connor, George T %A Hall, Ian P %A Cassano, Patricia A %K Adult %K Chromosomes, Human, Pair 11 %K Female %K Gene Expression Regulation %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Longitudinal Studies %K Male %K Respiration %X

BACKGROUND: Genome-wide association studies (GWAS) have identified numerous loci influencing cross-sectional lung function, but less is known about genes influencing longitudinal change in lung function.

METHODS: We performed GWAS of the rate of change in forced expiratory volume in the first second (FEV1) in 14 longitudinal, population-based cohort studies comprising 27,249 adults of European ancestry using linear mixed effects model and combined cohort-specific results using fixed effect meta-analysis to identify novel genetic loci associated with longitudinal change in lung function. Gene expression analyses were subsequently performed for identified genetic loci. As a secondary aim, we estimated the mean rate of decline in FEV1 by smoking pattern, irrespective of genotypes, across these 14 studies using meta-analysis.

RESULTS: The overall meta-analysis produced suggestive evidence for association at the novel IL16/STARD5/TMC3 locus on chromosome 15 (P  =  5.71 × 10(-7)). In addition, meta-analysis using the five cohorts with ≥3 FEV1 measurements per participant identified the novel ME3 locus on chromosome 11 (P  =  2.18 × 10(-8)) at genome-wide significance. Neither locus was associated with FEV1 decline in two additional cohort studies. We confirmed gene expression of IL16, STARD5, and ME3 in multiple lung tissues. Publicly available microarray data confirmed differential expression of all three genes in lung samples from COPD patients compared with controls. Irrespective of genotypes, the combined estimate for FEV1 decline was 26.9, 29.2 and 35.7 mL/year in never, former, and persistent smokers, respectively.

CONCLUSIONS: In this large-scale GWAS, we identified two novel genetic loci in association with the rate of change in FEV1 that harbor candidate genes with biologically plausible functional links to lung function.

%B PLoS One %V 9 %P e100776 %8 2014 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/24983941?dopt=Abstract %R 10.1371/journal.pone.0100776 %0 Journal Article %J Nat Genet %D 2014 %T Large-scale meta-analysis of genome-wide association data identifies six new risk loci for Parkinson's disease. %A Nalls, Mike A %A Pankratz, Nathan %A Lill, Christina M %A Do, Chuong B %A Hernandez, Dena G %A Saad, Mohamad %A DeStefano, Anita L %A Kara, Eleanna %A Bras, Jose %A Sharma, Manu %A Schulte, Claudia %A Keller, Margaux F %A Arepalli, Sampath %A Letson, Christopher %A Edsall, Connor %A Stefansson, Hreinn %A Liu, Xinmin %A Pliner, Hannah %A Lee, Joseph H %A Cheng, Rong %A Ikram, M Arfan %A Ioannidis, John P A %A Hadjigeorgiou, Georgios M %A Bis, Joshua C %A Martinez, Maria %A Perlmutter, Joel S %A Goate, Alison %A Marder, Karen %A Fiske, Brian %A Sutherland, Margaret %A Xiromerisiou, Georgia %A Myers, Richard H %A Clark, Lorraine N %A Stefansson, Kari %A Hardy, John A %A Heutink, Peter %A Chen, Honglei %A Wood, Nicholas W %A Houlden, Henry %A Payami, Haydeh %A Brice, Alexis %A Scott, William K %A Gasser, Thomas %A Bertram, Lars %A Eriksson, Nicholas %A Foroud, Tatiana %A Singleton, Andrew B %K Case-Control Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Parkinson Disease %K Polymorphism, Single Nucleotide %K Risk Factors %X

We conducted a meta-analysis of Parkinson's disease genome-wide association studies using a common set of 7,893,274 variants across 13,708 cases and 95,282 controls. Twenty-six loci were identified as having genome-wide significant association; these and 6 additional previously reported loci were then tested in an independent set of 5,353 cases and 5,551 controls. Of the 32 tested SNPs, 24 replicated, including 6 newly identified loci. Conditional analyses within loci showed that four loci, including GBA, GAK-DGKQ, SNCA and the HLA region, contain a secondary independent risk variant. In total, we identified and replicated 28 independent risk variants for Parkinson's disease across 24 loci. Although the effect of each individual locus was small, risk profile analysis showed substantial cumulative risk in a comparison of the highest and lowest quintiles of genetic risk (odds ratio (OR) = 3.31, 95% confidence interval (CI) = 2.55-4.30; P = 2 × 10(-16)). We also show six risk loci associated with proximal gene expression or DNA methylation.

%B Nat Genet %V 46 %P 989-93 %8 2014 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/25064009?dopt=Abstract %R 10.1038/ng.3043 %0 Journal Article %J N Engl J Med %D 2014 %T Loss-of-function mutations in APOC3, triglycerides, and coronary disease. %A Crosby, Jacy %A Peloso, Gina M %A Auer, Paul L %A Crosslin, David R %A Stitziel, Nathan O %A Lange, Leslie A %A Lu, Yingchang %A Tang, Zheng-Zheng %A Zhang, He %A Hindy, George %A Masca, Nicholas %A Stirrups, Kathleen %A Kanoni, Stavroula %A Do, Ron %A Jun, Goo %A Hu, Youna %A Kang, Hyun Min %A Xue, Chenyi %A Goel, Anuj %A Farrall, Martin %A Duga, Stefano %A Merlini, Pier Angelica %A Asselta, Rosanna %A Girelli, Domenico %A Olivieri, Oliviero %A Martinelli, Nicola %A Yin, Wu %A Reilly, Dermot %A Speliotes, Elizabeth %A Fox, Caroline S %A Hveem, Kristian %A Holmen, Oddgeir L %A Nikpay, Majid %A Farlow, Deborah N %A Assimes, Themistocles L %A Franceschini, Nora %A Robinson, Jennifer %A North, Kari E %A Martin, Lisa W %A DePristo, Mark %A Gupta, Namrata %A Escher, Stefan A %A Jansson, Jan-Håkan %A Van Zuydam, Natalie %A Palmer, Colin N A %A Wareham, Nicholas %A Koch, Werner %A Meitinger, Thomas %A Peters, Annette %A Lieb, Wolfgang %A Erbel, Raimund %A König, Inke R %A Kruppa, Jochen %A Degenhardt, Franziska %A Gottesman, Omri %A Bottinger, Erwin P %A O'Donnell, Christopher J %A Psaty, Bruce M %A Ballantyne, Christie M %A Abecasis, Goncalo %A Ordovas, Jose M %A Melander, Olle %A Watkins, Hugh %A Orho-Melander, Marju %A Ardissino, Diego %A Loos, Ruth J F %A McPherson, Ruth %A Willer, Cristen J %A Erdmann, Jeanette %A Hall, Alistair S %A Samani, Nilesh J %A Deloukas, Panos %A Schunkert, Heribert %A Wilson, James G %A Kooperberg, Charles %A Rich, Stephen S %A Tracy, Russell P %A Lin, Dan-Yu %A Altshuler, David %A Gabriel, Stacey %A Nickerson, Deborah A %A Jarvik, Gail P %A Cupples, L Adrienne %A Reiner, Alex P %A Boerwinkle, Eric %A Kathiresan, Sekar %K African Continental Ancestry Group %K Apolipoprotein C-III %K Coronary Disease %K European Continental Ancestry Group %K Exome %K Genotype %K Heterozygote %K Humans %K Liver %K Mutation %K Risk Factors %K Sequence Analysis, DNA %K Triglycerides %X

BACKGROUND: Plasma triglyceride levels are heritable and are correlated with the risk of coronary heart disease. Sequencing of the protein-coding regions of the human genome (the exome) has the potential to identify rare mutations that have a large effect on phenotype.

METHODS: We sequenced the protein-coding regions of 18,666 genes in each of 3734 participants of European or African ancestry in the Exome Sequencing Project. We conducted tests to determine whether rare mutations in coding sequence, individually or in aggregate within a gene, were associated with plasma triglyceride levels. For mutations associated with triglyceride levels, we subsequently evaluated their association with the risk of coronary heart disease in 110,970 persons.

RESULTS: An aggregate of rare mutations in the gene encoding apolipoprotein C3 (APOC3) was associated with lower plasma triglyceride levels. Among the four mutations that drove this result, three were loss-of-function mutations: a nonsense mutation (R19X) and two splice-site mutations (IVS2+1G→A and IVS3+1G→T). The fourth was a missense mutation (A43T). Approximately 1 in 150 persons in the study was a heterozygous carrier of at least one of these four mutations. Triglyceride levels in the carriers were 39% lower than levels in noncarriers (P<1×10(-20)), and circulating levels of APOC3 in carriers were 46% lower than levels in noncarriers (P=8×10(-10)). The risk of coronary heart disease among 498 carriers of any rare APOC3 mutation was 40% lower than the risk among 110,472 noncarriers (odds ratio, 0.60; 95% confidence interval, 0.47 to 0.75; P=4×10(-6)).

CONCLUSIONS: Rare mutations that disrupt APOC3 function were associated with lower levels of plasma triglycerides and APOC3. Carriers of these mutations were found to have a reduced risk of coronary heart disease. (Funded by the National Heart, Lung, and Blood Institute and others.).

%B N Engl J Med %V 371 %P 22-31 %8 2014 Jul 3 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24941081?dopt=Abstract %R 10.1056/NEJMoa1307095 %0 Journal Article %J J Am Heart Assoc %D 2014 %T A low-frequency variant in MAPK14 provides mechanistic evidence of a link with myeloperoxidase: a prognostic cardiovascular risk marker. %A Waterworth, Dawn M %A Li, Li %A Scott, Robert %A Warren, Liling %A Gillson, Christopher %A Aponte, Jennifer %A Sarov-Blat, Lea %A Sprecher, Dennis %A Dupuis, Josée %A Reiner, Alex %A Psaty, Bruce M %A Tracy, Russell P %A Lin, Honghuang %A McPherson, Ruth %A Chissoe, Stephanie %A Wareham, Nick %A Ehm, Margaret G %K Adult %K Aged %K Cardiovascular Diseases %K Dyslipidemias %K Exome %K Female %K Genotype %K Humans %K Linear Models %K Logistic Models %K Male %K Metabolic Syndrome X %K Middle Aged %K Mitogen-Activated Protein Kinase 11 %K Mitogen-Activated Protein Kinase 14 %K Obesity %K Peroxidase %K Polymorphism, Single Nucleotide %K Prognosis %K Risk Factors %K Sequence Analysis, DNA %X

BACKGROUND: Genetics can be used to predict drug effects and generate hypotheses around alternative indications. To support Losmapimod, a p38 mitogen-activated protein kinase inhibitor in development for acute coronary syndrome, we characterized gene variation in MAPK11/14 genes by exome sequencing and follow-up genotyping or imputation in participants well-phenotyped for cardiovascular and metabolic traits.

METHODS AND RESULTS: Investigation of genetic variation in MAPK11 and MAPK14 genes using additive genetic models in linear or logistic regression with cardiovascular, metabolic, and biomarker phenotypes highlighted an association of RS2859144 in MAPK14 with myeloperoxidase in a dyslipidemic population (Genetic Epidemiology of Metabolic Syndrome Study), P=2.3×10(-6)). This variant (or proxy) was consistently associated with myeloperoxidase in the Framingham Heart Study and Cardiovascular Health Study studies (replication meta-P=0.003), leading to a meta-P value of 9.96×10(-7) in the 3 dyslipidemic groups. The variant or its proxy was then profiled in additional population-based cohorts (up to a total of 58 930 subjects) including Cohorte Lausannoise, Ely, Fenland, European Prospective Investigation of Cancer, London Life Sciences Prospective Population Study, and the Genetics of Obesity Associations study obesity case-control for up to 40 cardiovascular and metabolic traits. Overall analysis identified the same single nucleotide polymorphisms to be nominally associated consistently with glomerular filtration rate (P=0.002) and risk of obesity (body mass index ≥30 kg/m(2), P=0.004).

CONCLUSIONS: As myeloperoxidase is a prognostic marker of coronary events, the MAPK14 variant may provide a mechanistic link between p38 map kinase and these events, providing information consistent with current indication of Losmapimod for acute coronary syndrome. If replicated, the association with glomerular filtration rate, along with previous biological findings, also provides support for kidney diseases as alternative indications.

%B J Am Heart Assoc %V 3 %8 2014 Aug %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25164947?dopt=Abstract %R 10.1161/JAHA.114.001074 %0 Journal Article %J Neurology %D 2014 %T Meta-analysis in more than 17,900 cases of ischemic stroke reveals a novel association at 12q24.12. %A Kilarski, Laura L %A Achterberg, Sefanja %A Devan, William J %A Traylor, Matthew %A Malik, Rainer %A Lindgren, Arne %A Pare, Guillame %A Sharma, Pankaj %A Slowik, Agniesczka %A Thijs, Vincent %A Walters, Matthew %A Worrall, Bradford B %A Sale, Michèle M %A Algra, Ale %A Kappelle, L Jaap %A Wijmenga, Cisca %A Norrving, Bo %A Sandling, Johanna K %A Rönnblom, Lars %A Goris, An %A Franke, Andre %A Sudlow, Cathie %A Rothwell, Peter M %A Levi, Christopher %A Holliday, Elizabeth G %A Fornage, Myriam %A Psaty, Bruce %A Gretarsdottir, Solveig %A Thorsteinsdottir, Unnar %A Seshadri, Sudha %A Mitchell, Braxton D %A Kittner, Steven %A Clarke, Robert %A Hopewell, Jemma C %A Bis, Joshua C %A Boncoraglio, Giorgio B %A Meschia, James %A Ikram, M Arfan %A Hansen, Bjorn M %A Montaner, Joan %A Thorleifsson, Gudmar %A Stefanson, Kari %A Rosand, Jonathan %A de Bakker, Paul I W %A Farrall, Martin %A Dichgans, Martin %A Markus, Hugh S %A Bevan, Steve %K Brain Ischemia %K Cerebral Hemorrhage %K Chromosomes, Human, Pair 12 %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Polymorphism, Single Nucleotide %K Risk %K Stroke %X

OBJECTIVES: To perform a genome-wide association study (GWAS) using the Immunochip array in 3,420 cases of ischemic stroke and 6,821 controls, followed by a meta-analysis with data from more than 14,000 additional ischemic stroke cases.

METHODS: Using the Immunochip, we genotyped 3,420 ischemic stroke cases and 6,821 controls. After imputation we meta-analyzed the results with imputed GWAS data from 3,548 cases and 5,972 controls recruited from the ischemic stroke WTCCC2 study, and with summary statistics from a further 8,480 cases and 56,032 controls in the METASTROKE consortium. A final in silico "look-up" of 2 single nucleotide polymorphisms in 2,522 cases and 1,899 controls was performed. Associations were also examined in 1,088 cases with intracerebral hemorrhage and 1,102 controls.

RESULTS: In an overall analysis of 17,970 cases of ischemic stroke and 70,764 controls, we identified a novel association on chromosome 12q24 (rs10744777, odds ratio [OR] 1.10 [1.07-1.13], p = 7.12 × 10(-11)) with ischemic stroke. The association was with all ischemic stroke rather than an individual stroke subtype, with similar effect sizes seen in different stroke subtypes. There was no association with intracerebral hemorrhage (OR 1.03 [0.90-1.17], p = 0.695).

CONCLUSION: Our results show, for the first time, a genetic risk locus associated with ischemic stroke as a whole, rather than in a subtype-specific manner. This finding was not associated with intracerebral hemorrhage.

%B Neurology %V 83 %P 678-85 %8 2014 Aug 19 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25031287?dopt=Abstract %R 10.1212/WNL.0000000000000707 %0 Journal Article %J PLoS Genet %D 2014 %T Meta-analysis of genome-wide association studies in African Americans provides insights into the genetic architecture of type 2 diabetes. %A Ng, Maggie C Y %A Shriner, Daniel %A Chen, Brian H %A Li, Jiang %A Chen, Wei-Min %A Guo, Xiuqing %A Liu, Jiankang %A Bielinski, Suzette J %A Yanek, Lisa R %A Nalls, Michael A %A Comeau, Mary E %A Rasmussen-Torvik, Laura J %A Jensen, Richard A %A Evans, Daniel S %A Sun, Yan V %A An, Ping %A Patel, Sanjay R %A Lu, Yingchang %A Long, Jirong %A Armstrong, Loren L %A Wagenknecht, Lynne %A Yang, Lingyao %A Snively, Beverly M %A Palmer, Nicholette D %A Mudgal, Poorva %A Langefeld, Carl D %A Keene, Keith L %A Freedman, Barry I %A Mychaleckyj, Josyf C %A Nayak, Uma %A Raffel, Leslie J %A Goodarzi, Mark O %A Chen, Y-D Ida %A Taylor, Herman A %A Correa, Adolfo %A Sims, Mario %A Couper, David %A Pankow, James S %A Boerwinkle, Eric %A Adeyemo, Adebowale %A Doumatey, Ayo %A Chen, Guanjie %A Mathias, Rasika A %A Vaidya, Dhananjay %A Singleton, Andrew B %A Zonderman, Alan B %A Igo, Robert P %A Sedor, John R %A Kabagambe, Edmond K %A Siscovick, David S %A McKnight, Barbara %A Rice, Kenneth %A Liu, Yongmei %A Hsueh, Wen-Chi %A Zhao, Wei %A Bielak, Lawrence F %A Kraja, Aldi %A Province, Michael A %A Bottinger, Erwin P %A Gottesman, Omri %A Cai, Qiuyin %A Zheng, Wei %A Blot, William J %A Lowe, William L %A Pacheco, Jennifer A %A Crawford, Dana C %A Grundberg, Elin %A Rich, Stephen S %A Hayes, M Geoffrey %A Shu, Xiao-Ou %A Loos, Ruth J F %A Borecki, Ingrid B %A Peyser, Patricia A %A Cummings, Steven R %A Psaty, Bruce M %A Fornage, Myriam %A Iyengar, Sudha K %A Evans, Michele K %A Becker, Diane M %A Kao, W H Linda %A Wilson, James G %A Rotter, Jerome I %A Sale, Michèle M %A Liu, Simin %A Rotimi, Charles N %A Bowden, Donald W %K African Americans %K Diabetes Mellitus, Type 2 %K Genome-Wide Association Study %K HLA-B27 Antigen %K HMGA2 Protein %K Humans %K KCNQ1 Potassium Channel %K Mutant Chimeric Proteins %K Polymorphism, Single Nucleotide %K Transcription Factor 7-Like 2 Protein %X

Type 2 diabetes (T2D) is more prevalent in African Americans than in Europeans. However, little is known about the genetic risk in African Americans despite the recent identification of more than 70 T2D loci primarily by genome-wide association studies (GWAS) in individuals of European ancestry. In order to investigate the genetic architecture of T2D in African Americans, the MEta-analysis of type 2 DIabetes in African Americans (MEDIA) Consortium examined 17 GWAS on T2D comprising 8,284 cases and 15,543 controls in African Americans in stage 1 analysis. Single nucleotide polymorphisms (SNPs) association analysis was conducted in each study under the additive model after adjustment for age, sex, study site, and principal components. Meta-analysis of approximately 2.6 million genotyped and imputed SNPs in all studies was conducted using an inverse variance-weighted fixed effect model. Replications were performed to follow up 21 loci in up to 6,061 cases and 5,483 controls in African Americans, and 8,130 cases and 38,987 controls of European ancestry. We identified three known loci (TCF7L2, HMGA2 and KCNQ1) and two novel loci (HLA-B and INS-IGF2) at genome-wide significance (4.15 × 10(-94) %B PLoS Genet %V 10 %P e1004517 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25102180?dopt=Abstract %R 10.1371/journal.pgen.1004517 %0 Journal Article %J Hum Mol Genet %D 2014 %T Meta-analysis of loci associated with age at natural menopause in African-American women. %A Chen, Christina T L %A Liu, Ching-Ti %A Chen, Gary K %A Andrews, Jeanette S %A Arnold, Alice M %A Dreyfus, Jill %A Franceschini, Nora %A Garcia, Melissa E %A Kerr, Kathleen F %A Li, Guo %A Lohman, Kurt K %A Musani, Solomon K %A Nalls, Michael A %A Raffel, Leslie J %A Smith, Jennifer %A Ambrosone, Christine B %A Bandera, Elisa V %A Bernstein, Leslie %A Britton, Angela %A Brzyski, Robert G %A Cappola, Anne %A Carlson, Christopher S %A Couper, David %A Deming, Sandra L %A Goodarzi, Mark O %A Heiss, Gerardo %A John, Esther M %A Lu, Xiaoning %A Le Marchand, Loïc %A Marciante, Kristin %A McKnight, Barbara %A Millikan, Robert %A Nock, Nora L %A Olshan, Andrew F %A Press, Michael F %A Vaiyda, Dhananjay %A Woods, Nancy F %A Taylor, Herman A %A Zhao, Wei %A Zheng, Wei %A Evans, Michele K %A Harris, Tamara B %A Henderson, Brian E %A Kardia, Sharon L R %A Kooperberg, Charles %A Liu, Yongmei %A Mosley, Thomas H %A Psaty, Bruce %A Wellons, Melissa %A Windham, Beverly G %A Zonderman, Alan B %A Cupples, L Adrienne %A Demerath, Ellen W %A Haiman, Christopher %A Murabito, Joanne M %A Rajkovic, Aleksandar %K African Americans %K Age Factors %K Chromosomes, Human %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Menopause %K United States %X

Age at menopause marks the end of a woman's reproductive life and its timing associates with risks for cancer, cardiovascular and bone disorders. GWAS and candidate gene studies conducted in women of European ancestry have identified 27 loci associated with age at menopause. The relevance of these loci to women of African ancestry has not been previously studied. We therefore sought to uncover additional menopause loci and investigate the relevance of European menopause loci by performing a GWAS meta-analysis in 6510 women with African ancestry derived from 11 studies across the USA. We did not identify any additional loci significantly associated with age at menopause in African Americans. We replicated the associations between six loci and age at menopause (P-value < 0.05): AMHR2, RHBLD2, PRIM1, HK3/UMC1, BRSK1/TMEM150B and MCM8. In addition, associations of 14 loci are directionally consistent with previous reports. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in women of African ancestry residing in USA.

%B Hum Mol Genet %V 23 %P 3327-42 %8 2014 Jun 15 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24493794?dopt=Abstract %R 10.1093/hmg/ddu041 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Multiancestral analysis of inflammation-related genetic variants and C-reactive protein in the population architecture using genomics and epidemiology study. %A Kocarnik, Jonathan M %A Pendergrass, Sarah A %A Carty, Cara L %A Pankow, James S %A Schumacher, Fredrick R %A Cheng, Iona %A Durda, Peter %A Ambite, Jose Luis %A Deelman, Ewa %A Cook, Nancy R %A Liu, Simin %A Wactawski-Wende, Jean %A Hutter, Carolyn %A Brown-Gentry, Kristin %A Wilson, Sarah %A Best, Lyle G %A Pankratz, Nathan %A Hong, Ching-Ping %A Cole, Shelley A %A Voruganti, V Saroja %A Bůzková, Petra %A Jorgensen, Neal W %A Jenny, Nancy S %A Wilkens, Lynne R %A Haiman, Christopher A %A Kolonel, Laurence N %A LaCroix, Andrea %A North, Kari %A Jackson, Rebecca %A Le Marchand, Loïc %A Hindorff, Lucia A %A Crawford, Dana C %A Gross, Myron %A Peters, Ulrike %K Adult %K African Continental Ancestry Group %K Aged %K Asian Continental Ancestry Group %K C-Reactive Protein %K Female %K Genetic Variation %K Genome-Wide Association Study %K Hispanic Americans %K Humans %K Indians, North American %K Inflammation %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K United States %K Young Adult %X

BACKGROUND: C-reactive protein (CRP) is a biomarker of inflammation. Genome-wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNPs) associated with CRP concentrations and inflammation-related traits such as cardiovascular disease, type 2 diabetes mellitus, and obesity. We aimed to replicate previous CRP-SNP associations, assess whether these associations generalize to additional race/ethnicity groups, and evaluate inflammation-related SNPs for a potentially pleiotropic association with CRP.

METHODS AND RESULTS: We selected and analyzed 16 CRP-associated and 250 inflammation-related GWAS SNPs among 40 473 African American, American Indian, Asian/Pacific Islander, European American, and Hispanic participants from 7 studies collaborating in the Population Architecture using Genomics and Epidemiology (PAGE) study. Fixed-effect meta-analyses combined study-specific race/ethnicity-stratified linear regression estimates to evaluate the association between each SNP and high-sensitivity CRP. Overall, 18 SNPs in 8 loci were significantly associated with CRP (Bonferroni-corrected P<3.1×10(-3) for replication, P<2.0×10(-4) for pleiotropy): Seven of these were specific to European Americans, while 9 additionally generalized to African Americans (1), Hispanics (5), or both (3); 1 SNP was seen only in African Americans and Hispanics. Two SNPs in the CELSR2/PSRC1/SORT1 locus showed a potentially novel association with CRP: rs599839 (P=2.0×10(-6)) and rs646776 (P=3.1×10(-5)).

CONCLUSIONS: We replicated 16 SNP-CRP associations, 10 of which generalized to African Americans and/or Hispanics. We also identified potentially novel pleiotropic associations with CRP for two SNPs previously associated with coronary artery disease and/or low-density lipoprotein-cholesterol. These findings demonstrate the benefit of evaluating genotype-phenotype associations in multiple race/ethnicity groups and looking for pleiotropic relationships among SNPs previously associated with related phenotypes.

%B Circ Cardiovasc Genet %V 7 %P 178-88 %8 2014 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24622110?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000173 %0 Journal Article %J Stroke %D 2014 %T Multilocus genetic risk score associates with ischemic stroke in case-control and prospective cohort studies. %A Malik, Rainer %A Bevan, Steve %A Nalls, Michael A %A Holliday, Elizabeth G %A Devan, William J %A Cheng, Yu-Ching %A Ibrahim-Verbaas, Carla A %A Verhaaren, Benjamin F J %A Bis, Joshua C %A Joon, Aron Y %A de Stefano, Anita L %A Fornage, Myriam %A Psaty, Bruce M %A Ikram, M Arfan %A Launer, Lenore J %A van Duijn, Cornelia M %A Sharma, Pankaj %A Mitchell, Braxton D %A Rosand, Jonathan %A Meschia, James F %A Levi, Christopher %A Rothwell, Peter M %A Sudlow, Cathie %A Markus, Hugh S %A Seshadri, Sudha %A Dichgans, Martin %K Adult %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Blood Pressure %K Brain Ischemia %K Case-Control Studies %K Cohort Studies %K Coronary Artery Disease %K Female %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Hypertension %K Male %K Middle Aged %K Multilocus Sequence Typing %K Polymorphism, Single Nucleotide %K Population %K Prospective Studies %K Reproducibility of Results %K Risk Assessment %K Risk Factors %K Sex Factors %K Stroke %X

BACKGROUND AND PURPOSE: Genome-wide association studies have revealed multiple common variants associated with known risk factors for ischemic stroke (IS). However, their aggregate effect on risk is uncertain. We aimed to generate a multilocus genetic risk score (GRS) for IS based on genome-wide association studies data from clinical-based samples and to establish its external validity in prospective population-based cohorts.

METHODS: Three thousand five hundred forty-eight clinic-based IS cases and 6399 controls from the Wellcome Trust Case Control Consortium 2 were used for derivation of the GRS. Subjects from the METASTROKE consortium served as a replication sample. The validation sample consisted of 22 751 participants from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium. We selected variants that had reached genome-wide significance in previous association studies on established risk factors for IS.

RESULTS: A combined GRS for atrial fibrillation, coronary artery disease, hypertension, and systolic blood pressure significantly associated with IS both in the case-control samples and in the prospective population-based studies. Subjects in the top quintile of the combined GRS had >2-fold increased risk of IS compared with subjects in the lowest quintile. Addition of the combined GRS to a simple model based on sex significantly improved the prediction of IS in the combined clinic-based samples but not in the population-based studies, and there was no significant improvement in net reclassification.

CONCLUSIONS: A multilocus GRS based on common variants for established cardiovascular risk factors was significantly associated with IS both in clinic-based samples and in the general population. However, the improvement in clinical risk prediction was found to be small.

%B Stroke %V 45 %P 394-402 %8 2014 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24436234?dopt=Abstract %R 10.1161/STROKEAHA.113.002938 %0 Journal Article %J PLoS One %D 2014 %T No evidence for genome-wide interactions on plasma fibrinogen by smoking, alcohol consumption and body mass index: results from meta-analyses of 80,607 subjects. %A Baumert, Jens %A Huang, Jie %A McKnight, Barbara %A Sabater-Lleal, Maria %A Steri, Maristella %A Chu, Audrey Y %A Trompet, Stella %A Lopez, Lorna M %A Fornage, Myriam %A Teumer, Alexander %A Tang, Weihong %A Rudnicka, Alicja R %A Mälarstig, Anders %A Hottenga, Jouke-Jan %A Kavousi, Maryam %A Lahti, Jari %A Tanaka, Toshiko %A Hayward, Caroline %A Huffman, Jennifer E %A Morange, Pierre-Emmanuel %A Rose, Lynda M %A Basu, Saonli %A Rumley, Ann %A Stott, David J %A Buckley, Brendan M %A de Craen, Anton J M %A Sanna, Serena %A Masala, Marco %A Biffar, Reiner %A Homuth, Georg %A Silveira, Angela %A Sennblad, Bengt %A Goel, Anuj %A Watkins, Hugh %A Müller-Nurasyid, Martina %A Rückerl, Regina %A Taylor, Kent %A Chen, Ming-Huei %A de Geus, Eco J C %A Hofman, Albert %A Witteman, Jacqueline C M %A de Maat, Moniek P M %A Palotie, Aarno %A Davies, Gail %A Siscovick, David S %A Kolcic, Ivana %A Wild, Sarah H %A Song, Jaejoon %A McArdle, Wendy L %A Ford, Ian %A Sattar, Naveed %A Schlessinger, David %A Grotevendt, Anne %A Franzosi, Maria Grazia %A Illig, Thomas %A Waldenberger, Melanie %A Lumley, Thomas %A Tofler, Geoffrey H %A Willemsen, Gonneke %A Uitterlinden, André G %A Rivadeneira, Fernando %A Räikkönen, Katri %A Chasman, Daniel I %A Folsom, Aaron R %A Lowe, Gordon D %A Westendorp, Rudi G J %A Slagboom, P Eline %A Cucca, Francesco %A Wallaschofski, Henri %A Strawbridge, Rona J %A Seedorf, Udo %A Koenig, Wolfgang %A Bis, Joshua C %A Mukamal, Kenneth J %A van Dongen, Jenny %A Widen, Elisabeth %A Franco, Oscar H %A Starr, John M %A Liu, Kiang %A Ferrucci, Luigi %A Polasek, Ozren %A Wilson, James F %A Oudot-Mellakh, Tiphaine %A Campbell, Harry %A Navarro, Pau %A Bandinelli, Stefania %A Eriksson, Johan %A Boomsma, Dorret I %A Dehghan, Abbas %A Clarke, Robert %A Hamsten, Anders %A Boerwinkle, Eric %A Jukema, J Wouter %A Naitza, Silvia %A Ridker, Paul M %A Völzke, Henry %A Deary, Ian J %A Reiner, Alexander P %A Trégouët, David-Alexandre %A O'Donnell, Christopher J %A Strachan, David P %A Peters, Annette %A Smith, Nicholas L %K Alcohol Drinking %K Body Mass Index %K Fibrinogen %K Gene-Environment Interaction %K Genomics %K Humans %K Smoking %X

Plasma fibrinogen is an acute phase protein playing an important role in the blood coagulation cascade having strong associations with smoking, alcohol consumption and body mass index (BMI). Genome-wide association studies (GWAS) have identified a variety of gene regions associated with elevated plasma fibrinogen concentrations. However, little is yet known about how associations between environmental factors and fibrinogen might be modified by genetic variation. Therefore, we conducted large-scale meta-analyses of genome-wide interaction studies to identify possible interactions of genetic variants and smoking status, alcohol consumption or BMI on fibrinogen concentration. The present study included 80,607 subjects of European ancestry from 22 studies. Genome-wide interaction analyses were performed separately in each study for about 2.6 million single nucleotide polymorphisms (SNPs) across the 22 autosomal chromosomes. For each SNP and risk factor, we performed a linear regression under an additive genetic model including an interaction term between SNP and risk factor. Interaction estimates were meta-analysed using a fixed-effects model. No genome-wide significant interaction with smoking status, alcohol consumption or BMI was observed in the meta-analyses. The most suggestive interaction was found for smoking and rs10519203, located in the LOC123688 region on chromosome 15, with a p value of 6.2 × 10(-8). This large genome-wide interaction study including 80,607 participants found no strong evidence of interaction between genetic variants and smoking status, alcohol consumption or BMI on fibrinogen concentrations. Further studies are needed to yield deeper insight in the interplay between environmental factors and gene variants on the regulation of fibrinogen concentrations.

%B PLoS One %V 9 %P e111156 %8 2014 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/25551457?dopt=Abstract %R 10.1371/journal.pone.0111156 %0 Journal Article %J Cytokine %D 2014 %T Novel gene variants predict serum levels of the cytokines IL-18 and IL-1ra in older adults. %A Matteini, A M %A Li, J %A Lange, E M %A Tanaka, T %A Lange, L A %A Tracy, R P %A Wang, Y %A Biggs, M L %A Arking, D E %A Fallin, M D %A Chakravarti, A %A Psaty, B M %A Bandinelli, S %A Ferrucci, L %A Reiner, A P %A Walston, J D %K Aged %K Aged, 80 and over %K Calcium-Binding Proteins %K CARD Signaling Adaptor Proteins %K Chromosomes, Human, Pair 2 %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genotype %K Haplotypes %K Humans %K Inflammation %K Interleukin 1 Receptor Antagonist Protein %K Interleukin-18 %K Male %K Polymorphism, Single Nucleotide %X

Activation of inflammatory pathways measured by serum inflammatory markers such as interleukin-18 (IL-18) and interleukin-1 receptor antagonist (IL-1ra) is strongly associated with the progression of chronic disease states in older adults. Given that these serum cytokine levels are in part a heritable trait, genetic variation may predict increased serum levels. Using the Cardiovascular Health Study and InCHIANTI cohorts, a genome-wide association study was performed to identify genetic variants that influence IL-18 and IL-1ra serum levels among older adults. Multiple linear regression models characterized the association between each SNP and log-transformed cytokine values. Tests for multiple independent signals within statistically significant loci were performed using haplotype analysis and regression models conditional on lead SNP in each region. Multiple SNPs were associated with these cytokines with genome-wide significance, including SNPs in the IL-18-BCO gene region of chromosome 2 for IL-18 (top SNP rs2250417, P=1.9×10(-32)) and in the IL-1 gene family region of chromosome 2 for IL-1ra (rs6743376, P=2.3×10(-26)). Haplotype tests and conditional linear regression models showed evidence of multiple independent signals in these regions. Serum IL-18 levels were also associated with a region on chromosome 2 containing the NLRC4 gene (rs12989936, P=2.7×10(-19)). These data characterize multiple robust genetic signals that influence IL-18 and IL-1ra cytokine production. In particular, the signal for serum IL-18 located on chromosome two is novel and potentially important in inflammasome triggered chronic activation of inflammation in older adults. Replication in independent cohorts is an important next step, as well as molecular studies to better understand the role of NLRC4.

%B Cytokine %V 65 %P 10-6 %8 2014 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24182552?dopt=Abstract %R 10.1016/j.cyto.2013.10.002 %0 Journal Article %J J Am Coll Cardiol %D 2014 %T Novel genetic markers associate with atrial fibrillation risk in Europeans and Japanese. %A Lubitz, Steven A %A Lunetta, Kathryn L %A Lin, Honghuang %A Arking, Dan E %A Trompet, Stella %A Li, Guo %A Krijthe, Bouwe P %A Chasman, Daniel I %A Barnard, John %A Kleber, Marcus E %A Dörr, Marcus %A Ozaki, Kouichi %A Smith, Albert V %A Müller-Nurasyid, Martina %A Walter, Stefan %A Agarwal, Sunil K %A Bis, Joshua C %A Brody, Jennifer A %A Chen, Lin Y %A Everett, Brendan M %A Ford, Ian %A Franco, Oscar H %A Harris, Tamara B %A Hofman, Albert %A Kääb, Stefan %A Mahida, Saagar %A Kathiresan, Sekar %A Kubo, Michiaki %A Launer, Lenore J %A Macfarlane, Peter W %A Magnani, Jared W %A McKnight, Barbara %A McManus, David D %A Peters, Annette %A Psaty, Bruce M %A Rose, Lynda M %A Rotter, Jerome I %A Silbernagel, Guenther %A Smith, Jonathan D %A Sotoodehnia, Nona %A Stott, David J %A Taylor, Kent D %A Tomaschitz, Andreas %A Tsunoda, Tatsuhiko %A Uitterlinden, André G %A Van Wagoner, David R %A Völker, Uwe %A Völzke, Henry %A Murabito, Joanne M %A Sinner, Moritz F %A Gudnason, Vilmundur %A Felix, Stephan B %A März, Winfried %A Chung, Mina %A Albert, Christine M %A Stricker, Bruno H %A Tanaka, Toshihiro %A Heckbert, Susan R %A Jukema, J Wouter %A Alonso, Alvaro %A Benjamin, Emelia J %A Ellinor, Patrick T %K Adult %K Aged %K Aged, 80 and over %K Asian Continental Ancestry Group %K Atrial Fibrillation %K Chromosome Mapping %K Chromosomes, Human, Pair 4 %K Europe %K European Continental Ancestry Group %K Female %K Genetic Markers %K Genetic Predisposition to Disease %K Homeodomain Proteins %K Humans %K Japan %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Transcription Factors %X

OBJECTIVES: This study sought to identify nonredundant atrial fibrillation (AF) genetic susceptibility signals and examine their cumulative relations with AF risk.

BACKGROUND: AF-associated loci span broad genomic regions that may contain multiple susceptibility signals. Whether multiple signals exist at AF loci has not been systematically explored.

METHODS: We performed association testing conditioned on the most significant, independently associated genetic markers at 9 established AF loci using 2 complementary techniques in 64,683 individuals of European ancestry (3,869 incident and 3,302 prevalent AF cases). Genetic risk scores were created and tested for association with AF in Europeans and an independent sample of 11,309 individuals of Japanese ancestry (7,916 prevalent AF cases).

RESULTS: We observed at least 4 distinct AF susceptibility signals on chromosome 4q25 upstream of PITX2, but not at the remaining 8 AF loci. A multilocus score comprised 12 genetic markers demonstrated an estimated 5-fold gradient in AF risk. We observed a similar spectrum of risk associated with these markers in Japanese. Regions containing AF signals on chromosome 4q25 displayed a greater degree of evolutionary conservation than the remainder of the locus, suggesting that they may tag regulatory elements.

CONCLUSIONS: The chromosome 4q25 AF locus is architecturally complex and harbors at least 4 AF susceptibility signals in individuals of European ancestry. Similar polygenic AF susceptibility exists between Europeans and Japanese. Future work is necessary to identify causal variants, determine mechanisms by which associated loci predispose to AF, and explore whether AF susceptibility signals classify individuals at risk for AF and related morbidity.

%B J Am Coll Cardiol %V 63 %P 1200-10 %8 2014 Apr 1 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24486271?dopt=Abstract %R 10.1016/j.jacc.2013.12.015 %0 Journal Article %J Nat Commun %D 2014 %T Pharmacogenetic meta-analysis of genome-wide association studies of LDL cholesterol response to statins. %A Postmus, Iris %A Trompet, Stella %A Deshmukh, Harshal A %A Barnes, Michael R %A Li, Xiaohui %A Warren, Helen R %A Chasman, Daniel I %A Zhou, Kaixin %A Arsenault, Benoit J %A Donnelly, Louise A %A Wiggins, Kerri L %A Avery, Christy L %A Griffin, Paula %A Feng, QiPing %A Taylor, Kent D %A Li, Guo %A Evans, Daniel S %A Smith, Albert V %A de Keyser, Catherine E %A Johnson, Andrew D %A de Craen, Anton J M %A Stott, David J %A Buckley, Brendan M %A Ford, Ian %A Westendorp, Rudi G J %A Slagboom, P Eline %A Sattar, Naveed %A Munroe, Patricia B %A Sever, Peter %A Poulter, Neil %A Stanton, Alice %A Shields, Denis C %A O'Brien, Eoin %A Shaw-Hawkins, Sue %A Chen, Y-D Ida %A Nickerson, Deborah A %A Smith, Joshua D %A Dubé, Marie Pierre %A Boekholdt, S Matthijs %A Hovingh, G Kees %A Kastelein, John J P %A McKeigue, Paul M %A Betteridge, John %A Neil, Andrew %A Durrington, Paul N %A Doney, Alex %A Carr, Fiona %A Morris, Andrew %A McCarthy, Mark I %A Groop, Leif %A Ahlqvist, Emma %A Bis, Joshua C %A Rice, Kenneth %A Smith, Nicholas L %A Lumley, Thomas %A Whitsel, Eric A %A Stürmer, Til %A Boerwinkle, Eric %A Ngwa, Julius S %A O'Donnell, Christopher J %A Vasan, Ramachandran S %A Wei, Wei-Qi %A Wilke, Russell A %A Liu, Ching-Ti %A Sun, Fangui %A Guo, Xiuqing %A Heckbert, Susan R %A Post, Wendy %A Sotoodehnia, Nona %A Arnold, Alice M %A Stafford, Jeanette M %A Ding, Jingzhong %A Herrington, David M %A Kritchevsky, Stephen B %A Eiriksdottir, Gudny %A Launer, Leonore J %A Harris, Tamara B %A Chu, Audrey Y %A Giulianini, Franco %A MacFadyen, Jean G %A Barratt, Bryan J %A Nyberg, Fredrik %A Stricker, Bruno H %A Uitterlinden, André G %A Hofman, Albert %A Rivadeneira, Fernando %A Emilsson, Valur %A Franco, Oscar H %A Ridker, Paul M %A Gudnason, Vilmundur %A Liu, Yongmei %A Denny, Joshua C %A Ballantyne, Christie M %A Rotter, Jerome I %A Adrienne Cupples, L %A Psaty, Bruce M %A Palmer, Colin N A %A Tardif, Jean-Claude %A Colhoun, Helen M %A Hitman, Graham %A Krauss, Ronald M %A Wouter Jukema, J %A Caulfield, Mark J %K Cholesterol, LDL %K Genome-Wide Association Study %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Pharmacogenetics %K Polymorphism, Single Nucleotide %X

Statins effectively lower LDL cholesterol levels in large studies and the observed interindividual response variability may be partially explained by genetic variation. Here we perform a pharmacogenetic meta-analysis of genome-wide association studies (GWAS) in studies addressing the LDL cholesterol response to statins, including up to 18,596 statin-treated subjects. We validate the most promising signals in a further 22,318 statin recipients and identify two loci, SORT1/CELSR2/PSRC1 and SLCO1B1, not previously identified in GWAS. Moreover, we confirm the previously described associations with APOE and LPA. Our findings advance the understanding of the pharmacogenetic architecture of statin response.

%B Nat Commun %V 5 %P 5068 %8 2014 Oct 28 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25350695?dopt=Abstract %R 10.1038/ncomms6068 %0 Journal Article %J Neuroscience %D 2014 %T Physical activity, inflammation, and volume of the aging brain. %A Braskie, M N %A Boyle, C P %A Rajagopalan, P %A Gutman, B A %A Toga, A W %A Raji, C A %A Tracy, R P %A Kuller, L H %A Becker, J T %A Lopez, O L %A Thompson, P M %K Aged %K Aged, 80 and over %K Aging %K Alzheimer Disease %K Apolipoproteins E %K Brain %K Female %K Humans %K Inflammation %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Motor Activity %K Neuroimmunomodulation %K Neuropsychological Tests %K Organ Size %K Parietal Lobe %K Surveys and Questionnaires %K Tumor Necrosis Factor-alpha %X

Physical activity influences inflammation, and both affect brain structure and Alzheimer's disease (AD) risk. We hypothesized that older adults with greater reported physical activity intensity and lower serum levels of the inflammatory marker tumor necrosis factor α (TNFα) would have larger regional brain volumes on subsequent magnetic resonance imaging (MRI) scans. In 43 cognitively intact older adults (79.3±4.8 years) and 39 patients with AD (81.9±5.1 years at the time of MRI) participating in the Cardiovascular Health Study, we examined year-1 reported physical activity intensity, year-5 blood serum TNFα measures, and year-9 volumetric brain MRI scans. We examined how prior physical activity intensity and TNFα related to subsequent total and regional brain volumes. Physical activity intensity was measured using the modified Minnesota Leisure Time Physical Activities questionnaire at year 1 of the study, when all subjects included here were cognitively intact. Stability of measures was established for exercise intensity over 9 years and TNFα over 3 years in a subset of subjects who had these measurements at multiple time points. When considered together, more intense physical activity intensity and lower serum TNFα were both associated with greater total brain volume on follow-up MRI scans. TNFα, but not physical activity, was associated with regional volumes of the inferior parietal lobule, a region previously associated with inflammation in AD patients. Physical activity and TNFα may independently influence brain structure in older adults.

%B Neuroscience %V 273 %P 199-209 %8 2014 Jul 25 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24836855?dopt=Abstract %R 10.1016/j.neuroscience.2014.05.005 %0 Journal Article %J Int J Stroke %D 2014 %T Plasma free fatty acids and risk of stroke in the Cardiovascular Health Study. %A Khawaja, Owais %A Maziarz, Marlena %A Biggs, Mary L %A Longstreth, William T %A Ix, Joachim H %A Kizer, Jorge R %A Zieman, Susan %A Tracy, Russell P %A Mozaffarian, Dariush %A Mukamal, Kenneth J %A Siscovick, David S %A Djoussé, Luc %K Aged %K Biomarkers %K Brain Ischemia %K Fatty Acids, Nonesterified %K Female %K Follow-Up Studies %K Humans %K Male %K Prospective Studies %K Risk %K Stroke %X

BACKGROUND: Although free fatty acids have been positively associated with risk factors for stroke, the role of plasma free fatty acids in the development of stroke has not been elucidated in older adults.

AIMS: We sought to examine the association between plasma free fatty acids and incident stroke.

METHODS: Prospective cohort of 4369 men and women≥65 years of age in the Cardiovascular Health Study. Plasma levels of free fatty acids were measured at the 1992-1993 examination and stroke events were adjudicated by a committee of experts including neurologists and neuroradiologists. Cox regression was used to estimate the relative risk of stroke associated with free fatty acids concentrations.

RESULTS: The average age among participants was 75±5·2 years. During a median follow-up of 11·4 years, 732 incident strokes occurred. The crude incidence rates of stroke were 14·5, 14·9, and 17·6 per 1000 person-years across increasing tertiles of plasma free fatty acids. The adjusted hazard ratio (95% confidence interval) for incident stroke was 1·05 (0·97-1·14) per standard deviation increase in plasma free fatty acids. Restriction to ischemic stroke did not alter the results [hazard ratio (95% confidence interval): 1·04 (0·96-1·14) per standard deviation higher free fatty acids], and there was no effect modification by adiposity (P interaction=0·18) or by diabetes (P interaction=0·15).

CONCLUSION: Our data did not show an association of plasma free fatty acids with incident stroke among community dwelling older adults.

%B Int J Stroke %V 9 %P 917-20 %8 2014 Oct %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/24447493?dopt=Abstract %R 10.1111/ijs.12216 %0 Journal Article %J Br J Nutr %D 2014 %T Plasma phospholipid and dietary α-linolenic acid, mortality, CHD and stroke: the Cardiovascular Health Study. %A Fretts, Amanda M %A Mozaffarian, Dariush %A Siscovick, David S %A Sitlani, Colleen %A Psaty, Bruce M %A Rimm, Eric B %A Song, Xiaoling %A McKnight, Barbara %A Spiegelman, Donna %A King, Irena B %A Lemaitre, Rozenn N %K Aged %K alpha-Linolenic Acid %K Cardiovascular Diseases %K Cohort Studies %K Coronary Disease %K Diet %K Female %K Humans %K Male %K Mortality %K Phospholipids %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stroke %K United States %X

Previous studies have suggested that long-chain n-3 fatty acids derived from seafood are associated with a lower risk of mortality, CHD and stroke. Whether α-linolenic acid (ALA, 18 : 3n-3), a plant-derived long-chain essential n-3 fatty acid, is associated with a lower risk of these outcomes is unclear. The aim of the present study was to examine the associations of plasma phospholipid and dietary ALA with the risk of mortality, CHD and stroke among older adults who participated in the Cardiovascular Health Study, a cohort study of adults aged ≥ 65 years. A total of 2709 participants were included in the plasma phospholipid ALA analysis and 2583 participants were included in the dietary ALA analysis. Cox regression was used to assess the associations of plasma phospholipid and dietary ALA with the risk of mortality, incident CHD and stroke. In minimally and multivariable-adjusted models, plasma phospholipid ALA was found to be not associated with the risk of mortality, incident CHD or stroke. After adjustment for age, sex, race, enrolment site, education, smoking status, diabetes, BMI, alcohol consumption, treated hypertension and total energy intake, higher dietary ALA intake was found to be associated with a lower risk of total and non-cardiovascular mortality; on comparing the highest quintiles of dietary ALA with the lowest quintiles, the HR for total mortality and non-cardiovascular mortality were found to be 0·73 (95 % CI 0·61, 0·88) and 0·64 (95 % CI 0·52, 0·80), respectively. Dietary ALA was found to be not associated with the risk of cardiovascular mortality, incident CHD or stroke. In conclusion, the results of the present suggest study that dietary ALA, but not plasma phospholipid ALA, is associated with a lower risk of total and non-cardiovascular mortality in older adults.

%B Br J Nutr %V 112 %P 1206-13 %8 2014 Oct 14 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/25159901?dopt=Abstract %R 10.1017/S0007114514001925 %0 Journal Article %J J Am Heart Assoc %D 2014 %T Plasma phospholipid saturated fatty acids and incident atrial fibrillation: the Cardiovascular Health Study. %A Fretts, Amanda M %A Mozaffarian, Dariush %A Siscovick, David S %A Djoussé, Luc %A Heckbert, Susan R %A King, Irena B %A McKnight, Barbara %A Sitlani, Colleen %A Sacks, Frank M %A Song, Xiaoling %A Sotoodehnia, Nona %A Spiegelman, Donna %A Wallace, Erin R %A Lemaitre, Rozenn N %K Aged %K Aged, 80 and over %K Atrial Fibrillation %K Eicosanoic Acids %K Fatty Acids %K Female %K Humans %K Longitudinal Studies %K Male %K Palmitic Acid %K Phospholipids %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Stearic Acids %K United States %X

BACKGROUND: Prior studies suggest that circulating fatty acids may influence the risk of atrial fibrillation (AF), but little is known about the associations of circulating saturated fatty acids with risk of AF.

METHODS AND RESULTS: The study population included 2899 participants from the Cardiovascular Health Study, a community-based longitudinal cohort of adults aged 65 years or older in the United States who were free of prevalent coronary heart disease and AF in 1992. Cox regression was used to assess the association of all the long-chain saturated fatty acids-palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0)-with incident AF. During a median of 11.2 years of follow-up, 707 cases of incident AF occurred. After adjustment for other AF risk factors, higher levels of circulating 16:0 were associated with a higher risk of AF (hazard ratio comparing highest and lowest quartiles: 1.48; 95% CI: 1.18, 1.86). In contrast, higher levels of circulating 18:0, 20:0, 22:0, and 24:0 were each associated with a lower risk of AF. The hazard ratios (95% CI) for AF in the top and bottom quartiles were 0.76 (95% CI: 0.61, 0.95) for 18:0; 0.78 (95% CI: 0.63, 0.97) for 20:0; 0.62 (95% CI: 0.50, 0.78) for 22:0; and 0.68 (95% CI: 0.55, 0.85) for 24:0.

CONCLUSIONS: Results from this prospective cohort study of older adults demonstrate divergent associations of circulating 16:0 versus longer-chain saturated fatty acids with incident AF, highlighting the need to investigate both determinants of these levels and potential pathways of the observed differential risk.

%B J Am Heart Assoc %V 3 %P e000889 %8 2014 Jun 26 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24970268?dopt=Abstract %R 10.1161/JAHA.114.000889 %0 Journal Article %J J Am Heart Assoc %D 2014 %T Plasma phospholipid trans-fatty acids levels, cardiovascular diseases, and total mortality: the cardiovascular health study. %A Wang, Qianyi %A Imamura, Fumiaki %A Lemaitre, Rozenn N %A Rimm, Eric B %A Wang, Molin %A King, Irena B %A Song, Xiaoling %A Siscovick, David %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Biomarkers %K Cardiovascular Diseases %K Cohort Studies %K Dietary Fats %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Mortality %K Phospholipids %K Prognosis %K Proportional Hazards Models %K Prospective Studies %K Trans Fatty Acids %X

BACKGROUND: While self-reported trans-fatty acid (TFA) consumption is linked to coronary heart disease (CHD), relationships between objective biomarkers of TFA subtypes (t-16:1n9, total t-18:1, and cis/trans-(c/t-), t/c- and t/t-18:2) and cardiovascular disease (CVD) or total mortality are not well established.

METHODS AND RESULTS: We evaluated 2742 adults in the Cardiovascular Health Study, aged 74±5 years and free of prevalent CVD, with plasma phospholipid TFA measures in 1992. Incident fatal and nonfatal CHD events, CVD and non-CVD mortality, and total mortality were centrally adjudicated through 2010. Risks were assessed using Cox proportional hazards. During 31 494 person-years, 1735 total deaths and 639 total CHD events occurred. In the multivariate model including mutual adjustment for the 5 TFA subtypes, circulating t/t-18:2 was associated with higher total mortality (extreme quintile hazard ratio (HR)=1.23, 95% CI=1.04 to 1.44, P-trend=0.01), CVD mortality (HR=1.40, 95% CI=1.05 to 1.86, P-trend=0.02), and total CHD (HR=1.39, 95% CI=1.06 to 1.83, P-trend=0.01). t/c-18:2 was positively related to total mortality (HR=1.19, P-trend=0.05), total CHD (HR=1.67, P-trend=0.002), and nonfatal CHD (HR=2.06, P-trend=0.002) after mutual adjustment; these associations were insignificant without mutual adjustment. Neither t-16:1n9 nor t-18:1 was significantly associated with total mortality or CVD, nor was c/t-18:2 if we excluded early cases.

CONCLUSIONS: Among circulating TFAs, t/t-18:2 was most adversely associated with total mortality, mainly due to the increased risk of CVD. t/c-18:2 was also positively associated with total mortality and CHD, but only after adjustment for other TFAs. These results highlight the need for further investigation of dietary sources, nondietary determinants, and health effects of specific TFA subtypes, especially t-18:2 isomers.

%B J Am Heart Assoc %V 3 %8 2014 Aug %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25164946?dopt=Abstract %R 10.1161/JAHA.114.000914 %0 Journal Article %J Stroke %D 2014 %T Predicting stroke through genetic risk functions: the CHARGE Risk Score Project. %A Ibrahim-Verbaas, Carla A %A Fornage, Myriam %A Bis, Joshua C %A Choi, Seung Hoan %A Psaty, Bruce M %A Meigs, James B %A Rao, Madhu %A Nalls, Mike %A Fontes, João D %A O'Donnell, Christopher J %A Kathiresan, Sekar %A Ehret, Georg B %A Fox, Caroline S %A Malik, Rainer %A Dichgans, Martin %A Schmidt, Helena %A Lahti, Jari %A Heckbert, Susan R %A Lumley, Thomas %A Rice, Kenneth %A Rotter, Jerome I %A Taylor, Kent D %A Folsom, Aaron R %A Boerwinkle, Eric %A Rosamond, Wayne D %A Shahar, Eyal %A Gottesman, Rebecca F %A Koudstaal, Peter J %A Amin, Najaf %A Wieberdink, Renske G %A Dehghan, Abbas %A Hofman, Albert %A Uitterlinden, André G %A DeStefano, Anita L %A Debette, Stephanie %A Xue, Luting %A Beiser, Alexa %A Wolf, Philip A %A DeCarli, Charles %A Ikram, M Arfan %A Seshadri, Sudha %A Mosley, Thomas H %A Longstreth, W T %A van Duijn, Cornelia M %A Launer, Lenore J %K Age Factors %K Aged %K Aged, 80 and over %K Area Under Curve %K Case-Control Studies %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Regression Analysis %K Risk Factors %K ROC Curve %K Sex Factors %K Stroke %X

BACKGROUND AND PURPOSE: Beyond the Framingham Stroke Risk Score, prediction of future stroke may improve with a genetic risk score (GRS) based on single-nucleotide polymorphisms associated with stroke and its risk factors.

METHODS: The study includes 4 population-based cohorts with 2047 first incident strokes from 22,720 initially stroke-free European origin participants aged ≥55 years, who were followed for up to 20 years. GRSs were constructed with 324 single-nucleotide polymorphisms implicated in stroke and 9 risk factors. The association of the GRS to first incident stroke was tested using Cox regression; the GRS predictive properties were assessed with area under the curve statistics comparing the GRS with age and sex, Framingham Stroke Risk Score models, and reclassification statistics. These analyses were performed per cohort and in a meta-analysis of pooled data. Replication was sought in a case-control study of ischemic stroke.

RESULTS: In the meta-analysis, adding the GRS to the Framingham Stroke Risk Score, age and sex model resulted in a significant improvement in discrimination (all stroke: Δjoint area under the curve=0.016, P=2.3×10(-6); ischemic stroke: Δjoint area under the curve=0.021, P=3.7×10(-7)), although the overall area under the curve remained low. In all the studies, there was a highly significantly improved net reclassification index (P<10(-4)).

CONCLUSIONS: The single-nucleotide polymorphisms associated with stroke and its risk factors result only in a small improvement in prediction of future stroke compared with the classical epidemiological risk factors for stroke.

%B Stroke %V 45 %P 403-12 %8 2014 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24436238?dopt=Abstract %R 10.1161/STROKEAHA.113.003044 %0 Journal Article %J Stroke %D 2014 %T Prediction of asymptomatic carotid artery stenosis in the general population: identification of high-risk groups. %A de Weerd, Marjolein %A Greving, Jacoba P %A Hedblad, Bo %A Lorenz, Matthias W %A Mathiesen, Ellisiv B %A O'Leary, Daniel H %A Rosvall, Maria %A Sitzer, Matthias %A de Borst, Gert Jan %A Buskens, Erik %A Bots, Michiel L %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Blood Pressure %K Carotid Stenosis %K Female %K Humans %K Life Style %K Male %K Mass Screening %K Middle Aged %K Prevalence %K Registries %K Risk %K Smoking %X

BACKGROUND AND PURPOSE: Because of a low prevalence of severe carotid stenosis in the general population, screening for presence of asymptomatic carotid artery stenosis (ACAS) is not warranted. Possibly, for certain subgroups, screening is worthwhile. The present study aims to develop prediction rules for the presence of ACAS (>50% and >70%).

METHODS: Individual participant data from 4 population-based cohort studies (Malmö Diet and Cancer Study, Tromsø Study, Carotid Atherosclerosis Progression Study, and Cardiovascular Health Study; totaling 23 706 participants) were pooled. Multivariable logistic regression was performed to determine which variables predict presence of ACAS (>50% and >70%). Calibration and discrimination of the models were assessed, and bootstrapping was used to correct for overfitting.

RESULTS: Age, sex, history of vascular disease, systolic and diastolic blood pressure, total cholesterol/high-density lipoprotein ratio, diabetes mellitus, and current smoking were predictors of stenosis (>50% and >70%). The calibration of the model was good confirmed by a nonsignificant Hosmer and Lemeshow test for moderate (P=0.59) and severe stenosis (P=0.07). The models discriminated well between participants with and without stenosis, with an area under the receiver operating characteristic curve corrected for over optimism of 0.82 (95% confidence interval, 0.80-0.84) for moderate stenosis and of 0.87 (95% confidence interval, 0.85-0.90) for severe stenosis. The regression coefficients of the predictors were converted into a score chart to facilitate practical application.

CONCLUSIONS: A clinical prediction rule was developed that allows identification of subgroups with high prevalence of moderate (>50%) and severe (>70%) ACAS. When confirmed in comparable cohorts, application of the prediction rule may lead to a reduction in the number needed to screen for ACAS.

%B Stroke %V 45 %P 2366-71 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/24994719?dopt=Abstract %R 10.1161/STROKEAHA.114.005145 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2014 %T Prognostic implications of microvascular and macrovascular abnormalities in older adults: cardiovascular health study. %A Kim, Dae Hyun %A Grodstein, Francine %A Newman, Anne B %A Chaves, Paulo H M %A Odden, Michelle C %A Klein, Ronald %A Sarnak, Mark J %A Patel, Kushang V %A Lipsitz, Lewis A %K Aged %K Aged, 80 and over %K Aging %K Ankle Brachial Index %K Disability Evaluation %K Electrocardiography %K Female %K Follow-Up Studies %K Forecasting %K Humans %K Life Expectancy %K Magnetic Resonance Imaging %K Male %K Microcirculation %K Prognosis %K Prospective Studies %K Risk Factors %K Vascular Malformations %X

BACKGROUND: Microvascular and macrovascular abnormalities are frequently found on noninvasive tests performed in older adults. Their prognostic implications on disability and life expectancy have not been collectively assessed.

METHODS: This prospective study included 2,452 adults (mean age: 79.5 years) with available measures of microvascular (brain, retina, kidney) and macrovascular abnormalities (brain, carotid, coronary, peripheral artery) in the Cardiovascular Health Study. The burden of microvascular and macrovascular abnormalities was examined in relation to total, activity-of-daily-living disability-free, and severe disability-free life expectancies in the next 10 years (1999-2009).

RESULTS: At 75 years, individuals with low burden of both abnormalities lived, on average, 8.71 years (95% confidence interval: 8.29, 9.12) of which 7.67 years (7.16, 8.17) were without disability. In comparison, individuals with high burden of both abnormalities had shortest total life expectancy (6.95 years [6.52, 7.37]; p < .001) and disability-free life expectancy (5.60 years [5.10, 6.11]; p < .001). Although total life expectancy was similarly reduced for those with high burden of either type of abnormalities (microvascular: 7.96 years [7.50, 8.42] vs macrovascular: 8.25 years [7.80, 8.70]; p = .10), microvascular abnormalities seemed to have larger impact than macrovascular abnormalities on disability-free life expectancy (6.45 years [5.90, 6.99] vs 6.96 years [6.43, 7.48]; p = .016). These results were consistent for severe disability-free life expectancy and in individuals without clinical cardiovascular disease.

CONCLUSIONS: Considering both microvascular and macrovascular abnormalities from multiple noninvasive tests may provide additional prognostic information on how older adults spend their remaining life. Optimal clinical use of this information remains to be determined.

%B J Gerontol A Biol Sci Med Sci %V 69 %P 1495-502 %8 2014 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24864308?dopt=Abstract %R 10.1093/gerona/glu074 %0 Journal Article %J Circulation %D 2014 %T Racial and regional differences in venous thromboembolism in the United States in 3 cohorts. %A Zakai, Neil A %A McClure, Leslie A %A Judd, Suzanne E %A Safford, Monika M %A Folsom, Aaron R %A Lutsey, Pamela L %A Cushman, Mary %K African Continental Ancestry Group %K Aged %K Cohort Studies %K European Continental Ancestry Group %K Female %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Prevalence %K Proportional Hazards Models %K Prospective Studies %K Residence Characteristics %K Risk Factors %K United States %K Venous Thromboembolism %X

BACKGROUND: Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.

METHODS AND RESULTS: We ascertained VTE from 3 prospective studies: the Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor-adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20-2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96-1.54). In REGARDS, there was a significant region-by-race interaction (P=0.01): Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08-2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61-1.14).

CONCLUSIONS: The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE.

%B Circulation %V 129 %P 1502-9 %8 2014 Apr 08 %G eng %N 14 %1 http://www.ncbi.nlm.nih.gov/pubmed/24508826?dopt=Abstract %R 10.1161/CIRCULATIONAHA.113.006472 %0 Journal Article %J Am J Prev Med %D 2014 %T Regular fish consumption and age-related brain gray matter loss. %A Raji, Cyrus A %A Erickson, Kirk I %A Lopez, Oscar L %A Kuller, Lewis H %A Gach, H Michael %A Thompson, Paul M %A Riverol, Mario %A Becker, James T %K Aged %K Aged, 80 and over %K Animals %K Brain %K Cross-Sectional Studies %K Diet %K Fatty Acids, Omega-3 %K Female %K Fishes %K Gray Matter %K Humans %K Life Style %K Magnetic Resonance Imaging %K Male %K Regression Analysis %K Surveys and Questionnaires %X

BACKGROUND: Brain health may be affected by modifiable lifestyle factors; consuming fish and antioxidative omega-3 fatty acids may reduce brain structural abnormality risk.

PURPOSE: To determine whether dietary fish consumption is related to brain structural integrity among cognitively normal elders.

METHODS: Data were analyzed from 260 cognitively normal individuals from the Cardiovascular Health Study with information on fish consumption from the National Cancer Institute Food Frequency Questionnaire and brain magnetic resonance imaging (MRI). The relationship between fish consumption data collected in 1989-1990 and brain structural MRI obtained in 1998-1999 was assessed using voxel-based morphometry in multiple regression analyses in 2012. Covariates were age, gender, race, education, white matter lesions, MRI-identified infarcts, waist-hip ratio, and physical activity as assessed by the number of city blocks walked in 1 week. Volumetric changes were further modeled with omega-3 fatty acid estimates to better understand the mechanistic link between fish consumption, brain health, and Alzheimer disease.

RESULTS: Weekly consumption of baked or broiled fish was positively associated with gray matter volumes in the hippocampus, precuneus, posterior cingulate, and orbital frontal cortex even after adjusting for covariates. These results did not change when including omega-3 fatty acid estimates in the analysis.

CONCLUSIONS: Dietary consumption of baked or broiled fish is related to larger gray matter volumes independent of omega-3 fatty acid content. These findings suggest that a confluence of lifestyle factors influence brain health, adding to the growing body of evidence that prevention strategies for late-life brain health need to begin decades earlier.

%B Am J Prev Med %V 47 %P 444-51 %8 2014 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25084680?dopt=Abstract %R 10.1016/j.amepre.2014.05.037 %0 Journal Article %J Kidney Int %D 2014 %T Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar. %A Wen, Chi Pang %A Matsushita, Kunihiro %A Coresh, Josef %A Iseki, Kunitoshi %A Islam, Muhammad %A Katz, Ronit %A McClellan, William %A Peralta, Carmen A %A Wang, Haiyan %A de Zeeuw, Dick %A Astor, Brad C %A Gansevoort, Ron T %A Levey, Andrew S %A Levin, Adeera %K Adult %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Albuminuria %K Asian Continental Ancestry Group %K Cardiovascular Diseases %K Cohort Studies %K Creatinine %K European Continental Ancestry Group %K Female %K Glomerular Filtration Rate %K Humans %K Kidney Failure, Chronic %K Male %K Middle Aged %K Odds Ratio %K Renal Insufficiency, Chronic %K Risk Factors %X

Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates (eGFR) and albuminuria across races using meta-regression in 1.1 million adults (75% Asians, 21% Whites, and 4% Blacks) from 45 cohorts. Results came mainly from 25 general population cohorts comprising 0.9 million individuals. The associations of lower eGFR and higher albuminuria with mortality and end-stage renal disease (ESRD) were largely similar across races. For example, in Asians, Whites, and Blacks, the adjusted hazard ratios (95% confidence interval) for eGFR 45-59 versus 90-104 ml/min per 1.73 m(2) were 1.3 (1.2-1.3), 1.1 (1.0-1.2), and 1.3 (1.1-1.7) for all-cause mortality, 1.6 (1.5-1.7), 1.4 (1.2-1.7), and 1.4 (0.7-2.9) for cardiovascular mortality, and 27.6 (11.1-68.7), 11.2 (6.0-20.9), and 4.1 (2.2-7.5) for ESRD, respectively. The corresponding hazard ratios for urine albumin-to-creatinine ratio 30-299 mg/g or dipstick 1+ versus an albumin-to-creatinine ratio under 10 or dipstick negative were 1.6 (1.4-1.8), 1.7 (1.5-1.9), and 1.8 (1.7-2.1) for all-cause mortality, 1.7 (1.4-2.0), 1.8 (1.5-2.1), and 2.8 (2.2-3.6) for cardiovascular mortality, and 7.4 (2.0-27.6), 4.0 (2.8-5.9), and 5.6 (3.4-9.2) for ESRD, respectively. Thus, the relative mortality or ESRD risks of lower eGFR and higher albuminuria were largely similar among three major races, supporting similar clinical approach to CKD definition and staging, across races.

%B Kidney Int %V 86 %P 819-27 %8 2014 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/24522492?dopt=Abstract %R 10.1038/ki.2013.553 %0 Journal Article %J J Environ Public Health %D 2014 %T Residential relocation by older adults in response to incident cardiovascular health events: a case-crossover analysis. %A Lovasi, Gina S %A Richardson, John M %A Rodriguez, Carlos J %A Kop, Willem J %A Ahmed, Ali %A Brown, Arleen F %A Greenlee, Heather %A Siscovick, David S %K Aged %K Cardiovascular Diseases %K Cross-Over Studies %K Female %K Humans %K Incidence %K Life Change Events %K Logistic Models %K Longitudinal Studies %K Male %K Prospective Studies %K Residence Characteristics %K United States %X

OBJECTIVE: We use a case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new home address.

METHODS: We conducted an ambidirectional case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new address using data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults from four U.S. sites beginning in 1989. Relocation was assessed twice a year during follow-up. Event occurrences were classified as present or absent for the period preceding the first reported move, as compared with an equal length of time immediately prior to and following this period.

RESULTS: Older adults (65+) that experience incident cardiovascular disease had an increased probability of reporting a change of residence during the following year (OR 1.6, 95% confidence interval (CI) = 1.2-2.1). Clinical conditions associated with relocation included stroke (OR: 2.0, 95% CI: 1.2-3.3), angina (OR: 1.6, 95% CI: 1.0-2.6), and congestive heart failure (OR: 1.5, 95% CI: 1.0-2.1).

CONCLUSIONS: Major incident cardiovascular disease may increase the probability of residential relocation in older adults. Case-crossover analyses represent an opportunity to investigate triggering events, but finer temporal resolution would be crucial for future research on residential relocations.

%B J Environ Public Health %V 2014 %P 951971 %8 2014 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/24782900?dopt=Abstract %R 10.1155/2014/951971 %0 Journal Article %J PLoS One %D 2014 %T A self-report risk index to predict occurrence of dementia in three independent cohorts of older adults: the ANU-ADRI. %A Anstey, Kaarin J %A Cherbuin, Nicolas %A Herath, Pushpani M %A Qiu, Chengxuan %A Kuller, Lewis H %A Lopez, Oscar L %A Wilson, Robert S %A Fratiglioni, Laura %K Adult %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Dementia %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Risk %K ROC Curve %K Self Report %X

BACKGROUND AND AIMS: The Australian National University AD Risk Index (ANU-ADRI, http://anuadri.anu.edu.au) is a self-report risk index developed using an evidence-based medicine approach to measure risk of Alzheimer's disease (AD). We aimed to evaluate the extent to which the ANU-ADRI can predict the risk of AD in older adults and to compare the ANU-ADRI to the dementia risk index developed from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study for middle-aged cohorts.

METHODS: This study included three validation cohorts, i.e., the Rush Memory and Aging Study (MAP) (n = 903, age ≥53 years), the Kungsholmen Project (KP) (n = 905, age ≥75 years), and the Cardiovascular Health Cognition Study (CVHS) (n = 2496, age ≥65 years) that were each followed for dementia. Baseline data were collected on exposure to the 15 risk factors included in the ANU-ADRI of which MAP had 10, KP had 8 and CVHS had 9. Risk scores and C-statistics were computed for individual participants for the ANU-ADRI and the CAIDE index.

RESULTS: For the ANU-ADRI using available data, the MAP study c-statistic was 0·637 (95% CI 0·596-0·678), for the KP study it was 0·740 (0·712-0·768) and for the CVHS it was 0·733 (0·691-0·776) for predicting AD. When a common set of risk and protective factors were used c-statistics were 0.689 (95% CI 0.650-0.727), 0.666 (0.628-0.704) and 0.734 (0.707-0.761) for MAP, KP and CVHS respectively. Results for CAIDE ranged from c-statistics of 0.488 (0.427-0.554) to 0.595 (0.565-0.625).

CONCLUSION: A composite risk score derived from the ANU-ADRI weights including 8-10 risk or protective factors is a valid, self-report tool to identify those at risk of AD and dementia. The accuracy can be further improved in studies including more risk factors and younger cohorts with long-term follow-up.

%B PLoS One %V 9 %P e86141 %8 2014 %G eng %N 1 %R 10.1371/journal.pone.0086141 %0 Journal Article %J Neurology %D 2014 %T Separate prediction of intracerebral hemorrhage and ischemic stroke. %A Ferket, Bart S %A van Kempen, Bob J H %A Wieberdink, Renske G %A Steyerberg, Ewout W %A Koudstaal, Peter J %A Hofman, Albert %A Shahar, Eyal %A Gottesman, Rebecca F %A Rosamond, Wayne %A Kizer, Jorge R %A Kronmal, Richard A %A Psaty, Bruce M %A Longstreth, W T %A Mosley, Thomas %A Folsom, Aaron R %A Hunink, M G Myriam %A Ikram, M Arfan %K Aged %K Aged, 80 and over %K Atherosclerosis %K Body Mass Index %K Brain Ischemia %K Cholesterol %K Female %K Humans %K Incidence %K Intracranial Hemorrhages %K Male %K Middle Aged %K Models, Statistical %K Predictive Value of Tests %K Risk Assessment %K Risk Factors %K Stroke %X

OBJECTIVES: To develop and validate 10-year cumulative incidence functions of intracerebral hemorrhage (ICH) and ischemic stroke (IS).

METHODS: We used data on 27,493 participants from 3 population-based cohort studies: the Atherosclerosis Risk in Communities Study, median age 54 years, 45% male, median follow-up 20.7 years; the Rotterdam Study, median age 68 years, 38% male, median follow-up 14.3 years; and the Cardiovascular Health Study, median age 71 years, 41% male, median follow-up 12.8 years. Among these participants, 325 ICH events, 2,559 IS events, and 9,909 nonstroke deaths occurred. We developed 10-year cumulative incidence functions for ICH and IS using stratified Cox regression and competing risks analysis. Basic models including only established nonlaboratory risk factors were extended with diastolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, body mass index, waist-to-hip ratio, and glomerular filtration rate. The cumulative incidence functions' performances were cross-validated in each cohort separately by Harrell C-statistic and calibration plots.

RESULTS: High total cholesterol/high-density lipoprotein cholesterol ratio decreased the ICH rates but increased IS rates (p for difference across stroke types <0.001). For both the ICH and IS models, C statistics increased more by model extension in the Atherosclerosis Risk in Communities and Cardiovascular Health Study cohorts. Improvements in C statistics were reproduced by cross-validation. Models were well calibrated in all cohorts. Correlations between 10-year ICH and IS risks were moderate in each cohort.

CONCLUSIONS: We developed and cross-validated cumulative incidence functions for separate prediction of 10-year ICH and IS risk. These functions can be useful to further specify an individual's stroke risk.

%B Neurology %V 82 %P 1804-12 %8 2014 May 20 %G eng %N 20 %1 http://www.ncbi.nlm.nih.gov/pubmed/24759844?dopt=Abstract %R 10.1212/WNL.0000000000000427 %0 Journal Article %J PLoS One %D 2014 %T Sequence analysis of six blood pressure candidate regions in 4,178 individuals: the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) targeted sequencing study. %A Morrison, Alanna C %A Bis, Joshua C %A Hwang, Shih-Jen %A Ehret, Georg B %A Lumley, Thomas %A Rice, Kenneth %A Muzny, Donna %A Gibbs, Richard A %A Boerwinkle, Eric %A Psaty, Bruce M %A Chakravarti, Aravinda %A Levy, Daniel %K Aging %K Blood Pressure %K Cohort Studies %K Heart %K Humans %K Sequence Analysis %X

BACKGROUND: Genome-wide association studies (GWAS) identified multiple loci for blood pressure (BP) and hypertension. Six genes--ATP2B1, CACNB2, CYP17A1, JAG1, PLEKHA7, and SH2B3--were evaluated for sequence variation with large effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP).

METHODS AND RESULTS: Targeted genomic sequence was determined in 4,178 European ancestry participants from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Common variants (≥50 minor allele copies) were evaluated individually and rare variants (minor allele frequency, MAF≤1%) were aggregated by locus. 464 common variants were identified across the 6 genes. An upstream CYP17A1 variant, rs11191416 (MAF = 0.09), was the most significant association for SBP (P = 0.0005); however the association was attenuated (P = 0.0469) after conditioning on the GWAS index single nucleotide polymorphism (SNP). A PLEKHA7 intronic variant was the strongest DBP association (rs12806040, MAF = 0.007, P = 0.0006) and was not in LD (r² = 0.01) with the GWAS SNP. A CACNB2 intronic SNP, rs1571787, was the most significant association with PP (MAF = 0.27, P = 0.0003), but was not independent from the GWAS SNP (r² = 0.34). Three variants (rs6163 and rs743572 in the CYP17A1 region and rs112467382 in PLEKHA7) were associated with BP traits (P<0.001). Rare variation, aggregately assessed in the 6 regions, was not significantly associated with BP measures.

CONCLUSION: Six targeted gene regions, previously identified by GWAS, did not harbor novel variation with large effects on BP in this sample.

%B PLoS One %V 9 %P e109155 %8 2014 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25275628?dopt=Abstract %R 10.1371/journal.pone.0109155 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Sequence variation in TMEM18 in association with body mass index: Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study. %A Liu, Ching-Ti %A Young, Kristin L %A Brody, Jennifer A %A Olden, Matthias %A Wojczynski, Mary K %A Heard-Costa, Nancy %A Li, Guo %A Morrison, Alanna C %A Muzny, Donna %A Gibbs, Richard A %A Reid, Jeffrey G %A Shao, Yaming %A Zhou, Yanhua %A Boerwinkle, Eric %A Heiss, Gerardo %A Wagenknecht, Lynne %A McKnight, Barbara %A Borecki, Ingrid B %A Fox, Caroline S %A North, Kari E %A Cupples, L Adrienne %K Adult %K Aged %K Aging %K Body Mass Index %K Cohort Studies %K Female %K Genetic Association Studies %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Heart Diseases %K Humans %K Male %K Membrane Proteins %K Middle Aged %K Polymorphism, Single Nucleotide %K Sequence Analysis, DNA %K Young Adult %X

BACKGROUND: Genome-wide association studies for body mass index (BMI) previously identified a locus near TMEM18. We conducted targeted sequencing of this region to investigate the role of common, low-frequency, and rare variants influencing BMI.

METHODS AND RESULTS: We sequenced TMEM18 and regions downstream of TMEM18 on chromosome 2 in 3976 individuals of European ancestry from 3 community-based cohorts (Atherosclerosis Risk in Communities, Cardiovascular Health Study, and Framingham Heart Study), including 200 adults selected for high BMI. We examined the association between BMI and variants identified in the region from nucleotide position 586 432 to 677 539 (hg18). Rare variants (minor allele frequency, <1%) were analyzed using a burden test and the sequence kernel association test. Results from the 3 cohort studies were meta-analyzed. We estimate that mean BMI is 0.43 kg/m(2) higher for each copy of the G allele of single-nucleotide polymorphism rs7596758 (minor allele frequency, 29%; P=3.46×10(-4)) using a Bonferroni threshold of P<4.6×10(-4). Analyses conditional on previous genome-wide association study single-nucleotide polymorphisms associated with BMI in the region led to attenuation of this signal and uncovered another independent (r(2)<0.2), statistically significant association, rs186019316 (P=2.11×10(-4)). Both rs186019316 and rs7596758 or proxies are located in transcription factor binding regions. No significant association with rare variants was found in either the exons of TMEM18 or the 3' genome-wide association study region.

CONCLUSIONS: Targeted sequencing around TMEM18 identified 2 novel BMI variants with possible regulatory function.

%B Circ Cardiovasc Genet %V 7 %P 344-9 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951660?dopt=Abstract %R 10.1161/CIRCGENETICS.13.000067 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Sequencing of 2 subclinical atherosclerosis candidate regions in 3669 individuals: Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study. %A Bis, Joshua C %A White, Charles C %A Franceschini, Nora %A Brody, Jennifer %A Zhang, Xiaoling %A Muzny, Donna %A Santibanez, Jireh %A Gibbs, Richard %A Liu, Xiaoming %A Lin, Honghuang %A Boerwinkle, Eric %A Psaty, Bruce M %A North, Kari E %A Cupples, L Adrienne %A O'Donnell, Christopher J %K Aged %K Aged, 80 and over %K Aging %K Atherosclerosis %K Class Ib Phosphatidylinositol 3-Kinase %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Sequence Analysis, DNA %K Sodium-Phosphate Cotransporter Proteins, Type I %X

BACKGROUND: Atherosclerosis, the precursor to coronary heart disease and stroke, is characterized by an accumulation of fatty cells in the arterial intimal-medial layers. Common carotid intima media thickness (cIMT) and plaque are subclinical atherosclerosis measures that predict cardiovascular disease events. Previously, genome-wide association studies demonstrated evidence for association with cIMT (SLC17A4) and plaque (PIK3CG).

METHODS AND RESULTS: We sequenced 120 kb around SLC17A4 (6p22.2) and 251 kb around PIK3CG (7q22.3) among 3669 European ancestry participants from the Atherosclerosis Risk in Communities (ARIC) study, Cardiovascular Health Study (CHS), and Framingham Heart Study (FHS) in Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Primary analyses focused on 438 common variants (minor allele frequency ≥1%), which were independently meta-analyzed. A 3' untranslated region CCDC71L variant (rs2286149), upstream from PIK3CG, was the most significant finding in cIMT (P=0.00033) and plaque (P=0.0004) analyses. A SLC17A4 intronic variant was also associated with cIMT (P=0.008). Both were in low linkage disequilibrium with the genome-wide association study single nucleotide polymorphisms. Gene-based tests including T1 count and sequence kernel association test for rare variants (minor allele frequency <1%) did not yield statistically significant associations. However, we observed nominal associations for rare variants in CCDC71L and SLC17A3 with cIMT and of the entire 7q22 region with plaque (P=0.05).

CONCLUSIONS: Common and rare variants in PIK3CG and SLC17A4 regions demonstrated modest association with subclinical atherosclerosis traits. Although not conclusive, these findings may help to understand the genetic architecture of regions previously implicated by genome-wide association studies and identify variants within these regions for further investigation in larger samples.

%B Circ Cardiovasc Genet %V 7 %P 359-64 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951662?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000116 %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Sequencing of SCN5A identifies rare and common variants associated with cardiac conduction: Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. %A Magnani, Jared W %A Brody, Jennifer A %A Prins, Bram P %A Arking, Dan E %A Lin, Honghuang %A Yin, Xiaoyan %A Liu, Ching-Ti %A Morrison, Alanna C %A Zhang, Feng %A Spector, Tim D %A Alonso, Alvaro %A Bis, Joshua C %A Heckbert, Susan R %A Lumley, Thomas %A Sitlani, Colleen M %A Cupples, L Adrienne %A Lubitz, Steven A %A Soliman, Elsayed Z %A Pulit, Sara L %A Newton-Cheh, Christopher %A O'Donnell, Christopher J %A Ellinor, Patrick T %A Benjamin, Emelia J %A Muzny, Donna M %A Gibbs, Richard A %A Santibanez, Jireh %A Taylor, Herman A %A Rotter, Jerome I %A Lange, Leslie A %A Psaty, Bruce M %A Jackson, Rebecca %A Rich, Stephen S %A Boerwinkle, Eric %A Jamshidi, Yalda %A Sotoodehnia, Nona %K Adult %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Heart Conduction System %K Heart Diseases %K Humans %K Male %K Middle Aged %K NAV1.5 Voltage-Gated Sodium Channel %K Polymorphism, Single Nucleotide %K Sequence Analysis, DNA %X

BACKGROUND: The cardiac sodium channel SCN5A regulates atrioventricular and ventricular conduction. Genetic variants in this gene are associated with PR and QRS intervals. We sought to characterize further the contribution of rare and common coding variation in SCN5A to cardiac conduction.

METHODS AND RESULTS: In Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study, we performed targeted exonic sequencing of SCN5A (n=3699, European ancestry individuals) and identified 4 common (minor allele frequency >1%) and 157 rare variants. Common and rare SCN5A coding variants were examined for association with PR and QRS intervals through meta-analysis of European ancestry participants from CHARGE, National Heart, Lung, and Blood Institute's Exome Sequencing Project (n=607), and the UK10K (n=1275) and by examining Exome Sequencing Project African ancestry participants (n=972). Rare coding SCN5A variants in aggregate were associated with PR interval in European and African ancestry participants (P=1.3×10(-3)). Three common variants were associated with PR and QRS interval duration among European ancestry participants and one among African ancestry participants. These included 2 well-known missense variants: rs1805124 (H558R) was associated with PR and QRS shortening in European ancestry participants (P=6.25×10(-4) and P=5.2×10(-3), respectively) and rs7626962 (S1102Y) was associated with PR shortening in those of African ancestry (P=2.82×10(-3)). Among European ancestry participants, 2 novel synonymous variants, rs1805126 and rs6599230, were associated with cardiac conduction. Our top signal, rs1805126 was associated with PR and QRS lengthening (P=3.35×10(-7) and P=2.69×10(-4), respectively) and rs6599230 was associated with PR shortening (P=2.67×10(-5)).

CONCLUSIONS: By sequencing SCN5A, we identified novel common and rare coding variants associated with cardiac conduction.

%B Circ Cardiovasc Genet %V 7 %P 365-73 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951663?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000098 %0 Journal Article %J Stroke %D 2014 %T Shared genetic susceptibility to ischemic stroke and coronary artery disease: a genome-wide analysis of common variants. %A Dichgans, Martin %A Malik, Rainer %A König, Inke R %A Rosand, Jonathan %A Clarke, Robert %A Gretarsdottir, Solveig %A Thorleifsson, Gudmar %A Mitchell, Braxton D %A Assimes, Themistocles L %A Levi, Christopher %A O'Donnell, Christopher J %A Fornage, Myriam %A Thorsteinsdottir, Unnur %A Psaty, Bruce M %A Hengstenberg, Christian %A Seshadri, Sudha %A Erdmann, Jeanette %A Bis, Joshua C %A Peters, Annette %A Boncoraglio, Giorgio B %A März, Winfried %A Meschia, James F %A Kathiresan, Sekar %A Ikram, M Arfan %A McPherson, Ruth %A Stefansson, Kari %A Sudlow, Cathie %A Reilly, Muredach P %A Thompson, John R %A Sharma, Pankaj %A Hopewell, Jemma C %A Chambers, John C %A Watkins, Hugh %A Rothwell, Peter M %A Roberts, Robert %A Markus, Hugh S %A Samani, Nilesh J %A Farrall, Martin %A Schunkert, Heribert %K Brain Ischemia %K Coronary Artery Disease %K Data Interpretation, Statistical %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Phenotype %K Polymorphism, Single Nucleotide %K Reproducibility of Results %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: Ischemic stroke (IS) and coronary artery disease (CAD) share several risk factors and each has a substantial heritability. We conducted a genome-wide analysis to evaluate the extent of shared genetic determination of the two diseases.

METHODS: Genome-wide association data were obtained from the METASTROKE, Coronary Artery Disease Genome-wide Replication and Meta-analysis (CARDIoGRAM), and Coronary Artery Disease (C4D) Genetics consortia. We first analyzed common variants reaching a nominal threshold of significance (P<0.01) for CAD for their association with IS and vice versa. We then examined specific overlap across phenotypes for variants that reached a high threshold of significance. Finally, we conducted a joint meta-analysis on the combined phenotype of IS or CAD. Corresponding analyses were performed restricted to the 2167 individuals with the ischemic large artery stroke (LAS) subtype.

RESULTS: Common variants associated with CAD at P<0.01 were associated with a significant excess risk for IS and for LAS and vice versa. Among the 42 known genome-wide significant loci for CAD, 3 and 5 loci were significantly associated with IS and LAS, respectively. In the joint meta-analyses, 15 loci passed genome-wide significance (P<5×10(-8)) for the combined phenotype of IS or CAD and 17 loci passed genome-wide significance for LAS or CAD. Because these loci had prior evidence for genome-wide significance for CAD, we specifically analyzed the respective signals for IS and LAS and found evidence for association at chr12q24/SH2B3 (PIS=1.62×10(-7)) and ABO (PIS=2.6×10(-4)), as well as at HDAC9 (PLAS=2.32×10(-12)), 9p21 (PLAS=3.70×10(-6)), RAI1-PEMT-RASD1 (PLAS=2.69×10(-5)), EDNRA (PLAS=7.29×10(-4)), and CYP17A1-CNNM2-NT5C2 (PLAS=4.9×10(-4)).

CONCLUSIONS: Our results demonstrate substantial overlap in the genetic risk of IS and particularly the LAS subtype with CAD.

%B Stroke %V 45 %P 24-36 %8 2014 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24262325?dopt=Abstract %R 10.1161/STROKEAHA.113.002707 %0 Journal Article %J Diabetologia %D 2014 %T Sleep duration does not mediate or modify association of common genetic variants with type 2 diabetes. %A Tare, Archana %A Lane, Jacqueline M %A Cade, Brian E %A Grant, Struan F A %A Chen, Ting-Hsu %A Punjabi, Naresh M %A Lauderdale, Diane S %A Zee, Phyllis C %A Gharib, Sina A %A Gottlieb, Daniel J %A Scheer, Frank A J L %A Redline, Susan %A Saxena, Richa %K Blood Glucose %K Body Composition %K Body Mass Index %K Cross-Sectional Studies %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Fasting %K Female %K Genetic Predisposition to Disease %K Genetic Variation %K Genotype %K Glucose Intolerance %K Glycated Hemoglobin A %K Humans %K Insulin Resistance %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %K Sleep %K Surveys and Questionnaires %K Time Factors %K United States %X

AIMS/HYPOTHESIS: Short and long sleep duration are associated with increased risk of type 2 diabetes. We aimed to investigate whether genetic variants for fasting glucose or type 2 diabetes associate with short or long sleep duration and whether sleep duration modifies the association of genetic variants with these traits.

METHODS: We examined the cross-sectional relationship between self-reported habitual sleep duration and prevalence of type 2 diabetes in individuals of European descent participating in five studies included in the Candidate Gene Association Resource (CARe), totalling 1,474 cases and 8,323 controls. We tested for association of 16 fasting glucose-associated variants, 27 type 2 diabetes-associated variants and aggregate genetic risk scores with continuous and dichotomised (≤5 h or ≥9 h) sleep duration using regression models adjusted for age, sex and BMI. Finally, we tested whether a gene × behaviour interaction of variants with sleep duration had an impact on fasting glucose or type 2 diabetes risk.

RESULTS: Short sleep duration was significantly associated with type 2 diabetes in CARe (OR 1.32; 95% CI 1.08, 1.61; p = 0.008). Variants previously associated with fasting glucose or type 2 diabetes and genetic risk scores were not associated with sleep duration. Furthermore, no study-wide significant interaction was observed between sleep duration and these variants on glycaemic traits. Nominal interactions were observed for sleep duration and PPARG rs1801282, CRY2 rs7943320 and HNF1B rs4430796 in influencing risk of type 2 diabetes (p < 0.05).

CONCLUSIONS/INTERPRETATION: Our findings suggest that differences in habitual sleep duration do not mediate or modify the relationship between common variants underlying glycaemic traits (including in circadian rhythm genes) and diabetes.

%B Diabetologia %V 57 %P 339-46 %8 2014 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24280871?dopt=Abstract %R 10.1007/s00125-013-3110-y %0 Journal Article %J Circ Cardiovasc Genet %D 2014 %T Strategies to design and analyze targeted sequencing data: cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study. %A Lin, Honghuang %A Wang, Min %A Brody, Jennifer A %A Bis, Joshua C %A Dupuis, Josée %A Lumley, Thomas %A McKnight, Barbara %A Rice, Kenneth M %A Sitlani, Colleen M %A Reid, Jeffrey G %A Bressler, Jan %A Liu, Xiaoming %A Davis, Brian C %A Johnson, Andrew D %A O'Donnell, Christopher J %A Kovar, Christie L %A Dinh, Huyen %A Wu, Yuanqing %A Newsham, Irene %A Chen, Han %A Broka, Andi %A DeStefano, Anita L %A Gupta, Mayetri %A Lunetta, Kathryn L %A Liu, Ching-Ti %A White, Charles C %A Xing, Chuanhua %A Zhou, Yanhua %A Benjamin, Emelia J %A Schnabel, Renate B %A Heckbert, Susan R %A Psaty, Bruce M %A Muzny, Donna M %A Cupples, L Adrienne %A Morrison, Alanna C %A Boerwinkle, Eric %K Adult %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Female %K Genetic Variation %K Genome-Wide Association Study %K Genomics %K Heart Diseases %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Research Design %K Sequence Analysis, DNA %X

BACKGROUND: Genome-wide association studies have identified thousands of genetic variants that influence a variety of diseases and health-related quantitative traits. However, the causal variants underlying the majority of genetic associations remain unknown. Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Targeted Sequencing Study aims to follow up genome-wide association study signals and identify novel associations of the allelic spectrum of identified variants with cardiovascular-related traits.

METHODS AND RESULTS: The study included 4231 participants from 3 CHARGE cohorts: the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and the Framingham Heart Study. We used a case-cohort design in which we selected both a random sample of participants and participants with extreme phenotypes for each of 14 traits. We sequenced and analyzed 77 genomic loci, which had previously been associated with ≥1 of 14 phenotypes. A total of 52 736 variants were characterized by sequencing and passed our stringent quality control criteria. For common variants (minor allele frequency ≥1%), we performed unweighted regression analyses to obtain P values for associations and weighted regression analyses to obtain effect estimates that accounted for the sampling design. For rare variants, we applied 2 approaches: collapsed aggregate statistics and joint analysis of variants using the sequence kernel association test.

CONCLUSIONS: We sequenced 77 genomic loci in participants from 3 cohorts. We established a set of filters to identify high-quality variants and implemented statistical and bioinformatics strategies to analyze the sequence data and identify potentially functional variants within genome-wide association study loci.

%B Circ Cardiovasc Genet %V 7 %P 335-43 %8 2014 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951659?dopt=Abstract %R 10.1161/CIRCGENETICS.113.000350 %0 Journal Article %J J Clin Endocrinol Metab %D 2014 %T Subclinical hypothyroidism, weight change, and body composition in the elderly: the Cardiovascular Health Study. %A Garin, Margaret C %A Arnold, Alice M %A Lee, Jennifer S %A Tracy, Russell P %A Cappola, Anne R %K Aged %K Aged, 80 and over %K Asymptomatic Diseases %K Body Composition %K Body Mass Index %K Cohort Studies %K Female %K Humans %K Hypothyroidism %K Male %K Thyroid Gland %K Weight Loss %X

BACKGROUND: Subclinical hypothyroidism is common in the elderly, yet its relationship with weight and body composition is unclear.

OBJECTIVE: We examined the relationship between subclinical hypothyroidism and weight change and body composition in older adults.

METHODS: A total of 427 subclinically hypothyroid and 2864 euthyroid U.S. individuals ≥65 years old enrolled in the Cardiovascular Health Study and not taking thyroid preparations were included. Analyses of 6-year weight change were performed, compared by thyroid status. A cross-sectional analysis of thyroid status and body composition was performed in a subset of 1276 participants who had dual-energy x-ray absorptiometry scans. Models were risk factor-adjusted and stratified by sex.

RESULTS: Overall, participants lost weight during follow-up (-0.38 kg/y in men, -0.37 kg/y in women). Subclinical hypothyroidism, when assessed at a single time point or persisting over 2 years, was not associated with a difference in weight change compared with euthyroidism. Subclinical hypothyroidism was also not associated with differences in lean mass, fat mass, or percent fat compared with euthyroidism. A TSH level 1 mU/L higher within the euthyroid or subclinical hypothyroid range was associated with a 0.51-kg higher baseline weight in women only (P < .001) but not with weight change in either sex. A 1 ng/dL higher free T4 level was associated with lower baseline weight and 0.32 kg/y greater weight loss in women only (P = .003). Baseline weight and weight change did not differ by T3 levels.

CONCLUSIONS: Our data do not support a clinically significant impact of subclinical hypothyroidism on weight status in the elderly.

%B J Clin Endocrinol Metab %V 99 %P 1220-6 %8 2014 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/24432998?dopt=Abstract %R 10.1210/jc.2013-3591 %0 Journal Article %J J Clin Endocrinol Metab %D 2014 %T Subclinical thyroid dysfunction and hip fracture and bone mineral density in older adults: the cardiovascular health study. %A Garin, Margaret C %A Arnold, Alice M %A Lee, Jennifer S %A Robbins, John %A Cappola, Anne R %K Absorptiometry, Photon %K Aged %K Aged, 80 and over %K Asymptomatic Diseases %K Bone Density %K Cardiovascular System %K Cohort Studies %K Cross-Sectional Studies %K Female %K Hip Fractures %K Humans %K Male %K Osteoporotic Fractures %K Risk Factors %K Sex Factors %K Thyroid Diseases %X

BACKGROUND: Subclinical thyroid dysfunction is common in the elderly, yet its relationship with hip fracture and bone mineral density (BMD) is unclear.

OBJECTIVE: We examined the association between endogenous subclinical hyper- and hypothyroidism and hip fracture and BMD in older adults.

METHODS: A total of 4936 US individuals 65 years old or older enrolled in the Cardiovascular Health Study and not taking thyroid preparations were included. Analyses of incident hip fracture were performed by thyroid status, over a median follow-up of 12 years. A cross-sectional analysis of thyroid status and BMD was performed in a subset of 1317 participants who had dual-energy x-ray absorptiometry scans. Models were adjusted for risk factors and stratified by sex.

RESULTS: No association was found between subclinical hypothyroidism and incident hip fracture compared with euthyroidism, when assessed at a single time point or persisting at two time points, in either women [hazard ratio (HR) 0.91, 95% confidence interval (CI) 0.69-1.20 for a single and HR 0.79, 95% CI 0.52-1.21 for two time points] or men (HR 1.27, 95% CI 0.82-1.95 for a single and HR 1.09, 95% CI 0.57-2.10 for two time points). Likewise, no association was found between subclinical hyperthyroidism and incident hip fracture in either sex (HR 1.11, 95% CI 0.55-2.25 in women and HR 1.78, 95% CI 0.56-5.66 in men). No association was found between subclinical thyroid dysfunction and BMD at the lumbar spine, total hip, or femoral neck sites.

CONCLUSIONS: Our data suggest no association between subclinical hypothyroidism or subclinical hyperthyroidism and hip fracture risk or BMD in older men and women. Additional data are needed to improve the precision of estimates for subclinical hyperthyroidism and in men.

%B J Clin Endocrinol Metab %V 99 %P 2657-64 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/24878045?dopt=Abstract %R 10.1210/jc.2014-1051 %0 Journal Article %J Heart Rhythm %D 2014 %T Targeted sequencing in candidate genes for atrial fibrillation: the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study. %A Lin, Honghuang %A Sinner, Moritz F %A Brody, Jennifer A %A Arking, Dan E %A Lunetta, Kathryn L %A Rienstra, Michiel %A Lubitz, Steven A %A Magnani, Jared W %A Sotoodehnia, Nona %A McKnight, Barbara %A McManus, David D %A Boerwinkle, Eric %A Psaty, Bruce M %A Rotter, Jerome I %A Bis, Joshua C %A Gibbs, Richard A %A Muzny, Donna %A Kovar, Christie L %A Morrison, Alanna C %A Gupta, Mayetri %A Folsom, Aaron R %A Kääb, Stefan %A Heckbert, Susan R %A Alonso, Alvaro %A Ellinor, Patrick T %A Benjamin, Emelia J %K Aged %K Atrial Fibrillation %K Female %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Homeodomain Proteins %K Humans %K Linkage Disequilibrium %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Receptors, Interleukin-6 %X

BACKGROUND: Genome-wide association studies (GWAS) have identified common genetic variants that predispose to atrial fibrillation (AF). It is unclear whether rare and low-frequency variants in genes implicated by such GWAS confer additional risk of AF.

OBJECTIVE: To study the association of genetic variants with AF at GWAS top loci.

METHODS: In the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study, we selected and sequenced 77 target gene regions from GWAS loci of complex diseases or traits, including 4 genes hypothesized to be related to AF (PRRX1, CAV1, CAV2, and ZFHX3). Sequencing was performed in participants with (n = 948) and without (n = 3330) AF from the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Massachusetts General Hospital.

RESULTS: One common variant (rs11265611; P = 1.70 × 10(-6)) intronic to IL6R (interleukin-6 receptor gene) was significantly associated with AF after Bonferroni correction (odds ratio 0.70; 95% confidence interval 0.58-0.85). The variant was not genotyped or imputed by prior GWAS, but it is in linkage disequilibrium (r(2) = .69) with the single-nucleotide polymorphism, with the strongest association with AF so far at this locus (rs4845625). In the rare variant joint analysis, damaging variants within the PRRX1 region showed significant association with AF after Bonferroni correction (P = .01).

CONCLUSIONS: We identified 1 common single-nucleotide polymorphism and 1 gene region that were significantly associated with AF. Future sequencing efforts with larger sample sizes and more comprehensive genome coverage are anticipated to identify additional AF-related variants.

%B Heart Rhythm %V 11 %P 452-7 %8 2014 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/24239840?dopt=Abstract %R 10.1016/j.hrthm.2013.11.012 %0 Journal Article %J Circ Arrhythm Electrophysiol %D 2014 %T Telomere length and the risk of atrial fibrillation: insights into the role of biological versus chronological aging. %A Roberts, Jason D %A Dewland, Thomas A %A Longoria, James %A Fitzpatrick, Annette L %A Ziv, Elad %A Hu, Donglei %A Lin, Jue %A Glidden, David V %A Psaty, Bruce M %A Burchard, Esteban G %A Blackburn, Elizabeth H %A Olgin, Jeffrey E %A Heckbert, Susan R %A Marcus, Gregory M %K Age Factors %K Aged %K Aging %K Atrial Fibrillation %K California %K Cardiac Surgical Procedures %K Cellular Senescence %K Cross-Sectional Studies %K Female %K Genetic Predisposition to Disease %K Humans %K Incidence %K Leukocytes %K Male %K Phenotype %K Polymorphism, Single Nucleotide %K Prospective Studies %K Risk Assessment %K Risk Factors %K Telomerase %K Telomere %K Time Factors %X

BACKGROUND: Advanced age is the most important risk factor for atrial fibrillation (AF); however, the mechanism remains unknown. Telomeres, regions of DNA that shorten with cell division, are considered reliable markers of biological aging. We sought to examine the association between leukocyte telomere length (LTL) and incident AF in a large population-based cohort using direct LTL measurements and genetic data. To further explore our findings, we compared atrial cell telomere length and LTL in cardiac surgery patients.

METHODS AND RESULTS: Mean LTL and the TERT rs2736100 single nucleotide polymorphism were assessed as predictors of incident AF in the Cardiovascular Health Study (CHS). Among the surgical patients, within subject comparison of atrial cell telomere length versus LTL was assessed. Among 1639 CHS participants, we observed no relationship between mean LTL and incident AF before and after adjustment for potential confounders (adjusted hazard ratio, 1.09; 95% confidence interval: 0.92-1.29; P=0.299); chronologic age remained strongly associated with AF in the same model. No association was observed between the TERT rs2736100 single nucleotide polymorphism and incident AF (adjusted hazard ratio: 0.95; 95% confidence interval: 0.88-1.04; P=0.265). In 35 cardiac surgery patients (26 with AF), atrial cell telomere length was longer than LTL (1.19 ± 0.20 versus 1.02 ± 0.25 [T/S ratio], P<0.001), a finding that remained consistent within the AF subgroup.

CONCLUSIONS: Our study revealed no evidence of an association between LTL and incident AF and no evidence of relative atrial cell telomere shortening in AF. Chronological aging independent of biological markers of aging is the primary risk factor for AF.

%B Circ Arrhythm Electrophysiol %V 7 %P 1026-32 %8 2014 Dec %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25381796?dopt=Abstract %R 10.1161/CIRCEP.114.001781 %0 Journal Article %J Clin Endocrinol (Oxf) %D 2014 %T Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study. %A Shores, Molly M %A Arnold, Alice M %A Biggs, Mary L %A Longstreth, W T %A Smith, Nicholas L %A Kizer, Jorge R %A Cappola, Anne R %A Hirsch, Calvin H %A Marck, Brett T %A Matsumoto, Alvin M %K Aged %K Aged, 80 and over %K Brain Ischemia %K Cardiovascular Physiological Phenomena %K Dihydrotestosterone %K Health %K Humans %K Incidence %K Longitudinal Studies %K Male %K Stroke %K Testosterone %X

OBJECTIVE: Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (DHT) was associated with incident ischaemic stroke in elderly men.

DESIGN: Cohort study.

PARTICIPANTS: Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.

MEASUREMENTS: Adjudicated ischaemic stroke.

RESULTS: Among 1032 men (mean age 76, range 66-97), followed for a median of 10 years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (P = 0·006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50-75 ng/dl, with greater risk of stroke at DHT levels above 75 ng/dl or below 50 ng/dl. Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0·77 (95% CI, 0·61, 0·98) per standard deviation in analyses adjusted for stroke risk factors.

CONCLUSIONS: Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal DHT level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.

%B Clin Endocrinol (Oxf) %V 81 %P 746-53 %8 2014 Nov %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/24645738?dopt=Abstract %R 10.1111/cen.12452 %0 Journal Article %J J Clin Endocrinol Metab %D 2014 %T Testosterone, dihydrotestosterone, and incident cardiovascular disease and mortality in the cardiovascular health study. %A Shores, Molly M %A Biggs, Mary L %A Arnold, Alice M %A Smith, Nicholas L %A Longstreth, W T %A Kizer, Jorge R %A Hirsch, Calvin H %A Cappola, Anne R %A Matsumoto, Alvin M %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Cause of Death %K Dihydrotestosterone %K Humans %K Incidence %K Longitudinal Studies %K Male %K Mortality %K Residence Characteristics %K Risk Factors %K Testosterone %X

CONTEXT: Low testosterone (T) is associated with prevalent cardiovascular disease (CVD) and mortality. DHT, a more potent androgen, may also be associated with CVD and mortality, but few studies have examined this.

OBJECTIVE: The study objective was to examine whether T and DHT are risk factors for incident CVD and mortality.

DESIGN: In a longitudinal cohort study, we evaluated whether total T, calculated free T (cFT), DHT, and calculated free DHT were associated with incident CVD and mortality in men in the Cardiovascular Health Study (mean age 76, range 66-97 years) who were free of CVD at the time of blood collection.

MAIN OUTCOME: The main outcomes were incident CVD and all-cause mortality.

RESULTS: Among 1032 men followed for a median of 9 years, 436 incident CVD events and 777 deaths occurred. In models adjusted for cardiovascular risk factors, total T and cFT were not associated with incident CVD or all-cause mortality, whereas DHT and calculated free DHT had curvilinear associations with incident CVD (P < .002 and P = .04, respectively) and all-cause mortality (P < .001 for both).

CONCLUSIONS: In a cohort of elderly men, DHT and calculated free DHT were associated with incident CVD and all-cause mortality. Further studies are needed to confirm these results and to clarify the underlying physiologic mechanisms.

%B J Clin Endocrinol Metab %V 99 %P 2061-8 %8 2014 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/24628549?dopt=Abstract %R 10.1210/jc.2013-3576 %0 Journal Article %J Hum Mol Genet %D 2014 %T Trans-ethnic meta-analysis of white blood cell phenotypes. %A Keller, Margaux F %A Reiner, Alexander P %A Okada, Yukinori %A van Rooij, Frank J A %A Johnson, Andrew D %A Chen, Ming-Huei %A Smith, Albert V %A Morris, Andrew P %A Tanaka, Toshiko %A Ferrucci, Luigi %A Zonderman, Alan B %A Lettre, Guillaume %A Harris, Tamara %A Garcia, Melissa %A Bandinelli, Stefania %A Qayyum, Rehan %A Yanek, Lisa R %A Becker, Diane M %A Becker, Lewis C %A Kooperberg, Charles %A Keating, Brendan %A Reis, Jared %A Tang, Hua %A Boerwinkle, Eric %A Kamatani, Yoichiro %A Matsuda, Koichi %A Kamatani, Naoyuki %A Nakamura, Yusuke %A Kubo, Michiaki %A Liu, Simin %A Dehghan, Abbas %A Felix, Janine F %A Hofman, Albert %A Uitterlinden, André G %A van Duijn, Cornelia M %A Franco, Oscar H %A Longo, Dan L %A Singleton, Andrew B %A Psaty, Bruce M %A Evans, Michelle K %A Cupples, L Adrienne %A Rotter, Jerome I %A O'Donnell, Christopher J %A Takahashi, Atsushi %A Wilson, James G %A Ganesh, Santhi K %A Nalls, Mike A %K African Americans %K Asian Continental Ancestry Group %K Bayes Theorem %K European Continental Ancestry Group %K Genome, Human %K Genome-Wide Association Study %K Genotype %K Humans %K Leukocyte Count %K Leukocytes %K Linkage Disequilibrium %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

White blood cell (WBC) count is a common clinical measure used as a predictor of certain aspects of human health, including immunity and infection status. WBC count is also a complex trait that varies among individuals and ancestry groups. Differences in linkage disequilibrium structure and heterogeneity in allelic effects are expected to play a role in the associations observed between populations. Prior genome-wide association study (GWAS) meta-analyses have identified genomic loci associated with WBC and its subtypes, but much of the heritability of these phenotypes remains unexplained. Using GWAS summary statistics for over 50 000 individuals from three diverse populations (Japanese, African-American and European ancestry), a Bayesian model methodology was employed to account for heterogeneity between ancestry groups. This approach was used to perform a trans-ethnic meta-analysis of total WBC, neutrophil and monocyte counts. Ten previously known associations were replicated and six new loci were identified, including several regions harboring genes related to inflammation and immune cell function. Ninety-five percent credible interval regions were calculated to narrow the association signals and fine-map the putatively causal variants within loci. Finally, a conditional analysis was performed on the most significant SNPs identified by the trans-ethnic meta-analysis (MA), and nine secondary signals within loci previously associated with WBC or its subtypes were identified. This work illustrates the potential of trans-ethnic analysis and ascribes a critical role to multi-ethnic cohorts and consortia in exploring complex phenotypes with respect to variants that lie outside the European-biased GWAS pool.

%B Hum Mol Genet %V 23 %P 6944-60 %8 2014 Dec 20 %G eng %N 25 %1 http://www.ncbi.nlm.nih.gov/pubmed/25096241?dopt=Abstract %R 10.1093/hmg/ddu401 %0 Journal Article %J Vasc Med %D 2014 %T Troponin T, NT-proBNP, and venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE). %A Folsom, Aaron R %A Lutsey, Pamela L %A Nambi, Vijay %A deFilippi, Christopher R %A Heckbert, Susan R %A Cushman, Mary %A Ballantyne, Christie M %K Aged %K Aged, 80 and over %K Atherosclerosis %K Biomarkers %K Female %K Heart Failure %K Humans %K Incidence %K Longitudinal Studies %K Male %K Middle Aged %K Natriuretic Peptide, Brain %K Peptide Fragments %K Prospective Studies %K Risk Factors %K Troponin T %K Venous Thromboembolism %X

Increased levels of plasma troponins and natriuretic peptides are markers of cardiac dysfunction associated with increased risk of cardiovascular disease. Little information exists on cardiac dysfunction and occurrence of venous thromboembolism (VTE). In two prospective epidemiological cohorts, we tested the hypothesis that high-sensitivity troponin T (TnT) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are associated positively with VTE occurrence. The Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS) measured plasma TnT and NT-proBNP in 13,719 men or women with no history of venous thrombosis, coronary heart disease, or heart failure and followed them for approximately 10 years for VTE occurrence (n = 348 VTEs). In both ARIC and CHS, TnT was associated positively with incidence of total VTE and provoked VTE, but not with unprovoked VTE: age, race, and sex-adjusted hazard ratios for total VTE in the pooled analysis were 1.00, 0.85, 1.36, 1.51, and 1.98 (p-trend <0.0001) across five categories of TnT. In contrast, the association of NT-proBNP with VTE was positive in ARIC (hazard ratios approximately 2.5-fold for the highest versus lowest NT-proBNP quintiles), but non-existent in CHS.

%B Vasc Med %V 19 %P 33-41 %8 2014 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/24558027?dopt=Abstract %R 10.1177/1358863X14520869 %0 Journal Article %J Neurology %D 2014 %T Vitamin D and the risk of dementia and Alzheimer disease. %A Littlejohns, Thomas J %A Henley, William E %A Lang, Iain A %A Annweiler, Cedric %A Beauchet, Olivier %A Chaves, Paulo H M %A Fried, Linda %A Kestenbaum, Bryan R %A Kuller, Lewis H %A Langa, Kenneth M %A Lopez, Oscar L %A Kos, Katarina %A Soni, Maya %A Llewellyn, David J %K Aged %K Alzheimer Disease %K Dementia %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Proportional Hazards Models %K Risk Factors %K United States %K Vitamin D %K Vitamin D Deficiency %X

OBJECTIVE: To determine whether low vitamin D concentrations are associated with an increased risk of incident all-cause dementia and Alzheimer disease.

METHODS: One thousand six hundred fifty-eight elderly ambulatory adults free from dementia, cardiovascular disease, and stroke who participated in the US population-based Cardiovascular Health Study between 1992-1993 and 1999 were included. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected in 1992-1993. Incident all-cause dementia and Alzheimer disease status were assessed during follow-up using National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria.

RESULTS: During a mean follow-up of 5.6 years, 171 participants developed all-cause dementia, including 102 cases of Alzheimer disease. Using Cox proportional hazards models, the multivariate adjusted hazard ratios (95% confidence interval [CI]) for incident all-cause dementia in participants who were severely 25(OH)D deficient (<25 nmol/L) and deficient (≥25 to <50 nmol/L) were 2.25 (95% CI: 1.23-4.13) and 1.53 (95% CI: 1.06-2.21) compared to participants with sufficient concentrations (≥50 nmol/L). The multivariate adjusted hazard ratios for incident Alzheimer disease in participants who were severely 25(OH)D deficient and deficient compared to participants with sufficient concentrations were 2.22 (95% CI: 1.02-4.83) and 1.69 (95% CI: 1.06-2.69). In multivariate adjusted penalized smoothing spline plots, the risk of all-cause dementia and Alzheimer disease markedly increased below a threshold of 50 nmol/L.

CONCLUSION: Our results confirm that vitamin D deficiency is associated with a substantially increased risk of all-cause dementia and Alzheimer disease. This adds to the ongoing debate about the role of vitamin D in nonskeletal conditions.

%B Neurology %V 83 %P 920-8 %8 2014 Sep 2 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25098535?dopt=Abstract %R 10.1212/WNL.0000000000000755 %0 Journal Article %J Am J Hum Genet %D 2014 %T Whole-exome sequencing identifies rare and low-frequency coding variants associated with LDL cholesterol. %A Lange, Leslie A %A Hu, Youna %A Zhang, He %A Xue, Chenyi %A Schmidt, Ellen M %A Tang, Zheng-Zheng %A Bizon, Chris %A Lange, Ethan M %A Smith, Joshua D %A Turner, Emily H %A Jun, Goo %A Kang, Hyun Min %A Peloso, Gina %A Auer, Paul %A Li, Kuo-Ping %A Flannick, Jason %A Zhang, Ji %A Fuchsberger, Christian %A Gaulton, Kyle %A Lindgren, Cecilia %A Locke, Adam %A Manning, Alisa %A Sim, Xueling %A Rivas, Manuel A %A Holmen, Oddgeir L %A Gottesman, Omri %A Lu, Yingchang %A Ruderfer, Douglas %A Stahl, Eli A %A Duan, Qing %A Li, Yun %A Durda, Peter %A Jiao, Shuo %A Isaacs, Aaron %A Hofman, Albert %A Bis, Joshua C %A Correa, Adolfo %A Griswold, Michael E %A Jakobsdottir, Johanna %A Smith, Albert V %A Schreiner, Pamela J %A Feitosa, Mary F %A Zhang, Qunyuan %A Huffman, Jennifer E %A Crosby, Jacy %A Wassel, Christina L %A Do, Ron %A Franceschini, Nora %A Martin, Lisa W %A Robinson, Jennifer G %A Assimes, Themistocles L %A Crosslin, David R %A Rosenthal, Elisabeth A %A Tsai, Michael %A Rieder, Mark J %A Farlow, Deborah N %A Folsom, Aaron R %A Lumley, Thomas %A Fox, Ervin R %A Carlson, Christopher S %A Peters, Ulrike %A Jackson, Rebecca D %A van Duijn, Cornelia M %A Uitterlinden, André G %A Levy, Daniel %A Rotter, Jerome I %A Taylor, Herman A %A Gudnason, Vilmundur %A Siscovick, David S %A Fornage, Myriam %A Borecki, Ingrid B %A Hayward, Caroline %A Rudan, Igor %A Chen, Y Eugene %A Bottinger, Erwin P %A Loos, Ruth J F %A Sætrom, Pål %A Hveem, Kristian %A Boehnke, Michael %A Groop, Leif %A McCarthy, Mark %A Meitinger, Thomas %A Ballantyne, Christie M %A Gabriel, Stacey B %A O'Donnell, Christopher J %A Post, Wendy S %A North, Kari E %A Reiner, Alexander P %A Boerwinkle, Eric %A Psaty, Bruce M %A Altshuler, David %A Kathiresan, Sekar %A Lin, Dan-Yu %A Jarvik, Gail P %A Cupples, L Adrienne %A Kooperberg, Charles %A Wilson, James G %A Nickerson, Deborah A %A Abecasis, Goncalo R %A Rich, Stephen S %A Tracy, Russell P %A Willer, Cristen J %K Adult %K Aged %K Apolipoproteins E %K Cholesterol, LDL %K Cohort Studies %K Dyslipidemias %K Exome %K Female %K Follow-Up Studies %K Gene Frequency %K Genetic Code %K Genome-Wide Association Study %K Genotype %K Humans %K Lipase %K Male %K Middle Aged %K Phenotype %K Polymorphism, Single Nucleotide %K Proprotein Convertase 9 %K Proprotein Convertases %K Receptors, LDL %K Sequence Analysis, DNA %K Serine Endopeptidases %X

Elevated low-density lipoprotein cholesterol (LDL-C) is a treatable, heritable risk factor for cardiovascular disease. Genome-wide association studies (GWASs) have identified 157 variants associated with lipid levels but are not well suited to assess the impact of rare and low-frequency variants. To determine whether rare or low-frequency coding variants are associated with LDL-C, we exome sequenced 2,005 individuals, including 554 individuals selected for extreme LDL-C (>98(th) or <2(nd) percentile). Follow-up analyses included sequencing of 1,302 additional individuals and genotype-based analysis of 52,221 individuals. We observed significant evidence of association between LDL-C and the burden of rare or low-frequency variants in PNPLA5, encoding a phospholipase-domain-containing protein, and both known and previously unidentified variants in PCSK9, LDLR and APOB, three known lipid-related genes. The effect sizes for the burden of rare variants for each associated gene were substantially higher than those observed for individual SNPs identified from GWASs. We replicated the PNPLA5 signal in an independent large-scale sequencing study of 2,084 individuals. In conclusion, this large whole-exome-sequencing study for LDL-C identified a gene not known to be implicated in LDL-C and provides unique insight into the design and analysis of similar experiments.

%B Am J Hum Genet %V 94 %P 233-45 %8 2014 Feb 06 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24507775?dopt=Abstract %R 10.1016/j.ajhg.2014.01.010 %0 Journal Article %J JAMA %D 2015 %T Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. %A Corrales-Medina, Vicente F %A Alvarez, Karina N %A Weissfeld, Lisa A %A Angus, Derek C %A Chirinos, Julio A %A Chang, Chung-Chou H %A Newman, Anne %A Loehr, Laura %A Folsom, Aaron R %A Elkind, Mitchell S %A Lyles, Mary F %A Kronmal, Richard A %A Yende, Sachin %K Aged %K Atherosclerosis %K Cardiovascular Diseases %K Cohort Studies %K Comorbidity %K Female %K Hospitalization %K Humans %K Male %K Middle Aged %K Pneumonia %K Risk Factors %X

IMPORTANCE: The risk of cardiovascular disease (CVD) after infection is poorly understood.

OBJECTIVE: To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD.

DESIGN, SETTINGS, AND PARTICIPANTS: We examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989-1994) and the Atherosclerosis Risk in Communities study (ARIC, n = 15,792; enrollment age, 45-64 years; enrollment period, 1987-1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status.

EXPOSURES: Hospitalization for pneumonia.

MAIN OUTCOMES AND MEASURES: Incident CVD (myocardial infarction, stroke, and fatal coronary heart disease).

RESULTS: Of 591 pneumonia cases in CHS, 206 had CVD events over 10 years after pneumonia hospitalization. CVD risk after pneumonia was highest in the first year. CVD occurred in 54 cases and 6 controls in the first 30 days (HR, 4.07; 95% CI, 2.86-5.27); 11 cases and 9 controls between 31 and 90 days (HR, 2.94; 95% CI, 2.18-3.70); and 22 cases and 55 controls between 91 days and 1 year (HR, 2.10; 95% CI, 1.59-2.60). Additional CVD risk remained elevated into the tenth year, when 4 cases and 12 controls developed CVD (HR, 1.86; 95% CI, 1.18-2.55). In ARIC, of 680 pneumonia cases, 112 had CVD over 10 years after hospitalization. CVD occurred in 4 cases and 3 controls in the first 30 days (HR, 2.38; 95% CI, 1.12-3.63); 4 cases and 0 controls between 31 and 90 days (HR, 2.40; 95% CI, 1.23-3.47); 11 cases and 8 controls between 91 days and 1 year (HR, 2.19; 95% CI, 1.20-3.19); and 8 cases and 7 controls during the second year (HR, 1.88; 95% CI, 1.10-2.66). After the second year, the HRs were no longer statistically significant.

CONCLUSIONS AND RELEVANCE: Hospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD.

%B JAMA %V 313 %P 264-74 %8 2015 Jan 20 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25602997?dopt=Abstract %R 10.1001/jama.2014.18229 %0 Journal Article %J Stroke %D 2015 %T Association between left atrial abnormality on ECG and vascular brain injury on MRI in the Cardiovascular Health Study. %A Kamel, Hooman %A Bartz, Traci M %A Longstreth, W T %A Okin, Peter M %A Thacker, Evan L %A Patton, Kristen K %A Stein, Phyllis K %A Gottesman, Rebecca F %A Heckbert, Susan R %A Kronmal, Richard A %A Elkind, Mitchell S V %A Soliman, Elsayed Z %K Aged %K Atrial Fibrillation %K Brain %K Brain Infarction %K Cardiovascular Diseases %K Cerebrovascular Trauma %K Electrocardiography %K Female %K Heart Atria %K Heart Diseases %K Humans %K Linear Models %K Magnetic Resonance Imaging %K Male %K Middle Aged %K Predictive Value of Tests %K Prospective Studies %K Regression Analysis %K Risk Factors %K Treatment Outcome %X

BACKGROUND AND PURPOSE: Emerging evidence suggests that atrial disease is associated with vascular brain injury in the absence of atrial fibrillation.

METHODS: The Cardiovascular Health Study prospectively enrolled community-dwelling adults aged ≥65 years. Among participants who underwent MRI, we examined associations of ECG left atrial abnormality with brain infarcts and leukoaraiosis. P-wave terminal force in lead V1 was the primary measure of left atrial abnormality; P-wave area and duration were secondary predictors. We excluded participants with atrial fibrillation before or on their index ECG. Primary outcomes were incident infarcts and worsening leukoaraiosis from initial to follow-up scan ≈5 years later. Secondary outcomes were prevalent infarcts and degree of leukoaraiosis on initial MRI. Relative risk (RR) and linear regression models were adjusted for vascular risk factors.

RESULTS: Among 3129 participants with ≥1 scan, each SD increase in P-wave terminal force in lead V1 was associated with a 0.05-point (95% confidence interval [CI], 0.0003-0.10) higher baseline white matter grade on a 10-point scale. P-wave terminal force in lead V1 was associated with prevalent infarcts of any type (RR per SD, 1.09; 95% CI, 1.04-1.16) and more so with prevalent nonlacunar infarcts (RR per SD, 1.22; 95% CI, 1.08-1.38). Among 1839 participants with 2 scans, P-wave terminal force in lead V1 was associated with worsening leukoaraiosis (RR per SD, 1.09; 95% CI, 1.01-1.18), but not with incident infarcts (RR per SD, 1.06; 95% CI, 0.93-1.20). Sensitivity analyses adjusting for incident atrial fibrillation found similar results. P-wave area and duration were not associated with outcomes.

CONCLUSIONS: ECG left atrial abnormality is associated with vascular brain injury in the absence of documented atrial fibrillation.

%B Stroke %V 46 %P 711-6 %8 2015 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25677594?dopt=Abstract %R 10.1161/STROKEAHA.114.007762 %0 Journal Article %J Neurobiol Aging %D 2015 %T Association of Alzheimer's disease GWAS loci with MRI markers of brain aging. %A Chauhan, Ganesh %A Adams, Hieab H H %A Bis, Joshua C %A Weinstein, Galit %A Yu, Lei %A Töglhofer, Anna Maria %A Smith, Albert Vernon %A van der Lee, Sven J %A Gottesman, Rebecca F %A Thomson, Russell %A Wang, Jing %A Yang, Qiong %A Niessen, Wiro J %A Lopez, Oscar L %A Becker, James T %A Phan, Thanh G %A Beare, Richard J %A Arfanakis, Konstantinos %A Fleischman, Debra %A Vernooij, Meike W %A Mazoyer, Bernard %A Schmidt, Helena %A Srikanth, Velandai %A Knopman, David S %A Jack, Clifford R %A Amouyel, Philippe %A Hofman, Albert %A DeCarli, Charles %A Tzourio, Christophe %A van Duijn, Cornelia M %A Bennett, David A %A Schmidt, Reinhold %A Longstreth, William T %A Mosley, Thomas H %A Fornage, Myriam %A Launer, Lenore J %A Seshadri, Sudha %A Ikram, M Arfan %A Debette, Stephanie %K Aging %K Alleles %K Alzheimer Disease %K Apolipoproteins E %K Brain %K Female %K Genome-Wide Association Study %K Hippocampus %K Humans %K Magnetic Resonance Imaging %K Male %K Organ Size %K Polymorphism, Single Nucleotide %K Risk %K Sialic Acid Binding Ig-like Lectin 3 %X

Whether novel risk variants of Alzheimer's disease (AD) identified through genome-wide association studies also influence magnetic resonance imaging-based intermediate phenotypes of AD in the general population is unclear. We studied association of 24 AD risk loci with intracranial volume, total brain volume, hippocampal volume (HV), white matter hyperintensity burden, and brain infarcts in a meta-analysis of genetic association studies from large population-based samples (N = 8175-11,550). In single-SNP based tests, AD risk allele of APOE (rs2075650) was associated with smaller HV (p = 0.0054) and CD33 (rs3865444) with smaller intracranial volume (p = 0.0058). In gene-based tests, there was associations of HLA-DRB1 with total brain volume (p = 0.0006) and BIN1 with HV (p = 0.00089). A weighted AD genetic risk score was associated with smaller HV (beta ± SE = -0.047 ± 0.013, p = 0.00041), even after excluding the APOE locus (p = 0.029). However, only association of AD genetic risk score with HV, including APOE, was significant after multiple testing correction (including number of independent phenotypes tested). These results suggest that novel AD genetic risk variants may contribute to structural brain aging in nondemented older community persons.

%B Neurobiol Aging %V 36 %P 1765.e7-16 %8 2015 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25670335?dopt=Abstract %R 10.1016/j.neurobiolaging.2014.12.028 %0 Journal Article %J JAMA %D 2015 %T Association of Cardiometabolic Multimorbidity With Mortality. %A Di Angelantonio, Emanuele %A Kaptoge, Stephen %A Wormser, David %A Willeit, Peter %A Butterworth, Adam S %A Bansal, Narinder %A O'Keeffe, Linda M %A Gao, Pei %A Wood, Angela M %A Burgess, Stephen %A Freitag, Daniel F %A Pennells, Lisa %A Peters, Sanne A %A Hart, Carole L %A Håheim, Lise Lund %A Gillum, Richard F %A Nordestgaard, Børge G %A Psaty, Bruce M %A Yeap, Bu B %A Knuiman, Matthew W %A Nietert, Paul J %A Kauhanen, Jussi %A Salonen, Jukka T %A Kuller, Lewis H %A Simons, Leon A %A van der Schouw, Yvonne T %A Barrett-Connor, Elizabeth %A Selmer, Randi %A Crespo, Carlos J %A Rodriguez, Beatriz %A Verschuren, W M Monique %A Salomaa, Veikko %A Svärdsudd, Kurt %A van der Harst, Pim %A Björkelund, Cecilia %A Wilhelmsen, Lars %A Wallace, Robert B %A Brenner, Hermann %A Amouyel, Philippe %A Barr, Elizabeth L M %A Iso, Hiroyasu %A Onat, Altan %A Trevisan, Maurizio %A D'Agostino, Ralph B %A Cooper, Cyrus %A Kavousi, Maryam %A Welin, Lennart %A Roussel, Ronan %A Hu, Frank B %A Sato, Shinichi %A Davidson, Karina W %A Howard, Barbara V %A Leening, Maarten J G %A Leening, Maarten %A Rosengren, Annika %A Dörr, Marcus %A Deeg, Dorly J H %A Kiechl, Stefan %A Stehouwer, Coen D A %A Nissinen, Aulikki %A Giampaoli, Simona %A Donfrancesco, Chiara %A Kromhout, Daan %A Price, Jackie F %A Peters, Annette %A Meade, Tom W %A Casiglia, Edoardo %A Lawlor, Debbie A %A Gallacher, John %A Nagel, Dorothea %A Franco, Oscar H %A Assmann, Gerd %A Dagenais, Gilles R %A Jukema, J Wouter %A Sundström, Johan %A Woodward, Mark %A Brunner, Eric J %A Khaw, Kay-Tee %A Wareham, Nicholas J %A Whitsel, Eric A %A Njølstad, Inger %A Hedblad, Bo %A Wassertheil-Smoller, Sylvia %A Engström, Gunnar %A Rosamond, Wayne D %A Selvin, Elizabeth %A Sattar, Naveed %A Thompson, Simon G %A Danesh, John %K Adult %K Aged %K Comorbidity %K Diabetes Mellitus %K Female %K Humans %K Life Expectancy %K Male %K Middle Aged %K Mortality %K Myocardial Infarction %K Risk Factors %K Stroke %X

IMPORTANCE: The prevalence of cardiometabolic multimorbidity is increasing.

OBJECTIVE: To estimate reductions in life expectancy associated with cardiometabolic multimorbidity.

DESIGN, SETTING, AND PARTICIPANTS: Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates.

EXPOSURES: A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI).

MAIN OUTCOMES AND MEASURES: All-cause mortality and estimated reductions in life expectancy.

RESULTS: In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy.

CONCLUSIONS AND RELEVANCE: Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.

%B JAMA %V 314 %P 52-60 %8 2015 Jul 7 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26151266?dopt=Abstract %R 10.1001/jama.2015.7008 %0 Journal Article %J Hum Mol Genet %D 2015 %T Association of exome sequences with plasma C-reactive protein levels in >9000 participants. %A Schick, Ursula M %A Auer, Paul L %A Bis, Joshua C %A Lin, Honghuang %A Wei, Peng %A Pankratz, Nathan %A Lange, Leslie A %A Brody, Jennifer %A Stitziel, Nathan O %A Kim, Daniel S %A Carlson, Christopher S %A Fornage, Myriam %A Haessler, Jeffery %A Hsu, Li %A Jackson, Rebecca D %A Kooperberg, Charles %A Leal, Suzanne M %A Psaty, Bruce M %A Boerwinkle, Eric %A Tracy, Russell %A Ardissino, Diego %A Shah, Svati %A Willer, Cristen %A Loos, Ruth %A Melander, Olle %A McPherson, Ruth %A Hovingh, Kees %A Reilly, Muredach %A Watkins, Hugh %A Girelli, Domenico %A Fontanillas, Pierre %A Chasman, Daniel I %A Gabriel, Stacey B %A Gibbs, Richard %A Nickerson, Deborah A %A Kathiresan, Sekar %A Peters, Ulrike %A Dupuis, Josée %A Wilson, James G %A Rich, Stephen S %A Morrison, Alanna C %A Benjamin, Emelia J %A Gross, Myron D %A Reiner, Alex P %K Adult %K African Americans %K C-Reactive Protein %K Cardiovascular Diseases %K Cohort Studies %K European Continental Ancestry Group %K Exome %K Female %K Gene Frequency %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Hepatocyte Nuclear Factor 1-alpha %K Humans %K Male %K Plasma %K Polymorphism, Single Nucleotide %K Receptors, Interleukin-6 %K Risk Factors %X

C-reactive protein (CRP) concentration is a heritable systemic marker of inflammation that is associated with cardiovascular disease risk. Genome-wide association studies have identified CRP-associated common variants associated in ∼25 genes. Our aims were to apply exome sequencing to (1) assess whether the candidate loci contain rare coding variants associated with CRP levels and (2) perform an exome-wide search for rare variants in novel genes associated with CRP levels. We exome-sequenced 6050 European-Americans (EAs) and 3109 African-Americans (AAs) from the NHLBI-ESP and the CHARGE consortia, and performed association tests of sequence data with measured CRP levels. In single-variant tests across candidate loci, a novel rare (minor allele frequency = 0.16%) CRP-coding variant (rs77832441-A; p.Thr59Met) was associated with 53% lower mean CRP levels (P = 2.9 × 10(-6)). We replicated the association of rs77832441 in an exome array analysis of 11 414 EAs (P = 3.0 × 10(-15)). Despite a strong effect on CRP levels, rs77832441 was not associated with inflammation-related phenotypes including coronary heart disease. We also found evidence for an AA-specific association of APOE-ε2 rs7214 with higher CRP levels. At the exome-wide significance level (P < 5.0 × 10(-8)), we confirmed associations for reported common variants of HNF1A, CRP, IL6R and TOMM40-APOE. In gene-based tests, a burden of rare/lower frequency variation in CRP in EAs (P ≤ 6.8 × 10(-4)) and in retinoic acid receptor-related orphan receptor α (RORA) in AAs (P = 1.7 × 10(-3)) were associated with CRP levels at the candidate gene level (P < 2.0 × 10(-3)). This inquiry did not elucidate novel genes, but instead demonstrated that variants distributed across the allele frequency spectrum within candidate genes contribute to CRP levels.

%B Hum Mol Genet %V 24 %P 559-71 %8 2015 Jan 15 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25187575?dopt=Abstract %R 10.1093/hmg/ddu450 %0 Journal Article %J Circ Cardiovasc Genet %D 2015 %T Association of Rare Loss-Of-Function Alleles in HAL, Serum Histidine: Levels and Incident Coronary Heart Disease. %A Yu, Bing %A Li, Alexander H %A Muzny, Donna %A Veeraraghavan, Narayanan %A de Vries, Paul S %A Bis, Joshua C %A Musani, Solomon K %A Alexander, Danny %A Morrison, Alanna C %A Franco, Oscar H %A Uitterlinden, Andre %A Hofman, Albert %A Dehghan, Abbas %A Wilson, James G %A Psaty, Bruce M %A Gibbs, Richard %A Wei, Peng %A Boerwinkle, Eric %K Adult %K African Americans %K Alleles %K Coronary Disease %K European Continental Ancestry Group %K Female %K Histidine %K Histidine Ammonia-Lyase %K Humans %K Male %K Mutation %X

BACKGROUND: Histidine is a semiessential amino acid with antioxidant and anti-inflammatory properties. Few data are available on the associations between genetic variants, histidine levels, and incident coronary heart disease (CHD) in a population-based sample.

METHODS AND RESULTS: By conducting whole exome sequencing on 1152 African Americans in the Atherosclerosis Risk in Communities (ARIC) study and focusing on loss-of-function (LoF) variants, we identified 3 novel rare LoF variants in HAL, a gene that encodes histidine ammonia-lyase in the first step of histidine catabolism. These LoF variants had large effects on blood histidine levels (β=0.26; P=1.2×10(-13)). The positive association with histidine levels was replicated by genotyping an independent sample of 718 ARIC African Americans (minor allele frequency=1%; P=1.2×10(-4)). In addition, high blood histidine levels were associated with reduced risk of developing incident CHD with an average of 21.5 years of follow-up among African Americans (hazard ratio=0.18; P=1.9×10(-4)). This finding was validated in an independent sample of European Americans from the Framingham Heart Study (FHS) Offspring Cohort. However, LoF variants in HAL were not directly significantly associated with incident CHD after meta-analyzing results from the CHARGE Consortium.

CONCLUSIONS: Three LoF mutations in HAL were associated with increased histidine levels, which in turn were shown to be inversely related to the risk of CHD among both African Americans and European Americans. Future investigations on the association between HAL gene variation and CHD are warranted.

%B Circ Cardiovasc Genet %V 8 %P 351-5 %8 2015 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25575548?dopt=Abstract %R 10.1161/CIRCGENETICS.114.000697 %0 Journal Article %J Diabetes Care %D 2015 %T Circulating and dietary trans fatty acids and incident type 2 diabetes in older adults: the Cardiovascular Health Study. %A Wang, Qianyi %A Imamura, Fumiaki %A Ma, Wenjie %A Wang, Molin %A Lemaitre, Rozenn N %A King, Irena B %A Song, Xiaoling %A Biggs, Mary L %A Delaney, Joseph A %A Mukamal, Kenneth J %A Djoussé, Luc %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Biomarkers %K Diabetes Mellitus, Type 2 %K Diabetic Angiopathies %K Dietary Fats, Unsaturated %K Epidemiologic Methods %K Female %K Food Habits %K Humans %K Male %K Phospholipids %K Trans Fatty Acids %X

OBJECTIVE: To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment.

RESEARCH DESIGN AND METHODS: In the Cardiovascular Health Study, plasma phospholipid trans (t)-16:1n9, t-18:1, and cis (c)/t-, t/c-, and t/t-18:2 were measured in blood drawn from 2,919 adults aged 74 ± 5 years and free of prevalent DM in 1992. Dietary TFA was estimated among 4,207 adults free of prevalent DM when dietary questionnaires were initially administered in 1989 or 1996. Incident DM was defined through 2010 by medication use or blood glucose levels. Risks were assessed by Cox proportional hazards.

RESULTS: In biomarker analyses, 287 DM cases occurred during 30,825 person-years. Both t-16:1n9 (extreme quartile hazard ratio 1.59 [95% CI 1.04-2.42], P-trend = 0.04) and t-18:1 (1.91 [1.20-3.03], P-trend = 0.01) levels were associated with higher incident DM after adjustment for de novo lipogenesis fatty acids. In dietary analyses, 407 DM cases occurred during 50,105 person-years. Incident DM was positively associated with consumption of total TFAs (1.38 [1.03-1.86], P-trend = 0.02), t-18:1 (1.32 [1.00-1.76], P-trend = 0.04), and t-18:2 (1.41 [1.05-1.89], P-trend = 0.02). After further adjustment for other dietary habits, however, the associations of estimated dietary TFA with DM were attenuated, and only nonsignificant positive trends remained.

CONCLUSIONS: Among older adults, plasma phospholipid t-16:1n9 and t-18:1 levels were positively related to DM after adjustment for de novo lipogenesis fatty acids. Estimated dietary TFA was not significantly associated with DM. These findings highlight the need for further observational, interventional, and experimental studies of the effects TFA on DM.

%B Diabetes Care %V 38 %P 1099-107 %8 2015 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25784660?dopt=Abstract %R 10.2337/dc14-2101 %0 Journal Article %J J Thromb Haemost %D 2015 %T Coagulation factor XII genetic variation, ex vivo thrombin generation, and stroke risk in the elderly: results from the Cardiovascular Health Study. %A Olson, N C %A Butenas, S %A Lange, L A %A Lange, E M %A Cushman, M %A Jenny, N S %A Walston, J %A Souto, J C %A Soria, J M %A Chauhan, G %A Debette, S %A Longstreth, W T %A Seshadri, S %A Reiner, A P %A Tracy, R P %K African Americans %K Age Factors %K Aged %K Blood Coagulation %K Brain Ischemia %K European Continental Ancestry Group %K Factor XII %K Female %K Gene Frequency %K Genetic Predisposition to Disease %K Humans %K Incidence %K Male %K Phenotype %K Polymorphism, Single Nucleotide %K Prospective Studies %K Risk Assessment %K Risk Factors %K Stroke %K Thrombin %K Time Factors %K United States %X

BACKGROUND: The relationships of thrombin generation (TG) with cardiovascular disease risk are underevaluated in population-based cohorts.

OBJECTIVES: To evaluate the relationships of TG influenced by the contact and tissue factor coagulation pathways ex vivo with common single-nucleotide polymorphisms (SNPs) and incident cardiovascular disease and stroke.

PATIENTS/METHODS: We measured peak TG (pTG) in baseline plasma samples of Cardiovascular Health Study participants (n = 5411), both with and without inhibitory anti-factor XIa antibody (pTG/FXIa(-) ). We evaluated their associations with ~ 50 000 SNPs by using the IBCv2 genotyping array, and with incident cardiovascular disease and stroke events over a median follow-up of 13.2 years.

RESULTS: The minor allele for an SNP in the FXII gene (F12), rs1801020, was associated with lower pTG in European-Americans (β = - 34.2 ± 3.5 nm; P = 3.3 × 10(-22) ; minor allele frequency [MAF] = 0.23) and African-Americans (β = - 31.1 ± 7.9 nm; P = 9.0 × 10(-5) ; MAF = 0.42). Lower FXIa-independent pTG (pTG/FXIa(-) ) was associated with the F12 rs1801020 minor allele, and higher pTG/FXIa(-) was associated with the ABO SNP rs657152 minor allele (β = 16.3 nm; P = 4.3 × 10(-9) ; MAF = 0.37). The risk factor-adjusted ischemic stroke hazard ratios were 1.09 (95% confidence interval CI 1.01-1.17; P = 0.03) for pTG, 1.06 (95% CI 0.98-1.15; P = 0.17) for pTG/FXIa(-) , and 1.11 (95% CI 1.02-1.21; P = 0.02) for FXIa-dependent pTG (pTG/FXIa(+) ), per one standard deviation increment (n = 834 ischemic strokes). In a multicohort candidate gene analysis, rs1801020 was not associated with incident ischemic stroke (β = - 0.02; standard error = 0.08; P = 0.81).

CONCLUSIONS: These results support the importance of contact activation pathway-dependent TG as a risk factor for ischemic stroke, and indicate the importance of F12 SNPs for TG ex vivo and in vivo.

%B J Thromb Haemost %V 13 %P 1867-77 %8 2015 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/26286125?dopt=Abstract %R 10.1111/jth.13111 %0 Journal Article %J Neurology %D 2015 %T Common variation in COL4A1/COL4A2 is associated with sporadic cerebral small vessel disease. %A Rannikmae, Kristiina %A Davies, Gail %A Thomson, Pippa A %A Bevan, Steve %A Devan, William J %A Falcone, Guido J %A Traylor, Matthew %A Anderson, Christopher D %A Battey, Thomas W K %A Radmanesh, Farid %A Deka, Ranjan %A Woo, Jessica G %A Martin, Lisa J %A Jimenez-Conde, Jordi %A Selim, Magdy %A Brown, Devin L %A Silliman, Scott L %A Kidwell, Chelsea S %A Montaner, Joan %A Langefeld, Carl D %A Slowik, Agnieszka %A Hansen, Bjorn M %A Lindgren, Arne G %A Meschia, James F %A Fornage, Myriam %A Bis, Joshua C %A Debette, Stephanie %A Ikram, Mohammad A %A Longstreth, Will T %A Schmidt, Reinhold %A Zhang, Cathy R %A Yang, Qiong %A Sharma, Pankaj %A Kittner, Steven J %A Mitchell, Braxton D %A Holliday, Elizabeth G %A Levi, Christopher R %A Attia, John %A Rothwell, Peter M %A Poole, Deborah L %A Boncoraglio, Giorgio B %A Psaty, Bruce M %A Malik, Rainer %A Rost, Natalia %A Worrall, Bradford B %A Dichgans, Martin %A Van Agtmael, Tom %A Woo, Daniel %A Markus, Hugh S %A Seshadri, Sudha %A Rosand, Jonathan %A Sudlow, Cathie L M %K Cerebral Small Vessel Diseases %K Collagen Type IV %K Genetic Association Studies %K Genetic Variation %K Humans %K Polymorphism, Single Nucleotide %X

OBJECTIVES: We hypothesized that common variants in the collagen genes COL4A1/COL4A2 are associated with sporadic forms of cerebral small vessel disease.

METHODS: We conducted meta-analyses of existing genotype data among individuals of European ancestry to determine associations of 1,070 common single nucleotide polymorphisms (SNPs) in the COL4A1/COL4A2 genomic region with the following: intracerebral hemorrhage and its subtypes (deep, lobar) (1,545 cases, 1,485 controls); ischemic stroke and its subtypes (cardioembolic, large vessel disease, lacunar) (12,389 cases, 62,004 controls); and white matter hyperintensities (2,733 individuals with ischemic stroke and 9,361 from population-based cohorts with brain MRI data). We calculated a statistical significance threshold that accounted for multiple testing and linkage disequilibrium between SNPs (p < 0.000084).

RESULTS: Three intronic SNPs in COL4A2 were significantly associated with deep intracerebral hemorrhage (lead SNP odds ratio [OR] 1.29, 95% confidence interval [CI] 1.14-1.46, p = 0.00003; r(2) > 0.9 between SNPs). Although SNPs associated with deep intracerebral hemorrhage did not reach our significance threshold for association with lacunar ischemic stroke (lead SNP OR 1.10, 95% CI 1.03-1.18, p = 0.0073), and with white matter hyperintensity volume in symptomatic ischemic stroke patients (lead SNP OR 1.07, 95% CI 1.01-1.13, p = 0.016), the direction of association was the same. There was no convincing evidence of association with white matter hyperintensities in population-based studies or with non-small vessel disease cerebrovascular phenotypes.

CONCLUSIONS: Our results indicate an association between common variation in the COL4A2 gene and symptomatic small vessel disease, particularly deep intracerebral hemorrhage. These findings merit replication studies, including in ethnic groups of non-European ancestry.

%B Neurology %V 84 %P 918-26 %8 2015 Mar 3 %G ENG %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/25653287?dopt=Abstract %R 10.1212/WNL.0000000000001309 %0 Journal Article %J Am J Clin Nutr %D 2015 %T Consumption of meat is associated with higher fasting glucose and insulin concentrations regardless of glucose and insulin genetic risk scores: a meta-analysis of 50,345 Caucasians. %A Fretts, Amanda M %A Follis, Jack L %A Nettleton, Jennifer A %A Lemaitre, Rozenn N %A Ngwa, Julius S %A Wojczynski, Mary K %A Kalafati, Ioanna Panagiota %A Varga, Tibor V %A Frazier-Wood, Alexis C %A Houston, Denise K %A Lahti, Jari %A Ericson, Ulrika %A van den Hooven, Edith H %A Mikkilä, Vera %A Kiefte-de Jong, Jessica C %A Mozaffarian, Dariush %A Rice, Kenneth %A Renstrom, Frida %A North, Kari E %A McKeown, Nicola M %A Feitosa, Mary F %A Kanoni, Stavroula %A Smith, Caren E %A Garcia, Melissa E %A Tiainen, Anna-Maija %A Sonestedt, Emily %A Manichaikul, Ani %A van Rooij, Frank J A %A Dimitriou, Maria %A Raitakari, Olli %A Pankow, James S %A Djoussé, Luc %A Province, Michael A %A Hu, Frank B %A Lai, Chao-Qiang %A Keller, Margaux F %A Perälä, Mia-Maria %A Rotter, Jerome I %A Hofman, Albert %A Graff, Misa %A Kähönen, Mika %A Mukamal, Kenneth %A Johansson, Ingegerd %A Ordovas, Jose M %A Liu, Yongmei %A Männistö, Satu %A Uitterlinden, André G %A Deloukas, Panos %A Seppälä, Ilkka %A Psaty, Bruce M %A Cupples, L Adrienne %A Borecki, Ingrid B %A Franks, Paul W %A Arnett, Donna K %A Nalls, Mike A %A Eriksson, Johan G %A Orho-Melander, Marju %A Franco, Oscar H %A Lehtimäki, Terho %A Dedoussis, George V %A Meigs, James B %A Siscovick, David S %K Blood Glucose %K Cohort Studies %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Hyperglycemia %K Hyperinsulinism %K Insulin %K Insulin Resistance %K Insulin-Secreting Cells %K Meat %K Meat Products %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Factors %X

BACKGROUND: Recent studies suggest that meat intake is associated with diabetes-related phenotypes. However, whether the associations of meat intake and glucose and insulin homeostasis are modified by genes related to glucose and insulin is unknown.

OBJECTIVE: We investigated the associations of meat intake and the interaction of meat with genotype on fasting glucose and insulin concentrations in Caucasians free of diabetes mellitus.

DESIGN: Fourteen studies that are part of the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium participated in the analysis. Data were provided for up to 50,345 participants. Using linear regression within studies and a fixed-effects meta-analysis across studies, we examined 1) the associations of processed meat and unprocessed red meat intake with fasting glucose and insulin concentrations; and 2) the interactions of processed meat and unprocessed red meat with genetic risk score related to fasting glucose or insulin resistance on fasting glucose and insulin concentrations.

RESULTS: Processed meat was associated with higher fasting glucose, and unprocessed red meat was associated with both higher fasting glucose and fasting insulin concentrations after adjustment for potential confounders [not including body mass index (BMI)]. For every additional 50-g serving of processed meat per day, fasting glucose was 0.021 mmol/L (95% CI: 0.011, 0.030 mmol/L) higher. Every additional 100-g serving of unprocessed red meat per day was associated with a 0.037-mmol/L (95% CI: 0.023, 0.051-mmol/L) higher fasting glucose concentration and a 0.049-ln-pmol/L (95% CI: 0.035, 0.063-ln-pmol/L) higher fasting insulin concentration. After additional adjustment for BMI, observed associations were attenuated and no longer statistically significant. The association of processed meat and fasting insulin did not reach statistical significance after correction for multiple comparisons. Observed associations were not modified by genetic loci known to influence fasting glucose or insulin resistance.

CONCLUSION: The association of higher fasting glucose and insulin concentrations with meat consumption was not modified by an index of glucose- and insulin-related single-nucleotide polymorphisms. Six of the participating studies are registered at clinicaltrials.gov as NCT0000513 (Atherosclerosis Risk in Communities), NCT00149435 (Cardiovascular Health Study), NCT00005136 (Family Heart Study), NCT00005121 (Framingham Heart Study), NCT00083369 (Genetics of Lipid Lowering Drugs and Diet Network), and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).

%B Am J Clin Nutr %V 102 %P 1266-78 %8 2015 Nov %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/26354543?dopt=Abstract %R 10.3945/ajcn.114.101238 %0 Journal Article %J JACC Heart Fail %D 2015 %T Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults: The Cardiovascular Health Study. %A Del Gobbo, Liana C %A Kalantarian, Shadi %A Imamura, Fumiaki %A Lemaitre, Rozenn %A Siscovick, David S %A Psaty, Bruce M %A Mozaffarian, Dariush %K Aged %K Alcohol Drinking %K Cohort Studies %K Diet %K Female %K Heart Failure %K Humans %K Incidence %K Male %K Motor Activity %K Obesity %K Proportional Hazards Models %K Prospective Studies %K Risk Factors %K Sedentary Lifestyle %K Smoking %K United States %X

OBJECTIVES: The goal of this study was to determine the relative contribution of major lifestyle factors on the development of heart failure (HF) in older adults.

BACKGROUND: HF incurs high morbidity, mortality, and health care costs among adults ≥65 years of age, which is the most rapidly growing segment of the U.S.

METHODS: We prospectively investigated separate and combined associations of lifestyle risk factors with incident HF (1,380 cases) over 21.5 years among 4,490 men and women in the Cardiovascular Health Study, which is a community-based cohort of older adults. Lifestyle factors included 4 dietary patterns (Alternative Healthy Eating Index, Dietary Approaches to Stop Hypertension, an American Heart Association 2020 dietary goals score, and a Biologic pattern, which was constructed using previous knowledge of cardiovascular disease dietary risk factors), 4 physical activity metrics (exercise intensity, walking pace, energy expended in leisure activity, and walking distance), alcohol intake, smoking, and obesity.

RESULTS: No dietary pattern was associated with developing HF (p > 0.05). Walking pace and leisure activity were associated with a 26% and 22% lower risk of HF, respectively (pace >3 mph vs. <2 mph; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; leisure activity ≥845 kcal/week vs. <845 kcal/week; HR: 0.78; 95% CI: 0.69 to 0.87). Modest alcohol intake, maintaining a body mass index <30 kg/m(2), and not smoking were also independently associated with a lower risk of HF. Participants with ≥4 healthy lifestyle factors had a 45% (HR: 0.55; 95% CI: 0.42 to 0.74) lower risk of HF. Heterogeneity by age, sex, cardiovascular disease, hypertension medication use, and diabetes was not observed.

CONCLUSIONS: Among older U.S. adults, physical activity, modest alcohol intake, avoiding obesity, and not smoking, but not dietary patterns, were associated with a lower risk of HF.

%B JACC Heart Fail %V 3 %P 520-8 %8 2015 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/26160366?dopt=Abstract %R 10.1016/j.jchf.2015.02.009 %0 Journal Article %J J Med Genet %D 2015 %T DCAF4, a novel gene associated with leucocyte telomere length. %A Mangino, Massimo %A Christiansen, Lene %A Stone, Rivka %A Hunt, Steven C %A Horvath, Kent %A Eisenberg, Dan T A %A Kimura, Masayuki %A Petersen, Inge %A Kark, Jeremy D %A Herbig, Utz %A Reiner, Alex P %A Benetos, Athanase %A Codd, Veryan %A Nyholt, Dale R %A Sinnreich, Ronit %A Christensen, Kaare %A Nassar, Hisham %A Hwang, Shih-Jen %A Levy, Daniel %A Bataille, Veronique %A Fitzpatrick, Annette L %A Chen, Wei %A Berenson, Gerald S %A Samani, Nilesh J %A Martin, Nicholas G %A Tishkoff, Sarah %A Schork, Nicholas J %A Kyvik, Kirsten Ohm %A Dalgård, Christine %A Spector, Timothy D %A Aviv, Abraham %K Alleles %K Carrier Proteins %K Gene Expression Regulation %K Genome-Wide Association Study %K Humans %K Leukocytes %K Melanoma %K Risk Factors %K Telomere %K Telomere Homeostasis %X

BACKGROUND: Leucocyte telomere length (LTL), which is fashioned by multiple genes, has been linked to a host of human diseases, including sporadic melanoma. A number of genes associated with LTL have already been identified through genome-wide association studies. The main aim of this study was to establish whether DCAF4 (DDB1 and CUL4-associated factor 4) is associated with LTL. In addition, using ingenuity pathway analysis (IPA), we examined whether LTL-associated genes in the general population might partially explain the inherently longer LTL in patients with sporadic melanoma, the risk for which is increased with ultraviolet radiation (UVR).

RESULTS: Genome-wide association (GWA) meta-analysis and de novo genotyping of 20 022 individuals revealed a novel association (p=6.4×10(-10)) between LTL and rs2535913, which lies within DCAF4. Notably, eQTL analysis showed that rs2535913 is associated with decline in DCAF4 expressions in both lymphoblastoid cells and sun-exposed skin (p=4.1×10(-3) and 2×10(-3), respectively). Moreover, IPA revealed that LTL-associated genes, derived from GWA meta-analysis (N=9190), are over-represented among genes engaged in melanoma pathways. Meeting increasingly stringent p value thresholds (p<0.05, <0.01, <0.005, <0.001) in the LTL-GWA meta-analysis, these genes were jointly over-represented for melanoma at p values ranging from 1.97×10(-169) to 3.42×10(-24).

CONCLUSIONS: We uncovered a new locus associated with LTL in the general population. We also provided preliminary findings that suggest a link of LTL through genetic mechanisms with UVR and melanoma in the general population.

%B J Med Genet %V 52 %P 157-62 %8 2015 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25624462?dopt=Abstract %R 10.1136/jmedgenet-2014-102681 %0 Journal Article %J Mol Nutr Food Res %D 2015 %T Dietary fatty acids modulate associations between genetic variants and circulating fatty acids in plasma and erythrocyte membranes: Meta-analysis of nine studies in the CHARGE consortium. %A Smith, Caren E %A Follis, Jack L %A Nettleton, Jennifer A %A Foy, Millennia %A Wu, Jason H Y %A Ma, Yiyi %A Tanaka, Toshiko %A Manichakul, Ani W %A Wu, Hongyu %A Chu, Audrey Y %A Steffen, Lyn M %A Fornage, Myriam %A Mozaffarian, Dariush %A Kabagambe, Edmond K %A Ferruci, Luigi %A Chen, Yii-Der Ida %A Rich, Stephen S %A Djoussé, Luc %A Ridker, Paul M %A Tang, Weihong %A McKnight, Barbara %A Tsai, Michael Y %A Bandinelli, Stefania %A Rotter, Jerome I %A Hu, Frank B %A Chasman, Daniel I %A Psaty, Bruce M %A Arnett, Donna K %A King, Irena B %A Sun, Qi %A Wang, Lu %A Lumley, Thomas %A Chiuve, Stephanie E %A Siscovick, David S %A Ordovas, Jose M %A Lemaitre, Rozenn N %K Acetyltransferases %K Acyltransferases %K Adaptor Proteins, Signal Transducing %K Carboxy-Lyases %K Diet %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Erythrocyte Membrane %K Fatty Acid Desaturases %K Fatty Acids %K Fatty Acids, Omega-3 %K Female %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

SCOPE: Tissue concentrations of omega-3 fatty acids may reduce cardiovascular disease risk, and genetic variants are associated with circulating fatty acids concentrations. Whether dietary fatty acids interact with genetic variants to modify circulating omega-3 fatty acids is unclear. We evaluated interactions between genetic variants and fatty acid intakes for circulating alpha-linoleic acid, eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid.

METHODS AND RESULTS: We conducted meta-analyses (N = 11 668) evaluating interactions between dietary fatty acids and genetic variants (rs174538 and rs174548 in FADS1 (fatty acid desaturase 1), rs7435 in AGPAT3 (1-acyl-sn-glycerol-3-phosphate), rs4985167 in PDXDC1 (pyridoxal-dependent decarboxylase domain-containing 1), rs780094 in GCKR (glucokinase regulatory protein), and rs3734398 in ELOVL2 (fatty acid elongase 2)). Stratification by measurement compartment (plasma versus erthyrocyte) revealed compartment-specific interactions between FADS1 rs174538 and rs174548 and dietary alpha-linolenic acid and linoleic acid for docosahexaenoic acid and docosapentaenoic acid.

CONCLUSION: Our findings reinforce earlier reports that genetically based differences in circulating fatty acids may be partially due to differences in the conversion of fatty acid precursors. Further, fatty acids measurement compartment may modify gene-diet relationships, and considering compartment may improve the detection of gene-fatty acids interactions for circulating fatty acid outcomes.

%B Mol Nutr Food Res %V 59 %P 1373-83 %8 2015 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/25626431?dopt=Abstract %R 10.1002/mnfr.201400734 %0 Journal Article %J PLoS One %D 2015 %T Drug-Gene Interactions of Antihypertensive Medications and Risk of Incident Cardiovascular Disease: A Pharmacogenomics Study from the CHARGE Consortium. %A Bis, Joshua C %A Sitlani, Colleen %A Irvin, Ryan %A Avery, Christy L %A Smith, Albert Vernon %A Sun, Fangui %A Evans, Daniel S %A Musani, Solomon K %A Li, Xiaohui %A Trompet, Stella %A Krijthe, Bouwe P %A Harris, Tamara B %A Quibrera, P Miguel %A Brody, Jennifer A %A Demissie, Serkalem %A Davis, Barry R %A Wiggins, Kerri L %A Tranah, Gregory J %A Lange, Leslie A %A Sotoodehnia, Nona %A Stott, David J %A Franco, Oscar H %A Launer, Lenore J %A Stürmer, Til %A Taylor, Kent D %A Cupples, L Adrienne %A Eckfeldt, John H %A Smith, Nicholas L %A Liu, Yongmei %A Wilson, James G %A Heckbert, Susan R %A Buckley, Brendan M %A Ikram, M Arfan %A Boerwinkle, Eric %A Chen, Yii-Der Ida %A de Craen, Anton J M %A Uitterlinden, André G %A Rotter, Jerome I %A Ford, Ian %A Hofman, Albert %A Sattar, Naveed %A Slagboom, P Eline %A Westendorp, Rudi G J %A Gudnason, Vilmundur %A Vasan, Ramachandran S %A Lumley, Thomas %A Cummings, Steven R %A Taylor, Herman A %A Post, Wendy %A Jukema, J Wouter %A Stricker, Bruno H %A Whitsel, Eric A %A Psaty, Bruce M %A Arnett, Donna %K African Americans %K Aged %K Antihypertensive Agents %K Cardiovascular Diseases %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Hypertension %K Incidence %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Treatment Outcome %X

BACKGROUND: Hypertension is a major risk factor for a spectrum of cardiovascular diseases (CVD), including myocardial infarction, sudden death, and stroke. In the US, over 65 million people have high blood pressure and a large proportion of these individuals are prescribed antihypertensive medications. Although large long-term clinical trials conducted in the last several decades have identified a number of effective antihypertensive treatments that reduce the risk of future clinical complications, responses to therapy and protection from cardiovascular events vary among individuals.

METHODS: Using a genome-wide association study among 21,267 participants with pharmaceutically treated hypertension, we explored the hypothesis that genetic variants might influence or modify the effectiveness of common antihypertensive therapies on the risk of major cardiovascular outcomes. The classes of drug treatments included angiotensin-converting enzyme inhibitors, beta-blockers, calcium channel blockers, and diuretics. In the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, each study performed array-based genome-wide genotyping, imputed to HapMap Phase II reference panels, and used additive genetic models in proportional hazards or logistic regression models to evaluate drug-gene interactions for each of four therapeutic drug classes. We used meta-analysis to combine study-specific interaction estimates for approximately 2 million single nucleotide polymorphisms (SNPs) in a discovery analysis among 15,375 European Ancestry participants (3,527 CVD cases) with targeted follow-up in a case-only study of 1,751 European Ancestry GenHAT participants as well as among 4,141 African-Americans (1,267 CVD cases).

RESULTS: Although drug-SNP interactions were biologically plausible, exposures and outcomes were well measured, and power was sufficient to detect modest interactions, we did not identify any statistically significant interactions from the four antihypertensive therapy meta-analyses (Pinteraction > 5.0×10-8). Similarly, findings were null for meta-analyses restricted to 66 SNPs with significant main effects on coronary artery disease or blood pressure from large published genome-wide association studies (Pinteraction ≥ 0.01). Our results suggest that there are no major pharmacogenetic influences of common SNPs on the relationship between blood pressure medications and the risk of incident CVD.

%B PLoS One %V 10 %P e0140496 %8 2015 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/26516778?dopt=Abstract %R 10.1371/journal.pone.0140496 %0 Journal Article %J Am J Epidemiol %D 2015 %T Empirically Derived Trajectories to Dementia Over 15 Years of Follow-up Identified by Using Mixed Membership Models. %A Lecci, Fabrizio %A Junker, Brian %A Kuller, Lewis H %A Lopez, Oscar L %A Becker, James T %K Age Distribution %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Apolipoprotein E4 %K Cardiovascular Diseases %K Comorbidity %K Dementia %K Diabetes Mellitus %K Disease Progression %K Female %K Follow-Up Studies %K Humans %K Magnetic Resonance Imaging %K Male %K Mild Cognitive Impairment %K Neuroimaging %K Prevalence %K Proportional Hazards Models %K Risk Factors %K Sex Distribution %X

Alzheimer disease is the most common form of dementia in the elderly, and the complex relationships among risk factors produce highly variable natural histories from normal cognition through the prodromal stage of mild cognitive impairment (MCI) to clinical dementia. We used a novel statistical approach, mixed membership trajectory models, to capture the variety of such pathways in 652 participants in the Cardiovascular Health Study Cognition Study over 22 years of follow-up (1992-2014). We identified 3 trajectories: a "healthy" profile with a peak probability of MCI between 95 and 100 years of age and only a 50% probability of dementia by age 100; an "intermediate" profile with a peak probability of MCI between 85 and 90 years of age and progression to dementia between 90 and 95 years; and an "unhealthy" profile with a peak probability of progressing to MCI between ages 75 and 80 years and to dementia between the ages of 80 and 85 years. Hypertension, education, race, and the ϵ4 allele of the apolipoprotein E gene all affected the closeness of an individual to 1 or more of the canonical trajectories. These results provide new insights into the natural history of Alzheimer disease and evidence for a potential difference in the pathophysiology of the development of dementia.

%B Am J Epidemiol %V 182 %P 366-74 %8 2015 Aug 15 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/26209524?dopt=Abstract %R 10.1093/aje/kwv051 %0 Journal Article %J Nature %D 2015 %T Exome sequencing identifies rare LDLR and APOA5 alleles conferring risk for myocardial infarction. %A Do, Ron %A Stitziel, Nathan O %A Won, Hong-Hee %A Jørgensen, Anders Berg %A Duga, Stefano %A Angelica Merlini, Pier %A Kiezun, Adam %A Farrall, Martin %A Goel, Anuj %A Zuk, Or %A Guella, Illaria %A Asselta, Rosanna %A Lange, Leslie A %A Peloso, Gina M %A Auer, Paul L %A Girelli, Domenico %A Martinelli, Nicola %A Farlow, Deborah N %A DePristo, Mark A %A Roberts, Robert %A Stewart, Alexander F R %A Saleheen, Danish %A Danesh, John %A Epstein, Stephen E %A Sivapalaratnam, Suthesh %A Hovingh, G Kees %A Kastelein, John J %A Samani, Nilesh J %A Schunkert, Heribert %A Erdmann, Jeanette %A Shah, Svati H %A Kraus, William E %A Davies, Robert %A Nikpay, Majid %A Johansen, Christopher T %A Wang, Jian %A Hegele, Robert A %A Hechter, Eliana %A März, Winfried %A Kleber, Marcus E %A Huang, Jie %A Johnson, Andrew D %A Li, Mingyao %A Burke, Greg L %A Gross, Myron %A Liu, Yongmei %A Assimes, Themistocles L %A Heiss, Gerardo %A Lange, Ethan M %A Folsom, Aaron R %A Taylor, Herman A %A Olivieri, Oliviero %A Hamsten, Anders %A Clarke, Robert %A Reilly, Dermot F %A Yin, Wu %A Rivas, Manuel A %A Donnelly, Peter %A Rossouw, Jacques E %A Psaty, Bruce M %A Herrington, David M %A Wilson, James G %A Rich, Stephen S %A Bamshad, Michael J %A Tracy, Russell P %A Cupples, L Adrienne %A Rader, Daniel J %A Reilly, Muredach P %A Spertus, John A %A Cresci, Sharon %A Hartiala, Jaana %A Tang, W H Wilson %A Hazen, Stanley L %A Allayee, Hooman %A Reiner, Alex P %A Carlson, Christopher S %A Kooperberg, Charles %A Jackson, Rebecca D %A Boerwinkle, Eric %A Lander, Eric S %A Schwartz, Stephen M %A Siscovick, David S %A McPherson, Ruth %A Tybjaerg-Hansen, Anne %A Abecasis, Goncalo R %A Watkins, Hugh %A Nickerson, Deborah A %A Ardissino, Diego %A Sunyaev, Shamil R %A O'Donnell, Christopher J %A Altshuler, David %A Gabriel, Stacey %A Kathiresan, Sekar %K Age Factors %K Age of Onset %K Alleles %K Apolipoproteins A %K Case-Control Studies %K Cholesterol, LDL %K Coronary Artery Disease %K Exome %K Female %K Genetic Predisposition to Disease %K Genetics, Population %K Heterozygote %K Humans %K Male %K Middle Aged %K Mutation %K Myocardial Infarction %K National Heart, Lung, and Blood Institute (U.S.) %K Receptors, LDL %K Triglycerides %K United States %X

Myocardial infarction (MI), a leading cause of death around the world, displays a complex pattern of inheritance. When MI occurs early in life, genetic inheritance is a major component to risk. Previously, rare mutations in low-density lipoprotein (LDL) genes have been shown to contribute to MI risk in individual families, whereas common variants at more than 45 loci have been associated with MI risk in the population. Here we evaluate how rare mutations contribute to early-onset MI risk in the population. We sequenced the protein-coding regions of 9,793 genomes from patients with MI at an early age (≤50 years in males and ≤60 years in females) along with MI-free controls. We identified two genes in which rare coding-sequence mutations were more frequent in MI cases versus controls at exome-wide significance. At low-density lipoprotein receptor (LDLR), carriers of rare non-synonymous mutations were at 4.2-fold increased risk for MI; carriers of null alleles at LDLR were at even higher risk (13-fold difference). Approximately 2% of early MI cases harbour a rare, damaging mutation in LDLR; this estimate is similar to one made more than 40 years ago using an analysis of total cholesterol. Among controls, about 1 in 217 carried an LDLR coding-sequence mutation and had plasma LDL cholesterol > 190 mg dl(-1). At apolipoprotein A-V (APOA5), carriers of rare non-synonymous mutations were at 2.2-fold increased risk for MI. When compared with non-carriers, LDLR mutation carriers had higher plasma LDL cholesterol, whereas APOA5 mutation carriers had higher plasma triglycerides. Recent evidence has connected MI risk with coding-sequence mutations at two genes functionally related to APOA5, namely lipoprotein lipase and apolipoprotein C-III (refs 18, 19). Combined, these observations suggest that, as well as LDL cholesterol, disordered metabolism of triglyceride-rich lipoproteins contributes to MI risk.

%B Nature %V 518 %P 102-6 %8 2015 Feb 5 %G eng %N 7537 %1 http://www.ncbi.nlm.nih.gov/pubmed/25487149?dopt=Abstract %R 10.1038/nature13917 %0 Journal Article %J Atherosclerosis %D 2015 %T Fetuin-A and risk of coronary heart disease: A Mendelian randomization analysis and a pooled analysis of AHSG genetic variants in 7 prospective studies. %A Laugsand, Lars E %A Ix, Joachim H %A Bartz, Traci M %A Djoussé, Luc %A Kizer, Jorge R %A Tracy, Russell P %A Dehghan, Abbas %A Rexrode, Kathryn %A Lopez, Oscar L %A Rimm, Eric B %A Siscovick, David S %A O'Donnell, Christopher J %A Newman, Anne %A Mukamal, Kenneth J %A Jensen, Majken K %K Aged %K Aged, 80 and over %K alpha-2-HS-Glycoprotein %K Carotid Intima-Media Thickness %K Coronary Vessels %K Female %K Genetic Variation %K Genotype %K Heart Diseases %K Humans %K Insulin Resistance %K Longitudinal Studies %K Male %K Mendelian Randomization Analysis %K Polymorphism, Single Nucleotide %K Prospective Studies %K Risk Factors %K Vascular Calcification %X

BACKGROUND AND AIMS: Fetuin-A has a plausible role in the inhibition of arterial calcification, but its association with risk of coronary heart disease (CHD) in the general population is unclear. We used two common genetic variants in the fetuin-A gene (AHSG) that are strongly associated with circulating fetuin-A levels to investigate the associations with risk of CHD and subclinical cardiovascular measures (intima-media thickness, ankle-arm index, and coronary artery calcification).

METHODS: Genetic variation and fetuin-A levels were assessed in 3299 community-living individuals (2733 Caucasians and 566 African Americans) 65 years of age or older, free of previous cardiovascular disease, who participated in the Cardiovascular Health Study (CHS) in 1992-1993.

RESULTS: Among Caucasians, both rs2248690 and rs4917 were associated with 12% lower fetuin-A concentrations per minor allele (P < 0.0001). The hazard ratios (HRs) per minor allele for incident CHD were 1.12 (95% CI: 1.00-1.26) for rs2248690 and 1.02 (0.91-1.14) for rs4917. Using both genotypes as an instrumental variable for measured fetuin-A, the HRs for one standard deviation increase in genetically determined fetuin-A levels on CHD risk were 0.84 (95% CI: 0.70-1.00) for rs2248690 and 0.97 (95% CI: 0.82-1.14) for rs4917, respectively. However, in CHS neither of the genotypes were associated with subclinical cardiovascular measures and when CHS data were meta-analyzed with data from six other prospective studies (totaling 26,702 Caucasian participants and 3295 CHD cases), the meta-analyzed HRs for incident CHD were 1.12 (0.93-1.34) and 1.06 (0.93-1.20) for rs2248690 and rs4917, respectively (p heterogeneity 0.005 and 0.0048).

CONCLUSION: Common variants in the AHSG gene are strongly associated with fetuin-A levels, but their concurrent association with CHD risk in current prospective studies is inconsistent. Further investigation in studies with measured fetuin-A and AHSG variants is needed to clarify the potential causal association of fetuin-A with CHD risk.

%B Atherosclerosis %V 243 %P 44-52 %8 2015 Nov %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26343871?dopt=Abstract %R 10.1016/j.atherosclerosis.2015.08.031 %0 Journal Article %J Hum Mol Genet %D 2015 %T Gene × dietary pattern interactions in obesity: analysis of up to 68 317 adults of European ancestry. %A Nettleton, Jennifer A %A Follis, Jack L %A Ngwa, Julius S %A Smith, Caren E %A Ahmad, Shafqat %A Tanaka, Toshiko %A Wojczynski, Mary K %A Voortman, Trudy %A Lemaitre, Rozenn N %A Kristiansson, Kati %A Nuotio, Marja-Liisa %A Houston, Denise K %A Perälä, Mia-Maria %A Qi, Qibin %A Sonestedt, Emily %A Manichaikul, Ani %A Kanoni, Stavroula %A Ganna, Andrea %A Mikkilä, Vera %A North, Kari E %A Siscovick, David S %A Harald, Kennet %A McKeown, Nicola M %A Johansson, Ingegerd %A Rissanen, Harri %A Liu, Yongmei %A Lahti, Jari %A Hu, Frank B %A Bandinelli, Stefania %A Rukh, Gull %A Rich, Stephen %A Booij, Lisanne %A Dmitriou, Maria %A Ax, Erika %A Raitakari, Olli %A Mukamal, Kenneth %A Männistö, Satu %A Hallmans, Göran %A Jula, Antti %A Ericson, Ulrika %A Jacobs, David R %A van Rooij, Frank J A %A Deloukas, Panos %A Sjogren, Per %A Kähönen, Mika %A Djoussé, Luc %A Perola, Markus %A Barroso, Inês %A Hofman, Albert %A Stirrups, Kathleen %A Viikari, Jorma %A Uitterlinden, André G %A Kalafati, Ioanna P %A Franco, Oscar H %A Mozaffarian, Dariush %A Salomaa, Veikko %A Borecki, Ingrid B %A Knekt, Paul %A Kritchevsky, Stephen B %A Eriksson, Johan G %A Dedoussis, George V %A Qi, Lu %A Ferrucci, Luigi %A Orho-Melander, Marju %A Zillikens, M Carola %A Ingelsson, Erik %A Lehtimäki, Terho %A Renstrom, Frida %A Cupples, L Adrienne %A Loos, Ruth J F %A Franks, Paul W %K Adult %K Body Mass Index %K Case-Control Studies %K Diet, Western %K Epistasis, Genetic %K European Continental Ancestry Group %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Obesity %K Polymorphism, Single Nucleotide %X

Obesity is highly heritable. Genetic variants showing robust associations with obesity traits have been identified through genome-wide association studies. We investigated whether a composite score representing healthy diet modifies associations of these variants with obesity traits. Totally, 32 body mass index (BMI)- and 14 waist-hip ratio (WHR)-associated single nucleotide polymorphisms were genotyped, and genetic risk scores (GRS) were calculated in 18 cohorts of European ancestry (n = 68 317). Diet score was calculated based on self-reported intakes of whole grains, fish, fruits, vegetables, nuts/seeds (favorable) and red/processed meats, sweets, sugar-sweetened beverages and fried potatoes (unfavorable). Multivariable adjusted, linear regression within each cohort followed by inverse variance-weighted, fixed-effects meta-analysis was used to characterize: (a) associations of each GRS with BMI and BMI-adjusted WHR and (b) diet score modification of genetic associations with BMI and BMI-adjusted WHR. Nominally significant interactions (P = 0.006-0.04) were observed between the diet score and WHR-GRS (but not BMI-GRS), two WHR loci (GRB14 rs10195252; LYPLAL1 rs4846567) and two BMI loci (LRRN6C rs10968576; MTIF3 rs4771122), for the respective BMI-adjusted WHR or BMI outcomes. Although the magnitudes of these select interactions were small, our data indicated that associations between genetic predisposition and obesity traits were stronger with a healthier diet. Our findings generate interesting hypotheses; however, experimental and functional studies are needed to determine their clinical relevance.

%B Hum Mol Genet %V 24 %P 4728-38 %8 2015 Aug 15 %G eng %N 16 %1 http://www.ncbi.nlm.nih.gov/pubmed/25994509?dopt=Abstract %R 10.1093/hmg/ddv186 %0 Journal Article %J Am J Hematol %D 2015 %T Gene-centric approach identifies new and known loci for FVIII activity and VWF antigen levels in European Americans and African Americans. %A Tang, Weihong %A Cushman, Mary %A Green, David %A Rich, Stephen S %A Lange, Leslie A %A Yang, Qiong %A Tracy, Russell P %A Tofler, Geoffrey H %A Basu, Saonli %A Wilson, James G %A Keating, Brendan J %A Weng, Lu-Chen %A Taylor, Herman A %A Jacobs, David R %A Delaney, Joseph A %A Palmer, Cameron D %A Young, Taylor %A Pankow, James S %A O'Donnell, Christopher J %A Smith, Nicholas L %A Reiner, Alexander P %A Folsom, Aaron R %K Adult %K African Americans %K Aged %K European Continental Ancestry Group %K Factor VIII %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Methionine Adenosyltransferase %K Middle Aged %K Polymorphism, Single Nucleotide %K Venous Thromboembolism %K von Willebrand Factor %X

Coagulation factor VIII and von Willebrand factor (VWF) are key proteins in procoagulant activation. Higher FVIII coagulant activity (FVIII :C) and VWF antigen (VWF :Ag) are risk factors for cardiovascular disease and venous thromboembolism. Beyond associations with ABO blood group, genetic determinants of FVIII and VWF are not well understood, especially in non European-American populations. We performed a genetic association study of FVIII :C and VWF:Ag that assessed 50,000 gene-centric single nucleotide polymorphisms (SNPs) in 18,556 European Americans (EAs) and 5,047 African Americans (AAs) from five population-based cohorts. Previously unreported associations for FVIII :C were identified in both AAs and EAs with KNG1 (most significantly associated SNP rs710446, Ile581Thr, Ile581Thr, P = 5.10 × 10(-7) in EAs and P = 3.88 × 10(-3) in AAs) and VWF rs7962217 (Gly2705Arg,P = 6.30 × 10(-9) in EAs and P = 2.98 × 10(-2) in AAs. Significant associations for FVIII :C were also observed with F8/TMLHE region SNP rs12557310 in EAs (P = 8.02 × 10(-10) ), with VWF rs1800380 in AAs (P = 5.62 × 10(-11) ), and with MAT1A rs2236568 in AAs (P51.69 × 10(-6) ). We replicated previously reported associations of FVIII :C and VWF :Ag with the ABO blood group, VWF rs1063856(Thr789Ala), rs216321 (Ala852Gln), and VWF rs2229446 (Arg2185Gln). Findings from this study expand our understanding of genetic influences for FVIII :C and VWF :Ag in both EAs and AAs.

%B Am J Hematol %V 90 %P 534-40 %8 2015 Jun %G eng %N 6 %R 10.1002/ajh.24005 %0 Journal Article %J Diabetes Care %D 2015 %T Gene-Environment Interactions of Circadian-Related Genes for Cardiometabolic Traits. %A Dashti, Hassan S %A Follis, Jack L %A Smith, Caren E %A Tanaka, Toshiko %A Garaulet, Marta %A Gottlieb, Daniel J %A Hruby, Adela %A Jacques, Paul F %A Kiefte-de Jong, Jessica C %A Lamon-Fava, Stefania %A Scheer, Frank A J L %A Bartz, Traci M %A Kovanen, Leena %A Wojczynski, Mary K %A Frazier-Wood, Alexis C %A Ahluwalia, Tarunveer S %A Perälä, Mia-Maria %A Jonsson, Anna %A Muka, Taulant %A Kalafati, Ioanna P %A Mikkilä, Vera %A Ordovas, Jose M %K Adult %K Alleles %K Blood Glucose %K Circadian Rhythm Signaling Peptides and Proteins %K Cohort Studies %K Diabetes Mellitus, Type 2 %K Diet, Fat-Restricted %K European Continental Ancestry Group %K Fasting %K Female %K Gene-Environment Interaction %K Humans %K Insulin Resistance %K Male %K Middle Aged %K Multicenter Studies as Topic %K Observational Studies as Topic %K Phenotype %K Polymorphism, Single Nucleotide %K Sleep %K Waist Circumference %X

OBJECTIVE: Common circadian-related gene variants associate with increased risk for metabolic alterations including type 2 diabetes. However, little is known about whether diet and sleep could modify associations between circadian-related variants (CLOCK-rs1801260, CRY2-rs11605924, MTNR1B-rs1387153, MTNR1B-rs10830963, NR1D1-rs2314339) and cardiometabolic traits (fasting glucose [FG], HOMA-insulin resistance, BMI, waist circumference, and HDL-cholesterol) to facilitate personalized recommendations.

RESEARCH DESIGN AND METHODS: We conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations and interactions between dietary intake/sleep duration and selected variants on cardiometabolic traits from 15 cohort studies including up to 28,190 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.

RESULTS: We observed significant associations between relative macronutrient intakes and glycemic traits and short sleep duration (<7 h) and higher FG and replicated known MTNR1B associations with glycemic traits. No interactions were evident after accounting for multiple comparisons. However, we observed nominally significant interactions (all P < 0.01) between carbohydrate intake and MTNR1B-rs1387153 for FG with a 0.003 mmol/L higher FG with each additional 1% carbohydrate intake in the presence of the T allele, between sleep duration and CRY2-rs11605924 for HDL-cholesterol with a 0.010 mmol/L higher HDL-cholesterol with each additional hour of sleep in the presence of the A allele, and between long sleep duration (≥9 h) and MTNR1B-rs1387153 for BMI with a 0.60 kg/m(2) higher BMI with long sleep duration in the presence of the T allele relative to normal sleep duration (≥7 to <9 h).

CONCLUSIONS: Our results suggest that lower carbohydrate intake and normal sleep duration may ameliorate cardiometabolic abnormalities conferred by common circadian-related genetic variants. Until further mechanistic examination of the nominally significant interactions is conducted, recommendations applicable to the general population regarding diet—specifically higher carbohydrate and lower fat composition—and normal sleep duration should continue to be emphasized among individuals with the investigated circadian-related gene variants.

%B Diabetes Care %V 38 %P 1456-66 %8 2015 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/26084345?dopt=Abstract %R 10.2337/dc14-2709 %0 Journal Article %J Stat Med %D 2015 %T Generalized estimating equations for genome-wide association studies using longitudinal phenotype data. %A Sitlani, Colleen M %A Rice, Kenneth M %A Lumley, Thomas %A McKnight, Barbara %A Cupples, L Adrienne %A Avery, Christy L %A Noordam, Raymond %A Stricker, Bruno H C %A Whitsel, Eric A %A Psaty, Bruce M %K Aged %K Aging %K Cardiovascular Diseases %K Cohort Studies %K Computer Simulation %K Cross-Sectional Studies %K Epidemiologic Research Design %K Gene-Environment Interaction %K Genetic Variation %K Genome, Human %K Genome-Wide Association Study %K Humans %K Longitudinal Studies %K Meta-Analysis as Topic %K Models, Genetic %K Pharmacogenetics %K Risk Assessment %K United States %X

Many longitudinal cohort studies have both genome-wide measures of genetic variation and repeated measures of phenotypes and environmental exposures. Genome-wide association study analyses have typically used only cross-sectional data to evaluate quantitative phenotypes and binary traits. Incorporation of repeated measures may increase power to detect associations, but also requires specialized analysis methods. Here, we discuss one such method-generalized estimating equations (GEE)-in the contexts of analysis of main effects of rare genetic variants and analysis of gene-environment interactions. We illustrate the potential for increased power using GEE analyses instead of cross-sectional analyses. We also address challenges that arise, such as the need for small-sample corrections when the minor allele frequency of a genetic variant and/or the prevalence of an environmental exposure is low. To illustrate methods for detection of gene-drug interactions on a genome-wide scale, using repeated measures data, we conduct single-study analyses and meta-analyses across studies in three large cohort studies participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium-the Atherosclerosis Risk in Communities study, the Cardiovascular Health Study, and the Rotterdam Study.

%B Stat Med %V 34 %P 118-30 %8 2015 Jan 15 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25297442?dopt=Abstract %R 10.1002/sim.6323 %0 Journal Article %J Stroke %D 2015 %T Genes from a translational analysis support a multifactorial nature of white matter hyperintensities. %A Lopez, Lorna M %A Hill, W David %A Harris, Sarah E %A Valdes Hernandez, Maria %A Munoz Maniega, Susana %A Bastin, Mark E %A Bailey, Emma %A Smith, Colin %A McBride, Martin %A McClure, John %A Graham, Delyth %A Dominiczak, Anna %A Yang, Qiong %A Fornage, Myriam %A Ikram, M Arfan %A Debette, Stephanie %A Launer, Lenore %A Bis, Joshua C %A Schmidt, Reinhold %A Seshadri, Sudha %A Porteous, David J %A Starr, John %A Deary, Ian J %A Wardlaw, Joanna M %K Aged %K Alzheimer Disease %K Animals %K Brain %K Causality %K Dementia %K Female %K Genome-Wide Association Study %K Humans %K Leukoencephalopathies %K Male %K Polymorphism, Single Nucleotide %K Rats %K Rats, Inbred SHR %K Rats, Wistar %K Risk Factors %K Translational Medical Research %K White Matter %X

BACKGROUND AND PURPOSE: White matter hyperintensities (WMH) of presumed vascular origin increase the risk of stroke and dementia. Despite strong WMH heritability, few gene associations have been identified. Relevant experimental models may be informative.

METHODS: We tested the associations between genes that were differentially expressed in brains of young spontaneously hypertensive stroke-prone rats and human WMH (using volume and visual score) in 621 subjects from the Lothian Birth Cohort 1936 (LBC1936). We then attempted replication in 9361 subjects from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE). We also tested the subjects from LBC1936 for previous genome-wide WMH associations found in subjects from CHARGE.

RESULTS: Of 126 spontaneously hypertensive stroke-prone rat genes, 10 were nominally associated with WMH volume or score in subjects from LBC1936, of which 5 (AFP, ALB, GNAI1, RBM8a, and MRPL18) were associated with both WMH volume and score (P<0.05); 2 of the 10 (XPNPEP1, P=6.7×10(-5); FARP1, P=0.024) plus another spontaneously hypertensive stroke-prone rat gene (USMG5, P=0.00014), on chromosomes 10, 13, and 10 respectively, were associated with WMH in subjects from CHARGE. Gene set enrichment showed significant associations for downregulated spontaneously hypertensive stroke-prone rat genes with WMH in humans. In subjects from LBC1936, we replicated CHARGE's genome-wide WMH associations on chromosomes 17 (TRIM65 and TRIM47) and, for the first time, 1 (PMF1).

CONCLUSIONS: Despite not passing multiple testing thresholds individually, these genes collectively are relevant to known WMH associations, proposed WMH mechanisms, or dementia: associations with Alzheimer's disease, late-life depression, ATP production, osmotic regulation, neurodevelopmental abnormalities, and cognitive impairment. If replicated further, they suggest a multifactorial nature for WMH and argue for more consideration of vascular contributions to dementia.

%B Stroke %V 46 %P 341-7 %8 2015 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25586835?dopt=Abstract %R 10.1161/STROKEAHA.114.007649 %0 Journal Article %J Mol Psychiatry %D 2015 %T Genetic contributions to variation in general cognitive function: a meta-analysis of genome-wide association studies in the CHARGE consortium (N=53949). %A Davies, G %A Armstrong, N %A Bis, J C %A Bressler, J %A Chouraki, V %A Giddaluru, S %A Hofer, E %A Ibrahim-Verbaas, C A %A Kirin, M %A Lahti, J %A van der Lee, S J %A Le Hellard, S %A Liu, T %A Marioni, R E %A Oldmeadow, C %A Postmus, I %A Smith, A V %A Smith, J A %A Thalamuthu, A %A Thomson, R %A Vitart, V %A Wang, J %A Yu, L %A Zgaga, L %A Zhao, W %A Boxall, R %A Harris, S E %A Hill, W D %A Liewald, D C %A Luciano, M %A Adams, H %A Ames, D %A Amin, N %A Amouyel, P %A Assareh, A A %A Au, R %A Becker, J T %A Beiser, A %A Berr, C %A Bertram, L %A Boerwinkle, E %A Buckley, B M %A Campbell, H %A Corley, J %A De Jager, P L %A Dufouil, C %A Eriksson, J G %A Espeseth, T %A Faul, J D %A Ford, I %A Gottesman, R F %A Griswold, M E %A Gudnason, V %A Harris, T B %A Heiss, G %A Hofman, A %A Holliday, E G %A Huffman, J %A Kardia, S L R %A Kochan, N %A Knopman, D S %A Kwok, J B %A Lambert, J-C %A Lee, T %A Li, G %A Li, S-C %A Loitfelder, M %A Lopez, O L %A Lundervold, A J %A Lundqvist, A %A Mather, K A %A Mirza, S S %A Nyberg, L %A Oostra, B A %A Palotie, A %A Papenberg, G %A Pattie, A %A Petrovic, K %A Polasek, O %A Psaty, B M %A Redmond, P %A Reppermund, S %A Rotter, J I %A Schmidt, H %A Schuur, M %A Schofield, P W %A Scott, R J %A Steen, V M %A Stott, D J %A van Swieten, J C %A Taylor, K D %A Trollor, J %A Trompet, S %A Uitterlinden, A G %A Weinstein, G %A Widen, E %A Windham, B G %A Jukema, J W %A Wright, A F %A Wright, M J %A Yang, Q %A Amieva, H %A Attia, J R %A Bennett, D A %A Brodaty, H %A de Craen, A J M %A Hayward, C %A Ikram, M A %A Lindenberger, U %A Nilsson, L-G %A Porteous, D J %A Räikkönen, K %A Reinvang, I %A Rudan, I %A Sachdev, P S %A Schmidt, R %A Schofield, P R %A Srikanth, V %A Starr, J M %A Turner, S T %A Weir, D R %A Wilson, J F %A van Duijn, C %A Launer, L %A Fitzpatrick, A L %A Seshadri, S %A Mosley, T H %A Deary, I J %K Aged %K Aged, 80 and over %K Atherosclerosis %K Cognition %K Cognition Disorders %K Cohort Studies %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K HMGN1 Protein %K Humans %K Male %K Middle Aged %K Neuropsychological Tests %K Phenotype %K Polymorphism, Single Nucleotide %K Scotland %X

General cognitive function is substantially heritable across the human life course from adolescence to old age. We investigated the genetic contribution to variation in this important, health- and well-being-related trait in middle-aged and older adults. We conducted a meta-analysis of genome-wide association studies of 31 cohorts (N=53,949) in which the participants had undertaken multiple, diverse cognitive tests. A general cognitive function phenotype was tested for, and created in each cohort by principal component analysis. We report 13 genome-wide significant single-nucleotide polymorphism (SNP) associations in three genomic regions, 6q16.1, 14q12 and 19q13.32 (best SNP and closest gene, respectively: rs10457441, P=3.93 × 10(-9), MIR2113; rs17522122, P=2.55 × 10(-8), AKAP6; rs10119, P=5.67 × 10(-9), APOE/TOMM40). We report one gene-based significant association with the HMGN1 gene located on chromosome 21 (P=1 × 10(-6)). These genes have previously been associated with neuropsychiatric phenotypes. Meta-analysis results are consistent with a polygenic model of inheritance. To estimate SNP-based heritability, the genome-wide complex trait analysis procedure was applied to two large cohorts, the Atherosclerosis Risk in Communities Study (N=6617) and the Health and Retirement Study (N=5976). The proportion of phenotypic variation accounted for by all genotyped common SNPs was 29% (s.e.=5%) and 28% (s.e.=7%), respectively. Using polygenic prediction analysis, ~1.2% of the variance in general cognitive function was predicted in the Generation Scotland cohort (N=5487; P=1.5 × 10(-17)). In hypothesis-driven tests, there was significant association between general cognitive function and four genes previously associated with Alzheimer's disease: TOMM40, APOE, ABCG1 and MEF2C.

%B Mol Psychiatry %V 20 %P 183-92 %8 2015 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25644384?dopt=Abstract %R 10.1038/mp.2014.188 %0 Journal Article %J J Lipid Res %D 2015 %T Genetic loci associated with circulating levels of very long-chain saturated fatty acids. %A Lemaitre, Rozenn N %A King, Irena B %A Kabagambe, Edmond K %A Wu, Jason H Y %A McKnight, Barbara %A Manichaikul, Ani %A Guan, Weihua %A Sun, Qi %A Chasman, Daniel I %A Foy, Millennia %A Wang, Lu %A Zhu, Jingwen %A Siscovick, David S %A Tsai, Michael Y %A Arnett, Donna K %A Psaty, Bruce M %A Djoussé, Luc %A Chen, Yii-der I %A Tang, Weihong %A Weng, Lu-Chen %A Wu, Hongyu %A Jensen, Majken K %A Chu, Audrey Y %A Jacobs, David R %A Rich, Stephen S %A Mozaffarian, Dariush %A Steffen, Lyn %A Rimm, Eric B %A Hu, Frank B %A Ridker, Paul M %A Fornage, Myriam %A Friedlander, Yechiel %K Cohort Studies %K Fatty Acids %K Genetic Loci %K Genetic Variation %K Genome-Wide Association Study %K Humans %X

Very long-chain saturated fatty acids (VLSFAs) are saturated fatty acids with 20 or more carbons. In contrast to the more abundant saturated fatty acids, such as palmitic acid, there is growing evidence that circulating VLSFAs may have beneficial biological properties. Whether genetic factors influence circulating levels of VLSFAs is not known. We investigated the association of common genetic variation with plasma phospholipid/erythrocyte levels of three VLSFAs by performing genome-wide association studies in seven population-based cohorts comprising 10,129 subjects of European ancestry. We observed associations of circulating VLSFA concentrations with common variants in two genes, serine palmitoyl-transferase long-chain base subunit 3 (SPTLC3), a gene involved in the rate-limiting step of de novo sphingolipid synthesis, and ceramide synthase 4 (CERS4). The SPTLC3 variant at rs680379 was associated with higher arachidic acid (20:0 , P = 5.81 × 10(-13)). The CERS4 variant at rs2100944 was associated with higher levels of 20:0 (P = 2.65 × 10(-40)) and in analyses that adjusted for 20:0, with lower levels of behenic acid (P = 4.22 × 10(-26)) and lignoceric acid (P = 3.20 × 10(-21)). These novel associations suggest an inter-relationship of circulating VLSFAs and sphingolipid synthesis.

%B J Lipid Res %V 56 %P 176-84 %8 2015 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25378659?dopt=Abstract %R 10.1194/jlr.M052456 %0 Journal Article %J Am J Clin Nutr %D 2015 %T Genetic loci associated with circulating phospholipid trans fatty acids: a meta-analysis of genome-wide association studies from the CHARGE Consortium. %A Mozaffarian, Dariush %A Kabagambe, Edmond K %A Johnson, Catherine O %A Lemaitre, Rozenn N %A Manichaikul, Ani %A Sun, Qi %A Foy, Millennia %A Wang, Lu %A Wiener, Howard %A Irvin, Marguerite R %A Rich, Stephen S %A Wu, Hongyu %A Jensen, Majken K %A Chasman, Daniel I %A Chu, Audrey Y %A Fornage, Myriam %A Steffen, Lyn %A King, Irena B %A McKnight, Barbara %A Psaty, Bruce M %A Djoussé, Luc %A Chen, Ida Y-D %A Wu, Jason H Y %A Siscovick, David S %A Ridker, Paul M %A Tsai, Michael Y %A Rimm, Eric B %A Hu, Frank B %A Arnett, Donna K %K African Americans %K Arachidonic Acid %K Asian Americans %K Biomarkers %K European Continental Ancestry Group %K Fatty Acids, Omega-6 %K Gene Frequency %K Genetic Association Studies %K Genetic Loci %K Genotyping Techniques %K Humans %K Phospholipids %K Polymorphism, Single Nucleotide %K Trans Fatty Acids %X

BACKGROUND: Circulating trans fatty acids (TFAs), which cannot be synthesized by humans, are linked to adverse health outcomes. Although TFAs are obtained from diet, little is known about subsequent influences (e.g., relating to incorporation, metabolism, or intercompetition with other fatty acids) that could alter circulating concentrations and possibly modulate or mediate impacts on health.

OBJECTIVE: The objective was to elucidate novel biologic pathways that may influence circulating TFAs by evaluating associations between common genetic variation and TFA biomarkers.

DESIGN: We performed meta-analyses using 7 cohorts of European-ancestry participants (n = 8013) having measured genome-wide variation in single-nucleotide polymorphisms (SNPs) and circulating TFA biomarkers (erythrocyte or plasma phospholipids), including trans-16:1n-7, total trans-18:1, trans/cis-18:2, cis/trans-18:2, and trans/trans-18:2. We further evaluated SNPs with genome-wide significant associations among African Americans (n = 1082), Chinese Americans (n = 669), and Hispanic Americans (n = 657) from 2 of these cohorts.

RESULTS: Among European-ancestry participants, 31 SNPs in or near the fatty acid desaturase (FADS) 1 and 2 cluster were associated with cis/trans-18:2; a top hit was rs174548 (β = 0.0035, P = 4.90 × 10(-15)), an SNP previously associated with circulating n-3 and n-6 polyunsaturated fatty acid concentrations. No significant association was identified for other TFAs. rs174548 in FADS1/2 was also associated with cis/trans-18:2 in Hispanic Americans (β = 0.0053, P = 1.05 × 10(-6)) and Chinese Americans (β = 0.0028, P = 0.002) but not African Americans (β = 0.0009, P = 0.34); however, in African Americans, fine mapping identified a top hit in FADS2 associated with cis/trans-18:2 (rs174579: β = 0.0118, P = 4.05 × 10(-5)). The association between rs174548 and cis/trans-18:2 remained significant after further adjustment for individual circulating n-3 and n-6 fatty acids, except arachidonic acid. After adjustment for arachidonic acid concentrations, the association between rs174548 and cis/trans-18:2 was nearly eliminated in European-ancestry participants (β-coefficient reduced by 86%), with similar reductions in Hispanic Americans and Chinese Americans.

CONCLUSIONS: Our findings provide novel evidence for genetic regulation of cis/trans-18:2 by the FADS1/2 cluster and suggest that this regulation may be influenced/mediated by concentrations of arachidonic acid, an n-6 polyunsaturated fat.

%B Am J Clin Nutr %V 101 %P 398-406 %8 2015 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25646338?dopt=Abstract %R 10.3945/ajcn.114.094557 %0 Journal Article %J Stroke %D 2015 %T Genetic overlap between diagnostic subtypes of ischemic stroke. %A Holliday, Elizabeth G %A Traylor, Matthew %A Malik, Rainer %A Bevan, Steve %A Falcone, Guido %A Hopewell, Jemma C %A Cheng, Yu-Ching %A Cotlarciuc, Ioana %A Bis, Joshua C %A Boerwinkle, Eric %A Boncoraglio, Giorgio B %A Clarke, Robert %A Cole, John W %A Fornage, Myriam %A Furie, Karen L %A Ikram, M Arfan %A Jannes, Jim %A Kittner, Steven J %A Lincz, Lisa F %A Maguire, Jane M %A Meschia, James F %A Mosley, Thomas H %A Nalls, Mike A %A Oldmeadow, Christopher %A Parati, Eugenio A %A Psaty, Bruce M %A Rothwell, Peter M %A Seshadri, Sudha %A Scott, Rodney J %A Sharma, Pankaj %A Sudlow, Cathie %A Wiggins, Kerri L %A Worrall, Bradford B %A Rosand, Jonathan %A Mitchell, Braxton D %A Dichgans, Martin %A Markus, Hugh S %A Levi, Christopher %A Attia, John %A Wray, Naomi R %K Alleles %K Atherosclerosis %K Cerebral Small Vessel Diseases %K Cohort Studies %K Data Interpretation, Statistical %K Embolism %K Genome-Wide Association Study %K Genotype %K Humans %K Ischemia %K Linear Models %K Meta-Analysis as Topic %K Phenotype %K Polymorphism, Single Nucleotide %K Stroke %X

BACKGROUND AND PURPOSE: Despite moderate heritability, the phenotypic heterogeneity of ischemic stroke has hampered gene discovery, motivating analyses of diagnostic subtypes with reduced sample sizes. We assessed evidence for a shared genetic basis among the 3 major subtypes: large artery atherosclerosis (LAA), cardioembolism, and small vessel disease (SVD), to inform potential cross-subtype analyses.

METHODS: Analyses used genome-wide summary data for 12 389 ischemic stroke cases (including 2167 LAA, 2405 cardioembolism, and 1854 SVD) and 62 004 controls from the Metastroke consortium. For 4561 cases and 7094 controls, individual-level genotype data were also available. Genetic correlations between subtypes were estimated using linear mixed models and polygenic profile scores. Meta-analysis of a combined LAA-SVD phenotype (4021 cases and 51 976 controls) was performed to identify shared risk alleles.

RESULTS: High genetic correlation was identified between LAA and SVD using linear mixed models (rg=0.96, SE=0.47, P=9×10(-4)) and profile scores (rg=0.72; 95% confidence interval, 0.52-0.93). Between LAA and cardioembolism and SVD and cardioembolism, correlation was moderate using linear mixed models but not significantly different from zero for profile scoring. Joint meta-analysis of LAA and SVD identified strong association (P=1×10(-7)) for single nucleotide polymorphisms near the opioid receptor μ1 (OPRM1) gene.

CONCLUSIONS: Our results suggest that LAA and SVD, which have been hitherto treated as genetically distinct, may share a substantial genetic component. Combined analyses of LAA and SVD may increase power to identify small-effect alleles influencing shared pathophysiological processes.

%B Stroke %V 46 %P 615-9 %8 2015 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25613305?dopt=Abstract %R 10.1161/STROKEAHA.114.007930 %0 Journal Article %J Nat Commun %D 2015 %T Genome of The Netherlands population-specific imputations identify an ABCA6 variant associated with cholesterol levels. %A van Leeuwen, Elisabeth M %A Karssen, Lennart C %A Deelen, Joris %A Isaacs, Aaron %A Medina-Gómez, Carolina %A Mbarek, Hamdi %A Kanterakis, Alexandros %A Trompet, Stella %A Postmus, Iris %A Verweij, Niek %A van Enckevort, David J %A Huffman, Jennifer E %A White, Charles C %A Feitosa, Mary F %A Bartz, Traci M %A Manichaikul, Ani %A Joshi, Peter K %A Peloso, Gina M %A Deelen, Patrick %A van Dijk, Freerk %A Willemsen, Gonneke %A de Geus, Eco J %A Milaneschi, Yuri %A Penninx, Brenda W J H %A Francioli, Laurent C %A Menelaou, Androniki %A Pulit, Sara L %A Rivadeneira, Fernando %A Hofman, Albert %A Oostra, Ben A %A Franco, Oscar H %A Mateo Leach, Irene %A Beekman, Marian %A de Craen, Anton J M %A Uh, Hae-Won %A Trochet, Holly %A Hocking, Lynne J %A Porteous, David J %A Sattar, Naveed %A Packard, Chris J %A Buckley, Brendan M %A Brody, Jennifer A %A Bis, Joshua C %A Rotter, Jerome I %A Mychaleckyj, Josyf C %A Campbell, Harry %A Duan, Qing %A Lange, Leslie A %A Wilson, James F %A Hayward, Caroline %A Polasek, Ozren %A Vitart, Veronique %A Rudan, Igor %A Wright, Alan F %A Rich, Stephen S %A Psaty, Bruce M %A Borecki, Ingrid B %A Kearney, Patricia M %A Stott, David J %A Adrienne Cupples, L %A Jukema, J Wouter %A van der Harst, Pim %A Sijbrands, Eric J %A Hottenga, Jouke-Jan %A Uitterlinden, André G %A Swertz, Morris A %A van Ommen, Gert-Jan B %A de Bakker, Paul I W %A Eline Slagboom, P %A Boomsma, Dorret I %A Wijmenga, Cisca %A van Duijn, Cornelia M %K ATP-Binding Cassette Transporters %K Cholesterol %K Gene Frequency %K Genetic Association Studies %K Humans %K Mutation, Missense %K Netherlands %X

Variants associated with blood lipid levels may be population-specific. To identify low-frequency variants associated with this phenotype, population-specific reference panels may be used. Here we impute nine large Dutch biobanks (~35,000 samples) with the population-specific reference panel created by the Genome of The Netherlands Project and perform association testing with blood lipid levels. We report the discovery of five novel associations at four loci (P value <6.61 × 10(-4)), including a rare missense variant in ABCA6 (rs77542162, p.Cys1359Arg, frequency 0.034), which is predicted to be deleterious. The frequency of this ABCA6 variant is 3.65-fold increased in the Dutch and its effect (βLDL-C=0.135, βTC=0.140) is estimated to be very similar to those observed for single variants in well-known lipid genes, such as LDLR.

%B Nat Commun %V 6 %P 6065 %8 2015 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25751400?dopt=Abstract %R 10.1038/ncomms7065 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2015 %T Genome-Wide Association Study and Linkage Analysis of the Healthy Aging Index. %A Minster, Ryan L %A Sanders, Jason L %A Singh, Jatinder %A Kammerer, Candace M %A Barmada, M Michael %A Matteini, Amy M %A Zhang, Qunyuan %A Wojczynski, Mary K %A Daw, E Warwick %A Brody, Jennifer A %A Arnold, Alice M %A Lunetta, Kathryn L %A Murabito, Joanne M %A Christensen, Kaare %A Perls, Thomas T %A Province, Michael A %A Newman, Anne B %K Aging %K Apolipoproteins E %K Forkhead Transcription Factors %K Genetic Linkage %K Genome-Wide Association Study %K Humans %K Longevity %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

BACKGROUND: The Healthy Aging Index (HAI) is a tool for measuring the extent of health and disease across multiple systems.

METHODS: We conducted a genome-wide association study and a genome-wide linkage analysis to map quantitative trait loci associated with the HAI and a modified HAI weighted for mortality risk in 3,140 individuals selected for familial longevity from the Long Life Family Study. The genome-wide association study used the Long Life Family Study as the discovery cohort and individuals from the Cardiovascular Health Study and the Framingham Heart Study as replication cohorts.

RESULTS: There were no genome-wide significant findings from the genome-wide association study; however, several single-nucleotide polymorphisms near ZNF704 on chromosome 8q21.13 were suggestively associated with the HAI in the Long Life Family Study (p < 10(-) (6)) and nominally replicated in the Cardiovascular Health Study and Framingham Heart Study. Linkage results revealed significant evidence (log-odds score = 3.36) for a quantitative trait locus for mortality-optimized HAI in women on chromosome 9p24-p23. However, results of fine-mapping studies did not implicate any specific candidate genes within this region of interest.

CONCLUSIONS: ZNF704 may be a potential candidate gene for studies of the genetic underpinnings of longevity.

%B J Gerontol A Biol Sci Med Sci %V 70 %P 1003-8 %8 2015 Aug %G ENG %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25758594?dopt=Abstract %R 10.1093/gerona/glv006 %0 Journal Article %J Mol Psychiatry %D 2015 %T Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. %A Cornelis, M C %A Byrne, E M %A Esko, T %A Nalls, M A %A Ganna, A %A Paynter, N %A Monda, K L %A Amin, N %A Fischer, K %A Renstrom, F %A Ngwa, J S %A Huikari, V %A Cavadino, A %A Nolte, I M %A Teumer, A %A Yu, K %A Marques-Vidal, P %A Rawal, R %A Manichaikul, A %A Wojczynski, M K %A Vink, J M %A Zhao, J H %A Burlutsky, G %A Lahti, J %A Mikkilä, V %A Lemaitre, R N %A Eriksson, J %A Musani, S K %A Tanaka, T %A Geller, F %A Luan, J %A Hui, J %A Mägi, R %A Dimitriou, M %A Garcia, M E %A Ho, W-K %A Wright, M J %A Rose, L M %A Magnusson, P K E %A Pedersen, N L %A Couper, D %A Oostra, B A %A Hofman, A %A Ikram, M A %A Tiemeier, H W %A Uitterlinden, A G %A van Rooij, F J A %A Barroso, I %A Johansson, I %A Xue, L %A Kaakinen, M %A Milani, L %A Power, C %A Snieder, H %A Stolk, R P %A Baumeister, S E %A Biffar, R %A Gu, F %A Bastardot, F %A Kutalik, Z %A Jacobs, D R %A Forouhi, N G %A Mihailov, E %A Lind, L %A Lindgren, C %A Michaëlsson, K %A Morris, A %A Jensen, M %A Khaw, K-T %A Luben, R N %A Wang, J J %A Männistö, S %A Perälä, M-M %A Kähönen, M %A Lehtimäki, T %A Viikari, J %A Mozaffarian, D %A Mukamal, K %A Psaty, B M %A Döring, A %A Heath, A C %A Montgomery, G W %A Dahmen, N %A Carithers, T %A Tucker, K L %A Ferrucci, L %A Boyd, H A %A Melbye, M %A Treur, J L %A Mellström, D %A Hottenga, J J %A Prokopenko, I %A Tönjes, A %A Deloukas, P %A Kanoni, S %A Lorentzon, M %A Houston, D K %A Liu, Y %A Danesh, J %A Rasheed, A %A Mason, M A %A Zonderman, A B %A Franke, L %A Kristal, B S %A Karjalainen, J %A Reed, D R %A Westra, H-J %A Evans, M K %A Saleheen, D %A Harris, T B %A Dedoussis, G %A Curhan, G %A Stumvoll, M %A Beilby, J %A Pasquale, L R %A Feenstra, B %A Bandinelli, S %A Ordovás, J M %A Chan, A T %A Peters, U %A Ohlsson, C %A Gieger, C %A Martin, N G %A Waldenberger, M %A Siscovick, D S %A Raitakari, O %A Eriksson, J G %A Mitchell, P %A Hunter, D J %A Kraft, P %A Rimm, E B %A Boomsma, D I %A Borecki, I B %A Loos, R J F %A Wareham, N J %A Vollenweider, P %A Caporaso, N %A Grabe, H J %A Neuhouser, M L %A Wolffenbuttel, B H R %A Hu, F B %A Hypponen, E %A Järvelin, M-R %A Cupples, L A %A Franks, P W %A Ridker, P M %A van Duijn, C M %A Heiss, G %A Metspalu, A %A North, K E %A Ingelsson, E %A Nettleton, J A %A van Dam, R M %A Chasman, D I %K Adaptor Proteins, Signal Transducing %K Basic Helix-Loop-Helix Leucine Zipper Transcription Factors %K Brain-Derived Neurotrophic Factor %K Coffea %K Cytochrome P-450 CYP1A2 %K Food Habits %K Genome-Wide Association Study %K Humans %K Phenotype %K Polymorphism, Single Nucleotide %X

Coffee, a major dietary source of caffeine, is among the most widely consumed beverages in the world and has received considerable attention regarding health risks and benefits. We conducted a genome-wide (GW) meta-analysis of predominately regular-type coffee consumption (cups per day) among up to 91,462 coffee consumers of European ancestry with top single-nucleotide polymorphisms (SNPs) followed-up in ~30 062 and 7964 coffee consumers of European and African-American ancestry, respectively. Studies from both stages were combined in a trans-ethnic meta-analysis. Confirmed loci were examined for putative functional and biological relevance. Eight loci, including six novel loci, met GW significance (log10Bayes factor (BF)>5.64) with per-allele effect sizes of 0.03-0.14 cups per day. Six are located in or near genes potentially involved in pharmacokinetics (ABCG2, AHR, POR and CYP1A2) and pharmacodynamics (BDNF and SLC6A4) of caffeine. Two map to GCKR and MLXIPL genes related to metabolic traits but lacking known roles in coffee consumption. Enhancer and promoter histone marks populate the regions of many confirmed loci and several potential regulatory SNPs are highly correlated with the lead SNP of each. SNP alleles near GCKR, MLXIPL, BDNF and CYP1A2 that were associated with higher coffee consumption have previously been associated with smoking initiation, higher adiposity and fasting insulin and glucose but lower blood pressure and favorable lipid, inflammatory and liver enzyme profiles (P<5 × 10(-8)).Our genetic findings among European and African-American adults reinforce the role of caffeine in mediating habitual coffee consumption and may point to molecular mechanisms underlying inter-individual variability in pharmacological and health effects of coffee.

%B Mol Psychiatry %V 20 %P 647-56 %8 2015 May %G ENG %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25288136?dopt=Abstract %R 10.1038/mp.2014.107 %0 Journal Article %J Biol Psychiatry %D 2015 %T Genome-wide studies of verbal declarative memory in nondemented older people: the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium. %A Debette, Stephanie %A Ibrahim Verbaas, Carla A %A Bressler, Jan %A Schuur, Maaike %A Smith, Albert %A Bis, Joshua C %A Davies, Gail %A Wolf, Christiane %A Gudnason, Vilmundur %A Chibnik, Lori B %A Yang, Qiong %A DeStefano, Anita L %A de Quervain, Dominique J F %A Srikanth, Velandai %A Lahti, Jari %A Grabe, Hans J %A Smith, Jennifer A %A Priebe, Lutz %A Yu, Lei %A Karbalai, Nazanin %A Hayward, Caroline %A Wilson, James F %A Campbell, Harry %A Petrovic, Katja %A Fornage, Myriam %A Chauhan, Ganesh %A Yeo, Robin %A Boxall, Ruth %A Becker, James %A Stegle, Oliver %A Mather, Karen A %A Chouraki, Vincent %A Sun, Qi %A Rose, Lynda M %A Resnick, Susan %A Oldmeadow, Christopher %A Kirin, Mirna %A Wright, Alan F %A Jonsdottir, Maria K %A Au, Rhoda %A Becker, Albert %A Amin, Najaf %A Nalls, Mike A %A Turner, Stephen T %A Kardia, Sharon L R %A Oostra, Ben %A Windham, Gwen %A Coker, Laura H %A Zhao, Wei %A Knopman, David S %A Heiss, Gerardo %A Griswold, Michael E %A Gottesman, Rebecca F %A Vitart, Veronique %A Hastie, Nicholas D %A Zgaga, Lina %A Rudan, Igor %A Polasek, Ozren %A Holliday, Elizabeth G %A Schofield, Peter %A Choi, Seung Hoan %A Tanaka, Toshiko %A An, Yang %A Perry, Rodney T %A Kennedy, Richard E %A Sale, Michèle M %A Wang, Jing %A Wadley, Virginia G %A Liewald, David C %A Ridker, Paul M %A Gow, Alan J %A Pattie, Alison %A Starr, John M %A Porteous, David %A Liu, Xuan %A Thomson, Russell %A Armstrong, Nicola J %A Eiriksdottir, Gudny %A Assareh, Arezoo A %A Kochan, Nicole A %A Widen, Elisabeth %A Palotie, Aarno %A Hsieh, Yi-Chen %A Eriksson, Johan G %A Vogler, Christian %A van Swieten, John C %A Shulman, Joshua M %A Beiser, Alexa %A Rotter, Jerome %A Schmidt, Carsten O %A Hoffmann, Wolfgang %A Nöthen, Markus M %A Ferrucci, Luigi %A Attia, John %A Uitterlinden, André G %A Amouyel, Philippe %A Dartigues, Jean-François %A Amieva, Hélène %A Räikkönen, Katri %A Garcia, Melissa %A Wolf, Philip A %A Hofman, Albert %A Longstreth, W T %A Psaty, Bruce M %A Boerwinkle, Eric %A DeJager, Philip L %A Sachdev, Perminder S %A Schmidt, Reinhold %A Breteler, Monique M B %A Teumer, Alexander %A Lopez, Oscar L %A Cichon, Sven %A Chasman, Daniel I %A Grodstein, Francine %A Müller-Myhsok, Bertram %A Tzourio, Christophe %A Papassotiropoulos, Andreas %A Bennett, David A %A Ikram, M Arfan %A Deary, Ian J %A van Duijn, Cornelia M %A Launer, Lenore %A Fitzpatrick, Annette L %A Seshadri, Sudha %A Mosley, Thomas H %K Aged %K Aged, 80 and over %K Aging %K Apolipoproteins E %K Claudin-5 %K Cohort Studies %K Female %K Genome-Wide Association Study %K Genotype %K Humans %K Male %K Memory Disorders %K Middle Aged %K Polymorphism, Single Nucleotide %K Proteins %K Proteoglycans %K Regression Analysis %K Sulfotransferases %K Verbal Learning %X

BACKGROUND: Memory performance in older persons can reflect genetic influences on cognitive function and dementing processes. We aimed to identify genetic contributions to verbal declarative memory in a community setting.

METHODS: We conducted genome-wide association studies for paragraph or word list delayed recall in 19 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, comprising 29,076 dementia- and stroke-free individuals of European descent, aged ≥45 years. Replication of suggestive associations (p < 5 × 10(-6)) was sought in 10,617 participants of European descent, 3811 African-Americans, and 1561 young adults.

RESULTS: rs4420638, near APOE, was associated with poorer delayed recall performance in discovery (p = 5.57 × 10(-10)) and replication cohorts (p = 5.65 × 10(-8)). This association was stronger for paragraph than word list delayed recall and in the oldest persons. Two associations with specific tests, in subsets of the total sample, reached genome-wide significance in combined analyses of discovery and replication (rs11074779 [HS3ST4], p = 3.11 × 10(-8), and rs6813517 [SPOCK3], p = 2.58 × 10(-8)) near genes involved in immune response. A genetic score combining 58 independent suggestive memory risk variants was associated with increasing Alzheimer disease pathology in 725 autopsy samples. Association of memory risk loci with gene expression in 138 human hippocampus samples showed cis-associations with WDR48 and CLDN5, both related to ubiquitin metabolism.

CONCLUSIONS: This largest study to date exploring the genetics of memory function in ~40,000 older individuals revealed genome-wide associations and suggested an involvement of immune and ubiquitin pathways.

%B Biol Psychiatry %V 77 %P 749-63 %8 2015 Apr 15 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25648963?dopt=Abstract %R 10.1016/j.biopsych.2014.08.027 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2015 %T GWAS of longevity in CHARGE consortium confirms APOE and FOXO3 candidacy. %A Broer, Linda %A Buchman, Aron S %A Deelen, Joris %A Evans, Daniel S %A Faul, Jessica D %A Lunetta, Kathryn L %A Sebastiani, Paola %A Smith, Jennifer A %A Smith, Albert V %A Tanaka, Toshiko %A Yu, Lei %A Arnold, Alice M %A Aspelund, Thor %A Benjamin, Emelia J %A De Jager, Philip L %A Eirkisdottir, Gudny %A Evans, Denis A %A Garcia, Melissa E %A Hofman, Albert %A Kaplan, Robert C %A Kardia, Sharon L R %A Kiel, Douglas P %A Oostra, Ben A %A Orwoll, Eric S %A Parimi, Neeta %A Psaty, Bruce M %A Rivadeneira, Fernando %A Rotter, Jerome I %A Seshadri, Sudha %A Singleton, Andrew %A Tiemeier, Henning %A Uitterlinden, André G %A Zhao, Wei %A Bandinelli, Stefania %A Bennett, David A %A Ferrucci, Luigi %A Gudnason, Vilmundur %A Harris, Tamara B %A Karasik, David %A Launer, Lenore J %A Perls, Thomas T %A Slagboom, P Eline %A Tranah, Gregory J %A Weir, David R %A Newman, Anne B %A van Duijn, Cornelia M %A Murabito, Joanne M %K Aged %K Aged, 80 and over %K Apolipoproteins E %K Cell Adhesion Molecules %K Cohort Studies %K Female %K Forkhead Box Protein O3 %K Forkhead Transcription Factors %K Genome-Wide Association Study %K Humans %K Longevity %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Receptors, Kainic Acid %X

BACKGROUND: The genetic contribution to longevity in humans has been estimated to range from 15% to 25%. Only two genes, APOE and FOXO3, have shown association with longevity in multiple independent studies.

METHODS: We conducted a meta-analysis of genome-wide association studies including 6,036 longevity cases, age ≥90 years, and 3,757 controls that died between ages 55 and 80 years. We additionally attempted to replicate earlier identified single nucleotide polymorphism (SNP) associations with longevity.

RESULTS: In our meta-analysis, we found suggestive evidence for the association of SNPs near CADM2 (odds ratio [OR] = 0.81; p value = 9.66 × 10(-7)) and GRIK2 (odds ratio = 1.24; p value = 5.09 × 10(-8)) with longevity. When attempting to replicate findings earlier identified in genome-wide association studies, only the APOE locus consistently replicated. In an additional look-up of the candidate gene FOXO3, we found that an earlier identified variant shows a highly significant association with longevity when including published data with our meta-analysis (odds ratio = 1.17; p value = 1.85×10(-10)).

CONCLUSIONS: We did not identify new genome-wide significant associations with longevity and did not replicate earlier findings except for APOE and FOXO3. Our inability to find new associations with survival to ages ≥90 years because longevity represents multiple complex traits with heterogeneous genetic underpinnings, or alternatively, that longevity may be regulated by rare variants that are not captured by standard genome-wide genotyping and imputation of common variants.

%B J Gerontol A Biol Sci Med Sci %V 70 %P 110-8 %8 2015 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25199915?dopt=Abstract %R 10.1093/gerona/glu166 %0 Journal Article %J Am J Clin Nutr %D 2015 %T Habitual sleep duration is associated with BMI and macronutrient intake and may be modified by CLOCK genetic variants. %A Dashti, Hassan S %A Follis, Jack L %A Smith, Caren E %A Tanaka, Toshiko %A Cade, Brian E %A Gottlieb, Daniel J %A Hruby, Adela %A Jacques, Paul F %A Lamon-Fava, Stefania %A Richardson, Kris %A Saxena, Richa %A Scheer, Frank A J L %A Kovanen, Leena %A Bartz, Traci M %A Perälä, Mia-Maria %A Jonsson, Anna %A Frazier-Wood, Alexis C %A Kalafati, Ioanna-Panagiota %A Mikkilä, Vera %A Partonen, Timo %A Lemaitre, Rozenn N %A Lahti, Jari %A Hernandez, Dena G %A Toft, Ulla %A Johnson, W Craig %A Kanoni, Stavroula %A Raitakari, Olli T %A Perola, Markus %A Psaty, Bruce M %A Ferrucci, Luigi %A Grarup, Niels %A Highland, Heather M %A Rallidis, Loukianos %A Kähönen, Mika %A Havulinna, Aki S %A Siscovick, David S %A Räikkönen, Katri %A Jørgensen, Torben %A Rotter, Jerome I %A Deloukas, Panos %A Viikari, Jorma S A %A Mozaffarian, Dariush %A Linneberg, Allan %A Seppälä, Ilkka %A Hansen, Torben %A Salomaa, Veikko %A Gharib, Sina A %A Eriksson, Johan G %A Bandinelli, Stefania %A Pedersen, Oluf %A Rich, Stephen S %A Dedoussis, George %A Lehtimäki, Terho %A Ordovas, Jose M %K Adult %K Body Mass Index %K CLOCK Proteins %K Cohort Studies %K Cross-Sectional Studies %K Diet %K Dietary Proteins %K Energy Intake %K European Continental Ancestry Group %K Fatty Acids, Unsaturated %K Female %K Gene-Environment Interaction %K Genetic Predisposition to Disease %K Humans %K Male %K Middle Aged %K Obesity %K Polymorphism, Single Nucleotide %K Sleep %K Young Adult %X

BACKGROUND: Short sleep duration has been associated with greater risks of obesity, hypertension, diabetes, and cardiovascular disease. Also, common genetic variants in the human Circadian Locomotor Output Cycles Kaput (CLOCK) show associations with ghrelin and total energy intake.

OBJECTIVES: We examined associations between habitual sleep duration, body mass index (BMI), and macronutrient intake and assessed whether CLOCK variants modify these associations.

DESIGN: We conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations of sleep duration and BMI and macronutrient intake as percentages of total energy as well as interactions with CLOCK variants from 9 cohort studies including up to 14,906 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium.

RESULTS: We observed a significant association between sleep duration and lower BMI (β ± SE = 0.16 ± 0.04, P < 0.0001) in the overall sample; however, associations between sleep duration and relative macronutrient intake were evident in age- and sex-stratified analyses only. We observed a significant association between sleep duration and lower saturated fatty acid intake in younger (aged 20-64 y) adults (men: 0.11 ± 0.06%, P = 0.03; women: 0.10 ± 0.05%, P = 0.04) and with lower carbohydrate (-0.31 ± 0.12%, P < 0.01), higher total fat (0.18 ± 0.09%, P = 0.05), and higher PUFA (0.05 ± 0.02%, P = 0.02) intakes in older (aged 65-80 y) women. In addition, the following 2 nominally significant interactions were observed: between sleep duration and rs12649507 on PUFA intake and between sleep duration and rs6858749 on protein intake.

CONCLUSIONS: Our results indicate that longer habitual sleep duration is associated with lower BMI and age- and sex-specific favorable dietary behaviors. Differences in the relative intake of specific macronutrients associated with short sleep duration could, at least in part, explain previously reported associations between short sleep duration and chronic metabolic abnormalities. In addition, the influence of obesity-associated CLOCK variants on the association between sleep duration and macronutrient intake suggests that longer habitual sleep duration could ameliorate the genetic predisposition to obesity via a favorable dietary profile.

%B Am J Clin Nutr %V 101 %P 135-43 %8 2015 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25527757?dopt=Abstract %R 10.3945/ajcn.114.095026 %0 Journal Article %J Lancet %D 2015 %T HMG-coenzyme A reductase inhibition, type 2 diabetes, and bodyweight: evidence from genetic analysis and randomised trials. %A Swerdlow, Daniel I %A Preiss, David %A Kuchenbaecker, Karoline B %A Holmes, Michael V %A Engmann, Jorgen E L %A Shah, Tina %A Sofat, Reecha %A Stender, Stefan %A Johnson, Paul C D %A Scott, Robert A %A Leusink, Maarten %A Verweij, Niek %A Sharp, Stephen J %A Guo, Yiran %A Giambartolomei, Claudia %A Chung, Christina %A Peasey, Anne %A Amuzu, Antoinette %A Li, KaWah %A Palmen, Jutta %A Howard, Philip %A Cooper, Jackie A %A Drenos, Fotios %A Li, Yun R %A Lowe, Gordon %A Gallacher, John %A Stewart, Marlene C W %A Tzoulaki, Ioanna %A Buxbaum, Sarah G %A van der A, Daphne L %A Forouhi, Nita G %A Onland-Moret, N Charlotte %A van der Schouw, Yvonne T %A Schnabel, Renate B %A Hubacek, Jaroslav A %A Kubinova, Ruzena %A Baceviciene, Migle %A Tamosiunas, Abdonas %A Pajak, Andrzej %A Topor-Madry, Roman %A Stepaniak, Urszula %A Malyutina, Sofia %A Baldassarre, Damiano %A Sennblad, Bengt %A Tremoli, Elena %A de Faire, Ulf %A Veglia, Fabrizio %A Ford, Ian %A Jukema, J Wouter %A Westendorp, Rudi G J %A de Borst, Gert Jan %A de Jong, Pim A %A Algra, Ale %A Spiering, Wilko %A Maitland-van der Zee, Anke H %A Klungel, Olaf H %A de Boer, Anthonius %A Doevendans, Pieter A %A Eaton, Charles B %A Robinson, Jennifer G %A Duggan, David %A Kjekshus, John %A Downs, John R %A Gotto, Antonio M %A Keech, Anthony C %A Marchioli, Roberto %A Tognoni, Gianni %A Sever, Peter S %A Poulter, Neil R %A Waters, David D %A Pedersen, Terje R %A Amarenco, Pierre %A Nakamura, Haruo %A McMurray, John J V %A Lewsey, James D %A Chasman, Daniel I %A Ridker, Paul M %A Maggioni, Aldo P %A Tavazzi, Luigi %A Ray, Kausik K %A Seshasai, Sreenivasa Rao Kondapally %A Manson, JoAnn E %A Price, Jackie F %A Whincup, Peter H %A Morris, Richard W %A Lawlor, Debbie A %A Smith, George Davey %A Ben-Shlomo, Yoav %A Schreiner, Pamela J %A Fornage, Myriam %A Siscovick, David S %A Cushman, Mary %A Kumari, Meena %A Wareham, Nick J %A Verschuren, W M Monique %A Redline, Susan %A Patel, Sanjay R %A Whittaker, John C %A Hamsten, Anders %A Delaney, Joseph A %A Dale, Caroline %A Gaunt, Tom R %A Wong, Andrew %A Kuh, Diana %A Hardy, Rebecca %A Kathiresan, Sekar %A Castillo, Berta A %A van der Harst, Pim %A Brunner, Eric J %A Tybjaerg-Hansen, Anne %A Marmot, Michael G %A Krauss, Ronald M %A Tsai, Michael %A Coresh, Josef %A Hoogeveen, Ronald C %A Psaty, Bruce M %A Lange, Leslie A %A Hakonarson, Hakon %A Dudbridge, Frank %A Humphries, Steve E %A Talmud, Philippa J %A Kivimaki, Mika %A Timpson, Nicholas J %A Langenberg, Claudia %A Asselbergs, Folkert W %A Voevoda, Mikhail %A Bobak, Martin %A Pikhart, Hynek %A Wilson, James G %A Reiner, Alex P %A Keating, Brendan J %A Hingorani, Aroon D %A Sattar, Naveed %K Aged %K Body Mass Index %K Body Weight %K Cholesterol, HDL %K Cholesterol, LDL %K Diabetes Mellitus, Type 2 %K Female %K Genetic Testing %K Humans %K Hydroxymethylglutaryl CoA Reductases %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Randomized Controlled Trials as Topic %K Risk Factors %X

BACKGROUND: Statins increase the risk of new-onset type 2 diabetes mellitus. We aimed to assess whether this increase in risk is a consequence of inhibition of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), the intended drug target.

METHODS: We used single nucleotide polymorphisms in the HMGCR gene, rs17238484 (for the main analysis) and rs12916 (for a subsidiary analysis) as proxies for HMGCR inhibition by statins. We examined associations of these variants with plasma lipid, glucose, and insulin concentrations; bodyweight; waist circumference; and prevalent and incident type 2 diabetes. Study-specific effect estimates per copy of each LDL-lowering allele were pooled by meta-analysis. These findings were compared with a meta-analysis of new-onset type 2 diabetes and bodyweight change data from randomised trials of statin drugs. The effects of statins in each randomised trial were assessed using meta-analysis.

FINDINGS: Data were available for up to 223 463 individuals from 43 genetic studies. Each additional rs17238484-G allele was associated with a mean 0·06 mmol/L (95% CI 0·05-0·07) lower LDL cholesterol and higher body weight (0·30 kg, 0·18-0·43), waist circumference (0·32 cm, 0·16-0·47), plasma insulin concentration (1·62%, 0·53-2·72), and plasma glucose concentration (0·23%, 0·02-0·44). The rs12916 SNP had similar effects on LDL cholesterol, bodyweight, and waist circumference. The rs17238484-G allele seemed to be associated with higher risk of type 2 diabetes (odds ratio [OR] per allele 1·02, 95% CI 1·00-1·05); the rs12916-T allele association was consistent (1·06, 1·03-1·09). In 129 170 individuals in randomised trials, statins lowered LDL cholesterol by 0·92 mmol/L (95% CI 0·18-1·67) at 1-year of follow-up, increased bodyweight by 0·24 kg (95% CI 0·10-0·38 in all trials; 0·33 kg, 95% CI 0·24-0·42 in placebo or standard care controlled trials and -0·15 kg, 95% CI -0·39 to 0·08 in intensive-dose vs moderate-dose trials) at a mean of 4·2 years (range 1·9-6·7) of follow-up, and increased the odds of new-onset type 2 diabetes (OR 1·12, 95% CI 1·06-1·18 in all trials; 1·11, 95% CI 1·03-1·20 in placebo or standard care controlled trials and 1·12, 95% CI 1·04-1·22 in intensive-dose vs moderate dose trials).

INTERPRETATION: The increased risk of type 2 diabetes noted with statins is at least partially explained by HMGCR inhibition.

FUNDING: The funding sources are cited at the end of the paper.

%B Lancet %V 385 %P 351-61 %8 2015 Jan 24 %G eng %N 9965 %1 http://www.ncbi.nlm.nih.gov/pubmed/25262344?dopt=Abstract %R 10.1016/S0140-6736(14)61183-1 %0 Journal Article %J Ann Behav Med %D 2015 %T Husbands' and Wives' Physical Activity and Depressive Symptoms: Longitudinal Findings from the Cardiovascular Health Study. %A Monin, Joan K %A Levy, Becca %A Chen, Baibing %A Fried, Terri %A Stahl, Sarah T %A Schulz, Richard %A Doyle, Margaret %A Kershaw, Trace %K Aged %K Cardiovascular System %K Depression %K Female %K Health Surveys %K Humans %K Longitudinal Studies %K Male %K Motor Activity %K Sex Characteristics %K Spouses %X

BACKGROUND: When examining older adults' health behaviors and psychological health, it is important to consider the social context.

PURPOSE: The purpose of this study was to examine in older adult marriages whether each spouse's physical activity predicted changes in their own (actor effects) and their partner's (partner effects) depressive symptoms. Gender differences were also examined.

METHOD: Each spouse within 1260 married couples (at baseline) in the Cardiovascular Health Study completed self-report measures at wave 1 (1989-1990), wave 3 (1992-1993), and wave 7 (1996-1997). Dyadic path analyses were performed.

RESULTS: Husbands' physical activity significantly predicted own decreased depressive symptoms (actor effect). For both spouses, own physical activity did not significantly predict the spouse's depressive symptoms (partner effects). However, husbands' physical activity and depressive symptoms predicted wives' physical activity and depressive symptoms (partner effects), respectively. Depressive symptoms did not predict physical activity.

CONCLUSION: Findings suggest that husbands' physical activity is particularly influential for older married couples' psychological health.

%B Ann Behav Med %V 49 %P 704-14 %8 2015 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25868508?dopt=Abstract %R 10.1007/s12160-015-9705-4 %0 Journal Article %J Am J Cardiol %D 2015 %T Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults ≥65 years with heart failure. %A Lo, Alexander X %A Donnelly, John P %A McGwin, Gerald %A Bittner, Vera %A Ahmed, Ali %A Brown, Cynthia J %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Early Diagnosis %K Female %K Follow-Up Studies %K Gait %K Geriatric Assessment %K Heart Failure %K Humans %K Male %K Odds Ratio %K Predictive Value of Tests %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Risk Factors %K Sensitivity and Specificity %K Survival Analysis %K United States %K Walking %X

Mobility and function are important predictors of survival. However, their combined impact on mortality in adults ≥65 years with heart failure (HF) is not well understood. This study examined the role of gait speed and instrumental activities of daily living (IADL) in all-cause mortality in a cohort of 1,119 community-dwelling Cardiovascular Health Study participants ≥65 years with incident HF. Data on HF and mortality were collected through annual examinations or contact during the 10-year follow-up period. Slower gait speed (<0.8 m/s vs ≥0.8 m/s) and IADL impairment (≥1 vs 0 areas of dependence) were determined from baseline and follow-up assessments. A total of 740 (66%) of the 1,119 participants died during the follow-up period. Multivariate Cox proportional hazards models showed that impairments in either gait speed (hazard ratio 1.37, 95% confidence interval 1.10 to 1.70; p = 0.004) or IADL (hazard ratio 1.56, 95% confidence interval 1.29-1.89; p <0.001), measured within 1 year before the diagnosis of incident HF, were independently associated with mortality, adjusting for sociodemographic and clinical characteristics. The combined presence of slower gait speed and IADL impairment was associated with a greater risk of mortality and suggested an additive relation between gait speed and IADL. In conclusion, gait speed and IADL are important risk factors for mortality in adults ≥65 years with HF, but the combined impairments of both gait speed and IADL can have an especially important impact on mortality.

%B Am J Cardiol %V 115 %P 797-801 %8 2015 Mar 15 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25655868?dopt=Abstract %R 10.1016/j.amjcard.2014.12.044 %0 Journal Article %J Hum Mol Genet %D 2015 %T Integrative pathway genomics of lung function and airflow obstruction. %A Gharib, Sina A %A Loth, Daan W %A Soler Artigas, Maria %A Birkland, Timothy P %A Wilk, Jemma B %A Wain, Louise V %A Brody, Jennifer A %A Obeidat, Ma'en %A Hancock, Dana B %A Tang, Wenbo %A Rawal, Rajesh %A Boezen, H Marike %A Imboden, Medea %A Huffman, Jennifer E %A Lahousse, Lies %A Alves, Alexessander C %A Manichaikul, Ani %A Hui, Jennie %A Morrison, Alanna C %A Ramasamy, Adaikalavan %A Smith, Albert Vernon %A Gudnason, Vilmundur %A Surakka, Ida %A Vitart, Veronique %A Evans, David M %A Strachan, David P %A Deary, Ian J %A Hofman, Albert %A Gläser, Sven %A Wilson, James F %A North, Kari E %A Zhao, Jing Hua %A Heckbert, Susan R %A Jarvis, Deborah L %A Probst-Hensch, Nicole %A Schulz, Holger %A Barr, R Graham %A Jarvelin, Marjo-Riitta %A O'Connor, George T %A Kähönen, Mika %A Cassano, Patricia A %A Hysi, Pirro G %A Dupuis, Josée %A Hayward, Caroline %A Psaty, Bruce M %A Hall, Ian P %A Parks, William C %A Tobin, Martin D %A London, Stephanie J %K Airway Obstruction %K Animals %K Cell Proliferation %K European Continental Ancestry Group %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genomics %K Humans %K Immune System %K Lung %K Male %K Metabolic Networks and Pathways %K Mice %K Phenotype %K Polymorphism, Single Nucleotide %K Signal Transduction %X

Chronic respiratory disorders are important contributors to the global burden of disease. Genome-wide association studies (GWASs) of lung function measures have identified several trait-associated loci, but explain only a modest portion of the phenotypic variability. We postulated that integrating pathway-based methods with GWASs of pulmonary function and airflow obstruction would identify a broader repertoire of genes and processes influencing these traits. We performed two independent GWASs of lung function and applied gene set enrichment analysis to one of the studies and validated the results using the second GWAS. We identified 131 significantly enriched gene sets associated with lung function and clustered them into larger biological modules involved in diverse processes including development, immunity, cell signaling, proliferation and arachidonic acid. We found that enrichment of gene sets was not driven by GWAS-significant variants or loci, but instead by those with less stringent association P-values. Next, we applied pathway enrichment analysis to a meta-analyzed GWAS of airflow obstruction. We identified several biologic modules that functionally overlapped with those associated with pulmonary function. However, differences were also noted, including enrichment of extracellular matrix (ECM) processes specifically in the airflow obstruction study. Network analysis of the ECM module implicated a candidate gene, matrix metalloproteinase 10 (MMP10), as a putative disease target. We used a knockout mouse model to functionally validate MMP10's role in influencing lung's susceptibility to cigarette smoke-induced emphysema. By integrating pathway analysis with population-based genomics, we unraveled biologic processes underlying pulmonary function traits and identified a candidate gene for obstructive lung disease.

%B Hum Mol Genet %V 24 %P 6836-48 %8 2015 Dec 1 %G eng %N 23 %1 http://www.ncbi.nlm.nih.gov/pubmed/26395457?dopt=Abstract %R 10.1093/hmg/ddv378 %0 Journal Article %J Am Heart J %D 2015 %T Intermediate and long-term risk of new-onset heart failure after hospitalization for pneumonia in elderly adults. %A Corrales-Medina, Vicente F %A Taljaard, Monica %A Yende, Sachin %A Kronmal, Richard %A Dwivedi, Girish %A Newman, Anne B %A Elkind, Mitchell S V %A Lyles, Mary F %A Chirinos, Julio A %K Aged %K Disease Progression %K Female %K Follow-Up Studies %K Forecasting %K Heart Failure %K Hospitalization %K Humans %K Incidence %K Inpatients %K Male %K Patient Readmission %K Pneumonia %K Proportional Hazards Models %K Retrospective Studies %K Risk Assessment %K Risk Factors %K Time Factors %X

BACKGROUND: Pneumonia is associated with high risk of heart failure (HF) in the short term (30 days) postinfection. Whether this association persists beyond this period is unknown.

METHODS: We studied 5,613 elderly (≥65 years) adults enrolled in the Cardiovascular Health Study between 1989 and 1994 at 4 US communities. Participants had no clinical diagnosis of HF at enrollment, and they were followed up through December 2010. Hospitalizations for pneumonia were identified using validated International Classification of Disease Ninth Revision codes. A centralized committee adjudicated new-onset HF events. Using Cox regression, we estimated adjusted hazard ratios (HRs) of new-onset HF at different time intervals after hospitalization for pneumonia.

RESULTS: A total of 652 participants hospitalized for pneumonia during follow-up were still alive and free of clinical diagnosis of HF by day 30 posthospitalization. Relative to the time of their hospitalization, new-onset HF occurred in 22 cases between 31 and 90 days (HR 6.9, 95% CI 4.46-10.63, P < .001), 14 cases between 91 days and 6 months (HR 3.2, 95% CI 1.88-5.50, P < .001), 20 cases between 6 months and 1 year (HR 2.6, 95% CI 1.64-4.04, P < .001), 76 cases between 1 and 5 years (HR 1.7, 95% CI 1.30-2.12, P < .001), and 71 cases after 5 years (HR 2.0, 95% CI 1.56-2.58, P < .001). Results were robust to sensitivity analyses using stringent definitions of pneumonia and extreme assumptions for potential informative censoring.

CONCLUSION: Hospitalization for pneumonia is associated with increased risk of new-onset HF in the intermediate and long term. Studies should characterize the mechanisms of this association in order to prevent HF in elderly pneumonia survivors.

%B Am Heart J %V 170 %P 306-12 %8 2015 Aug %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26299228?dopt=Abstract %R 10.1016/j.ahj.2015.04.028 %0 Journal Article %J J Am Geriatr Soc %D 2015 %T Lower Extremity Proximal Muscle Function and Dyspnea in Older Persons. %A Vaz Fragoso, Carlos A %A Araujo, Katy %A Leo-Summers, Linda %A Van Ness, Peter H %K Aged %K Aged, 80 and over %K Cross-Sectional Studies %K Dyspnea %K Female %K Frail Elderly %K Geriatric Assessment %K Humans %K Lower Extremity %K Male %K Motor Activity %K Muscle Contraction %K Prevalence %K Retrospective Studies %K Spirometry %K United States %X

OBJECTIVES: To evaluate the association between performance on a single chair stand and moderate to severe exertional dyspnea.

DESIGN: Cross-sectional.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Community-dwelling individuals aged 65 and older (N = 4,413; mean age 72.6; female, n = 2,518 (57.1%); nonwhite, n = 199 (4.5%); obese, n = 788 (17.9%); history of smoking, n = 2,410 (54.6%)).

MEASUREMENTS: Performance on single chair stand (poor (unable to rise without arm use) vs normal (able to rise without arm use)), moderate to severe exertional dyspnea (American Thoracic Society grade ≥2), age, sex, ethnicity, obesity, smoking, frailty status (Fried-defined nonfrail, prefrail, frail), high cardiopulmonary risk (composite of cardiopulmonary diseases and diabetes mellitus), spirometric impairment, arthritis, depression, stroke, and kidney disease.

RESULTS: Poor performance on the single chair stand was established in 369 (8.4%) and moderate to severe exertional dyspnea in 773 (17.5%). Prefrail status was established in 2,210 (50.1%), frail status in 360 (8.2%), arthritis in 2,241 (51.4%), high cardiopulmonary risk in 2,469 (55.9%), spirometric impairment in 1,076 (24.4%), kidney disease in 111 (2.5%), depression in 107 (2.4%), and stroke in 93 (2.1%). In multivariable regression models, poor performance on the single chair stand was associated with moderate to severe exertional dyspnea (unadjusted odds ratio (OR) = 3.48, 95% confidence interval (CI) = 2.78-4.36; adjusted OR = 1.85, 95% CI = 1.41-2.41).

CONCLUSION: Poor performance on a single chair stand was associated with an adjusted 85% greater likelihood of moderate to severe exertional dyspnea than normal performance. These results suggest that reduced proximal muscle function of the lower extremities is associated with moderate to severe exertional dyspnea, even after adjusting for multiple confounders.

%B J Am Geriatr Soc %V 63 %P 1628-33 %8 2015 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/26200804?dopt=Abstract %R 10.1111/jgs.13529 %0 Journal Article %J Nat Commun %D 2015 %T Low-frequency and rare exome chip variants associate with fasting glucose and type 2 diabetes susceptibility. %A Wessel, Jennifer %A Chu, Audrey Y %A Willems, Sara M %A Wang, Shuai %A Yaghootkar, Hanieh %A Brody, Jennifer A %A Dauriz, Marco %A Hivert, Marie-France %A Raghavan, Sridharan %A Lipovich, Leonard %A Hidalgo, Bertha %A Fox, Keolu %A Huffman, Jennifer E %A An, Ping %A Lu, Yingchang %A Rasmussen-Torvik, Laura J %A Grarup, Niels %A Ehm, Margaret G %A Li, Li %A Baldridge, Abigail S %A Stančáková, Alena %A Abrol, Ravinder %A Besse, Céline %A Boland, Anne %A Bork-Jensen, Jette %A Fornage, Myriam %A Freitag, Daniel F %A Garcia, Melissa E %A Guo, Xiuqing %A Hara, Kazuo %A Isaacs, Aaron %A Jakobsdottir, Johanna %A Lange, Leslie A %A Layton, Jill C %A Li, Man %A Hua Zhao, Jing %A Meidtner, Karina %A Morrison, Alanna C %A Nalls, Mike A %A Peters, Marjolein J %A Sabater-Lleal, Maria %A Schurmann, Claudia %A Silveira, Angela %A Smith, Albert V %A Southam, Lorraine %A Stoiber, Marcus H %A Strawbridge, Rona J %A Taylor, Kent D %A Varga, Tibor V %A Allin, Kristine H %A Amin, Najaf %A Aponte, Jennifer L %A Aung, Tin %A Barbieri, Caterina %A Bihlmeyer, Nathan A %A Boehnke, Michael %A Bombieri, Cristina %A Bowden, Donald W %A Burns, Sean M %A Chen, Yuning %A Chen, Yii-DerI %A Cheng, Ching-Yu %A Correa, Adolfo %A Czajkowski, Jacek %A Dehghan, Abbas %A Ehret, Georg B %A Eiriksdottir, Gudny %A Escher, Stefan A %A Farmaki, Aliki-Eleni %A Frånberg, Mattias %A Gambaro, Giovanni %A Giulianini, Franco %A Goddard, William A %A Goel, Anuj %A Gottesman, Omri %A Grove, Megan L %A Gustafsson, Stefan %A Hai, Yang %A Hallmans, Göran %A Heo, Jiyoung %A Hoffmann, Per %A Ikram, Mohammad K %A Jensen, Richard A %A Jørgensen, Marit E %A Jørgensen, Torben %A Karaleftheri, Maria %A Khor, Chiea C %A Kirkpatrick, Andrea %A Kraja, Aldi T %A Kuusisto, Johanna %A Lange, Ethan M %A Lee, I T %A Lee, Wen-Jane %A Leong, Aaron %A Liao, Jiemin %A Liu, Chunyu %A Liu, Yongmei %A Lindgren, Cecilia M %A Linneberg, Allan %A Malerba, Giovanni %A Mamakou, Vasiliki %A Marouli, Eirini %A Maruthur, Nisa M %A Matchan, Angela %A McKean-Cowdin, Roberta %A McLeod, Olga %A Metcalf, Ginger A %A Mohlke, Karen L %A Muzny, Donna M %A Ntalla, Ioanna %A Palmer, Nicholette D %A Pasko, Dorota %A Peter, Andreas %A Rayner, Nigel W %A Renstrom, Frida %A Rice, Ken %A Sala, Cinzia F %A Sennblad, Bengt %A Serafetinidis, Ioannis %A Smith, Jennifer A %A Soranzo, Nicole %A Speliotes, Elizabeth K %A Stahl, Eli A %A Stirrups, Kathleen %A Tentolouris, Nikos %A Thanopoulou, Anastasia %A Torres, Mina %A Traglia, Michela %A Tsafantakis, Emmanouil %A Javad, Sundas %A Yanek, Lisa R %A Zengini, Eleni %A Becker, Diane M %A Bis, Joshua C %A Brown, James B %A Cupples, L Adrienne %A Hansen, Torben %A Ingelsson, Erik %A Karter, Andrew J %A Lorenzo, Carlos %A Mathias, Rasika A %A Norris, Jill M %A Peloso, Gina M %A Sheu, Wayne H-H %A Toniolo, Daniela %A Vaidya, Dhananjay %A Varma, Rohit %A Wagenknecht, Lynne E %A Boeing, Heiner %A Bottinger, Erwin P %A Dedoussis, George %A Deloukas, Panos %A Ferrannini, Ele %A Franco, Oscar H %A Franks, Paul W %A Gibbs, Richard A %A Gudnason, Vilmundur %A Hamsten, Anders %A Harris, Tamara B %A Hattersley, Andrew T %A Hayward, Caroline %A Hofman, Albert %A Jansson, Jan-Håkan %A Langenberg, Claudia %A Launer, Lenore J %A Levy, Daniel %A Oostra, Ben A %A O'Donnell, Christopher J %A O'Rahilly, Stephen %A Padmanabhan, Sandosh %A Pankow, James S %A Polasek, Ozren %A Province, Michael A %A Rich, Stephen S %A Ridker, Paul M %A Rudan, Igor %A Schulze, Matthias B %A Smith, Blair H %A Uitterlinden, André G %A Walker, Mark %A Watkins, Hugh %A Wong, Tien Y %A Zeggini, Eleftheria %A Laakso, Markku %A Borecki, Ingrid B %A Chasman, Daniel I %A Pedersen, Oluf %A Psaty, Bruce M %A Tai, E Shyong %A van Duijn, Cornelia M %A Wareham, Nicholas J %A Waterworth, Dawn M %A Boerwinkle, Eric %A Kao, W H Linda %A Florez, Jose C %A Loos, Ruth J F %A Wilson, James G %A Frayling, Timothy M %A Siscovick, David S %A Dupuis, Josée %A Rotter, Jerome I %A Meigs, James B %A Scott, Robert A %A Goodarzi, Mark O %K African Continental Ancestry Group %K Blood Glucose %K Diabetes Mellitus, Type 2 %K European Continental Ancestry Group %K Exome %K Fasting %K Genetic Association Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genetic Variation %K Glucagon-Like Peptide-1 Receptor %K Glucose-6-Phosphatase %K Humans %K Insulin %K Mutation Rate %K Oligonucleotide Array Sequence Analysis %K Polymorphism, Single Nucleotide %X

Fasting glucose and insulin are intermediate traits for type 2 diabetes. Here we explore the role of coding variation on these traits by analysis of variants on the HumanExome BeadChip in 60,564 non-diabetic individuals and in 16,491 T2D cases and 81,877 controls. We identify a novel association of a low-frequency nonsynonymous SNV in GLP1R (A316T; rs10305492; MAF=1.4%) with lower FG (β=-0.09±0.01 mmol l(-1), P=3.4 × 10(-12)), T2D risk (OR[95%CI]=0.86[0.76-0.96], P=0.010), early insulin secretion (β=-0.07±0.035 pmolinsulin mmolglucose(-1), P=0.048), but higher 2-h glucose (β=0.16±0.05 mmol l(-1), P=4.3 × 10(-4)). We identify a gene-based association with FG at G6PC2 (pSKAT=6.8 × 10(-6)) driven by four rare protein-coding SNVs (H177Y, Y207S, R283X and S324P). We identify rs651007 (MAF=20%) in the first intron of ABO at the putative promoter of an antisense lncRNA, associating with higher FG (β=0.02±0.004 mmol l(-1), P=1.3 × 10(-8)). Our approach identifies novel coding variant associations and extends the allelic spectrum of variation underlying diabetes-related quantitative traits and T2D susceptibility.

%B Nat Commun %V 6 %P 5897 %8 2015 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25631608?dopt=Abstract %R 10.1038/ncomms6897 %0 Journal Article %J Eur Heart J %D 2015 %T Mendelian randomization of blood lipids for coronary heart disease. %A Holmes, Michael V %A Asselbergs, Folkert W %A Palmer, Tom M %A Drenos, Fotios %A Lanktree, Matthew B %A Nelson, Christopher P %A Dale, Caroline E %A Padmanabhan, Sandosh %A Finan, Chris %A Swerdlow, Daniel I %A Tragante, Vinicius %A van Iperen, Erik P A %A Sivapalaratnam, Suthesh %A Shah, Sonia %A Elbers, Clara C %A Shah, Tina %A Engmann, Jorgen %A Giambartolomei, Claudia %A White, Jon %A Zabaneh, Delilah %A Sofat, Reecha %A McLachlan, Stela %A Doevendans, Pieter A %A Balmforth, Anthony J %A Hall, Alistair S %A North, Kari E %A Almoguera, Berta %A Hoogeveen, Ron C %A Cushman, Mary %A Fornage, Myriam %A Patel, Sanjay R %A Redline, Susan %A Siscovick, David S %A Tsai, Michael Y %A Karczewski, Konrad J %A Hofker, Marten H %A Verschuren, W Monique %A Bots, Michiel L %A van der Schouw, Yvonne T %A Melander, Olle %A Dominiczak, Anna F %A Morris, Richard %A Ben-Shlomo, Yoav %A Price, Jackie %A Kumari, Meena %A Baumert, Jens %A Peters, Annette %A Thorand, Barbara %A Koenig, Wolfgang %A Gaunt, Tom R %A Humphries, Steve E %A Clarke, Robert %A Watkins, Hugh %A Farrall, Martin %A Wilson, James G %A Rich, Stephen S %A de Bakker, Paul I W %A Lange, Leslie A %A Davey Smith, George %A Reiner, Alex P %A Talmud, Philippa J %A Kivimaki, Mika %A Lawlor, Debbie A %A Dudbridge, Frank %A Samani, Nilesh J %A Keating, Brendan J %A Hingorani, Aroon D %A Casas, Juan P %K Case-Control Studies %K Cholesterol, HDL %K Coronary Artery Disease %K Female %K Gene Frequency %K Genotype %K Genotyping Techniques %K Humans %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk Assessment %K Triglycerides %X

AIMS: To investigate the causal role of high-density lipoprotein cholesterol (HDL-C) and triglycerides in coronary heart disease (CHD) using multiple instrumental variables for Mendelian randomization.

METHODS AND RESULTS: We developed weighted allele scores based on single nucleotide polymorphisms (SNPs) with established associations with HDL-C, triglycerides, and low-density lipoprotein cholesterol (LDL-C). For each trait, we constructed two scores. The first was unrestricted, including all independent SNPs associated with the lipid trait identified from a prior meta-analysis (threshold P < 2 × 10(-6)); and the second a restricted score, filtered to remove any SNPs also associated with either of the other two lipid traits at P ≤ 0.01. Mendelian randomization meta-analyses were conducted in 17 studies including 62,199 participants and 12,099 CHD events. Both the unrestricted and restricted allele scores for LDL-C (42 and 19 SNPs, respectively) associated with CHD. For HDL-C, the unrestricted allele score (48 SNPs) was associated with CHD (OR: 0.53; 95% CI: 0.40, 0.70), per 1 mmol/L higher HDL-C, but neither the restricted allele score (19 SNPs; OR: 0.91; 95% CI: 0.42, 1.98) nor the unrestricted HDL-C allele score adjusted for triglycerides, LDL-C, or statin use (OR: 0.81; 95% CI: 0.44, 1.46) showed a robust association. For triglycerides, the unrestricted allele score (67 SNPs) and the restricted allele score (27 SNPs) were both associated with CHD (OR: 1.62; 95% CI: 1.24, 2.11 and 1.61; 95% CI: 1.00, 2.59, respectively) per 1-log unit increment. However, the unrestricted triglyceride score adjusted for HDL-C, LDL-C, and statin use gave an OR for CHD of 1.01 (95% CI: 0.59, 1.75).

CONCLUSION: The genetic findings support a causal effect of triglycerides on CHD risk, but a causal role for HDL-C, though possible, remains less certain.

%B Eur Heart J %V 36 %P 539-50 %8 2015 Mar 01 %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/24474739?dopt=Abstract %R 10.1093/eurheartj/eht571 %0 Journal Article %J Am J Hum Genet %D 2015 %T Meta-analysis of 65,734 individuals identifies TSPAN15 and SLC44A2 as two susceptibility loci for venous thromboembolism. %A Germain, Marine %A Chasman, Daniel I %A de Haan, Hugoline %A Tang, Weihong %A Lindström, Sara %A Weng, Lu-Chen %A de Andrade, Mariza %A de Visser, Marieke C H %A Wiggins, Kerri L %A Suchon, Pierre %A Saut, Noémie %A Smadja, David M %A Le Gal, Grégoire %A van Hylckama Vlieg, Astrid %A Di Narzo, Antonio %A Hao, Ke %A Nelson, Christopher P %A Rocanin-Arjo, Ares %A Folkersen, Lasse %A Monajemi, Ramin %A Rose, Lynda M %A Brody, Jennifer A %A Slagboom, Eline %A Aïssi, Dylan %A Gagnon, France %A Deleuze, Jean-Francois %A Deloukas, Panos %A Tzourio, Christophe %A Dartigues, Jean-François %A Berr, Claudine %A Taylor, Kent D %A Civelek, Mete %A Eriksson, Per %A Psaty, Bruce M %A Houwing-Duitermaat, Jeanine %A Goodall, Alison H %A Cambien, Francois %A Kraft, Peter %A Amouyel, Philippe %A Samani, Nilesh J %A Basu, Saonli %A Ridker, Paul M %A Rosendaal, Frits R %A Kabrhel, Christopher %A Folsom, Aaron R %A Heit, John %A Reitsma, Pieter H %A Trégouët, David-Alexandre %A Smith, Nicholas L %A Morange, Pierre-Emmanuel %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genotype %K Humans %K Membrane Glycoproteins %K Membrane Transport Proteins %K Odds Ratio %K Tetraspanins %K Venous Thromboembolism %X

Venous thromboembolism (VTE), the third leading cause of cardiovascular mortality, is a complex thrombotic disorder with environmental and genetic determinants. Although several genetic variants have been found associated with VTE, they explain a minor proportion of VTE risk in cases. We undertook a meta-analysis of genome-wide association studies (GWASs) to identify additional VTE susceptibility genes. Twelve GWASs totaling 7,507 VTE case subjects and 52,632 control subjects formed our discovery stage where 6,751,884 SNPs were tested for association with VTE. Nine loci reached the genome-wide significance level of 5 × 10(-8) including six already known to associate with VTE (ABO, F2, F5, F11, FGG, and PROCR) and three unsuspected loci. SNPs mapping to these latter were selected for replication in three independent case-control studies totaling 3,009 VTE-affected individuals and 2,586 control subjects. This strategy led to the identification and replication of two VTE-associated loci, TSPAN15 and SLC44A2, with lead risk alleles associated with odds ratio for disease of 1.31 (p = 1.67 × 10(-16)) and 1.21 (p = 2.75 × 10(-15)), respectively. The lead SNP at the TSPAN15 locus is the intronic rs78707713 and the lead SLC44A2 SNP is the non-synonymous rs2288904 previously shown to associate with transfusion-related acute lung injury. We further showed that these two variants did not associate with known hemostatic plasma markers. TSPAN15 and SLC44A2 do not belong to conventional pathways for thrombosis and have not been associated to other cardiovascular diseases nor related quantitative biomarkers. Our findings uncovered unexpected actors of VTE etiology and pave the way for novel mechanistic concepts of VTE pathophysiology.

%B Am J Hum Genet %V 96 %P 532-42 %8 2015 Apr 2 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25772935?dopt=Abstract %R 10.1016/j.ajhg.2015.01.019 %0 Journal Article %J Stroke %D 2015 %T Meta-Analysis of Genome-Wide Association Studies Identifies Genetic Risk Factors for Stroke in African Americans. %A Carty, Cara L %A Keene, Keith L %A Cheng, Yu-Ching %A Meschia, James F %A Chen, Wei-Min %A Nalls, Mike %A Bis, Joshua C %A Kittner, Steven J %A Rich, Stephen S %A Tajuddin, Salman %A Zonderman, Alan B %A Evans, Michele K %A Langefeld, Carl D %A Gottesman, Rebecca %A Mosley, Thomas H %A Shahar, Eyal %A Woo, Daniel %A Yaffe, Kristine %A Liu, Yongmei %A Sale, Michèle M %A Dichgans, Martin %A Malik, Rainer %A Longstreth, W T %A Mitchell, Braxton D %A Psaty, Bruce M %A Kooperberg, Charles %A Reiner, Alexander %A Worrall, Bradford B %A Fornage, Myriam %K African Americans %K Case-Control Studies %K Cohort Studies %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Polymorphism, Single Nucleotide %K Risk Factors %K Stroke %X

BACKGROUND AND PURPOSE: The majority of genome-wide association studies (GWAS) of stroke have focused on European-ancestry populations; however, none has been conducted in African Americans, despite the disproportionately high burden of stroke in this population. The Consortium of Minority Population Genome-Wide Association Studies of Stroke (COMPASS) was established to identify stroke susceptibility loci in minority populations.

METHODS: Using METAL, we conducted meta-analyses of GWAS in 14 746 African Americans (1365 ischemic and 1592 total stroke cases) from COMPASS, and tested genetic variants with P<10(-6) for validation in METASTROKE, a consortium of ischemic stroke genetic studies in European-ancestry populations. We also evaluated stroke loci previously identified in European-ancestry populations.

RESULTS: The 15q21.3 locus linked with lipid levels and hypertension was associated with total stroke (rs4471613; P=3.9×10(-8)) in African Americans. Nominal associations (P<10(-6)) for total or ischemic stroke were observed for 18 variants in or near genes implicated in cell cycle/mRNA presplicing (PTPRG, CDC5L), platelet function (HPS4), blood-brain barrier permeability (CLDN17), immune response (ELTD1, WDFY4, and IL1F10-IL1RN), and histone modification (HDAC9). Two of these loci achieved nominal significance in METASTROKE: 5q35.2 (P=0.03), and 1p31.1 (P=0.018). Four of 7 previously reported ischemic stroke loci (PITX2, HDAC9, CDKN2A/CDKN2B, and ZFHX3) were nominally associated (P<0.05) with stroke in COMPASS.

CONCLUSIONS: We identified a novel genetic variant associated with total stroke in African Americans and found that ischemic stroke loci identified in European-ancestry populations may also be relevant for African Americans. Our findings support investigation of diverse populations to identify and characterize genetic risk factors, and the importance of shared genetic risk across populations.

%B Stroke %V 46 %P 2063-8 %8 2015 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/26089329?dopt=Abstract %R 10.1161/STROKEAHA.115.009044 %0 Journal Article %J Am J Kidney Dis %D 2015 %T A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury. %A James, Matthew T %A Grams, Morgan E %A Woodward, Mark %A Elley, C Raina %A Green, Jamie A %A Wheeler, David C %A de Jong, Paul %A Gansevoort, Ron T %A Levey, Andrew S %A Warnock, David G %A Sarnak, Mark J %K Acute Kidney Injury %K Adult %K Aged %K Comorbidity %K Diabetes Mellitus %K Disease Progression %K Female %K Glomerular Filtration Rate %K Humans %K Hypertension %K Incidence %K Kidney Failure, Chronic %K Male %K Middle Aged %K Prognosis %K Renal Insufficiency, Chronic %X

BACKGROUND: Diabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain.

STUDY DESIGN: Meta-analysis of cohort studies.

SETTING & POPULATION: 8 general-population (1,285,045 participants) and 5 chronic kidney disease (CKD; 79,519 participants) cohorts.

SELECTION CRITERIA FOR STUDIES: Cohorts participating in the CKD Prognosis Consortium.

PREDICTORS: Diabetes and hypertension status, eGFR by the 2009 CKD Epidemiology Collaboration creatinine equation, urine ACR, and interactions.

OUTCOME: Hospitalization with AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results.

RESULTS: During a mean follow-up of 4 years, there were 16,480 episodes of AKI in the general-population and 2,087 episodes in the CKD cohorts. Low eGFRs and high ACRs were associated with higher risks of AKI in individuals with or without diabetes and with or without hypertension. When compared to a common reference of eGFR of 80mL/min/1.73m(2) in nondiabetic patients, HRs for AKI were generally higher in diabetic patients at any level of eGFR. The same was true for diabetic patients at all levels of ACR compared with nondiabetic patients. The risk gradient for AKI with lower eGFRs was greater in those without diabetes than with diabetes, but similar with higher ACRs in those without versus with diabetes. Those with hypertension had a higher risk of AKI at eGFRs>60mL/min/1.73m(2) than those without hypertension. However, risk gradients for AKI with both lower eGFRs and higher ACRs were greater for those without than with hypertension.

LIMITATIONS: AKI identified by diagnostic code.

CONCLUSIONS: Lower eGFRs and higher ACRs are associated with higher risks of AKI among individuals with or without either diabetes or hypertension.

%B Am J Kidney Dis %V 66 %P 602-12 %8 2015 Oct %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25975964?dopt=Abstract %R 10.1053/j.ajkd.2015.02.338 %0 Journal Article %J J Am Geriatr Soc %D 2015 %T Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study. %A Kim, Dae Hyun %A Grodstein, Francine %A Newman, Anne B %A Chaves, Paulo H M %A Odden, Michelle C %A Klein, Ronald %A Sarnak, Mark J %A Lipsitz, Lewis A %K Aged %K Aged, 80 and over %K Cognition %K Cross-Sectional Studies %K Female %K Humans %K Male %K Neuropsychological Tests %K Vascular Malformations %X

OBJECTIVES: To evaluate and compare the associations between microvascular and macrovascular abnormalities and cognitive and physical function

DESIGN: Cross-sectional analysis of the Cardiovascular Health Study (1998-1999).

SETTING: Community.

PARTICIPANTS: Individuals with available data on three or more of five microvascular abnormalities (brain, retina, kidney) and three or more of six macrovascular abnormalities (brain, carotid artery, heart, peripheral artery) (N = 2,452; mean age 79.5).

MEASUREMENTS: Standardized composite scores derived from three cognitive tests (Modified Mini-Mental State Examination, Digit-Symbol Substitution Test, Trail-Making Test (TMT)) and three physical tests (gait speed, grip strength, 5-time sit to stand)

RESULTS: Participants with high microvascular and macrovascular burden had worse cognitive (mean score difference = -0.30, 95% confidence interval (CI) = -0.37 to -0.24) and physical (mean score difference = -0.32, 95% CI = -0.38 to -0.26) function than those with low microvascular and macrovascular burden. Individuals with high microvascular burden alone had similarly lower scores than those with high macrovascular burden alone (cognitive function: -0.16, 95% CI = -0.24 to -0.08 vs -0.13, 95% CI = -0.20 to -0.06; physical function: -0.15, 95% CI = -0.22 to -0.08 vs -0.12, 95% CI = -0.18 to -0.06). Psychomotor speed and working memory, assessed using the TMT, were only impaired in the presence of high microvascular burden. Of the 11 vascular abnormalities considered, white matter hyperintensity, cystatin C-based glomerular filtration rate, large brain infarct, and ankle-arm index were independently associated with cognitive and physical function.

CONCLUSION: Microvascular and macrovascular abnormalities assessed using noninvasive tests of the brain, kidney, and peripheral artery were independently associated with poor cognitive and physical function in older adults. Future research should evaluate the usefulness of these tests in prognostication.

%B J Am Geriatr Soc %V 63 %P 1886-93 %8 2015 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/26338279?dopt=Abstract %R 10.1111/jgs.13594 %0 Journal Article %J Circ Cardiovasc Genet %D 2015 %T Multiethnic genome-wide association study of cerebral white matter hyperintensities on MRI. %A Verhaaren, Benjamin F J %A Debette, Stephanie %A Bis, Joshua C %A Smith, Jennifer A %A Ikram, M Kamran %A Adams, Hieab H %A Beecham, Ashley H %A Rajan, Kumar B %A Lopez, Lorna M %A Barral, Sandra %A van Buchem, Mark A %A van der Grond, Jeroen %A Smith, Albert V %A Hegenscheid, Katrin %A Aggarwal, Neelum T %A de Andrade, Mariza %A Atkinson, Elizabeth J %A Beekman, Marian %A Beiser, Alexa S %A Blanton, Susan H %A Boerwinkle, Eric %A Brickman, Adam M %A Bryan, R Nick %A Chauhan, Ganesh %A Chen, Christopher P L H %A Chouraki, Vincent %A de Craen, Anton J M %A Crivello, Fabrice %A Deary, Ian J %A Deelen, Joris %A De Jager, Philip L %A Dufouil, Carole %A Elkind, Mitchell S V %A Evans, Denis A %A Freudenberger, Paul %A Gottesman, Rebecca F %A Guðnason, Vilmundur %A Habes, Mohamad %A Heckbert, Susan R %A Heiss, Gerardo %A Hilal, Saima %A Hofer, Edith %A Hofman, Albert %A Ibrahim-Verbaas, Carla A %A Knopman, David S %A Lewis, Cora E %A Liao, Jiemin %A Liewald, David C M %A Luciano, Michelle %A van der Lugt, Aad %A Martinez, Oliver O %A Mayeux, Richard %A Mazoyer, Bernard %A Nalls, Mike %A Nauck, Matthias %A Niessen, Wiro J %A Oostra, Ben A %A Psaty, Bruce M %A Rice, Kenneth M %A Rotter, Jerome I %A von Sarnowski, Bettina %A Schmidt, Helena %A Schreiner, Pamela J %A Schuur, Maaike %A Sidney, Stephen S %A Sigurdsson, Sigurdur %A Slagboom, P Eline %A Stott, David J M %A van Swieten, John C %A Teumer, Alexander %A Töglhofer, Anna Maria %A Traylor, Matthew %A Trompet, Stella %A Turner, Stephen T %A Tzourio, Christophe %A Uh, Hae-Won %A Uitterlinden, André G %A Vernooij, Meike W %A Wang, Jing J %A Wong, Tien Y %A Wardlaw, Joanna M %A Windham, B Gwen %A Wittfeld, Katharina %A Wolf, Christiane %A Wright, Clinton B %A Yang, Qiong %A Zhao, Wei %A Zijdenbos, Alex %A Jukema, J Wouter %A Sacco, Ralph L %A Kardia, Sharon L R %A Amouyel, Philippe %A Mosley, Thomas H %A Longstreth, W T %A DeCarli, Charles C %A van Duijn, Cornelia M %A Schmidt, Reinhold %A Launer, Lenore J %A Grabe, Hans J %A Seshadri, Sudha S %A Ikram, M Arfan %A Fornage, Myriam %K Aged %K Aged, 80 and over %K Chromosomes, Human %K Continental Population Groups %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Meta-Analysis as Topic %K Middle Aged %K Models, Genetic %K Stroke %K White Matter %X

BACKGROUND: The burden of cerebral white matter hyperintensities (WMH) is associated with an increased risk of stroke, dementia, and death. WMH are highly heritable, but their genetic underpinnings are incompletely characterized. To identify novel genetic variants influencing WMH burden, we conducted a meta-analysis of multiethnic genome-wide association studies.

METHODS AND RESULTS: We included 21 079 middle-aged to elderly individuals from 29 population-based cohorts, who were free of dementia and stroke and were of European (n=17 936), African (n=1943), Hispanic (n=795), and Asian (n=405) descent. WMH burden was quantified on MRI either by a validated automated segmentation method or a validated visual grading scale. Genotype data in each study were imputed to the 1000 Genomes reference. Within each ethnic group, we investigated the relationship between each single-nucleotide polymorphism and WMH burden using a linear regression model adjusted for age, sex, intracranial volume, and principal components of ancestry. A meta-analysis was conducted for each ethnicity separately and for the combined sample. In the European descent samples, we confirmed a previously known locus on chr17q25 (P=2.7×10(-19)) and identified novel loci on chr10q24 (P=1.6×10(-9)) and chr2p21 (P=4.4×10(-8)). In the multiethnic meta-analysis, we identified 2 additional loci, on chr1q22 (P=2.0×10(-8)) and chr2p16 (P=1.5×10(-8)). The novel loci contained genes that have been implicated in Alzheimer disease (chr2p21 and chr10q24), intracerebral hemorrhage (chr1q22), neuroinflammatory diseases (chr2p21), and glioma (chr10q24 and chr2p16).

CONCLUSIONS: We identified 4 novel genetic loci that implicate inflammatory and glial proliferative pathways in the development of WMH in addition to previously proposed ischemic mechanisms.

%B Circ Cardiovasc Genet %V 8 %P 398-409 %8 2015 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25663218?dopt=Abstract %R 10.1161/CIRCGENETICS.114.000858 %0 Journal Article %J Mol Psychiatry %D 2015 %T Novel loci associated with usual sleep duration: the CHARGE Consortium Genome-Wide Association Study. %A Gottlieb, D J %A Hek, K %A Chen, T-H %A Watson, N F %A Eiriksdottir, G %A Byrne, E M %A Cornelis, M %A Warby, S C %A Bandinelli, S %A Cherkas, L %A Evans, D S %A Grabe, H J %A Lahti, J %A Li, M %A Lehtimäki, T %A Lumley, T %A Marciante, K D %A Pérusse, L %A Psaty, B M %A Robbins, J %A Tranah, G J %A Vink, J M %A Wilk, J B %A Stafford, J M %A Bellis, C %A Biffar, R %A Bouchard, C %A Cade, B %A Curhan, G C %A Eriksson, J G %A Ewert, R %A Ferrucci, L %A Fülöp, T %A Gehrman, P R %A Goodloe, R %A Harris, T B %A Heath, A C %A Hernandez, D %A Hofman, A %A Hottenga, J-J %A Hunter, D J %A Jensen, M K %A Johnson, A D %A Kähönen, M %A Kao, L %A Kraft, P %A Larkin, E K %A Lauderdale, D S %A Luik, A I %A Medici, M %A Montgomery, G W %A Palotie, A %A Patel, S R %A Pistis, G %A Porcu, E %A Quaye, L %A Raitakari, O %A Redline, S %A Rimm, E B %A Rotter, J I %A Smith, A V %A Spector, T D %A Teumer, A %A Uitterlinden, A G %A Vohl, M-C %A Widen, E %A Willemsen, G %A Young, T %A Zhang, X %A Liu, Y %A Blangero, J %A Boomsma, D I %A Gudnason, V %A Hu, F %A Mangino, M %A Martin, N G %A O'Connor, G T %A Stone, K L %A Tanaka, T %A Viikari, J %A Gharib, S A %A Punjabi, N M %A Räikkönen, K %A Völzke, H %A Mignot, E %A Tiemeier, H %K Adult %K African Americans %K Aged %K Dyssomnias %K European Continental Ancestry Group %K Female %K Genetic Association Studies %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Self Report %K Sleep %X

Usual sleep duration is a heritable trait correlated with psychiatric morbidity, cardiometabolic disease and mortality, although little is known about the genetic variants influencing this trait. A genome-wide association study (GWAS) of usual sleep duration was conducted using 18 population-based cohorts totaling 47 180 individuals of European ancestry. Genome-wide significant association was identified at two loci. The strongest is located on chromosome 2, in an intergenic region 35- to 80-kb upstream from the thyroid-specific transcription factor PAX8 (lowest P=1.1 × 10(-9)). This finding was replicated in an African-American sample of 4771 individuals (lowest P=9.3 × 10(-4)). The strongest combined association was at rs1823125 (P=1.5 × 10(-10), minor allele frequency 0.26 in the discovery sample, 0.12 in the replication sample), with each copy of the minor allele associated with a sleep duration 3.1 min longer per night. The alleles associated with longer sleep duration were associated in previous GWAS with a more favorable metabolic profile and a lower risk of attention deficit hyperactivity disorder. Understanding the mechanisms underlying these associations may help elucidate biological mechanisms influencing sleep duration and its association with psychiatric, metabolic and cardiovascular disease.

%B Mol Psychiatry %V 20 %P 1232-9 %8 2015 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/25469926?dopt=Abstract %R 10.1038/mp.2014.133 %0 Journal Article %J Neurobiol Aging %D 2015 %T Physical activity, body mass index, and brain atrophy in Alzheimer's disease. %A Boyle, Christina P %A Raji, Cyrus A %A Erickson, Kirk I %A Lopez, Oscar L %A Becker, James T %A Gach, H Michael %A Longstreth, W T %A Teverovskiy, Leonid %A Kuller, Lewis H %A Carmichael, Owen T %A Thompson, Paul M %K Aged %K Aged, 80 and over %K Aging %K Alzheimer Disease %K Atrophy %K Biomarkers %K Body Mass Index %K Brain %K Cognitive Dysfunction %K Cross-Sectional Studies %K Diffusion Magnetic Resonance Imaging %K Female %K Humans %K Magnetic Resonance Imaging %K Male %K Motor Activity %K Neuroimaging %X

The purpose of this study was to use a novel imaging biomarker to assess associations between physical activity (PA), body mass index (BMI), and brain structure in normal aging, mild cognitive impairment, and Alzheimer's dementia. We studied 963 participants (mean age: 74.1 ± 4.4 years) from the multisite Cardiovascular Health Study including healthy controls (n = 724), Alzheimer's dementia patients (n = 104), and people with mild cognitive impairment (n = 135). Volumetric brain images were processed using tensor-based morphometry to analyze regional brain volumes. We regressed the local brain tissue volume on reported PA and computed BMI, and performed conjunction analyses using both variables. Covariates included age, sex, and study site. PA was independently associated with greater whole brain and regional brain volumes and reduced ventricular dilation. People with higher BMI had lower whole brain and regional brain volumes. A PA-BMI conjunction analysis showed brain preservation with PA and volume loss with increased BMI in overlapping brain regions. In one of the largest voxel-based cross-sectional studies to date, PA and lower BMI may be beneficial to the brain across the spectrum of aging and neurodegeneration.

%B Neurobiol Aging %V 36 Suppl 1 %P S194-S202 %8 2015 Jan %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/25248607?dopt=Abstract %R 10.1016/j.neurobiolaging.2014.05.036 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2015 %T Plasma Levels of Soluble Interleukin-2 Receptor α: Associations With Clinical Cardiovascular Events and Genome-Wide Association Scan. %A Durda, Peter %A Sabourin, Jeremy %A Lange, Ethan M %A Nalls, Mike A %A Mychaleckyj, Josyf C %A Jenny, Nancy Swords %A Li, Jin %A Walston, Jeremy %A Harris, Tamara B %A Psaty, Bruce M %A Valdar, William %A Liu, Yongmei %A Cushman, Mary %A Reiner, Alex P %A Tracy, Russell P %A Lange, Leslie A %K Adult %K African Americans %K Age Distribution %K Aged %K Cardiovascular Diseases %K Cohort Studies %K Coronary Artery Disease %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Incidence %K Interleukin-2 Receptor alpha Subunit %K Kaplan-Meier Estimate %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Sex Distribution %K Survival Analysis %X

OBJECTIVE: Interleukin (IL) -2 receptor subunit α regulates lymphocyte activation, which plays an important role in atherosclerosis. Associations between soluble IL-2Rα (sIL-2Rα) and cardiovascular disease (CVD) have not been widely studied and little is known about the genetic determinants of sIL-2Rα levels.

APPROACH AND RESULTS: We measured baseline levels of sIL-2Rα in 4408 European American (EA) and 766 African American (AA) adults from the Cardiovascular Health Study (CHS) and examined associations with baseline CVD risk factors, subclinical CVD, and incident CVD events. We also performed a genome-wide association study for sIL-2Rα in CHS (2964 EAs and 683 AAs) and further combined CHS EA results with those from two other EA cohorts in a meta-analysis (n=4464 EAs). In age, sex- and race- adjusted models, sIL-2Rα was positively associated with current smoking, type 2 diabetes mellitus, hypertension, insulin, waist circumference, C-reactive protein, IL-6, fibrinogen, internal carotid wall thickness, all-cause mortality, CVD mortality, and incident CVD, stroke, and heart failure. When adjusted for baseline CVD risk factors and subclinical CVD, associations with all-cause mortality, CVD mortality, and heart failure remained significant in both EAs and AAs. In the EA genome-wide association study analysis, we observed 52 single-nucleotide polymorphisms in the chromosome 10p15-14 region, which contains IL2RA, IL15RA, and RMB17, that reached genome-wide significance (P<5×10(-8)). The most significant single-nucleotide polymorphism was rs7911500 (P=1.31×10(-75)). The EA meta-analysis results were highly consistent with CHS-only results. No single-nucleotide polymorphisms reached statistical significance in the AAs.

CONCLUSIONS: These results support a role for sIL-2Rα in atherosclerosis and provide evidence for multiple-associated single-nucleotide polymorphisms at chromosome 10p15-14.

%B Arterioscler Thromb Vasc Biol %V 35 %P 2246-53 %8 2015 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/26293465?dopt=Abstract %R 10.1161/ATVBAHA.115.305289 %0 Journal Article %J Am J Clin Nutr %D 2015 %T Plasma phospholipid very-long-chain saturated fatty acids and incident diabetes in older adults: the Cardiovascular Health Study. %A Lemaitre, Rozenn N %A Fretts, Amanda M %A Sitlani, Colleen M %A Biggs, Mary L %A Mukamal, Kenneth %A King, Irena B %A Song, Xiaoling %A Djoussé, Luc %A Siscovick, David S %A McKnight, Barbara %A Sotoodehnia, Nona %A Kizer, Jorge R %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Biomarkers %K Cross-Sectional Studies %K Diabetes Mellitus %K Diet %K Eicosanoic Acids %K Fatty Acids %K Fatty Acids, Nonesterified %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Observational Studies as Topic %K Palmitic Acid %K Phospholipids %K Prospective Studies %K Risk Factors %K Triglycerides %X

BACKGROUND: Circulating saturated fatty acids (SFAs) are integrated biomarkers of diet and metabolism that may influence the pathogenesis of diabetes. In epidemiologic studies, circulating levels of palmitic acid (16:0) are associated with diabetes; however, very-long-chain SFAs (VLSFAs), with 20 or more carbons, differ from palmitic acid in their biological activities, and little is known of the association of circulating VLSFA with diabetes.

OBJECTIVE: By using data from the Cardiovascular Health Study, we examined the associations of plasma phospholipid VLSFA levels measured at baseline with subsequent incident diabetes.

DESIGN: A total of 3179 older adults, with a mean age of 75 y at study baseline (1992-1993), were followed through 2011. We used multiple proportional hazards regression to examine the associations of arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) with diabetes.

RESULTS: Baseline levels of each VLSFA were cross-sectionally associated with lower triglyceride levels and lower circulating palmitic acid. We identified 284 incident diabetes cases during follow-up. Compared with the lowest quartile, levels of arachidic acid in the highest quartile of the fatty acid distribution were associated with a 47% lower risk of diabetes (95% CI: 23%, 63%; P-trend: <0.001), after adjustment for demographics, lifestyle factors, and clinical conditions. In analogous comparisons, levels of behenic and lignoceric acid were similarly associated with 33% (95% CI: 6%, 53%; P-trend: 0.02) and 37% (95% CI: 11%, 55%; P-trend: 0.01) lower diabetes risk, respectively. Adjustment for triglycerides and palmitic acid attenuated the associations toward the null, and only the association of arachidic acid remained statistically significant (32% lower risk for fourth vs. first quartile; P-trend: 0.04).

CONCLUSIONS: These results suggest that circulating VLSFAs are associated with a lower risk of diabetes, and these associations may be mediated by lower triglycerides and palmitic acid. The study highlights the need to distinguish the effects of different SFAs and to explore determinants of circulating VLSFAs. This trial was registered at clinicaltrials.gov as NCT00005133.

%B Am J Clin Nutr %V 101 %P 1047-54 %8 2015 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25787996?dopt=Abstract %R 10.3945/ajcn.114.101857 %0 Journal Article %J PLoS One %D 2015 %T Population genomic analysis of 962 whole genome sequences of humans reveals natural selection in non-coding regions. %A Yu, Fuli %A Lu, Jian %A Liu, Xiaoming %A Gazave, Elodie %A Chang, Diana %A Raj, Srilakshmi %A Hunter-Zinck, Haley %A Blekhman, Ran %A Arbiza, Leonardo %A Van Hout, Cris %A Morrison, Alanna %A Johnson, Andrew D %A Bis, Joshua %A Cupples, L Adrienne %A Psaty, Bruce M %A Muzny, Donna %A Yu, Jin %A Gibbs, Richard A %A Keinan, Alon %A Clark, Andrew G %A Boerwinkle, Eric %K DNA, Intergenic %K Genetic Loci %K Humans %K Metagenomics %K Open Reading Frames %K Polymorphism, Single Nucleotide %X

Whole genome analysis in large samples from a single population is needed to provide adequate power to assess relative strengths of natural selection across different functional components of the genome. In this study, we analyzed next-generation sequencing data from 962 European Americans, and found that as expected approximately 60% of the top 1% of positive selection signals lie in intergenic regions, 33% in intronic regions, and slightly over 1% in coding regions. Several detailed functional annotation categories in intergenic regions showed statistically significant enrichment in positively selected loci when compared to the null distribution of the genomic span of ENCODE categories. There was a significant enrichment of purifying selection signals detected in enhancers, transcription factor binding sites, microRNAs and target sites, but not on lincRNA or piRNAs, suggesting different evolutionary constraints for these domains. Loci in "repressed or low activity regions" and loci near or overlapping the transcription start site were the most significantly over-represented annotations among the top 1% of signals for positive selection.

%B PLoS One %V 10 %P e0121644 %8 2015 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25807536?dopt=Abstract %R 10.1371/journal.pone.0121644 %0 Journal Article %J Am J Clin Nutr %D 2015 %T Prospective association of fatty acids in the de novo lipogenesis pathway with risk of type 2 diabetes: the Cardiovascular Health Study. %A Ma, Wenjie %A Wu, Jason H Y %A Wang, Qianyi %A Lemaitre, Rozenn N %A Mukamal, Kenneth J %A Djoussé, Luc %A King, Irena B %A Song, Xiaoling %A Biggs, Mary L %A Delaney, Joseph A %A Kizer, Jorge R %A Siscovick, David S %A Mozaffarian, Dariush %K Aged %K Biomarkers %K Cohort Studies %K Cross-Sectional Studies %K Diabetes Mellitus, Type 2 %K Female %K Follow-Up Studies %K Humans %K Incidence %K Lipogenesis %K Liver %K Male %K Palmitic Acid %K Phospholipids %K Prevalence %K Proportional Hazards Models %K Risk Factors %K Stearic Acids %K United States %K Up-Regulation %X

BACKGROUND: Experimental evidence suggests that hepatic de novo lipogenesis (DNL) affects insulin homeostasis via synthesis of saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs). Few prospective studies have used fatty acid biomarkers to assess associations with type 2 diabetes.

OBJECTIVES: We investigated associations of major circulating SFAs [palmitic acid (16:0) and stearic acid (18:0)] and MUFA [oleic acid (18:1n-9)] in the DNL pathway with metabolic risk factors and incident diabetes in community-based older U.S. adults in the Cardiovascular Health Study. We secondarily assessed other DNL fatty acid biomarkers [myristic acid (14:0), palmitoleic acid (16:1n-7), 7-hexadecenoic acid (16:1n-9), and vaccenic acid (18:1n-7)] and estimated dietary SFAs and MUFAs.

DESIGN: In 3004 participants free of diabetes, plasma phospholipid fatty acids were measured in 1992, and incident diabetes was identified by medication use and blood glucose. Usual diets were assessed by using repeated food-frequency questionnaires. Multivariable linear and Cox regression were used to assess associations with metabolic risk factors and incident diabetes, respectively.

RESULTS: At baseline, circulating palmitic acid and stearic acid were positively associated with adiposity, triglycerides, inflammation biomarkers, and insulin resistance (P-trend < 0.01 each), whereas oleic acid showed generally beneficial associations (P-trend < 0.001 each). During 30,763 person-years, 297 incident diabetes cases occurred. With adjustment for demographics and lifestyle, palmitic acid (extreme-quintile HR: 1.89; 95% CI: 1.27, 2.83; P-trend = 0.001) and stearic acid (HR: 1.62; 95% CI: 1.09, 2.41; P-trend = 0.006) were associated with higher diabetes risk, whereas oleic acid was not significantly associated. In secondary analyses, vaccenic acid was inversely associated with diabetes (HR: 0.56; 95% CI: 0.38, 0.83; P-trend = 0.005). Other fatty acid biomarkers and estimated dietary SFAs or MUFAs were not significantly associated with incident diabetes.

CONCLUSIONS: In this large prospective cohort, circulating palmitic acid and stearic acid were associated with higher diabetes risk, and vaccenic acid was associated with lower diabetes risk. These results indicate a need for additional investigation of biological mechanisms linking specific fatty acids in the DNL pathway to the pathogenesis of diabetes.

%B Am J Clin Nutr %V 101 %P 153-63 %8 2015 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25527759?dopt=Abstract %R 10.3945/ajcn.114.092601 %0 Journal Article %J PLoS One %D 2015 %T Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events. %A Gijsberts, Crystel M %A Groenewegen, Karlijn A %A Hoefer, Imo E %A Eijkemans, Marinus J C %A Asselbergs, Folkert W %A Anderson, Todd J %A Britton, Annie R %A Dekker, Jacqueline M %A Engström, Gunnar %A Evans, Greg W %A de Graaf, Jacqueline %A Grobbee, Diederick E %A Hedblad, Bo %A Holewijn, Suzanne %A Ikeda, Ai %A Kitagawa, Kazuo %A Kitamura, Akihiko %A de Kleijn, Dominique P V %A Lonn, Eva M %A Lorenz, Matthias W %A Mathiesen, Ellisiv B %A Nijpels, Giel %A Okazaki, Shuhei %A O'Leary, Daniel H %A Pasterkamp, Gerard %A Peters, Sanne A E %A Polak, Joseph F %A Price, Jacqueline F %A Robertson, Christine %A Rembold, Christopher M %A Rosvall, Maria %A Rundek, Tatjana %A Salonen, Jukka T %A Sitzer, Matthias %A Stehouwer, Coen D A %A Bots, Michiel L %A den Ruijter, Hester M %K Adult %K Age Distribution %K Aged %K Carotid Artery Diseases %K Carotid Intima-Media Thickness %K Cholesterol, HDL %K Cholesterol, LDL %K Comorbidity %K Continental Population Groups %K Diabetes Mellitus %K Dyslipidemias %K Ethnic Groups %K Female %K Follow-Up Studies %K Global Health %K Humans %K Hypertension %K Incidence %K Linear Models %K Male %K Middle Aged %K Myocardial Infarction %K Prevalence %K Proportional Hazards Models %K Risk Factors %K Smoking %K Stroke %X

BACKGROUND: Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events.

METHODS: We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity.

RESULTS: Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites.

CONCLUSION: The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.

%B PLoS One %V 10 %P e0132321 %8 2015 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/26134404?dopt=Abstract %R 10.1371/journal.pone.0132321 %0 Journal Article %J JAMA Neurol %D 2015 %T Rare and Coding Region Genetic Variants Associated With Risk of Ischemic Stroke: The NHLBI Exome Sequence Project. %A Auer, Paul L %A Nalls, Mike %A Meschia, James F %A Worrall, Bradford B %A Longstreth, W T %A Seshadri, Sudha %A Kooperberg, Charles %A Burger, Kathleen M %A Carlson, Christopher S %A Carty, Cara L %A Chen, Wei-Min %A Cupples, L Adrienne %A DeStefano, Anita L %A Fornage, Myriam %A Hardy, John %A Hsu, Li %A Jackson, Rebecca D %A Jarvik, Gail P %A Kim, Daniel S %A Lakshminarayan, Kamakshi %A Lange, Leslie A %A Manichaikul, Ani %A Quinlan, Aaron R %A Singleton, Andrew B %A Thornton, Timothy A %A Nickerson, Deborah A %A Peters, Ulrike %A Rich, Stephen S %K Aged %K Brain Ischemia %K Exome %K Female %K Genetic Predisposition to Disease %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Muscle Proteins %K National Heart, Lung, and Blood Institute (U.S.) %K Nuclear Proteins %K Open Reading Frames %K Palmitoyl-CoA Hydrolase %K Stroke %K United States %X

IMPORTANCE: Stroke is the second leading cause of death and the third leading cause of years of life lost. Genetic factors contribute to stroke prevalence, and candidate gene and genome-wide association studies (GWAS) have identified variants associated with ischemic stroke risk. These variants often have small effects without obvious biological significance. Exome sequencing may discover predicted protein-altering variants with a potentially large effect on ischemic stroke risk.

OBJECTIVE: To investigate the contribution of rare and common genetic variants to ischemic stroke risk by targeting the protein-coding regions of the human genome.

DESIGN, SETTING, AND PARTICIPANTS: The National Heart, Lung, and Blood Institute (NHLBI) Exome Sequencing Project (ESP) analyzed approximately 6000 participants from numerous cohorts of European and African ancestry. For discovery, 365 cases of ischemic stroke (small-vessel and large-vessel subtypes) and 809 European ancestry controls were sequenced; for replication, 47 affected sibpairs concordant for stroke subtype and an African American case-control series were sequenced, with 1672 cases and 4509 European ancestry controls genotyped. The ESP's exome sequencing and genotyping started on January 1, 2010, and continued through June 30, 2012. Analyses were conducted on the full data set between July 12, 2012, and July 13, 2013.

MAIN OUTCOMES AND MEASURES: Discovery of new variants or genes contributing to ischemic stroke risk and subtype (primary analysis) and determination of support for protein-coding variants contributing to risk in previously published candidate genes (secondary analysis).

RESULTS: We identified 2 novel genes associated with an increased risk of ischemic stroke: a protein-coding variant in PDE4DIP (rs1778155; odds ratio, 2.15; P = 2.63 × 10(-8)) with an intracellular signal transduction mechanism and in ACOT4 (rs35724886; odds ratio, 2.04; P = 1.24 × 10(-7)) with a fatty acid metabolism; confirmation of PDE4DIP was observed in affected sibpair families with large-vessel stroke subtype and in African Americans. Replication of protein-coding variants in candidate genes was observed for 2 previously reported GWAS associations: ZFHX3 (cardioembolic stroke) and ABCA1 (large-vessel stroke).

CONCLUSIONS AND RELEVANCE: Exome sequencing discovered 2 novel genes and mechanisms, PDE4DIP and ACOT4, associated with increased risk for ischemic stroke. In addition, ZFHX3 and ABCA1 were discovered to have protein-coding variants associated with ischemic stroke. These results suggest that genetic variation in novel pathways contributes to ischemic stroke risk and serves as a target for prediction, prevention, and therapy.

%B JAMA Neurol %V 72 %P 781-8 %8 2015 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/25961151?dopt=Abstract %R 10.1001/jamaneurol.2015.0582 %0 Journal Article %J Blood %D 2015 %T Rare and low-frequency variants and their association with plasma levels of fibrinogen, FVII, FVIII, and vWF. %A Huffman, Jennifer E %A de Vries, Paul S %A Morrison, Alanna C %A Sabater-Lleal, Maria %A Kacprowski, Tim %A Auer, Paul L %A Brody, Jennifer A %A Chasman, Daniel I %A Chen, Ming-Huei %A Guo, Xiuqing %A Lin, Li-An %A Marioni, Riccardo E %A Müller-Nurasyid, Martina %A Yanek, Lisa R %A Pankratz, Nathan %A Grove, Megan L %A de Maat, Moniek P M %A Cushman, Mary %A Wiggins, Kerri L %A Qi, Lihong %A Sennblad, Bengt %A Harris, Sarah E %A Polasek, Ozren %A Riess, Helene %A Rivadeneira, Fernando %A Rose, Lynda M %A Goel, Anuj %A Taylor, Kent D %A Teumer, Alexander %A Uitterlinden, André G %A Vaidya, Dhananjay %A Yao, Jie %A Tang, Weihong %A Levy, Daniel %A Waldenberger, Melanie %A Becker, Diane M %A Folsom, Aaron R %A Giulianini, Franco %A Greinacher, Andreas %A Hofman, Albert %A Huang, Chiang-Ching %A Kooperberg, Charles %A Silveira, Angela %A Starr, John M %A Strauch, Konstantin %A Strawbridge, Rona J %A Wright, Alan F %A McKnight, Barbara %A Franco, Oscar H %A Zakai, Neil %A Mathias, Rasika A %A Psaty, Bruce M %A Ridker, Paul M %A Tofler, Geoffrey H %A Völker, Uwe %A Watkins, Hugh %A Fornage, Myriam %A Hamsten, Anders %A Deary, Ian J %A Boerwinkle, Eric %A Koenig, Wolfgang %A Rotter, Jerome I %A Hayward, Caroline %A Dehghan, Abbas %A Reiner, Alex P %A O'Donnell, Christopher J %A Smith, Nicholas L %K Cohort Studies %K Factor VII %K Factor VIII %K Fibrinogen %K Gene Frequency %K Genetic Association Studies %K Genetic Variation %K Humans %K Nerve Tissue Proteins %K Polymorphism, Single Nucleotide %K Potassium Channels %K von Willebrand Factor %X

Fibrinogen, coagulation factor VII (FVII), and factor VIII (FVIII) and its carrier von Willebrand factor (vWF) play key roles in hemostasis. Previously identified common variants explain only a small fraction of the trait heritabilities, and additional variations may be explained by associations with rarer variants with larger effects. The aim of this study was to identify low-frequency (minor allele frequency [MAF] ≥0.01 and <0.05) and rare (MAF <0.01) variants that influence plasma concentrations of these 4 hemostatic factors by meta-analyzing exome chip data from up to 76,000 participants of 4 ancestries. We identified 12 novel associations of low-frequency (n = 2) and rare (n = 10) variants across the fibrinogen, FVII, FVIII, and vWF traits that were independent of previously identified associations. Novel loci were found within previously reported genes and had effect sizes much larger than and independent of previously identified common variants. In addition, associations at KCNT1, HID1, and KATNB1 identified new candidate genes related to hemostasis for follow-up replication and functional genomic analysis. Newly identified low-frequency and rare-variant associations accounted for modest amounts of trait variance and therefore are unlikely to increase predicted trait heritability but provide new information for understanding individual variation in hemostasis pathways.

%B Blood %V 126 %P e19-29 %8 2015 Sep 10 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/26105150?dopt=Abstract %R 10.1182/blood-2015-02-624551 %0 Journal Article %J J Alzheimers Dis %D 2015 %T Relationship between Systemic and Cerebral Vascular Disease and Brain Structure Integrity in Normal Elderly Individuals. %A Riverol, Mario %A Becker, James T %A Lopez, Oscar L %A Raji, Cyrus A %A Thompson, Paul M %A Carmichael, Owen T %A Gach, H Michael %A Longstreth, William T %A Fried, Linda %A Tracy, Russell P %A Kuller, Lewis H %K Aged %K Aged, 80 and over %K Analysis of Variance %K Brain %K Cerebrovascular Disorders %K Female %K Humans %K Image Processing, Computer-Assisted %K Logistic Models %K Magnetic Resonance Imaging %K Male %K Neuropsychological Tests %K Peripheral Vascular Diseases %K Predictive Value of Tests %K Retrospective Studies %K White Matter %X

Cerebral white matter lesions (WMLs) are considered a reflection of cerebral and systemic small vessel disease (SVD), and are associated with reductions in brain volume. Like the brain, the kidney is also sensitive to factors that affect vasculature. Glomerular dysfunction due to renal vascular damage can be measured with different biochemical parameters, such as creatinine or cystatin C, although cystatin C is considered to be more accurate than creatinine in the elderly. The purpose of the study was to determine whether manifestations of SVD in the kidney can predict SVD-based damage to the brain. We examined the relationship between glomerular dysfunction as a measure of SVD on WMLs, gray matter (GM) volume, and cognition in 735 cognitively normal participants from the Cardiovascular Health Study Cognition Study. The multivariate analyses controlled for demographic characteristics, hypertension, heart disease, diabetes, Apolipoprotein 4 allele, C reactive protein, lipids, physical activity, smoking, and body mass index (BMI). Elevated cystatin C levels were associated with lower neuropsychological test scores, the presence of MRI-identified brain infarcts, the severity of WMLs, and GM atrophy five years later. In adjusted models, GM volume was significantly associated with cystatin-C only until BMI and severity of WMLs were added to the model, meaning that the effect of SVD on GM volume is mediated by these two variables. These findings suggest that age-related SVD is a process that leads to altered brain structure, and creates a vulnerability state for cognitive decline.

%B J Alzheimers Dis %V 44 %P 319-28 %8 2015 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25213770?dopt=Abstract %R 10.3233/JAD-141077 %0 Journal Article %J J Am Heart Assoc %D 2015 %T Resting heart rate and risk of incident heart failure: three prospective cohort studies and a systematic meta-analysis. %A Khan, Hassan %A Kunutsor, Setor %A Kalogeropoulos, Andreas P %A Georgiopoulou, Vasiliki V %A Newman, Anne B %A Harris, Tamara B %A Bibbins-Domingo, Kirsten %A Kauhanen, Jussi %A Gheorghiade, Mihai %A Fonarow, Gregg C %A Kritchevsky, Stephen B %A Laukkanen, Jari A %A Butler, Javed %K Age Distribution %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Female %K Heart Failure %K Heart Rate %K Humans %K Incidence %K Japan %K Male %K Predictive Value of Tests %K Prospective Studies %K Rest %K Risk Assessment %K Severity of Illness Index %K Sex Distribution %K Survival Rate %X

BACKGROUND: The relationship between resting heart rate (RHR) and incident heart failure (HF) has been questioned.

METHODS AND RESULTS: RHR was assessed at baseline in 7073 participants in 3 prospective cohorts (Cardiovascular Health Study, Health ABC study and Kuopio Ischemic Heart Disease Study) that recorded 1189 incident HF outcomes during 92 702 person-years of follow-up. Mean age of participants was 67 (9.9) years and mean RHR was 64.6 (11.1) bpm. Baseline RHR correlated (P<0.001) positively with body mass index (r=0.10), fasting glucose (r=0.18), and C-reactive protein (r=0.20); and inversely with serum creatinine (r=-0.05) and albumin (r=-0.05). Baseline RHR was non-linearly associated with HF risk. The age and sex-adjusted hazard ratio for HF comparing the top (>72 bpm) versus the bottom (<57 bpm) quartile of baseline RHR was 1.48 (95% confidence interval [CI] 1.26 to 1.74) and was modestly attenuated (1.30, 95% CI 1.10 to 1.53) with further adjustment for body mass index, history of diabetes, hypertension, smoking status, serum creatinine, and left ventricular hypertrophy. These findings remained consistent in analyses accounting for incident coronary heart disease, excluding individuals with prior cardiovascular events, or those taking beta-blockers; and in subgroups defined by several individual participant characteristics. In a pooled random effects meta-analysis of 7 population-based studies (43 051 participants and 3476 HF events), the overall hazard ratio comparing top versus bottom fourth of RHR was 1.40 (95% CI: 1.19 to 1.64).

CONCLUSIONS: There is a non-linear association between RHR and incident HF. Further research is needed to understand the physiologic foundations of this association.

%B J Am Heart Assoc %V 4 %P e001364 %8 2015 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25589535?dopt=Abstract %R 10.1161/JAHA.114.001364 %0 Journal Article %J Heart Rhythm %D 2015 %T Serial measures of cardiac troponin T levels by a highly sensitive assay and incident atrial fibrillation in a prospective cohort of ambulatory older adults. %A Hussein, Ayman A %A Bartz, Traci M %A Gottdiener, John S %A Sotoodehnia, Nona %A Heckbert, Susan R %A Lloyd-Jones, Donald %A Kizer, Jorge R %A Christenson, Robert %A Wazni, Oussama %A DeFilippi, Christopher %K Aged %K Atrial Fibrillation %K Biomarkers %K Electrocardiography %K Female %K Heart Failure %K Humans %K Incidence %K Longitudinal Studies %K Male %K Outpatients %K Risk Assessment %K Risk Factors %K Statistics as Topic %K Troponin T %K United States %X

BACKGROUND: Various mechanisms in cardiac remodeling related to atrial fibrillation (AF) lead to elevated circulating cardiac troponin levels, but little is known about such elevations upstream to AF onset.

OBJECTIVE: The purpose of this study was to study the association between circulating troponin levels as assessed by a highly sensitive cardiac troponin T (hs-cTnT) assay and incident atrial fibrillation (AF).

METHODS: In a large prospective cohort of ambulatory older adults [the Cardiovascular Health Study (CHS)], hs-cTnT levels were measured in sera that were collected at enrollment from 4262 participants without AF (2871 with follow-up measurements). Incident AF was identified by electrocardiograms during CHS visits, hospital discharge diagnoses, and Medicare files, including outpatient and physician claims diagnoses.

RESULTS: Over median follow-up of 11.2 years (interquartile range 6.1-16.5), 1363 participants (32.0%) developed AF. Higher baseline levels of hs-cTnT were associated with incident AF in covariate-adjusted analyses accounting for demographics, traditional risk factors, and incident heart failure in time-dependent analyzes (hazard ratio for 3rd tertile vs undetectable 1.75, 95% confidence interval 1.48-2.08). This association was statistically significant in analyses that additionally adjusted for biomarkers of inflammation and hemodynamic strain (hazard ratio for 3rd tertile vs undetectable 1.38, 95% confidence interval 1.16-1.65). Significant associations were also found when hs-cTnT levels were treated as a continuous variable and when examining change from baseline of hs-cTnT levels and incident AF.

CONCLUSION: The findings show a significant association of circulating troponin levels in ambulatory older adults with incident AF beyond that of traditional risk factors, incident heart failure, and biomarkers of inflammation and hemodynamic strain.

%B Heart Rhythm %V 12 %P 879-85 %8 2015 May %G ENG %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25602173?dopt=Abstract %R 10.1016/j.hrthm.2015.01.020 %0 Journal Article %J Neurology %D 2015 %T Shared genetic basis for migraine and ischemic stroke: A genome-wide analysis of common variants. %A Malik, Rainer %A Freilinger, Tobias %A Winsvold, Bendik S %A Anttila, Verneri %A Vander Heiden, Jason %A Traylor, Matthew %A de Vries, Boukje %A Holliday, Elizabeth G %A Terwindt, Gisela M %A Sturm, Jonathan %A Bis, Joshua C %A Hopewell, Jemma C %A Ferrari, Michel D %A Rannikmae, Kristiina %A Wessman, Maija %A Kallela, Mikko %A Kubisch, Christian %A Fornage, Myriam %A Meschia, James F %A Lehtimäki, Terho %A Sudlow, Cathie %A Clarke, Robert %A Chasman, Daniel I %A Mitchell, Braxton D %A Maguire, Jane %A Kaprio, Jaakko %A Farrall, Martin %A Raitakari, Olli T %A Kurth, Tobias %A Ikram, M Arfan %A Reiner, Alex P %A Longstreth, W T %A Rothwell, Peter M %A Strachan, David P %A Sharma, Pankaj %A Seshadri, Sudha %A Quaye, Lydia %A Cherkas, Lynn %A Schürks, Markus %A Rosand, Jonathan %A Ligthart, Lannie %A Boncoraglio, Giorgio B %A Davey Smith, George %A van Duijn, Cornelia M %A Stefansson, Kari %A Worrall, Bradford B %A Nyholt, Dale R %A Markus, Hugh S %A van den Maagdenberg, Arn M J M %A Cotsapas, Chris %A Zwart, John A %A Palotie, Aarno %A Dichgans, Martin %K Brain Ischemia %K Genome-Wide Association Study %K Humans %K Migraine with Aura %K Migraine without Aura %K Stroke %X

OBJECTIVE: To quantify genetic overlap between migraine and ischemic stroke (IS) with respect to common genetic variation.

METHODS: We applied 4 different approaches to large-scale meta-analyses of genome-wide data on migraine (23,285 cases and 95,425 controls) and IS (12,389 cases and 62,004 controls). First, we queried known genome-wide significant loci for both disorders, looking for potential overlap of signals. We then analyzed the overall shared genetic load using polygenic scores and estimated the genetic correlation between disease subtypes using data derived from these models. We further interrogated genomic regions of shared risk using analysis of covariance patterns between the 2 phenotypes using cross-phenotype spatial mapping.

RESULTS: We found substantial genetic overlap between migraine and IS using all 4 approaches. Migraine without aura (MO) showed much stronger overlap with IS and its subtypes than migraine with aura (MA). The strongest overlap existed between MO and large artery stroke (LAS; p = 6.4 × 10(-28) for the LAS polygenic score in MO) and between MO and cardioembolic stroke (CE; p = 2.7 × 10(-20) for the CE score in MO).

CONCLUSIONS: Our findings indicate shared genetic susceptibility to migraine and IS, with a particularly strong overlap between MO and both LAS and CE pointing towards shared mechanisms. Our observations on MA are consistent with a limited role of common genetic variants in this subtype.

%B Neurology %V 84 %P 2132-45 %8 2015 May 26 %G eng %N 21 %1 http://www.ncbi.nlm.nih.gov/pubmed/25934857?dopt=Abstract %R 10.1212/WNL.0000000000001606 %0 Journal Article %J J Am Geriatr Soc %D 2015 %T Social Network Size and Cranial Magnetic Resonance Imaging Findings in Older Adults: The Cardiovascular Health Study. %A Flatt, Jason D %A Rosso, Andrea L %A Aizenstein, Howard J %A Schulz, Richard %A Longstreth, W T %A Newman, Anne B %A Fowler, Nicole R %A Rosano, Caterina %K Aged %K Brain %K Cardiovascular Diseases %K Cross-Sectional Studies %K Female %K Geriatric Assessment %K Humans %K Magnetic Resonance Imaging %K Male %K Neuroimaging %K Social Participation %K Social Support %B J Am Geriatr Soc %V 63 %P 2430-2 %8 2015 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/26603076?dopt=Abstract %R 10.1111/jgs.13805 %0 Journal Article %J J Clin Endocrinol Metab %D 2015 %T Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis. %A Chaker, Layal %A Baumgartner, Christine %A den Elzen, Wendy P J %A Ikram, M Arfan %A Blum, Manuel R %A Collet, Tinh-Hai %A Bakker, Stephan J L %A Dehghan, Abbas %A Drechsler, Christiane %A Luben, Robert N %A Hofman, Albert %A Portegies, Marileen L P %A Medici, Marco %A Iervasi, Giorgio %A Stott, David J %A Ford, Ian %A Bremner, Alexandra %A Wanner, Christoph %A Ferrucci, Luigi %A Newman, Anne B %A Dullaart, Robin P %A Sgarbi, José A %A Ceresini, Graziano %A Maciel, Rui M B %A Westendorp, Rudi G %A Jukema, J Wouter %A Imaizumi, Misa %A Franklyn, Jayne A %A Bauer, Douglas C %A Walsh, John P %A Razvi, Salman %A Khaw, Kay-Tee %A Cappola, Anne R %A Völzke, Henry %A Franco, Oscar H %A Gussekloo, Jacobijn %A Rodondi, Nicolas %A Peeters, Robin P %K Adult %K Asymptomatic Diseases %K Female %K Humans %K Hypothyroidism %K Incidence %K Male %K Risk Factors %K Stroke %K Thyrotropin %X

OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism.

DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels.

DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations.

CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.

%B J Clin Endocrinol Metab %V 100 %P 2181-91 %8 2015 Jun %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/25856213?dopt=Abstract %R 10.1210/jc.2015-1438 %0 Journal Article %J JAMA %D 2015 %T Subclinical thyroid dysfunction and fracture risk: a meta-analysis. %A Blum, Manuel R %A Bauer, Douglas C %A Collet, Tinh-Hai %A Fink, Howard A %A Cappola, Anne R %A da Costa, Bruno R %A Wirth, Christina D %A Peeters, Robin P %A Asvold, Bjørn O %A den Elzen, Wendy P J %A Luben, Robert N %A Imaizumi, Misa %A Bremner, Alexandra P %A Gogakos, Apostolos %A Eastell, Richard %A Kearney, Patricia M %A Strotmeyer, Elsa S %A Wallace, Erin R %A Hoff, Mari %A Ceresini, Graziano %A Rivadeneira, Fernando %A Uitterlinden, André G %A Stott, David J %A Westendorp, Rudi G J %A Khaw, Kay-Tee %A Langhammer, Arnuf %A Ferrucci, Luigi %A Gussekloo, Jacobijn %A Williams, Graham R %A Walsh, John P %A Jüni, Peter %A Aujesky, Drahomir %A Rodondi, Nicolas %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Female %K Fractures, Bone %K Hip Fractures %K Humans %K Hyperthyroidism %K Hypothyroidism %K Male %K Middle Aged %K Risk Factors %K Spinal Fractures %K Thyrotropin %K Young Adult %X

IMPORTANCE: Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking.

OBJECTIVE: To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures.

DATA SOURCES AND STUDY SELECTION: The databases of MEDLINE and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures.

DATA EXTRACTION: Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan. Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH <0.45 mIU/L), and subclinical hypothyroidism (TSH ≥4.50-19.99 mIU/L) with normal thyroxine concentrations.

MAIN OUTCOME AND MEASURES: The primary outcome was hip fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes.

RESULTS: Among 70,298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762,401 person-years of follow-up, hip fracture occurred in 2975 participants (4.6%; 12 studies), any fracture in 2528 participants (9.0%; 8 studies), nonspine fracture in 2018 participants (8.4%; 8 studies), and spine fracture in 296 participants (1.3%; 6 studies). In age- and sex-adjusted analyses, the hazard ratio (HR) for subclinical hyperthyroidism vs euthyroidism was 1.36 for hip fracture (95% CI, 1.13-1.64; 146 events in 2082 participants vs 2534 in 56,471); for any fracture, HR was 1.28 (95% CI, 1.06-1.53; 121 events in 888 participants vs 2203 in 25,901); for nonspine fracture, HR was 1.16 (95% CI, 0.95-1.41; 107 events in 946 participants vs 1745 in 21,722); and for spine fracture, HR was 1.51 (95% CI, 0.93-2.45; 17 events in 732 participants vs 255 in 20,328). Lower TSH was associated with higher fracture rates: for TSH of less than 0.10 mIU/L, HR was 1.61 for hip fracture (95% CI, 1.21-2.15; 47 events in 510 participants); for any fracture, HR was 1.98 (95% CI, 1.41-2.78; 44 events in 212 participants); for nonspine fracture, HR was 1.61 (95% CI, 0.96-2.71; 32 events in 185 participants); and for spine fracture, HR was 3.57 (95% CI, 1.88-6.78; 8 events in 162 participants). Risks were similar after adjustment for other fracture risk factors. Endogenous subclinical hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19-1.93) for hip fracture, 1.42 (95% CI, 1.16-1.74) for any fracture, and 1.74 (95% CI, 1.01-2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk.

CONCLUSIONS AND RELEVANCE: Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures.

%B JAMA %V 313 %P 2055-65 %8 2015 May 26 %G eng %N 20 %1 http://www.ncbi.nlm.nih.gov/pubmed/26010634?dopt=Abstract %R 10.1001/jama.2015.5161 %0 Journal Article %J Communications in Statistics-Simulation and Computation %D 2015 %T Time to diagnosis: accounting for differential follow-up times in cohort studies. %A Bůzková, Petra %E Lumley, Thomas %K 62N01 %K Covariate-dependent follow-up %K Discrete survival data %K Multi-cohort studies %K Primary 62N02 %K Secondary 62H12 %X Cox regression is widely used to analyze discrete survival time data. Differential endpoint follow-up across sub-cohorts where distribution of a covariate varies may cause typical estimators to be biased or inefficient. We demonstrate that with Cardiovascular Health Study data for incident type 2 diabetes. Two cohorts with extremely different race distribution have differential follow-up for fasting glucose levels. We study various scenarios of Cox regression. We suggest an alternative approach, Poisson generalized estimating equations with an offset to accommodate the differential follow-up. We use simulations to contrast the methods. %B Communications in Statistics-Simulation and Computation %V 44 %8 2015 %G eng %N 1 %& 247 %0 Journal Article %J J Alzheimers Dis %D 2015 %T Voxel Level Survival Analysis of Grey Matter Volume and Incident Mild Cognitive Impairment or Alzheimer's Disease. %A Zeifman, Lubov E %A Eddy, William F %A Lopez, Oscar L %A Kuller, Lewis H %A Raji, Cyrus %A Thompson, Paul M %A Becker, James T %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Chi-Square Distribution %K Disease Progression %K Female %K Gray Matter %K Humans %K Incidence %K Magnetic Resonance Imaging %K Male %K Mild Cognitive Impairment %K Neuropsychological Tests %K Psychiatric Status Rating Scales %K Survival Analysis %X

The purpose of this study was to identify, at the voxel level, brain regions associated with the time to develop mild cognitive impairment (MCI) or Alzheimer's disease (AD) from normal cognition. We analyzed incident MCI (n = 58) or AD (n = 151) in 292 cognitively normal participants in the Cardiovascular Health Study-Cognition Study (mean age = 79.2 ± 3.6 years). We used segmented, modulated grey matter maps from 3D (spoiled gradient echo) MRI scans obtained in 1998/99 (with clinical follow-up through 2012) that were smoothed with a 3-D 4 mm Gaussian filter. We fit approximately 1.92 million voxel-level Cox proportional hazard models to examine the grey matter volume effect on time to event, adjusting for age, sex, and diabetes. We used the significance threshold of p <  0.005 with contiguity threshold of at least 68 voxels (false detection probability <2.5×10 -8). Areas within the mesial temporal lobe (MTL), anterior temporal lobe, hippocampus, and posterior cingulate gyrus were associated with time to MCI or AD. The presence of white matter lesions (a marker of small vessel disease in the brain) was associated with the volumes of the MTL and precuneus; MRI-identified infarcts also predicted MTL volume. These findings are important because we identified critical brain regions that predict a person's increased likelihood of developing MCI or AD over a decade prior to the onset of clinical symptoms; these critical brain regions were themselves affected by the presence of vascular disease.

%B J Alzheimers Dis %V 46 %P 167-78 %8 2015 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25720412?dopt=Abstract %R 10.3233/JAD-150047 %0 Journal Article %J Stroke %D 2015 %T White Matter Lesion Progression: Genome-Wide Search for Genetic Influences. %A Hofer, Edith %A Cavalieri, Margherita %A Bis, Joshua C %A DeCarli, Charles %A Fornage, Myriam %A Sigurdsson, Sigurdur %A Srikanth, Velandai %A Trompet, Stella %A Verhaaren, Benjamin F J %A Wolf, Christiane %A Yang, Qiong %A Adams, Hieab H H %A Amouyel, Philippe %A Beiser, Alexa %A Buckley, Brendan M %A Callisaya, Michele %A Chauhan, Ganesh %A de Craen, Anton J M %A Dufouil, Carole %A van Duijn, Cornelia M %A Ford, Ian %A Freudenberger, Paul %A Gottesman, Rebecca F %A Gudnason, Vilmundur %A Heiss, Gerardo %A Hofman, Albert %A Lumley, Thomas %A Martinez, Oliver %A Mazoyer, Bernard %A Moran, Chris %A Niessen, Wiro J %A Phan, Thanh %A Psaty, Bruce M %A Satizabal, Claudia L %A Sattar, Naveed %A Schilling, Sabrina %A Shibata, Dean K %A Slagboom, P Eline %A Smith, Albert %A Stott, David J %A Taylor, Kent D %A Thomson, Russell %A Töglhofer, Anna M %A Tzourio, Christophe %A van Buchem, Mark %A Wang, Jing %A Westendorp, Rudi G J %A Windham, B Gwen %A Vernooij, Meike W %A Zijdenbos, Alex %A Beare, Richard %A Debette, Stephanie %A Ikram, M Arfan %A Jukema, J Wouter %A Launer, Lenore J %A Longstreth, W T %A Mosley, Thomas H %A Seshadri, Sudha %A Schmidt, Helena %A Schmidt, Reinhold %K Adult %K Aged %K Cohort Studies %K Disease Progression %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Leukoencephalopathies %K Male %K Middle Aged %K Prospective Studies %K White Matter %X

BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants associated with WML progression in elderly participants from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium.

METHODS: Heritability of WML progression was calculated in the Framingham Heart Study. The genome-wide association study included 7773 elderly participants from 10 cohorts. To assess the relative contribution of genetic factors to progression of WML, we compared in 7 cohorts risk models including demographics, vascular risk factors plus single-nucleotide polymorphisms that have been shown to be associated cross-sectionally with WML in the current and previous association studies.

RESULTS: A total of 1085 subjects showed WML progression. The heritability estimate for WML progression was low at 6.5%, and no single-nucleotide polymorphisms achieved genome-wide significance (P<5×10(-8)). Four loci were suggestive (P<1×10(-5)) of an association with WML progression: 10q24.32 (rs10883817, P=1.46×10(-6)); 12q13.13 (rs4761974, P=8.71×10(-7)); 20p12.1 (rs6135309, P=3.69×10(-6)); and 4p15.31 (rs7664442, P=2.26×10(-6)). Variants that have been previously related to WML explained only 0.8% to 11.7% more of the variance in WML progression than age, vascular risk factors, and baseline WML burden.

CONCLUSIONS: Common genetic factors contribute little to the progression of age-related WML in middle-aged and older adults. Future research on determinants of WML progression should focus more on environmental, lifestyle, or host-related biological factors.

%B Stroke %V 46 %P 3048-57 %8 2015 Nov %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/26451028?dopt=Abstract %R 10.1161/STROKEAHA.115.009252 %0 Journal Article %J JAMA Intern Med %D 2016 %T -3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies %A Del Gobbo, L. C. %A Imamura, F. %A Aslibekyan, S. %A Marklund, M. %A Virtanen, J. K. %A Wennberg, M. %A Yakoob, M. Y. %A Chiuve, S. E. %A Dela Cruz, L. %A Frazier-Wood, A. C. %A Fretts, A. M. %A Guallar, E. %A Matsumoto, C. %A Prem, K. %A Tanaka, T. %A Wu, J. H. %A Zhou, X. %A Helmer, C. %A Ingelsson, E. %A Yuan, J. M. %A Barberger-Gateau, P. %A Campos, H. %A Chaves, P. H. %A é, L. %A Giles, G. G. %A mez-Aracena, J. %A Hodge, A. M. %A Hu, F. B. %A Jansson, J. H. %A Johansson, I. %A Khaw, K. T. %A Koh, W. P. %A Lemaitre, R. N. %A Lind, L. %A Luben, R. N. %A Rimm, E. B. %A rus, U. %A Samieri, C. %A Franks, P. W. %A Siscovick, D. S. %A Stampfer, M. %A Steffen, L. M. %A Steffen, B. T. %A Tsai, M. Y. %A van Dam, R. M. %A Voutilainen, S. %A Willett, W. C. %A Woodward, M. %A Mozaffarian, D. %X -3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers.\ -3) for incident CHD.\ A global consortium of 19 studies identified by November 2014.\ -3 biomarkers and ascertained CHD.\ -6 levels, and FADS desaturase genes.\ Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI).\ -3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses.\ -3 fatty acids are associated with a modestly lower incidence of fatal CHD. %B JAMA Intern Med %V 176 %P 1155–1166 %8 Aug %G eng %0 Journal Article %J J Am Coll Cardiol %D 2016 %T 52 Genetic Loci Influencing Myocardial Mass. %A van der Harst, Pim %A van Setten, Jessica %A Verweij, Niek %A Vogler, Georg %A Franke, Lude %A Maurano, Matthew T %A Wang, Xinchen %A Mateo Leach, Irene %A Eijgelsheim, Mark %A Sotoodehnia, Nona %A Hayward, Caroline %A Sorice, Rossella %A Meirelles, Osorio %A Lyytikäinen, Leo-Pekka %A Polasek, Ozren %A Tanaka, Toshiko %A Arking, Dan E %A Ulivi, Sheila %A Trompet, Stella %A Müller-Nurasyid, Martina %A Smith, Albert V %A Dörr, Marcus %A Kerr, Kathleen F %A Magnani, Jared W %A del Greco M, Fabiola %A Zhang, Weihua %A Nolte, Ilja M %A Silva, Claudia T %A Padmanabhan, Sandosh %A Tragante, Vinicius %A Esko, Tõnu %A Abecasis, Goncalo R %A Adriaens, Michiel E %A Andersen, Karl %A Barnett, Phil %A Bis, Joshua C %A Bodmer, Rolf %A Buckley, Brendan M %A Campbell, Harry %A Cannon, Megan V %A Chakravarti, Aravinda %A Chen, Lin Y %A Delitala, Alessandro %A Devereux, Richard B %A Doevendans, Pieter A %A Dominiczak, Anna F %A Ferrucci, Luigi %A Ford, Ian %A Gieger, Christian %A Harris, Tamara B %A Haugen, Eric %A Heinig, Matthias %A Hernandez, Dena G %A Hillege, Hans L %A Hirschhorn, Joel N %A Hofman, Albert %A Hubner, Norbert %A Hwang, Shih-Jen %A Iorio, Annamaria %A Kähönen, Mika %A Kellis, Manolis %A Kolcic, Ivana %A Kooner, Ishminder K %A Kooner, Jaspal S %A Kors, Jan A %A Lakatta, Edward G %A Lage, Kasper %A Launer, Lenore J %A Levy, Daniel %A Lundby, Alicia %A Macfarlane, Peter W %A May, Dalit %A Meitinger, Thomas %A Metspalu, Andres %A Nappo, Stefania %A Naitza, Silvia %A Neph, Shane %A Nord, Alex S %A Nutile, Teresa %A Okin, Peter M %A Olsen, Jesper V %A Oostra, Ben A %A Penninger, Josef M %A Pennacchio, Len A %A Pers, Tune H %A Perz, Siegfried %A Peters, Annette %A Pinto, Yigal M %A Pfeufer, Arne %A Pilia, Maria Grazia %A Pramstaller, Peter P %A Prins, Bram P %A Raitakari, Olli T %A Raychaudhuri, Soumya %A Rice, Ken M %A Rossin, Elizabeth J %A Rotter, Jerome I %A Schafer, Sebastian %A Schlessinger, David %A Schmidt, Carsten O %A Sehmi, Jobanpreet %A Silljé, Herman H W %A Sinagra, Gianfranco %A Sinner, Moritz F %A Slowikowski, Kamil %A Soliman, Elsayed Z %A Spector, Timothy D %A Spiering, Wilko %A Stamatoyannopoulos, John A %A Stolk, Ronald P %A Strauch, Konstantin %A Tan, Sian-Tsung %A Tarasov, Kirill V %A Trinh, Bosco %A Uitterlinden, André G %A van den Boogaard, Malou %A van Duijn, Cornelia M %A van Gilst, Wiek H %A Viikari, Jorma S %A Visscher, Peter M %A Vitart, Veronique %A Völker, Uwe %A Waldenberger, Melanie %A Weichenberger, Christian X %A Westra, Harm-Jan %A Wijmenga, Cisca %A Wolffenbuttel, Bruce H %A Yang, Jian %A Bezzina, Connie R %A Munroe, Patricia B %A Snieder, Harold %A Wright, Alan F %A Rudan, Igor %A Boyer, Laurie A %A Asselbergs, Folkert W %A van Veldhuisen, Dirk J %A Stricker, Bruno H %A Psaty, Bruce M %A Ciullo, Marina %A Sanna, Serena %A Lehtimäki, Terho %A Wilson, James F %A Bandinelli, Stefania %A Alonso, Alvaro %A Gasparini, Paolo %A Jukema, J Wouter %A Kääb, Stefan %A Gudnason, Vilmundur %A Felix, Stephan B %A Heckbert, Susan R %A de Boer, Rudolf A %A Newton-Cheh, Christopher %A Hicks, Andrew A %A Chambers, John C %A Jamshidi, Yalda %A Visel, Axel %A Christoffels, Vincent M %A Isaacs, Aaron %A Samani, Nilesh J %A de Bakker, Paul I W %X

BACKGROUND: Myocardial mass is a key determinant of cardiac muscle function and hypertrophy. Myocardial depolarization leading to cardiac muscle contraction is reflected by the amplitude and duration of the QRS complex on the electrocardiogram (ECG). Abnormal QRS amplitude or duration reflect changes in myocardial mass and conduction, and are associated with increased risk of heart failure and death.

OBJECTIVES: This meta-analysis sought to gain insights into the genetic determinants of myocardial mass.

METHODS: We carried out a genome-wide association meta-analysis of 4 QRS traits in up to 73,518 individuals of European ancestry, followed by extensive biological and functional assessment.

RESULTS: We identified 52 genomic loci, of which 32 are novel, that are reliably associated with 1 or more QRS phenotypes at p < 1 × 10(-8). These loci are enriched in regions of open chromatin, histone modifications, and transcription factor binding, suggesting that they represent regions of the genome that are actively transcribed in the human heart. Pathway analyses provided evidence that these loci play a role in cardiac hypertrophy. We further highlighted 67 candidate genes at the identified loci that are preferentially expressed in cardiac tissue and associated with cardiac abnormalities in Drosophila melanogaster and Mus musculus. We validated the regulatory function of a novel variant in the SCN5A/SCN10A locus in vitro and in vivo.

CONCLUSIONS: Taken together, our findings provide new insights into genes and biological pathways controlling myocardial mass and may help identify novel therapeutic targets.

%B J Am Coll Cardiol %V 68 %P 1435-48 %8 2016 Sep 27 %G eng %N 13 %R 10.1016/j.jacc.2016.07.729 %0 Journal Article %J Nutr Metab Cardiovasc Dis %D 2016 %T The association of lean and fat mass with all-cause mortality in older adults: The Cardiovascular Health Study. %A Spahillari, A %A Mukamal, K J %A DeFilippi, C %A Kizer, J R %A Gottdiener, J S %A Djoussé, L %A Lyles, M F %A Bartz, T M %A Murthy, V L %A Shah, R V %X

BACKGROUND AND AIMS: Understanding contributions of lean and fat tissue to cardiovascular and non-cardiovascular mortality may help clarify areas of prevention in older adults. We aimed to define distributions of lean and fat tissue in older adults and their contributions to cause-specific mortality.

METHODS AND RESULTS: A total of 1335 participants of the Cardiovascular Health Study (CHS) who underwent dual-energy x-ray absorptiometry (DEXA) scans were included. We used principal components analysis (PCA) to define two independent sources of variation in DEXA-derived body composition, corresponding to principal components composed of lean ("lean PC") and fat ("fat PC") tissue. We used Cox proportional hazards regression using these PCs to investigate the relationship between body composition with cardiovascular and non-cardiovascular mortality. Mean age was 76.2 ± 4.8 years (56% women) with mean body mass index 27.1 ± 4.4 kg/m(2). A greater lean PC was associated with lower all-cause (HR = 0.91, 95% CI 0.84-0.98, P = 0.01) and cardiovascular mortality (HR = 0.84, 95% CI 0.74-0.95, P = 0.005). The lowest quartile of the fat PC (least adiposity) was associated with a greater hazard of all-cause mortality (HR = 1.24, 95% CI 1.04-1.48, P = 0.02) relative to fat PCs between the 25th-75th percentile, but the highest quartile did not have a significantly greater hazard (P = 0.70).

CONCLUSION: Greater lean tissue mass is associated with improved cardiovascular and overall mortality in the elderly. The lowest levels of fat tissue mass are linked with adverse prognosis, but the highest levels show no significant mortality protection. Prevention efforts in the elderly frail may be best targeted toward improvements in lean muscle mass.

%B Nutr Metab Cardiovasc Dis %8 2016 Jun 28 %G eng %R 10.1016/j.numecd.2016.06.011 %0 Journal Article %J PLoS One %D 2016 %T Association of Smoking, Alcohol, and Obesity with Cardiovascular Death and Ischemic Stroke in Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study and Cardiovascular Health Study (CHS). %A Kwon, Younghoon %A Norby, Faye L %A Jensen, Paul N %A Agarwal, Sunil K %A Soliman, Elsayed Z %A Lip, Gregory Y H %A Longstreth, W T %A Alonso, Alvaro %A Heckbert, Susan R %A Chen, Lin Y %K Aged %K Alcohol Drinking %K Atrial Fibrillation %K Cardiovascular Diseases %K Female %K Humans %K Male %K Middle Aged %K Obesity %K Smoking %K Stroke %X

Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke and cardiovascular (CV) death. Whether modifiable lifestyle risk factors are associated with these CV outcomes in AF is unknown. Among Atherosclerosis Risk in Communities (ARIC) study and Cardiovascular Health Study (CHS) participants with incident AF, we estimated the risk of composite endpoint of ischemic stroke or CV death associated with candidate modifiable risk factor (smoking, heavy alcohol consumption, or high body mass index [BMI]), and computed the C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) of incorporating each factor into the CHA2DS2-VASc. Among 1222 ARIC (mean age: 63.4) and 756 CHS (mean age: 79.1) participants with incident AF, during mean follow-up of 6.9 years and 5.7 years, there were 332 and 335 composite events respectively. Compared with never smokers, current smokers had a higher incidence of the composite endpoint in ARIC [HR: 1.65 (1.21-2.26)] but not in CHS [HR: 1.05 (0.69-1.61)]. In ARIC, the addition of current smoking did not improve risk prediction over and above the CHA2DS2-VASc. No significant associations were observed with alcohol consumption or BMI with CVD outcomes in AF patients from either cohort. Smoking is associated with an increased risk of ischemic stroke or CV death in ARIC, which comprised mostly middle-aged to young-old (65-74 years), but not in CHS, which comprised mostly middle-old or oldest-old (≥75 years) adults with AF. However, addition of smoking to the CHA2DS2-VASc score did not improve risk prediction of these outcomes.

%B PLoS One %V 11 %P e0147065 %8 2016 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26756465?dopt=Abstract %R 10.1371/journal.pone.0147065 %0 Journal Article %J Eur J Hum Genet %D 2016 %T Association of the IGF1 gene with fasting insulin levels. %A Willems, Sara M %A Cornes, Belinda K %A Brody, Jennifer A %A Morrison, Alanna C %A Lipovich, Leonard %A Dauriz, Marco %A Chen, Yuning %A Liu, Ching-Ti %A Rybin, Denis V %A Gibbs, Richard A %A Muzny, Donna %A Pankow, James S %A Psaty, Bruce M %A Boerwinkle, Eric %A Rotter, Jerome I %A Siscovick, David S %A Vasan, Ramachandran S %A Kaplan, Robert C %A Isaacs, Aaron %A Dupuis, Josée %A van Duijn, Cornelia M %A Meigs, James B %X

Insulin-like growth factor 1 (IGF-I) has been associated with insulin resistance. Genome-wide association studies (GWASs) of fasting insulin (FI) identified single-nucleotide variants (SNVs) near the IGF1 gene, raising two hypotheses: (1) these associations are mediated by IGF-I levels and (2) these noncoding variants either tag other functional variants in the region or are directly functional. In our study, analyses including 5141 individuals from population-based cohorts suggest that FI associations near IGF1 are not mediated by IGF-I. Analyses of targeted sequencing data in 3539 individuals reveal a large number of novel rare variants at the IGF1 locus and show a FI association with a subset of rare nonsynonymous variants (PSKAT=5.7 × 10(-4)). Conditional analyses suggest that this association is partly explained by the GWAS signal and the presence of a residual independent rare variant effect (Pconditional=0.019). Annotation using ENCODE data suggests that the GWAS variants may have a direct functional role in insulin biology. In conclusion, our study provides insight into variation present at the IGF1 locus and into the genetic architecture underlying FI levels, suggesting that FI associations of SNVs near IGF1 are not mediated by IGF-I and suggesting a role for both rare nonsynonymous and common functional variants in insulin biology.

%B Eur J Hum Genet %V 24 %P 1337-43 %8 2016 Aug %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/26860063?dopt=Abstract %R 10.1038/ejhg.2016.4 %0 Journal Article %J Metabolism %D 2016 %T Associations of insulin resistance, inflammation and liver synthetic function with very low-density lipoprotein: The Cardiovascular Health Study. %A Jiang, Z Gordon %A de Boer, Ian H %A Mackey, Rachel H %A Jensen, Majken K %A Lai, Michelle %A Robson, Simon C %A Tracy, Russell %A Kuller, Lewis H %A Mukamal, Kenneth J %K Aged %K Aged, 80 and over %K C-Reactive Protein %K Cross-Sectional Studies %K Factor VII %K Female %K Humans %K Inflammation %K Insulin Resistance %K Lipoproteins, VLDL %K Liver %K Liver Function Tests %K Male %K Risk Factors %K Socioeconomic Factors %X

INTRODUCTION: Production of very low-density lipoprotein (VLDL) is increased in states of metabolic syndrome, leading to hypertriglyceridemia. However, metabolic syndrome is often associated with non-alcoholic fatty liver disease, which leads to liver fibrosis and inflammation that may decrease VLDL production. In this study, we aim to determine the interactive impact on VLDL profiles from insulin resistance, impairment in liver synthetic function and inflammation.

METHODS: We examined cross-sectional associations of insulin sensitivity, inflammation, and liver synthetic function with VLDL particle (VLDL-P) concentration and size among 1,850 older adults in the Cardiovascular Health Study.

RESULTS: Indices for high insulin sensitivity and low liver synthetic function were associated with lower concentrations of VLDL-P. In addition, insulin resistance preferentially increased concentration of large VLDL and was associated with mean VLDL size. Indices for inflammation however demonstrated a nonlinear relationship with both VLDL-P concentration and VLDL size. When mutually adjusted, one standard deviation (SD) increment in Matsuda index and C-reactive protein (CRP) were associated with 4.9 nmol/L (-8.2 to -1.5, p=0.005) and 6.3 nmol/L (-11.0 to -1.6, p=0.009) lower VLDL-P concentration respectively. In contrast, one-SD increment in factor VII, a marker for liver synthetic function, was associated with 16.9 nmol/L (12.6-21.2, p<0.001) higher VLDL-P concentration. Furthermore, a one-SD increment in the Matsuda index was associated with 1.1 nm (-2.0 to -0.3, p=0.006) smaller mean VLDL size, whereas CRP and factor VII were not associated with VLDL size.

CONCLUSION: Insulin sensitivity, inflammation and markers for liver synthetic function differentially impact VLDL-P concentration and VLDL size. These results underscore the complex effects of insulin resistance and its complications on VLDL production.

%B Metabolism %V 65 %P 92-9 %8 2016 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26892520?dopt=Abstract %R 10.1016/j.metabol.2015.10.017 %0 Journal Article %J J Nutr %D 2016 %T Associations of Plasma Phospholipid SFAs with Total and Cause-Specific Mortality in Older Adults Differ According to SFA Chain Length. %A Fretts, Amanda M %A Mozaffarian, Dariush %A Siscovick, David S %A King, Irena B %A McKnight, Barbara %A Psaty, Bruce M %A Rimm, Eric B %A Sitlani, Colleen %A Sacks, Frank M %A Song, Xiaoling %A Sotoodehnia, Nona %A Spiegelman, Donna %A Lemaitre, Rozenn N %K Aged %K Aged, 80 and over %K Cause of Death %K Diet %K Dietary Fats %K Eicosanoic Acids %K Fatty Acids %K Female %K Humans %K Male %K Mortality %K Palmitic Acid %K Phospholipids %K Prospective Studies %K Risk Factors %K Stearic Acids %X

BACKGROUND: Not much is known about the relations of circulating saturated fatty acids (SFAs), which are influenced by both metabolic and dietary determinants, with total and cause-specific mortality.

OBJECTIVE: We examined the associations of plasma phospholipid SFAs with total and cause-specific mortality among 3941 older adults from the Cardiovascular Health Study, a population-based prospective study of adults aged ≥65 y who were followed from 1992 through 2011.

METHODS: The relations of total and cause-specific mortality with plasma phospholipid palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) were assessed using Cox proportional hazards models.

RESULTS: During 45,450 person-years of follow-up, 3134 deaths occurred. Higher concentrations of the plasma phospholipid SFAs 18:0, 22:0, and 24:0 were associated with a lower risk of total mortality [multivariable-adjusted HRs (95% CIs)] for the top compared with the bottom quintile: 0.85 (0.75, 0.95) for 18:0; 0.85 (0.75, 0.95) for 22:0; and 0.80 (0.71, 0.90) for 24:0. In contrast, plasma 16:0 concentrations in the highest quintile were associated with a higher risk of total mortality compared with concentrations in the lowest quintile [1.25 (1.11, 1.41)]. We also found no association of plasma phospholipid 20:0 with total mortality.

CONCLUSIONS: These findings suggest that the associations of plasma phospholipid SFAs with the risk of death differ according to SFA chain length and support future studies to better characterize the determinants of circulating SFAs and to explore the mechanisms underlying these relations.

%B J Nutr %V 146 %P 298-305 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26701797?dopt=Abstract %R 10.3945/jn.115.222117 %0 Journal Article %J Stroke %D 2016 %T Changes in Depressive Symptoms and Subsequent Risk of Stroke in the Cardiovascular Health Study. %A Gilsanz, Paola %A Kubzansky, Laura D %A Tchetgen Tchetgen, Eric J %A Wang, Qianyi %A Kawachi, Ichiro %A Patton, Kristen K %A Fitzpatrick, Annette L %A Kop, Willem J %A Longstreth, W T %A Glymour, M Maria %X

BACKGROUND AND PURPOSE: Depression is associated with stroke, but the effects of changes in depressive symptoms on stroke risk are not well understood. This study examined whether depressive symptom changes across 2 successive annual assessments were associated with incident stroke the following year.

METHODS: We used visit data from 4319 participants of the Cardiovascular Health Study who were stroke free at baseline to examine whether changes in depressive symptoms classified across 2 consecutive annual assessments predicted incident first stroke during the subsequent year. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale (high versus low at ≥10). Survival models were inverse probability weighted to adjust for demographics, health behaviors, medical conditions, past depressive symptoms, censoring, and survival.

RESULTS: During follow-up, 334 strokes occurred. Relative to stable low scores of depressive symptoms, improved depression symptoms were associated with almost no excess risk of stroke (adjusted hazards ratio, 1.02; 95% confidence interval, 0.66-1.58). New-onset symptoms were nonsignificantly associated with elevated stroke risk (adjusted hazards ratio, 1.44; 95% confidence interval, 0.97-2.14), whereas persistently high depressive symptoms were associated with elevated adjusted hazard of all-cause stroke (adjusted hazards ratio, 1.65; 95% confidence interval, 1.06-2.56). No evidence for effect modification by race, age, or sex was found.

CONCLUSIONS: Persistently high symptoms of depression predicted elevated hazard of stroke. Participants with improved depressive symptoms had no elevation in stroke risk. Such findings suggest that strategies to reduce depressive symptoms may ameliorate stroke risk.

%B Stroke %8 2016 Dec 06 %G eng %R 10.1161/STROKEAHA.116.013554 %0 Journal Article %J Hum Mol Genet %D 2016 %T Common variants in DRD2 are associated with sleep duration: the CARe consortium. %A Cade, Brian E %A Gottlieb, Daniel J %A Lauderdale, Diane S %A Bennett, David A %A Buchman, Aron S %A Buxbaum, Sarah G %A De Jager, Philip L %A Evans, Daniel S %A Fulop, Tibor %A Gharib, Sina A %A Johnson, W Craig %A Kim, Hyun %A Larkin, Emma K %A Lee, Seung Ku %A Lim, Andrew S %A Punjabi, Naresh M %A Shin, Chol %A Stone, Katie L %A Tranah, Gregory J %A Weng, Jia %A Yaffe, Kristine %A Zee, Phyllis C %A Patel, Sanjay R %A Zhu, Xiaofeng %A Redline, Susan %A Saxena, Richa %K Cohort Studies %K Ethnic Groups %K Humans %K Polymorphism, Single Nucleotide %K Polysomnography %K Receptors, Dopamine D2 %K Sleep %K Time Factors %X

Sleep duration is implicated in the etiologies of chronic diseases and premature mortality. However, the genetic basis for sleep duration is poorly defined. We sought to identify novel genetic components influencing sleep duration in a multi-ethnic sample. Meta-analyses were conducted of genetic associations with self-reported, habitual sleep duration from seven Candidate Gene Association Resource (CARe) cohorts of over 25 000 individuals of African, Asian, European and Hispanic American ancestry. All individuals were genotyped for ∼50 000 SNPs from 2000 candidate heart, lung, blood and sleep genes. African-Americans had additional genome-wide genotypes. Four cohorts provided replication. A SNP (rs17601612) in the dopamine D2 receptor gene (DRD2) was significantly associated with sleep duration (P = 9.8 × 10(-7)). Conditional analysis identified a second DRD2 signal with opposite effects on sleep duration. In exploratory analysis, suggestive association was observed for rs17601612 with polysomnographically determined sleep latency (P = 0.002). The lead DRD2 signal was recently identified in a schizophrenia GWAS, and a genetic risk score of 11 additional schizophrenia GWAS loci genotyped on the IBC array was also associated with longer sleep duration (P = 0.03). These findings support a role for DRD2 in influencing sleep duration. Our work motivates future pharmocogenetics research on alerting agents such as caffeine and modafinil that interact with the dopaminergic pathway and further investigation of genetic overlap between sleep and neuro-psychiatric traits.

%B Hum Mol Genet %V 25 %P 167-79 %8 2016 Jan 1 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26464489?dopt=Abstract %R 10.1093/hmg/ddv434 %0 Journal Article %J Diabetes Res Clin Pract %D 2016 %T Diabetes mellitus and venous thromboembolism: A systematic review and meta-analysis. %A Bell, Elizabeth J %A Folsom, Aaron R %A Lutsey, Pamela L %A Selvin, Elizabeth %A Zakai, Neil A %A Cushman, Mary %A Alonso, Alvaro %X

UNLABELLED: Diabetes mellitus (DM) may be a risk factor for venous thromboembolism (VTE) but results are inconsistent.

AIM: We conducted a systematic review and meta-analysis of epidemiologic studies to quantify the association between DM and VTE.

METHODS AND RESULTS: We included studies identified in PubMed, Web of Science, and CINAHL through 07/31/2014. We identified 19 studies that met our selection criteria. We pooled RRs using a random-effects model: the pooled RR for the association of DM with VTE was 1.10 (95% CI: 0.94-1.29). Between-study heterogeneity was explored with a forest plot, funnel plot, meta-regression, and a stratified analysis. Between-study heterogeneity was observed and not explained by study design, method of DM assessment, or degree of adjustment for confounding. Sensitivity analyses omitted one study at a time to assess the influence of any single study on the pooled estimate. These analyses indicated that one large study was highly influential; when this study was excluded, the pooled estimate increased and just reached statistical significance: 1.16 (95% CI: 1.01-1.34).

CONCLUSIONS: This meta-analysis suggests either no association or a modest positive one between DM and VTE in the general population. DM is unlikely to play a major role in VTE development.

%B Diabetes Res Clin Pract %V 111 %P 10-8 %8 2016 Jan %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/26612139?dopt=Abstract %R 10.1016/j.diabres.2015.10.019 %0 Journal Article %J J Am Coll Cardiol %D 2016 %T Diagnostic Yield and Clinical Utility of Sequencing Familial Hypercholesterolemia Genes in Patients With Severe Hypercholesterolemia. %A Khera, Amit V %A Won, Hong-Hee %A Peloso, Gina M %A Lawson, Kim S %A Bartz, Traci M %A Deng, Xuan %A van Leeuwen, Elisabeth M %A Natarajan, Pradeep %A Emdin, Connor A %A Bick, Alexander G %A Morrison, Alanna C %A Brody, Jennifer A %A Gupta, Namrata %A Nomura, Akihiro %A Kessler, Thorsten %A Duga, Stefano %A Bis, Joshua C %A van Duijn, Cornelia M %A Cupples, L Adrienne %A Psaty, Bruce %A Rader, Daniel J %A Danesh, John %A Schunkert, Heribert %A McPherson, Ruth %A Farrall, Martin %A Watkins, Hugh %A Lander, Eric %A Wilson, James G %A Correa, Adolfo %A Boerwinkle, Eric %A Merlini, Piera Angelica %A Ardissino, Diego %A Saleheen, Danish %A Gabriel, Stacey %A Kathiresan, Sekar %X

BACKGROUND: Approximately 7% of American adults have severe hypercholesterolemia (untreated low-density lipoprotein [LDL] cholesterol ≥190 mg/dl), which may be due to familial hypercholesterolemia (FH). Lifelong LDL cholesterol elevations in FH mutation carriers may confer coronary artery disease (CAD) risk beyond that captured by a single LDL cholesterol measurement.

OBJECTIVES: This study assessed the prevalence of an FH mutation among those with severe hypercholesterolemia and determined whether CAD risk varies according to mutation status beyond the observed LDL cholesterol level.

METHODS: Three genes causative for FH (LDLR, APOB, and PCSK9) were sequenced in 26,025 participants from 7 case-control studies (5,540 CAD case subjects, 8,577 CAD-free control subjects) and 5 prospective cohort studies (11,908 participants). FH mutations included loss-of-function variants in LDLR, missense mutations in LDLR predicted to be damaging, and variants linked to FH in ClinVar, a clinical genetics database.

RESULTS: Among 20,485 CAD-free control and prospective cohort participants, 1,386 (6.7%) had LDL cholesterol ≥190 mg/dl; of these, only 24 (1.7%) carried an FH mutation. Within any stratum of observed LDL cholesterol, risk of CAD was higher among FH mutation carriers than noncarriers. Compared with a reference group with LDL cholesterol <130 mg/dl and no mutation, participants with LDL cholesterol ≥190 mg/dl and no FH mutation had a 6-fold higher risk for CAD (odds ratio: 6.0; 95% confidence interval: 5.2 to 6.9), whereas those with both LDL cholesterol ≥190 mg/dl and an FH mutation demonstrated a 22-fold increased risk (odds ratio: 22.3; 95% confidence interval: 10.7 to 53.2). In an analysis of participants with serial lipid measurements over many years, FH mutation carriers had higher cumulative exposure to LDL cholesterol than noncarriers.

CONCLUSIONS: Among participants with LDL cholesterol ≥190 mg/dl, gene sequencing identified an FH mutation in <2%. However, for any observed LDL cholesterol, FH mutation carriers had substantially increased risk for CAD.

%B J Am Coll Cardiol %V 67 %P 2578-89 %8 2016 Jun 7 %G eng %N 22 %1 http://www.ncbi.nlm.nih.gov/pubmed/27050191?dopt=Abstract %R 10.1016/j.jacc.2016.03.520 %0 Journal Article %J Age Ageing %D 2016 %T Digit Symbol Substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults. %A Rosano, Caterina %A Perera, Subashan %A Inzitari, Marco %A Newman, Anne B %A Longstreth, William T %A Studenski, Stephanie %X

OBJECTIVE: to examine whether psychomotor speed predicts individual and combined disorders in cognition, mobility and mood and if white matter hyperintensities explain these associations.

DESIGN AND SETTING: longitudinal; Cardiovascular Health Study.

SUBJECTS: 5,888 participants (57.6% women, 15.7% black, 75.1 (5.5), mean years (SD)).

METHODS: psychomotor speed (Digit Symbol Substitution Test (DSST)) and small vessel disease (white matter hyperintensities (WMH)) were measured in 1992-94. Global cognition (Modified Mini-Mental State (3MS) examination), mobility (gait speed (GS)) and mood (Center for Epidemiologic Studies Depression (CES-D) scale) were measured annually over 5 years and classified as clinical, subclinical or no disorders based on established values (3MS: 80 and 85 points; GS: 0.6 and 1.0 m/s; CES-D: 10 and 5 points). Analyses were adjusted for demographics, baseline status, education, diabetes, hypertension, ankle-arm index.

RESULTS: among those with no disorder in cognition, mobility and mood (N = 619) in 1992-94, being in the lowest DSST quartile compared to the highest was associated with nearly twice the odds of developing 1+ clinical or subclinical disorders (N = 413) during follow-up. Associations were stronger for incident clinical disorders in cognition (OR: 8.44, p < 0.01) or mobility (OR: 9.09, p < 0.05) than for mood (OR: 1.88, p < 0.10). Results were similar after adjustment for WMH.

CONCLUSIONS: slower psychomotor speed may serve as a biomarker of risk of clinical disorders of cognition, mobility and mood. While in part attributable to vascular brain disease, other potentially modifiable contributors may be present. Further studying the causes of psychomotor slowing with ageing might provide novel insights into age-related brain disorders.

%B Age Ageing %V 45 %P 688-95 %8 2016 Sep %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27496932?dopt=Abstract %R 10.1093/ageing/afw116 %0 Journal Article %J PLoS Genet %D 2016 %T Discovery of Genetic Variation on Chromosome 5q22 Associated with Mortality in Heart Failure. %A Smith, J Gustav %A Felix, Janine F %A Morrison, Alanna C %A Kalogeropoulos, Andreas %A Trompet, Stella %A Wilk, Jemma B %A Gidlöf, Olof %A Wang, Xinchen %A Morley, Michael %A Mendelson, Michael %A Joehanes, Roby %A Ligthart, Symen %A Shan, Xiaoyin %A Bis, Joshua C %A Wang, Ying A %A Sjögren, Marketa %A Ngwa, Julius %A Brandimarto, Jeffrey %A Stott, David J %A Aguilar, David %A Rice, Kenneth M %A Sesso, Howard D %A Demissie, Serkalem %A Buckley, Brendan M %A Taylor, Kent D %A Ford, Ian %A Yao, Chen %A Liu, Chunyu %A Sotoodehnia, Nona %A van der Harst, Pim %A Stricker, Bruno H Ch %A Kritchevsky, Stephen B %A Liu, Yongmei %A Gaziano, J Michael %A Hofman, Albert %A Moravec, Christine S %A Uitterlinden, André G %A Kellis, Manolis %A van Meurs, Joyce B %A Margulies, Kenneth B %A Dehghan, Abbas %A Levy, Daniel %A Olde, Björn %A Psaty, Bruce M %A Cupples, L Adrienne %A Jukema, J Wouter %A Djoussé, Luc %A Franco, Oscar H %A Boerwinkle, Eric %A Boyer, Laurie A %A Newton-Cheh, Christopher %A Butler, Javed %A Vasan, Ramachandran S %A Cappola, Thomas P %A Smith, Nicholas L %X

Failure of the human heart to maintain sufficient output of blood for the demands of the body, heart failure, is a common condition with high mortality even with modern therapeutic alternatives. To identify molecular determinants of mortality in patients with new-onset heart failure, we performed a meta-analysis of genome-wide association studies and follow-up genotyping in independent populations. We identified and replicated an association for a genetic variant on chromosome 5q22 with 36% increased risk of death in subjects with heart failure (rs9885413, P = 2.7x10-9). We provide evidence from reporter gene assays, computational predictions and epigenomic marks that this polymorphism increases activity of an enhancer region active in multiple human tissues. The polymorphism was further reproducibly associated with a DNA methylation signature in whole blood (P = 4.5x10-40) that also associated with allergic sensitization and expression in blood of the cytokine TSLP (P = 1.1x10-4). Knockdown of the transcription factor predicted to bind the enhancer region (NHLH1) in a human cell line (HEK293) expressing NHLH1 resulted in lower TSLP expression. In addition, we observed evidence of recent positive selection acting on the risk allele in populations of African descent. Our findings provide novel genetic leads to factors that influence mortality in patients with heart failure.

%B PLoS Genet %V 12 %P e1006034 %8 2016 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27149122?dopt=Abstract %R 10.1371/journal.pgen.1006034 %0 Journal Article %J Mol Psychiatry %D 2016 %T A DNA methylation biomarker of alcohol consumption. %A Liu, C %A Marioni, R E %A Hedman, Å K %A Pfeiffer, L %A Tsai, P-C %A Reynolds, L M %A Just, A C %A Duan, Q %A Boer, C G %A Tanaka, T %A Elks, C E %A Aslibekyan, S %A Brody, J A %A Kühnel, B %A Herder, C %A Almli, L M %A Zhi, D %A Wang, Y %A Huan, T %A Yao, C %A Mendelson, M M %A Joehanes, R %A Liang, L %A Love, S-A %A Guan, W %A Shah, S %A McRae, A F %A Kretschmer, A %A Prokisch, H %A Strauch, K %A Peters, A %A Visscher, P M %A Wray, N R %A Guo, X %A Wiggins, K L %A Smith, A K %A Binder, E B %A Ressler, K J %A Irvin, M R %A Absher, D M %A Hernandez, D %A Ferrucci, L %A Bandinelli, S %A Lohman, K %A Ding, J %A Trevisi, L %A Gustafsson, S %A Sandling, J H %A Stolk, L %A Uitterlinden, A G %A Yet, I %A Castillo-Fernandez, J E %A Spector, T D %A Schwartz, J D %A Vokonas, P %A Lind, L %A Li, Y %A Fornage, M %A Arnett, D K %A Wareham, N J %A Sotoodehnia, N %A Ong, K K %A van Meurs, J B J %A Conneely, K N %A Baccarelli, A A %A Deary, I J %A Bell, J T %A North, K E %A Liu, Y %A Waldenberger, M %A London, S J %A Ingelsson, E %A Levy, D %X

The lack of reliable measures of alcohol intake is a major obstacle to the diagnosis and treatment of alcohol-related diseases. Epigenetic modifications such as DNA methylation may provide novel biomarkers of alcohol use. To examine this possibility, we performed an epigenome-wide association study of methylation of cytosine-phosphate-guanine dinucleotide (CpG) sites in relation to alcohol intake in 13 population-based cohorts (ntotal=13 317; 54% women; mean age across cohorts 42-76 years) using whole blood (9643 European and 2423 African ancestries) or monocyte-derived DNA (588 European, 263 African and 400 Hispanic ancestry) samples. We performed meta-analysis and variable selection in whole-blood samples of people of European ancestry (n=6926) and identified 144 CpGs that provided substantial discrimination (area under the curve=0.90-0.99) for current heavy alcohol intake (⩾42 g per day in men and ⩾28 g per day in women) in four replication cohorts. The ancestry-stratified meta-analysis in whole blood identified 328 (9643 European ancestry samples) and 165 (2423 African ancestry samples) alcohol-related CpGs at Bonferroni-adjusted P<1 × 10(-7). Analysis of the monocyte-derived DNA (n=1251) identified 62 alcohol-related CpGs at P<1 × 10(-7). In whole-blood samples of people of European ancestry, we detected differential methylation in two neurotransmitter receptor genes, the γ-Aminobutyric acid-A receptor delta and γ-aminobutyric acid B receptor subunit 1; their differential methylation was associated with expression levels of a number of genes involved in immune function. In conclusion, we have identified a robust alcohol-related DNA methylation signature and shown the potential utility of DNA methylation as a clinically useful diagnostic test to detect current heavy alcohol consumption.Molecular Psychiatry advance online publication, 15 November 2016; doi:10.1038/mp.2016.192.

%B Mol Psychiatry %8 2016 Nov 15 %G eng %R 10.1038/mp.2016.192 %0 Journal Article %J Genome Biol %D 2016 %T DNA methylation signatures of chronic low-grade inflammation are associated with complex diseases. %A Ligthart, Symen %A Marzi, Carola %A Aslibekyan, Stella %A Mendelson, Michael M %A Conneely, Karen N %A Tanaka, Toshiko %A Colicino, Elena %A Waite, Lindsay L %A Joehanes, Roby %A Guan, Weihua %A Brody, Jennifer A %A Elks, Cathy %A Marioni, Riccardo %A Jhun, Min A %A Agha, Golareh %A Bressler, Jan %A Ward-Caviness, Cavin K %A Chen, Brian H %A Huan, Tianxiao %A Bakulski, Kelly %A Salfati, Elias L %A Fiorito, Giovanni %A Wahl, Simone %A Schramm, Katharina %A Sha, Jin %A Hernandez, Dena G %A Just, Allan C %A Smith, Jennifer A %A Sotoodehnia, Nona %A Pilling, Luke C %A Pankow, James S %A Tsao, Phil S %A Liu, Chunyu %A Zhao, Wei %A Guarrera, Simonetta %A Michopoulos, Vasiliki J %A Smith, Alicia K %A Peters, Marjolein J %A Melzer, David %A Vokonas, Pantel %A Fornage, Myriam %A Prokisch, Holger %A Bis, Joshua C %A Chu, Audrey Y %A Herder, Christian %A Grallert, Harald %A Yao, Chen %A Shah, Sonia %A McRae, Allan F %A Lin, Honghuang %A Horvath, Steve %A Fallin, Daniele %A Hofman, Albert %A Wareham, Nicholas J %A Wiggins, Kerri L %A Feinberg, Andrew P %A Starr, John M %A Visscher, Peter M %A Murabito, Joanne M %A Kardia, Sharon L R %A Absher, Devin M %A Binder, Elisabeth B %A Singleton, Andrew B %A Bandinelli, Stefania %A Peters, Annette %A Waldenberger, Melanie %A Matullo, Giuseppe %A Schwartz, Joel D %A Demerath, Ellen W %A Uitterlinden, André G %A van Meurs, Joyce B J %A Franco, Oscar H %A Chen, Yii-Der Ida %A Levy, Daniel %A Turner, Stephen T %A Deary, Ian J %A Ressler, Kerry J %A Dupuis, Josée %A Ferrucci, Luigi %A Ong, Ken K %A Assimes, Themistocles L %A Boerwinkle, Eric %A Koenig, Wolfgang %A Arnett, Donna K %A Baccarelli, Andrea A %A Benjamin, Emelia J %A Dehghan, Abbas %X

BACKGROUND: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

RESULTS: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10(-7)) in the discovery panel of European ancestry and replicated (P < 2.29 × 10(-4)) 58 CpG sites (45 unique loci) among African Americans. To further characterize the molecular and clinical relevance of the findings, we examined the association with gene expression, genetic sequence variants, and clinical outcomes. DNA methylation at nine (16%) CpG sites was associated with whole blood gene expression in cis (P < 8.47 × 10(-5)), ten (17%) CpG sites were associated with a nearby genetic variant (P < 2.50 × 10(-3)), and 51 (88%) were also associated with at least one related cardiometabolic entity (P < 9.58 × 10(-5)). An additive weighted score of replicated CpG sites accounted for up to 6% inter-individual variation (R2) of age-adjusted and sex-adjusted CRP, independent of known CRP-related genetic variants.

CONCLUSION: We have completed an EWAS of chronic low-grade inflammation and identified many novel genetic loci underlying inflammation that may serve as targets for the development of novel therapeutic interventions for inflammation.

%B Genome Biol %V 17 %P 255 %8 2016 Dec 12 %G eng %N 1 %R 10.1186/s13059-016-1119-5 %0 Journal Article %J J Am Geriatr Soc %D 2016 %T Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition. %A Miner, Brienne %A Tinetti, Mary E %A Van Ness, Peter H %A Han, Ling %A Leo-Summers, Linda %A Newman, Anne B %A Lee, Patty J %A Vaz Fragoso, Carlos A %X

OBJECTIVES: To evaluate the associations between a broad array of cardiorespiratory and noncardiorespiratory impairments and dyspnea in older persons.

DESIGN: Cross-sectional.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Community-dwelling persons (N = 4,413; mean age 72.6, 57.1% female, 4.5% African American, 27.2%

MEASUREMENTS: Dyspnea severity (moderate to severe defined as American Thoracic Society Grade ≥2) and several impairments, including those established using spirometry (forced expiratory volume in 1 second (FEV1 )), maximal inspiratory pressure (respiratory muscle strength), echocardiography, ankle-brachial index, blood pressure, whole-body muscle mass (bioelectrical impedance), single chair stand (lower extremity function), grip strength, serum hemoglobin and creatinine, Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination, medication use, and body mass index (BMI).

RESULTS: In a multivariable logistic regression model, impairments that had strong associations with moderate to severe dyspnea were FEV1 less than the lower limit of normal (adjusted odds ratio (aOR) = 2.88, 95% confidence interval (CI) = 2.37-3.49), left ventricular ejection fraction less than 45% (aOR = 2.12, 95% CI = 1.43, 3.16), unable to perform a single chair stand (aOR = 2.10, 95% CI = 1.61-2.73), depressive symptoms (CES-D score ≥16; aOR = 2.02, 95% CI = 1.26-3.23), and obesity (BMI ≥30; aOR = 2.07, 95% CI = 1.67-2.55). Impairments with modest but still statistically significant associations with moderate to severe dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (aORs = 1.31-1.71).

CONCLUSION: In community-dwelling older persons, several cardiorespiratory and noncardiorespiratory impairments were significantly associated with moderate to severe dyspnea, akin to a multifactorial geriatric health condition.

%B J Am Geriatr Soc %V 64 %P 2042-2050 %8 2016 Oct %G eng %N 10 %R 10.1111/jgs.14290 %0 Journal Article %J Genet Epidemiol %D 2016 %T An Empirical Comparison of Joint and Stratified Frameworks for Studying G × E Interactions: Systolic Blood Pressure and Smoking in the CHARGE Gene-Lifestyle Interactions Working Group. %A Sung, Yun Ju %A Winkler, Thomas W %A Manning, Alisa K %A Aschard, Hugues %A Gudnason, Vilmundur %A Harris, Tamara B %A Smith, Albert V %A Boerwinkle, Eric %A Brown, Michael R %A Morrison, Alanna C %A Fornage, Myriam %A Lin, Li-An %A Richard, Melissa %A Bartz, Traci M %A Psaty, Bruce M %A Hayward, Caroline %A Polasek, Ozren %A Marten, Jonathan %A Rudan, Igor %A Feitosa, Mary F %A Kraja, Aldi T %A Province, Michael A %A Deng, Xuan %A Fisher, Virginia A %A Zhou, Yanhua %A Bielak, Lawrence F %A Smith, Jennifer %A Huffman, Jennifer E %A Padmanabhan, Sandosh %A Smith, Blair H %A Ding, Jingzhong %A Liu, Yongmei %A Lohman, Kurt %A Bouchard, Claude %A Rankinen, Tuomo %A Rice, Treva K %A Arnett, Donna %A Schwander, Karen %A Guo, Xiuqing %A Palmas, Walter %A Rotter, Jerome I %A Alfred, Tamuno %A Bottinger, Erwin P %A Loos, Ruth J F %A Amin, Najaf %A Franco, Oscar H %A van Duijn, Cornelia M %A Vojinovic, Dina %A Chasman, Daniel I %A Ridker, Paul M %A Rose, Lynda M %A Kardia, Sharon %A Zhu, Xiaofeng %A Rice, Kenneth %A Borecki, Ingrid B %A Rao, Dabeeru C %A Gauderman, W James %A Cupples, L Adrienne %X

Studying gene-environment (G × E) interactions is important, as they extend our knowledge of the genetic architecture of complex traits and may help to identify novel variants not detected via analysis of main effects alone. The main statistical framework for studying G × E interactions uses a single regression model that includes both the genetic main and G × E interaction effects (the "joint" framework). The alternative "stratified" framework combines results from genetic main-effect analyses carried out separately within the exposed and unexposed groups. Although there have been several investigations using theory and simulation, an empirical comparison of the two frameworks is lacking. Here, we compare the two frameworks using results from genome-wide association studies of systolic blood pressure for 3.2 million low frequency and 6.5 million common variants across 20 cohorts of European ancestry, comprising 79,731 individuals. Our cohorts have sample sizes ranging from 456 to 22,983 and include both family-based and population-based samples. In cohort-specific analyses, the two frameworks provided similar inference for population-based cohorts. The agreement was reduced for family-based cohorts. In meta-analyses, agreement between the two frameworks was less than that observed in cohort-specific analyses, despite the increased sample size. In meta-analyses, agreement depended on (1) the minor allele frequency, (2) inclusion of family-based cohorts in meta-analysis, and (3) filtering scheme. The stratified framework appears to approximate the joint framework well only for common variants in population-based cohorts. We conclude that the joint framework is the preferred approach and should be used to control false positives when dealing with low-frequency variants and/or family-based cohorts.

%B Genet Epidemiol %V 40 %P 404-15 %8 2016 Jul %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27230302?dopt=Abstract %R 10.1002/gepi.21978 %0 Journal Article %J Circ Cardiovasc Genet %D 2016 %T Epigenetic Signatures of Cigarette Smoking. %A Joehanes, Roby %A Just, Allan C %A Marioni, Riccardo E %A Pilling, Luke C %A Reynolds, Lindsay M %A Mandaviya, Pooja R %A Guan, Weihua %A Xu, Tao %A Elks, Cathy E %A Aslibekyan, Stella %A Moreno-Macias, Hortensia %A Smith, Jennifer A %A Brody, Jennifer A %A Dhingra, Radhika %A Yousefi, Paul %A Pankow, James S %A Kunze, Sonja %A Shah, Sonia H %A McRae, Allan F %A Lohman, Kurt %A Sha, Jin %A Absher, Devin M %A Ferrucci, Luigi %A Zhao, Wei %A Demerath, Ellen W %A Bressler, Jan %A Grove, Megan L %A Huan, Tianxiao %A Liu, Chunyu %A Mendelson, Michael M %A Yao, Chen %A Kiel, Douglas P %A Peters, Annette %A Wang-Sattler, Rui %A Visscher, Peter M %A Wray, Naomi R %A Starr, John M %A Ding, Jingzhong %A Rodriguez, Carlos J %A Wareham, Nicholas J %A Irvin, Marguerite R %A Zhi, Degui %A Barrdahl, Myrto %A Vineis, Paolo %A Ambatipudi, Srikant %A Uitterlinden, André G %A Hofman, Albert %A Schwartz, Joel %A Colicino, Elena %A Hou, Lifang %A Vokonas, Pantel S %A Hernandez, Dena G %A Singleton, Andrew B %A Bandinelli, Stefania %A Turner, Stephen T %A Ware, Erin B %A Smith, Alicia K %A Klengel, Torsten %A Binder, Elisabeth B %A Psaty, Bruce M %A Taylor, Kent D %A Gharib, Sina A %A Swenson, Brenton R %A Liang, Liming %A DeMeo, Dawn L %A O'Connor, George T %A Herceg, Zdenko %A Ressler, Kerry J %A Conneely, Karen N %A Sotoodehnia, Nona %A Kardia, Sharon L R %A Melzer, David %A Baccarelli, Andrea A %A van Meurs, Joyce B J %A Romieu, Isabelle %A Arnett, Donna K %A Ong, Ken K %A Liu, Yongmei %A Waldenberger, Melanie %A Deary, Ian J %A Fornage, Myriam %A Levy, Daniel %A London, Stephanie J %X

BACKGROUND: DNA methylation leaves a long-term signature of smoking exposure and is one potential mechanism by which tobacco exposure predisposes to adverse health outcomes, such as cancers, osteoporosis, lung, and cardiovascular disorders.

METHODS AND RESULTS: To comprehensively determine the association between cigarette smoking and DNA methylation, we conducted a meta-analysis of genome-wide DNA methylation assessed using the Illumina BeadChip 450K array on 15 907 blood-derived DNA samples from participants in 16 cohorts (including 2433 current, 6518 former, and 6956 never smokers). Comparing current versus never smokers, 2623 cytosine-phosphate-guanine sites (CpGs), annotated to 1405 genes, were statistically significantly differentially methylated at Bonferroni threshold of P<1×10(-7) (18 760 CpGs at false discovery rate <0.05). Genes annotated to these CpGs were enriched for associations with several smoking-related traits in genome-wide studies including pulmonary function, cancers, inflammatory diseases, and heart disease. Comparing former versus never smokers, 185 of the CpGs that differed between current and never smokers were significant P<1×10(-7) (2623 CpGs at false discovery rate <0.05), indicating a pattern of persistent altered methylation, with attenuation, after smoking cessation. Transcriptomic integration identified effects on gene expression at many differentially methylated CpGs.

CONCLUSIONS: Cigarette smoking has a broad impact on genome-wide methylation that, at many loci, persists many years after smoking cessation. Many of the differentially methylated genes were novel genes with respect to biological effects of smoking and might represent therapeutic targets for prevention or treatment of tobacco-related diseases. Methylation at these sites could also serve as sensitive and stable biomarkers of lifetime exposure to tobacco smoke.

%B Circ Cardiovasc Genet %V 9 %P 436-447 %8 2016 Oct %G eng %N 5 %R 10.1161/CIRCGENETICS.116.001506 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Evaluation of a Genetic Risk Score to Improve Risk Prediction for Alzheimer's Disease. %A Chouraki, Vincent %A Reitz, Christiane %A Maury, Fleur %A Bis, Joshua C %A Bellenguez, Céline %A Yu, Lei %A Jakobsdottir, Johanna %A Mukherjee, Shubhabrata %A Adams, Hieab H %A Choi, Seung Hoan %A Larson, Eric B %A Fitzpatrick, Annette %A Uitterlinden, André G %A De Jager, Philip L %A Hofman, Albert %A Gudnason, Vilmundur %A Vardarajan, Badri %A Ibrahim-Verbaas, Carla %A van der Lee, Sven J %A Lopez, Oscar %A Dartigues, Jean-François %A Berr, Claudine %A Amouyel, Philippe %A Bennett, David A %A van Duijn, Cornelia %A DeStefano, Anita L %A Launer, Lenore J %A Ikram, M Arfan %A Crane, Paul K %A Lambert, Jean-Charles %A Mayeux, Richard %A Seshadri, Sudha %X

Effective prevention of Alzheimer's disease (AD) requires the development of risk prediction tools permitting preclinical intervention. We constructed a genetic risk score (GRS) comprising common genetic variants associated with AD, evaluated its association with incident AD and assessed its capacity to improve risk prediction over traditional models based on age, sex, education, and APOEɛ4. In eight prospective cohorts included in the International Genomics of Alzheimer's Project (IGAP), we derived weighted sum of risk alleles from the 19 top SNPs reported by the IGAP GWAS in participants aged 65 and older without prevalent dementia. Hazard ratios (HR) of incident AD were estimated in Cox models. Improvement in risk prediction was measured by the difference in C-index (Δ-C), the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI>0). Overall, 19,687 participants at risk were included, of whom 2,782 developed AD. The GRS was associated with a 17% increase in AD risk (pooled HR = 1.17; 95% CI =   [1.13-1.21] per standard deviation increase in GRS; p-value =  2.86×10-16). This association was stronger among persons with at least one APOEɛ4 allele (HRGRS = 1.24; 95% CI =   [1.15-1.34]) than in others (HRGRS = 1.13; 95% CI =   [1.08-1.18]; pinteraction = 3.45×10-2). Risk prediction after seven years of follow-up showed a small improvement when adding the GRS to age, sex, APOEɛ4, and education (Δ-Cindex =  0.0043 [0.0019-0.0067]). Similar patterns were observed for IDI and NRI>0. In conclusion, a risk score incorporating common genetic variation outside the APOEɛ4 locus improved AD risk prediction and may facilitate risk stratification for prevention trials.

%B J Alzheimers Dis %V 53 %P 921-32 %8 2016 Jun 18 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/27340842?dopt=Abstract %R 10.3233/JAD-150749 %0 Journal Article %J Am J Hum Genet %D 2016 %T Exome Genotyping Identifies Pleiotropic Variants Associated with Red Blood Cell Traits. %A Chami, Nathalie %A Chen, Ming-Huei %A Slater, Andrew J %A Eicher, John D %A Evangelou, Evangelos %A Tajuddin, Salman M %A Love-Gregory, Latisha %A Kacprowski, Tim %A Schick, Ursula M %A Nomura, Akihiro %A Giri, Ayush %A Lessard, Samuel %A Brody, Jennifer A %A Schurmann, Claudia %A Pankratz, Nathan %A Yanek, Lisa R %A Manichaikul, Ani %A Pazoki, Raha %A Mihailov, Evelin %A Hill, W David %A Raffield, Laura M %A Burt, Amber %A Bartz, Traci M %A Becker, Diane M %A Becker, Lewis C %A Boerwinkle, Eric %A Bork-Jensen, Jette %A Bottinger, Erwin P %A O'Donoghue, Michelle L %A Crosslin, David R %A de Denus, Simon %A Dubé, Marie-Pierre %A Elliott, Paul %A Engström, Gunnar %A Evans, Michele K %A Floyd, James S %A Fornage, Myriam %A Gao, He %A Greinacher, Andreas %A Gudnason, Vilmundur %A Hansen, Torben %A Harris, Tamara B %A Hayward, Caroline %A Hernesniemi, Jussi %A Highland, Heather M %A Hirschhorn, Joel N %A Hofman, Albert %A Irvin, Marguerite R %A Kähönen, Mika %A Lange, Ethan %A Launer, Lenore J %A Lehtimäki, Terho %A Li, Jin %A Liewald, David C M %A Linneberg, Allan %A Liu, Yongmei %A Lu, Yingchang %A Lyytikäinen, Leo-Pekka %A Mägi, Reedik %A Mathias, Rasika A %A Melander, Olle %A Metspalu, Andres %A Mononen, Nina %A Nalls, Mike A %A Nickerson, Deborah A %A Nikus, Kjell %A O'Donnell, Chris J %A Orho-Melander, Marju %A Pedersen, Oluf %A Petersmann, Astrid %A Polfus, Linda %A Psaty, Bruce M %A Raitakari, Olli T %A Raitoharju, Emma %A Richard, Melissa %A Rice, Kenneth M %A Rivadeneira, Fernando %A Rotter, Jerome I %A Schmidt, Frank %A Smith, Albert Vernon %A Starr, John M %A Taylor, Kent D %A Teumer, Alexander %A Thuesen, Betina H %A Torstenson, Eric S %A Tracy, Russell P %A Tzoulaki, Ioanna %A Zakai, Neil A %A Vacchi-Suzzi, Caterina %A van Duijn, Cornelia M %A van Rooij, Frank J A %A Cushman, Mary %A Deary, Ian J %A Velez Edwards, Digna R %A Vergnaud, Anne-Claire %A Wallentin, Lars %A Waterworth, Dawn M %A White, Harvey D %A Wilson, James G %A Zonderman, Alan B %A Kathiresan, Sekar %A Grarup, Niels %A Esko, Tõnu %A Loos, Ruth J F %A Lange, Leslie A %A Faraday, Nauder %A Abumrad, Nada A %A Edwards, Todd L %A Ganesh, Santhi K %A Auer, Paul L %A Johnson, Andrew D %A Reiner, Alexander P %A Lettre, Guillaume %X

Red blood cell (RBC) traits are important heritable clinical biomarkers and modifiers of disease severity. To identify coding genetic variants associated with these traits, we conducted meta-analyses of seven RBC phenotypes in 130,273 multi-ethnic individuals from studies genotyped on an exome array. After conditional analyses and replication in 27,480 independent individuals, we identified 16 new RBC variants. We found low-frequency missense variants in MAP1A (rs55707100, minor allele frequency [MAF] = 3.3%, p = 2 × 10(-10) for hemoglobin [HGB]) and HNF4A (rs1800961, MAF = 2.4%, p < 3 × 10(-8) for hematocrit [HCT] and HGB). In African Americans, we identified a nonsense variant in CD36 associated with higher RBC distribution width (rs3211938, MAF = 8.7%, p = 7 × 10(-11)) and showed that it is associated with lower CD36 expression and strong allelic imbalance in ex vivo differentiated human erythroblasts. We also identified a rare missense variant in ALAS2 (rs201062903, MAF = 0.2%) associated with lower mean corpuscular volume and mean corpuscular hemoglobin (p < 8 × 10(-9)). Mendelian mutations in ALAS2 are a cause of sideroblastic anemia and erythropoietic protoporphyria. Gene-based testing highlighted three rare missense variants in PKLR, a gene mutated in Mendelian non-spherocytic hemolytic anemia, associated with HGB and HCT (SKAT p < 8 × 10(-7)). These rare, low-frequency, and common RBC variants showed pleiotropy, being also associated with platelet, white blood cell, and lipid traits. Our association results and functional annotation suggest the involvement of new genes in human erythropoiesis. We also confirm that rare and low-frequency variants play a role in the architecture of complex human traits, although their phenotypic effect is generally smaller than originally anticipated.

%B Am J Hum Genet %V 99 %P 8-21 %8 2016 Jul 7 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27346685?dopt=Abstract %R 10.1016/j.ajhg.2016.05.007 %0 Journal Article %J Hum Mol Genet %D 2016 %T Fine-mapping, novel loci identification, and SNP association transferability in a genome-wide association study of QRS duration in African Americans. %A Evans, Daniel S %A Avery, Christy L %A Nalls, Mike A %A Li, Guo %A Barnard, John %A Smith, Erin N %A Tanaka, Toshiko %A Butler, Anne M %A Buxbaum, Sarah G %A Alonso, Alvaro %A Arking, Dan E %A Berenson, Gerald S %A Bis, Joshua C %A Buyske, Steven %A Carty, Cara L %A Chen, Wei %A Chung, Mina K %A Cummings, Steven R %A Deo, Rajat %A Eaton, Charles B %A Fox, Ervin R %A Heckbert, Susan R %A Heiss, Gerardo %A Hindorff, Lucia A %A Hsueh, Wen-Chi %A Isaacs, Aaron %A Jamshidi, Yalda %A Kerr, Kathleen F %A Liu, Felix %A Liu, Yongmei %A Lohman, Kurt K %A Magnani, Jared W %A Maher, Joseph F %A Mehra, Reena %A Meng, Yan A %A Musani, Solomon K %A Newton-Cheh, Christopher %A North, Kari E %A Psaty, Bruce M %A Redline, Susan %A Rotter, Jerome I %A Schnabel, Renate B %A Schork, Nicholas J %A Shohet, Ralph V %A Singleton, Andrew B %A Smith, Jonathan D %A Soliman, Elsayed Z %A Srinivasan, Sathanur R %A Taylor, Herman A %A Van Wagoner, David R %A Wilson, James G %A Young, Taylor %A Zhang, Zhu-Ming %A Zonderman, Alan B %A Evans, Michele K %A Ferrucci, Luigi %A Murray, Sarah S %A Tranah, Gregory J %A Whitsel, Eric A %A Reiner, Alex P %A Sotoodehnia, Nona %X

The electrocardiographic QRS duration, a measure of ventricular depolarization and conduction, is associated with cardiovascular mortality. While single nucleotide polymorphisms (SNPs) associated with QRS duration have been identified at 22 loci in populations of European descent, the genetic architecture of QRS duration in non-European populations is largely unknown. We therefore performed a genome-wide association study (GWAS) meta-analysis of QRS duration in 13,031 African Americans from ten cohorts and a transethnic GWAS meta-analysis with additional results from populations of European descent. In the African American GWAS, a single genome-wide significant SNP association was identified (rs3922844, P = 4 × 10(-14)) in intron 16 of SCN5A, a voltage-gated cardiac sodium channel gene. The QRS-prolonging rs3922844 C allele was also associated with decreased SCN5A RNA expression in human atrial tissue (P = 1.1 × 10(-4)). High density genotyping revealed that the SCN5A association region in African Americans was confined to intron 16. Transethnic GWAS meta-analysis identified novel SNP associations on chromosome 18 in MYL12A (rs1662342, P = 4.9 × 10(-8)) and chromosome 1 near CD1E and SPTA1 (rs7547997, P = 7.9 × 10(-9)). The 22 QRS loci previously identified in populations of European descent were enriched for significant SNP associations with QRS duration in African Americans (P = 9.9 × 10(-7)), and index SNP associations in or near SCN5A, SCN10A, CDKN1A, NFIA, HAND1, TBX5 and SETBP1 replicated in African Americans. In summary, rs3922844 was associated with QRS duration and SCN5A expression, two novel QRS loci were identified using transethnic meta-analysis, and a significant proportion of QRS-SNP associations discovered in populations of European descent were transferable to African Americans when adequate power was achieved.

%B Hum Mol Genet %8 2016 Aug 29 %G eng %R 10.1093/hmg/ddw284 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2016 %T Gait Speed Predicts Incident Disability: A Pooled Analysis. %A Perera, Subashan %A Patel, Kushang V %A Rosano, Caterina %A Rubin, Susan M %A Satterfield, Suzanne %A Harris, Tamara %A Ensrud, Kristine %A Orwoll, Eric %A Lee, Christine G %A Chandler, Julie M %A Newman, Anne B %A Cauley, Jane A %A Guralnik, Jack M %A Ferrucci, Luigi %A Studenski, Stephanie A %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K Disability Evaluation %K Disabled Persons %K Female %K Gait %K Geriatric Assessment %K Humans %K Independent Living %K Male %K Mobility Limitation %K Predictive Value of Tests %K Prognosis %K Psychomotor Performance %K Risk Assessment %K Risk Factors %K ROC Curve %K Survival Analysis %K United States %X

BACKGROUND: Functional independence with aging is an important goal for individuals and society. Simple prognostic indicators can inform health promotion and care planning, but evidence is limited by heterogeneity in measures of function.

METHODS: We performed a pooled analysis of data from seven studies of 27,220 community-dwelling older adults aged 65 or older with baseline gait speed, followed for disability and mortality. Outcomes were incident inability or dependence on another person in bathing or dressing; and difficulty walking ¼ - ½ mile or climbing 10 steps within 3 years.

RESULTS: Participants with faster baseline gait had lower rates of incident disability. In subgroups (defined by 0.2 m/s-wide intervals from <0.4 to ≥ 1.4 m/s) with increasingly greater gait speed, 3-year rates of bathing or dressing dependence trended from 10% to 1% in men, and from 15% to 1% in women, while mobility difficulty trended from 47% to 4% in men and 40% to 6% in women. The age-adjusted relative risk ratio per 0.1 m/s greater speed for bathing or dressing dependence in men was 0.68 (0.57-0.81) and in women: 0.74 (0.66-0.82); for mobility difficulty, men: 0.75 (0.68-0.82), women: 0.73 (0.67-0.80). Results were similar for combined disability and mortality. Effects were largely consistent across subgroups based on age, gender, race, body mass index, prior hospitalization, and selected chronic conditions. In the presence of multiple other risk factors for disability, gait speed significantly increased the area under the receiver operator characteristic curve.

CONCLUSION: In older adults, gait speed predicts 3 year incidence of bathing or dressing dependence, mobility difficulty, and a composite outcome of disability and mortality.

%B J Gerontol A Biol Sci Med Sci %V 71 %P 63-71 %8 2016 Jan %G ENG %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26297942?dopt=Abstract %R 10.1093/gerona/glv126 %0 Journal Article %J Sci Rep %D 2016 %T {Gene-gene Interaction Analyses for Atrial Fibrillation %A Lin, H. %A Mueller-Nurasyid, M. %A Smith, A. V. %A Arking, D. E. %A Barnard, J. %A Bartz, T. M. %A Lunetta, K. L. %A Lohman, K. %A Kleber, M. E. %A Lubitz, S. A. %A Geelhoed, B. %A Trompet, S. %A Niemeijer, M. N. %A Kacprowski, T. %A Chasman, D. I. %A Klarin, D. %A Sinner, M. F. %A Waldenberger, M. %A Meitinger, T. %A Harris, T. B. %A Launer, L. J. %A Soliman, E. Z. %A Chen, L. Y. %A Smith, J. D. %A Van Wagoner, D. R. %A Rotter, J. I. %A Psaty, B. M. %A Xie, Z. %A Hendricks, A. E. %A Ding, J. %A Delgado, G. E. %A Verweij, N. %A van der Harst, P. %A Macfarlane, P. W. %A Ford, I. %A Hofman, A. %A Uitterlinden, A. %A Heeringa, J. %A Franco, O. H. %A Kors, J. A. %A Weiss, S. %A V?lzke, H. %A Rose, L. M. %A Natarajan, P. %A Kathiresan, S. %A K??b, S. %A Gudnason, V. %A Alonso, A. %A Chung, M. K. %A Heckbert, S. R. %A Benjamin, E. J. %A Liu, Y. %A M?rz, W. %A Rienstra, M. %A Jukema, J. W. %A Stricker, B. H. %A D?rr, M. %A Albert, C. M. %A Ellinor, P. T. %X {Atrial fibrillation (AF) is a heritable disease that affects more than thirty million individuals worldwide. Extensive efforts have been devoted to the study of genetic determinants of AF. The objective of our study is to examine the effect of gene-gene interaction on AF susceptibility. We performed a large-scale association analysis of gene-gene interactions with AF in 8,173 AF cases, and 65,237 AF-free referents collected from 15 studies for discovery. We examined putative interactions between genome-wide SNPs and 17 known AF-related SNPs. The top interactions were then tested for association in an independent cohort for replication, which included more than 2,363 AF cases and 114,746 AF-free referents. One interaction, between rs7164883 at the HCN4 locus and rs4980345 at the SLC28A1 locus, was found to be significantly associated with AF in the discovery cohorts (interaction OR = 1.44, 95% CI: 1.27-1.65 %B Sci Rep %V 6 %P 35371 %8 11 %G eng %0 Journal Article %J Nat Commun %D 2016 %T {Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function %A Pattaro, C. %A Teumer, A. %A Gorski, M. %A Chu, A. Y. %A Li, M. %A Mijatovic, V. %A Garnaas, M. %A Tin, A. %A Sorice, R. %A Li, Y. %A Taliun, D. %A Olden, M. %A Foster, M. %A Yang, Q. %A Chen, M. H. %A Pers, T. H. %A Johnson, A. D. %A Ko, Y. A. %A Fuchsberger, C. %A Tayo, B. %A Nalls, M. %A Feitosa, M. F. %A Isaacs, A. %A Dehghan, A. %A d'Adamo, P. %A Adeyemo, A. %A Dieffenbach, A. K. %A Zonderman, A. B. %A Nolte, I. M. %A van der Most, P. J. %A Wright, A. F. %A Shuldiner, A. R. %A Morrison, A. C. %A Hofman, A. %A Smith, A. V. %A Dreisbach, A. W. %A Franke, A. %A Uitterlinden, A. G. %A Metspalu, A. %A Tonjes, A. %A Lupo, A. %A Robino, A. %A Johansson, ?. %A Demirkan, A. %A Kollerits, B. %A Freedman, B. I. %A Ponte, B. %A Oostra, B. A. %A Paulweber, B. %A Kr?mer, B. K. %A Mitchell, B. D. %A Buckley, B. M. %A Peralta, C. A. %A Hayward, C. %A Helmer, C. %A Rotimi, C. N. %A Shaffer, C. M. %A M?ller, C. %A Sala, C. %A van Duijn, C. M. %A Saint-Pierre, A. %A Ackermann, D. %A Shriner, D. %A Ruggiero, D. %A Toniolo, D. %A Lu, Y. %A Cusi, D. %A Czamara, D. %A Ellinghaus, D. %A Siscovick, D. S. %A Ruderfer, D. %A Gieger, C. %A Grallert, H. %A Rochtchina, E. %A Atkinson, E. J. %A Holliday, E. G. %A Boerwinkle, E. %A Salvi, E. %A Bottinger, E. P. %A Murgia, F. %A Rivadeneira, F. %A Ernst, F. %A Kronenberg, F. %A Hu, F. B. %A Navis, G. J. %A Curhan, G. C. %A Ehret, G. B. %A Homuth, G. %A Coassin, S. %A Thun, G. A. %A Pistis, G. %A Gambaro, G. %A Malerba, G. %A Montgomery, G. W. %A Eiriksdottir, G. %A Jacobs, G. %A Li, G. %A Wichmann, H. E. %A Campbell, H. %A Schmidt, H. %A Wallaschofski, H. %A V?lzke, H. %A Brenner, H. %A Kroemer, H. K. %A Kramer, H. %A Lin, H. %A Leach, I. M. %A Ford, I. %A Guessous, I. %A Rudan, I. %A Prokopenko, I. %A Borecki, I. %A Heid, I. M. %A Kolcic, I. %A Persico, I. %A Jukema, J. W. %A Wilson, J. F. %A Felix, J. F. %A Divers, J. %A Lambert, J. C. %A Stafford, J. M. %A Gaspoz, J. M. %A Smith, J. A. %A Faul, J. D. %A Wang, J. J. %A Ding, J. %A Hirschhorn, J. N. %A Attia, J. %A Whitfield, J. B. %A Chalmers, J. %A Viikari, J. %A Coresh, J. %A Denny, J. C. %A Karjalainen, J. %A Fernandes, J. K. %A Endlich, K. %A Butterbach, K. %A Keene, K. L. %A Lohman, K. %A Portas, L. %A Launer, L. J. %A Lyytik?inen, L. P. %A Yengo, L. %A Franke, L. %A Ferrucci, L. %A Rose, L. M. %A Kedenko, L. %A Rao, M. %A Struchalin, M. %A Kleber, M. E. %A Cavalieri, M. %A Haun, M. %A Cornelis, M. C. %A Ciullo, M. %A Pirastu, M. %A de Andrade, M. %A McEvoy, M. A. %A Woodward, M. %A Adam, M. %A Cocca, M. %A Nauck, M. %A Imboden, M. %A Waldenberger, M. %A Pruijm, M. %A Metzger, M. %A Stumvoll, M. %A Evans, M. K. %A Sale, M. M. %A K?h?nen, M. %A Boban, M. %A Bochud, M. %A Rheinberger, M. %A Verweij, N. %A Bouatia-Naji, N. %A Martin, N. G. %A Hastie, N. %A Probst-Hensch, N. %A Soranzo, N. %A Devuyst, O. %A Raitakari, O. %A Gottesman, O. %A Franco, O. H. %A Polasek, O. %A Gasparini, P. %A Munroe, P. B. %A Ridker, P. M. %A Mitchell, P. %A Muntner, P. %A Meisinger, C. %A Smit, J. H. %A Kovacs, P. %A Wild, P. S. %A Froguel, P. %A Rettig, R. %A M?gi, R. %A Biffar, R. %A Schmidt, R. %A Middelberg, R. P. %A Carroll, R. J. %A Penninx, B. W. %A Scott, R. J. %A Katz, R. %A Sedaghat, S. %A Wild, S. H. %A Kardia, S. L. %A Ulivi, S. %A Hwang, S. J. %A Enroth, S. %A Kloiber, S. %A Trompet, S. %A Stengel, B. %A Hancock, S. J. %A Turner, S. T. %A Rosas, S. E. %A Stracke, S. %A Harris, T. B. %A Zeller, T. %A Zemunik, T. %A Lehtim?ki, T. %A Illig, T. %A Aspelund, T. %A Nikopensius, T. %A Esko, T. %A Tanaka, T. %A Gyllensten, U. %A V?lker, U. %A Emilsson, V. %A Vitart, V. %A Aalto, V. %A Gudnason, V. %A Chouraki, V. %A Chen, W. M. %A Igl, W. %A M?rz, W. %A Koenig, W. %A Lieb, W. %A Loos, R. J. %A Liu, Y. %A Snieder, H. %A Pramstaller, P. P. %A Parsa, A. %A O'Connell, J. R. %A Susztak, K. %A Hamet, P. %A Tremblay, J. %A De Boer, I. H. %A B?ger, C. A. %A Goessling, W. %A Chasman, D. I. %A K?ttgen, A. %A Kao, W. H. %A Fox, C. S. %A Abecasis, G. R. %A Adair, L. S. %A Alexander, M. %A Altshuler, D. %A Amin, N. %A Arking, D. E. %A Arora, P. %A Aulchenko, Y. %A Bakker, S. J. %A Bandinelli, S. %A Barroso, I. %A Beckmann, J. S. %A Beilby, J. P. %A Bergman, R. N. %A Bergmann, S. %A Bis, J. C. %A Boehnke, M. %A Bonnycastle, L. L. %A Bornstein, S. R. %A Bots, M. L. %A Bragg-Gresham, J. L. %A Brand, S. M. %A Brand, E. %A Braund, P. S. %A Brown, M. J. %A Burton, P. R. %A Casas, J. P. %A Caulfield, M. J. %A Chakravarti, A. %A Chambers, J. C. %A Chandak, G. R. %A Chang, Y. P. %A Charchar, F. J. %A Chaturvedi, N. %A Shin Cho, Y. %A Clarke, R. %A Collins, F. S. %A Collins, R. %A Connell, J. M. %A Cooper, J. A. %A Cooper, M. N. %A Cooper, R. S. %A Corsi, A. M. %A D?rr, M. %A Dahgam, S. %A Danesh, J. %A Davey Smith, G. %A Day, I. N. %A Deloukas, P. %A Denniff, M. %A Dominiczak, A. F. %A Dong, Y. %A Doumatey, A. %A Elliott, P. %A Elosua, R. %A Erdmann, J. %A Eyheramendy, S. %A Farrall, M. %A Fava, C. %A Forrester, T. %A Fowkes, F. G. %A Fox, E. R. %A Frayling, T. M. %A Galan, P. %A Ganesh, S. K. %A Garcia, M. %A Gaunt, T. R. %A Glazer, N. L. %A Go, M. J. %A Goel, A. %A Gr?ssler, J. %A Grobbee, D. E. %A Groop, L. %A Guarrera, S. %A Guo, X. %A Hadley, D. %A Hamsten, A. %A Han, B. G. %A Hardy, R. %A Hartikainen, A. L. %A Heath, S. %A Heckbert, S. R. %A Hedblad, B. %A Hercberg, S. %A Hernandez, D. %A Hicks, A. A. %A Hilton, G. %A Hingorani, A. D. %A Bolton, J. A. %A Hopewell, J. C. %A Howard, P. %A Humphries, S. E. %A Hunt, S. C. %A Hveem, K. %A Ikram, M. A. %A Islam, M. %A Iwai, N. %A Jarvelin, M. R. %A Jackson, A. U. %A Jafar, T. H. %A Janipalli, C. S. %A Johnson, T. %A Kathiresan, S. %A Khaw, K. T. %A Kim, H. L. %A Kinra, S. %A Kita, Y. %A Kivimaki, M. %A Kooner, J. S. %A Kumar, M. J. %A Kuh, D. %A Kulkarni, S. R. %A Kumari, M. %A Kuusisto, J. %A Kuznetsova, T. %A Laakso, M. %A Laan, M. %A Laitinen, J. %A Lakatta, E. G. %A Langefeld, C. D. %A Larson, M. G. %A Lathrop, M. %A Lawlor, D. A. %A Lawrence, R. W. %A Lee, J. Y. %A Lee, N. R. %A Levy, D. %A Li, Y. %A Longstreth, W. T. %A Luan, J. %A Lucas, G. %A Ludwig, B. %A Mangino, M. %A Mani, K. R. %A Marmot, M. G. %A Mattace-Raso, F. U. %A Matullo, G. %A McArdle, W. L. %A McKenzie, C. A. %A Meitinger, T. %A Melander, O. %A Meneton, P. %A Meschia, J. F. %A Miki, T. %A Milaneschi, Y. %A Mohlke, K. L. %A Mooser, V. %A Morken, M. A. %A Morris, R. W. %A Mosley, T. H. %A Najjar, S. %A Narisu, N. %A Newton-Cheh, C. %A Nguyen, K. D. %A Nilsson, P. %A Nyberg, F. %A O'Donnell, C. J. %A Ogihara, T. %A Ohkubo, T. %A Okamura, T. %A Ong, R. T. %A Ongen, H. %A Onland-Moret, N. C. %A O'Reilly, P. F. %A Org, E. %A Orru, M. %A Palmas, W. %A Palmen, J. %A Palmer, L. J. %A Palmer, N. D. %A Parker, A. N. %A Peden, J. F. %A Peltonen, L. %A Perola, M. %A Pihur, V. %A Platou, C. G. %A Plump, A. %A Prabhakaran, D. %A Psaty, B. M. %A Raffel, L. J. %A Rao, D. C. %A Rasheed, A. %A Ricceri, F. %A Rice, K. M. %A Rosengren, A. %A Rotter, J. I. %A Rudock, M. E. %A S?ber, S. %A Salako, T. %A Saleheen, D. %A Salomaa, V. %A Samani, N. J. %A Schwartz, S. M. %A Schwarz, P. E. %A Scott, L. J. %A Scott, J. %A Scuteri, A. %A Sehmi, J. S. %A Seielstad, M. %A Seshadri, S. %A Sharma, P. %A Shaw-Hawkins, S. %A Shi, G. %A Shrine, N. R. %A Sijbrands, E. J. %A Sim, X. %A Singleton, A. %A Sj?gren, M. %A Smith, N. L. %A Soler Artigas, M. %A Spector, T. D. %A Staessen, J. A. %A Stancakova, A. %A Steinle, N. I. %A Strachan, D. P. %A Stringham, H. M. %A Sun, Y. V. %A Swift, A. J. %A Tabara, Y. %A Tai, E. S. %A Talmud, P. J. %A Taylor, A. %A Terzic, J. %A Thelle, D. S. %A Tobin, M. D. %A Tomaszewski, M. %A Tripathy, V. %A Tuomilehto, J. %A Tzoulaki, I. %A Uda, M. %A Ueshima, H. %A Uiterwaal, C. S. %A Umemura, S. %A van der Harst, P. %A van der Schouw, Y. T. %A van Gilst, W. H. %A Vartiainen, E. %A Vasan, R. S. %A Veldre, G. %A Verwoert, G. C. %A Viigimaa, M. %A Vinay, D. G. %A Vineis, P. %A Voight, B. F. %A Vollenweider, P. %A Wagenknecht, L. E. %A Wain, L. V. %A Wang, X. %A Wang, T. J. %A Wareham, N. J. %A Watkins, H. %A Weder, A. B. %A Whincup, P. H. %A Wiggins, K. L. %A Witteman, J. C. %A Wong, A. %A Wu, Y. %A Yajnik, C. S. %A Yao, J. %A Young, J. H. %A Zelenika, D. %A Zhai, G. %A Zhang, W. %A Zhang, F. %A Zhao, J. H. %A Zhu, H. %A Zhu, X. %A Zitting, P. %A Zukowska-Szczechowska, E. %A Okada, Y. %A Wu, J. Y. %A Gu, D. %A Takeuchi, F. %A Takahashi, A. %A Maeda, S. %A Tsunoda, T. %A Chen, P. %A Lim, S. C. %A Wong, T. Y. %A Liu, J. %A Young, T. L. %A Aung, T. %A Teo, Y. Y. %A Kim, Y. J. %A Kang, D. %A Chen, C. H. %A Tsai, F. J. %A Chang, L. C. %A Fann, S. J. %A Mei, H. %A Hixson, J. E. %A Chen, S. %A Katsuya, T. %A Isono, M. %A Albrecht, E. %A Yamamoto, K. %A Kubo, M. %A Nakamura, Y. %A Kamatani, N. %A Kato, N. %A He, J. %A Chen, Y. T. %A Tanaka, T. %A Reilly, M. P. %A Schunkert, H. %A Assimes, T. L. %A Hall, A. %A Hengstenberg, C. %A K?nig, I. R. %A Laaksonen, R. %A McPherson, R. %A Thompson, J. R. %A Thorsteinsdottir, U. %A Ziegler, A. %A Absher, D. %A Chen, L. %A Cupples, L. A. %A Halperin, E. %A Li, M. %A Musunuru, K. %A Preuss, M. %A Schillert, A. %A Thorleifsson, G. %A Wells, G. A. %A Holm, H. %A Roberts, R. %A Stewart, A. F. %A Fortmann, S. %A Go, A. %A Hlatky, M. %A Iribarren, C. %A Knowles, J. %A Myers, R. %A Quertermous, T. %A Sidney, S. %A Risch, N. %A Tang, H. %A Blankenberg, S. %A Schnabel, R. %A Sinning, C. %A Lackner, K. J. %A Tiret, L. %A Nicaud, V. %A Cambien, F. %A Bickel, C. %A Rupprecht, H. J. %A Perret, C. %A Proust, C. %A M?nzel, T. F. %A Barbalic, M. %A Chen, I. Y. %A Demissie-Banjaw, S. %A Folsom, A. %A Lumley, T. %A Marciante, K. %A Taylor, K. D. %A Volcik, K. %A Gretarsdottir, S. %A Gulcher, J. R. %A Kong, A. %A Stefansson, K. %A Thorgeirsson, G. %A Andersen, K. %A Fischer, M. %A Grosshennig, A. %A Linsel-Nitschke, P. %A Stark, K. %A Schreiber, S. %A Aherrahrou, Z. %A Bruse, P. %A Doering, A. %A Klopp, N. %A Diemert, P. %A Loley, C. %A Medack, A. %A Nahrstedt, J. %A Peters, A. %A Wagner, A. K. %A Willenborg, C. %A B?hm, B. O. %A Dobnig, H. %A Grammer, T. B. %A Hoffmann, M. M. %A Meinitzer, A. %A Winkelmann, B. R. %A Pilz, S. %A Renner, W. %A Scharnagl, H. %A Stojakovic, T. %A Tomaschitz, A. %A Winkler, K. %A Guiducci, C. %A Burtt, N. %A Gabriel, S. B. %A Dandona, S. %A Jarinova, O. %A Qu, L. %A Wilensky, R. %A Matthai, W. %A Hakonarson, H. H. %A Devaney, J. %A Burnett, M. S. %A Pichard, A. D. %A Kent, K. M. %A Satler, L. %A Lindsay, J. M. %A Waksman, R. %A Knouff, C. W. %A Waterworth, D. M. %A Walker, M. C. %A Epstein, S. E. %A Rader, D. J. %A Nelson, C. P. %A Wright, B. J. %A Balmforth, A. J. %A Ball, S. G. %A Loehr, L. R. %A Rosamond, W. D. %A Benjamin, E. %A Haritunians, T. %A Couper, D. %A Murabito, J. %A Wang, Y. A. %A Stricker, B. H. %A Chang, P. P. %A Willerson, J. T. %A Felix, S. B. %A Watzinger, N. %A Aragam, J. %A Zweiker, R. %A Lind, L. %A Rodeheffer, R. J. %A Greiser, K. H. %A Deckers, J. W. %A Stritzke, J. %A Ingelsson, E. %A Kullo, I. %A Haerting, J. %A Reffelmann, T. %A Redfield, M. M. %A Werdan, K. %A Mitchell, G. F. %A Arnett, D. K. %A Gottdiener, J. S. %A Blettner, M. %A Friedrich, N. %X Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways. %B Nat Commun %V 7 %P 10023 %8 Jan %G eng %0 Journal Article %J JAMA Cardiol %D 2016 %T Genetic Investigation Into the Differential Risk of Atrial Fibrillation Among Black and White Individuals. %A Roberts, Jason D %A Hu, Donglei %A Heckbert, Susan R %A Alonso, Alvaro %A Dewland, Thomas A %A Vittinghoff, Eric %A Liu, Yongmei %A Psaty, Bruce M %A Olgin, Jeffrey E %A Magnani, Jared W %A Huntsman, Scott %A Burchard, Esteban G %A Arking, Dan E %A Bibbins-Domingo, Kirsten %A Harris, Tamara B %A Perez, Marco V %A Ziv, Elad %A Marcus, Gregory M %X

IMPORTANCE: White persons have a higher risk of atrial fibrillation (AF) compared with black individuals despite a lower prevalence of risk factors. This difference may be due, at least in part, to genetic factors.

OBJECTIVES: To determine whether 9 single-nucleotide polymorphisms (SNPs) associated with AF account for this paradoxical differential racial risk for AF and to use admixture mapping to search genome-wide for loci that may account for this phenomenon.

DESIGN, SETTING, AND PARTICIPANTS: Genome-wide admixture analysis and candidate SNP study involving 3 population-based cohort studies that were initiated between 1987 and 1997, including the Cardiovascular Health Study (CHS) (n = 4173), the Atherosclerosis Risk in Communities (ARIC) (n = 12 341) study, and the Health, Aging, and Body Composition (Health ABC) (n = 1015) study. In all 3 studies, race was self-identified. Cox proportional hazards regression models and the proportion of treatment effect method were used to determine the impact of 9 AF-risk SNPs among participants from CHS and the ARIC study. The present study began July 1, 2012, and was completed in 2015.

MAIN OUTCOMES AND MEASURES: Incident AF systematically ascertained using clinic visit electrocardiograms, hospital discharge diagnosis codes, death certificates, and Medicare claims data.

RESULTS: A single SNP, rs10824026 (chromosome 10: position 73661450), was found to significantly mediate the higher risk for AF in white participants compared with black participants in CHS (11.4%; 95% CI, 2.9%-29.9%) and ARIC (31.7%; 95% CI, 16.0%-53.0%). Admixture mapping was performed in a meta-analysis of black participants within CHS (n = 811), ARIC (n = 3112), and Health ABC (n = 1015). No loci that reached the prespecified statistical threshold for genome-wide significance were identified.

CONCLUSIONS AND RELEVANCE: The rs10824026 SNP on chromosome 10q22 mediates a modest proportion of the increased risk of AF among white individuals compared with black individuals, potentially through an effect on gene expression levels of MYOZ1. No additional genetic variants accounting for a significant portion of the differential racial risk of AF were identified with genome-wide admixture mapping, suggesting that additional genetic or environmental influences beyond single SNPs in isolation may account for the paradoxical racial risk of AF among white individuals and black individuals.

%B JAMA Cardiol %V 1 %P 442-50 %8 2016 Jul 1 %G eng %N 4 %R 10.1001/jamacardio.2016.1185 %0 Journal Article %J J Am Soc Nephrol %D 2016 %T Genetic Variants Associated with Circulating Parathyroid Hormone. %A Robinson-Cohen, Cassianne %A Lutsey, Pamela L %A Kleber, Marcus E %A Nielson, Carrie M %A Mitchell, Braxton D %A Bis, Joshua C %A Eny, Karen M %A Portas, Laura %A Eriksson, Joel %A Lorentzon, Mattias %A Koller, Daniel L %A Milaneschi, Yuri %A Teumer, Alexander %A Pilz, Stefan %A Nethander, Maria %A Selvin, Elizabeth %A Tang, Weihong %A Weng, Lu-Chen %A Wong, Hoi Suen %A Lai, Dongbing %A Peacock, Munro %A Hannemann, Anke %A Völker, Uwe %A Homuth, Georg %A Nauk, Matthias %A Murgia, Federico %A Pattee, Jack W %A Orwoll, Eric %A Zmuda, Joseph M %A Riancho, Jose Antonio %A Wolf, Myles %A Williams, Frances %A Penninx, Brenda %A Econs, Michael J %A Ryan, Kathleen A %A Ohlsson, Claes %A Paterson, Andrew D %A Psaty, Bruce M %A Siscovick, David S %A Rotter, Jerome I %A Pirastu, Mario %A Streeten, Elizabeth %A März, Winfried %A Fox, Caroline %A Coresh, Josef %A Wallaschofski, Henri %A Pankow, James S %A de Boer, Ian H %A Kestenbaum, Bryan %X

Parathyroid hormone (PTH) is a primary calcium regulatory hormone. Elevated serum PTH concentrations in primary and secondary hyperparathyroidism have been associated with bone disease, hypertension, and in some studies, cardiovascular mortality. Genetic causes of variation in circulating PTH concentrations are incompletely understood. We performed a genome-wide association study of serum PTH concentrations among 29,155 participants of European ancestry from 13 cohort studies (n=22,653 and n=6502 in discovery and replication analyses, respectively). We evaluated the association of single nucleotide polymorphisms (SNPs) with natural log-transformed PTH concentration adjusted for age, sex, season, study site, and principal components of ancestry. We discovered associations of SNPs from five independent regions with serum PTH concentration, including the strongest association with rs6127099 upstream of CYP24A1 (P=4.2 × 10(-53)), a gene that encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-dihydroxyvitamin D. Each additional copy of the minor allele at this SNP associated with 7% higher serum PTH concentration. The other SNPs associated with serum PTH concentration included rs4074995 within RGS14 (P=6.6 × 10(-17)), rs219779 adjacent to CLDN14 (P=3.5 × 10(-16)), rs4443100 near RTDR1 (P=8.7 × 10(-9)), and rs73186030 near CASR (P=4.8 × 10(-8)). Of these five SNPs, rs6127099, rs4074995, and rs219779 replicated. Thus, common genetic variants located near genes involved in vitamin D metabolism and calcium and renal phosphate transport associated with differences in circulating PTH concentrations. Future studies could identify the causal variants at these loci, and the clinical and functional relevance of these variants should be pursued.

%B J Am Soc Nephrol %8 2016 Dec 07 %G eng %R 10.1681/ASN.2016010069 %0 Journal Article %J Eur J Hum Genet %D 2016 %T Genetic variants in RBFOX3 are associated with sleep latency. %A Amin, Najaf %A Allebrandt, Karla V %A van der Spek, Ashley %A Müller-Myhsok, Bertram %A Hek, Karin %A Teder-Laving, Maris %A Hayward, Caroline %A Esko, Tõnu %A van Mill, Josine G %A Mbarek, Hamdi %A Watson, Nathaniel F %A Melville, Scott A %A Del Greco, Fabiola M %A Byrne, Enda M %A Oole, Edwin %A Kolcic, Ivana %A Chen, Ting-Hsu %A Evans, Daniel S %A Coresh, Josef %A Vogelzangs, Nicole %A Karjalainen, Juha %A Willemsen, Gonneke %A Gharib, Sina A %A Zgaga, Lina %A Mihailov, Evelin %A Stone, Katie L %A Campbell, Harry %A Brouwer, Rutger Ww %A Demirkan, Ayse %A Isaacs, Aaron %A Dogas, Zoran %A Marciante, Kristin D %A Campbell, Susan %A Borovecki, Fran %A Luik, Annemarie I %A Li, Man %A Hottenga, Jouke Jan %A Huffman, Jennifer E %A van den Hout, Mirjam Cgn %A Cummings, Steven R %A Aulchenko, Yurii S %A Gehrman, Philip R %A Uitterlinden, André G %A Wichmann, Heinz-Erich %A Müller-Nurasyid, Martina %A Fehrmann, Rudolf Sn %A Montgomery, Grant W %A Hofman, Albert %A Kao, Wen Hong Linda %A Oostra, Ben A %A Wright, Alan F %A Vink, Jacqueline M %A Wilson, James F %A Pramstaller, Peter P %A Hicks, Andrew A %A Polasek, Ozren %A Punjabi, Naresh M %A Redline, Susan %A Psaty, Bruce M %A Heath, Andrew C %A Merrow, Martha %A Tranah, Gregory J %A Gottlieb, Daniel J %A Boomsma, Dorret I %A Martin, Nicholas G %A Rudan, Igor %A Tiemeier, Henning %A van IJcken, Wilfred Fj %A Penninx, Brenda W %A Metspalu, Andres %A Meitinger, Thomas %A Franke, Lude %A Roenneberg, Till %A van Duijn, Cornelia M %X

Time to fall asleep (sleep latency) is a major determinant of sleep quality. Chronic, long sleep latency is a major characteristic of sleep-onset insomnia and/or delayed sleep phase syndrome. In this study we aimed to discover common polymorphisms that contribute to the genetics of sleep latency. We performed a meta-analysis of genome-wide association studies (GWAS) including 2 572 737 single nucleotide polymorphisms (SNPs) established in seven European cohorts including 4242 individuals. We found a cluster of three highly correlated variants (rs9900428, rs9907432 and rs7211029) in the RNA-binding protein fox-1 homolog 3 gene (RBFOX3) associated with sleep latency (P-values=5.77 × 10(-08), 6.59 × 10(-)(08) and 9.17 × 10(-)(08)). These SNPs were replicated in up to 12 independent populations including 30 377 individuals (P-values=1.5 × 10(-)(02), 7.0 × 10(-)(03) and 2.5 × 10(-)(03); combined meta-analysis P-values=5.5 × 10(-07), 5.4 × 10(-07) and 1.0 × 10(-07)). A functional prediction of RBFOX3 based on co-expression with other genes shows that this gene is predominantly expressed in brain (P-value=1.4 × 10(-316)) and the central nervous system (P-value=7.5 × 10(-)(321)). The predicted function of RBFOX3 based on co-expression analysis with other genes shows that this gene is significantly involved in the release cycle of neurotransmitters including gamma-aminobutyric acid and various monoamines (P-values<2.9 × 10(-11)) that are crucial in triggering the onset of sleep. To conclude, in this first large-scale GWAS of sleep latency we report a novel association of variants in RBFOX3 gene. Further, a functional prediction of RBFOX3 supports the involvement of RBFOX3 with sleep latency.

%B Eur J Hum Genet %V 24 %P 1488-95 %8 2016 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/27142678?dopt=Abstract %R 10.1038/ejhg.2016.31 %0 Journal Article %J Nat Genet %D 2016 %T {The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals %A Ehret, G. B. %A Ferreira, T. %A Chasman, D. I. %A Jackson, A. U. %A Schmidt, E. M. %A Johnson, T. %A Thorleifsson, G. %A Luan, J. %A Donnelly, L. A. %A Kanoni, S. %A Petersen, A. K. %A Pihur, V. %A Strawbridge, R. J. %A Shungin, D. %A Hughes, M. F. %A Meirelles, O. %A Kaakinen, M. %A Bouatia-Naji, N. %A Kristiansson, K. %A Shah, S. %A Kleber, M. E. %A Guo, X. %A Lyytik?inen, L. P. %A Fava, C. %A Eriksson, N. %A Nolte, I. M. %A Magnusson, P. K. %A Salfati, E. L. %A Rallidis, L. S. %A Theusch, E. %A Smith, A. J. P. %A Folkersen, L. %A Witkowska, K. %A Pers, T. H. %A Joehanes, R. %A Kim, S. K. %A Lataniotis, L. %A Jansen, R. %A Johnson, A. D. %A Warren, H. %A Kim, Y. J. %A Zhao, W. %A Wu, Y. %A Tayo, B. O. %A Bochud, M. %A Absher, D. %A Adair, L. S. %A Amin, N. %A Arking, D. E. %A Axelsson, T. %A Baldassarre, D. %A Balkau, B. %A Bandinelli, S. %A Barnes, M. R. %A Barroso, I. %A Bevan, S. %A Bis, J. C. %A Bjornsdottir, G. %A Boehnke, M. %A Boerwinkle, E. %A Bonnycastle, L. L. %A Boomsma, D. I. %A Bornstein, S. R. %A Brown, M. J. %A Burnier, M. %A Cabrera, C. P. %A Chambers, J. C. %A Chang, I. S. %A Cheng, C. Y. %A Chines, P. S. %A Chung, R. H. %A Collins, F. S. %A Connell, J. M. %A D?ring, A. %A Dallongeville, J. %A Danesh, J. %A de Faire, U. %A Delgado, G. %A Dominiczak, A. F. %A Doney, A. S. F. %A Drenos, F. %A Edkins, S. %A Eicher, J. D. %A Elosua, R. %A Enroth, S. %A Erdmann, J. %A Eriksson, P. %A Esko, T. %A Evangelou, E. %A Evans, A. %A Fall, T. %A Farrall, M. %A Felix, J. F. %A Ferri?res, J. %A Ferrucci, L. %A Fornage, M. %A Forrester, T. %A Franceschini, N. %A Duran, O. H. F. %A Franco-Cereceda, A. %A Fraser, R. M. %A Ganesh, S. K. %A Gao, H. %A Gertow, K. %A Gianfagna, F. %A Gigante, B. %A Giulianini, F. %A Goel, A. %A Goodall, A. H. %A Goodarzi, M. O. %A Gorski, M. %A Gr??ler, J. %A Groves, C. %A Gudnason, V. %A Gyllensten, U. %A Hallmans, G. %A Hartikainen, A. L. %A Hassinen, M. %A Havulinna, A. S. %A Hayward, C. %A Hercberg, S. %A Herzig, K. H. %A Hicks, A. A. %A Hingorani, A. D. %A Hirschhorn, J. N. %A Hofman, A. %A Holmen, J. %A Holmen, O. L. %A Hottenga, J. J. %A Howard, P. %A Hsiung, C. A. %A Hunt, S. C. %A Ikram, M. A. %A Illig, T. %A Iribarren, C. %A Jensen, R. A. %A K?h?nen, M. %A Kang, H. %A Kathiresan, S. %A Keating, B. J. %A Khaw, K. T. %A Kim, Y. K. %A Kim, E. %A Kivimaki, M. %A Klopp, N. %A Kolovou, G. %A Komulainen, P. %A Kooner, J. S. %A Kosova, G. %A Krauss, R. M. %A Kuh, D. %A Kutalik, Z. %A Kuusisto, J. %A Kval?y, K. %A Lakka, T. A. %A Lee, N. R. %A Lee, I. T. %A Lee, W. J. %A Levy, D. %A Li, X. %A Liang, K. W. %A Lin, H. %A Lin, L. %A Lindstr?m, J. %A Lobbens, S. %A M?nnist?, S. %A M?ller, G. %A M?ller-Nurasyid, M. %A Mach, F. %A Markus, H. S. %A Marouli, E. %A McCarthy, M. I. %A McKenzie, C. A. %A Meneton, P. %A Menni, C. %A Metspalu, A. %A Mijatovic, V. %A Moilanen, L. %A Montasser, M. E. %A Morris, A. D. %A Morrison, A. C. %A Mulas, A. %A Nagaraja, R. %A Narisu, N. %A Nikus, K. %A O'Donnell, C. J. %A O'Reilly, P. F. %A Ong, K. K. %A Paccaud, F. %A Palmer, C. D. %A Parsa, A. %A Pedersen, N. L. %A Penninx, B. W. %A Perola, M. %A Peters, A. %A Poulter, N. %A Pramstaller, P. P. %A Psaty, B. M. %A Quertermous, T. %A Rao, D. C. %A Rasheed, A. %A Rayner, N. W. N. W. R. %A Renstr?m, F. %A Rettig, R. %A Rice, K. M. %A Roberts, R. %A Rose, L. M. %A Rossouw, J. %A Samani, N. J. %A Sanna, S. %A Saramies, J. %A Schunkert, H. %A Sebert, S. %A Sheu, W. H. %A Shin, Y. A. %A Sim, X. %A Smit, J. H. %A Smith, A. V. %A Sosa, M. X. %A Spector, T. D. %A Stan??kov?, A. %A Stanton, A. %A Stirrups, K. E. %A Stringham, H. M. %A Sundstrom, J. %A Swift, A. J. %A Syv?nen, A. C. %A Tai, E. S. %A Tanaka, T. %A Tarasov, K. V. %A Teumer, A. %A Thorsteinsdottir, U. %A Tobin, M. D. %A Tremoli, E. %A Uitterlinden, A. G. %A Uusitupa, M. %A Vaez, A. %A Vaidya, D. %A van Duijn, C. M. %A van Iperen, E. P. A. %A Vasan, R. S. %A Verwoert, G. C. %A Virtamo, J. %A Vitart, V. %A Voight, B. F. %A Vollenweider, P. %A Wagner, A. %A Wain, L. V. %A Wareham, N. J. %A Watkins, H. %A Weder, A. B. %A Westra, H. J. %A Wilks, R. %A Wilsgaard, T. %A Wilson, J. F. %A Wong, T. Y. %A Yang, T. P. %A Yao, J. %A Yengo, L. %A Zhang, W. %A Zhao, J. H. %A Zhu, X. %A Bovet, P. %A Cooper, R. S. %A Mohlke, K. L. %A Saleheen, D. %A Lee, J. Y. %A Elliott, P. %A Gierman, H. J. %A Willer, C. J. %A Franke, L. %A Hovingh, G. K. %A Taylor, K. D. %A Dedoussis, G. %A Sever, P. %A Wong, A. %A Lind, L. %A Assimes, T. L. %A Nj?lstad, I. %A Schwarz, P. E. %A Langenberg, C. %A Snieder, H. %A Caulfield, M. J. %A Melander, O. %A Laakso, M. %A Saltevo, J. %A Rauramaa, R. %A Tuomilehto, J. %A Ingelsson, E. %A Lehtim?ki, T. %A Hveem, K. %A Palmas, W. %A M?rz, W. %A Kumari, M. %A Salomaa, V. %A Chen, Y. I. %A Rotter, J. I. %A Froguel, P. %A Jarvelin, M. R. %A Lakatta, E. G. %A Kuulasmaa, K. %A Franks, P. W. %A Hamsten, A. %A Wichmann, H. E. %A Palmer, C. N. A. %A Stefansson, K. %A Ridker, P. M. %A Loos, R. J. F. %A Chakravarti, A. %A Deloukas, P. %A Morris, A. P. %A Newton-Cheh, C. %A Munroe, P. B. %X To dissect the genetic architecture of blood pressure and assess effects on target organ damage, we analyzed 128,272 SNPs from targeted and genome-wide arrays in 201,529 individuals of European ancestry, and genotypes from an additional 140,886 individuals were used for validation. We identified 66 blood pressure-associated loci, of which 17 were new; 15 harbored multiple distinct association signals. The 66 index SNPs were enriched for cis-regulatory elements, particularly in vascular endothelial cells, consistent with a primary role in blood pressure control through modulation of vascular tone across multiple tissues. The 66 index SNPs combined in a risk score showed comparable effects in 64,421 individuals of non-European descent. The 66-SNP blood pressure risk score was significantly associated with target organ damage in multiple tissues but with minor effects in the kidney. Our findings expand current knowledge of blood pressure-related pathways and highlight tissues beyond the classical renal system in blood pressure regulation. %B Nat Genet %V 48 %P 1171–1184 %8 10 %G eng %0 Journal Article %J Stroke %D 2016 %T Genome-Wide Association Analysis of Young-Onset Stroke Identifies a Locus on Chromosome 10q25 Near HABP2. %A Cheng, Yu-Ching %A Stanne, Tara M %A Giese, Anne-Katrin %A Ho, Weang Kee %A Traylor, Matthew %A Amouyel, Philippe %A Holliday, Elizabeth G %A Malik, Rainer %A Xu, Huichun %A Kittner, Steven J %A Cole, John W %A O'Connell, Jeffrey R %A Danesh, John %A Rasheed, Asif %A Zhao, Wei %A Engelter, Stefan %A Grond-Ginsbach, Caspar %A Kamatani, Yoichiro %A Lathrop, Mark %A Leys, Didier %A Thijs, Vincent %A Metso, Tiina M %A Tatlisumak, Turgut %A Pezzini, Alessandro %A Parati, Eugenio A %A Norrving, Bo %A Bevan, Steve %A Rothwell, Peter M %A Sudlow, Cathie %A Slowik, Agnieszka %A Lindgren, Arne %A Walters, Matthew R %A Jannes, Jim %A Shen, Jess %A Crosslin, David %A Doheny, Kimberly %A Laurie, Cathy C %A Kanse, Sandip M %A Bis, Joshua C %A Fornage, Myriam %A Mosley, Thomas H %A Hopewell, Jemma C %A Strauch, Konstantin %A Müller-Nurasyid, Martina %A Gieger, Christian %A Waldenberger, Melanie %A Peters, Annette %A Meisinger, Christine %A Ikram, M Arfan %A Longstreth, W T %A Meschia, James F %A Seshadri, Sudha %A Sharma, Pankaj %A Worrall, Bradford %A Jern, Christina %A Levi, Christopher %A Dichgans, Martin %A Boncoraglio, Giorgio B %A Markus, Hugh S %A Debette, Stephanie %A Rolfs, Arndt %A Saleheen, Danish %A Mitchell, Braxton D %K Adult %K African Continental Ancestry Group %K Age of Onset %K Aged %K Asian Continental Ancestry Group %K Brain Ischemia %K Chromosomes, Human, Pair 10 %K Computer Simulation %K DNA, Intergenic %K European Continental Ancestry Group %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Odds Ratio %K Polymorphism, Single Nucleotide %K Serine Endopeptidases %K Stroke %X

BACKGROUND AND PURPOSE: Although a genetic contribution to ischemic stroke is well recognized, only a handful of stroke loci have been identified by large-scale genetic association studies to date. Hypothesizing that genetic effects might be stronger for early- versus late-onset stroke, we conducted a 2-stage meta-analysis of genome-wide association studies, focusing on stroke cases with an age of onset <60 years.

METHODS: The discovery stage of our genome-wide association studies included 4505 cases and 21 968 controls of European, South-Asian, and African ancestry, drawn from 6 studies. In Stage 2, we selected the lead genetic variants at loci with association P<5×10(-6) and performed in silico association analyses in an independent sample of ≤1003 cases and 7745 controls.

RESULTS: One stroke susceptibility locus at 10q25 reached genome-wide significance in the combined analysis of all samples from the discovery and follow-up stages (rs11196288; odds ratio =1.41; P=9.5×10(-9)). The associated locus is in an intergenic region between TCF7L2 and HABP2. In a further analysis in an independent sample, we found that 2 single nucleotide polymorphisms in high linkage disequilibrium with rs11196288 were significantly associated with total plasma factor VII-activating protease levels, a product of HABP2.

CONCLUSIONS: HABP2, which encodes an extracellular serine protease involved in coagulation, fibrinolysis, and inflammatory pathways, may be a genetic susceptibility locus for early-onset stroke.

%B Stroke %V 47 %P 307-16 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26732560?dopt=Abstract %R 10.1161/STROKEAHA.115.011328 %0 Journal Article %J PLoS One %D 2016 %T Genome-Wide Association Study for Incident Myocardial Infarction and Coronary Heart Disease in Prospective Cohort Studies: The CHARGE Consortium. %A Dehghan, Abbas %A Bis, Joshua C %A White, Charles C %A Smith, Albert Vernon %A Morrison, Alanna C %A Cupples, L Adrienne %A Trompet, Stella %A Chasman, Daniel I %A Lumley, Thomas %A Völker, Uwe %A Buckley, Brendan M %A Ding, Jingzhong %A Jensen, Majken K %A Folsom, Aaron R %A Kritchevsky, Stephen B %A Girman, Cynthia J %A Ford, Ian %A Dörr, Marcus %A Salomaa, Veikko %A Uitterlinden, André G %A Eiriksdottir, Gudny %A Vasan, Ramachandran S %A Franceschini, Nora %A Carty, Cara L %A Virtamo, Jarmo %A Demissie, Serkalem %A Amouyel, Philippe %A Arveiler, Dominique %A Heckbert, Susan R %A Ferrieres, Jean %A Ducimetiere, Pierre %A Smith, Nicholas L %A Wang, Ying A %A Siscovick, David S %A Rice, Kenneth M %A Wiklund, Per-Gunnar %A Taylor, Kent D %A Evans, Alun %A Kee, Frank %A Rotter, Jerome I %A Karvanen, Juha %A Kuulasmaa, Kari %A Heiss, Gerardo %A Kraft, Peter %A Launer, Lenore J %A Hofman, Albert %A Markus, Marcello R P %A Rose, Lynda M %A Silander, Kaisa %A Wagner, Peter %A Benjamin, Emelia J %A Lohman, Kurt %A Stott, David J %A Rivadeneira, Fernando %A Harris, Tamara B %A Levy, Daniel %A Liu, Yongmei %A Rimm, Eric B %A Jukema, J Wouter %A Völzke, Henry %A Ridker, Paul M %A Blankenberg, Stefan %A Franco, Oscar H %A Gudnason, Vilmundur %A Psaty, Bruce M %A Boerwinkle, Eric %A O'Donnell, Christopher J %K Aged %K Cohort Studies %K Cooperative Behavior %K Coronary Artery Disease %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Prospective Studies %X

BACKGROUND: Data are limited on genome-wide association studies (GWAS) for incident coronary heart disease (CHD). Moreover, it is not known whether genetic variants identified to date also associate with risk of CHD in a prospective setting.

METHODS: We performed a two-stage GWAS analysis of incident myocardial infarction (MI) and CHD in a total of 64,297 individuals (including 3898 MI cases, 5465 CHD cases). SNPs that passed an arbitrary threshold of 5×10-6 in Stage I were taken to Stage II for further discovery. Furthermore, in an analysis of prognosis, we studied whether known SNPs from former GWAS were associated with total mortality in individuals who experienced MI during follow-up.

RESULTS: In Stage I 15 loci passed the threshold of 5×10-6; 8 loci for MI and 8 loci for CHD, for which one locus overlapped and none were reported in previous GWAS meta-analyses. We took 60 SNPs representing these 15 loci to Stage II of discovery. Four SNPs near QKI showed nominally significant association with MI (p-value<8.8×10-3) and three exceeded the genome-wide significance threshold when Stage I and Stage II results were combined (top SNP rs6941513: p = 6.2×10-9). Despite excellent power, the 9p21 locus SNP (rs1333049) was only modestly associated with MI (HR = 1.09, p-value = 0.02) and marginally with CHD (HR = 1.06, p-value = 0.08). Among an inception cohort of those who experienced MI during follow-up, the risk allele of rs1333049 was associated with a decreased risk of subsequent mortality (HR = 0.90, p-value = 3.2×10-3).

CONCLUSIONS: QKI represents a novel locus that may serve as a predictor of incident CHD in prospective studies. The association of the 9p21 locus both with increased risk of first myocardial infarction and longer survival after MI highlights the importance of study design in investigating genetic determinants of complex disorders.

%B PLoS One %V 11 %P e0144997 %8 2016 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26950853?dopt=Abstract %R 10.1371/journal.pone.0144997 %0 Journal Article %J Bone Rep %D 2016 %T A genome-wide association study meta-analysis of clinical fracture in 10,012 African American women. %A Taylor, Kira C %A Evans, Daniel S %A Edwards, Digna R Velez %A Edwards, Todd L %A Sofer, Tamar %A Li, Guo %A Liu, Youfang %A Franceschini, Nora %A Jackson, Rebecca D %A Giri, Ayush %A Donneyong, Macarius %A Psaty, Bruce %A Rotter, Jerome I %A LaCroix, Andrea Z %A Jordan, Joanne M %A Robbins, John A %A Lewis, Beth %A Stefanick, Marcia L %A Liu, Yongmei %A Garcia, Melissa %A Harris, Tamara %A Cauley, Jane A %A North, Kari E %X

BACKGROUND: Osteoporosis is a major public health problem associated with excess disability and mortality. It is estimated that 50-70% of the variation in osteoporotic fracture risk is attributable to genetic factors. The purpose of this hypothesis-generating study was to identify possible genetic determinants of fracture among African American (AA) women in a GWAS meta-analysis.

METHODS: Data on clinical fractures (all fractures except fingers, toes, face, skull or sternum) were analyzed among AA female participants in the Women's Health Initiative (WHI) (N = 8155), Cardiovascular Health Study (CHS) (N = 504), BioVU (N = 704), Health ABC (N = 651), and the Johnston County Osteoarthritis Project (JoCoOA) (N = 291). Affymetrix (WHI) and Illumina (Health ABC, JoCoOA, BioVU, CHS) GWAS panels were used for genotyping, and a 1:1 ratio of YRI:CEU HapMap haplotypes was used as an imputation reference panel. We used Cox proportional hazard models or logistic regression to evaluate the association of ~ 2.5 million SNPs with fracture risk, adjusting for ancestry, age, and geographic region where applicable. We conducted a fixed-effects, inverse variance-weighted meta-analysis. Genome-wide significance was set at P < 5 × 10- 8.

RESULTS: One SNP, rs12775980 in an intron of SVIL on chromosome 10p11.2, reached genome-wide significance (P = 4.0 × 10- 8). Although this SNP has a low minor allele frequency (0.03), there was no evidence for heterogeneity of effects across the studies (I2 = 0). This locus was not reported in any previous osteoporosis-related GWA studies. We also interrogated previously reported GWA-significant loci associated with fracture or bone mineral density in our data. One locus (SMOC1) generalized, but overall there was not substantial evidence of generalization. Possible reasons for the lack of generalization are discussed.

CONCLUSION: This GWAS meta-analysis of fractures in African American women identified a potentially novel locus in the supervillin gene, which encodes a platelet-associated factor and was previously associated with platelet thrombus formation in African Americans. If validated in other populations of African descent, these findings suggest potential new mechanisms involved in fracture that may be particularly important among African Americans.

%B Bone Rep %V 5 %P 233-242 %8 2016 Dec %G eng %R 10.1016/j.bonr.2016.08.005 %0 Journal Article %J Diabetes %D 2016 %T Genome-Wide Association Study of the Modified Stumvoll Insulin Sensitivity Index Identifies BCL2 and FAM19A2 as Novel Insulin Sensitivity Loci. %A Walford, Geoffrey A %A Gustafsson, Stefan %A Rybin, Denis %A Stančáková, Alena %A Chen, Han %A Liu, Ching-Ti %A Hong, Jaeyoung %A Jensen, Richard A %A Rice, Ken %A Morris, Andrew P %A Mägi, Reedik %A Tönjes, Anke %A Prokopenko, Inga %A Kleber, Marcus E %A Delgado, Graciela %A Silbernagel, Günther %A Jackson, Anne U %A Appel, Emil V %A Grarup, Niels %A Lewis, Joshua P %A Montasser, May E %A Landenvall, Claes %A Staiger, Harald %A Luan, Jian'an %A Frayling, Timothy M %A Weedon, Michael N %A Xie, Weijia %A Morcillo, Sonsoles %A Martínez-Larrad, María Teresa %A Biggs, Mary L %A Chen, Yii-Der Ida %A Corbaton-Anchuelo, Arturo %A Færch, Kristine %A Gómez-Zumaquero, Juan Miguel %A Goodarzi, Mark O %A Kizer, Jorge R %A Koistinen, Heikki A %A Leong, Aaron %A Lind, Lars %A Lindgren, Cecilia %A Machicao, Fausto %A Manning, Alisa K %A Martín-Núñez, Gracia María %A Rojo-Martínez, Gemma %A Rotter, Jerome I %A Siscovick, David S %A Zmuda, Joseph M %A Zhang, Zhongyang %A Serrano-Ríos, Manuel %A Smith, Ulf %A Soriguer, Federico %A Hansen, Torben %A Jørgensen, Torben J %A Linnenberg, Allan %A Pedersen, Oluf %A Walker, Mark %A Langenberg, Claudia %A Scott, Robert A %A Wareham, Nicholas J %A Fritsche, Andreas %A Häring, Hans-Ulrich %A Stefan, Norbert %A Groop, Leif %A O'Connell, Jeff R %A Boehnke, Michael %A Bergman, Richard N %A Collins, Francis S %A Mohlke, Karen L %A Tuomilehto, Jaakko %A März, Winfried %A Kovacs, Peter %A Stumvoll, Michael %A Psaty, Bruce M %A Kuusisto, Johanna %A Laakso, Markku %A Meigs, James B %A Dupuis, Josée %A Ingelsson, Erik %A Florez, Jose C %X

Genome-wide association studies (GWAS) have found few common variants that influence fasting measures of insulin sensitivity. We hypothesized that a GWAS of an integrated assessment of fasting and dynamic measures of insulin sensitivity would detect novel common variants. We performed a GWAS of the modified Stumvoll Insulin Sensitivity Index (ISI) within the Meta-Analyses of Glucose and Insulin-Related Traits Consortium. Discovery for genetic association was performed in 16,753 individuals, and replication was attempted for the 23 most significant novel loci in 13,354 independent individuals. Association with ISI was tested in models adjusted for age, sex, and BMI and in a model analyzing the combined influence of the genotype effect adjusted for BMI and the interaction effect between the genotype and BMI on ISI (model 3). In model 3, three variants reached genome-wide significance: rs13422522 (NYAP2; P = 8.87 × 10(-11)), rs12454712 (BCL2; P = 2.7 × 10(-8)), and rs10506418 (FAM19A2; P = 1.9 × 10(-8)). The association at NYAP2 was eliminated by conditioning on the known IRS1 insulin sensitivity locus; the BCL2 and FAM19A2 associations were independent of known cardiometabolic loci. In conclusion, we identified two novel loci and replicated known variants associated with insulin sensitivity. Further studies are needed to clarify the causal variant and function at the BCL2 and FAM19A2 loci.

%B Diabetes %V 65 %P 3200-11 %8 2016 Oct %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/27416945?dopt=Abstract %R 10.2337/db16-0199 %0 Journal Article %J Aging Cell %D 2016 %T Genomewide meta-analysis identifies loci associated with IGF-I and IGFBP-3 levels with impact on age-related traits. %A Teumer, Alexander %A Qi, Qibin %A Nethander, Maria %A Aschard, Hugues %A Bandinelli, Stefania %A Beekman, Marian %A Berndt, Sonja I %A Bidlingmaier, Martin %A Broer, Linda %A Cappola, Anne %A Ceda, Gian Paolo %A Chanock, Stephen %A Chen, Ming-Huei %A Chen, Tai C %A Chen, Yii-Der Ida %A Chung, Jonathan %A Del Greco Miglianico, Fabiola %A Eriksson, Joel %A Ferrucci, Luigi %A Friedrich, Nele %A Gnewuch, Carsten %A Goodarzi, Mark O %A Grarup, Niels %A Guo, Tingwei %A Hammer, Elke %A Hayes, Richard B %A Hicks, Andrew A %A Hofman, Albert %A Houwing-Duistermaat, Jeanine J %A Hu, Frank %A Hunter, David J %A Husemoen, Lise L %A Isaacs, Aaron %A Jacobs, Kevin B %A Janssen, Joop A M J L %A Jansson, John-Olov %A Jehmlich, Nico %A Johnson, Simon %A Juul, Anders %A Karlsson, Magnus %A Kilpeläinen, Tuomas O %A Kovacs, Peter %A Kraft, Peter %A Li, Chao %A Linneberg, Allan %A Liu, Yongmei %A Loos, Ruth J F %A Lorentzon, Mattias %A Lu, Yingchang %A Maggio, Marcello %A Mägi, Reedik %A Meigs, James %A Mellström, Dan %A Nauck, Matthias %A Newman, Anne B %A Pollak, Michael N %A Pramstaller, Peter P %A Prokopenko, Inga %A Psaty, Bruce M %A Reincke, Martin %A Rimm, Eric B %A Rotter, Jerome I %A Saint Pierre, Aude %A Schurmann, Claudia %A Seshadri, Sudha %A Sjögren, Klara %A Slagboom, P Eline %A Strickler, Howard D %A Stumvoll, Michael %A Suh, Yousin %A Sun, Qi %A Zhang, Cuilin %A Svensson, Johan %A Tanaka, Toshiko %A Tare, Archana %A Tönjes, Anke %A Uh, Hae-Won %A van Duijn, Cornelia M %A van Heemst, Diana %A Vandenput, Liesbeth %A Vasan, Ramachandran S %A Völker, Uwe %A Willems, Sara M %A Ohlsson, Claes %A Wallaschofski, Henri %A Kaplan, Robert C %X

The growth hormone/insulin-like growth factor (IGF) axis can be manipulated in animal models to promote longevity, and IGF-related proteins including IGF-I and IGF-binding protein-3 (IGFBP-3) have also been implicated in risk of human diseases including cardiovascular diseases, diabetes, and cancer. Through genomewide association study of up to 30 884 adults of European ancestry from 21 studies, we confirmed and extended the list of previously identified loci associated with circulating IGF-I and IGFBP-3 concentrations (IGF1, IGFBP3, GCKR, TNS3, GHSR, FOXO3, ASXL2, NUBP2/IGFALS, SORCS2, and CELSR2). Significant sex interactions, which were characterized by different genotype-phenotype associations between men and women, were found only for associations of IGFBP-3 concentrations with SNPs at the loci IGFBP3 and SORCS2. Analyses of SNPs, gene expression, and protein levels suggested that interplay between IGFBP3 and genes within the NUBP2 locus (IGFALS and HAGH) may affect circulating IGF-I and IGFBP-3 concentrations. The IGF-I-decreasing allele of SNP rs934073, which is an eQTL of ASXL2, was associated with lower adiposity and higher likelihood of survival beyond 90 years. The known longevity-associated variant rs2153960 (FOXO3) was observed to be a genomewide significant SNP for IGF-I concentrations. Bioinformatics analysis suggested enrichment of putative regulatory elements among these IGF-I- and IGFBP-3-associated loci, particularly of rs646776 at CELSR2. In conclusion, this study identified several loci associated with circulating IGF-I and IGFBP-3 concentrations and provides clues to the potential role of the IGF axis in mediating effects of known (FOXO3) and novel (ASXL2) longevity-associated loci.

%B Aging Cell %V 15 %P 811-24 %8 2016 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27329260?dopt=Abstract %R 10.1111/acel.12490 %0 Journal Article %J Aging Cell %D 2016 %T GWAS analysis of handgrip and lower body strength in older adults in the CHARGE consortium. %A Matteini, Amy M %A Tanaka, Toshiko %A Karasik, David %A Atzmon, Gil %A Chou, Wen-Chi %A Eicher, John D %A Johnson, Andrew D %A Arnold, Alice M %A Callisaya, Michele L %A Davies, Gail %A Evans, Daniel S %A Holtfreter, Birte %A Lohman, Kurt %A Lunetta, Kathryn L %A Mangino, Massimo %A Smith, Albert V %A Smith, Jennifer A %A Teumer, Alexander %A Yu, Lei %A Arking, Dan E %A Buchman, Aron S %A Chibinik, Lori B %A De Jager, Philip L %A Evans, Denis A %A Faul, Jessica D %A Garcia, Melissa E %A Gillham-Nasenya, Irina %A Gudnason, Vilmundur %A Hofman, Albert %A Hsu, Yi-Hsiang %A Ittermann, Till %A Lahousse, Lies %A Liewald, David C %A Liu, Yongmei %A Lopez, Lorna %A Rivadeneira, Fernando %A Rotter, Jerome I %A Siggeirsdottir, Kristin %A Starr, John M %A Thomson, Russell %A Tranah, Gregory J %A Uitterlinden, André G %A Völker, Uwe %A Völzke, Henry %A Weir, David R %A Yaffe, Kristine %A Zhao, Wei %A Zhuang, Wei Vivian %A Zmuda, Joseph M %A Bennett, David A %A Cummings, Steven R %A Deary, Ian J %A Ferrucci, Luigi %A Harris, Tamara B %A Kardia, Sharon L R %A Kocher, Thomas %A Kritchevsky, Stephen B %A Psaty, Bruce M %A Seshadri, Sudha %A Spector, Timothy D %A Srikanth, Velandai K %A Windham, B Gwen %A Zillikens, M Carola %A Newman, Anne B %A Walston, Jeremy D %A Kiel, Douglas P %A Murabito, Joanne M %X

Decline in muscle strength with aging is an important predictor of health trajectory in the elderly. Several factors, including genetics, are proposed contributors to variability in muscle strength. To identify genetic contributors to muscle strength, a meta-analysis of genomewide association studies of handgrip was conducted. Grip strength was measured using a handheld dynamometer in 27 581 individuals of European descent over 65 years of age from 14 cohort studies. Genomewide association analysis was conducted on ~2.7 million imputed and genotyped variants (SNPs). Replication of the most significant findings was conducted using data from 6393 individuals from three cohorts. GWAS of lower body strength was also characterized in a subset of cohorts. Two genomewide significant (P-value< 5 × 10(-8) ) and 39 suggestive (P-value< 5 × 10(-5) ) associations were observed from meta-analysis of the discovery cohorts. After meta-analysis with replication cohorts, genomewide significant association was observed for rs752045 on chromosome 8 (β = 0.47, SE = 0.08, P-value = 5.20 × 10(-10) ). This SNP is mapped to an intergenic region and is located within an accessible chromatin region (DNase hypersensitivity site) in skeletal muscle myotubes differentiated from the human skeletal muscle myoblasts cell line. This locus alters a binding motif of the CCAAT/enhancer-binding protein-β (CEBPB) that is implicated in muscle repair mechanisms. GWAS of lower body strength did not yield significant results. A common genetic variant in a chromosomal region that regulates myotube differentiation and muscle repair may contribute to variability in grip strength in the elderly. Further studies are needed to uncover the mechanisms that link this genetic variant with muscle strength.

%B Aging Cell %V 15 %P 792-800 %8 2016 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27325353?dopt=Abstract %R 10.1111/acel.12468 %0 Journal Article %J Mol Psychiatry %D 2016 %T GWAS for executive function and processing speed suggests involvement of the CADM2 gene. %A Ibrahim-Verbaas, C A %A Bressler, J %A Debette, S %A Schuur, M %A Smith, A V %A Bis, J C %A Davies, G %A Trompet, S %A Smith, J A %A Wolf, C %A Chibnik, L B %A Liu, Y %A Vitart, V %A Kirin, M %A Petrovic, K %A Polasek, O %A Zgaga, L %A Fawns-Ritchie, C %A Hoffmann, P %A Karjalainen, J %A Lahti, J %A Llewellyn, D J %A Schmidt, C O %A Mather, K A %A Chouraki, V %A Sun, Q %A Resnick, S M %A Rose, L M %A Oldmeadow, C %A Stewart, M %A Smith, B H %A Gudnason, V %A Yang, Q %A Mirza, S S %A Jukema, J W %A deJager, P L %A Harris, T B %A Liewald, D C %A Amin, N %A Coker, L H %A Stegle, O %A Lopez, O L %A Schmidt, R %A Teumer, A %A Ford, I %A Karbalai, N %A Becker, J T %A Jonsdottir, M K %A Au, R %A Fehrmann, R S N %A Herms, S %A Nalls, M %A Zhao, W %A Turner, S T %A Yaffe, K %A Lohman, K %A van Swieten, J C %A Kardia, S L R %A Knopman, D S %A Meeks, W M %A Heiss, G %A Holliday, E G %A Schofield, P W %A Tanaka, T %A Stott, D J %A Wang, J %A Ridker, P %A Gow, A J %A Pattie, A %A Starr, J M %A Hocking, L J %A Armstrong, N J %A McLachlan, S %A Shulman, J M %A Pilling, L C %A Eiriksdottir, G %A Scott, R J %A Kochan, N A %A Palotie, A %A Hsieh, Y-C %A Eriksson, J G %A Penman, A %A Gottesman, R F %A Oostra, B A %A Yu, L %A DeStefano, A L %A Beiser, A %A Garcia, M %A Rotter, J I %A Nöthen, M M %A Hofman, A %A Slagboom, P E %A Westendorp, R G J %A Buckley, B M %A Wolf, P A %A Uitterlinden, A G %A Psaty, B M %A Grabe, H J %A Bandinelli, S %A Chasman, D I %A Grodstein, F %A Räikkönen, K %A Lambert, J-C %A Porteous, D J %A Price, J F %A Sachdev, P S %A Ferrucci, L %A Attia, J R %A Rudan, I %A Hayward, C %A Wright, A F %A Wilson, J F %A Cichon, S %A Franke, L %A Schmidt, H %A Ding, J %A de Craen, A J M %A Fornage, M %A Bennett, D A %A Deary, I J %A Ikram, M A %A Launer, L J %A Fitzpatrick, A L %A Seshadri, S %A van Duijn, C M %A Mosley, T H %X

To identify common variants contributing to normal variation in two specific domains of cognitive functioning, we conducted a genome-wide association study (GWAS) of executive functioning and information processing speed in non-demented older adults from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) consortium. Neuropsychological testing was available for 5429-32,070 subjects of European ancestry aged 45 years or older, free of dementia and clinical stroke at the time of cognitive testing from 20 cohorts in the discovery phase. We analyzed performance on the Trail Making Test parts A and B, the Letter Digit Substitution Test (LDST), the Digit Symbol Substitution Task (DSST), semantic and phonemic fluency tests, and the Stroop Color and Word Test. Replication was sought in 1311-21860 subjects from 20 independent cohorts. A significant association was observed in the discovery cohorts for the single-nucleotide polymorphism (SNP) rs17518584 (discovery P-value=3.12 × 10(-8)) and in the joint discovery and replication meta-analysis (P-value=3.28 × 10(-9) after adjustment for age, gender and education) in an intron of the gene cell adhesion molecule 2 (CADM2) for performance on the LDST/DSST. Rs17518584 is located about 170 kb upstream of the transcription start site of the major transcript for the CADM2 gene, but is within an intron of a variant transcript that includes an alternative first exon. The variant is associated with expression of CADM2 in the cingulate cortex (P-value=4 × 10(-4)). The protein encoded by CADM2 is involved in glutamate signaling (P-value=7.22 × 10(-15)), gamma-aminobutyric acid (GABA) transport (P-value=1.36 × 10(-11)) and neuron cell-cell adhesion (P-value=1.48 × 10(-13)). Our findings suggest that genetic variation in the CADM2 gene is associated with individual differences in information processing speed.

%B Mol Psychiatry %V 21 %P 189-97 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25869804?dopt=Abstract %R 10.1038/mp.2015.37 %0 Journal Article %J Eur J Prev Cardiol %D 2016 %T Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration. %A Willeit, Peter %A Thompson, Simon G %A Agewall, Stefan %A Bergström, Göran %A Bickel, Horst %A Catapano, Alberico L %A Chien, Kuo-Liong %A de Groot, Eric %A Empana, Jean-Philippe %A Etgen, Thorleif %A Franco, Oscar H %A Iglseder, Bernhard %A Johnsen, Stein H %A Kavousi, Maryam %A Lind, Lars %A Liu, Jing %A Mathiesen, Ellisiv B %A Norata, Giuseppe D %A Olsen, Michael H %A Papagianni, Aikaterini %A Poppert, Holger %A Price, Jackie F %A Sacco, Ralph L %A Yanez, David N %A Zhao, Dong %A Schminke, Ulf %A Bülbül, Alpaslan %A Polak, Joseph F %A Sitzer, Matthias %A Hofman, Albert %A Grigore, Liliana %A Dörr, Marcus %A Su, Ta-Chen %A Ducimetiere, Pierre %A Xie, Wuxiang %A Ronkainen, Kimmo %A Kiechl, Stefan %A Rundek, Tatjana %A Robertson, Christine %A Fagerberg, Björn %A Bokemark, Lena %A Steinmetz, Helmuth %A Ikram, M Arfan %A Völzke, Henry %A Lin, Hung-Ju %A Plichart, Matthieu %A Tuomainen, Tomi-Pekka %A Desvarieux, Moïse %A McLachlan, Stela %A Schmidt, Caroline %A Kauhanen, Jussi %A Willeit, Johann %A Lorenz, Matthias W %A Sander, Dirk %X

BACKGROUND: Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population.

METHODS: Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses.

RESULTS: Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p < 0.001); 0.0072 mm for fibrinogen (p < 0.001); and 0.0025 mm for leucocyte count (p = 0.033). 'Inflammatory load', defined as the number of elevated inflammatory markers (i.e. in upper two quintiles), showed a positive linear association with baseline CCA-IMT (p < 0.001). Longitudinal associations of baseline inflammatory markers and changes therein with CCA-IMT progression were null or at most weak. Participants with the highest 'inflammatory load' had a greater CCA-IMT progression (p = 0.015).

CONCLUSION: Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.

%B Eur J Prev Cardiol %V 23 %P 194-205 %8 2016 Jan %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25416041?dopt=Abstract %R 10.1177/2047487314560664 %0 Journal Article %J J Clin Endocrinol Metab %D 2016 %T Insulinlike growth factor binding protein-1 and ghrelin predict health outcomes among older adults: CHS cohort. %A Kaplan, Robert C %A Strizich, Garrett %A Aneke-Nash, Chino %A Dominguez-Islas, Clara %A Bůzková, Petra %A Strickler, Howard %A Rohan, Thomas %A Pollak, Michael %A Kuller, Lewis %A Kizer, Jorge R %A Cappola, Anne %A Li, Christopher I %A Psaty, Bruce M %A Newman, Anne %X

CONTEXT: Multiple diseases may explain the association of the growth hormone / insulinlike growth factor-I (GH/IGF-I) axis with longevity.

OBJECTIVE: To relate circulating GH/IGF-I system protein levels with major health events.

DESIGN: Cohort study Setting: Four US communities Participants: Adults (n=2268) 65 years and older free of diabetes and cardiovascular disease.

MEASUREMENTS: We assessed insulinlike growth factor binding protein-1 (IGFBP-1) and ghrelin in fasting and 2-hour oral glucose tolerance test (OGTT) blood samples, as well as fasting IGF-I and IGFBP-3. Hazard ratios for mortality and a composite outcome for first incident myocardial infarction, stroke, heart failure, hip fracture, or death were adjusted for sociodemographic, behavioral, and physiologic covariates.

RESULTS: During 13,930 person-years of follow-up, 48.1% individuals sustained one or more components of the composite outcome and 31.8% died. Versus the lowest quartiles, the highest quartiles of fasting and 2-h ghrelin were associated with a 27% higher (95% CI: 6%, 53%) and 39% higher (95% CI: 14%, 71%) risks of the composite outcome, respectively. The highest quartile of 2-h IGFBP-1 was associated with 35% higher (95% CI: 1%, 52%) risk of the composite endpoint. Similarly, higher mortality was significantly associated with higher fasting and 2-h ghrelin level, and with 2-h IGFBP-1 level. When examined together, 2-h post-OGTT levels of IGFBP-1 and ghrelin tended to predict outcomes better than fasting levels.

CONCLUSIONS: Circulating IGFBP-1 and ghrelin measured during an OGTT predict major health events and death in older adults, which may explain the influence of the GH-IGF-axis on lifespan and health.

%B J Clin Endocrinol Metab %P jc20162779 %8 2016 Nov 07 %G eng %R 10.1210/jc.2016-2779 %0 Journal Article %J Am J Clin Nutr %D 2016 %T Interaction of methylation-related genetic variants with circulating fatty acids on plasma lipids: a meta-analysis of 7 studies and methylation analysis of 3 studies in the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium. %A Ma, Yiyi %A Follis, Jack L %A Smith, Caren E %A Tanaka, Toshiko %A Manichaikul, Ani W %A Chu, Audrey Y %A Samieri, Cecilia %A Zhou, Xia %A Guan, Weihua %A Wang, Lu %A Biggs, Mary L %A Chen, Yii-der I %A Hernandez, Dena G %A Borecki, Ingrid %A Chasman, Daniel I %A Rich, Stephen S %A Ferrucci, Luigi %A Irvin, Marguerite Ryan %A Aslibekyan, Stella %A Zhi, Degui %A Tiwari, Hemant K %A Claas, Steven A %A Sha, Jin %A Kabagambe, Edmond K %A Lai, Chao-Qiang %A Parnell, Laurence D %A Lee, Yu-Chi %A Amouyel, Philippe %A Lambert, Jean-Charles %A Psaty, Bruce M %A King, Irena B %A Mozaffarian, Dariush %A McKnight, Barbara %A Bandinelli, Stefania %A Tsai, Michael Y %A Ridker, Paul M %A Ding, Jingzhong %A Mstat, Kurt Lohmant %A Liu, Yongmei %A Sotoodehnia, Nona %A Barberger-Gateau, Pascale %A Steffen, Lyn M %A Siscovick, David S %A Absher, Devin %A Arnett, Donna K %A Ordovas, Jose M %A Lemaitre, Rozenn N %K Apolipoproteins E %K ATP Binding Cassette Transporter 1 %K Cholesterol, HDL %K Cohort Studies %K Diet %K DNA Methylation %K Eicosapentaenoic Acid %K Epigenesis, Genetic %K Fatty Acids %K Gene Expression Regulation %K Humans %K Lipids %K Polymorphism, Single Nucleotide %K Promoter Regions, Genetic %K Triglycerides %X

BACKGROUND: DNA methylation is influenced by diet and single nucleotide polymorphisms (SNPs), and methylation modulates gene expression.

OBJECTIVE: We aimed to explore whether the gene-by-diet interactions on blood lipids act through DNA methylation.

DESIGN: We selected 7 SNPs on the basis of predicted relations in fatty acids, methylation, and lipids. We conducted a meta-analysis and a methylation and mediation analysis with the use of data from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) consortium and the ENCODE (Encyclopedia of DNA Elements) consortium.

RESULTS: On the basis of the meta-analysis of 7 cohorts in the CHARGE consortium, higher plasma HDL cholesterol was associated with fewer C alleles at ATP-binding cassette subfamily A member 1 (ABCA1) rs2246293 (β = -0.6 mg/dL, P = 0.015) and higher circulating eicosapentaenoic acid (EPA) (β = 3.87 mg/dL, P = 5.62 × 10(21)). The difference in HDL cholesterol associated with higher circulating EPA was dependent on genotypes at rs2246293, and it was greater for each additional C allele (β = 1.69 mg/dL, P = 0.006). In the GOLDN (Genetics of Lipid Lowering Drugs and Diet Network) study, higher ABCA1 promoter cg14019050 methylation was associated with more C alleles at rs2246293 (β = 8.84%, P = 3.51 × 10(18)) and lower circulating EPA (β = -1.46%, P = 0.009), and the mean difference in methylation of cg14019050 that was associated with higher EPA was smaller with each additional C allele of rs2246293 (β = -2.83%, P = 0.007). Higher ABCA1 cg14019050 methylation was correlated with lower ABCA1 expression (r = -0.61, P = 0.009) in the ENCODE consortium and lower plasma HDL cholesterol in the GOLDN study (r = -0.12, P = 0.0002). An additional mediation analysis was meta-analyzed across the GOLDN study, Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis. Compared with the model without the adjustment of cg14019050 methylation, the model with such adjustment provided smaller estimates of the mean plasma HDL cholesterol concentration in association with both the rs2246293 C allele and EPA and a smaller difference by rs2246293 genotypes in the EPA-associated HDL cholesterol. However, the differences between 2 nested models were NS (P > 0.05).

CONCLUSION: We obtained little evidence that the gene-by-fatty acid interactions on blood lipids act through DNA methylation.

%B Am J Clin Nutr %V 103 %P 567-78 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26791180?dopt=Abstract %R 10.3945/ajcn.115.112987 %0 Journal Article %J Proc Natl Acad Sci U S A %D 2016 %T KLB is associated with alcohol drinking, and its gene product β-Klotho is necessary for FGF21 regulation of alcohol preference. %A Schumann, Gunter %A Liu, Chunyu %A O'Reilly, Paul %A Gao, He %A Song, Parkyong %A Xu, Bing %A Ruggeri, Barbara %A Amin, Najaf %A Jia, Tianye %A Preis, Sarah %A Segura Lepe, Marcelo %A Akira, Shizuo %A Barbieri, Caterina %A Baumeister, Sebastian %A Cauchi, Stephane %A Clarke, Toni-Kim %A Enroth, Stefan %A Fischer, Krista %A Hällfors, Jenni %A Harris, Sarah E %A Hieber, Saskia %A Hofer, Edith %A Hottenga, Jouke-Jan %A Johansson, Asa %A Joshi, Peter K %A Kaartinen, Niina %A Laitinen, Jaana %A Lemaitre, Rozenn %A Loukola, Anu %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Mangino, Massimo %A Manichaikul, Ani %A Mbarek, Hamdi %A Milaneschi, Yuri %A Moayyeri, Alireza %A Mukamal, Kenneth %A Nelson, Christopher %A Nettleton, Jennifer %A Partinen, Eemil %A Rawal, Rajesh %A Robino, Antonietta %A Rose, Lynda %A Sala, Cinzia %A Satoh, Takashi %A Schmidt, Reinhold %A Schraut, Katharina %A Scott, Robert %A Smith, Albert Vernon %A Starr, John M %A Teumer, Alexander %A Trompet, Stella %A Uitterlinden, André G %A Venturini, Cristina %A Vergnaud, Anne-Claire %A Verweij, Niek %A Vitart, Veronique %A Vuckovic, Dragana %A Wedenoja, Juho %A Yengo, Loic %A Yu, Bing %A Zhang, Weihua %A Zhao, Jing Hua %A Boomsma, Dorret I %A Chambers, John %A Chasman, Daniel I %A Daniela, Toniolo %A de Geus, Eco %A Deary, Ian %A Eriksson, Johan G %A Esko, Tõnu %A Eulenburg, Volker %A Franco, Oscar H %A Froguel, Philippe %A Gieger, Christian %A Grabe, Hans J %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Harris, Tamara B %A Hartikainen, Anna-Liisa %A Heath, Andrew C %A Hocking, Lynne %A Hofman, Albert %A Huth, Cornelia %A Jarvelin, Marjo-Riitta %A Jukema, J Wouter %A Kaprio, Jaakko %A Kooner, Jaspal S %A Kutalik, Zoltán %A Lahti, Jari %A Langenberg, Claudia %A Lehtimäki, Terho %A Liu, Yongmei %A Madden, Pamela A F %A Martin, Nicholas %A Morrison, Alanna %A Penninx, Brenda %A Pirastu, Nicola %A Psaty, Bruce %A Raitakari, Olli %A Ridker, Paul %A Rose, Richard %A Rotter, Jerome I %A Samani, Nilesh J %A Schmidt, Helena %A Spector, Tim D %A Stott, David %A Strachan, David %A Tzoulaki, Ioanna %A van der Harst, Pim %A van Duijn, Cornelia M %A Marques-Vidal, Pedro %A Vollenweider, Peter %A Wareham, Nicholas J %A Whitfield, John B %A Wilson, James %A Wolffenbuttel, Bruce %A Bakalkin, Georgy %A Evangelou, Evangelos %A Liu, Yun %A Rice, Kenneth M %A Desrivières, Sylvane %A Kliewer, Steven A %A Mangelsdorf, David J %A Müller, Christian P %A Levy, Daniel %A Elliott, Paul %X

Excessive alcohol consumption is a major public health problem worldwide. Although drinking habits are known to be inherited, few genes have been identified that are robustly linked to alcohol drinking. We conducted a genome-wide association metaanalysis and replication study among >105,000 individuals of European ancestry and identified β-Klotho (KLB) as a locus associated with alcohol consumption (rs11940694; P = 9.2 × 10(-12)). β-Klotho is an obligate coreceptor for the hormone FGF21, which is secreted from the liver and implicated in macronutrient preference in humans. We show that brain-specific β-Klotho KO mice have an increased alcohol preference and that FGF21 inhibits alcohol drinking by acting on the brain. These data suggest that a liver-brain endocrine axis may play an important role in the regulation of alcohol drinking behavior and provide a unique pharmacologic target for reducing alcohol consumption.

%B Proc Natl Acad Sci U S A %V 113 %P 14372-14377 %8 2016 Dec 13 %G eng %N 50 %R 10.1073/pnas.1611243113 %0 Journal Article %J Am J Hum Genet %D 2016 %T Large-Scale Exome-wide Association Analysis Identifies Loci for White Blood Cell Traits and Pleiotropy with Immune-Mediated Diseases. %A Tajuddin, Salman M %A Schick, Ursula M %A Eicher, John D %A Chami, Nathalie %A Giri, Ayush %A Brody, Jennifer A %A Hill, W David %A Kacprowski, Tim %A Li, Jin %A Lyytikäinen, Leo-Pekka %A Manichaikul, Ani %A Mihailov, Evelin %A O'Donoghue, Michelle L %A Pankratz, Nathan %A Pazoki, Raha %A Polfus, Linda M %A Smith, Albert Vernon %A Schurmann, Claudia %A Vacchi-Suzzi, Caterina %A Waterworth, Dawn M %A Evangelou, Evangelos %A Yanek, Lisa R %A Burt, Amber %A Chen, Ming-Huei %A van Rooij, Frank J A %A Floyd, James S %A Greinacher, Andreas %A Harris, Tamara B %A Highland, Heather M %A Lange, Leslie A %A Liu, Yongmei %A Mägi, Reedik %A Nalls, Mike A %A Mathias, Rasika A %A Nickerson, Deborah A %A Nikus, Kjell %A Starr, John M %A Tardif, Jean-Claude %A Tzoulaki, Ioanna %A Velez Edwards, Digna R %A Wallentin, Lars %A Bartz, Traci M %A Becker, Lewis C %A Denny, Joshua C %A Raffield, Laura M %A Rioux, John D %A Friedrich, Nele %A Fornage, Myriam %A Gao, He %A Hirschhorn, Joel N %A Liewald, David C M %A Rich, Stephen S %A Uitterlinden, Andre %A Bastarache, Lisa %A Becker, Diane M %A Boerwinkle, Eric %A de Denus, Simon %A Bottinger, Erwin P %A Hayward, Caroline %A Hofman, Albert %A Homuth, Georg %A Lange, Ethan %A Launer, Lenore J %A Lehtimäki, Terho %A Lu, Yingchang %A Metspalu, Andres %A O'Donnell, Chris J %A Quarells, Rakale C %A Richard, Melissa %A Torstenson, Eric S %A Taylor, Kent D %A Vergnaud, Anne-Claire %A Zonderman, Alan B %A Crosslin, David R %A Deary, Ian J %A Dörr, Marcus %A Elliott, Paul %A Evans, Michele K %A Gudnason, Vilmundur %A Kähönen, Mika %A Psaty, Bruce M %A Rotter, Jerome I %A Slater, Andrew J %A Dehghan, Abbas %A White, Harvey D %A Ganesh, Santhi K %A Loos, Ruth J F %A Esko, Tõnu %A Faraday, Nauder %A Wilson, James G %A Cushman, Mary %A Johnson, Andrew D %A Edwards, Todd L %A Zakai, Neil A %A Lettre, Guillaume %A Reiner, Alex P %A Auer, Paul L %X

White blood cells play diverse roles in innate and adaptive immunity. Genetic association analyses of phenotypic variation in circulating white blood cell (WBC) counts from large samples of otherwise healthy individuals can provide insights into genes and biologic pathways involved in production, differentiation, or clearance of particular WBC lineages (myeloid, lymphoid) and also potentially inform the genetic basis of autoimmune, allergic, and blood diseases. We performed an exome array-based meta-analysis of total WBC and subtype counts (neutrophils, monocytes, lymphocytes, basophils, and eosinophils) in a multi-ancestry discovery and replication sample of ∼157,622 individuals from 25 studies. We identified 16 common variants (8 of which were coding variants) associated with one or more WBC traits, the majority of which are pleiotropically associated with autoimmune diseases. Based on functional annotation, these loci included genes encoding surface markers of myeloid, lymphoid, or hematopoietic stem cell differentiation (CD69, CD33, CD87), transcription factors regulating lineage specification during hematopoiesis (ASXL1, IRF8, IKZF1, JMJD1C, ETS2-PSMG1), and molecules involved in neutrophil clearance/apoptosis (C10orf54, LTA), adhesion (TNXB), or centrosome and microtubule structure/function (KIF9, TUBD1). Together with recent reports of somatic ASXL1 mutations among individuals with idiopathic cytopenias or clonal hematopoiesis of undetermined significance, the identification of a common regulatory 3' UTR variant of ASXL1 suggests that both germline and somatic ASXL1 mutations contribute to lower blood counts in otherwise asymptomatic individuals. These association results shed light on genetic mechanisms that regulate circulating WBC counts and suggest a prominent shared genetic architecture with inflammatory and autoimmune diseases.

%B Am J Hum Genet %V 99 %P 22-39 %8 2016 Jul 7 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27346689?dopt=Abstract %R 10.1016/j.ajhg.2016.05.003 %0 Journal Article %J Pharmacogenomics J %D 2016 %T Large-scale pharmacogenomic study of sulfonylureas and the QT, JT and QRS intervals: CHARGE Pharmacogenomics Working Group. %A Floyd, J S %A Sitlani, C M %A Avery, C L %A Noordam, R %A Li, X %A Smith, A V %A Gogarten, S M %A Li, J %A Broer, L %A Evans, D S %A Trompet, S %A Brody, J A %A Stewart, J D %A Eicher, J D %A Seyerle, A A %A Roach, J %A Lange, L A %A Lin, H J %A Kors, J A %A Harris, T B %A Li-Gao, R %A Sattar, N %A Cummings, S R %A Wiggins, K L %A Napier, M D %A Stürmer, T %A Bis, J C %A Kerr, K F %A Uitterlinden, A G %A Taylor, K D %A Stott, D J %A de Mutsert, R %A Launer, L J %A Busch, E L %A Méndez-Giráldez, R %A Sotoodehnia, N %A Soliman, E Z %A Li, Y %A Duan, Q %A Rosendaal, F R %A Slagboom, P E %A Wilhelmsen, K C %A Reiner, A P %A Chen, Y-DI %A Heckbert, S R %A Kaplan, R C %A Rice, K M %A Jukema, J W %A Johnson, A D %A Liu, Y %A Mook-Kanamori, D O %A Gudnason, V %A Wilson, J G %A Rotter, J I %A Laurie, C C %A Psaty, B M %A Whitsel, E A %A Cupples, L A %A Stricker, B H %X

Sulfonylureas, a commonly used class of medication used to treat type 2 diabetes, have been associated with an increased risk of cardiovascular disease. Their effects on QT interval duration and related electrocardiographic phenotypes are potential mechanisms for this adverse effect. In 11 ethnically diverse cohorts that included 71 857 European, African-American and Hispanic/Latino ancestry individuals with repeated measures of medication use and electrocardiogram (ECG) measurements, we conducted a pharmacogenomic genome-wide association study of sulfonylurea use and three ECG phenotypes: QT, JT and QRS intervals. In ancestry-specific meta-analyses, eight novel pharmacogenomic loci met the threshold for genome-wide significance (P<5 × 10(-8)), and a pharmacokinetic variant in CYP2C9 (rs1057910) that has been associated with sulfonylurea-related treatment effects and other adverse drug reactions in previous studies was replicated. Additional research is needed to replicate the novel findings and to understand their biological basis.The Pharmacogenomics Journal advance online publication, 13 December 2016; doi:10.1038/tpj.2016.90.

%B Pharmacogenomics J %8 2016 Dec 13 %G eng %R 10.1038/tpj.2016.90 %0 Journal Article %J Am J Med %D 2016 %T Lifetime Risk of Venous Thromboembolism in Two Cohort Studies. %A Bell, Elizabeth J %A Lutsey, Pamela L %A Basu, Saonli %A Cushman, Mary %A Heckbert, Susan R %A Lloyd-Jones, Donald M %A Folsom, Aaron R %K African Continental Ancestry Group %K Aged %K Anemia, Sickle Cell %K Cohort Studies %K Factor V %K Follow-Up Studies %K Heterozygote %K Humans %K Kaplan-Meier Estimate %K Middle Aged %K Obesity %K Risk %K Sickle Cell Trait %K United States %K Venous Thromboembolism %X

BACKGROUND: Greater public awareness of venous thromboembolism may be an important next step for optimizing venous thromboembolism prevention and treatment. "Lifetime risk" is an easily interpretable way of presenting risk information. Therefore, we sought to calculate the lifetime risk of venous thromboembolism (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: We followed participants aged 45-64 years in ARIC (n = 14,185) and ≥65 in CHS (n = 5414) at baseline visits (1987-1989 in ARIC, 1989-1990 and 1992-1993 in CHS) for incident venous thromboembolism (n = 728 in ARIC through 2011 and n = 172 in CHS through 2001). We estimated lifetime risks and 95% confidence intervals of incident venous thromboembolism using a modified Kaplan-Meier method, accounting for the competing risk of death from other causes.

RESULTS: At age 45 years, the remaining lifetime risk of venous thromboembolism in ARIC was 8.1% (95% confidence interval, 7.1-8.7). High-risk groups were African Americans (11.5% lifetime risk), those with obesity (10.9%), heterozygous for the factor V Leiden (17.1%), or with sickle cell trait or disease (18.2%). Lifetime risk estimates differed by cohort; these differences were explained by differences in time period of venous thromboembolism ascertainment.

CONCLUSIONS: At least 1 in 12 middle-aged adults will develop venous thromboembolism in their remaining lifetime. This estimate of lifetime risk may be useful to promote awareness of venous thromboembolism and guide decisions at both clinical and policy levels.

%B Am J Med %V 129 %P 339.e19-26 %8 2016 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26597668?dopt=Abstract %R 10.1016/j.amjmed.2015.10.014 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Longitudinal Relationships between Caloric Expenditure and Gray Matter in the Cardiovascular Health Study. %A Raji, Cyrus A %A Merrill, David A %A Eyre, Harris %A Mallam, Sravya %A Torosyan, Nare %A Erickson, Kirk I %A Lopez, Oscar L %A Becker, James T %A Carmichael, Owen T %A Gach, H Michael %A Thompson, Paul M %A Longstreth, W T %A Kuller, Lewis H %X

BACKGROUND: Physical activity (PA) can be neuroprotective and reduce the risk for Alzheimer's disease (AD). In assessing physical activity, caloric expenditure is a proxy marker reflecting the sum total of multiple physical activity types conducted by an individual.

OBJECTIVE: To assess caloric expenditure, as a proxy marker of PA, as a predictive measure of gray matter (GM) volumes in the normal and cognitively impaired elderly persons.

METHODS: All subjects in this study were recruited from the Institutional Review Board approved Cardiovascular Health Study (CHS), a multisite population-based longitudinal study in persons aged 65 and older. We analyzed a sub-sample of CHS participants 876 subjects (mean age 78.3, 57.5% F, 42.5% M) who had i) energy output assessed as kilocalories (kcal) per week using the standardized Minnesota Leisure-Time Activities questionnaire, ii) cognitive assessments for clinical classification of normal cognition, mild cognitive impairment (MCI), and AD, and iii) volumetric MR imaging of the brain. Voxel-based morphometry modeled the relationship between kcal/week and GM volumes while accounting for standard covariates including head size, age, sex, white matter hyperintensity lesions, MCI or AD status, and site. Multiple comparisons were controlled using a False Discovery Rate of 5 percent.

RESULTS: Higher energy output, from a variety of physical activity types, was associated with larger GM volumes in frontal, temporal, and parietal lobes, as well as hippocampus, thalamus, and basal ganglia. High levels of caloric expenditure moderated neurodegeneration-associated volume loss in the precuneus, posterior cingulate, and cerebellar vermis.

CONCLUSION: Increasing energy output from a variety of physical activities is related to larger gray matter volumes in the elderly, regardless of cognitive status.

%B J Alzheimers Dis %V 52 %P 719-29 %8 2016 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26967227?dopt=Abstract %R 10.3233/JAD-160057 %0 Journal Article %J Nat Genet %D 2016 %T Meta-analysis identifies common and rare variants influencing blood pressure and overlapping with metabolic trait loci. %A Liu, Chunyu %A Kraja, Aldi T %A Smith, Jennifer A %A Brody, Jennifer A %A Franceschini, Nora %A Bis, Joshua C %A Rice, Kenneth %A Morrison, Alanna C %A Lu, Yingchang %A Weiss, Stefan %A Guo, Xiuqing %A Palmas, Walter %A Martin, Lisa W %A Chen, Yii-Der Ida %A Surendran, Praveen %A Drenos, Fotios %A Cook, James P %A Auer, Paul L %A Chu, Audrey Y %A Giri, Ayush %A Zhao, Wei %A Jakobsdottir, Johanna %A Lin, Li-An %A Stafford, Jeanette M %A Amin, Najaf %A Mei, Hao %A Yao, Jie %A Voorman, Arend %A Larson, Martin G %A Grove, Megan L %A Smith, Albert V %A Hwang, Shih-Jen %A Chen, Han %A Huan, Tianxiao %A Kosova, Gulum %A Stitziel, Nathan O %A Kathiresan, Sekar %A Samani, Nilesh %A Schunkert, Heribert %A Deloukas, Panos %A Li, Man %A Fuchsberger, Christian %A Pattaro, Cristian %A Gorski, Mathias %A Kooperberg, Charles %A Papanicolaou, George J %A Rossouw, Jacques E %A Faul, Jessica D %A Kardia, Sharon L R %A Bouchard, Claude %A Raffel, Leslie J %A Uitterlinden, André G %A Franco, Oscar H %A Vasan, Ramachandran S %A O'Donnell, Christopher J %A Taylor, Kent D %A Liu, Kiang %A Bottinger, Erwin P %A Gottesman, Omri %A Daw, E Warwick %A Giulianini, Franco %A Ganesh, Santhi %A Salfati, Elias %A Harris, Tamara B %A Launer, Lenore J %A Dörr, Marcus %A Felix, Stephan B %A Rettig, Rainer %A Völzke, Henry %A Kim, Eric %A Lee, Wen-Jane %A Lee, I-Te %A Sheu, Wayne H-H %A Tsosie, Krystal S %A Edwards, Digna R Velez %A Liu, Yongmei %A Correa, Adolfo %A Weir, David R %A Völker, Uwe %A Ridker, Paul M %A Boerwinkle, Eric %A Gudnason, Vilmundur %A Reiner, Alexander P %A van Duijn, Cornelia M %A Borecki, Ingrid B %A Edwards, Todd L %A Chakravarti, Aravinda %A Rotter, Jerome I %A Psaty, Bruce M %A Loos, Ruth J F %A Fornage, Myriam %A Ehret, Georg B %A Newton-Cheh, Christopher %A Levy, Daniel %A Chasman, Daniel I %X

Meta-analyses of association results for blood pressure using exome-centric single-variant and gene-based tests identified 31 new loci in a discovery stage among 146,562 individuals, with follow-up and meta-analysis in 180,726 additional individuals (total n = 327,288). These blood pressure-associated loci are enriched for known variants for cardiometabolic traits. Associations were also observed for the aggregation of rare and low-frequency missense variants in three genes, NPR1, DBH, and PTPMT1. In addition, blood pressure associations at 39 previously reported loci were confirmed. The identified variants implicate biological pathways related to cardiometabolic traits, vascular function, and development. Several new variants are inferred to have roles in transcription or as hubs in protein-protein interaction networks. Genetic risk scores constructed from the identified variants were strongly associated with coronary disease and myocardial infarction. This large collection of blood pressure-associated loci suggests new therapeutic strategies for hypertension, emphasizing a link with cardiometabolic risk.

%B Nat Genet %V 48 %P 1162-70 %8 2016 Oct %G eng %N 10 %R 10.1038/ng.3660 %0 Journal Article %J Hum Mol Genet %D 2016 %T A meta-analysis of 120 246 individuals identifies 18 new loci for fibrinogen concentration. %A de Vries, Paul S %A Chasman, Daniel I %A Sabater-Lleal, Maria %A Chen, Ming-Huei %A Huffman, Jennifer E %A Steri, Maristella %A Tang, Weihong %A Teumer, Alexander %A Marioni, Riccardo E %A Grossmann, Vera %A Hottenga, Jouke J %A Trompet, Stella %A Müller-Nurasyid, Martina %A Zhao, Jing Hua %A Brody, Jennifer A %A Kleber, Marcus E %A Guo, Xiuqing %A Wang, Jie Jin %A Auer, Paul L %A Attia, John R %A Yanek, Lisa R %A Ahluwalia, Tarunveer S %A Lahti, Jari %A Venturini, Cristina %A Tanaka, Toshiko %A Bielak, Lawrence F %A Joshi, Peter K %A Rocanin-Arjo, Ares %A Kolcic, Ivana %A Navarro, Pau %A Rose, Lynda M %A Oldmeadow, Christopher %A Riess, Helene %A Mazur, Johanna %A Basu, Saonli %A Goel, Anuj %A Yang, Qiong %A Ghanbari, Mohsen %A Willemsen, Gonneke %A Rumley, Ann %A Fiorillo, Edoardo %A de Craen, Anton J M %A Grotevendt, Anne %A Scott, Robert %A Taylor, Kent D %A Delgado, Graciela E %A Yao, Jie %A Kifley, Annette %A Kooperberg, Charles %A Qayyum, Rehan %A Lopez, Lorna M %A Berentzen, Tina L %A Räikkönen, Katri %A Mangino, Massimo %A Bandinelli, Stefania %A Peyser, Patricia A %A Wild, Sarah %A Trégouët, David-Alexandre %A Wright, Alan F %A Marten, Jonathan %A Zemunik, Tatijana %A Morrison, Alanna C %A Sennblad, Bengt %A Tofler, Geoffrey %A de Maat, Moniek P M %A de Geus, Eco J C %A Lowe, Gordon D %A Zoledziewska, Magdalena %A Sattar, Naveed %A Binder, Harald %A Völker, Uwe %A Waldenberger, Melanie %A Khaw, Kay-Tee %A McKnight, Barbara %A Huang, Jie %A Jenny, Nancy S %A Holliday, Elizabeth G %A Qi, Lihong %A Mcevoy, Mark G %A Becker, Diane M %A Starr, John M %A Sarin, Antti-Pekka %A Hysi, Pirro G %A Hernandez, Dena G %A Jhun, Min A %A Campbell, Harry %A Hamsten, Anders %A Rivadeneira, Fernando %A McArdle, Wendy L %A Slagboom, P Eline %A Zeller, Tanja %A Koenig, Wolfgang %A Psaty, Bruce M %A Haritunians, Talin %A Liu, Jingmin %A Palotie, Aarno %A Uitterlinden, André G %A Stott, David J %A Hofman, Albert %A Franco, Oscar H %A Polasek, Ozren %A Rudan, Igor %A Morange, Pierre-Emmanuel %A Wilson, James F %A Kardia, Sharon L R %A Ferrucci, Luigi %A Spector, Tim D %A Eriksson, Johan G %A Hansen, Torben %A Deary, Ian J %A Becker, Lewis C %A Scott, Rodney J %A Mitchell, Paul %A März, Winfried %A Wareham, Nick J %A Peters, Annette %A Greinacher, Andreas %A Wild, Philipp S %A Jukema, J Wouter %A Boomsma, Dorret I %A Hayward, Caroline %A Cucca, Francesco %A Tracy, Russell %A Watkins, Hugh %A Reiner, Alex P %A Folsom, Aaron R %A Ridker, Paul M %A O'Donnell, Christopher J %A Smith, Nicholas L %A Strachan, David P %A Dehghan, Abbas %X

Genome-wide association studies have previously identified 23 genetic loci associated with circulating fibrinogen concentration. These studies used HapMap imputation and did not examine the X-chromosome. 1000 Genomes imputation provides better coverage of uncommon variants, and includes indels. We conducted a genome-wide association analysis of 34 studies imputed to the 1000 Genomes Project reference panel and including ∼120 000 participants of European ancestry (95 806 participants with data on the X-chromosome). Approximately 10.7 million single-nucleotide polymorphisms and 1.2 million indels were examined. We identified 41 genome-wide significant fibrinogen loci; of which, 18 were newly identified. There were no genome-wide significant signals on the X-chromosome. The lead variants of five significant loci were indels. We further identified six additional independent signals, including three rare variants, at two previously characterized loci: FGB and IRF1. Together the 41 loci explain 3% of the variance in plasma fibrinogen concentration.

%B Hum Mol Genet %V 25 %P 358-70 %8 2016 Jan 15 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26561523?dopt=Abstract %R 10.1093/hmg/ddv454 %0 Journal Article %J J Med Genet %D 2016 %T Meta-analysis of 49 549 individuals imputed with the 1000 Genomes Project reveals an exonic damaging variant in ANGPTL4 determining fasting TG levels. %A van Leeuwen, Elisabeth M %A Sabo, Aniko %A Bis, Joshua C %A Huffman, Jennifer E %A Manichaikul, Ani %A Smith, Albert V %A Feitosa, Mary F %A Demissie, Serkalem %A Joshi, Peter K %A Duan, Qing %A Marten, Jonathan %A van Klinken, Jan B %A Surakka, Ida %A Nolte, Ilja M %A Zhang, Weihua %A Mbarek, Hamdi %A Li-Gao, Ruifang %A Trompet, Stella %A Verweij, Niek %A Evangelou, Evangelos %A Lyytikäinen, Leo-Pekka %A Tayo, Bamidele O %A Deelen, Joris %A van der Most, Peter J %A van der Laan, Sander W %A Arking, Dan E %A Morrison, Alanna %A Dehghan, Abbas %A Franco, Oscar H %A Hofman, Albert %A Rivadeneira, Fernando %A Sijbrands, Eric J %A Uitterlinden, André G %A Mychaleckyj, Josyf C %A Campbell, Archie %A Hocking, Lynne J %A Padmanabhan, Sandosh %A Brody, Jennifer A %A Rice, Kenneth M %A White, Charles C %A Harris, Tamara %A Isaacs, Aaron %A Campbell, Harry %A Lange, Leslie A %A Rudan, Igor %A Kolcic, Ivana %A Navarro, Pau %A Zemunik, Tatijana %A Salomaa, Veikko %A Kooner, Angad S %A Kooner, Jaspal S %A Lehne, Benjamin %A Scott, William R %A Tan, Sian-Tsung %A de Geus, Eco J %A Milaneschi, Yuri %A Penninx, Brenda W J H %A Willemsen, Gonneke %A de Mutsert, Renée %A Ford, Ian %A Gansevoort, Ron T %A Segura-Lepe, Marcelo P %A Raitakari, Olli T %A Viikari, Jorma S %A Nikus, Kjell %A Forrester, Terrence %A McKenzie, Colin A %A de Craen, Anton J M %A de Ruijter, Hester M %A Pasterkamp, Gerard %A Snieder, Harold %A Oldehinkel, Albertine J %A Slagboom, P Eline %A Cooper, Richard S %A Kähönen, Mika %A Lehtimäki, Terho %A Elliott, Paul %A van der Harst, Pim %A Jukema, J Wouter %A Mook-Kanamori, Dennis O %A Boomsma, Dorret I %A Chambers, John C %A Swertz, Morris %A Ripatti, Samuli %A Willems van Dijk, Ko %A Vitart, Veronique %A Polasek, Ozren %A Hayward, Caroline %A Wilson, James G %A Wilson, James F %A Gudnason, Vilmundur %A Rich, Stephen S %A Psaty, Bruce M %A Borecki, Ingrid B %A Boerwinkle, Eric %A Rotter, Jerome I %A Cupples, L Adrienne %A van Duijn, Cornelia M %X

BACKGROUND: So far, more than 170 loci have been associated with circulating lipid levels through genome-wide association studies (GWAS). These associations are largely driven by common variants, their function is often not known, and many are likely to be markers for the causal variants. In this study we aimed to identify more new rare and low-frequency functional variants associated with circulating lipid levels.

METHODS: We used the 1000 Genomes Project as a reference panel for the imputations of GWAS data from ∼60 000 individuals in the discovery stage and ∼90 000 samples in the replication stage.

RESULTS: Our study resulted in the identification of five new associations with circulating lipid levels at four loci. All four loci are within genes that can be linked biologically to lipid metabolism. One of the variants, rs116843064, is a damaging missense variant within the ANGPTL4 gene.

CONCLUSIONS: This study illustrates that GWAS with high-scale imputation may still help us unravel the biological mechanism behind circulating lipid levels.

%B J Med Genet %V 53 %P 441-9 %8 2016 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/27036123?dopt=Abstract %R 10.1136/jmedgenet-2015-103439 %0 Journal Article %J J Med Genet %D 2016 %T Meta-analysis of genome-wide association studies of HDL cholesterol response to statins. %A Postmus, Iris %A Warren, Helen R %A Trompet, Stella %A Arsenault, Benoit J %A Avery, Christy L %A Bis, Joshua C %A Chasman, Daniel I %A de Keyser, Catherine E %A Deshmukh, Harshal A %A Evans, Daniel S %A Feng, QiPing %A Li, Xiaohui %A Smit, Roelof A J %A Smith, Albert V %A Sun, Fangui %A Taylor, Kent D %A Arnold, Alice M %A Barnes, Michael R %A Barratt, Bryan J %A Betteridge, John %A Boekholdt, S Matthijs %A Boerwinkle, Eric %A Buckley, Brendan M %A Chen, Y-D Ida %A de Craen, Anton J M %A Cummings, Steven R %A Denny, Joshua C %A Dubé, Marie Pierre %A Durrington, Paul N %A Eiriksdottir, Gudny %A Ford, Ian %A Guo, Xiuqing %A Harris, Tamara B %A Heckbert, Susan R %A Hofman, Albert %A Hovingh, G Kees %A Kastelein, John J P %A Launer, Leonore J %A Liu, Ching-Ti %A Liu, Yongmei %A Lumley, Thomas %A McKeigue, Paul M %A Munroe, Patricia B %A Neil, Andrew %A Nickerson, Deborah A %A Nyberg, Fredrik %A O'Brien, Eoin %A O'Donnell, Christopher J %A Post, Wendy %A Poulter, Neil %A Vasan, Ramachandran S %A Rice, Kenneth %A Rich, Stephen S %A Rivadeneira, Fernando %A Sattar, Naveed %A Sever, Peter %A Shaw-Hawkins, Sue %A Shields, Denis C %A Slagboom, P Eline %A Smith, Nicholas L %A Smith, Joshua D %A Sotoodehnia, Nona %A Stanton, Alice %A Stott, David J %A Stricker, Bruno H %A Stürmer, Til %A Uitterlinden, André G %A Wei, Wei-Qi %A Westendorp, Rudi G J %A Whitsel, Eric A %A Wiggins, Kerri L %A Wilke, Russell A %A Ballantyne, Christie M %A Colhoun, Helen M %A Cupples, L Adrienne %A Franco, Oscar H %A Gudnason, Vilmundur %A Hitman, Graham %A Palmer, Colin N A %A Psaty, Bruce M %A Ridker, Paul M %A Stafford, Jeanette M %A Stein, Charles M %A Tardif, Jean-Claude %A Caulfield, Mark J %A Jukema, J Wouter %A Rotter, Jerome I %A Krauss, Ronald M %X

BACKGROUND: In addition to lowering low density lipoprotein cholesterol (LDL-C), statin therapy also raises high density lipoprotein cholesterol (HDL-C) levels. Inter-individual variation in HDL-C response to statins may be partially explained by genetic variation.

METHODS AND RESULTS: We performed a meta-analysis of genome-wide association studies (GWAS) to identify variants with an effect on statin-induced high density lipoprotein cholesterol (HDL-C) changes. The 123 most promising signals with p<1×10(-4) from the 16 769 statin-treated participants in the first analysis stage were followed up in an independent group of 10 951 statin-treated individuals, providing a total sample size of 27 720 individuals. The only associations of genome-wide significance (p<5×10(-8)) were between minor alleles at the CETP locus and greater HDL-C response to statin treatment.

CONCLUSIONS: Based on results from this study that included a relatively large sample size, we suggest that CETP may be the only detectable locus with common genetic variants that influence HDL-C response to statins substantially in individuals of European descent. Although CETP is known to be associated with HDL-C, we provide evidence that this pharmacogenetic effect is independent of its association with baseline HDL-C levels.

%B J Med Genet %V 53 %P 835-845 %8 2016 Dec %G eng %N 12 %R 10.1136/jmedgenet-2016-103966 %0 Journal Article %J Circ Cardiovasc Genet %D 2016 %T Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis. %A Natarajan, Pradeep %A Bis, Joshua C %A Bielak, Lawrence F %A Cox, Amanda J %A Dörr, Marcus %A Feitosa, Mary F %A Franceschini, Nora %A Guo, Xiuqing %A Hwang, Shih-Jen %A Isaacs, Aaron %A Jhun, Min A %A Kavousi, Maryam %A Li-Gao, Ruifang %A Lyytikäinen, Leo-Pekka %A Marioni, Riccardo E %A Schminke, Ulf %A Stitziel, Nathan O %A Tada, Hayato %A van Setten, Jessica %A Smith, Albert V %A Vojinovic, Dina %A Yanek, Lisa R %A Yao, Jie %A Yerges-Armstrong, Laura M %A Amin, Najaf %A Baber, Usman %A Borecki, Ingrid B %A Carr, J Jeffrey %A Chen, Yii-Der Ida %A Cupples, L Adrienne %A de Jong, Pim A %A de Koning, Harry %A de Vos, Bob D %A Demirkan, Ayse %A Fuster, Valentin %A Franco, Oscar H %A Goodarzi, Mark O %A Harris, Tamara B %A Heckbert, Susan R %A Heiss, Gerardo %A Hoffmann, Udo %A Hofman, Albert %A Išgum, Ivana %A Jukema, J Wouter %A Kähönen, Mika %A Kardia, Sharon L R %A Kral, Brian G %A Launer, Lenore J %A Massaro, Joseph %A Mehran, Roxana %A Mitchell, Braxton D %A Mosley, Thomas H %A de Mutsert, Renée %A Newman, Anne B %A Nguyen, Khanh-Dung %A North, Kari E %A O'Connell, Jeffrey R %A Oudkerk, Matthijs %A Pankow, James S %A Peloso, Gina M %A Post, Wendy %A Province, Michael A %A Raffield, Laura M %A Raitakari, Olli T %A Reilly, Dermot F %A Rivadeneira, Fernando %A Rosendaal, Frits %A Sartori, Samantha %A Taylor, Kent D %A Teumer, Alexander %A Trompet, Stella %A Turner, Stephen T %A Uitterlinden, André G %A Vaidya, Dhananjay %A van der Lugt, Aad %A Völker, Uwe %A Wardlaw, Joanna M %A Wassel, Christina L %A Weiss, Stefan %A Wojczynski, Mary K %A Becker, Diane M %A Becker, Lewis C %A Boerwinkle, Eric %A Bowden, Donald W %A Deary, Ian J %A Dehghan, Abbas %A Felix, Stephan B %A Gudnason, Vilmundur %A Lehtimäki, Terho %A Mathias, Rasika %A Mook-Kanamori, Dennis O %A Psaty, Bruce M %A Rader, Daniel J %A Rotter, Jerome I %A Wilson, James G %A van Duijn, Cornelia M %A Völzke, Henry %A Kathiresan, Sekar %A Peyser, Patricia A %A O'Donnell, Christopher J %X

BACKGROUND: -The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease (CHD). We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the risk of subsequent CHD.

METHODS AND RESULTS: -We studied a total of 25,109 European ancestry and African-American participants with coronary artery calcification (CAC) measured by cardiac computed tomography and 52,869 with common carotid intima media thickness (CIMT) measured by ultrasonography within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Participants were genotyped for 247,870 DNA sequence variants (231,539 in exons) across the genome. A meta-analysis of exome-wide association studies was performed across cohorts for CAC and CIMT. APOB p.Arg3527Gln was associated with four-fold excess CAC (P = 3×10(-10)). The APOE ε2 allele (p.Arg176Cys) was associated with both 22.3% reduced CAC (P = 1×10(-12)) and 1.4% reduced CIMT (P = 4×10(-14)) in carriers compared with non-carriers. In secondary analyses conditioning on LDL cholesterol concentration, the ε2 protective association with CAC, although attenuated, remained strongly significant. Additionally, the presence of ε2 was associated with reduced risk for CHD (OR 0.77; P = 1×10(-11)).

CONCLUSIONS: -Exome-wide association meta-analysis demonstrates that protein-coding variants in APOB and APOE associate with subclinical atherosclerosis. APOE ε2 represents the first significant association for multiple subclinical atherosclerosis traits across multiple ethnicities as well as clinical CHD.

%B Circ Cardiovasc Genet %8 2016 Nov 21 %G eng %R 10.1161/CIRCGENETICS.116.001572 %0 Journal Article %J Lancet Diabetes Endocrinol %D 2016 %T Natriuretic peptides and integrated risk assessment for cardiovascular disease: an individual-participant-data meta-analysis. %A Willeit, Peter %A Kaptoge, Stephen %A Welsh, Paul %A Butterworth, Adam %A Chowdhury, Rajiv %A Spackman, Sarah %A Pennells, Lisa %A Gao, Pei %A Burgess, Stephen %A Freitag, Daniel %A Sweeting, Michael %A Wood, Angela %A Cook, Nancy %A Judd, Suzanne %A Trompet, Stella %A Nambi, Vijay %A Olsen, Michael %A Everett, Brendan %A Kee, Frank %A Arnlöv, Johan %A Salomaa, Veikko %A Levy, Daniel %A Kauhanen, Jussi %A Laukkanen, Jari %A Kavousi, Maryam %A Ninomiya, Toshiharu %A Casas, Juan-Pablo %A Daniels, Lori %A Lind, Lars %A Kistorp, Caroline %A Rosenberg, Jens %A Mueller, Thomas %A Rubattu, Speranza %A Panagiotakos, Demosthenes %A Franco, Oscar %A de Lemos, James %A Luchner, Andreas %A Kizer, Jorge %A Kiechl, Stefan %A Salonen, Jukka %A Goya Wannamethee, S %A de Boer, Rudolf %A Nordestgaard, Børge %A Andersson, Jonas %A Jørgensen, Torben %A Melander, Olle %A Ballantyne, Christie %A DeFilippi, Christopher %A Ridker, Paul %A Cushman, Mary %A Rosamond, Wayne %A Thompson, Simon %A Gudnason, Vilmundur %A Sattar, Naveed %A Danesh, John %A Di Angelantonio, Emanuele %K Aged %K Biomarkers %K Cardiovascular Diseases %K Female %K Humans %K Male %K Middle Aged %K Natriuretic Peptide, Brain %K Peptide Fragments %K Prospective Studies %K Risk Assessment %X

BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present by predicting heart failure and enhancing coronary heart disease and stroke risk assessment.

METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes, with no language restrictions. We calculated risk ratios and measures of risk discrimination and reclassification across predicted 10 year risk categories (ie, <5%, 5% to <7·5%, and ≥7·5%), adding assessment of NT-proBNP concentration to that of conventional risk factors (ie, age, sex, smoking status, systolic blood pressure, history of diabetes, and total and HDL cholesterol concentrations). Primary outcomes were the combination of coronary heart disease and stroke, and the combination of coronary heart disease, stroke, and heart failure.

FINDINGS: We recorded 5500 coronary heart disease, 4002 stroke, and 2212 heart failure outcomes among 95 617 participants without a history of cardiovascular disease in 40 prospective studies. Risk ratios (for a comparison of the top third vs bottom third of NT-proBNP concentrations, adjusted for conventional risk factors) were 1·76 (95% CI 1·56-1·98) for the combination of coronary heart disease and stroke and 2·00 (1·77-2·26) for the combination of coronary heart disease, stroke, and heart failure. Addition of information about NT-proBNP concentration to a model containing conventional risk factors was associated with a C-index increase of 0·012 (0·010-0·014) and a net reclassification improvement of 0·027 (0·019-0·036) for the combination of coronary heart disease and stroke and a C-index increase of 0·019 (0·016-0·022) and a net reclassification improvement of 0·028 (0·019-0·038) for the combination of coronary heart disease, stroke, and heart failure.

INTERPRETATION: In people without baseline cardiovascular disease, NT-proBNP concentration assessment strongly predicted first-onset heart failure and augmented coronary heart disease and stroke prediction, suggesting that NT-proBNP concentration assessment could be used to integrate heart failure into cardiovascular disease primary prevention.

FUNDING: British Heart Foundation, Austrian Science Fund, UK Medical Research Council, National Institute for Health Research, European Research Council, and European Commission Framework Programme 7.

%B Lancet Diabetes Endocrinol %V 4 %P 840-9 %8 2016 10 %G eng %N 10 %R 10.1016/S2213-8587(16)30196-6 %0 Journal Article %J Ethn Dis %D 2016 %T Neighborhood Characteristics are Associated with Racial and Gender Variation in Walking among Older Adults: the Cardiovascular Health Study. %A Yan, Tingjian %A Liang, Li-Jung %A Vassar, Stefanie %A Katz, Monica Cheung %A Escarce, José J %A Longstreth, W T Jr %A Merkin, Sharon Stein %A Brown, Arleen F %X

OBJECTIVE: To examine variation by race and gender in the association between neighborhood socioeconomic status and walking among community-dwelling older adults.

DESIGN: Cross-sectional.

SETTING: Cardiovascular Health Study, a longitudinal population-based cohort.

PARTICIPANTS: 4,849 adults, aged > 65 years.

MEASUREMENTS: Participants reported the number of city blocks walked in the prior week. Neighborhood socioeconomic status (NSES) was measured at the level of the census tract. Negative binominal regression models were constructed to test the association between NSES and blocks walked. In the fully adjusted models, we included two-way and three-way interaction terms among race, gender, and NSES.

RESULTS: In adjusted analyses, among White residents in the lowest NSES quartile (most disadvantaged), men walked 64% more than women (P<.001), while in the highest NSES (most advantaged), men walked 43% more than women (P<.001). Among African American residents in the lowest NSES quartile, men walked 196% more blocks than women (P<.001).

CONCLUSIONS: Female gender is more strongly associated with walking for African Americans than for Whites in low SES neighborhoods but had a similar association with walking for both African Americans and Whites in high SES neighborhoods.

%B Ethn Dis %V 26 %P 17-26 %8 2016 Jan 21 %G ENG %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26843792?dopt=Abstract %R 10.18865/ed.26.1.17 %0 Journal Article %J Am J Epidemiol %D 2016 %T Neighborhood Socioeconomic Status and Cognitive Function in Late Life. %A Rosso, Andrea L %A Flatt, Jason D %A Carlson, Michelle C %A Lovasi, Gina S %A Rosano, Caterina %A Brown, Arleen F %A Matthews, Karen A %A Gianaros, Peter J %X

Neighborhood socioeconomic status (NSES) is associated with cognitive function, independently of individual demographic, health, and socioeconomic characteristics. However, research has been largely cross-sectional, and mechanisms of the association are unknown. In 1992-1993, Cardiovascular Health Study participants (n = 3,595; mean age = 74.8 years; 15.7% black) underwent cognitive testing and magnetic resonance imaging of white matter hyperintensities (WMH), and their addresses were geocoded. NSES was calculated using 1990 US Census data (block groups; 6 measures of wealth, education, and occupation). The Modified Mini-Mental State Examination (3MS) was used to assess general cognition, and the Digit Symbol Substitution Test (DSST) was used to assess speed of processing annually for 6 years. Associations of race-specific NSES tertiles with 3MS, DSST, and WMH were estimated using linear mixed-effects models accounting for geographic clustering, stratified by race, and adjusted for demographic, health, and individual socioeconomic status (education, income, lifetime occupational status) variables. In fully adjusted models, higher NSES was associated with higher 3MS scores in blacks (mean difference between highest and lowest NSES = 2.4 points; P = 0.004) and whites (mean difference = 0.7 points; P = 0.02) at baseline but not with changes in 3MS over time. NSES was marginally associated with DSST and was not associated with WMH. Adjustment for WMH did not attenuate NSES-3MS associations. Associations of NSES with cognition in late adulthood differ by race, are not explained by WMH, and are evident only at baseline.

%B Am J Epidemiol %V 183 %P 1088-97 %8 2016 Jun 15 %G eng %N 12 %R 10.1093/aje/kwv337 %0 Journal Article %J Mol Psychiatry %D 2016 %T A novel Alzheimer disease locus located near the gene encoding tau protein. %A Jun, G %A Ibrahim-Verbaas, C A %A Vronskaya, M %A Lambert, J-C %A Chung, J %A Naj, A C %A Kunkle, B W %A Wang, L-S %A Bis, J C %A Bellenguez, C %A Harold, D %A Lunetta, K L %A DeStefano, A L %A Grenier-Boley, B %A Sims, R %A Beecham, G W %A Smith, A V %A Chouraki, V %A Hamilton-Nelson, K L %A Ikram, M A %A Fiévet, N %A Denning, N %A Martin, E R %A Schmidt, H %A Kamatani, Y %A Dunstan, M L %A Valladares, O %A Laza, A R %A Zelenika, D %A Ramirez, A %A Foroud, T M %A Choi, S-H %A Boland, A %A Becker, T %A Kukull, W A %A van der Lee, S J %A Pasquier, F %A Cruchaga, C %A Beekly, D %A Fitzpatrick, A L %A Hanon, O %A Gill, M %A Barber, R %A Gudnason, V %A Campion, D %A Love, S %A Bennett, D A %A Amin, N %A Berr, C %A Tsolaki, Magda %A Buxbaum, J D %A Lopez, O L %A Deramecourt, V %A Fox, N C %A Cantwell, L B %A Tárraga, L %A Dufouil, C %A Hardy, J %A Crane, P K %A Eiriksdottir, G %A Hannequin, D %A Clarke, R %A Evans, D %A Mosley, T H %A Letenneur, L %A Brayne, C %A Maier, W %A De Jager, P %A Emilsson, V %A Dartigues, J-F %A Hampel, H %A Kamboh, M I %A de Bruijn, R F A G %A Tzourio, C %A Pastor, P %A Larson, E B %A Rotter, J I %A O'Donovan, M C %A Montine, T J %A Nalls, M A %A Mead, S %A Reiman, E M %A Jonsson, P V %A Holmes, C %A St George-Hyslop, P H %A Boada, M %A Passmore, P %A Wendland, J R %A Schmidt, R %A Morgan, K %A Winslow, A R %A Powell, J F %A Carasquillo, M %A Younkin, S G %A Jakobsdóttir, J %A Kauwe, J S K %A Wilhelmsen, K C %A Rujescu, D %A Nöthen, M M %A Hofman, A %A Jones, L %A Haines, J L %A Psaty, B M %A Van Broeckhoven, C %A Holmans, P %A Launer, L J %A Mayeux, R %A Lathrop, M %A Goate, A M %A Escott-Price, V %A Seshadri, S %A Pericak-Vance, M A %A Amouyel, P %A Williams, J %A van Duijn, C M %A Schellenberg, G D %A Farrer, L A %K Alzheimer Disease %K Apolipoprotein E4 %K Chromosomes, Human, Pair 17 %K Genome-Wide Association Study %K Humans %K Polymorphism, Single Nucleotide %K tau Proteins %X

APOE ɛ4, the most significant genetic risk factor for Alzheimer disease (AD), may mask effects of other loci. We re-analyzed genome-wide association study (GWAS) data from the International Genomics of Alzheimer's Project (IGAP) Consortium in APOE ɛ4+ (10 352 cases and 9207 controls) and APOE ɛ4- (7184 cases and 26 968 controls) subgroups as well as in the total sample testing for interaction between a single-nucleotide polymorphism (SNP) and APOE ɛ4 status. Suggestive associations (P<1 × 10(-4)) in stage 1 were evaluated in an independent sample (stage 2) containing 4203 subjects (APOE ɛ4+: 1250 cases and 536 controls; APOE ɛ4-: 718 cases and 1699 controls). Among APOE ɛ4- subjects, novel genome-wide significant (GWS) association was observed with 17 SNPs (all between KANSL1 and LRRC37A on chromosome 17 near MAPT) in a meta-analysis of the stage 1 and stage 2 data sets (best SNP, rs2732703, P=5·8 × 10(-9)). Conditional analysis revealed that rs2732703 accounted for association signals in the entire 100-kilobase region that includes MAPT. Except for previously identified AD loci showing stronger association in APOE ɛ4+ subjects (CR1 and CLU) or APOE ɛ4- subjects (MS4A6A/MS4A4A/MS4A6E), no other SNPs were significantly associated with AD in a specific APOE genotype subgroup. In addition, the finding in the stage 1 sample that AD risk is significantly influenced by the interaction of APOE with rs1595014 in TMEM106B (P=1·6 × 10(-7)) is noteworthy, because TMEM106B variants have previously been associated with risk of frontotemporal dementia. Expression quantitative trait locus analysis revealed that rs113986870, one of the GWS SNPs near rs2732703, is significantly associated with four KANSL1 probes that target transcription of the first translated exon and an untranslated exon in hippocampus (P ⩽ 1.3 × 10(-8)), frontal cortex (P ⩽ 1.3 × 10(-9)) and temporal cortex (P⩽1.2 × 10(-11)). Rs113986870 is also strongly associated with a MAPT probe that targets transcription of alternatively spliced exon 3 in frontal cortex (P=9.2 × 10(-6)) and temporal cortex (P=2.6 × 10(-6)). Our APOE-stratified GWAS is the first to show GWS association for AD with SNPs in the chromosome 17q21.31 region. Replication of this finding in independent samples is needed to verify that SNPs in this region have significantly stronger effects on AD risk in persons lacking APOE ɛ4 compared with persons carrying this allele, and if this is found to hold, further examination of this region and studies aimed at deciphering the mechanism(s) are warranted.

%B Mol Psychiatry %V 21 %P 108-17 %8 2016 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25778476?dopt=Abstract %R 10.1038/mp.2015.23 %0 Journal Article %J Circ Cardiovasc Genet %D 2016 %T Novel Genetic Loci Associated With Retinal Microvascular Diameter. %A Jensen, Richard A %A Sim, Xueling %A Smith, Albert Vernon %A Li, Xiaohui %A Jakobsdottir, Johanna %A Cheng, Ching-Yu %A Brody, Jennifer A %A Cotch, Mary Frances %A McKnight, Barbara %A Klein, Ronald %A Wang, Jie Jin %A Kifley, Annette %A Harris, Tamara B %A Launer, Lenore J %A Taylor, Kent D %A Klein, Barbara E K %A Raffel, Leslie J %A Li, Xiang %A Ikram, M Arfan %A Klaver, Caroline C %A van der Lee, Sven J %A Mutlu, Unal %A Hofman, Albert %A Uitterlinden, André G %A Liu, Chunyu %A Kraja, Aldi T %A Mitchell, Paul %A Gudnason, Vilmundur %A Rotter, Jerome I %A Boerwinkle, Eric %A van Duijn, Cornelia M %A Psaty, Bruce M %A Wong, Tien Y %X

BACKGROUND: There is increasing evidence that retinal microvascular diameters are associated with cardiovascular and cerebrovascular conditions. The shared genetic effects of these associations are currently unknown. The aim of this study was to increase our understanding of the genetic factors that mediate retinal vessel size.

METHODS AND RESULTS: This study extends previous genome-wide association study results using 24 000+ multiethnic participants from 7 discovery cohorts and 5000+ subjects of European ancestry from 2 replication cohorts. Using the Illumina HumanExome BeadChip, we investigate the association of single-nucleotide polymorphisms and variants collectively across genes with summary measures of retinal vessel diameters, referred to as the central retinal venule equivalent and the central retinal arteriole equivalent. We report 4 new loci associated with central retinal venule equivalent, one of which is also associated with central retinal arteriole equivalent. The 4 single-nucleotide polymorphisms are rs7926971 in TEAD1 (P=3.1×10(-) (11); minor allele frequency=0.43), rs201259422 in TSPAN10 (P=4.4×10(-9); minor allele frequency=0.27), rs5442 in GNB3 (P=7.0×10(-10); minor allele frequency=0.05), and rs1800407 in OCA2 (P=3.4×10(-8); minor allele frequency=0.05). The latter single-nucleotide polymorphism, rs1800407, was also associated with central retinal arteriole equivalent (P=6.5×10(-12)). Results from the gene-based burden tests were null. In phenotype look-ups, single-nucleotide polymorphism rs201255422 was associated with both systolic (P=0.001) and diastolic blood pressures (P=8.3×10(-04)).

CONCLUSIONS: Our study expands the understanding of genetic factors influencing the size of the retinal microvasculature. These findings may also provide insight into the relationship between retinal and systemic microvascular disease.

%B Circ Cardiovasc Genet %V 9 %P 45-54 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26567291?dopt=Abstract %R 10.1161/CIRCGENETICS.115.001142 %0 Journal Article %J Nat Neurosci %D 2016 %T {Novel genetic loci underlying human intracranial volume identified through genome-wide association %A Adams, H. H. %A Hibar, D. P. %A Chouraki, V. %A Stein, J. L. %A Nyquist, P. A. %A Renter?a, M. E. %A Trompet, S. %A Arias-Vasquez, A. %A Seshadri, S. %A Desrivi?res, S. %A Beecham, A. H. %A Jahanshad, N. %A Wittfeld, K. %A van der Lee, S. J. %A Abramovic, L. %A Alhusaini, S. %A Amin, N. %A Andersson, M. %A Arfanakis, K. %A Aribisala, B. S. %A Armstrong, N. J. %A Athanasiu, L. %A Axelsson, T. %A Beiser, A. %A Bernard, M. %A Bis, J. C. %A Blanken, L. M. %A Blanton, S. H. %A Bohlken, M. M. %A Boks, M. P. %A Bralten, J. %A Brickman, A. M. %A Carmichael, O. %A Chakravarty, M. M. %A Chauhan, G. %A Chen, Q. %A Ching, C. R. %A Cuellar-Partida, G. %A Braber, A. D. %A Doan, N. T. %A Ehrlich, S. %A Filippi, I. %A Ge, T. %A Giddaluru, S. %A Goldman, A. L. %A Gottesman, R. F. %A Greven, C. U. %A Grimm, O. %A Griswold, M. E. %A Guadalupe, T. %A Hass, J. %A Haukvik, U. K. %A Hilal, S. %A Hofer, E. %A Hoehn, D. %A Holmes, A. J. %A Hoogman, M. %A Janowitz, D. %A Jia, T. %A Kasperaviciute, D. %A Kim, S. %A Klein, M. %A Kraemer, B. %A Lee, P. H. %A Liao, J. %A Liewald, D. C. %A Lopez, L. M. %A Luciano, M. %A Macare, C. %A Marquand, A. %A Matarin, M. %A Mather, K. A. %A Mattheisen, M. %A Mazoyer, B. %A McKay, D. R. %A McWhirter, R. %A Milaneschi, Y. %A Mirza-Schreiber, N. %A Muetzel, R. L. %A Maniega, S. M. %A Nho, K. %A Nugent, A. C. %A Loohuis, L. M. %A Oosterlaan, J. %A Papmeyer, M. %A Pappa, I. %A Pirpamer, L. %A Pudas, S. %A P?tz, B. %A Rajan, K. B. %A Ramasamy, A. %A Richards, J. S. %A Risacher, S. L. %A Roiz-Santia?ez, R. %A Rommelse, N. %A Rose, E. J. %A Royle, N. A. %A Rundek, T. %A S?mann, P. G. %A Satizabal, C. L. %A Schmaal, L. %A Schork, A. J. %A Shen, L. %A Shin, J. %A Shumskaya, E. %A Smith, A. V. %A Sprooten, E. %A Strike, L. T. %A Teumer, A. %A Thomson, R. %A Tordesillas-Gutierrez, D. %A Toro, R. %A Trabzuni, D. %A Vaidya, D. %A van der Grond, J. %A van der Meer, D. %A Van Donkelaar, M. M. %A Van Eijk, K. R. %A Van Erp, T. G. %A van Rooij, D. %A Walton, E. %A Westlye, L. T. %A Whelan, C. D. %A Windham, B. G. %A Winkler, A. M. %A Woldehawariat, G. %A Wolf, C. %A Wolfers, T. %A Xu, B. %A Yanek, L. R. %A Yang, J. %A Zijdenbos, A. %A Zwiers, M. P. %A Agartz, I. %A Aggarwal, N. T. %A Almasy, L. %A Ames, D. %A Amouyel, P. %A Andreassen, O. A. %A Arepalli, S. %A Assareh, A. A. %A Barral, S. %A Bastin, M. E. %A Becker, D. M. %A Becker, J. T. %A Bennett, D. A. %A Blangero, J. %A van Bokhoven, H. %A Boomsma, D. I. %A Brodaty, H. %A Brouwer, R. M. %A Brunner, H. G. %A Buckner, R. L. %A Buitelaar, J. K. %A Bulayeva, K. B. %A Cahn, W. %A Calhoun, V. D. %A Cannon, D. M. %A Cavalleri, G. L. %A Chen, C. %A Cheng, C. Y. %A Cichon, S. %A Cookson, M. R. %A Corvin, A. %A Crespo-Facorro, B. %A Curran, J. E. %A Czisch, M. %A Dale, A. M. %A Davies, G. E. %A De Geus, E. J. %A De Jager, P. L. %A de Zubicaray, G. I. %A Delanty, N. %A Depondt, C. %A DeStefano, A. L. %A Dillman, A. %A Djurovic, S. %A Donohoe, G. %A Drevets, W. C. %A Duggirala, R. %A Dyer, T. D. %A Erk, S. %A Espeseth, T. %A Evans, D. A. %A Fedko, I. O. %A Fern?ndez, G. %A Ferrucci, L. %A Fisher, S. E. %A Fleischman, D. A. %A Ford, I. %A Foroud, T. M. %A Fox, P. T. %A Francks, C. %A Fukunaga, M. %A Gibbs, J. R. %A Glahn, D. C. %A Gollub, R. L. %A G?ring, H. H. %A Grabe, H. J. %A Green, R. C. %A Gruber, O. %A Gudnason, V. %A Guelfi, S. %A Hansell, N. K. %A Hardy, J. %A Hartman, C. A. %A Hashimoto, R. %A Hegenscheid, K. %A Heinz, A. %A Le Hellard, S. %A Hernandez, D. G. %A Heslenfeld, D. J. %A Ho, B. C. %A Hoekstra, P. J. %A Hoffmann, W. %A Hofman, A. %A Holsboer, F. %A Homuth, G. %A Hosten, N. %A Hottenga, J. J. %A Hulshoff Pol, H. E. %A Ikeda, M. %A Ikram, M. K. %A Jack, C. R. %A Jenkinson, M. %A Johnson, R. %A J?nsson, E. G. %A Jukema, J. W. %A Kahn, R. S. %A Kanai, R. %A Kloszewska, I. %A Knopman, D. S. %A Kochunov, P. %A Kwok, J. B. %A Lawrie, S. M. %A Lema?tre, H. %A Liu, X. %A Longo, D. L. %A Longstreth, W. T. %A Lopez, O. L. %A Lovestone, S. %A Martinez, O. %A Martinot, J. L. %A Mattay, V. S. %A McDonald, C. %A McIntosh, A. M. %A McMahon, K. L. %A McMahon, F. J. %A Mecocci, P. %A Melle, I. %A Meyer-Lindenberg, A. %A Mohnke, S. %A Montgomery, G. W. %A Morris, D. W. %A Mosley, T. H. %A M?hleisen, T. W. %A M?ller-Myhsok, B. %A Nalls, M. A. %A Nauck, M. %A Nichols, T. E. %A Niessen, W. J. %A N?then, M. M. %A Nyberg, L. %A Ohi, K. %A Olvera, R. L. %A Ophoff, R. A. %A Pandolfo, M. %A Paus, T. %A Pausova, Z. %A Penninx, B. W. %A Pike, G. B. %A Potkin, S. G. %A Psaty, B. M. %A Reppermund, S. %A Rietschel, M. %A Roffman, J. L. %A Romanczuk-Seiferth, N. %A Rotter, J. I. %A Ryten, M. %A Sacco, R. L. %A Sachdev, P. S. %A Saykin, A. J. %A Schmidt, R. %A Schofield, P. R. %A Sigurdsson, S. %A Simmons, A. %A Singleton, A. %A Sisodiya, S. M. %A Smith, C. %A Smoller, J. W. %A Soininen, H. %A Srikanth, V. %A Steen, V. M. %A Stott, D. J. %A Sussmann, J. E. %A Thalamuthu, A. %A Tiemeier, H. %A Toga, A. W. %A Traynor, B. J. %A Troncoso, J. %A Turner, J. A. %A Tzourio, C. %A Uitterlinden, A. G. %A Hern?ndez, M. C. %A Van der Brug, M. %A van der Lugt, A. %A Van der Wee, N. J. %A van Duijn, C. M. %A Van Haren, N. E. %A Van T Ent, D. %A van Tol, M. J. %A Vardarajan, B. N. %A Veltman, D. J. %A Vernooij, M. W. %A V?lzke, H. %A Walter, H. %A Wardlaw, J. M. %A Wassink, T. H. %A Weale, M. E. %A Weinberger, D. R. %A Weiner, M. W. %A Wen, W. %A Westman, E. %A White, T. %A Wong, T. Y. %A Wright, C. B. %A Zielke, H. R. %A Zonderman, A. B. %A Deary, I. J. %A DeCarli, C. %A Schmidt, H. %A Martin, N. G. %A De Craen, A. J. %A Wright, M. J. %A Launer, L. J. %A Schumann, G. %A Fornage, M. %A Franke, B. %A Debette, S. %A Medland, S. E. %A Ikram, M. A. %A Thompson, P. M. %X Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously unknown loci for intracranial volume and confirmed two known signals. Four of the loci were also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρgenetic = 0.748), which indicates a similar genetic background and allowed us to identify four additional loci through meta-analysis (Ncombined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, and Parkinson's disease, and were enriched near genes involved in growth pathways, including PI3K-AKT signaling. These findings identify the biological underpinnings of intracranial volume and their link to physiological and pathological traits. %B Nat Neurosci %V 19 %P 1569–1582 %8 12 %G eng %0 Journal Article %J Am J Hypertens %D 2016 %T Orthostatic Hypotension and Risk of Venous Thromboembolism in 2 Cohort Studies. %A Bell, Elizabeth J %A Agarwal, Sunil K %A Cushman, Mary %A Heckbert, Susan R %A Lutsey, Pamela L %A Folsom, Aaron R %X

BACKGROUND: Although venous stasis is a risk factor for venous thromboembolism (VTE) and orthostatic hypotension (OH) can cause venous stasis, to our knowledge no study has examined the relationship between OH and VTE risk. We sought to quantify the association between OH and VTE (deep vein thrombosis or pulmonary embolism) using data from 2 large, prospective cohort studies: the Cardiovascular Health Study (CHS) and the Atherosclerosis Risk in Communities (ARIC) Study. We hypothesized that OH was positively associated with incident VTE.

METHODS: We measured OH-defined as a drop in systolic blood pressure (SBP) of at least 20 mm Hg or diastolic blood pressure (DBP) of at least 10 mm Hg within 3 minutes of standing-in participants aged 45-64 years in ARIC (n = 12,480) and ≥65 years in CHS (n = 5,027) at baseline visits (1987-1989 in ARIC; 1989-1990 and 1992-1993 in CHS), and followed participants for incident VTE (n = 568 in ARIC through 2011 and n = 148 in CHS through 2001). We calculated adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for incident VTE in relation to OH status.

RESULTS: In CHS, there was a positive association between OH status and incident VTE (HR for VTE = 1.74 (95% CI: 1.20-2.51)). In contrast, there was no association between OH and VTE in the ARIC study (HR for VTE = 0.97 (95% CI: 0.70-1.33)).

CONCLUSIONS: Community-dwelling older adults with OH had a moderately increased risk of VTE. These results were not seen in a population-based middle-aged cohort.

%B Am J Hypertens %V 29 %P 634-40 %8 2016 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/26306405?dopt=Abstract %R 10.1093/ajh/hpv151 %0 Journal Article %J Circulation %D 2016 %T Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study. %A Soares-Miranda, Luisa %A Siscovick, David S %A Psaty, Bruce M %A Longstreth, W T %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Coronary Disease %K Female %K Follow-Up Studies %K Health Status %K Humans %K Leisure Activities %K Male %K Motor Activity %K Proportional Hazards Models %K Prospective Studies %K Sampling Studies %K Stroke %K United States %K Walking %X

BACKGROUND: Although guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those >75 years. In addition, with advancing age the ability to perform some types of PA might decrease, making light-moderate exercise such as walking especially important to meet recommendations.

METHODS AND RESULTS: Prospective cohort analysis among 4207 US men and women of a mean age of 73 years (standard deviation=6) who were free of CVD at baseline in the Cardiovascular Health Study were followed from 1989 to 1999. PA was assessed and cumulatively updated over time to minimize misclassification and assess the long-term effects of habitual activity. Walking (pace, blocks, combined walking score) was updated annually from baseline through 1999. Leisure-time activity and exercise intensity were updated at baseline, 1992, and 1996. Incident CVD (fatal or nonfatal myocardial infarction, coronary death, or stroke) was adjudicated using medical records. During 41,995 person-years of follow-up, 1182 CVD events occurred. After multivariable adjustment, greater PA was inversely associated with coronary heart disease, stroke (especially ischemic stroke), and total CVD, even in those ≥75 years. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk. For example, in comparison with a walking pace <2 mph, those that habitually walked at a pace >3 mph had a lower risk of coronary heart disease (0.50; confidence interval, 0.38-0.67), stroke (0.47; confidence interval, 033-0.66), and CVD (0.50; confidence interval, 0.40-0.62).

CONCLUSIONS: These data provide empirical evidence supporting PA recommendations, in particular, walking, to reduce the incidence of CVD among older adults.

%B Circulation %V 133 %P 147-55 %8 2016 Jan 12 %G ENG %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26538582?dopt=Abstract %R 10.1161/CIRCULATIONAHA.115.018323 %0 Journal Article %J Am J Hum Genet %D 2016 %T Platelet-Related Variants Identified by Exomechip Meta-analysis in 157,293 Individuals. %A Eicher, John D %A Chami, Nathalie %A Kacprowski, Tim %A Nomura, Akihiro %A Chen, Ming-Huei %A Yanek, Lisa R %A Tajuddin, Salman M %A Schick, Ursula M %A Slater, Andrew J %A Pankratz, Nathan %A Polfus, Linda %A Schurmann, Claudia %A Giri, Ayush %A Brody, Jennifer A %A Lange, Leslie A %A Manichaikul, Ani %A Hill, W David %A Pazoki, Raha %A Elliot, Paul %A Evangelou, Evangelos %A Tzoulaki, Ioanna %A Gao, He %A Vergnaud, Anne-Claire %A Mathias, Rasika A %A Becker, Diane M %A Becker, Lewis C %A Burt, Amber %A Crosslin, David R %A Lyytikäinen, Leo-Pekka %A Nikus, Kjell %A Hernesniemi, Jussi %A Kähönen, Mika %A Raitoharju, Emma %A Mononen, Nina %A Raitakari, Olli T %A Lehtimäki, Terho %A Cushman, Mary %A Zakai, Neil A %A Nickerson, Deborah A %A Raffield, Laura M %A Quarells, Rakale %A Willer, Cristen J %A Peloso, Gina M %A Abecasis, Goncalo R %A Liu, Dajiang J %A Deloukas, Panos %A Samani, Nilesh J %A Schunkert, Heribert %A Erdmann, Jeanette %A Fornage, Myriam %A Richard, Melissa %A Tardif, Jean-Claude %A Rioux, John D %A Dubé, Marie-Pierre %A de Denus, Simon %A Lu, Yingchang %A Bottinger, Erwin P %A Loos, Ruth J F %A Smith, Albert Vernon %A Harris, Tamara B %A Launer, Lenore J %A Gudnason, Vilmundur %A Velez Edwards, Digna R %A Torstenson, Eric S %A Liu, Yongmei %A Tracy, Russell P %A Rotter, Jerome I %A Rich, Stephen S %A Highland, Heather M %A Boerwinkle, Eric %A Li, Jin %A Lange, Ethan %A Wilson, James G %A Mihailov, Evelin %A Mägi, Reedik %A Hirschhorn, Joel %A Metspalu, Andres %A Esko, Tõnu %A Vacchi-Suzzi, Caterina %A Nalls, Mike A %A Zonderman, Alan B %A Evans, Michele K %A Engström, Gunnar %A Orho-Melander, Marju %A Melander, Olle %A O'Donoghue, Michelle L %A Waterworth, Dawn M %A Wallentin, Lars %A White, Harvey D %A Floyd, James S %A Bartz, Traci M %A Rice, Kenneth M %A Psaty, Bruce M %A Starr, J M %A Liewald, David C M %A Hayward, Caroline %A Deary, Ian J %A Greinacher, Andreas %A Völker, Uwe %A Thiele, Thomas %A Völzke, Henry %A van Rooij, Frank J A %A Uitterlinden, André G %A Franco, Oscar H %A Dehghan, Abbas %A Edwards, Todd L %A Ganesh, Santhi K %A Kathiresan, Sekar %A Faraday, Nauder %A Auer, Paul L %A Reiner, Alex P %A Lettre, Guillaume %A Johnson, Andrew D %X

Platelet production, maintenance, and clearance are tightly controlled processes indicative of platelets' important roles in hemostasis and thrombosis. Platelets are common targets for primary and secondary prevention of several conditions. They are monitored clinically by complete blood counts, specifically with measurements of platelet count (PLT) and mean platelet volume (MPV). Identifying genetic effects on PLT and MPV can provide mechanistic insights into platelet biology and their role in disease. Therefore, we formed the Blood Cell Consortium (BCX) to perform a large-scale meta-analysis of Exomechip association results for PLT and MPV in 157,293 and 57,617 individuals, respectively. Using the low-frequency/rare coding variant-enriched Exomechip genotyping array, we sought to identify genetic variants associated with PLT and MPV. In addition to confirming 47 known PLT and 20 known MPV associations, we identified 32 PLT and 18 MPV associations not previously observed in the literature across the allele frequency spectrum, including rare large effect (FCER1A), low-frequency (IQGAP2, MAP1A, LY75), and common (ZMIZ2, SMG6, PEAR1, ARFGAP3/PACSIN2) variants. Several variants associated with PLT/MPV (PEAR1, MRVI1, PTGES3) were also associated with platelet reactivity. In concurrent BCX analyses, there was overlap of platelet-associated variants with red (MAP1A, TMPRSS6, ZMIZ2) and white (PEAR1, ZMIZ2, LY75) blood cell traits, suggesting common regulatory pathways with shared genetic architecture among these hematopoietic lineages. Our large-scale Exomechip analyses identified previously undocumented associations with platelet traits and further indicate that several complex quantitative hematological, lipid, and cardiovascular traits share genetic factors.

%B Am J Hum Genet %V 99 %P 40-55 %8 2016 Jul 7 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27346686?dopt=Abstract %R 10.1016/j.ajhg.2016.05.005 %0 Journal Article %J Front Genet %D 2016 %T Pleiotropic Meta-Analyses of Longitudinal Studies Discover Novel Genetic Variants Associated with Age-Related Diseases. %A He, Liang %A Kernogitski, Yelena %A Kulminskaya, Irina %A Loika, Yury %A Arbeev, Konstantin G %A Loiko, Elena %A Bagley, Olivia %A Duan, Matt %A Yashkin, Arseniy %A Ukraintseva, Svetlana V %A Kovtun, Mikhail %A Yashin, Anatoliy I %A Kulminski, Alexander M %X

Age-related diseases may result from shared biological mechanisms in intrinsic processes of aging. Genetic effects on age-related diseases are often modulated by environmental factors due to their little contribution to fitness or are mediated through certain endophenotypes. Identification of genetic variants with pleiotropic effects on both common complex diseases and endophenotypes may reveal potential conflicting evolutionary pressures and deliver new insights into shared genetic contribution to healthspan and lifespan. Here, we performed pleiotropic meta-analyses of genetic variants using five NIH-funded datasets by integrating univariate summary statistics for age-related diseases and endophenotypes. We investigated three groups of traits: (1) endophenotypes such as blood glucose, blood pressure, lipids, hematocrit, and body mass index, (2) time-to-event outcomes such as the age-at-onset of diabetes mellitus (DM), cancer, cardiovascular diseases (CVDs) and neurodegenerative diseases (NDs), and (3) both combined. In addition to replicating previous findings, we identify seven novel genome-wide significant loci (< 5e-08), out of which five are low-frequency variants. Specifically, from Group 2, we find rs7632505 on 3q21.1 in , rs460976 on 21q22.3 (1 kb from ) and rs12420422 on 11q24.1 predominantly associated with a variety of CVDs, rs4905014 in associated with stroke and heart failure, rs7081476 on 10p12.1 in associated with multiple diseases including DM, CVDs, and NDs. From Group 3, we find rs8082812 on 18p11.22 and rs1869717 on 4q31.3 associated with both endophenotypes and CVDs. Our follow-up analyses show that rs7632505, rs4905014, and rs8082812 have age-dependent effects on coronary heart disease or stroke. Functional annotation suggests that most of these SNPs are within regulatory regions or DNase clusters and in linkage disequilibrium with expression quantitative trait loci, implying their potential regulatory influence on the expression of nearby genes. Our mediation analyses suggest that the effects of some SNPs are mediated by specific endophenotypes. In conclusion, these findings indicate that loci with pleiotropic effects on age-related disorders tend to be enriched in genes involved in underlying mechanisms potentially related to nervous, cardiovascular and immune system functions, stress resistance, inflammation, ion channels and hematopoiesis, supporting the hypothesis of shared pathological role of infection, and inflammation in chronic age-related diseases.

%B Front Genet %V 7 %P 179 %8 2016 %G eng %R 10.3389/fgene.2016.00179 %0 Journal Article %J Circ Heart Fail %D 2016 %T Predicting Heart Failure With Preserved and Reduced Ejection Fraction: The International Collaboration on Heart Failure Subtypes. %A Ho, Jennifer E %A Enserro, Danielle %A Brouwers, Frank P %A Kizer, Jorge R %A Shah, Sanjiv J %A Psaty, Bruce M %A Bartz, Traci M %A Santhanakrishnan, Rajalakshmi %A Lee, Douglas S %A Chan, Cheeling %A Liu, Kiang %A Blaha, Michael J %A Hillege, Hans L %A van der Harst, Pim %A van Gilst, Wiek H %A Kop, Willem J %A Gansevoort, Ron T %A Vasan, Ramachandran S %A Gardin, Julius M %A Levy, Daniel %A Gottdiener, John S %A de Boer, Rudolf A %A Larson, Martin G %X

BACKGROUND: Heart failure (HF) is a prevalent and deadly disease, and preventive strategies focused on at-risk individuals are needed. Current HF prediction models have not examined HF subtypes. We sought to develop and validate risk prediction models for HF with preserved and reduced ejection fraction (HFpEF, HFrEF).

METHODS AND RESULTS: Of 28,820 participants from 4 community-based cohorts, 982 developed incident HFpEF and 909 HFrEF during a median follow-up of 12 years. Three cohorts were combined, and a 2:1 random split was used for derivation and internal validation, with the fourth cohort as external validation. Models accounted for multiple competing risks (death, other HF subtype, and unclassified HF). The HFpEF-specific model included age, sex, systolic blood pressure, body mass index, antihypertensive treatment, and previous myocardial infarction; it had good discrimination in derivation (c-statistic 0.80; 95% confidence interval [CI], 0.78-0.82) and validation samples (internal: 0.79; 95% CI, 0.77-0.82 and external: 0.76; 95% CI: 0.71-0.80). The HFrEF-specific model additionally included smoking, left ventricular hypertrophy, left bundle branch block, and diabetes mellitus; it had good discrimination in derivation (c-statistic 0.82; 95% CI, 0.80-0.84) and validation samples (internal: 0.80; 95% CI, 0.78-0.83 and external: 0.76; 95% CI, 0.71-0.80). Age was more strongly associated with HFpEF, and male sex, left ventricular hypertrophy, bundle branch block, previous myocardial infarction, and smoking with HFrEF (P value for each comparison ≤0.02).

CONCLUSIONS: We describe and validate risk prediction models for HF subtypes and show good discrimination in a large sample. Some risk factors differed between HFpEF and HFrEF, supporting the notion of pathogenetic differences among HF subtypes.

%B Circ Heart Fail %V 9 %8 2016 Jun %G eng %N 6 %R 10.1161/CIRCHEARTFAILURE.115.003116 %0 Journal Article %J Nat Commun %D 2016 %T A principal component meta-analysis on multiple anthropometric traits identifies novel loci for body shape. %A Ried, Janina S %A Jeff M, Janina %A Chu, Audrey Y %A Bragg-Gresham, Jennifer L %A van Dongen, Jenny %A Huffman, Jennifer E %A Ahluwalia, Tarunveer S %A Cadby, Gemma %A Eklund, Niina %A Eriksson, Joel %A Esko, Tõnu %A Feitosa, Mary F %A Goel, Anuj %A Gorski, Mathias %A Hayward, Caroline %A Heard-Costa, Nancy L %A Jackson, Anne U %A Jokinen, Eero %A Kanoni, Stavroula %A Kristiansson, Kati %A Kutalik, Zoltán %A Lahti, Jari %A Luan, Jian'an %A Mägi, Reedik %A Mahajan, Anubha %A Mangino, Massimo %A Medina-Gómez, Carolina %A Monda, Keri L %A Nolte, Ilja M %A Perusse, Louis %A Prokopenko, Inga %A Qi, Lu %A Rose, Lynda M %A Salvi, Erika %A Smith, Megan T %A Snieder, Harold %A Stančáková, Alena %A Ju Sung, Yun %A Tachmazidou, Ioanna %A Teumer, Alexander %A Thorleifsson, Gudmar %A van der Harst, Pim %A Walker, Ryan W %A Wang, Sophie R %A Wild, Sarah H %A Willems, Sara M %A Wong, Andrew %A Zhang, Weihua %A Albrecht, Eva %A Couto Alves, Alexessander %A Bakker, Stephan J L %A Barlassina, Cristina %A Bartz, Traci M %A Beilby, John %A Bellis, Claire %A Bergman, Richard N %A Bergmann, Sven %A Blangero, John %A Blüher, Matthias %A Boerwinkle, Eric %A Bonnycastle, Lori L %A Bornstein, Stefan R %A Bruinenberg, Marcel %A Campbell, Harry %A Chen, Yii-Der Ida %A Chiang, Charleston W K %A Chines, Peter S %A Collins, Francis S %A Cucca, Fracensco %A Cupples, L Adrienne %A D'Avila, Francesca %A de Geus, Eco J C %A Dedoussis, George %A Dimitriou, Maria %A Döring, Angela %A Eriksson, Johan G %A Farmaki, Aliki-Eleni %A Farrall, Martin %A Ferreira, Teresa %A Fischer, Krista %A Forouhi, Nita G %A Friedrich, Nele %A Gjesing, Anette Prior %A Glorioso, Nicola %A Graff, Mariaelisa %A Grallert, Harald %A Grarup, Niels %A Gräßler, Jürgen %A Grewal, Jagvir %A Hamsten, Anders %A Harder, Marie Neergaard %A Hartman, Catharina A %A Hassinen, Maija %A Hastie, Nicholas %A Hattersley, Andrew Tym %A Havulinna, Aki S %A Heliövaara, Markku %A Hillege, Hans %A Hofman, Albert %A Holmen, Oddgeir %A Homuth, Georg %A Hottenga, Jouke-Jan %A Hui, Jennie %A Husemoen, Lise Lotte %A Hysi, Pirro G %A Isaacs, Aaron %A Ittermann, Till %A Jalilzadeh, Shapour %A James, Alan L %A Jørgensen, Torben %A Jousilahti, Pekka %A Jula, Antti %A Marie Justesen, Johanne %A Justice, Anne E %A Kähönen, Mika %A Karaleftheri, Maria %A Tee Khaw, Kay %A Keinanen-Kiukaanniemi, Sirkka M %A Kinnunen, Leena %A Knekt, Paul B %A Koistinen, Heikki A %A Kolcic, Ivana %A Kooner, Ishminder K %A Koskinen, Seppo %A Kovacs, Peter %A Kyriakou, Theodosios %A Laitinen, Tomi %A Langenberg, Claudia %A Lewin, Alexandra M %A Lichtner, Peter %A Lindgren, Cecilia M %A Lindström, Jaana %A Linneberg, Allan %A Lorbeer, Roberto %A Lorentzon, Mattias %A Luben, Robert %A Lyssenko, Valeriya %A Männistö, Satu %A Manunta, Paolo %A Leach, Irene Mateo %A McArdle, Wendy L %A McKnight, Barbara %A Mohlke, Karen L %A Mihailov, Evelin %A Milani, Lili %A Mills, Rebecca %A Montasser, May E %A Morris, Andrew P %A Müller, Gabriele %A Musk, Arthur W %A Narisu, Narisu %A Ong, Ken K %A Oostra, Ben A %A Osmond, Clive %A Palotie, Aarno %A Pankow, James S %A Paternoster, Lavinia %A Penninx, Brenda W %A Pichler, Irene %A Pilia, Maria G %A Polasek, Ozren %A Pramstaller, Peter P %A Raitakari, Olli T %A Rankinen, Tuomo %A Rao, D C %A Rayner, Nigel W %A Ribel-Madsen, Rasmus %A Rice, Treva K %A Richards, Marcus %A Ridker, Paul M %A Rivadeneira, Fernando %A Ryan, Kathy A %A Sanna, Serena %A Sarzynski, Mark A %A Scholtens, Salome %A Scott, Robert A %A Sebert, Sylvain %A Southam, Lorraine %A Sparsø, Thomas Hempel %A Steinthorsdottir, Valgerdur %A Stirrups, Kathleen %A Stolk, Ronald P %A Strauch, Konstantin %A Stringham, Heather M %A Swertz, Morris A %A Swift, Amy J %A Tönjes, Anke %A Tsafantakis, Emmanouil %A van der Most, Peter J %A van Vliet-Ostaptchouk, Jana V %A Vandenput, Liesbeth %A Vartiainen, Erkki %A Venturini, Cristina %A Verweij, Niek %A Viikari, Jorma S %A Vitart, Veronique %A Vohl, Marie-Claude %A Vonk, Judith M %A Waeber, Gérard %A Widen, Elisabeth %A Willemsen, Gonneke %A Wilsgaard, Tom %A Winkler, Thomas W %A Wright, Alan F %A Yerges-Armstrong, Laura M %A Hua Zhao, Jing %A Zillikens, M Carola %A Boomsma, Dorret I %A Bouchard, Claude %A Chambers, John C %A Chasman, Daniel I %A Cusi, Daniele %A Gansevoort, Ron T %A Gieger, Christian %A Hansen, Torben %A Hicks, Andrew A %A Hu, Frank %A Hveem, Kristian %A Jarvelin, Marjo-Riitta %A Kajantie, Eero %A Kooner, Jaspal S %A Kuh, Diana %A Kuusisto, Johanna %A Laakso, Markku %A Lakka, Timo A %A Lehtimäki, Terho %A Metspalu, Andres %A Njølstad, Inger %A Ohlsson, Claes %A Oldehinkel, Albertine J %A Palmer, Lyle J %A Pedersen, Oluf %A Perola, Markus %A Peters, Annette %A Psaty, Bruce M %A Puolijoki, Hannu %A Rauramaa, Rainer %A Rudan, Igor %A Salomaa, Veikko %A Schwarz, Peter E H %A Shudiner, Alan R %A Smit, Jan H %A Sørensen, Thorkild I A %A Spector, Timothy D %A Stefansson, Kari %A Stumvoll, Michael %A Tremblay, Angelo %A Tuomilehto, Jaakko %A Uitterlinden, André G %A Uusitupa, Matti %A Völker, Uwe %A Vollenweider, Peter %A Wareham, Nicholas J %A Watkins, Hugh %A Wilson, James F %A Zeggini, Eleftheria %A Abecasis, Goncalo R %A Boehnke, Michael %A Borecki, Ingrid B %A Deloukas, Panos %A van Duijn, Cornelia M %A Fox, Caroline %A Groop, Leif C %A Heid, Iris M %A Hunter, David J %A Kaplan, Robert C %A McCarthy, Mark I %A North, Kari E %A O'Connell, Jeffrey R %A Schlessinger, David %A Thorsteinsdottir, Unnur %A Strachan, David P %A Frayling, Timothy %A Hirschhorn, Joel N %A Müller-Nurasyid, Martina %A Loos, Ruth J F %K Anthropometry %K Body Size %K Genome-Wide Association Study %K Genotype %K Humans %K Models, Genetic %K Principal Component Analysis %X

Large consortia have revealed hundreds of genetic loci associated with anthropometric traits, one trait at a time. We examined whether genetic variants affect body shape as a composite phenotype that is represented by a combination of anthropometric traits. We developed an approach that calculates averaged PCs (AvPCs) representing body shape derived from six anthropometric traits (body mass index, height, weight, waist and hip circumference, waist-to-hip ratio). The first four AvPCs explain >99% of the variability, are heritable, and associate with cardiometabolic outcomes. We performed genome-wide association analyses for each body shape composite phenotype across 65 studies and meta-analysed summary statistics. We identify six novel loci: LEMD2 and CD47 for AvPC1, RPS6KA5/C14orf159 and GANAB for AvPC3, and ARL15 and ANP32 for AvPC4. Our findings highlight the value of using multiple traits to define complex phenotypes for discovery, which are not captured by single-trait analyses, and may shed light onto new pathways.

%B Nat Commun %V 7 %P 13357 %8 2016 11 23 %G eng %R 10.1038/ncomms13357 %0 Journal Article %J Circ Cardiovasc Genet %D 2016 %T Rare Exome Sequence Variants in CLCN6 Reduce Blood Pressure Levels and Hypertension Risk. %A Yu, Bing %A Pulit, Sara L %A Hwang, Shih-Jen %A Brody, Jennifer A %A Amin, Najaf %A Auer, Paul L %A Bis, Joshua C %A Boerwinkle, Eric %A Burke, Gregory L %A Chakravarti, Aravinda %A Correa, Adolfo %A Dreisbach, Albert W %A Franco, Oscar H %A Ehret, Georg B %A Franceschini, Nora %A Hofman, Albert %A Lin, Dan-Yu %A Metcalf, Ginger A %A Musani, Solomon K %A Muzny, Donna %A Palmas, Walter %A Raffel, Leslie %A Reiner, Alex %A Rice, Ken %A Rotter, Jerome I %A Veeraraghavan, Narayanan %A Fox, Ervin %A Guo, Xiuqing %A North, Kari E %A Gibbs, Richard A %A van Duijn, Cornelia M %A Psaty, Bruce M %A Levy, Daniel %A Newton-Cheh, Christopher %A Morrison, Alanna C %X

BACKGROUND: Rare genetic variants influence blood pressure (BP).

METHODS AND RESULTS: Whole-exome sequencing was performed on DNA samples from 17 956 individuals of European ancestry and African ancestry (14 497, first-stage discovery and 3459, second-stage discovery) to examine the effect of rare variants on hypertension and 4 BP traits: systolic BP, diastolic BP, pulse pressure, and mean arterial pressure. Tests of ≈170 000 common variants (minor allele frequency, ≥1%; statistical significance, P≤2.9×10(-7)) and gene-based tests of rare variants (minor allele frequency, <1%; ≈17 000 genes; statistical significance, P≤1.5×10(-6)) were evaluated for each trait and ancestry, followed by multiethnic meta-analyses. In the first-stage discovery, rare coding variants (splicing, stop-gain, stop-loss, nonsynonymous variants, or indels) in CLCN6 were associated with lower diastolic BP (cumulative minor allele frequency, 1.3%; β=-3.20; P=4.1×10(-6)) and were independent of a nearby common variant (rs17367504) previously associated with BP. CLCN6 rare variants were also associated with lower systolic BP (β=-4.11; P=2.8×10(-4)), mean arterial pressure (β=-3.50; P=8.9×10(-6)), and reduced hypertension risk (odds ratio, 0.72; P=0.017). Meta-analysis of the 2-stage discovery samples showed that CLCN6 was associated with lower diastolic BP at exome-wide significance (cumulative minor allele frequency, 1.1%; β=-3.30; P=5.0×10(-7)).

CONCLUSIONS: These findings implicate the effect of rare coding variants in CLCN6 in BP variation and offer new insights into BP regulation.

%B Circ Cardiovasc Genet %V 9 %P 64-70 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26658788?dopt=Abstract %R 10.1161/CIRCGENETICS.115.001215 %0 Journal Article %J PLoS Genet %D 2016 %T Rare Functional Variant in TM2D3 is Associated with Late-Onset Alzheimer's Disease. %A Jakobsdottir, Johanna %A van der Lee, Sven J %A Bis, Joshua C %A Chouraki, Vincent %A Li-Kroeger, David %A Yamamoto, Shinya %A Grove, Megan L %A Naj, Adam %A Vronskaya, Maria %A Salazar, Jose L %A DeStefano, Anita L %A Brody, Jennifer A %A Smith, Albert V %A Amin, Najaf %A Sims, Rebecca %A Ibrahim-Verbaas, Carla A %A Choi, Seung-Hoan %A Satizabal, Claudia L %A Lopez, Oscar L %A Beiser, Alexa %A Ikram, M Arfan %A Garcia, Melissa E %A Hayward, Caroline %A Varga, Tibor V %A Ripatti, Samuli %A Franks, Paul W %A Hallmans, Göran %A Rolandsson, Olov %A Jansson, Jan-Håkon %A Porteous, David J %A Salomaa, Veikko %A Eiriksdottir, Gudny %A Rice, Kenneth M %A Bellen, Hugo J %A Levy, Daniel %A Uitterlinden, André G %A Emilsson, Valur %A Rotter, Jerome I %A Aspelund, Thor %A O'Donnell, Christopher J %A Fitzpatrick, Annette L %A Launer, Lenore J %A Hofman, Albert %A Wang, Li-San %A Williams, Julie %A Schellenberg, Gerard D %A Boerwinkle, Eric %A Psaty, Bruce M %A Seshadri, Sudha %A Shulman, Joshua M %A Gudnason, Vilmundur %A van Duijn, Cornelia M %X

We performed an exome-wide association analysis in 1393 late-onset Alzheimer's disease (LOAD) cases and 8141 controls from the CHARGE consortium. We found that a rare variant (P155L) in TM2D3 was enriched in Icelanders (~0.5% versus <0.05% in other European populations). In 433 LOAD cases and 3903 controls from the Icelandic AGES sub-study, P155L was associated with increased risk and earlier onset of LOAD [odds ratio (95% CI) = 7.5 (3.5-15.9), p = 6.6x10-9]. Mutation in the Drosophila TM2D3 homolog, almondex, causes a phenotype similar to loss of Notch/Presenilin signaling. Human TM2D3 is capable of rescuing these phenotypes, but this activity is abolished by P155L, establishing it as a functionally damaging allele. Our results establish a rare TM2D3 variant in association with LOAD susceptibility, and together with prior work suggests possible links to the β-amyloid cascade.

%B PLoS Genet %V 12 %P e1006327 %8 2016 Oct %G eng %N 10 %R 10.1371/journal.pgen.1006327 %0 Journal Article %J Mol Psychiatry %D 2016 %T Rare, low frequency and common coding variants in CHRNA5 and their contribution to nicotine dependence in European and African Americans. %A Olfson, E %A Saccone, N L %A Johnson, E O %A Chen, L-S %A Culverhouse, R %A Doheny, K %A Foltz, S M %A Fox, L %A Gogarten, S M %A Hartz, S %A Hetrick, K %A Laurie, C C %A Marosy, B %A Amin, N %A Arnett, D %A Barr, R G %A Bartz, T M %A Bertelsen, S %A Borecki, I B %A Brown, M R %A Chasman, D I %A van Duijn, C M %A Feitosa, M F %A Fox, E R %A Franceschini, N %A Franco, O H %A Grove, M L %A Guo, X %A Hofman, A %A Kardia, S L R %A Morrison, A C %A Musani, S K %A Psaty, B M %A Rao, D C %A Reiner, A P %A Rice, K %A Ridker, P M %A Rose, L M %A Schick, U M %A Schwander, K %A Uitterlinden, A G %A Vojinovic, D %A Wang, J-C %A Ware, E B %A Wilson, G %A Yao, J %A Zhao, W %A Breslau, N %A Hatsukami, D %A Stitzel, J A %A Rice, J %A Goate, A %A Bierut, L J %X

The common nonsynonymous variant rs16969968 in the α5 nicotinic receptor subunit gene (CHRNA5) is the strongest genetic risk factor for nicotine dependence in European Americans and contributes to risk in African Americans. To comprehensively examine whether other CHRNA5 coding variation influences nicotine dependence risk, we performed targeted sequencing on 1582 nicotine-dependent cases (Fagerström Test for Nicotine Dependence score⩾4) and 1238 non-dependent controls, with independent replication of common and low frequency variants using 12 studies with exome chip data. Nicotine dependence was examined using logistic regression with individual common variants (minor allele frequency (MAF)⩾0.05), aggregate low frequency variants (0.05>MAF⩾0.005) and aggregate rare variants (MAF<0.005). Meta-analysis of primary results was performed with replication studies containing 12 174 heavy and 11 290 light smokers. Next-generation sequencing with 180 × coverage identified 24 nonsynonymous variants and 2 frameshift deletions in CHRNA5, including 9 novel variants in the 2820 subjects. Meta-analysis confirmed the risk effect of the only common variant (rs16969968, European ancestry: odds ratio (OR)=1.3, P=3.5 × 10(-11); African ancestry: OR=1.3, P=0.01) and demonstrated that three low frequency variants contributed an independent risk (aggregate term, European ancestry: OR=1.3, P=0.005; African ancestry: OR=1.4, P=0.0006). The remaining 22 rare coding variants were associated with increased risk of nicotine dependence in the European American primary sample (OR=12.9, P=0.01) and in the same risk direction in African Americans (OR=1.5, P=0.37). Our results indicate that common, low frequency and rare CHRNA5 coding variants are independently associated with nicotine dependence risk. These newly identified variants likely influence the risk for smoking-related diseases such as lung cancer.

%B Mol Psychiatry %V 21 %P 601-7 %8 2016 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/26239294?dopt=Abstract %R 10.1038/mp.2015.105 %0 Journal Article %J Cerebrovasc Dis Extra %D 2016 %T Risk Factors for Incident Carotid Artery Revascularization among Older Adults: The Cardiovascular Health Study. %A Garg, Parveen K %A Koh, Willam J H %A Delaney, Joseph A %A Halm, Ethan A %A Hirsch, Calvin H %A Longstreth, William T %A Mukamal, Kenneth J %A Kucharska-Newton, Anna %A Polak, Joseph F %A Curtis, Lesley %X

BACKGROUND: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults.

METHODS: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), 5,107 participants without a prior history of carotid endarterectomy (CEA) or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses. Cox proportional hazards multivariable analysis was used to determine independent risk factors for incident carotid artery revascularization.

RESULTS: Over a mean follow-up of 13.5 years, 141 participants underwent carotid artery revascularization, 97% were CEA. Baseline degree of stenosis and incident ischemic cerebral events occurring during follow-up were the strongest predictors of incident revascularization. After adjustment for these, factors independently associated with an increased risk of incident revascularization were: hypertension (HR 1.53; 95% CI: 1.05-2.23), peripheral arterial disease (HR 2.57; 95% CI: 1.34-4.93), and low-density lipoprotein cholesterol (HR 1.23 per standard deviation [SD] increment [35.4 mg/dL]; 95% CI: 1.04-1.46). Factors independently associated with a lower risk of incident revascularization were: female gender (HR 0.51; 95% CI: 0.34-0.77) and older age (HR 0.69 per SD increment [5.5 years]; 95% CI: 0.56-0.86).

CONCLUSIONS: Even after accounting for carotid stenosis and incident cerebral ischemic events, carotid revascularization is related to age, gender, and cardiovascular risk factors. Further study of these demographic disparities and the role of risk factor control is warranted.

%B Cerebrovasc Dis Extra %V 6 %P 129-139 %8 2016 Nov 16 %G eng %N 3 %R 10.1159/000452426 %0 Journal Article %J Alzheimers Dement %D 2016 %T Risk of dementia and death in the long-term follow-up of the Pittsburgh Cardiovascular Health Study-Cognition Study. %A Kuller, Lewis H %A Lopez, Oscar L %A Becker, James T %A Chang, Yuefang %A Newman, Anne B %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Apolipoprotein E4 %K Brain %K Cardiovascular Diseases %K Cognition %K Dementia %K European Continental Ancestry Group %K Female %K Follow-Up Studies %K Humans %K Magnetic Resonance Imaging %K Male %K Neuropsychological Tests %K Pennsylvania %K Risk Factors %K Walking %X

INTRODUCTION: Increasing life expectancy has resulted in a larger population of older individuals at risk of dementia.

METHODS: The Cardiovascular Health Study-Cognition Study followed 532 participants from 1998-99 (mean age 79) to 2013 (mean age 93) for death and dementia.

RESULTS: Risk of death was determined by extent of coronary artery calcium, high-sensitivity cardiac troponin, brain natriuretic peptide, and white matter grade. Significant predictors of dementia were age, apolipoprotein-E4, vocabulary raw score, hippocampal volume, ventricular size, cognitive performance, and number of blocks walked. By 2013, 160 of 532 were alive, including 19 cognitively normal. Those with normal cognition had higher grade education, better cognition test scores, greater hippocampal volume, faster gait speed, and number of blocks walked as compared with survivors who were demented.

DISCUSSION: Few survived free of dementia and disability. Prevention and delay of cognitive decline for this older population is an imperative.

%B Alzheimers Dement %V 12 %P 170-83 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26519786?dopt=Abstract %R 10.1016/j.jalz.2015.08.165 %0 Journal Article %J Pharmacogenomics %D 2016 %T Rooted in risk: genetic predisposition for low-density lipoprotein cholesterol level associates with diminished low-density lipoprotein cholesterol response to statin treatment. %A Smit, Roelof Aj %A Postmus, Iris %A Trompet, Stella %A Barnes, Michael R %A Warren, Helen %A Arsenault, Benoit J %A Chasman, Daniel I %A Cupples, L Adrienne %A Hitman, Graham A %A Krauss, Ronald M %A Li, Xiaohui %A Psaty, Bruce M %A Stein, Charles M %A Rotter, Jerome I %A Jukema, J Wouter %K Cholesterol, LDL %K Genetic Predisposition to Disease %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Pharmacogenetics %K Polymorphism, Single Nucleotide %K Triglycerides %X

AIMS: To utilize previously reported lead SNPs for low-density lipoprotein cholesterol (LDL-c) levels to find additional loci of importance to statin response, and examine whether genetic predisposition to LDL-c levels associates with differential statin response.

METHODS: We investigated effects on statin response of 59 LDL-c SNPs, by combining summary level statistics from the Global Lipids Genetics and Genomic Investigation of Statin Therapy consortia.

RESULTS: Lead SNPs for APOE, SORT1 and NPC1L1 were associated with a decreased LDL-c response to statin treatment, as was overall genetic predisposition for increased LDL-c levels as quantified with 59 SNPs, with a 5.4% smaller statin response per standard deviation increase in genetically raised LDL-c levels.

CONCLUSION: Genetic predisposition for increased LDL-c level may decrease efficacy of statin therapy.

%B Pharmacogenomics %V 17 %P 1621-1628 %8 2016 10 %G eng %N 15 %R 10.2217/pgs-2016-0091 %0 Journal Article %J Osteoporos Int %D 2016 %T Soluble CD14 and fracture risk. %A Bethel, M %A Bůžková, P %A Fink, H A %A Robbins, J A %A Cauley, J A %A Lee, J %A Barzilay, J I %A Jalal, D I %A Carbone, L D %X

UNLABELLED: Soluble CD14 (sCD14) is an inflammatory marker associated with osteoclasts. Using Cox proportional hazards models, we found a positive association between plasma levels of sCD14 and risk of incident fracture among participants in the Cardiovascular Health Study. sCD14 may be useful in identifying those at risk for fracture.

INTRODUCTION: Soluble CD14, a proinflammatory cytokine, is primarily derived from macrophages/monocytes that can differentiate into osteoclasts. The purpose of this study was to examine the relationship between sCD14 levels and osteoporotic fractures.

METHODS: In the Cardiovascular Health Study, 5462 men and women had sCD14 levels measured at baseline. Incident hip fractures (median follow-up time 12.5 years) and incident composite fractures (defined as the first hip, pelvis, humerus, or distal radius fracture, median follow-up 8.6 years) were identified from hospital discharge summaries and/or Medicare claims data. Cox proportional hazards models were used to model the association between sCD14 levels and time to incident hip or composite fracture, overall and as a function of race and gender.

RESULTS: In unadjusted models, there was a positive association between sCD14 levels (per 1 standard deviation increase, i.e., 361.6 ng/mL) and incident hip (HR, 1.26; 95 % CI, 1.17, 1.36) and composite (HR, 1.20; 95 % CI, 1.12, 1.28) fractures. When models were fully adjusted for demographics, lifestyle factors, and medication use, these associations were no longer significant. However, in whites, the association of sCD14 levels with hip fractures remained significant in fully adjusted models (HR, 1.11; 95 % CI, 1.01-1.23). Associations of sCD14 levels with hip and composite fracture did not differ between men and women.

CONCLUSIONS: In this large cohort of community-dwelling older adults, higher sCD14 levels were associated with an increased risk of incident hip fractures in whites.

%B Osteoporos Int %V 27 %P 1755-63 %8 2016 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/26659065?dopt=Abstract %R 10.1007/s00198-015-3439-9 %0 Journal Article %J J Am Soc Nephrol %D 2016 %T SOS2 and ACP1 Loci Identified through Large-Scale Exome Chip Analysis Regulate Kidney Development and Function. %A Li, Man %A Li, Yong %A Weeks, Olivia %A Mijatovic, Vladan %A Teumer, Alexander %A Huffman, Jennifer E %A Tromp, Gerard %A Fuchsberger, Christian %A Gorski, Mathias %A Lyytikäinen, Leo-Pekka %A Nutile, Teresa %A Sedaghat, Sanaz %A Sorice, Rossella %A Tin, Adrienne %A Yang, Qiong %A Ahluwalia, Tarunveer S %A Arking, Dan E %A Bihlmeyer, Nathan A %A Böger, Carsten A %A Carroll, Robert J %A Chasman, Daniel I %A Cornelis, Marilyn C %A Dehghan, Abbas %A Faul, Jessica D %A Feitosa, Mary F %A Gambaro, Giovanni %A Gasparini, Paolo %A Giulianini, Franco %A Heid, Iris %A Huang, Jinyan %A Imboden, Medea %A Jackson, Anne U %A Jeff, Janina %A Jhun, Min A %A Katz, Ronit %A Kifley, Annette %A Kilpeläinen, Tuomas O %A Kumar, Ashish %A Laakso, Markku %A Li-Gao, Ruifang %A Lohman, Kurt %A Lu, Yingchang %A Mägi, Reedik %A Malerba, Giovanni %A Mihailov, Evelin %A Mohlke, Karen L %A Mook-Kanamori, Dennis O %A Robino, Antonietta %A Ruderfer, Douglas %A Salvi, Erika %A Schick, Ursula M %A Schulz, Christina-Alexandra %A Smith, Albert V %A Smith, Jennifer A %A Traglia, Michela %A Yerges-Armstrong, Laura M %A Zhao, Wei %A Goodarzi, Mark O %A Kraja, Aldi T %A Liu, Chunyu %A Wessel, Jennifer %A Boerwinkle, Eric %A Borecki, Ingrid B %A Bork-Jensen, Jette %A Bottinger, Erwin P %A Braga, Daniele %A Brandslund, Ivan %A Brody, Jennifer A %A Campbell, Archie %A Carey, David J %A Christensen, Cramer %A Coresh, Josef %A Crook, Errol %A Curhan, Gary C %A Cusi, Daniele %A de Boer, Ian H %A de Vries, Aiko P J %A Denny, Joshua C %A Devuyst, Olivier %A Dreisbach, Albert W %A Endlich, Karlhans %A Esko, Tõnu %A Franco, Oscar H %A Fulop, Tibor %A Gerhard, Glenn S %A Glümer, Charlotte %A Gottesman, Omri %A Grarup, Niels %A Gudnason, Vilmundur %A Harris, Tamara B %A Hayward, Caroline %A Hocking, Lynne %A Hofman, Albert %A Hu, Frank B %A Husemoen, Lise Lotte N %A Jackson, Rebecca D %A Jørgensen, Torben %A Jørgensen, Marit E %A Kähönen, Mika %A Kardia, Sharon L R %A König, Wolfgang %A Kooperberg, Charles %A Kriebel, Jennifer %A Launer, Lenore J %A Lauritzen, Torsten %A Lehtimäki, Terho %A Levy, Daniel %A Linksted, Pamela %A Linneberg, Allan %A Liu, Yongmei %A Loos, Ruth J F %A Lupo, Antonio %A Meisinger, Christine %A Melander, Olle %A Metspalu, Andres %A Mitchell, Paul %A Nauck, Matthias %A Nürnberg, Peter %A Orho-Melander, Marju %A Parsa, Afshin %A Pedersen, Oluf %A Peters, Annette %A Peters, Ulrike %A Polasek, Ozren %A Porteous, David %A Probst-Hensch, Nicole M %A Psaty, Bruce M %A Qi, Lu %A Raitakari, Olli T %A Reiner, Alex P %A Rettig, Rainer %A Ridker, Paul M %A Rivadeneira, Fernando %A Rossouw, Jacques E %A Schmidt, Frank %A Siscovick, David %A Soranzo, Nicole %A Strauch, Konstantin %A Toniolo, Daniela %A Turner, Stephen T %A Uitterlinden, André G %A Ulivi, Sheila %A Velayutham, Dinesh %A Völker, Uwe %A Völzke, Henry %A Waldenberger, Melanie %A Wang, Jie Jin %A Weir, David R %A Witte, Daniel %A Kuivaniemi, Helena %A Fox, Caroline S %A Franceschini, Nora %A Goessling, Wolfram %A Köttgen, Anna %A Chu, Audrey Y %X

Genome-wide association studies have identified >50 common variants associated with kidney function, but these variants do not fully explain the variation in eGFR. We performed a two-stage meta-analysis of associations between genotypes from the Illumina exome array and eGFR on the basis of serum creatinine (eGFRcrea) among participants of European ancestry from the CKDGen Consortium (nStage1: 111,666; nStage2: 48,343). In single-variant analyses, we identified single nucleotide polymorphisms at seven new loci associated with eGFRcrea (PPM1J, EDEM3, ACP1, SPEG, EYA4, CYP1A1, and ATXN2L; PStage1<3.7×10(-7)), of which most were common and annotated as nonsynonymous variants. Gene-based analysis identified associations of functional rare variants in three genes with eGFRcrea, including a novel association with the SOS Ras/Rho guanine nucleotide exchange factor 2 gene, SOS2 (P=5.4×10(-8) by sequence kernel association test). Experimental follow-up in zebrafish embryos revealed changes in glomerular gene expression and renal tubule morphology in the embryonic kidney of acp1- and sos2-knockdowns. These developmental abnormalities associated with altered blood clearance rate and heightened prevalence of edema. This study expands the number of loci associated with kidney function and identifies novel genes with potential roles in kidney formation.

%B J Am Soc Nephrol %8 2016 Dec 05 %G eng %R 10.1681/ASN.2016020131 %0 Journal Article %J J Am Geriatr Soc %D 2016 %T Spousal Associations Between Frailty and Depressive Symptoms: Longitudinal Findings from the Cardiovascular Health Study. %A Monin, Joan %A Doyle, Margaret %A Levy, Becca %A Schulz, Richard %A Fried, Terri %A Kershaw, Trace %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Depression %K Female %K Frail Elderly %K Humans %K Longitudinal Studies %K Male %K Risk Factors %K Spouses %K United States %X

OBJECTIVES: To determine whether older adult spouses' frailty states and depressive symptoms are interrelated over time.

DESIGN: Longitudinal, dyadic path analysis using the Actor-Partner Interdependence Model.

SETTING: Data were from baseline (1989-90), Wave 3 (1992-93), and Wave 7 (1996-97), all waves in which frailty and depressive symptoms were measured, of the Cardiovascular Health Study (CHS), a multisite, longitudinal, observational study of risk factors for cardiovascular disease in adults aged 65 and older.

PARTICIPANTS: Spouses in 1,260 community-dwelling married couples.

MEASUREMENTS: Frailty was measured using the CHS criteria, categorized as nonfrail, prefrail, or frail. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale.

RESULTS: Within individuals (actor effects), greater frailty predicted greater subsequent depressive symptoms, and greater depressive symptoms predicted greater subsequent frailty. Between spouses (partner effects), an individual's greater frailty predicted the spouse's greater frailty, and an individual's greater depressive symptoms predicted the spouse's greater depressive symptoms.

CONCLUSION: Frailty and depressive symptoms are interrelated in older adult spouses. For older couples, interventions to prevent or treat frailty and depression that focus on couples may be more effective than those that focus on individuals.

%B J Am Geriatr Soc %V 64 %P 824-30 %8 2016 Apr %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/27100578?dopt=Abstract %R 10.1111/jgs.14023 %0 Journal Article %J Circulation %D 2016 %T Study of Cardiovascular Health Outcomes in the Era of Claims Data: The Cardiovascular Health Study. %A Psaty, Bruce M %A Delaney, Joseph A %A Arnold, Alice M %A Curtis, Lesley H %A Fitzpatrick, Annette L %A Heckbert, Susan R %A McKnight, Barbara %A Ives, Diane %A Gottdiener, John S %A Kuller, Lewis H %A Longstreth, W T %K Blood Glucose %K Cardiovascular Diseases %K Female %K Follow-Up Studies %K Health Surveys %K Hospitalization %K Hospitals, Veterans %K Humans %K Insurance Claim Review %K International Classification of Diseases %K Lipids %K Male %K Managed Care Programs %K Medicare %K Risk Factors %K Sampling Studies %K Treatment Outcome %K United States %X

BACKGROUND: Increasingly, the diagnostic codes from administrative claims data are being used as clinical outcomes.

METHODS AND RESULTS: Data from the Cardiovascular Health Study (CHS) were used to compare event rates and risk factor associations between adjudicated hospitalized cardiovascular events and claims-based methods of defining events. The outcomes of myocardial infarction (MI), stroke, and heart failure were defined in 3 ways: the CHS adjudicated event (CHS[adj]), selected International Classification of Diseases, Ninth Edition diagnostic codes only in the primary position for Medicare claims data from the Center for Medicare & Medicaid Services (CMS[1st]), and the same selected diagnostic codes in any position (CMS[any]). Conventional claims-based methods of defining events had high positive predictive values but low sensitivities. For instance, the positive predictive value of International Classification of Diseases, Ninth Edition code 410.x1 for a new acute MI in the first position was 90.6%, but this code identified only 53.8% of incident MIs. The observed event rates for CMS[1st] were low. For MI, the incidence was 14.9 events per 1000 person-years for CHS[adj] MI, 8.6 for CMS[1st] MI, and 12.2 for CMS[any] MI. In general, cardiovascular disease risk factor associations were similar across the 3 methods of defining events. Indeed, traditional cardiovascular disease risk factors were also associated with all first hospitalizations not resulting from an MI.

CONCLUSIONS: The use of diagnostic codes from claims data as clinical events, especially when restricted to primary diagnoses, leads to an underestimation of event rates. Additionally, claims-based events data represent a composite end point that includes the outcome of interest and selected (misclassified) nonevent hospitalizations.

%B Circulation %V 133 %P 156-64 %8 2016 Jan 12 %G ENG %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26538580?dopt=Abstract %R 10.1161/CIRCULATIONAHA.115.018610 %0 Journal Article %J J Am Coll Cardiol %D 2016 %T Subclinical Cardiovascular Disease and Death, Dementia, and Coronary Heart Disease in Patients 80+ Years. %A Kuller, Lewis H %A Lopez, Oscar L %A Mackey, Rachel H %A Rosano, Caterina %A Edmundowicz, Daniel %A Becker, James T %A Newman, Anne B %K Age Factors %K Aged, 80 and over %K Cause of Death %K Coronary Artery Disease %K Dementia %K Female %K Humans %K Incidence %K Male %K Pennsylvania %K Retrospective Studies %K Risk Factors %K Survival Rate %X

BACKGROUND: The successful prevention and treatment of coronary heart disease (CHD) and stroke has resulted in a substantial increase in longevity, with subsequent growth in the population of older people at risk for dementia.

OBJECTIVES: The authors evaluated the relationship of coronary and other peripheral atherosclerosis to risk of death, dementia, and CHD in the very elderly. Because the extent of vascular disease differs substantially between men and women, sex- and race-specific analyses were included, with a specific focus on women with low coronary artery calcium (CAC) Agatston scores.

METHODS: We evaluated the relationship between measures of subclinical cardiovascular disease (CAC, carotid intimal medial thickness, stenosis, and ankle brachial index) and risk of dementia, CHD, and total mortality in 532 participants of the Cardiovascular Health Study-Cognition Study from 1998/1999 (mean age, 80 years) to 2012/2013 (mean age, 93 years).

RESULTS: Thirty-six percent of participants had CAC scores >400. Women and African-Americans had lower CAC scores. Few men had low CAC scores. CAC score and number of coronary calcifications were directly related to age-adjusted total mortality and CHD. The age-specific incidence of dementia was higher than for CHD. Only about 25% of deaths were caused by CHD and 16% by dementia. Approximately 64% of those who died had a prior diagnosis of dementia. White women with low CAC scores had a significantly decreased incidence of dementia.

CONCLUSIONS: In subjects 80+ years of age, there is a greater incidence of dementia than of CHD. CAC, as a marker of atherosclerosis, is a determinant of mortality, and risk of CHD and myocardial infarction. White women with low CAC scores had a significantly decreased risk of dementia. A very important unanswered question, especially in the very elderly, is whether prevention of atherosclerosis and its complications is associated with less Alzheimer disease pathology and dementia. (Cardiovascular Health Study [CHS]; NCT00005133).

%B J Am Coll Cardiol %V 67 %P 1013-22 %8 2016 Mar 8 %G ENG %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/26940919?dopt=Abstract %R 10.1016/j.jacc.2015.12.034 %0 Journal Article %J Hum Mol Genet %D 2016 %T Targeted Sequencing of Genome Wide Significant Loci Associated with Bone Mineral Density (BMD) Reveals Significant Novel and Rare Variants: The Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Targeted Sequencing Study. %A Hsu, Yi-Hsiang %A Li, Guo %A Liu, Ching-Ti %A Brody, Jennifer A %A Karasik, David %A Chou, Wen-Chi %A Demissie, Serkalem %A Nandakumar, Kannabiran %A Zhou, Yanhua %A Cheng, Chia-Ho %A Gill, Richard %A Gibbs, Richard A %A Muzny, Donna %A Santibanez, Jireh %A Estrada, Karol %A Rivadeneira, Fernando %A Harris, Tamara %A Gudnason, Vilmundur %A Uitterlinden, Andre %A Psaty, Bruce M %A Robbins, John A %A Adrienne Cupples, L %A Kiel, Douglas P %X

BACKGROUND: Bone mineral density (BMD) is a heritable phenotype that predicts fracture risk. We performed fine-mapping by targeted sequencing at WLS, MEF2C, ARHGAP1/F2 and JAG1 loci prioritized by eQTL and bioinformatic approaches among 56 BMD loci from our previous GWAS meta-analysis.

METHODS AND RESULTS: Targeted sequencing was conducted in 1,291 Caucasians from the Framingham Heart Study (n=925) and Cardiovascular Health Study (n=366), including 206 women and men with extreme low femoral neck (FN) BMD. A total of 4,964 sequence variants (SNVs) were observed and 80% were rare with MAF <1%. The associations between previously identified SNPs in these loci and BMD, while nominally significant in sequenced participants, were no longer significant after multiple testing corrections. Conditional analyses did not find protein-coding variants that may be responsible for GWAS signals. On the other hand, in the sequenced subjects, we identified novel associations in WLS, ARHGAP1, and 5' of MEF2C (p-values < 8x10(-5); false discovery rate (FDR) q-values < 0.01) that were much more strongly associated with BMD compared to the GWAS SNPs. These associated SNVs are less-common; independent from previous GWAS signals in the same loci; and located in gene regulatory elements.

CONCLUSIONS: Our findings suggest that protein-coding variants in selected GWAS loci did not contribute to GWAS signals. By performing targeted sequencing in GWAS loci, we identified less-common and rare non-coding SNVs associated with BMD independently from GWAS common SNPs, suggesting both common and less-common variants may associate with disease risks and phenotypes in the same loci.

%B Hum Mol Genet %8 2016 Sep 11 %G eng %R 10.1093/hmg/ddw289 %0 Journal Article %J J Clin Endocrinol Metab %D 2016 %T Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis. %A Chaker, Layal %A Baumgartner, Christine %A den Elzen, Wendy P J %A Collet, Tinh-Hai %A Ikram, M Arfan %A Blum, Manuel R %A Dehghan, Abbas %A Drechsler, Christiane %A Luben, Robert N %A Portegies, Marileen L P %A Iervasi, Giorgio %A Medici, Marco %A Stott, David J %A Dullaart, Robin P %A Ford, Ian %A Bremner, Alexandra %A Newman, Anne B %A Wanner, Christoph %A Sgarbi, José A %A Dörr, Marcus %A Longstreth, W T %A Psaty, Bruce M %A Ferrucci, Luigi %A Maciel, Rui M B %A Westendorp, Rudi G %A Jukema, J Wouter %A Ceresini, Graziano %A Imaizumi, Misa %A Hofman, Albert %A Bakker, Stephan J L %A Franklyn, Jayne A %A Khaw, Kay-Tee %A Bauer, Douglas C %A Walsh, John P %A Razvi, Salman %A Gussekloo, Jacobijn %A Völzke, Henry %A Franco, Oscar H %A Cappola, Anne R %A Rodondi, Nicolas %A Peeters, Robin P %X

CONTEXT: The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously.

DESIGN AND SETTING: We identified studies through a systematic literature search and the Thyroid Studies Collaboration, a collaboration of prospective cohort studies. Studies measuring baseline TSH, free T4, and stroke outcomes were included, and we collected individual participant data from each study, including thyroid function measurements and incident all stroke (combined fatal and nonfatal) and fatal stroke. The applied reference range for TSH levels was between 0.45 and 4.49 mIU/L.

RESULTS: We collected individual participant data on 43 598 adults with TSH within the reference range from 17 cohorts, with a median follow-up of 11.6 years (interquartile range 5.1-13.9), including 449 908 person-years. Age- and sex-adjusted pooled hazard ratio for TSH was 0.78 (95% confidence interval [CI] 0.65-0.95 across the reference range of TSH) for all stroke and 0.83 (95% CI 0.62-1.09) for fatal stroke. For the free T4 analyses, the hazard ratio was 1.08 (95% CI 0.99-1.15 per SD increase) for all stroke and 1.10 (95% CI 1.04-1.19) for fatal stroke. This was independent of cardiovascular risk factors including systolic blood pressure, total cholesterol, smoking, and prevalent diabetes.

CONCLUSION: Higher levels of TSH within the reference range may decrease the risk of stroke, highlighting the need for further research focusing on the clinical consequences associated with differences within the reference range of thyroid function.

%B J Clin Endocrinol Metab %V 101 %P 4270-4282 %8 2016 Nov %G eng %N 11 %R 10.1210/jc.2016-2255 %0 Journal Article %J Am J Hum Genet %D 2016 %T Trans-ethnic Meta-analysis and Functional Annotation Illuminates the Genetic Architecture of Fasting Glucose and Insulin. %A Liu, Ching-Ti %A Raghavan, Sridharan %A Maruthur, Nisa %A Kabagambe, Edmond Kato %A Hong, Jaeyoung %A Ng, Maggie C Y %A Hivert, Marie-France %A Lu, Yingchang %A An, Ping %A Bentley, Amy R %A Drolet, Anne M %A Gaulton, Kyle J %A Guo, Xiuqing %A Armstrong, Loren L %A Irvin, Marguerite R %A Li, Man %A Lipovich, Leonard %A Rybin, Denis V %A Taylor, Kent D %A Agyemang, Charles %A Palmer, Nicholette D %A Cade, Brian E %A Chen, Wei-Min %A Dauriz, Marco %A Delaney, Joseph A C %A Edwards, Todd L %A Evans, Daniel S %A Evans, Michele K %A Lange, Leslie A %A Leong, Aaron %A Liu, Jingmin %A Liu, Yongmei %A Nayak, Uma %A Patel, Sanjay R %A Porneala, Bianca C %A Rasmussen-Torvik, Laura J %A Snijder, Marieke B %A Stallings, Sarah C %A Tanaka, Toshiko %A Yanek, Lisa R %A Zhao, Wei %A Becker, Diane M %A Bielak, Lawrence F %A Biggs, Mary L %A Bottinger, Erwin P %A Bowden, Donald W %A Chen, Guanjie %A Correa, Adolfo %A Couper, David J %A Crawford, Dana C %A Cushman, Mary %A Eicher, John D %A Fornage, Myriam %A Franceschini, Nora %A Fu, Yi-Ping %A Goodarzi, Mark O %A Gottesman, Omri %A Hara, Kazuo %A Harris, Tamara B %A Jensen, Richard A %A Johnson, Andrew D %A Jhun, Min A %A Karter, Andrew J %A Keller, Margaux F %A Kho, Abel N %A Kizer, Jorge R %A Krauss, Ronald M %A Langefeld, Carl D %A Li, Xiaohui %A Liang, Jingling %A Liu, Simin %A Lowe, William L %A Mosley, Thomas H %A North, Kari E %A Pacheco, Jennifer A %A Peyser, Patricia A %A Patrick, Alan L %A Rice, Kenneth M %A Selvin, Elizabeth %A Sims, Mario %A Smith, Jennifer A %A Tajuddin, Salman M %A Vaidya, Dhananjay %A Wren, Mary P %A Yao, Jie %A Zhu, Xiaofeng %A Ziegler, Julie T %A Zmuda, Joseph M %A Zonderman, Alan B %A Zwinderman, Aeilko H %A Adeyemo, Adebowale %A Boerwinkle, Eric %A Ferrucci, Luigi %A Hayes, M Geoffrey %A Kardia, Sharon L R %A Miljkovic, Iva %A Pankow, James S %A Rotimi, Charles N %A Sale, Michèle M %A Wagenknecht, Lynne E %A Arnett, Donna K %A Chen, Yii-Der Ida %A Nalls, Michael A %A Province, Michael A %A Kao, W H Linda %A Siscovick, David S %A Psaty, Bruce M %A Wilson, James G %A Loos, Ruth J F %A Dupuis, Josée %A Rich, Stephen S %A Florez, Jose C %A Rotter, Jerome I %A Morris, Andrew P %A Meigs, James B %X

Knowledge of the genetic basis of the type 2 diabetes (T2D)-related quantitative traits fasting glucose (FG) and insulin (FI) in African ancestry (AA) individuals has been limited. In non-diabetic subjects of AA (n = 20,209) and European ancestry (EA; n = 57,292), we performed trans-ethnic (AA+EA) fine-mapping of 54 established EA FG or FI loci with detailed functional annotation, assessed their relevance in AA individuals, and sought previously undescribed loci through trans-ethnic (AA+EA) meta-analysis. We narrowed credible sets of variants driving association signals for 22/54 EA-associated loci; 18/22 credible sets overlapped with active islet-specific enhancers or transcription factor (TF) binding sites, and 21/22 contained at least one TF motif. Of the 54 EA-associated loci, 23 were shared between EA and AA. Replication with an additional 10,096 AA individuals identified two previously undescribed FI loci, chrX FAM133A (rs213676) and chr5 PELO (rs6450057). Trans-ethnic analyses with regulatory annotation illuminate the genetic architecture of glycemic traits and suggest gene regulation as a target to advance precision medicine for T2D. Our approach to utilize state-of-the-art functional annotation and implement trans-ethnic association analysis for discovery and fine-mapping offers a framework for further follow-up and characterization of GWAS signals of complex trait loci.

%B Am J Hum Genet %V 99 %P 56-75 %8 2016 Jul 7 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27321945?dopt=Abstract %R 10.1016/j.ajhg.2016.05.006 %0 Journal Article %J Hum Mol Genet %D 2016 %T Twenty-eight genetic loci associated with ST-T-wave amplitudes of the electrocardiogram. %A Verweij, Niek %A Mateo Leach, Irene %A Isaacs, Aaron %A Arking, Dan E %A Bis, Joshua C %A Pers, Tune H %A van den Berg, Marten E %A Lyytikäinen, Leo-Pekka %A Barnett, Phil %A Wang, Xinchen %A Soliman, Elsayed Z %A van Duijn, Cornelia M %A Kähönen, Mika %A van Veldhuisen, Dirk J %A Kors, Jan A %A Raitakari, Olli T %A Silva, Claudia T %A Lehtimäki, Terho %A Hillege, Hans L %A Hirschhorn, Joel N %A Boyer, Laurie A %A van Gilst, Wiek H %A Alonso, Alvaro %A Sotoodehnia, Nona %A Eijgelsheim, Mark %A de Boer, Rudolf A %A de Bakker, Paul I W %A Franke, Lude %A van der Harst, Pim %K Adaptor Proteins, Signal Transducing %K Arrhythmias, Cardiac %K Basic Helix-Loop-Helix Transcription Factors %K Brugada Syndrome %K Cardiac Conduction System Disease %K Death, Sudden, Cardiac %K Electrocardiography %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Heart Conduction System %K Humans %K Male %K NAV1.5 Voltage-Gated Sodium Channel %K Polymorphism, Single Nucleotide %K Repressor Proteins %K Shab Potassium Channels %K Shal Potassium Channels %X

The ST-segment and adjacent T-wave (ST-T wave) amplitudes of the electrocardiogram are quantitative characteristics of cardiac repolarization. Repolarization abnormalities have been linked to ventricular arrhythmias and sudden cardiac death. We performed the first genome-wide association meta-analysis of ST-T-wave amplitudes in up to 37 977 individuals identifying 71 robust genotype-phenotype associations clustered within 28 independent loci. Fifty-four genes were prioritized as candidates underlying the phenotypes, including genes with established roles in the cardiac repolarization phase (SCN5A/SCN10A, KCND3, KCNB1, NOS1AP and HEY2) and others with as yet undefined cardiac function. These associations may provide insights in the spatiotemporal contribution of genetic variation influencing cardiac repolarization and provide novel leads for future functional follow-up.

%B Hum Mol Genet %V 25 %P 2093-2103 %8 2016 05 15 %G eng %N 10 %R 10.1093/hmg/ddw058 %0 Journal Article %J Am J Cardiol %D 2016 %T Usefulness of Left Ventricular Mass and Geometry for Determining 10-Year Prediction of Cardiovascular Disease in Adults Aged >65 Years (from the Cardiovascular Health Study). %A Desai, Chintan S %A Bartz, Traci M %A Gottdiener, John S %A Lloyd-Jones, Donald M %A Gardin, Julius M %X

Left ventricular (LV) mass and geometry are associated with risk of cardiovascular disease (CVD). We sought to determine whether LV mass and geometry contribute to risk prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy. We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing traditional risk factors and determined the net reclassification improvement (NRI) for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke), and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black, mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to 1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted in an event NRI of -0.011 (95% CI -0.037 to 0.028) and nonevent NRI of 0.034 (95% CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for CVD resulted in an event NRI of 0.013 (95% CI -0.0335 to 0.0311) and a nonevent NRI of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven primarily by improved reclassification of nonevents.

%B Am J Cardiol %V 118 %P 684-90 %8 2016 Sep 1 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27457431?dopt=Abstract %R 10.1016/j.amjcard.2016.06.016 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Vitamin D and Memory Decline: Two Population-Based Prospective Studies. %A Kuźma, Elżbieta %A Soni, Maya %A Littlejohns, Thomas J %A Ranson, Janice M %A van Schoor, Natasja M %A Deeg, Dorly J H %A Comijs, Hannie %A Chaves, Paulo H M %A Kestenbaum, Bryan R %A Kuller, Lewis H %A Lopez, Oscar L %A Becker, James T %A Langa, Kenneth M %A Henley, William E %A Lang, Iain A %A Ukoumunne, Obioha C %A Llewellyn, David J %X

BACKGROUND: Vitamin D deficiency has been linked with dementia risk, cognitive decline, and executive dysfunction. However, the association with memory remains largely unknown.

OBJECTIVE: To investigate whether low serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with memory decline.

METHODS: We used data on 1,291 participants from the US Cardiovascular Health Study (CHS) and 915 participants from the Dutch Longitudinal Aging Study Amsterdam (LASA) who were dementia-free at baseline, had valid vitamin D measurements, and follow-up memory assessments. The Benton Visual Retention Test (in the CHS) and Rey's Auditory Verbal Learning Test (in the LASA) were used to assess visual and verbal memory, respectively.

RESULTS: In the CHS, those moderately and severely deficient in serum 25(OH)D changed -0.03 SD (95% CI: -0.06 to 0.01) and -0.10 SD (95% CI: -0.19 to -0.02) per year respectively in visual memory compared to those sufficient (p = 0.02). In the LASA, moderate and severe deficiency in serum 25(OH)D was associated with a mean change of 0.01 SD (95% CI: -0.01 to 0.02) and -0.01 SD (95% CI: -0.04 to 0.02) per year respectively in verbal memory compared to sufficiency (p = 0.34).

CONCLUSIONS: Our findings suggest an association between severe vitamin D deficiency and visual memory decline but no association with verbal memory decline. They warrant further investigation in prospective studies assessing different memory subtypes.

%B J Alzheimers Dis %V 50 %P 1099-108 %8 2016 %G ENG %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/26836174?dopt=Abstract %R 10.3233/JAD-150811 %0 Journal Article %J PLoS One %D 2016 %T Vitamin D and Risk of Neuroimaging Abnormalities. %A Littlejohns, Thomas J %A Kos, Katarina %A Henley, William E %A Lang, Iain A %A Annweiler, Cedric %A Beauchet, Olivier %A Chaves, Paulo H M %A Kestenbaum, Bryan R %A Kuller, Lewis H %A Langa, Kenneth M %A Lopez, Oscar L %A Llewellyn, David J %X

Vitamin D deficiency has been linked with an increased risk of incident all-cause dementia and Alzheimer's disease. The aim of the current study was to explore the potential mechanisms underlying these associations by determining whether low vitamin D concentrations are associated with the development of incident cerebrovascular and neurodegenerative neuroimaging abnormalities. The population consisted of 1,658 participants aged ≥65 years from the US-based Cardiovascular Health Study who were free from prevalent cardiovascular disease, stroke and dementia at baseline in 1992-93. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected at baseline. The first MRI scan was conducted between 1991-1994 and the second MRI scan was conducted between 1997-1999. Change in white matter grade, ventricular grade and presence of infarcts between MRI scan one and two were used to define neuroimaging abnormalities. During a mean follow-up of 5.0 years, serum 25(OH)D status was not significantly associated with the development of any neuroimaging abnormalities. Using logistic regression models, the multivariate adjusted odds ratios (95% confidence interval) for worsening white matter grade in participants who were severely 25(OH)D deficient (<25 nmol/L) and deficient (≥25-50 nmol/L) were 0.76 (0.35-1.66) and 1.09 (0.76-1.55) compared to participants with sufficient concentrations (≥50 nmol/L). The multivariate adjusted odds ratios for ventricular grade in participants who were severely 25(OH)D deficient and deficient were 0.49 (0.20-1.19) and 1.12 (0.79-1.59) compared to those sufficient. The multivariate adjusted odds ratios for incident infarcts in participants who were severely 25(OH)D deficient and deficient were 1.95 (0.84-4.54) and 0.73 (0.47-1.95) compared to those sufficient. Overall, serum vitamin D concentrations could not be shown to be associated with the development of cerebrovascular or neurodegenerative neuroimaging abnormalities in Cardiovascular Health Study participants.

%B PLoS One %V 11 %P e0154896 %8 2016 %G eng %N 5 %R 10.1371/journal.pone.0154896 %0 Journal Article %J PLoS Genet %D 2016 %T Whole Exome Sequencing in Atrial Fibrillation. %A Lubitz, Steven A %A Brody, Jennifer A %A Bihlmeyer, Nathan A %A Roselli, Carolina %A Weng, Lu-Chen %A Christophersen, Ingrid E %A Alonso, Alvaro %A Boerwinkle, Eric %A Gibbs, Richard A %A Bis, Joshua C %A Cupples, L Adrienne %A Mohler, Peter J %A Nickerson, Deborah A %A Muzny, Donna %A Perez, Marco V %A Psaty, Bruce M %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Lunetta, Kathryn L %A Benjamin, Emelia J %A Heckbert, Susan R %A Arking, Dan E %A Ellinor, Patrick T %A Lin, Honghuang %X

Atrial fibrillation (AF) is a morbid and heritable arrhythmia. Over 35 genes have been reported to underlie AF, most of which were described in small candidate gene association studies. Replication remains lacking for most, and therefore the contribution of coding variation to AF susceptibility remains poorly understood. We examined whole exome sequencing data in a large community-based sample of 1,734 individuals with and 9,423 without AF from the Framingham Heart Study, Cardiovascular Health Study, Atherosclerosis Risk in Communities Study, and NHLBI-GO Exome Sequencing Project and meta-analyzed the results. We also examined whether genetic variation was enriched in suspected AF genes (N = 37) in AF cases versus controls. The mean age ranged from 59 to 73 years; 8,656 (78%) were of European ancestry. None of the 99,404 common variants evaluated was significantly associated after adjusting for multiple testing. Among the most significantly associated variants was a common (allele frequency = 86%) missense variant in SYNPO2L (rs3812629, p.Pro707Leu, [odds ratio 1.27, 95% confidence interval 1.13-1.43, P = 6.6x10-5]) which lies at a known AF susceptibility locus and is in linkage disequilibrium with a top marker from prior analyses at the locus. We did not observe significant associations between rare variants and AF in gene-based tests. Individuals with AF did not display any statistically significant enrichment for common or rare coding variation in previously implicated AF genes. In conclusion, we did not observe associations between coding genetic variants and AF, suggesting that large-effect coding variation is not the predominant mechanism underlying AF. A coding variant in SYNPO2L requires further evaluation to determine whether it is causally related to AF. Efforts to identify biologically meaningful coding variation underlying AF may require large sample sizes or populations enriched for large genetic effects.

%B PLoS Genet %V 12 %P e1006284 %8 2016 Sep %G eng %N 9 %R 10.1371/journal.pgen.1006284 %0 Journal Article %J Am J Hum Genet %D 2016 %T Whole-Exome Sequencing Identifies Loci Associated with Blood Cell Traits and Reveals a Role for Alternative GFI1B Splice Variants in Human Hematopoiesis. %A Polfus, Linda M %A Khajuria, Rajiv K %A Schick, Ursula M %A Pankratz, Nathan %A Pazoki, Raha %A Brody, Jennifer A %A Chen, Ming-Huei %A Auer, Paul L %A Floyd, James S %A Huang, Jie %A Lange, Leslie %A van Rooij, Frank J A %A Gibbs, Richard A %A Metcalf, Ginger %A Muzny, Donna %A Veeraraghavan, Narayanan %A Walter, Klaudia %A Chen, Lu %A Yanek, Lisa %A Becker, Lewis C %A Peloso, Gina M %A Wakabayashi, Aoi %A Kals, Mart %A Metspalu, Andres %A Esko, Tõnu %A Fox, Keolu %A Wallace, Robert %A Franceschini, Nora %A Matijevic, Nena %A Rice, Kenneth M %A Bartz, Traci M %A Lyytikäinen, Leo-Pekka %A Kähönen, Mika %A Lehtimäki, Terho %A Raitakari, Olli T %A Li-Gao, Ruifang %A Mook-Kanamori, Dennis O %A Lettre, Guillaume %A van Duijn, Cornelia M %A Franco, Oscar H %A Rich, Stephen S %A Rivadeneira, Fernando %A Hofman, Albert %A Uitterlinden, André G %A Wilson, James G %A Psaty, Bruce M %A Soranzo, Nicole %A Dehghan, Abbas %A Boerwinkle, Eric %A Zhang, Xiaoling %A Johnson, Andrew D %A O'Donnell, Christopher J %A Johnsen, Jill M %A Reiner, Alexander P %A Ganesh, Santhi K %A Sankaran, Vijay G %B Am J Hum Genet %V 99 %P 785 %8 2016 Sep 01 %G eng %N 3 %R 10.1016/j.ajhg.2016.08.002 %0 Journal Article %J Lancet Diabetes Endocrinol %D 2017 %T 740 adults from 20 prospective cohort studies %A Wu, J. H. Y. %A Marklund, M. %A Imamura, F. %A Tintle, N. %A Ardisson Korat, A. V. %A de Goede, J. %A Zhou, X. %A Yang, W. S. %A de Oliveira Otto, M. C. %A ger, J. %A Qureshi, W. %A Virtanen, J. K. %A Bassett, J. K. %A Frazier-Wood, A. C. %A Lankinen, M. %A Murphy, R. A. %A Rajaobelina, K. %A Del Gobbo, L. C. %A Forouhi, N. G. %A Luben, R. %A Khaw, K. T. %A Wareham, N. %A Kalsbeek, A. %A Veenstra, J. %A Luo, J. %A Hu, F. B. %A Lin, H. J. %A Siscovick, D. S. %A Boeing, H. %A Chen, T. A. %A Steffen, B. %A Steffen, L. M. %A Hodge, A. %A Eriksdottir, G. %A Smith, A. V. %A Gudnason, V. %A Harris, T. B. %A Brouwer, I. A. %A Berr, C. %A Helmer, C. %A Samieri, C. %A Laakso, M. %A Tsai, M. Y. %A Giles, G. G. %A Nurmi, T. %A Wagenknecht, L. %A Schulze, M. B. %A Lemaitre, R. N. %A Chien, K. L. %A Soedamah-Muthu, S. S. %A Geleijnse, J. M. %A Sun, Q. %A Harris, W. S. %A Lind, L. %A v, J. %A Riserus, U. %A Micha, R. %A Mozaffarian, D. %X The metabolic effects of omega-6 polyunsaturated fatty acids (PUFAs) remain contentious, and little evidence is available regarding their potential role in primary prevention of type 2 diabetes. We aimed to assess the associations of linoleic acid and arachidonic acid biomarkers with incident type 2 diabetes.\ We did a pooled analysis of new, harmonised, individual-level analyses for the biomarkers linoleic acid and its metabolite arachidonic acid and incident type 2 diabetes. We analysed data from 20 prospective cohort studies from ten countries (Iceland, the Netherlands, the USA, Taiwan, the UK, Germany, Finland, Australia, Sweden, and France), with biomarkers sampled between 1970 and 2010. Participants included in the analyses were aged 18 years or older and had data available for linoleic acid and arachidonic acid biomarkers at baseline. We excluded participants with type 2 diabetes at baseline. The main outcome was the association between omega-6 PUFA biomarkers and incident type 2 diabetes. We assessed the relative risk of type 2 diabetes prospectively for each cohort and lipid compartment separately using a prespecified analytic plan for exposures, covariates, effect modifiers, and analysis, and the findings were then pooled using inverse-variance weighted meta-analysis.\ 13).\ Findings suggest that linoleic acid has long-term benefits for the prevention of type 2 diabetes and that arachidonic acid is not harmful.\ Funders are shown in the appendix. %B Lancet Diabetes Endocrinol %V 5 %P 965–974 %8 Dec %G eng %0 Journal Article %J Neurol Genet %D 2017 %T The Alzheimer's Disease Sequencing Project: Study design and sample selection. %A Beecham, Gary W %A Bis, J C %A Martin, E R %A Choi, S-H %A DeStefano, A L %A van Duijn, C M %A Fornage, M %A Gabriel, S B %A Koboldt, D C %A Larson, D E %A Naj, A C %A Psaty, B M %A Salerno, W %A Bush, W S %A Foroud, T M %A Wijsman, E %A Farrer, L A %A Goate, A %A Haines, J L %A Pericak-Vance, Margaret A %A Boerwinkle, E %A Mayeux, R %A Seshadri, S %A Schellenberg, G %B Neurol Genet %V 3 %P e194 %8 2017 Oct %G eng %N 5 %R 10.1212/NXG.0000000000000194 %0 Journal Article %J Nat Genet %D 2017 %T Analysis commons, a team approach to discovery in a big-data environment for genetic epidemiology. %A Brody, Jennifer A %A Morrison, Alanna C %A Bis, Joshua C %A O'Connell, Jeffrey R %A Brown, Michael R %A Huffman, Jennifer E %A Ames, Darren C %A Carroll, Andrew %A Conomos, Matthew P %A Gabriel, Stacey %A Gibbs, Richard A %A Gogarten, Stephanie M %A Gupta, Namrata %A Jaquish, Cashell E %A Johnson, Andrew D %A Lewis, Joshua P %A Liu, Xiaoming %A Manning, Alisa K %A Papanicolaou, George J %A Pitsillides, Achilleas N %A Rice, Kenneth M %A Salerno, William %A Sitlani, Colleen M %A Smith, Nicholas L %A Heckbert, Susan R %A Laurie, Cathy C %A Mitchell, Braxton D %A Vasan, Ramachandran S %A Rich, Stephen S %A Rotter, Jerome I %A Wilson, James G %A Boerwinkle, Eric %A Psaty, Bruce M %A Cupples, L Adrienne %B Nat Genet %V 49 %P 1560-1563 %8 2017 Oct 27 %G eng %N 11 %R 10.1038/ng.3968 %0 Journal Article %J Hum Genet %D 2017 %T Assessing the causal relationship between obesity and venous thromboembolism through a Mendelian Randomization study. %A Lindström, Sara %A Germain, Marine %A Crous-Bou, Marta %A Smith, Erin N %A Morange, Pierre-Emmanuel %A van Hylckama Vlieg, Astrid %A de Haan, Hugoline G %A Chasman, Daniel %A Ridker, Paul %A Brody, Jennifer %A de Andrade, Mariza %A Heit, John A %A Tang, Weihong %A DeVivo, Immaculata %A Grodstein, Francine %A Smith, Nicholas L %A Tregouet, David %A Kabrhel, Christopher %K Adult %K Body Mass Index %K Case-Control Studies %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Incidence %K Logistic Models %K Male %K Mendelian Randomization Analysis %K Obesity %K Polymorphism, Single Nucleotide %K Proportional Hazards Models %K Venous Thromboembolism %X

Observational studies have shown an association between obesity and venous thromboembolism (VTE) but it is not known if observed associations are causal, due to reverse causation or confounding bias. We conducted a Mendelian Randomization study of body mass index (BMI) and VTE. We identified 95 single nucleotide polymorphisms (SNPs) that have been previously associated with BMI and assessed the association between genetically predicted high BMI and VTE leveraging data from a previously conducted GWAS within the INVENT consortium comprising a total of 7507 VTE cases and 52,632 controls of European ancestry. Five BMI SNPs were associated with VTE at P < 0.05, with the strongest association seen for the FTO SNP rs1558902 (OR 1.07, 95% CI 1.02-1.12, P = 0.005). In addition, we observed a significant association between genetically predicted BMI and VTE (OR = 1.59, 95% CI 1.30-1.93 per standard deviation increase in BMI, P = 5.8 × 10). Our study provides evidence for a causal relationship between high BMI and risk of VTE. Reducing obesity levels will likely result in lower incidence in VTE.

%B Hum Genet %V 136 %P 897-902 %8 2017 07 %G eng %N 7 %R 10.1007/s00439-017-1811-x %0 Journal Article %J JAMA Oncol %D 2017 %T Association Between Telomere Length and Risk of Cancer and Non-Neoplastic Diseases: A Mendelian Randomization Study. %A Haycock, Philip C %A Burgess, Stephen %A Nounu, Aayah %A Zheng, Jie %A Okoli, George N %A Bowden, Jack %A Wade, Kaitlin Hazel %A Timpson, Nicholas J %A Evans, David M %A Willeit, Peter %A Aviv, Abraham %A Gaunt, Tom R %A Hemani, Gibran %A Mangino, Massimo %A Ellis, Hayley Patricia %A Kurian, Kathreena M %A Pooley, Karen A %A Eeles, Rosalind A %A Lee, Jeffrey E %A Fang, Shenying %A Chen, Wei V %A Law, Matthew H %A Bowdler, Lisa M %A Iles, Mark M %A Yang, Qiong %A Worrall, Bradford B %A Markus, Hugh Stephen %A Hung, Rayjean J %A Amos, Chris I %A Spurdle, Amanda B %A Thompson, Deborah J %A O'Mara, Tracy A %A Wolpin, Brian %A Amundadottir, Laufey %A Stolzenberg-Solomon, Rachael %A Trichopoulou, Antonia %A Onland-Moret, N Charlotte %A Lund, Eiliv %A Duell, Eric J %A Canzian, Federico %A Severi, Gianluca %A Overvad, Kim %A Gunter, Marc J %A Tumino, Rosario %A Svenson, Ulrika %A van Rij, Andre %A Baas, Annette F %A Bown, Matthew J %A Samani, Nilesh J %A van t'Hof, Femke N G %A Tromp, Gerard %A Jones, Gregory T %A Kuivaniemi, Helena %A Elmore, James R %A Johansson, Mattias %A Mckay, James %A Scelo, Ghislaine %A Carreras-Torres, Robert %A Gaborieau, Valerie %A Brennan, Paul %A Bracci, Paige M %A Neale, Rachel E %A Olson, Sara H %A Gallinger, Steven %A Li, Donghui %A Petersen, Gloria M %A Risch, Harvey A %A Klein, Alison P %A Han, Jiali %A Abnet, Christian C %A Freedman, Neal D %A Taylor, Philip R %A Maris, John M %A Aben, Katja K %A Kiemeney, Lambertus A %A Vermeulen, Sita H %A Wiencke, John K %A Walsh, Kyle M %A Wrensch, Margaret %A Rice, Terri %A Turnbull, Clare %A Litchfield, Kevin %A Paternoster, Lavinia %A Standl, Marie %A Abecasis, Goncalo R %A SanGiovanni, John Paul %A Li, Yong %A Mijatovic, Vladan %A Sapkota, Yadav %A Low, Siew-Kee %A Zondervan, Krina T %A Montgomery, Grant W %A Nyholt, Dale R %A van Heel, David A %A Hunt, Karen %A Arking, Dan E %A Ashar, Foram N %A Sotoodehnia, Nona %A Woo, Daniel %A Rosand, Jonathan %A Comeau, Mary E %A Brown, W Mark %A Silverman, Edwin K %A Hokanson, John E %A Cho, Michael H %A Hui, Jennie %A Ferreira, Manuel A %A Thompson, Philip J %A Morrison, Alanna C %A Felix, Janine F %A Smith, Nicholas L %A Christiano, Angela M %A Petukhova, Lynn %A Betz, Regina C %A Fan, Xing %A Zhang, Xuejun %A Zhu, Caihong %A Langefeld, Carl D %A Thompson, Susan D %A Wang, Feijie %A Lin, Xu %A Schwartz, David A %A Fingerlin, Tasha %A Rotter, Jerome I %A Cotch, Mary Frances %A Jensen, Richard A %A Munz, Matthias %A Dommisch, Henrik %A Schaefer, Arne S %A Han, Fang %A Ollila, Hanna M %A Hillary, Ryan P %A Albagha, Omar %A Ralston, Stuart H %A Zeng, Chenjie %A Zheng, Wei %A Shu, Xiao-Ou %A Reis, Andre %A Uebe, Steffen %A Hüffmeier, Ulrike %A Kawamura, Yoshiya %A Otowa, Takeshi %A Sasaki, Tsukasa %A Hibberd, Martin Lloyd %A Davila, Sonia %A Xie, Gang %A Siminovitch, Katherine %A Bei, Jin-Xin %A Zeng, Yi-Xin %A Försti, Asta %A Chen, Bowang %A Landi, Stefano %A Franke, Andre %A Fischer, Annegret %A Ellinghaus, David %A Flores, Carlos %A Noth, Imre %A Ma, Shwu-Fan %A Foo, Jia Nee %A Liu, Jianjun %A Kim, Jong-Won %A Cox, David G %A Delattre, Olivier %A Mirabeau, Olivier %A Skibola, Christine F %A Tang, Clara S %A Garcia-Barcelo, Merce %A Chang, Kai-Ping %A Su, Wen-Hui %A Chang, Yu-Sun %A Martin, Nicholas G %A Gordon, Scott %A Wade, Tracey D %A Lee, Chaeyoung %A Kubo, Michiaki %A Cha, Pei-Chieng %A Nakamura, Yusuke %A Levy, Daniel %A Kimura, Masayuki %A Hwang, Shih-Jen %A Hunt, Steven %A Spector, Tim %A Soranzo, Nicole %A Manichaikul, Ani W %A Barr, R Graham %A Kahali, Bratati %A Speliotes, Elizabeth %A Yerges-Armstrong, Laura M %A Cheng, Ching-Yu %A Jonas, Jost B %A Wong, Tien Yin %A Fogh, Isabella %A Lin, Kuang %A Powell, John F %A Rice, Kenneth %A Relton, Caroline L %A Martin, Richard M %A Davey Smith, George %K Adult %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Germ-Line Mutation %K Humans %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Neoplasms %K Polymorphism, Single Nucleotide %K Risk Assessment %K Telomere %K Telomere Homeostasis %X

Importance: The causal direction and magnitude of the association between telomere length and incidence of cancer and non-neoplastic diseases is uncertain owing to the susceptibility of observational studies to confounding and reverse causation.

Objective: To conduct a Mendelian randomization study, using germline genetic variants as instrumental variables, to appraise the causal relevance of telomere length for risk of cancer and non-neoplastic diseases.

Data Sources: Genomewide association studies (GWAS) published up to January 15, 2015.

Study Selection: GWAS of noncommunicable diseases that assayed germline genetic variation and did not select cohort or control participants on the basis of preexisting diseases. Of 163 GWAS of noncommunicable diseases identified, summary data from 103 were available.

Data Extraction and Synthesis: Summary association statistics for single nucleotide polymorphisms (SNPs) that are strongly associated with telomere length in the general population.

Main Outcomes and Measures: Odds ratios (ORs) and 95% confidence intervals (CIs) for disease per standard deviation (SD) higher telomere length due to germline genetic variation.

Results: Summary data were available for 35 cancers and 48 non-neoplastic diseases, corresponding to 420 081 cases (median cases, 2526 per disease) and 1 093 105 controls (median, 6789 per disease). Increased telomere length due to germline genetic variation was generally associated with increased risk for site-specific cancers. The strongest associations (ORs [95% CIs] per 1-SD change in genetically increased telomere length) were observed for glioma, 5.27 (3.15-8.81); serous low-malignant-potential ovarian cancer, 4.35 (2.39-7.94); lung adenocarcinoma, 3.19 (2.40-4.22); neuroblastoma, 2.98 (1.92-4.62); bladder cancer, 2.19 (1.32-3.66); melanoma, 1.87 (1.55-2.26); testicular cancer, 1.76 (1.02-3.04); kidney cancer, 1.55 (1.08-2.23); and endometrial cancer, 1.31 (1.07-1.61). Associations were stronger for rarer cancers and at tissue sites with lower rates of stem cell division. There was generally little evidence of association between genetically increased telomere length and risk of psychiatric, autoimmune, inflammatory, diabetic, and other non-neoplastic diseases, except for coronary heart disease (OR, 0.78 [95% CI, 0.67-0.90]), abdominal aortic aneurysm (OR, 0.63 [95% CI, 0.49-0.81]), celiac disease (OR, 0.42 [95% CI, 0.28-0.61]) and interstitial lung disease (OR, 0.09 [95% CI, 0.05-0.15]).

Conclusions and Relevance: It is likely that longer telomeres increase risk for several cancers but reduce risk for some non-neoplastic diseases, including cardiovascular diseases.

%B JAMA Oncol %V 3 %P 636-651 %8 2017 May 01 %G eng %N 5 %R 10.1001/jamaoncol.2016.5945 %0 Journal Article %J JAMA Cardiol %D 2017 %T Association of Coronary Artery Calcium Score vs Age With Cardiovascular Risk in Older Adults: An Analysis of Pooled Population-Based Studies. %A Yano, Yuichiro %A O'Donnell, Christopher J %A Kuller, Lewis %A Kavousi, Maryam %A Erbel, Raimund %A Ning, Hongyan %A D'Agostino, Ralph %A Newman, Anne B %A Nasir, Khurram %A Hofman, Albert %A Lehmann, Nils %A Dhana, Klodian %A Blankstein, Ron %A Hoffmann, Udo %A Möhlenkamp, Stefan %A Massaro, Joseph M %A Mahabadi, Amir-Abbas %A Lima, João A C %A Ikram, M Arfan %A Jöckel, Karl-Heinz %A Franco, Oscar H %A Liu, Kiang %A Lloyd-Jones, Donald %A Greenland, Philip %X

Importance: Besides age, other discriminators of atherosclerotic cardiovascular disease (ASCVD) risk are needed in older adults.

Objectives: To examine the predictive ability of coronary artery calcium (CAC) score vs age for incident ASCVD and how risk prediction changes by adding CAC score and removing only age from prediction models.

Design, Setting, and Participants: We conducted an analysis of pooled US population-based studies, including the Framingham Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Results were compared with 2 European cohorts, the Rotterdam Study and the Heinz Nixdorf Recall Study. Participants underwent CAC scoring between 1998 and 2006 using cardiac computed tomography. The participants included adults older than 60 years without known ASCVD at baseline.

Exposures: Coronary artery calcium scores.

Main Outcomes and Measures: Incident ASCVD events including coronary heart disease (CHD) and stroke.

Results: The study included 4778 participants from 3 US cohorts, with a mean age of 70.1 years; 2582 (54.0%) were women, and 2431 (50.9%) were nonwhite. Over 11 years of follow-up (44 152 person-years), 405 CHD and 228 stroke events occurred. Coronary artery calcium score (vs age) had a greater association with incident CHD (C statistic, 0.733 vs 0.690; C statistics difference, 0.043; 95% CI of difference, 0.009-0.075) and modestly improved prediction of incident stroke (C statistic, 0.695 vs 0.670; C statistics difference, 0.025; 95% CI of difference, -0.015 to 0.064). Adding CAC score to models including traditional cardiovascular risk factors, with only age being removed, provided improved discrimination for incident CHD (C statistic, 0.735 vs 0.703; C statistics difference, 0.032; 95% CI of difference, 0.002-0.062) but not for stroke. Coronary artery calcium score was more likely than age to provide higher category-free net reclassification improvement among participants who experienced an ASCVD event (0.390; 95% CI, 0.312-0.467 vs 0.08; 95% CI -0.001 to 0.181) and to result in more accurate reclassification of risk for ASCVD events among these individuals. The findings were similar in the 2 European cohorts (n = 4990).

Conclusions and Relevance: Coronary artery calcium may be an alternative marker besides age to better discriminate between lower and higher CHD risk in older adults. Whether CAC score can assist in guiding the decision to initiate statin treatment for primary prevention in older adults requires further investigation.

%B JAMA Cardiol %8 2017 Jul 26 %G eng %R 10.1001/jamacardio.2017.2498 %0 Journal Article %J JAMA Ophthalmol %D 2017 %T Association of Diabetic Macular Edema and Proliferative Diabetic Retinopathy With Cardiovascular Disease: A Systematic Review and Meta-analysis. %A Xie, Jing %A Ikram, M Kamran %A Cotch, Mary Frances %A Klein, Barbara %A Varma, Rohit %A Shaw, Jonathan E %A Klein, Ronald %A Mitchell, Paul %A Lamoureux, Ecosse L %A Wong, Tien Yin %K Cardiovascular Diseases %K Diabetic Retinopathy %K Global Health %K Humans %K Incidence %K Macular Edema %K Risk Factors %X

Importance: Previous studies on the relationship between diabetic retinopathy (DR) and cardiovascular disease (CVD) focused on the early stages of DR. Understanding whether patients with type 2 diabetes and severe stages of DR (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]) have a higher risk of CVD will allow physicians to more effectively counsel patients.

Objective: To examine the association of severe stages of DR (DME and PDR) with incident CVD in patients with type 2 diabetes.

Data Sources: English-language publications were reviewed for articles evaluating the relationship of DR and CVD in MEDLINE, EMBASE, Current Contents, and the Cochrane Library from inception (January 1, 1950) to December 31, 2014, using the search terms diabetic retinopathy OR macular edema AND stroke OR cerebrovascular disease OR coronary artery disease OR heart failure OR myocardial infarction OR angina pectoris OR acute coronary syndrome OR coronary artery disease OR cardiomyopathy.

Study Selection: Among 656 studies screened for eligibility, 7604 individuals were included from 8 prospective population-based studies with data on photographic-based DR grading, follow-up visits, and well-defined incident CVD end point.

Data Extraction and Synthesis: Two independent reviewers conducted a systematic search of the 4 databases, and a single pooled database was developed. Incidence rate ratios (IRRs) were estimated for patients with DME, PDR, and vision-threatening DR, compared with persons without these conditions, by using individual participant data followed by a standard inverse-variance meta-analysis (2-step analysis). The review and analyses were performed from January 1, 2009, to January 1, 2017.

Main Outcome and Measures: Incident CVD, including coronary heart disease, stroke, or death from cardiovascular causes.

Results: Among 7604 patients with type 2 diabetes, the prevalence of DME was 4.6% and PDR, 7.4%. After a mean follow-up of 5.9 years (range, 3.2-10.1 years), 1203 incident CVD events, including 916 coronary heart disease cases, were reported. Persons with DME or PDR were more likely to have incident CVD (IRR, 1.39; 95% CI, 1.16-1.67) and fatal CVD (IRR, 2.33; 95% CI, 1.49-3.67) compared with those without DME or PDR.

Conclusions and Relevance: Patients with type 2 diabetes and DME or PDR have an increased risk of incident CVD, which suggests that these persons should be followed up more closely to prevent CVD.

%B JAMA Ophthalmol %V 135 %P 586-593 %8 2017 Jun 01 %G eng %N 6 %R 10.1001/jamaophthalmol.2017.0988 %0 Journal Article %J JAMA Cardiol %D 2017 %T Association of Mitochondrial DNA Copy Number With Cardiovascular Disease. %A Ashar, Foram N %A Zhang, Yiyi %A Longchamps, Ryan J %A Lane, John %A Moes, Anna %A Grove, Megan L %A Mychaleckyj, Josyf C %A Taylor, Kent D %A Coresh, Josef %A Rotter, Jerome I %A Boerwinkle, Eric %A Pankratz, Nathan %A Guallar, Eliseo %A Arking, Dan E %X

Importance: Mitochondrial dysfunction is a core component of the aging process and may play a key role in atherosclerotic cardiovascular disease. Mitochondrial DNA copy number (mtDNA-CN), which represents the number of mitochondria per cell and number of mitochondrial genomes per mitochondrion, is an indirect biomarker of mitochondrial function.

Objective: To determine whether mtDNA-CN, measured in an easily accessible tissue (buffy coat/circulating leukocytes), can improve risk classification for cardiovascular disease (CVD) and help guide initiation of statin therapy for primary prevention of CVD.

Design, Setting, and Participants: Prospective, population-based cohort analysis including 21 870 participants (20 163 free from CVD at baseline) from 3 studies: Cardiovascular Health Study (CHS), Atherosclerosis Risk in Communities Study (ARIC), and Multiethnic Study of Atherosclerosis (MESA). The mean follow-up was 13.5 years. The study included 11 153 participants from ARIC, 4830 from CHS, and 5887 from MESA. Analysis of the data was conducted from March 10, 2014, to January 29, 2017.

Exposures: Mitochondrial DNA-CN measured from buffy coat/circulating leukocytes.

Main Outcomes and Measures: Incident CVD, which combines coronary heart disease, defined as the first incident myocardial infarction or death owing to coronary heart disease, and stroke, defined as the first nonfatal stroke or death owing to stroke.

Results: Of the 21 870 participants, the mean age was 62.4 years (ARIC, 57.9 years; MESA, 62.4 years; and CHS, 72.5 years), and 54.7% of participants were women. The hazard ratios for incident coronary heart disease, stroke, and CVD associated with a 1-SD decrease in mtDNA-CN were 1.29 (95% CI, 1.24-1.33), 1.11 (95% CI, 1.06-1.16), and 1.23 (95% CI, 1.19-1.26). The associations persisted after adjustment for traditional CVD risk factors. Addition of mtDNA-CN to the 2013 American College of Cardiology/American Heart Association Pooled Cohorts Equations for estimating 10-year hard atherosclerosis CVD risk was associated with improved risk classification (continuous net reclassification index, 0.194; 95% CI, 0.130-0.258; P < .001). Mitochondrial DNA-CN further improved sensitivity and specificity for the 2013 American College of Cardiology/American Heart Association recommendations on initiating statin therapy for primary prevention of ASCVD (net 221 individuals appropriately downclassified and net 15 individuals appropriately upclassified).

Conclusions and Relevance: Mitochondrial DNA-CN was independently associated with incident CVD in 3 large prospective studies and may have potential clinical utility in improving CVD risk classification.

%B JAMA Cardiol %V 2 %P 1247-1255 %8 2017 Nov 01 %G eng %N 11 %R 10.1001/jamacardio.2017.3683 %0 Journal Article %J BMC Med Inform Decis Mak %D 2017 %T Automatic identification of variables in epidemiological datasets using logic regression. %A Lorenz, Matthias W %A Abdi, Negin Ashtiani %A Scheckenbach, Frank %A Pflug, Anja %A Bülbül, Alpaslan %A Catapano, Alberico L %A Agewall, Stefan %A Ezhov, Marat %A Bots, Michiel L %A Kiechl, Stefan %A Orth, Andreas %X

BACKGROUND: For an individual participant data (IPD) meta-analysis, multiple datasets must be transformed in a consistent format, e.g. using uniform variable names. When large numbers of datasets have to be processed, this can be a time-consuming and error-prone task. Automated or semi-automated identification of variables can help to reduce the workload and improve the data quality. For semi-automation high sensitivity in the recognition of matching variables is particularly important, because it allows creating software which for a target variable presents a choice of source variables, from which a user can choose the matching one, with only low risk of having missed a correct source variable.

METHODS: For each variable in a set of target variables, a number of simple rules were manually created. With logic regression, an optimal Boolean combination of these rules was searched for every target variable, using a random subset of a large database of epidemiological and clinical cohort data (construction subset). In a second subset of this database (validation subset), this optimal combination rules were validated.

RESULTS: In the construction sample, 41 target variables were allocated on average with a positive predictive value (PPV) of 34%, and a negative predictive value (NPV) of 95%. In the validation sample, PPV was 33%, whereas NPV remained at 94%. In the construction sample, PPV was 50% or less in 63% of all variables, in the validation sample in 71% of all variables.

CONCLUSIONS: We demonstrated that the application of logic regression in a complex data management task in large epidemiological IPD meta-analyses is feasible. However, the performance of the algorithm is poor, which may require backup strategies.

%B BMC Med Inform Decis Mak %V 17 %P 40 %8 2017 Apr 13 %G eng %N 1 %R 10.1186/s12911-017-0429-1 %0 Journal Article %J Psychosom Med %D 2017 %T Bivariate Genome-Wide Association Study of Depressive Symptoms with Type 2 Diabetes and Quantitative Glycemic Traits. %A Haljas, Kadri %A Amare, Azmeraw T %A Alizadeh, Behrooz Z %A Hsu, Yi-Hsiang %A Mosley, Thomas %A Newman, Anne %A Murabito, Joanne %A Tiemeier, Henning %A Tanaka, Toshiko %A van Duijn, Cornelia %A Ding, Jingzhong %A Llewellyn, David J %A Bennett, David A %A Terracciano, Antonio %A Launer, Lenore %A Ladwig, Karl-Heinz %A Cornelis, Marylin C %A Teumer, Alexander %A Grabe, Hans %A Kardia, Sharon L R %A Ware, Erin B %A Smith, Jennifer A %A Snieder, Harold %A Eriksson, Johan G %A Groop, Leif %A Räikkönen, Katri %A Lahti, Jari %X

OBJECTIVE: Shared genetic background may explain phenotypic associations between depression and Type-2-Diabetes (T2D). We aimed to study, on a genome-wide level, if genetic correlation and pleiotropic loci exist between depressive symptoms and T2D or glycemic traits.

METHODS: We estimated SNP-based heritability and analyzed genetic correlation between depressive symptoms and T2D and glycemic traits with the LD Score Regression (LDSC) by combining summary statistics of previously conducted meta-analyses for depressive symptoms by CHARGE consortium (N = 51,258), T2D by Diagram consortium (N = 34,840 patients and 114,981 controls), fasting glucose, fasting insulin, HOMA-β, and HOMA-IR by MAGIC consortium (N = 58,074). Finally, we investigated pleiotropic loci using a bivariate GWAS approach with summary statistics from GWAS meta-analyses and reported loci with genome-wide significant bivariate association p-value (p < 5x10). Biological annotation and function of significant pleiotropic SNPs were assessed in several databases.

RESULTS: The SNP-based heritability ranged from 0.04 to 0.10 in each individual trait. In the LDSC analyses, depressive symptoms showed no significant genetic correlation with T2D or glycemic traits (p > 0.37). Yet, we identified pleiotropic genetic variations for depressive symptoms and T2D (in the IGF2BP2, CDKAL1, CDKN2B-AS, and PLEKHA1 genes), and fasting glucose (in the MADD, CDKN2B-AS, PEX16, and MTNR1B genes).

CONCLUSIONS: We found no significant overall genetic correlations between depressive symptoms, T2D or glycemic traits suggesting major differences in underlying biology of these traits. Yet, several potential pleiotropic loci were identified between depressive symptoms, T2D and fasting glucose suggesting that previously established phenotypic associations may be partly explained by genetic variation in these specific loci.

%B Psychosom Med %8 2017 Dec 27 %G eng %R 10.1097/PSY.0000000000000555 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2017 %T Blood Pressure and Heart Rate Measures Associated With Increased Risk of Covert Brain Infarction and Worsening Leukoaraiosis in Older Adults. %A Leung, Lester Y %A Bartz, Traci M %A Rice, Kenneth %A Floyd, James %A Psaty, Bruce %A Gutierrez, Jose %A Longstreth, W T %A Mukamal, Kenneth J %K Age Factors %K Aged %K Antihypertensive Agents %K Blood Pressure %K Cerebral Infarction %K Disease Progression %K Female %K Heart Rate %K Humans %K Hypertension %K Incidence %K Leukoaraiosis %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Prospective Studies %K Pulsatile Flow %K Risk Factors %K Time Factors %K United States %X

OBJECTIVE: In people without previous stroke, covert findings on serial magnetic resonance imaging (MRI) of incident brain infarcts and worsening leukoaraiosis are associated with increased risk for ischemic stroke and dementia. We evaluated whether various measures of blood pressure (BP) and heart rate are associated with these MRI findings.

APPROACH AND RESULTS: In the CHS (Cardiovascular Health Study), a longitudinal cohort study of older adults, we used relative risk regression to assess the associations of mean, variability, and trend in systolic BP, diastolic BP, and heart rate measured at 4 annual clinic visits between 2 brain MRIs with incident covert brain infarction and worsening white matter grade (using a 10-point scale to characterize leukoaraiosis). We included participants who had both brain MRIs, no stroke before the follow-up MRI, and no change in antihypertensive medication status during follow-up. Among 878 eligible participants, incident covert brain infarction occurred in 15% and worsening white matter grade in 27%. Mean systolic BP was associated with increased risk for incident covert brain infarction (relative risk per 10 mm Hg, 1.28; 95% confidence interval, 1.12-1.47), and mean diastolic BP was associated with increased risk for worsening white matter grade (relative risk per 10 mm Hg, 1.45; 95% confidence interval, 1.24-1.69). These findings persisted in secondary and sensitivity analyses.

CONCLUSIONS: Elevated mean systolic BP is associated with increased risk for covert brain infarction, and elevated mean diastolic BP is associated with increased risk for worsening leukoaraiosis. These findings reinforce the importance of hypertension in the development of silent cerebrovascular diseases, but the pathophysiologic relationships to BP for each may differ.

%B Arterioscler Thromb Vasc Biol %V 37 %P 1579-1586 %8 2017 Aug %G eng %N 8 %R 10.1161/ATVBAHA.117.309298 %0 Journal Article %J Exp Gerontol %D 2017 %T Causal effects of cardiovascular risk factors on onset of major age-related diseases: A time-to-event Mendelian randomization study. %A He, Liang %A Culminskaya, Irina %A Loika, Yury %A Arbeev, Konstantin G %A Bagley, Olivia %A Duan, Matt %A Yashin, Anatoliy I %A Kulminski, Alexander M %X

BACKGROUNDS: Elucidating the causal effects of common intermediate risk factors on the onset of age-related diseases is indispensable for developing prevention and intervention procedures.

METHODS: We conducted two-stage time-to-event Mendelian randomization meta-analyses combining five large-scale longitudinal cohorts to investigate dynamic causal effects of cardiovascular disease risk factors including body mass index (BMI), systolic blood pressure (SBP), and lipids on the age-at-onset of age-related diseases. We constructed weighted polygenic scores based on genetic markers from previously reported genome-wide association studies as instrumental variables to estimate the causal effects. To avoid false positive due to potential pleiotropic effects of the genetic markers, we performed a leave-one-out sensitivity analysis and an MR-Egger sensitivity analysis that we expanded in the survival context.

RESULTS: Our results show that elevated BMI increases the absolute risk of type 2 diabetes (T2D) (p=7.68e-04), heart failure (p=9.03e-03), and cardiovascular diseases (CVD) (p=1.69e-03) and the causal effects start at different ages. A significant association between BMI and the risk of stroke is observed; however, the sensitivity analyses suggest that the association is attributed to the potential pleiotropic effects of rs2867125 and rs1558902. Raised SBP levels are significantly associated with the development of atrial fibrillation (p=6.42e-03). Low-density lipoprotein cholesterol (LDL-C) levels are inversely associated with the age-at-onset of T2D (p=1.05e-02). In addition, LDL-C and triglycerides are inversely associated with the risks of cancer and T2D, respectively. Nevertheless, the sensitivity analyses suggest that these associations are probably due to pleiotropic effects of several single-nucleotide polymorphisms including rs4970834 and rs1260326.

CONCLUSIONS: Our results highlight the involvement of BMI in the development of multiple age-related diseases. Some observed causal associations can attribute to pleiotropic effects of some genetic variations. These findings have important implications in unraveling causal effects of common risk factors on age-related diseases and guiding effective intervention strategies to reduce the incidence of these diseases.

%B Exp Gerontol %8 2017 Sep 28 %G eng %R 10.1016/j.exger.2017.09.019 %0 Journal Article %J PLoS One %D 2017 %T Comparison of HapMap and 1000 Genomes Reference Panels in a Large-Scale Genome-Wide Association Study. %A de Vries, Paul S %A Sabater-Lleal, Maria %A Chasman, Daniel I %A Trompet, Stella %A Ahluwalia, Tarunveer S %A Teumer, Alexander %A Kleber, Marcus E %A Chen, Ming-Huei %A Wang, Jie Jin %A Attia, John R %A Marioni, Riccardo E %A Steri, Maristella %A Weng, Lu-Chen %A Pool, Rene %A Grossmann, Vera %A Brody, Jennifer A %A Venturini, Cristina %A Tanaka, Toshiko %A Rose, Lynda M %A Oldmeadow, Christopher %A Mazur, Johanna %A Basu, Saonli %A Frånberg, Mattias %A Yang, Qiong %A Ligthart, Symen %A Hottenga, Jouke J %A Rumley, Ann %A Mulas, Antonella %A de Craen, Anton J M %A Grotevendt, Anne %A Taylor, Kent D %A Delgado, Graciela E %A Kifley, Annette %A Lopez, Lorna M %A Berentzen, Tina L %A Mangino, Massimo %A Bandinelli, Stefania %A Morrison, Alanna C %A Hamsten, Anders %A Tofler, Geoffrey %A de Maat, Moniek P M %A Draisma, Harmen H M %A Lowe, Gordon D %A Zoledziewska, Magdalena %A Sattar, Naveed %A Lackner, Karl J %A Völker, Uwe %A McKnight, Barbara %A Huang, Jie %A Holliday, Elizabeth G %A McEvoy, Mark A %A Starr, John M %A Hysi, Pirro G %A Hernandez, Dena G %A Guan, Weihua %A Rivadeneira, Fernando %A McArdle, Wendy L %A Slagboom, P Eline %A Zeller, Tanja %A Psaty, Bruce M %A Uitterlinden, André G %A de Geus, Eco J C %A Stott, David J %A Binder, Harald %A Hofman, Albert %A Franco, Oscar H %A Rotter, Jerome I %A Ferrucci, Luigi %A Spector, Tim D %A Deary, Ian J %A März, Winfried %A Greinacher, Andreas %A Wild, Philipp S %A Cucca, Francesco %A Boomsma, Dorret I %A Watkins, Hugh %A Tang, Weihong %A Ridker, Paul M %A Jukema, Jan W %A Scott, Rodney J %A Mitchell, Paul %A Hansen, Torben %A O'Donnell, Christopher J %A Smith, Nicholas L %A Strachan, David P %A Dehghan, Abbas %X

An increasing number of genome-wide association (GWA) studies are now using the higher resolution 1000 Genomes Project reference panel (1000G) for imputation, with the expectation that 1000G imputation will lead to the discovery of additional associated loci when compared to HapMap imputation. In order to assess the improvement of 1000G over HapMap imputation in identifying associated loci, we compared the results of GWA studies of circulating fibrinogen based on the two reference panels. Using both HapMap and 1000G imputation we performed a meta-analysis of 22 studies comprising the same 91,953 individuals. We identified six additional signals using 1000G imputation, while 29 loci were associated using both HapMap and 1000G imputation. One locus identified using HapMap imputation was not significant using 1000G imputation. The genome-wide significance threshold of 5×10-8 is based on the number of independent statistical tests using HapMap imputation, and 1000G imputation may lead to further independent tests that should be corrected for. When using a stricter Bonferroni correction for the 1000G GWA study (P-value < 2.5×10-8), the number of loci significant only using HapMap imputation increased to 4 while the number of loci significant only using 1000G decreased to 5. In conclusion, 1000G imputation enabled the identification of 20% more loci than HapMap imputation, although the advantage of 1000G imputation became less clear when a stricter Bonferroni correction was used. More generally, our results provide insights that are applicable to the implementation of other dense reference panels that are under development.

%B PLoS One %V 12 %P e0167742 %8 2017 %G eng %N 1 %R 10.1371/journal.pone.0167742 %0 Journal Article %J Aging (Albany NY) %D 2017 %T The complex genetics of gait speed: genome-wide meta-analysis approach. %A Ben-Avraham, Dan %A Karasik, David %A Verghese, Joe %A Lunetta, Kathryn L %A Smith, Jennifer A %A Eicher, John D %A Vered, Rotem %A Deelen, Joris %A Arnold, Alice M %A Buchman, Aron S %A Tanaka, Toshiko %A Faul, Jessica D %A Nethander, Maria %A Fornage, Myriam %A Adams, Hieab H %A Matteini, Amy M %A Callisaya, Michele L %A Smith, Albert V %A Yu, Lei %A De Jager, Philip L %A Evans, Denis A %A Gudnason, Vilmundur %A Hofman, Albert %A Pattie, Alison %A Corley, Janie %A Launer, Lenore J %A Knopman, Davis S %A Parimi, Neeta %A Turner, Stephen T %A Bandinelli, Stefania %A Beekman, Marian %A Gutman, Danielle %A Sharvit, Lital %A Mooijaart, Simon P %A Liewald, David C %A Houwing-Duistermaat, Jeanine J %A Ohlsson, Claes %A Moed, Matthijs %A Verlinden, Vincent J %A Mellström, Dan %A van der Geest, Jos N %A Karlsson, Magnus %A Hernandez, Dena %A McWhirter, Rebekah %A Liu, Yongmei %A Thomson, Russell %A Tranah, Gregory J %A Uitterlinden, André G %A Weir, David R %A Zhao, Wei %A Starr, John M %A Johnson, Andrew D %A Ikram, M Arfan %A Bennett, David A %A Cummings, Steven R %A Deary, Ian J %A Harris, Tamara B %A Kardia, Sharon L R %A Mosley, Thomas H %A Srikanth, Velandai K %A Windham, Beverly G %A Newman, Ann B %A Walston, Jeremy D %A Davies, Gail %A Evans, Daniel S %A Slagboom, Eline P %A Ferrucci, Luigi %A Kiel, Douglas P %A Murabito, Joanne M %A Atzmon, Gil %X

Emerging evidence suggests that the basis for variation in late-life mobility is attributable, in part, to genetic factors, which may become increasingly important with age. Our objective was to systematically assess the contribution of genetic variation to gait speed in older individuals. We conducted a meta-analysis of gait speed GWASs in 31,478 older adults from 17 cohorts of the CHARGE consortium, and validated our results in 2,588 older adults from 4 independent studies. We followed our initial discoveries with network and eQTL analysis of candidate signals in tissues. The meta-analysis resulted in a list of 536 suggestive genome wide significant SNPs in or near 69 genes. Further interrogation with Pathway Analysis placed gait speed as a polygenic complex trait in five major networks. Subsequent eQTL analysis revealed several SNPs significantly associated with the expression of PRSS16, WDSUB1 and PTPRT, which in addition to the meta-analysis and pathway suggested that genetic effects on gait speed may occur through synaptic function and neuronal development pathways. No genome-wide significant signals for gait speed were identified from this moderately large sample of older adults, suggesting that more refined physical function phenotypes will be needed to identify the genetic basis of gait speed in aging.

%B Aging (Albany NY) %V 9 %P 209-246 %8 2017 Jan 10 %G eng %N 1 %R 10.18632/aging.101151 %0 Journal Article %J Am J Epidemiol %D 2017 %T Concordance With Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults. %A Greenlee, Heather %A Strizich, Garrett %A Lovasi, Gina S %A Kaplan, Robert C %A Biggs, Mary L %A Li, Christopher I %A Richardson, John %A Burke, Gregory L %A Fitzpatrick, Annette L %A Fretts, Amanda M %A Psaty, Bruce M %A Fried, Linda P %K Aged %K Aged, 80 and over %K American Cancer Society %K American Heart Association %K Body Mass Index %K Cardiovascular Diseases %K Cause of Death %K Diet %K Exercise %K Female %K Guideline Adherence %K Healthy Lifestyle %K Humans %K Incidence %K Longitudinal Studies %K Male %K Neoplasms %K Practice Guidelines as Topic %K Prospective Studies %K United States %X

Reports on the associations between multiple clinical and behavioral health indicators and major health outcomes among older adults are scarce. We prospectively examined concordance with guidelines from the American Cancer Society and American Heart Association for disease prevention in relation to cancer, cardiovascular disease (CVD), and mortality among Cardiovascular Health Study enrollees aged 65-98 years who, at baseline assessment in 1989-1996 (n = 3,491), were free of CVD and cancer. Total and cause-specific mortality, as well as incidence of cancer and CVD, were lower with higher guideline concordance. Independent of body mass index, blood pressure, total cholesterol, and fasting plasma glucose, better health behaviors (diet, physical activity, and alcohol consumption) were associated with lower mortality (2-sided P < 0.0001). Among individuals with ideal levels for 3-4 of these 4 cardiometabolic biomarkers, those with poor concordance with health behavior recommendations had higher mortality compared with those who had the highest concordance with these behavioral recommendations (adjusted mortality hazard ratio = 1.82, 95% confidence interval: 1.25, 2.67). Older adults who are concordant with recommendations for cancer and CVD prevention have reduced rates of chronic disease and mortality. Interventions to achieve and maintain healthy lifestyle behaviors may offer benefits both in the presence and absence of adverse traditional clinical risk factors.

%B Am J Epidemiol %V 186 %P 1168-1179 %8 2017 Nov 15 %G eng %N 10 %R 10.1093/aje/kwx150 %0 Journal Article %J Alzheimer Dis Assoc Disord %D 2017 %T Coronary Artery Bypass Graft Surgery and Dementia Risk in the Cardiovascular Health Study. %A Kuźma, Elżbieta %A Airdrie, Jac %A Littlejohns, Thomas J %A Lourida, Ilianna %A Thompson-Coon, Jo %A Lang, Iain A %A Scrobotovici, Monica %A Thacker, Evan L %A Fitzpatrick, Annette %A Kuller, Lewis H %A Lopez, Oscar L %A Longstreth, William T %A Ukoumunne, Obioha C %A Llewellyn, David J %X

INTRODUCTION: The association between history of coronary artery bypass graft surgery (CABG) and dementia risk remains unclear.

METHODS: We conducted a prospective cohort analysis using data on 3155 elderly adults free from prevalent dementia from the US population-based Cardiovascular Health Study (CHS) with adjudicated incident all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), and mixed dementia.

RESULTS: In the CHS, the hazard ratio (HR) for all-cause dementia was 1.93 [95% confidence interval (CI), 1.36-2.74] for those with CABG history compared with those with no CABG history after adjustment for potential confounders. Similar HRs were observed for AD (HR=1.71; 95% CI, 0.98-2.98), VaD (HR=1.42; 95% CI, 0.56-3.65), and mixed dementia (HR=2.73; 95% CI, 1.55-4.80). The same pattern of results was observed when these CHS findings were pooled with a prior prospective study, the pooled HRs were 1.96 (95% CI, 1.42-2.69) for all-cause dementia, 1.71 (95% CI, 1.04-2.79) for AD and 2.20 (95% CI, 0.78-6.19) for VaD.

DISCUSSION: Our results suggest CABG history is associated with long-term dementia risk. Further investigation is warranted to examine the causal mechanisms which may explain this relationship or whether the association reflects differences in coronary artery disease severity.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

%B Alzheimer Dis Assoc Disord %8 2017 Mar 03 %G eng %R 10.1097/WAD.0000000000000191 %0 Journal Article %J Hum Mol Genet %D 2017 %T Detection of genetic loci associated with plasma fetuin-A: A meta-analysis of genome-wide association studies from the CHARGE Consortium. %A Jensen, Majken K %A Jensen, Richard A %A Mukamal, Kenneth J %A Guo, Xiuqing %A Yao, Jie %A Sun, Qi %A Cornelis, Marilyn %A Liu, Yongmei %A Chen, Ming-Huei %A Kizer, Jorge R %A Djoussé, Luc %A Siscovick, David S %A Psaty, Bruce M %A Zmuda, Joseph M %A Rotter, Jerome I %A Garcia, Melissa %A Harris, Tamara %A Chen, Ida %A Goodarzi, Mark O %A Nalls, Michael A %A Keller, Margaux %A Arnold, Alice M %A Newman, Anne %A Hoogeeven, Ron C %A Rexrode, Kathryn M %A Rimm, Eric B %A Hu, Frank B %A Vasan, Ramachandran S %A Katz, Ronit %A Pankow, James S %A Ix, Joachim H %X

Plasma fetuin-A is associated with type 2 diabetes, and AHSG, the gene encoding fetuin-A, has been identified as a susceptibility locus for diabetes and metabolic syndrome. Thus far, unbiased investigations of the genetic determinants of plasma fetuin-A concentrations have not been conducted. We searched for single nucleotide polymorphisms (SNPs) related to fetuin-A concentrations by a genome-wide association study in six population-based studies.We examined the association of fetuin-A levels with ∼ 2.5 million genotyped and imputed SNPs in 9,055 participants of European descent and 2,119 African Americans. In both ethnicities, strongest associations were centered in a region with a high degree of LD near the AHSG locus. Among 136 genome-wide significant (p < 0.05x10-8) SNPs near the AHSG locus, the top SNP was rs4917 (p = 1.27x10-303), a known coding SNP in exon 6 that is associated with a 0.06 g/L (∼13%) lower fetuin-A level. This variant alone explained 14% of the variation in fetuin-A levels. Analyses conditioned on rs4917 indicated that the strong association with the AHSG locus stems from additional independent associations of multiple variants among European Americans. In conclusion, levels of fetuin-A in plasma are strongly associated with SNPs in its encoding gene, AHSG, but not elsewhere in the genome. Given the strength of the associations observed for multiple independent SNPs, the AHSG gene is an example of a candidate locus suitable for additional investigations including fine mapping to elucidate the biological basis of the findings and further functional experiments to clarify AHSG as a potential therapeutic target.

%B Hum Mol Genet %8 2017 Apr 03 %G eng %R 10.1093/hmg/ddx091 %0 Journal Article %J JAMA Neurol %D 2017 %T Disability Trajectories Before and After Stroke and Myocardial Infarction: The Cardiovascular Health Study. %A Dhamoon, Mandip S %A Longstreth, W T %A Bartz, Traci M %A Kaplan, Robert C %A Elkind, Mitchell S V %K Activities of Daily Living %K Aged %K Brain Ischemia %K Cohort Studies %K Disabled Persons %K Disease Progression %K Female %K Humans %K Male %K Myocardial Infarction %K Prospective Studies %K Stroke %X

Importance: Ischemic strokes may accelerate long-term functional decline apart from their acute effects on neurologic function.

Objective: To test whether the increase in long-term disability is steeper after than before the event for ischemic stroke but not myocardial infarction (MI).

Design, Settings, and Participants: In the population-based, prospective cohort Cardiovascular Health Study (1989-2013), longitudinal follow-up was conducted for a mean (SD) of 13 (6.2) years. Follow-up data were used until September 1, 2013; data analysis was performed from August 1, 2013, to June 1, 2016. Models based on generalized estimating equations adjusted for baseline covariates and included a test for different slopes of disability before and after the event. Participants included 5888 Medicare-eligible individuals 65 years or older who were not institutionalized, expected to reside in the area for 3 or more years, and able to provide informed consent. Exclusions were needing a wheelchair, receiving hospice care, and undergoing radiotherapy or chemotherapy.

Exposures: Ischemic stroke and MI.

Main Outcomes and Measures: Annual assessments with a disability scale (measuring activities of daily living [ADLs] and instrumental ADLs). The number of ADLs and instrumental ADLs (range, 0-12) that the participant could not perform was analyzed continuously.

Results: The mean (SD) age of the entire cohort (n = 5888) was 72.8 (5.6) years; 2495 (42.4%) were male. During follow-up, 382 (6.5%) participants had ischemic stroke and 395 (6.7%) had MI with 1 or more disability assessment after the event. There was a mean of 3.7 (2.4) visits before stroke and 3.7 (2.3) visits after stroke; there was a mean of 3.8 (2.5) visits before MI and 3.8 (2.4) visits after MI. The increase in disability near the time of the event was greater for stroke (0.88 points on the disability scale; 95% CI, 0.57 to 1.20; P < .001) than MI (0.20 points on the disability scale; 95% CI, 0.06 to 0.35; P = .006). The annual increase in disability before stroke (0.06 points per year; 95% CI, 0.002 to 0.12; P = .04) more than tripled after stroke (0.15 additional points per year; 95% CI, 0.004 to 0.30; P = .04). The annual increase in disability before MI (0.04 points per year; 95% CI, 0.004 to 0.08; P = .03) did not change significantly after MI (0.02 additional points per year; 95% CI, -0.07 to 0.11; P = .69).

Conclusions and Relevance: In this large, population-based study, a trajectory of increasing disability became significantly steeper after stroke but not after MI. Thus, in addition to the acute brain injury and consequent impairment, ischemic stroke may also be associated with potentially treatable long-term adverse effects on the brain that lead to accelerated functional decline.

%B JAMA Neurol %V 74 %P 1439-1445 %8 2017 Dec 01 %G eng %N 12 %R 10.1001/jamaneurol.2017.2802 %0 Journal Article %J PLoS Genet %D 2017 %T Discovery and fine-mapping of adiposity loci using high density imputation of genome-wide association studies in individuals of African ancestry: African ancestry anthropometry genetics consortium. %A Ng, Maggie C Y %A Graff, Mariaelisa %A Lu, Yingchang %A Justice, Anne E %A Mudgal, Poorva %A Liu, Ching-Ti %A Young, Kristin %A Yanek, Lisa R %A Feitosa, Mary F %A Wojczynski, Mary K %A Rand, Kristin %A Brody, Jennifer A %A Cade, Brian E %A Dimitrov, Latchezar %A Duan, Qing %A Guo, Xiuqing %A Lange, Leslie A %A Nalls, Michael A %A Okut, Hayrettin %A Tajuddin, Salman M %A Tayo, Bamidele O %A Vedantam, Sailaja %A Bradfield, Jonathan P %A Chen, Guanjie %A Chen, Wei-Min %A Chesi, Alessandra %A Irvin, Marguerite R %A Padhukasahasram, Badri %A Smith, Jennifer A %A Zheng, Wei %A Allison, Matthew A %A Ambrosone, Christine B %A Bandera, Elisa V %A Bartz, Traci M %A Berndt, Sonja I %A Bernstein, Leslie %A Blot, William J %A Bottinger, Erwin P %A Carpten, John %A Chanock, Stephen J %A Chen, Yii-Der Ida %A Conti, David V %A Cooper, Richard S %A Fornage, Myriam %A Freedman, Barry I %A Garcia, Melissa %A Goodman, Phyllis J %A Hsu, Yu-Han H %A Hu, Jennifer %A Huff, Chad D %A Ingles, Sue A %A John, Esther M %A Kittles, Rick %A Klein, Eric %A Li, Jin %A McKnight, Barbara %A Nayak, Uma %A Nemesure, Barbara %A Ogunniyi, Adesola %A Olshan, Andrew %A Press, Michael F %A Rohde, Rebecca %A Rybicki, Benjamin A %A Salako, Babatunde %A Sanderson, Maureen %A Shao, Yaming %A Siscovick, David S %A Stanford, Janet L %A Stevens, Victoria L %A Stram, Alex %A Strom, Sara S %A Vaidya, Dhananjay %A Witte, John S %A Yao, Jie %A Zhu, Xiaofeng %A Ziegler, Regina G %A Zonderman, Alan B %A Adeyemo, Adebowale %A Ambs, Stefan %A Cushman, Mary %A Faul, Jessica D %A Hakonarson, Hakon %A Levin, Albert M %A Nathanson, Katherine L %A Ware, Erin B %A Weir, David R %A Zhao, Wei %A Zhi, Degui %A Arnett, Donna K %A Grant, Struan F A %A Kardia, Sharon L R %A Oloapde, Olufunmilayo I %A Rao, D C %A Rotimi, Charles N %A Sale, Michèle M %A Williams, L Keoki %A Zemel, Babette S %A Becker, Diane M %A Borecki, Ingrid B %A Evans, Michele K %A Harris, Tamara B %A Hirschhorn, Joel N %A Li, Yun %A Patel, Sanjay R %A Psaty, Bruce M %A Rotter, Jerome I %A Wilson, James G %A Bowden, Donald W %A Cupples, L Adrienne %A Haiman, Christopher A %A Loos, Ruth J F %A North, Kari E %X

Genome-wide association studies (GWAS) have identified >300 loci associated with measures of adiposity including body mass index (BMI) and waist-to-hip ratio (adjusted for BMI, WHRadjBMI), but few have been identified through screening of the African ancestry genomes. We performed large scale meta-analyses and replications in up to 52,895 individuals for BMI and up to 23,095 individuals for WHRadjBMI from the African Ancestry Anthropometry Genetics Consortium (AAAGC) using 1000 Genomes phase 1 imputed GWAS to improve coverage of both common and low frequency variants in the low linkage disequilibrium African ancestry genomes. In the sex-combined analyses, we identified one novel locus (TCF7L2/HABP2) for WHRadjBMI and eight previously established loci at P < 5×10-8: seven for BMI, and one for WHRadjBMI in African ancestry individuals. An additional novel locus (SPRYD7/DLEU2) was identified for WHRadjBMI when combined with European GWAS. In the sex-stratified analyses, we identified three novel loci for BMI (INTS10/LPL and MLC1 in men, IRX4/IRX2 in women) and four for WHRadjBMI (SSX2IP, CASC8, PDE3B and ZDHHC1/HSD11B2 in women) in individuals of African ancestry or both African and European ancestry. For four of the novel variants, the minor allele frequency was low (<5%). In the trans-ethnic fine mapping of 47 BMI loci and 27 WHRadjBMI loci that were locus-wide significant (P < 0.05 adjusted for effective number of variants per locus) from the African ancestry sex-combined and sex-stratified analyses, 26 BMI loci and 17 WHRadjBMI loci contained ≤ 20 variants in the credible sets that jointly account for 99% posterior probability of driving the associations. The lead variants in 13 of these loci had a high probability of being causal. As compared to our previous HapMap imputed GWAS for BMI and WHRadjBMI including up to 71,412 and 27,350 African ancestry individuals, respectively, our results suggest that 1000 Genomes imputation showed modest improvement in identifying GWAS loci including low frequency variants. Trans-ethnic meta-analyses further improved fine mapping of putative causal variants in loci shared between the African and European ancestry populations.

%B PLoS Genet %V 13 %P e1006719 %8 2017 Apr 21 %G eng %N 4 %R 10.1371/journal.pgen.1006719 %0 Journal Article %J J Lipid Res %D 2017 %T Discovery and fine-mapping of loci associated with monounsaturated fatty acids through trans-ethnic meta-analysis in Chinese and European populations. %A Hu, Yao %A Tanaka, Toshiko %A Zhu, Jingwen %A Guan, Weihua %A Wu, Jason H Y %A Psaty, Bruce M %A McKnight, Barbara %A King, Irena B %A Sun, Qi %A Richard, Melissa %A Manichaikul, Ani %A Frazier-Wood, Alexis C %A Kabagambe, Edmond K %A Hopkins, Paul N %A Ordovas, Jose M %A Ferrucci, Luigi %A Bandinelli, Stefania %A Arnett, Donna K %A Chen, Yii-der I %A Liang, Shuang %A Siscovick, David S %A Tsai, Michael Y %A Rich, Stephen S %A Fornage, Myriam %A Hu, Frank B %A Rimm, Eric B %A Jensen, Majken K %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %A Steffen, Lyn M %A Morris, Andrew P %A Li, Huaixing %A Lin, Xu %X

Monounsaturated fatty acids (MUFAs) are unsaturated fatty acids with one double bond and are derived from endogenous synthesis and dietary intake. Accumulating evidence has suggested that plasma and erythrocyte MUFA levels were associated with cardiometabolic disorders including cardiovascular disease (CVD), type 2 diabetes (T2D) and metabolic syndrome (MS). Previous genome-wide association studies (GWAS) have identified seven loci for plasma and erythrocyte palmitoleic acid and oleic acid levels in populations of European origin. To identify additional MUFA-associated loci and the potential causal variant at each locus, we performed ethnic-specific GWAS meta-analyses and trans-ethnic meta-analyses in over 15,000 participants of Chinese- and European-ancestry. We identified novel genome-wide significant associations for vaccenic acid at FADS1/2 and PKD2L1 [log10(Bayes factor)>=8.07] and for gondoic acid at FADS1/2 and GCKR [log10(Bayes factor)>=61619;6.22], and also observed improved fine-mapping resolutions at FADS1/2 and GCKR loci. The greatest improvement was observed at GCKR, where the number of variants in the 99% credible set was reduced from 16 (covering ~95kb) to five (covering ~20kb, including a missense variant rs1260326) after trans-ethnic meta-analysis. We also confirmed the previously reported associations of PKD2L1, FADS1/2, GCKR and HIF1AN with palmitoleic acid and of FADS1/2 and LPCAT3 with oleic acid in the Chinese-specific GWAS and trans-ethnic meta-analyses. Pathway-based analyses suggested that the identified loci were enriched in unsaturated fatty acids metabolism and signaling pathways. Our findings provided novel insight into the genetic basis relevant to MUFA metabolism and biology.

%B J Lipid Res %8 2017 Mar 15 %G eng %R 10.1194/jlr.P071860 %0 Journal Article %J BioData Min %D 2017 %T Discovery and replication of SNP-SNP interactions for quantitative lipid traits in over 60,000 individuals. %A Holzinger, Emily R %A Verma, Shefali S %A Moore, Carrie B %A Hall, Molly %A De, Rishika %A Gilbert-Diamond, Diane %A Lanktree, Matthew B %A Pankratz, Nathan %A Amuzu, Antoinette %A Burt, Amber %A Dale, Caroline %A Dudek, Scott %A Furlong, Clement E %A Gaunt, Tom R %A Kim, Daniel Seung %A Riess, Helene %A Sivapalaratnam, Suthesh %A Tragante, Vinicius %A van Iperen, Erik P A %A Brautbar, Ariel %A Carrell, David S %A Crosslin, David R %A Jarvik, Gail P %A Kuivaniemi, Helena %A Kullo, Iftikhar J %A Larson, Eric B %A Rasmussen-Torvik, Laura J %A Tromp, Gerard %A Baumert, Jens %A Cruickshanks, Karen J %A Farrall, Martin %A Hingorani, Aroon D %A Hovingh, G K %A Kleber, Marcus E %A Klein, Barbara E %A Klein, Ronald %A Koenig, Wolfgang %A Lange, Leslie A %A Mӓrz, Winfried %A North, Kari E %A Charlotte Onland-Moret, N %A Reiner, Alex P %A Talmud, Philippa J %A van der Schouw, Yvonne T %A Wilson, James G %A Kivimaki, Mika %A Kumari, Meena %A Moore, Jason H %A Drenos, Fotios %A Asselbergs, Folkert W %A Keating, Brendan J %A Ritchie, Marylyn D %X

BACKGROUND: The genetic etiology of human lipid quantitative traits is not fully elucidated, and interactions between variants may play a role. We performed a gene-centric interaction study for four different lipid traits: low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TG).

RESULTS: Our analysis consisted of a discovery phase using a merged dataset of five different cohorts (n = 12,853 to n = 16,849 depending on lipid phenotype) and a replication phase with ten independent cohorts totaling up to 36,938 additional samples. Filters are often applied before interaction testing to correct for the burden of testing all pairwise interactions. We used two different filters: 1. A filter that tested only single nucleotide polymorphisms (SNPs) with a main effect of p < 0.001 in a previous association study. 2. A filter that only tested interactions identified by Biofilter 2.0. Pairwise models that reached an interaction significance level of p < 0.001 in the discovery dataset were tested for replication. We identified thirteen SNP-SNP models that were significant in more than one replication cohort after accounting for multiple testing.

CONCLUSIONS: These results may reveal novel insights into the genetic etiology of lipid levels. Furthermore, we developed a pipeline to perform a computationally efficient interaction analysis with multi-cohort replication.

%B BioData Min %V 10 %P 25 %8 2017 %G eng %R 10.1186/s13040-017-0145-5 %0 Journal Article %J Hum Mol Genet %D 2017 %T Discovery of novel heart rate-associated loci using the Exome Chip. %A van den Berg, Marten E %A Warren, Helen R %A Cabrera, Claudia P %A Verweij, Niek %A Mifsud, Borbala %A Haessler, Jeffrey %A Bihlmeyer, Nathan A %A Fu, Yi-Ping %A Weiss, Stefan %A Lin, Henry J %A Grarup, Niels %A Li-Gao, Ruifang %A Pistis, Giorgio %A Shah, Nabi %A Brody, Jennifer A %A Müller-Nurasyid, Martina %A Lin, Honghuang %A Mei, Hao %A Smith, Albert V %A Lyytikäinen, Leo-Pekka %A Hall, Leanne M %A van Setten, Jessica %A Trompet, Stella %A Prins, Bram P %A Isaacs, Aaron %A Radmanesh, Farid %A Marten, Jonathan %A Entwistle, Aiman %A Kors, Jan A %A Silva, Claudia T %A Alonso, Alvaro %A Bis, Joshua C %A de Boer, Rudolf %A de Haan, Hugoline G %A de Mutsert, Renée %A Dedoussis, George %A Dominiczak, Anna F %A Doney, Alex S F %A Ellinor, Patrick T %A Eppinga, Ruben N %A Felix, Stephan B %A Guo, Xiuqing %A Hagemeijer, Yanick %A Hansen, Torben %A Harris, Tamara B %A Heckbert, Susan R %A Huang, Paul L %A Hwang, Shih-Jen %A Kähönen, Mika %A Kanters, Jørgen K %A Kolcic, Ivana %A Launer, Lenore J %A Li, Man %A Yao, Jie %A Linneberg, Allan %A Liu, Simin %A Macfarlane, Peter W %A Mangino, Massimo %A Morris, Andrew D %A Mulas, Antonella %A Murray, Alison D %A Nelson, Christopher P %A Orrù, Marco %A Padmanabhan, Sandosh %A Peters, Annette %A Porteous, David J %A Poulter, Neil %A Psaty, Bruce M %A Qi, Lihong %A Raitakari, Olli T %A Rivadeneira, Fernando %A Roselli, Carolina %A Rudan, Igor %A Sattar, Naveed %A Sever, Peter %A Sinner, Moritz F %A Soliman, Elsayed Z %A Spector, Timothy D %A Stanton, Alice V %A Stirrups, Kathleen E %A Taylor, Kent D %A Tobin, Martin D %A Uitterlinden, Andre %A Vaartjes, Ilonca %A Hoes, Arno W %A van der Meer, Peter %A Völker, Uwe %A Waldenberger, Melanie %A Xie, Zhijun %A Zoledziewska, Magdalena %A Tinker, Andrew %A Polasek, Ozren %A Rosand, Jonathan %A Jamshidi, Yalda %A van Duijn, Cornelia M %A Zeggini, Eleftheria %A Wouter Jukema, J %A Asselbergs, Folkert W %A Samani, Nilesh J %A Lehtimäki, Terho %A Gudnason, Vilmundur %A Wilson, James %A Lubitz, Steven A %A Kääb, Stefan %A Sotoodehnia, Nona %A Caulfield, Mark J %A Palmer, Colin N A %A Sanna, Serena %A Mook-Kanamori, Dennis O %A Deloukas, Panos %A Pedersen, Oluf %A Rotter, Jerome I %A Dörr, Marcus %A O'Donnell, Chris J %A Hayward, Caroline %A Arking, Dan E %A Kooperberg, Charles %A van der Harst, Pim %A Eijgelsheim, Mark %A Stricker, Bruno H %A Munroe, Patricia B %X

Background Resting heart rate is a heritable trait, and an increase in heart rate is associated with increased mortality risk. GWAS analyses have found loci associated with resting heart rate, at the time of our study these loci explained 0.9% of the variation.Aim To discover new genetic loci associated with heart rate from Exome Chip meta-analyses.Methods Heart rate was measured from either elecrtrocardiograms or pulse recordings. We meta-analysed heart rate association results from 104,452 European-ancestry individuals from 30 cohorts, genotyped using the Exome Chip. Twenty-four variants were selected for follow-up in an independent dataset (UK Biobank, N = 134,251). Conditional and gene-based testing was undertaken, and variants were investigated with bioinformatics methods.Results We discovered five novel heart rate loci, and one new independent low-frequency non-synonymous variant in an established heart rate locus (KIAA1755). Lead variants in four of the novel loci are non-synonymous variants in the genes C10orf71, DALDR3, TESK2, SEC31B. The variant at SEC31B is significantly associated with SEC31B expression in heart and tibial nerve tissue. Further candidate genes were detected from long range regulatory chromatin interactions in heart tissue (SCD, SLF2, MAPK8). We observed significant enrichment in DNase I hypersensitive sites in fetal heart and lung. Moreover, enrichment was seen for the first time in human neuronal progenitor cells (derived from embryonic stem cells) and fetal muscle samples by including our novel variants.Conclusion Our findings advance the knowledge of the genetic architecture of heart rate, and indicate new candidate genes for follow-up functional studies.

%B Hum Mol Genet %8 2017 Apr 03 %G eng %R 10.1093/hmg/ddx113 %0 Journal Article %J Am J Hum Genet %D 2017 %T DNA Methylation Analysis Identifies Loci for Blood Pressure Regulation. %A Richard, Melissa A %A Huan, Tianxiao %A Ligthart, Symen %A Gondalia, Rahul %A Jhun, Min A %A Brody, Jennifer A %A Irvin, Marguerite R %A Marioni, Riccardo %A Shen, Jincheng %A Tsai, Pei-Chien %A Montasser, May E %A Jia, Yucheng %A Syme, Catriona %A Salfati, Elias L %A Boerwinkle, Eric %A Guan, Weihua %A Mosley, Thomas H %A Bressler, Jan %A Morrison, Alanna C %A Liu, Chunyu %A Mendelson, Michael M %A Uitterlinden, André G %A van Meurs, Joyce B %A Franco, Oscar H %A Zhang, Guosheng %A Li, Yun %A Stewart, James D %A Bis, Joshua C %A Psaty, Bruce M %A Chen, Yii-Der Ida %A Kardia, Sharon L R %A Zhao, Wei %A Turner, Stephen T %A Absher, Devin %A Aslibekyan, Stella %A Starr, John M %A McRae, Allan F %A Hou, Lifang %A Just, Allan C %A Schwartz, Joel D %A Vokonas, Pantel S %A Menni, Cristina %A Spector, Tim D %A Shuldiner, Alan %A Damcott, Coleen M %A Rotter, Jerome I %A Palmas, Walter %A Liu, Yongmei %A Paus, Tomáš %A Horvath, Steve %A O'Connell, Jeffrey R %A Guo, Xiuqing %A Pausova, Zdenka %A Assimes, Themistocles L %A Sotoodehnia, Nona %A Smith, Jennifer A %A Arnett, Donna K %A Deary, Ian J %A Baccarelli, Andrea A %A Bell, Jordana T %A Whitsel, Eric %A Dehghan, Abbas %A Levy, Daniel %A Fornage, Myriam %K Aged %K Blood Pressure %K CpG Islands %K Cross-Sectional Studies %K DNA Methylation %K Epigenesis, Genetic %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Mendelian Randomization Analysis %K Middle Aged %K Nerve Tissue Proteins %K Quantitative Trait Loci %K Tetraspanins %X

Genome-wide association studies have identified hundreds of genetic variants associated with blood pressure (BP), but sequence variation accounts for a small fraction of the phenotypic variance. Epigenetic changes may alter the expression of genes involved in BP regulation and explain part of the missing heritability. We therefore conducted a two-stage meta-analysis of the cross-sectional associations of systolic and diastolic BP with blood-derived genome-wide DNA methylation measured on the Infinium HumanMethylation450 BeadChip in 17,010 individuals of European, African American, and Hispanic ancestry. Of 31 discovery-stage cytosine-phosphate-guanine (CpG) dinucleotides, 13 replicated after Bonferroni correction (discovery: N = 9,828, p < 1.0 × 10-7; replication: N = 7,182, p < 1.6 × 10-3). The replicated methylation sites are heritable (h2 > 30%) and independent of known BP genetic variants, explaining an additional 1.4% and 2.0% of the interindividual variation in systolic and diastolic BP, respectively. Bidirectional Mendelian randomization among up to 4,513 individuals of European ancestry from 4 cohorts suggested that methylation at cg08035323 (TAF1B-YWHAQ) influences BP, while BP influences methylation at cg00533891 (ZMIZ1), cg00574958 (CPT1A), and cg02711608 (SLC1A5). Gene expression analyses further identified six genes (TSPAN2, SLC7A11, UNC93B1, CPT1A, PTMS, and LPCAT3) with evidence of triangular associations between methylation, gene expression, and BP. Additional integrative Mendelian randomization analyses of gene expression and DNA methylation suggested that the expression of TSPAN2 is a putative mediator of association between DNA methylation at cg23999170 and BP. These findings suggest that heritable DNA methylation plays a role in regulating BP independently of previously known genetic variants.

%B Am J Hum Genet %V 101 %P 888-902 %8 2017 Dec 07 %G eng %N 6 %R 10.1016/j.ajhg.2017.09.028 %0 Journal Article %J Nat Genet %D 2017 %T Exome-wide association study of plasma lipids in >300,000 individuals. %A Liu, Dajiang J %A Peloso, Gina M %A Yu, Haojie %A Butterworth, Adam S %A Wang, Xiao %A Mahajan, Anubha %A Saleheen, Danish %A Emdin, Connor %A Alam, Dewan %A Alves, Alexessander Couto %A Amouyel, Philippe %A Di Angelantonio, Emanuele %A Arveiler, Dominique %A Assimes, Themistocles L %A Auer, Paul L %A Baber, Usman %A Ballantyne, Christie M %A Bang, Lia E %A Benn, Marianne %A Bis, Joshua C %A Boehnke, Michael %A Boerwinkle, Eric %A Bork-Jensen, Jette %A Bottinger, Erwin P %A Brandslund, Ivan %A Brown, Morris %A Busonero, Fabio %A Caulfield, Mark J %A Chambers, John C %A Chasman, Daniel I %A Chen, Y Eugene %A Chen, Yii-Der Ida %A Chowdhury, Rajiv %A Christensen, Cramer %A Chu, Audrey Y %A Connell, John M %A Cucca, Francesco %A Cupples, L Adrienne %A Damrauer, Scott M %A Davies, Gail %A Deary, Ian J %A Dedoussis, George %A Denny, Joshua C %A Dominiczak, Anna %A Dubé, Marie-Pierre %A Ebeling, Tapani %A Eiriksdottir, Gudny %A Esko, Tõnu %A Farmaki, Aliki-Eleni %A Feitosa, Mary F %A Ferrario, Marco %A Ferrieres, Jean %A Ford, Ian %A Fornage, Myriam %A Franks, Paul W %A Frayling, Timothy M %A Frikke-Schmidt, Ruth %A Fritsche, Lars G %A Frossard, Philippe %A Fuster, Valentin %A Ganesh, Santhi K %A Gao, Wei %A Garcia, Melissa E %A Gieger, Christian %A Giulianini, Franco %A Goodarzi, Mark O %A Grallert, Harald %A Grarup, Niels %A Groop, Leif %A Grove, Megan L %A Gudnason, Vilmundur %A Hansen, Torben %A Harris, Tamara B %A Hayward, Caroline %A Hirschhorn, Joel N %A Holmen, Oddgeir L %A Huffman, Jennifer %A Huo, Yong %A Hveem, Kristian %A Jabeen, Sehrish %A Jackson, Anne U %A Jakobsdottir, Johanna %A Jarvelin, Marjo-Riitta %A Jensen, Gorm B %A Jørgensen, Marit E %A Jukema, J Wouter %A Justesen, Johanne M %A Kamstrup, Pia R %A Kanoni, Stavroula %A Karpe, Fredrik %A Kee, Frank %A Khera, Amit V %A Klarin, Derek %A Koistinen, Heikki A %A Kooner, Jaspal S %A Kooperberg, Charles %A Kuulasmaa, Kari %A Kuusisto, Johanna %A Laakso, Markku %A Lakka, Timo %A Langenberg, Claudia %A Langsted, Anne %A Launer, Lenore J %A Lauritzen, Torsten %A Liewald, David C M %A Lin, Li An %A Linneberg, Allan %A Loos, Ruth J F %A Lu, Yingchang %A Lu, Xiangfeng %A Mägi, Reedik %A Mälarstig, Anders %A Manichaikul, Ani %A Manning, Alisa K %A Mäntyselkä, Pekka %A Marouli, Eirini %A Masca, Nicholas G D %A Maschio, Andrea %A Meigs, James B %A Melander, Olle %A Metspalu, Andres %A Morris, Andrew P %A Morrison, Alanna C %A Mulas, Antonella %A Müller-Nurasyid, Martina %A Munroe, Patricia B %A Neville, Matt J %A Nielsen, Jonas B %A Nielsen, Sune F %A Nordestgaard, Børge G %A Ordovas, Jose M %A Mehran, Roxana %A O'Donnell, Christoper J %A Orho-Melander, Marju %A Molony, Cliona M %A Muntendam, Pieter %A Padmanabhan, Sandosh %A Palmer, Colin N A %A Pasko, Dorota %A Patel, Aniruddh P %A Pedersen, Oluf %A Perola, Markus %A Peters, Annette %A Pisinger, Charlotta %A Pistis, Giorgio %A Polasek, Ozren %A Poulter, Neil %A Psaty, Bruce M %A Rader, Daniel J %A Rasheed, Asif %A Rauramaa, Rainer %A Reilly, Dermot F %A Reiner, Alex P %A Renstrom, Frida %A Rich, Stephen S %A Ridker, Paul M %A Rioux, John D %A Robertson, Neil R %A Roden, Dan M %A Rotter, Jerome I %A Rudan, Igor %A Salomaa, Veikko %A Samani, Nilesh J %A Sanna, Serena %A Sattar, Naveed %A Schmidt, Ellen M %A Scott, Robert A %A Sever, Peter %A Sevilla, Raquel S %A Shaffer, Christian M %A Sim, Xueling %A Sivapalaratnam, Suthesh %A Small, Kerrin S %A Smith, Albert V %A Smith, Blair H %A Somayajula, Sangeetha %A Southam, Lorraine %A Spector, Timothy D %A Speliotes, Elizabeth K %A Starr, John M %A Stirrups, Kathleen E %A Stitziel, Nathan %A Strauch, Konstantin %A Stringham, Heather M %A Surendran, Praveen %A Tada, Hayato %A Tall, Alan R %A Tang, Hua %A Tardif, Jean-Claude %A Taylor, Kent D %A Trompet, Stella %A Tsao, Philip S %A Tuomilehto, Jaakko %A Tybjaerg-Hansen, Anne %A van Zuydam, Natalie R %A Varbo, Anette %A Varga, Tibor V %A Virtamo, Jarmo %A Waldenberger, Melanie %A Wang, Nan %A Wareham, Nick J %A Warren, Helen R %A Weeke, Peter E %A Weinstock, Joshua %A Wessel, Jennifer %A Wilson, James G %A Wilson, Peter W F %A Xu, Ming %A Yaghootkar, Hanieh %A Young, Robin %A Zeggini, Eleftheria %A Zhang, He %A Zheng, Neil S %A Zhang, Weihua %A Zhang, Yan %A Zhou, Wei %A Zhou, Yanhua %A Zoledziewska, Magdalena %A Howson, Joanna M M %A Danesh, John %A McCarthy, Mark I %A Cowan, Chad A %A Abecasis, Goncalo %A Deloukas, Panos %A Musunuru, Kiran %A Willer, Cristen J %A Kathiresan, Sekar %K Coronary Artery Disease %K Diabetes Mellitus, Type 2 %K Exome %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genetic Variation %K Genotype %K Humans %K Lipids %K Macular Degeneration %K Phenotype %K Risk Factors %X

We screened variants on an exome-focused genotyping array in >300,000 participants (replication in >280,000 participants) and identified 444 independent variants in 250 loci significantly associated with total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C), and/or triglycerides (TG). At two loci (JAK2 and A1CF), experimental analysis in mice showed lipid changes consistent with the human data. We also found that: (i) beta-thalassemia trait carriers displayed lower TC and were protected from coronary artery disease (CAD); (ii) excluding the CETP locus, there was not a predictable relationship between plasma HDL-C and risk for age-related macular degeneration; (iii) only some mechanisms of lowering LDL-C appeared to increase risk for type 2 diabetes (T2D); and (iv) TG-lowering alleles involved in hepatic production of TG-rich lipoproteins (TM6SF2 and PNPLA3) tracked with higher liver fat, higher risk for T2D, and lower risk for CAD, whereas TG-lowering alleles involved in peripheral lipolysis (LPL and ANGPTL4) had no effect on liver fat but decreased risks for both T2D and CAD.

%B Nat Genet %V 49 %P 1758-1766 %8 2017 Dec %G eng %N 12 %R 10.1038/ng.3977 %0 Journal Article %J Stroke %D 2017 %T Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults. %A Winovich, Divya Thekkethala %A Longstreth, William T %A Arnold, Alice M %A Varadhan, Ravi %A Zeki Al Hazzouri, Adina %A Cushman, Mary %A Newman, Anne B %A Odden, Michelle C %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Brain Ischemia %K Cohort Studies %K Female %K Follow-Up Studies %K Frail Elderly %K Humans %K Male %K Recovery of Function %K Risk Factors %K Stroke %K Survival Rate %X

BACKGROUND AND PURPOSE: Little is known about factors that predispose older adults to poor recovery after a stroke. In this study, we sought to evaluate prestroke measures of frailty and related factors as markers of vulnerability to poor outcomes after ischemic stroke.

METHODS: In participants aged 65 to 99 years with incident ischemic strokes from the Cardiovascular Health Study, we evaluated the association of several risk factors (frailty, frailty components, C-reactive protein, interleukin-6, and cystatin C) assessed before stroke with stroke outcomes of survival, cognitive decline (≥5 points on Modified Mini-Mental State Examination), and activities of daily living decline (increase in limitations).

RESULTS: Among 717 participants with incident ischemic stroke with survival data, slow walking speed, low grip strength, and cystatin C were independently associated with shorter survival. Among participants <80 years of age, frailty and interleukin-6 were also associated with shorter survival. Among 509 participants with recovery data, slow walking speed, and low grip strength were associated with both cognitive and activities of daily living decline poststroke. C-reactive protein and interleukin-6 were associated with poststroke cognitive decline among men only. Frailty status was associated with activities of daily living decline among women only.

CONCLUSIONS: Markers of physical function-walking speed and grip strength-were consistently associated with survival and recovery after ischemic stroke. Inflammation, kidney function, and frailty also seemed to be determinants of survival and recovery after an ischemic stroke. These markers of vulnerability may identify targets for differing pre and poststroke medical management and rehabilitation among older adults at risk of poor stroke outcomes.

%B Stroke %V 48 %P 1818-1826 %8 2017 Jul %G eng %N 7 %R 10.1161/STROKEAHA.117.016726 %0 Journal Article %J Circ Cardiovasc Genet %D 2017 %T Fifteen Genetic Loci Associated With the Electrocardiographic P Wave. %A Christophersen, Ingrid E %A Magnani, Jared W %A Yin, Xiaoyan %A Barnard, John %A Weng, Lu-Chen %A Arking, Dan E %A Niemeijer, Maartje N %A Lubitz, Steven A %A Avery, Christy L %A Duan, Qing %A Felix, Stephan B %A Bis, Joshua C %A Kerr, Kathleen F %A Isaacs, Aaron %A Müller-Nurasyid, Martina %A Müller, Christian %A North, Kari E %A Reiner, Alex P %A Tinker, Lesley F %A Kors, Jan A %A Teumer, Alexander %A Petersmann, Astrid %A Sinner, Moritz F %A Bůzková, Petra %A Smith, Jonathan D %A Van Wagoner, David R %A Völker, Uwe %A Waldenberger, Melanie %A Peters, Annette %A Meitinger, Thomas %A Limacher, Marian C %A Wilhelmsen, Kirk C %A Psaty, Bruce M %A Hofman, Albert %A Uitterlinden, Andre %A Krijthe, Bouwe P %A Zhang, Zhu-Ming %A Schnabel, Renate B %A Kääb, Stefan %A van Duijn, Cornelia %A Rotter, Jerome I %A Sotoodehnia, Nona %A Dörr, Marcus %A Li, Yun %A Chung, Mina K %A Soliman, Elsayed Z %A Alonso, Alvaro %A Whitsel, Eric A %A Stricker, Bruno H %A Benjamin, Emelia J %A Heckbert, Susan R %A Ellinor, Patrick T %K Arrhythmias, Cardiac %K Caveolin 1 %K Caveolin 2 %K Electrocardiography %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Heart Atria %K Humans %K NAV1.5 Voltage-Gated Sodium Channel %K NAV1.8 Voltage-Gated Sodium Channel %K T-Box Domain Proteins %X

BACKGROUND: The P wave on an ECG is a measure of atrial electric function, and its characteristics may serve as predictors for atrial arrhythmias. Increased mean P-wave duration and P-wave terminal force traditionally have been used as markers for left atrial enlargement, and both have been associated with increased risk of atrial fibrillation. Here, we explore the genetic basis of P-wave morphology through meta-analysis of genome-wide association study results for P-wave duration and P-wave terminal force from 12 cohort studies.

METHODS AND RESULTS: We included 44 456 individuals, of which 6778 (16%) were of African ancestry. Genotyping, imputation, and genome-wide association study were performed at each study site. Summary-level results were meta-analyzed centrally using inverse-variance weighting. In meta-analyses of P-wave duration, we identified 6 significant (P<5×10-8) novel loci and replicated a prior association with SCN10A. We identified 3 loci at SCN5A, TBX5, and CAV1/CAV2 that were jointly associated with the PR interval, PR segment, and P-wave duration. We identified 6 novel loci in meta-analysis of P-wave terminal force. Four of the identified genetic loci were significantly associated with gene expression in 329 left atrial samples. Finally, we observed that some of the loci associated with the P wave were linked to overall atrial conduction, whereas others identified distinct phases of atrial conduction.

CONCLUSIONS: We have identified 6 novel genetic loci associated with P-wave duration and 6 novel loci associated with P-wave terminal force. Future studies of these loci may aid in identifying new targets for drugs that may modify atrial conduction or treat atrial arrhythmias.

%B Circ Cardiovasc Genet %V 10 %8 2017 Aug %G eng %N 4 %R 10.1161/CIRCGENETICS.116.001667 %0 Journal Article %J Heart Rhythm %D 2017 %T Fine mapping of QT interval regions in global populations refines previously identified QT interval loci and identifies signals unique to African and Hispanic descent populations. %A Avery, Christy L %A Wassel, Christina L %A Richard, Melissa A %A Highland, Heather M %A Bien, Stephanie %A Zubair, Niha %A Soliman, Elsayed Z %A Fornage, Myriam %A Bielinski, Suzette J %A Tao, Ran %A Seyerle, Amanda A %A Shah, Sanjiv J %A Lloyd-Jones, Donald M %A Buyske, Steven %A Rotter, Jerome I %A Post, Wendy S %A Rich, Stephen S %A Hindorff, Lucia A %A Jeff, Janina M %A Shohet, Ralph V %A Sotoodehnia, Nona %A Lin, Dan Yu %A Whitsel, Eric A %A Peters, Ulrike %A Haiman, Christopher A %A Crawford, Dana C %A Kooperberg, Charles %A North, Kari E %X

BACKGROUND: The electrocardiographically measured QT interval (QT) is heritable and its prolongation is an established risk factor for several cardiovascular diseases. Yet, most QT genetic studies have been performed in European ancestral populations, possibly reducing their global relevance.

OBJECTIVE: To leverage diversity and improve biological insight, we fine mapped 16 of the 35 previously identified QT loci (46%) in populations of African American (n = 12,410) and Hispanic/Latino (n = 14,837) ancestry.

METHODS: Racial/ethnic-specific multiple linear regression analyses adjusted for heart rate and clinical covariates were examined separately and in combination after inverse-variance weighted trans-ethnic meta-analysis.

RESULTS: The 16 fine-mapped QT loci included on the Illumina Metabochip represented 21 independent signals, of which 16 (76%) were significantly (P-value≤9.1×10(-5)) associated with QT. Through sequential conditional analysis we also identified three trans-ethnic novel SNPs at ATP1B1, SCN5A-SCN10A, and KCNQ1 and three Hispanic/Latino-specific novel SNPs at NOS1AP and SCN5A-SCN10A (two novel SNPs) with evidence of associations with QT independent of previous identified GWAS lead SNPs. Linkage disequilibrium patterns helped to narrow the region likely to contain the functional variants at several loci, including NOS1AP, USP50-TRPM7, and PRKCA, although intervals surrounding SLC35F1-PLN and CNOT1 remained broad in size (>100 kb). Finally, bioinformatics-based functional characterization suggested a regulatory function in cardiac tissues for the majority of independent signals that generalized and the novel SNPs.

CONCLUSION: Our findings suggest that a majority of identified SNPs implicate gene regulatory dysfunction in QT prolongation, that the same loci influence variation in QT across global populations, and that additional, novel, population-specific QT signals exist.

%B Heart Rhythm %V 14 %P 572-580 %8 2017 Apr %G eng %N 4 %R 10.1016/j.hrthm.2016.12.021 %0 Journal Article %J Int J Obes (Lond) %D 2017 %T Generalization and fine mapping of European ancestry-based central adiposity variants in African ancestry populations. %A Yoneyama, S %A Yao, J %A Guo, X %A Fernandez-Rhodes, L %A Lim, U %A Boston, J %A Bůžková, P %A Carlson, C S %A Cheng, I %A Cochran, B %A Cooper, R %A Ehret, G %A Fornage, M %A Gong, J %A Gross, M %A Gu, C C %A Haessler, J %A Haiman, C A %A Henderson, B %A Hindorff, L A %A Houston, D %A Irvin, M R %A Jackson, R %A Kuller, L %A Leppert, M %A Lewis, C E %A Li, R %A Le Marchand, L %A Matise, T C %A Nguyen, K-Dh %A Chakravarti, A %A Pankow, J S %A Pankratz, N %A Pooler, L %A Ritchie, M D %A Bien, S A %A Wassel, C L %A Chen, Y-DI %A Taylor, K D %A Allison, M %A Rotter, J I %A Schreiner, P J %A Schumacher, F %A Wilkens, L %A Boerwinkle, E %A Kooperberg, C %A Peters, U %A Buyske, S %A Graff, M %A North, K E %X

BACKGROUND/OBJECTIVES: Central adiposity measures such as waist circumference (WC) and waist-to-hip ratio (WHR) are associated with cardiometabolic disorders independently of body mass index (BMI) and are gaining clinically utility. Several studies report genetic variants associated with central adiposity, but most utilize only European ancestry populations. Understanding whether the genetic associations discovered among mainly European descendants are shared with African ancestry populations will help elucidate the biological underpinnings of abdominal fat deposition.

SUBJECTS/METHODS: To identify the underlying functional genetic determinants of body fat distribution, we conducted an array-wide association meta-analysis among persons of African ancestry across seven studies/consortia participating in the Population Architecture using Genomics and Epidemiology (PAGE) consortium. We used the Metabochip array, designed for fine-mapping cardiovascular-associated loci, to explore novel array-wide associations with WC and WHR among 15 945 African descendants using all and sex-stratified groups. We further interrogated 17 known WHR regions for African ancestry-specific variants.

RESULTS: Of the 17 WHR loci, eight single-nucleotide polymorphisms (SNPs) located in four loci were replicated in the sex-combined or sex-stratified meta-analyses. Two of these eight independently associated with WHR after conditioning on the known variant in European descendants (rs12096179 in TBX15-WARS2 and rs2059092 in ADAMTS9). In the fine-mapping assessment, the putative functional region was reduced across all four loci but to varying degrees (average 40% drop in number of putative SNPs and 20% drop in genomic region). Similar to previous studies, the significant SNPs in the female-stratified analysis were stronger than the significant SNPs from the sex-combined analysis. No novel associations were detected in the array-wide analyses.

CONCLUSIONS: Of 17 previously identified loci, four loci replicated in the African ancestry populations of this study. Utilizing different linkage disequilibrium patterns observed between European and African ancestries, we narrowed the suggestive region containing causative variants for all four loci.

%B Int J Obes (Lond) %V 41 %P 324-331 %8 2017 Feb %G eng %N 2 %R 10.1038/ijo.2016.207 %0 Journal Article %J Sci Rep %D 2017 %T Genetic Interactions with Age, Sex, Body Mass Index, and Hypertension in Relation to Atrial Fibrillation: The AFGen Consortium. %A Weng, Lu-Chen %A Lunetta, Kathryn L %A Müller-Nurasyid, Martina %A Smith, Albert Vernon %A Thériault, Sébastien %A Weeke, Peter E %A Barnard, John %A Bis, Joshua C %A Lyytikäinen, Leo-Pekka %A Kleber, Marcus E %A Martinsson, Andreas %A Lin, Henry J %A Rienstra, Michiel %A Trompet, Stella %A Krijthe, Bouwe P %A Dörr, Marcus %A Klarin, Derek %A Chasman, Daniel I %A Sinner, Moritz F %A Waldenberger, Melanie %A Launer, Lenore J %A Harris, Tamara B %A Soliman, Elsayed Z %A Alonso, Alvaro %A Paré, Guillaume %A Teixeira, Pedro L %A Denny, Joshua C %A Shoemaker, M Benjamin %A Van Wagoner, David R %A Smith, Jonathan D %A Psaty, Bruce M %A Sotoodehnia, Nona %A Taylor, Kent D %A Kähönen, Mika %A Nikus, Kjell %A Delgado, Graciela E %A Melander, Olle %A Engström, Gunnar %A Yao, Jie %A Guo, Xiuqing %A Christophersen, Ingrid E %A Ellinor, Patrick T %A Geelhoed, Bastiaan %A Verweij, Niek %A Macfarlane, Peter %A Ford, Ian %A Heeringa, Jan %A Franco, Oscar H %A Uitterlinden, André G %A Völker, Uwe %A Teumer, Alexander %A Rose, Lynda M %A Kääb, Stefan %A Gudnason, Vilmundur %A Arking, Dan E %A Conen, David %A Roden, Dan M %A Chung, Mina K %A Heckbert, Susan R %A Benjamin, Emelia J %A Lehtimäki, Terho %A März, Winfried %A Smith, J Gustav %A Rotter, Jerome I %A van der Harst, Pim %A Jukema, J Wouter %A Stricker, Bruno H %A Felix, Stephan B %A Albert, Christine M %A Lubitz, Steven A %X

It is unclear whether genetic markers interact with risk factors to influence atrial fibrillation (AF) risk. We performed genome-wide interaction analyses between genetic variants and age, sex, hypertension, and body mass index in the AFGen Consortium. Study-specific results were combined using meta-analysis (88,383 individuals of European descent, including 7,292 with AF). Variants with nominal interaction associations in the discovery analysis were tested for association in four independent studies (131,441 individuals, including 5,722 with AF). In the discovery analysis, the AF risk associated with the minor rs6817105 allele (at the PITX2 locus) was greater among subjects ≤ 65 years of age than among those > 65 years (interaction p-value = 4.0 × 10-5). The interaction p-value exceeded genome-wide significance in combined discovery and replication analyses (interaction p-value = 1.7 × 10-8). We observed one genome-wide significant interaction with body mass index and several suggestive interactions with age, sex, and body mass index in the discovery analysis. However, none was replicated in the independent sample. Our findings suggest that the pathogenesis of AF may differ according to age in individuals of European descent, but we did not observe evidence of statistically significant genetic interactions with sex, body mass index, or hypertension on AF risk.

%B Sci Rep %V 7 %P 11303 %8 2017 Sep 12 %G eng %N 1 %R 10.1038/s41598-017-09396-7 %0 Journal Article %J Nat Genet %D 2017 %T Genetic loci associated with chronic obstructive pulmonary disease overlap with loci for lung function and pulmonary fibrosis. %A Hobbs, Brian D %A de Jong, Kim %A Lamontagne, Maxime %A Bossé, Yohan %A Shrine, Nick %A Artigas, Maria Soler %A Wain, Louise V %A Hall, Ian P %A Jackson, Victoria E %A Wyss, Annah B %A London, Stephanie J %A North, Kari E %A Franceschini, Nora %A Strachan, David P %A Beaty, Terri H %A Hokanson, John E %A Crapo, James D %A Castaldi, Peter J %A Chase, Robert P %A Bartz, Traci M %A Heckbert, Susan R %A Psaty, Bruce M %A Gharib, Sina A %A Zanen, Pieter %A Lammers, Jan W %A Oudkerk, Matthijs %A Groen, H J %A Locantore, Nicholas %A Tal-Singer, Ruth %A Rennard, Stephen I %A Vestbo, Jørgen %A Timens, Wim %A Paré, Peter D %A Latourelle, Jeanne C %A Dupuis, Josée %A O'Connor, George T %A Wilk, Jemma B %A Kim, Woo Jin %A Lee, Mi Kyeong %A Oh, Yeon-Mok %A Vonk, Judith M %A de Koning, Harry J %A Leng, Shuguang %A Belinsky, Steven A %A Tesfaigzi, Yohannes %A Manichaikul, Ani %A Wang, Xin-Qun %A Rich, Stephen S %A Barr, R Graham %A Sparrow, David %A Litonjua, Augusto A %A Bakke, Per %A Gulsvik, Amund %A Lahousse, Lies %A Brusselle, Guy G %A Stricker, Bruno H %A Uitterlinden, André G %A Ampleford, Elizabeth J %A Bleecker, Eugene R %A Woodruff, Prescott G %A Meyers, Deborah A %A Qiao, Dandi %A Lomas, David A %A Yim, Jae-Joon %A Kim, Deog Kyeom %A Hawrylkiewicz, Iwona %A Sliwinski, Pawel %A Hardin, Megan %A Fingerlin, Tasha E %A Schwartz, David A %A Postma, Dirkje S %A MacNee, William %A Tobin, Martin D %A Silverman, Edwin K %A Boezen, H Marike %A Cho, Michael H %X

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide. We performed a genetic association study in 15,256 cases and 47,936 controls, with replication of select top results (P < 5 × 10(-6)) in 9,498 cases and 9,748 controls. In the combined meta-analysis, we identified 22 loci associated at genome-wide significance, including 13 new associations with COPD. Nine of these 13 loci have been associated with lung function in general population samples, while 4 (EEFSEC, DSP, MTCL1, and SFTPD) are new. We noted two loci shared with pulmonary fibrosis (FAM13A and DSP) but that had opposite risk alleles for COPD. None of our loci overlapped with genome-wide associations for asthma, although one locus has been implicated in joint susceptibility to asthma and obesity. We also identified genetic correlation between COPD and asthma. Our findings highlight new loci associated with COPD, demonstrate the importance of specific loci associated with lung function to COPD, and identify potential regions of genetic overlap between COPD and other respiratory diseases.

%B Nat Genet %V 49 %P 426-432 %8 2017 Mar %G eng %N 3 %R 10.1038/ng.3752 %0 Journal Article %J Nat Commun %D 2017 %T Genetic loci associated with heart rate variability and their effects on cardiac disease risk. %A Nolte, Ilja M %A Munoz, M Loretto %A Tragante, Vinicius %A Amare, Azmeraw T %A Jansen, Rick %A Vaez, Ahmad %A von der Heyde, Benedikt %A Avery, Christy L %A Bis, Joshua C %A Dierckx, Bram %A van Dongen, Jenny %A Gogarten, Stephanie M %A Goyette, Philippe %A Hernesniemi, Jussi %A Huikari, Ville %A Hwang, Shih-Jen %A Jaju, Deepali %A Kerr, Kathleen F %A Kluttig, Alexander %A Krijthe, Bouwe P %A Kumar, Jitender %A van der Laan, Sander W %A Lyytikäinen, Leo-Pekka %A Maihofer, Adam X %A Minassian, Arpi %A van der Most, Peter J %A Müller-Nurasyid, Martina %A Nivard, Michel %A Salvi, Erika %A Stewart, James D %A Thayer, Julian F %A Verweij, Niek %A Wong, Andrew %A Zabaneh, Delilah %A Zafarmand, Mohammad H %A Abdellaoui, Abdel %A Albarwani, Sulayma %A Albert, Christine %A Alonso, Alvaro %A Ashar, Foram %A Auvinen, Juha %A Axelsson, Tomas %A Baker, Dewleen G %A de Bakker, Paul I W %A Barcella, Matteo %A Bayoumi, Riad %A Bieringa, Rob J %A Boomsma, Dorret %A Boucher, Gabrielle %A Britton, Annie R %A Christophersen, Ingrid %A Dietrich, Andrea %A Ehret, George B %A Ellinor, Patrick T %A Eskola, Markku %A Felix, Janine F %A Floras, John S %A Franco, Oscar H %A Friberg, Peter %A Gademan, Maaike G J %A Geyer, Mark A %A Giedraitis, Vilmantas %A Hartman, Catharina A %A Hemerich, Daiane %A Hofman, Albert %A Hottenga, Jouke-Jan %A Huikuri, Heikki %A Hutri-Kähönen, Nina %A Jouven, Xavier %A Junttila, Juhani %A Juonala, Markus %A Kiviniemi, Antti M %A Kors, Jan A %A Kumari, Meena %A Kuznetsova, Tatiana %A Laurie, Cathy C %A Lefrandt, Joop D %A Li, Yong %A Li, Yun %A Liao, Duanping %A Limacher, Marian C %A Lin, Henry J %A Lindgren, Cecilia M %A Lubitz, Steven A %A Mahajan, Anubha %A McKnight, Barbara %A Zu Schwabedissen, Henriette Meyer %A Milaneschi, Yuri %A Mononen, Nina %A Morris, Andrew P %A Nalls, Mike A %A Navis, Gerjan %A Neijts, Melanie %A Nikus, Kjell %A North, Kari E %A O'Connor, Daniel T %A Ormel, Johan %A Perz, Siegfried %A Peters, Annette %A Psaty, Bruce M %A Raitakari, Olli T %A Risbrough, Victoria B %A Sinner, Moritz F %A Siscovick, David %A Smit, Johannes H %A Smith, Nicholas L %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Staessen, Jan A %A Stein, Phyllis K %A Stilp, Adrienne M %A Stolarz-Skrzypek, Katarzyna %A Strauch, Konstantin %A Sundström, Johan %A Swenne, Cees A %A Syvänen, Ann-Christine %A Tardif, Jean-Claude %A Taylor, Kent D %A Teumer, Alexander %A Thornton, Timothy A %A Tinker, Lesley E %A Uitterlinden, André G %A van Setten, Jessica %A Voss, Andreas %A Waldenberger, Melanie %A Wilhelmsen, Kirk C %A Willemsen, Gonneke %A Wong, Quenna %A Zhang, Zhu-Ming %A Zonderman, Alan B %A Cusi, Daniele %A Evans, Michele K %A Greiser, Halina K %A van der Harst, Pim %A Hassan, Mohammad %A Ingelsson, Erik %A Jarvelin, Marjo-Riitta %A Kääb, Stefan %A Kähönen, Mika %A Kivimaki, Mika %A Kooperberg, Charles %A Kuh, Diana %A Lehtimäki, Terho %A Lind, Lars %A Nievergelt, Caroline M %A O'Donnell, Chris J %A Oldehinkel, Albertine J %A Penninx, Brenda %A Reiner, Alexander P %A Riese, Harriëtte %A van Roon, Arie M %A Rioux, John D %A Rotter, Jerome I %A Sofer, Tamar %A Stricker, Bruno H %A Tiemeier, Henning %A Vrijkotte, Tanja G M %A Asselbergs, Folkert W %A Brundel, Bianca J J M %A Heckbert, Susan R %A Whitsel, Eric A %A den Hoed, Marcel %A Snieder, Harold %A de Geus, Eco J C %X

Reduced cardiac vagal control reflected in low heart rate variability (HRV) is associated with greater risks for cardiac morbidity and mortality. In two-stage meta-analyses of genome-wide association studies for three HRV traits in up to 53,174 individuals of European ancestry, we detect 17 genome-wide significant SNPs in eight loci. HRV SNPs tag non-synonymous SNPs (in NDUFA11 and KIAA1755), expression quantitative trait loci (eQTLs) (influencing GNG11, RGS6 and NEO1), or are located in genes preferentially expressed in the sinoatrial node (GNG11, RGS6 and HCN4). Genetic risk scores account for 0.9 to 2.6% of the HRV variance. Significant genetic correlation is found for HRV with heart rate (-0.74 %B Nat Commun %V 8 %P 15805 %8 2017 Jun 14 %G eng %R 10.1038/ncomms15805 %0 Journal Article %J Circulation %D 2017 %T {Genetic Risk Prediction of Atrial Fibrillation %A Lubitz, S. A. %A Yin, X. %A Lin, H. J. %A Kolek, M. %A Smith, J. G. %A Trompet, S. %A Rienstra, M. %A Rost, N. S. %A Teixeira, P. L. %A Almgren, P. %A Anderson, C. D. %A Chen, L. Y. %A Engstr?m, G. %A Ford, I. %A Furie, K. L. %A Guo, X. %A Larson, M. G. %A Lunetta, K. L. %A Macfarlane, P. W. %A Psaty, B. M. %A Soliman, E. Z. %A Sotoodehnia, N. %A Stott, D. J. %A Taylor, K. D. %A Weng, L. C. %A Yao, J. %A Geelhoed, B. %A Verweij, N. %A Siland, J. E. %A Kathiresan, S. %A Roselli, C. %A Roden, D. M. %A van der Harst, P. %A Darbar, D. %A Jukema, J. W. %A Melander, O. %A Rosand, J. %A Rotter, J. I. %A Heckbert, S. R. %A Ellinor, P. T. %A Alonso, A. %A Benjamin, E. J. %X Atrial fibrillation (AF) has a substantial genetic basis. Identification of individuals at greatest AF risk could minimize the incidence of cardioembolic stroke.\ To determine whether genetic data can stratify risk for development of AF, we examined associations between AF genetic risk scores and incident AF in 5 prospective studies comprising 18 919 individuals of European ancestry. We examined associations between AF genetic risk scores and ischemic stroke in a separate study of 509 ischemic stroke cases (202 cardioembolic [40%]) and 3028 referents. Scores were based on 11 to 719 common variants (≥5%) associated with AF at P values ranging from <1×10-3 to <1×10-8 in a prior independent genetic association study.\ Incident AF occurred in 1032 individuals (5.5%). AF genetic risk scores were associated with new-onset AF after adjustment for clinical risk factors. The pooled hazard ratio for incident AF for the highest versus lowest quartile of genetic risk scores ranged from 1.28 (719 variants; 95% confidence interval, 1.13-1.46; P=1.5×10-4) to 1.67 (25 variants; 95% confidence interval, 1.47-1.90; P=9.3×10-15). Discrimination of combined clinical and genetic risk scores varied across studies and scores (maximum C statistic, 0.629-0.811; maximum ΔC statistic from clinical score alone, 0.009-0.017). AF genetic risk was associated with stroke in age- and sex-adjusted models. For example, individuals in the highest versus lowest quartile of a 127-variant score had a 2.49-fold increased odds of cardioembolic stroke (95% confidence interval, 1.39-4.58; P=2.7×10-3). The effect persisted after the exclusion of individuals (n=70) with known AF (odds ratio, 2.25; 95% confidence interval, 1.20-4.40; P=0.01).\ Comprehensive AF genetic risk scores were associated with incident AF beyond associations for clinical AF risk factors but offered small improvements in discrimination. AF genetic risk was also associated with cardioembolic stroke in age- and sex-adjusted analyses. Efforts are warranted to determine whether AF genetic risk may improve identification of subclinical AF or help distinguish between stroke mechanisms. %B Circulation %V 135 %P 1311–1320 %8 Apr %G eng %0 Journal Article %J Diabetes %D 2017 %T Genetically Determined Plasma Lipid Levels and Risk of Diabetic Retinopathy: A Mendelian Randomization Study. %A Sobrin, Lucia %A Chong, Yong He %A Fan, Qiao %A Gan, Alfred %A Stanwyck, Lynn K %A Kaidonis, Georgia %A Craig, Jamie E %A Kim, Jihye %A Liao, Wen-Ling %A Huang, Yu-Chuen %A Lee, Wen-Jane %A Hung, Yi-Jen %A Guo, Xiuqing %A Hai, Yang %A Ipp, Eli %A Pollack, Samuela %A Hancock, Heather %A Price, Alkes %A Penman, Alan %A Mitchell, Paul %A Liew, Gerald %A Smith, Albert V %A Gudnason, Vilmundur %A Tan, Gavin %A Klein, Barbara E K %A Kuo, Jane %A Li, Xiaohui %A Christiansen, Mark W %A Psaty, Bruce M %A Sandow, Kevin %A Jensen, Richard A %A Klein, Ronald %A Cotch, Mary Frances %A Wang, Jie Jin %A Jia, Yucheng %A Chen, Ching J %A Chen, Yii-Der Ida %A Rotter, Jerome I %A Tsai, Fuu-Jen %A Hanis, Craig L %A Burdon, Kathryn P %A Wong, Tien Yin %A Cheng, Ching-Yu %K Aged %K Diabetic Retinopathy %K Female %K Genome-Wide Association Study %K Humans %K Lipids %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Polymorphism, Single Nucleotide %K Risk %X

Results from observational studies examining dyslipidemia as a risk factor for diabetic retinopathy (DR) have been inconsistent. We evaluated the causal relationship between plasma lipids and DR using a Mendelian randomization approach. We pooled genome-wide association studies summary statistics from 18 studies for two DR phenotypes: any DR (N = 2,969 case and 4,096 control subjects) and severe DR (N = 1,277 case and 3,980 control subjects). Previously identified lipid-associated single nucleotide polymorphisms served as instrumental variables. Meta-analysis to combine the Mendelian randomization estimates from different cohorts was conducted. There was no statistically significant change in odds ratios of having any DR or severe DR for any of the lipid fractions in the primary analysis that used single nucleotide polymorphisms that did not have a pleiotropic effect on another lipid fraction. Similarly, there was no significant association in the Caucasian and Chinese subgroup analyses. This study did not show evidence of a causal role of the four lipid fractions on DR. However, the study had limited power to detect odds ratios less than 1.23 per SD in genetically induced increase in plasma lipid levels, thus we cannot exclude that causal relationships with more modest effect sizes exist.

%B Diabetes %V 66 %P 3130-3141 %8 2017 12 %G eng %N 12 %R 10.2337/db17-0398 %0 Journal Article %J Nat Genet %D 2017 %T {Genome-wide association analysis identifies novel blood pressure loci and offers biological insights into cardiovascular risk %A Warren, H. R. %A Evangelou, E. %A Cabrera, C. P. %A Gao, H. %A Ren, M. %A Mifsud, B. %A Ntalla, I. %A Surendran, P. %A Liu, C. %A Cook, J. P. %A Kraja, A. T. %A Drenos, F. %A Loh, M. %A Verweij, N. %A Marten, J. %A Karaman, I. %A Lepe, M. P. %A O'Reilly, P. F. %A Knight, J. %A Snieder, H. %A Kato, N. %A He, J. %A Tai, E. S. %A Said, M. A. %A Porteous, D. %A Alver, M. %A Poulter, N. %A Farrall, M. %A Gansevoort, R. T. %A Padmanabhan, S. %A M?gi, R. %A Stanton, A. %A Connell, J. %A Bakker, S. J. %A Metspalu, A. %A Shields, D. C. %A Thom, S. %A Brown, M. %A Sever, P. %A Esko, T. %A Hayward, C. %A van der Harst, P. %A Saleheen, D. %A Chowdhury, R. %A Chambers, J. C. %A Chasman, D. I. %A Chakravarti, A. %A Newton-Cheh, C. %A Lindgren, C. M. %A Levy, D. %A Kooner, J. S. %A Keavney, B. %A Tomaszewski, M. %A Samani, N. J. %A Howson, J. M. %A Tobin, M. D. %A Munroe, P. B. %A Ehret, G. B. %A Wain, L. V. %A V?lker, U. %A Vollenweider, P. %A Wild, S. %A Willemsen, G. %A Wright, A. F. %A Yao, J. %A Th?riault, S. %A Conen, D. %A John, A. %A Sever, P. %A Debette, S. %A Mook-Kanamori, D. O. %A Zeggini, E. %A Spector, T. D. %A van der Harst, P. %A Palmer, C. N. %A Vergnaud, A. C. %A Loos, R. J. %A Polasek, O. %A Starr, J. M. %A Girotto, G. %A Hayward, C. %A Kooner, J. S. %A Lindgren, C. M. %A Vitart, V. %A Samani, N. J. %A Tuomilehto, J. %A Gyllensten, U. %A Knekt, P. %A Deary, I. J. %A Ciullo, M. %A Elosua, R. %A Keavney, B. D. %A Hicks, A. A. %A Scott, R. A. %A Gasparini, P. %A Laan, M. %A Liu, Y. %A Watkins, H. %A Hartman, C. A. %A Salomaa, V. %A Toniolo, D. %A Perola, M. %A Wilson, J. F. %A Schmidt, H. %A Zhao, J. H. %A Lehtim?ki, T. %A van Duijn, C. M. %A Gudnason, V. %A Psaty, B. M. %A Peters, A. %A Rettig, R. %A James, A. %A Jukema, J. W. %A Strachan, D. P. %A Palmas, W. %A Metspalu, A. %A Ingelsson, E. %A Boomsma, D. I. %A Franco, O. H. %A Bochud, M. %A Newton-Cheh, C. %A Munroe, P. B. %A Elliott, P. %A Chasman, D. I. %A Chakravarti, A. %A Knight, J. %A Morris, A. P. %A Levy, D. %A Tobin, M. D. %A Snieder, H. %A Caulfield, M. J. %A Ehret, G. B. %A Barnes, M. R. %A Tzoulaki, I. %A Caulfield, M. J. %A Elliott, P. %X Elevated blood pressure is the leading heritable risk factor for cardiovascular disease worldwide. We report genetic association of blood pressure (systolic, diastolic, pulse pressure) among UK Biobank participants of European ancestry with independent replication in other cohorts, and robust validation of 107 independent loci. We also identify new independent variants at 11 previously reported blood pressure loci. In combination with results from a range of in silico functional analyses and wet bench experiments, our findings highlight new biological pathways for blood pressure regulation enriched for genes expressed in vascular tissues and identify potential therapeutic targets for hypertension. Results from genetic risk score models raise the possibility of a precision medicine approach through early lifestyle intervention to offset the impact of blood pressure-raising genetic variants on future cardiovascular disease risk. %B Nat Genet %V 49 %P 403–415 %8 Mar %G eng %0 Journal Article %J PLoS One %D 2017 %T Genome-wide association meta-analysis of fish and EPA+DHA consumption in 17 US and European cohorts. %A Mozaffarian, Dariush %A Dashti, Hassan S %A Wojczynski, Mary K %A Chu, Audrey Y %A Nettleton, Jennifer A %A Männistö, Satu %A Kristiansson, Kati %A Reedik, Mägi %A Lahti, Jari %A Houston, Denise K %A Cornelis, Marilyn C %A van Rooij, Frank J A %A Dimitriou, Maria %A Kanoni, Stavroula %A Mikkilä, Vera %A Steffen, Lyn M %A de Oliveira Otto, Marcia C %A Qi, Lu %A Psaty, Bruce %A Djoussé, Luc %A Rotter, Jerome I %A Harald, Kennet %A Perola, Markus %A Rissanen, Harri %A Jula, Antti %A Krista, Fischer %A Mihailov, Evelin %A Feitosa, Mary F %A Ngwa, Julius S %A Xue, Luting %A Jacques, Paul F %A Perälä, Mia-Maria %A Palotie, Aarno %A Liu, Yongmei %A Nalls, Nike A %A Ferrucci, Luigi %A Hernandez, Dena %A Manichaikul, Ani %A Tsai, Michael Y %A Kiefte-de Jong, Jessica C %A Hofman, Albert %A Uitterlinden, André G %A Rallidis, Loukianos %A Ridker, Paul M %A Rose, Lynda M %A Buring, Julie E %A Lehtimäki, Terho %A Kähönen, Mika %A Viikari, Jorma %A Lemaitre, Rozenn %A Salomaa, Veikko %A Knekt, Paul %A Metspalu, Andres %A Borecki, Ingrid B %A Cupples, L Adrienne %A Eriksson, Johan G %A Kritchevsky, Stephen B %A Bandinelli, Stefania %A Siscovick, David %A Franco, Oscar H %A Deloukas, Panos %A Dedoussis, George %A Chasman, Daniel I %A Raitakari, Olli %A Tanaka, Toshiko %K Adult %K Aged %K Cohort Studies %K Docosahexaenoic Acids %K Eicosapentaenoic Acid %K Europe %K European Continental Ancestry Group %K Female %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Seafood %K United States %X

BACKGROUND: Regular fish and omega-3 consumption may have several health benefits and are recommended by major dietary guidelines. Yet, their intakes remain remarkably variable both within and across populations, which could partly owe to genetic influences.

OBJECTIVE: To identify common genetic variants that influence fish and dietary eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA) consumption.

DESIGN: We conducted genome-wide association (GWA) meta-analysis of fish (n = 86,467) and EPA+DHA (n = 62,265) consumption in 17 cohorts of European descent from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium Nutrition Working Group. Results from cohort-specific GWA analyses (additive model) for fish and EPA+DHA consumption were adjusted for age, sex, energy intake, and population stratification, and meta-analyzed separately using fixed-effect meta-analysis with inverse variance weights (METAL software). Additionally, heritability was estimated in 2 cohorts.

RESULTS: Heritability estimates for fish and EPA+DHA consumption ranged from 0.13-0.24 and 0.12-0.22, respectively. A significant GWA for fish intake was observed for rs9502823 on chromosome 6: each copy of the minor allele (FreqA = 0.015) was associated with 0.029 servings/day (~1 serving/month) lower fish consumption (P = 1.96x10-8). No significant association was observed for EPA+DHA, although rs7206790 in the obesity-associated FTO gene was among top hits (P = 8.18x10-7). Post-hoc calculations demonstrated 95% statistical power to detect a genetic variant associated with effect size of 0.05% for fish and 0.08% for EPA+DHA.

CONCLUSIONS: These novel findings suggest that non-genetic personal and environmental factors are principal determinants of the remarkable variation in fish consumption, representing modifiable targets for increasing intakes among all individuals. Genes underlying the signal at rs72838923 and mechanisms for the association warrant further investigation.

%B PLoS One %V 12 %P e0186456 %8 2017 %G eng %N 12 %R 10.1371/journal.pone.0186456 %0 Journal Article %J Circ Cardiovasc Genet %D 2017 %T Genome-Wide Association Study Meta-Analysis of Long-Term Average Blood Pressure in East Asians. %A Li, Changwei %A Kim, Yun Kyoung %A Dorajoo, Rajkumar %A Li, Huaixing %A Lee, I-Te %A Cheng, Ching-Yu %A He, Meian %A Sheu, Wayne H-H %A Guo, Xiuqing %A Ganesh, Santhi K %A He, Jiang %A Lee, Juyoung %A Liu, Jianjun %A Hu, Yao %A Rao, Dabeeru C %A Tsai, Fuu-Jen %A Koh, Jia Yu %A Hu, Hua %A Liang, Kae-Woei %A Palmas, Walter %A Hixson, James E %A Han, Sohee %A Teo, Yik-Ying %A Wang, Yiqin %A Chen, Jing %A Lu, Chieh Hsiang %A Zheng, Yingfeng %A Gui, Lixuan %A Lee, Wen-Jane %A Yao, Jie %A Gu, Dongfeng %A Han, Bok-Ghee %A Sim, Xueling %A Sun, Liang %A Zhao, Jinying %A Chen, Chien-Hsiun %A Kumari, Neelam %A He, Yunfeng %A Taylor, Kent D %A Raffel, Leslie J %A Moon, Sanghoon %A Rotter, Jerome I %A Ida Chen, Yii-Der %A Wu, Tangchun %A Wong, Tien Yin %A Wu, Jer-Yuarn %A Lin, Xu %A Tai, E-Shyong %A Kim, Bong-Jo %A Kelly, Tanika N %K Asian Continental Ancestry Group %K Blood Pressure %K Far East %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Male %K Phenotype %K Polymorphism, Single Nucleotide %X

BACKGROUND: Genome-wide single marker and gene-based meta-analyses of long-term average (LTA) blood pressure (BP) phenotypes may reveal novel findings for BP.

METHODS AND RESULTS: We conducted genome-wide analysis among 18 422 East Asian participants (stage 1) followed by replication study of ≤46 629 participants of European ancestry (stage 2). Significant single-nucleotide polymorphisms and genes were determined by a P<5.0×10-8 and 2.5×10-6, respectively, in joint analyses of stage-1 and stage-2 data. We identified 1 novel ARL3 variant, rs4919669 at 10q24.32, influencing LTA systolic BP (stage-1 P=5.03×10-8, stage-2 P=8.64×10-3, joint P=2.63×10-8) and mean arterial pressure (stage-1 P=3.59×10-9, stage-2 P=2.35×10-2, joint P=2.64×10-8). Three previously reported BP loci (WBP1L, NT5C2, and ATP2B1) were also identified for all BP phenotypes. Gene-based analysis provided the first robust evidence for association of KCNJ11 with LTA systolic BP (stage-1 P=8.55×10-6, stage-2 P=1.62×10-5, joint P=3.28×10-9) and mean arterial pressure (stage-1 P=9.19×10-7, stage-2 P=9.69×10-5, joint P=2.15×10-9) phenotypes. Fourteen genes (TMEM180, ACTR1A, SUFU, ARL3, SFXN2, WBP1L, CYP17A1, C10orf32, C10orf32-ASMT, AS3MT, CNNM2, and NT5C2 at 10q24.32; ATP2B1 at 12q21.33; and NCR3LG1 at 11p15.1) implicated by previous genome-wide association study meta-analyses were also identified. Among the loci identified by the previous genome-wide association study meta-analysis of LTA BP, we transethnically replicated associations of the KCNK3 marker rs1275988 at 2p23.3 with LTA systolic BP and mean arterial pressure phenotypes (P=1.27×10-4 and 3.30×10-4, respectively).

CONCLUSIONS: We identified 1 novel variant and 1 novel gene and present the first direct evidence of relevance of the KCNK3 locus for LTA BP among East Asians.

%B Circ Cardiovasc Genet %V 10 %P e001527 %8 2017 Apr %G eng %N 2 %R 10.1161/CIRCGENETICS.116.001527 %0 Journal Article %J J Med Genet %D 2017 %T A genome-wide interaction analysis of tricyclic/tetracyclic antidepressants and RR and QT intervals: a pharmacogenomics study from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. %A Noordam, Raymond %A Sitlani, Colleen M %A Avery, Christy L %A Stewart, James D %A Gogarten, Stephanie M %A Wiggins, Kerri L %A Trompet, Stella %A Warren, Helen R %A Sun, Fangui %A Evans, Daniel S %A Li, Xiaohui %A Li, Jin %A Smith, Albert V %A Bis, Joshua C %A Brody, Jennifer A %A Busch, Evan L %A Caulfield, Mark J %A Chen, Yii-der I %A Cummings, Steven R %A Cupples, L Adrienne %A Duan, Qing %A Franco, Oscar H %A Méndez-Giráldez, Rául %A Harris, Tamara B %A Heckbert, Susan R %A van Heemst, Diana %A Hofman, Albert %A Floyd, James S %A Kors, Jan A %A Launer, Lenore J %A Li, Yun %A Li-Gao, Ruifang %A Lange, Leslie A %A Lin, Henry J %A de Mutsert, Renée %A Napier, Melanie D %A Newton-Cheh, Christopher %A Poulter, Neil %A Reiner, Alexander P %A Rice, Kenneth M %A Roach, Jeffrey %A Rodriguez, Carlos J %A Rosendaal, Frits R %A Sattar, Naveed %A Sever, Peter %A Seyerle, Amanda A %A Slagboom, P Eline %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Stott, David J %A Stürmer, Til %A Taylor, Kent D %A Thornton, Timothy A %A Uitterlinden, André G %A Wilhelmsen, Kirk C %A Wilson, James G %A Gudnason, Vilmundur %A Jukema, J Wouter %A Laurie, Cathy C %A Liu, Yongmei %A Mook-Kanamori, Dennis O %A Munroe, Patricia B %A Rotter, Jerome I %A Vasan, Ramachandran S %A Psaty, Bruce M %A Stricker, Bruno H %A Whitsel, Eric A %X

BACKGROUND: Increased heart rate and a prolonged QT interval are important risk factors for cardiovascular morbidity and mortality, and can be influenced by the use of various medications, including tricyclic/tetracyclic antidepressants (TCAs). We aim to identify genetic loci that modify the association between TCA use and RR and QT intervals.

METHODS AND RESULTS: We conducted race/ethnic-specific genome-wide interaction analyses (with HapMap phase II imputed reference panel imputation) of TCAs and resting RR and QT intervals in cohorts of European (n=45 706; n=1417 TCA users), African (n=10 235; n=296 TCA users) and Hispanic/Latino (n=13 808; n=147 TCA users) ancestry, adjusted for clinical covariates. Among the populations of European ancestry, two genome-wide significant loci were identified for RR interval: rs6737205 in BRE (β=56.3, pinteraction=3.9e(-9)) and rs9830388 in UBE2E2 (β=25.2, pinteraction=1.7e(-8)). In Hispanic/Latino cohorts, rs2291477 in TGFBR3 significantly modified the association between TCAs and QT intervals (β=9.3, pinteraction=2.55e(-8)). In the meta-analyses of the other ethnicities, these loci either were excluded from the meta-analyses (as part of quality control), or their effects did not reach the level of nominal statistical significance (pinteraction>0.05). No new variants were identified in these ethnicities. No additional loci were identified after inverse-variance-weighted meta-analysis of the three ancestries.

CONCLUSIONS: Among Europeans, TCA interactions with variants in BRE and UBE2E2 were identified in relation to RR intervals. Among Hispanic/Latinos, variants in TGFBR3 modified the relation between TCAs and QT intervals. Future studies are required to confirm our results.

%B J Med Genet %V 54 %P 313-323 %8 2017 May %G eng %N 5 %R 10.1136/jmedgenet-2016-104112 %0 Journal Article %J Mol Nutr Food Res %D 2017 %T Genome-Wide Interactions with Dairy Intake for Body Mass Index in Adults of European Descent. %A Smith, Caren E %A Follis, Jack L %A Dashti, Hassan S %A Tanaka, Toshiko %A Graff, Mariaelisa %A Fretts, Amanda M %A Kilpeläinen, Tuomas O %A Wojczynski, Mary K %A Richardson, Kris %A Nalls, Mike A %A Schulz, Christina-Alexandra %A Liu, Yongmei %A Frazier-Wood, Alexis C %A van Eekelen, Esther %A Wang, Carol %A de Vries, Paul S %A Mikkilä, Vera %A Rohde, Rebecca %A Psaty, Bruce M %A Hansen, Torben %A Feitosa, Mary F %A Lai, Chao-Qiang %A Houston, Denise K %A Ferruci, Luigi %A Ericson, Ulrika %A Wang, Zhe %A de Mutsert, Renée %A Oddy, Wendy H %A de Jonge, Ester A L %A Seppälä, Ilkka %A Justice, Anne E %A Lemaitre, Rozenn N %A Sørensen, Thorkild I A %A Province, Michael A %A Parnell, Laurence D %A Garcia, Melissa E %A Bandinelli, Stefania %A Orho-Melander, Marju %A Rich, Stephen S %A Rosendaal, Frits R %A Pennell, Craig E %A Kiefte-de Jong, Jessica C %A Kähönen, Mika %A Young, Kristin L %A Pedersen, Oluf %A Aslibekyan, Stella %A Rotter, Jerome I %A Mook-Kanamori, Dennis O %A Zillikens, M Carola %A Raitakari, Olli T %A North, Kari E %A Overvad, Kim %A Arnett, Donna K %A Hofman, Albert %A Lehtimäki, Terho %A Tjønneland, Anne %A Uitterlinden, André G %A Rivadeneira, Fernando %A Franco, Oscar H %A German, J Bruce %A Siscovick, David S %A Cupples, L Adrienne %A Ordovas, Jose M %X

SCOPE: Body weight responds variably to the intake of dairy foods. Genetic variation may contribute to inter-individual variability in associations between body weight and dairy consumption.

METHODS AND RESULTS: A genome-wide interaction study to discover genetic variants that account for variation in BMI in the context of low-fat, high-fat and total dairy intake in cross-sectional analysis was conducted. Data from nine discovery studies (up to 25 513 European descent individuals) were meta-analyzed. Twenty-six genetic variants reached the selected significance threshold (p-interaction <10-7) , and six independent variants (LINC01512-rs7751666, PALM2/AKAP2-rs914359, ACTA2-rs1388, PPP1R12A-rs7961195, LINC00333-rs9635058, AC098847.1-rs1791355) were evaluated meta-analytically for replication of interaction in up to 17 675 individuals. Variant rs9635058 (128 kb 3' of LINC00333) was replicated (p-interaction = 0.004). In the discovery cohorts, rs9635058 interacted with dairy (p-interaction = 7.36 × 10-8) such that each serving of low-fat dairy was associated with 0.225 kg m-2 lower BMI per each additional copy of the effect allele (A). A second genetic variant (ACTA2-rs1388) approached interaction replication significance for low-fat dairy exposure.

CONCLUSION: Body weight responses to dairy intake may be modified by genotype, in that greater dairy intake may protect a genetic subgroup from higher body weight.

%B Mol Nutr Food Res %8 2017 Sep 21 %G eng %R 10.1002/mnfr.201700347 %0 Journal Article %J Nat Commun %D 2017 %T Genome-wide meta-analysis associates HLA-DQA1/DRB1 and LPA and lifestyle factors with human longevity. %A Joshi, Peter K %A Pirastu, Nicola %A Kentistou, Katherine A %A Fischer, Krista %A Hofer, Edith %A Schraut, Katharina E %A Clark, David W %A Nutile, Teresa %A Barnes, Catriona L K %A Timmers, Paul R H J %A Shen, Xia %A Gandin, Ilaria %A McDaid, Aaron F %A Hansen, Thomas Folkmann %A Gordon, Scott D %A Giulianini, Franco %A Boutin, Thibaud S %A Abdellaoui, Abdel %A Zhao, Wei %A Medina-Gómez, Carolina %A Bartz, Traci M %A Trompet, Stella %A Lange, Leslie A %A Raffield, Laura %A van der Spek, Ashley %A Galesloot, Tessel E %A Proitsi, Petroula %A Yanek, Lisa R %A Bielak, Lawrence F %A Payton, Antony %A Murgia, Federico %A Concas, Maria Pina %A Biino, Ginevra %A Tajuddin, Salman M %A Seppälä, Ilkka %A Amin, Najaf %A Boerwinkle, Eric %A Børglum, Anders D %A Campbell, Archie %A Demerath, Ellen W %A Demuth, Ilja %A Faul, Jessica D %A Ford, Ian %A Gialluisi, Alessandro %A Gögele, Martin %A Graff, Mariaelisa %A Hingorani, Aroon %A Hottenga, Jouke-Jan %A Hougaard, David M %A Hurme, Mikko A %A Ikram, M Arfan %A Jylhä, Marja %A Kuh, Diana %A Ligthart, Lannie %A Lill, Christina M %A Lindenberger, Ulman %A Lumley, Thomas %A Mägi, Reedik %A Marques-Vidal, Pedro %A Medland, Sarah E %A Milani, Lili %A Nagy, Reka %A Ollier, William E R %A Peyser, Patricia A %A Pramstaller, Peter P %A Ridker, Paul M %A Rivadeneira, Fernando %A Ruggiero, Daniela %A Saba, Yasaman %A Schmidt, Reinhold %A Schmidt, Helena %A Slagboom, P Eline %A Smith, Blair H %A Smith, Jennifer A %A Sotoodehnia, Nona %A Steinhagen-Thiessen, Elisabeth %A van Rooij, Frank J A %A Verbeek, André L %A Vermeulen, Sita H %A Vollenweider, Peter %A Wang, Yunpeng %A Werge, Thomas %A Whitfield, John B %A Zonderman, Alan B %A Lehtimäki, Terho %A Evans, Michele K %A Pirastu, Mario %A Fuchsberger, Christian %A Bertram, Lars %A Pendleton, Neil %A Kardia, Sharon L R %A Ciullo, Marina %A Becker, Diane M %A Wong, Andrew %A Psaty, Bruce M %A van Duijn, Cornelia M %A Wilson, James G %A Jukema, J Wouter %A Kiemeney, Lambertus %A Uitterlinden, André G %A Franceschini, Nora %A North, Kari E %A Weir, David R %A Metspalu, Andres %A Boomsma, Dorret I %A Hayward, Caroline %A Chasman, Daniel %A Martin, Nicholas G %A Sattar, Naveed %A Campbell, Harry %A Esko, Tõnu %A Kutalik, Zoltán %A Wilson, James F %X

Genomic analysis of longevity offers the potential to illuminate the biology of human aging. Here, using genome-wide association meta-analysis of 606,059 parents' survival, we discover two regions associated with longevity (HLA-DQA1/DRB1 and LPA). We also validate previous suggestions that APOE, CHRNA3/5, CDKN2A/B, SH2B3 and FOXO3A influence longevity. Next we show that giving up smoking, educational attainment, openness to new experience and high-density lipoprotein (HDL) cholesterol levels are most positively genetically correlated with lifespan while susceptibility to coronary artery disease (CAD), cigarettes smoked per day, lung cancer, insulin resistance and body fat are most negatively correlated. We suggest that the effect of education on lifespan is principally mediated through smoking while the effect of obesity appears to act via CAD. Using instrumental variables, we suggest that an increase of one body mass index unit reduces lifespan by 7 months while 1 year of education adds 11 months to expected lifespan.Variability in human longevity is genetically influenced. Using genetic data of parental lifespan, the authors identify associations at HLA-DQA/DRB1 and LPA and find that genetic variants that increase educational attainment have a positive effect on lifespan whereas increasing BMI negatively affects lifespan.

%B Nat Commun %V 8 %P 910 %8 2017 Oct 13 %G eng %N 1 %R 10.1038/s41467-017-00934-5 %0 Journal Article %J Nat Commun %D 2017 %T {Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits %A Justice, A. E. %A Winkler, T. W. %A Feitosa, M. F. %A Graff, M. %A Fisher, V. A. %A Young, K. %A Barata, L. %A Deng, X. %A Czajkowski, J. %A Hadley, D. %A Ngwa, J. S. %A Ahluwalia, T. S. %A Chu, A. Y. %A Heard-Costa, N. L. %A Lim, E. %A Perez, J. %A Eicher, J. D. %A Kutalik, Z. %A Xue, L. %A Mahajan, A. %A Renstr?m, F. %A Wu, J. %A Qi, Q. %A Ahmad, S. %A Alfred, T. %A Amin, N. %A Bielak, L. F. %A Bonnefond, A. %A Bragg, J. %A Cadby, G. %A Chittani, M. %A Coggeshall, S. %A Corre, T. %A Direk, N. %A Eriksson, J. %A Fischer, K. %A Gorski, M. %A Neergaard Harder, M. %A Horikoshi, M. %A Huang, T. %A Huffman, J. E. %A Jackson, A. U. %A Justesen, J. M. %A Kanoni, S. %A Kinnunen, L. %A Kleber, M. E. %A Komulainen, P. %A Kumari, M. %A Lim, U. %A Luan, J. %A Lyytik?inen, L. P. %A Mangino, M. %A Manichaikul, A. %A Marten, J. %A Middelberg, R. P. S. %A M?ller-Nurasyid, M. %A Navarro, P. %A P?russe, L. %A Pervjakova, N. %A Sarti, C. %A Smith, A. V. %A Smith, J. A. %A Stan??kov?, A. %A Strawbridge, R. J. %A Stringham, H. M. %A Sung, Y. J. %A Tanaka, T. %A Teumer, A. %A Trompet, S. %A van der Laan, S. W. %A van der Most, P. J. %A Van Vliet-Ostaptchouk, J. V. %A Vedantam, S. L. %A Verweij, N. %A Vink, J. M. %A Vitart, V. %A Wu, Y. %A Yengo, L. %A Zhang, W. %A Hua Zhao, J. %A Zimmermann, M. E. %A Zubair, N. %A Abecasis, G. R. %A Adair, L. S. %A Afaq, S. %A Afzal, U. %A Bakker, S. J. L. %A Bartz, T. M. %A Beilby, J. %A Bergman, R. N. %A Bergmann, S. %A Biffar, R. %A Blangero, J. %A Boerwinkle, E. %A Bonnycastle, L. L. %A Bottinger, E. %A Braga, D. %A Buckley, B. M. %A Buyske, S. %A Campbell, H. %A Chambers, J. C. %A Collins, F. S. %A Curran, J. E. %A de Borst, G. J. %A de Craen, A. J. M. %A de Geus, E. J. C. %A Dedoussis, G. %A Delgado, G. E. %A den Ruijter, H. M. %A Eiriksdottir, G. %A Eriksson, A. L. %A Esko, T. %A Faul, J. D. %A Ford, I. %A Forrester, T. %A Gertow, K. %A Gigante, B. %A Glorioso, N. %A Gong, J. %A Grallert, H. %A Grammer, T. B. %A Grarup, N. %A Haitjema, S. %A Hallmans, G. %A Hamsten, A. %A Hansen, T. %A Harris, T. B. %A Hartman, C. A. %A Hassinen, M. %A Hastie, N. D. %A Heath, A. C. %A Hernandez, D. %A Hindorff, L. %A Hocking, L. J. %A Hollensted, M. %A Holmen, O. L. %A Homuth, G. %A Jan Hottenga, J. %A Huang, J. %A Hung, J. %A Hutri-K?h?nen, N. %A Ingelsson, E. %A James, A. L. %A Jansson, J. O. %A Jarvelin, M. R. %A Jhun, M. A. %A J?rgensen, M. E. %A Juonala, M. %A K?h?nen, M. %A Karlsson, M. %A Koistinen, H. A. %A Kolcic, I. %A Kolovou, G. %A Kooperberg, C. %A Kr?mer, B. K. %A Kuusisto, J. %A Kval?y, K. %A Lakka, T. A. %A Langenberg, C. %A Launer, L. J. %A Leander, K. %A Lee, N. R. %A Lind, L. %A Lindgren, C. M. %A Linneberg, A. %A Lobbens, S. %A Loh, M. %A Lorentzon, M. %A Luben, R. %A Lubke, G. %A Ludolph-Donislawski, A. %A Lupoli, S. %A Madden, P. A. F. %A M?nnikk?, R. %A Marques-Vidal, P. %A Martin, N. G. %A McKenzie, C. A. %A McKnight, B. %A Mellstr?m, D. %A Menni, C. %A Montgomery, G. W. %A Musk, A. B. %A Narisu, N. %A Nauck, M. %A Nolte, I. M. %A Oldehinkel, A. J. %A Olden, M. %A Ong, K. K. %A Padmanabhan, S. %A Peyser, P. A. %A Pisinger, C. %A Porteous, D. J. %A Raitakari, O. T. %A Rankinen, T. %A Rao, D. C. %A Rasmussen-Torvik, L. J. %A Rawal, R. %A Rice, T. %A Ridker, P. M. %A Rose, L. M. %A Bien, S. A. %A Rudan, I. %A Sanna, S. %A Sarzynski, M. A. %A Sattar, N. %A Savonen, K. %A Schlessinger, D. %A Scholtens, S. %A Schurmann, C. %A Scott, R. A. %A Sennblad, B. %A Siemelink, M. A. %A Silbernagel, G. %A Slagboom, P. E. %A Snieder, H. %A Staessen, J. A. %A Stott, D. J. %A Swertz, M. A. %A Swift, A. J. %A Taylor, K. D. %A Tayo, B. O. %A Thorand, B. %A Thuillier, D. %A Tuomilehto, J. %A Uitterlinden, A. G. %A Vandenput, L. %A Vohl, M. C. %A V?lzke, H. %A Vonk, J. M. %A Waeber, G. %A Waldenberger, M. %A Westendorp, R. G. J. %A Wild, S. %A Willemsen, G. %A Wolffenbuttel, B. H. R. %A Wong, A. %A Wright, A. F. %A Zhao, W. %A Zillikens, M. C. %A Baldassarre, D. %A Balkau, B. %A Bandinelli, S. %A B?ger, C. A. %A Boomsma, D. I. %A Bouchard, C. %A Bruinenberg, M. %A Chasman, D. I. %A Chen, Y. D. %A Chines, P. S. %A Cooper, R. S. %A Cucca, F. %A Cusi, D. %A Faire, U. %A Ferrucci, L. %A Franks, P. W. %A Froguel, P. %A Gordon-Larsen, P. %A Grabe, H. J. %A Gudnason, V. %A Haiman, C. A. %A Hayward, C. %A Hveem, K. %A Johnson, A. D. %A Wouter Jukema, J. %A Kardia, S. L. R. %A Kivimaki, M. %A Kooner, J. S. %A Kuh, D. %A Laakso, M. %A Lehtim?ki, T. %A Marchand, L. L. %A M?rz, W. %A McCarthy, M. I. %A Metspalu, A. %A Morris, A. P. %A Ohlsson, C. %A Palmer, L. J. %A Pasterkamp, G. %A Pedersen, O. %A Peters, A. %A Peters, U. %A Polasek, O. %A Psaty, B. M. %A Qi, L. %A Rauramaa, R. %A Smith, B. H. %A S?rensen, T. I. A. %A Strauch, K. %A Tiemeier, H. %A Tremoli, E. %A van der Harst, P. %A Vestergaard, H. %A Vollenweider, P. %A Wareham, N. J. %A Weir, D. R. %A Whitfield, J. B. %A Wilson, J. F. %A Tyrrell, J. %A Frayling, T. M. %A Barroso, I. %A Boehnke, M. %A Deloukas, P. %A Fox, C. S. %A Hirschhorn, J. N. %A Hunter, D. J. %A Spector, T. D. %A Strachan, D. P. %A van Duijn, C. M. %A Heid, I. M. %A Mohlke, K. L. %A Marchini, J. %A Loos, R. J. F. %A Kilpel?inen, T. O. %A Liu, C. T. %A Borecki, I. B. %A North, K. E. %A Cupples, L. A. %X Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution. %B Nat Commun %V 8 %P 14977 %8 04 %G eng %0 Journal Article %J Am J Hum Genet %D 2017 %T Genome-wide Trans-ethnic Meta-analysis Identifies Seven Genetic Loci Influencing Erythrocyte Traits and a Role for RBPMS in Erythropoiesis. %A van Rooij, Frank J A %A Qayyum, Rehan %A Smith, Albert V %A Zhou, Yi %A Trompet, Stella %A Tanaka, Toshiko %A Keller, Margaux F %A Chang, Li-Ching %A Schmidt, Helena %A Yang, Min-Lee %A Chen, Ming-Huei %A Hayes, James %A Johnson, Andrew D %A Yanek, Lisa R %A Mueller, Christian %A Lange, Leslie %A Floyd, James S %A Ghanbari, Mohsen %A Zonderman, Alan B %A Jukema, J Wouter %A Hofman, Albert %A van Duijn, Cornelia M %A Desch, Karl C %A Saba, Yasaman %A Ozel, Ayse B %A Snively, Beverly M %A Wu, Jer-Yuarn %A Schmidt, Reinhold %A Fornage, Myriam %A Klein, Robert J %A Fox, Caroline S %A Matsuda, Koichi %A Kamatani, Naoyuki %A Wild, Philipp S %A Stott, David J %A Ford, Ian %A Slagboom, P Eline %A Yang, Jaden %A Chu, Audrey Y %A Lambert, Amy J %A Uitterlinden, André G %A Franco, Oscar H %A Hofer, Edith %A Ginsburg, David %A Hu, Bella %A Keating, Brendan %A Schick, Ursula M %A Brody, Jennifer A %A Li, Jun Z %A Chen, Zhao %A Zeller, Tanja %A Guralnik, Jack M %A Chasman, Daniel I %A Peters, Luanne L %A Kubo, Michiaki %A Becker, Diane M %A Li, Jin %A Eiriksdottir, Gudny %A Rotter, Jerome I %A Levy, Daniel %A Grossmann, Vera %A Patel, Kushang V %A Chen, Chien-Hsiun %A Ridker, Paul M %A Tang, Hua %A Launer, Lenore J %A Rice, Kenneth M %A Li-Gao, Ruifang %A Ferrucci, Luigi %A Evans, Michelle K %A Choudhuri, Avik %A Trompouki, Eirini %A Abraham, Brian J %A Yang, Song %A Takahashi, Atsushi %A Kamatani, Yoichiro %A Kooperberg, Charles %A Harris, Tamara B %A Jee, Sun Ha %A Coresh, Josef %A Tsai, Fuu-Jen %A Longo, Dan L %A Chen, Yuan-Tsong %A Felix, Janine F %A Yang, Qiong %A Psaty, Bruce M %A Boerwinkle, Eric %A Becker, Lewis C %A Mook-Kanamori, Dennis O %A Wilson, James G %A Gudnason, Vilmundur %A O'Donnell, Christopher J %A Dehghan, Abbas %A Cupples, L Adrienne %A Nalls, Michael A %A Morris, Andrew P %A Okada, Yukinori %A Reiner, Alexander P %A Zon, Leonard I %A Ganesh, Santhi K %X

Genome-wide association studies (GWASs) have identified loci for erythrocyte traits in primarily European ancestry populations. We conducted GWAS meta-analyses of six erythrocyte traits in 71,638 individuals from European, East Asian, and African ancestries using a Bayesian approach to account for heterogeneity in allelic effects and variation in the structure of linkage disequilibrium between ethnicities. We identified seven loci for erythrocyte traits including a locus (RBPMS/GTF2E2) associated with mean corpuscular hemoglobin and mean corpuscular volume. Statistical fine-mapping at this locus pointed to RBPMS at this locus and excluded nearby GTF2E2. Using zebrafish morpholino to evaluate loss of function, we observed a strong in vivo erythropoietic effect for RBPMS but not for GTF2E2, supporting the statistical fine-mapping at this locus and demonstrating that RBPMS is a regulator of erythropoiesis. Our findings show the utility of trans-ethnic GWASs for discovery and characterization of genetic loci influencing hematologic traits.

%B Am J Hum Genet %V 100 %P 51-63 %8 2017 Jan 05 %G eng %N 1 %R 10.1016/j.ajhg.2016.11.016 %0 Journal Article %J Sci Adv %D 2017 %T The GH receptor exon 3 deletion is a marker of male-specific exceptional longevity associated with increased GH sensitivity and taller stature. %A Ben-Avraham, Danny %A Govindaraju, Diddahally R %A Budagov, Temuri %A Fradin, Delphine %A Durda, Peter %A Liu, Bing %A Ott, Sandy %A Gutman, Danielle %A Sharvit, Lital %A Kaplan, Robert %A Bougnères, Pierre %A Reiner, Alex %A Shuldiner, Alan R %A Cohen, Pinchas %A Barzilai, Nir %A Atzmon, Gil %X

Although both growth hormone (GH) and insulin-like growth factor 1 (IGF-1) signaling were shown to regulate life span in lower organisms, the role of GH signaling in human longevity remains unclear. Because a GH receptor exon 3 deletion (d3-GHR) appears to modulate GH sensitivity in humans, we hypothesized that this polymorphism could play a role in human longevity. We report a linear increased prevalence of d3-GHR homozygosity with age in four independent cohorts of long-lived individuals: 841 participants [567 of the Longevity Genes Project (LGP) (8% increase; P = 0.01), 152 of the Old Order Amish (16% increase; P = 0.02), 61 of the Cardiovascular Health Study (14.2% increase; P = 0.14), and 61 of the French Long-Lived Study (23.5% increase; P = 0.02)]. In addition, mega analysis of males in all cohorts resulted in a significant positive trend with age (26% increase; P = 0.007), suggesting sexual dimorphism for GH action in longevity. Further, on average, LGP d3/d3 homozygotes were 1 inch taller than the wild-type (WT) allele carriers (P = 0.05) and also showed lower serum IGF-1 levels (P = 0.003). Multivariate regression analysis indicated that the presence of d3/d3 genotype adds approximately 10 years to life span. The LGP d3/d3-GHR transformed lymphocytes exhibited superior growth and extracellular signal-regulated kinase activation, to GH treatment relative to WT GHR lymphocytes (P < 0.01), indicating a GH dose response. The d3-GHR variant is a common genetic polymorphism that modulates GH responsiveness throughout the life span and positively affects male longevity.

%B Sci Adv %V 3 %P e1602025 %8 2017 Jun %G eng %N 6 %R 10.1126/sciadv.1602025 %0 Journal Article %J PLoS Med %D 2017 %T Impact of common genetic determinants of Hemoglobin A1c on type 2 diabetes risk and diagnosis in ancestrally diverse populations: A transethnic genome-wide meta-analysis. %A Wheeler, Eleanor %A Leong, Aaron %A Liu, Ching-Ti %A Hivert, Marie-France %A Strawbridge, Rona J %A Podmore, Clara %A Li, Man %A Yao, Jie %A Sim, Xueling %A Hong, Jaeyoung %A Chu, Audrey Y %A Zhang, Weihua %A Wang, Xu %A Chen, Peng %A Maruthur, Nisa M %A Porneala, Bianca C %A Sharp, Stephen J %A Jia, Yucheng %A Kabagambe, Edmond K %A Chang, Li-Ching %A Chen, Wei-Min %A Elks, Cathy E %A Evans, Daniel S %A Fan, Qiao %A Giulianini, Franco %A Go, Min Jin %A Hottenga, Jouke-Jan %A Hu, Yao %A Jackson, Anne U %A Kanoni, Stavroula %A Kim, Young Jin %A Kleber, Marcus E %A Ladenvall, Claes %A Lecoeur, Cécile %A Lim, Sing-Hui %A Lu, Yingchang %A Mahajan, Anubha %A Marzi, Carola %A Nalls, Mike A %A Navarro, Pau %A Nolte, Ilja M %A Rose, Lynda M %A Rybin, Denis V %A Sanna, Serena %A Shi, Yuan %A Stram, Daniel O %A Takeuchi, Fumihiko %A Tan, Shu Pei %A van der Most, Peter J %A van Vliet-Ostaptchouk, Jana V %A Wong, Andrew %A Yengo, Loic %A Zhao, Wanting %A Goel, Anuj %A Martinez Larrad, Maria Teresa %A Radke, Dörte %A Salo, Perttu %A Tanaka, Toshiko %A van Iperen, Erik P A %A Abecasis, Goncalo %A Afaq, Saima %A Alizadeh, Behrooz Z %A Bertoni, Alain G %A Bonnefond, Amélie %A Böttcher, Yvonne %A Bottinger, Erwin P %A Campbell, Harry %A Carlson, Olga D %A Chen, Chien-Hsiun %A Cho, Yoon Shin %A Garvey, W Timothy %A Gieger, Christian %A Goodarzi, Mark O %A Grallert, Harald %A Hamsten, Anders %A Hartman, Catharina A %A Herder, Christian %A Hsiung, Chao Agnes %A Huang, Jie %A Igase, Michiya %A Isono, Masato %A Katsuya, Tomohiro %A Khor, Chiea-Chuen %A Kiess, Wieland %A Kohara, Katsuhiko %A Kovacs, Peter %A Lee, Juyoung %A Lee, Wen-Jane %A Lehne, Benjamin %A Li, Huaixing %A Liu, Jianjun %A Lobbens, Stephane %A Luan, Jian'an %A Lyssenko, Valeriya %A Meitinger, Thomas %A Miki, Tetsuro %A Miljkovic, Iva %A Moon, Sanghoon %A Mulas, Antonella %A Müller, Gabriele %A Müller-Nurasyid, Martina %A Nagaraja, Ramaiah %A Nauck, Matthias %A Pankow, James S %A Polasek, Ozren %A Prokopenko, Inga %A Ramos, Paula S %A Rasmussen-Torvik, Laura %A Rathmann, Wolfgang %A Rich, Stephen S %A Robertson, Neil R %A Roden, Michael %A Roussel, Ronan %A Rudan, Igor %A Scott, Robert A %A Scott, William R %A Sennblad, Bengt %A Siscovick, David S %A Strauch, Konstantin %A Sun, Liang %A Swertz, Morris %A Tajuddin, Salman M %A Taylor, Kent D %A Teo, Yik-Ying %A Tham, Yih Chung %A Tönjes, Anke %A Wareham, Nicholas J %A Willemsen, Gonneke %A Wilsgaard, Tom %A Hingorani, Aroon D %A Egan, Josephine %A Ferrucci, Luigi %A Hovingh, G Kees %A Jula, Antti %A Kivimaki, Mika %A Kumari, Meena %A Njølstad, Inger %A Palmer, Colin N A %A Serrano Ríos, Manuel %A Stumvoll, Michael %A Watkins, Hugh %A Aung, Tin %A Blüher, Matthias %A Boehnke, Michael %A Boomsma, Dorret I %A Bornstein, Stefan R %A Chambers, John C %A Chasman, Daniel I %A Chen, Yii-Der Ida %A Chen, Yduan-Tsong %A Cheng, Ching-Yu %A Cucca, Francesco %A de Geus, Eco J C %A Deloukas, Panos %A Evans, Michele K %A Fornage, Myriam %A Friedlander, Yechiel %A Froguel, Philippe %A Groop, Leif %A Gross, Myron D %A Harris, Tamara B %A Hayward, Caroline %A Heng, Chew-Kiat %A Ingelsson, Erik %A Kato, Norihiro %A Kim, Bong-Jo %A Koh, Woon-Puay %A Kooner, Jaspal S %A Körner, Antje %A Kuh, Diana %A Kuusisto, Johanna %A Laakso, Markku %A Lin, Xu %A Liu, Yongmei %A Loos, Ruth J F %A Magnusson, Patrik K E %A März, Winfried %A McCarthy, Mark I %A Oldehinkel, Albertine J %A Ong, Ken K %A Pedersen, Nancy L %A Pereira, Mark A %A Peters, Annette %A Ridker, Paul M %A Sabanayagam, Charumathi %A Sale, Michele %A Saleheen, Danish %A Saltevo, Juha %A Schwarz, Peter Eh %A Sheu, Wayne H H %A Snieder, Harold %A Spector, Timothy D %A Tabara, Yasuharu %A Tuomilehto, Jaakko %A van Dam, Rob M %A Wilson, James G %A Wilson, James F %A Wolffenbuttel, Bruce H R %A Wong, Tien Yin %A Wu, Jer-Yuarn %A Yuan, Jian-Min %A Zonderman, Alan B %A Soranzo, Nicole %A Guo, Xiuqing %A Roberts, David J %A Florez, Jose C %A Sladek, Robert %A Dupuis, Josée %A Morris, Andrew P %A Tai, E-Shyong %A Selvin, Elizabeth %A Rotter, Jerome I %A Langenberg, Claudia %A Barroso, Inês %A Meigs, James B %K Diabetes Mellitus, Type 2 %K Genetic Variation %K Genome-Wide Association Study %K Glycated Hemoglobin A %K Humans %K Phenotype %K Risk %X

BACKGROUND: Glycated hemoglobin (HbA1c) is used to diagnose type 2 diabetes (T2D) and assess glycemic control in patients with diabetes. Previous genome-wide association studies (GWAS) have identified 18 HbA1c-associated genetic variants. These variants proved to be classifiable by their likely biological action as erythrocytic (also associated with erythrocyte traits) or glycemic (associated with other glucose-related traits). In this study, we tested the hypotheses that, in a very large scale GWAS, we would identify more genetic variants associated with HbA1c and that HbA1c variants implicated in erythrocytic biology would affect the diagnostic accuracy of HbA1c. We therefore expanded the number of HbA1c-associated loci and tested the effect of genetic risk-scores comprised of erythrocytic or glycemic variants on incident diabetes prediction and on prevalent diabetes screening performance. Throughout this multiancestry study, we kept a focus on interancestry differences in HbA1c genetics performance that might influence race-ancestry differences in health outcomes.

METHODS & FINDINGS: Using genome-wide association meta-analyses in up to 159,940 individuals from 82 cohorts of European, African, East Asian, and South Asian ancestry, we identified 60 common genetic variants associated with HbA1c. We classified variants as implicated in glycemic, erythrocytic, or unclassified biology and tested whether additive genetic scores of erythrocytic variants (GS-E) or glycemic variants (GS-G) were associated with higher T2D incidence in multiethnic longitudinal cohorts (N = 33,241). Nineteen glycemic and 22 erythrocytic variants were associated with HbA1c at genome-wide significance. GS-G was associated with higher T2D risk (incidence OR = 1.05, 95% CI 1.04-1.06, per HbA1c-raising allele, p = 3 × 10-29); whereas GS-E was not (OR = 1.00, 95% CI 0.99-1.01, p = 0.60). In Europeans and Asians, erythrocytic variants in aggregate had only modest effects on the diagnostic accuracy of HbA1c. Yet, in African Americans, the X-linked G6PD G202A variant (T-allele frequency 11%) was associated with an absolute decrease in HbA1c of 0.81%-units (95% CI 0.66-0.96) per allele in hemizygous men, and 0.68%-units (95% CI 0.38-0.97) in homozygous women. The G6PD variant may cause approximately 2% (N = 0.65 million, 95% CI 0.55-0.74) of African American adults with T2D to remain undiagnosed when screened with HbA1c. Limitations include the smaller sample sizes for non-European ancestries and the inability to classify approximately one-third of the variants. Further studies in large multiethnic cohorts with HbA1c, glycemic, and erythrocytic traits are required to better determine the biological action of the unclassified variants.

CONCLUSIONS: As G6PD deficiency can be clinically silent until illness strikes, we recommend investigation of the possible benefits of screening for the G6PD genotype along with using HbA1c to diagnose T2D in populations of African ancestry or groups where G6PD deficiency is common. Screening with direct glucose measurements, or genetically-informed HbA1c diagnostic thresholds in people with G6PD deficiency, may be required to avoid missed or delayed diagnoses.

%B PLoS Med %V 14 %P e1002383 %8 2017 Sep %G eng %N 9 %R 10.1371/journal.pmed.1002383 %0 Journal Article %J Nat Commun %D 2017 %T Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. %A Zillikens, M Carola %A Demissie, Serkalem %A Hsu, Yi-Hsiang %A Yerges-Armstrong, Laura M %A Chou, Wen-Chi %A Stolk, Lisette %A Livshits, Gregory %A Broer, Linda %A Johnson, Toby %A Koller, Daniel L %A Kutalik, Zoltán %A Luan, Jian'an %A Malkin, Ida %A Ried, Janina S %A Smith, Albert V %A Thorleifsson, Gudmar %A Vandenput, Liesbeth %A Hua Zhao, Jing %A Zhang, Weihua %A Aghdassi, Ali %A Åkesson, Kristina %A Amin, Najaf %A Baier, Leslie J %A Barroso, Inês %A Bennett, David A %A Bertram, Lars %A Biffar, Rainer %A Bochud, Murielle %A Boehnke, Michael %A Borecki, Ingrid B %A Buchman, Aron S %A Byberg, Liisa %A Campbell, Harry %A Campos Obanda, Natalia %A Cauley, Jane A %A Cawthon, Peggy M %A Cederberg, Henna %A Chen, Zhao %A Cho, Nam H %A Jin Choi, Hyung %A Claussnitzer, Melina %A Collins, Francis %A Cummings, Steven R %A De Jager, Philip L %A Demuth, Ilja %A Dhonukshe-Rutten, Rosalie A M %A Diatchenko, Luda %A Eiriksdottir, Gudny %A Enneman, Anke W %A Erdos, Mike %A Eriksson, Johan G %A Eriksson, Joel %A Estrada, Karol %A Evans, Daniel S %A Feitosa, Mary F %A Fu, Mao %A Garcia, Melissa %A Gieger, Christian %A Girke, Thomas %A Glazer, Nicole L %A Grallert, Harald %A Grewal, Jagvir %A Han, Bok-Ghee %A Hanson, Robert L %A Hayward, Caroline %A Hofman, Albert %A Hoffman, Eric P %A Homuth, Georg %A Hsueh, Wen-Chi %A Hubal, Monica J %A Hubbard, Alan %A Huffman, Kim M %A Husted, Lise B %A Illig, Thomas %A Ingelsson, Erik %A Ittermann, Till %A Jansson, John-Olov %A Jordan, Joanne M %A Jula, Antti %A Karlsson, Magnus %A Khaw, Kay-Tee %A Kilpeläinen, Tuomas O %A Klopp, Norman %A Kloth, Jacqueline S L %A Koistinen, Heikki A %A Kraus, William E %A Kritchevsky, Stephen %A Kuulasmaa, Teemu %A Kuusisto, Johanna %A Laakso, Markku %A Lahti, Jari %A Lang, Thomas %A Langdahl, Bente L %A Launer, Lenore J %A Lee, Jong-Young %A Lerch, Markus M %A Lewis, Joshua R %A Lind, Lars %A Lindgren, Cecilia %A Liu, Yongmei %A Liu, Tian %A Liu, Youfang %A Ljunggren, Osten %A Lorentzon, Mattias %A Luben, Robert N %A Maixner, William %A McGuigan, Fiona E %A Medina-Gómez, Carolina %A Meitinger, Thomas %A Melhus, Håkan %A Mellström, Dan %A Melov, Simon %A Michaëlsson, Karl %A Mitchell, Braxton D %A Morris, Andrew P %A Mosekilde, Leif %A Newman, Anne %A Nielson, Carrie M %A O'Connell, Jeffrey R %A Oostra, Ben A %A Orwoll, Eric S %A Palotie, Aarno %A Parker, Stephen C J %A Peacock, Munro %A Perola, Markus %A Peters, Annette %A Polasek, Ozren %A Prince, Richard L %A Räikkönen, Katri %A Ralston, Stuart H %A Ripatti, Samuli %A Robbins, John A %A Rotter, Jerome I %A Rudan, Igor %A Salomaa, Veikko %A Satterfield, Suzanne %A Schadt, Eric E %A Schipf, Sabine %A Scott, Laura %A Sehmi, Joban %A Shen, Jian %A Soo Shin, Chan %A Sigurdsson, Gunnar %A Smith, Shad %A Soranzo, Nicole %A Stančáková, Alena %A Steinhagen-Thiessen, Elisabeth %A Streeten, Elizabeth A %A Styrkarsdottir, Unnur %A Swart, Karin M A %A Tan, Sian-Tsung %A Tarnopolsky, Mark A %A Thompson, Patricia %A Thomson, Cynthia A %A Thorsteinsdottir, Unnur %A Tikkanen, Emmi %A Tranah, Gregory J %A Tuomilehto, Jaakko %A van Schoor, Natasja M %A Verma, Arjun %A Vollenweider, Peter %A Völzke, Henry %A Wactawski-Wende, Jean %A Walker, Mark %A Weedon, Michael N %A Welch, Ryan %A Wichmann, H-Erich %A Widen, Elisabeth %A Williams, Frances M K %A Wilson, James F %A Wright, Nicole C %A Xie, Weijia %A Yu, Lei %A Zhou, Yanhua %A Chambers, John C %A Döring, Angela %A van Duijn, Cornelia M %A Econs, Michael J %A Gudnason, Vilmundur %A Kooner, Jaspal S %A Psaty, Bruce M %A Spector, Timothy D %A Stefansson, Kari %A Rivadeneira, Fernando %A Uitterlinden, André G %A Wareham, Nicholas J %A Ossowski, Vicky %A Waterworth, Dawn %A Loos, Ruth J F %A Karasik, David %A Harris, Tamara B %A Ohlsson, Claes %A Kiel, Douglas P %X

Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p < 5 × 10-8) or suggestively genome wide (p < 2.3 × 10-6). Replication in 63,475 (47,227 of European ancestry) individuals from 33 cohorts for whole body lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.

%B Nat Commun %V 8 %P 80 %8 2017 Jul 19 %G eng %N 1 %R 10.1038/s41467-017-00031-7 %0 Journal Article %J Nat Genet %D 2017 %T Large-scale analyses of common and rare variants identify 12 new loci associated with atrial fibrillation. %A Christophersen, Ingrid E %A Rienstra, Michiel %A Roselli, Carolina %A Yin, Xiaoyan %A Geelhoed, Bastiaan %A Barnard, John %A Lin, Honghuang %A Arking, Dan E %A Smith, Albert V %A Albert, Christine M %A Chaffin, Mark %A Tucker, Nathan R %A Li, Molong %A Klarin, Derek %A Bihlmeyer, Nathan A %A Low, Siew-Kee %A Weeke, Peter E %A Müller-Nurasyid, Martina %A Smith, J Gustav %A Brody, Jennifer A %A Niemeijer, Maartje N %A Dörr, Marcus %A Trompet, Stella %A Huffman, Jennifer %A Gustafsson, Stefan %A Schurmann, Claudia %A Kleber, Marcus E %A Lyytikäinen, Leo-Pekka %A Seppälä, Ilkka %A Malik, Rainer %A Horimoto, Andrea R V R %A Perez, Marco %A Sinisalo, Juha %A Aeschbacher, Stefanie %A Thériault, Sébastien %A Yao, Jie %A Radmanesh, Farid %A Weiss, Stefan %A Teumer, Alexander %A Choi, Seung Hoan %A Weng, Lu-Chen %A Clauss, Sebastian %A Deo, Rajat %A Rader, Daniel J %A Shah, Svati H %A Sun, Albert %A Hopewell, Jemma C %A Debette, Stephanie %A Chauhan, Ganesh %A Yang, Qiong %A Worrall, Bradford B %A Paré, Guillaume %A Kamatani, Yoichiro %A Hagemeijer, Yanick P %A Verweij, Niek %A Siland, Joylene E %A Kubo, Michiaki %A Smith, Jonathan D %A Van Wagoner, David R %A Bis, Joshua C %A Perz, Siegfried %A Psaty, Bruce M %A Ridker, Paul M %A Magnani, Jared W %A Harris, Tamara B %A Launer, Lenore J %A Shoemaker, M Benjamin %A Padmanabhan, Sandosh %A Haessler, Jeffrey %A Bartz, Traci M %A Waldenberger, Melanie %A Lichtner, Peter %A Arendt, Marina %A Krieger, Jose E %A Kähönen, Mika %A Risch, Lorenz %A Mansur, Alfredo J %A Peters, Annette %A Smith, Blair H %A Lind, Lars %A Scott, Stuart A %A Lu, Yingchang %A Bottinger, Erwin B %A Hernesniemi, Jussi %A Lindgren, Cecilia M %A Wong, Jorge A %A Huang, Jie %A Eskola, Markku %A Morris, Andrew P %A Ford, Ian %A Reiner, Alex P %A Delgado, Graciela %A Chen, Lin Y %A Chen, Yii-Der Ida %A Sandhu, Roopinder K %A Li, Man %A Boerwinkle, Eric %A Eisele, Lewin %A Lannfelt, Lars %A Rost, Natalia %A Anderson, Christopher D %A Taylor, Kent D %A Campbell, Archie %A Magnusson, Patrik K %A Porteous, David %A Hocking, Lynne J %A Vlachopoulou, Efthymia %A Pedersen, Nancy L %A Nikus, Kjell %A Orho-Melander, Marju %A Hamsten, Anders %A Heeringa, Jan %A Denny, Joshua C %A Kriebel, Jennifer %A Darbar, Dawood %A Newton-Cheh, Christopher %A Shaffer, Christian %A Macfarlane, Peter W %A Heilmann-Heimbach, Stefanie %A Almgren, Peter %A Huang, Paul L %A Sotoodehnia, Nona %A Soliman, Elsayed Z %A Uitterlinden, André G %A Hofman, Albert %A Franco, Oscar H %A Völker, Uwe %A Jöckel, Karl-Heinz %A Sinner, Moritz F %A Lin, Henry J %A Guo, Xiuqing %A Dichgans, Martin %A Ingelsson, Erik %A Kooperberg, Charles %A Melander, Olle %A Loos, Ruth J F %A Laurikka, Jari %A Conen, David %A Rosand, Jonathan %A van der Harst, Pim %A Lokki, Marja-Liisa %A Kathiresan, Sekar %A Pereira, Alexandre %A Jukema, J Wouter %A Hayward, Caroline %A Rotter, Jerome I %A März, Winfried %A Lehtimäki, Terho %A Stricker, Bruno H %A Chung, Mina K %A Felix, Stephan B %A Gudnason, Vilmundur %A Alonso, Alvaro %A Roden, Dan M %A Kääb, Stefan %A Chasman, Daniel I %A Heckbert, Susan R %A Benjamin, Emelia J %A Tanaka, Toshihiro %A Lunetta, Kathryn L %A Lubitz, Steven A %A Ellinor, Patrick T %X

Atrial fibrillation affects more than 33 million people worldwide and increases the risk of stroke, heart failure, and death. Fourteen genetic loci have been associated with atrial fibrillation in European and Asian ancestry groups. To further define the genetic basis of atrial fibrillation, we performed large-scale, trans-ancestry meta-analyses of common and rare variant association studies. The genome-wide association studies (GWAS) included 17,931 individuals with atrial fibrillation and 115,142 referents; the exome-wide association studies (ExWAS) and rare variant association studies (RVAS) involved 22,346 cases and 132,086 referents. We identified 12 new genetic loci that exceeded genome-wide significance, implicating genes involved in cardiac electrical and structural remodeling. Our results nearly double the number of known genetic loci for atrial fibrillation, provide insights into the molecular basis of atrial fibrillation, and may facilitate the identification of new potential targets for drug discovery.

%B Nat Genet %V 49 %P 946-952 %8 2017 Jun %G eng %N 6 %R 10.1038/ng.3843 %0 Journal Article %J Cell Rep %D 2017 %T Large-Scale Cognitive GWAS Meta-Analysis Reveals Tissue-Specific Neural Expression and Potential Nootropic Drug Targets. %A Lam, Max %A Trampush, Joey W %A Yu, Jin %A Knowles, Emma %A Davies, Gail %A Liewald, David C %A Starr, John M %A Djurovic, Srdjan %A Melle, Ingrid %A Sundet, Kjetil %A Christoforou, Andrea %A Reinvang, Ivar %A DeRosse, Pamela %A Lundervold, Astri J %A Steen, Vidar M %A Espeseth, Thomas %A Räikkönen, Katri %A Widen, Elisabeth %A Palotie, Aarno %A Eriksson, Johan G %A Giegling, Ina %A Konte, Bettina %A Roussos, Panos %A Giakoumaki, Stella %A Burdick, Katherine E %A Payton, Antony %A Ollier, William %A Chiba-Falek, Ornit %A Attix, Deborah K %A Need, Anna C %A Cirulli, Elizabeth T %A Voineskos, Aristotle N %A Stefanis, Nikos C %A Avramopoulos, Dimitrios %A Hatzimanolis, Alex %A Arking, Dan E %A Smyrnis, Nikolaos %A Bilder, Robert M %A Freimer, Nelson A %A Cannon, Tyrone D %A London, Edythe %A Poldrack, Russell A %A Sabb, Fred W %A Congdon, Eliza %A Conley, Emily Drabant %A Scult, Matthew A %A Dickinson, Dwight %A Straub, Richard E %A Donohoe, Gary %A Morris, Derek %A Corvin, Aiden %A Gill, Michael %A Hariri, Ahmad R %A Weinberger, Daniel R %A Pendleton, Neil %A Bitsios, Panos %A Rujescu, Dan %A Lahti, Jari %A Le Hellard, Stephanie %A Keller, Matthew C %A Andreassen, Ole A %A Deary, Ian J %A Glahn, David C %A Malhotra, Anil K %A Lencz, Todd %X

Here, we present a large (n = 107,207) genome-wide association study (GWAS) of general cognitive ability ("g"), further enhanced by combining results with a large-scale GWAS of educational attainment. We identified 70 independent genomic loci associated with general cognitive ability. Results showed significant enrichment for genes causing Mendelian disorders with an intellectual disability phenotype. Competitive pathway analysis implicated the biological processes of neurogenesis and synaptic regulation, as well as the gene targets of two pharmacologic agents: cinnarizine, a T-type calcium channel blocker, and LY97241, a potassium channel inhibitor. Transcriptome-wide and epigenome-wide analysis revealed that the implicated loci were enriched for genes expressed across all brain regions (most strongly in the cerebellum). Enrichment was exclusive to genes expressed in neurons but not oligodendrocytes or astrocytes. Finally, we report genetic correlations between cognitive ability and disparate phenotypes including psychiatric disorders, several autoimmune disorders, longevity, and maternal age at first birth.

%B Cell Rep %V 21 %P 2597-2613 %8 2017 Nov 28 %G eng %N 9 %R 10.1016/j.celrep.2017.11.028 %0 Journal Article %J J Clin Invest %D 2017 %T Large-scale genome-wide analysis identifies genetic variants associated with cardiac structure and function. %A Wild, Philipp S %A Felix, Janine F %A Schillert, Arne %A Teumer, Alexander %A Chen, Ming-Huei %A Leening, Maarten J G %A Völker, Uwe %A Großmann, Vera %A Brody, Jennifer A %A Irvin, Marguerite R %A Shah, Sanjiv J %A Pramana, Setia %A Lieb, Wolfgang %A Schmidt, Reinhold %A Stanton, Alice V %A Malzahn, Dörthe %A Smith, Albert Vernon %A Sundström, Johan %A Minelli, Cosetta %A Ruggiero, Daniela %A Lyytikäinen, Leo-Pekka %A Tiller, Daniel %A Smith, J Gustav %A Monnereau, Claire %A Di Tullio, Marco R %A Musani, Solomon K %A Morrison, Alanna C %A Pers, Tune H %A Morley, Michael %A Kleber, Marcus E %A Aragam, Jayashri %A Benjamin, Emelia J %A Bis, Joshua C %A Bisping, Egbert %A Broeckel, Ulrich %A Cheng, Susan %A Deckers, Jaap W %A del Greco M, Fabiola %A Edelmann, Frank %A Fornage, Myriam %A Franke, Lude %A Friedrich, Nele %A Harris, Tamara B %A Hofer, Edith %A Hofman, Albert %A Huang, Jie %A Hughes, Alun D %A Kähönen, Mika %A Investigators, Knhi %A Kruppa, Jochen %A Lackner, Karl J %A Lannfelt, Lars %A Laskowski, Rafael %A Launer, Lenore J %A Leosdottir, Margrét %A Lin, Honghuang %A Lindgren, Cecilia M %A Loley, Christina %A MacRae, Calum A %A Mascalzoni, Deborah %A Mayet, Jamil %A Medenwald, Daniel %A Morris, Andrew P %A Müller, Christian %A Müller-Nurasyid, Martina %A Nappo, Stefania %A Nilsson, Peter M %A Nuding, Sebastian %A Nutile, Teresa %A Peters, Annette %A Pfeufer, Arne %A Pietzner, Diana %A Pramstaller, Peter P %A Raitakari, Olli T %A Rice, Kenneth M %A Rivadeneira, Fernando %A Rotter, Jerome I %A Ruohonen, Saku T %A Sacco, Ralph L %A Samdarshi, Tandaw E %A Schmidt, Helena %A Sharp, Andrew S P %A Shields, Denis C %A Sorice, Rossella %A Sotoodehnia, Nona %A Stricker, Bruno H %A Surendran, Praveen %A Thom, Simon %A Töglhofer, Anna M %A Uitterlinden, André G %A Wachter, Rolf %A Völzke, Henry %A Ziegler, Andreas %A Münzel, Thomas %A März, Winfried %A Cappola, Thomas P %A Hirschhorn, Joel N %A Mitchell, Gary F %A Smith, Nicholas L %A Fox, Ervin R %A Dueker, Nicole D %A Jaddoe, Vincent W V %A Melander, Olle %A Russ, Martin %A Lehtimäki, Terho %A Ciullo, Marina %A Hicks, Andrew A %A Lind, Lars %A Gudnason, Vilmundur %A Pieske, Burkert %A Barron, Anthony J %A Zweiker, Robert %A Schunkert, Heribert %A Ingelsson, Erik %A Liu, Kiang %A Arnett, Donna K %A Psaty, Bruce M %A Blankenberg, Stefan %A Larson, Martin G %A Felix, Stephan B %A Franco, Oscar H %A Zeller, Tanja %A Vasan, Ramachandran S %A Dörr, Marcus %X

BACKGROUND: Understanding the genetic architecture of cardiac structure and function may help to prevent and treat heart disease. This investigation sought to identify common genetic variations associated with inter-individual variability in cardiac structure and function.

METHODS: A GWAS meta-analysis of echocardiographic traits was performed, including 46,533 individuals from 30 studies (EchoGen consortium). The analysis included 16 traits of left ventricular (LV) structure, and systolic and diastolic function.

RESULTS: The discovery analysis included 21 cohorts for structural and systolic function traits (n = 32,212) and 17 cohorts for diastolic function traits (n = 21,852). Replication was performed in 5 cohorts (n = 14,321) and 6 cohorts (n = 16,308), respectively. Besides 5 previously reported loci, the combined meta-analysis identified 10 additional genome-wide significant SNPs: rs12541595 near MTSS1 and rs10774625 in ATXN2 for LV end-diastolic internal dimension; rs806322 near KCNRG, rs4765663 in CACNA1C, rs6702619 near PALMD, rs7127129 in TMEM16A, rs11207426 near FGGY, rs17608766 in GOSR2, and rs17696696 in CFDP1 for aortic root diameter; and rs12440869 in IQCH for Doppler transmitral A-wave peak velocity. Findings were in part validated in other cohorts and in GWAS of related disease traits. The genetic loci showed associations with putative signaling pathways, and with gene expression in whole blood, monocytes, and myocardial tissue.

CONCLUSION: The additional genetic loci identified in this large meta-analysis of cardiac structure and function provide insights into the underlying genetic architecture of cardiac structure and warrant follow-up in future functional studies.

FUNDING: For detailed information per study, see Acknowledgments.

%B J Clin Invest %V 127 %P 1798-1812 %8 2017 May 01 %G eng %N 5 %R 10.1172/JCI84840 %0 Journal Article %J Nat Commun %D 2017 %T Large-scale GWAS identifies multiple loci for hand grip strength providing biological insights into muscular fitness. %A Willems, Sara M %A Wright, Daniel J %A Day, Felix R %A Trajanoska, Katerina %A Joshi, Peter K %A Morris, John A %A Matteini, Amy M %A Garton, Fleur C %A Grarup, Niels %A Oskolkov, Nikolay %A Thalamuthu, Anbupalam %A Mangino, Massimo %A Liu, Jun %A Demirkan, Ayse %A Lek, Monkol %A Xu, Liwen %A Wang, Guan %A Oldmeadow, Christopher %A Gaulton, Kyle J %A Lotta, Luca A %A Miyamoto-Mikami, Eri %A Rivas, Manuel A %A White, Tom %A Loh, Po-Ru %A Aadahl, Mette %A Amin, Najaf %A Attia, John R %A Austin, Krista %A Benyamin, Beben %A Brage, Søren %A Cheng, Yu-Ching %A Cięszczyk, Paweł %A Derave, Wim %A Eriksson, Karl-Fredrik %A Eynon, Nir %A Linneberg, Allan %A Lucia, Alejandro %A Massidda, Myosotis %A Mitchell, Braxton D %A Miyachi, Motohiko %A Murakami, Haruka %A Padmanabhan, Sandosh %A Pandey, Ashutosh %A Papadimitriou, Ioannis %A Rajpal, Deepak K %A Sale, Craig %A Schnurr, Theresia M %A Sessa, Francesco %A Shrine, Nick %A Tobin, Martin D %A Varley, Ian %A Wain, Louise V %A Wray, Naomi R %A Lindgren, Cecilia M %A MacArthur, Daniel G %A Waterworth, Dawn M %A McCarthy, Mark I %A Pedersen, Oluf %A Khaw, Kay-Tee %A Kiel, Douglas P %A Pitsiladis, Yannis %A Fuku, Noriyuki %A Franks, Paul W %A North, Kathryn N %A van Duijn, Cornelia M %A Mather, Karen A %A Hansen, Torben %A Hansson, Ola %A Spector, Tim %A Murabito, Joanne M %A Richards, J Brent %A Rivadeneira, Fernando %A Langenberg, Claudia %A Perry, John R B %A Wareham, Nick J %A Scott, Robert A %X

Hand grip strength is a widely used proxy of muscular fitness, a marker of frailty, and predictor of a range of morbidities and all-cause mortality. To investigate the genetic determinants of variation in grip strength, we perform a large-scale genetic discovery analysis in a combined sample of 195,180 individuals and identify 16 loci associated with grip strength (P<5 × 10) in combined analyses. A number of these loci contain genes implicated in structure and function of skeletal muscle fibres (ACTG1), neuronal maintenance and signal transduction (PEX14, TGFA, SYT1), or monogenic syndromes with involvement of psychomotor impairment (PEX14, LRPPRC and KANSL1). Mendelian randomization analyses are consistent with a causal effect of higher genetically predicted grip strength on lower fracture risk. In conclusion, our findings provide new biological insight into the mechanistic underpinnings of grip strength and the causal role of muscular strength in age-related morbidities and mortality.

%B Nat Commun %V 8 %P 16015 %8 2017 Jul 12 %G eng %R 10.1038/ncomms16015 %0 Journal Article %J Exp Gerontol %D 2017 %T Leisure-time physical activity and leukocyte telomere length among older women. %A Shadyab, Aladdin H %A Lamonte, Michael J %A Kooperberg, Charles %A Reiner, Alexander P %A Carty, Cara L %A Manini, Todd M %A Hou, Lifang %A Di, Chongzhi %A Macera, Caroline A %A Gallo, Linda C %A Shaffer, Richard A %A Jain, Sonia %A LaCroix, Andrea Z %X

BACKGROUND: Shortened leukocyte telomere length (LTL), a purported marker of cellular aging, is associated with morbidity and mortality. However, the association of physical activity, a modifiable lifestyle behavior, with LTL has not been adequately studied among older adults.

METHODS: In this cross-sectional study, we examined associations of various intensity levels of leisure-time physical activity with LTL among 1476 older white and African American women from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study. Self-reported physical activity was assessed by questionnaire, and LTL was measured by Southern blot. The association between physical activity and LTL was evaluated using multiple linear regression models adjusted for demographic characteristics, lifestyle behaviors, and health-related variables.

RESULTS: Women were on average aged 79.2 (standard deviation 6.7) years old. In the final model adjusted for age, race/ethnicity, education, marital status, smoking, alcohol, body mass index, a history of chronic diseases, and hormone therapy use, LTL was on average 110 (95% confidence interval, 20-190) base pairs longer among women in the highest (≥17.00MET-hours/week) compared with the lowest (<1.25MET-hours/week) level of total leisure-time physical activity (P for trend=0.02). Higher levels of moderate-to-vigorous physical activity (P for trend=0.04) and faster walking speed (P for trend=0.03) were also associated with longer LTL in the fully-adjusted models.

CONCLUSION: Older women participating in greater amounts of total leisure-time physical activity and moderate-to-vigorous physical activity had longer LTL.

%B Exp Gerontol %V 95 %P 141-147 %8 2017 Sep %G eng %R 10.1016/j.exger.2017.05.019 %0 Journal Article %J Am J Hum Genet %D 2017 %T Low-Frequency Synonymous Coding Variation in CYP2R1 Has Large Effects on Vitamin D Levels and Risk of Multiple Sclerosis. %A Manousaki, Despoina %A Dudding, Tom %A Haworth, Simon %A Hsu, Yi-Hsiang %A Liu, Ching-Ti %A Medina-Gómez, Carolina %A Voortman, Trudy %A van der Velde, Nathalie %A Melhus, Håkan %A Robinson-Cohen, Cassianne %A Cousminer, Diana L %A Nethander, Maria %A Vandenput, Liesbeth %A Noordam, Raymond %A Forgetta, Vincenzo %A Greenwood, Celia M T %A Biggs, Mary L %A Psaty, Bruce M %A Rotter, Jerome I %A Zemel, Babette S %A Mitchell, Jonathan A %A Taylor, Bruce %A Lorentzon, Mattias %A Karlsson, Magnus %A Jaddoe, Vincent V W %A Tiemeier, Henning %A Campos-Obando, Natalia %A Franco, Oscar H %A Utterlinden, Andre G %A Broer, Linda %A van Schoor, Natasja M %A Ham, Annelies C %A Ikram, M Arfan %A Karasik, David %A de Mutsert, Renée %A Rosendaal, Frits R %A den Heijer, Martin %A Wang, Thomas J %A Lind, Lars %A Orwoll, Eric S %A Mook-Kanamori, Dennis O %A Michaëlsson, Karl %A Kestenbaum, Bryan %A Ohlsson, Claes %A Mellström, Dan %A de Groot, Lisette C P G M %A Grant, Struan F A %A Kiel, Douglas P %A Zillikens, M Carola %A Rivadeneira, Fernando %A Sawcer, Stephen %A Timpson, Nicholas J %A Richards, J Brent %K Cholestanetriol 26-Monooxygenase %K Cytochrome P450 Family 2 %K Gene Frequency %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Multiple Sclerosis %K Polymorphism, Single Nucleotide %K Risk Factors %K Vitamin D %K Vitamin D Deficiency %X

Vitamin D insufficiency is common, correctable, and influenced by genetic factors, and it has been associated with risk of several diseases. We sought to identify low-frequency genetic variants that strongly increase the risk of vitamin D insufficiency and tested their effect on risk of multiple sclerosis, a disease influenced by low vitamin D concentrations. We used whole-genome sequencing data from 2,619 individuals through the UK10K program and deep-imputation data from 39,655 individuals genotyped genome-wide. Meta-analysis of the summary statistics from 19 cohorts identified in CYP2R1 the low-frequency (minor allele frequency = 2.5%) synonymous coding variant g.14900931G>A (p.Asp120Asp) (rs117913124[A]), which conferred a large effect on 25-hydroxyvitamin D (25OHD) levels (-0.43 SD of standardized natural log-transformed 25OHD per A allele; p value = 1.5 × 10(-88)). The effect on 25OHD was four times larger and independent of the effect of a previously described common variant near CYP2R1. By analyzing 8,711 individuals, we showed that heterozygote carriers of this low-frequency variant have an increased risk of vitamin D insufficiency (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.78-2.78, p = 1.26 × 10(-12)). Individuals carrying one copy of this variant also had increased odds of multiple sclerosis (OR = 1.4, 95% CI = 1.19-1.64, p = 2.63 × 10(-5)) in a sample of 5,927 case and 5,599 control subjects. In conclusion, we describe a low-frequency CYP2R1 coding variant that exerts the largest effect upon 25OHD levels identified to date in the general European population and implicates vitamin D in the etiology of multiple sclerosis.

%B Am J Hum Genet %V 101 %P 227-238 %8 2017 Aug 03 %G eng %N 2 %R 10.1016/j.ajhg.2017.06.014 %0 Journal Article %J Circ Cardiovasc Genet %D 2017 %T New Blood Pressure-Associated Loci Identified in Meta-Analyses of 475 000 Individuals. %A Kraja, Aldi T %A Cook, James P %A Warren, Helen R %A Surendran, Praveen %A Liu, Chunyu %A Evangelou, Evangelos %A Manning, Alisa K %A Grarup, Niels %A Drenos, Fotios %A Sim, Xueling %A Smith, Albert Vernon %A Amin, Najaf %A Blakemore, Alexandra I F %A Bork-Jensen, Jette %A Brandslund, Ivan %A Farmaki, Aliki-Eleni %A Fava, Cristiano %A Ferreira, Teresa %A Herzig, Karl-Heinz %A Giri, Ayush %A Giulianini, Franco %A Grove, Megan L %A Guo, Xiuqing %A Harris, Sarah E %A Have, Christian T %A Havulinna, Aki S %A Zhang, He %A Jørgensen, Marit E %A Käräjämäki, AnneMari %A Kooperberg, Charles %A Linneberg, Allan %A Little, Louis %A Liu, Yongmei %A Bonnycastle, Lori L %A Lu, Yingchang %A Mägi, Reedik %A Mahajan, Anubha %A Malerba, Giovanni %A Marioni, Riccardo E %A Mei, Hao %A Menni, Cristina %A Morrison, Alanna C %A Padmanabhan, Sandosh %A Palmas, Walter %A Poveda, Alaitz %A Rauramaa, Rainer %A Rayner, Nigel William %A Riaz, Muhammad %A Rice, Ken %A Richard, Melissa A %A Smith, Jennifer A %A Southam, Lorraine %A Stančáková, Alena %A Stirrups, Kathleen E %A Tragante, Vinicius %A Tuomi, Tiinamaija %A Tzoulaki, Ioanna %A Varga, Tibor V %A Weiss, Stefan %A Yiorkas, Andrianos M %A Young, Robin %A Zhang, Weihua %A Barnes, Michael R %A Cabrera, Claudia P %A Gao, He %A Boehnke, Michael %A Boerwinkle, Eric %A Chambers, John C %A Connell, John M %A Christensen, Cramer K %A de Boer, Rudolf A %A Deary, Ian J %A Dedoussis, George %A Deloukas, Panos %A Dominiczak, Anna F %A Dörr, Marcus %A Joehanes, Roby %A Edwards, Todd L %A Esko, Tõnu %A Fornage, Myriam %A Franceschini, Nora %A Franks, Paul W %A Gambaro, Giovanni %A Groop, Leif %A Hallmans, Göran %A Hansen, Torben %A Hayward, Caroline %A Heikki, Oksa %A Ingelsson, Erik %A Tuomilehto, Jaakko %A Jarvelin, Marjo-Riitta %A Kardia, Sharon L R %A Karpe, Fredrik %A Kooner, Jaspal S %A Lakka, Timo A %A Langenberg, Claudia %A Lind, Lars %A Loos, Ruth J F %A Laakso, Markku %A McCarthy, Mark I %A Melander, Olle %A Mohlke, Karen L %A Morris, Andrew P %A Palmer, Colin N A %A Pedersen, Oluf %A Polasek, Ozren %A Poulter, Neil R %A Province, Michael A %A Psaty, Bruce M %A Ridker, Paul M %A Rotter, Jerome I %A Rudan, Igor %A Salomaa, Veikko %A Samani, Nilesh J %A Sever, Peter J %A Skaaby, Tea %A Stafford, Jeanette M %A Starr, John M %A van der Harst, Pim %A van der Meer, Peter %A van Duijn, Cornelia M %A Vergnaud, Anne-Claire %A Gudnason, Vilmundur %A Wareham, Nicholas J %A Wilson, James G %A Willer, Cristen J %A Witte, Daniel R %A Zeggini, Eleftheria %A Saleheen, Danish %A Butterworth, Adam S %A Danesh, John %A Asselbergs, Folkert W %A Wain, Louise V %A Ehret, Georg B %A Chasman, Daniel I %A Caulfield, Mark J %A Elliott, Paul %A Lindgren, Cecilia M %A Levy, Daniel %A Newton-Cheh, Christopher %A Munroe, Patricia B %A Howson, Joanna M M %X

BACKGROUND: Genome-wide association studies have recently identified >400 loci that harbor DNA sequence variants that influence blood pressure (BP). Our earlier studies identified and validated 56 single nucleotide variants (SNVs) associated with BP from meta-analyses of exome chip genotype data. An additional 100 variants yielded suggestive evidence of association.

METHODS AND RESULTS: Here, we augment the sample with 140 886 European individuals from the UK Biobank, in whom 77 of the 100 suggestive SNVs were available for association analysis with systolic BP or diastolic BP or pulse pressure. We performed 2 meta-analyses, one in individuals of European, South Asian, African, and Hispanic descent (pan-ancestry, ≈475 000), and the other in the subset of individuals of European descent (≈423 000). Twenty-one SNVs were genome-wide significant (P<5×10-8) for BP, of which 4 are new BP loci: rs9678851 (missense, SLC4A1AP), rs7437940 (AFAP1), rs13303 (missense, STAB1), and rs1055144 (7p15.2). In addition, we identified a potentially independent novel BP-associated SNV, rs3416322 (missense, SYNPO2L) at a known locus, uncorrelated with the previously reported SNVs. Two SNVs are associated with expression levels of nearby genes, and SNVs at 3 loci are associated with other traits. One SNV with a minor allele frequency <0.01, (rs3025380 at DBH) was genome-wide significant.

CONCLUSIONS: We report 4 novel loci associated with BP regulation, and 1 independent variant at an established BP locus. This analysis highlights several candidate genes with variation that alter protein function or gene expression for potential follow-up.

%B Circ Cardiovasc Genet %V 10 %8 2017 Oct %G eng %N 5 %R 10.1161/CIRCGENETICS.117.001778 %0 Journal Article %J Hypertension %D 2017 %T Novel Blood Pressure Locus and Gene Discovery Using Genome-Wide Association Study and Expression Data Sets From Blood and the Kidney. %A Wain, Louise V %A Vaez, Ahmad %A Jansen, Rick %A Joehanes, Roby %A van der Most, Peter J %A Erzurumluoglu, A Mesut %A O'Reilly, Paul F %A Cabrera, Claudia P %A Warren, Helen R %A Rose, Lynda M %A Verwoert, Germaine C %A Hottenga, Jouke-Jan %A Strawbridge, Rona J %A Esko, Tõnu %A Arking, Dan E %A Hwang, Shih-Jen %A Guo, Xiuqing %A Kutalik, Zoltán %A Trompet, Stella %A Shrine, Nick %A Teumer, Alexander %A Ried, Janina S %A Bis, Joshua C %A Smith, Albert V %A Amin, Najaf %A Nolte, Ilja M %A Lyytikäinen, Leo-Pekka %A Mahajan, Anubha %A Wareham, Nicholas J %A Hofer, Edith %A Joshi, Peter K %A Kristiansson, Kati %A Traglia, Michela %A Havulinna, Aki S %A Goel, Anuj %A Nalls, Mike A %A Sõber, Siim %A Vuckovic, Dragana %A Luan, Jian'an %A del Greco M, Fabiola %A Ayers, Kristin L %A Marrugat, Jaume %A Ruggiero, Daniela %A Lopez, Lorna M %A Niiranen, Teemu %A Enroth, Stefan %A Jackson, Anne U %A Nelson, Christopher P %A Huffman, Jennifer E %A Zhang, Weihua %A Marten, Jonathan %A Gandin, Ilaria %A Harris, Sarah E %A Zemunik, Tatijana %A Lu, Yingchang %A Evangelou, Evangelos %A Shah, Nabi %A de Borst, Martin H %A Mangino, Massimo %A Prins, Bram P %A Campbell, Archie %A Li-Gao, Ruifang %A Chauhan, Ganesh %A Oldmeadow, Christopher %A Abecasis, Goncalo %A Abedi, Maryam %A Barbieri, Caterina M %A Barnes, Michael R %A Batini, Chiara %A Beilby, John %A Blake, Tineka %A Boehnke, Michael %A Bottinger, Erwin P %A Braund, Peter S %A Brown, Morris %A Brumat, Marco %A Campbell, Harry %A Chambers, John C %A Cocca, Massimiliano %A Collins, Francis %A Connell, John %A Cordell, Heather J %A Damman, Jeffrey J %A Davies, Gail %A de Geus, Eco J %A de Mutsert, Renée %A Deelen, Joris %A Demirkale, Yusuf %A Doney, Alex S F %A Dörr, Marcus %A Farrall, Martin %A Ferreira, Teresa %A Frånberg, Mattias %A Gao, He %A Giedraitis, Vilmantas %A Gieger, Christian %A Giulianini, Franco %A Gow, Alan J %A Hamsten, Anders %A Harris, Tamara B %A Hofman, Albert %A Holliday, Elizabeth G %A Hui, Jennie %A Jarvelin, Marjo-Riitta %A Johansson, Asa %A Johnson, Andrew D %A Jousilahti, Pekka %A Jula, Antti %A Kähönen, Mika %A Kathiresan, Sekar %A Khaw, Kay-Tee %A Kolcic, Ivana %A Koskinen, Seppo %A Langenberg, Claudia %A Larson, Marty %A Launer, Lenore J %A Lehne, Benjamin %A Liewald, David C M %A Lin, Li %A Lind, Lars %A Mach, François %A Mamasoula, Chrysovalanto %A Menni, Cristina %A Mifsud, Borbala %A Milaneschi, Yuri %A Morgan, Anna %A Morris, Andrew D %A Morrison, Alanna C %A Munson, Peter J %A Nandakumar, Priyanka %A Nguyen, Quang Tri %A Nutile, Teresa %A Oldehinkel, Albertine J %A Oostra, Ben A %A Org, Elin %A Padmanabhan, Sandosh %A Palotie, Aarno %A Paré, Guillaume %A Pattie, Alison %A Penninx, Brenda W J H %A Poulter, Neil %A Pramstaller, Peter P %A Raitakari, Olli T %A Ren, Meixia %A Rice, Kenneth %A Ridker, Paul M %A Riese, Harriëtte %A Ripatti, Samuli %A Robino, Antonietta %A Rotter, Jerome I %A Rudan, Igor %A Saba, Yasaman %A Saint Pierre, Aude %A Sala, Cinzia F %A Sarin, Antti-Pekka %A Schmidt, Reinhold %A Scott, Rodney %A Seelen, Marc A %A Shields, Denis C %A Siscovick, David %A Sorice, Rossella %A Stanton, Alice %A Stott, David J %A Sundström, Johan %A Swertz, Morris %A Taylor, Kent D %A Thom, Simon %A Tzoulaki, Ioanna %A Tzourio, Christophe %A Uitterlinden, André G %A Völker, Uwe %A Vollenweider, Peter %A Wild, Sarah %A Willemsen, Gonneke %A Wright, Alan F %A Yao, Jie %A Thériault, Sébastien %A Conen, David %A Attia, John %A Sever, Peter %A Debette, Stephanie %A Mook-Kanamori, Dennis O %A Zeggini, Eleftheria %A Spector, Tim D %A van der Harst, Pim %A Palmer, Colin N A %A Vergnaud, Anne-Claire %A Loos, Ruth J F %A Polasek, Ozren %A Starr, John M %A Girotto, Giorgia %A Hayward, Caroline %A Kooner, Jaspal S %A Lindgren, Cecila M %A Vitart, Veronique %A Samani, Nilesh J %A Tuomilehto, Jaakko %A Gyllensten, Ulf %A Knekt, Paul %A Deary, Ian J %A Ciullo, Marina %A Elosua, Roberto %A Keavney, Bernard D %A Hicks, Andrew A %A Scott, Robert A %A Gasparini, Paolo %A Laan, Maris %A Liu, Yongmei %A Watkins, Hugh %A Hartman, Catharina A %A Salomaa, Veikko %A Toniolo, Daniela %A Perola, Markus %A Wilson, James F %A Schmidt, Helena %A Zhao, Jing Hua %A Lehtimäki, Terho %A van Duijn, Cornelia M %A Gudnason, Vilmundur %A Psaty, Bruce M %A Peters, Annette %A Rettig, Rainer %A James, Alan %A Jukema, J Wouter %A Strachan, David P %A Palmas, Walter %A Metspalu, Andres %A Ingelsson, Erik %A Boomsma, Dorret I %A Franco, Oscar H %A Bochud, Murielle %A Newton-Cheh, Christopher %A Munroe, Patricia B %A Elliott, Paul %A Chasman, Daniel I %A Chakravarti, Aravinda %A Knight, Joanne %A Morris, Andrew P %A Levy, Daniel %A Tobin, Martin D %A Snieder, Harold %A Caulfield, Mark J %A Ehret, Georg B %X

Elevated blood pressure is a major risk factor for cardiovascular disease and has a substantial genetic contribution. Genetic variation influencing blood pressure has the potential to identify new pharmacological targets for the treatment of hypertension. To discover additional novel blood pressure loci, we used 1000 Genomes Project-based imputation in 150 134 European ancestry individuals and sought significant evidence for independent replication in a further 228 245 individuals. We report 6 new signals of association in or near HSPB7, TNXB, LRP12, LOC283335, SEPT9, and AKT2, and provide new replication evidence for a further 2 signals in EBF2 and NFKBIA Combining large whole-blood gene expression resources totaling 12 607 individuals, we investigated all novel and previously reported signals and identified 48 genes with evidence for involvement in blood pressure regulation that are significant in multiple resources. Three novel kidney-specific signals were also detected. These robustly implicated genes may provide new leads for therapeutic innovation.

%B Hypertension %8 2017 Jul 24 %G eng %R 10.1161/HYPERTENSIONAHA.117.09438 %0 Journal Article %J Nat Commun %D 2017 %T {Novel genetic loci associated with hippocampal volume %A Hibar, D. P. %A Adams, H. H. H. %A Jahanshad, N. %A Chauhan, G. %A Stein, J. L. %A Hofer, E. %A Renteria, M. E. %A Bis, J. C. %A Arias-Vasquez, A. %A Ikram, M. K. %A Desrivi?res, S. %A Vernooij, M. W. %A Abramovic, L. %A Alhusaini, S. %A Amin, N. %A Andersson, M. %A Arfanakis, K. %A Aribisala, B. S. %A Armstrong, N. J. %A Athanasiu, L. %A Axelsson, T. %A Beecham, A. H. %A Beiser, A. %A Bernard, M. %A Blanton, S. H. %A Bohlken, M. M. %A Boks, M. P. %A Bralten, J. %A Brickman, A. M. %A Carmichael, O. %A Chakravarty, M. M. %A Chen, Q. %A Ching, C. R. K. %A Chouraki, V. %A Cuellar-Partida, G. %A Crivello, F. %A den Braber, A. %A Doan, N. T. %A Ehrlich, S. %A Giddaluru, S. %A Goldman, A. L. %A Gottesman, R. F. %A Grimm, O. %A Griswold, M. E. %A Guadalupe, T. %A Gutman, B. A. %A Hass, J. %A Haukvik, U. K. %A Hoehn, D. %A Holmes, A. J. %A Hoogman, M. %A Janowitz, D. %A Jia, T. %A J?rgensen, K. N. %A Karbalai, N. %A Kasperaviciute, D. %A Kim, S. %A Klein, M. %A Kraemer, B. %A Lee, P. H. %A Liewald, D. C. M. %A Lopez, L. M. %A Luciano, M. %A Macare, C. %A Marquand, A. F. %A Matarin, M. %A Mather, K. A. %A Mattheisen, M. %A McKay, D. R. %A Milaneschi, Y. %A Mu?oz Maniega, S. %A Nho, K. %A Nugent, A. C. %A Nyquist, P. %A Loohuis, L. M. O. %A Oosterlaan, J. %A Papmeyer, M. %A Pirpamer, L. %A P?tz, B. %A Ramasamy, A. %A Richards, J. S. %A Risacher, S. L. %A Roiz-Santia?ez, R. %A Rommelse, N. %A Ropele, S. %A Rose, E. J. %A Royle, N. A. %A Rundek, T. %A S?mann, P. G. %A Saremi, A. %A Satizabal, C. L. %A Schmaal, L. %A Schork, A. J. %A Shen, L. %A Shin, J. %A Shumskaya, E. %A Smith, A. V. %A Sprooten, E. %A Strike, L. T. %A Teumer, A. %A Tordesillas-Gutierrez, D. %A Toro, R. %A Trabzuni, D. %A Trompet, S. %A Vaidya, D. %A van der Grond, J. %A van der Lee, S. J. %A van der Meer, D. %A van Donkelaar, M. M. J. %A Van Eijk, K. R. %A van Erp, T. G. M. %A van Rooij, D. %A Walton, E. %A Westlye, L. T. %A Whelan, C. D. %A Windham, B. G. %A Winkler, A. M. %A Wittfeld, K. %A Woldehawariat, G. %A Wolf, C. %A Wolfers, T. %A Yanek, L. R. %A Yang, J. %A Zijdenbos, A. %A Zwiers, M. P. %A Agartz, I. %A Almasy, L. %A Ames, D. %A Amouyel, P. %A Andreassen, O. A. %A Arepalli, S. %A Assareh, A. A. %A Barral, S. %A Bastin, M. E. %A Becker, D. M. %A Becker, J. T. %A Bennett, D. A. %A Blangero, J. %A van Bokhoven, H. %A Boomsma, D. I. %A Brodaty, H. %A Brouwer, R. M. %A Brunner, H. G. %A Buckner, R. L. %A Buitelaar, J. K. %A Bulayeva, K. B. %A Cahn, W. %A Calhoun, V. D. %A Cannon, D. M. %A Cavalleri, G. L. %A Cheng, C. Y. %A Cichon, S. %A Cookson, M. R. %A Corvin, A. %A Crespo-Facorro, B. %A Curran, J. E. %A Czisch, M. %A Dale, A. M. %A Davies, G. E. %A de Craen, A. J. M. %A de Geus, E. J. C. %A De Jager, P. L. %A de Zubicaray, G. I. %A Deary, I. J. %A Debette, S. %A DeCarli, C. %A Delanty, N. %A Depondt, C. %A DeStefano, A. %A Dillman, A. %A Djurovic, S. %A Donohoe, G. %A Drevets, W. C. %A Duggirala, R. %A Dyer, T. D. %A Enzinger, C. %A Erk, S. %A Espeseth, T. %A Fedko, I. O. %A Fern?ndez, G. %A Ferrucci, L. %A Fisher, S. E. %A Fleischman, D. A. %A Ford, I. %A Fornage, M. %A Foroud, T. M. %A Fox, P. T. %A Francks, C. %A Fukunaga, M. %A Gibbs, J. R. %A Glahn, D. C. %A Gollub, R. L. %A G?ring, H. H. H. %A Green, R. C. %A Gruber, O. %A Gudnason, V. %A Guelfi, S. %A H?berg, A. K. %A Hansell, N. K. %A Hardy, J. %A Hartman, C. A. %A Hashimoto, R. %A Hegenscheid, K. %A Heinz, A. %A Le Hellard, S. %A Hernandez, D. G. %A Heslenfeld, D. J. %A Ho, B. C. %A Hoekstra, P. J. %A Hoffmann, W. %A Hofman, A. %A Holsboer, F. %A Homuth, G. %A Hosten, N. %A Hottenga, J. J. %A Huentelman, M. %A Hulshoff Pol, H. E. %A Ikeda, M. %A Jack, C. R. %A Jenkinson, M. %A Johnson, R. %A J?nsson, E. G. %A Jukema, J. W. %A Kahn, R. S. %A Kanai, R. %A Kloszewska, I. %A Knopman, D. S. %A Kochunov, P. %A Kwok, J. B. %A Lawrie, S. M. %A Lema?tre, H. %A Liu, X. %A Longo, D. L. %A Lopez, O. L. %A Lovestone, S. %A Martinez, O. %A Martinot, J. L. %A Mattay, V. S. %A McDonald, C. %A McIntosh, A. M. %A McMahon, F. J. %A McMahon, K. L. %A Mecocci, P. %A Melle, I. %A Meyer-Lindenberg, A. %A Mohnke, S. %A Montgomery, G. W. %A Morris, D. W. %A Mosley, T. H. %A M?hleisen, T. W. %A M?ller-Myhsok, B. %A Nalls, M. A. %A Nauck, M. %A Nichols, T. E. %A Niessen, W. J. %A N?then, M. M. %A Nyberg, L. %A Ohi, K. %A Olvera, R. L. %A Ophoff, R. A. %A Pandolfo, M. %A Paus, T. %A Pausova, Z. %A Penninx, B. W. J. H. %A Pike, G. B. %A Potkin, S. G. %A Psaty, B. M. %A Reppermund, S. %A Rietschel, M. %A Roffman, J. L. %A Romanczuk-Seiferth, N. %A Rotter, J. I. %A Ryten, M. %A Sacco, R. L. %A Sachdev, P. S. %A Saykin, A. J. %A Schmidt, R. %A Schmidt, H. %A Schofield, P. R. %A Sigursson, S. %A Simmons, A. %A Singleton, A. %A Sisodiya, S. M. %A Smith, C. %A Smoller, J. W. %A Soininen, H. %A Steen, V. M. %A Stott, D. J. %A Sussmann, J. E. %A Thalamuthu, A. %A Toga, A. W. %A Traynor, B. J. %A Troncoso, J. %A Tsolaki, M. %A Tzourio, C. %A Uitterlinden, A. G. %A Hern?ndez, M. C. V. %A Van der Brug, M. %A van der Lugt, A. %A Van der Wee, N. J. A. %A van Haren, N. E. M. %A van 't Ent, D. %A van Tol, M. J. %A Vardarajan, B. N. %A Vellas, B. %A Veltman, D. J. %A V?lzke, H. %A Walter, H. %A Wardlaw, J. M. %A Wassink, T. H. %A Weale, M. E. %A Weinberger, D. R. %A Weiner, M. W. %A Wen, W. %A Westman, E. %A White, T. %A Wong, T. Y. %A Wright, C. B. %A Zielke, R. H. %A Zonderman, A. B. %A Martin, N. G. %A van Duijn, C. M. %A Wright, M. J. %A Longstreth, W. T. %A Schumann, G. %A Grabe, H. J. %A Franke, B. %A Launer, L. J. %A Medland, S. E. %A Seshadri, S. %A Thompson, P. M. %A Ikram, M. A. %X The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence of a localized effect along the dentate gyrus, subiculum, CA1 and fissure. Further, we show that genetic variants associated with decreased hippocampal volume are also associated with increased risk for Alzheimer's disease (rg=-0.155). Our findings suggest novel biological pathways through which human genetic variation influences hippocampal volume and risk for neuropsychiatric illness. %B Nat Commun %V 8 %P 13624 %8 01 %G eng %0 Journal Article %J Stroke %D 2017 %T Omega-3 Fatty Acids and Incident Ischemic Stroke and Its Atherothrombotic and Cardioembolic Subtypes in 3 US Cohorts. %A Saber, Hamidreza %A Yakoob, Mohammad Yawar %A Shi, Peilin %A Longstreth, W T %A Lemaitre, Rozenn N %A Siscovick, David %A Rexrode, Kathryn M %A Willett, Walter C %A Mozaffarian, Dariush %K Adult %K Aged %K Aged, 80 and over %K Biomarkers %K Brain Ischemia %K Cardiovascular Diseases %K Case-Control Studies %K Cohort Studies %K Fatty Acids, Omega-3 %K Female %K Follow-Up Studies %K Humans %K Incidence %K Intracranial Arteriosclerosis %K Intracranial Embolism %K Intracranial Thrombosis %K Male %K Middle Aged %K Prospective Studies %K Random Allocation %K Risk Factors %K Stroke %K United States %X

BACKGROUND AND PURPOSE: The associations of individual long-chain n-3 polyunsaturated fatty acids with incident ischemic stroke and its main subtypes are not well established. We aimed to investigate prospectively the relationship of circulating eicosapentaenoic acid, docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with risk of total ischemic, atherothrombotic, and cardioembolic stroke.

METHODS: We measured circulating phospholipid fatty acids at baseline in 3 separate US cohorts: CHS (Cardiovascular Health Study), NHS (Nurses' Health Study), and HPFS (Health Professionals Follow-Up Study). Ischemic strokes were prospectively adjudicated and classified into atherothrombotic (large- and small-vessel infarctions) or cardioembolic by imaging studies and medical records. Risk according to fatty acid levels was assessed using Cox proportional hazards (CHS) or conditional logistic regression (NHS, HPFS) according to study design. Cohort findings were pooled using fixed-effects meta-analysis.

RESULTS: A total of 953 incident ischemic strokes were identified (408 atherothrombotic, 256 cardioembolic, and 289 undetermined subtypes) during median follow-up of 11.2 years (CHS) and 8.3 years (pooled, NHS and HPFS). After multivariable adjustment, lower risk of total ischemic stroke was seen with higher DPA (highest versus lowest quartiles; pooled hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.58-0.92) and DHA (HR, 0.80; 95% CI, 0.64-1.00) but not eicosapentaenoic acid (HR, 0.94; 95% CI, 0.77-1.19). DHA was associated with lower risk of atherothrombotic stroke (HR, 0.53; 95% CI, 0.34-0.83) and DPA with lower risk of cardioembolic stroke (HR, 0.58; 95% CI, 0.37-0.92). Findings in each individual cohort were consistent with pooled results.

CONCLUSIONS: In 3 large US cohorts, higher circulating levels of DHA were inversely associated with incident atherothrombotic stroke and DPA with cardioembolic stroke. These novel findings suggest differential pathways of benefit for DHA, DPA, and eicosapentaenoic acid.

%B Stroke %V 48 %P 2678-2685 %8 2017 Oct %G eng %N 10 %R 10.1161/STROKEAHA.117.018235 %0 Journal Article %J Circ Cardiovasc Genet %D 2017 %T PCSK9 Loss-of-Function Variants, Low-Density Lipoprotein Cholesterol, and Risk of Coronary Heart Disease and Stroke: Data From 9 Studies of Blacks and Whites. %A Kent, Shia T %A Rosenson, Robert S %A Avery, Christy L %A Chen, Yii-der I %A Correa, Adolfo %A Cummings, Steven R %A Cupples, L Adrienne %A Cushman, Mary %A Evans, Daniel S %A Gudnason, Vilmundur %A Harris, Tamara B %A Howard, George %A Irvin, Marguerite R %A Judd, Suzanne E %A Jukema, J Wouter %A Lange, Leslie %A Levitan, Emily B %A Li, Xiaohui %A Liu, Yongmei %A Post, Wendy S %A Postmus, Iris %A Psaty, Bruce M %A Rotter, Jerome I %A Safford, Monika M %A Sitlani, Colleen M %A Smith, Albert V %A Stewart, James D %A Trompet, Stella %A Sun, Fangui %A Vasan, Ramachandran S %A Woolley, J Michael %A Whitsel, Eric A %A Wiggins, Kerri L %A Wilson, James G %A Muntner, Paul %X

BACKGROUND: PCSK9 loss-of-function (LOF) variants allow for the examination of the effects of lifetime reduced low-density lipoprotein cholesterol (LDL-C) on cardiovascular events. We examined the association of PCSK9 LOF variants with LDL-C and incident coronary heart disease and stroke through a meta-analysis of data from 8 observational cohorts and 1 randomized trial of statin therapy.

METHODS AND RESULTS: These 9 studies together included 17 459 blacks with 403 (2.3%) having at least 1 Y142X or C679X variant and 31 306 whites with 955 (3.1%) having at least 1 R46L variant. Unadjusted odds ratios for associations between PCSK9 LOF variants and incident coronary heart disease (851 events in blacks and 2662 events in whites) and stroke (523 events in blacks and 1660 events in whites) were calculated using pooled Mantel-Haenszel estimates with continuity correction factors. Pooling results across studies using fixed-effects inverse-variance-weighted models, PCSK9 LOF variants were associated with 35 mg/dL (95% confidence interval [CI], 32-39) lower LDL-C in blacks and 13 mg/dL (95% CI, 11-16) lower LDL-C in whites. PCSK9 LOF variants were associated with a pooled odds ratio for coronary heart disease of 0.51 (95% CI, 0.28-0.92) in blacks and 0.82 (95% CI, 0.63-1.06) in whites. PCSK9 LOF variants were not associated with incident stroke (odds ratio, 0.84; 95% CI, 0.48-1.47 in blacks and odds ratio, 1.06; 95% CI, 0.80-1.41 in whites).

CONCLUSIONS: PCSK9 LOF variants were associated with lower LDL-C and coronary heart disease incidence. PCSK9 LOF variants were not associated with stroke risk.

%B Circ Cardiovasc Genet %V 10 %P e001632 %8 2017 Aug %G eng %N 4 %R 10.1161/CIRCGENETICS.116.001632 %0 Journal Article %J Pharmacogenomics J %D 2017 %T Pharmacogenomics study of thiazide diuretics and QT interval in multi-ethnic populations: the cohorts for heart and aging research in genomic epidemiology. %A Seyerle, A A %A Sitlani, C M %A Noordam, R %A Gogarten, S M %A Li, J %A Li, X %A Evans, D S %A Sun, F %A Laaksonen, M A %A Isaacs, A %A Kristiansson, K %A Highland, H M %A Stewart, J D %A Harris, T B %A Trompet, S %A Bis, J C %A Peloso, G M %A Brody, J A %A Broer, L %A Busch, E L %A Duan, Q %A Stilp, A M %A O'Donnell, C J %A Macfarlane, P W %A Floyd, J S %A Kors, J A %A Lin, H J %A Li-Gao, R %A Sofer, T %A Méndez-Giráldez, R %A Cummings, S R %A Heckbert, S R %A Hofman, A %A Ford, I %A Li, Y %A Launer, L J %A Porthan, K %A Newton-Cheh, C %A Napier, M D %A Kerr, K F %A Reiner, A P %A Rice, K M %A Roach, J %A Buckley, B M %A Soliman, E Z %A de Mutsert, R %A Sotoodehnia, N %A Uitterlinden, A G %A North, K E %A Lee, C R %A Gudnason, V %A Stürmer, T %A Rosendaal, F R %A Taylor, K D %A Wiggins, K L %A Wilson, J G %A Chen, Y-DI %A Kaplan, R C %A Wilhelmsen, K %A Cupples, L A %A Salomaa, V %A van Duijn, C %A Jukema, J W %A Liu, Y %A Mook-Kanamori, D O %A Lange, L A %A Vasan, R S %A Smith, A V %A Stricker, B H %A Laurie, C C %A Rotter, J I %A Whitsel, E A %A Psaty, B M %A Avery, C L %X

Thiazide diuretics, commonly used antihypertensives, may cause QT interval (QT) prolongation, a risk factor for highly fatal and difficult to predict ventricular arrhythmias. We examined whether common single-nucleotide polymorphisms (SNPs) modified the association between thiazide use and QT or its component parts (QRS interval, JT interval) by performing ancestry-specific, trans-ethnic and cross-phenotype genome-wide analyses of European (66%), African American (15%) and Hispanic (19%) populations (N=78 199), leveraging longitudinal data, incorporating corrected standard errors to account for underestimation of interaction estimate variances and evaluating evidence for pathway enrichment. Although no loci achieved genome-wide significance (P<5 × 10(-8)), we found suggestive evidence (P<5 × 10(-6)) for SNPs modifying the thiazide-QT association at 22 loci, including ion transport loci (for example, NELL1, KCNQ3). The biologic plausibility of our suggestive results and simulations demonstrating modest power to detect interaction effects at genome-wide significant levels indicate that larger studies and innovative statistical methods are warranted in future efforts evaluating thiazide-SNP interactions.The Pharmacogenomics Journal advance online publication, 18 July 2017; doi:10.1038/tpj.2017.10.

%B Pharmacogenomics J %8 2017 Jul 18 %G eng %R 10.1038/tpj.2017.10 %0 Journal Article %J Ann Clin Transl Neurol %D 2017 %T Physical activity predicts reduced plasma β amyloid in the Cardiovascular Health Study. %A Stillman, Chelsea M %A Lopez, Oscar L %A Becker, James T %A Kuller, Lewis H %A Mehta, Pankaj D %A Tracy, Russell P %A Erickson, Kirk I %X

OBJECTIVE: Higher levels of physical activity (PA) reduce the risk of cognitive impairment, but the underlying mechanisms are unclear. Using longitudinal data from the Cardiovascular Health Study, we examined whether PA predicted plasma Aβ levels and risk for cognitive decline 9-13 years later.

METHODS: Linear and logistic regressions (controlling for APOE status, age, gender, body mass index, cardiovascular disease, brain white matter lesions, and cystatin C levels) tested associations between PA, Aβ, and cognitive impairment in a sample of 149 cognitively normal older adults (mean age 83 years).

RESULTS: More PA at baseline predicted lower levels of Aβ 9-13 years later. Higher Aβ levels at year 9 predicted greater risk for cognitive impairment at year 13. Levels of Aβ at year 9 mediated the relationship between PA and cognitive impairment.

INTERPRETATION: Greater PA may reduce plasma levels of a neurotoxic peptide at an age when the risk for cognitive impairment is especially high.

%B Ann Clin Transl Neurol %V 4 %P 284-291 %8 2017 May %G eng %N 5 %R 10.1002/acn3.397 %0 Journal Article %J Eur J Heart Fail %D 2017 %T Predictors and outcomes of heart failure with mid-range ejection fraction. %A Bhambhani, Vijeta %A Kizer, Jorge R %A Lima, João A C %A van der Harst, Pim %A Bahrami, Hossein %A Nayor, Matthew %A de Filippi, Christopher R %A Enserro, Danielle %A Blaha, Michael J %A Cushman, Mary %A Wang, Thomas J %A Gansevoort, Ron T %A Fox, Caroline S %A Gaggin, Hanna K %A Kop, Willem J %A Liu, Kiang %A Vasan, Ramachandran S %A Psaty, Bruce M %A Lee, Douglas S %A Brouwers, Frank P %A Hillege, Hans L %A Bartz, Traci M %A Benjamin, Emelia J %A Chan, Cheeling %A Allison, Matthew %A Gardin, Julius M %A Januzzi, James L %A Levy, Daniel %A Herrington, David M %A van Gilst, Wiek H %A Bertoni, Alain G %A Larson, Martin G %A de Boer, Rudolf A %A Gottdiener, John S %A Shah, Sanjiv J %A Ho, Jennifer E %X

AIMS: While heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF) are well described, determinants and outcomes of heart failure with mid-range ejection fraction (HFmrEF) remain unclear. We sought to examine clinical and biochemical predictors of incident HFmrEF in the community.

METHODS AND RESULTS: We pooled data from four community-based longitudinal cohorts, with ascertainment of new heart failure (HF) classified into HFmrEF [ejection fraction (EF) 41-49%], HFpEF (EF ≥50%), and HFrEF (EF ≤40%). Predictors of incident HF subtypes were assessed using multivariable Cox models. Among 28 820 participants free of HF followed for a median of 12 years, there were 200 new HFmrEF cases, compared with 811 HFpEF and 1048 HFrEF. Clinical predictors of HFmrEF included age, male sex, systolic blood pressure, diabetes mellitus, and prior myocardial infarction (multivariable adjusted P ≤ 0.003 for all). Biomarkers that predicted HFmrEF included natriuretic peptides, cystatin-C, and high-sensitivity troponin (P ≤ 0.0004 for all). Natriuretic peptides were stronger predictors of HFrEF [hazard ratio (HR) 2.00 per 1 standard deviation increase, 95% confidence interval (CI) 1.81-2.20] than of HFmrEF (HR 1.51, 95% CI 1.20-1.90, P = 0.01 for difference), and did not differ in their association with incident HFmrEF and HFpEF (HR 1.56, 95% CI 1.41-1.73, P = 0.68 for difference). All-cause mortality following the onset of HFmrEF was worse than that of HFpEF (50 vs. 39 events per 1000 person-years, P = 0.02), but comparable to that of HFrEF (46 events per 1000 person-years, P = 0.78).

CONCLUSIONS: We found overlap in predictors of incident HFmrEF with other HF subtypes. In contrast, mortality risk after HFmrEF was worse than HFpEF, and similar to HFrEF.

%B Eur J Heart Fail %8 2017 Dec 11 %G eng %R 10.1002/ejhf.1091 %0 Journal Article %J Neurology %D 2017 %T Predictors of incident epilepsy in older adults: The Cardiovascular Health Study. %A Choi, Hyunmi %A Pack, Alison %A Elkind, Mitchell S V %A Longstreth, W T %A Ton, Thanh G N %A Onchiri, Frankline %X

OBJECTIVE: To determine the prevalence, incidence, and predictors of epilepsy among older adults in the Cardiovascular Health Study (CHS).

METHODS: We analyzed data prospectively collected in CHS and merged with data from outpatient Medicare administrative claims. We identified cases with epilepsy using self-report, antiepileptic medication, hospitalization discharge ICD-9 codes, and outpatient Medicare ICD-9 codes. We used Cox proportional hazards regression to identify factors independently associated with incident epilepsy.

RESULTS: At baseline, 42% of the 5,888 participants were men and 84% were white. At enrollment, 3.7% (215 of 5,888) met the criteria for prevalent epilepsy. During 14 years of follow-up totaling 48,651 person-years, 120 participants met the criteria for incident epilepsy, yielding an incidence rate of 2.47 per 1,000 person-years. The period prevalence of epilepsy by the end of follow-up was 5.7% (335 of 5,888). Epilepsy incidence rates were significantly higher among blacks than nonblacks: 4.44 vs 2.17 per 1,000 person-years (p < 0.001). In multivariable analyses, risk of incident epilepsy was significantly higher among blacks compared to nonblacks (hazard ratio [HR] 4.04, 95% confidence interval [CI] 1.99-8.17), those 75 to 79 compared to those 65 to 69 years of age (HR 2.07, 95% CI 1.21-3.55), and those with history of stroke (HR 3.49, 95% CI 1.37-8.88).

CONCLUSIONS: Epilepsy in older adults in the United States was common. Blacks, the very old, and those with history of stroke have a higher risk of incident epilepsy. The association with race remains unexplained.

%B Neurology %V 88 %P 870-877 %8 2017 Feb 28 %G eng %N 9 %R 10.1212/WNL.0000000000003662 %0 Journal Article %J Nat Genet %D 2017 %T Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease. %A Sims, Rebecca %A van der Lee, Sven J %A Naj, Adam C %A Bellenguez, Céline %A Badarinarayan, Nandini %A Jakobsdottir, Johanna %A Kunkle, Brian W %A Boland, Anne %A Raybould, Rachel %A Bis, Joshua C %A Martin, Eden R %A Grenier-Boley, Benjamin %A Heilmann-Heimbach, Stefanie %A Chouraki, Vincent %A Kuzma, Amanda B %A Sleegers, Kristel %A Vronskaya, Maria %A Ruiz, Agustin %A Graham, Robert R %A Olaso, Robert %A Hoffmann, Per %A Grove, Megan L %A Vardarajan, Badri N %A Hiltunen, Mikko %A Nöthen, Markus M %A White, Charles C %A Hamilton-Nelson, Kara L %A Epelbaum, Jacques %A Maier, Wolfgang %A Choi, Seung-Hoan %A Beecham, Gary W %A Dulary, Cécile %A Herms, Stefan %A Smith, Albert V %A Funk, Cory C %A Derbois, Céline %A Forstner, Andreas J %A Ahmad, Shahzad %A Li, Hongdong %A Bacq, Delphine %A Harold, Denise %A Satizabal, Claudia L %A Valladares, Otto %A Squassina, Alessio %A Thomas, Rhodri %A Brody, Jennifer A %A Qu, Liming %A Sánchez-Juan, Pascual %A Morgan, Taniesha %A Wolters, Frank J %A Zhao, Yi %A Garcia, Florentino Sanchez %A Denning, Nicola %A Fornage, Myriam %A Malamon, John %A Naranjo, Maria Candida Deniz %A Majounie, Elisa %A Mosley, Thomas H %A Dombroski, Beth %A Wallon, David %A Lupton, Michelle K %A Dupuis, Josée %A Whitehead, Patrice %A Fratiglioni, Laura %A Medway, Christopher %A Jian, Xueqiu %A Mukherjee, Shubhabrata %A Keller, Lina %A Brown, Kristelle %A Lin, Honghuang %A Cantwell, Laura B %A Panza, Francesco %A McGuinness, Bernadette %A Moreno-Grau, Sonia %A Burgess, Jeremy D %A Solfrizzi, Vincenzo %A Proitsi, Petra %A Adams, Hieab H %A Allen, Mariet %A Seripa, Davide %A Pastor, Pau %A Cupples, L Adrienne %A Price, Nathan D %A Hannequin, Didier %A Frank-García, Ana %A Levy, Daniel %A Chakrabarty, Paramita %A Caffarra, Paolo %A Giegling, Ina %A Beiser, Alexa S %A Giedraitis, Vilmantas %A Hampel, Harald %A Garcia, Melissa E %A Wang, Xue %A Lannfelt, Lars %A Mecocci, Patrizia %A Eiriksdottir, Gudny %A Crane, Paul K %A Pasquier, Florence %A Boccardi, Virginia %A Henández, Isabel %A Barber, Robert C %A Scherer, Martin %A Tarraga, Lluis %A Adams, Perrie M %A Leber, Markus %A Chen, Yuning %A Albert, Marilyn S %A Riedel-Heller, Steffi %A Emilsson, Valur %A Beekly, Duane %A Braae, Anne %A Schmidt, Reinhold %A Blacker, Deborah %A Masullo, Carlo %A Schmidt, Helena %A Doody, Rachelle S %A Spalletta, Gianfranco %A Jr, W T Longstreth %A Fairchild, Thomas J %A Bossù, Paola %A Lopez, Oscar L %A Frosch, Matthew P %A Sacchinelli, Eleonora %A Ghetti, Bernardino %A Yang, Qiong %A Huebinger, Ryan M %A Jessen, Frank %A Li, Shuo %A Kamboh, M Ilyas %A Morris, John %A Sotolongo-Grau, Oscar %A Katz, Mindy J %A Corcoran, Chris %A Dunstan, Melanie %A Braddel, Amy %A Thomas, Charlene %A Meggy, Alun %A Marshall, Rachel %A Gerrish, Amy %A Chapman, Jade %A Aguilar, Miquel %A Taylor, Sarah %A Hill, Matt %A Fairén, Mònica Díez %A Hodges, Angela %A Vellas, Bruno %A Soininen, Hilkka %A Kloszewska, Iwona %A Daniilidou, Makrina %A Uphill, James %A Patel, Yogen %A Hughes, Joseph T %A Lord, Jenny %A Turton, James %A Hartmann, Annette M %A Cecchetti, Roberta %A Fenoglio, Chiara %A Serpente, Maria %A Arcaro, Marina %A Caltagirone, Carlo %A Orfei, Maria Donata %A Ciaramella, Antonio %A Pichler, Sabrina %A Mayhaus, Manuel %A Gu, Wei %A Lleo, Alberto %A Fortea, Juan %A Blesa, Rafael %A Barber, Imelda S %A Brookes, Keeley %A Cupidi, Chiara %A Maletta, Raffaele Giovanni %A Carrell, David %A Sorbi, Sandro %A Moebus, Susanne %A Urbano, Maria %A Pilotto, Alberto %A Kornhuber, Johannes %A Bosco, Paolo %A Todd, Stephen %A Craig, David %A Johnston, Janet %A Gill, Michael %A Lawlor, Brian %A Lynch, Aoibhinn %A Fox, Nick C %A Hardy, John %A Albin, Roger L %A Apostolova, Liana G %A Arnold, Steven E %A Asthana, Sanjay %A Atwood, Craig S %A Baldwin, Clinton T %A Barnes, Lisa L %A Barral, Sandra %A Beach, Thomas G %A Becker, James T %A Bigio, Eileen H %A Bird, Thomas D %A Boeve, Bradley F %A Bowen, James D %A Boxer, Adam %A Burke, James R %A Burns, Jeffrey M %A Buxbaum, Joseph D %A Cairns, Nigel J %A Cao, Chuanhai %A Carlson, Chris S %A Carlsson, Cynthia M %A Carney, Regina M %A Carrasquillo, Minerva M %A Carroll, Steven L %A Diaz, Carolina Ceballos %A Chui, Helena C %A Clark, David G %A Cribbs, David H %A Crocco, Elizabeth A %A DeCarli, Charles %A Dick, Malcolm %A Duara, Ranjan %A Evans, Denis A %A Faber, Kelley M %A Fallon, Kenneth B %A Fardo, David W %A Farlow, Martin R %A Ferris, Steven %A Foroud, Tatiana M %A Galasko, Douglas R %A Gearing, Marla %A Geschwind, Daniel H %A Gilbert, John R %A Graff-Radford, Neill R %A Green, Robert C %A Growdon, John H %A Hamilton, Ronald L %A Harrell, Lindy E %A Honig, Lawrence S %A Huentelman, Matthew J %A Hulette, Christine M %A Hyman, Bradley T %A Jarvik, Gail P %A Abner, Erin %A Jin, Lee-Way %A Jun, Gyungah %A Karydas, Anna %A Kaye, Jeffrey A %A Kim, Ronald %A Kowall, Neil W %A Kramer, Joel H %A LaFerla, Frank M %A Lah, James J %A Leverenz, James B %A Levey, Allan I %A Li, Ge %A Lieberman, Andrew P %A Lunetta, Kathryn L %A Lyketsos, Constantine G %A Marson, Daniel C %A Martiniuk, Frank %A Mash, Deborah C %A Masliah, Eliezer %A McCormick, Wayne C %A McCurry, Susan M %A McDavid, Andrew N %A McKee, Ann C %A Mesulam, Marsel %A Miller, Bruce L %A Miller, Carol A %A Miller, Joshua W %A Morris, John C %A Murrell, Jill R %A Myers, Amanda J %A O'Bryant, Sid %A Olichney, John M %A Pankratz, Vernon S %A Parisi, Joseph E %A Paulson, Henry L %A Perry, William %A Peskind, Elaine %A Pierce, Aimee %A Poon, Wayne W %A Potter, Huntington %A Quinn, Joseph F %A Raj, Ashok %A Raskind, Murray %A Reisberg, Barry %A Reitz, Christiane %A Ringman, John M %A Roberson, Erik D %A Rogaeva, Ekaterina %A Rosen, Howard J %A Rosenberg, Roger N %A Sager, Mark A %A Saykin, Andrew J %A Schneider, Julie A %A Schneider, Lon S %A Seeley, William W %A Smith, Amanda G %A Sonnen, Joshua A %A Spina, Salvatore %A Stern, Robert A %A Swerdlow, Russell H %A Tanzi, Rudolph E %A Thornton-Wells, Tricia A %A Trojanowski, John Q %A Troncoso, Juan C %A Van Deerlin, Vivianna M %A Van Eldik, Linda J %A Vinters, Harry V %A Vonsattel, Jean Paul %A Weintraub, Sandra %A Welsh-Bohmer, Kathleen A %A Wilhelmsen, Kirk C %A Williamson, Jennifer %A Wingo, Thomas S %A Woltjer, Randall L %A Wright, Clinton B %A Yu, Chang-En %A Yu, Lei %A Garzia, Fabienne %A Golamaully, Feroze %A Septier, Gislain %A Engelborghs, Sebastien %A Vandenberghe, Rik %A De Deyn, Peter P %A Fernadez, Carmen Muñoz %A Benito, Yoland Aladro %A Thonberg, Håkan %A Forsell, Charlotte %A Lilius, Lena %A Kinhult-Ståhlbom, Anne %A Kilander, Lena %A Brundin, RoseMarie %A Concari, Letizia %A Helisalmi, Seppo %A Koivisto, Anne Maria %A Haapasalo, Annakaisa %A Dermecourt, Vincent %A Fiévet, Nathalie %A Hanon, Olivier %A Dufouil, Carole %A Brice, Alexis %A Ritchie, Karen %A Dubois, Bruno %A Himali, Jayanadra J %A Keene, C Dirk %A Tschanz, JoAnn %A Fitzpatrick, Annette L %A Kukull, Walter A %A Norton, Maria %A Aspelund, Thor %A Larson, Eric B %A Munger, Ron %A Rotter, Jerome I %A Lipton, Richard B %A Bullido, María J %A Hofman, Albert %A Montine, Thomas J %A Coto, Eliecer %A Boerwinkle, Eric %A Petersen, Ronald C %A Alvarez, Victoria %A Rivadeneira, Fernando %A Reiman, Eric M %A Gallo, Maura %A O'Donnell, Christopher J %A Reisch, Joan S %A Bruni, Amalia Cecilia %A Royall, Donald R %A Dichgans, Martin %A Sano, Mary %A Galimberti, Daniela %A St George-Hyslop, Peter %A Scarpini, Elio %A Tsuang, Debby W %A Mancuso, Michelangelo %A Bonuccelli, Ubaldo %A Winslow, Ashley R %A Daniele, Antonio %A Wu, Chuang-Kuo %A Peters, Oliver %A Nacmias, Benedetta %A Riemenschneider, Matthias %A Heun, Reinhard %A Brayne, Carol %A Rubinsztein, David C %A Bras, Jose %A Guerreiro, Rita %A Al-Chalabi, Ammar %A Shaw, Christopher E %A Collinge, John %A Mann, David %A Tsolaki, Magda %A Clarimon, Jordi %A Sussams, Rebecca %A Lovestone, Simon %A O'Donovan, Michael C %A Owen, Michael J %A Behrens, Timothy W %A Mead, Simon %A Goate, Alison M %A Uitterlinden, André G %A Holmes, Clive %A Cruchaga, Carlos %A Ingelsson, Martin %A Bennett, David A %A Powell, John %A Golde, Todd E %A Graff, Caroline %A De Jager, Philip L %A Morgan, Kevin %A Ertekin-Taner, Nilufer %A Combarros, Onofre %A Psaty, Bruce M %A Passmore, Peter %A Younkin, Steven G %A Berr, Claudine %A Gudnason, Vilmundur %A Rujescu, Dan %A Dickson, Dennis W %A Dartigues, Jean-François %A DeStefano, Anita L %A Ortega-Cubero, Sara %A Hakonarson, Hakon %A Campion, Dominique %A Boada, Merce %A Kauwe, John Keoni %A Farrer, Lindsay A %A Van Broeckhoven, Christine %A Ikram, M Arfan %A Jones, Lesley %A Haines, Jonathan L %A Tzourio, Christophe %A Launer, Lenore J %A Escott-Price, Valentina %A Mayeux, Richard %A Deleuze, Jean-Francois %A Amin, Najaf %A Holmans, Peter A %A Pericak-Vance, Margaret A %A Amouyel, Philippe %A van Duijn, Cornelia M %A Ramirez, Alfredo %A Wang, Li-San %A Lambert, Jean-Charles %A Seshadri, Sudha %A Williams, Julie %A Schellenberg, Gerard D %K Adaptor Proteins, Signal Transducing %K Alzheimer Disease %K Amino Acid Sequence %K Case-Control Studies %K Exome %K Gene Expression Profiling %K Gene Frequency %K Genetic Predisposition to Disease %K Genotype %K Humans %K Immunity, Innate %K Linkage Disequilibrium %K Membrane Glycoproteins %K Microglia %K Odds Ratio %K Phospholipase C gamma %K Polymorphism, Single Nucleotide %K Protein Interaction Maps %K Receptors, Immunologic %K Sequence Homology, Amino Acid %X

We identified rare coding variants associated with Alzheimer's disease in a three-stage case-control study of 85,133 subjects. In stage 1, we genotyped 34,174 samples using a whole-exome microarray. In stage 2, we tested associated variants (P < 1 × 10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, we used an additional 14,997 samples to test the most significant stage 2 associations (P < 5 × 10-8) using imputed genotypes. We observed three new genome-wide significant nonsynonymous variants associated with Alzheimer's disease: a protective variant in PLCG2 (rs72824905: p.Pro522Arg, P = 5.38 × 10-10, odds ratio (OR) = 0.68, minor allele frequency (MAF)cases = 0.0059, MAFcontrols = 0.0093), a risk variant in ABI3 (rs616338: p.Ser209Phe, P = 4.56 × 10-10, OR = 1.43, MAFcases = 0.011, MAFcontrols = 0.008), and a new genome-wide significant variant in TREM2 (rs143332484: p.Arg62His, P = 1.55 × 10-14, OR = 1.67, MAFcases = 0.0143, MAFcontrols = 0.0089), a known susceptibility gene for Alzheimer's disease. These protein-altering changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified risk genes in Alzheimer's disease. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to the development of Alzheimer's disease.

%B Nat Genet %V 49 %P 1373-1384 %8 2017 Sep %G eng %N 9 %R 10.1038/ng.3916 %0 Journal Article %J PLoS Genet %D 2017 %T Rare coding variants pinpoint genes that control human hematological traits. %A Mousas, Abdou %A Ntritsos, Georgios %A Chen, Ming-Huei %A Song, Ci %A Huffman, Jennifer E %A Tzoulaki, Ioanna %A Elliott, Paul %A Psaty, Bruce M %A Auer, Paul L %A Johnson, Andrew D %A Evangelou, Evangelos %A Lettre, Guillaume %A Reiner, Alexander P %K Asthma %K Databases, Genetic %K Endometriosis %K Female %K Fibrin Fibrinogen Degradation Products %K Gene Frequency %K Genetic Loci %K Genome, Human %K Genome-Wide Association Study %K Humans %K Interleukin-33 %K Linear Models %K Logistic Models %K Male %K Mutation, Missense %K Phenotype %K Plasminogen %K Platelet Count %K Polymorphism, Single Nucleotide %K Principal Component Analysis %K Protein Splicing %K Rhinitis, Allergic %K Sequence Analysis, DNA %X

The identification of rare coding or splice site variants remains the most straightforward strategy to link genes with human phenotypes. Here, we analyzed the association between 137,086 rare (minor allele frequency (MAF) <1%) coding or splice site variants and 15 hematological traits in up to 308,572 participants. We found 56 such rare coding or splice site variants at P<5x10-8, including 31 that are associated with a blood-cell phenotype for the first time. All but one of these 31 new independent variants map to loci previously implicated in hematopoiesis by genome-wide association studies (GWAS). This includes a rare splice acceptor variant (rs146597587, MAF = 0.5%) in interleukin 33 (IL33) associated with reduced eosinophil count (P = 2.4x10-23), and lower risk of asthma (P = 2.6x10-7, odds ratio [95% confidence interval] = 0.56 [0.45-0.70]) and allergic rhinitis (P = 4.2x10-4, odds ratio = 0.55 [0.39-0.76]). The single new locus identified in our study is defined by a rare p.Arg172Gly missense variant (rs145535174, MAF = 0.05%) in plasminogen (PLG) associated with increased platelet count (P = 6.8x10-9), and decreased D-dimer concentration (P = 0.018) and platelet reactivity (P<0.03). Finally, our results indicate that searching for rare coding or splice site variants in very large sample sizes can help prioritize causal genes at many GWAS loci associated with complex human diseases and traits.

%B PLoS Genet %V 13 %P e1006925 %8 2017 Aug %G eng %N 8 %R 10.1371/journal.pgen.1006925 %0 Journal Article %J J Am Coll Cardiol %D 2017 %T Relationship Between Physical Activity, Body Mass Index, and Risk of Heart Failure. %A Pandey, Ambarish %A LaMonte, Michael %A Klein, Liviu %A Ayers, Colby %A Psaty, Bruce M %A Eaton, Charles B %A Allen, Norrina B %A de Lemos, James A %A Carnethon, Mercedes %A Greenland, Philip %A Berry, Jarett D %X

BACKGROUND: Lower leisure-time physical activity (LTPA) and higher body mass index (BMI) are independently associated with risk of heart failure (HF). However, it is unclear if this relationship is consistent for both heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).

OBJECTIVES: This study sought to quantify dose-response associations between LTPA, BMI, and the risk of different HF subtypes.

METHODS: Individual-level data from 3 cohort studies (WHI [Women's Health Initiative], MESA [Multi-Ethnic Study of Atherosclerosis], and CHS [Cardiovascular Health Study]) were pooled and participants were stratified into guideline-recommended categories of LTPA and BMI. Associations between LTPA, BMI, and risk of overall HF, HFpEF (ejection fraction ≥45%), and HFrEF (ejection fraction <45%) were assessed by using multivariable adjusted Cox models and restricted cubic splines.

RESULTS: The study included 51,451 participants with 3,180 HF events (1,252 HFpEF, 914 HFrEF, and 1,014 unclassified HF). In the adjusted analysis, there was a dose-dependent association between higher LTPA levels, lower BMI, and overall HF risk. Among HF subtypes, LTPA in any dose range was not associated with HFrEF risk. In contrast, lower levels of LTPA (<500 MET-min/week) were not associated with HFpEF risk, and dose-dependent associations with lower HFpEF risk were observed at higher levels. Compared with no LTPA, higher than twice the guideline-recommended minimum LTPA levels (>1,000 MET-min/week) were associated with an 19% lower risk of HFpEF (hazard ratio: 0.81; 95% confidence interval: 0.68 to 0.97). The dose-response relationship for BMI with HFpEF risk was also more consistent than with HFrEF risk, such that increasing BMI above the normal range (≥25 kg/m(2)) was associated with a greater increase in risk of HFpEF than HFrEF.

CONCLUSIONS: Our study findings show strong, dose-dependent associations between LTPA levels, BMI, and risk of overall HF. Among HF subtypes, higher LTPA levels and lower BMI were more consistently associated with lower risk of HFpEF compared with HFrEF.

%B J Am Coll Cardiol %V 69 %P 1129-1142 %8 2017 Mar 07 %G eng %N 9 %R 10.1016/j.jacc.2016.11.081 %0 Journal Article %J Transl Psychiatry %D 2017 %T Short telomere length is associated with impaired cognitive performance in European ancestry cohorts. %A Hägg, S %A Zhan, Y %A Karlsson, R %A Gerritsen, L %A Ploner, A %A van der Lee, S J %A Broer, L %A Deelen, J %A Marioni, R E %A Wong, A %A Lundquist, A %A Zhu, G %A Hansell, N K %A Sillanpää, E %A Fedko, I O %A Amin, N A %A Beekman, M %A de Craen, A J M %A Degerman, S %A Harris, S E %A Kan, K-J %A Martin-Ruiz, C M %A Montgomery, G W %A Adolfsson, A N %A Reynolds, C A %A Samani, N J %A Suchiman, H E D %A Viljanen, A %A von Zglinicki, T %A Wright, M J %A Hottenga, J-J %A Boomsma, D I %A Rantanen, T %A Kaprio, J A %A Nyholt, D R %A Martin, N G %A Nyberg, L %A Adolfsson, R %A Kuh, D %A Starr, J M %A Deary, I J %A Slagboom, P E %A van Duijn, C M %A Codd, V %A Pedersen, N L %K Adult %K Aged %K Apolipoprotein E4 %K Cognitive Dysfunction %K Cohort Studies %K European Continental Ancestry Group %K Female %K Genetic Carrier Screening %K Genotype %K Humans %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Neuropsychological Tests %K Psychometrics %K Statistics as Topic %K Telomere %X

The association between telomere length (TL) dynamics on cognitive performance over the life-course is not well understood. This study meta-analyses observational and causal associations between TL and six cognitive traits, with stratifications on APOE genotype, in a Mendelian Randomization (MR) framework. Twelve European cohorts (N=17 052; mean age=59.2±8.8 years) provided results for associations between qPCR-measured TL (T/S-ratio scale) and general cognitive function, mini-mental state exam (MMSE), processing speed by digit symbol substitution test (DSST), visuospatial functioning, memory and executive functioning (STROOP). In addition, a genetic risk score (GRS) for TL including seven known genetic variants for TL was calculated, and used in associations with cognitive traits as outcomes in all cohorts. Observational analyses showed that longer telomeres were associated with better scores on DSST (β=0.051 per s.d.-increase of TL; 95% confidence interval (CI): 0.024, 0.077; P=0.0002), and MMSE (β=0.025; 95% CI: 0.002, 0.047; P=0.03), and faster STROOP (β=-0.053; 95% CI: -0.087, -0.018; P=0.003). Effects for DSST were stronger in APOE ɛ4 non-carriers (β=0.081; 95% CI: 0.045, 0.117; P=1.0 × 10-5), whereas carriers performed better in STROOP (β=-0.074; 95% CI: -0.140, -0.009; P=0.03). Causal associations were found for STROOP only (β=-0.598 per s.d.-increase of TL; 95% CI: -1.125, -0.072; P=0.026), with a larger effect in ɛ4-carriers (β=-0.699; 95% CI: -1.330, -0.069; P=0.03). Two-sample replication analyses using CHARGE summary statistics showed causal effects between TL and general cognitive function and DSST, but not with STROOP. In conclusion, we suggest causal effects from longer TL on better cognitive performance, where APOE ɛ4-carriers might be at differential risk.

%B Transl Psychiatry %V 7 %P e1100 %8 2017 04 18 %G eng %N 4 %R 10.1038/tp.2017.73 %0 Journal Article %J PLoS Genet %D 2017 %T Single-trait and multi-trait genome-wide association analyses identify novel loci for blood pressure in African-ancestry populations. %A Liang, Jingjing %A Le, Thu H %A Edwards, Digna R Velez %A Tayo, Bamidele O %A Gaulton, Kyle J %A Smith, Jennifer A %A Lu, Yingchang %A Jensen, Richard A %A Chen, Guanjie %A Yanek, Lisa R %A Schwander, Karen %A Tajuddin, Salman M %A Sofer, Tamar %A Kim, Wonji %A Kayima, James %A McKenzie, Colin A %A Fox, Ervin %A Nalls, Michael A %A Young, J Hunter %A Sun, Yan V %A Lane, Jacqueline M %A Cechova, Sylvia %A Zhou, Jie %A Tang, Hua %A Fornage, Myriam %A Musani, Solomon K %A Wang, Heming %A Lee, Juyoung %A Adeyemo, Adebowale %A Dreisbach, Albert W %A Forrester, Terrence %A Chu, Pei-Lun %A Cappola, Anne %A Evans, Michele K %A Morrison, Alanna C %A Martin, Lisa W %A Wiggins, Kerri L %A Hui, Qin %A Zhao, Wei %A Jackson, Rebecca D %A Ware, Erin B %A Faul, Jessica D %A Reiner, Alex P %A Bray, Michael %A Denny, Joshua C %A Mosley, Thomas H %A Palmas, Walter %A Guo, Xiuqing %A Papanicolaou, George J %A Penman, Alan D %A Polak, Joseph F %A Rice, Kenneth %A Taylor, Ken D %A Boerwinkle, Eric %A Bottinger, Erwin P %A Liu, Kiang %A Risch, Neil %A Hunt, Steven C %A Kooperberg, Charles %A Zonderman, Alan B %A Laurie, Cathy C %A Becker, Diane M %A Cai, Jianwen %A Loos, Ruth J F %A Psaty, Bruce M %A Weir, David R %A Kardia, Sharon L R %A Arnett, Donna K %A Won, Sungho %A Edwards, Todd L %A Redline, Susan %A Cooper, Richard S %A Rao, D C %A Rotter, Jerome I %A Rotimi, Charles %A Levy, Daniel %A Chakravarti, Aravinda %A Zhu, Xiaofeng %A Franceschini, Nora %K African Americans %K Animals %K Basic Helix-Loop-Helix Transcription Factors %K Blood Pressure %K Cadherins %K Case-Control Studies %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Hypertension %K Male %K Membrane Proteins %K Mice %K Multifactorial Inheritance %K Polymorphism, Single Nucleotide %X

Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25×10-8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH/TMBIM4) and multiple-trait analyses identified one novel locus (FRMD3) for blood pressure. At these three loci, as well as at GRP20/CDH17, associated variants had alleles common only in African-ancestry populations. Functional annotation showed enrichment for genes expressed in immune and kidney cells, as well as in heart and vascular cells/tissues. Experiments driven by these findings and using angiotensin-II induced hypertension in mice showed altered kidney mRNA expression of six genes, suggesting their potential role in hypertension. Our study provides new evidence for genes related to hypertension susceptibility, and the need to study African-ancestry populations in order to identify biologic factors contributing to hypertension.

%B PLoS Genet %V 13 %P e1006728 %8 2017 May %G eng %N 5 %R 10.1371/journal.pgen.1006728 %0 Journal Article %J J Bone Miner Res %D 2017 %T Soluble Inflammatory Markers and Risk of Incident Fractures in Older Adults: The Cardiovascular Health Study. %A Stojanović, Danijela %A Bůzková, Petra %A Mukamal, Kenneth J %A Heckbert, Susan R %A Psaty, Bruce M %A Fink, Howard A %A Cauley, Jane A %A Wallace, Erin %A Curtis, Lesley H %A Hirsch, Calvin %A Budoff, Matthew %A Li, Dong %A Young, Rebekah %A Jalal, Diana %A Delaney, Joseph Ac %X

Several in vitro and animal studies have showed that inflammatory markers play a role in bone remodeling and pathogenesis of osteoporosis. Additionally, some human longitudinal studies showed suggestive associations between elevated inflammatory markers and increased risk of nontraumatic fractures. We examined several inflammatory markers and multiple fracture types in a single study of older individuals with extensive follow-up. We assessed the association of four inflammatory markers with the risk of incident hip fractures among 5265 participants of the Cardiovascular Health Study (CHS) and a composite endpoint of incident fractures of the hip, pelvis, humerus, or proximal forearm in 4477 participants. Among CHS participants followed between 1992 and 2009, we observed 480 incident hip fractures during a median follow-up of 11 years. In the composite fracture analysis cohort of 4477 participants, we observed 711 fractures during a median follow-up of 7 years. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for hip fracture associated with doubling of IL-6 were HR 1.15 (95% CI, 1.02 to 1.30) overall and HR 1.17 (95% CI, 1.01 to 1.35) in women. We also observed a positive association between each unit increase in white blood cell (WBC) count and risk of hip fracture: HR 1.04 (95% CI, 1.01 to 1.06) overall and HR 1.06 (95% CI, 0.95 to 1.20) in women. We observed no significant associations between any of the four inflammatory markers and a composite fracture endpoint. Our findings suggest that chronic inflammatory and immune processes may be related to higher rates of incident hip fractures. © 2017 American Society for Bone and Mineral Research.

%B J Bone Miner Res %8 2017 Oct 04 %G eng %R 10.1002/jbmr.3301 %0 Journal Article %J J Am Heart Assoc %D 2017 %T Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly. %A Kuller, Lewis H %A Lopez, Oscar L %A Gottdiener, John S %A Kitzman, Dalane W %A Becker, James T %A Chang, Yuefang %A Newman, Anne B %X

BACKGROUND: Heart failure (HF) and dementia are major causes of disability and death among older individuals. Risk factors and biomarkers of HF may be determinants of dementia in the elderly. We evaluated the relationship between biomarkers of cardiovascular disease and HF and risk of dementia and death. Three hypotheses were tested: (1) higher levels of high-sensitivity cardiac troponin T, N-terminal of prohormone brain natriuretic peptide, and cystatin C predict risk of death, cardiovascular disease, HF, and dementia; (2) higher levels of cardiovascular disease biomarkers are associated with increased risk of HF and then secondary increased risk of dementia; and (3) risk of dementia is lower among participants with a combination of lower coronary artery calcium, atherosclerosis, and lower high-sensitivity cardiac troponin T (myocardial injury).

METHODS AND RESULTS: The Cardiovascular Health Study Cognition Study was a continuation of the Cardiovascular Health Study limited to the Pittsburgh, PA, center from 1998-1999 to 2014. In 1992-1994, 924 participants underwent magnetic resonance imaging of the brain. There were 199 deaths and 116 developed dementia before 1998-1999. Of the 609 participants eligible for the Pittsburgh Cardiovascular Health Study Cognition Study, 87.5% (n=532) were included in the study. There were 120 incident HF cases and 72% had dementia. In 80 of 87, dementia preceded HF. A combination of low coronary artery calcium score and low high-sensitivity cardiac troponin T was significantly associated with reduced risk of dementia and HF.

CONCLUSIONS: Most participants with HF had dementia but with onset before HF. Lower high-sensitivity cardiac troponin T and coronary artery calcium was associated with low risk of dementia based on a small number of events.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005133.

%B J Am Heart Assoc %V 6 %8 2017 Jul 22 %G eng %N 7 %R 10.1161/JAHA.116.005353 %0 Journal Article %J J Thromb Haemost %D 2017 %T Taller height as a risk factor for venous thromboembolism: a Mendelian randomization meta-analysis. %A Roetker, N S %A Armasu, S M %A Pankow, J S %A Lutsey, P L %A Tang, W %A Rosenberg, M A %A Palmer, T M %A MacLehose, R F %A Heckbert, S R %A Cushman, M %A de Andrade, M %A Folsom, A R %X

BACKGROUND: Taller height is associated with greater risk of venous thromboembolism (VTE).

OBJECTIVES: We used instrumental variable (IV) techniques (Mendelian randomization) to further explore this relationship METHODS: Participants of European ancestry were included from two cohort studies [Atherosclerosis Risk in Communities (ARIC) study and Cardiovascular Health Study (CHS)] and one case-control study [Mayo Clinic VTE Study (Mayo)]. We created two weighted genetic risk scores (GRS) for height; the full GRS included 668 single nucleotide polymorphisms (SNPs) from a previously published meta-analysis and the restricted GRS included a subset of 362 SNPs not associated with weight independently of height. Standard logistic regression and IV models were used to estimate odds ratios (ORs) for VTE per 10 cm increment in height. ORs were pooled across the three studies using inverse variance weighted random effects meta-analysis RESULTS: Among 9143 ARIC and 3180 CHS participants free of VTE at baseline, there were 367 and 109 incident VTE events. There were 1143 VTE cases and 1292 controls included from Mayo. The pooled ORs from non-IV models and models using the full and restricted GRSs as IVs were 1.27 (95% CI: 1.11, 1.46), 1.34 (95% CI: 1.04, 1.73), and 1.45 (95% CI: 1.04, 2.01) per 10 cm greater height, respectively CONCLUSIONS: Taller height is associated with an increased risk of VTE in adults of European ancestry. Possible explanations for this association, including that taller people may have greater venous surface area, greater number of venous valves, or greater hydrostatic pressure, need to be explored further. This article is protected by copyright. All rights reserved.

%B J Thromb Haemost %8 2017 Apr 26 %G eng %R 10.1111/jth.13719 %0 Journal Article %J Aging (Albany NY) %D 2017 %T Telomeres and the natural lifespan limit in humans. %A Steenstrup, Troels %A Kark, Jeremy D %A Verhulst, Simon %A Thinggaard, Mikael %A Hjelmborg, Jacob V B %A Dalgård, Christine %A Kyvik, Kirsten Ohm %A Christiansen, Lene %A Mangino, Massimo %A Spector, Timothy D %A Petersen, Inge %A Kimura, Masayuki %A Benetos, Athanase %A Labat, Carlos %A Sinnreich, Ronit %A Hwang, Shih-Jen %A Levy, Daniel %A Hunt, Steven C %A Fitzpatrick, Annette L %A Chen, Wei %A Berenson, Gerald S %A Barbieri, Michelangela %A Paolisso, Giuseppe %A Gadalla, Shahinaz M %A Savage, Sharon A %A Christensen, Kaare %A Yashin, Anatoliy I %A Arbeev, Konstantin G %A Aviv, Abraham %X

An ongoing debate in demography has focused on whether the human lifespan has a maximal natural limit. Taking a mechanistic perspective, and knowing that short telomeres are associated with diminished longevity, we examined whether telomere length dynamics during adult life could set a maximal natural lifespan limit. We define leukocyte telomere length of 5 kb as the 'telomeric brink', which denotes a high risk of imminent death. We show that a subset of adults may reach the telomeric brink within the current life expectancy and more so for a 100-year life expectancy. Thus, secular trends in life expectancy should confront a biological limit due to crossing the telomeric brink.

%B Aging (Albany NY) %V 9 %P 1130-1142 %8 2017 Apr %G eng %N 4 %R 10.18632/aging.101216 %0 Journal Article %J Circulation %D 2017 %T Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. %A Baumgartner, Christine %A da Costa, Bruno R %A Collet, Tinh-Hai %A Feller, Martin %A Floriani, Carmen %A Bauer, Douglas C %A Cappola, Anne R %A Heckbert, Susan R %A Ceresini, Graziano %A Gussekloo, Jacobijn %A den Elzen, Wendy P J %A Peeters, Robin P %A Luben, Robert %A Völzke, Henry %A Dörr, Marcus %A Walsh, John P %A Bremner, Alexandra %A Iacoviello, Massimo %A Macfarlane, Peter %A Heeringa, Jan %A Stott, David J %A Westendorp, Rudi G J %A Khaw, Kay-Tee %A Magnani, Jared W %A Aujesky, Drahomir %A Rodondi, Nicolas %K Adult %K Aged %K Aged, 80 and over %K Asymptomatic Diseases %K Atrial Fibrillation %K Biomarkers %K Chi-Square Distribution %K Female %K Humans %K Hypothyroidism %K Incidence %K Male %K Middle Aged %K Predictive Value of Tests %K Prognosis %K Proportional Hazards Models %K Risk Assessment %K Risk Factors %K Thyroid Function Tests %K Thyroid Gland %K Thyrotropin %K Thyroxine %K Time Factors %K Young Adult %X

BACKGROUND: Atrial fibrillation (AF) is a highly prevalent disorder leading to heart failure, stroke, and death. Enhanced understanding of modifiable risk factors may yield opportunities for prevention. The risk of AF is increased in subclinical hyperthyroidism, but it is uncertain whether variations in thyroid function within the normal range or subclinical hypothyroidism are also associated with AF.

METHODS: We conducted a systematic review and obtained individual participant data from prospective cohort studies that measured thyroid function at baseline and assessed incident AF. Studies were identified from MEDLINE and EMBASE databases from inception to July 27, 2016. The euthyroid state was defined as thyroid-stimulating hormone (TSH) 0.45 to 4.49 mIU/L, and subclinical hypothyroidism as TSH 4.5 to 19.9 mIU/L with free thyroxine (fT4) levels within reference range. The association of TSH levels in the euthyroid and subclinical hypothyroid range with incident AF was examined by using Cox proportional hazards models. In euthyroid participants, we additionally examined the association between fT4 levels and incident AF.

RESULTS: Of 30 085 participants from 11 cohorts (278 955 person-years of follow-up), 1958 (6.5%) had subclinical hypothyroidism and 2574 individuals (8.6%) developed AF during follow-up. TSH at baseline was not significantly associated with incident AF in euthyroid participants or those with subclinical hypothyroidism. Higher fT4 levels at baseline in euthyroid individuals were associated with increased AF risk in age- and sex-adjusted analyses (hazard ratio, 1.45; 95% confidence interval, 1.26-1.66, for the highest quartile versus the lowest quartile of fT4; P for trend ≤0.001 across quartiles). Estimates did not substantially differ after further adjustment for preexisting cardiovascular disease.

CONCLUSIONS: In euthyroid individuals, higher circulating fT4 levels, but not TSH levels, are associated with increased risk of incident AF.

%B Circulation %V 136 %P 2100-2116 %8 2017 Nov 28 %G eng %N 22 %R 10.1161/CIRCULATIONAHA.117.028753 %0 Journal Article %J Hum Genet %D 2017 %T Trans-ethnic fine-mapping of genetic loci for body mass index in the diverse ancestral populations of the Population Architecture using Genomics and Epidemiology (PAGE) Study reveals evidence for multiple signals at established loci. %A Fernandez-Rhodes, Lindsay %A Gong, Jian %A Haessler, Jeffrey %A Franceschini, Nora %A Graff, Mariaelisa %A Nishimura, Katherine K %A Wang, Yujie %A Highland, Heather M %A Yoneyama, Sachiko %A Bush, William S %A Goodloe, Robert %A Ritchie, Marylyn D %A Crawford, Dana %A Gross, Myron %A Fornage, Myriam %A Bůzková, Petra %A Tao, Ran %A Isasi, Carmen %A Avilés-Santa, Larissa %A Daviglus, Martha %A Mackey, Rachel H %A Houston, Denise %A Gu, C Charles %A Ehret, Georg %A Nguyen, Khanh-Dung H %A Lewis, Cora E %A Leppert, Mark %A Irvin, Marguerite R %A Lim, Unhee %A Haiman, Christopher A %A Le Marchand, Loïc %A Schumacher, Fredrick %A Wilkens, Lynne %A Lu, Yingchang %A Bottinger, Erwin P %A Loos, Ruth J L %A Sheu, Wayne H-H %A Guo, Xiuqing %A Lee, Wen-Jane %A Hai, Yang %A Hung, Yi-Jen %A Absher, Devin %A Wu, I-Chien %A Taylor, Kent D %A Lee, I-Te %A Liu, Yeheng %A Wang, Tzung-Dau %A Quertermous, Thomas %A Juang, Jyh-Ming J %A Rotter, Jerome I %A Assimes, Themistocles %A Hsiung, Chao A %A Chen, Yii-Der Ida %A Prentice, Ross %A Kuller, Lewis H %A Manson, JoAnn E %A Kooperberg, Charles %A Smokowski, Paul %A Robinson, Whitney R %A Gordon-Larsen, Penny %A Li, Rongling %A Hindorff, Lucia %A Buyske, Steven %A Matise, Tara C %A Peters, Ulrike %A North, Kari E %K Body Mass Index %K Ethnic Groups %K Genetics, Population %K Humans %K Obesity %X

Most body mass index (BMI) genetic loci have been identified in studies of primarily European ancestries. The effect of these loci in other racial/ethnic groups is less clear. Thus, we aimed to characterize the generalizability of 170 established BMI variants, or their proxies, to diverse US populations and trans-ethnically fine-map 36 BMI loci using a sample of >102,000 adults of African, Hispanic/Latino, Asian, European and American Indian/Alaskan Native descent from the Population Architecture using Genomics and Epidemiology Study. We performed linear regression of the natural log of BMI (18.5-70 kg/m(2)) on the additive single nucleotide polymorphisms (SNPs) at BMI loci on the MetaboChip (Illumina, Inc.), adjusting for age, sex, population stratification, study site, or relatedness. We then performed fixed-effect meta-analyses and a Bayesian trans-ethnic meta-analysis to empirically cluster by allele frequency differences. Finally, we approximated conditional and joint associations to test for the presence of secondary signals. We noted directional consistency with the previously reported risk alleles beyond what would have been expected by chance (binomial p < 0.05). Nearly, a quarter of the previously described BMI index SNPs and 29 of 36 densely-genotyped BMI loci on the MetaboChip replicated/generalized in trans-ethnic analyses. We observed multiple signals at nine loci, including the description of seven loci with novel multiple signals. This study supports the generalization of most common genetic loci to diverse ancestral populations and emphasizes the importance of dense multiethnic genomic data in refining the functional variation at genetic loci of interest and describing several loci with multiple underlying genetic variants.

%B Hum Genet %V 136 %P 771-800 %8 2017 Jun %G eng %N 6 %R 10.1007/s00439-017-1787-6 %0 Journal Article %J Eur J Epidemiol %D 2017 %T Trends in the incidence of dementia: design and methods in the Alzheimer Cohorts Consortium. %A Chibnik, Lori B %A Wolters, Frank J %A Bäckman, Kristoffer %A Beiser, Alexa %A Berr, Claudine %A Bis, Joshua C %A Boerwinkle, Eric %A Bos, Daniel %A Brayne, Carol %A Dartigues, Jean-François %A Darweesh, Sirwan K L %A Debette, Stephanie %A Davis-Plourde, Kendra L %A Dufouil, Carole %A Fornage, Myriam %A Grasset, Leslie %A Gudnason, Vilmundur %A Hadjichrysanthou, Christoforos %A Helmer, Catherine %A Ikram, M Arfan %A Ikram, M Kamran %A Kern, Silke %A Kuller, Lewis H %A Launer, Lenore %A Lopez, Oscar L %A Matthews, Fiona %A Meirelles, Osorio %A Mosley, Thomas %A Ower, Alison %A Psaty, Bruce M %A Satizabal, Claudia L %A Seshadri, Sudha %A Skoog, Ingmar %A Stephan, Blossom C M %A Tzourio, Christophe %A Waziry, Reem %A Wong, Mei Mei %A Zettergren, Anna %A Hofman, Albert %X

Several studies have reported a decline in incidence of dementia which may have large implications for the projected burden of disease, and provide important guidance to preventive efforts. However, reports are conflicting or inconclusive with regard to the impact of gender and education with underlying causes of a presumed declining trend remaining largely unidentified. The Alzheimer Cohorts Consortium aggregates data from nine international population-based cohorts to determine changes in the incidence of dementia since 1990. We will employ Poisson regression models to calculate incidence rates in each cohort and Cox proportional hazard regression to compare 5-year cumulative hazards across study-specific epochs. Finally, we will meta-analyse changes per decade across cohorts, and repeat all analysis stratified by sex, education and APOE genotype. In all cohorts combined, there are data on almost 69,000 people at risk of dementia with the range of follow-up years between 2 and 27. The average age at baseline is similar across cohorts ranging between 72 and 77. Uniting a wide range of disease-specific and methodological expertise in research teams, the first analyses within the Alzheimer Cohorts Consortium are underway to tackle outstanding challenges in the assessment of time-trends in dementia occurrence.

%B Eur J Epidemiol %V 32 %P 931-938 %8 2017 Oct %G eng %N 10 %R 10.1007/s10654-017-0320-5 %0 Journal Article %J J Alzheimers Dis %D 2018 %T Aortic Stiffness is Associated with Increased Risk of Incident Dementia in Older Adults. %A Cui, Chendi %A Sekikawa, Akira %A Kuller, Lewis H %A Lopez, Oscar L %A Newman, Anne B %A Kuipers, Allison L %A Mackey, Rachel H %X

Cardiovascular disease risk factors, including age, hypertension, and diabetes, contribute to aortic stiffness and subclinical cardiovascular and brain disease, increasing dementia risk. Aortic stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), reduces the buffering of pulsatile blood flow, exposing cerebral small arteries to microvascular damage. High cfPWV is related to white matter hyperintensities and brain amyloid deposition, and to cognitive decline, but it is unclear whether cfPWV independently predicts incident dementia. Therefore, we tested the hypothesis that cfPWV predicts incident dementia in older adults, independent of potential confounders. The Cardiovascular Health Study Cognition Study followed 532 non-demented older adults with annual cognitive exams from 1998-99 through 2013. CfPWV was measured on 356 (mean age = 78, 59% women) between 1996-2000. Over 15 years, 212 (59.6%) developed dementia (median time from cfPWV measurement = 4 years). In age and sex-adjusted Cox models, cfPWV was significantly associated with increased risk of dementia, but systolic blood pressure, mean arterial pressure and pulse pressure were not. CfPWV (transformed as - 1/cfPWV) remained significantly associated with dementia risk when further adjusted for education, race, APOEɛ4, diabetes, body mass index, mean arterial pressure, and anti-hypertensive medication (hazard ratio = 1.60, 95% CI = 1.02, 2.51). Results were similar when further adjusted for baseline global cognition, subclinical brain measures, and coronary artery calcification. Finally, higher cfPWV was related to lower physical activity intensity and higher systolic blood pressure, heart rate, and waist circumference measured 5 years prior. An important unanswered question is whether interventions to slow arterial stiffening can reduce the risk of dementia.

%B J Alzheimers Dis %V 66 %P 297-306 %8 2018 %G eng %N 1 %R 10.3233/JAD-180449 %0 Journal Article %J Bone %D 2018 %T Association of bone mineral density with hemoglobin and change in hemoglobin among older men and women: The Cardiovascular Health Study. %A Valderrábano, Rodrigo J %A Bůzková, Petra %A Chang, Po-Yin %A Zakai, Neil A %A Fink, Howard A %A Robbins, John A %A Lee, Jennifer S %A Wu, Joy Y %X

PURPOSE: Osteoblasts and their precursors support hematopoiesis in the bone marrow. We hypothesized that declines in Hgb levels are associated with bone mineral density (BMD).

METHODS: The Cardiovascular Health Study is a prospective longitudinal study that enrolled 5888 community-dwelling adults aged >65 years and measured hemoglobin twice, in 1989-90 and 1992-93, as well as BMD by dual-energy X-ray absorptiometry (DXA) in 1994-95. In a subset of 1513 men and women with a Hgb in 1992-93 and BMD, we used linear regression to estimate associations of Hgb (per standard deviation (SD)) with total hip (TH), lumbar spine (LS) and total body (TB) BMD, and used Poisson regression to estimate associations of anemia (in 1992-93; Hgb <13 g/dL in men; <12 g/dL in women) with "low BMD" defined as T-score less than -1 at the TH. In 1277 participants with Hgb measured on average 2.9 years apart and BMD, we used linear regression to estimate the associations of annualized change in Hgb with TH, LS and TB BMD. All models included age, sex, study-site, race, smoking, alcohol use, weight, height, steroid use, physical activity score, self-reported health, previous cardiovascular disease and prior anti-fracture medication use.

RESULTS: No significant association was observed between Hgb, measured a mean 2.2 years prior to BMD, and BMD at the TH and LS in men (TH beta = -0.60 [x 10 g/cmper 1.1 g/dL Hgb], 95% CI: -1.88 to 0.68; LS beta = -1.69, 95% CI: -3.83 to 0.45) or women (TH beta = -0.49 [x 10 g/cmper 1.3 g/dL Hgb], 95% CI: -1.57 to 0.59; LS beta = -0.40, 95% CI: -2.57 to 1.76). Anemia was not observed to be significantly associated with low BMD in men (RR = 0.99, 95% CI: 0.72-1.40) nor women (RR = 0.98, 95% CI: 0.82-1.17). The mean change in Hgb was a loss of 0.06 g/dL/year (SD = 0.32). Change in Hgb was not observed to be significantly associated with BMD in men (TH beta = -0.55[x 10 g/cmper 1 g/dL annualized Hgb change], 95% CI: -4.28 to 3.19; LS beta = 0.63, 95% CI: -5.38 to 6.65) or women (TH beta = 0.92, 95% CI: -1.96 to 3.79; LS beta = -1.77, 95% CI: -7.52 to 3.98). No significant association was observed between anemia and low bone density by T-score in men and women.

CONCLUSIONS: These findings support neither the hypothesis that low Hgb prior to bone density or decreases in Hgb are associated with bone density in older community-dwelling adults nor the use of Hgb level as a case-finding tool to prompt BMD measurement.

%B Bone %V 120 %P 321-326 %8 2018 Nov 15 %G eng %R 10.1016/j.bone.2018.11.010 %0 Journal Article %J JAMA Cardiol %D 2018 %T Association of Cardiovascular Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction. %A de Boer, Rudolf A %A Nayor, Matthew %A deFilippi, Christopher R %A Enserro, Danielle %A Bhambhani, Vijeta %A Kizer, Jorge R %A Blaha, Michael J %A Brouwers, Frank P %A Cushman, Mary %A Lima, João A C %A Bahrami, Hossein %A van der Harst, Pim %A Wang, Thomas J %A Gansevoort, Ron T %A Fox, Caroline S %A Gaggin, Hanna K %A Kop, Willem J %A Liu, Kiang %A Vasan, Ramachandran S %A Psaty, Bruce M %A Lee, Douglas S %A Hillege, Hans L %A Bartz, Traci M %A Benjamin, Emelia J %A Chan, Cheeling %A Allison, Matthew %A Gardin, Julius M %A Januzzi, James L %A Shah, Sanjiv J %A Levy, Daniel %A Herrington, David M %A Larson, Martin G %A van Gilst, Wiek H %A Gottdiener, John S %A Bertoni, Alain G %A Ho, Jennifer E %X

Importance: Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF) as opposed to reduced ejection fraction (HFrEF), yet associations of biomarkers with future heart failure subtype are incompletely understood.

Objective: To evaluate the associations of 12 cardiovascular biomarkers with incident HFpEF vs HFrEF among adults from the general population.

Design, Setting, and Participants: This study included 4 longitudinal community-based cohorts: the Cardiovascular Health Study (1989-1990; 1992-1993 for supplemental African-American cohort), the Framingham Heart Study (1995-1998), the Multi-Ethnic Study of Atherosclerosis (2000-2002), and the Prevention of Renal and Vascular End-stage Disease study (1997-1998). Each cohort had prospective ascertainment of incident HFpEF and HFrEF. Data analysis was performed from June 25, 2015, to November 9, 2017.

Exposures: The following biomarkers were examined: N-terminal pro B-type natriuretic peptide or brain natriuretic peptide, high-sensitivity troponin T or I, C-reactive protein (CRP), urinary albumin to creatinine ratio (UACR), renin to aldosterone ratio, D-dimer, fibrinogen, soluble suppressor of tumorigenicity, galectin-3, cystatin C, plasminogen activator inhibitor 1, and interleukin 6.

Main Outcomes and Measures: Development of incident HFpEF and incident HFrEF.

Results: Among the 22 756 participants in these 4 cohorts (12 087 women and 10 669 men; mean [SD] age, 60 [13] years) in the study, during a median follow-up of 12 years, 633 participants developed incident HFpEF, and 841 developed HFrEF. In models adjusted for clinical risk factors of heart failure, 2 biomarkers were significantly associated with incident HFpEF: UACR (hazard ratio [HR], 1.33; 95% CI, 1.20-1.48; P < .001) and natriuretic peptides (HR, 1.27; 95% CI, 1.16-1.40; P < .001), with suggestive associations for high-sensitivity troponin (HR, 1.11; 95% CI, 1.03-1.19; P = .008), plasminogen activator inhibitor 1 (HR, 1.22; 95% CI, 1.03-1.45; P = .02), and fibrinogen (HR, 1.12; 95% CI, 1.03-1.22; P = .01). By contrast, 6 biomarkers were associated with incident HFrEF: natriuretic peptides (HR, 1.54; 95% CI, 1.41-1.68; P < .001), UACR (HR, 1.21; 95% CI, 1.11-1.32; P < .001), high-sensitivity troponin (HR, 1.37; 95% CI, 1.29-1.46; P < .001), cystatin C (HR, 1.19; 95% CI, 1.11-1.27; P < .001), D-dimer (HR, 1.22; 95% CI, 1.11-1.35; P < .001), and CRP (HR, 1.19; 95% CI, 1.11-1.28; P < .001). When directly compared, natriuretic peptides, high-sensitivity troponin, and CRP were more strongly associated with HFrEF compared with HFpEF.

Conclusions and Relevance: Biomarkers of renal dysfunction, endothelial dysfunction, and inflammation were associated with incident HFrEF. By contrast, only natriuretic peptides and UACR were associated with HFpEF. These findings highlight the need for future studies focused on identifying novel biomarkers of the risk of HFpEF.

%B JAMA Cardiol %8 2018 Jan 10 %G eng %R 10.1001/jamacardio.2017.4987 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2018 %T Association of Frailty with Recovery from Disability among Community-Dwelling Older Adults: Results from Two Large U.S. Cohorts. %A Wu, Chenkai %A Kim, Dae H %A Xue, Qian-Li %A Lee, David S H %A Varadhan, Ravi %A Odden, Michelle C %X

Background: Disability in activities of daily living (ADLs) is a dynamic process and transitions among different disability states are common. However, little is known about factors affecting recovery from disability. We examined the association between frailty and recovery from disability among non-disabled community-dwelling elders.

Methods: We studied 1023 adults from the Cardiovascular Health Study (CHS) and 685 adults from the Health and Retirement Study (HRS), who were ≥65 years and had incident disability, defined as having difficulty in ≥1 ADL (dressing, eating, toileting, bathing, transferring, walking across a room). Disability recovery was defined as having no difficulty in any ADLs. Frailty was assessed by slowness, weakness, exhaustion, inactivity, and shrinking. Persons were classified as "non-frail" (0 criteria), "prefrail" (1-2 criteria), or "frail" (3-5 criteria).

Results: In total, 539 (52.7%) CHS participants recovered from disability within one year. Almost two-thirds of non-frail persons recovered, while less than two-fifths of the frail recovered. In the HRS, 234 (34.2%) participants recovered from disability within two years. Approximately half of the non-frail recovered, while less than one-fifth of the frail recovered. After adjustment, prefrail and frail CHS participants were 16% and 36% less likely to recover than the non-frail, respectively. In the HRS, frail persons had a 41% lower likelihood of recovery than the non-frail.

Conclusions: Frailty is an independent predictor of poor recovery from disability among non-disabled older adults. These findings validate frailty as a marker of decreased resilience and may offer opportunities for individualized interventions and geriatric care based on frailty assessment.

%B J Gerontol A Biol Sci Med Sci %8 2018 Apr 10 %G eng %R 10.1093/gerona/gly080 %0 Journal Article %J JACC Heart Fail %D 2018 %T The Association of Obesity and Cardiometabolic Traits With Incident HFpEF and HFrEF. %A Savji, Nazir %A Meijers, Wouter C %A Bartz, Traci M %A Bhambhani, Vijeta %A Cushman, Mary %A Nayor, Matthew %A Kizer, Jorge R %A Sarma, Amy %A Blaha, Michael J %A Gansevoort, Ron T %A Gardin, Julius M %A Hillege, Hans L %A Ji, Fei %A Kop, Willem J %A Lau, Emily S %A Lee, Douglas S %A Sadreyev, Ruslan %A van Gilst, Wiek H %A Wang, Thomas J %A Zanni, Markella V %A Vasan, Ramachandran S %A Allen, Norrina B %A Psaty, Bruce M %A van der Harst, Pim %A Levy, Daniel %A Larson, Martin %A Shah, Sanjiv J %A de Boer, Rudolf A %A Gottdiener, John S %A Ho, Jennifer E %X

OBJECTIVES: This study evaluated the associations of obesity and cardiometabolic traits with incident heart failure with preserved versus reduced ejection fraction (HFpEF vs. HFrEF). Given known sex differences in HF subtype, we examined men and women separately.

BACKGROUND: Recent studies suggest that obesity confers greater risk of HFpEF versus HFrEF. Contributions of associated metabolic traits to HFpEF are less clear.

METHODS: We studied 22,681 participants from 4 community-based cohorts followed for incident HFpEF versus HFrEF (ejection fraction ≥50% vs. <50%). We evaluated the association of body mass index (BMI) and cardiometabolic traits with incident HF subtype using Cox models.

RESULTS: The mean age was 60 ± 13 years, and 53% were women. Over a median follow-up of 12 years, 628 developed incident HFpEF and 835 HFrEF. Greater BMI portended higher risk of HFpEF compared with HFrEF (hazard ratio [HR]: 1.34 per 1-SD increase in BMI; 95% confidence interval [CI]: 1.24 to 1.45 vs. HR: 1.18; 95% CI: 1.10 to 1.27). Similarly, insulin resistance (homeostatic model assessment of insulin resistance) was associated with HFpEF (HR: 1.20 per 1-SD; 95% CI: 1.05 to 1.37), but not HFrEF (HR: 0.99; 95% CI: 0.88 to 1.11; p < 0.05 for difference HFpEF vs. HFrEF). We found that the differential association of BMI with HFpEF versus HFrEF was more pronounced among women (p for difference HFpEF vs. HFrEF = 0.01) when compared with men (p = 0.34).

CONCLUSIONS: Obesity and related cardiometabolic traits including insulin resistance are more strongly associated with risk of future HFpEF versus HFrEF. The differential risk of HFpEF with obesity seems particularly pronounced among women and may underlie sex differences in HF subtypes.

%B JACC Heart Fail %V 6 %P 701-709 %8 2018 Aug %G eng %N 8 %R 10.1016/j.jchf.2018.05.018 %0 Journal Article %J J Thromb Haemost %D 2018 %T Associations of activated coagulation factor VII and factor VIIa-antithrombin levels with genome-wide polymorphisms and cardiovascular disease risk. %A Olson, N C %A Raffield, L M %A Lange, L A %A Lange, E M %A Longstreth, W T %A Chauhan, G %A Debette, S %A Seshadri, S %A Reiner, A P %A Tracy, R P %X

ESSENTIALS: Essentials A fraction of coagulation factor VII circulates in blood as an activated protease (FVIIa). We evaluated FVIIa and FVIIa-antithrombin (FVIIa-AT) levels in the Cardiovascular Health Study. Polymorphisms in the F7 and PROCR loci were associated with FVIIa and FVIIa-AT levels. FVIIa may be an ischemic stroke risk factor in older adults and FVIIa-AT may assess mortality risk.

SUMMARY: Background A fraction of coagulation factor (F) VII circulates as an active protease (FVIIa). FVIIa also circulates as an inactivated complex with antithrombin (FVIIa-AT). Objective Evaluate associations of FVIIa and FVIIa-AT with genome-wide single nucleotide polymorphisms (SNPs) and incident coronary heart disease, ischemic stroke and mortality. Patients/Methods We measured FVIIa and FVIIa-AT in 3486 Cardiovascular Health Study (CHS) participants. We performed a genome-wide association scan for FVIIa and FVIIa-AT in European-Americans (n = 2410) and examined associations of FVII phenotypes with incident cardiovascular disease. Results In European-Americans, the most significant SNP for FVIIa and FVIIa-AT was rs1755685 in the F7 promoter region on chromosome 13 (FVIIa, β = -25.9 mU mL-1 per minor allele; FVIIa-AT, β = -26.6 pm per minor allele). Phenotypes were also associated with rs867186 located in PROCR on chromosome 20 (FVIIa, β = 7.8 mU mL-1 per minor allele; FVIIa-AT, β = 9.9 per minor allele). Adjusted for risk factors, a one standard deviation higher FVIIa was associated with increased risk of ischemic stroke (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.01, 1.23). Higher FVIIa-AT was associated with mortality from all causes (HR, 1.08; 95% CI, 1.03, 1.12). Among European-American CHS participants the rs1755685 minor allele was associated with lower ischemic stroke (HR, 0.69; 95% CI, 0.54, 0.88), but this association was not replicated in a larger multi-cohort analysis. Conclusions The results support the importance of the F7 and PROCR loci in variation in circulating FVIIa and FVIIa-AT. The findings suggest FVIIa is a risk factor for ischemic stroke in older adults, whereas higher FVIIa-AT may reflect mortality risk.

%B J Thromb Haemost %V 16 %P 19-30 %8 2018 Jan %G eng %N 1 %R 10.1111/jth.13899 %0 Journal Article %J Stroke %D 2018 %T Atrial Cardiopathy and the Risk of Ischemic Stroke in the CHS (Cardiovascular Health Study). %A Kamel, Hooman %A Bartz, Traci M %A Elkind, Mitchell S V %A Okin, Peter M %A Thacker, Evan L %A Patton, Kristen K %A Stein, Phyllis K %A deFilippi, Christopher R %A Gottesman, Rebecca F %A Heckbert, Susan R %A Kronmal, Richard A %A Soliman, Elsayed Z %A Longstreth, W T %X

BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke.

METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline. Exposures were several markers of atrial cardiopathy: baseline P-wave terminal force in ECG lead V, left atrial dimension on echocardiogram, and N terminal pro B type natriuretic peptide (NT-proBNP), as well as incident AF. Incident AF was ascertained from 12-lead electrocardiograms at annual study visits for the first decade after study enrollment and from inpatient and outpatient Medicare data throughout follow-up. The primary outcome was incident ischemic stroke. We used Cox proportional hazards models that included all 4 atrial cardiopathy markers along with adjustment for demographic characteristics and established vascular risk factors.

RESULTS: Among 3723 participants who were free of stroke and AF at baseline and who had data on all atrial cardiopathy markers, 585 participants (15.7%) experienced an incident ischemic stroke during a median 12.9 years of follow-up. When all atrial cardiopathy markers were combined in 1 Cox model, we found significant associations with stroke for P-wave terminal force in ECG lead V (hazard ratio per 1000 μV*ms 1.04; 95% confidence interval, 1.001-1.08), log-transformed NT-proBNP (hazard ratio per doubling of NT-proBNP, 1.09; 95% confidence interval, 1.03-1.16), and incident AF (hazard ratio, 2.04; 95% confidence interval, 1.67-2.48) but not left atrial dimension (hazard ratio per cm, 0.96; 95% confidence interval, 0.84-1.10).

CONCLUSIONS: In addition to clinically apparent AF, other evidence of abnormal atrial substrate is associated with subsequent ischemic stroke. This finding is consistent with the hypothesis that thromboembolism from the left atrium may occur in the setting of several different manifestations of atrial disease.

%B Stroke %V 49 %P 980-986 %8 2018 Apr %G eng %N 4 %R 10.1161/STROKEAHA.117.020059 %0 Journal Article %J J Am Heart Assoc %D 2018 %T Circulating Very Long-Chain Saturated Fatty Acids and Heart Failure: The Cardiovascular Health Study. %A Lemaitre, Rozenn N %A McKnight, Barbara %A Sotoodehnia, Nona %A Fretts, Amanda M %A Qureshi, Waqas T %A Song, Xiaoling %A King, Irena B %A Sitlani, Colleen M %A Siscovick, David S %A Psaty, Bruce M %A Mozaffarian, Dariush %X

Background Circulating very-long-chain saturated fatty acids ( VLSFAs ) are integrated biomarkers of diet and metabolism that may point to new risk pathways and potential targets for heart failure ( HF ) prevention. The associations of VLSFA to HF in humans are not known. Methods and Results Using a cohort study design, we studied the associations of serially measured plasma phospholipid VLSFA with incident HF in the Cardiovascular Health Study. We investigated the associations of time-varying levels of the 3 major circulating VLSFAs , lignoceric acid (24:0), behenic acid (22:0), and arachidic acid (20:0), with the risk of incident HF using Cox regression. During 45030 person-years among 4249 participants, we identified 1304 cases of incident HF , including 489 with preserved and 310 with reduced ejection fraction. Adjusting for major HF risk factors and other circulating fatty acids, higher levels of each VLSFAs were associated with lower risk of incident HF ( P trend≤0.0007 each). The hazard ratio comparing the highest quintile to the lowest quintile was 0.67 (95% confidence interval, 0.55-0.81) for 24:0, 0.72 (95% confidence interval, 0.60-0.87) for 22:0 and 0.72 (95% confidence interval, 0.59-0.88) for 20:0. The associations were similar in subgroups defined by sex, age, body mass index, coronary heart disease, and diabetes mellitus. Among those with ejection fraction data, the associations appeared similar for those with preserved and with reduced ejection fraction. Conclusions Higher levels of circulating VLSFAs are associated with lower risk of incident HF in older adults. These novel associations should prompt further research on the role of VLSFA in HF , including relevant new risk pathways. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 00005133.

%B J Am Heart Assoc %V 7 %P e010019 %8 2018 Nov 06 %G eng %N 21 %R 10.1161/JAHA.118.010019 %0 Journal Article %J Circ Genom Precis Med %D 2018 %T Common and Rare Coding Genetic Variation Underlying the Electrocardiographic PR Interval. %A Lin, Honghuang %A van Setten, Jessica %A Smith, Albert V %A Bihlmeyer, Nathan A %A Warren, Helen R %A Brody, Jennifer A %A Radmanesh, Farid %A Hall, Leanne %A Grarup, Niels %A Müller-Nurasyid, Martina %A Boutin, Thibaud %A Verweij, Niek %A Lin, Henry J %A Li-Gao, Ruifang %A van den Berg, Marten E %A Marten, Jonathan %A Weiss, Stefan %A Prins, Bram P %A Haessler, Jeffrey %A Lyytikäinen, Leo-Pekka %A Mei, Hao %A Harris, Tamara B %A Launer, Lenore J %A Li, Man %A Alonso, Alvaro %A Soliman, Elsayed Z %A Connell, John M %A Huang, Paul L %A Weng, Lu-Chen %A Jameson, Heather S %A Hucker, William %A Hanley, Alan %A Tucker, Nathan R %A Chen, Yii-Der Ida %A Bis, Joshua C %A Rice, Kenneth M %A Sitlani, Colleen M %A Kors, Jan A %A Xie, Zhijun %A Wen, Chengping %A Magnani, Jared W %A Nelson, Christopher P %A Kanters, Jørgen K %A Sinner, Moritz F %A Strauch, Konstantin %A Peters, Annette %A Waldenberger, Melanie %A Meitinger, Thomas %A Bork-Jensen, Jette %A Pedersen, Oluf %A Linneberg, Allan %A Rudan, Igor %A de Boer, Rudolf A %A van der Meer, Peter %A Yao, Jie %A Guo, Xiuqing %A Taylor, Kent D %A Sotoodehnia, Nona %A Rotter, Jerome I %A Mook-Kanamori, Dennis O %A Trompet, Stella %A Rivadeneira, Fernando %A Uitterlinden, Andre %A Eijgelsheim, Mark %A Padmanabhan, Sandosh %A Smith, Blair H %A Völzke, Henry %A Felix, Stephan B %A Homuth, Georg %A Völker, Uwe %A Mangino, Massimo %A Spector, Timothy D %A Bots, Michiel L %A Perez, Marco %A Kähönen, Mika %A Raitakari, Olli T %A Gudnason, Vilmundur %A Arking, Dan E %A Munroe, Patricia B %A Psaty, Bruce M %A van Duijn, Cornelia M %A Benjamin, Emelia J %A Rosand, Jonathan %A Samani, Nilesh J %A Hansen, Torben %A Kääb, Stefan %A Polasek, Ozren %A van der Harst, Pim %A Heckbert, Susan R %A Jukema, J Wouter %A Stricker, Bruno H %A Hayward, Caroline %A Dörr, Marcus %A Jamshidi, Yalda %A Asselbergs, Folkert W %A Kooperberg, Charles %A Lehtimäki, Terho %A Wilson, James G %A Ellinor, Patrick T %A Lubitz, Steven A %A Isaacs, Aaron %X

BACKGROUND: Electrical conduction from the cardiac sinoatrial node to the ventricles is critical for normal heart function. Genome-wide association studies have identified more than a dozen common genetic loci that are associated with PR interval. However, it is unclear whether rare and low-frequency variants also contribute to PR interval heritability.

METHODS: We performed large-scale meta-analyses of the PR interval that included 83 367 participants of European ancestry and 9436 of African ancestry. We examined both common and rare variants associated with the PR interval.

RESULTS: We identified 31 genetic loci that were significantly associated with PR interval after Bonferroni correction (<1.2×10), including 11 novel loci that have not been reported previously. Many of these loci are involved in heart morphogenesis. In gene-based analysis, we found that multiple rare variants at (=5.9×10) and (=1.1×10) were associated with PR interval. locus also was implicated in the common variant analysis, whereas was a novel locus.

CONCLUSIONS: We identified common variants at 11 novel loci and rare variants within 2 gene regions that were significantly associated with PR interval. Our findings provide novel insights to the current understanding of atrioventricular conduction, which is critical for cardiac activity and an important determinant of health.

%B Circ Genom Precis Med %V 11 %P e002037 %8 2018 May %G eng %N 5 %R 10.1161/CIRCGEN.117.002037 %0 Journal Article %J Circ Genom Precis Med %D 2018 %T Common Coding Variants in Are Associated With the Nav1.8 Late Current and Cardiac Conduction. %A Macri, Vincenzo %A Brody, Jennifer A %A Arking, Dan E %A Hucker, William J %A Yin, Xiaoyan %A Lin, Honghuang %A Mills, Robert W %A Sinner, Moritz F %A Lubitz, Steven A %A Liu, Ching-Ti %A Morrison, Alanna C %A Alonso, Alvaro %A Li, Ning %A Fedorov, Vadim V %A Janssen, Paul M %A Bis, Joshua C %A Heckbert, Susan R %A Dolmatova, Elena V %A Lumley, Thomas %A Sitlani, Colleen M %A Cupples, L Adrienne %A Pulit, Sara L %A Newton-Cheh, Christopher %A Barnard, John %A Smith, Jonathan D %A Van Wagoner, David R %A Chung, Mina K %A Vlahakes, Gus J %A O'Donnell, Christopher J %A Rotter, Jerome I %A Margulies, Kenneth B %A Morley, Michael P %A Cappola, Thomas P %A Benjamin, Emelia J %A Muzny, Donna %A Gibbs, Richard A %A Jackson, Rebecca D %A Magnani, Jared W %A Herndon, Caroline N %A Rich, Stephen S %A Psaty, Bruce M %A Milan, David J %A Boerwinkle, Eric %A Mohler, Peter J %A Sotoodehnia, Nona %A Ellinor, Patrick T %X

BACKGROUND: Genetic variants at the / locus are strongly associated with electrocardiographic PR and QRS intervals. While is the canonical cardiac sodium channel gene, the role of in cardiac conduction is less well characterized.

METHODS: We sequenced the locus in 3699 European-ancestry individuals to identify variants associated with cardiac conduction, and replicated our findings in 21,000 individuals of European ancestry. We examined association with expression in human atrial tissue. We explored the biophysical effect of variation on channel function using cellular electrophysiology.

RESULTS: We identified 2 intronic single nucleotide polymorphisms in high linkage disequilibrium (  =0.86) with each other to be the strongest signals for PR (rs10428132, β=-4.74, =1.52×10) and QRS intervals (rs6599251, QRS β=-0.73; =1.2×10), respectively. Although these variants were not associated with or expression in human atrial tissue (n=490), they were in high linkage disequilibrium (  ≥0.72) with a common missense variant, rs6795970 (V1073A). In total, we identified 7 missense variants, 4 of which (I962V, P1045T, V1073A, and L1092P) were associated with cardiac conduction. These 4 missense variants cluster in the cytoplasmic linker of the second and third domains of the SCN10A protein and together form 6 common haplotypes. Using cellular electrophysiology, we found that haplotypes associated with shorter PR intervals had a significantly larger percentage of late current compared with wild-type (I962V+V1073A+L1092P, 20.2±3.3%, =0.03, and I962V+V1073A, 22.4±0.8%, =0.0004 versus wild-type 11.7±1.6%), and the haplotype associated with the longest PR interval had a significantly smaller late current percentage (P1045T, 6.4±1.2%, =0.03).

CONCLUSIONS: Our findings suggest an association between genetic variation in , the late sodium current, and alterations in cardiac conduction.

%B Circ Genom Precis Med %V 11 %P e001663 %8 2018 May %G eng %N 5 %R 10.1161/CIRCGEN.116.001663 %0 Journal Article %J Eur Heart J %D 2018 %T A comprehensive evaluation of the genetic architecture of sudden cardiac arrest. %A Ashar, Foram N %A Mitchell, Rebecca N %A Albert, Christine M %A Newton-Cheh, Christopher %A Brody, Jennifer A %A Müller-Nurasyid, Martina %A Moes, Anna %A Meitinger, Thomas %A Mak, Angel %A Huikuri, Heikki %A Junttila, M Juhani %A Goyette, Philippe %A Pulit, Sara L %A Pazoki, Raha %A Tanck, Michael W %A Blom, Marieke T %A Zhao, XiaoQing %A Havulinna, Aki S %A Jabbari, Reza %A Glinge, Charlotte %A Tragante, Vinicius %A Escher, Stefan A %A Chakravarti, Aravinda %A Ehret, Georg %A Coresh, Josef %A Li, Man %A Prineas, Ronald J %A Franco, Oscar H %A Kwok, Pui-Yan %A Lumley, Thomas %A Dumas, Florence %A McKnight, Barbara %A Rotter, Jerome I %A Lemaitre, Rozenn N %A Heckbert, Susan R %A O'Donnell, Christopher J %A Hwang, Shih-Jen %A Tardif, Jean-Claude %A VanDenburgh, Martin %A Uitterlinden, André G %A Hofman, Albert %A Stricker, Bruno H C %A de Bakker, Paul I W %A Franks, Paul W %A Jansson, Jan-Håkan %A Asselbergs, Folkert W %A Halushka, Marc K %A Maleszewski, Joseph J %A Tfelt-Hansen, Jacob %A Engstrøm, Thomas %A Salomaa, Veikko %A Virmani, Renu %A Kolodgie, Frank %A Wilde, Arthur A M %A Tan, Hanno L %A Bezzina, Connie R %A Eijgelsheim, Mark %A Rioux, John D %A Jouven, Xavier %A Kääb, Stefan %A Psaty, Bruce M %A Siscovick, David S %A Arking, Dan E %A Sotoodehnia, Nona %X

Aims: Sudden cardiac arrest (SCA) accounts for 10% of adult mortality in Western populations. We aim to identify potential loci associated with SCA and to identify risk factors causally associated with SCA.

Methods and results: We carried out a large genome-wide association study (GWAS) for SCA (n = 3939 cases, 25 989 non-cases) to examine common variation genome-wide and in candidate arrhythmia genes. We also exploited Mendelian randomization (MR) methods using cross-trait multi-variant genetic risk score associations (GRSA) to assess causal relationships of 18 risk factors with SCA. No variants were associated with SCA at genome-wide significance, nor were common variants in candidate arrhythmia genes associated with SCA at nominal significance. Using cross-trait GRSA, we established genetic correlation between SCA and (i) coronary artery disease (CAD) and traditional CAD risk factors (blood pressure, lipids, and diabetes), (ii) height and BMI, and (iii) electrical instability traits (QT and atrial fibrillation), suggesting aetiologic roles for these traits in SCA risk.

Conclusions: Our findings show that a comprehensive approach to the genetic architecture of SCA can shed light on the determinants of a complex life-threatening condition with multiple influencing factors in the general population. The results of this genetic analysis, both positive and negative findings, have implications for evaluating the genetic architecture of patients with a family history of SCA, and for efforts to prevent SCA in high-risk populations and the general community.

%B Eur Heart J %8 2018 Aug 28 %G eng %R 10.1093/eurheartj/ehy474 %0 Journal Article %J Clin Chem %D 2018 %T {Dairy Consumption and Body Mass Index Among Adults: Mendelian Randomization Analysis of 184802 Individuals from 25 Studies %A Huang, T. %A Ding, M. %A Bergholdt, H. K. M. %A Wang, T. %A Heianza, Y. %A Sun, D. %A Frazier-Wood, A. C. %A Aslibekyan, S. %A North, K. E. %A Voortman, T. %A Graff, M. %A Smith, C. E. %A Lai, C. Q. %A Varbo, A. %A Lemaitre, R. N. %A de Jonge, M. E. A. L. %A Fumeron, F. %A Corella, D. %A Wang, C. A. %A Tj?nneland, A. %A Overvad, K. %A S?rensen, T. I. A. %A Feitosa, M. F. %A Wojczynski, M. K. %A K?h?nen, M. %A Renstr?m, F. %A Psaty, B. M. %A Siscovick, D. S. %A Barroso, I. %A Johansson, I. %A Hernandez, D. %A Ferrucci, L. %A Bandinelli, S. %A Linneberg, A. %A Zillikens, M. C. %A Sandholt, C. H. %A Pedersen, O. %A Hansen, T. %A Schulz, C. A. %A Sonestedt, E. %A Orho-Melander, M. %A Chen, T. A. %A Rotter, J. I. %A Allison, M. A. %A Rich, S. S. %A Sorl?, J. V. %A Coltell, O. %A Pennell, C. E. %A Eastwood, P. %A Hofman, A. %A Uitterlinden, A. G. %A van Rooij, F. J. A. %A Chu, A. Y. %A Rose, L. M. %A Ridker, P. M. %A Viikari, J. %A Raitakari, O. %A Lehtim?ki, T. %A Mikkil?, V. %A Willett, W. C. %A Wang, Y. %A Tucker, K. L. %A Ordovas, J. M. %A Kilpel?inen, T. O. %A Province, M. A. %A Franks, P. W. %A Arnett, D. K. %A Tanaka, T. %A Toft, U. %A Ericson, U. %A Franco, O. H. %A Mozaffarian, D. %A Hu, F. B. %A Chasman, D. I. %A Nordestgaard, B. G. %A Ellervik, C. %A Qi, L. %X Associations between dairy intake and body mass index (BMI) have been inconsistently observed in epidemiological studies, and the causal relationship remains ill defined.\ We performed Mendelian randomization (MR) analysis using an established dairy intake-associated genetic polymorphism located upstream of the lactase gene (LCT-13910 C/T, rs4988235) as an instrumental variable (IV). Linear regression models were fitted to analyze associations between (a) dairy intake and BMI, (b) rs4988235 and dairy intake, and (c) rs4988235 and BMI in each study. The causal effect of dairy intake on BMI was quantified by IV estimators among 184802 participants from 25 studies.\ Higher dairy intake was associated with higher BMI (β = 0.03 kg/m2 per serving/day; 95% CI, 0.00-0.06; P = 0.04), whereas the LCT genotype with 1 or 2 T allele was significantly associated with 0.20 (95% CI, 0.14-0.25) serving/day higher dairy intake (P = 3.15 × 10-12) and 0.12 (95% CI, 0.06-0.17) kg/m2 higher BMI (P = 2.11 × 10-5). MR analysis showed that the genetically determined higher dairy intake was significantly associated with higher BMI (β = 0.60 kg/m2 per serving/day; 95% CI, 0.27-0.92; P = 3.0 × 10-4).\ The present study provides strong evidence to support a causal effect of higher dairy intake on increased BMI among adults. %B Clin Chem %V 64 %P 183–191 %8 01 %G eng %0 Journal Article %J Hum Mol Genet %D 2018 %T Discovery, fine-mapping, and conditional analyses of genetic variants associated with C-reactive protein in multiethnic populations using the Metabochip in the Population Architecture using Genomics and Epidemiology (PAGE) study. %A Kocarnik, Jonathan M %A Richard, Melissa %A Graff, Misa %A Haessler, Jeffrey %A Bien, Stephanie %A Carlson, Chris %A Carty, Cara L %A Reiner, Alexander P %A Avery, Christy L %A Ballantyne, Christie M %A LaCroix, Andrea Z %A Assimes, Themistocles L %A Barbalic, Maja %A Pankratz, Nathan %A Tang, Weihong %A Tao, Ran %A Chen, Dongquan %A Talavera, Gregory A %A Daviglus, Martha L %A Chirinos-Medina, Diana A %A Pereira, Rocio %A Nishimura, Katie %A Bůzková, Petra %A Best, Lyle G %A Ambite, Jose Luis %A Cheng, Iona %A Crawford, Dana C %A Hindorff, Lucia A %A Fornage, Myriam %A Heiss, Gerardo %A North, Kari E %A Haiman, Christopher A %A Peters, Ulrike %A Le Marchand, Loïc %A Kooperberg, Charles %X

C-reactive protein (CRP) is a circulating biomarker indicative of systemic inflammation. We aimed to evaluate genetic associations with CRP levels among non-European-ancestry populations through discovery, fine-mapping and conditional analyses. A total of 30 503 non-European-ancestry participants from 6 studies participating in the Population Architecture using Genomics and Epidemiology study had serum high-sensitivity CRP measurements and ∼200 000 single nucleotide polymorphisms (SNPs) genotyped on the Metabochip. We evaluated the association between each SNP and log-transformed CRP levels using multivariate linear regression, with additive genetic models adjusted for age, sex, the first four principal components of genetic ancestry, and study-specific factors. Differential linkage disequilibrium patterns between race/ethnicity groups were used to fine-map regions associated with CRP levels. Conditional analyses evaluated for multiple independent signals within genetic regions. One hundred and sixty-three unique variants in 12 loci in overall or race/ethnicity-stratified Metabochip-wide scans reached a Bonferroni-corrected P-value <2.5E-7. Three loci have no (HACL1, OLFML2B) or only limited (PLA2G6) previous associations with CRP levels. Six loci had different top hits in race/ethnicity-specific versus overall analyses. Fine-mapping refined the signal in six loci, particularly in HNF1A. Conditional analyses provided evidence for secondary signals in LEPR, IL1RN and HNF1A, and for multiple independent signals in CRP and APOE. We identified novel variants and loci associated with CRP levels, generalized known CRP associations to a multiethnic study population, refined association signals at several loci and found evidence for multiple independent signals at several well-known loci. This study demonstrates the benefit of conducting inclusive genetic association studies in large multiethnic populations.

%B Hum Mol Genet %V 27 %P 2940-2953 %8 2018 Aug 15 %G eng %N 16 %R 10.1093/hmg/ddy211 %0 Journal Article %J Blood %D 2018 %T DNA methylation age is associated with an altered hemostatic profile in a multi-ethnic meta-analysis. %A Ward-Caviness, Cavin K %A Huffman, Jennifer E %A Evertt, Karl %A Germain, Marine %A van Dongen, Jenny %A Hill, W David %A Jhun, Min A %A Brody, Jennifer A %A Ghanbari, Mohsen %A Du, Lei %A Roetker, Nicholas S %A de Vries, Paul S %A Waldenberger, Melanie %A Gieger, Christian %A Wolf, Petra %A Prokisch, Holger %A Koenig, Wolfgang %A O'Donnell, Christopher J %A Levy, Daniel %A Liu, Chunyu %A Truong, Vinh %A Wells, Philip S %A Trégouët, David-Alexandre %A Tang, Weihong %A Morrison, Alanna C %A Boerwinkle, Eric %A Wiggins, Kerri L %A McKnight, Barbara %A Guo, Xiuqing %A Psaty, Bruce M %A Sotoodenia, Nona %A Boomsa, Dorret I %A Willemsen, Gonneke %A Ligthart, Lannie %A Deary, Ian J %A Zhao, Wei %A Ware, Erin B %A Kardia, Sharon L R %A van Meurs, Joyce B J %A Uitterlinden, André G %A Franco, Oscar H %A Eriksson, Per %A Franco-Cereceda, Anders %A Pankow, James S %A Johnson, Andrew D %A Gagnon, France %A Morange, Pierre-Emmanuel %A de Geus, Eco J C %A Starr, John M %A Smith, Jennifer A %A Dehghan, Abbas %A Björck, Hanna M %A Smith, Nicholas L %A Peters, Annette %X

Many hemostatic factors are associated with age and age-related diseases, however much remains unknown about the biological mechanisms linking aging and hemostatic factors. DNA methylation is a novel means by which to assess epigenetic aging, which is a measure of age and the aging processes as determined by altered epigenetic states. We used a meta-analysis approach to examine the association between measures of epigenetic aging and hemostatic factors, as well as a clotting time measure. For fibrinogen, we used European and African-ancestry participants who were meta-analyzed separately and combined via a random effects meta-analysis. All other measures only included participants of European-ancestry. We found that 1-year higher extrinsic epigenetic age as compared to chronological age was associated with higher fibrinogen (0.004 g/L per year; 95% CI: 0.001, 0.007; P = 0.01) and plasminogen activator inhibitor 1 (PAI-1; 0.13 U/mL per year; 95% CI: 0.07, 0.20; P = 6.6x10-5) concentrations as well as lower activated partial thromboplastin time, a measure of clotting time. We replicated PAI-1 associations using an independent cohort. To further elucidate potential functional mechanisms we associated epigenetic aging with expression levels of the PAI-1 protein encoding gene (SERPINE1) and the three fibrinogen subunit-encoding genes (FGA, FGG, and FGB), in both peripheral blood and aorta intima-media samples. We observed associations between accelerated epigenetic aging and transcription of FGG in both tissues. Collectively, our results indicate that accelerated epigenetic aging is associated with a pro-coagulation hemostatic profile, and that epigenetic aging may regulate hemostasis in part via gene transcription.

%B Blood %8 2018 Jul 24 %G eng %R 10.1182/blood-2018-02-831347 %0 Journal Article %J Eur Heart J %D 2018 %T Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies. %A Pennells, Lisa %A Kaptoge, Stephen %A Wood, Angela %A Sweeting, Mike %A Zhao, Xiaohui %A White, Ian %A Burgess, Stephen %A Willeit, Peter %A Bolton, Thomas %A Moons, Karel G M %A van der Schouw, Yvonne T %A Selmer, Randi %A Khaw, Kay-Tee %A Gudnason, Vilmundur %A Assmann, Gerd %A Amouyel, Philippe %A Salomaa, Veikko %A Kivimaki, Mika %A Nordestgaard, Børge G %A Blaha, Michael J %A Kuller, Lewis H %A Brenner, Hermann %A Gillum, Richard F %A Meisinger, Christa %A Ford, Ian %A Knuiman, Matthew W %A Rosengren, Annika %A Lawlor, Debbie A %A Völzke, Henry %A Cooper, Cyrus %A Marín Ibañez, Alejandro %A Casiglia, Edoardo %A Kauhanen, Jussi %A Cooper, Jackie A %A Rodriguez, Beatriz %A Sundström, Johan %A Barrett-Connor, Elizabeth %A Dankner, Rachel %A Nietert, Paul J %A Davidson, Karina W %A Wallace, Robert B %A Blazer, Dan G %A Björkelund, Cecilia %A Donfrancesco, Chiara %A Krumholz, Harlan M %A Nissinen, Aulikki %A Davis, Barry R %A Coady, Sean %A Whincup, Peter H %A Jørgensen, Torben %A Ducimetiere, Pierre %A Trevisan, Maurizio %A Engström, Gunnar %A Crespo, Carlos J %A Meade, Tom W %A Visser, Marjolein %A Kromhout, Daan %A Kiechl, Stefan %A Daimon, Makoto %A Price, Jackie F %A Gómez de la Cámara, Agustin %A Wouter Jukema, J %A Lamarche, Benoît %A Onat, Altan %A Simons, Leon A %A Kavousi, Maryam %A Ben-Shlomo, Yoav %A Gallacher, John %A Dekker, Jacqueline M %A Arima, Hisatomi %A Shara, Nawar %A Tipping, Robert W %A Roussel, Ronan %A Brunner, Eric J %A Koenig, Wolfgang %A Sakurai, Masaru %A Pavlovic, Jelena %A Gansevoort, Ron T %A Nagel, Dorothea %A Goldbourt, Uri %A Barr, Elizabeth L M %A Palmieri, Luigi %A Njølstad, Inger %A Sato, Shinichi %A Monique Verschuren, W M %A Varghese, Cherian V %A Graham, Ian %A Onuma, Oyere %A Greenland, Philip %A Woodward, Mark %A Ezzati, Majid %A Psaty, Bruce M %A Sattar, Naveed %A Jackson, Rod %A Ridker, Paul M %A Cook, Nancy R %A D'Agostino, Ralph B %A Thompson, Simon G %A Danesh, John %A Di Angelantonio, Emanuele %X

Aims: There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied.

Methods and results: Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms.

Conclusion: Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need.

%B Eur Heart J %8 2018 Nov 22 %G eng %R 10.1093/eurheartj/ehy653 %0 Journal Article %J Stroke %D 2018 %T Exome Chip Analysis Identifies Low-Frequency and Rare Variants in for White Matter Hyperintensities on Brain Magnetic Resonance Imaging. %A Jian, Xueqiu %A Satizabal, Claudia L %A Smith, Albert V %A Wittfeld, Katharina %A Bis, Joshua C %A Smith, Jennifer A %A Hsu, Fang-Chi %A Nho, Kwangsik %A Hofer, Edith %A Hagenaars, Saskia P %A Nyquist, Paul A %A Mishra, Aniket %A Adams, Hieab H H %A Li, Shuo %A Teumer, Alexander %A Zhao, Wei %A Freedman, Barry I %A Saba, Yasaman %A Yanek, Lisa R %A Chauhan, Ganesh %A van Buchem, Mark A %A Cushman, Mary %A Royle, Natalie A %A Bryan, R Nick %A Niessen, Wiro J %A Windham, Beverly G %A DeStefano, Anita L %A Habes, Mohamad %A Heckbert, Susan R %A Palmer, Nicholette D %A Lewis, Cora E %A Eiriksdottir, Gudny %A Maillard, Pauline %A Mathias, Rasika A %A Homuth, Georg %A Valdés-Hernández, Maria Del C %A Divers, Jasmin %A Beiser, Alexa S %A Langner, Sönke %A Rice, Kenneth M %A Bastin, Mark E %A Yang, Qiong %A Maldjian, Joseph A %A Starr, John M %A Sidney, Stephen %A Risacher, Shannon L %A Uitterlinden, André G %A Gudnason, Vilmundur G %A Nauck, Matthias %A Rotter, Jerome I %A Schreiner, Pamela J %A Boerwinkle, Eric %A van Duijn, Cornelia M %A Mazoyer, Bernard %A von Sarnowski, Bettina %A Gottesman, Rebecca F %A Levy, Daniel %A Sigurdsson, Sigurdur %A Vernooij, Meike W %A Turner, Stephen T %A Schmidt, Reinhold %A Wardlaw, Joanna M %A Psaty, Bruce M %A Mosley, Thomas H %A DeCarli, Charles S %A Saykin, Andrew J %A Bowden, Donald W %A Becker, Diane M %A Deary, Ian J %A Schmidt, Helena %A Kardia, Sharon L R %A Ikram, M Arfan %A Debette, Stephanie %A Grabe, Hans J %A Longstreth, W T %A Seshadri, Sudha %A Launer, Lenore J %A Fornage, Myriam %X

BACKGROUND AND PURPOSE: White matter hyperintensities (WMH) on brain magnetic resonance imaging are typical signs of cerebral small vessel disease and may indicate various preclinical, age-related neurological disorders, such as stroke. Though WMH are highly heritable, known common variants explain a small proportion of the WMH variance. The contribution of low-frequency/rare coding variants to WMH burden has not been explored.

METHODS: In the discovery sample we recruited 20 719 stroke/dementia-free adults from 13 population-based cohort studies within the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, among which 17 790 were of European ancestry and 2929 of African ancestry. We genotyped these participants at ≈250 000 mostly exonic variants with Illumina HumanExome BeadChip arrays. We performed ethnicity-specific linear regression on rank-normalized WMH in each study separately, which were then combined in meta-analyses to test for association with single variants and genes aggregating the effects of putatively functional low-frequency/rare variants. We then sought replication of the top findings in 1192 adults (European ancestry) with whole exome/genome sequencing data from 2 independent studies.

RESULTS: At 17q25, we confirmed the association of multiple common variants in , , and (<6×10). We also identified a novel association with 2 low-frequency nonsynonymous variants in (lead, rs34136221; =4.5×10) partially independent of known common signal (=1.4×10). We further identified a locus at 2q33 containing common variants in , , and (lead, rs2351524; =1.9×10). Although our novel findings were not replicated because of limited power and possible differences in study design, meta-analysis of the discovery and replication samples yielded stronger association for the 2 low-frequency variants (=2.8×10).

CONCLUSIONS: Both common and low-frequency/rare functional variants influence WMH. Larger replication and experimental follow-up are essential to confirm our findings and uncover the biological causal mechanisms of age-related WMH.

%B Stroke %8 2018 Jul 12 %G eng %R 10.1161/STROKEAHA.118.020689 %0 Journal Article %J Genome Biol %D 2018 %T Exome-chip meta-analysis identifies novel loci associated with cardiac conduction, including ADAMTS6. %A Prins, Bram P %A Mead, Timothy J %A Brody, Jennifer A %A Sveinbjornsson, Gardar %A Ntalla, Ioanna %A Bihlmeyer, Nathan A %A van den Berg, Marten %A Bork-Jensen, Jette %A Cappellani, Stefania %A Van Duijvenboden, Stefan %A Klena, Nikolai T %A Gabriel, George C %A Liu, Xiaoqin %A Gulec, Cagri %A Grarup, Niels %A Haessler, Jeffrey %A Hall, Leanne M %A Iorio, Annamaria %A Isaacs, Aaron %A Li-Gao, Ruifang %A Lin, Honghuang %A Liu, Ching-Ti %A Lyytikäinen, Leo-Pekka %A Marten, Jonathan %A Mei, Hao %A Müller-Nurasyid, Martina %A Orini, Michele %A Padmanabhan, Sandosh %A Radmanesh, Farid %A Ramirez, Julia %A Robino, Antonietta %A Schwartz, Molly %A van Setten, Jessica %A Smith, Albert V %A Verweij, Niek %A Warren, Helen R %A Weiss, Stefan %A Alonso, Alvaro %A Arnar, David O %A Bots, Michiel L %A de Boer, Rudolf A %A Dominiczak, Anna F %A Eijgelsheim, Mark %A Ellinor, Patrick T %A Guo, Xiuqing %A Felix, Stephan B %A Harris, Tamara B %A Hayward, Caroline %A Heckbert, Susan R %A Huang, Paul L %A Jukema, J W %A Kähönen, Mika %A Kors, Jan A %A Lambiase, Pier D %A Launer, Lenore J %A Li, Man %A Linneberg, Allan %A Nelson, Christopher P %A Pedersen, Oluf %A Perez, Marco %A Peters, Annette %A Polasek, Ozren %A Psaty, Bruce M %A Raitakari, Olli T %A Rice, Kenneth M %A Rotter, Jerome I %A Sinner, Moritz F %A Soliman, Elsayed Z %A Spector, Tim D %A Strauch, Konstantin %A Thorsteinsdottir, Unnur %A Tinker, Andrew %A Trompet, Stella %A Uitterlinden, Andre %A Vaartjes, Ilonca %A van der Meer, Peter %A Völker, Uwe %A Völzke, Henry %A Waldenberger, Melanie %A Wilson, James G %A Xie, Zhijun %A Asselbergs, Folkert W %A Dörr, Marcus %A van Duijn, Cornelia M %A Gasparini, Paolo %A Gudbjartsson, Daniel F %A Gudnason, Vilmundur %A Hansen, Torben %A Kääb, Stefan %A Kanters, Jørgen K %A Kooperberg, Charles %A Lehtimäki, Terho %A Lin, Henry J %A Lubitz, Steven A %A Mook-Kanamori, Dennis O %A Conti, Francesco J %A Newton-Cheh, Christopher H %A Rosand, Jonathan %A Rudan, Igor %A Samani, Nilesh J %A Sinagra, Gianfranco %A Smith, Blair H %A Holm, Hilma %A Stricker, Bruno H %A Ulivi, Sheila %A Sotoodehnia, Nona %A Apte, Suneel S %A van der Harst, Pim %A Stefansson, Kari %A Munroe, Patricia B %A Arking, Dan E %A Lo, Cecilia W %A Jamshidi, Yalda %X

BACKGROUND: Genome-wide association studies conducted on QRS duration, an electrocardiographic measurement associated with heart failure and sudden cardiac death, have led to novel biological insights into cardiac function. However, the variants identified fall predominantly in non-coding regions and their underlying mechanisms remain unclear.

RESULTS: Here, we identify putative functional coding variation associated with changes in the QRS interval duration by combining Illumina HumanExome BeadChip genotype data from 77,898 participants of European ancestry and 7695 of African descent in our discovery cohort, followed by replication in 111,874 individuals of European ancestry from the UK Biobank and deCODE cohorts. We identify ten novel loci, seven within coding regions, including ADAMTS6, significantly associated with QRS duration in gene-based analyses. ADAMTS6 encodes a secreted metalloprotease of currently unknown function. In vitro validation analysis shows that the QRS-associated variants lead to impaired ADAMTS6 secretion and loss-of function analysis in mice demonstrates a previously unappreciated role for ADAMTS6 in connexin 43 gap junction expression, which is essential for myocardial conduction.

CONCLUSIONS: Our approach identifies novel coding and non-coding variants underlying ventricular depolarization and provides a possible mechanism for the ADAMTS6-associated conduction changes.

%B Genome Biol %V 19 %P 87 %8 2018 07 17 %G eng %N 1 %R 10.1186/s13059-018-1457-6 %0 Journal Article %J Circ Genom Precis Med %D 2018 %T ExomeChip-Wide Analysis of 95 626 Individuals Identifies 10 Novel Loci Associated With QT and JT Intervals. %A Bihlmeyer, Nathan A %A Brody, Jennifer A %A Smith, Albert Vernon %A Warren, Helen R %A Lin, Honghuang %A Isaacs, Aaron %A Liu, Ching-Ti %A Marten, Jonathan %A Radmanesh, Farid %A Hall, Leanne M %A Grarup, Niels %A Mei, Hao %A Müller-Nurasyid, Martina %A Huffman, Jennifer E %A Verweij, Niek %A Guo, Xiuqing %A Yao, Jie %A Li-Gao, Ruifang %A van den Berg, Marten %A Weiss, Stefan %A Prins, Bram P %A van Setten, Jessica %A Haessler, Jeffrey %A Lyytikäinen, Leo-Pekka %A Li, Man %A Alonso, Alvaro %A Soliman, Elsayed Z %A Bis, Joshua C %A Austin, Tom %A Chen, Yii-Der Ida %A Psaty, Bruce M %A Harrris, Tamara B %A Launer, Lenore J %A Padmanabhan, Sandosh %A Dominiczak, Anna %A Huang, Paul L %A Xie, Zhijun %A Ellinor, Patrick T %A Kors, Jan A %A Campbell, Archie %A Murray, Alison D %A Nelson, Christopher P %A Tobin, Martin D %A Bork-Jensen, Jette %A Hansen, Torben %A Pedersen, Oluf %A Linneberg, Allan %A Sinner, Moritz F %A Peters, Annette %A Waldenberger, Melanie %A Meitinger, Thomas %A Perz, Siegfried %A Kolcic, Ivana %A Rudan, Igor %A de Boer, Rudolf A %A van der Meer, Peter %A Lin, Henry J %A Taylor, Kent D %A de Mutsert, Renée %A Trompet, Stella %A Jukema, J Wouter %A Maan, Arie C %A Stricker, Bruno H C %A Rivadeneira, Fernando %A Uitterlinden, Andre %A Völker, Uwe %A Homuth, Georg %A Völzke, Henry %A Felix, Stephan B %A Mangino, Massimo %A Spector, Timothy D %A Bots, Michiel L %A Perez, Marco %A Raitakari, Olli T %A Kähönen, Mika %A Mononen, Nina %A Gudnason, Vilmundur %A Munroe, Patricia B %A Lubitz, Steven A %A van Duijn, Cornelia M %A Newton-Cheh, Christopher H %A Hayward, Caroline %A Rosand, Jonathan %A Samani, Nilesh J %A Kanters, Jørgen K %A Wilson, James G %A Kääb, Stefan %A Polasek, Ozren %A van der Harst, Pim %A Heckbert, Susan R %A Rotter, Jerome I %A Mook-Kanamori, Dennis O %A Eijgelsheim, Mark %A Dörr, Marcus %A Jamshidi, Yalda %A Asselbergs, Folkert W %A Kooperberg, Charles %A Lehtimäki, Terho %A Arking, Dan E %A Sotoodehnia, Nona %X

BACKGROUND: QT interval, measured through a standard ECG, captures the time it takes for the cardiac ventricles to depolarize and repolarize. JT interval is the component of the QT interval that reflects ventricular repolarization alone. Prolonged QT interval has been linked to higher risk of sudden cardiac arrest.

METHODS AND RESULTS: We performed an ExomeChip-wide analysis for both QT and JT intervals, including 209 449 variants, both common and rare, in 17 341 genes from the Illumina Infinium HumanExome BeadChip. We identified 10 loci that modulate QT and JT interval duration that have not been previously reported in the literature using single-variant statistical models in a meta-analysis of 95 626 individuals from 23 cohorts (comprised 83 884 European ancestry individuals, 9610 blacks, 1382 Hispanics, and 750 Asians). This brings the total number of ventricular repolarization associated loci to 45. In addition, our approach of using coding variants has highlighted the role of 17 specific genes for involvement in ventricular repolarization, 7 of which are in novel loci.

CONCLUSIONS: Our analyses show a role for myocyte internal structure and interconnections in modulating QT interval duration, adding to previous known roles of potassium, sodium, and calcium ion regulation, as well as autonomic control. We anticipate that these discoveries will open new paths to the goal of making novel remedies for the prevention of lethal ventricular arrhythmias and sudden cardiac arrest.

%B Circ Genom Precis Med %V 11 %P e001758 %8 2018 Jan %G eng %N 1 %R 10.1161/CIRCGEN.117.001758 %0 Journal Article %J Genet Epidemiol %D 2018 %T FastSKAT: Sequence kernel association tests for very large sets of markers. %A Lumley, Thomas %A Brody, Jennifer %A Peloso, Gina %A Morrison, Alanna %A Rice, Kenneth %K Algorithms %K Chromosomes, Human %K Genetic Association Studies %K Genetic Markers %K Histones %K Humans %K Sequence Analysis, DNA %K Statistics as Topic %K Time Factors %X

The sequence kernel association test (SKAT) is widely used to test for associations between a phenotype and a set of genetic variants that are usually rare. Evaluating tail probabilities or quantiles of the null distribution for SKAT requires computing the eigenvalues of a matrix related to the genotype covariance between markers. Extracting the full set of eigenvalues of this matrix (an n×n matrix, for n subjects) has computational complexity proportional to n . As SKAT is often used when n104 , this step becomes a major bottleneck in its use in practice. We therefore propose fastSKAT, a new computationally inexpensive but accurate approximations to the tail probabilities, in which the k largest eigenvalues of a weighted genotype covariance matrix or the largest singular values of a weighted genotype matrix are extracted, and a single term based on the Satterthwaite approximation is used for the remaining eigenvalues. While the method is not particularly sensitive to the choice of k, we also describe how to choose its value, and show how fastSKAT can automatically alert users to the rare cases where the choice may affect results. As well as providing faster implementation of SKAT, the new method also enables entirely new applications of SKAT that were not possible before; we give examples grouping variants by topologically associating domains, and comparing chromosome-wide association by class of histone marker.

%B Genet Epidemiol %V 42 %P 516-527 %8 2018 09 %G eng %N 6 %R 10.1002/gepi.22136 %0 Journal Article %J PLoS Med %D 2018 %T Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies. %A Imamura, Fumiaki %A Fretts, Amanda %A Marklund, Matti %A Ardisson Korat, Andres V %A Yang, Wei-Sin %A Lankinen, Maria %A Qureshi, Waqas %A Helmer, Catherine %A Chen, Tzu-An %A Wong, Kerry %A Bassett, Julie K %A Murphy, Rachel %A Tintle, Nathan %A Yu, Chaoyu Ian %A Brouwer, Ingeborg A %A Chien, Kuo-Liong %A Frazier-Wood, Alexis C %A Del Gobbo, Liana C %A Djoussé, Luc %A Geleijnse, Johanna M %A Giles, Graham G %A de Goede, Janette %A Gudnason, Vilmundur %A Harris, William S %A Hodge, Allison %A Hu, Frank %A Koulman, Albert %A Laakso, Markku %A Lind, Lars %A Lin, Hung-Ju %A McKnight, Barbara %A Rajaobelina, Kalina %A Riserus, Ulf %A Robinson, Jennifer G %A Samieri, Cecilia %A Siscovick, David S %A Soedamah-Muthu, Sabita S %A Sotoodehnia, Nona %A Sun, Qi %A Tsai, Michael Y %A Uusitupa, Matti %A Wagenknecht, Lynne E %A Wareham, Nick J %A Wu, Jason HY %A Micha, Renata %A Forouhi, Nita G %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %K Aged %K Australia %K Biomarkers %K Dairy Products %K Diabetes Mellitus, Type 2 %K Dietary Fats %K Europe %K Fatty Acids %K Fatty Acids, Monounsaturated %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Prospective Studies %K Sex Factors %K Taiwan %K United States %X

BACKGROUND: We aimed to investigate prospective associations of circulating or adipose tissue odd-chain fatty acids 15:0 and 17:0 and trans-palmitoleic acid, t16:1n-7, as potential biomarkers of dairy fat intake, with incident type 2 diabetes (T2D).

METHODS AND FINDINGS: Sixteen prospective cohorts from 12 countries (7 from the United States, 7 from Europe, 1 from Australia, 1 from Taiwan) performed new harmonised individual-level analysis for the prospective associations according to a standardised plan. In total, 63,682 participants with a broad range of baseline ages and BMIs and 15,180 incident cases of T2D over the average of 9 years of follow-up were evaluated. Study-specific results were pooled using inverse-variance-weighted meta-analysis. Prespecified interactions by age, sex, BMI, and race/ethnicity were explored in each cohort and were meta-analysed. Potential heterogeneity by cohort-specific characteristics (regions, lipid compartments used for fatty acid assays) was assessed with metaregression. After adjustment for potential confounders, including measures of adiposity (BMI, waist circumference) and lipogenesis (levels of palmitate, triglycerides), higher levels of 15:0, 17:0, and t16:1n-7 were associated with lower incidence of T2D. In the most adjusted model, the hazard ratio (95% CI) for incident T2D per cohort-specific 10th to 90th percentile range of 15:0 was 0.80 (0.73-0.87); of 17:0, 0.65 (0.59-0.72); of t16:1n7, 0.82 (0.70-0.96); and of their sum, 0.71 (0.63-0.79). In exploratory analyses, similar associations for 15:0, 17:0, and the sum of all three fatty acids were present in both genders but stronger in women than in men (pinteraction < 0.001). Whereas studying associations with biomarkers has several advantages, as limitations, the biomarkers do not distinguish between different food sources of dairy fat (e.g., cheese, yogurt, milk), and residual confounding by unmeasured or imprecisely measured confounders may exist.

CONCLUSIONS: In a large meta-analysis that pooled the findings from 16 prospective cohort studies, higher levels of 15:0, 17:0, and t16:1n-7 were associated with a lower risk of T2D.

%B PLoS Med %V 15 %P e1002670 %8 2018 10 %G eng %N 10 %R 10.1371/journal.pmed.1002670 %0 Journal Article %J Am J Hematol %D 2018 %T Generalization and fine mapping of red blood cell trait genetic associations to multi-ethnic populations: The PAGE Study. %A Jo Hodonsky, Chani %A Schurmann, Claudia %A Schick, Ursula M %A Kocarnik, Jonathan %A Tao, Ran %A van Rooij, Frank Ja %A Wassel, Christina %A Buyske, Steve %A Fornage, Myriam %A Hindorff, Lucia A %A Floyd, James S %A Ganesh, Santhi K %A Lin, Dan-Yu %A North, Kari E %A Reiner, Alex P %A Loos, Ruth Jf %A Kooperberg, Charles %A Avery, Christy L %X

Red blood cell (RBC) traits provide insight into a wide range of physiological states and exhibit moderate to high heritability, making them excellent candidates for genetic studies to inform underlying biologic mechanisms. Previous RBC trait genome-wide association studies were performed primarily in European- or Asian-ancestry populations, missing opportunities to inform understanding of RBC genetic architecture in diverse populations and reduce intervals surrounding putative functional SNPs through fine-mapping. Here, we report the first fine-mapping of six correlated (Pearson's r range: |0.04 - 0.92|) RBC traits in up to 19,036 African Americans and 19,562 Hispanic/Latinos participants of the Population Architecture using Genomics and Epidemiology (PAGE) consortium. Trans-ethnic meta-analysis of race/ethnic- and study-specific estimates for approximately 11,000 SNPs flanking 13 previously identified association signals as well as 150,000 additional array-wide SNPs was performed using inverse-variance meta-analysis after adjusting for study and clinical covariates. Approximately half of previously reported index SNP-RBC trait associations generalized to the trans-ethnic study population (p<1.7x10 ); previously unreported independent association signals within the ABO region reinforce the potential for multiple functional variants affecting the same locus. Trans-ethnic fine-mapping did not reveal additional signals at the HFE locus independent of the known functional variants. Finally, we identified a potential novel association in the Hispanic/Latino study population at the HECTD4/RPL6 locus for RBC count (p=1.9x10 ). The identification of a previously unknown association, generalization of a large proportion of known association signals, and refinement of known association signals all exemplify the benefits of genetic studies in diverse populations. This article is protected by copyright. All rights reserved.

%B Am J Hematol %8 2018 Jun 15 %G eng %R 10.1002/ajh.25161 %0 Journal Article %J Nat Genet %D 2018 %T Genetic analysis of over 1 million people identifies 535 new loci associated with blood pressure traits. %A Evangelou, Evangelos %A Warren, Helen R %A Mosen-Ansorena, David %A Mifsud, Borbala %A Pazoki, Raha %A Gao, He %A Ntritsos, Georgios %A Dimou, Niki %A Cabrera, Claudia P %A Karaman, Ibrahim %A Ng, Fu Liang %A Evangelou, Marina %A Witkowska, Katarzyna %A Tzanis, Evan %A Hellwege, Jacklyn N %A Giri, Ayush %A Velez Edwards, Digna R %A Sun, Yan V %A Cho, Kelly %A Gaziano, J Michael %A Wilson, Peter W F %A Tsao, Philip S %A Kovesdy, Csaba P %A Esko, Tõnu %A Mägi, Reedik %A Milani, Lili %A Almgren, Peter %A Boutin, Thibaud %A Debette, Stephanie %A Ding, Jun %A Giulianini, Franco %A Holliday, Elizabeth G %A Jackson, Anne U %A Li-Gao, Ruifang %A Lin, Wei-Yu %A Luan, Jian'an %A Mangino, Massimo %A Oldmeadow, Christopher %A Prins, Bram Peter %A Qian, Yong %A Sargurupremraj, Muralidharan %A Shah, Nabi %A Surendran, Praveen %A Thériault, Sébastien %A Verweij, Niek %A Willems, Sara M %A Zhao, Jing-Hua %A Amouyel, Philippe %A Connell, John %A de Mutsert, Renée %A Doney, Alex S F %A Farrall, Martin %A Menni, Cristina %A Morris, Andrew D %A Noordam, Raymond %A Paré, Guillaume %A Poulter, Neil R %A Shields, Denis C %A Stanton, Alice %A Thom, Simon %A Abecasis, Goncalo %A Amin, Najaf %A Arking, Dan E %A Ayers, Kristin L %A Barbieri, Caterina M %A Batini, Chiara %A Bis, Joshua C %A Blake, Tineka %A Bochud, Murielle %A Boehnke, Michael %A Boerwinkle, Eric %A Boomsma, Dorret I %A Bottinger, Erwin P %A Braund, Peter S %A Brumat, Marco %A Campbell, Archie %A Campbell, Harry %A Chakravarti, Aravinda %A Chambers, John C %A Chauhan, Ganesh %A Ciullo, Marina %A Cocca, Massimiliano %A Collins, Francis %A Cordell, Heather J %A Davies, Gail %A Borst, Martin H de %A Geus, Eco J de %A Deary, Ian J %A Deelen, Joris %A del Greco M, Fabiola %A Demirkale, Cumhur Yusuf %A Dörr, Marcus %A Ehret, Georg B %A Elosua, Roberto %A Enroth, Stefan %A Erzurumluoglu, A Mesut %A Ferreira, Teresa %A Frånberg, Mattias %A Franco, Oscar H %A Gandin, Ilaria %A Gasparini, Paolo %A Giedraitis, Vilmantas %A Gieger, Christian %A Girotto, Giorgia %A Goel, Anuj %A Gow, Alan J %A Gudnason, Vilmundur %A Guo, Xiuqing %A Gyllensten, Ulf %A Hamsten, Anders %A Harris, Tamara B %A Harris, Sarah E %A Hartman, Catharina A %A Havulinna, Aki S %A Hicks, Andrew A %A Hofer, Edith %A Hofman, Albert %A Hottenga, Jouke-Jan %A Huffman, Jennifer E %A Hwang, Shih-Jen %A Ingelsson, Erik %A James, Alan %A Jansen, Rick %A Jarvelin, Marjo-Riitta %A Joehanes, Roby %A Johansson, Asa %A Johnson, Andrew D %A Joshi, Peter K %A Jousilahti, Pekka %A Jukema, J Wouter %A Jula, Antti %A Kähönen, Mika %A Kathiresan, Sekar %A Keavney, Bernard D %A Khaw, Kay-Tee %A Knekt, Paul %A Knight, Joanne %A Kolcic, Ivana %A Kooner, Jaspal S %A Koskinen, Seppo %A Kristiansson, Kati %A Kutalik, Zoltán %A Laan, Maris %A Larson, Marty %A Launer, Lenore J %A Lehne, Benjamin %A Lehtimäki, Terho %A Liewald, David C M %A Lin, Li %A Lind, Lars %A Lindgren, Cecilia M %A Liu, Yongmei %A Loos, Ruth J F %A Lopez, Lorna M %A Lu, Yingchang %A Lyytikäinen, Leo-Pekka %A Mahajan, Anubha %A Mamasoula, Chrysovalanto %A Marrugat, Jaume %A Marten, Jonathan %A Milaneschi, Yuri %A Morgan, Anna %A Morris, Andrew P %A Morrison, Alanna C %A Munson, Peter J %A Nalls, Mike A %A Nandakumar, Priyanka %A Nelson, Christopher P %A Niiranen, Teemu %A Nolte, Ilja M %A Nutile, Teresa %A Oldehinkel, Albertine J %A Oostra, Ben A %A O'Reilly, Paul F %A Org, Elin %A Padmanabhan, Sandosh %A Palmas, Walter %A Palotie, Aarno %A Pattie, Alison %A Penninx, Brenda W J H %A Perola, Markus %A Peters, Annette %A Polasek, Ozren %A Pramstaller, Peter P %A Nguyen, Quang Tri %A Raitakari, Olli T %A Ren, Meixia %A Rettig, Rainer %A Rice, Kenneth %A Ridker, Paul M %A Ried, Janina S %A Riese, Harriëtte %A Ripatti, Samuli %A Robino, Antonietta %A Rose, Lynda M %A Rotter, Jerome I %A Rudan, Igor %A Ruggiero, Daniela %A Saba, Yasaman %A Sala, Cinzia F %A Salomaa, Veikko %A Samani, Nilesh J %A Sarin, Antti-Pekka %A Schmidt, Reinhold %A Schmidt, Helena %A Shrine, Nick %A Siscovick, David %A Smith, Albert V %A Snieder, Harold %A Sõber, Siim %A Sorice, Rossella %A Starr, John M %A Stott, David J %A Strachan, David P %A Strawbridge, Rona J %A Sundström, Johan %A Swertz, Morris A %A Taylor, Kent D %A Teumer, Alexander %A Tobin, Martin D %A Tomaszewski, Maciej %A Toniolo, Daniela %A Traglia, Michela %A Trompet, Stella %A Tuomilehto, Jaakko %A Tzourio, Christophe %A Uitterlinden, André G %A Vaez, Ahmad %A van der Most, Peter J %A van Duijn, Cornelia M %A Vergnaud, Anne-Claire %A Verwoert, Germaine C %A Vitart, Veronique %A Völker, Uwe %A Vollenweider, Peter %A Vuckovic, Dragana %A Watkins, Hugh %A Wild, Sarah H %A Willemsen, Gonneke %A Wilson, James F %A Wright, Alan F %A Yao, Jie %A Zemunik, Tatijana %A Zhang, Weihua %A Attia, John R %A Butterworth, Adam S %A Chasman, Daniel I %A Conen, David %A Cucca, Francesco %A Danesh, John %A Hayward, Caroline %A Howson, Joanna M M %A Laakso, Markku %A Lakatta, Edward G %A Langenberg, Claudia %A Melander, Olle %A Mook-Kanamori, Dennis O %A Palmer, Colin N A %A Risch, Lorenz %A Scott, Robert A %A Scott, Rodney J %A Sever, Peter %A Spector, Tim D %A van der Harst, Pim %A Wareham, Nicholas J %A Zeggini, Eleftheria %A Levy, Daniel %A Munroe, Patricia B %A Newton-Cheh, Christopher %A Brown, Morris J %A Metspalu, Andres %A Hung, Adriana M %A O'Donnell, Christopher J %A Edwards, Todd L %A Psaty, Bruce M %A Tzoulaki, Ioanna %A Barnes, Michael R %A Wain, Louise V %A Elliott, Paul %A Caulfield, Mark J %X

High blood pressure is a highly heritable and modifiable risk factor for cardiovascular disease. We report the largest genetic association study of blood pressure traits (systolic, diastolic and pulse pressure) to date in over 1 million people of European ancestry. We identify 535 novel blood pressure loci that not only offer new biological insights into blood pressure regulation but also highlight shared genetic architecture between blood pressure and lifestyle exposures. Our findings identify new biological pathways for blood pressure regulation with potential for improved cardiovascular disease prevention in the future.

%B Nat Genet %V 50 %P 1412-1425 %8 2018 Oct %G eng %N 10 %R 10.1038/s41588-018-0205-x %0 Journal Article %J J Am Soc Nephrol %D 2018 %T Genetic Variants Associated with Circulating Fibroblast Growth Factor 23. %A Robinson-Cohen, Cassianne %A Bartz, Traci M %A Lai, Dongbing %A Ikizler, T Alp %A Peacock, Munro %A Imel, Erik A %A Michos, Erin D %A Foroud, Tatiana M %A Åkesson, Kristina %A Taylor, Kent D %A Malmgren, Linnea %A Matsushita, Kunihiro %A Nethander, Maria %A Eriksson, Joel %A Ohlsson, Claes %A Mellström, Daniel %A Wolf, Myles %A Ljunggren, Osten %A McGuigan, Fiona %A Rotter, Jerome I %A Karlsson, Magnus %A Econs, Michael J %A Ix, Joachim H %A Lutsey, Pamela L %A Psaty, Bruce M %A de Boer, Ian H %A Kestenbaum, Bryan R %X

BACKGROUND: Fibroblast growth factor 23 (FGF23), a bone-derived hormone that regulates phosphorus and vitamin D metabolism, contributes to the pathogenesis of mineral and bone disorders in CKD and is an emerging cardiovascular risk factor. Central elements of FGF23 regulation remain incompletely understood; genetic variation may help explain interindividual differences.

METHODS: We performed a meta-analysis of genome-wide association studies of circulating FGF23 concentrations among 16,624 participants of European ancestry from seven cohort studies, excluding participants with eGFR<30 ml/min per 1.73 m to focus on FGF23 under normal conditions. We evaluated the association of single-nucleotide polymorphisms (SNPs) with natural log-transformed FGF23 concentration, adjusted for age, sex, study site, and principal components of ancestry. A second model additionally adjusted for BMI and eGFR.

RESULTS: We discovered 154 SNPs from five independent regions associated with FGF23 concentration. The SNP with the strongest association, rs17216707 (=3.0×10), lies upstream of , which encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D. Each additional copy of the T allele at this locus is associated with 5% higher FGF23 concentration. Another locus strongly associated with variations in FGF23 concentration is rs11741640, within and upstream of (a gene involved in renal phosphate transport). Additional adjustment for BMI and eGFR did not materially alter the magnitude of these associations. Another top locus (within , the ABO blood group transferase gene) was no longer statistically significant at the genome-wide level.

CONCLUSIONS: Common genetic variants located near genes involved in vitamin D metabolism and renal phosphate transport are associated with differences in circulating FGF23 concentrations.

%B J Am Soc Nephrol %8 2018 Sep 14 %G eng %R 10.1681/ASN.2018020192 %0 Journal Article %J Dement Geriatr Cogn Disord %D 2018 %T Genetic Variation in Genes Underlying Diverse Dementias May Explain a Small Proportion of Cases in the Alzheimer's Disease Sequencing Project. %A Blue, Elizabeth E %A Bis, Joshua C %A Dorschner, Michael O %A Tsuang, Debby W %A Barral, Sandra M %A Beecham, Gary %A Below, Jennifer E %A Bush, William S %A Butkiewicz, Mariusz %A Cruchaga, Carlos %A DeStefano, Anita %A Farrer, Lindsay A %A Goate, Alison %A Haines, Jonathan %A Jaworski, Jim %A Jun, Gyungah %A Kunkle, Brian %A Kuzma, Amanda %A Lee, Jenny J %A Lunetta, Kathryn L %A Ma, Yiyi %A Martin, Eden %A Naj, Adam %A Nato, Alejandro Q %A Navas, Patrick %A Nguyen, Hiep %A Reitz, Christiane %A Reyes, Dolly %A Salerno, William %A Schellenberg, Gerard D %A Seshadri, Sudha %A Sohi, Harkirat %A Thornton, Timothy A %A Valadares, Otto %A van Duijn, Cornelia %A Vardarajan, Badri N %A Wang, Li-San %A Boerwinkle, Eric %A Dupuis, Josée %A Pericak-Vance, Margaret A %A Mayeux, Richard %A Wijsman, Ellen M %X

BACKGROUND/AIMS: The Alzheimer's Disease Sequencing Project (ADSP) aims to identify novel genes influencing Alzheimer's disease (AD). Variants within genes known to cause dementias other than AD have previously been associated with AD risk. We describe evidence of co-segregation and associations between variants in dementia genes and clinically diagnosed AD within the ADSP.

METHODS: We summarize the properties of known pathogenic variants within dementia genes, describe the co-segregation of variants annotated as "pathogenic" in ClinVar and new candidates observed in ADSP families, and test for associations between rare variants in dementia genes in the ADSP case-control study. The participants were clinically evaluated for AD, and they represent European, Caribbean Hispanic, and isolate Dutch populations.

RESULTS/CONCLUSIONS: Pathogenic variants in dementia genes were predominantly rare and conserved coding changes. Pathogenic variants within ARSA, CSF1R, and GRN were observed, and candidate variants in GRN and CHMP2B were nominated in ADSP families. An independent case-control study provided evidence of an association between variants in TREM2, APOE, ARSA, CSF1R, PSEN1, and MAPT and risk of AD. Variants in genes which cause dementing disorders may influence the clinical diagnosis of AD in a small proportion of cases within the ADSP.

%B Dement Geriatr Cogn Disord %V 45 %P 1-17 %8 2018 %G eng %N 1-2 %R 10.1159/000485503 %0 Journal Article %J Am J Hum Genet %D 2018 %T Genome Analyses of >200,000 Individuals Identify 58 Loci for Chronic Inflammation and Highlight Pathways that Link Inflammation and Complex Disorders. %A Ligthart, Symen %A Vaez, Ahmad %A Võsa, Urmo %A Stathopoulou, Maria G %A de Vries, Paul S %A Prins, Bram P %A van der Most, Peter J %A Tanaka, Toshiko %A Naderi, Elnaz %A Rose, Lynda M %A Wu, Ying %A Karlsson, Robert %A Barbalic, Maja %A Lin, Honghuang %A Pool, Rene %A Zhu, Gu %A Mace, Aurelien %A Sidore, Carlo %A Trompet, Stella %A Mangino, Massimo %A Sabater-Lleal, Maria %A Kemp, John P %A Abbasi, Ali %A Kacprowski, Tim %A Verweij, Niek %A Smith, Albert V %A Huang, Tao %A Marzi, Carola %A Feitosa, Mary F %A Lohman, Kurt K %A Kleber, Marcus E %A Milaneschi, Yuri %A Mueller, Christian %A Huq, Mahmudul %A Vlachopoulou, Efthymia %A Lyytikäinen, Leo-Pekka %A Oldmeadow, Christopher %A Deelen, Joris %A Perola, Markus %A Zhao, Jing Hua %A Feenstra, Bjarke %A Amini, Marzyeh %A Lahti, Jari %A Schraut, Katharina E %A Fornage, Myriam %A Suktitipat, Bhoom %A Chen, Wei-Min %A Li, Xiaohui %A Nutile, Teresa %A Malerba, Giovanni %A Luan, Jian'an %A Bak, Tom %A Schork, Nicholas %A del Greco M, Fabiola %A Thiering, Elisabeth %A Mahajan, Anubha %A Marioni, Riccardo E %A Mihailov, Evelin %A Eriksson, Joel %A Ozel, Ayse Bilge %A Zhang, Weihua %A Nethander, Maria %A Cheng, Yu-Ching %A Aslibekyan, Stella %A Ang, Wei %A Gandin, Ilaria %A Yengo, Loic %A Portas, Laura %A Kooperberg, Charles %A Hofer, Edith %A Rajan, Kumar B %A Schurmann, Claudia %A den Hollander, Wouter %A Ahluwalia, Tarunveer S %A Zhao, Jing %A Draisma, Harmen H M %A Ford, Ian %A Timpson, Nicholas %A Teumer, Alexander %A Huang, Hongyan %A Wahl, Simone %A Liu, Yongmei %A Huang, Jie %A Uh, Hae-Won %A Geller, Frank %A Joshi, Peter K %A Yanek, Lisa R %A Trabetti, Elisabetta %A Lehne, Benjamin %A Vozzi, Diego %A Verbanck, Marie %A Biino, Ginevra %A Saba, Yasaman %A Meulenbelt, Ingrid %A O'Connell, Jeff R %A Laakso, Markku %A Giulianini, Franco %A Magnusson, Patrik K E %A Ballantyne, Christie M %A Hottenga, Jouke Jan %A Montgomery, Grant W %A Rivadineira, Fernando %A Rueedi, Rico %A Steri, Maristella %A Herzig, Karl-Heinz %A Stott, David J %A Menni, Cristina %A Frånberg, Mattias %A St Pourcain, Beate %A Felix, Stephan B %A Pers, Tune H %A Bakker, Stephan J L %A Kraft, Peter %A Peters, Annette %A Vaidya, Dhananjay %A Delgado, Graciela %A Smit, Johannes H %A Großmann, Vera %A Sinisalo, Juha %A Seppälä, Ilkka %A Williams, Stephen R %A Holliday, Elizabeth G %A Moed, Matthijs %A Langenberg, Claudia %A Räikkönen, Katri %A Ding, Jingzhong %A Campbell, Harry %A Sale, Michèle M %A Chen, Yii-der I %A James, Alan L %A Ruggiero, Daniela %A Soranzo, Nicole %A Hartman, Catharina A %A Smith, Erin N %A Berenson, Gerald S %A Fuchsberger, Christian %A Hernandez, Dena %A Tiesler, Carla M T %A Giedraitis, Vilmantas %A Liewald, David %A Fischer, Krista %A Mellström, Dan %A Larsson, Anders %A Wang, Yunmei %A Scott, William R %A Lorentzon, Matthias %A Beilby, John %A Ryan, Kathleen A %A Pennell, Craig E %A Vuckovic, Dragana %A Balkau, Beverly %A Concas, Maria Pina %A Schmidt, Reinhold %A Mendes de Leon, Carlos F %A Bottinger, Erwin P %A Kloppenburg, Margreet %A Paternoster, Lavinia %A Boehnke, Michael %A Musk, A W %A Willemsen, Gonneke %A Evans, David M %A Madden, Pamela A F %A Kähönen, Mika %A Kutalik, Zoltán %A Zoledziewska, Magdalena %A Karhunen, Ville %A Kritchevsky, Stephen B %A Sattar, Naveed %A Lachance, Genevieve %A Clarke, Robert %A Harris, Tamara B %A Raitakari, Olli T %A Attia, John R %A van Heemst, Diana %A Kajantie, Eero %A Sorice, Rossella %A Gambaro, Giovanni %A Scott, Robert A %A Hicks, Andrew A %A Ferrucci, Luigi %A Standl, Marie %A Lindgren, Cecilia M %A Starr, John M %A Karlsson, Magnus %A Lind, Lars %A Li, Jun Z %A Chambers, John C %A Mori, Trevor A %A de Geus, Eco J C N %A Heath, Andrew C %A Martin, Nicholas G %A Auvinen, Juha %A Buckley, Brendan M %A de Craen, Anton J M %A Waldenberger, Melanie %A Strauch, Konstantin %A Meitinger, Thomas %A Scott, Rodney J %A McEvoy, Mark %A Beekman, Marian %A Bombieri, Cristina %A Ridker, Paul M %A Mohlke, Karen L %A Pedersen, Nancy L %A Morrison, Alanna C %A Boomsma, Dorret I %A Whitfield, John B %A Strachan, David P %A Hofman, Albert %A Vollenweider, Peter %A Cucca, Francesco %A Jarvelin, Marjo-Riitta %A Jukema, J Wouter %A Spector, Tim D %A Hamsten, Anders %A Zeller, Tanja %A Uitterlinden, André G %A Nauck, Matthias %A Gudnason, Vilmundur %A Qi, Lu %A Grallert, Harald %A Borecki, Ingrid B %A Rotter, Jerome I %A März, Winfried %A Wild, Philipp S %A Lokki, Marja-Liisa %A Boyle, Michael %A Salomaa, Veikko %A Melbye, Mads %A Eriksson, Johan G %A Wilson, James F %A Penninx, Brenda W J H %A Becker, Diane M %A Worrall, Bradford B %A Gibson, Greg %A Krauss, Ronald M %A Ciullo, Marina %A Zaza, Gianluigi %A Wareham, Nicholas J %A Oldehinkel, Albertine J %A Palmer, Lyle J %A Murray, Sarah S %A Pramstaller, Peter P %A Bandinelli, Stefania %A Heinrich, Joachim %A Ingelsson, Erik %A Deary, Ian J %A Mägi, Reedik %A Vandenput, Liesbeth %A van der Harst, Pim %A Desch, Karl C %A Kooner, Jaspal S %A Ohlsson, Claes %A Hayward, Caroline %A Lehtimäki, Terho %A Shuldiner, Alan R %A Arnett, Donna K %A Beilin, Lawrence J %A Robino, Antonietta %A Froguel, Philippe %A Pirastu, Mario %A Jess, Tine %A Koenig, Wolfgang %A Loos, Ruth J F %A Evans, Denis A %A Schmidt, Helena %A Smith, George Davey %A Slagboom, P Eline %A Eiriksdottir, Gudny %A Morris, Andrew P %A Psaty, Bruce M %A Tracy, Russell P %A Nolte, Ilja M %A Boerwinkle, Eric %A Visvikis-Siest, Sophie %A Reiner, Alex P %A Gross, Myron %A Bis, Joshua C %A Franke, Lude %A Franco, Oscar H %A Benjamin, Emelia J %A Chasman, Daniel I %A Dupuis, Josée %A Snieder, Harold %A Dehghan, Abbas %A Alizadeh, Behrooz Z %X

C-reactive protein (CRP) is a sensitive biomarker of chronic low-grade inflammation and is associated with multiple complex diseases. The genetic determinants of chronic inflammation remain largely unknown, and the causal role of CRP in several clinical outcomes is debated. We performed two genome-wide association studies (GWASs), on HapMap and 1000 Genomes imputed data, of circulating amounts of CRP by using data from 88 studies comprising 204,402 European individuals. Additionally, we performed in silico functional analyses and Mendelian randomization analyses with several clinical outcomes. The GWAS meta-analyses of CRP revealed 58 distinct genetic loci (p < 5 × 10). After adjustment for body mass index in the regression analysis, the associations at all except three loci remained. The lead variants at the distinct loci explained up to 7.0% of the variance in circulating amounts of CRP. We identified 66 gene sets that were organized in two substantially correlated clusters, one mainly composed of immune pathways and the other characterized by metabolic pathways in the liver. Mendelian randomization analyses revealed a causal protective effect of CRP on schizophrenia and a risk-increasing effect on bipolar disorder. Our findings provide further insights into the biology of inflammation and could lead to interventions for treating inflammation and its clinical consequences.

%B Am J Hum Genet %V 103 %P 691-706 %8 2018 Nov 01 %G eng %N 5 %R 10.1016/j.ajhg.2018.09.009 %0 Journal Article %J Nat Commun %D 2018 %T Genome-wide analyses identify a role for SLC17A4 and AADAT in thyroid hormone regulation. %A Teumer, Alexander %A Chaker, Layal %A Groeneweg, Stefan %A Li, Yong %A Di Munno, Celia %A Barbieri, Caterina %A Schultheiss, Ulla T %A Traglia, Michela %A Ahluwalia, Tarunveer S %A Akiyama, Masato %A Appel, Emil Vincent R %A Arking, Dan E %A Arnold, Alice %A Astrup, Arne %A Beekman, Marian %A Beilby, John P %A Bekaert, Sofie %A Boerwinkle, Eric %A Brown, Suzanne J %A De Buyzere, Marc %A Campbell, Purdey J %A Ceresini, Graziano %A Cerqueira, Charlotte %A Cucca, Francesco %A Deary, Ian J %A Deelen, Joris %A Eckardt, Kai-Uwe %A Ekici, Arif B %A Eriksson, Johan G %A Ferrrucci, Luigi %A Fiers, Tom %A Fiorillo, Edoardo %A Ford, Ian %A Fox, Caroline S %A Fuchsberger, Christian %A Galesloot, Tessel E %A Gieger, Christian %A Gögele, Martin %A De Grandi, Alessandro %A Grarup, Niels %A Greiser, Karin Halina %A Haljas, Kadri %A Hansen, Torben %A Harris, Sarah E %A van Heemst, Diana %A den Heijer, Martin %A Hicks, Andrew A %A den Hollander, Wouter %A Homuth, Georg %A Hui, Jennie %A Ikram, M Arfan %A Ittermann, Till %A Jensen, Richard A %A Jing, Jiaojiao %A Jukema, J Wouter %A Kajantie, Eero %A Kamatani, Yoichiro %A Kasbohm, Elisa %A Kaufman, Jean-Marc %A Kiemeney, Lambertus A %A Kloppenburg, Margreet %A Kronenberg, Florian %A Kubo, Michiaki %A Lahti, Jari %A Lapauw, Bruno %A Li, Shuo %A Liewald, David C M %A Lim, Ee Mun %A Linneberg, Allan %A Marina, Michela %A Mascalzoni, Deborah %A Matsuda, Koichi %A Medenwald, Daniel %A Meisinger, Christa %A Meulenbelt, Ingrid %A De Meyer, Tim %A Meyer zu Schwabedissen, Henriette E %A Mikolajczyk, Rafael %A Moed, Matthijs %A Netea-Maier, Romana T %A Nolte, Ilja M %A Okada, Yukinori %A Pala, Mauro %A Pattaro, Cristian %A Pedersen, Oluf %A Petersmann, Astrid %A Porcu, Eleonora %A Postmus, Iris %A Pramstaller, Peter P %A Psaty, Bruce M %A Ramos, Yolande F M %A Rawal, Rajesh %A Redmond, Paul %A Richards, J Brent %A Rietzschel, Ernst R %A Rivadeneira, Fernando %A Roef, Greet %A Rotter, Jerome I %A Sala, Cinzia F %A Schlessinger, David %A Selvin, Elizabeth %A Slagboom, P Eline %A Soranzo, Nicole %A Sørensen, Thorkild I A %A Spector, Timothy D %A Starr, John M %A Stott, David J %A Taes, Youri %A Taliun, Daniel %A Tanaka, Toshiko %A Thuesen, Betina %A Tiller, Daniel %A Toniolo, Daniela %A Uitterlinden, André G %A Visser, W Edward %A Walsh, John P %A Wilson, Scott G %A Wolffenbuttel, Bruce H R %A Yang, Qiong %A Zheng, Hou-Feng %A Cappola, Anne %A Peeters, Robin P %A Naitza, Silvia %A Völzke, Henry %A Sanna, Serena %A Köttgen, Anna %A Visser, Theo J %A Medici, Marco %X

Thyroid dysfunction is an important public health problem, which affects 10% of the general population and increases the risk of cardiovascular morbidity and mortality. Many aspects of thyroid hormone regulation have only partly been elucidated, including its transport, metabolism, and genetic determinants. Here we report a large meta-analysis of genome-wide association studies for thyroid function and dysfunction, testing 8 million genetic variants in up to 72,167 individuals. One-hundred-and-nine independent genetic variants are associated with these traits. A genetic risk score, calculated to assess their combined effects on clinical end points, shows significant associations with increased risk of both overt (Graves' disease) and subclinical thyroid disease, as well as clinical complications. By functional follow-up on selected signals, we identify a novel thyroid hormone transporter (SLC17A4) and a metabolizing enzyme (AADAT). Together, these results provide new knowledge about thyroid hormone physiology and disease, opening new possibilities for therapeutic targets.

%B Nat Commun %V 9 %P 4455 %8 2018 10 26 %G eng %N 1 %R 10.1038/s41467-018-06356-1 %0 Journal Article %J PLoS One %D 2018 %T Genome-wide association meta-analysis of circulating odd-numbered chain saturated fatty acids: Results from the CHARGE Consortium. %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A Sun, Qi %A King, Irena B %A Wu, Jason H Y %A Manichaikul, Ani %A Rich, Stephen S %A Tsai, Michael Y %A Chen, Y D %A Fornage, Myriam %A Weihua, Guan %A Aslibekyan, Stella %A Irvin, Marguerite R %A Kabagambe, Edmond K %A Arnett, Donna K %A Jensen, Majken K %A McKnight, Barbara %A Psaty, Bruce M %A Steffen, Lyn M %A Smith, Caren E %A Riserus, Ulf %A Lind, Lars %A Hu, Frank B %A Rimm, Eric B %A Siscovick, David S %A Mozaffarian, Dariush %K Fatty Acids %K Genome-Wide Association Study %K Humans %K Introns %K Lactase %K Myosins %K Polymorphism, Single Nucleotide %K Sphingomyelins %K Sphingosine N-Acyltransferase %K Tumor Suppressor Proteins %X

BACKGROUND: Odd-numbered chain saturated fatty acids (OCSFA) have been associated with potential health benefits. Although some OCSFA (e.g., C15:0 and C17:0) are found in meats and dairy products, sources and metabolism of C19:0 and C23:0 are relatively unknown, and the influence of non-dietary determinants, including genetic factors, on circulating levels of OCSFA is not established.

OBJECTIVE: To elucidate the biological processes that influence circulating levels of OCSFA by investigating associations between genetic variation and OCSFA.

DESIGN: We performed a meta-analysis of genome-wide association studies (GWAS) of plasma phospholipid/erythrocyte levels of C15:0, C17:0, C19:0, and C23:0 among 11,494 individuals of European descent. We also investigated relationships between specific single nucleotide polymorphisms (SNPs) in the lactase (LCT) gene, associated with adult-onset lactase intolerance, with circulating levels of dairy-derived OCSFA, and evaluated associations of candidate sphingolipid genes with C23:0 levels.

RESULTS: We found no genome-wide significant evidence that common genetic variation is associated with circulating levels of C15:0 or C23:0. In two cohorts with available data, we identified one intronic SNP (rs13361131) in myosin X gene (MYO10) associated with C17:0 level (P = 1.37×10-8), and two intronic SNP (rs12874278 and rs17363566) in deleted in lymphocytic leukemia 1 (DLEU1) region associated with C19:0 level (P = 7.07×10-9). In contrast, when using a candidate-gene approach, we found evidence that three SNPs in LCT (rs11884924, rs16832067, and rs3816088) are associated with circulating C17:0 level (adjusted P = 4×10-2). In addition, nine SNPs in the ceramide synthase 4 (CERS4) region were associated with circulating C23:0 levels (adjusted P<5×10-2).

CONCLUSIONS: Our findings suggest that circulating levels of OCSFA may be predominantly influenced by non-genetic factors. SNPs associated with C17:0 level in the LCT gene may reflect genetic influence in dairy consumption or in metabolism of dairy foods. SNPs associated with C23:0 may reflect a role of genetic factors in the synthesis of sphingomyelin.

%B PLoS One %V 13 %P e0196951 %8 2018 %G eng %N 5 %R 10.1371/journal.pone.0196951 %0 Journal Article %J Sci Rep %D 2018 %T Genome-wide association study and meta-analysis identify loci associated with ventricular and supraventricular ectopy. %A Napier, Melanie D %A Franceschini, Nora %A Gondalia, Rahul %A Stewart, James D %A Méndez-Giráldez, Rául %A Sitlani, Colleen M %A Seyerle, Amanda A %A Highland, Heather M %A Li, Yun %A Wilhelmsen, Kirk C %A Yan, Song %A Duan, Qing %A Roach, Jeffrey %A Yao, Jie %A Guo, Xiuqing %A Taylor, Kent D %A Heckbert, Susan R %A Rotter, Jerome I %A North, Kari E %A Reiner, Alexander P %A Zhang, Zhu-Ming %A Tinker, Lesley F %A Liao, Duanping %A Laurie, Cathy C %A Gogarten, Stephanie M %A Lin, Henry J %A Brody, Jennifer A %A Bartz, Traci M %A Psaty, Bruce M %A Sotoodehnia, Nona %A Soliman, Elsayed Z %A Avery, Christy L %A Whitsel, Eric A %X

The genetic basis of supraventricular and ventricular ectopy (SVE, VE) remains largely uncharacterized, despite established genetic mechanisms of arrhythmogenesis. To identify novel genetic variants associated with SVE/VE in ancestrally diverse human populations, we conducted a genome-wide association study of electrocardiographically identified SVE and VE in five cohorts including approximately 43,000 participants of African, European and Hispanic/Latino ancestry. In thirteen ancestry-stratified subgroups, we tested multivariable-adjusted associations of SVE and VE with single nucleotide polymorphism (SNP) dosage. We combined subgroup-specific association estimates in inverse variance-weighted, fixed-effects and Bayesian meta-analyses. We also combined fixed-effects meta-analytic t-test statistics for SVE and VE in multi-trait SNP association analyses. No loci reached genome-wide significance in trans-ethnic meta-analyses. However, we found genome-wide significant SNPs intronic to an apoptosis-enhancing gene previously associated with QRS interval duration (FAF1; lead SNP rs7545860; effect allele frequency = 0.02; P = 2.0 × 10) in multi-trait analysis among European ancestry participants and near a locus encoding calcium-dependent glycoproteins (DSC3; lead SNP rs8086068; effect allele frequency = 0.17) in meta-analysis of SVE (P = 4.0 × 10) and multi-trait analysis (P = 2.9 × 10) among African ancestry participants. The novel findings suggest several mechanisms by which genetic variation may predispose to ectopy in humans and highlight the potential value of leveraging pleiotropy in future studies of ectopy-related phenotypes.

%B Sci Rep %V 8 %P 5675 %8 2018 Apr 04 %G eng %N 1 %R 10.1038/s41598-018-23843-z %0 Journal Article %J Nat Commun %D 2018 %T Genome-wide association study in 79,366 European-ancestry individuals informs the genetic architecture of 25-hydroxyvitamin D levels. %A Jiang, Xia %A O'Reilly, Paul F %A Aschard, Hugues %A Hsu, Yi-Hsiang %A Richards, J Brent %A Dupuis, Josée %A Ingelsson, Erik %A Karasik, David %A Pilz, Stefan %A Berry, Diane %A Kestenbaum, Bryan %A Zheng, Jusheng %A Luan, Jianan %A Sofianopoulou, Eleni %A Streeten, Elizabeth A %A Albanes, Demetrius %A Lutsey, Pamela L %A Yao, Lu %A Tang, Weihong %A Econs, Michael J %A Wallaschofski, Henri %A Völzke, Henry %A Zhou, Ang %A Power, Chris %A McCarthy, Mark I %A Michos, Erin D %A Boerwinkle, Eric %A Weinstein, Stephanie J %A Freedman, Neal D %A Huang, Wen-Yi %A van Schoor, Natasja M %A van der Velde, Nathalie %A Groot, Lisette C P G M de %A Enneman, Anke %A Cupples, L Adrienne %A Booth, Sarah L %A Vasan, Ramachandran S %A Liu, Ching-Ti %A Zhou, Yanhua %A Ripatti, Samuli %A Ohlsson, Claes %A Vandenput, Liesbeth %A Lorentzon, Mattias %A Eriksson, Johan G %A Shea, M Kyla %A Houston, Denise K %A Kritchevsky, Stephen B %A Liu, Yongmei %A Lohman, Kurt K %A Ferrucci, Luigi %A Peacock, Munro %A Gieger, Christian %A Beekman, Marian %A Slagboom, Eline %A Deelen, Joris %A Heemst, Diana van %A Kleber, Marcus E %A März, Winfried %A de Boer, Ian H %A Wood, Alexis C %A Rotter, Jerome I %A Rich, Stephen S %A Robinson-Cohen, Cassianne %A den Heijer, Martin %A Jarvelin, Marjo-Riitta %A Cavadino, Alana %A Joshi, Peter K %A Wilson, James F %A Hayward, Caroline %A Lind, Lars %A Michaëlsson, Karl %A Trompet, Stella %A Zillikens, M Carola %A Uitterlinden, André G %A Rivadeneira, Fernando %A Broer, Linda %A Zgaga, Lina %A Campbell, Harry %A Theodoratou, Evropi %A Farrington, Susan M %A Timofeeva, Maria %A Dunlop, Malcolm G %A Valdes, Ana M %A Tikkanen, Emmi %A Lehtimäki, Terho %A Lyytikäinen, Leo-Pekka %A Kähönen, Mika %A Raitakari, Olli T %A Mikkilä, Vera %A Ikram, M Arfan %A Sattar, Naveed %A Jukema, J Wouter %A Wareham, Nicholas J %A Langenberg, Claudia %A Forouhi, Nita G %A Gundersen, Thomas E %A Khaw, Kay-Tee %A Butterworth, Adam S %A Danesh, John %A Spector, Timothy %A Wang, Thomas J %A Hyppönen, Elina %A Kraft, Peter %A Kiel, Douglas P %X

Vitamin D is a steroid hormone precursor that is associated with a range of human traits and diseases. Previous GWAS of serum 25-hydroxyvitamin D concentrations have identified four genome-wide significant loci (GC, NADSYN1/DHCR7, CYP2R1, CYP24A1). In this study, we expand the previous SUNLIGHT Consortium GWAS discovery sample size from 16,125 to 79,366 (all European descent). This larger GWAS yields two additional loci harboring genome-wide significant variants (P = 4.7×10 at rs8018720 in SEC23A, and P = 1.9×10 at rs10745742 in AMDHD1). The overall estimate of heritability of 25-hydroxyvitamin D serum concentrations attributable to GWAS common SNPs is 7.5%, with statistically significant loci explaining 38% of this total. Further investigation identifies signal enrichment in immune and hematopoietic tissues, and clustering with autoimmune diseases in cell-type-specific analysis. Larger studies are required to identify additional common SNPs, and to explore the role of rare or structural variants and gene-gene interactions in the heritability of circulating 25-hydroxyvitamin D levels.

%B Nat Commun %V 9 %P 260 %8 2018 Jan 17 %G eng %N 1 %R 10.1038/s41467-017-02662-2 %0 Journal Article %J Nat Commun %D 2018 %T Genome-wide association study of 23,500 individuals identifies 7 loci associated with brain ventricular volume. %A Vojinovic, Dina %A Adams, Hieab H %A Jian, Xueqiu %A Yang, Qiong %A Smith, Albert Vernon %A Bis, Joshua C %A Teumer, Alexander %A Scholz, Markus %A Armstrong, Nicola J %A Hofer, Edith %A Saba, Yasaman %A Luciano, Michelle %A Bernard, Manon %A Trompet, Stella %A Yang, Jingyun %A Gillespie, Nathan A %A van der Lee, Sven J %A Neumann, Alexander %A Ahmad, Shahzad %A Andreassen, Ole A %A Ames, David %A Amin, Najaf %A Arfanakis, Konstantinos %A Bastin, Mark E %A Becker, Diane M %A Beiser, Alexa S %A Beyer, Frauke %A Brodaty, Henry %A Bryan, R Nick %A Bülow, Robin %A Dale, Anders M %A De Jager, Philip L %A Deary, Ian J %A DeCarli, Charles %A Fleischman, Debra A %A Gottesman, Rebecca F %A van der Grond, Jeroen %A Gudnason, Vilmundur %A Harris, Tamara B %A Homuth, Georg %A Knopman, David S %A Kwok, John B %A Lewis, Cora E %A Li, Shuo %A Loeffler, Markus %A Lopez, Oscar L %A Maillard, Pauline %A El Marroun, Hanan %A Mather, Karen A %A Mosley, Thomas H %A Muetzel, Ryan L %A Nauck, Matthias %A Nyquist, Paul A %A Panizzon, Matthew S %A Pausova, Zdenka %A Psaty, Bruce M %A Rice, Ken %A Rotter, Jerome I %A Royle, Natalie %A Satizabal, Claudia L %A Schmidt, Reinhold %A Schofield, Peter R %A Schreiner, Pamela J %A Sidney, Stephen %A Stott, David J %A Thalamuthu, Anbupalam %A Uitterlinden, André G %A Valdés Hernández, Maria C %A Vernooij, Meike W %A Wen, Wei %A White, Tonya %A Witte, A Veronica %A Wittfeld, Katharina %A Wright, Margaret J %A Yanek, Lisa R %A Tiemeier, Henning %A Kremen, William S %A Bennett, David A %A Jukema, J Wouter %A Paus, Tomáš %A Wardlaw, Joanna M %A Schmidt, Helena %A Sachdev, Perminder S %A Villringer, Arno %A Grabe, Hans Jörgen %A Longstreth, W T %A van Duijn, Cornelia M %A Launer, Lenore J %A Seshadri, Sudha %A Ikram, M Arfan %A Fornage, Myriam %X

The volume of the lateral ventricles (LV) increases with age and their abnormal enlargement is a key feature of several neurological and psychiatric diseases. Although lateral ventricular volume is heritable, a comprehensive investigation of its genetic determinants is lacking. In this meta-analysis of genome-wide association studies of 23,533 healthy middle-aged to elderly individuals from 26 population-based cohorts, we identify 7 genetic loci associated with LV volume. These loci map to chromosomes 3q28, 7p22.3, 10p12.31, 11q23.1, 12q23.3, 16q24.2, and 22q13.1 and implicate pathways related to tau pathology, S1P signaling, and cytoskeleton organization. We also report a significant genetic overlap between the thalamus and LV volumes (ρ = -0.59, p-value = 3.14 × 10), suggesting that these brain structures may share a common biology. These genetic associations of LV volume provide insights into brain morphology.

%B Nat Commun %V 9 %P 3945 %8 2018 Sep 26 %G eng %N 1 %R 10.1038/s41467-018-06234-w %0 Journal Article %J Circulation %D 2018 %T Genome-Wide Association Trans-Ethnic Meta-Analyses Identifies Novel Associations Regulating Coagulation Factor VIII and von Willebrand Factor Plasma Levels. %A Sabater-Lleal, Maria %A Huffman, Jennifer E %A de Vries, Paul S %A Marten, Jonathan %A Mastrangelo, Michael A %A Song, Ci %A Pankratz, Nathan %A Ward-Caviness, Cavin K %A Yanek, Lisa R %A Trompet, Stella %A Delgado, Graciela E %A Guo, Xiuqing %A Bartz, Traci M %A Martinez-Perez, Angel %A Germain, Marine %A de Haan, Hugoline G %A Ozel, Ayse B %A Polasek, Ozren %A Smith, Albert V %A Eicher, John D %A Reiner, Alex P %A Tang, Weihong %A Davies, Neil M %A Stott, David J %A Rotter, Jerome I %A Tofler, Geoffrey H %A Boerwinkle, Eric %A de Maat, Moniek P M %A Kleber, Marcus E %A Welsh, Paul %A Brody, Jennifer A %A Chen, Ming-Huei %A Vaidya, Dhananjay %A Soria, José Manuel %A Suchon, Pierre %A van Hylckama Vlieg, Astrid %A Desch, Karl C %A Kolcic, Ivana %A Joshi, Peter K %A Launer, Lenore J %A Harris, Tamara B %A Campbell, Harry %A Rudan, Igor %A Becker, Diane M %A Li, Jun Z %A Rivadeneira, Fernando %A Uitterlinden, André G %A Hofman, Albert %A Franco, Oscar H %A Cushman, Mary %A Psaty, Bruce M %A Morange, Pierre-Emmanuel %A McKnight, Barbara %A Chong, Michael R %A Fernandez-Cadenas, Israel %A Rosand, Jonathan %A Lindgren, Arne %A Gudnason, Vilmundur %A Wilson, James F %A Hayward, Caroline %A Ginsburg, David %A Fornage, Myriam %A Rosendaal, Frits R %A Souto, Juan Carlos %A Becker, Lewis C %A Jenny, Nancy S %A März, Winfried %A Jukema, J Wouter %A Dehghan, Abbas %A Trégouët, David-Alexandre %A Morrison, Alanna C %A Johnson, Andrew D %A O'Donnell, Christopher J %A Strachan, David P %A Lowenstein, Charles J %A Smith, Nicholas L %X

BACKGROUND: Factor VIII (FVIII) and its carrier protein von Willebrand factor (VWF) are associated with risk of arterial and venous thrombosis and with hemorrhagic disorders. We aimed to identify and functionally test novel genetic associations regulating plasma FVIII and VWF.

METHODS: We meta-analyzed genome-wide association results from 46,354 individuals of European, African, East Asian, and Hispanic ancestry. All studies performed linear regression analysis using an additive genetic model and associated approximately 35 million imputed variants with natural-log transformed phenotype levels. In vitro gene silencing in cultured endothelial cells was performed for candidate genes to provide additional evidence on association and function. Two-sample Mendelian randomization (MR) analyses were applied to test the causal role of FVIII and VWF plasma levels on the risk of arterial and venous thrombotic events.

RESULTS: We identified 13 novel genome-wide significant (p≤2.5x10) associations; 7 with FVIII levels ( FCHO2/TMEM171/TNPO1, HLA, SOX17/RP1, LINC00583/NFIB, RAB5C-KAT2A, RPL3/TAB1/SYNGR1, and ARSA) and 11 with VWF levels ( PDHB/PXK/KCTD6, SLC39A8, FCHO2/TMEM171/TNPO1, HLA, GIMAP7/GIMAP4, OR13C5/NIPSNAP, DAB2IP, C2CD4B, RAB5C-KAT2A, TAB1/SYNGR1, and ARSA), beyond 10 previously reported associations with these phenotypes. Functional validation provided further evidence of association for all loci on VWF except ARSA and DAB2IP. MR suggested causal effects of plasma FVIII activity levels on venous thrombosis and coronary artery disease risk and plasma VWF levels on ischemic stroke risk.

CONCLUSIONS: The meta-analysis identified 13 novel genetic loci regulating FVIII and VWF plasma levels, 10 of which we validated functionally. We provide some evidence for a causal role of these proteins in thrombotic events.

%B Circulation %8 2018 Nov 20 %G eng %R 10.1161/CIRCULATIONAHA.118.034532 %0 Journal Article %J PLoS Genet %D 2018 %T Genome-wide meta-analysis of 158,000 individuals of European ancestry identifies three loci associated with chronic back pain. %A Suri, Pradeep %A Palmer, Melody R %A Tsepilov, Yakov A %A Freidin, Maxim B %A Boer, Cindy G %A Yau, Michelle S %A Evans, Daniel S %A Gelemanovic, Andrea %A Bartz, Traci M %A Nethander, Maria %A Arbeeva, Liubov %A Karssen, Lennart %A Neogi, Tuhina %A Campbell, Archie %A Mellström, Dan %A Ohlsson, Claes %A Marshall, Lynn M %A Orwoll, Eric %A Uitterlinden, Andre %A Rotter, Jerome I %A Lauc, Gordan %A Psaty, Bruce M %A Karlsson, Magnus K %A Lane, Nancy E %A Jarvik, Gail P %A Polasek, Ozren %A Hochberg, Marc %A Jordan, Joanne M %A van Meurs, Joyce B J %A Jackson, Rebecca %A Nielson, Carrie M %A Mitchell, Braxton D %A Smith, Blair H %A Hayward, Caroline %A Smith, Nicholas L %A Aulchenko, Yurii S %A Williams, Frances M K %X

Back pain is the #1 cause of years lived with disability worldwide, yet surprisingly little is known regarding the biology underlying this symptom. We conducted a genome-wide association study (GWAS) meta-analysis of chronic back pain (CBP). Adults of European ancestry were included from 15 cohorts in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and from the UK Biobank interim data release. CBP cases were defined as those reporting back pain present for ≥3-6 months; non-cases were included as comparisons ("controls"). Each cohort conducted genotyping using commercially available arrays followed by imputation. GWAS used logistic regression models with additive genetic effects, adjusting for age, sex, study-specific covariates, and population substructure. The threshold for genome-wide significance in the fixed-effect inverse-variance weighted meta-analysis was p<5×10-8. Suggestive (p<5×10-7) and genome-wide significant (p<5×10-8) variants were carried forward for replication or further investigation in the remaining UK Biobank participants not included in the discovery sample. The discovery sample comprised 158,025 individuals, including 29,531 CBP cases. A genome-wide significant association was found for the intronic variant rs12310519 in SOX5 (OR 1.08, p = 7.2×10-10). This was subsequently replicated in 283,752 UK Biobank participants not included in the discovery sample, including 50,915 cases (OR 1.06, p = 5.3×10-11), and exceeded genome-wide significance in joint meta-analysis (OR 1.07, p = 4.5×10-19). We found suggestive associations at three other loci in the discovery sample, two of which exceeded genome-wide significance in joint meta-analysis: an intergenic variant, rs7833174, located between CCDC26 and GSDMC (OR 1.05, p = 4.4×10-13), and an intronic variant, rs4384683, in DCC (OR 0.97, p = 2.4×10-10). In this first reported meta-analysis of GWAS for CBP, we identified and replicated a genetic locus associated with CBP (SOX5). We also identified 2 other loci that reached genome-wide significance in a 2-stage joint meta-analysis (CCDC26/GSDMC and DCC).

%B PLoS Genet %V 14 %P e1007601 %8 2018 Sep %G eng %N 9 %R 10.1371/journal.pgen.1007601 %0 Journal Article %J Pharmacogenomics J %D 2018 %T Genome-wide meta-analysis of SNP-by9-ACEI/ARB and SNP-by-thiazide diuretic and effect on serum potassium in cohorts of European and African ancestry. %A Irvin, Marguerite R %A Sitlani, Colleen M %A Noordam, Raymond %A Avery, Christie L %A Bis, Joshua C %A Floyd, James S %A Li, Jin %A Limdi, Nita A %A Srinivasasainagendra, Vinodh %A Stewart, James %A de Mutsert, Renée %A Mook-Kanamori, Dennis O %A Lipovich, Leonard %A Kleinbrink, Erica L %A Smith, Albert %A Bartz, Traci M %A Whitsel, Eric A %A Uitterlinden, André G %A Wiggins, Kerri L %A Wilson, James G %A Zhi, Degui %A Stricker, Bruno H %A Rotter, Jerome I %A Arnett, Donna K %A Psaty, Bruce M %A Lange, Leslie A %X

We evaluated interactions of SNP-by-ACE-I/ARB and SNP-by-TD on serum potassium (K+) among users of antihypertensive treatments (anti-HTN). Our study included seven European-ancestry (EA) (N = 4835) and four African-ancestry (AA) cohorts (N = 2016). We performed race-stratified, fixed-effect, inverse-variance-weighted meta-analyses of 2.5 million SNP-by-drug interaction estimates; race-combined meta-analysis; and trans-ethnic fine-mapping. Among EAs, we identified 11 significant SNPs (P < 5 × 10) for SNP-ACE-I/ARB interactions on serum K+ that were located between NR2F1-AS1 and ARRDC3-AS1 on chromosome 5 (top SNP rs6878413 P = 1.7 × 10; ratio of serum K+ in ACE-I/ARB exposed compared to unexposed is 1.0476, 1.0280, 1.0088 for the TT, AT, and AA genotypes, respectively). Trans-ethnic fine mapping identified the same group of SNPs on chromosome 5 as genome-wide significant for the ACE-I/ARB analysis. In conclusion, SNP-by-ACE-I /ARB interaction analyses uncovered loci that, if replicated, could have future implications for the prevention of arrhythmias due to anti-HTN treatment-related hyperkalemia. Before these loci can be identified as clinically relevant, future validation studies of equal or greater size in comparison to our discovery effort are needed.

%B Pharmacogenomics J %8 2018 Jun 01 %G eng %R 10.1038/s41397-018-0021-9 %0 Journal Article %J Nat Commun %D 2018 %T GWAS and colocalization analyses implicate carotid intima-media thickness and carotid plaque loci in cardiovascular outcomes. %A Franceschini, Nora %A Giambartolomei, Claudia %A de Vries, Paul S %A Finan, Chris %A Bis, Joshua C %A Huntley, Rachael P %A Lovering, Ruth C %A Tajuddin, Salman M %A Winkler, Thomas W %A Graff, Misa %A Kavousi, Maryam %A Dale, Caroline %A Smith, Albert V %A Hofer, Edith %A van Leeuwen, Elisabeth M %A Nolte, Ilja M %A Lu, Lingyi %A Scholz, Markus %A Sargurupremraj, Muralidharan %A Pitkänen, Niina %A Franzén, Oscar %A Joshi, Peter K %A Noordam, Raymond %A Marioni, Riccardo E %A Hwang, Shih-Jen %A Musani, Solomon K %A Schminke, Ulf %A Palmas, Walter %A Isaacs, Aaron %A Correa, Adolfo %A Zonderman, Alan B %A Hofman, Albert %A Teumer, Alexander %A Cox, Amanda J %A Uitterlinden, André G %A Wong, Andrew %A Smit, Andries J %A Newman, Anne B %A Britton, Annie %A Ruusalepp, Arno %A Sennblad, Bengt %A Hedblad, Bo %A Pasaniuc, Bogdan %A Penninx, Brenda W %A Langefeld, Carl D %A Wassel, Christina L %A Tzourio, Christophe %A Fava, Cristiano %A Baldassarre, Damiano %A O'Leary, Daniel H %A Teupser, Daniel %A Kuh, Diana %A Tremoli, Elena %A Mannarino, Elmo %A Grossi, Enzo %A Boerwinkle, Eric %A Schadt, Eric E %A Ingelsson, Erik %A Veglia, Fabrizio %A Rivadeneira, Fernando %A Beutner, Frank %A Chauhan, Ganesh %A Heiss, Gerardo %A Snieder, Harold %A Campbell, Harry %A Völzke, Henry %A Markus, Hugh S %A Deary, Ian J %A Jukema, J Wouter %A de Graaf, Jacqueline %A Price, Jacqueline %A Pott, Janne %A Hopewell, Jemma C %A Liang, Jingjing %A Thiery, Joachim %A Engmann, Jorgen %A Gertow, Karl %A Rice, Kenneth %A Taylor, Kent D %A Dhana, Klodian %A Kiemeney, Lambertus A L M %A Lind, Lars %A Raffield, Laura M %A Launer, Lenore J %A Holdt, Lesca M %A Dörr, Marcus %A Dichgans, Martin %A Traylor, Matthew %A Sitzer, Matthias %A Kumari, Meena %A Kivimaki, Mika %A Nalls, Mike A %A Melander, Olle %A Raitakari, Olli %A Franco, Oscar H %A Rueda-Ochoa, Oscar L %A Roussos, Panos %A Whincup, Peter H %A Amouyel, Philippe %A Giral, Philippe %A Anugu, Pramod %A Wong, Quenna %A Malik, Rainer %A Rauramaa, Rainer %A Burkhardt, Ralph %A Hardy, Rebecca %A Schmidt, Reinhold %A de Mutsert, Renée %A Morris, Richard W %A Strawbridge, Rona J %A Wannamethee, S Goya %A Hägg, Sara %A Shah, Sonia %A McLachlan, Stela %A Trompet, Stella %A Seshadri, Sudha %A Kurl, Sudhir %A Heckbert, Susan R %A Ring, Susan %A Harris, Tamara B %A Lehtimäki, Terho %A Galesloot, Tessel E %A Shah, Tina %A de Faire, Ulf %A Plagnol, Vincent %A Rosamond, Wayne D %A Post, Wendy %A Zhu, Xiaofeng %A Zhang, Xiaoling %A Guo, Xiuqing %A Saba, Yasaman %A Dehghan, Abbas %A Seldenrijk, Adrie %A Morrison, Alanna C %A Hamsten, Anders %A Psaty, Bruce M %A van Duijn, Cornelia M %A Lawlor, Deborah A %A Mook-Kanamori, Dennis O %A Bowden, Donald W %A Schmidt, Helena %A Wilson, James F %A Wilson, James G %A Rotter, Jerome I %A Wardlaw, Joanna M %A Deanfield, John %A Halcox, Julian %A Lyytikäinen, Leo-Pekka %A Loeffler, Markus %A Evans, Michele K %A Debette, Stephanie %A Humphries, Steve E %A Völker, Uwe %A Gudnason, Vilmundur %A Hingorani, Aroon D %A Björkegren, Johan L M %A Casas, Juan P %A O'Donnell, Christopher J %K ADAMTS9 Protein %K Amino Acid Oxidoreductases %K Carotid Intima-Media Thickness %K Coronary Disease %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Lod Score %K Plaque, Atherosclerotic %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Risk Factors %X

Carotid artery intima media thickness (cIMT) and carotid plaque are measures of subclinical atherosclerosis associated with ischemic stroke and coronary heart disease (CHD). Here, we undertake meta-analyses of genome-wide association studies (GWAS) in 71,128 individuals for cIMT, and 48,434 individuals for carotid plaque traits. We identify eight novel susceptibility loci for cIMT, one independent association at the previously-identified PINX1 locus, and one novel locus for carotid plaque. Colocalization analysis with nearby vascular expression quantitative loci (cis-eQTLs) derived from arterial wall and metabolic tissues obtained from patients with CHD identifies candidate genes at two potentially additional loci, ADAMTS9 and LOXL4. LD score regression reveals significant genetic correlations between cIMT and plaque traits, and both cIMT and plaque with CHD, any stroke subtype and ischemic stroke. Our study provides insights into genes and tissue-specific regulatory mechanisms linking atherosclerosis both to its functional genomic origins and its clinical consequences in humans.

%B Nat Commun %V 9 %P 5141 %8 2018 12 03 %G eng %N 1 %R 10.1038/s41467-018-07340-5 %0 Journal Article %J Am J Epidemiol %D 2018 %T Harmonization of Respiratory Data From 9 US Population-Based Cohorts: The NHLBI Pooled Cohorts Study. %A Oelsner, Elizabeth C %A Balte, Pallavi P %A Cassano, Patricia A %A Couper, David %A Enright, Paul L %A Folsom, Aaron R %A Hankinson, John %A Jacobs, David R %A Kalhan, Ravi %A Kaplan, Robert %A Kronmal, Richard %A Lange, Leslie %A Loehr, Laura R %A London, Stephanie J %A Navas Acien, Ana %A Newman, Anne B %A O'Connor, George T %A Schwartz, Joseph E %A Smith, Lewis J %A Yeh, Fawn %A Zhang, Yiyi %A Moran, Andrew E %A Mwasongwe, Stanford %A White, Wendy B %A Yende, Sachin %A Barr, R Graham %X

Chronic lower respiratory diseases (CLRDs) are the fourth leading cause of death in the United States. To support investigations into CLRD risk determinants and new approaches to primary prevention, we aimed to harmonize and pool respiratory data from US general population-based cohorts. Data were obtained from prospective cohorts that performed prebronchodilator spirometry and were harmonized following 2005 ATS/ERS standards. In cohorts conducting follow-up for noncardiovascular events, CLRD events were defined as hospitalizations/deaths adjudicated as CLRD-related or assigned relevant administrative codes. Coding and variable names were applied uniformly. The pooled sample included 65,251 adults in 9 cohorts followed-up for CLRD-related mortality over 653,380 person-years during 1983-2016. Average baseline age was 52 years; 56% were female; 49% were never-smokers; and racial/ethnic composition was 44% white, 22% black, 28% Hispanic/Latino, and 5% American Indian. Over 96% had complete data on smoking, clinical CLRD diagnoses, and dyspnea. After excluding invalid spirometry examinations (13%), there were 105,696 valid examinations (median, 2 per participant). Of 29,351 participants followed for CLRD hospitalizations, median follow-up was 14 years; only 5% were lost to follow-up at 10 years. The NHLBI Pooled Cohorts Study provides a harmonization standard applied to a large, US population-based sample that may be used to advance epidemiologic research on CLRD.

%B Am J Epidemiol %V 187 %P 2265-2278 %8 2018 Nov 01 %G eng %N 11 %R 10.1093/aje/kwy139 %0 Journal Article %J Clin Cardiol %D 2018 %T Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes. %A Lee, Hwa Mu %A Zhao, Yanglu %A Liu, Michael A %A Yanez, David %A Carnethon, Mercedes %A Graham Barr, R %A Wong, Nathan D %X

BACKGROUND: Individuals with metabolic syndrome (MetS) and diabetes (DM) are more likely to have decreased lung function and are at greater risk of cardiovascular disease (CVD).

HYPOTHESIS: Lung-function measures can predict CVD events in older persons with MetS, DM, and neither condition.

METHODS: We followed 4114 participants age ≥ 65 years with and without MetS or DM in the Cardiovascular Health Study. Cox regression examined the association of forced vital capacity (FVC) and 1-second forced expiratory volume (FEV ; percent of predicted values) with incident coronary heart disease and CVD events over 12.9 years.

RESULTS: DM was present in 537 (13.1%) and MetS in 1277 (31.0%) participants. Comparing fourth vs first quartiles for FVC, risk of CVD events was 16% (HR: 0.84, 95% CI: 0.59-1.18), 23% (HR: 0.77, 95% CI: 0.60-0.99), and 30% (HR: 0.70, 95% CI: 0.58-0.84) lower in DM, MetS, and neither disease groups, respectively. For FEV , CVD risk was lower by 2% (HR: 0.98, 95% CI: 0.70-1.37), 26% (HR: 0.74, 95% CI: 0.59-0.93), and 31% (HR: 0.69, 95% CI: 0.57-0.82) in DM. Findings were strongest for predicting congestive heart failure (CHF) in all disease groups. C-statistics increased significantly with addition of FEV or FVC over risk factors for CVD and CHF among those with neither MetS nor DM.

CONCLUSIONS: FEV and FVC are inversely related to CVD in older adults with and without MetS, but not DM (except for CHF); however, their value in incremental risk prediction beyond standard risk factors is limited mainly to metabolically healthier persons.

%B Clin Cardiol %V 41 %P 959-965 %8 2018 Jul %G eng %N 7 %R 10.1002/clc.22985 %0 Journal Article %J Am J Hum Genet %D 2018 %T A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure. %A Sung, Yun J %A Winkler, Thomas W %A de Las Fuentes, Lisa %A Bentley, Amy R %A Brown, Michael R %A Kraja, Aldi T %A Schwander, Karen %A Ntalla, Ioanna %A Guo, Xiuqing %A Franceschini, Nora %A Lu, Yingchang %A Cheng, Ching-Yu %A Sim, Xueling %A Vojinovic, Dina %A Marten, Jonathan %A Musani, Solomon K %A Li, Changwei %A Feitosa, Mary F %A Kilpeläinen, Tuomas O %A Richard, Melissa A %A Noordam, Raymond %A Aslibekyan, Stella %A Aschard, Hugues %A Bartz, Traci M %A Dorajoo, Rajkumar %A Liu, Yongmei %A Manning, Alisa K %A Rankinen, Tuomo %A Smith, Albert Vernon %A Tajuddin, Salman M %A Tayo, Bamidele O %A Warren, Helen R %A Zhao, Wei %A Zhou, Yanhua %A Matoba, Nana %A Sofer, Tamar %A Alver, Maris %A Amini, Marzyeh %A Boissel, Mathilde %A Chai, Jin Fang %A Chen, Xu %A Divers, Jasmin %A Gandin, Ilaria %A Gao, Chuan %A Giulianini, Franco %A Goel, Anuj %A Harris, Sarah E %A Hartwig, Fernando Pires %A Horimoto, Andrea R V R %A Hsu, Fang-Chi %A Jackson, Anne U %A Kähönen, Mika %A Kasturiratne, Anuradhani %A Kuhnel, Brigitte %A Leander, Karin %A Lee, Wen-Jane %A Lin, Keng-Hung %A 'an Luan, Jian %A McKenzie, Colin A %A Meian, He %A Nelson, Christopher P %A Rauramaa, Rainer %A Schupf, Nicole %A Scott, Robert A %A Sheu, Wayne H H %A Stančáková, Alena %A Takeuchi, Fumihiko %A van der Most, Peter J %A Varga, Tibor V %A Wang, Heming %A Wang, Yajuan %A Ware, Erin B %A Weiss, Stefan %A Wen, Wanqing %A Yanek, Lisa R %A Zhang, Weihua %A Zhao, Jing Hua %A Afaq, Saima %A Alfred, Tamuno %A Amin, Najaf %A Arking, Dan %A Aung, Tin %A Barr, R Graham %A Bielak, Lawrence F %A Boerwinkle, Eric %A Bottinger, Erwin P %A Braund, Peter S %A Brody, Jennifer A %A Broeckel, Ulrich %A Cabrera, Claudia P %A Cade, Brian %A Caizheng, Yu %A Campbell, Archie %A Canouil, Mickaël %A Chakravarti, Aravinda %A Chauhan, Ganesh %A Christensen, Kaare %A Cocca, Massimiliano %A Collins, Francis S %A Connell, John M %A de Mutsert, Renée %A de Silva, H Janaka %A Debette, Stephanie %A Dörr, Marcus %A Duan, Qing %A Eaton, Charles B %A Ehret, Georg %A Evangelou, Evangelos %A Faul, Jessica D %A Fisher, Virginia A %A Forouhi, Nita G %A Franco, Oscar H %A Friedlander, Yechiel %A Gao, He %A Gigante, Bruna %A Graff, Misa %A Gu, C Charles %A Gu, Dongfeng %A Gupta, Preeti %A Hagenaars, Saskia P %A Harris, Tamara B %A He, Jiang %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hirata, Makoto %A Hofman, Albert %A Howard, Barbara V %A Hunt, Steven %A Irvin, Marguerite R %A Jia, Yucheng %A Joehanes, Roby %A Justice, Anne E %A Katsuya, Tomohiro %A Kaufman, Joel %A Kerrison, Nicola D %A Khor, Chiea Chuen %A Koh, Woon-Puay %A Koistinen, Heikki A %A Komulainen, Pirjo %A Kooperberg, Charles %A Krieger, Jose E %A Kubo, Michiaki %A Kuusisto, Johanna %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lehne, Benjamin %A Lewis, Cora E %A Li, Yize %A Lim, Sing Hui %A Lin, Shiow %A Liu, Ching-Ti %A Liu, Jianjun %A Liu, Jingmin %A Liu, Kiang %A Liu, Yeheng %A Loh, Marie %A Lohman, Kurt K %A Long, Jirong %A Louie, Tin %A Mägi, Reedik %A Mahajan, Anubha %A Meitinger, Thomas %A Metspalu, Andres %A Milani, Lili %A Momozawa, Yukihide %A Morris, Andrew P %A Mosley, Thomas H %A Munson, Peter %A Murray, Alison D %A Nalls, Mike A %A Nasri, Ubaydah %A Norris, Jill M %A North, Kari %A Ogunniyi, Adesola %A Padmanabhan, Sandosh %A Palmas, Walter R %A Palmer, Nicholette D %A Pankow, James S %A Pedersen, Nancy L %A Peters, Annette %A Peyser, Patricia A %A Polasek, Ozren %A Raitakari, Olli T %A Renstrom, Frida %A Rice, Treva K %A Ridker, Paul M %A Robino, Antonietta %A Robinson, Jennifer G %A Rose, Lynda M %A Rudan, Igor %A Sabanayagam, Charumathi %A Salako, Babatunde L %A Sandow, Kevin %A Schmidt, Carsten O %A Schreiner, Pamela J %A Scott, William R %A Seshadri, Sudha %A Sever, Peter %A Sitlani, Colleen M %A Smith, Jennifer A %A Snieder, Harold %A Starr, John M %A Strauch, Konstantin %A Tang, Hua %A Taylor, Kent D %A Teo, Yik Ying %A Tham, Yih Chung %A Uitterlinden, André G %A Waldenberger, Melanie %A Wang, Lihua %A Wang, Ya X %A Wei, Wen Bin %A Williams, Christine %A Wilson, Gregory %A Wojczynski, Mary K %A Yao, Jie %A Yuan, Jian-Min %A Zonderman, Alan B %A Becker, Diane M %A Boehnke, Michael %A Bowden, Donald W %A Chambers, John C %A Chen, Yii-Der Ida %A de Faire, Ulf %A Deary, Ian J %A Esko, Tõnu %A Farrall, Martin %A Forrester, Terrence %A Franks, Paul W %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Horta, Bernardo Lessa %A Hung, Yi-Jen %A Jonas, Jost B %A Kato, Norihiro %A Kooner, Jaspal S %A Laakso, Markku %A Lehtimäki, Terho %A Liang, Kae-Woei %A Magnusson, Patrik K E %A Newman, Anne B %A Oldehinkel, Albertine J %A Pereira, Alexandre C %A Redline, Susan %A Rettig, Rainer %A Samani, Nilesh J %A Scott, James %A Shu, Xiao-Ou %A van der Harst, Pim %A Wagenknecht, Lynne E %A Wareham, Nicholas J %A Watkins, Hugh %A Weir, David R %A Wickremasinghe, Ananda R %A Wu, Tangchun %A Zheng, Wei %A Kamatani, Yoichiro %A Laurie, Cathy C %A Bouchard, Claude %A Cooper, Richard S %A Evans, Michele K %A Gudnason, Vilmundur %A Kardia, Sharon L R %A Kritchevsky, Stephen B %A Levy, Daniel %A O'Connell, Jeff R %A Psaty, Bruce M %A van Dam, Rob M %A Sims, Mario %A Arnett, Donna K %A Mook-Kanamori, Dennis O %A Kelly, Tanika N %A Fox, Ervin R %A Hayward, Caroline %A Fornage, Myriam %A Rotimi, Charles N %A Province, Michael A %A van Duijn, Cornelia M %A Tai, E Shyong %A Wong, Tien Yin %A Loos, Ruth J F %A Reiner, Alex P %A Rotter, Jerome I %A Zhu, Xiaofeng %A Bierut, Laura J %A Gauderman, W James %A Caulfield, Mark J %A Elliott, Paul %A Rice, Kenneth %A Munroe, Patricia B %A Morrison, Alanna C %A Cupples, L Adrienne %A Rao, Dabeeru C %A Chasman, Daniel I %X

Genome-wide association analysis advanced understanding of blood pressure (BP), a major risk factor for vascular conditions such as coronary heart disease and stroke. Accounting for smoking behavior may help identify BP loci and extend our knowledge of its genetic architecture. We performed genome-wide association meta-analyses of systolic and diastolic BP incorporating gene-smoking interactions in 610,091 individuals. Stage 1 analysis examined ∼18.8 million SNPs and small insertion/deletion variants in 129,913 individuals from four ancestries (European, African, Asian, and Hispanic) with follow-up analysis of promising variants in 480,178 additional individuals from five ancestries. We identified 15 loci that were genome-wide significant (p < 5 × 10) in stage 1 and formally replicated in stage 2. A combined stage 1 and 2 meta-analysis identified 66 additional genome-wide significant loci (13, 35, and 18 loci in European, African, and trans-ancestry, respectively). A total of 56 known BP loci were also identified by our results (p < 5 × 10). Of the newly identified loci, ten showed significant interaction with smoking status, but none of them were replicated in stage 2. Several loci were identified in African ancestry, highlighting the importance of genetic studies in diverse populations. The identified loci show strong evidence for regulatory features and support shared pathophysiology with cardiometabolic and addiction traits. They also highlight a role in BP regulation for biological candidates such as modulators of vascular structure and function (CDKN1B, BCAR1-CFDP1, PXDN, EEA1), ciliopathies (SDCCAG8, RPGRIP1L), telomere maintenance (TNKS, PINX1, AKTIP), and central dopaminergic signaling (MSRA, EBF2).

%B Am J Hum Genet %V 102 %P 375-400 %8 2018 Mar 01 %G eng %N 3 %R 10.1016/j.ajhg.2018.01.015 %0 Journal Article %J Nat Commun %D 2018 %T Large-scale whole-exome sequencing association studies identify rare functional variants influencing serum urate levels. %A Tin, Adrienne %A Li, Yong %A Brody, Jennifer A %A Nutile, Teresa %A Chu, Audrey Y %A Huffman, Jennifer E %A Yang, Qiong %A Chen, Ming-Huei %A Robinson-Cohen, Cassianne %A Mace, Aurelien %A Liu, Jun %A Demirkan, Ayse %A Sorice, Rossella %A Sedaghat, Sanaz %A Swen, Melody %A Yu, Bing %A Ghasemi, Sahar %A Teumer, Alexanda %A Vollenweider, Peter %A Ciullo, Marina %A Li, Meng %A Uitterlinden, André G %A Kraaij, Robert %A Amin, Najaf %A van Rooij, Jeroen %A Kutalik, Zoltán %A Dehghan, Abbas %A McKnight, Barbara %A van Duijn, Cornelia M %A Morrison, Alanna %A Psaty, Bruce M %A Boerwinkle, Eric %A Fox, Caroline S %A Woodward, Owen M %A Köttgen, Anna %K Exome %K Genetic Predisposition to Disease %K Glucose Transport Proteins, Facilitative %K Humans %K Kidney Function Tests %K Meta-Analysis as Topic %K Organic Anion Transporters %K Organic Cation Transport Proteins %K Protein Structure, Secondary %K Uric Acid %X

Elevated serum urate levels can cause gout, an excruciating disease with suboptimal treatment. Previous GWAS identified common variants with modest effects on serum urate. Here we report large-scale whole-exome sequencing association studies of serum urate and kidney function among ≤19,517 European ancestry and African-American individuals. We identify aggregate associations of low-frequency damaging variants in the urate transporters SLC22A12 (URAT1; p = 1.3 × 10) and SLC2A9 (p = 4.5 × 10). Gout risk in rare SLC22A12 variant carriers is halved (OR = 0.5, p = 4.9 × 10). Selected rare variants in SLC22A12 are validated in transport studies, confirming three as loss-of-function (R325W, R405C, and T467M) and illustrating the therapeutic potential of the new URAT1-blocker lesinurad. In SLC2A9, mapping of rare variants of large effects onto the predicted protein structure reveals new residues that may affect urate binding. These findings provide new insights into the genetic architecture of serum urate, and highlight molecular targets in SLC22A12 and SLC2A9 for lowering serum urate and preventing gout.

%B Nat Commun %V 9 %P 4228 %8 2018 10 12 %G eng %N 1 %R 10.1038/s41467-018-06620-4 %0 Journal Article %J Neurology %D 2018 %T Left atrial diameter and vascular brain injury on MRI: The Cardiovascular Health Study. %A Yaghi, Shadi %A Bartz, Traci M %A Kronmal, Richard %A Kamel, Hooman %A Gottdiener, John %A Longstreth, W T %A Elkind, Mitchell S V %X

OBJECTIVE: To determine the association left atrial diameter (LAD) and vascular brain injury on brain MRI.

METHODS: We analyzed data from the Cardiovascular Health Study (CHS), a prospective cohort of community-dwelling adults ≥65 years old. LAD was measured from 2-dimensional transthoracic echocardiograms. Among CHS participants who underwent brain MRI, we examined associations of LAD with brain infarcts and leukoaraiosis. Primary outcomes (number for analysis) were prevalent infarcts (2,327) and degree of leukoaraiosis on initial MRI (2,315). Secondary outcomes were prevalent nonlacunar infarcts (2,327), incident infarcts (939), incident nonlacunar infarcts (1,185), and degree of leukoaraiosis on follow-up MRI adjusted for initial MRI (1,158). Relative risk (RR) and linear regression models were adjusted for demographics, vascular risk factors, and potential confounders.

RESULTS: Mean age of the 2,335 participants with initial brain MRI was 72.0 ± 4.8 years; 38.7% were men; and 29.0% participants had prevalent infarcts. In multivariable, fully adjusted models, LAD was associated with prevalent infarcts (RR 1.20, 95% confidence interval [CI] 1.08-1.34) and prevalent nonlacunar infarcts (RR 1.28, 95% CI 1.06-1.54) but not with leukoaraiosis (-0.08, 95% CI -0.17 to 0.07), incident infarcts (RR 1.00, 95% CI 0.78-1.29), nonlacunar infarcts (RR 0.98, 95% CI 0.67-1.42), or worsening leukoaraiosis (-0.04, 95% CI -0.10 to 0.02).

CONCLUSION: LAD is independently associated with prevalent brain infarcts, particularly nonlacunar infarcts, but not leukoaraiosis. Larger studies are needed to determine associations with incident infarct risk and whether this risk in patients with left atrial enlargement can be reduced with anticoagulant agents.

%B Neurology %8 2018 Aug 29 %G eng %R 10.1212/WNL.0000000000006228 %0 Journal Article %J Am J Hum Genet %D 2018 %T {Life-Course Genome-wide Association Study Meta-analysis of Total Body BMD and Assessment of Age-Specific Effects %A Medina-Gomez, C. %A Kemp, J. P. %A Trajanoska, K. %A Luan, J. %A Chesi, A. %A Ahluwalia, T. S. %A Mook-Kanamori, D. O. %A Ham, A. %A Hartwig, F. P. %A Evans, D. S. %A Joro, R. %A Nedeljkovic, I. %A Zheng, H. F. %A Zhu, K. %A Atalay, M. %A Liu, C. T. %A Nethander, M. %A Broer, L. %A Porleifsson, G. %A Mullin, B. H. %A Handelman, S. K. %A Nalls, M. A. %A Jessen, L. E. %A Heppe, D. H. M. %A Richards, J. B. %A Wang, C. %A Chawes, B. %A Schraut, K. E. %A Amin, N. %A Wareham, N. %A Karasik, D. %A Van der Velde, N. %A Ikram, M. A. %A Zemel, B. S. %A Zhou, Y. %A Carlsson, C. J. %A Liu, Y. %A McGuigan, F. E. %A Boer, C. G. %A B?nnelykke, K. %A Ralston, S. H. %A Robbins, J. A. %A Walsh, J. P. %A Zillikens, M. C. %A Langenberg, C. %A Li-Gao, R. %A Williams, F. M. K. %A Harris, T. B. %A Akesson, K. %A Jackson, R. D. %A Sigurdsson, G. %A den Heijer, M. %A van der Eerden, B. C. J. %A van de Peppel, J. %A Spector, T. D. %A Pennell, C. %A Horta, B. L. %A Felix, J. F. %A Zhao, J. H. %A Wilson, S. G. %A de Mutsert, R. %A Bisgaard, H. %A Styrk?rsd?ttir, U. %A Jaddoe, V. W. %A Orwoll, E. %A Lakka, T. A. %A Scott, R. %A Grant, S. F. A. %A Lorentzon, M. %A van Duijn, C. M. %A Wilson, J. F. %A Stefansson, K. %A Psaty, B. M. %A Kiel, D. P. %A Ohlsson, C. %A Ntzani, E. %A van Wijnen, A. J. %A Forgetta, V. %A Ghanbari, M. %A Logan, J. G. %A Williams, G. R. %A Bassett, J. H. D. %A Croucher, P. I. %A Evangelou, E. %A Uitterlinden, A. G. %A Ackert-Bicknell, C. L. %A Tobias, J. H. %A Evans, D. M. %A Rivadeneira, F. %X Bone mineral density (BMD) assessed by DXA is used to evaluate bone health. In children, total body (TB) measurements are commonly used; in older individuals, BMD at the lumbar spine (LS) and femoral neck (FN) is used to diagnose osteoporosis. To date, genetic variants in more than 60 loci have been identified as associated with BMD. To investigate the genetic determinants of TB-BMD variation along the life course and test for age-specific effects, we performed a meta-analysis of 30 genome-wide association studies (GWASs) of TB-BMD including 66,628 individuals overall and divided across five age strata, each spanning 15 years. We identified variants associated with TB-BMD at 80 loci, of which 36 have not been previously identified; overall, they explain approximately 10% of the TB-BMD variance when combining all age groups and influence the risk of fracture. Pathway and enrichment analysis of the association signals showed clustering within gene sets implicated in the regulation of cell growth and SMAD proteins, overexpressed in the musculoskeletal system, and enriched in enhancer and promoter regions. These findings reveal TB-BMD as a relevant trait for genetic studies of osteoporosis, enabling the identification of variants and pathways influencing different bone compartments. Only variants in ESR1 and close proximity to RANKL showed a clear effect dependency on age. This most likely indicates that the majority of genetic variants identified influence BMD early in life and that their effect can be captured throughout the life course. %B Am J Hum Genet %V 102 %P 88–102 %8 01 %G eng %0 Journal Article %J Circ Heart Fail %D 2018 %T Long-Term Cognitive Decline After Newly Diagnosed Heart Failure: Longitudinal Analysis in the CHS (Cardiovascular Health Study). %A Hammond, Christa A %A Blades, Natalie J %A Chaudhry, Sarwat I %A Dodson, John A %A Longstreth, W T %A Heckbert, Susan R %A Psaty, Bruce M %A Arnold, Alice M %A Dublin, Sascha %A Sitlani, Colleen M %A Gardin, Julius M %A Thielke, Stephen M %A Nanna, Michael G %A Gottesman, Rebecca F %A Newman, Anne B %A Thacker, Evan L %X

BACKGROUND: Heart failure (HF) is associated with cognitive impairment. However, we know little about the time course of cognitive change after HF diagnosis, the importance of comorbid atrial fibrillation, or the role of ejection fraction. We sought to determine the associations of incident HF with rates of cognitive decline and whether these differed by atrial fibrillation status or reduced versus preserved ejection fraction.

METHODS AND RESULTS: Participants were 4864 men and women aged ≥65 years without a history of HF and free of clinical stroke in the CHS (Cardiovascular Health Study)-a community-based prospective cohort study in the United States, with cognition assessed annually from 1989/1990 through 1998/1999. We identified 496 participants with incident HF by review of hospital discharge summaries and Medicare claims data, with adjudication according to standard criteria. Global cognitive ability was measured by the Modified Mini-Mental State Examination. In adjusted models, 5-year decline in model-predicted mean Modified Mini-Mental State Examination score was 10.2 points (95% confidence interval, 8.6-11.8) after incident HF diagnosed at 80 years of age, compared with a mean 5-year decline of 5.8 points (95% confidence interval, 5.3-6.2) from 80 to 85 years of age without HF. The association was stronger at older ages than at younger ages, did not vary significantly in the presence versus absence of atrial fibrillation (=0.084), and did not vary significantly by reduced versus preserved ejection fraction (=0.734).

CONCLUSIONS: Decline in global cognitive ability tends to be faster after HF diagnosis than without HF. Clinical and public health implications of this finding warrant further attention.

%B Circ Heart Fail %V 11 %P e004476 %8 2018 Mar %G eng %N 3 %R 10.1161/CIRCHEARTFAILURE.117.004476 %0 Journal Article %J Nephrol Dial Transplant %D 2018 %T Low thyroid function is not associated with an accelerated deterioration in renal function. %A Meuwese, Christiaan L %A van Diepen, Merel %A Cappola, Anne R %A Sarnak, Mark J %A Shlipak, Michael G %A Bauer, Douglas C %A Fried, Linda P %A Iacoviello, Massimo %A Vaes, Bert %A Degryse, Jean %A Khaw, Kay-Tee %A Luben, Robert N %A Asvold, Bjørn O %A Bjøro, Trine %A Vatten, Lars J %A de Craen, Anton J M %A Trompet, Stella %A Iervasi, Giorgio %A Molinaro, Sabrina %A Ceresini, Graziano %A Ferrucci, Luigi %A Dullaart, Robin P F %A Bakker, Stephan J L %A Jukema, J Wouter %A Kearney, Patricia M %A Stott, David J %A Peeters, Robin P %A Franco, Oscar H %A Völzke, Henry %A Walsh, John P %A Bremner, Alexandra %A Sgarbi, José A %A Maciel, Rui M B %A Imaizumi, Misa %A Ohishi, Waka %A Dekker, Friedo W %A Rodondi, Nicolas %A Gussekloo, Jacobijn %A den Elzen, Wendy P J %X

Background: Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups.

Methods: Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models.

Results: A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function.

Conclusions: Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.

%B Nephrol Dial Transplant %8 2018 Apr 18 %G eng %R 10.1093/ndt/gfy071 %0 Journal Article %J Br J Nutr %D 2018 %T Meta-analysis across Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium provides evidence for an association of serum vitamin D with pulmonary function. %A Xu, Jiayi %A Bartz, Traci M %A Chittoor, Geetha %A Eiriksdottir, Gudny %A Manichaikul, Ani W %A Sun, Fangui %A Terzikhan, Natalie %A Zhou, Xia %A Booth, Sarah L %A Brusselle, Guy G %A de Boer, Ian H %A Fornage, Myriam %A Frazier-Wood, Alexis C %A Graff, Mariaelisa %A Gudnason, Vilmundur %A Harris, Tamara B %A Hofman, Albert %A Hou, Ruixue %A Houston, Denise K %A Jacobs, David R %A Kritchevsky, Stephen B %A Latourelle, Jeanne %A Lemaitre, Rozenn N %A Lutsey, Pamela L %A O'Connor, George %A Oelsner, Elizabeth C %A Pankow, James S %A Psaty, Bruce M %A Rohde, Rebecca R %A Rich, Stephen S %A Rotter, Jerome I %A Smith, Lewis J %A Stricker, Bruno H %A Voruganti, V Saroja %A Wang, Thomas J %A Zillikens, M Carola %A Barr, R Graham %A Dupuis, Josée %A Gharib, Sina A %A Lahousse, Lies %A London, Stephanie J %A North, Kari E %A Smith, Albert V %A Steffen, Lyn M %A Hancock, Dana B %A Cassano, Patricia A %X

The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)-pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D-pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (P race difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (P race difference=0·56). Among EA, the 25(OH)D-FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.

%B Br J Nutr %P 1-12 %8 2018 Sep 12 %G eng %R 10.1017/S0007114518002180 %0 Journal Article %J Wellcome Open Res %D 2018 %T Meta-analysis of exome array data identifies six novel genetic loci for lung function. %A Jackson, Victoria E %A Latourelle, Jeanne C %A Wain, Louise V %A Smith, Albert V %A Grove, Megan L %A Bartz, Traci M %A Obeidat, Ma'en %A Province, Michael A %A Gao, Wei %A Qaiser, Beenish %A Porteous, David J %A Cassano, Patricia A %A Ahluwalia, Tarunveer S %A Grarup, Niels %A Li, Jin %A Altmaier, Elisabeth %A Marten, Jonathan %A Harris, Sarah E %A Manichaikul, Ani %A Pottinger, Tess D %A Li-Gao, Ruifang %A Lind-Thomsen, Allan %A Mahajan, Anubha %A Lahousse, Lies %A Imboden, Medea %A Teumer, Alexander %A Prins, Bram %A Lyytikäinen, Leo-Pekka %A Eiriksdottir, Gudny %A Franceschini, Nora %A Sitlani, Colleen M %A Brody, Jennifer A %A Bossé, Yohan %A Timens, Wim %A Kraja, Aldi %A Loukola, Anu %A Tang, Wenbo %A Liu, Yongmei %A Bork-Jensen, Jette %A Justesen, Johanne M %A Linneberg, Allan %A Lange, Leslie A %A Rawal, Rajesh %A Karrasch, Stefan %A Huffman, Jennifer E %A Smith, Blair H %A Davies, Gail %A Burkart, Kristin M %A Mychaleckyj, Josyf C %A Bonten, Tobias N %A Enroth, Stefan %A Lind, Lars %A Brusselle, Guy G %A Kumar, Ashish %A Stubbe, Beate %A Kähönen, Mika %A Wyss, Annah B %A Psaty, Bruce M %A Heckbert, Susan R %A Hao, Ke %A Rantanen, Taina %A Kritchevsky, Stephen B %A Lohman, Kurt %A Skaaby, Tea %A Pisinger, Charlotta %A Hansen, Torben %A Schulz, Holger %A Polasek, Ozren %A Campbell, Archie %A Starr, John M %A Rich, Stephen S %A Mook-Kanamori, Dennis O %A Johansson, Asa %A Ingelsson, Erik %A Uitterlinden, André G %A Weiss, Stefan %A Raitakari, Olli T %A Gudnason, Vilmundur %A North, Kari E %A Gharib, Sina A %A Sin, Don D %A Taylor, Kent D %A O'Connor, George T %A Kaprio, Jaakko %A Harris, Tamara B %A Pederson, Oluf %A Vestergaard, Henrik %A Wilson, James G %A Strauch, Konstantin %A Hayward, Caroline %A Kerr, Shona %A Deary, Ian J %A Barr, R Graham %A de Mutsert, Renée %A Gyllensten, Ulf %A Morris, Andrew P %A Ikram, M Arfan %A Probst-Hensch, Nicole %A Gläser, Sven %A Zeggini, Eleftheria %A Lehtimäki, Terho %A Strachan, David P %A Dupuis, Josée %A Morrison, Alanna C %A Hall, Ian P %A Tobin, Martin D %A London, Stephanie J %X

Over 90 regions of the genome have been associated with lung function to date, many of which have also been implicated in chronic obstructive pulmonary disease. We carried out meta-analyses of exome array data and three lung function measures: forced expiratory volume in one second (FEV ), forced vital capacity (FVC) and the ratio of FEV to FVC (FEV /FVC). These analyses by the SpiroMeta and CHARGE consortia included 60,749 individuals of European ancestry from 23 studies, and 7,721 individuals of African Ancestry from 5 studies in the discovery stage, with follow-up in up to 111,556 independent individuals. We identified significant (P<2·8x10 ) associations with six SNPs: a nonsynonymous variant in , which is predicted to be damaging, three intronic SNPs ( and ) and two intergenic SNPs near to and Expression quantitative trait loci analyses found evidence for regulation of gene expression at three signals and implicated several genes, including and . Further interrogation of these loci could provide greater understanding of the determinants of lung function and pulmonary disease.

%B Wellcome Open Res %V 3 %P 4 %8 2018 %G eng %R 10.12688/wellcomeopenres.12583.3 %0 Journal Article %J Nat Genet %D 2018 %T Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks. %A Demenais, Florence %A Margaritte-Jeannin, Patricia %A Barnes, Kathleen C %A Cookson, William O C %A Altmüller, Janine %A Ang, Wei %A Barr, R Graham %A Beaty, Terri H %A Becker, Allan B %A Beilby, John %A Bisgaard, Hans %A Bjornsdottir, Unnur Steina %A Bleecker, Eugene %A Bønnelykke, Klaus %A Boomsma, Dorret I %A Bouzigon, Emmanuelle %A Brightling, Christopher E %A Brossard, Myriam %A Brusselle, Guy G %A Burchard, Esteban %A Burkart, Kristin M %A Bush, Andrew %A Chan-Yeung, Moira %A Chung, Kian Fan %A Couto Alves, Alexessander %A Curtin, John A %A Custovic, Adnan %A Daley, Denise %A de Jongste, Johan C %A Del-Rio-Navarro, Blanca E %A Donohue, Kathleen M %A Duijts, Liesbeth %A Eng, Celeste %A Eriksson, Johan G %A Farrall, Martin %A Fedorova, Yuliya %A Feenstra, Bjarke %A Ferreira, Manuel A %A Freidin, Maxim B %A Gajdos, Zofia %A Gauderman, Jim %A Gehring, Ulrike %A Geller, Frank %A Genuneit, Jon %A Gharib, Sina A %A Gilliland, Frank %A Granell, Raquel %A Graves, Penelope E %A Gudbjartsson, Daniel F %A Haahtela, Tari %A Heckbert, Susan R %A Heederik, Dick %A Heinrich, Joachim %A Heliövaara, Markku %A Henderson, John %A Himes, Blanca E %A Hirose, Hiroshi %A Hirschhorn, Joel N %A Hofman, Albert %A Holt, Patrick %A Hottenga, Jouke %A Hudson, Thomas J %A Hui, Jennie %A Imboden, Medea %A Ivanov, Vladimir %A Jaddoe, Vincent W V %A James, Alan %A Janson, Christer %A Jarvelin, Marjo-Riitta %A Jarvis, Deborah %A Jones, Graham %A Jonsdottir, Ingileif %A Jousilahti, Pekka %A Kabesch, Michael %A Kähönen, Mika %A Kantor, David B %A Karunas, Alexandra S %A Khusnutdinova, Elza %A Koppelman, Gerard H %A Kozyrskyj, Anita L %A Kreiner, Eskil %A Kubo, Michiaki %A Kumar, Rajesh %A Kumar, Ashish %A Kuokkanen, Mikko %A Lahousse, Lies %A Laitinen, Tarja %A Laprise, Catherine %A Lathrop, Mark %A Lau, Susanne %A Lee, Young-Ae %A Lehtimäki, Terho %A Letort, Sébastien %A Levin, Albert M %A Li, Guo %A Liang, Liming %A Loehr, Laura R %A London, Stephanie J %A Loth, Daan W %A Manichaikul, Ani %A Marenholz, Ingo %A Martinez, Fernando J %A Matheson, Melanie C %A Mathias, Rasika A %A Matsumoto, Kenji %A Mbarek, Hamdi %A McArdle, Wendy L %A Melbye, Mads %A Melén, Erik %A Meyers, Deborah %A Michel, Sven %A Mohamdi, Hamida %A Musk, Arthur W %A Myers, Rachel A %A Nieuwenhuis, Maartje A E %A Noguchi, Emiko %A O'Connor, George T %A Ogorodova, Ludmila M %A Palmer, Cameron D %A Palotie, Aarno %A Park, Julie E %A Pennell, Craig E %A Pershagen, Göran %A Polonikov, Alexey %A Postma, Dirkje S %A Probst-Hensch, Nicole %A Puzyrev, Valery P %A Raby, Benjamin A %A Raitakari, Olli T %A Ramasamy, Adaikalavan %A Rich, Stephen S %A Robertson, Colin F %A Romieu, Isabelle %A Salam, Muhammad T %A Salomaa, Veikko %A Schlünssen, Vivi %A Scott, Robert %A Selivanova, Polina A %A Sigsgaard, Torben %A Simpson, Angela %A Siroux, Valérie %A Smith, Lewis J %A Solodilova, Maria %A Standl, Marie %A Stefansson, Kari %A Strachan, David P %A Stricker, Bruno H %A Takahashi, Atsushi %A Thompson, Philip J %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tiesler, Carla M T %A Torgerson, Dara G %A Tsunoda, Tatsuhiko %A Uitterlinden, André G %A van der Valk, Ralf J P %A Vaysse, Amaury %A Vedantam, Sailaja %A von Berg, Andrea %A von Mutius, Erika %A Vonk, Judith M %A Waage, Johannes %A Wareham, Nick J %A Weiss, Scott T %A White, Wendy B %A Wickman, Magnus %A Widen, Elisabeth %A Willemsen, Gonneke %A Williams, L Keoki %A Wouters, Inge M %A Yang, James J %A Zhao, Jing Hua %A Moffatt, Miriam F %A Ober, Carole %A Nicolae, Dan L %X

We examined common variation in asthma risk by conducting a meta-analysis of worldwide asthma genome-wide association studies (23,948 asthma cases, 118,538 controls) of individuals from ethnically diverse populations. We identified five new asthma loci, found two new associations at two known asthma loci, established asthma associations at two loci previously implicated in the comorbidity of asthma plus hay fever, and confirmed nine known loci. Investigation of pleiotropy showed large overlaps in genetic variants with autoimmune and inflammatory diseases. The enrichment in enhancer marks at asthma risk loci, especially in immune cells, suggested a major role of these loci in the regulation of immunologically related mechanisms.

%B Nat Genet %V 50 %P 42-53 %8 2018 Jan %G eng %N 1 %R 10.1038/s41588-017-0014-7 %0 Journal Article %J Nat Genet %D 2018 %T Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes. %A Malik, Rainer %A Chauhan, Ganesh %A Traylor, Matthew %A Sargurupremraj, Muralidharan %A Okada, Yukinori %A Mishra, Aniket %A Rutten-Jacobs, Loes %A Giese, Anne-Katrin %A van der Laan, Sander W %A Gretarsdottir, Solveig %A Anderson, Christopher D %A Chong, Michael %A Adams, Hieab H H %A Ago, Tetsuro %A Almgren, Peter %A Amouyel, Philippe %A Ay, Hakan %A Bartz, Traci M %A Benavente, Oscar R %A Bevan, Steve %A Boncoraglio, Giorgio B %A Brown, Robert D %A Butterworth, Adam S %A Carrera, Caty %A Carty, Cara L %A Chasman, Daniel I %A Chen, Wei-Min %A Cole, John W %A Correa, Adolfo %A Cotlarciuc, Ioana %A Cruchaga, Carlos %A Danesh, John %A de Bakker, Paul I W %A DeStefano, Anita L %A den Hoed, Marcel %A Duan, Qing %A Engelter, Stefan T %A Falcone, Guido J %A Gottesman, Rebecca F %A Grewal, Raji P %A Gudnason, Vilmundur %A Gustafsson, Stefan %A Haessler, Jeffrey %A Harris, Tamara B %A Hassan, Ahamad %A Havulinna, Aki S %A Heckbert, Susan R %A Holliday, Elizabeth G %A Howard, George %A Hsu, Fang-Chi %A Hyacinth, Hyacinth I %A Ikram, M Arfan %A Ingelsson, Erik %A Irvin, Marguerite R %A Jian, Xueqiu %A Jimenez-Conde, Jordi %A Johnson, Julie A %A Jukema, J Wouter %A Kanai, Masahiro %A Keene, Keith L %A Kissela, Brett M %A Kleindorfer, Dawn O %A Kooperberg, Charles %A Kubo, Michiaki %A Lange, Leslie A %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lee, Jin-Moo %A Lemmens, Robin %A Leys, Didier %A Lewis, Cathryn M %A Lin, Wei-Yu %A Lindgren, Arne G %A Lorentzen, Erik %A Magnusson, Patrik K %A Maguire, Jane %A Manichaikul, Ani %A McArdle, Patrick F %A Meschia, James F %A Mitchell, Braxton D %A Mosley, Thomas H %A Nalls, Michael A %A Ninomiya, Toshiharu %A O'Donnell, Martin J %A Psaty, Bruce M %A Pulit, Sara L %A Rannikmae, Kristiina %A Reiner, Alexander P %A Rexrode, Kathryn M %A Rice, Kenneth %A Rich, Stephen S %A Ridker, Paul M %A Rost, Natalia S %A Rothwell, Peter M %A Rotter, Jerome I %A Rundek, Tatjana %A Sacco, Ralph L %A Sakaue, Saori %A Sale, Michèle M %A Salomaa, Veikko %A Sapkota, Bishwa R %A Schmidt, Reinhold %A Schmidt, Carsten O %A Schminke, Ulf %A Sharma, Pankaj %A Slowik, Agnieszka %A Sudlow, Cathie L M %A Tanislav, Christian %A Tatlisumak, Turgut %A Taylor, Kent D %A Thijs, Vincent N S %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tiedt, Steffen %A Trompet, Stella %A Tzourio, Christophe %A van Duijn, Cornelia M %A Walters, Matthew %A Wareham, Nicholas J %A Wassertheil-Smoller, Sylvia %A Wilson, James G %A Wiggins, Kerri L %A Yang, Qiong %A Yusuf, Salim %A Bis, Joshua C %A Pastinen, Tomi %A Ruusalepp, Arno %A Schadt, Eric E %A Koplev, Simon %A Björkegren, Johan L M %A Codoni, Veronica %A Civelek, Mete %A Smith, Nicholas L %A Trégouët, David A %A Christophersen, Ingrid E %A Roselli, Carolina %A Lubitz, Steven A %A Ellinor, Patrick T %A Tai, E Shyong %A Kooner, Jaspal S %A Kato, Norihiro %A He, Jiang %A van der Harst, Pim %A Elliott, Paul %A Chambers, John C %A Takeuchi, Fumihiko %A Johnson, Andrew D %A Sanghera, Dharambir K %A Melander, Olle %A Jern, Christina %A Strbian, Daniel %A Fernandez-Cadenas, Israel %A Longstreth, W T %A Rolfs, Arndt %A Hata, Jun %A Woo, Daniel %A Rosand, Jonathan %A Paré, Guillaume %A Hopewell, Jemma C %A Saleheen, Danish %A Stefansson, Kari %A Worrall, Bradford B %A Kittner, Steven J %A Seshadri, Sudha %A Fornage, Myriam %A Markus, Hugh S %A Howson, Joanna M M %A Kamatani, Yoichiro %A Debette, Stephanie %A Dichgans, Martin %A Malik, Rainer %A Chauhan, Ganesh %A Traylor, Matthew %A Sargurupremraj, Muralidharan %A Okada, Yukinori %A Mishra, Aniket %A Rutten-Jacobs, Loes %A Giese, Anne-Katrin %A van der Laan, Sander W %A Gretarsdottir, Solveig %A Anderson, Christopher D %A Chong, Michael %A Adams, Hieab H H %A Ago, Tetsuro %A Almgren, Peter %A Amouyel, Philippe %A Ay, Hakan %A Bartz, Traci M %A Benavente, Oscar R %A Bevan, Steve %A Boncoraglio, Giorgio B %A Brown, Robert D %A Butterworth, Adam S %A Carrera, Caty %A Carty, Cara L %A Chasman, Daniel I %A Chen, Wei-Min %A Cole, John W %A Correa, Adolfo %A Cotlarciuc, Ioana %A Cruchaga, Carlos %A Danesh, John %A de Bakker, Paul I W %A DeStefano, Anita L %A Hoed, Marcel den %A Duan, Qing %A Engelter, Stefan T %A Falcone, Guido J %A Gottesman, Rebecca F %A Grewal, Raji P %A Gudnason, Vilmundur %A Gustafsson, Stefan %A Haessler, Jeffrey %A Harris, Tamara B %A Hassan, Ahamad %A Havulinna, Aki S %A Heckbert, Susan R %A Holliday, Elizabeth G %A Howard, George %A Hsu, Fang-Chi %A Hyacinth, Hyacinth I %A Ikram, M Arfan %A Ingelsson, Erik %A Irvin, Marguerite R %A Jian, Xueqiu %A Jimenez-Conde, Jordi %A Johnson, Julie A %A Jukema, J Wouter %A Kanai, Masahiro %A Keene, Keith L %A Kissela, Brett M %A Kleindorfer, Dawn O %A Kooperberg, Charles %A Kubo, Michiaki %A Lange, Leslie A %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lee, Jin-Moo %A Lemmens, Robin %A Leys, Didier %A Lewis, Cathryn M %A Lin, Wei-Yu %A Lindgren, Arne G %A Lorentzen, Erik %A Magnusson, Patrik K %A Maguire, Jane %A Manichaikul, Ani %A McArdle, Patrick F %A Meschia, James F %A Mitchell, Braxton D %A Mosley, Thomas H %A Nalls, Michael A %A Ninomiya, Toshiharu %A O'Donnell, Martin J %A Psaty, Bruce M %A Pulit, Sara L %A Rannikmae, Kristiina %A Reiner, Alexander P %A Rexrode, Kathryn M %A Rice, Kenneth %A Rich, Stephen S %A Ridker, Paul M %A Rost, Natalia S %A Rothwell, Peter M %A Rotter, Jerome I %A Rundek, Tatjana %A Sacco, Ralph L %A Sakaue, Saori %A Sale, Michèle M %A Salomaa, Veikko %A Sapkota, Bishwa R %A Schmidt, Reinhold %A Schmidt, Carsten O %A Schminke, Ulf %A Sharma, Pankaj %A Slowik, Agnieszka %A Sudlow, Cathie L M %A Tanislav, Christian %A Tatlisumak, Turgut %A Taylor, Kent D %A Thijs, Vincent N S %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tiedt, Steffen %A Trompet, Stella %A Tzourio, Christophe %A van Duijn, Cornelia M %A Walters, Matthew %A Wareham, Nicholas J %A Wassertheil-Smoller, Sylvia %A Wilson, James G %A Wiggins, Kerri L %A Yang, Qiong %A Yusuf, Salim %A Amin, Najaf %A Aparicio, Hugo S %A Arnett, Donna K %A Attia, John %A Beiser, Alexa S %A Berr, Claudine %A Buring, Julie E %A Bustamante, Mariana %A Caso, Valeria %A Cheng, Yu-Ching %A Choi, Seung Hoan %A Chowhan, Ayesha %A Cullell, Natalia %A Dartigues, Jean-François %A Delavaran, Hossein %A Delgado, Pilar %A Dörr, Marcus %A Engström, Gunnar %A Ford, Ian %A Gurpreet, Wander S %A Hamsten, Anders %A Heitsch, Laura %A Hozawa, Atsushi %A Ibanez, Laura %A Ilinca, Andreea %A Ingelsson, Martin %A Iwasaki, Motoki %A Jackson, Rebecca D %A Jood, Katarina %A Jousilahti, Pekka %A Kaffashian, Sara %A Kalra, Lalit %A Kamouchi, Masahiro %A Kitazono, Takanari %A Kjartansson, Olafur %A Kloss, Manja %A Koudstaal, Peter J %A Krupinski, Jerzy %A Labovitz, Daniel L %A Laurie, Cathy C %A Levi, Christopher R %A Li, Linxin %A Lind, Lars %A Lindgren, Cecilia M %A Lioutas, Vasileios %A Liu, Yong Mei %A Lopez, Oscar L %A Makoto, Hirata %A Martinez-Majander, Nicolas %A Matsuda, Koichi %A Minegishi, Naoko %A Montaner, Joan %A Morris, Andrew P %A Muiño, Elena %A Müller-Nurasyid, Martina %A Norrving, Bo %A Ogishima, Soichi %A Parati, Eugenio A %A Peddareddygari, Leema Reddy %A Pedersen, Nancy L %A Pera, Joanna %A Perola, Markus %A Pezzini, Alessandro %A Pileggi, Silvana %A Rabionet, Raquel %A Riba-Llena, Iolanda %A Ribasés, Marta %A Romero, Jose R %A Roquer, Jaume %A Rudd, Anthony G %A Sarin, Antti-Pekka %A Sarju, Ralhan %A Sarnowski, Chloe %A Sasaki, Makoto %A Satizabal, Claudia L %A Satoh, Mamoru %A Sattar, Naveed %A Sawada, Norie %A Sibolt, Gerli %A Sigurdsson, Ásgeir %A Smith, Albert %A Sobue, Kenji %A Soriano-Tárraga, Carolina %A Stanne, Tara %A Stine, O Colin %A Stott, David J %A Strauch, Konstantin %A Takai, Takako %A Tanaka, Hideo %A Tanno, Kozo %A Teumer, Alexander %A Tomppo, Liisa %A Torres-Aguila, Nuria P %A Touze, Emmanuel %A Tsugane, Shoichiro %A Uitterlinden, André G %A Valdimarsson, Einar M %A van der Lee, Sven J %A Völzke, Henry %A Wakai, Kenji %A Weir, David %A Williams, Stephen R %A Wolfe, Charles D A %A Wong, Quenna %A Xu, Huichun %A Yamaji, Taiki %A Sanghera, Dharambir K %A Melander, Olle %A Jern, Christina %A Strbian, Daniel %A Fernandez-Cadenas, Israel %A Longstreth, W T %A Rolfs, Arndt %A Hata, Jun %A Woo, Daniel %A Rosand, Jonathan %A Paré, Guillaume %A Hopewell, Jemma C %A Saleheen, Danish %A Stefansson, Kari %A Worrall, Bradford B %A Kittner, Steven J %A Seshadri, Sudha %A Fornage, Myriam %A Markus, Hugh S %A Howson, Joanna M M %A Kamatani, Yoichiro %A Debette, Stephanie %A Dichgans, Martin %X

Stroke has multiple etiologies, but the underlying genes and pathways are largely unknown. We conducted a multiancestry genome-wide-association meta-analysis in 521,612 individuals (67,162 cases and 454,450 controls) and discovered 22 new stroke risk loci, bringing the total to 32. We further found shared genetic variation with related vascular traits, including blood pressure, cardiac traits, and venous thromboembolism, at individual loci (n = 18), and using genetic risk scores and linkage-disequilibrium-score regression. Several loci exhibited distinct association and pleiotropy patterns for etiological stroke subtypes. Eleven new susceptibility loci indicate mechanisms not previously implicated in stroke pathophysiology, with prioritization of risk variants and genes accomplished through bioinformatics analyses using extensive functional datasets. Stroke risk loci were significantly enriched in drug targets for antithrombotic therapy.

%B Nat Genet %V 50 %P 524-537 %8 2018 Apr %G eng %N 4 %R 10.1038/s41588-018-0058-3 %0 Journal Article %J Nat Genet %D 2018 %T Multi-ethnic genome-wide association study for atrial fibrillation. %A Roselli, Carolina %A Chaffin, Mark D %A Weng, Lu-Chen %A Aeschbacher, Stefanie %A Ahlberg, Gustav %A Albert, Christine M %A Almgren, Peter %A Alonso, Alvaro %A Anderson, Christopher D %A Aragam, Krishna G %A Arking, Dan E %A Barnard, John %A Bartz, Traci M %A Benjamin, Emelia J %A Bihlmeyer, Nathan A %A Bis, Joshua C %A Bloom, Heather L %A Boerwinkle, Eric %A Bottinger, Erwin B %A Brody, Jennifer A %A Calkins, Hugh %A Campbell, Archie %A Cappola, Thomas P %A Carlquist, John %A Chasman, Daniel I %A Chen, Lin Y %A Chen, Yii-Der Ida %A Choi, Eue-Keun %A Choi, Seung Hoan %A Christophersen, Ingrid E %A Chung, Mina K %A Cole, John W %A Conen, David %A Cook, James %A Crijns, Harry J %A Cutler, Michael J %A Damrauer, Scott M %A Daniels, Brian R %A Darbar, Dawood %A Delgado, Graciela %A Denny, Joshua C %A Dichgans, Martin %A Dörr, Marcus %A Dudink, Elton A %A Dudley, Samuel C %A Esa, Nada %A Esko, Tõnu %A Eskola, Markku %A Fatkin, Diane %A Felix, Stephan B %A Ford, Ian %A Franco, Oscar H %A Geelhoed, Bastiaan %A Grewal, Raji P %A Gudnason, Vilmundur %A Guo, Xiuqing %A Gupta, Namrata %A Gustafsson, Stefan %A Gutmann, Rebecca %A Hamsten, Anders %A Harris, Tamara B %A Hayward, Caroline %A Heckbert, Susan R %A Hernesniemi, Jussi %A Hocking, Lynne J %A Hofman, Albert %A Horimoto, Andrea R V R %A Huang, Jie %A Huang, Paul L %A Huffman, Jennifer %A Ingelsson, Erik %A Ipek, Esra Gucuk %A Ito, Kaoru %A Jimenez-Conde, Jordi %A Johnson, Renee %A Jukema, J Wouter %A Kääb, Stefan %A Kähönen, Mika %A Kamatani, Yoichiro %A Kane, John P %A Kastrati, Adnan %A Kathiresan, Sekar %A Katschnig-Winter, Petra %A Kavousi, Maryam %A Kessler, Thorsten %A Kietselaer, Bas L %A Kirchhof, Paulus %A Kleber, Marcus E %A Knight, Stacey %A Krieger, Jose E %A Kubo, Michiaki %A Launer, Lenore J %A Laurikka, Jari %A Lehtimäki, Terho %A Leineweber, Kirsten %A Lemaitre, Rozenn N %A Li, Man %A Lim, Hong Euy %A Lin, Henry J %A Lin, Honghuang %A Lind, Lars %A Lindgren, Cecilia M %A Lokki, Marja-Liisa %A London, Barry %A Loos, Ruth J F %A Low, Siew-Kee %A Lu, Yingchang %A Lyytikäinen, Leo-Pekka %A Macfarlane, Peter W %A Magnusson, Patrik K %A Mahajan, Anubha %A Malik, Rainer %A Mansur, Alfredo J %A Marcus, Gregory M %A Margolin, Lauren %A Margulies, Kenneth B %A März, Winfried %A McManus, David D %A Melander, Olle %A Mohanty, Sanghamitra %A Montgomery, Jay A %A Morley, Michael P %A Morris, Andrew P %A Müller-Nurasyid, Martina %A Natale, Andrea %A Nazarian, Saman %A Neumann, Benjamin %A Newton-Cheh, Christopher %A Niemeijer, Maartje N %A Nikus, Kjell %A Nilsson, Peter %A Noordam, Raymond %A Oellers, Heidi %A Olesen, Morten S %A Orho-Melander, Marju %A Padmanabhan, Sandosh %A Pak, Hui-Nam %A Paré, Guillaume %A Pedersen, Nancy L %A Pera, Joanna %A Pereira, Alexandre %A Porteous, David %A Psaty, Bruce M %A Pulit, Sara L %A Pullinger, Clive R %A Rader, Daniel J %A Refsgaard, Lena %A Ribasés, Marta %A Ridker, Paul M %A Rienstra, Michiel %A Risch, Lorenz %A Roden, Dan M %A Rosand, Jonathan %A Rosenberg, Michael A %A Rost, Natalia %A Rotter, Jerome I %A Saba, Samir %A Sandhu, Roopinder K %A Schnabel, Renate B %A Schramm, Katharina %A Schunkert, Heribert %A Schurman, Claudia %A Scott, Stuart A %A Seppälä, Ilkka %A Shaffer, Christian %A Shah, Svati %A Shalaby, Alaa A %A Shim, Jaemin %A Shoemaker, M Benjamin %A Siland, Joylene E %A Sinisalo, Juha %A Sinner, Moritz F %A Slowik, Agnieszka %A Smith, Albert V %A Smith, Blair H %A Smith, J Gustav %A Smith, Jonathan D %A Smith, Nicholas L %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Stricker, Bruno H %A Sun, Albert %A Sun, Han %A Svendsen, Jesper H %A Tanaka, Toshihiro %A Tanriverdi, Kahraman %A Taylor, Kent D %A Teder-Laving, Maris %A Teumer, Alexander %A Thériault, Sébastien %A Trompet, Stella %A Tucker, Nathan R %A Tveit, Arnljot %A Uitterlinden, André G %A van der Harst, Pim %A Van Gelder, Isabelle C %A Van Wagoner, David R %A Verweij, Niek %A Vlachopoulou, Efthymia %A Völker, Uwe %A Wang, Biqi %A Weeke, Peter E %A Weijs, Bob %A Weiss, Raul %A Weiss, Stefan %A Wells, Quinn S %A Wiggins, Kerri L %A Wong, Jorge A %A Woo, Daniel %A Worrall, Bradford B %A Yang, Pil-Sung %A Yao, Jie %A Yoneda, Zachary T %A Zeller, Tanja %A Zeng, Lingyao %A Lubitz, Steven A %A Lunetta, Kathryn L %A Ellinor, Patrick T %X

Atrial fibrillation (AF) affects more than 33 million individuals worldwide and has a complex heritability. We conducted the largest meta-analysis of genome-wide association studies (GWAS) for AF to date, consisting of more than half a million individuals, including 65,446 with AF. In total, we identified 97 loci significantly associated with AF, including 67 that were novel in a combined-ancestry analysis, and 3 that were novel in a European-specific analysis. We sought to identify AF-associated genes at the GWAS loci by performing RNA-sequencing and expression quantitative trait locus analyses in 101 left atrial samples, the most relevant tissue for AF. We also performed transcriptome-wide analyses that identified 57 AF-associated genes, 42 of which overlap with GWAS loci. The identified loci implicate genes enriched within cardiac developmental, electrophysiological, contractile and structural pathways. These results extend our understanding of the biological pathways underlying AF and may facilitate the development of therapeutics for AF.

%B Nat Genet %V 50 %P 1225-1233 %8 2018 Sep %G eng %N 9 %R 10.1038/s41588-018-0133-9 %0 Journal Article %J Nat Commun %D 2018 %T Multiethnic meta-analysis identifies ancestry-specific and cross-ancestry loci for pulmonary function. %A Wyss, Annah B %A Sofer, Tamar %A Lee, Mi Kyeong %A Terzikhan, Natalie %A Nguyen, Jennifer N %A Lahousse, Lies %A Latourelle, Jeanne C %A Smith, Albert Vernon %A Bartz, Traci M %A Feitosa, Mary F %A Gao, Wei %A Ahluwalia, Tarunveer S %A Tang, Wenbo %A Oldmeadow, Christopher %A Duan, Qing %A de Jong, Kim %A Wojczynski, Mary K %A Wang, Xin-Qun %A Noordam, Raymond %A Hartwig, Fernando Pires %A Jackson, Victoria E %A Wang, Tianyuan %A Obeidat, Ma'en %A Hobbs, Brian D %A Huan, Tianxiao %A Gui, Hongsheng %A Parker, Margaret M %A Hu, Donglei %A Mogil, Lauren S %A Kichaev, Gleb %A Jin, Jianping %A Graff, Mariaelisa %A Harris, Tamara B %A Kalhan, Ravi %A Heckbert, Susan R %A Paternoster, Lavinia %A Burkart, Kristin M %A Liu, Yongmei %A Holliday, Elizabeth G %A Wilson, James G %A Vonk, Judith M %A Sanders, Jason L %A Barr, R Graham %A de Mutsert, Renée %A Menezes, Ana Maria Baptista %A Adams, Hieab H H %A van den Berge, Maarten %A Joehanes, Roby %A Levin, Albert M %A Liberto, Jennifer %A Launer, Lenore J %A Morrison, Alanna C %A Sitlani, Colleen M %A Celedón, Juan C %A Kritchevsky, Stephen B %A Scott, Rodney J %A Christensen, Kaare %A Rotter, Jerome I %A Bonten, Tobias N %A Wehrmeister, Fernando César %A Bossé, Yohan %A Xiao, Shujie %A Oh, Sam %A Franceschini, Nora %A Brody, Jennifer A %A Kaplan, Robert C %A Lohman, Kurt %A McEvoy, Mark %A Province, Michael A %A Rosendaal, Frits R %A Taylor, Kent D %A Nickle, David C %A Williams, L Keoki %A Burchard, Esteban G %A Wheeler, Heather E %A Sin, Don D %A Gudnason, Vilmundur %A North, Kari E %A Fornage, Myriam %A Psaty, Bruce M %A Myers, Richard H %A O'Connor, George %A Hansen, Torben %A Laurie, Cathy C %A Cassano, Patricia A %A Sung, Joohon %A Kim, Woo Jin %A Attia, John R %A Lange, Leslie %A Boezen, H Marike %A Thyagarajan, Bharat %A Rich, Stephen S %A Mook-Kanamori, Dennis O %A Horta, Bernardo Lessa %A Uitterlinden, André G %A Im, Hae Kyung %A Cho, Michael H %A Brusselle, Guy G %A Gharib, Sina A %A Dupuis, Josée %A Manichaikul, Ani %A London, Stephanie J %X

Nearly 100 loci have been identified for pulmonary function, almost exclusively in studies of European ancestry populations. We extend previous research by meta-analyzing genome-wide association studies of 1000 Genomes imputed variants in relation to pulmonary function in a multiethnic population of 90,715 individuals of European (N = 60,552), African (N = 8429), Asian (N = 9959), and Hispanic/Latino (N = 11,775) ethnicities. We identify over 50 additional loci at genome-wide significance in ancestry-specific or multiethnic meta-analyses. Using recent fine-mapping methods incorporating functional annotation, gene expression, and differences in linkage disequilibrium between ethnicities, we further shed light on potential causal variants and genes at known and newly identified loci. Several of the novel genes encode proteins with predicted or established drug targets, including KCNK2 and CDK12. Our study highlights the utility of multiethnic and integrative genomics approaches to extend existing knowledge of the genetics of lung function and clinical relevance of implicated loci.

%B Nat Commun %V 9 %P 2976 %8 2018 Jul 30 %G eng %N 1 %R 10.1038/s41467-018-05369-0 %0 Journal Article %J Am J Respir Cell Mol Biol %D 2018 %T Multiethnic Meta-Analysis Identifies RAI1 as a Possible Obstructive Sleep Apnea-related Quantitative Trait Locus in Men. %A Chen, Han %A Cade, Brian E %A Gleason, Kevin J %A Bjonnes, Andrew C %A Stilp, Adrienne M %A Sofer, Tamar %A Conomos, Matthew P %A Ancoli-Israel, Sonia %A Arens, Raanan %A Azarbarzin, Ali %A Bell, Graeme I %A Below, Jennifer E %A Chun, Sung %A Evans, Daniel S %A Ewert, Ralf %A Frazier-Wood, Alexis C %A Gharib, Sina A %A Haba-Rubio, José %A Hagen, Erika W %A Heinzer, Raphael %A Hillman, David R %A Johnson, W Craig %A Kutalik, Zoltán %A Lane, Jacqueline M %A Larkin, Emma K %A Lee, Seung Ku %A Liang, Jingjing %A Loredo, Jose S %A Mukherjee, Sutapa %A Palmer, Lyle J %A Papanicolaou, George J %A Penzel, Thomas %A Peppard, Paul E %A Post, Wendy S %A Ramos, Alberto R %A Rice, Ken %A Rotter, Jerome I %A Sands, Scott A %A Shah, Neomi A %A Shin, Chol %A Stone, Katie L %A Stubbe, Beate %A Sul, Jae Hoon %A Tafti, Mehdi %A Taylor, Kent D %A Teumer, Alexander %A Thornton, Timothy A %A Tranah, Gregory J %A Wang, Chaolong %A Wang, Heming %A Warby, Simon C %A Wellman, D Andrew %A Zee, Phyllis C %A Hanis, Craig L %A Laurie, Cathy C %A Gottlieb, Daniel J %A Patel, Sanjay R %A Zhu, Xiaofeng %A Sunyaev, Shamil R %A Saxena, Richa %A Lin, Xihong %A Redline, Susan %X

Obstructive sleep apnea (OSA) is a common heritable disorder displaying marked sexual dimorphism in disease prevalence and progression. Previous genetic association studies have identified a few genetic loci associated with OSA and related quantitative traits, but they have only focused on single ethnic groups, and a large proportion of the heritability remains unexplained. The apnea-hypopnea index (AHI) is a commonly used quantitative measure characterizing OSA severity. Because OSA differs by sex, and the pathophysiology of obstructive events differ in rapid eye movement (REM) and non-REM (NREM) sleep, we hypothesized that additional genetic association signals would be identified by analyzing the NREM/REM-specific AHI and by conducting sex-specific analyses in multiethnic samples. We performed genome-wide association tests for up to 19,733 participants of African, Asian, European, and Hispanic/Latino American ancestry in 7 studies. We identified rs12936587 on chromosome 17 as a possible quantitative trait locus for NREM AHI in men (N = 6,737; P = 1.7 × 10) but not in women (P = 0.77). The association with NREM AHI was replicated in a physiological research study (N = 67; P = 0.047). This locus overlapping the RAI1 gene and encompassing genes PEMT1, SREBF1, and RASD1 was previously reported to be associated with coronary artery disease, lipid metabolism, and implicated in Potocki-Lupski syndrome and Smith-Magenis syndrome, which are characterized by abnormal sleep phenotypes. We also identified gene-by-sex interactions in suggestive association regions, suggesting that genetic variants for AHI appear to vary by sex, consistent with the clinical observations of strong sexual dimorphism.

%B Am J Respir Cell Mol Biol %V 58 %P 391-401 %8 2018 Mar %G eng %N 3 %R 10.1165/rcmb.2017-0237OC %0 Journal Article %J PLoS One %D 2018 %T Novel genetic associations for blood pressure identified via gene-alcohol interaction in up to 570K individuals across multiple ancestries. %A Feitosa, Mary F %A Kraja, Aldi T %A Chasman, Daniel I %A Sung, Yun J %A Winkler, Thomas W %A Ntalla, Ioanna %A Guo, Xiuqing %A Franceschini, Nora %A Cheng, Ching-Yu %A Sim, Xueling %A Vojinovic, Dina %A Marten, Jonathan %A Musani, Solomon K %A Li, Changwei %A Bentley, Amy R %A Brown, Michael R %A Schwander, Karen %A Richard, Melissa A %A Noordam, Raymond %A Aschard, Hugues %A Bartz, Traci M %A Bielak, Lawrence F %A Dorajoo, Rajkumar %A Fisher, Virginia %A Hartwig, Fernando P %A Horimoto, Andrea R V R %A Lohman, Kurt K %A Manning, Alisa K %A Rankinen, Tuomo %A Smith, Albert V %A Tajuddin, Salman M %A Wojczynski, Mary K %A Alver, Maris %A Boissel, Mathilde %A Cai, Qiuyin %A Campbell, Archie %A Chai, Jin Fang %A Chen, Xu %A Divers, Jasmin %A Gao, Chuan %A Goel, Anuj %A Hagemeijer, Yanick %A Harris, Sarah E %A He, Meian %A Hsu, Fang-Chi %A Jackson, Anne U %A Kähönen, Mika %A Kasturiratne, Anuradhani %A Komulainen, Pirjo %A Kuhnel, Brigitte %A Laguzzi, Federica %A Luan, Jian'an %A Matoba, Nana %A Nolte, Ilja M %A Padmanabhan, Sandosh %A Riaz, Muhammad %A Rueedi, Rico %A Robino, Antonietta %A Said, M Abdullah %A Scott, Robert A %A Sofer, Tamar %A Stančáková, Alena %A Takeuchi, Fumihiko %A Tayo, Bamidele O %A van der Most, Peter J %A Varga, Tibor V %A Vitart, Veronique %A Wang, Yajuan %A Ware, Erin B %A Warren, Helen R %A Weiss, Stefan %A Wen, Wanqing %A Yanek, Lisa R %A Zhang, Weihua %A Zhao, Jing Hua %A Afaq, Saima %A Amin, Najaf %A Amini, Marzyeh %A Arking, Dan E %A Aung, Tin %A Boerwinkle, Eric %A Borecki, Ingrid %A Broeckel, Ulrich %A Brown, Morris %A Brumat, Marco %A Burke, Gregory L %A Canouil, Mickaël %A Chakravarti, Aravinda %A Charumathi, Sabanayagam %A Ida Chen, Yii-Der %A Connell, John M %A Correa, Adolfo %A de Las Fuentes, Lisa %A de Mutsert, Renée %A de Silva, H Janaka %A Deng, Xuan %A Ding, Jingzhong %A Duan, Qing %A Eaton, Charles B %A Ehret, Georg %A Eppinga, Ruben N %A Evangelou, Evangelos %A Faul, Jessica D %A Felix, Stephan B %A Forouhi, Nita G %A Forrester, Terrence %A Franco, Oscar H %A Friedlander, Yechiel %A Gandin, Ilaria %A Gao, He %A Ghanbari, Mohsen %A Gigante, Bruna %A Gu, C Charles %A Gu, Dongfeng %A Hagenaars, Saskia P %A Hallmans, Göran %A Harris, Tamara B %A He, Jiang %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hirata, Makoto %A Howard, Barbara V %A Ikram, M Arfan %A John, Ulrich %A Katsuya, Tomohiro %A Khor, Chiea Chuen %A Kilpeläinen, Tuomas O %A Koh, Woon-Puay %A Krieger, Jose E %A Kritchevsky, Stephen B %A Kubo, Michiaki %A Kuusisto, Johanna %A Lakka, Timo A %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lehne, Benjamin %A Lewis, Cora E %A Li, Yize %A Lin, Shiow %A Liu, Jianjun %A Liu, Jingmin %A Loh, Marie %A Louie, Tin %A Mägi, Reedik %A McKenzie, Colin A %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Milani, Lili %A Mohlke, Karen L %A Momozawa, Yukihide %A Nalls, Mike A %A Nelson, Christopher P %A Sotoodehnia, Nona %A Norris, Jill M %A O'Connell, Jeff R %A Palmer, Nicholette D %A Perls, Thomas %A Pedersen, Nancy L %A Peters, Annette %A Peyser, Patricia A %A Poulter, Neil %A Raffel, Leslie J %A Raitakari, Olli T %A Roll, Kathryn %A Rose, Lynda M %A Rosendaal, Frits R %A Rotter, Jerome I %A Schmidt, Carsten O %A Schreiner, Pamela J %A Schupf, Nicole %A Scott, William R %A Sever, Peter S %A Shi, Yuan %A Sidney, Stephen %A Sims, Mario %A Sitlani, Colleen M %A Smith, Jennifer A %A Snieder, Harold %A Starr, John M %A Strauch, Konstantin %A Stringham, Heather M %A Tan, Nicholas Y Q %A Tang, Hua %A Taylor, Kent D %A Teo, Yik Ying %A Tham, Yih Chung %A Turner, Stephen T %A Uitterlinden, André G %A Vollenweider, Peter %A Waldenberger, Melanie %A Wang, Lihua %A Wang, Ya Xing %A Wei, Wen Bin %A Williams, Christine %A Yao, Jie %A Yu, Caizheng %A Yuan, Jian-Min %A Zhao, Wei %A Zonderman, Alan B %A Becker, Diane M %A Boehnke, Michael %A Bowden, Donald W %A Chambers, John C %A Deary, Ian J %A Esko, Tõnu %A Farrall, Martin %A Franks, Paul W %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Jonas, Jost Bruno %A Kamatani, Yoichiro %A Kato, Norihiro %A Kooner, Jaspal S %A Kutalik, Zoltán %A Laakso, Markku %A Laurie, Cathy C %A Leander, Karin %A Lehtimäki, Terho %A Study, Lifelines Cohort %A Magnusson, Patrik K E %A Oldehinkel, Albertine J %A Penninx, Brenda W J H %A Polasek, Ozren %A Porteous, David J %A Rauramaa, Rainer %A Samani, Nilesh J %A Scott, James %A Shu, Xiao-Ou %A van der Harst, Pim %A Wagenknecht, Lynne E %A Wareham, Nicholas J %A Watkins, Hugh %A Weir, David R %A Wickremasinghe, Ananda R %A Wu, Tangchun %A Zheng, Wei %A Bouchard, Claude %A Christensen, Kaare %A Evans, Michele K %A Gudnason, Vilmundur %A Horta, Bernardo L %A Kardia, Sharon L R %A Liu, Yongmei %A Pereira, Alexandre C %A Psaty, Bruce M %A Ridker, Paul M %A van Dam, Rob M %A Gauderman, W James %A Zhu, Xiaofeng %A Mook-Kanamori, Dennis O %A Fornage, Myriam %A Rotimi, Charles N %A Cupples, L Adrienne %A Kelly, Tanika N %A Fox, Ervin R %A Hayward, Caroline %A van Duijn, Cornelia M %A Tai, E Shyong %A Wong, Tien Yin %A Kooperberg, Charles %A Palmas, Walter %A Rice, Kenneth %A Morrison, Alanna C %A Elliott, Paul %A Caulfield, Mark J %A Munroe, Patricia B %A Rao, Dabeeru C %A Province, Michael A %A Levy, Daniel %X

Heavy alcohol consumption is an established risk factor for hypertension; the mechanism by which alcohol consumption impact blood pressure (BP) regulation remains unknown. We hypothesized that a genome-wide association study accounting for gene-alcohol consumption interaction for BP might identify additional BP loci and contribute to the understanding of alcohol-related BP regulation. We conducted a large two-stage investigation incorporating joint testing of main genetic effects and single nucleotide variant (SNV)-alcohol consumption interactions. In Stage 1, genome-wide discovery meta-analyses in ≈131K individuals across several ancestry groups yielded 3,514 SNVs (245 loci) with suggestive evidence of association (P < 1.0 x 10-5). In Stage 2, these SNVs were tested for independent external replication in ≈440K individuals across multiple ancestries. We identified and replicated (at Bonferroni correction threshold) five novel BP loci (380 SNVs in 21 genes) and 49 previously reported BP loci (2,159 SNVs in 109 genes) in European ancestry, and in multi-ancestry meta-analyses (P < 5.0 x 10-8). For African ancestry samples, we detected 18 potentially novel BP loci (P < 5.0 x 10-8) in Stage 1 that warrant further replication. Additionally, correlated meta-analysis identified eight novel BP loci (11 genes). Several genes in these loci (e.g., PINX1, GATA4, BLK, FTO and GABBR2) have been previously reported to be associated with alcohol consumption. These findings provide insights into the role of alcohol consumption in the genetic architecture of hypertension.

%B PLoS One %V 13 %P e0198166 %8 2018 %G eng %N 6 %R 10.1371/journal.pone.0198166 %0 Journal Article %J Am J Respir Crit Care Med %D 2018 %T Omega-3 Fatty Acids and Genome-wide Interaction Analyses Reveal DPP10-Pulmonary Function Association. %A Xu, Jiayi %A Gaddis, Nathan C %A Bartz, Traci M %A Hou, Ruixue %A Manichaikul, Ani W %A Pankratz, Nathan %A Smith, Albert V %A Sun, Fangui %A Terzikhan, Natalie %A Markunas, Christina A %A Patchen, Bonnie K %A Schu, Matthew %A Beydoun, May A %A Brusselle, Guy G %A Eiriksdottir, Gudny %A Zhou, Xia %A Wood, Alexis C %A Graff, Mariaelisa %A Harris, Tamara B %A Ikram, M Arfan %A Jacobs, David R %A Launer, Lenore J %A Lemaitre, Rozenn N %A O'Connor, George %A Oelsner, Elizabeth C %A Psaty, Bruce M %A Ramachandran, Vasan S %A Rohde, Rebecca R %A Rich, Stephen S %A Rotter, Jerome I %A Seshadri, Sudha %A Smith, Lewis J %A Tiemeier, Henning %A Tsai, Michael Y %A Uitterlinden, André G %A Voruganti, V Saroja %A Xu, Hanfei %A Zilhão, Nuno R %A Fornage, Myriam %A Zillikens, M Carola %A London, Stephanie J %A Barr, R Graham %A Dupuis, Josée %A Gharib, Sina A %A Gudnason, Vilmundur %A Lahousse, Lies %A North, Kari E %A Steffen, Lyn M %A Cassano, Patricia A %A Hancock, Dana B %X

RATIONALE: Omega-3 poly-unsaturated fatty acids (n-3 PUFAs) have anti-inflammatory properties that could benefit adults with comprised pulmonary health.

OBJECTIVE: To investigate n-3 PUFA associations with spirometric measures of pulmonary function tests (PFTs) and determine underlying genetic susceptibility.

METHODS: Associations of n-3 PUFA biomarkers (alpha-linolenic acid, eicosapentaenoic acid, docosapentaenoic acid [DPA], and docosahexaenoic acid [DHA]) were evaluated with PFTs (forced expiratory volume in the first second [FEV], forced vital capacity [FVC], and [FEV/FVC]) in meta-analyses across seven cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (N=16,134 of European or African ancestry). PFT-associated n-3 PUFAs were carried forward to genome-wide interaction analyses in the four largest cohorts (N=11,962) and replicated in one cohort (N=1,687). Cohort-specific results were combined using joint 2 degree-of-freedom (2df) meta-analyses of single nucleotide polymorphism (SNP) associations and their interactions with n-3 PUFAs.

RESULTS: DPA and DHA were positively associated with FEV1 and FVC (P<0.025), with evidence for effect modification by smoking and by sex. Genome-wide analyses identified a novel association of rs11693320-an intronic DPP10 SNP-with FVC when incorporating an interaction with DHA, and the finding was replicated (P=9.4×10 across discovery and replication cohorts). The rs11693320-A allele (frequency~80%) was associated with lower FVC (P=2.1×10; β= -161.0mL), and the association was attenuated by higher DHA levels (P=2.1×10; β=36.2mL).

CONCLUSIONS: We corroborated beneficial effects of n-3 PUFAs on pulmonary function. By modeling genome-wide n-3 PUFA interactions, we identified a novel DPP10 SNP association with FVC that was not detectable in much larger studies ignoring this interaction.

%B Am J Respir Crit Care Med %8 2018 Sep 10 %G eng %R 10.1164/rccm.201802-0304OC %0 Journal Article %J Environ Int %D 2018 %T Outdoor air pollution and mosaic loss of chromosome Y in older men from the Cardiovascular Health Study. %A Wong, Jason Y Y %A Margolis, Helene G %A Machiela, Mitchell %A Zhou, Weiyin %A Odden, Michelle C %A Psaty, Bruce M %A Robbins, John %A Jones, Rena R %A Rotter, Jerome I %A Chanock, Stephen J %A Rothman, Nathaniel %A Lan, Qing %A Lee, Jennifer S %X

BACKGROUND: Mosaic loss of chromosome Y (mLOY) can occur in a fraction of cells as men age, which is potentially linked to increased mortality risk. Smoking is related to mLOY; however, the contribution of air pollution is unclear.

OBJECTIVE: We investigated whether exposure to outdoor air pollution, age, and smoking were associated with mLOY.

METHODS: We analyzed baseline (1989-1993) blood samples from 933 men ≥65 years of age from the prospective Cardiovascular Health Study. Particulate matter ≤10 μm (PM), carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone data were obtained from the U.S. EPA Aerometric Information Retrieval System for the year prior to baseline. Inverse-distance weighted air monitor data were used to estimate each participants' monthly residential exposure. mLOY was detected with standard methods using signal intensity (median log-R ratio (mLRR)) of the male-specific chromosome Y regions from Illumina array data. Linear regression models were used to evaluate relations between mean exposure in the prior year, age, smoking and continuous mLRR.

RESULTS: Increased PM was associated with mLOY, namely decreased mLRR (p-trend = 0.03). Compared with the lowest tertile (≤28.5 μg/m), the middle (28.5-31.0 μg/m; β = -0.0044, p = 0.09) and highest (≥31 μg/m; β = -0.0054, p = 0.04) tertiles had decreased mLRR, adjusted for age, clinic, race/cohort, smoking status and pack-years. Additionally, increasing age (β = -0.00035, p = 0.06) and smoking pack-years (β = -0.00011, p = 1.4E-3) were associated with decreased mLRR, adjusted for each other and race/cohort. No significant associations were found for other pollutants.

CONCLUSIONS: PM may increase leukocyte mLOY, a marker of genomic instability. The sample size was modest and replication is warranted.

%B Environ Int %V 116 %P 239-247 %8 2018 Apr 23 %G eng %R 10.1016/j.envint.2018.04.030 %0 Journal Article %J Nat Commun %D 2018 %T PR interval genome-wide association meta-analysis identifies 50 loci associated with atrial and atrioventricular electrical activity. %A van Setten, Jessica %A Brody, Jennifer A %A Jamshidi, Yalda %A Swenson, Brenton R %A Butler, Anne M %A Campbell, Harry %A Del Greco, Fabiola M %A Evans, Daniel S %A Gibson, Quince %A Gudbjartsson, Daniel F %A Kerr, Kathleen F %A Krijthe, Bouwe P %A Lyytikäinen, Leo-Pekka %A Müller, Christian %A Müller-Nurasyid, Martina %A Nolte, Ilja M %A Padmanabhan, Sandosh %A Ritchie, Marylyn D %A Robino, Antonietta %A Smith, Albert V %A Steri, Maristella %A Tanaka, Toshiko %A Teumer, Alexander %A Trompet, Stella %A Ulivi, Sheila %A Verweij, Niek %A Yin, Xiaoyan %A Arnar, David O %A Asselbergs, Folkert W %A Bader, Joel S %A Barnard, John %A Bis, Josh %A Blankenberg, Stefan %A Boerwinkle, Eric %A Bradford, Yuki %A Buckley, Brendan M %A Chung, Mina K %A Crawford, Dana %A den Hoed, Marcel %A Denny, Josh C %A Dominiczak, Anna F %A Ehret, Georg B %A Eijgelsheim, Mark %A Ellinor, Patrick T %A Felix, Stephan B %A Franco, Oscar H %A Franke, Lude %A Harris, Tamara B %A Holm, Hilma %A Ilaria, Gandin %A Iorio, Annamaria %A Kähönen, Mika %A Kolcic, Ivana %A Kors, Jan A %A Lakatta, Edward G %A Launer, Lenore J %A Lin, Honghuang %A Lin, Henry J %A Loos, Ruth J F %A Lubitz, Steven A %A Macfarlane, Peter W %A Magnani, Jared W %A Leach, Irene Mateo %A Meitinger, Thomas %A Mitchell, Braxton D %A Münzel, Thomas %A Papanicolaou, George J %A Peters, Annette %A Pfeufer, Arne %A Pramstaller, Peter P %A Raitakari, Olli T %A Rotter, Jerome I %A Rudan, Igor %A Samani, Nilesh J %A Schlessinger, David %A Silva Aldana, Claudia T %A Sinner, Moritz F %A Smith, Jonathan D %A Snieder, Harold %A Soliman, Elsayed Z %A Spector, Timothy D %A Stott, David J %A Strauch, Konstantin %A Tarasov, Kirill V %A Thorsteinsdottir, Unnur %A Uitterlinden, André G %A Van Wagoner, David R %A Völker, Uwe %A Völzke, Henry %A Waldenberger, Melanie %A Jan Westra, Harm %A Wild, Philipp S %A Zeller, Tanja %A Alonso, Alvaro %A Avery, Christy L %A Bandinelli, Stefania %A Benjamin, Emelia J %A Cucca, Francesco %A Dörr, Marcus %A Ferrucci, Luigi %A Gasparini, Paolo %A Gudnason, Vilmundur %A Hayward, Caroline %A Heckbert, Susan R %A Hicks, Andrew A %A Jukema, J Wouter %A Kääb, Stefan %A Lehtimäki, Terho %A Liu, Yongmei %A Munroe, Patricia B %A Parsa, Afshin %A Polasek, Ozren %A Psaty, Bruce M %A Roden, Dan M %A Schnabel, Renate B %A Sinagra, Gianfranco %A Stefansson, Kari %A Stricker, Bruno H %A van der Harst, Pim %A van Duijn, Cornelia M %A Wilson, James F %A Gharib, Sina A %A de Bakker, Paul I W %A Isaacs, Aaron %A Arking, Dan E %A Sotoodehnia, Nona %X

Electrocardiographic PR interval measures atrio-ventricular depolarization and conduction, and abnormal PR interval is a risk factor for atrial fibrillation and heart block. Our genome-wide association study of over 92,000 European-descent individuals identifies 44 PR interval loci (34 novel). Examination of these loci reveals known and previously not-yet-reported biological processes involved in cardiac atrial electrical activity. Genes in these loci are over-represented in cardiac disease processes including heart block and atrial fibrillation. Variants in over half of the 44 loci were associated with atrial or blood transcript expression levels, or were in high linkage disequilibrium with missense variants. Six additional loci were identified either by meta-analysis of ~105,000 African and European-descent individuals and/or by pleiotropic analyses combining PR interval with heart rate, QRS interval, and atrial fibrillation. These findings implicate developmental pathways, and identify transcription factors, ion-channel genes, and cell-junction/cell-signaling proteins in atrio-ventricular conduction, identifying potential targets for drug development.

%B Nat Commun %V 9 %P 2904 %8 2018 Jul 25 %G eng %N 1 %R 10.1038/s41467-018-04766-9 %0 Journal Article %J PLoS One %D 2018 %T Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration. %A Lorenz, Matthias W %A Gao, Lu %A Ziegelbauer, Kathrin %A Norata, Giuseppe Danilo %A Empana, Jean Philippe %A Schmidtmann, Irene %A Lin, Hung-Ju %A McLachlan, Stela %A Bokemark, Lena %A Ronkainen, Kimmo %A Amato, Mauro %A Schminke, Ulf %A Srinivasan, Sathanur R %A Lind, Lars %A Okazaki, Shuhei %A Stehouwer, Coen D A %A Willeit, Peter %A Polak, Joseph F %A Steinmetz, Helmuth %A Sander, Dirk %A Poppert, Holger %A Desvarieux, Moïse %A Ikram, M Arfan %A Johnsen, Stein Harald %A Staub, Daniel %A Sirtori, Cesare R %A Iglseder, Bernhard %A Beloqui, Oscar %A Engström, Gunnar %A Friera, Alfonso %A Rozza, Francesco %A Xie, Wuxiang %A Parraga, Grace %A Grigore, Liliana %A Plichart, Matthieu %A Blankenberg, Stefan %A Su, Ta-Chen %A Schmidt, Caroline %A Tuomainen, Tomi-Pekka %A Veglia, Fabrizio %A Völzke, Henry %A Nijpels, Giel %A Willeit, Johann %A Sacco, Ralph L %A Franco, Oscar H %A Uthoff, Heiko %A Hedblad, Bo %A Suarez, Carmen %A Izzo, Raffaele %A Zhao, Dong %A Wannarong, Thapat %A Catapano, Alberico %A Ducimetiere, Pierre %A Espinola-Klein, Christine %A Chien, Kuo-Liong %A Price, Jackie F %A Bergström, Göran %A Kauhanen, Jussi %A Tremoli, Elena %A Dörr, Marcus %A Berenson, Gerald %A Kitagawa, Kazuo %A Dekker, Jacqueline M %A Kiechl, Stefan %A Sitzer, Matthias %A Bickel, Horst %A Rundek, Tatjana %A Hofman, Albert %A Mathiesen, Ellisiv B %A Castelnuovo, Samuela %A Landecho, Manuel F %A Rosvall, Maria %A Gabriel, Rafael %A de Luca, Nicola %A Liu, Jing %A Baldassarre, Damiano %A Kavousi, Maryam %A de Groot, Eric %A Bots, Michiel L %A Yanez, David N %A Thompson, Simon G %K Aged %K Cardiovascular Diseases %K Carotid Intima-Media Thickness %K Female %K Humans %K Intersectoral Collaboration %K Male %K Middle Aged %K Prognosis %K Risk Factors %X

AIMS: Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk.

METHODS AND RESULTS: From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C.

CONCLUSIONS: We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.

%B PLoS One %V 13 %P e0191172 %8 2018 %G eng %N 4 %R 10.1371/journal.pone.0191172 %0 Journal Article %J Gut %D 2018 %T Protein and glycomic plasma markers for early detection of adenoma and colon cancer. %A Rho, Jung-Hyun %A Ladd, Jon J %A Li, Christopher I %A Potter, John D %A Zhang, Yuzheng %A Shelley, David %A Shibata, David %A Coppola, Domenico %A Yamada, Hiroyuki %A Toyoda, Hidenori %A Tada, Toshifumi %A Kumada, Takashi %A Brenner, Dean E %A Hanash, Samir M %A Lampe, Paul D %K Adaptor Proteins, Signal Transducing %K Adenoma %K Adult %K Aged %K Aged, 80 and over %K Biomarkers, Tumor %K CA-19-9 Antigen %K Case-Control Studies %K Colonic Neoplasms %K Cytokine Receptor gp130 %K Early Detection of Cancer %K ErbB Receptors %K Female %K Humans %K Hyaluronan Receptors %K Lewis X Antigen %K Male %K Middle Aged %K Oligosaccharides %K Protein Array Analysis %K von Willebrand Factor %X

OBJECTIVE: To discover and confirm blood-based colon cancer early-detection markers.

DESIGN: We created a high-density antibody microarray to detect differences in protein levels in plasma from individuals diagnosed with colon cancer <3 years after blood was drawn (ie, prediagnostic) and cancer-free, matched controls. Potential markers were tested on plasma samples from people diagnosed with adenoma or cancer, compared with controls. Components of an optimal 5-marker panel were tested via immunoblotting using a third sample set, Luminex assay in a large fourth sample set and immunohistochemistry (IHC) on tissue microarrays.

RESULTS: In the prediagnostic samples, we found 78 significantly (t-test) increased proteins, 32 of which were confirmed in the diagnostic samples. From these 32, optimal 4-marker panels of BAG family molecular chaperone regulator 4 (BAG4), interleukin-6 receptor subunit beta (IL6ST), von Willebrand factor (VWF) and CD44 or epidermal growth factor receptor (EGFR) were established. Each panel member and the panels also showed increases in the diagnostic adenoma and cancer samples in independent third and fourth sample sets via immunoblot and Luminex, respectively. IHC results showed increased levels of BAG4, IL6ST and CD44 in adenoma and cancer tissues. Inclusion of EGFR and CD44 sialyl Lewis-A and Lewis-X content increased the panel performance. The protein/glycoprotein panel was statistically significantly higher in colon cancer samples, characterised by a range of area under the curves from 0.90 (95% CI 0.82 to 0.98) to 0.86 (95% CI 0.83 to 0.88), for the larger second and fourth sets, respectively.

CONCLUSIONS: A panel including BAG4, IL6ST, VWF, EGFR and CD44 protein/glycomics performed well for detection of early stages of colon cancer and should be further examined in larger studies.

%B Gut %V 67 %P 473-484 %8 2018 03 %G eng %N 3 %R 10.1136/gutjnl-2016-312794 %0 Journal Article %J Hum Genet %D 2018 %T Rare loss of function variants in candidate genes and risk of colorectal cancer. %A Rosenthal, Elisabeth A %A Shirts, Brian H %A Amendola, Laura M %A Horike-Pyne, Martha %A Robertson, Peggy D %A Hisama, Fuki M %A Bennett, Robin L %A Dorschner, Michael O %A Nickerson, Deborah A %A Stanaway, Ian B %A Nassir, Rami %A Vickers, Kathy T %A Li, Christopher %A Grady, William M %A Peters, Ulrike %A Jarvik, Gail P %X

Although ~ 25% of colorectal cancer or polyp (CRC/P) cases show familial aggregation, current germline genetic testing identifies a causal genotype in the 16 major genes associated with high penetrance CRC/P in only 20% of these cases. As there are likely other genes underlying heritable CRC/P, we evaluated the association of variation at novel loci with CRC/P. We evaluated 158 a priori selected candidate genes by comparing the number of rare potentially disruptive variants (PDVs) found in 84 CRC/P cases without an identified CRC/P risk-associated variant and 2440 controls. We repeated this analysis using an additional 73 CRC/P cases. We also compared the frequency of PDVs in select genes among CRC/P cases with two publicly available data sets. We found a significant enrichment of PDVs in cases vs. controls: 20% of cases vs. 11.5% of controls with ≥ 1 PDV (OR = 1.9, p = 0.01) in the original set of cases. Among the second cohort of CRC/P cases, 18% had a PDV, significantly different from 11.5% (p = 0.02). Logistic regression, adjusting for ancestry and multiple testing, indicated association between CRC/P and PDVs in NTHL1 (p = 0.0001), BRCA2 (p = 0.01) and BRIP1 (p = 0.04). However, there was no significant difference in the frequency of PDVs at each of these genes between all 157 CRC/P cases and two publicly available data sets. These results suggest an increased presence of PDVs in CRC/P cases and support further investigation of the association of NTHL1, BRCA2 and BRIP1 variation with CRC/P.

%B Hum Genet %8 2018 Sep 28 %G eng %R 10.1007/s00439-018-1938-4 %0 Journal Article %J Nat Genet %D 2018 %T Refining the accuracy of validated target identification through coding variant fine-mapping in type 2 diabetes. %A Mahajan, Anubha %A Wessel, Jennifer %A Willems, Sara M %A Zhao, Wei %A Robertson, Neil R %A Chu, Audrey Y %A Gan, Wei %A Kitajima, Hidetoshi %A Taliun, Daniel %A Rayner, N William %A Guo, Xiuqing %A Lu, Yingchang %A Li, Man %A Jensen, Richard A %A Hu, Yao %A Huo, Shaofeng %A Lohman, Kurt K %A Zhang, Weihua %A Cook, James P %A Prins, Bram Peter %A Flannick, Jason %A Grarup, Niels %A Trubetskoy, Vassily Vladimirovich %A Kravic, Jasmina %A Kim, Young Jin %A Rybin, Denis V %A Yaghootkar, Hanieh %A Müller-Nurasyid, Martina %A Meidtner, Karina %A Li-Gao, Ruifang %A Varga, Tibor V %A Marten, Jonathan %A Li, Jin %A Smith, Albert Vernon %A An, Ping %A Ligthart, Symen %A Gustafsson, Stefan %A Malerba, Giovanni %A Demirkan, Ayse %A Tajes, Juan Fernandez %A Steinthorsdottir, Valgerdur %A Wuttke, Matthias %A Lecoeur, Cécile %A Preuss, Michael %A Bielak, Lawrence F %A Graff, Marielisa %A Highland, Heather M %A Justice, Anne E %A Liu, Dajiang J %A Marouli, Eirini %A Peloso, Gina Marie %A Warren, Helen R %A Afaq, Saima %A Afzal, Shoaib %A Ahlqvist, Emma %A Almgren, Peter %A Amin, Najaf %A Bang, Lia B %A Bertoni, Alain G %A Bombieri, Cristina %A Bork-Jensen, Jette %A Brandslund, Ivan %A Brody, Jennifer A %A Burtt, Noel P %A Canouil, Mickaël %A Chen, Yii-Der Ida %A Cho, Yoon Shin %A Christensen, Cramer %A Eastwood, Sophie V %A Eckardt, Kai-Uwe %A Fischer, Krista %A Gambaro, Giovanni %A Giedraitis, Vilmantas %A Grove, Megan L %A de Haan, Hugoline G %A Hackinger, Sophie %A Hai, Yang %A Han, Sohee %A Tybjærg-Hansen, Anne %A Hivert, Marie-France %A Isomaa, Bo %A Jäger, Susanne %A Jørgensen, Marit E %A Jørgensen, Torben %A Käräjämäki, AnneMari %A Kim, Bong-Jo %A Kim, Sung Soo %A Koistinen, Heikki A %A Kovacs, Peter %A Kriebel, Jennifer %A Kronenberg, Florian %A Läll, Kristi %A Lange, Leslie A %A Lee, Jung-Jin %A Lehne, Benjamin %A Li, Huaixing %A Lin, Keng-Hung %A Linneberg, Allan %A Liu, Ching-Ti %A Liu, Jun %A Loh, Marie %A Mägi, Reedik %A Mamakou, Vasiliki %A McKean-Cowdin, Roberta %A Nadkarni, Girish %A Neville, Matt %A Nielsen, Sune F %A Ntalla, Ioanna %A Peyser, Patricia A %A Rathmann, Wolfgang %A Rice, Kenneth %A Rich, Stephen S %A Rode, Line %A Rolandsson, Olov %A Schönherr, Sebastian %A Selvin, Elizabeth %A Small, Kerrin S %A Stančáková, Alena %A Surendran, Praveen %A Taylor, Kent D %A Teslovich, Tanya M %A Thorand, Barbara %A Thorleifsson, Gudmar %A Tin, Adrienne %A Tönjes, Anke %A Varbo, Anette %A Witte, Daniel R %A Wood, Andrew R %A Yajnik, Pranav %A Yao, Jie %A Yengo, Loic %A Young, Robin %A Amouyel, Philippe %A Boeing, Heiner %A Boerwinkle, Eric %A Bottinger, Erwin P %A Chowdhury, Rajiv %A Collins, Francis S %A Dedoussis, George %A Dehghan, Abbas %A Deloukas, Panos %A Ferrario, Marco M %A Ferrieres, Jean %A Florez, Jose C %A Frossard, Philippe %A Gudnason, Vilmundur %A Harris, Tamara B %A Heckbert, Susan R %A Howson, Joanna M M %A Ingelsson, Martin %A Kathiresan, Sekar %A Kee, Frank %A Kuusisto, Johanna %A Langenberg, Claudia %A Launer, Lenore J %A Lindgren, Cecilia M %A Männistö, Satu %A Meitinger, Thomas %A Melander, Olle %A Mohlke, Karen L %A Moitry, Marie %A Morris, Andrew D %A Murray, Alison D %A de Mutsert, Renée %A Orho-Melander, Marju %A Owen, Katharine R %A Perola, Markus %A Peters, Annette %A Province, Michael A %A Rasheed, Asif %A Ridker, Paul M %A Rivadineira, Fernando %A Rosendaal, Frits R %A Rosengren, Anders H %A Salomaa, Veikko %A Sheu, Wayne H-H %A Sladek, Rob %A Smith, Blair H %A Strauch, Konstantin %A Uitterlinden, André G %A Varma, Rohit %A Willer, Cristen J %A Blüher, Matthias %A Butterworth, Adam S %A Chambers, John Campbell %A Chasman, Daniel I %A Danesh, John %A van Duijn, Cornelia %A Dupuis, Josée %A Franco, Oscar H %A Franks, Paul W %A Froguel, Philippe %A Grallert, Harald %A Groop, Leif %A Han, Bok-Ghee %A Hansen, Torben %A Hattersley, Andrew T %A Hayward, Caroline %A Ingelsson, Erik %A Kardia, Sharon L R %A Karpe, Fredrik %A Kooner, Jaspal Singh %A Köttgen, Anna %A Kuulasmaa, Kari %A Laakso, Markku %A Lin, Xu %A Lind, Lars %A Liu, Yongmei %A Loos, Ruth J F %A Marchini, Jonathan %A Metspalu, Andres %A Mook-Kanamori, Dennis %A Nordestgaard, Børge G %A Palmer, Colin N A %A Pankow, James S %A Pedersen, Oluf %A Psaty, Bruce M %A Rauramaa, Rainer %A Sattar, Naveed %A Schulze, Matthias B %A Soranzo, Nicole %A Spector, Timothy D %A Stefansson, Kari %A Stumvoll, Michael %A Thorsteinsdottir, Unnur %A Tuomi, Tiinamaija %A Tuomilehto, Jaakko %A Wareham, Nicholas J %A Wilson, James G %A Zeggini, Eleftheria %A Scott, Robert A %A Barroso, Inês %A Frayling, Timothy M %A Goodarzi, Mark O %A Meigs, James B %A Boehnke, Michael %A Saleheen, Danish %A Morris, Andrew P %A Rotter, Jerome I %A McCarthy, Mark I %X

We aggregated coding variant data for 81,412 type 2 diabetes cases and 370,832 controls of diverse ancestry, identifying 40 coding variant association signals (P < 2.2 × 10); of these, 16 map outside known risk-associated loci. We make two important observations. First, only five of these signals are driven by low-frequency variants: even for these, effect sizes are modest (odds ratio ≤1.29). Second, when we used large-scale genome-wide association data to fine-map the associated variants in their regional context, accounting for the global enrichment of complex trait associations in coding sequence, compelling evidence for coding variant causality was obtained for only 16 signals. At 13 others, the associated coding variants clearly represent 'false leads' with potential to generate erroneous mechanistic inference. Coding variant associations offer a direct route to biological insight for complex diseases and identification of validated therapeutic targets; however, appropriate mechanistic inference requires careful specification of their causal contribution to disease predisposition.

%B Nat Genet %V 50 %P 559-571 %8 2018 Apr %G eng %N 4 %R 10.1038/s41588-018-0084-1 %0 Journal Article %J J Clin Endocrinol Metab %D 2018 %T The relation between thyroid function and anemia: a pooled analysis of individual participant data. %A Wopereis, Daisy M %A Du Puy, Robert S %A van Heemst, Diana %A Walsh, John P %A Bremner, Alexandra %A Bakker, Stephan J L %A Bauer, Douglas C %A Cappola, Anne R %A Ceresini, Graziano %A Degryse, Jean %A Dullaart, Robin P F %A Feller, Martin %A Ferrucci, Luigi %A Floriani, Carmen %A Franco, Oscar H %A Iacoviello, Massimo %A Iervasi, Georgio %A Imaizumi, Misa %A Jukema, J Wouter %A Khaw, Kay-Tee %A Luben, Robert N %A Molinaro, Sabrina %A Nauck, Matthias %A Patel, Kushang V %A Peeters, Robin P %A Psaty, Bruce M %A Razvi, Salman %A Schindhelm, Roger K %A van Schoor, Natasja M %A Stott, David J %A Vaes, Bert %A Vanderpump, Mark P J %A Völzke, Henry %A Westendorp, Rudi G J %A Rodondi, Nicolas %A Cobbaert, Christa M %A Gussekloo, Jacobijn %A den Elzen, Wendy P J %X

Context: Anemia and thyroid dysfunction often co-occur and both increase with age. Human data on the relationship between thyroid disease and anemia are scarce.

Objective: To investigate the cross-sectional and longitudinal associations between clinical thyroid status and anemia.

Design: Individual participant data meta-analysis.

Setting: Sixteen cohorts participating in the Thyroid Studies Collaboration (n=42 162).

Main outcome measures: Primary outcome measure was anemia (hemoglobin <130 g/L in men and <120 g/L in women).

Results: Cross-sectionally, participants with abnormal thyroid status had an increased risk of having anemia compared with euthyroid participants (overt hypothyroidism, pooled odds ratio 1.84 [95% CI: 1.35-2.50], subclinical hypothyroidism 1.21 [1.02-1.43], subclinical hyperthyroidism 1.27 [1.03-1.57], overt hyperthyroidism 1.69 [1.00-2.87]). Hemoglobin levels were lower in all groups compared to participants with euthyroidism. In the longitudinal analyses (n=25,466 from 14 cohorts), the pooled hazard ratio for the risk of development of anemia was 1.38 [95% CI: 0.86-2.20] for overt hypothyroidism, 1.18 [1.00-1.38] for subclinical hypothyroidism, 1.15 [0.94-1.42] for subclinical hyperthyroidism and 1.47 [0.91-2.38] for overt hyperthyroidism. Sensitivity analyses excluding thyroid medication or high levels of C-reactive protein yielded similar results. No differences in mean annual change in hemoglobin levels were observed between the thyroid hormone status groups.

Conclusion: Higher odds of having anemia were observed in both participants with hypothyroid function and hyperthyroid function. In addition, reduced thyroid function at baseline showed a trend of increased risk of developing anemia during follow-up. It remains to be assessed in a randomized controlled trial whether treatment is effective in reducing anemia.

%B J Clin Endocrinol Metab %8 2018 Aug 02 %G eng %R 10.1210/jc.2018-00481 %0 Journal Article %J Am J Kidney Dis %D 2018 %T Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium. %A Inker, Lesley A %A Grams, Morgan E %A Levey, Andrew S %A Coresh, Josef %A Cirillo, Massimo %A Collins, John F %A Gansevoort, Ron T %A Gutierrez, Orlando M %A Hamano, Takayuki %A Heine, Gunnar H %A Ishikawa, Shizukiyo %A Jee, Sun Ha %A Kronenberg, Florian %A Landray, Martin J %A Miura, Katsuyuki %A Nadkarni, Girish N %A Peralta, Carmen A %A Rothenbacher, Dietrich %A Schaeffner, Elke %A Sedaghat, Sanaz %A Shlipak, Michael G %A Zhang, Luxia %A van Zuilen, Arjan D %A Hallan, Stein I %A Kovesdy, Csaba P %A Woodward, Mark %A Levin, Adeera %X

RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.

STUDY DESIGN: Cross-sectional individual participant-level analyses in a global consortium.

SETTING & STUDY POPULATIONS: 17 CKD and 38 general population and high-risk cohorts.

SELECTION CRITERIA FOR STUDIES: Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.

DATA EXTRACTION: Data were obtained and analyzed between July 2015 and January 2018.

ANALYTICAL APPROACH: We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.

RESULTS: The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).

LIMITATIONS: Variations in study era, health care delivery system, typical diet, and laboratory assays.

CONCLUSIONS: Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.

%B Am J Kidney Dis %8 2018 Oct 19 %G eng %R 10.1053/j.ajkd.2018.08.013 %0 Journal Article %J J Am Heart Assoc %D 2018 %T Reversal of Aging-Induced Increases in Aortic Stiffness by Targeting Cytoskeletal Protein-Protein Interfaces. %A Nicholson, Christopher J %A Singh, Kuldeep %A Saphirstein, Robert J %A Gao, Yuan Z %A Li, Qian %A Chiu, Joanna G %A Leavis, Paul %A Verwoert, Germaine C %A Mitchell, G F %A Porter, Tyrone %A Morgan, Kathleen G %X

BACKGROUND: The proximal aorta normally functions as a critical shock absorber that protects small downstream vessels from damage by pressure and flow pulsatility generated by the heart during systole. This shock absorber function is impaired with age because of aortic stiffening.

METHODS AND RESULTS: We examined the contribution of common genetic variation to aortic stiffness in humans by interrogating results from the AortaGen Consortium genome-wide association study of carotid-femoral pulse wave velocity. Common genetic variation in the N-WASP () locus is associated with carotid-femoral pulse wave velocity (rs600420, =0.0051). Thus, we tested the hypothesis that decoy proteins designed to disrupt the interaction of cytoskeletal proteins such as N-WASP with its binding partners in the vascular smooth muscle cytoskeleton could decrease ex vivo stiffness of aortas from a mouse model of aging. A synthetic decoy peptide construct of N-WASP significantly reduced activated stiffness in ex vivo aortas of aged mice. Two other cytoskeletal constructs targeted to VASP and talin-vinculin interfaces similarly decreased aging-induced ex vivo active stiffness by on-target specific actions. Furthermore, packaging these decoy peptides into microbubbles enables the peptides to be ultrasound-targeted to the wall of the proximal aorta to attenuate ex vivo active stiffness.

CONCLUSIONS: We conclude that decoy peptides targeted to vascular smooth muscle cytoskeletal protein-protein interfaces and microbubble packaged can decrease aortic stiffness ex vivo. Our results provide proof of concept at the ex vivo level that decoy peptides targeted to cytoskeletal protein-protein interfaces may lead to substantive dynamic modulation of aortic stiffness.

%B J Am Heart Assoc %V 7 %8 2018 Jul 18 %G eng %N 15 %R 10.1161/JAHA.118.008926 %0 Journal Article %J Lancet %D 2018 %T Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. %A Wood, Angela M %A Kaptoge, Stephen %A Butterworth, Adam S %A Willeit, Peter %A Warnakula, Samantha %A Bolton, Thomas %A Paige, Ellie %A Paul, Dirk S %A Sweeting, Michael %A Burgess, Stephen %A Bell, Steven %A Astle, William %A Stevens, David %A Koulman, Albert %A Selmer, Randi M %A Verschuren, W M Monique %A Sato, Shinichi %A Njølstad, Inger %A Woodward, Mark %A Salomaa, Veikko %A Nordestgaard, Børge G %A Yeap, Bu B %A Fletcher, Astrid %A Melander, Olle %A Kuller, Lewis H %A Balkau, Beverley %A Marmot, Michael %A Koenig, Wolfgang %A Casiglia, Edoardo %A Cooper, Cyrus %A Arndt, Volker %A Franco, Oscar H %A Wennberg, Patrik %A Gallacher, John %A de la Cámara, Agustin Gómez %A Völzke, Henry %A Dahm, Christina C %A Dale, Caroline E %A Bergmann, Manuela M %A Crespo, Carlos J %A van der Schouw, Yvonne T %A Kaaks, Rudolf %A Simons, Leon A %A Lagiou, Pagona %A Schoufour, Josje D %A Boer, Jolanda M A %A Key, Timothy J %A Rodriguez, Beatriz %A Moreno-Iribas, Conchi %A Davidson, Karina W %A Taylor, James O %A Sacerdote, Carlotta %A Wallace, Robert B %A Quiros, J Ramon %A Tumino, Rosario %A Blazer, Dan G %A Linneberg, Allan %A Daimon, Makoto %A Panico, Salvatore %A Howard, Barbara %A Skeie, Guri %A Strandberg, Timo %A Weiderpass, Elisabete %A Nietert, Paul J %A Psaty, Bruce M %A Kromhout, Daan %A Salamanca-Fernandez, Elena %A Kiechl, Stefan %A Krumholz, Harlan M %A Grioni, Sara %A Palli, Domenico %A Huerta, José M %A Price, Jackie %A Sundström, Johan %A Arriola, Larraitz %A Arima, Hisatomi %A Travis, Ruth C %A Panagiotakos, Demosthenes B %A Karakatsani, Anna %A Trichopoulou, Antonia %A Kühn, Tilman %A Grobbee, Diederick E %A Barrett-Connor, Elizabeth %A van Schoor, Natasja %A Boeing, Heiner %A Overvad, Kim %A Kauhanen, Jussi %A Wareham, Nick %A Langenberg, Claudia %A Forouhi, Nita %A Wennberg, Maria %A Després, Jean-Pierre %A Cushman, Mary %A Cooper, Jackie A %A Rodriguez, Carlos J %A Sakurai, Masaru %A Shaw, Jonathan E %A Knuiman, Matthew %A Voortman, Trudy %A Meisinger, Christa %A Tjønneland, Anne %A Brenner, Hermann %A Palmieri, Luigi %A Dallongeville, Jean %A Brunner, Eric J %A Assmann, Gerd %A Trevisan, Maurizio %A Gillum, Richard F %A Ford, Ian %A Sattar, Naveed %A Lazo, Mariana %A Thompson, Simon G %A Ferrari, Pietro %A Leon, David A %A Smith, George Davey %A Peto, Richard %A Jackson, Rod %A Banks, Emily %A Di Angelantonio, Emanuele %A Danesh, John %X

BACKGROUND: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease.

METHODS: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th-95th percentile 1·04-13·5]) from 71 011 participants from 37 studies.

FINDINGS: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1·14, 95% CI, 1·10-1·17), coronary disease excluding myocardial infarction (1·06, 1·00-1·11), heart failure (1·09, 1·03-1·15), fatal hypertensive disease (1·24, 1·15-1·33); and fatal aortic aneurysm (1·15, 1·03-1·28). By contrast, increased alcohol consumption was log-linearly associated with a lower risk of myocardial infarction (HR 0·94, 0·91-0·97). In comparison to those who reported drinking >0-≤100 g per week, those who reported drinking >100-≤200 g per week, >200-≤350 g per week, or >350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively.

INTERPRETATION: In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.

FUNDING: UK Medical Research Council, British Heart Foundation, National Institute for Health Research, European Union Framework 7, and European Research Council.

%B Lancet %V 391 %P 1513-1523 %8 2018 04 14 %G eng %N 10129 %R 10.1016/S0140-6736(18)30134-X %0 Journal Article %J BMJ %D 2018 %T Serial circulating omega 3 polyunsaturated fatty acids and healthy ageing among older adults in the Cardiovascular Health Study: prospective cohort study. %A Lai, Heidi Tm %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A McKnight, Barbara %A Song, Xiaoling %A King, Irena B %A Chaves, Paulo Hm %A Odden, Michelle C %A Newman, Anne B %A Siscovick, David S %A Mozaffarian, Dariush %X

OBJECTIVE: To determine the longitudinal association between serial biomarker measures of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) levels and healthy ageing.

DESIGN: Prospective cohort study.

SETTING: Four communities in the United States (Cardiovascular Health Study) from 1992 to 2015.

PARTICIPANTS: 2622 adults with a mean (SD) age of 74.4 (4.8) and with successful healthy ageing at baseline in 1992-93.

EXPOSURE: Cumulative levels of plasma phospholipid n3-PUFAs were measured using gas chromatography in 1992-93, 1998-99, and 2005-06, expressed as percentage of total fatty acids, including α-linolenic acid from plants and eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid from seafoood.

MAIN OUTCOME MEASURE: Healthy ageing defined as survival without chronic diseases (ie, cardiovascular disease, cancer, lung disease, and severe chronic kidney disease), the absence of cognitive and physical dysfunction, or death from other causes not part of the healthy ageing outcome after age 65. Events were centrally adjudicated or determined from medical records and diagnostic tests.

RESULTS: Higher levels of long chain n3-PUFAs were associated with an 18% lower risk (95% confidence interval 7% to 28%) of unhealthy ageing per interquintile range after multivariable adjustments with time-varying exposure and covariates. Individually, higher eicosapentaenoic acid and docosapentaenoic acid (but not docosahexaenoic acid) levels were associated with a lower risk: 15% (6% to 23%) and 16% (6% to 25%), respectively. α-linolenic acid from plants was not noticeably associated with unhealthy ageing (hazard ratio 0.92, 95% confidence interval 0.83 to 1.02).

CONCLUSIONS: In older adults, a higher cumulative level of serially measured circulating n3-PUFAs from seafood (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid), eicosapentaenoic acid, and docosapentaenoic acid (but not docosahexaenoic acid from seafood or α-linolenic acid from plants) was associated with a higher likelihood of healthy ageing. These findings support guidelines for increased dietary consumption of n3-PUFAs in older adults.

%B BMJ %V 363 %P k4067 %8 2018 Oct 17 %G eng %R 10.1136/bmj.k4067 %0 Journal Article %J Am J Clin Nutr %D 2018 %T Serial measures of circulating biomarkers of dairy fat and total and cause-specific mortality in older adults: the Cardiovascular Health Study. %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A Song, Xiaoling %A King, Irena B %A Siscovick, David S %A Mozaffarian, Dariush %X

Background: Controversy has emerged about the benefits compared with harms of dairy fat, including concerns over long-term effects. Previous observational studies have assessed self-reported estimates of consumption or a single biomarker measure at baseline, which may lead to suboptimal estimation of true risk.

Objective: The aim of this study was to investigate prospective associations of serial measures of plasma phospholipid fatty acids pentadecanoic (15:0), heptadecanoic (17:0), and trans-palmitoleic (trans-16:1n-7) acids with total mortality, cause-specific mortality, and cardiovascular disease (CVD) risk among older adults.

Design: Among 2907 US adults aged ≥65 y and free of CVD at baseline, circulating fatty acid concentrations were measured serially at baseline, 6 y, and 13 y. Deaths and CVD events were assessed and adjudicated centrally. Prospective associations were assessed by multivariate-adjusted Cox models incorporating time-dependent exposures and covariates.

Results: During 22 y of follow-up, 2428 deaths occurred, including 833 from CVD, 1595 from non-CVD causes, and 1301 incident CVD events. In multivariable models, circulating pentadecanoic, heptadecanoic, and trans-palmitoleic acids were not significantly associated with total mortality, with extreme-quintile HRs of 1.05 for pentadecanoic (95% CI: 0.91, 1.22), 1.07 for heptadecanoic (95% CI: 0.93, 1.23), and 1.05 for trans-palmitoleic (95% CI: 0.91, 1.20) acids. Circulating heptadecanoic acid was associated with lower CVD mortality (extreme-quintile HR: 0.77; 95% CI: 0.61, 0.98), especially stroke mortality, with a 42% lower risk when comparing extreme quintiles of heptadecanoic acid concentrations (HR: 0.58; 95% CI: 0.35, 0.97). In contrast, heptadecanoic acid was associated with a higher risk of non-CVD mortality (HR: 1.27; 95% CI: 1.07, 1.52), which was not clearly related to any single subtype of non-CVD death. No significant associations of pentadecanoic, heptadecanoic, or trans-palmitoleic acids were seen for total incident CVD, coronary heart disease, or stroke.

Conclusions: Long-term exposure to circulating phospholipid pentadecanoic, heptadecanoic, or trans-palmitoleic acids was not significantly associated with total mortality or incident CVD among older adults. High circulating heptadecanoic acid was inversely associated with CVD and stroke mortality and potentially associated with higher risk of non-CVD death.

%B Am J Clin Nutr %8 2018 Jul 11 %G eng %R 10.1093/ajcn/nqy117 %0 Journal Article %J Clin Cardiol %D 2018 %T Serum Androgens and Risk of Atrial Fibrillation in Older Men: The Cardiovascular Health Study. %A Rosenberg, Michael A %A Shores, Molly M %A Matsumoto, Alvin M %A Bůzková, Petra %A Lange, Leslie A %A Kronmal, Richard A %A Heckbert, Susan R %A Mukamal, Kenneth J %X

BACKGROUND: Decline in serum androgens is common among older men and has been associated with cardiovascular disease, although its role in risk of atrial fibrillation (AF) has not been well defined.

HYPOTHESIS: Low serum androgens are associated with an increased risk of AF.

METHODS: We examined the prospective associations between testosterone, its more active metabolite dihydrotestosterone (DHT), and sex-hormone binding globulin (SHBG) with risk of AF among 1019 otherwise healthy men of average age 76.3±4.9 years in the Cardiovascular Health Study.

RESULTS: After median follow-up of 9.5 years, 304 (30%) men developed AF. We detected a nonlinear association with risk of incident AF in both free and total DHT, in which subjects with the lowest levels had a higher risk of incident AF. After adjustment for demographics, clinical risk factors, left atrial diameter, and serum NT-proBNP levels, men with free DHT less than 0.16 ng/dL were at increased risk compared with men with higher levels (HR 1.48, CI 1.01-2.17, p<0.05). Sensitivity analyses confirmed that the increased risk was not cutpoint-specific, with a significant association noted up to cutpoints less than ~0.2 ng/dL. We also detected a complex nonlinear association between SHBG and incident AF, in which subjects in the middle quintile (52.9 - 65.3 nmol/L) had increased risk.

CONCLUSION: Among older men, low free DHT is associated with an increased risk of incident atrial fibrillation. Further studies are needed to explore mechanisms for this association.

%B Clin Cardiol %8 2018 Apr 19 %G eng %R 10.1002/clc.22965 %0 Journal Article %J Circulation %D 2018 %T Sex and Race Differences in Lifetime Risk of Heart Failure With Preserved Ejection Fraction and Heart Failure With Reduced Ejection Fraction. %A Pandey, Ambarish %A Omar, Wally %A Ayers, Colby %A LaMonte, Michael %A Klein, Liviu %A Allen, Norrina B %A Kuller, Lewis H %A Greenland, Philip %A Eaton, Charles B %A Gottdiener, John S %A Lloyd-Jones, Donald M %A Berry, Jarett D %X

BACKGROUND: Lifetime risk of heart failure has been estimated to range from 20% to 46% in diverse sex and race groups. However, lifetime risk estimates for the 2 HF phenotypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), are not known.

METHODS: Participant-level data from 2 large prospective cohort studies, the CHS (Cardiovascular Health Study) and MESA (Multiethnic Study of Atherosclerosis), were pooled, excluding individuals with prevalent HF at baseline. Remaining lifetime risk estimates for HFpEF (EF ≥45%) and HFrEF (EF <45%) were determined at different index ages with the use of a modified Kaplan-Meier method with mortality and the other HF subtype as competing risks.

RESULTS: We included 12 417 participants >45 years of age (22.2% blacks, 44.8% men) who were followed up for median duration of 11.6 years with 2178 overall incident HF events with 561 HFrEF events and 726 HFpEF events. At the index age of 45 years, the lifetime risk for any HF through 90 years of age was higher in men than women (27.4% versus 23.8%). Among HF subtypes, the lifetime risk for HFrEF was higher in men than women (10.6% versus 5.8%). In contrast, the lifetime risk for HFpEF was similar in men and women. In race-stratified analyses, lifetime risk for overall HF was higher in nonblacks than blacks (25.9% versus 22.4%). Among HF subtypes, the lifetime risk for HFpEF was higher in nonblacks than blacks (11.2% versus 7.7%), whereas that for HFrEF was similar across the 2 groups. Among participants with antecedent myocardial infarction before HF diagnosis, the remaining lifetime risks for HFpEF and HFrEF were up to 2.5-fold and 4-fold higher, respectively, compared with those without antecedent myocardial infarction.

CONCLUSIONS: Lifetime risks for HFpEF and HFrEF vary by sex, race, and history of antecedent myocardial infarction. These insights into the distribution of HF risk and its subtypes could inform the development of targeted strategies to improve population-level HF prevention and control.

%B Circulation %V 137 %P 1814-1823 %8 2018 Apr 24 %G eng %N 17 %R 10.1161/CIRCULATIONAHA.117.031622 %0 Journal Article %J J Am Heart Assoc %D 2018 %T Social Network Trajectories in Myocardial Infarction Versus Ischemic Stroke. %A Dhand, Amar %A Longstreth, W T %A Chaves, Paulo H M %A Dhamoon, Mandip S %X

BACKGROUND: Changes in social networks are rarely examined before and after various diseases because of insufficient data. CHS (The Cardiovascular Health Study) offers an opportunity to compare social network trajectories surrounding well-adjudicated myocardial infarction (MI) or stroke events. We tested the hypothesis that social networks will be stable after MI and decrease after stroke.

METHODS AND RESULTS: We examined trajectories of the Lubben Social Network Scale score (LSNS, range 0-50) before and after vascular events over 11 years. The LSNS assesses engagement in family networks, friends' networks, and social supports. We used a linear mixed model with repeated measures and fixed effects to compare the change in social network score before and after events in 395 people with MI and 382 with ischemic stroke. Over a mean of 12.4 years of follow-up for MI and 11.1 years for stroke, we examined an average of 4 social network scores for each participant. We controlled for sociodemographics, baseline cognitive function, and comorbidities. The participants' mean age was 73.5, 51% were women, and 88% were non-Hispanic white. After MI, the social network trajectory remained stable compared with the baseline trajectory (-0.06 points per year, adjusted =0.2356). After stroke, the social network trajectory declined compared with the baseline trajectory (-0.14 points per year, adjusted =0.0364).

CONCLUSIONS: Social networks remained stable after MI and declined after stroke. This small and persistent decline after adjustment for potential confounders is notable because it deviates from stable network trajectories found in CHS participants and is specific to stroke.

%B J Am Heart Assoc %V 7 %8 2018 Apr 13 %G eng %N 8 %R 10.1161/JAHA.117.008029 %0 Journal Article %J Aging (Albany NY) %D 2018 %T Strong impact of natural-selection-free heterogeneity in genetics of age-related phenotypes. %A Kulminski, Alexander M %A Huang, Jian %A Loika, Yury %A Arbeev, Konstantin G %A Bagley, Olivia %A Yashkin, Arseniy %A Duan, Matt %A Culminskaya, Irina %K Aging %K Computational Biology %K Gene Expression Regulation %K Genome-Wide Association Study %K Genotype %K Humans %K Polymorphism, Single Nucleotide %X

A conceptual difficulty in genetics of age-related phenotypes that make individuals vulnerable to disease in post-reproductive life is genetic heterogeneity attributed to an undefined role of evolution in establishing their molecular mechanisms. Here, we performed univariate and pleiotropic genome-wide meta-analyses of 20 age-related phenotypes leveraging longitudinal information in a sample of 33,431 individuals and dealing with the natural-selection-free genetic heterogeneity. We identified 142 non-proxy single nucleotide polymorphisms (SNPs) with phenotype-specific (18 SNPs) and pleiotropic (124 SNPs) associations at genome-wide level. Univariate meta-analysis identified two novel (11.1%) and replicated 16 SNPs whereas pleiotropic meta-analysis identified 115 novel (92.7%) and nine replicated SNPs. Pleiotropic associations for most novel (93.9%) and all replicated SNPs were strongly impacted by the natural-selection-free genetic heterogeneity in its unconventional form of antagonistic heterogeneity, implying antagonistic directions of genetic effects for directly correlated phenotypes. Our results show that the common genome-wide approach is well adapted to handle homogeneous univariate associations within Mendelian framework whereas most associations with age-related phenotypes are more complex and well beyond that framework. Dissecting the natural-selection-free genetic heterogeneity is critical for gaining insights into genetics of age-related phenotypes and has substantial and unexplored yet potential for improving efficiency of genome-wide analysis.

%B Aging (Albany NY) %V 10 %P 492-514 %8 2018 03 29 %G eng %N 3 %R 10.18632/aging.101407 %0 Journal Article %J Nat Commun %D 2018 %T Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function. %A Davies, Gail %A Lam, Max %A Harris, Sarah E %A Trampush, Joey W %A Luciano, Michelle %A Hill, W David %A Hagenaars, Saskia P %A Ritchie, Stuart J %A Marioni, Riccardo E %A Fawns-Ritchie, Chloe %A Liewald, David C M %A Okely, Judith A %A Ahola-Olli, Ari V %A Barnes, Catriona L K %A Bertram, Lars %A Bis, Joshua C %A Burdick, Katherine E %A Christoforou, Andrea %A DeRosse, Pamela %A Djurovic, Srdjan %A Espeseth, Thomas %A Giakoumaki, Stella %A Giddaluru, Sudheer %A Gustavson, Daniel E %A Hayward, Caroline %A Hofer, Edith %A Ikram, M Arfan %A Karlsson, Robert %A Knowles, Emma %A Lahti, Jari %A Leber, Markus %A Li, Shuo %A Mather, Karen A %A Melle, Ingrid %A Morris, Derek %A Oldmeadow, Christopher %A Palviainen, Teemu %A Payton, Antony %A Pazoki, Raha %A Petrovic, Katja %A Reynolds, Chandra A %A Sargurupremraj, Muralidharan %A Scholz, Markus %A Smith, Jennifer A %A Smith, Albert V %A Terzikhan, Natalie %A Thalamuthu, Anbupalam %A Trompet, Stella %A van der Lee, Sven J %A Ware, Erin B %A Windham, B Gwen %A Wright, Margaret J %A Yang, Jingyun %A Yu, Jin %A Ames, David %A Amin, Najaf %A Amouyel, Philippe %A Andreassen, Ole A %A Armstrong, Nicola J %A Assareh, Amelia A %A Attia, John R %A Attix, Deborah %A Avramopoulos, Dimitrios %A Bennett, David A %A Böhmer, Anne C %A Boyle, Patricia A %A Brodaty, Henry %A Campbell, Harry %A Cannon, Tyrone D %A Cirulli, Elizabeth T %A Congdon, Eliza %A Conley, Emily Drabant %A Corley, Janie %A Cox, Simon R %A Dale, Anders M %A Dehghan, Abbas %A Dick, Danielle %A Dickinson, Dwight %A Eriksson, Johan G %A Evangelou, Evangelos %A Faul, Jessica D %A Ford, Ian %A Freimer, Nelson A %A Gao, He %A Giegling, Ina %A Gillespie, Nathan A %A Gordon, Scott D %A Gottesman, Rebecca F %A Griswold, Michael E %A Gudnason, Vilmundur %A Harris, Tamara B %A Hartmann, Annette M %A Hatzimanolis, Alex %A Heiss, Gerardo %A Holliday, Elizabeth G %A Joshi, Peter K %A Kähönen, Mika %A Kardia, Sharon L R %A Karlsson, Ida %A Kleineidam, Luca %A Knopman, David S %A Kochan, Nicole A %A Konte, Bettina %A Kwok, John B %A Le Hellard, Stephanie %A Lee, Teresa %A Lehtimäki, Terho %A Li, Shu-Chen %A Liu, Tian %A Koini, Marisa %A London, Edythe %A Longstreth, Will T %A Lopez, Oscar L %A Loukola, Anu %A Luck, Tobias %A Lundervold, Astri J %A Lundquist, Anders %A Lyytikäinen, Leo-Pekka %A Martin, Nicholas G %A Montgomery, Grant W %A Murray, Alison D %A Need, Anna C %A Noordam, Raymond %A Nyberg, Lars %A Ollier, William %A Papenberg, Goran %A Pattie, Alison %A Polasek, Ozren %A Poldrack, Russell A %A Psaty, Bruce M %A Reppermund, Simone %A Riedel-Heller, Steffi G %A Rose, Richard J %A Rotter, Jerome I %A Roussos, Panos %A Rovio, Suvi P %A Saba, Yasaman %A Sabb, Fred W %A Sachdev, Perminder S %A Satizabal, Claudia L %A Schmid, Matthias %A Scott, Rodney J %A Scult, Matthew A %A Simino, Jeannette %A Slagboom, P Eline %A Smyrnis, Nikolaos %A Soumaré, Aïcha %A Stefanis, Nikos C %A Stott, David J %A Straub, Richard E %A Sundet, Kjetil %A Taylor, Adele M %A Taylor, Kent D %A Tzoulaki, Ioanna %A Tzourio, Christophe %A Uitterlinden, Andre %A Vitart, Veronique %A Voineskos, Aristotle N %A Kaprio, Jaakko %A Wagner, Michael %A Wagner, Holger %A Weinhold, Leonie %A Wen, K Hoyan %A Widen, Elisabeth %A Yang, Qiong %A Zhao, Wei %A Adams, Hieab H H %A Arking, Dan E %A Bilder, Robert M %A Bitsios, Panos %A Boerwinkle, Eric %A Chiba-Falek, Ornit %A Corvin, Aiden %A De Jager, Philip L %A Debette, Stephanie %A Donohoe, Gary %A Elliott, Paul %A Fitzpatrick, Annette L %A Gill, Michael %A Glahn, David C %A Hägg, Sara %A Hansell, Narelle K %A Hariri, Ahmad R %A Ikram, M Kamran %A Jukema, J Wouter %A Vuoksimaa, Eero %A Keller, Matthew C %A Kremen, William S %A Launer, Lenore %A Lindenberger, Ulman %A Palotie, Aarno %A Pedersen, Nancy L %A Pendleton, Neil %A Porteous, David J %A Räikkönen, Katri %A Raitakari, Olli T %A Ramirez, Alfredo %A Reinvang, Ivar %A Rudan, Igor %A Schmidt, Reinhold %A Schmidt, Helena %A Schofield, Peter W %A Schofield, Peter R %A Starr, John M %A Steen, Vidar M %A Trollor, Julian N %A Turner, Steven T %A van Duijn, Cornelia M %A Villringer, Arno %A Weinberger, Daniel R %A Weir, David R %A Wilson, James F %A Malhotra, Anil %A McIntosh, Andrew M %A Gale, Catharine R %A Seshadri, Sudha %A Mosley, Thomas H %A Bressler, Jan %A Lencz, Todd %A Deary, Ian J %X

General cognitive function is a prominent and relatively stable human trait that is associated with many important life outcomes. We combine cognitive and genetic data from the CHARGE and COGENT consortia, and UK Biobank (total N = 300,486; age 16-102) and find 148 genome-wide significant independent loci (P < 5 × 10) associated with general cognitive function. Within the novel genetic loci are variants associated with neurodegenerative and neurodevelopmental disorders, physical and psychiatric illnesses, and brain structure. Gene-based analyses find 709 genes associated with general cognitive function. Expression levels across the cortex are associated with general cognitive function. Using polygenic scores, up to 4.3% of variance in general cognitive function is predicted in independent samples. We detect significant genetic overlap between general cognitive function, reaction time, and many health variables including eyesight, hypertension, and longevity. In conclusion we identify novel genetic loci and pathways contributing to the heritability of general cognitive function.

%B Nat Commun %V 9 %P 2098 %8 2018 May 29 %G eng %N 1 %R 10.1038/s41467-018-04362-x %0 Journal Article %J Diabetologia %D 2018 %T Sugar-sweetened beverage intake associations with fasting glucose and insulin concentrations are not modified by selected genetic variants in a ChREBP-FGF21 pathway: a meta-analysis. %A McKeown, Nicola M %A Dashti, Hassan S %A Ma, Jiantao %A Haslam, Danielle E %A Kiefte-de Jong, Jessica C %A Smith, Caren E %A Tanaka, Toshiko %A Graff, Mariaelisa %A Lemaitre, Rozenn N %A Rybin, Denis %A Sonestedt, Emily %A Frazier-Wood, Alexis C %A Mook-Kanamori, Dennis O %A Li, Yanping %A Wang, Carol A %A Leermakers, Elisabeth T M %A Mikkilä, Vera %A Young, Kristin L %A Mukamal, Kenneth J %A Cupples, L Adrienne %A Schulz, Christina-Alexandra %A Chen, Tzu-An %A Li-Gao, Ruifang %A Huang, Tao %A Oddy, Wendy H %A Raitakari, Olli %A Rice, Kenneth %A Meigs, James B %A Ericson, Ulrika %A Steffen, Lyn M %A Rosendaal, Frits R %A Hofman, Albert %A Kähönen, Mika %A Psaty, Bruce M %A Brunkwall, Louise %A Uitterlinden, André G %A Viikari, Jorma %A Siscovick, David S %A Seppälä, Ilkka %A North, Kari E %A Mozaffarian, Dariush %A Dupuis, Josée %A Orho-Melander, Marju %A Rich, Stephen S %A de Mutsert, Renée %A Qi, Lu %A Pennell, Craig E %A Franco, Oscar H %A Lehtimäki, Terho %A Herman, Mark A %X

AIMS/HYPOTHESIS: Sugar-sweetened beverages (SSBs) are a major dietary contributor to fructose intake. A molecular pathway involving the carbohydrate responsive element-binding protein (ChREBP) and the metabolic hormone fibroblast growth factor 21 (FGF21) may influence sugar metabolism and, thereby, contribute to fructose-induced metabolic disease. We hypothesise that common variants in 11 genes involved in fructose metabolism and the ChREBP-FGF21 pathway may interact with SSB intake to exacerbate positive associations between higher SSB intake and glycaemic traits.

METHODS: Data from 11 cohorts (six discovery and five replication) in the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided association and interaction results from 34,748 adults of European descent. SSB intake (soft drinks, fruit punches, lemonades or other fruit drinks) was derived from food-frequency questionnaires and food diaries. In fixed-effects meta-analyses, we quantified: (1) the associations between SSBs and glycaemic traits (fasting glucose and fasting insulin); and (2) the interactions between SSBs and 18 independent SNPs related to the ChREBP-FGF21 pathway.

RESULTS: In our combined meta-analyses of discovery and replication cohorts, after adjustment for age, sex, energy intake, BMI and other dietary covariates, each additional serving of SSB intake was associated with higher fasting glucose (β ± SE 0.014 ± 0.004 [mmol/l], p = 1.5 × 10-3) and higher fasting insulin (0.030 ± 0.005 [log e pmol/l], p = 2.0 × 10-10). No significant interactions on glycaemic traits were observed between SSB intake and selected SNPs. While a suggestive interaction was observed in the discovery cohorts with a SNP (rs1542423) in the β-Klotho (KLB) locus on fasting insulin (0.030 ± 0.011 log e pmol/l, uncorrected p = 0.006), results in the replication cohorts and combined meta-analyses were non-significant.

CONCLUSIONS/INTERPRETATION: In this large meta-analysis, we observed that SSB intake was associated with higher fasting glucose and insulin. Although a suggestive interaction with a genetic variant in the ChREBP-FGF21 pathway was observed in the discovery cohorts, this observation was not confirmed in the replication analysis.

TRIAL REGISTRATION: Trials related to this study were registered at clinicaltrials.gov as NCT00005131 (Atherosclerosis Risk in Communities), NCT00005133 (Cardiovascular Health Study), NCT00005121 (Framingham Offspring Study), NCT00005487 (Multi-Ethnic Study of Atherosclerosis) and NCT00005152 (Nurses' Health Study).

%B Diabetologia %V 61 %P 317-330 %8 2018 Feb %G eng %N 2 %R 10.1007/s00125-017-4475-0 %0 Journal Article %J Neuroimage %D 2018 %T Systemic inflammation as a predictor of brain aging: Contributions of physical activity, metabolic risk, and genetic risk. %A Corlier, Fabian %A Hafzalla, George %A Faskowitz, Joshua %A Kuller, Lewis H %A Becker, James T %A Lopez, Oscar L %A Thompson, Paul M %A Braskie, Meredith N %X

Inflammatory processes may contribute to risk for Alzheimer's disease (AD) and age-related brain degeneration. Metabolic and genetic risk factors, and physical activity may, in turn, influence these inflammatory processes. Some of these risk factors are modifiable, and interact with each other. Understanding how these processes together relate to brain aging will help to inform future interventions to treat or prevent cognitive decline. We used brain magnetic resonance imaging (MRI) to scan 335 older adult humans (mean age 77.3 ± 3.4 years) who remained non-demented for the duration of the 9-year longitudinal study. We used structural equation modeling (SEM) in a subset of 226 adults to evaluate whether measures of baseline peripheral inflammation (serum C-reactive protein levels; CRP), mediated the baseline contributions of genetic and metabolic risk, and physical activity, to regional cortical thickness in AD-relevant brain regions at study year 9. We found that both baseline metabolic risk and AD risk variant apolipoprotein E ε4 (APOE4), modulated baseline serum CRP. Higher baseline CRP levels, in turn, predicted thinner regional cortex at year 9, and mediated an effect between higher metabolic risk and thinner cortex in those regions. A higher polygenic risk score composed of variants in immune-associated AD risk genes (other than APOE) was associated with thinner regional cortex. However, CRP levels did not mediate this effect, suggesting that other mechanisms may be responsible for the elevated AD risk. We found interactions between genetic and environmental factors and structural brain health. Our findings support the role of metabolic risk and peripheral inflammation in age-related brain decline.

%B Neuroimage %V 172 %P 118-129 %8 2018 May 15 %G eng %R 10.1016/j.neuroimage.2017.12.027 %0 Journal Article %J J Thromb Haemost %D 2018 %T Targeted sequencing to identify novel genetic risk factors for deep vein thrombosis: a study of 734 genes. %A de Haan, H G %A van Hylckama Vlieg, A %A Lotta, L A %A Gorski, Marcin M %A Bucciarelli, P %A Martinelli, I %A Baglin, T P %A Peyvandi, F %A Rosendaal, F R %X

BACKGROUND: Although several genetic risk factors for deep vein thrombosis (DVT) are known, almost all related to hemostasis, a large genetic component remains unexplained.

OBJECTIVES: We aimed to identify novel genetic determinants using targeted DNA sequencing.

PATIENTS/METHODS: We included 899 DVT patients and 599 controls from three case-control studies (DVT-Milan, MEGA, and THE-VTE) for sequencing of the coding regions of 734 genes involved in hemostasis or related pathways. We performed single-variant association tests for common variants (minor allele frequency [MAF]≥1%) and gene-based tests for rare variants (MAF≤1%), accounting for multiple testing by the false discovery rate (FDR).

RESULTS: Sixty-two out of 3,617 common variants were associated with DVT risk (FDR<0.10). Most of these mapped to F5, ABO, FGA-FGG, and CYP4V2-KLKB1-F11. Lead variant at F5 was rs6672595 (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.29-1.92), in moderate linkage with known variant rs4524. Reciprocal conditional analyses suggested that intronic variation might drive this association. We also observed a secondary association at the F11 region: missense KLKB1 variant rs3733402 remained associated conditional on known variants rs2039614 and rs2289252 (OR 1.36, 95% CI 1.10-1.69). Two novel variant associations were observed, in CBS and MASP1, but these did not replicate in the meta-analysis data from the INVENT consortium. There was no support for a burden of rare variants contributing to DVT risk (FDR>0.2).

CONCLUSIONS: We confirmed associations between DVT and common variants in F5, ABO, FGA-FGG, and CYP4V2-KLKB1-F11 and observed secondary signals in F5 and CYP4V2-KLKB1-F11 that warrant replication and fine-mapping in larger studies. This article is protected by copyright. All rights reserved.

%B J Thromb Haemost %8 2018 Aug 31 %G eng %R 10.1111/jth.14279 %0 Journal Article %J JACC Heart Fail %D 2018 %T Temporal Trends in the Incidence of and Mortality Associated With Heart Failure With Preserved and Reduced Ejection Fraction. %A Tsao, Connie W %A Lyass, Asya %A Enserro, Danielle %A Larson, Martin G %A Ho, Jennifer E %A Kizer, Jorge R %A Gottdiener, John S %A Psaty, Bruce M %A Vasan, Ramachandran S %X

OBJECTIVES: This study aimed to determine temporal trends in the incidence of and mortality associated with heart failure (HF) and its subtypes (heart failure with reduced ejection fraction [HFrEF] and heart rate with preserved ejection fraction [HFpEF]) in the community.

BACKGROUND: Major shifts in cardiovascular disease risk factor prevalence and advances in therapies may have influenced HF incidence and mortality.

METHODS: In the FHS (Framingham Heart Study) and CHS (Cardiovascular Health Study), for participants who were ≥60 years of age and free of HF (n = 15,217; 60% women; 2,524 incident HF cases; 115,703 person-years of follow-up), we estimated adjusted incidence rate ratios of HF, HFrEF, and HFpEF from 1990 to 1999 and 2000 to 2009. We compared the cumulative incidence of and mortality associated with HFrEF versus HFpEF within and between decades.

RESULTS: Across the 2 decades, HF incidence rate ratio was similar (p = 0.13). The incidence rate ratio of HFrEF declined (p = 0.0029), whereas HFpEF increased (p < 0.001). Although HFrEF incidence declined more in men than in women, men had a higher incidence of HFrEF than women in each decade (p < 0.001). The incidence of HFpEF significantly increased over time in both men and women (p < 0.001 and p = 0.02, respectively). During follow-up after HF, 1,701 individuals died (67.4%; HFrEF, n = 557 [33%]; HFpEF, n = 474 [29%]). There were no significant differences in mortality rates (overall, cardiovascular disease, and noncardiovascular disease) across decades within HF subtypes or between HFrEF and HFpEF within decade.

CONCLUSIONS: In several U.S. community-based samples from 1990 to 2009, we observed divergent trends of decreasing HFrEF and increasing HFpEF incidence, with stable overall HF incidence and high risk for mortality. Our findings highlight the need to elucidate factors contributing to these observations.

%B JACC Heart Fail %V 6 %P 678-685 %8 2018 Aug %G eng %N 8 %R 10.1016/j.jchf.2018.03.006 %0 Journal Article %J Int J Obes (Lond) %D 2018 %T Trans-ethnic analysis of metabochip data identifies two new loci associated with BMI. %A Gong, J %A Nishimura, K K %A Fernandez-Rhodes, L %A Haessler, J %A Bien, S %A Graff, M %A Lim, U %A Lu, Y %A Gross, M %A Fornage, M %A Yoneyama, S %A Isasi, C R %A Bůžková, P %A Daviglus, M %A Lin, D-Y %A Tao, R %A Goodloe, R %A Bush, W S %A Farber-Eger, E %A Boston, J %A Dilks, H H %A Ehret, G %A Gu, C C %A Lewis, C E %A Nguyen, K-D H %A Cooper, R %A Leppert, M %A Irvin, M R %A Bottinger, E P %A Wilkens, L R %A Haiman, C A %A Park, L %A Monroe, K R %A Cheng, I %A Stram, D O %A Carlson, C S %A Jackson, R %A Kuller, L %A Houston, D %A Kooperberg, C %A Buyske, S %A Hindorff, L A %A Crawford, D C %A Loos, R J F %A Le Marchand, L %A Matise, T C %A North, K E %A Peters, U %X

OBJECTIVE: Body mass index (BMI) is commonly used to assess obesity, which is associated with numerous diseases and negative health outcomes. BMI has been shown to be a heritable, polygenic trait, with close to 100 loci previously identified and replicated in multiple populations. We aim to replicate known BMI loci and identify novel associations in a trans-ethnic study population.

SUBJECTS: Using eligible participants from the Population Architecture using Genomics and Epidemiology consortium, we conducted a trans-ethnic meta-analysis of 102 514 African Americans, Hispanics, Asian/Native Hawaiian, Native Americans and European Americans. Participants were genotyped on over 200 000 SNPs on the Illumina Metabochip custom array, or imputed into the 1000 Genomes Project (Phase I). Linear regression of the natural log of BMI, adjusting for age, sex, study site (if applicable), and ancestry principal components, was conducted for each race/ethnicity within each study cohort. Race/ethnicity-specific, and combined meta-analyses used fixed-effects models.

RESULTS: We replicated 15 of 21 BMI loci included on the Metabochip, and identified two novel BMI loci at 1q41 (rs2820436) and 2q31.1 (rs10930502) at the Metabochip-wide significance threshold (P<2.5 × 10). Bioinformatic functional investigation of SNPs at these loci suggests a possible impact on pathways that regulate metabolism and adipose tissue.

CONCLUSION: Conducting studies in genetically diverse populations continues to be a valuable strategy for replicating known loci and uncovering novel BMI associations.

%B Int J Obes (Lond) %V 42 %P 384-390 %8 2018 Mar %G eng %N 3 %R 10.1038/ijo.2017.304 %0 Journal Article %J J Clin Endocrinol Metab %D 2018 %T Trans-ethnic Evaluation Identifies Novel Low Frequency Loci Associated with 25-Hydroxyvitamin D Concentrations. %A Hong, Jaeyoung %A Hatchell, Kathryn E %A Bradfield, Jonathan P %A Andrew, Bjonnes %A Alessandra, Chesi %A Chao-Qiang, Lai %A Langefeld, Carl D %A Lu, Lingyi %A Lu, Yingchang %A Lutsey, Pamela L %A Musani, Solomon K %A Nalls, Mike A %A Robinson-Cohen, Cassianne %A Roizen, Jeffery D %A Saxena, Richa %A Tucker, Katherine L %A Ziegler, Julie T %A Arking, Dan E %A Bis, Joshua C %A Boerwinkle, Eric %A Bottinger, Erwin P %A Bowden, Donald W %A Gilsanz, Vincente %A Houston, Denise K %A Kalkwarf, Heidi J %A Kelly, Andrea %A Lappe, Joan M %A Liu, Yongmei %A Michos, Erin D %A Oberfield, Sharon E %A Palmer, Nicholette D %A Rotter, Jerome I %A Sapkota, Bishwa %A Shepherd, John A %A Wilson, James G %A Basu, Saonli %A de Boer, Ian H %A Divers, Jasmin %A Freedman, Barry I %A Grant, Struan F A %A Hakanarson, Hakon %A Harris, Tamara B %A Kestenbaum, Bryan R %A Kritchevsky, Stephen B %A Loos, Ruth J F %A Norris, Jill M %A Norwood, Arnita F %A Ordovas, Jose M %A Pankow, James S %A Psaty, Bruce M %A Sanhgera, Dharambir K %A Wagenknecht, Lynne E %A Zemel, Babette S %A Meigs, James %A Dupuis, Josée %A Florez, Jose C %A Wang, Thomas %A Liu, Ching-Ti %A Engelman, Corinne D %A Billings, Liana K %X

Context: Vitamin D inadequacy is common in the adult population of the United States. While the genetic determinants underlying vitamin D inadequacy have been studied in people of European ancestry, less is known in Hispanic or African ancestry populations.

Objective: The TRANSCEN-D (TRANS-ethniC Evaluation of vitamiN D GWAS) consortium was assembled to replicate genetic associations with 25-hydroxyvitamin D (25(OH)D) concentrations from the meta-analyses of European ancestry (SUNLIGHT) and to identify novel genetic variants related to vitamin D concentrations in African and Hispanic ancestries.

Design: Ancestry-specific (Hispanic and African) and trans-ethnic (Hispanic, African and European) meta-analyses were performed using the METAL software.

Patients or Other Participants: In total, 8,541 African-American and 3,485 Hispanic-American (from North America) participants from twelve cohorts, and 16,124 European participants from SUNLIGHT were included in the study.

Main Outcome Measure(s): Blood concentrations of 25(OH)D were measured for all participants.

Results: Ancestry-specific analyses in African and Hispanic Americans replicated SNPs in GC (2 and 4 SNPs, respectively). A potentially novel SNP (rs79666294) near the KIF4B gene was identified in the African-American cohort. Trans-ethnic evaluation replicated GC and DHCR7 region SNPs. Additionally, the trans-ethnic analyses revealed novel SNPs rs719700 and rs1410656 near the ANO6/ARID2 and HTR2A genes, respectively.

Conclusions: Ancestry-specific and trans-ethnic GWAS of 25(OH)D confirmed findings in GC and DHCR7 for African and Hispanic American samples and revealed novel findings near KIF4B, ANO6/ARID2, and HTR2A. The biological mechanisms that link these regions with 25(OH)D metabolism require further investigation.

%B J Clin Endocrinol Metab %8 2018 Jan 09 %G eng %R 10.1210/jc.2017-01802 %0 Journal Article %J J Clin Med %D 2018 %T Validation of the REGARDS Severe Sepsis Risk Score. %A Wang, Henry E %A Donnelly, John P %A Yende, Sachin %A Levitan, Emily B %A Shapiro, Nathan I %A Dai, Yuling %A Zhao, Hong %A Heiss, Gerardo %A Odden, Michelle %A Newman, Anne %A Safford, Monika %X

There are no validated systems for characterizing long-term risk of severe sepsis in community-dwelling adults. We tested the ability of the REasons for Geographic and Racial Differences in Stroke-Severe Sepsis Risk Score (REGARDS-SSRS) to predict 10-year severe sepsis risk in separate cohorts of community-dwelling adults. We internally tested the REGARDS-SSRS on the REGARDS-Medicare subcohort. We then externally validated the REGARDS-SSRS using (1) the Cardiovascular Health Study (CHS) and (2) the Atherosclerosis Risk in Communities (ARIC) cohorts. Participants included community-dwelling adults: REGARDS-Medicare, age ≥65 years, = 9522; CHS, age ≥65 years, = 5888; ARIC, age 45⁻64 years, = 11,584. The primary exposure was 10-year severe sepsis risk, predicted by the REGARDS-SSRS from participant sociodemographics, health behaviors, chronic medical conditions and select biomarkers. The primary outcome was first severe sepsis hospitalizations, defined as the concurrent presence of ICD-9 discharge diagnoses for a serious infection and organ dysfunction. Median SSRS in the cohorts were: REGARDS-Medicare 11 points (IQR 7⁻16), CHS 10 (IQR 6⁻15), ARIC 7 (IQR 5⁻10). Severe sepsis incidence rates were: REGARDS-Medicare 30.7 per 1000 person-years (95% CI: 29.2⁻32.2); CHS 11.9 (10.9⁻12.9); ARIC 6.8 (6.3⁻7.3). SSRS discrimination for first severe sepsis events were: REGARDS-Medicare C-statistic 0.704 (95% CI: 0.691⁻0.718), CHS 0.696 (0.675⁻0.716), ARIC 0.697 (0.677⁻0.716). The REGARDS-SRSS may potentially play a role in identifying community-dwelling adults at high severe sepsis risk.

%B J Clin Med %V 7 %8 2018 Dec 11 %G eng %N 12 %R 10.3390/jcm7120536 %0 Journal Article %J Mol Psychiatry %D 2018 %T Whole exome sequencing study identifies novel rare and common Alzheimer's-Associated variants involved in immune response and transcriptional regulation. %A Bis, Joshua C %A Jian, Xueqiu %A Kunkle, Brian W %A Chen, Yuning %A Hamilton-Nelson, Kara L %A Bush, William S %A Salerno, William J %A Lancour, Daniel %A Ma, Yiyi %A Renton, Alan E %A Marcora, Edoardo %A Farrell, John J %A Zhao, Yi %A Qu, Liming %A Ahmad, Shahzad %A Amin, Najaf %A Amouyel, Philippe %A Beecham, Gary W %A Below, Jennifer E %A Campion, Dominique %A Charbonnier, Camille %A Chung, Jaeyoon %A Crane, Paul K %A Cruchaga, Carlos %A Cupples, L Adrienne %A Dartigues, Jean-François %A Debette, Stephanie %A Deleuze, Jean-Francois %A Fulton, Lucinda %A Gabriel, Stacey B %A Genin, Emmanuelle %A Gibbs, Richard A %A Goate, Alison %A Grenier-Boley, Benjamin %A Gupta, Namrata %A Haines, Jonathan L %A Havulinna, Aki S %A Helisalmi, Seppo %A Hiltunen, Mikko %A Howrigan, Daniel P %A Ikram, M Arfan %A Kaprio, Jaakko %A Konrad, Jan %A Kuzma, Amanda %A Lander, Eric S %A Lathrop, Mark %A Lehtimäki, Terho %A Lin, Honghuang %A Mattila, Kari %A Mayeux, Richard %A Muzny, Donna M %A Nasser, Waleed %A Neale, Benjamin %A Nho, Kwangsik %A Nicolas, Gaël %A Patel, Devanshi %A Pericak-Vance, Margaret A %A Perola, Markus %A Psaty, Bruce M %A Quenez, Olivier %A Rajabli, Farid %A Redon, Richard %A Reitz, Christiane %A Remes, Anne M %A Salomaa, Veikko %A Sarnowski, Chloe %A Schmidt, Helena %A Schmidt, Michael %A Schmidt, Reinhold %A Soininen, Hilkka %A Thornton, Timothy A %A Tosto, Giuseppe %A Tzourio, Christophe %A van der Lee, Sven J %A van Duijn, Cornelia M %A Vardarajan, Badri %A Wang, Weixin %A Wijsman, Ellen %A Wilson, Richard K %A Witten, Daniela %A Worley, Kim C %A Zhang, Xiaoling %A Bellenguez, Céline %A Lambert, Jean-Charles %A Kurki, Mitja I %A Palotie, Aarno %A Daly, Mark %A Boerwinkle, Eric %A Lunetta, Kathryn L %A DeStefano, Anita L %A Dupuis, Josée %A Martin, Eden R %A Schellenberg, Gerard D %A Seshadri, Sudha %A Naj, Adam C %A Fornage, Myriam %A Farrer, Lindsay A %X

The Alzheimer's Disease Sequencing Project (ADSP) undertook whole exome sequencing in 5,740 late-onset Alzheimer disease (AD) cases and 5,096 cognitively normal controls primarily of European ancestry (EA), among whom 218 cases and 177 controls were Caribbean Hispanic (CH). An age-, sex- and APOE based risk score and family history were used to select cases most likely to harbor novel AD risk variants and controls least likely to develop AD by age 85 years. We tested ~1.5 million single nucleotide variants (SNVs) and 50,000 insertion-deletion polymorphisms (indels) for association to AD, using multiple models considering individual variants as well as gene-based tests aggregating rare, predicted functional, and loss of function variants. Sixteen single variants and 19 genes that met criteria for significant or suggestive associations after multiple-testing correction were evaluated for replication in four independent samples; three with whole exome sequencing (2,778 cases, 7,262 controls) and one with genome-wide genotyping imputed to the Haplotype Reference Consortium panel (9,343 cases, 11,527 controls). The top findings in the discovery sample were also followed-up in the ADSP whole-genome sequenced family-based dataset (197 members of 42 EA families and 501 members of 157 CH families). We identified novel and predicted functional genetic variants in genes previously associated with AD. We also detected associations in three novel genes: IGHG3 (p = 9.8 × 10), an immunoglobulin gene whose antibodies interact with β-amyloid, a long non-coding RNA AC099552.4 (p = 1.2 × 10), and a zinc-finger protein ZNF655 (gene-based p = 5.0 × 10). The latter two suggest an important role for transcriptional regulation in AD pathogenesis.

%B Mol Psychiatry %8 2018 Aug 14 %G eng %R 10.1038/s41380-018-0112-7 %0 Journal Article %J Ann Clin Transl Neurol %D 2018 %T Whole genome sequencing of Caribbean Hispanic families with late-onset Alzheimer's disease. %A Vardarajan, Badri N %A Barral, Sandra %A Jaworski, James %A Beecham, Gary W %A Blue, Elizabeth %A Tosto, Giuseppe %A Reyes-Dumeyer, Dolly %A Medrano, Martin %A Lantigua, Rafael %A Naj, Adam %A Thornton, Timothy %A DeStefano, Anita %A Martin, Eden %A Wang, Li-San %A Brown, Lisa %A Bush, William %A van Duijn, Cornelia %A Goate, Allison %A Farrer, Lindsay %A Haines, Jonathan L %A Boerwinkle, Eric %A Schellenberg, Gerard %A Wijsman, Ellen %A Pericak-Vance, Margaret A %A Mayeux, Richard %A Wang, Li-San %X

Objective: To identify rare causal variants underlying known loci that segregate with late-onset Alzheimer's disease (LOAD) in multiplex families.

Methods: We analyzed whole genome sequences (WGS) from 351 members of 67 Caribbean Hispanic (CH) families from Dominican Republic and New York multiply affected by LOAD. Members of 67 CH and additional 47 Caucasian families underwent WGS as a part of the Alzheimer's Disease Sequencing Project (ADSP). All members of 67 CH families, an additional 48 CH families and an independent CH case-control cohort were subsequently genotyped for validation. Patients met criteria for LOAD, and controls were determined to be dementia free. We investigated rare variants segregating within families and gene-based associations with disease within LOAD GWAS loci.

Results: A variant in p.R434W, segregated significantly with LOAD in two large families (OR = 5.77, 95% CI: 1.07-30.9, = 0.041). In addition, missense mutations in and under previously reported linkage peaks at 7q14.3 and 11q12.3 segregated completely in one family and in follow-up genotyping both were nominally significant ( < 0.05). We also identified rare variants in a number of genes associated with LOAD in prior genome wide association studies, including ( = 0.049), ( = 0.0098) and ( = 0.040).

Conclusions and Relevance: Rare variants in multiple genes influence the risk of LOAD disease in multiplex families. These results suggest that rare variants may underlie loci identified in genome wide association studies.

%B Ann Clin Transl Neurol %V 5 %P 406-417 %8 2018 Apr %G eng %N 4 %R 10.1002/acn3.537 %0 Journal Article %J Ann Clin Transl Neurol %D 2018 %T Whole-exome sequencing in 20,197 persons for rare variants in Alzheimer's disease. %A Raghavan, Neha S %A Brickman, Adam M %A Andrews, Howard %A Manly, Jennifer J %A Schupf, Nicole %A Lantigua, Rafael %A Wolock, Charles J %A Kamalakaran, Sitharthan %A Petrovski, Slave %A Tosto, Giuseppe %A Vardarajan, Badri N %A Goldstein, David B %A Mayeux, Richard %X

Objective: The genetic bases of Alzheimer's disease remain uncertain. An international effort to fully articulate genetic risks and protective factors is underway with the hope of identifying potential therapeutic targets and preventive strategies. The goal here was to identify and characterize the frequency and impact of rare and ultra-rare variants in Alzheimer's disease, using whole-exome sequencing in 20,197 individuals.

Methods: We used a gene-based collapsing analysis of loss-of-function ultra-rare variants in a case-control study design with data from the Washington Heights-Inwood Columbia Aging Project, the Alzheimer's Disease Sequencing Project and unrelated individuals from the Institute of Genomic Medicine at Columbia University.

Results: We identified 19 cases carrying extremely rare loss-of-function variants among a collection of 6,965 cases and a single loss-of-function variant among 13,252 controls ( = 2.17 × 10; OR: 36.2 [95% CI: 5.8-1493.0]). Age-at-onset was 7 years earlier for patients with qualifying variant compared with noncarriers. No other gene attained a study-wide level of statistical significance, but multiple top-ranked genes, including , and were among candidates for follow-up studies.

Interpretation: This study implicates ultra-rare, loss-of-function variants in as a significant genetic risk factor for Alzheimer's disease and provides a comprehensive dataset comparing the burden of rare variation in nearly all human genes in Alzheimer's disease cases and controls. This is the first investigation to establish a genome-wide statistically significant association between multiple extremely rare loss-of-function variants in and Alzheimer's disease in a large whole-exome study of unrelated cases and controls.

%B Ann Clin Transl Neurol %V 5 %P 832-842 %8 2018 Jul %G eng %N 7 %R 10.1002/acn3.582 %0 Journal Article %J J Am Geriatr Soc %D 2019 %T Abnormal Fasting Glucose Increases Risk of Unrecognized Myocardial Infarctions in an Elderly Cohort. %A Stacey, Richard Brandon %A Zgibor, Janice %A Leaverton, Paul E %A Schocken, Douglas D %A Peregoy, Jennifer A %A Lyles, Mary F %A Bertoni, Alain G %A Burke, Gregory L %X

OBJECTIVES: To investigate glucose levels as a risk factor for unrecognized myocardial infarctions (UMIs).

DESIGN: Cohort SETTING: Cardiovascular Health Study.

PARTICIPANTS: Individuals aged 65 and older with fasting glucose measurements (N=4,355; normal fasting glucose (NFG), n = 2,041; impaired fasting glucose (IFG), n = 1,706; DM: n = 608; 40% male, 84% white, mean age 72.4 ± 5.6).

MEASUREMENTS: The relationship between glucose levels and UMI was examined. Participants with prior coronary heart disease (CHD) or UMI on initial electrocardiography were excluded. Using Minnesota codes, UMI was identified according to the presence of pathological Q-waves or minor Q-waves with ST-T abnormalities. Crude and adjusted hazard ratios (HRs) were calculated. Analyses were adjusted for age, sex, body mass index (BMI), hypertension, antihypertensive and lipid-lowering medication use, total cholesterol, high-density lipoprotein cholesterol, and smoking status.

RESULTS: Over a mean follow-up of 6 years, there were 459 incident UMIs (NFG, n=202; IFG, n=183; DM, n=74). Participants with IFG were slightly more likely than those with NFG to experience a UMI (hazard ratio (HR)=1.11, 95% confidence interval (CI)=0.91-1.36, p = .30), and those with DM were more likely than those with NFG to experience a UMI (HR=1.65, 95% CI=1.25-2.13, p < .001). After adjustment HR for UMI in IFG those with IFG were no more likely than those with NFG to experience a UMI (HR=1.01, 95% CI=0.82-1.24, p = .93), whereas those with DM were more likely than those with NFG to experience a UMI (HR=1.37, 95% CI=1.02-1.81, p = .03). The 2-hour oral glucose tolerance test was not statistically significantly associated with UMI.

CONCLUSION: Fasting glucose status, particularly in the diabetic range, forecasted UMI during 6 years of follow-up in elderly adults. Further studies are needed to clarify the level of glucose at which risk is greater. J Am Geriatr Soc 67:43-49, 2019.

%B J Am Geriatr Soc %V 67 %P 43-49 %8 2019 Jan %G eng %N 1 %R 10.1111/jgs.15604 %0 Journal Article %J Hum Mol Genet %D 2019 %T Admixture mapping identifies novel loci for obstructive sleep apnea in Hispanic/Latino Americans. %A Wang, Heming %A Cade, Brian E %A Sofer, Tamar %A Sands, Scott A %A Chen, Han %A Browning, Sharon R %A Stilp, Adrienne M %A Louie, Tin L %A Thornton, Timothy A %A Johnson, W Craig %A Below, Jennifer E %A Conomos, Matthew P %A Evans, Daniel S %A Gharib, Sina A %A Guo, Xiuqing %A Wood, Alexis C %A Mei, Hao %A Yaffe, Kristine %A Loredo, Jose S %A Ramos, Alberto R %A Barrett-Connor, Elizabeth %A Ancoli-Israel, Sonia %A Zee, Phyllis C %A Arens, Raanan %A Shah, Neomi A %A Taylor, Kent D %A Tranah, Gregory J %A Stone, Katie L %A Hanis, Craig L %A Wilson, James G %A Gottlieb, Daniel J %A Patel, Sanjay R %A Rice, Ken %A Post, Wendy S %A Rotter, Jerome I %A Sunyaev, Shamil R %A Cai, Jianwen %A Lin, Xihong %A Purcell, Shaun M %A Laurie, Cathy C %A Saxena, Richa %A Redline, Susan %A Zhu, Xiaofeng %X

Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of cardiovascular disease and mortality. Its prevalence and severity vary across ancestral background. Although OSA traits are heritable, few genetic associations have been identified. To identify genetic regions associated with OSA and improve statistical power, we applied admixture mapping on three primary OSA traits [the apnea hypopnea index (AHI), overnight average oxyhemoglobin saturation (SaO2) and percentage time SaO2 < 90%] and a secondary trait (respiratory event duration) in a Hispanic/Latino American population study of 11 575 individuals with significant variation in ancestral background. Linear mixed models were performed using previously inferred African, European and Amerindian local genetic ancestry markers. Global African ancestry was associated with a lower AHI, higher SaO2 and shorter event duration. Admixture mapping analysis of the primary OSA traits identified local African ancestry at the chromosomal region 2q37 as genome-wide significantly associated with AHI (P < 5.7 × 10-5), and European and Amerindian ancestries at 18q21 suggestively associated with both AHI and percentage time SaO2 < 90% (P < 10-3). Follow-up joint ancestry-SNP association analyses identified novel variants in ferrochelatase (FECH), significantly associated with AHI and percentage time SaO2 < 90% after adjusting for multiple tests (P < 8 × 10-6). These signals contributed to the admixture mapping associations and were replicated in independent cohorts. In this first admixture mapping study of OSA, novel associations with variants in the iron/heme metabolism pathway suggest a role for iron in influencing respiratory traits underlying OSA.

%B Hum Mol Genet %V 28 %P 675-687 %8 2019 02 15 %G eng %N 4 %R 10.1093/hmg/ddy387 %0 Journal Article %J Am J Respir Crit Care Med %D 2019 %T Albuminuria, Lung Function Decline, and Risk of Incident Chronic Obstructive Pulmonary Disease. The NHLBI Pooled Cohorts Study. %A Oelsner, Elizabeth C %A Balte, Pallavi P %A Grams, Morgan E %A Cassano, Patricia A %A Jacobs, David R %A Barr, R Graham %A Burkart, Kristin M %A Kalhan, Ravi %A Kronmal, Richard %A Loehr, Laura R %A O'Connor, George T %A Schwartz, Joseph E %A Shlipak, Michael %A Tracy, Russell P %A Tsai, Michael Y %A White, Wendy %A Yende, Sachin %X

RATIONALE: Chronic lower respiratory diseases (CLRDs), including chronic obstructive pulmonary disease (COPD) and asthma, are the fourth leading cause of death. Prior studies suggest that albuminuria, a biomarker of endothelial injury, is increased in patients with COPD.

OBJECTIVES: To test whether albuminuria was associated with lung function decline and incident CLRDs.

METHODS: Six U.S. population-based cohorts were harmonized and pooled. Participants with prevalent clinical lung disease were excluded. Albuminuria (urine albumin-to-creatinine ratio) was measured in spot samples. Lung function was assessed by spirometry. Incident CLRD-related hospitalizations and deaths were classified via adjudication and/or administrative criteria. Mixed and proportional hazards models were used to test individual-level associations adjusted for age, height, weight, sex, race/ethnicity, education, birth year, cohort, smoking status, pack-years of smoking, renal function, hypertension, diabetes, and medications.

MEASUREMENTS AND MAIN RESULTS: Among 10,961 participants with preserved lung function, mean age at albuminuria measurement was 60 years, 51% were never-smokers, median albuminuria was 5.6 mg/g, and mean FEV decline was 31.5 ml/yr. For each SD increase in log-transformed albuminuria, there was 2.81% greater FEV decline (95% confidence interval [CI], 0.86-4.76%; P = 0.0047), 11.02% greater FEV/FVC decline (95% CI, 4.43-17.62%; P = 0.0011), and 15% increased hazard of incident spirometry-defined moderate-to-severe COPD (95% CI, 2-31%, P = 0.0021). Each SD log-transformed albuminuria increased hazards of incident COPD-related hospitalization/mortality by 26% (95% CI, 18-34%, P < 0.0001) among 14,213 participants followed for events. Asthma events were not significantly associated. Associations persisted in participants without current smoking, diabetes, hypertension, or cardiovascular disease.

CONCLUSIONS: Albuminuria was associated with greater lung function decline, incident spirometry-defined COPD, and incident COPD-related events in a U.S. population-based sample.

%B Am J Respir Crit Care Med %V 199 %P 321-332 %8 2019 Feb 01 %G eng %N 3 %R 10.1164/rccm.201803-0402OC %0 Journal Article %J Sci Rep %D 2019 %T Alcohol consumption and leukocyte telomere length. %A Dixit, Shalini %A Whooley, Mary A %A Vittinghoff, Eric %A Roberts, Jason D %A Heckbert, Susan R %A Fitzpatrick, Annette L %A Lin, Jue %A Leung, Cindy %A Mukamal, Kenneth J %A Marcus, Gregory M %X

The relationship between alcohol consumption and mortality generally exhibits a U-shaped curve. The longevity observed with moderate alcohol consumption may be explained by other confounding factors, and, if such a relationship is present, the mechanism is not well understood. Indeed, the optimal amount of alcohol consumption for health has yet to be determined. Leukocyte telomere length is an emerging quantifiable marker of biological age and health, and a shorter telomere length is a predictor of increased mortality. Because leukocyte telomere length is a quantifiable and objectively measurable biomarker of aging, we sought to identify the amount of alcohol consumption associated with the longest telomere length and least telomere length attrition. Among over 2,000 participants from two distinct cohort studies, we found no pattern of alcohol consumption that was associated with longer telomere length or less telomere length attrition over time. Binge drinking may reduce telomere length. Using telomere length as a marker of age and health, these data fail to demonstrate any benefits of alcohol consumption, even when consumed in moderation.

%B Sci Rep %V 9 %P 1404 %8 2019 Feb 05 %G eng %N 1 %R 10.1038/s41598-019-38904-0 %0 Journal Article %J Alzheimers Dement (N Y) %D 2019 %T {Alzheimer's disease progression and risk factors: A standardized comparison between six large data sets %A Evans, S. %A McRae-McKee, K. %A Hadjichrysanthou, C. %A Wong, M. M. %A Ames, D. %A Lopez, O. %A de Wolf, F. %A Anderson, R. M. %X There exist a large number of cohort studies that have been used to identify genetic and biological risk factors for developing Alzheimer's disease (AD). However, there is a disagreement between studies as to how strongly these risk factors affect the rate of progression through diagnostic groups toward AD. We have calculated the probability of transitioning through diagnostic groups in six studies and considered how uncertainty around the strength of the effect of these risk factors affects estimates of the distribution of individuals in each diagnostic group in an AD clinical trial simulator. In this work, we identify the optimal choice of widely collected variables for comparing data sets and calculating probabilities of progression toward AD. We use the estimated transition probabilities to inform stochastic simulations of AD progression that are based on a Markov model and compare predicted incidence rates to those in a community-based study, the Cardiovascular Health Study. %B Alzheimers Dement (N Y) %V 5 %P 515–523 %G eng %0 Journal Article %J JAMA Cardiol %D 2019 %T Assessment of the Relationship Between Genetic Determinants of Thyroid Function and Atrial Fibrillation: A Mendelian Randomization Study. %A Ellervik, Christina %A Roselli, Carolina %A Christophersen, Ingrid E %A Alonso, Alvaro %A Pietzner, Maik %A Sitlani, Collen M %A Trompet, Stella %A Arking, Dan E %A Geelhoed, Bastiaan %A Guo, Xiuqing %A Kleber, Marcus E %A Lin, Henry J %A Lin, Honghuang %A Macfarlane, Peter %A Selvin, Elizabeth %A Shaffer, Christian %A Smith, Albert V %A Verweij, Niek %A Weiss, Stefan %A Cappola, Anne R %A Dörr, Marcus %A Gudnason, Vilmundur %A Heckbert, Susan %A Mooijaart, Simon %A März, Winfried %A Psaty, Bruce M %A Ridker, Paul M %A Roden, Dan %A Stott, David J %A Völzke, Henry %A Benjamin, Emelia J %A Delgado, Graciela %A Ellinor, Patrick %A Homuth, Georg %A Köttgen, Anna %A Jukema, Johan W %A Lubitz, Steven A %A Mora, Samia %A Rienstra, Michiel %A Rotter, Jerome I %A Shoemaker, M Benjamin %A Sotoodehnia, Nona %A Taylor, Kent D %A van der Harst, Pim %A Albert, Christine M %A Chasman, Daniel I %X

Importance: Increased free thyroxine (FT4) and decreased thyrotropin are associated with increased risk of atrial fibrillation (AF) in observational studies, but direct involvement is unclear.

Objective: To evaluate the potential direct involvement of thyroid traits on AF.

Design, Setting, and Participants: Study-level mendelian randomization (MR) included 11 studies, and summary-level MR included 55 114 AF cases and 482 295 referents, all of European ancestry.

Exposures: Genomewide significant variants were used as instruments for standardized FT4 and thyrotropin levels within the reference range, standardized triiodothyronine (FT3):FT4 ratio, hypothyroidism, standardized thyroid peroxidase antibody levels, and hyperthyroidism. Mendelian randomization used genetic risk scores in study-level analysis or individual single-nucleotide polymorphisms in 2-sample MR for the summary-level data.

Main Outcomes and Measures: Prevalent and incident AF.

Results: The study-level analysis included 7679 individuals with AF and 49 233 referents (mean age [standard error], 62 [3] years; 15 859 men [29.7%]). In study-level random-effects meta-analysis, the pooled hazard ratio of FT4 levels (nanograms per deciliter) for incident AF was 1.55 (95% CI, 1.09-2.20; P = .02; I2 = 76%) and the pooled odds ratio (OR) for prevalent AF was 2.80 (95% CI, 1.41-5.54; P = .003; I2 = 64%) in multivariable-adjusted analyses. The FT4 genetic risk score was associated with an increase in FT4 by 0.082 SD (standard error, 0.007; P < .001) but not with incident AF (risk ratio, 0.84; 95% CI, 0.62-1.14; P = .27) or prevalent AF (OR, 1.32; 95% CI, 0.64-2.73; P = .46). Similarly, in summary-level inverse-variance weighted random-effects MR, gene-based FT4 within the reference range was not associated with AF (OR, 1.01; 95% CI, 0.89-1.14; P = .88). However, gene-based increased FT3:FT4 ratio, increased thyrotropin within the reference range, and hypothyroidism were associated with AF with inverse-variance weighted random-effects OR of 1.33 (95% CI, 1.08-1.63; P = .006), 0.88 (95% CI, 0.84-0.92; P < .001), and 0.94 (95% CI, 0.90-0.99; P = .009), respectively, and robust to tests of horizontal pleiotropy. However, the subset of hypothyroidism single-nucleotide polymorphisms involved in autoimmunity and thyroid peroxidase antibodies levels were not associated with AF. Gene-based hyperthyroidism was associated with AF with MR-Egger OR of 1.31 (95% CI, 1.05-1.63; P = .02) with evidence of horizontal pleiotropy (P = .045).

Conclusions and Relevance: Genetically increased FT3:FT4 ratio and hyperthyroidism, but not FT4 within the reference range, were associated with increased AF, and increased thyrotropin within the reference range and hypothyroidism were associated with decreased AF, supporting a pathway involving the pituitary-thyroid-cardiac axis.

%B JAMA Cardiol %8 2019 Jan 23 %G eng %R 10.1001/jamacardio.2018.4635 %0 Journal Article %J Calcif Tissue Int %D 2019 %T The Association of Aromatic Amino Acids with Incident Hip Fracture, aBMD, and Body Composition from the Cardiovascular Health Study. %A Le, Brian %A Bůzková, Petra %A Robbins, John A %A Fink, Howard A %A Raiford, Mattie %A Isales, Carlos M %A Shikany, James M %A Coughlin, Steven S %A Carbone, Laura D %X

In 5187 persons from the Cardiovascular Health Study, there was no significant association of dietary intakes of aromatic amino acids (AAA) with areal BMD of the hip or body composition. However, those who had the lowest dietary intakes of AAA were at increased risk for incident hip fractures. Prior studies of the association of protein intake with osteoporosis are conflicting and have not directly examined the relationship of aromatic amino acids (AAA) with fractures, areal bone mineral density (aBMD), and body composition. We sought to determine the relationship of dietary intakes of AAA with osteoporosis parameters in elderly men and women. 5187 men and women aged ≥ 65 years from the Cardiovascular Health Study (CHS) with dietary intakes of AAA (tryptophan, phenylalanine, tyrosine) estimated by food frequency questionnaire (FFQ) were included. We examined the relationship between a one-time estimate of daily dietary AAA intake with risk of incident hip fractures over a median of 13.2 years of fracture follow-up. A subset (n = 1336) who had dual energy X-ray absorptiometry (DXA) performed were included in a cross-sectional analysis of the association of dietary AAA intake with aBMD of the total hip and measurements of body composition. In multivariable models adjusted for demographic and clinical variables, medication use, and diet, higher dietary AAA intake was not significantly associated with incident hip fractures. All hazard ratios (HR) were less than one (tryptophan, HR 0.14, 95% CI 0.01 to 1.89; phenylalanine, HR 0.60, 95% CI 0.23 to 1.55; tyrosine, HR 0.59, 95% CI 0.27 to 1.32), but confidence intervals were wide and included no difference. However, in post hoc analyses, the lowest quartile of intake for each AAA was associated with an increased risk for hip fracture compared to higher quartiles (p ≤ 0.047 for all). Dietary AAA intakes were not significantly associated with total hip aBMD or any measurements of body composition. Overall, there was no significant association of dietary AAA intake with hip fractures, aBMD of the hip, or body composition. However, there may be a subset of elderly individuals with low dietary intakes of AAA who are at increased for hip fractures.

%B Calcif Tissue Int %V 105 %P 161-172 %8 2019 Aug %G eng %N 2 %R 10.1007/s00223-019-00562-9 %0 Journal Article %J Bone %D 2019 %T {Association of bone mineral density with hemoglobin and change in hemoglobin among older men and women: The Cardiovascular Health Study %A Valderr?bano, R. J. %A Buzkova, P. %A Chang, P. Y. %A Zakai, N. A. %A Fink, H. A. %A Robbins, J. A. %A Lee, J. S. %A Wu, J. Y. %X Osteoblasts and their precursors support hematopoiesis in the bone marrow. We hypothesized that declines in Hgb levels are associated with bone mineral density (BMD).\ The Cardiovascular Health Study is a prospective longitudinal study that enrolled 5888 community-dwelling adults aged >65 years and measured hemoglobin twice, in 1989-90 and 1992-93, as well as BMD by dual-energy X-ray absorptiometry (DXA) in 1994-95. In a subset of 1513 men and women with a Hgb in 1992-93 and BMD, we used linear regression to estimate associations of Hgb (per standard deviation (SD)) with total hip (TH), lumbar spine (LS) and total body (TB) BMD, and used Poisson regression to estimate associations of anemia (in 1992-93; Hgb <13 g/dL in men; <12 g/dL in women) with "low BMD" defined as T-score less than -1 at the TH. In 1277 participants with Hgb measured on average 2.9 years apart and BMD, we used linear regression to estimate the associations of annualized change in Hgb with TH, LS and TB BMD. All models included age, sex, study-site, race, smoking, alcohol use, weight, height, steroid use, physical activity score, self-reported health, previous cardiovascular disease and prior anti-fracture medication use.\ No significant association was observed between Hgb, measured a mean 2.2 years prior to BMD, and BMD at the TH and LS in men (TH beta = -0.60 [x 10-2 g/cm2per 1.1 g/dL Hgb], 95% CI: -1.88 to 0.68; LS beta = -1.69, 95% CI: -3.83 to 0.45) or women (TH beta = -0.49 [x 10-2 g/cm2per 1.3 g/dL Hgb], 95% CI: -1.57 to 0.59; LS beta = -0.40, 95% CI: -2.57 to 1.76). Anemia was not observed to be significantly associated with low BMD in men (RR = 0.99, 95% CI: 0.72-1.40) nor women (RR = 0.98, 95% CI: 0.82-1.17). The mean change in Hgb was a loss of 0.06 g/dL/year (SD = 0.32). Change in Hgb was not observed to be significantly associated with BMD in men (TH beta = -0.55[x 10-2 g/cm2per 1 g/dL annualized Hgb change], 95% CI: -4.28 to 3.19; LS beta = 0.63, 95% CI: -5.38 to 6.65) or women (TH beta = 0.92, 95% CI: -1.96 to 3.79; LS beta = -1.77, 95% CI: -7.52 to 3.98). No significant association was observed between anemia and low bone density by T-score in men and women.\ These findings support neither the hypothesis that low Hgb prior to bone density or decreases in Hgb are associated with bone density in older community-dwelling adults nor the use of Hgb level as a case-finding tool to prompt BMD measurement. %B Bone %V 120 %P 321–326 %8 03 %G eng %0 Journal Article %J Am J Clin Nutr %D 2019 %T {Association of dietary folate and vitamin B-12 intake with genome-wide DNA methylation in blood: a large-scale epigenome-wide association analysis in 5841 individuals %A Mandaviya, P. R. %A Joehanes, R. %A Brody, J. %A Castillo-Fernandez, J. E. %A Dekkers, K. F. %A Do, A. N. %A Graff, M. %A H?nninen, I. K. %A Tanaka, T. %A de Jonge, E. A. L. %A Kiefte-de Jong, J. C. %A Absher, D. M. %A Aslibekyan, S. %A de Rijke, Y. B. %A Fornage, M. %A Hernandez, D. G. %A Hurme, M. A. %A Ikram, M. A. %A Jacques, P. F. %A Justice, A. E. %A Kiel, D. P. %A Lemaitre, R. N. %A Mendelson, M. M. %A Mikkil?, V. %A Moore, A. Z. %A Pallister, T. %A Raitakari, O. T. %A Schalkwijk, C. G. %A Sha, J. %A Slagboom, E. P. E. %A Smith, C. E. %A Stehouwer, C. D. A. %A Tsai, P. C. %A Uitterlinden, A. G. %A van der Kallen, C. J. H. %A van Heemst, D. %A Arnett, D. K. %A Bandinelli, S. %A Bell, J. T. %A Heijmans, B. T. %A Lehtim?ki, T. %A Levy, D. %A North, K. E. %A Sotoodehnia, N. %A van Greevenbroek, M. M. J. %A van Meurs, J. B. J. %A Heil, S. G. %X Folate and vitamin B-12 are essential micronutrients involved in the donation of methyl groups in cellular metabolism. However, associations between intake of these nutrients and genome-wide DNA methylation levels have not been studied comprehensively in humans.\ The aim of this study was to assess whether folate and/or vitamin B-12 intake are asssociated with genome-wide changes in DNA methylation in leukocytes.\ A large-scale epigenome-wide association study of folate and vitamin B-12 intake was performed on DNA from 5841 participants from 10 cohorts using Illumina 450k arrays. Folate and vitamin B-12 intakes were calculated from food-frequency questionnaires (FFQs). Continuous and categorical (low compared with high intake) linear regression mixed models were applied per cohort, controlling for confounders. A meta-analysis was performed to identify significant differentially methylated positions (DMPs) and regions (DMRs), and a pathway analysis was performed on the DMR annotated genes.\ The categorical model resulted in 6 DMPs, which are all negatively associated with folate intake, annotated to FAM64A, WRAP73, FRMD8, CUX1, and LCN8 genes, which have a role in cellular processes including centrosome localization, cell proliferation, and tumorigenesis. Regional analysis showed 74 folate-associated DMRs, of which 73 were negatively associated with folate intake. The most significant folate-associated DMR was a 400-base pair (bp) spanning region annotated to the LGALS3BP gene. In the categorical model, vitamin B-12 intake was associated with 29 DMRs annotated to 48 genes, of which the most significant was a 1100-bp spanning region annotated to the calcium-binding tyrosine phosphorylation-regulated gene (CABYR). Vitamin B-12 intake was not associated with DMPs.\ We identified novel epigenetic loci that are associated with folate and vitamin B-12 intake. Interestingly, we found a negative association between folate and DNA methylation. Replication of these methylation loci is necessary in future studies. %B Am J Clin Nutr %V 110 %P 437–450 %8 08 %G eng %0 Journal Article %J J Bone Miner Res %D 2019 %T Association of Dietary Niacin Intake With Incident Hip Fracture, BMD, and Body Composition: The Cardiovascular Health Study. %A Carbone, Laura D %A Bůzková, Petra %A Fink, Howard A %A Raiford, Mattie %A Le, Brian %A Isales, Carlos M %A Shikany, James M %A Coughlin, Steven S %A Robbins, John A %X

Interest in niacin has increased in the setting of reports suggesting that niacin plays a role in diseases of aging. No study to date has examined the association of dietary niacin intake with multiple skeletal health parameters including bone mineral density (BMD), hip fractures, and body composition, and none have included both African American and white men and women. Participants included 5187 men and women ≥65 years from the Cardiovascular Health Study (CHS). Mean daily dietary niacin intake was 32.6 mg, with quartiles 1 through 4 defined as 3.6 to 21.8 mg/day, 21.9 to 30.2 mg/day, 30.3 to 40.9 mg/day, and 41.0 to 102.4 mg/day, respectively. Risk of incident hip fracture per 10 mg increment of daily dietary niacin intake was estimated using proportional hazards models. During a median follow-up of 13 years, 725 participants had an incident hip fracture. In models adjusted for demographic and clinical characteristics and diet, dietary niacin intake was significantly associated with an increased risk of hip fractures (hazard ratio [HR] 1.12; 95% CI, 1.01 to 1.24) with spline models suggesting a U-shaped association. In post hoc analyses, both the lowest (HR 1.31; 95% CI, 1.04 to 1.66) and highest (HR 1.53; 95% CI, 1.20 to 1.95) quartiles of niacin intake were associated with an increased risk of incident hip fracture versus quartiles 2 and 3. There was a trend for a significant inverse association of dietary niacin intake with hip BMD (p = 0.06), but no significant association with total body BMD or any body composition measures. In this cohort of elderly, community-dwelling African American and white men and women, both high and low dietary niacin intakes were associated with a significantly increased risk of subsequent hip fracture, suggesting a possible U-shaped association. By comparison, dietary niacin may have an inverse linear association with hip BMD. © 2018 American Society for Bone and Mineral Research.

%B J Bone Miner Res %8 2019 Jan 19 %G eng %R 10.1002/jbmr.3639 %0 Journal Article %J Brain %D 2019 %T Association of variants in HTRA1 and NOTCH3 with MRI-defined extremes of cerebral small vessel disease in older subjects. %A Mishra, Aniket %A Chauhan, Ganesh %A Violleau, Marie-Helene %A Vojinovic, Dina %A Jian, Xueqiu %A Bis, Joshua C %A Li, Shuo %A Saba, Yasaman %A Grenier-Boley, Benjamin %A Yang, Qiong %A Bartz, Traci M %A Hofer, Edith %A Soumaré, Aïcha %A Peng, Fen %A Duperron, Marie-Gabrielle %A Foglio, Mario %A Mosley, Thomas H %A Schmidt, Reinhold %A Psaty, Bruce M %A Launer, Lenore J %A Boerwinkle, Eric %A Zhu, Yicheng %A Mazoyer, Bernard %A Lathrop, Mark %A Bellenguez, Céline %A van Duijn, Cornelia M %A Ikram, M Arfan %A Schmidt, Helena %A Longstreth, W T %A Fornage, Myriam %A Seshadri, Sudha %A Joutel, Anne %A Tzourio, Christophe %A Debette, Stephanie %X

We report a composite extreme phenotype design using distribution of white matter hyperintensities and brain infarcts in a population-based cohort of older persons for gene-mapping of cerebral small vessel disease. We demonstrate its application in the 3C-Dijon whole exome sequencing (WES) study (n = 1924, nWESextremes = 512), with both single variant and gene-based association tests. We used other population-based cohort studies participating in the CHARGE consortium for replication, using whole exome sequencing (nWES = 2,868, nWESextremes = 956) and genome-wide genotypes (nGW = 9924, nGWextremes = 3308). We restricted our study to candidate genes known to harbour mutations for Mendelian small vessel disease: NOTCH3, HTRA1, COL4A1, COL4A2 and TREX1. We identified significant associations of a common intronic variant in HTRA1, rs2293871 using single variant association testing (Pdiscovery = 8.21 × 10-5, Preplication = 5.25 × 10-3, Pcombined = 4.72 × 10-5) and of NOTCH3 using gene-based tests (Pdiscovery = 1.61 × 10-2, Preplication = 3.99 × 10-2, Pcombined = 5.31 × 10-3). Follow-up analysis identified significant association of rs2293871 with small vessel ischaemic stroke, and two blood expression quantitative trait loci of HTRA1 in linkage disequilibrium. Additionally, we identified two participants in the 3C-Dijon cohort (0.4%) carrying heterozygote genotypes at known pathogenic variants for familial small vessel disease within NOTCH3 and HTRA1. In conclusion, our proof-of-concept study provides strong evidence that using a novel composite MRI-derived phenotype for extremes of small vessel disease can facilitate the identification of genetic variants underlying small vessel disease, both common variants and those with rare and low frequency. The findings demonstrate shared mechanisms and a continuum between genes underlying Mendelian small vessel disease and those contributing to the common, multifactorial form of the disease.

%B Brain %8 2019 Mar 11 %G eng %R 10.1093/brain/awz024 %0 Journal Article %J Nat Commun %D 2019 %T Associations of autozygosity with a broad range of human phenotypes. %A Clark, David W %A Okada, Yukinori %A Moore, Kristjan H S %A Mason, Dan %A Pirastu, Nicola %A Gandin, Ilaria %A Mattsson, Hannele %A Barnes, Catriona L K %A Lin, Kuang %A Zhao, Jing Hua %A Deelen, Patrick %A Rohde, Rebecca %A Schurmann, Claudia %A Guo, Xiuqing %A Giulianini, Franco %A Zhang, Weihua %A Medina-Gómez, Carolina %A Karlsson, Robert %A Bao, Yanchun %A Bartz, Traci M %A Baumbach, Clemens %A Biino, Ginevra %A Bixley, Matthew J %A Brumat, Marco %A Chai, Jin-Fang %A Corre, Tanguy %A Cousminer, Diana L %A Dekker, Annelot M %A Eccles, David A %A van Eijk, Kristel R %A Fuchsberger, Christian %A Gao, He %A Germain, Marine %A Gordon, Scott D %A de Haan, Hugoline G %A Harris, Sarah E %A Hofer, Edith %A Huerta-Chagoya, Alicia %A Igartua, Catherine %A Jansen, Iris E %A Jia, Yucheng %A Kacprowski, Tim %A Karlsson, Torgny %A Kleber, Marcus E %A Li, Shengchao Alfred %A Li-Gao, Ruifang %A Mahajan, Anubha %A Matsuda, Koichi %A Meidtner, Karina %A Meng, Weihua %A Montasser, May E %A van der Most, Peter J %A Munz, Matthias %A Nutile, Teresa %A Palviainen, Teemu %A Prasad, Gauri %A Prasad, Rashmi B %A Priyanka, Tallapragada Divya Sri %A Rizzi, Federica %A Salvi, Erika %A Sapkota, Bishwa R %A Shriner, Daniel %A Skotte, Line %A Smart, Melissa C %A Smith, Albert Vernon %A van der Spek, Ashley %A Spracklen, Cassandra N %A Strawbridge, Rona J %A Tajuddin, Salman M %A Trompet, Stella %A Turman, Constance %A Verweij, Niek %A Viberti, Clara %A Wang, Lihua %A Warren, Helen R %A Wootton, Robyn E %A Yanek, Lisa R %A Yao, Jie %A Yousri, Noha A %A Zhao, Wei %A Adeyemo, Adebowale A %A Afaq, Saima %A Aguilar-Salinas, Carlos Alberto %A Akiyama, Masato %A Albert, Matthew L %A Allison, Matthew A %A Alver, Maris %A Aung, Tin %A Azizi, Fereidoun %A Bentley, Amy R %A Boeing, Heiner %A Boerwinkle, Eric %A Borja, Judith B %A de Borst, Gert J %A Bottinger, Erwin P %A Broer, Linda %A Campbell, Harry %A Chanock, Stephen %A Chee, Miao-Li %A Chen, Guanjie %A Chen, Yii-der I %A Chen, Zhengming %A Chiu, Yen-Feng %A Cocca, Massimiliano %A Collins, Francis S %A Concas, Maria Pina %A Corley, Janie %A Cugliari, Giovanni %A van Dam, Rob M %A Damulina, Anna %A Daneshpour, Maryam S %A Day, Felix R %A Delgado, Graciela E %A Dhana, Klodian %A Doney, Alexander S F %A Dörr, Marcus %A Doumatey, Ayo P %A Dzimiri, Nduna %A Ebenesersdóttir, S Sunna %A Elliott, Joshua %A Elliott, Paul %A Ewert, Ralf %A Felix, Janine F %A Fischer, Krista %A Freedman, Barry I %A Girotto, Giorgia %A Goel, Anuj %A Gögele, Martin %A Goodarzi, Mark O %A Graff, Mariaelisa %A Granot-Hershkovitz, Einat %A Grodstein, Francine %A Guarrera, Simonetta %A Gudbjartsson, Daniel F %A Guity, Kamran %A Gunnarsson, Bjarni %A Guo, Yu %A Hagenaars, Saskia P %A Haiman, Christopher A %A Halevy, Avner %A Harris, Tamara B %A Hedayati, Mehdi %A van Heel, David A %A Hirata, Makoto %A Höfer, Imo %A Hsiung, Chao Agnes %A Huang, Jinyan %A Hung, Yi-Jen %A Ikram, M Arfan %A Jagadeesan, Anuradha %A Jousilahti, Pekka %A Kamatani, Yoichiro %A Kanai, Masahiro %A Kerrison, Nicola D %A Kessler, Thorsten %A Khaw, Kay-Tee %A Khor, Chiea Chuen %A de Kleijn, Dominique P V %A Koh, Woon-Puay %A Kolcic, Ivana %A Kraft, Peter %A Krämer, Bernhard K %A Kutalik, Zoltán %A Kuusisto, Johanna %A Langenberg, Claudia %A Launer, Lenore J %A Lawlor, Deborah A %A Lee, I-Te %A Lee, Wen-Jane %A Lerch, Markus M %A Li, Liming %A Liu, Jianjun %A Loh, Marie %A London, Stephanie J %A Loomis, Stephanie %A Lu, Yingchang %A Luan, Jian'an %A Mägi, Reedik %A Manichaikul, Ani W %A Manunta, Paolo %A Másson, Gísli %A Matoba, Nana %A Mei, Xue W %A Meisinger, Christa %A Meitinger, Thomas %A Mezzavilla, Massimo %A Milani, Lili %A Millwood, Iona Y %A Momozawa, Yukihide %A Moore, Amy %A Morange, Pierre-Emmanuel %A Moreno-Macias, Hortensia %A Mori, Trevor A %A Morrison, Alanna C %A Muka, Taulant %A Murakami, Yoshinori %A Murray, Alison D %A de Mutsert, Renée %A Mychaleckyj, Josyf C %A Nalls, Mike A %A Nauck, Matthias %A Neville, Matt J %A Nolte, Ilja M %A Ong, Ken K %A Orozco, Lorena %A Padmanabhan, Sandosh %A Pálsson, Gunnar %A Pankow, James S %A Pattaro, Cristian %A Pattie, Alison %A Polasek, Ozren %A Poulter, Neil %A Pramstaller, Peter P %A Quintana-Murci, Lluis %A Räikkönen, Katri %A Ralhan, Sarju %A Rao, Dabeeru C %A van Rheenen, Wouter %A Rich, Stephen S %A Ridker, Paul M %A Rietveld, Cornelius A %A Robino, Antonietta %A van Rooij, Frank J A %A Ruggiero, Daniela %A Saba, Yasaman %A Sabanayagam, Charumathi %A Sabater-Lleal, Maria %A Sala, Cinzia Felicita %A Salomaa, Veikko %A Sandow, Kevin %A Schmidt, Helena %A Scott, Laura J %A Scott, William R %A Sedaghati-Khayat, Bahareh %A Sennblad, Bengt %A van Setten, Jessica %A Sever, Peter J %A Sheu, Wayne H-H %A Shi, Yuan %A Shrestha, Smeeta %A Shukla, Sharvari Rahul %A Sigurdsson, Jon K %A Sikka, Timo Tonis %A Singh, Jai Rup %A Smith, Blair H %A Stančáková, Alena %A Stanton, Alice %A Starr, John M %A Stefansdottir, Lilja %A Straker, Leon %A Sulem, Patrick %A Sveinbjornsson, Gardar %A Swertz, Morris A %A Taylor, Adele M %A Taylor, Kent D %A Terzikhan, Natalie %A Tham, Yih-Chung %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tillander, Annika %A Tracy, Russell P %A Tusié-Luna, Teresa %A Tzoulaki, Ioanna %A Vaccargiu, Simona %A Vangipurapu, Jagadish %A Veldink, Jan H %A Vitart, Veronique %A Völker, Uwe %A Vuoksimaa, Eero %A Wakil, Salma M %A Waldenberger, Melanie %A Wander, Gurpreet S %A Wang, Ya Xing %A Wareham, Nicholas J %A Wild, Sarah %A Yajnik, Chittaranjan S %A Yuan, Jian-Min %A Zeng, Lingyao %A Zhang, Liang %A Zhou, Jie %A Amin, Najaf %A Asselbergs, Folkert W %A Bakker, Stephan J L %A Becker, Diane M %A Lehne, Benjamin %A Bennett, David A %A van den Berg, Leonard H %A Berndt, Sonja I %A Bharadwaj, Dwaipayan %A Bielak, Lawrence F %A Bochud, Murielle %A Boehnke, Mike %A Bouchard, Claude %A Bradfield, Jonathan P %A Brody, Jennifer A %A Campbell, Archie %A Carmi, Shai %A Caulfield, Mark J %A Cesarini, David %A Chambers, John C %A Chandak, Giriraj Ratan %A Cheng, Ching-Yu %A Ciullo, Marina %A Cornelis, Marilyn %A Cusi, Daniele %A Smith, George Davey %A Deary, Ian J %A Dorajoo, Rajkumar %A van Duijn, Cornelia M %A Ellinghaus, David %A Erdmann, Jeanette %A Eriksson, Johan G %A Evangelou, Evangelos %A Evans, Michele K %A Faul, Jessica D %A Feenstra, Bjarke %A Feitosa, Mary %A Foisy, Sylvain %A Franke, Andre %A Friedlander, Yechiel %A Gasparini, Paolo %A Gieger, Christian %A Gonzalez, Clicerio %A Goyette, Philippe %A Grant, Struan F A %A Griffiths, Lyn R %A Groop, Leif %A Gudnason, Vilmundur %A Gyllensten, Ulf %A Hakonarson, Hakon %A Hamsten, Anders %A van der Harst, Pim %A Heng, Chew-Kiat %A Hicks, Andrew A %A Hochner, Hagit %A Huikuri, Heikki %A Hunt, Steven C %A Jaddoe, Vincent W V %A De Jager, Philip L %A Johannesson, Magnus %A Johansson, Asa %A Jonas, Jost B %A Jukema, J Wouter %A Junttila, Juhani %A Kaprio, Jaakko %A Kardia, Sharon L R %A Karpe, Fredrik %A Kumari, Meena %A Laakso, Markku %A van der Laan, Sander W %A Lahti, Jari %A Laudes, Matthias %A Lea, Rodney A %A Lieb, Wolfgang %A Lumley, Thomas %A Martin, Nicholas G %A März, Winfried %A Matullo, Giuseppe %A McCarthy, Mark I %A Medland, Sarah E %A Merriman, Tony R %A Metspalu, Andres %A Meyer, Brian F %A Mohlke, Karen L %A Montgomery, Grant W %A Mook-Kanamori, Dennis %A Munroe, Patricia B %A North, Kari E %A Nyholt, Dale R %A O'Connell, Jeffery R %A Ober, Carole %A Oldehinkel, Albertine J %A Palmas, Walter %A Palmer, Colin %A Pasterkamp, Gerard G %A Patin, Etienne %A Pennell, Craig E %A Perusse, Louis %A Peyser, Patricia A %A Pirastu, Mario %A Polderman, Tinca J C %A Porteous, David J %A Posthuma, Danielle %A Psaty, Bruce M %A Rioux, John D %A Rivadeneira, Fernando %A Rotimi, Charles %A Rotter, Jerome I %A Rudan, Igor %A den Ruijter, Hester M %A Sanghera, Dharambir K %A Sattar, Naveed %A Schmidt, Reinhold %A Schulze, Matthias B %A Schunkert, Heribert %A Scott, Robert A %A Shuldiner, Alan R %A Sim, Xueling %A Small, Neil %A Smith, Jennifer A %A Sotoodehnia, Nona %A Tai, E-Shyong %A Teumer, Alexander %A Timpson, Nicholas J %A Toniolo, Daniela %A Trégouët, David-Alexandre %A Tuomi, Tiinamaija %A Vollenweider, Peter %A Wang, Carol A %A Weir, David R %A Whitfield, John B %A Wijmenga, Cisca %A Wong, Tien-Yin %A Wright, John %A Yang, Jingyun %A Yu, Lei %A Zemel, Babette S %A Zonderman, Alan B %A Perola, Markus %A Magnusson, Patrik K E %A Uitterlinden, André G %A Kooner, Jaspal S %A Chasman, Daniel I %A Loos, Ruth J F %A Franceschini, Nora %A Franke, Lude %A Haley, Chris S %A Hayward, Caroline %A Walters, Robin G %A Perry, John R B %A Esko, Tõnu %A Helgason, Agnar %A Stefansson, Kari %A Joshi, Peter K %A Kubo, Michiaki %A Wilson, James F %X

In many species, the offspring of related parents suffer reduced reproductive success, a phenomenon known as inbreeding depression. In humans, the importance of this effect has remained unclear, partly because reproduction between close relatives is both rare and frequently associated with confounding social factors. Here, using genomic inbreeding coefficients (F) for >1.4 million individuals, we show that F is significantly associated (p < 0.0005) with apparently deleterious changes in 32 out of 100 traits analysed. These changes are associated with runs of homozygosity (ROH), but not with common variant homozygosity, suggesting that genetic variants associated with inbreeding depression are predominantly rare. The effect on fertility is striking: F equivalent to the offspring of first cousins is associated with a 55% decrease [95% CI 44-66%] in the odds of having children. Finally, the effects of F are confirmed within full-sibling pairs, where the variation in F is independent of all environmental confounding.

%B Nat Commun %V 10 %P 4957 %8 2019 Oct 31 %G eng %N 1 %R 10.1038/s41467-019-12283-6 %0 Journal Article %J Am. J. Clin. Nutr. %D 2019 %T {Associations of circulating very-long-chain saturated fatty acids and incident type 2 diabetes: a pooled analysis of prospective cohort studies %A Fretts, A. M. %A Imamura, F. %A Marklund, M. %A Micha, R. %A Wu, J. H. Y. %A Murphy, R. A. %A Chien, K. L. %A McKnight, B. %A Tintle, N. %A Forouhi, N. G. %A Qureshi, W. T. %A Virtanen, J. K. %A Wong, K. %A Wood, A. C. %A Lankinen, M. %A Rajaobelina, K. %A Harris, T. B. %A Djouss?, L. %A Harris, B. %A Wareham, N. J. %A Steffen, L. M. %A Laakso, M. %A Veenstra, J. %A Samieri, C. %A Brouwer, I. A. %A Yu, C. I. %A Koulman, A. %A Steffen, B. T. %A Helmer, C. %A Sotoodehnia, N. %A Siscovick, D. %A Gudnason, V. %A Wagenknecht, L. %A Voutilainen, S. %A Tsai, M. Y. %A Uusitupa, M. %A Kalsbeek, A. %A Berr, C. %A Mozaffarian, D. %A Lemaitre, R. N. %X Saturated fatty acids (SFAs) of different chain lengths have unique metabolic and biological effects, and a small number of recent studies suggest that higher circulating concentrations of the very-long-chain SFAs (VLSFAs) arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) are associated with a lower risk of diabetes. Confirmation of these findings in a large and diverse population is needed.\ We investigated the associations of circulating VLSFAs 20:0, 22:0, and 24:0 with incident type 2 diabetes in prospective studies.\ Twelve studies that are part of the Fatty Acids and Outcomes Research Consortium participated in the analysis. Using Cox or logistic regression within studies and an inverse-variance-weighted meta-analysis across studies, we examined the associations of VLSFAs 20:0, 22:0, and 24:0 with incident diabetes among 51,431 participants.\ There were 14,276 cases of incident diabetes across participating studies. Higher circulating concentrations of 20:0, 22:0, and 24:0 were each associated with a lower risk of incident diabetes. Pooling across cohorts, the RR (95% CI) for incident diabetes comparing the 90th percentile to the 10th percentile was 0.78 (0.70, 0.87) for 20:0, 0.84 (0.77, 0.91) for 22:0, and 0.75 (0.69, 0.83) for 24:0 after adjustment for demographic, lifestyle, adiposity, and other health factors. Results were fully attenuated in exploratory models that adjusted for circulating 16:0 and triglycerides.\ Results from this pooled analysis indicate that higher concentrations of circulating VLSFAs 20:0, 22:0, and 24:0 are each associated with a lower risk of diabetes. %B Am. J. Clin. Nutr. %V 109 %P 1216–1223 %8 04 %G eng %0 Journal Article %J PLoS Genet %D 2019 %T Associations of variants In the hexokinase 1 and interleukin 18 receptor regions with oxyhemoglobin saturation during sleep. %A Cade, Brian E %A Chen, Han %A Stilp, Adrienne M %A Louie, Tin %A Ancoli-Israel, Sonia %A Arens, Raanan %A Barfield, Richard %A Below, Jennifer E %A Cai, Jianwen %A Conomos, Matthew P %A Evans, Daniel S %A Frazier-Wood, Alexis C %A Gharib, Sina A %A Gleason, Kevin J %A Gottlieb, Daniel J %A Hillman, David R %A Johnson, W Craig %A Lederer, David J %A Lee, Jiwon %A Loredo, Jose S %A Mei, Hao %A Mukherjee, Sutapa %A Patel, Sanjay R %A Post, Wendy S %A Purcell, Shaun M %A Ramos, Alberto R %A Reid, Kathryn J %A Rice, Ken %A Shah, Neomi A %A Sofer, Tamar %A Taylor, Kent D %A Thornton, Timothy A %A Wang, Heming %A Yaffe, Kristine %A Zee, Phyllis C %A Hanis, Craig L %A Palmer, Lyle J %A Rotter, Jerome I %A Stone, Katie L %A Tranah, Gregory J %A Wilson, James G %A Sunyaev, Shamil R %A Laurie, Cathy C %A Zhu, Xiaofeng %A Saxena, Richa %A Lin, Xihong %A Redline, Susan %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Cell Adhesion Molecules, Neuronal %K Computational Biology %K Extracellular Matrix Proteins %K Female %K Gene Regulatory Networks %K Genetic Variation %K Genome-Wide Association Study %K Hexokinase %K Humans %K Hypoxia %K Interleukin-18 Receptor alpha Subunit %K Male %K Middle Aged %K Nerve Tissue Proteins %K NLR Family, Pyrin Domain-Containing 3 Protein %K Oxygen %K Oxyhemoglobins %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Serine Endopeptidases %K Sleep %K Sleep Apnea Syndromes %K Young Adult %X

Sleep disordered breathing (SDB)-related overnight hypoxemia is associated with cardiometabolic disease and other comorbidities. Understanding the genetic bases for variations in nocturnal hypoxemia may help understand mechanisms influencing oxygenation and SDB-related mortality. We conducted genome-wide association tests across 10 cohorts and 4 populations to identify genetic variants associated with three correlated measures of overnight oxyhemoglobin saturation: average and minimum oxyhemoglobin saturation during sleep and the percent of sleep with oxyhemoglobin saturation under 90%. The discovery sample consisted of 8,326 individuals. Variants with p < 1 × 10(-6) were analyzed in a replication group of 14,410 individuals. We identified 3 significantly associated regions, including 2 regions in multi-ethnic analyses (2q12, 10q22). SNPs in the 2q12 region associated with minimum SpO2 (rs78136548 p = 2.70 × 10(-10)). SNPs at 10q22 were associated with all three traits including average SpO2 (rs72805692 p = 4.58 × 10(-8)). SNPs in both regions were associated in over 20,000 individuals and are supported by prior associations or functional evidence. Four additional significant regions were detected in secondary sex-stratified and combined discovery and replication analyses, including a region overlapping Reelin, a known marker of respiratory complex neurons.These are the first genome-wide significant findings reported for oxyhemoglobin saturation during sleep, a phenotype of high clinical interest. Our replicated associations with HK1 and IL18R1 suggest that variants in inflammatory pathways, such as the biologically-plausible NLRP3 inflammasome, may contribute to nocturnal hypoxemia.

%B PLoS Genet %V 15 %P e1007739 %8 2019 04 %G eng %N 4 %R 10.1371/journal.pgen.1007739 %0 Journal Article %J Circulation %D 2019 %T Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality. %A Marklund, Matti %A Wu, Jason H Y %A Imamura, Fumiaki %A Del Gobbo, Liana C %A Fretts, Amanda %A de Goede, Janette %A Shi, Peilin %A Tintle, Nathan %A Wennberg, Maria %A Aslibekyan, Stella %A Chen, Tzu-An %A de Oliveira Otto, Marcia C %A Hirakawa, Yoichiro %A Eriksen, Helle Højmark %A Kröger, Janine %A Laguzzi, Federica %A Lankinen, Maria %A Murphy, Rachel A %A Prem, Kiesha %A Samieri, Cecilia %A Virtanen, Jyrki %A Wood, Alexis C %A Wong, Kerry %A Yang, Wei-Sin %A Zhou, Xia %A Baylin, Ana %A Boer, Jolanda M A %A Brouwer, Ingeborg A %A Campos, Hannia %A Chaves, Paulo H M %A Chien, Kuo-Liong %A de Faire, Ulf %A Djoussé, Luc %A Eiriksdottir, Gudny %A El-Abbadi, Naglaa %A Forouhi, Nita G %A Michael Gaziano, J %A Geleijnse, Johanna M %A Gigante, Bruna %A Giles, Graham %A Guallar, Eliseo %A Gudnason, Vilmundur %A Harris, Tamara %A Harris, William S %A Helmer, Catherine %A Hellenius, Mai-Lis %A Hodge, Allison %A Hu, Frank B %A Jacques, Paul F %A Jansson, Jan-Håkan %A Kalsbeek, Anya %A Khaw, Kay-Tee %A Koh, Woon-Puay %A Laakso, Markku %A Leander, Karin %A Lin, Hung-Ju %A Lind, Lars %A Luben, Robert %A Luo, Juhua %A McKnight, Barbara %A Mursu, Jaakko %A Ninomiya, Toshiharu %A Overvad, Kim %A Psaty, Bruce M %A Rimm, Eric %A Schulze, Matthias B %A Siscovick, David %A Skjelbo Nielsen, Michael %A Smith, Albert V %A Steffen, Brian T %A Steffen, Lyn %A Sun, Qi %A Sundström, Johan %A Tsai, Michael Y %A Tunstall-Pedoe, Hugh %A Uusitupa, Matti I J %A van Dam, Rob M %A Veenstra, Jenna %A Monique Verschuren, W M %A Wareham, Nick %A Willett, Walter %A Woodward, Mark %A Yuan, Jian-Min %A Micha, Renata %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %A Riserus, Ulf %X

BACKGROUND: Global dietary recommendations for and cardiovascular effects of linoleic acid, the major dietary omega-6 fatty acid, and its major metabolite, arachidonic acid, remain controversial. To address this uncertainty and inform international recommendations, we evaluated how in vivo circulating and tissue levels of linoleic acid (LA) and arachidonic acid (AA) relate to incident cardiovascular disease (CVD) across multiple international studies.

METHODS: We performed harmonized, de novo, individual-level analyses in a global consortium of 30 prospective observational studies from 13 countries. Multivariable-adjusted associations of circulating and adipose tissue LA and AA biomarkers with incident total CVD and subtypes (coronary heart disease, ischemic stroke, cardiovascular mortality) were investigated according to a prespecified analytic plan. Levels of LA and AA, measured as the percentage of total fatty acids, were evaluated linearly according to their interquintile range (ie, the range between the midpoint of the first and fifth quintiles), and categorically by quintiles. Study-specific results were pooled using inverse-variance-weighted meta-analysis. Heterogeneity was explored by age, sex, race, diabetes mellitus, statin use, aspirin use, omega-3 levels, and fatty acid desaturase 1 genotype (when available).

RESULTS: In 30 prospective studies with medians of follow-up ranging 2.5 to 31.9 years, 15 198 incident cardiovascular events occurred among 68 659 participants. Higher levels of LA were significantly associated with lower risks of total CVD, cardiovascular mortality, and ischemic stroke, with hazard ratios per interquintile range of 0.93 (95% CI, 0.88-0.99), 0.78 (0.70-0.85), and 0.88 (0.79-0.98), respectively, and nonsignificantly with lower coronary heart disease risk (0.94; 0.88-1.00). Relationships were similar for LA evaluated across quintiles. AA levels were not associated with higher risk of cardiovascular outcomes; in a comparison of extreme quintiles, higher levels were associated with lower risk of total CVD (0.92; 0.86-0.99). No consistent heterogeneity by population subgroups was identified in the observed relationships.

CONCLUSIONS: In pooled global analyses, higher in vivo circulating and tissue levels of LA and possibly AA were associated with lower risk of major cardiovascular events. These results support a favorable role for LA in CVD prevention.

%B Circulation %V 139 %P 2422-2436 %8 2019 May 21 %G eng %N 21 %R 10.1161/CIRCULATIONAHA.118.038908 %0 Journal Article %J Circulation %D 2019 %T Blood Leukocyte DNA Methylation Predicts Risk of Future Myocardial Infarction and Coronary Heart Disease. %A Agha, Golareh %A Mendelson, Michael M %A Ward-Caviness, Cavin K %A Joehanes, Roby %A Huan, Tianxiao %A Gondalia, Rahul %A Salfati, Elias %A Brody, Jennifer A %A Fiorito, Giovanni %A Bressler, Jan %A Chen, Brian H %A Ligthart, Symen %A Guarrera, Simonetta %A Colicino, Elena %A Just, Allan C %A Wahl, Simone %A Gieger, Christian %A Vandiver, Amy R %A Tanaka, Toshiko %A Hernandez, Dena G %A Pilling, Luke C %A Singleton, Andrew B %A Sacerdote, Carlotta %A Krogh, Vittorio %A Panico, Salvatore %A Tumino, Rosario %A Li, Yun %A Zhang, Guosheng %A Stewart, James D %A Floyd, James S %A Wiggins, Kerri L %A Rotter, Jerome I %A Multhaup, Michael %A Bakulski, Kelly %A Horvath, Steven %A Tsao, Philip S %A Absher, Devin M %A Vokonas, Pantel %A Hirschhorn, Joel %A Fallin, M Daniele %A Liu, Chunyu %A Bandinelli, Stefania %A Boerwinkle, Eric %A Dehghan, Abbas %A Schwartz, Joel D %A Psaty, Bruce M %A Feinberg, Andrew P %A Hou, Lifang %A Ferrucci, Luigi %A Sotoodehnia, Nona %A Matullo, Giuseppe %A Peters, Annette %A Fornage, Myriam %A Assimes, Themistocles L %A Whitsel, Eric A %A Levy, Daniel %A Baccarelli, Andrea A %K Adult %K Aged %K Cohort Studies %K Coronary Disease %K CpG Islands %K DNA Methylation %K Europe %K Female %K Genome-Wide Association Study %K Humans %K Incidence %K Leukocytes %K Male %K Middle Aged %K Myocardial Infarction %K Population Groups %K Prognosis %K Prospective Studies %K Risk %K United States %X

BACKGROUND: DNA methylation is implicated in coronary heart disease (CHD), but current evidence is based on small, cross-sectional studies. We examined blood DNA methylation in relation to incident CHD across multiple prospective cohorts.

METHODS: Nine population-based cohorts from the United States and Europe profiled epigenome-wide blood leukocyte DNA methylation using the Illumina Infinium 450k microarray, and prospectively ascertained CHD events including coronary insufficiency/unstable angina, recognized myocardial infarction, coronary revascularization, and coronary death. Cohorts conducted race-specific analyses adjusted for age, sex, smoking, education, body mass index, blood cell type proportions, and technical variables. We conducted fixed-effect meta-analyses across cohorts.

RESULTS: Among 11 461 individuals (mean age 64 years, 67% women, 35% African American) free of CHD at baseline, 1895 developed CHD during a mean follow-up of 11.2 years. Methylation levels at 52 CpG (cytosine-phosphate-guanine) sites were associated with incident CHD or myocardial infarction (false discovery rate<0.05). These CpGs map to genes with key roles in calcium regulation (ATP2B2, CASR, GUCA1B, HPCAL1), and genes identified in genome- and epigenome-wide studies of serum calcium (CASR), serum calcium-related risk of CHD (CASR), coronary artery calcified plaque (PTPRN2), and kidney function (CDH23, HPCAL1), among others. Mendelian randomization analyses supported a causal effect of DNA methylation on incident CHD; these CpGs map to active regulatory regions proximal to long non-coding RNA transcripts.

CONCLUSION: Methylation of blood-derived DNA is associated with risk of future CHD across diverse populations and may serve as an informative tool for gaining further insight on the development of CHD.

%B Circulation %V 140 %P 645-657 %8 2019 08 20 %G eng %N 8 %R 10.1161/CIRCULATIONAHA.118.039357 %0 Journal Article %J Nat Genet %D 2019 %T A catalog of genetic loci associated with kidney function from analyses of a million individuals. %A Wuttke, Matthias %A Li, Yong %A Li, Man %A Sieber, Karsten B %A Feitosa, Mary F %A Gorski, Mathias %A Tin, Adrienne %A Wang, Lihua %A Chu, Audrey Y %A Hoppmann, Anselm %A Kirsten, Holger %A Giri, Ayush %A Chai, Jin-Fang %A Sveinbjornsson, Gardar %A Tayo, Bamidele O %A Nutile, Teresa %A Fuchsberger, Christian %A Marten, Jonathan %A Cocca, Massimiliano %A Ghasemi, Sahar %A Xu, Yizhe %A Horn, Katrin %A Noce, Damia %A van der Most, Peter J %A Sedaghat, Sanaz %A Yu, Zhi %A Akiyama, Masato %A Afaq, Saima %A Ahluwalia, Tarunveer S %A Almgren, Peter %A Amin, Najaf %A Arnlöv, Johan %A Bakker, Stephan J L %A Bansal, Nisha %A Baptista, Daniela %A Bergmann, Sven %A Biggs, Mary L %A Biino, Ginevra %A Boehnke, Michael %A Boerwinkle, Eric %A Boissel, Mathilde %A Bottinger, Erwin P %A Boutin, Thibaud S %A Brenner, Hermann %A Brumat, Marco %A Burkhardt, Ralph %A Butterworth, Adam S %A Campana, Eric %A Campbell, Archie %A Campbell, Harry %A Canouil, Mickaël %A Carroll, Robert J %A Catamo, Eulalia %A Chambers, John C %A Chee, Miao-Ling %A Chee, Miao-Li %A Chen, Xu %A Cheng, Ching-Yu %A Cheng, Yurong %A Christensen, Kaare %A Cifkova, Renata %A Ciullo, Marina %A Concas, Maria Pina %A Cook, James P %A Coresh, Josef %A Corre, Tanguy %A Sala, Cinzia Felicita %A Cusi, Daniele %A Danesh, John %A Daw, E Warwick %A de Borst, Martin H %A De Grandi, Alessandro %A de Mutsert, Renée %A de Vries, Aiko P J %A Degenhardt, Frauke %A Delgado, Graciela %A Demirkan, Ayse %A Di Angelantonio, Emanuele %A Dittrich, Katalin %A Divers, Jasmin %A Dorajoo, Rajkumar %A Eckardt, Kai-Uwe %A Ehret, Georg %A Elliott, Paul %A Endlich, Karlhans %A Evans, Michele K %A Felix, Janine F %A Foo, Valencia Hui Xian %A Franco, Oscar H %A Franke, Andre %A Freedman, Barry I %A Freitag-Wolf, Sandra %A Friedlander, Yechiel %A Froguel, Philippe %A Gansevoort, Ron T %A Gao, He %A Gasparini, Paolo %A Gaziano, J Michael %A Giedraitis, Vilmantas %A Gieger, Christian %A Girotto, Giorgia %A Giulianini, Franco %A Gögele, Martin %A Gordon, Scott D %A Gudbjartsson, Daniel F %A Gudnason, Vilmundur %A Haller, Toomas %A Hamet, Pavel %A Harris, Tamara B %A Hartman, Catharina A %A Hayward, Caroline %A Hellwege, Jacklyn N %A Heng, Chew-Kiat %A Hicks, Andrew A %A Hofer, Edith %A Huang, Wei %A Hutri-Kähönen, Nina %A Hwang, Shih-Jen %A Ikram, M Arfan %A Indridason, Olafur S %A Ingelsson, Erik %A Ising, Marcus %A Jaddoe, Vincent W V %A Jakobsdottir, Johanna %A Jonas, Jost B %A Joshi, Peter K %A Josyula, Navya Shilpa %A Jung, Bettina %A Kähönen, Mika %A Kamatani, Yoichiro %A Kammerer, Candace M %A Kanai, Masahiro %A Kastarinen, Mika %A Kerr, Shona M %A Khor, Chiea-Chuen %A Kiess, Wieland %A Kleber, Marcus E %A Koenig, Wolfgang %A Kooner, Jaspal S %A Körner, Antje %A Kovacs, Peter %A Kraja, Aldi T %A Krajcoviechova, Alena %A Kramer, Holly %A Krämer, Bernhard K %A Kronenberg, Florian %A Kubo, Michiaki %A Kuhnel, Brigitte %A Kuokkanen, Mikko %A Kuusisto, Johanna %A La Bianca, Martina %A Laakso, Markku %A Lange, Leslie A %A Langefeld, Carl D %A Lee, Jeannette Jen-Mai %A Lehne, Benjamin %A Lehtimäki, Terho %A Lieb, Wolfgang %A Lim, Su-Chi %A Lind, Lars %A Lindgren, Cecilia M %A Liu, Jun %A Liu, Jianjun %A Loeffler, Markus %A Loos, Ruth J F %A Lucae, Susanne %A Lukas, Mary Ann %A Lyytikäinen, Leo-Pekka %A Mägi, Reedik %A Magnusson, Patrik K E %A Mahajan, Anubha %A Martin, Nicholas G %A Martins, Jade %A März, Winfried %A Mascalzoni, Deborah %A Matsuda, Koichi %A Meisinger, Christa %A Meitinger, Thomas %A Melander, Olle %A Metspalu, Andres %A Mikaelsdottir, Evgenia K %A Milaneschi, Yuri %A Miliku, Kozeta %A Mishra, Pashupati P %A Mohlke, Karen L %A Mononen, Nina %A Montgomery, Grant W %A Mook-Kanamori, Dennis O %A Mychaleckyj, Josyf C %A Nadkarni, Girish N %A Nalls, Mike A %A Nauck, Matthias %A Nikus, Kjell %A Ning, Boting %A Nolte, Ilja M %A Noordam, Raymond %A O'Connell, Jeffrey %A O'Donoghue, Michelle L %A Olafsson, Isleifur %A Oldehinkel, Albertine J %A Orho-Melander, Marju %A Ouwehand, Willem H %A Padmanabhan, Sandosh %A Palmer, Nicholette D %A Palsson, Runolfur %A Penninx, Brenda W J H %A Perls, Thomas %A Perola, Markus %A Pirastu, Mario %A Pirastu, Nicola %A Pistis, Giorgio %A Podgornaia, Anna I %A Polasek, Ozren %A Ponte, Belen %A Porteous, David J %A Poulain, Tanja %A Pramstaller, Peter P %A Preuss, Michael H %A Prins, Bram P %A Province, Michael A %A Rabelink, Ton J %A Raffield, Laura M %A Raitakari, Olli T %A Reilly, Dermot F %A Rettig, Rainer %A Rheinberger, Myriam %A Rice, Kenneth M %A Ridker, Paul M %A Rivadeneira, Fernando %A Rizzi, Federica %A Roberts, David J %A Robino, Antonietta %A Rossing, Peter %A Rudan, Igor %A Rueedi, Rico %A Ruggiero, Daniela %A Ryan, Kathleen A %A Saba, Yasaman %A Sabanayagam, Charumathi %A Salomaa, Veikko %A Salvi, Erika %A Saum, Kai-Uwe %A Schmidt, Helena %A Schmidt, Reinhold %A Schöttker, Ben %A Schulz, Christina-Alexandra %A Schupf, Nicole %A Shaffer, Christian M %A Shi, Yuan %A Smith, Albert V %A Smith, Blair H %A Soranzo, Nicole %A Spracklen, Cassandra N %A Strauch, Konstantin %A Stringham, Heather M %A Stumvoll, Michael %A Svensson, Per O %A Szymczak, Silke %A Tai, E-Shyong %A Tajuddin, Salman M %A Tan, Nicholas Y Q %A Taylor, Kent D %A Teren, Andrej %A Tham, Yih-Chung %A Thiery, Joachim %A Thio, Chris H L %A Thomsen, Hauke %A Thorleifsson, Gudmar %A Toniolo, Daniela %A Tönjes, Anke %A Tremblay, Johanne %A Tzoulaki, Ioanna %A Uitterlinden, André G %A Vaccargiu, Simona %A van Dam, Rob M %A van der Harst, Pim %A van Duijn, Cornelia M %A Velez Edward, Digna R %A Verweij, Niek %A Vogelezang, Suzanne %A Völker, Uwe %A Vollenweider, Peter %A Waeber, Gérard %A Waldenberger, Melanie %A Wallentin, Lars %A Wang, Ya Xing %A Wang, Chaolong %A Waterworth, Dawn M %A Bin Wei, Wen %A White, Harvey %A Whitfield, John B %A Wild, Sarah H %A Wilson, James F %A Wojczynski, Mary K %A Wong, Charlene %A Wong, Tien-Yin %A Xu, Liang %A Yang, Qiong %A Yasuda, Masayuki %A Yerges-Armstrong, Laura M %A Zhang, Weihua %A Zonderman, Alan B %A Rotter, Jerome I %A Bochud, Murielle %A Psaty, Bruce M %A Vitart, Veronique %A Wilson, James G %A Dehghan, Abbas %A Parsa, Afshin %A Chasman, Daniel I %A Ho, Kevin %A Morris, Andrew P %A Devuyst, Olivier %A Akilesh, Shreeram %A Pendergrass, Sarah A %A Sim, Xueling %A Böger, Carsten A %A Okada, Yukinori %A Edwards, Todd L %A Snieder, Harold %A Stefansson, Kari %A Hung, Adriana M %A Heid, Iris M %A Scholz, Markus %A Teumer, Alexander %A Köttgen, Anna %A Pattaro, Cristian %K Chromosome Mapping %K European Continental Ancestry Group %K Genetic Association Studies %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K Inheritance Patterns %K Kidney Function Tests %K Phenotype %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Quantitative Trait, Heritable %K Renal Insufficiency, Chronic %K Uromodulin %X

Chronic kidney disease (CKD) is responsible for a public health burden with multi-systemic complications. Through trans-ancestry meta-analysis of genome-wide association studies of estimated glomerular filtration rate (eGFR) and independent replication (n = 1,046,070), we identified 264 associated loci (166 new). Of these, 147 were likely to be relevant for kidney function on the basis of associations with the alternative kidney function marker blood urea nitrogen (n = 416,178). Pathway and enrichment analyses, including mouse models with renal phenotypes, support the kidney as the main target organ. A genetic risk score for lower eGFR was associated with clinically diagnosed CKD in 452,264 independent individuals. Colocalization analyses of associations with eGFR among 783,978 European-ancestry individuals and gene expression across 46 human tissues, including tubulo-interstitial and glomerular kidney compartments, identified 17 genes differentially expressed in kidney. Fine-mapping highlighted missense driver variants in 11 genes and kidney-specific regulatory variants. These results provide a comprehensive priority list of molecular targets for translational research.

%B Nat Genet %V 51 %P 957-972 %8 2019 06 %G eng %N 6 %R 10.1038/s41588-019-0407-x %0 Journal Article %J Circ Genom Precis Med %D 2019 %T Common Genetic Variation in Relation to Brachial Vascular Dimensions and Flow-Mediated Vasodilation. %A Dörr, Marcus %A Hamburg, Naomi M %A Müller, Christian %A Smith, Nicholas L %A Gustafsson, Stefan %A Lehtimäki, Terho %A Teumer, Alexander %A Zeller, Tanja %A Li, Xiaohui %A Lind, Lars %A Raitakari, Olli T %A Völker, Uwe %A Blankenberg, Stefan %A McKnight, Barbara %A Morris, Andrew P %A Kähönen, Mika %A Lemaitre, Rozenn N %A Wild, Philipp S %A Nauck, Matthias %A Völzke, Henry %A Münzel, Thomas %A Mitchell, Gary F %A Psaty, Bruce M %A Lindgren, Cecilia M %A Larson, Martin G %A Felix, Stephan B %A Ingelsson, Erik %A Lyytikäinen, Leo-Pekka %A Herrington, David %A Benjamin, Emelia J %A Schnabel, Renate B %B Circ Genom Precis Med %V 12 %P e002409 %8 2019 Feb %G eng %N 2 %R 10.1161/CIRCGEN.118.002409 %0 Journal Article %J Am J Clin Nutr %D 2019 %T Disentangling the genetics of lean mass. %A Karasik, David %A Zillikens, M Carola %A Hsu, Yi-Hsiang %A Aghdassi, Ali %A Åkesson, Kristina %A Amin, Najaf %A Barroso, Inês %A Bennett, David A %A Bertram, Lars %A Bochud, Murielle %A Borecki, Ingrid B %A Broer, Linda %A Buchman, Aron S %A Byberg, Liisa %A Campbell, Harry %A Campos-Obando, Natalia %A Cauley, Jane A %A Cawthon, Peggy M %A Chambers, John C %A Chen, Zhao %A Cho, Nam H %A Choi, Hyung Jin %A Chou, Wen-Chi %A Cummings, Steven R %A de Groot, Lisette C P G M %A De Jager, Phillip L %A Demuth, Ilja %A Diatchenko, Luda %A Econs, Michael J %A Eiriksdottir, Gudny %A Enneman, Anke W %A Eriksson, Joel %A Eriksson, Johan G %A Estrada, Karol %A Evans, Daniel S %A Feitosa, Mary F %A Fu, Mao %A Gieger, Christian %A Grallert, Harald %A Gudnason, Vilmundur %A Lenore, Launer J %A Hayward, Caroline %A Hofman, Albert %A Homuth, Georg %A Huffman, Kim M %A Husted, Lise B %A Illig, Thomas %A Ingelsson, Erik %A Ittermann, Till %A Jansson, John-Olov %A Johnson, Toby %A Biffar, Reiner %A Jordan, Joanne M %A Jula, Antti %A Karlsson, Magnus %A Khaw, Kay-Tee %A Kilpeläinen, Tuomas O %A Klopp, Norman %A Kloth, Jacqueline S L %A Koller, Daniel L %A Kooner, Jaspal S %A Kraus, William E %A Kritchevsky, Stephen %A Kutalik, Zoltán %A Kuulasmaa, Teemu %A Kuusisto, Johanna %A Laakso, Markku %A Lahti, Jari %A Lang, Thomas %A Langdahl, Bente L %A Lerch, Markus M %A Lewis, Joshua R %A Lill, Christina %A Lind, Lars %A Lindgren, Cecilia %A Liu, Yongmei %A Livshits, Gregory %A Ljunggren, Osten %A Loos, Ruth J F %A Lorentzon, Mattias %A Luan, Jian'an %A Luben, Robert N %A Malkin, Ida %A McGuigan, Fiona E %A Medina-Gómez, Carolina %A Meitinger, Thomas %A Melhus, Håkan %A Mellström, Dan %A Michaëlsson, Karl %A Mitchell, Braxton D %A Morris, Andrew P %A Mosekilde, Leif %A Nethander, Maria %A Newman, Anne B %A O'Connell, Jeffery R %A Oostra, Ben A %A Orwoll, Eric S %A Palotie, Aarno %A Peacock, Munro %A Perola, Markus %A Peters, Annette %A Prince, Richard L %A Psaty, Bruce M %A Räikkönen, Katri %A Ralston, Stuart H %A Ripatti, Samuli %A Rivadeneira, Fernando %A Robbins, John A %A Rotter, Jerome I %A Rudan, Igor %A Salomaa, Veikko %A Satterfield, Suzanne %A Schipf, Sabine %A Shin, Chan Soo %A Smith, Albert V %A Smith, Shad B %A Soranzo, Nicole %A Spector, Timothy D %A Stančáková, Alena %A Stefansson, Kari %A Steinhagen-Thiessen, Elisabeth %A Stolk, Lisette %A Streeten, Elizabeth A %A Styrkarsdottir, Unnur %A Swart, Karin M A %A Thompson, Patricia %A Thomson, Cynthia A %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tikkanen, Emmi %A Tranah, Gregory J %A Uitterlinden, André G %A van Duijn, Cornelia M %A van Schoor, Natasja M %A Vandenput, Liesbeth %A Vollenweider, Peter %A Völzke, Henry %A Wactawski-Wende, Jean %A Walker, Mark %A J Wareham, Nicholas %A Waterworth, Dawn %A Weedon, Michael N %A Wichmann, H-Erich %A Widen, Elisabeth %A Williams, Frances M K %A Wilson, James F %A Wright, Nicole C %A Yerges-Armstrong, Laura M %A Yu, Lei %A Zhang, Weihua %A Zhao, Jing Hua %A Zhou, Yanhua %A Nielson, Carrie M %A Harris, Tamara B %A Demissie, Serkalem %A Kiel, Douglas P %A Ohlsson, Claes %X

Background: Lean body mass (LM) plays an important role in mobility and metabolic function. We previously identified five loci associated with LM adjusted for fat mass in kilograms. Such an adjustment may reduce the power to identify genetic signals having an association with both lean mass and fat mass.

Objectives: To determine the impact of different fat mass adjustments on genetic architecture of LM and identify additional LM loci.

Methods: We performed genome-wide association analyses for whole-body LM (20 cohorts of European ancestry with n = 38,292) measured using dual-energy X-ray absorptiometry) or bioelectrical impedance analysis, adjusted for sex, age, age2, and height with or without fat mass adjustments (Model 1 no fat adjustment; Model 2 adjustment for fat mass as a percentage of body mass; Model 3 adjustment for fat mass in kilograms).

Results: Seven single-nucleotide polymorphisms (SNPs) in separate loci, including one novel LM locus (TNRC6B), were successfully replicated in an additional 47,227 individuals from 29 cohorts. Based on the strengths of the associations in Model 1 vs Model 3, we divided the LM loci into those with an effect on both lean mass and fat mass in the same direction and refer to those as "sumo wrestler" loci (FTO and MC4R). In contrast, loci with an impact specifically on LM were termed "body builder" loci (VCAN and ADAMTSL3). Using existing available genome-wide association study databases, LM increasing alleles of SNPs in sumo wrestler loci were associated with an adverse metabolic profile, whereas LM increasing alleles of SNPs in "body builder" loci were associated with metabolic protection.

Conclusions: In conclusion, we identified one novel LM locus (TNRC6B). Our results suggest that a genetically determined increase in lean mass might exert either harmful or protective effects on metabolic traits, depending on its relation to fat mass.

%B Am J Clin Nutr %V 109 %P 276-287 %8 2019 Feb 01 %G eng %N 2 %R 10.1093/ajcn/nqy272 %0 Journal Article %J Sleep %D 2019 %T Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American-specific associations. %A Barfield, Richard %A Wang, Heming %A Liu, Yongmei %A Brody, Jennifer A %A Swenson, Brenton %A Li, Ruitong %A Bartz, Traci M %A Sotoodehnia, Nona %A Chen, Yii-der I %A Cade, Brian E %A Chen, Han %A Patel, Sanjay R %A Zhu, Xiaofeng %A Gharib, Sina A %A Johnson, W Craig %A Rotter, Jerome I %A Saxena, Richa %A Purcell, Shaun %A Lin, Xihong %A Redline, Susan %A Sofer, Tamar %X

STUDY OBJECTIVES: Daytime sleepiness is a consequence of inadequate sleep, sleep-wake control disorder, or other medical conditions. Population variability in prevalence of daytime sleepiness is likely due to genetic and biological factors as well as social and environmental influences. DNA methylation (DNAm) potentially influences multiple health outcomes. Here, we explored the association between DNAm and daytime sleepiness quantified by the Epworth Sleepiness Scale (ESS).

METHODS: We performed multi-ethnic and ethnic-specific epigenome-wide association studies for DNAm and ESS in the Multi-Ethnic Study of Atherosclerosis (MESA; n = 619) and the Cardiovascular Health Study (n = 483), with cross-study replication and meta-analysis. Genetic variants near ESS-associated DNAm were analyzed for methylation quantitative trait loci and followed with replication of genotype-sleepiness associations in the UK Biobank.

RESULTS: In MESA only, we detected four DNAm-ESS associations: one across all race/ethnic groups; three in African-Americans (AA) only. Two of the MESA AA associations, in genes KCTD5 and RXRA, nominally replicated in CHS (p-value < 0.05). In the AA meta-analysis, we detected 14 DNAm-ESS associations (FDR q-value < 0.05, top association p-value = 4.26 × 10-8). Three DNAm sites mapped to genes (CPLX3, GFAP, and C7orf50) with biological relevance. We also found evidence for associations with DNAm sites in RAI1, a gene associated with sleep and circadian phenotypes. UK Biobank follow-up analyses detected SNPs in RAI1, RXRA, and CPLX3 with nominal sleepiness associations.

CONCLUSIONS: We identified methylation sites in multiple genes possibly implicated in daytime sleepiness. Most significant DNAm-ESS associations were specific to AA. Future work is needed to identify mechanisms driving ancestry-specific methylation effects.

%B Sleep %8 2019 May 29 %G eng %R 10.1093/sleep/zsz101 %0 Journal Article %J Eur Heart J %D 2019 %T {Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies %A Pennells, L. %A Kaptoge, S. %A Wood, A. %A Sweeting, M. %A Zhao, X. %A White, I. %A Burgess, S. %A Willeit, P. %A Bolton, T. %A Moons, K. G. M. %A van der Schouw, Y. T. %A Selmer, R. %A Khaw, K. T. %A Gudnason, V. %A Assmann, G. %A Amouyel, P. %A Salomaa, V. %A Kivimaki, M. %A Nordestgaard, B. G. %A Blaha, M. J. %A Kuller, L. H. %A Brenner, H. %A Gillum, R. F. %A Meisinger, C. %A Ford, I. %A Knuiman, M. W. %A Rosengren, A. %A Lawlor, D. A. %A V?lzke, H. %A Cooper, C. %A Mar?n Iba?ez, A. %A Casiglia, E. %A Kauhanen, J. %A Cooper, J. A. %A Rodriguez, B. %A Sundstr?m, J. %A Barrett-Connor, E. %A Dankner, R. %A Nietert, P. J. %A Davidson, K. W. %A Wallace, R. B. %A Blazer, D. G. %A Bj?rkelund, C. %A Donfrancesco, C. %A Krumholz, H. M. %A Nissinen, A. %A Davis, B. R. %A Coady, S. %A Whincup, P. H. %A J?rgensen, T. %A Ducimetiere, P. %A Trevisan, M. %A Engstr?m, G. %A Crespo, C. J. %A Meade, T. W. %A Visser, M. %A Kromhout, D. %A Kiechl, S. %A Daimon, M. %A Price, J. F. %A G?mez de la C?mara, A. %A Wouter Jukema, J. %A Lamarche, B. %A Onat, A. %A Simons, L. A. %A Kavousi, M. %A Ben-Shlomo, Y. %A Gallacher, J. %A Dekker, J. M. %A Arima, H. %A Shara, N. %A Tipping, R. W. %A Roussel, R. %A Brunner, E. J. %A Koenig, W. %A Sakurai, M. %A Pavlovic, J. %A Gansevoort, R. T. %A Nagel, D. %A Goldbourt, U. %A Barr, E. L. M. %A Palmieri, L. %A Nj?lstad, I. %A Sato, S. %A Monique Verschuren, W. M. %A Varghese, C. V. %A Graham, I. %A Onuma, O. %A Greenland, P. %A Woodward, M. %A Ezzati, M. %A Psaty, B. M. %A Sattar, N. %A Jackson, R. %A Ridker, P. M. %A Cook, N. R. %A D'Agostino, R. B. %A Thompson, S. G. %A Danesh, J. %A Di Angelantonio, E. %A Tipping, R. W. %A Simpson, L. M. %A Pressel, S. L. %A Couper, D. J. %A Nambi, V. %A Matsushita, K. %A Folsom, A. R. %A Shaw, J. E. %A Magliano, D. J. %A Zimmet, P. Z. %A Knuiman, M. W. %A Whincup, P. H. %A Wannamethee, S. G. %A Willeit, J. %A Santer, P. %A Egger, G. %A Casas, J. P. %A Amuzu, A. %A Ben-Shlomo, Y. %A Gallacher, J. %A Tikhonoff, V. %A Casiglia, E. %A Sutherland, S. E. %A Nietert, P. J. %A Cushman, M. %A Psaty, B. M. %A S?gaard, A. J. %A H?heim, L. L. %A Ariansen, I. %A Tybj?rg-Hansen, A. %A Jensen, G. B. %A Schnohr, P. %A Giampaoli, S. %A Vanuzzo, D. %A Panico, S. %A Palmieri, L. %A Balkau, B. %A Bonnet, F. %A Marre, M. %A de la C?mara, A. G. %A Rubio Herrera, M. A. %A Friedlander, Y. %A McCallum, J. %A McLachlan, S. %A Guralnik, J. %A Phillips, C. L. %A Khaw, K. T. %A Wareham, N. %A Sch?ttker, B. %A Saum, K. U. %A Holleczek, B. %A Nissinen, A. %A Tolonen, H. %A Giampaoli, S. %A Donfrancesco, C. %A Vartiainen, E. %A Jousilahti, P. %A Harald, K. %A D?Agostino, R. B. %A Massaro, J. M. %A Pencina, M. %A Vasan, R. %A Kayama, T. %A Kato, T. %A Oizumi, T. %A Jespersen, J. %A M?ller, L. %A Bladbjerg, E. M. %A Chetrit, A. %A Rosengren, A. %A Wilhelmsen, L. %A Bj?rkelund, C. %A Lissner, L. %A Nagel, D. %A Dennison, E. %A Kiyohara, Y. %A Ninomiya, T. %A Doi, Y. %A Rodriguez, B. %A Nijpels, G. %A Stehouwer, C. D. A. %A Sato, S. %A Kazumasa, Y. %A Iso, H. %A Goldbourt, U. %A Salomaa, V. %A Vartiainen, E. %A Kurl, S. %A Tuomainen, T. P. %A Salonen, J. T. %A Visser, M. %A Deeg, D. J. H. %A Meade, T. W. %A Nilsson, P. M. %A Hedblad, B. %A Melander, O. %A De Boer, I. H. %A DeFilippis, A. P. %A Verschuren, W. M. M. %A Sattar, N. %A Watt, G. %A Meisinger, C. %A Koenig, W. %A Rosengren, A. %A Kuller, L. H. %A Tverdal, A. %A Gillum, R. F. %A Cooper, J. A. %A Kirkland, S. %A Shimbo, D. %A Shaffer, J. %A Sato, S. %A Kazumasa, Y. %A Iso, H. %A Ducimetiere, P. %A Bakker, S. J. L. %A van der Harst, P. %A Hillege, H. L. %A Crespo, C. J. %A Amouyel, P. %A Dallongeville, J. %A Assmann, G. %A Schulte, H. %A Trompet, S. %A Smit, R. A. J. %A Stott, D. J. %A van der Schouw, Y. T. %A Despr?s, J. P. %A Cantin, B. %A Dagenais, G. R. %A Laughlin, G. %A Wingard, D. %A Trevisan, M. %A Aspelund, T. %A Eiriksdottir, G. %A Gudmundsson, E. F. %A Ikram, A. %A van Rooij, F. J. A. %A Franco, O. H. %A Rueda-Ochoa, O. L. %A Muka, T. %A Glisic, M. %A Tunstall-Pedoe, H. %A V?lzke, H. %A Howard, B. V. %A Zhang, Y. %A Jolly, S. %A Gallacher, J. %A Davey-Smith, G. %A Can, G. %A Y?ksel, H. %A Nakagawa, H. %A Morikawa, Y. %A Miura, K. %A Nj?lstad, I. %A Ingelsson, M. %A Giedraitis, V. %A Ridker, P. M. %A Gaziano, J. M. %A Kivimaki, M. %A Shipley, M. %A Brunner, E. J. %A Arndt, V. %A Brenner, H. %A Cook, N. %A Ridker, P. M. %A Ford, I. %A Sattar, N. %A Iba?ez, A. M. %A Geleijnse, J. M. %X There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied.\ Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms.\ Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need. %B Eur Heart J %V 40 %P 621–631 %8 02 %G eng %0 Journal Article %J Nature %D 2019 %T {Exome sequencing of 20,791 cases of type 2 diabetes and 24,440 controls %A Flannick, J. %A Mercader, J. M. %A Fuchsberger, C. %A Udler, M. S. %A Mahajan, A. %A Wessel, J. %A Teslovich, T. M. %A Caulkins, L. %A Koesterer, R. %A Barajas-Olmos, F. %A Blackwell, T. W. %A Boerwinkle, E. %A Brody, J. A. %A Centeno-Cruz, F. %A Chen, L. %A Chen, S. %A Contreras-Cubas, C. %A C?rdova, E. %A Correa, A. %A Cortes, M. %A DeFronzo, R. A. %A Dolan, L. %A Drews, K. L. %A Elliott, A. %A Floyd, J. S. %A Gabriel, S. %A Garay-Sevilla, M. E. %A Garc?a-Ortiz, H. %A Gross, M. %A Han, S. %A Heard-Costa, N. L. %A Jackson, A. U. %A J?rgensen, M. E. %A Kang, H. M. %A Kelsey, M. %A Kim, B. J. %A Koistinen, H. A. %A Kuusisto, J. %A Leader, J. B. %A Linneberg, A. %A Liu, C. T. %A Liu, J. %A Lyssenko, V. %A Manning, A. K. %A Marcketta, A. %A Malacara-Hernandez, J. M. %A Mart?nez-Hern?ndez, A. %A Matsuo, K. %A Mayer-Davis, E. %A Mendoza-Caamal, E. %A Mohlke, K. L. %A Morrison, A. C. %A Ndungu, A. %A Ng, M. C. Y. %A O'Dushlaine, C. %A Payne, A. J. %A Pihoker, C. %A Post, W. S. %A Preuss, M. %A Psaty, B. M. %A Vasan, R. S. %A Rayner, N. W. %A Reiner, A. P. %A Revilla-Monsalve, C. %A Robertson, N. R. %A Santoro, N. %A Schurmann, C. %A So, W. Y. %A Sober?n, X. %A Stringham, H. M. %A Strom, T. M. %A Tam, C. H. T. %A Thameem, F. %A Tomlinson, B. %A Torres, J. M. %A Tracy, R. P. %A van Dam, R. M. %A Vujkovic, M. %A Wang, S. %A Welch, R. P. %A Witte, D. R. %A Wong, T. Y. %A Atzmon, G. %A Barzilai, N. %A Blangero, J. %A Bonnycastle, L. L. %A Bowden, D. W. %A Chambers, J. C. %A Chan, E. %A Cheng, C. Y. %A Cho, Y. S. %A Collins, F. S. %A de Vries, P. S. %A Duggirala, R. %A Glaser, B. %A Gonzalez, C. %A Gonzalez, M. E. %A Groop, L. %A Kooner, J. S. %A Kwak, S. H. %A Laakso, M. %A Lehman, D. M. %A Nilsson, P. %A Spector, T. D. %A Tai, E. S. %A Tuomi, T. %A Tuomilehto, J. %A Wilson, J. G. %A Aguilar-Salinas, C. A. %A Bottinger, E. %A Burke, B. %A Carey, D. J. %A Chan, J. C. N. %A Dupuis, J. %A Frossard, P. %A Heckbert, S. R. %A Hwang, M. Y. %A Kim, Y. J. %A Kirchner, H. L. %A Lee, J. Y. %A Lee, J. %A Loos, R. J. F. %A Ma, R. C. W. %A Morris, A. D. %A O'Donnell, C. J. %A Palmer, C. N. A. %A Pankow, J. %A Park, K. S. %A Rasheed, A. %A Saleheen, D. %A Sim, X. %A Small, K. S. %A Teo, Y. Y. %A Haiman, C. %A Hanis, C. L. %A Henderson, B. E. %A Orozco, L. %A Tusi?-Luna, T. %A Dewey, F. E. %A Baras, A. %A Gieger, C. %A Meitinger, T. %A Strauch, K. %A Lange, L. %A Grarup, N. %A Hansen, T. %A Pedersen, O. %A Zeitler, P. %A Dabelea, D. %A Abecasis, G. %A Bell, G. I. %A Cox, N. J. %A Seielstad, M. %A Sladek, R. %A Meigs, J. B. %A Rich, S. S. %A Rotter, J. I. %A Altshuler, D. %A Burtt, N. P. %A Scott, L. J. %A Morris, A. P. %A Florez, J. C. %A McCarthy, M. I. %A Boehnke, M. %X Protein-coding genetic variants that strongly affect disease risk can yield relevant clues to disease pathogenesis. Here we report exome-sequencing analyses of 20,791 individuals with type 2 diabetes (T2D) and 24,440 non-diabetic control participants from 5 ancestries. We identify gene-level associations of rare variants (with minor allele frequencies of less than 0.5%) in 4 genes at exome-wide significance, including a series of more than 30 SLC30A8 alleles that conveys protection against T2D, and in 12 gene sets, including those corresponding to T2D drug targets (P = 6.1 × 10-3) and candidate genes from knockout mice (P = 5.2 × 10-3). Within our study, the strongest T2D gene-level signals for rare variants explain at most 25% of the heritability of the strongest common single-variant signals, and the gene-level effect sizes of the rare variants that we observed in established T2D drug targets will require 75,000-185,000 sequenced cases to achieve exome-wide significance. We propose a method to interpret these modest rare-variant associations and to incorporate these associations into future target or gene prioritization efforts. %B Nature %V 570 %P 71–76 %8 06 %G eng %0 Journal Article %J Am J Hum Genet %D 2019 %T {Exome-Derived Adiponectin-Associated Variants Implicate Obesity and Lipid Biology %A Spracklen, C. N. %A Karaderi, T. %A Yaghootkar, H. %A Schurmann, C. %A Fine, R. S. %A Kutalik, Z. %A Preuss, M. H. %A Lu, Y. %A Wittemans, L. B. L. %A Adair, L. S. %A Allison, M. %A Amin, N. %A Auer, P. L. %A Bartz, T. M. %A her, M. %A Boehnke, M. %A Borja, J. B. %A Bork-Jensen, J. %A Broer, L. %A Chasman, D. I. %A Chen, Y. I. %A Chirstofidou, P. %A Demirkan, A. %A van Duijn, C. M. %A Feitosa, M. F. %A Garcia, M. E. %A Graff, M. %A Grallert, H. %A Grarup, N. %A Guo, X. %A Haesser, J. %A Hansen, T. %A Harris, T. B. %A Highland, H. M. %A Hong, J. %A Ikram, M. A. %A Ingelsson, E. %A Jackson, R. %A Jousilahti, P. %A nen, M. %A Kizer, J. R. %A Kovacs, P. %A Kriebel, J. %A Laakso, M. %A Lange, L. A. %A ki, T. %A Li, J. %A Li-Gao, R. %A Lind, L. %A Luan, J. %A inen, L. P. %A MacGregor, S. %A Mackey, D. A. %A Mahajan, A. %A Mangino, M. %A ö, S. %A McCarthy, M. I. %A McKnight, B. %A Medina-Gomez, C. %A Meigs, J. B. %A Molnos, S. %A Mook-Kanamori, D. %A Morris, A. P. %A de Mutsert, R. %A Nalls, M. A. %A Nedeljkovic, I. %A North, K. E. %A Pennell, C. E. %A Pradhan, A. D. %A Province, M. A. %A Raitakari, O. T. %A Raulerson, C. K. %A Reiner, A. P. %A Ridker, P. M. %A Ripatti, S. %A Roberston, N. %A Rotter, J. I. %A Salomaa, V. %A rate, A. A. %A Sitlani, C. M. %A Spector, T. D. %A Strauch, K. %A Stumvoll, M. %A Taylor, K. D. %A Thuesen, B. %A njes, A. %A Uitterlinden, A. G. %A Venturini, C. %A Walker, M. %A Wang, C. A. %A Wang, S. %A Wareham, N. J. %A Willems, S. M. %A Willems van Dijk, K. %A Wilson, J. G. %A Wu, Y. %A Yao, J. %A Young, K. L. %A Langenberg, C. %A Frayling, T. M. %A inen, T. O. %A Lindgren, C. M. %A Loos, R. J. F. %A Mohlke, K. L. %X ) with at least one obesity or lipid trait. Candidate genes include PRKAR2A, PTH1R, and HDAC9, which have been suggested to play roles in adipocyte differentiation or bone marrow adipose tissue. Taken together, these findings provide further insights into the processes that influence circulating adiponectin levels. %B Am J Hum Genet %V 105 %P 15–28 %8 Jul %G eng %0 Journal Article %J Am J Hum Genet %D 2019 %T {Exome-Derived Adiponectin-Associated Variants Implicate Obesity and Lipid Biology %A Spracklen, C. N. %A Karaderi, T. %A Yaghootkar, H. %A Schurmann, C. %A Fine, R. S. %A Kutalik, Z. %A Preuss, M. H. %A Lu, Y. %A Wittemans, L. B. L. %A Adair, L. S. %A Allison, M. %A Amin, N. %A Auer, P. L. %A Bartz, T. M. %A her, M. %A Boehnke, M. %A Borja, J. B. %A Bork-Jensen, J. %A Broer, L. %A Chasman, D. I. %A Chen, Y. I. %A Chirstofidou, P. %A Demirkan, A. %A van Duijn, C. M. %A Feitosa, M. F. %A Garcia, M. E. %A Graff, M. %A Grallert, H. %A Grarup, N. %A Guo, X. %A Haesser, J. %A Hansen, T. %A Harris, T. B. %A Highland, H. M. %A Hong, J. %A Ikram, M. A. %A Ingelsson, E. %A Jackson, R. %A Jousilahti, P. %A nen, M. %A Kizer, J. R. %A Kovacs, P. %A Kriebel, J. %A Laakso, M. %A Lange, L. A. %A ki, T. %A Li, J. %A Li-Gao, R. %A Lind, L. %A Luan, J. %A inen, L. P. %A MacGregor, S. %A Mackey, D. A. %A Mahajan, A. %A Mangino, M. %A ö, S. %A McCarthy, M. I. %A McKnight, B. %A Medina-Gomez, C. %A Meigs, J. B. %A Molnos, S. %A Mook-Kanamori, D. %A Morris, A. P. %A de Mutsert, R. %A Nalls, M. A. %A Nedeljkovic, I. %A North, K. E. %A Pennell, C. E. %A Pradhan, A. D. %A Province, M. A. %A Raitakari, O. T. %A Raulerson, C. K. %A Reiner, A. P. %A Ridker, P. M. %A Ripatti, S. %A Roberston, N. %A Rotter, J. I. %A Salomaa, V. %A rate, A. A. %A Sitlani, C. M. %A Spector, T. D. %A Strauch, K. %A Stumvoll, M. %A Taylor, K. D. %A Thuesen, B. %A njes, A. %A Uitterlinden, A. G. %A Venturini, C. %A Walker, M. %A Wang, C. A. %A Wang, S. %A Wareham, N. J. %A Willems, S. M. %A Willems van Dijk, K. %A Wilson, J. G. %A Wu, Y. %A Yao, J. %A Young, K. L. %A Langenberg, C. %A Frayling, T. M. %A inen, T. O. %A Lindgren, C. M. %A Loos, R. J. F. %A Mohlke, K. L. %B Am J Hum Genet %V 105 %P 670–671 %8 Sep %G eng %0 Journal Article %J Nat Genet %D 2019 %T Genetic architecture of subcortical brain structures in 38,851 individuals. %A Satizabal, Claudia L %A Adams, Hieab H H %A Hibar, Derrek P %A White, Charles C %A Knol, Maria J %A Stein, Jason L %A Scholz, Markus %A Sargurupremraj, Muralidharan %A Jahanshad, Neda %A Roshchupkin, Gennady V %A Smith, Albert V %A Bis, Joshua C %A Jian, Xueqiu %A Luciano, Michelle %A Hofer, Edith %A Teumer, Alexander %A van der Lee, Sven J %A Yang, Jingyun %A Yanek, Lisa R %A Lee, Tom V %A Li, Shuo %A Hu, Yanhui %A Koh, Jia Yu %A Eicher, John D %A Desrivières, Sylvane %A Arias-Vasquez, Alejandro %A Chauhan, Ganesh %A Athanasiu, Lavinia %A Rentería, Miguel E %A Kim, Sungeun %A Hoehn, David %A Armstrong, Nicola J %A Chen, Qiang %A Holmes, Avram J %A den Braber, Anouk %A Kloszewska, Iwona %A Andersson, Micael %A Espeseth, Thomas %A Grimm, Oliver %A Abramovic, Lucija %A Alhusaini, Saud %A Milaneschi, Yuri %A Papmeyer, Martina %A Axelsson, Tomas %A Ehrlich, Stefan %A Roiz-Santiañez, Roberto %A Kraemer, Bernd %A Håberg, Asta K %A Jones, Hannah J %A Pike, G Bruce %A Stein, Dan J %A Stevens, Allison %A Bralten, Janita %A Vernooij, Meike W %A Harris, Tamara B %A Filippi, Irina %A Witte, A Veronica %A Guadalupe, Tulio %A Wittfeld, Katharina %A Mosley, Thomas H %A Becker, James T %A Doan, Nhat Trung %A Hagenaars, Saskia P %A Saba, Yasaman %A Cuellar-Partida, Gabriel %A Amin, Najaf %A Hilal, Saima %A Nho, Kwangsik %A Mirza-Schreiber, Nazanin %A Arfanakis, Konstantinos %A Becker, Diane M %A Ames, David %A Goldman, Aaron L %A Lee, Phil H %A Boomsma, Dorret I %A Lovestone, Simon %A Giddaluru, Sudheer %A Le Hellard, Stephanie %A Mattheisen, Manuel %A Bohlken, Marc M %A Kasperaviciute, Dalia %A Schmaal, Lianne %A Lawrie, Stephen M %A Agartz, Ingrid %A Walton, Esther %A Tordesillas-Gutierrez, Diana %A Davies, Gareth E %A Shin, Jean %A Ipser, Jonathan C %A Vinke, Louis N %A Hoogman, Martine %A Jia, Tianye %A Burkhardt, Ralph %A Klein, Marieke %A Crivello, Fabrice %A Janowitz, Deborah %A Carmichael, Owen %A Haukvik, Unn K %A Aribisala, Benjamin S %A Schmidt, Helena %A Strike, Lachlan T %A Cheng, Ching-Yu %A Risacher, Shannon L %A Pütz, Benno %A Fleischman, Debra A %A Assareh, Amelia A %A Mattay, Venkata S %A Buckner, Randy L %A Mecocci, Patrizia %A Dale, Anders M %A Cichon, Sven %A Boks, Marco P %A Matarin, Mar %A Penninx, Brenda W J H %A Calhoun, Vince D %A Chakravarty, M Mallar %A Marquand, Andre F %A Macare, Christine %A Kharabian Masouleh, Shahrzad %A Oosterlaan, Jaap %A Amouyel, Philippe %A Hegenscheid, Katrin %A Rotter, Jerome I %A Schork, Andrew J %A Liewald, David C M %A de Zubicaray, Greig I %A Wong, Tien Yin %A Shen, Li %A Sämann, Philipp G %A Brodaty, Henry %A Roffman, Joshua L %A de Geus, Eco J C %A Tsolaki, Magda %A Erk, Susanne %A van Eijk, Kristel R %A Cavalleri, Gianpiero L %A van der Wee, Nic J A %A McIntosh, Andrew M %A Gollub, Randy L %A Bulayeva, Kazima B %A Bernard, Manon %A Richards, Jennifer S %A Himali, Jayandra J %A Loeffler, Markus %A Rommelse, Nanda %A Hoffmann, Wolfgang %A Westlye, Lars T %A Valdés Hernández, Maria C %A Hansell, Narelle K %A van Erp, Theo G M %A Wolf, Christiane %A Kwok, John B J %A Vellas, Bruno %A Heinz, Andreas %A Olde Loohuis, Loes M %A Delanty, Norman %A Ho, Beng-Choon %A Ching, Christopher R K %A Shumskaya, Elena %A Singh, Baljeet %A Hofman, Albert %A van der Meer, Dennis %A Homuth, Georg %A Psaty, Bruce M %A Bastin, Mark E %A Montgomery, Grant W %A Foroud, Tatiana M %A Reppermund, Simone %A Hottenga, Jouke-Jan %A Simmons, Andrew %A Meyer-Lindenberg, Andreas %A Cahn, Wiepke %A Whelan, Christopher D %A van Donkelaar, Marjolein M J %A Yang, Qiong %A Hosten, Norbert %A Green, Robert C %A Thalamuthu, Anbupalam %A Mohnke, Sebastian %A Hulshoff Pol, Hilleke E %A Lin, Honghuang %A Jack, Clifford R %A Schofield, Peter R %A Mühleisen, Thomas W %A Maillard, Pauline %A Potkin, Steven G %A Wen, Wei %A Fletcher, Evan %A Toga, Arthur W %A Gruber, Oliver %A Huentelman, Matthew %A Davey Smith, George %A Launer, Lenore J %A Nyberg, Lars %A Jönsson, Erik G %A Crespo-Facorro, Benedicto %A Koen, Nastassja %A Greve, Douglas N %A Uitterlinden, André G %A Weinberger, Daniel R %A Steen, Vidar M %A Fedko, Iryna O %A Groenewold, Nynke A %A Niessen, Wiro J %A Toro, Roberto %A Tzourio, Christophe %A Longstreth, William T %A Ikram, M Kamran %A Smoller, Jordan W %A van Tol, Marie-Jose %A Sussmann, Jessika E %A Paus, Tomáš %A Lemaître, Hervé %A Schroeter, Matthias L %A Mazoyer, Bernard %A Andreassen, Ole A %A Holsboer, Florian %A Depondt, Chantal %A Veltman, Dick J %A Turner, Jessica A %A Pausova, Zdenka %A Schumann, Gunter %A van Rooij, Daan %A Djurovic, Srdjan %A Deary, Ian J %A McMahon, Katie L %A Müller-Myhsok, Bertram %A Brouwer, Rachel M %A Soininen, Hilkka %A Pandolfo, Massimo %A Wassink, Thomas H %A Cheung, Joshua W %A Wolfers, Thomas %A Martinot, Jean-Luc %A Zwiers, Marcel P %A Nauck, Matthias %A Melle, Ingrid %A Martin, Nicholas G %A Kanai, Ryota %A Westman, Eric %A Kahn, René S %A Sisodiya, Sanjay M %A White, Tonya %A Saremi, Arvin %A van Bokhoven, Hans %A Brunner, Han G %A Völzke, Henry %A Wright, Margaret J %A van 't Ent, Dennis %A Nöthen, Markus M %A Ophoff, Roel A %A Buitelaar, Jan K %A Fernández, Guillén %A Sachdev, Perminder S %A Rietschel, Marcella %A van Haren, Neeltje E M %A Fisher, Simon E %A Beiser, Alexa S %A Francks, Clyde %A Saykin, Andrew J %A Mather, Karen A %A Romanczuk-Seiferth, Nina %A Hartman, Catharina A %A DeStefano, Anita L %A Heslenfeld, Dirk J %A Weiner, Michael W %A Walter, Henrik %A Hoekstra, Pieter J %A Nyquist, Paul A %A Franke, Barbara %A Bennett, David A %A Grabe, Hans J %A Johnson, Andrew D %A Chen, Christopher %A van Duijn, Cornelia M %A Lopez, Oscar L %A Fornage, Myriam %A Wardlaw, Joanna M %A Schmidt, Reinhold %A DeCarli, Charles %A De Jager, Philip L %A Villringer, Arno %A Debette, Stephanie %A Gudnason, Vilmundur %A Medland, Sarah E %A Shulman, Joshua M %A Thompson, Paul M %A Seshadri, Sudha %A Ikram, M Arfan %X

Subcortical brain structures are integral to motion, consciousness, emotions and learning. We identified common genetic variation related to the volumes of the nucleus accumbens, amygdala, brainstem, caudate nucleus, globus pallidus, putamen and thalamus, using genome-wide association analyses in almost 40,000 individuals from CHARGE, ENIGMA and UK Biobank. We show that variability in subcortical volumes is heritable, and identify 48 significantly associated loci (40 novel at the time of analysis). Annotation of these loci by utilizing gene expression, methylation and neuropathological data identified 199 genes putatively implicated in neurodevelopment, synaptic signaling, axonal transport, apoptosis, inflammation/infection and susceptibility to neurological disorders. This set of genes is significantly enriched for Drosophila orthologs associated with neurodevelopmental phenotypes, suggesting evolutionarily conserved mechanisms. Our findings uncover novel biology and potential drug targets underlying brain development and disease.

%B Nat Genet %V 51 %P 1624-1636 %8 2019 Nov %G eng %N 11 %R 10.1038/s41588-019-0511-y %0 Journal Article %J Nat Genet %D 2019 %T Genetic meta-analysis of diagnosed Alzheimer's disease identifies new risk loci and implicates Aβ, tau, immunity and lipid processing. %A Kunkle, Brian W %A Grenier-Boley, Benjamin %A Sims, Rebecca %A Bis, Joshua C %A Damotte, Vincent %A Naj, Adam C %A Boland, Anne %A Vronskaya, Maria %A van der Lee, Sven J %A Amlie-Wolf, Alexandre %A Bellenguez, Céline %A Frizatti, Aura %A Chouraki, Vincent %A Martin, Eden R %A Sleegers, Kristel %A Badarinarayan, Nandini %A Jakobsdottir, Johanna %A Hamilton-Nelson, Kara L %A Moreno-Grau, Sonia %A Olaso, Robert %A Raybould, Rachel %A Chen, Yuning %A Kuzma, Amanda B %A Hiltunen, Mikko %A Morgan, Taniesha %A Ahmad, Shahzad %A Vardarajan, Badri N %A Epelbaum, Jacques %A Hoffmann, Per %A Boada, Merce %A Beecham, Gary W %A Garnier, Jean-Guillaume %A Harold, Denise %A Fitzpatrick, Annette L %A Valladares, Otto %A Moutet, Marie-Laure %A Gerrish, Amy %A Smith, Albert V %A Qu, Liming %A Bacq, Delphine %A Denning, Nicola %A Jian, Xueqiu %A Zhao, Yi %A Del Zompo, Maria %A Fox, Nick C %A Choi, Seung-Hoan %A Mateo, Ignacio %A Hughes, Joseph T %A Adams, Hieab H %A Malamon, John %A Sanchez-Garcia, Florentino %A Patel, Yogen %A Brody, Jennifer A %A Dombroski, Beth A %A Naranjo, Maria Candida Deniz %A Daniilidou, Makrina %A Eiriksdottir, Gudny %A Mukherjee, Shubhabrata %A Wallon, David %A Uphill, James %A Aspelund, Thor %A Cantwell, Laura B %A Garzia, Fabienne %A Galimberti, Daniela %A Hofer, Edith %A Butkiewicz, Mariusz %A Fin, Bertrand %A Scarpini, Elio %A Sarnowski, Chloe %A Bush, Will S %A Meslage, Stéphane %A Kornhuber, Johannes %A White, Charles C %A Song, Yuenjoo %A Barber, Robert C %A Engelborghs, Sebastiaan %A Sordon, Sabrina %A Voijnovic, Dina %A Adams, Perrie M %A Vandenberghe, Rik %A Mayhaus, Manuel %A Cupples, L Adrienne %A Albert, Marilyn S %A De Deyn, Peter P %A Gu, Wei %A Himali, Jayanadra J %A Beekly, Duane %A Squassina, Alessio %A Hartmann, Annette M %A Orellana, Adelina %A Blacker, Deborah %A Rodriguez-Rodriguez, Eloy %A Lovestone, Simon %A Garcia, Melissa E %A Doody, Rachelle S %A Munoz-Fernadez, Carmen %A Sussams, Rebecca %A Lin, Honghuang %A Fairchild, Thomas J %A Benito, Yolanda A %A Holmes, Clive %A Karamujić-Čomić, Hata %A Frosch, Matthew P %A Thonberg, Håkan %A Maier, Wolfgang %A Roschupkin, Gena %A Ghetti, Bernardino %A Giedraitis, Vilmantas %A Kawalia, Amit %A Li, Shuo %A Huebinger, Ryan M %A Kilander, Lena %A Moebus, Susanne %A Hernandez, Isabel %A Kamboh, M Ilyas %A Brundin, RoseMarie %A Turton, James %A Yang, Qiong %A Katz, Mindy J %A Concari, Letizia %A Lord, Jenny %A Beiser, Alexa S %A Keene, C Dirk %A Helisalmi, Seppo %A Kloszewska, Iwona %A Kukull, Walter A %A Koivisto, Anne Maria %A Lynch, Aoibhinn %A Tarraga, Lluis %A Larson, Eric B %A Haapasalo, Annakaisa %A Lawlor, Brian %A Mosley, Thomas H %A Lipton, Richard B %A Solfrizzi, Vincenzo %A Gill, Michael %A Longstreth, W T %A Montine, Thomas J %A Frisardi, Vincenza %A Diez-Fairen, Monica %A Rivadeneira, Fernando %A Petersen, Ronald C %A Deramecourt, Vincent %A Alvarez, Ignacio %A Salani, Francesca %A Ciaramella, Antonio %A Boerwinkle, Eric %A Reiman, Eric M %A Fiévet, Nathalie %A Rotter, Jerome I %A Reisch, Joan S %A Hanon, Olivier %A Cupidi, Chiara %A Andre Uitterlinden, A G %A Royall, Donald R %A Dufouil, Carole %A Maletta, Raffaele Giovanni %A de Rojas, Itziar %A Sano, Mary %A Brice, Alexis %A Cecchetti, Roberta %A George-Hyslop, Peter St %A Ritchie, Karen %A Tsolaki, Magda %A Tsuang, Debby W %A Dubois, Bruno %A Craig, David %A Wu, Chuang-Kuo %A Soininen, Hilkka %A Avramidou, Despoina %A Albin, Roger L %A Fratiglioni, Laura %A Germanou, Antonia %A Apostolova, Liana G %A Keller, Lina %A Koutroumani, Maria %A Arnold, Steven E %A Panza, Francesco %A Gkatzima, Olymbia %A Asthana, Sanjay %A Hannequin, Didier %A Whitehead, Patrice %A Atwood, Craig S %A Caffarra, Paolo %A Hampel, Harald %A Quintela, Inés %A Carracedo, Angel %A Lannfelt, Lars %A Rubinsztein, David C %A Barnes, Lisa L %A Pasquier, Florence %A Frölich, Lutz %A Barral, Sandra %A McGuinness, Bernadette %A Beach, Thomas G %A Johnston, Janet A %A Becker, James T %A Passmore, Peter %A Bigio, Eileen H %A Schott, Jonathan M %A Bird, Thomas D %A Warren, Jason D %A Boeve, Bradley F %A Lupton, Michelle K %A Bowen, James D %A Proitsi, Petra %A Boxer, Adam %A Powell, John F %A Burke, James R %A Kauwe, John S K %A Burns, Jeffrey M %A Mancuso, Michelangelo %A Buxbaum, Joseph D %A Bonuccelli, Ubaldo %A Cairns, Nigel J %A McQuillin, Andrew %A Cao, Chuanhai %A Livingston, Gill %A Carlson, Chris S %A Bass, Nicholas J %A Carlsson, Cynthia M %A Hardy, John %A Carney, Regina M %A Bras, Jose %A Carrasquillo, Minerva M %A Guerreiro, Rita %A Allen, Mariet %A Chui, Helena C %A Fisher, Elizabeth %A Masullo, Carlo %A Crocco, Elizabeth A %A DeCarli, Charles %A Bisceglio, Gina %A Dick, Malcolm %A Ma, Li %A Duara, Ranjan %A Graff-Radford, Neill R %A Evans, Denis A %A Hodges, Angela %A Faber, Kelley M %A Scherer, Martin %A Fallon, Kenneth B %A Riemenschneider, Matthias %A Fardo, David W %A Heun, Reinhard %A Farlow, Martin R %A Kölsch, Heike %A Ferris, Steven %A Leber, Markus %A Foroud, Tatiana M %A Heuser, Isabella %A Galasko, Douglas R %A Giegling, Ina %A Gearing, Marla %A Hüll, Michael %A Geschwind, Daniel H %A Gilbert, John R %A Morris, John %A Green, Robert C %A Mayo, Kevin %A Growdon, John H %A Feulner, Thomas %A Hamilton, Ronald L %A Harrell, Lindy E %A Drichel, Dmitriy %A Honig, Lawrence S %A Cushion, Thomas D %A Huentelman, Matthew J %A Hollingworth, Paul %A Hulette, Christine M %A Hyman, Bradley T %A Marshall, Rachel %A Jarvik, Gail P %A Meggy, Alun %A Abner, Erin %A Menzies, Georgina E %A Jin, Lee-Way %A Leonenko, Ganna %A Real, Luis M %A Jun, Gyungah R %A Baldwin, Clinton T %A Grozeva, Detelina %A Karydas, Anna %A Russo, Giancarlo %A Kaye, Jeffrey A %A Kim, Ronald %A Jessen, Frank %A Kowall, Neil W %A Vellas, Bruno %A Kramer, Joel H %A Vardy, Emma %A LaFerla, Frank M %A Jöckel, Karl-Heinz %A Lah, James J %A Dichgans, Martin %A Leverenz, James B %A Mann, David %A Levey, Allan I %A Pickering-Brown, Stuart %A Lieberman, Andrew P %A Klopp, Norman %A Lunetta, Kathryn L %A Wichmann, H-Erich %A Lyketsos, Constantine G %A Morgan, Kevin %A Marson, Daniel C %A Brown, Kristelle %A Martiniuk, Frank %A Medway, Christopher %A Mash, Deborah C %A Nöthen, Markus M %A Masliah, Eliezer %A Hooper, Nigel M %A McCormick, Wayne C %A Daniele, Antonio %A McCurry, Susan M %A Bayer, Anthony %A McDavid, Andrew N %A Gallacher, John %A McKee, Ann C %A van den Bussche, Hendrik %A Mesulam, Marsel %A Brayne, Carol %A Miller, Bruce L %A Riedel-Heller, Steffi %A Miller, Carol A %A Miller, Joshua W %A Al-Chalabi, Ammar %A Morris, John C %A Shaw, Christopher E %A Myers, Amanda J %A Wiltfang, Jens %A O'Bryant, Sid %A Olichney, John M %A Alvarez, Victoria %A Parisi, Joseph E %A Singleton, Andrew B %A Paulson, Henry L %A Collinge, John %A Perry, William R %A Mead, Simon %A Peskind, Elaine %A Cribbs, David H %A Rossor, Martin %A Pierce, Aimee %A Ryan, Natalie S %A Poon, Wayne W %A Nacmias, Benedetta %A Potter, Huntington %A Sorbi, Sandro %A Quinn, Joseph F %A Sacchinelli, Eleonora %A Raj, Ashok %A Spalletta, Gianfranco %A Raskind, Murray %A Caltagirone, Carlo %A Bossù, Paola %A Orfei, Maria Donata %A Reisberg, Barry %A Clarke, Robert %A Reitz, Christiane %A Smith, A David %A Ringman, John M %A Warden, Donald %A Roberson, Erik D %A Wilcock, Gordon %A Rogaeva, Ekaterina %A Bruni, Amalia Cecilia %A Rosen, Howard J %A Gallo, Maura %A Rosenberg, Roger N %A Ben-Shlomo, Yoav %A Sager, Mark A %A Mecocci, Patrizia %A Saykin, Andrew J %A Pastor, Pau %A Cuccaro, Michael L %A Vance, Jeffery M %A Schneider, Julie A %A Schneider, Lori S %A Slifer, Susan %A Seeley, William W %A Smith, Amanda G %A Sonnen, Joshua A %A Spina, Salvatore %A Stern, Robert A %A Swerdlow, Russell H %A Tang, Mitchell %A Tanzi, Rudolph E %A Trojanowski, John Q %A Troncoso, Juan C %A Van Deerlin, Vivianna M %A Van Eldik, Linda J %A Vinters, Harry V %A Vonsattel, Jean Paul %A Weintraub, Sandra %A Welsh-Bohmer, Kathleen A %A Wilhelmsen, Kirk C %A Williamson, Jennifer %A Wingo, Thomas S %A Woltjer, Randall L %A Wright, Clinton B %A Yu, Chang-En %A Yu, Lei %A Saba, Yasaman %A Pilotto, Alberto %A Bullido, María J %A Peters, Oliver %A Crane, Paul K %A Bennett, David %A Bosco, Paola %A Coto, Eliecer %A Boccardi, Virginia %A De Jager, Phil L %A Lleo, Alberto %A Warner, Nick %A Lopez, Oscar L %A Ingelsson, Martin %A Deloukas, Panagiotis %A Cruchaga, Carlos %A Graff, Caroline %A Gwilliam, Rhian %A Fornage, Myriam %A Goate, Alison M %A Sánchez-Juan, Pascual %A Kehoe, Patrick G %A Amin, Najaf %A Ertekin-Taner, Nilifur %A Berr, Claudine %A Debette, Stephanie %A Love, Seth %A Launer, Lenore J %A Younkin, Steven G %A Dartigues, Jean-François %A Corcoran, Chris %A Ikram, M Arfan %A Dickson, Dennis W %A Nicolas, Gaël %A Campion, Dominique %A Tschanz, JoAnn %A Schmidt, Helena %A Hakonarson, Hakon %A Clarimon, Jordi %A Munger, Ron %A Schmidt, Reinhold %A Farrer, Lindsay A %A Van Broeckhoven, Christine %A C O'Donovan, Michael %A DeStefano, Anita L %A Jones, Lesley %A Haines, Jonathan L %A Deleuze, Jean-Francois %A Owen, Michael J %A Gudnason, Vilmundur %A Mayeux, Richard %A Escott-Price, Valentina %A Psaty, Bruce M %A Ramirez, Alfredo %A Wang, Li-San %A Ruiz, Agustin %A van Duijn, Cornelia M %A Holmans, Peter A %A Seshadri, Sudha %A Williams, Julie %A Amouyel, Phillippe %A Schellenberg, Gerard D %A Lambert, Jean-Charles %A Pericak-Vance, Margaret A %X

Risk for late-onset Alzheimer's disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loci, we performed a large genome-wide association meta-analysis of clinically diagnosed LOAD (94,437 individuals). We confirm 20 previous LOAD risk loci and identify five new genome-wide loci (IQCK, ACE, ADAM10, ADAMTS1, and WWOX), two of which (ADAM10, ACE) were identified in a recent genome-wide association (GWAS)-by-familial-proxy of Alzheimer's or dementia. Fine-mapping of the human leukocyte antigen (HLA) region confirms the neurological and immune-mediated disease haplotype HLA-DR15 as a risk factor for LOAD. Pathway analysis implicates immunity, lipid metabolism, tau binding proteins, and amyloid precursor protein (APP) metabolism, showing that genetic variants affecting APP and Aβ processing are associated not only with early-onset autosomal dominant Alzheimer's disease but also with LOAD. Analyses of risk genes and pathways show enrichment for rare variants (P = 1.32 × 10), indicating that additional rare variants remain to be identified. We also identify important genetic correlations between LOAD and traits such as family history of dementia and education.

%B Nat Genet %V 51 %P 414-430 %8 2019 Mar %G eng %N 3 %R 10.1038/s41588-019-0358-2 %0 Journal Article %J Nat Commun %D 2019 %T {Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria %A Teumer, A. %A Li, Y. %A Ghasemi, S. %A Prins, B. P. %A Wuttke, M. %A Hermle, T. %A Giri, A. %A Sieber, K. B. %A Qiu, C. %A Kirsten, H. %A Tin, A. %A Chu, A. Y. %A Bansal, N. %A Feitosa, M. F. %A Wang, L. %A Chai, J. F. %A Cocca, M. %A Fuchsberger, C. %A Gorski, M. %A Hoppmann, A. %A Horn, K. %A Li, M. %A Marten, J. %A Noce, D. %A Nutile, T. %A Sedaghat, S. %A Sveinbjornsson, G. %A Tayo, B. O. %A van der Most, P. J. %A Xu, Y. %A Yu, Z. %A Gerstner, L. %A ?rnl?v, J. %A Bakker, S. J. L. %A Baptista, D. %A Biggs, M. L. %A Boerwinkle, E. %A Brenner, H. %A Burkhardt, R. %A Carroll, R. J. %A Chee, M. L. %A Chee, M. L. %A Chen, M. %A Cheng, C. Y. %A Cook, J. P. %A Coresh, J. %A Corre, T. %A Danesh, J. %A de Borst, M. H. %A De Grandi, A. %A de Mutsert, R. %A de Vries, A. P. J. %A Degenhardt, F. %A Dittrich, K. %A Divers, J. %A Eckardt, K. U. %A Ehret, G. %A Endlich, K. %A Felix, J. F. %A Franco, O. H. %A Franke, A. %A Freedman, B. I. %A Freitag-Wolf, S. %A Gansevoort, R. T. %A Giedraitis, V. %A G?gele, M. %A Grundner-Culemann, F. %A Gudbjartsson, D. F. %A Gudnason, V. %A Hamet, P. %A Harris, T. B. %A Hicks, A. A. %A Holm, H. %A Foo, V. H. X. %A Hwang, S. J. %A Ikram, M. A. %A Ingelsson, E. %A Jaddoe, V. W. V. %A Jakobsdottir, J. %A Josyula, N. S. %A Jung, B. %A K?h?nen, M. %A Khor, C. C. %A Kiess, W. %A Koenig, W. %A K?rner, A. %A Kovacs, P. %A Kramer, H. %A Kr?mer, B. K. %A Kronenberg, F. %A Lange, L. A. %A Langefeld, C. D. %A Lee, J. J. %A Lehtim?ki, T. %A Lieb, W. %A Lim, S. C. %A Lind, L. %A Lindgren, C. M. %A Liu, J. %A Loeffler, M. %A Lyytik?inen, L. P. %A Mahajan, A. %A Maranville, J. C. %A Mascalzoni, D. %A McMullen, B. %A Meisinger, C. %A Meitinger, T. %A Miliku, K. %A Mook-Kanamori, D. O. %A M?ller-Nurasyid, M. %A Mychaleckyj, J. C. %A Nauck, M. %A Nikus, K. %A Ning, B. %A Noordam, R. %A Connell, J. O. %A Olafsson, I. %A Palmer, N. D. %A Peters, A. %A Podgornaia, A. I. %A Ponte, B. %A Poulain, T. %A Pramstaller, P. P. %A Rabelink, T. J. %A Raffield, L. M. %A Reilly, D. F. %A Rettig, R. %A Rheinberger, M. %A Rice, K. M. %A Rivadeneira, F. %A Runz, H. %A Ryan, K. A. %A Sabanayagam, C. %A Saum, K. U. %A Sch?ttker, B. %A Shaffer, C. M. %A Shi, Y. %A Smith, A. V. %A Strauch, K. %A Stumvoll, M. %A Sun, B. B. %A Szymczak, S. %A Tai, E. S. %A Tan, N. Y. Q. %A Taylor, K. D. %A Teren, A. %A Tham, Y. C. %A Thiery, J. %A Thio, C. H. L. %A Thomsen, H. %A Thorsteinsdottir, U. %A T?njes, A. %A Tremblay, J. %A Uitterlinden, A. G. %A van der Harst, P. %A Verweij, N. %A Vogelezang, S. %A V?lker, U. %A Waldenberger, M. %A Wang, C. %A Wilson, O. D. %A Wong, C. %A Wong, T. Y. %A Yang, Q. %A Yasuda, M. %A Akilesh, S. %A Bochud, M. %A B?ger, C. A. %A Devuyst, O. %A Edwards, T. L. %A Ho, K. %A Morris, A. P. %A Parsa, A. %A Pendergrass, S. A. %A Psaty, B. M. %A Rotter, J. I. %A Stefansson, K. %A Wilson, J. G. %A Susztak, K. %A Snieder, H. %A Heid, I. M. %A Scholz, M. %A Butterworth, A. S. %A Hung, A. M. %A Pattaro, C. %A K?ttgen, A. %X Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria. %B Nat Commun %V 10 %P 4130 %8 09 %G eng %0 Journal Article %J Commun Biol %D 2019 %T {A genome-wide association study identifies genetic loci associated with specific lobar brain volumes %A van der Lee, S. J. %A Knol, M. J. %A Chauhan, G. %A Satizabal, C. L. %A Smith, A. V. %A Hofer, E. %A Bis, J. C. %A Hibar, D. P. %A Hilal, S. %A van den Akker, E. B. %A Arfanakis, K. %A Bernard, M. %A Yanek, L. R. %A Amin, N. %A Crivello, F. %A Cheung, J. W. %A Harris, T. B. %A Saba, Y. %A Lopez, O. L. %A Li, S. %A van der Grond, J. %A Yu, L. %A Paus, T. %A Roshchupkin, G. V. %A Amouyel, P. %A Jahanshad, N. %A Taylor, K. D. %A Yang, Q. %A Mathias, R. A. %A Boehringer, S. %A Mazoyer, B. %A Rice, K. %A Cheng, C. Y. %A Maillard, P. %A van Heemst, D. %A Wong, T. Y. %A Niessen, W. J. %A Beiser, A. S. %A Beekman, M. %A Zhao, W. %A Nyquist, P. A. %A Chen, C. %A Launer, L. J. %A Psaty, B. M. %A Ikram, M. K. %A Vernooij, M. W. %A Schmidt, H. %A Pausova, Z. %A Becker, D. M. %A De Jager, P. L. %A Thompson, P. M. %A van Duijn, C. M. %A Bennett, D. A. %A Slagboom, P. E. %A Schmidt, R. %A Longstreth, W. T. %A Ikram, M. A. %A Seshadri, S. %A Debette, S. %A Gudnason, V. %A Adams, H. H. H. %A DeCarli, C. %X Brain lobar volumes are heritable but genetic studies are limited. We performed genome-wide association studies of frontal, occipital, parietal and temporal lobe volumes in 16,016 individuals, and replicated our findings in 8,789 individuals. We identified six genetic loci associated with specific lobar volumes independent of intracranial volume. Two loci, associated with occipital (6q22.32) and temporal lobe volume (12q14.3), were previously reported to associate with intracranial and hippocampal volume, respectively. We identified four loci previously unknown to affect brain volumes: 3q24 for parietal lobe volume, and 1q22, 4p16.3 and 14q23.1 for occipital lobe volume. The associated variants were located in regions enriched for histone modifications (DAAM1 and THBS3), or close to genes causing Mendelian brain-related diseases (ZIC4 and FGFRL1). No genetic overlap between lobar volumes and neurological or psychiatric diseases was observed. Our findings reveal part of the complex genetics underlying brain development and suggest a role for regulatory regions in determining brain volumes. %B Commun Biol %V 2 %P 285 %G eng %0 Journal Article %J Am J Hypertens %D 2019 %T {Genome-Wide Association Study of Apparent Treatment-Resistant Hypertension in the CHARGE Consortium: The CHARGE Pharmacogenetics Working Group %A Irvin, M. R. %A Sitlani, C. M. %A Floyd, J. S. %A Psaty, B. M. %A Bis, J. C. %A Wiggins, K. L. %A Whitsel, E. A. %A Sturmer, T. %A Stewart, J. %A Raffield, L. %A Sun, F. %A Liu, C. T. %A Xu, H. %A Cupples, A. L. %A Tanner, R. M. %A Rossing, P. %A Smith, A. %A Zilh?o, N. R. %A Launer, L. J. %A Noordam, R. %A Rotter, J. I. %A Yao, J. %A Li, X. %A Guo, X. %A Limdi, N. %A Sundaresan, A. %A Lange, L. %A Correa, A. %A Stott, D. J. %A Ford, I. %A Jukema, J. W. %A Gudnason, V. %A Mook-Kanamori, D. O. %A Trompet, S. %A Palmas, W. %A Warren, H. R. %A Hellwege, J. N. %A Giri, A. %A O'Donnell, C. %A Hung, A. M. %A Edwards, T. L. %A Ahluwalia, T. S. %A Arnett, D. K. %A Avery, C. L. %X {Only a handful of genetic discovery efforts in apparent treatment-resistant hypertension (aTRH) have been described.\ We conducted a case-control genome-wide association study of aTRH among persons treated for hypertension, using data from 10 cohorts of European ancestry (EA) and 5 cohorts of African ancestry (AA). Cases were treated with 3 different antihypertensive medication classes and had blood pressure (BP) above goal (systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg) or 4 or more medication classes regardless of BP control (nEA = 931 %B Am J Hypertens %V 32 %P 1146–1153 %8 11 %G eng %0 Journal Article %J Am J Hypertens %D 2019 %T Genome-Wide Association Study of Apparent Treatment-Resistant Hypertension in the CHARGE Consortium: The CHARGE Pharmacogenetics Working Group. %A Irvin, Marguerite R %A Sitlani, Colleen M %A Floyd, James S %A Psaty, Bruce M %A Bis, Joshua C %A Wiggins, Kerri L %A Whitsel, Eric A %A Stürmer, Til %A Stewart, James %A Raffield, Laura %A Sun, Fangui %A Liu, Ching-Ti %A Xu, Hanfei %A Cupples, Adrienne L %A Tanner, Rikki M %A Rossing, Peter %A Smith, Albert %A Zilhão, Nuno R %A Launer, Lenore J %A Noordam, Raymond %A Rotter, Jerome I %A Yao, Jie %A Li, Xiaohui %A Guo, Xiuqing %A Limdi, Nita %A Sundaresan, Aishwarya %A Lange, Leslie %A Correa, Adolfo %A Stott, David J %A Ford, Ian %A Jukema, J Wouter %A Gudnason, Vilmundur %A Mook-Kanamori, Dennis O %A Trompet, Stella %A Palmas, Walter %A Warren, Helen R %A Hellwege, Jacklyn N %A Giri, Ayush %A O'donnell, Christopher %A Hung, Adriana M %A Edwards, Todd L %A Ahluwalia, Tarunveer S %A Arnett, Donna K %A Avery, Christy L %K Aged %K Antihypertensive Agents %K Black or African American %K Blood Pressure %K Case-Control Studies %K DNA (Cytosine-5-)-Methyltransferases %K DNA Methyltransferase 3A %K DNA-Binding Proteins %K Drug Resistance %K Dystrophin-Associated Proteins %K Europe %K Female %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Hypertension %K Male %K Middle Aged %K Myosin Heavy Chains %K Myosin Type V %K Neuropeptides %K Pharmacogenetics %K Pharmacogenomic Variants %K Polymorphism, Single Nucleotide %K Risk Assessment %K Risk Factors %K Transcription Factors %K United States %K White People %X

BACKGROUND: Only a handful of genetic discovery efforts in apparent treatment-resistant hypertension (aTRH) have been described.

METHODS: We conducted a case-control genome-wide association study of aTRH among persons treated for hypertension, using data from 10 cohorts of European ancestry (EA) and 5 cohorts of African ancestry (AA). Cases were treated with 3 different antihypertensive medication classes and had blood pressure (BP) above goal (systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg) or 4 or more medication classes regardless of BP control (nEA = 931, nAA = 228). Both a normotensive control group and a treatment-responsive control group were considered in separate analyses. Normotensive controls were untreated (nEA = 14,210, nAA = 2,480) and had systolic BP/diastolic BP < 140/90 mm Hg. Treatment-responsive controls (nEA = 5,266, nAA = 1,817) had BP at goal (<140/90 mm Hg), while treated with one antihypertensive medication class. Individual cohorts used logistic regression with adjustment for age, sex, study site, and principal components for ancestry to examine the association of single-nucleotide polymorphisms with case-control status. Inverse variance-weighted fixed-effects meta-analyses were carried out using METAL.

RESULTS: The known hypertension locus, CASZ1, was a top finding among EAs (P = 1.1 × 10-8) and in the race-combined analysis (P = 1.5 × 10-9) using the normotensive control group (rs12046278, odds ratio = 0.71 (95% confidence interval: 0.6-0.8)). Single-nucleotide polymorphisms in this locus were robustly replicated in the Million Veterans Program (MVP) study in consideration of a treatment-responsive control group. There were no statistically significant findings for the discovery analyses including treatment-responsive controls.

CONCLUSION: This genomic discovery effort for aTRH identified CASZ1 as an aTRH risk locus.

%B Am J Hypertens %V 32 %P 1146-1153 %8 2019 Nov 15 %G eng %N 12 %R 10.1093/ajh/hpz150 %0 Journal Article %J Am J Clin Nutr %D 2019 %T Genome-wide association study of breakfast skipping links clock regulation with food timing. %A Dashti, Hassan S %A Merino, Jordi %A Lane, Jacqueline M %A Song, Yanwei %A Smith, Caren E %A Tanaka, Toshiko %A McKeown, Nicola M %A Tucker, Chandler %A Sun, Dianjianyi %A Bartz, Traci M %A Li-Gao, Ruifang %A Nisa, Hoirun %A Reutrakul, Sirimon %A Lemaitre, Rozenn N %A Alshehri, Tahani M %A de Mutsert, Renée %A Bazzano, Lydia %A Qi, Lu %A Knutson, Kristen L %A Psaty, Bruce M %A Mook-Kanamori, Dennis O %A Perica, Vesna Boraska %A Neuhouser, Marian L %A Scheer, Frank A J L %A Rutter, Martin K %A Garaulet, Marta %A Saxena, Richa %X

BACKGROUND: Little is known about the contribution of genetic variation to food timing, and breakfast has been determined to exhibit the most heritable meal timing. As breakfast timing and skipping are not routinely measured in large cohort studies, alternative approaches include analyses of correlated traits.

OBJECTIVES: The aim of this study was to elucidate breakfast skipping genetic variants through a proxy-phenotype genome-wide association study (GWAS) for breakfast cereal skipping, a commonly assessed correlated trait.

METHODS: We leveraged the statistical power of the UK Biobank (n = 193,860) to identify genetic variants related to breakfast cereal skipping as a proxy-phenotype for breakfast skipping and applied several in silico approaches to investigate mechanistic functions and links to traits/diseases. Next, we attempted validation of our approach in smaller breakfast skipping GWAS from the TwinUK (n = 2,006) and the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium (n = 11,963).

RESULTS: In the UK Biobank, we identified 6 independent GWAS variants, including those implicated for caffeine (ARID3B/CYP1A1), carbohydrate metabolism (FGF21), schizophrenia (ZNF804A), and encoding enzymes important for N6-methyladenosine RNA transmethylation (METTL4, YWHAB, and YTHDF3), which regulates the pace of the circadian clock. Expression of identified genes was enriched in the cerebellum. Genome-wide correlation analyses indicated positive correlations with anthropometric traits. Through Mendelian randomization (MR), we observed causal links between genetically determined breakfast skipping and higher body mass index, more depressive symptoms, and smoking. In bidirectional MR, we demonstrated a causal link between being an evening person and skipping breakfast, but not vice versa. We observed association of our signals in an independent breakfast skipping GWAS in another British cohort (P = 0.032), TwinUK, but not in a meta-analysis of non-British cohorts from the CHARGE consortium (P = 0.095).

CONCLUSIONS: Our proxy-phenotype GWAS identified 6 genetic variants for breakfast skipping, linking clock regulation with food timing and suggesting a possible beneficial role of regular breakfast intake as part of a healthy lifestyle.

%B Am J Clin Nutr %8 2019 Jun 13 %G eng %R 10.1093/ajcn/nqz076 %0 Journal Article %J Clin Pharmacol Ther %D 2019 %T Genomewide Association Study of Statin-Induced Myopathy in Patients Recruited Using the UK Clinical Practice Research Datalink. %A Carr, Daniel F %A Francis, Ben %A Jorgensen, Andrea L %A Zhang, Eunice %A Chinoy, Hector %A Heckbert, Susan R %A Bis, Joshua C %A Brody, Jennifer A %A Floyd, James S %A Psaty, Bruce M %A Molokhia, Mariam %A Lapeyre-Mestre, Maryse %A Conforti, Anita %A Alfirevic, Ana %A van Staa, Tjeerd %A Pirmohamed, Munir %K Adverse Drug Reaction Reporting Systems %K Case-Control Studies %K Databases, Factual %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Hydroxymethylglutaryl-CoA Reductase Inhibitors %K Liver-Specific Organic Anion Transporter 1 %K Muscular Diseases %K Pharmacogenomic Variants %K Polymorphism, Single Nucleotide %K Reproducibility of Results %K Risk Factors %K Severity of Illness Index %K United Kingdom %X

Statins can be associated with myopathy. We have undertaken a genomewide association study (GWAS) to discover and validate genetic risk factors for statin-induced myopathy in a "real-world" setting. One hundred thirty-five patients with statin myopathy recruited via the UK Clinical Practice Research Datalink were genotyped using the Illumina OmniExpress Exome version 1.0 Bead Chip and compared with the Wellcome Trust Case-Control Consortium (n = 2,501). Nominally statistically significant single nucleotide polymorphism (SNP) signals in the GWAS (P < 5 × 10 ) were further evaluated in several independent cohorts (comprising 332 cases and 449 drug-tolerant controls). Only one (rs4149056/c.521C>T in the SLCO1B1 gene) SNP was genomewide significant in the severe myopathy (creatine kinase > 10 × upper limit of normal or rhabdomyolysis) group (P = 2.55 × 10 ; odds ratio 5.15; 95% confidence interval 3.13-8.45). The association with SLCO1B1 was present for several statins and replicated in the independent validation cohorts. The data highlight the role of SLCO1B1 c.521C>T SNP as a replicable genetic risk factor for statin myopathy. No other novel genetic risk factors with a similar effect size were identified.

%B Clin Pharmacol Ther %V 106 %P 1353-1361 %8 2019 12 %G eng %N 6 %R 10.1002/cpt.1557 %0 Journal Article %J Circulation %D 2019 %T {Genome-Wide Association Transethnic Meta-Analyses Identifies Novel Associations Regulating Coagulation Factor VIII and von Willebrand Factor Plasma Levels %A Sabater-Lleal, M. %A Huffman, J. E. %A de Vries, P. S. %A Marten, J. %A Mastrangelo, M. A. %A Song, C. %A Pankratz, N. %A Ward-Caviness, C. K. %A Yanek, L. R. %A Trompet, S. %A Delgado, G. E. %A Guo, X. %A Bartz, T. M. %A Martinez-Perez, A. %A Germain, M. %A de Haan, H. G. %A Ozel, A. B. %A Polasek, O. %A Smith, A. V. %A Eicher, J. D. %A Reiner, A. P. %A Tang, W. %A Davies, N. M. %A Stott, D. J. %A Rotter, J. I. %A Tofler, G. H. %A Boerwinkle, E. %A de Maat, M. P. M. %A Kleber, M. E. %A Welsh, P. %A Brody, J. A. %A Chen, M. H. %A Vaidya, D. %A Soria, J. M. %A Suchon, P. %A van Hylckama Vlieg, A. %A Desch, K. C. %A Kolcic, I. %A Joshi, P. K. %A Launer, L. J. %A Harris, T. B. %A Campbell, H. %A Rudan, I. %A Becker, D. M. %A Li, J. Z. %A Rivadeneira, F. %A Uitterlinden, A. G. %A Hofman, A. %A Franco, O. H. %A Cushman, M. %A Psaty, B. M. %A Morange, P. E. %A McKnight, B. %A Chong, M. R. %A Fernandez-Cadenas, I. %A Rosand, J. %A Lindgren, A. %A Gudnason, V. %A Wilson, J. F. %A Hayward, C. %A Ginsburg, D. %A Fornage, M. %A Rosendaal, F. R. %A Souto, J. C. %A Becker, L. C. %A Jenny, N. S. %A M?rz, W. %A Jukema, J. W. %A Dehghan, A. %A Tr?gou?t, D. A. %A Morrison, A. C. %A Johnson, A. D. %A O'Donnell, C. J. %A Strachan, D. P. %A Lowenstein, C. J. %A Smith, N. L. %X Factor VIII (FVIII) and its carrier protein von Willebrand factor (VWF) are associated with risk of arterial and venous thrombosis and with hemorrhagic disorders. We aimed to identify and functionally test novel genetic associations regulating plasma FVIII and VWF.\ We meta-analyzed genome-wide association results from 46 354 individuals of European, African, East Asian, and Hispanic ancestry. All studies performed linear regression analysis using an additive genetic model and associated ≈35 million imputed variants with natural log-transformed phenotype levels. In vitro gene silencing in cultured endothelial cells was performed for candidate genes to provide additional evidence on association and function. Two-sample Mendelian randomization analyses were applied to test the causal role of FVIII and VWF plasma levels on the risk of arterial and venous thrombotic events.\ We identified 13 novel genome-wide significant ( P≤2.5×10-8) associations, 7 with FVIII levels ( FCHO2/TMEM171/TNPO1, HLA, SOX17/RP1, LINC00583/NFIB, RAB5C-KAT2A, RPL3/TAB1/SYNGR1, and ARSA) and 11 with VWF levels ( PDHB/PXK/KCTD6, SLC39A8, FCHO2/TMEM171/TNPO1, HLA, GIMAP7/GIMAP4, OR13C5/NIPSNAP, DAB2IP, C2CD4B, RAB5C-KAT2A, TAB1/SYNGR1, and ARSA), beyond 10 previously reported associations with these phenotypes. Functional validation provided further evidence of association for all loci on VWF except ARSA and DAB2IP. Mendelian randomization suggested causal effects of plasma FVIII activity levels on venous thrombosis and coronary artery disease risk and plasma VWF levels on ischemic stroke risk.\ The meta-analysis identified 13 novel genetic loci regulating FVIII and VWF plasma levels, 10 of which we validated functionally. We provide some evidence for a causal role of these proteins in thrombotic events. %B Circulation %V 139 %P 620–635 %8 01 %G eng %0 Journal Article %J Mol Genet Genomic Med %D 2019 %T Genome-wide meta-analysis of SNP and antihypertensive medication interactions on left ventricular traits in African Americans. %A Do, Anh N %A Zhao, Wei %A Baldridge, Abigail S %A Raffield, Laura M %A Wiggins, Kerri L %A Shah, Sanjiv J %A Aslibekyan, Stella %A Tiwari, Hemant K %A Limdi, Nita %A Zhi, Degui %A Sitlani, Colleen M %A Taylor, Kent D %A Psaty, Bruce M %A Sotoodehnia, Nona %A Brody, Jennifer A %A Rasmussen-Torvik, Laura J %A Lloyd-Jones, Donald %A Lange, Leslie A %A Wilson, James G %A Smith, Jennifer A %A Kardia, Sharon L R %A Mosley, Thomas H %A Vasan, Ramachandran S %A Arnett, Donna K %A Irvin, Marguerite R %K African Americans %K Angiotensin-Converting Enzyme Inhibitors %K Antihypertensive Agents %K Calcium Channel Blockers %K Humans %K Observational Studies as Topic %K Pharmacogenomic Variants %K Polymorphism, Single Nucleotide %K Sodium Chloride Symporter Inhibitors %K Ventricular Dysfunction, Left %X

BACKGROUND: Left ventricular (LV) hypertrophy affects up to 43% of African Americans (AAs). Antihypertensive treatment reduces LV mass (LVM). However, interindividual variation in LV traits in response to antihypertensive treatments exists. We hypothesized that genetic variants may modify the association of antihypertensive treatment class with LV traits measured by echocardiography.

METHODS: We evaluated the main effects of the three most common antihypertensive treatments for AAs as well as the single nucleotide polymorphism (SNP)-by-drug interaction on LVM and relative wall thickness (RWT) in 2,068 participants across five community-based cohorts. Treatments included thiazide diuretics (TDs), angiotensin converting enzyme inhibitors (ACE-Is), and dihydropyridine calcium channel blockers (dCCBs) and were compared in a pairwise manner. We performed fixed effects inverse variance weighted meta-analyses of main effects of drugs and 2.5 million SNP-by-drug interaction estimates.

RESULTS: We observed that dCCBs versus TDs were associated with higher LVM after adjusting for covariates (p = 0.001). We report three SNPs at a single locus on chromosome 20 that modified the association between RWT and treatment when comparing dCCBs to ACE-Is with consistent effects across cohorts (smallest p = 4.7 × 10 , minor allele frequency range 0.09-0.12). This locus has been linked to LV hypertrophy in a previous study. A marginally significant locus in BICD1 (rs326641) was validated in an external population.

CONCLUSIONS: Our study identified one locus having genome-wide significant SNP-by-drug interaction effect on RWT among dCCB users in comparison to ACE-I users. Upon additional validation in future studies, our findings can enhance the precision of medical approaches in hypertension treatment.

%B Mol Genet Genomic Med %V 7 %P e00788 %8 2019 10 %G eng %N 10 %R 10.1002/mgg3.788 %0 Journal Article %J Pharmacogenomics J %D 2019 %T Genome-wide meta-analysis of variant-by-diuretic interactions as modulators of lipid traits in persons of European and African ancestry. %A de Las Fuentes, L %A Sung, Y J %A Sitlani, C M %A Avery, C L %A Bartz, T M %A Keyser, C de %A Evans, D S %A Li, X %A Musani, S K %A Ruiter, R %A Smith, A V %A Sun, F %A Trompet, S %A Xu, H %A Arnett, D K %A Bis, J C %A Broeckel, U %A Busch, E L %A Chen, Y-D I %A Correa, A %A Cummings, S R %A Floyd, J S %A Ford, I %A Guo, X %A Harris, T B %A Ikram, M A %A Lange, L %A Launer, L J %A Reiner, A P %A Schwander, K %A Smith, N L %A Sotoodehnia, N %A Stewart, J D %A Stott, D J %A Stürmer, T %A Taylor, K D %A Uitterlinden, A %A Vasan, R S %A Wiggins, K L %A Cupples, L A %A Gudnason, V %A Heckbert, S R %A Jukema, J W %A Liu, Y %A Psaty, B M %A Rao, D C %A Rotter, J I %A Stricker, B %A Wilson, J G %A Whitsel, E A %X

Hypertension (HTN) is a significant risk factor for cardiovascular morbidity and mortality. Metabolic abnormalities, including adverse cholesterol and triglycerides (TG) profiles, are frequent comorbid findings with HTN and contribute to cardiovascular disease. Diuretics, which are used to treat HTN and heart failure, have been associated with worsening of fasting lipid concentrations. Genome-wide meta-analyses with 39,710 European-ancestry (EA) individuals and 9925 African-ancestry (AA) individuals were performed to identify genetic variants that modify the effect of loop or thiazide diuretic use on blood lipid concentrations. Both longitudinal and cross sectional data were used to compute cohort-specific interaction results, which were then combined through meta-analysis in each ancestry. These ancestry-specific results were further combined through trans-ancestry meta-analysis. Analysis of EA data identified two genome-wide significant (p < 5 × 10) loci with single nucleotide variant (SNV)-loop diuretic interaction on TG concentrations (including COL11A1). Analysis of AA data identified one genome-wide significant locus adjacent to BMP2 with SNV-loop diuretic interaction on TG concentrations. Trans-ancestry analysis strengthened evidence of association for SNV-loop diuretic interaction at two loci (KIAA1217 and BAALC). There were few significant SNV-thiazide diuretic interaction associations on TG concentrations and for either diuretic on cholesterol concentrations. Several promising loci were identified that may implicate biologic pathways that contribute to adverse metabolic side effects from diuretic therapy.

%B Pharmacogenomics J %8 2019 Dec 06 %G eng %R 10.1038/s41397-019-0132-y %0 Journal Article %J Blood %D 2019 %T Genomic and transcriptomic association studies identify 16 novel susceptibility loci for venous thromboembolism. %A Lindström, Sara %A Wang, Lu %A Smith, Erin N %A Gordon, William %A van Hylckama Vlieg, Astrid %A de Andrade, Mariza %A Brody, Jennifer A %A Pattee, Jack W %A Haessler, Jeffrey %A Brumpton, Ben M %A Chasman, Daniel I %A Suchon, Pierre %A Chen, Ming-Huei %A Turman, Constance %A Germain, Marine %A Wiggins, Kerri L %A MacDonald, James %A Braekkan, Sigrid K %A Armasu, Sebastian M %A Pankratz, Nathan %A Jackson, Rebecca D %A Nielsen, Jonas B %A Giulianini, Franco %A Puurunen, Marja K %A Ibrahim, Manal %A Heckbert, Susan R %A Damrauer, Scott M %A Natarajan, Pradeep %A Klarin, Derek %A de Vries, Paul S %A Sabater-Lleal, Maria %A Huffman, Jennifer E %A Bammler, Theo K %A Frazer, Kelly A %A McCauley, Bryan M %A Taylor, Kent %A Pankow, James S %A Reiner, Alexander P %A Gabrielsen, Maiken E %A Deleuze, Jean-Francois %A O'Donnell, Chris J %A Kim, Jihye %A McKnight, Barbara %A Kraft, Peter %A Hansen, John-Bjarne %A Rosendaal, Frits R %A Heit, John A %A Psaty, Bruce M %A Tang, Weihong %A Kooperberg, Charles %A Hveem, Kristian %A Ridker, Paul M %A Morange, Pierre-Emmanuel %A Johnson, Andrew D %A Kabrhel, Christopher %A Trégouët, David-Alexandre %A Smith, Nicholas L %X

Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality. To advance our understanding of the biology contributing to VTE, we conducted a genome-wide association study (GWAS) of VTE and a transcriptome-wide association study (TWAS) based on imputed gene expression from whole blood and liver. We meta-analyzed GWAS data from 18 studies for 30 234 VTE cases and 172 122 controls and assessed the association between 12 923 718 genetic variants and VTE. We generated variant prediction scores of gene expression from whole blood and liver tissue and assessed them for association with VTE. Mendelian randomization analyses were conducted for traits genetically associated with novel VTE loci. We identified 34 independent genetic signals for VTE risk from GWAS meta-analysis, of which 14 are newly reported associations. This included 11 newly associated genetic loci (C1orf198, PLEK, OSMR-AS1, NUGGC/SCARA5, GRK5, MPHOSPH9, ARID4A, PLCG2, SMG6, EIF5A, and STX10) of which 6 replicated, and 3 new independent signals in 3 known genes. Further, TWAS identified 5 additional genetic loci with imputed gene expression levels differing between cases and controls in whole blood (SH2B3, SPSB1, RP11-747H7.3, RP4-737E23.2) and in liver (ERAP1). At some GWAS loci, we found suggestive evidence that the VTE association signal for novel and previously known regions colocalized with expression quantitative trait locus signals. Mendelian randomization analyses suggested that blood traits may contribute to the underlying risk of VTE. To conclude, we identified 16 novel susceptibility loci for VTE; for some loci, the association signals are likely mediated through gene expression of nearby genes.

%B Blood %V 134 %P 1645-1657 %8 2019 Nov 07 %G eng %N 19 %R 10.1182/blood.2019000435 %0 Journal Article %J Elife %D 2019 %T Genomics of 1 million parent lifespans implicates novel pathways and common diseases and distinguishes survival chances. %A Timmers, Paul Rhj %A Mounier, Ninon %A Läll, Kristi %A Fischer, Krista %A Ning, Zheng %A Feng, Xiao %A Bretherick, Andrew D %A Clark, David W %A Agbessi, M %A Ahsan, H %A Alves, I %A Andiappan, A %A Awadalla, P %A Battle, A %A Bonder, M J %A Boomsma, D %A Christiansen, M %A Claringbould, A %A Deelen, P %A van Dongen, J %A Esko, T %A Favé, M %A Franke, L %A Frayling, T %A Gharib, S A %A Gibson, G %A Hemani, G %A Jansen, R %A Kalnapenkis, A %A Kasela, S %A Kettunen, J %A Kim, Y %A Kirsten, H %A Kovacs, P %A Krohn, K %A Kronberg-Guzman, J %A Kukushkina, V %A Kutalik, Z %A Kähönen, M %A Lee, B %A Lehtimäki, T %A Loeffler, M %A Marigorta, U %A Metspalu, A %A van Meurs, J %A Milani, L %A Müller-Nurasyid, M %A Nauck, M %A Nivard, M %A Penninx, B %A Perola, M %A Pervjakova, N %A Pierce, B %A Powell, J %A Prokisch, H %A Psaty, B M %A Raitakari, O %A Ring, S %A Ripatti, S %A Rotzschke, O %A Ruëger, S %A Saha, A %A Scholz, M %A Schramm, K %A Seppälä, I %A Stumvoll, M %A Sullivan, P %A Teumer, A %A Thiery, J %A Tong, L %A Tönjes, A %A Verlouw, J %A Visscher, P M %A Võsa, U %A Völker, U %A Yaghootkar, H %A Yang, J %A Zeng, B %A Zhang, F %A Agbessi, M %A Ahsan, H %A Alves, I %A Andiappan, A %A Awadalla, P %A Battle, A %A Bonder, M J %A Boomsma, D %A Christiansen, M %A Claringbould, A %A Deelen, P %A van Dongen, J %A Esko, T %A Favé, M %A Franke, L %A Frayling, T %A Gharib, S A %A Gibson, G %A Hemani, G %A Jansen, R %A Kalnapenkis, A %A Kasela, S %A Kettunen, J %A Kim, Y %A Kirsten, H %A Kovacs, P %A Krohn, K %A Kronberg-Guzman, J %A Kukushkina, V %A Kutalik, Z %A Kähönen, M %A Lee, B %A Lehtimäki, T %A Loeffler, M %A Marigorta, U %A Metspalu, A %A van Meurs, J %A Milani, L %A Müller-Nurasyid, M %A Nauck, M %A Nivard, M %A Penninx, B %A Perola, M %A Pervjakova, N %A Pierce, B %A Powell, J %A Prokisch, H %A Psaty, B M %A Raitakari, O %A Ring, S %A Ripatti, S %A Rotzschke, O %A Ruëger, S %A Saha, A %A Scholz, M %A Schramm, K %A Seppälä, I %A Stumvoll, M %A Sullivan, P %A Teumer, A %A Thiery, J %A Tong, L %A Tönjes, A %A Verlouw, J %A Visscher, P M %A Võsa, U %A Völker, U %A Yaghootkar, H %A Yang, J %A Zeng, B %A Zhang, F %A Shen, Xia %A Esko, Tõnu %A Kutalik, Zoltán %A Wilson, James F %A Joshi, Peter K %X

We use a genome-wide association of 1 million parental lifespans of genotyped subjects and data on mortality risk factors to validate previously unreplicated findings near , , , , , and 13q21.31, and identify and replicate novel findings near , , and . We also validate previous findings near 5q33.3/ and , whilst finding contradictory evidence at other loci. Gene set and cell-specific analyses show that expression in foetal brain cells and adult dorsolateral prefrontal cortex is enriched for lifespan variation, as are gene pathways involving lipid proteins and homeostasis, vesicle-mediated transport, and synaptic function. Individual genetic variants that increase dementia, cardiovascular disease, and lung cancer - but not other cancers - explain the most variance. Resulting polygenic scores show a mean lifespan difference of around five years of life across the deciles.

Editorial note: This article has been through an editorial process in which the authors decide how to respond to the issues raised during peer review. The Reviewing Editor's assessment is that all the issues have been addressed (see decision letter).

%B Elife %V 8 %8 2019 Jan 15 %G eng %R 10.7554/eLife.39856 %0 Journal Article %J Am J Epidemiol %D 2019 %T Heterogeneous Exposure Associations in Observational Cohort Studies: The Example of Blood Pressure in Older Adults. %A Odden, Michelle C %A Rawlings, Andreea M %A Khodadadi, Abtin %A Fern, Xiaoli %A Shlipak, Michael G %A Bibbins-Domingo, Kirsten %A Covinsky, Kenneth %A Kanaya, Alka M %A Lee, Anne %A Haan, Mary N %A Newman, Anne B %A Psaty, Bruce M %A Peralta, Carmen A %X

Heterogeneous exposure associations (HEAs) can be defined as differences in the association of a exposure with an outcome among subgroups that differ by a set of characteristics. This manuscript intends to foster discussion of HEAs in the epidemiological literature, and present a variant of the random forest algorithm that can be used to identify HEAs. We demonstrate the use of this algorithm in the setting of the association of systolic blood pressure and death in older adults. The training set included pooled data from the baseline examination of the Cardiovascular Health Study (1989-1993), the Health, Aging, and Body Composition study (1997-1998), and the Sacramento Area Latino Study on Aging (1998-1999). The test set included data from the National Health and Nutrition Examination Survey (1999-2002). The hazard ratios ranged from 1.25 (95% CI: 1.13, 1.37) per 10 mmHg higher systolic blood pressure in men aged ≤67 years with diastolic blood pressure >80 mmHg, to 1.00 (0.96, 1.03) in women with creatinine <0.7 mg/dL and a history of hypertension. HEAs have the potential to improve our understanding of disease mechanisms in diverse populations, and guide the design of randomized controlled trials to control exposures in heterogeneous populations.

%B Am J Epidemiol %8 2019 Oct 08 %G eng %R 10.1093/aje/kwz218 %0 Journal Article %J Stat Med %D 2019 %T High-dimensional longitudinal classification with the multinomial fused lasso. %A Adhikari, Samrachana %A Lecci, Fabrizio %A Becker, James T %A Junker, Brian W %A Kuller, Lewis H %A Lopez, Oscar L %A Tibshirani, Ryan J %X

We study regularized estimation in high-dimensional longitudinal classification problems, using the lasso and fused lasso regularizers. The constructed coefficient estimates are piecewise constant across the time dimension in the longitudinal problem, with adaptively selected change points (break points). We present an efficient algorithm for computing such estimates, based on proximal gradient descent. We apply our proposed technique to a longitudinal data set on Alzheimer's disease from the Cardiovascular Health Study Cognition Study. Using data analysis and a simulation study, we motivate and demonstrate several practical considerations such as the selection of tuning parameters and the assessment of model stability. While race, gender, vascular and heart disease, lack of caregivers, and deterioration of learning and memory are all important predictors of dementia, we also find that these risk factors become more relevant in the later stages of life.

%B Stat Med %8 2019 Jan 30 %G eng %R 10.1002/sim.8100 %0 Journal Article %J PLoS One %D 2019 %T {The impact of APOE genotype on survival: Results of 38,537 participants from six population-based cohorts (E2-CHARGE) %A Wolters, F. J. %A Yang, Q. %A Biggs, M. L. %A Jakobsdottir, J. %A Li, S. %A Evans, D. S. %A Bis, J. C. %A Harris, T. B. %A Vasan, R. S. %A Zilhao, N. R. %A Ghanbari, M. %A Ikram, M. A. %A Launer, L. %A Psaty, B. M. %A Tranah, G. J. %A Kulminski, A. M. %A Gudnason, V. %A Seshadri, S. %X Apolipoprotein E is a glycoprotein best known as a mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has long been associated with increased risks of Alzheimer's disease and mortality, but the effect of the less prevalent APOE-ε2 allele on diseases in the elderly and survival remains elusive.\ We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six population-based cohort studies (Rotterdam Study, AGES-Reykjavik Study, Cardiovascular Health Study, Health-ABC Study, and the family-based Framingham Heart Study and Long Life Family Study) to determine the association of APOE, and in particular APOE-ε2, with survival in the population.\ During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90-0.99; P = 1.1*10-2), whereas APOE-ε4 carriers were at increased risk of death (HR 1.17,1.12-1.21; P = 2.8*10-16). APOE was associated with mortality risk in a dose-dependent manner, with risk estimates lowest for homozygous APOE-ε2 (HR 0.89,0.74-1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37-1.70). After censoring for dementia, effect estimates remained similar for APOE-ε2 (HR 0.95,0.90-1.01), but attenuated for APOE-ε4 (HR 1.07,1.01-1.12). Results were broadly similar across cohorts, and did not differ by age or sex. APOE genotype was associated with baseline lipid fractions (e.g. mean difference(95%CI) in LDL(mg/dL) for ε2 versus ε33: -17.1(-18.1-16.0), and ε4 versus ε33: +5.7(4.8;6.5)), but the association between APOE and mortality was unaltered after adjustment for baseline LDL or cardiovascular disease. Given the European ancestry of the study population, results may not apply to other ethnicities.\ Compared with APOE-ε3, APOE-ε2 is associated with prolonged survival, whereas mortality risk is increased for APOE-ε4 carriers. Further collaborative efforts are needed to unravel the role of APOE and in particular APOE-ε2 in health and disease. %B PLoS One %V 14 %P e0219668 %G eng %0 Journal Article %J J Health Psychol %D 2019 %T {The impact of both spousal caregivers' and care recipients' health on relationship satisfaction in the Caregiver Health Effects Study %A Monin, J. K. %A Levy, B. %A Doyle, M. %A Schulz, R. %A Kershaw, T. %X This study examined, with a sample of older adult, caregiving couples, whether each spouse's health was associated with their own and their partner's relationship satisfaction. Dyads (n = 233; age = 64-99 years) in the Caregiver Health Effects Study, ancillary to the Cardiovascular Health Study, reported relationship satisfaction, depressive symptoms, disability, and self-reported health. The cross-sectional Actor-Partner Interdependence Model showed that for both caregivers and care recipients, greater depressive symptoms and lower self-reported health related to lower relationship satisfaction (actor effects). Caregivers had lower relationship satisfaction when they were more disabled (actor effect) and when care recipients were more depressed (partner effect). %B J Health Psychol %V 24 %P 1744–1755 %8 10 %G eng %0 Journal Article %J Am J Hum Genet %D 2019 %T Impact of Rare and Common Genetic Variants on Diabetes Diagnosis by Hemoglobin A1c in Multi-Ancestry Cohorts: The Trans-Omics for Precision Medicine Program. %A Sarnowski, Chloe %A Leong, Aaron %A Raffield, Laura M %A Wu, Peitao %A de Vries, Paul S %A DiCorpo, Daniel %A Guo, Xiuqing %A Xu, Huichun %A Liu, Yongmei %A Zheng, Xiuwen %A Hu, Yao %A Brody, Jennifer A %A Goodarzi, Mark O %A Hidalgo, Bertha A %A Highland, Heather M %A Jain, Deepti %A Liu, Ching-Ti %A Naik, Rakhi P %A O'Connell, Jeffrey R %A Perry, James A %A Porneala, Bianca C %A Selvin, Elizabeth %A Wessel, Jennifer %A Psaty, Bruce M %A Curran, Joanne E %A Peralta, Juan M %A Blangero, John %A Kooperberg, Charles %A Mathias, Rasika %A Johnson, Andrew D %A Reiner, Alexander P %A Mitchell, Braxton D %A Cupples, L Adrienne %A Vasan, Ramachandran S %A Correa, Adolfo %A Morrison, Alanna C %A Boerwinkle, Eric %A Rotter, Jerome I %A Rich, Stephen S %A Manning, Alisa K %A Dupuis, Josée %A Meigs, James B %X

Hemoglobin A1c (HbA1c) is widely used to diagnose diabetes and assess glycemic control in individuals with diabetes. However, nonglycemic determinants, including genetic variation, may influence how accurately HbA1c reflects underlying glycemia. Analyzing the NHLBI Trans-Omics for Precision Medicine (TOPMed) sequence data in 10,338 individuals from five studies and four ancestries (6,158 Europeans, 3,123 African-Americans, 650 Hispanics, and 407 East Asians), we confirmed five regions associated with HbA1c (GCK in Europeans and African-Americans, HK1 in Europeans and Hispanics, FN3K and/or FN3KRP in Europeans, and G6PD in African-Americans and Hispanics) and we identified an African-ancestry-specific low-frequency variant (rs1039215 in HBG2 and HBE1, minor allele frequency (MAF) = 0.03). The most associated G6PD variant (rs1050828-T, p.Val98Met, MAF = 12% in African-Americans, MAF = 2% in Hispanics) lowered HbA1c (-0.88% in hemizygous males, -0.34% in heterozygous females) and explained 23% of HbA1c variance in African-Americans and 4% in Hispanics. Additionally, we identified a rare distinct G6PD coding variant (rs76723693, p.Leu353Pro, MAF = 0.5%; -0.98% in hemizygous males, -0.46% in heterozygous females) and detected significant association with HbA1c when aggregating rare missense variants in G6PD. We observed similar magnitude and direction of effects for rs1039215 (HBG2) and rs76723693 (G6PD) in the two largest TOPMed African American cohorts, and we replicated the rs76723693 association in the UK Biobank African-ancestry participants. These variants in G6PD and HBG2 were monomorphic in the European and Asian samples. African or Hispanic ancestry individuals carrying G6PD variants may be underdiagnosed for diabetes when screened with HbA1c. Thus, assessment of these variants should be considered for incorporation into precision medicine approaches for diabetes diagnosis.

%B Am J Hum Genet %V 105 %P 706-718 %8 2019 Oct 03 %G eng %N 4 %R 10.1016/j.ajhg.2019.08.010 %0 Journal Article %J Genet Epidemiol %D 2019 %T A large-scale exome array analysis of venous thromboembolism. %A Lindström, Sara %A Brody, Jennifer A %A Turman, Constance %A Germain, Marine %A Bartz, Traci M %A Smith, Erin N %A Chen, Ming-Huei %A Puurunen, Marja %A Chasman, Daniel %A Hassler, Jeffrey %A Pankratz, Nathan %A Basu, Saonli %A Guan, Weihua %A Gyorgy, Beata %A Ibrahim, Manal %A Empana, Jean-Philippe %A Olaso, Robert %A Jackson, Rebecca %A Braekkan, Sigrid K %A McKnight, Barbara %A Deleuze, Jean-Francois %A O'Donnell, Cristopher J %A Jouven, Xavier %A Frazer, Kelly A %A Psaty, Bruce M %A Wiggins, Kerri L %A Taylor, Kent %A Reiner, Alexander P %A Heckbert, Susan R %A Kooperberg, Charles %A Ridker, Paul %A Hansen, John-Bjarne %A Tang, Weihong %A Johnson, Andrew D %A Morange, Pierre-Emmanuel %A Trégouët, David A %A Kraft, Peter %A Smith, Nicholas L %A Kabrhel, Christopher %X

Although recent Genome-Wide Association Studies have identified novel associations for common variants, there has been no comprehensive exome-wide search for low-frequency variants that affect the risk of venous thromboembolism (VTE). We conducted a meta-analysis of 11 studies comprising 8,332 cases and 16,087 controls of European ancestry and 382 cases and 1,476 controls of African American ancestry genotyped with the Illumina HumanExome BeadChip. We used the seqMeta package in R to conduct single variant and gene-based rare variant tests. In the single variant analysis, we limited our analysis to the 64,794 variants with at least 40 minor alleles across studies (minor allele frequency [MAF] ~0.08%). We confirmed associations with previously identified VTE loci, including ABO, F5, F11, and FGA. After adjusting for multiple testing, we observed no novel significant findings in single variant or gene-based analysis. Given our sample size, we had greater than 80% power to detect minimum odds ratios greater than 1.5 and 1.8 for a single variant with MAF of 0.01 and 0.005, respectively. Larger studies and sequence data may be needed to identify novel low-frequency and rare variants associated with VTE risk.

%B Genet Epidemiol %8 2019 Jan 19 %G eng %R 10.1002/gepi.22187 %0 Journal Article %J Nephrol Dial Transplant %D 2019 %T {Low thyroid function is not associated with an accelerated deterioration in renal function %A Meuwese, C. L. %A van Diepen, M. %A Cappola, A. R. %A Sarnak, M. J. %A Shlipak, M. G. %A Bauer, D. C. %A Fried, L. P. %A Iacoviello, M. %A Vaes, B. %A Degryse, J. %A Khaw, K. T. %A Luben, R. N. %A ?svold, B. O. %A Bj?ro, T. %A Vatten, L. J. %A de Craen, A. J. M. %A Trompet, S. %A Iervasi, G. %A Molinaro, S. %A Ceresini, G. %A Ferrucci, L. %A Dullaart, R. P. F. %A Bakker, S. J. L. %A Jukema, J. W. %A Kearney, P. M. %A Stott, D. J. %A Peeters, R. P. %A Franco, O. H. %A V?lzke, H. %A Walsh, J. P. %A Bremner, A. %A Sgarbi, J. A. %A Maciel, R. M. B. %A Imaizumi, M. %A Ohishi, W. %A Dekker, F. W. %A Rodondi, N. %A Gussekloo, J. %A den Elzen, W. P. J. %X Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups.\ Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models.\ A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) -4.07 (-6.37 to -1.78) and -2.40 (-3.78 to -1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50-4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function.\ Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations. %B Nephrol Dial Transplant %V 34 %P 650–659 %8 04 %G eng %0 Journal Article %J Nat Commun %D 2019 %T {A meta-analysis of genome-wide association studies identifies multiple longevity genes %A Deelen, J. %A Evans, D. S. %A Arking, D. E. %A Tesi, N. %A Nygaard, M. %A Liu, X. %A Wojczynski, M. K. %A Biggs, M. L. %A van der Spek, A. %A Atzmon, G. %A Ware, E. B. %A Sarnowski, C. %A Smith, A. V. %A Sepp?l?, I. %A Cordell, H. J. %A Dose, J. %A Amin, N. %A Arnold, A. M. %A Ayers, K. L. %A Barzilai, N. %A Becker, E. J. %A Beekman, M. %A Blanch?, H. %A Christensen, K. %A Christiansen, L. %A Collerton, J. C. %A Cubaynes, S. %A Cummings, S. R. %A Davies, K. %A Debrabant, B. %A Deleuze, J. F. %A Duncan, R. %A Faul, J. D. %A Franceschi, C. %A Galan, P. %A Gudnason, V. %A Harris, T. B. %A Huisman, M. %A Hurme, M. A. %A Jagger, C. %A Jansen, I. %A Jylh?, M. %A K?h?nen, M. %A Karasik, D. %A Kardia, S. L. R. %A Kingston, A. %A Kirkwood, T. B. L. %A Launer, L. J. %A Lehtim?ki, T. %A Lieb, W. %A Lyytik?inen, L. P. %A Martin-Ruiz, C. %A Min, J. %A Nebel, A. %A Newman, A. B. %A Nie, C. %A Nohr, E. A. %A Orwoll, E. S. %A Perls, T. T. %A Province, M. A. %A Psaty, B. M. %A Raitakari, O. T. %A Reinders, M. J. T. %A Robine, J. M. %A Rotter, J. I. %A Sebastiani, P. %A Smith, J. %A S?rensen, T. I. A. %A Taylor, K. D. %A Uitterlinden, A. G. %A van der Flier, W. %A van der Lee, S. J. %A van Duijn, C. M. %A van Heemst, D. %A Vaupel, J. W. %A Weir, D. %A Ye, K. %A Zeng, Y. %A Zheng, W. %A Holstege, H. %A Kiel, D. P. %A Lunetta, K. L. %A Slagboom, P. E. %A Murabito, J. M. %X Human longevity is heritable, but genome-wide association (GWA) studies have had limited success. Here, we perform two meta-analyses of GWA studies of a rigorous longevity phenotype definition including 11,262/3484 cases surviving at or beyond the age corresponding to the 90th/99th survival percentile, respectively, and 25,483 controls whose age at death or at last contact was at or below the age corresponding to the 60th survival percentile. Consistent with previous reports, rs429358 (apolipoprotein E (ApoE) ε4) is associated with lower odds of surviving to the 90th and 99th percentile age, while rs7412 (ApoE ε2) shows the opposite. Moreover, rs7676745, located near GPR78, associates with lower odds of surviving to the 90th percentile age. Gene-level association analysis reveals a role for tissue-specific expression of multiple genes in longevity. Finally, genetic correlation of the longevity GWA results with that of several disease-related phenotypes points to a shared genetic architecture between health and longevity. %B Nat Commun %V 10 %P 3669 %8 08 %G eng %0 Journal Article %J Nat Commun %D 2019 %T {A meta-analysis of genome-wide association studies identifies multiple longevity genes %A Deelen, J. %A Evans, D. S. %A Arking, D. E. %A Tesi, N. %A Nygaard, M. %A Liu, X. %A Wojczynski, M. K. %A Biggs, M. L. %A van der Spek, A. %A Atzmon, G. %A Ware, E. B. %A Sarnowski, C. %A Smith, A. V. %A ä, I. %A Cordell, H. J. %A Dose, J. %A Amin, N. %A Arnold, A. M. %A Ayers, K. L. %A Barzilai, N. %A Becker, E. J. %A Beekman, M. %A é, H. %A Christensen, K. %A Christiansen, L. %A Collerton, J. C. %A Cubaynes, S. %A Cummings, S. R. %A Davies, K. %A Debrabant, B. %A Deleuze, J. F. %A Duncan, R. %A Faul, J. D. %A Franceschi, C. %A Galan, P. %A Gudnason, V. %A Harris, T. B. %A Huisman, M. %A Hurme, M. A. %A Jagger, C. %A Jansen, I. %A ä, M. %A nen, M. %A Karasik, D. %A Kardia, S. L. R. %A Kingston, A. %A Kirkwood, T. B. L. %A Launer, L. J. %A ki, T. %A Lieb, W. %A inen, L. P. %A Martin-Ruiz, C. %A Min, J. %A Nebel, A. %A Newman, A. B. %A Nie, C. %A Nohr, E. A. %A Orwoll, E. S. %A Perls, T. T. %A Province, M. A. %A Psaty, B. M. %A Raitakari, O. T. %A Reinders, M. J. T. %A Robine, J. M. %A Rotter, J. I. %A Sebastiani, P. %A Smith, J. %A rensen, T. I. A. %A Taylor, K. D. %A Uitterlinden, A. G. %A van der Flier, W. %A van der Lee, S. J. %A van Duijn, C. M. %A van Heemst, D. %A Vaupel, J. W. %A Weir, D. %A Ye, K. %A Zeng, Y. %A Zheng, W. %A Holstege, H. %A Kiel, D. P. %A Lunetta, K. L. %A Slagboom, P. E. %A Murabito, J. M. %X 2) shows the opposite. Moreover, rs7676745, located near GPR78, associates with lower odds of surviving to the 90th percentile age. Gene-level association analysis reveals a role for tissue-specific expression of multiple genes in longevity. Finally, genetic correlation of the longevity GWA results with that of several disease-related phenotypes points to a shared genetic architecture between health and longevity. %B Nat Commun %V 10 %P 3669 %8 Aug %G eng %0 Journal Article %J J Bone Miner Res %D 2019 %T {Meta-Analysis of Genomewide Association Studies Reveals Genetic Variants for Hip Bone Geometry %A Hsu, Y. H. %A Estrada, K. %A Evangelou, E. %A Ackert-Bicknell, C. %A Akesson, K. %A Beck, T. %A Brown, S. J. %A Capellini, T. %A Carbone, L. %A Cauley, J. %A Cheung, C. L. %A Cummings, S. R. %A Czerwinski, S. %A Demissie, S. %A Econs, M. %A Evans, D. %A Farber, C. %A Gautvik, K. %A Harris, T. %A Kammerer, C. %A Kemp, J. %A Koller, D. L. %A Kung, A. %A Lawlor, D. %A Lee, M. %A Lorentzon, M. %A McGuigan, F. %A Medina-Gomez, C. %A Mitchell, B. %A Newman, A. %A Nielson, C. %A Ohlsson, C. %A Peacock, M. %A Reppe, S. %A Richards, J. B. %A Robbins, J. %A Sigurdsson, G. %A Spector, T. D. %A Stefansson, K. %A Streeten, E. %A Styrkarsdottir, U. %A Tobias, J. %A Trajanoska, K. %A Uitterlinden, A. %A Vandenput, L. %A Wilson, S. G. %A Yerges-Armstrong, L. %A Young, M. %A Zillikens, M. C. %A Rivadeneira, F. %A Kiel, D. P. %A Karasik, D. %X Hip geometry is an important predictor of fracture. We performed a meta-analysis of GWAS studies in adults to identify genetic variants that are associated with proximal femur geometry phenotypes. We analyzed four phenotypes: (i) femoral neck length; (ii) neck-shaft angle; (iii) femoral neck width, and (iv) femoral neck section modulus, estimated from DXA scans using algorithms of hip structure analysis. In the Discovery stage, 10 cohort studies were included in the fixed-effect meta-analysis, with up to 18,719 men and women ages 16 to 93 years. Association analyses were performed with ∼2.5 million polymorphisms under an additive model adjusted for age, body mass index, and height. Replication analyses of meta-GWAS significant loci (at adjusted genomewide significance [GWS], threshold p ≤ 2.6 × 10-8 ) were performed in seven additional cohorts in silico. We looked up SNPs associated in our analysis, for association with height, bone mineral density (BMD), and fracture. In meta-analysis (combined Discovery and Replication stages), GWS associations were found at 5p15 (IRX1 and ADAMTS16); 5q35 near FGFR4; at 12p11 (in CCDC91); 11q13 (near LRP5 and PPP6R3 (rs7102273)). Several hip geometry signals overlapped with BMD, including LRP5 (chr. 11). Chr. 11 SNP rs7102273 was associated with any-type fracture (p = 7.5 × 10-5 ). We used bone transcriptome data and discovered several significant eQTLs, including rs7102273 and PPP6R3 expression (p = 0.0007), and rs6556301 (intergenic, chr.5 near FGFR4) and PDLIM7 expression (p = 0.005). In conclusion, we found associations between several genes and hip geometry measures that explained 12% to 22% of heritability at different sites. The results provide a defined set of genes related to biological pathways relevant to BMD and etiology of bone fragility. © 2019 American Society for Bone and Mineral Research. %B J Bone Miner Res %V 34 %P 1284–1296 %8 07 %G eng %0 Journal Article %J Am J Epidemiol %D 2019 %T Multi-Ancestry Genome-Wide Association Study of Lipid Levels Incorporating Gene-Alcohol Interactions. %A de Vries, Paul S %A Brown, Michael R %A Bentley, Amy R %A Sung, Yun J %A Winkler, Thomas W %A Ntalla, Ioanna %A Schwander, Karen %A Kraja, Aldi T %A Guo, Xiuqing %A Franceschini, Nora %A Cheng, Ching-Yu %A Sim, Xueling %A Vojinovic, Dina %A Huffman, Jennifer E %A Musani, Solomon K %A Li, Changwei %A Feitosa, Mary F %A Richard, Melissa A %A Noordam, Raymond %A Aschard, Hugues %A Bartz, Traci M %A Bielak, Lawrence F %A Deng, Xuan %A Dorajoo, Rajkumar %A Lohman, Kurt K %A Manning, Alisa K %A Rankinen, Tuomo %A Smith, Albert V %A Tajuddin, Salman M %A Evangelou, Evangelos %A Graff, Mariaelisa %A Alver, Maris %A Boissel, Mathilde %A Chai, Jin Fang %A Chen, Xu %A Divers, Jasmin %A Gandin, Ilaria %A Gao, Chuan %A Goel, Anuj %A Hagemeijer, Yanick %A Harris, Sarah E %A Hartwig, Fernando P %A He, Meian %A Horimoto, Andrea R V R %A Hsu, Fang-Chi %A Jackson, Anne U %A Kasturiratne, Anuradhani %A Komulainen, Pirjo %A Kuhnel, Brigitte %A Laguzzi, Federica %A Lee, Joseph H %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Matoba, Nana %A Nolte, Ilja M %A Pietzner, Maik %A Riaz, Muhammad %A Said, M Abdullah %A Scott, Robert A %A Sofer, Tamar %A Stančáková, Alena %A Takeuchi, Fumihiko %A Tayo, Bamidele O %A van der Most, Peter J %A Varga, Tibor V %A Wang, Yajuan %A Ware, Erin B %A Wen, Wanqing %A Yanek, Lisa R %A Zhang, Weihua %A Zhao, Jing Hua %A Afaq, Saima %A Amin, Najaf %A Amini, Marzyeh %A Arking, Dan E %A Aung, Tin %A Ballantyne, Christie %A Boerwinkle, Eric %A Broeckel, Ulrich %A Campbell, Archie %A Canouil, Mickaël %A Charumathi, Sabanayagam %A Chen, Yii-Der Ida %A Connell, John M %A de Faire, Ulf %A de Las Fuentes, Lisa %A de Mutsert, Renée %A de Silva, H Janaka %A Ding, Jingzhong %A Dominiczak, Anna F %A Duan, Qing %A Eaton, Charles B %A Eppinga, Ruben N %A Faul, Jessica D %A Fisher, Virginia %A Forrester, Terrence %A Franco, Oscar H %A Friedlander, Yechiel %A Ghanbari, Mohsen %A Giulianini, Franco %A Grabe, Hans J %A Grove, Megan L %A Gu, C Charles %A Harris, Tamara B %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hirata, Makoto %A Hixson, James E %A Howard, Barbara V %A Ikram, M Arfan %A Jacobs, David R %A Johnson, Craig %A Jonas, Jost Bruno %A Kammerer, Candace M %A Katsuya, Tomohiro %A Khor, Chiea Chuen %A Kilpeläinen, Tuomas O %A Koh, Woon-Puay %A Koistinen, Heikki A %A Kolcic, Ivana %A Kooperberg, Charles %A Krieger, Jose E %A Kritchevsky, Steve B %A Kubo, Michiaki %A Kuusisto, Johanna %A Lakka, Timo A %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lehne, Benjamin %A Lemaitre, Rozenn N %A Li, Yize %A Liang, Jingjing %A Liu, Jianjun %A Liu, Kiang %A Loh, Marie %A Louie, Tin %A Mägi, Reedik %A Manichaikul, Ani W %A McKenzie, Colin A %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Milani, Lili %A Mohlke, Karen L %A Mosley, Thomas H %A Mukamal, Kenneth J %A Nalls, Mike A %A Nauck, Matthias %A Nelson, Christopher P %A Sotoodehnia, Nona %A O'Connell, Jeff R %A Palmer, Nicholette D %A Pazoki, Raha %A Pedersen, Nancy L %A Peters, Annette %A Peyser, Patricia A %A Polasek, Ozren %A Poulter, Neil %A Raffel, Leslie J %A Raitakari, Olli T %A Reiner, Alex P %A Rice, Treva K %A Rich, Stephen S %A Robino, Antonietta %A Robinson, Jennifer G %A Rose, Lynda M %A Rudan, Igor %A Schmidt, Carsten O %A Schreiner, Pamela J %A Scott, William R %A Sever, Peter %A Shi, Yuan %A Sidney, Stephen %A Sims, Mario %A Smith, Blair H %A Smith, Jennifer A %A Snieder, Harold %A Starr, John M %A Strauch, Konstantin %A Tan, Nicholas %A Taylor, Kent D %A Teo, Yik Ying %A Tham, Yih Chung %A Uitterlinden, André G %A van Heemst, Diana %A Vuckovic, Dragana %A Waldenberger, Melanie %A Wang, Lihua %A Wang, Yujie %A Wang, Zhe %A Wei, Wen Bin %A Williams, Christine %A Wilson, Gregory %A Wojczynski, Mary K %A Yao, Jie %A Yu, Bing %A Yu, Caizheng %A Yuan, Jian-Min %A Zhao, Wei %A Zonderman, Alan B %A Becker, Diane M %A Boehnke, Michael %A Bowden, Donald W %A Chambers, John C %A Deary, Ian J %A Esko, Tõnu %A Farrall, Martin %A Franks, Paul W %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Horta, Bernardo L %A Kamatani, Yoichiro %A Kato, Norihiro %A Kooner, Jaspal S %A Laakso, Markku %A Leander, Karin %A Lehtimäki, Terho %A Magnusson, Patrik K E %A Penninx, Brenda %A Pereira, Alexandre C %A Rauramaa, Rainer %A Samani, Nilesh J %A Scott, James %A Shu, Xiao-Ou %A van der Harst, Pim %A Wagenknecht, Lynne E %A Wang, Ya Xing %A Wareham, Nicholas J %A Watkins, Hugh %A Weir, David R %A Wickremasinghe, Ananda R %A Zheng, Wei %A Elliott, Paul %A North, Kari E %A Bouchard, Claude %A Evans, Michele K %A Gudnason, Vilmundur %A Liu, Ching-Ti %A Liu, Yongmei %A Psaty, Bruce M %A Ridker, Paul M %A van Dam, Rob M %A Kardia, Sharon L R %A Zhu, Xiaofeng %A Rotimi, Charles N %A Mook-Kanamori, Dennis O %A Fornage, Myriam %A Kelly, Tanika N %A Fox, Ervin R %A Hayward, Caroline %A van Duijn, Cornelia M %A Tai, E Shyong %A Wong, Tien Yin %A Liu, Jingmin %A Rotter, Jerome I %A Gauderman, W James %A Province, Michael A %A Munroe, Patricia B %A Rice, Kenneth %A Chasman, Daniel I %A Cupples, L Adrienne %A Rao, Dabeeru C %A Morrison, Alanna C %X

An individual's lipid profile is influenced by genetic variants and alcohol consumption, but the contribution of interactions between these exposures has not been studied. We therefore incorporated gene-alcohol interactions into a multi-ancestry genome-wide association study of levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. We included 45 studies in Stage 1 (genome-wide discovery) and 66 studies in Stage 2 (focused follow-up), for a total of 394,584 individuals from five ancestry groups. Genetic main and interaction effects were jointly assessed by a 2 degrees of freedom (DF) test, and a 1 DF test was used to assess the interaction effects alone. Variants at 495 loci were at least suggestively associated (P < 1 × 10-6) with lipid levels in Stage 1 and were evaluated in Stage 2, followed by combined analyses of Stage 1 and Stage 2. In the combined analysis of Stage 1 and Stage 2, 147 independent loci were associated with lipid levels at P < 5 × 10-8 using 2 DF tests, of which 18 were novel. No genome-wide significant associations were found testing the interaction effect alone. The novel loci included several genes (PCSK5, VEGFB, and A1CF) with a putative role in lipid metabolism based on existing evidence from cellular and experimental models.

%B Am J Epidemiol %8 2019 Jan 29 %G eng %R 10.1093/aje/kwz005 %0 Journal Article %J Nat Genet %D 2019 %T Multi-ancestry genome-wide gene-smoking interaction study of 387,272 individuals identifies new loci associated with serum lipids. %A Bentley, Amy R %A Sung, Yun J %A Brown, Michael R %A Winkler, Thomas W %A Kraja, Aldi T %A Ntalla, Ioanna %A Schwander, Karen %A Chasman, Daniel I %A Lim, Elise %A Deng, Xuan %A Guo, Xiuqing %A Liu, Jingmin %A Lu, Yingchang %A Cheng, Ching-Yu %A Sim, Xueling %A Vojinovic, Dina %A Huffman, Jennifer E %A Musani, Solomon K %A Li, Changwei %A Feitosa, Mary F %A Richard, Melissa A %A Noordam, Raymond %A Baker, Jenna %A Chen, Guanjie %A Aschard, Hugues %A Bartz, Traci M %A Ding, Jingzhong %A Dorajoo, Rajkumar %A Manning, Alisa K %A Rankinen, Tuomo %A Smith, Albert V %A Tajuddin, Salman M %A Zhao, Wei %A Graff, Mariaelisa %A Alver, Maris %A Boissel, Mathilde %A Chai, Jin Fang %A Chen, Xu %A Divers, Jasmin %A Evangelou, Evangelos %A Gao, Chuan %A Goel, Anuj %A Hagemeijer, Yanick %A Harris, Sarah E %A Hartwig, Fernando P %A He, Meian %A Horimoto, Andrea R V R %A Hsu, Fang-Chi %A Hung, Yi-Jen %A Jackson, Anne U %A Kasturiratne, Anuradhani %A Komulainen, Pirjo %A Kuhnel, Brigitte %A Leander, Karin %A Lin, Keng-Hung %A Luan, Jian'an %A Lyytikäinen, Leo-Pekka %A Matoba, Nana %A Nolte, Ilja M %A Pietzner, Maik %A Prins, Bram %A Riaz, Muhammad %A Robino, Antonietta %A Said, M Abdullah %A Schupf, Nicole %A Scott, Robert A %A Sofer, Tamar %A Stančáková, Alena %A Takeuchi, Fumihiko %A Tayo, Bamidele O %A van der Most, Peter J %A Varga, Tibor V %A Wang, Tzung-Dau %A Wang, Yajuan %A Ware, Erin B %A Wen, Wanqing %A Xiang, Yong-Bing %A Yanek, Lisa R %A Zhang, Weihua %A Zhao, Jing Hua %A Adeyemo, Adebowale %A Afaq, Saima %A Amin, Najaf %A Amini, Marzyeh %A Arking, Dan E %A Arzumanyan, Zorayr %A Aung, Tin %A Ballantyne, Christie %A Barr, R Graham %A Bielak, Lawrence F %A Boerwinkle, Eric %A Bottinger, Erwin P %A Broeckel, Ulrich %A Brown, Morris %A Cade, Brian E %A Campbell, Archie %A Canouil, Mickaël %A Charumathi, Sabanayagam %A Chen, Yii-Der Ida %A Christensen, Kaare %A Concas, Maria Pina %A Connell, John M %A de Las Fuentes, Lisa %A de Silva, H Janaka %A de Vries, Paul S %A Doumatey, Ayo %A Duan, Qing %A Eaton, Charles B %A Eppinga, Ruben N %A Faul, Jessica D %A Floyd, James S %A Forouhi, Nita G %A Forrester, Terrence %A Friedlander, Yechiel %A Gandin, Ilaria %A Gao, He %A Ghanbari, Mohsen %A Gharib, Sina A %A Gigante, Bruna %A Giulianini, Franco %A Grabe, Hans J %A Gu, C Charles %A Harris, Tamara B %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hirata, Makoto %A Hixson, James E %A Ikram, M Arfan %A Jia, Yucheng %A Joehanes, Roby %A Johnson, Craig %A Jonas, Jost Bruno %A Justice, Anne E %A Katsuya, Tomohiro %A Khor, Chiea Chuen %A Kilpeläinen, Tuomas O %A Koh, Woon-Puay %A Kolcic, Ivana %A Kooperberg, Charles %A Krieger, Jose E %A Kritchevsky, Stephen B %A Kubo, Michiaki %A Kuusisto, Johanna %A Lakka, Timo A %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Lehne, Benjamin %A Lewis, Cora E %A Li, Yize %A Liang, Jingjing %A Lin, Shiow %A Liu, Ching-Ti %A Liu, Jianjun %A Liu, Kiang %A Loh, Marie %A Lohman, Kurt K %A Louie, Tin %A Luzzi, Anna %A Mägi, Reedik %A Mahajan, Anubha %A Manichaikul, Ani W %A McKenzie, Colin A %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Milani, Lili %A Mohlke, Karen L %A Momozawa, Yukihide %A Morris, Andrew P %A Murray, Alison D %A Nalls, Mike A %A Nauck, Matthias %A Nelson, Christopher P %A North, Kari E %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Papanicolau, George J %A Pedersen, Nancy L %A Peters, Annette %A Peyser, Patricia A %A Polasek, Ozren %A Poulter, Neil %A Raitakari, Olli T %A Reiner, Alex P %A Renstrom, Frida %A Rice, Treva K %A Rich, Stephen S %A Robinson, Jennifer G %A Rose, Lynda M %A Rosendaal, Frits R %A Rudan, Igor %A Schmidt, Carsten O %A Schreiner, Pamela J %A Scott, William R %A Sever, Peter %A Shi, Yuan %A Sidney, Stephen %A Sims, Mario %A Smith, Jennifer A %A Snieder, Harold %A Starr, John M %A Strauch, Konstantin %A Stringham, Heather M %A Tan, Nicholas Y Q %A Tang, Hua %A Taylor, Kent D %A Teo, Yik Ying %A Tham, Yih Chung %A Tiemeier, Henning %A Turner, Stephen T %A Uitterlinden, André G %A van Heemst, Diana %A Waldenberger, Melanie %A Wang, Heming %A Wang, Lan %A Wang, Lihua %A Wei, Wen Bin %A Williams, Christine A %A Wilson, Gregory %A Wojczynski, Mary K %A Yao, Jie %A Young, Kristin %A Yu, Caizheng %A Yuan, Jian-Min %A Zhou, Jie %A Zonderman, Alan B %A Becker, Diane M %A Boehnke, Michael %A Bowden, Donald W %A Chambers, John C %A Cooper, Richard S %A de Faire, Ulf %A Deary, Ian J %A Elliott, Paul %A Esko, Tõnu %A Farrall, Martin %A Franks, Paul W %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Horta, Bernardo L %A Juang, Jyh-Ming Jimmy %A Kamatani, Yoichiro %A Kammerer, Candace M %A Kato, Norihiro %A Kooner, Jaspal S %A Laakso, Markku %A Laurie, Cathy C %A Lee, I-Te %A Lehtimäki, Terho %A Magnusson, Patrik K E %A Oldehinkel, Albertine J %A Penninx, Brenda W J H %A Pereira, Alexandre C %A Rauramaa, Rainer %A Redline, Susan %A Samani, Nilesh J %A Scott, James %A Shu, Xiao-Ou %A van der Harst, Pim %A Wagenknecht, Lynne E %A Wang, Jun-Sing %A Wang, Ya Xing %A Wareham, Nicholas J %A Watkins, Hugh %A Weir, David R %A Wickremasinghe, Ananda R %A Wu, Tangchun %A Zeggini, Eleftheria %A Zheng, Wei %A Bouchard, Claude %A Evans, Michele K %A Gudnason, Vilmundur %A Kardia, Sharon L R %A Liu, Yongmei %A Psaty, Bruce M %A Ridker, Paul M %A van Dam, Rob M %A Mook-Kanamori, Dennis O %A Fornage, Myriam %A Province, Michael A %A Kelly, Tanika N %A Fox, Ervin R %A Hayward, Caroline %A van Duijn, Cornelia M %A Tai, E Shyong %A Wong, Tien Yin %A Loos, Ruth J F %A Franceschini, Nora %A Rotter, Jerome I %A Zhu, Xiaofeng %A Bierut, Laura J %A Gauderman, W James %A Rice, Kenneth %A Munroe, Patricia B %A Morrison, Alanna C %A Rao, Dabeeru C %A Rotimi, Charles N %A Cupples, L Adrienne %X

The concentrations of high- and low-density-lipoprotein cholesterol and triglycerides are influenced by smoking, but it is unknown whether genetic associations with lipids may be modified by smoking. We conducted a multi-ancestry genome-wide gene-smoking interaction study in 133,805 individuals with follow-up in an additional 253,467 individuals. Combined meta-analyses identified 13 new loci associated with lipids, some of which were detected only because association differed by smoking status. Additionally, we demonstrate the importance of including diverse populations, particularly in studies of interactions with lifestyle factors, where genomic and lifestyle differences by ancestry may contribute to novel findings.

%B Nat Genet %V 51 %P 636-648 %8 2019 Apr %G eng %N 4 %R 10.1038/s41588-019-0378-y %0 Journal Article %J Hum. Mol. Genet. %D 2019 %T {A multi-ancestry genome-wide study incorporating gene-smoking interactions identifies multiple new loci for pulse pressure and mean arterial pressure %A Sung, Y. J. %A de Las Fuentes, L. %A Winkler, T. W. %A Chasman, D. I. %A Bentley, A. R. %A Kraja, A. T. %A Ntalla, I. %A Warren, H. R. %A Guo, X. %A Schwander, K. %A Manning, A. K. %A Brown, M. R. %A Aschard, H. %A Feitosa, M. F. %A Franceschini, N. %A Lu, Y. %A Cheng, C. Y. %A Sim, X. %A Vojinovic, D. %A Marten, J. %A Musani, S. K. %A Kilpel?inen, T. O. %A Richard, M. A. %A Aslibekyan, S. %A Bartz, T. M. %A Dorajoo, R. %A Li, C. %A Liu, Y. %A Rankinen, T. %A Smith, A. V. %A Tajuddin, S. M. %A Tayo, B. O. %A Zhao, W. %A Zhou, Y. %A Matoba, N. %A Sofer, T. %A Alver, M. %A Amini, M. %A Boissel, M. %A Chai, J. F. %A Chen, X. %A Divers, J. %A Gandin, I. %A Gao, C. %A Giulianini, F. %A Goel, A. %A Harris, S. E. %A Hartwig, F. P. %A He, M. %A Horimoto, A. R. V. R. %A Hsu, F. C. %A Jackson, A. U. %A Kammerer, C. M. %A Kasturiratne, A. %A Komulainen, P. %A K?hnel, B. %A Leander, K. %A Lee, W. J. %A Lin, K. H. %A Luan, J. %A Lyytik?inen, L. P. %A McKenzie, C. A. %A Nelson, C. P. %A Noordam, R. %A Scott, R. A. %A Sheu, W. H. H. %A Stan??kov?, A. %A Takeuchi, F. %A van der Most, P. J. %A Varga, T. V. %A Waken, R. J. %A Wang, H. %A Wang, Y. %A Ware, E. B. %A Weiss, S. %A Wen, W. %A Yanek, L. R. %A Zhang, W. %A Zhao, J. H. %A Afaq, S. %A Alfred, T. %A Amin, N. %A Arking, D. E. %A Aung, T. %A Barr, R. G. %A Bielak, L. F. %A Boerwinkle, E. %A Bottinger, E. P. %A Braund, P. S. %A Brody, J. A. %A Broeckel, U. %A Cade, B. %A Campbell, A. %A Canouil, M. %A Chakravarti, A. %A Cocca, M. %A Collins, F. S. %A Connell, J. M. %A de Mutsert, R. %A de Silva, H. J. %A D?rr, M. %A Duan, Q. %A Eaton, C. B. %A Ehret, G. %A Evangelou, E. %A Faul, J. D. %A Forouhi, N. G. %A Franco, O. H. %A Friedlander, Y. %A Gao, H. %A Gigante, B. %A Gu, C. C. %A Gupta, P. %A Hagenaars, S. P. %A Harris, T. B. %A He, J. %A Heikkinen, S. %A Heng, C. K. %A Hofman, A. %A Howard, B. V. %A Hunt, S. C. %A Irvin, M. R. %A Jia, Y. %A Katsuya, T. %A Kaufman, J. %A Kerrison, N. D. %A Khor, C. C. %A Koh, W. P. %A Koistinen, H. A. %A Kooperberg, C. B. %A Krieger, J. E. %A Kubo, M. %A Kutalik, Z. %A Kuusisto, J. %A Lakka, T. A. %A Langefeld, C. D. %A Langenberg, C. %A Launer, L. J. %A Lee, J. H. %A Lehne, B. %A Levy, D. %A Lewis, C. E. %A Li, Y. %A Lim, S. H. %A Liu, C. T. %A Liu, J. %A Liu, J. %A Liu, Y. %A Loh, M. %A Lohman, K. K. %A Louie, T. %A M?gi, R. %A Matsuda, K. %A Meitinger, T. %A Metspalu, A. %A Milani, L. %A Momozawa, Y. %A Mosley, T. H. %A Nalls, M. A. %A Nasri, U. %A O'Connell, J. R. %A Ogunniyi, A. %A Palmas, W. R. %A Palmer, N. D. %A Pankow, J. S. %A Pedersen, N. L. %A Peters, A. %A Peyser, P. A. %A Polasek, O. %A Porteous, D. %A Raitakari, O. T. %A Renstr?m, F. %A Rice, T. K. %A Ridker, P. M. %A Robino, A. %A Robinson, J. G. %A Rose, L. M. %A Rudan, I. %A Sabanayagam, C. %A Salako, B. L. %A Sandow, K. %A Schmidt, C. O. %A Schreiner, P. J. %A Scott, W. R. %A Sever, P. %A Sims, M. %A Sitlani, C. M. %A Smith, B. H. %A Smith, J. A. %A Snieder, H. %A Starr, J. M. %A Strauch, K. %A Tang, H. %A Taylor, K. D. %A Teo, Y. Y. %A Tham, Y. C. %A Uitterlinden, A. G. %A Waldenberger, M. %A Wang, L. %A Wang, Y. X. %A Wei, W. B. %A Wilson, G. %A Wojczynski, M. K. %A Xiang, Y. B. %A Yao, J. %A Yuan, J. M. %A Zonderman, A. B. %A Becker, D. M. %A Boehnke, M. %A Bowden, D. W. %A Chambers, J. C. %A Chen, Y. I. %A Weir, D. R. %A de Faire, U. %A Deary, I. J. %A Esko, T. %A Farrall, M. %A Forrester, T. %A Freedman, B. I. %A Froguel, P. %A Gasparini, P. %A Gieger, C. %A Horta, B. L. %A Hung, Y. J. %A Jonas, J. B. %A Kato, N. %A Kooner, J. S. %A Laakso, M. %A Lehtim?ki, T. %A Liang, K. W. %A Magnusson, P. K. E. %A Oldehinkel, A. J. %A Pereira, A. C. %A Perls, T. %A Rauramaa, R. %A Redline, S. %A Rettig, R. %A Samani, N. J. %A Scott, J. %A Shu, X. O. %A van der Harst, P. %A Wagenknecht, L. E. %A Wareham, N. J. %A Watkins, H. %A Wickremasinghe, A. R. %A Wu, T. %A Kamatani, Y. %A Laurie, C. C. %A Bouchard, C. %A Cooper, R. S. %A Evans, M. K. %A Gudnason, V. %A Hixson, J. %A Kardia, S. L. R. %A Kritchevsky, S. B. %A Psaty, B. M. %A van Dam, R. M. %A Arnett, D. K. %A Mook-Kanamori, D. O. %A Fornage, M. %A Fox, E. R. %A Hayward, C. %A van Duijn, C. M. %A Tai, E. S. %A Wong, T. Y. %A Loos, R. J. F. %A Reiner, A. P. %A Rotimi, C. N. %A Bierut, L. J. %A Zhu, X. %A Cupples, L. A. %A Province, M. A. %A Rotter, J. I. %A Franks, P. W. %A Rice, K. %A Elliott, P. %A Caulfield, M. J. %A Gauderman, W. J. %A Munroe, P. B. %A Rao, D. C. %A Morrison, A. C. %X Elevated blood pressure (BP), a leading cause of global morbidity and mortality, is influenced by both genetic and lifestyle factors. Cigarette smoking is one such lifestyle factor. Across five ancestries, we performed a genome-wide gene-smoking interaction study of mean arterial pressure (MAP) and pulse pressure (PP) in 129 913 individuals in stage 1 and follow-up analysis in 480 178 additional individuals in stage 2. We report here 136 loci significantly associated with MAP and/or PP. Of these, 61 were previously published through main-effect analysis of BP traits, 37 were recently reported by us for systolic BP and/or diastolic BP through gene-smoking interaction analysis and 38 were newly identified (P < 5 × 10-8, false discovery rate < 0.05). We also identified nine new signals near known loci. Of the 136 loci, 8 showed significant interaction with smoking status. They include CSMD1 previously reported for insulin resistance and BP in the spontaneously hypertensive rats. Many of the 38 new loci show biologic plausibility for a role in BP regulation. SLC26A7 encodes a chloride/bicarbonate exchanger expressed in the renal outer medullary collecting duct. AVPR1A is widely expressed, including in vascular smooth muscle cells, kidney, myocardium and brain. FHAD1 is a long non-coding RNA overexpressed in heart failure. TMEM51 was associated with contractile function in cardiomyocytes. CASP9 plays a central role in cardiomyocyte apoptosis. Identified only in African ancestry were 30 novel loci. Our findings highlight the value of multi-ancestry investigations, particularly in studies of interaction with lifestyle factors, where genomic and lifestyle differences may contribute to novel findings. %B Hum. Mol. Genet. %8 Apr %G eng %0 Journal Article %J Nat Commun %D 2019 %T Multi-ancestry sleep-by-SNP interaction analysis in 126,926 individuals reveals lipid loci stratified by sleep duration. %A Noordam, Raymond %A Bos, Maxime M %A Wang, Heming %A Winkler, Thomas W %A Bentley, Amy R %A Kilpeläinen, Tuomas O %A de Vries, Paul S %A Sung, Yun Ju %A Schwander, Karen %A Cade, Brian E %A Manning, Alisa %A Aschard, Hugues %A Brown, Michael R %A Chen, Han %A Franceschini, Nora %A Musani, Solomon K %A Richard, Melissa %A Vojinovic, Dina %A Aslibekyan, Stella %A Bartz, Traci M %A de Las Fuentes, Lisa %A Feitosa, Mary %A Horimoto, Andrea R %A Ilkov, Marjan %A Kho, Minjung %A Kraja, Aldi %A Li, Changwei %A Lim, Elise %A Liu, Yongmei %A Mook-Kanamori, Dennis O %A Rankinen, Tuomo %A Tajuddin, Salman M %A van der Spek, Ashley %A Wang, Zhe %A Marten, Jonathan %A Laville, Vincent %A Alver, Maris %A Evangelou, Evangelos %A Graff, Maria E %A He, Meian %A Kuhnel, Brigitte %A Lyytikäinen, Leo-Pekka %A Marques-Vidal, Pedro %A Nolte, Ilja M %A Palmer, Nicholette D %A Rauramaa, Rainer %A Shu, Xiao-Ou %A Snieder, Harold %A Weiss, Stefan %A Wen, Wanqing %A Yanek, Lisa R %A Adolfo, Correa %A Ballantyne, Christie %A Bielak, Larry %A Biermasz, Nienke R %A Boerwinkle, Eric %A Dimou, Niki %A Eiriksdottir, Gudny %A Gao, Chuan %A Gharib, Sina A %A Gottlieb, Daniel J %A Haba-Rubio, José %A Harris, Tamara B %A Heikkinen, Sami %A Heinzer, Raphael %A Hixson, James E %A Homuth, Georg %A Ikram, M Arfan %A Komulainen, Pirjo %A Krieger, Jose E %A Lee, Jiwon %A Liu, Jingmin %A Lohman, Kurt K %A Luik, Annemarie I %A Mägi, Reedik %A Martin, Lisa W %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Nalls, Mike A %A O'Connell, Jeff %A Peters, Annette %A Peyser, Patricia %A Raitakari, Olli T %A Reiner, Alex P %A Rensen, Patrick C N %A Rice, Treva K %A Rich, Stephen S %A Roenneberg, Till %A Rotter, Jerome I %A Schreiner, Pamela J %A Shikany, James %A Sidney, Stephen S %A Sims, Mario %A Sitlani, Colleen M %A Sofer, Tamar %A Strauch, Konstantin %A Swertz, Morris A %A Taylor, Kent D %A Uitterlinden, André G %A van Duijn, Cornelia M %A Völzke, Henry %A Waldenberger, Melanie %A Wallance, Robert B %A van Dijk, Ko Willems %A Yu, Caizheng %A Zonderman, Alan B %A Becker, Diane M %A Elliott, Paul %A Esko, Tõnu %A Gieger, Christian %A Grabe, Hans J %A Lakka, Timo A %A Lehtimäki, Terho %A North, Kari E %A Penninx, Brenda W J H %A Vollenweider, Peter %A Wagenknecht, Lynne E %A Wu, Tangchun %A Xiang, Yong-Bing %A Zheng, Wei %A Arnett, Donna K %A Bouchard, Claude %A Evans, Michele K %A Gudnason, Vilmundur %A Kardia, Sharon %A Kelly, Tanika N %A Kritchevsky, Stephen B %A Loos, Ruth J F %A Pereira, Alexandre C %A Province, Mike %A Psaty, Bruce M %A Rotimi, Charles %A Zhu, Xiaofeng %A Amin, Najaf %A Cupples, L Adrienne %A Fornage, Myriam %A Fox, Ervin F %A Guo, Xiuqing %A Gauderman, W James %A Rice, Kenneth %A Kooperberg, Charles %A Munroe, Patricia B %A Liu, Ching-Ti %A Morrison, Alanna C %A Rao, Dabeeru C %A van Heemst, Diana %A Redline, Susan %X

Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known lipid loci such as LPL and PCSK9. The previously unreported lipid loci have a modest explained variance in lipid levels: most notable, gene-short-sleep interactions explain 4.25% of the variance in triglyceride level. Collectively, these findings contribute to our understanding of the biological mechanisms involved in sleep-associated adverse lipid profiles.

%B Nat Commun %V 10 %P 5121 %8 2019 Nov 12 %G eng %N 1 %R 10.1038/s41467-019-12958-0 %0 Journal Article %J Nat Commun %D 2019 %T Multi-ancestry study of blood lipid levels identifies four loci interacting with physical activity. %A Kilpeläinen, Tuomas O %A Bentley, Amy R %A Noordam, Raymond %A Sung, Yun Ju %A Schwander, Karen %A Winkler, Thomas W %A Jakupović, Hermina %A Chasman, Daniel I %A Manning, Alisa %A Ntalla, Ioanna %A Aschard, Hugues %A Brown, Michael R %A de Las Fuentes, Lisa %A Franceschini, Nora %A Guo, Xiuqing %A Vojinovic, Dina %A Aslibekyan, Stella %A Feitosa, Mary F %A Kho, Minjung %A Musani, Solomon K %A Richard, Melissa %A Wang, Heming %A Wang, Zhe %A Bartz, Traci M %A Bielak, Lawrence F %A Campbell, Archie %A Dorajoo, Rajkumar %A Fisher, Virginia %A Hartwig, Fernando P %A Horimoto, Andrea R V R %A Li, Changwei %A Lohman, Kurt K %A Marten, Jonathan %A Sim, Xueling %A Smith, Albert V %A Tajuddin, Salman M %A Alver, Maris %A Amini, Marzyeh %A Boissel, Mathilde %A Chai, Jin Fang %A Chen, Xu %A Divers, Jasmin %A Evangelou, Evangelos %A Gao, Chuan %A Graff, Mariaelisa %A Harris, Sarah E %A He, Meian %A Hsu, Fang-Chi %A Jackson, Anne U %A Zhao, Jing Hua %A Kraja, Aldi T %A Kuhnel, Brigitte %A Laguzzi, Federica %A Lyytikäinen, Leo-Pekka %A Nolte, Ilja M %A Rauramaa, Rainer %A Riaz, Muhammad %A Robino, Antonietta %A Rueedi, Rico %A Stringham, Heather M %A Takeuchi, Fumihiko %A van der Most, Peter J %A Varga, Tibor V %A Verweij, Niek %A Ware, Erin B %A Wen, Wanqing %A Li, Xiaoyin %A Yanek, Lisa R %A Amin, Najaf %A Arnett, Donna K %A Boerwinkle, Eric %A Brumat, Marco %A Cade, Brian %A Canouil, Mickaël %A Chen, Yii-Der Ida %A Concas, Maria Pina %A Connell, John %A de Mutsert, Renée %A de Silva, H Janaka %A de Vries, Paul S %A Demirkan, Ayse %A Ding, Jingzhong %A Eaton, Charles B %A Faul, Jessica D %A Friedlander, Yechiel %A Gabriel, Kelley P %A Ghanbari, Mohsen %A Giulianini, Franco %A Gu, Chi Charles %A Gu, Dongfeng %A Harris, Tamara B %A He, Jiang %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hunt, Steven C %A Ikram, M Arfan %A Jonas, Jost B %A Koh, Woon-Puay %A Komulainen, Pirjo %A Krieger, Jose E %A Kritchevsky, Stephen B %A Kutalik, Zoltán %A Kuusisto, Johanna %A Langefeld, Carl D %A Langenberg, Claudia %A Launer, Lenore J %A Leander, Karin %A Lemaitre, Rozenn N %A Lewis, Cora E %A Liang, Jingjing %A Liu, Jianjun %A Mägi, Reedik %A Manichaikul, Ani %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Mohlke, Karen L %A Mosley, Thomas H %A Murray, Alison D %A Nalls, Mike A %A Nang, Ei-Ei Khaing %A Nelson, Christopher P %A Nona, Sotoodehnia %A Norris, Jill M %A Nwuba, Chiamaka Vivian %A O'Connell, Jeff %A Palmer, Nicholette D %A Papanicolau, George J %A Pazoki, Raha %A Pedersen, Nancy L %A Peters, Annette %A Peyser, Patricia A %A Polasek, Ozren %A Porteous, David J %A Poveda, Alaitz %A Raitakari, Olli T %A Rich, Stephen S %A Risch, Neil %A Robinson, Jennifer G %A Rose, Lynda M %A Rudan, Igor %A Schreiner, Pamela J %A Scott, Robert A %A Sidney, Stephen S %A Sims, Mario %A Smith, Jennifer A %A Snieder, Harold %A Sofer, Tamar %A Starr, John M %A Sternfeld, Barbara %A Strauch, Konstantin %A Tang, Hua %A Taylor, Kent D %A Tsai, Michael Y %A Tuomilehto, Jaakko %A Uitterlinden, André G %A van der Ende, M Yldau %A van Heemst, Diana %A Voortman, Trudy %A Waldenberger, Melanie %A Wennberg, Patrik %A Wilson, Gregory %A Xiang, Yong-Bing %A Yao, Jie %A Yu, Caizheng %A Yuan, Jian-Min %A Zhao, Wei %A Zonderman, Alan B %A Becker, Diane M %A Boehnke, Michael %A Bowden, Donald W %A de Faire, Ulf %A Deary, Ian J %A Elliott, Paul %A Esko, Tõnu %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Kato, Norihiro %A Laakso, Markku %A Lakka, Timo A %A Lehtimäki, Terho %A Magnusson, Patrik K E %A Oldehinkel, Albertine J %A Penninx, Brenda W J H %A Samani, Nilesh J %A Shu, Xiao-Ou %A van der Harst, Pim %A van Vliet-Ostaptchouk, Jana V %A Vollenweider, Peter %A Wagenknecht, Lynne E %A Wang, Ya X %A Wareham, Nicholas J %A Weir, David R %A Wu, Tangchun %A Zheng, Wei %A Zhu, Xiaofeng %A Evans, Michele K %A Franks, Paul W %A Gudnason, Vilmundur %A Hayward, Caroline %A Horta, Bernardo L %A Kelly, Tanika N %A Liu, Yongmei %A North, Kari E %A Pereira, Alexandre C %A Ridker, Paul M %A Tai, E Shyong %A van Dam, Rob M %A Fox, Ervin R %A Kardia, Sharon L R %A Liu, Ching-Ti %A Mook-Kanamori, Dennis O %A Province, Michael A %A Redline, Susan %A van Duijn, Cornelia M %A Rotter, Jerome I %A Kooperberg, Charles B %A Gauderman, W James %A Psaty, Bruce M %A Rice, Kenneth %A Munroe, Patricia B %A Fornage, Myriam %A Cupples, L Adrienne %A Rotimi, Charles N %A Morrison, Alanna C %A Rao, Dabeeru C %A Loos, Ruth J F %K Adolescent %K Adult %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Asian Continental Ancestry Group %K Brazil %K Calcium-Binding Proteins %K Cholesterol %K Cholesterol, HDL %K Cholesterol, LDL %K European Continental Ancestry Group %K Exercise %K Female %K Genetic Loci %K Genome-Wide Association Study %K Genotype %K Hispanic Americans %K Humans %K LIM-Homeodomain Proteins %K Lipid Metabolism %K Lipids %K Male %K Membrane Proteins %K Microtubule-Associated Proteins %K Middle Aged %K Muscle Proteins %K Nerve Tissue Proteins %K Transcription Factors %K Triglycerides %K Young Adult %X

Many genetic loci affect circulating lipid levels, but it remains unknown whether lifestyle factors, such as physical activity, modify these genetic effects. To identify lipid loci interacting with physical activity, we performed genome-wide analyses of circulating HDL cholesterol, LDL cholesterol, and triglyceride levels in up to 120,979 individuals of European, African, Asian, Hispanic, and Brazilian ancestry, with follow-up of suggestive associations in an additional 131,012 individuals. We find four loci, in/near CLASP1, LHX1, SNTA1, and CNTNAP2, that are associated with circulating lipid levels through interaction with physical activity; higher levels of physical activity enhance the HDL cholesterol-increasing effects of the CLASP1, LHX1, and SNTA1 loci and attenuate the LDL cholesterol-increasing effect of the CNTNAP2 locus. The CLASP1, LHX1, and SNTA1 regions harbor genes linked to muscle function and lipid metabolism. Our results elucidate the role of physical activity interactions in the genetic contribution to blood lipid levels.

%B Nat Commun %V 10 %P 376 %8 2019 01 22 %G eng %N 1 %R 10.1038/s41467-018-08008-w %0 Journal Article %J Diabetes %D 2019 %T Multiethnic Genome-Wide Association Study of Diabetic Retinopathy Using Liability Threshold Modeling of Duration of Diabetes and Glycemic Control. %A Pollack, Samuela %A Igo, Robert P %A Jensen, Richard A %A Christiansen, Mark %A Li, Xiaohui %A Cheng, Ching-Yu %A Ng, Maggie C Y %A Smith, Albert V %A Rossin, Elizabeth J %A Segrè, Ayellet V %A Davoudi, Samaneh %A Tan, Gavin S %A Chen, Yii-Der Ida %A Kuo, Jane Z %A Dimitrov, Latchezar M %A Stanwyck, Lynn K %A Meng, Weihua %A Hosseini, S Mohsen %A Imamura, Minako %A Nousome, Darryl %A Kim, Jihye %A Hai, Yang %A Jia, Yucheng %A Ahn, Jeeyun %A Leong, Aaron %A Shah, Kaanan %A Park, Kyu Hyung %A Guo, Xiuqing %A Ipp, Eli %A Taylor, Kent D %A Adler, Sharon G %A Sedor, John R %A Freedman, Barry I %A Lee, I-Te %A Sheu, Wayne H-H %A Kubo, Michiaki %A Takahashi, Atsushi %A Hadjadj, Samy %A Marre, Michel %A Trégouët, David-Alexandre %A McKean-Cowdin, Roberta %A Varma, Rohit %A McCarthy, Mark I %A Groop, Leif %A Ahlqvist, Emma %A Lyssenko, Valeriya %A Agardh, Elisabet %A Morris, Andrew %A Doney, Alex S F %A Colhoun, Helen M %A Toppila, Iiro %A Sandholm, Niina %A Groop, Per-Henrik %A Maeda, Shiro %A Hanis, Craig L %A Penman, Alan %A Chen, Ching J %A Hancock, Heather %A Mitchell, Paul %A Craig, Jamie E %A Chew, Emily Y %A Paterson, Andrew D %A Grassi, Michael A %A Palmer, Colin %A Bowden, Donald W %A Yaspan, Brian L %A Siscovick, David %A Cotch, Mary Frances %A Wang, Jie Jin %A Burdon, Kathryn P %A Wong, Tien Y %A Klein, Barbara E K %A Klein, Ronald %A Rotter, Jerome I %A Iyengar, Sudha K %A Price, Alkes L %A Sobrin, Lucia %X

To identify genetic variants associated with diabetic retinopathy (DR), we performed a large multiethnic genome-wide association study. Discovery included eight European cohorts ( = 3,246) and seven African American cohorts ( = 2,611). We meta-analyzed across cohorts using inverse-variance weighting, with and without liability threshold modeling of glycemic control and duration of diabetes. Variants with a value <1 × 10 were investigated in replication cohorts that included 18,545 European, 16,453 Asian, and 2,710 Hispanic subjects. After correction for multiple testing, the C allele of rs142293996 in an intron of nuclear VCP-like () was associated with DR in European discovery cohorts ( = 2.1 × 10), but did not reach genome-wide significance after meta-analysis with replication cohorts. We applied the Disease Association Protein-Protein Link Evaluator (DAPPLE) to our discovery results to test for evidence of risk being spread across underlying molecular pathways. One protein-protein interaction network built from genes in regions associated with proliferative DR was found to have significant connectivity ( = 0.0009) and corroborated with gene set enrichment analyses. These findings suggest that genetic variation in as well as variation within a protein-protein interaction network that includes genes implicated in inflammation, may influence risk for DR.

%B Diabetes %V 68 %P 441-456 %8 2019 Feb %G eng %N 2 %R 10.2337/db18-0567 %0 Journal Article %J Nat Hum Behav %D 2019 %T {New alcohol-related genes suggest shared genetic mechanisms with neuropsychiatric disorders %A Evangelou, E. %A Gao, H. %A Chu, C. %A Ntritsos, G. %A Blakeley, P. %A Butts, A. R. %A Pazoki, R. %A Suzuki, H. %A Koskeridis, F. %A Yiorkas, A. M. %A Karaman, I. %A Elliott, J. %A Luo, Q. %A Aeschbacher, S. %A Bartz, T. M. %A Baumeister, S. E. %A Braund, P. S. %A Brown, M. R. %A Brody, J. A. %A Clarke, T. K. %A Dimou, N. %A Faul, J. D. %A Homuth, G. %A Jackson, A. U. %A Kentistou, K. A. %A Joshi, P. K. %A Lemaitre, R. N. %A Lind, P. A. %A Lyytik?inen, L. P. %A Mangino, M. %A Milaneschi, Y. %A Nelson, C. P. %A Nolte, I. M. %A Per?l?, M. M. %A Polasek, O. %A Porteous, D. %A Ratliff, S. M. %A Smith, J. A. %A Stan??kov?, A. %A Teumer, A. %A Tuominen, S. %A Th?riault, S. %A Vangipurapu, J. %A Whitfield, J. B. %A Wood, A. %A Yao, J. %A Yu, B. %A Zhao, W. %A Arking, D. E. %A Auvinen, J. %A Liu, C. %A M?nnikk?, M. %A Risch, L. %A Rotter, J. I. %A Snieder, H. %A Veijola, J. %A Blakemore, A. I. %A Boehnke, M. %A Campbell, H. %A Conen, D. %A Eriksson, J. G. %A Grabe, H. J. %A Guo, X. %A van der Harst, P. %A Hartman, C. A. %A Hayward, C. %A Heath, A. C. %A Jarvelin, M. R. %A K?h?nen, M. %A Kardia, S. L. R. %A K?hne, M. %A Kuusisto, J. %A Laakso, M. %A Lahti, J. %A Lehtim?ki, T. %A McIntosh, A. M. %A Mohlke, K. L. %A Morrison, A. C. %A Martin, N. G. %A Oldehinkel, A. J. %A Penninx, B. W. J. H. %A Psaty, B. M. %A Raitakari, O. T. %A Rudan, I. %A Samani, N. J. %A Scott, L. J. %A Spector, T. D. %A Verweij, N. %A Weir, D. R. %A Wilson, J. F. %A Levy, D. %A Tzoulaki, I. %A Bell, J. D. %A Matthews, P. M. %A Rothenfluh, A. %A Desrivi?res, S. %A Schumann, G. %A Elliott, P. %X Excessive alcohol consumption is one of the main causes of death and disability worldwide. Alcohol consumption is a heritable complex trait. Here we conducted a meta-analysis of genome-wide association studies of alcohol consumption (g d-1) from the UK Biobank, the Alcohol Genome-Wide Consortium and the Cohorts for Heart and Aging Research in Genomic Epidemiology Plus consortia, collecting data from 480,842 people of European descent to decipher the genetic architecture of alcohol intake. We identified 46 new common loci and investigated their potential functional importance using magnetic resonance imaging data and gene expression studies. We identify genetic pathways associated with alcohol consumption and suggest genetic mechanisms that are shared with neuropsychiatric disorders such as schizophrenia. %B Nat Hum Behav %V 3 %P 950–961 %8 09 %G eng %0 Journal Article %J Am J Respir Crit Care Med %D 2019 %T {Omega-3 Fatty Acids and Genome-Wide Interaction Analyses Reveal DPP10-Pulmonary Function Association %A Xu, J. %A Gaddis, N. C. %A Bartz, T. M. %A Hou, R. %A Manichaikul, A. W. %A Pankratz, N. %A Smith, A. V. %A Sun, F. %A Terzikhan, N. %A Markunas, C. A. %A Patchen, B. K. %A Schu, M. %A Beydoun, M. A. %A Brusselle, G. G. %A Eiriksdottir, G. %A Zhou, X. %A Wood, A. C. %A Graff, M. %A Harris, T. B. %A Ikram, M. A. %A Jacobs, D. R. %A Launer, L. J. %A Lemaitre, R. N. %A O'Connor, G. T. %A Oelsner, E. C. %A Psaty, B. M. %A Vasan, R. S. %A Rohde, R. R. %A Rich, S. S. %A Rotter, J. I. %A Seshadri, S. %A Smith, L. J. %A Tiemeier, H. %A Tsai, M. Y. %A Uitterlinden, A. G. %A Voruganti, V. S. %A Xu, H. %A Zilh?o, N. R. %A Fornage, M. %A Zillikens, M. C. %A London, S. J. %A Barr, R. G. %A Dupuis, J. %A Gharib, S. A. %A Gudnason, V. %A Lahousse, L. %A North, K. E. %A Steffen, L. M. %A Cassano, P. A. %A Hancock, D. B. %X Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have anti-inflammatory properties that could benefit adults with comprised pulmonary health.\ To investigate n-3 PUFA associations with spirometric measures of pulmonary function tests (PFTs) and determine underlying genetic susceptibility.\ Associations of n-3 PUFA biomarkers (α-linolenic acid, eicosapentaenoic acid, docosapentaenoic acid [DPA], and docosahexaenoic acid [DHA]) were evaluated with PFTs (FEV1, FVC, and FEV1/FVC) in meta-analyses across seven cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (N = 16,134 of European or African ancestry). PFT-associated n-3 PUFAs were carried forward to genome-wide interaction analyses in the four largest cohorts (N = 11,962) and replicated in one cohort (N = 1,687). Cohort-specific results were combined using joint 2 degree-of-freedom (2df) meta-analyses of SNP associations and their interactions with n-3 PUFAs.\ DPA and DHA were positively associated with FEV1 and FVC (P < 0.025), with evidence for effect modification by smoking and by sex. Genome-wide analyses identified a novel association of rs11693320-an intronic DPP10 SNP-with FVC when incorporating an interaction with DHA, and the finding was replicated (P2df = 9.4 × 10-9 across discovery and replication cohorts). The rs11693320-A allele (frequency, ∼80%) was associated with lower FVC (PSNP = 2.1 × 10-9; βSNP = -161.0 ml), and the association was attenuated by higher DHA levels (PSNP×DHA interaction = 2.1 × 10-7; βSNP×DHA interaction = 36.2 ml).\ We corroborated beneficial effects of n-3 PUFAs on pulmonary function. By modeling genome-wide n-3 PUFA interactions, we identified a novel DPP10 SNP association with FVC that was not detectable in much larger studies ignoring this interaction. %B Am J Respir Crit Care Med %V 199 %P 631–642 %8 03 %G eng %0 Journal Article %J PLoS One %D 2019 %T Pharmacogenomics of statin-related myopathy: Meta-analysis of rare variants from whole-exome sequencing. %A Floyd, James S %A Bloch, Katarzyna M %A Brody, Jennifer A %A Maroteau, Cyrielle %A Siddiqui, Moneeza K %A Gregory, Richard %A Carr, Daniel F %A Molokhia, Mariam %A Liu, Xiaoming %A Bis, Joshua C %A Ahmed, Ammar %A Liu, Xuan %A Hallberg, Pär %A Yue, Qun-Ying %A Magnusson, Patrik K E %A Brisson, Diane %A Wiggins, Kerri L %A Morrison, Alanna C %A Khoury, Etienne %A McKeigue, Paul %A Stricker, Bruno H %A Lapeyre-Mestre, Maryse %A Heckbert, Susan R %A Gallagher, Arlene M %A Chinoy, Hector %A Gibbs, Richard A %A Bondon-Guitton, Emmanuelle %A Tracy, Russell %A Boerwinkle, Eric %A Gaudet, Daniel %A Conforti, Anita %A van Staa, Tjeerd %A Sitlani, Colleen M %A Rice, Kenneth M %A Maitland-van der Zee, Anke-Hilse %A Wadelius, Mia %A Morris, Andrew P %A Pirmohamed, Munir %A Palmer, Colin A N %A Psaty, Bruce M %A Alfirevic, Ana %X

AIMS: Statin-related myopathy (SRM), which includes rhabdomyolysis, is an uncommon but important adverse drug reaction because the number of people prescribed statins world-wide is large. Previous association studies of common genetic variants have had limited success in identifying a genetic basis for this adverse drug reaction. We conducted a multi-site whole-exome sequencing study to investigate whether rare coding variants confer an increased risk of SRM.

METHODS AND RESULTS: SRM 3-5 cases (N = 505) and statin treatment-tolerant controls (N = 2047) were recruited from multiple sites in North America and Europe. SRM 3-5 was defined as symptoms consistent with muscle injury and an elevated creatine phosphokinase level >4 times upper limit of normal without another likely cause of muscle injury. Whole-exome sequencing and variant calling was coordinated from two analysis centres, and results of single-variant and gene-based burden tests were meta-analysed. No genome-wide significant associations were identified. Given the large number of cases, we had 80% power to identify a variant with minor allele frequency of 0.01 that increases the risk of SRM 6-fold at genome-wide significance.

CONCLUSIONS: In this large whole-exome sequencing study of severe statin-related muscle injury conducted to date, we did not find evidence that rare coding variants are responsible for this adverse drug reaction. Larger sample sizes would be required to identify rare variants with small effects, but it is unclear whether such findings would be clinically actionable.

%B PLoS One %V 14 %P e0218115 %8 2019 %G eng %N 6 %R 10.1371/journal.pone.0218115 %0 Journal Article %J Circ Heart Fail %D 2019 %T Plasma Ceramides and Sphingomyelins in Relation to Heart Failure Risk. %A Lemaitre, Rozenn N %A Jensen, Paul N %A Hoofnagle, Andrew %A McKnight, Barbara %A Fretts, Amanda M %A King, Irena B %A Siscovick, David S %A Psaty, Bruce M %A Heckbert, Susan R %A Mozaffarian, Dariush %A Sotoodehnia, Nona %X

BACKGROUND: Ceramides exhibit multiple biological activities that may influence the pathophysiology of heart failure. These activities may be influenced by the saturated fatty acid carried by the ceramide (Cer). However, the associations of different circulating Cer species, and their sphingomyelin (SM) precursors, with heart failure have received limited attention.

METHODS AND RESULTS: We studied the associations of plasma Cer and SM species with incident heart failure in the Cardiovascular Health Study. We examined 8 species: Cer and SM with palmitic acid (Cer-16 and SM-16), species with arachidic acid (Cer-20 and SM-20), species with behenic acid (Cer-22 and SM-22), and species with lignoceric acid (Cer-24 and SM-24). During a median follow-up of 9.4 years, we identified 1179 cases of incident heart failure among 4249 study participants. In Cox regression analyses adjusted for risk factors, higher levels of Cer-16 and SM-16 were associated with higher risk of incident heart failure (hazard ratio for one SD increase:1.25 [95% CI, 1.16-1.36] and 1.28 [1.18-1.40], respectively). In contrast, higher levels of Cer-22 were associated with lower risk of heart failure in multivariable analyses further adjusted for Cer-16 (hazard ratio, 0.85 [0.78-0.92]); and higher levels of SM-20, SM-22 and SM-24 were associated with lower risk of heart failure in analyses further adjusted for SM-16 (hazard ratios, 0.83 [0.77-0.90], 0.81 [0.75-0.88], and 0.83 [0.77-0.90], respectively). No statistically significant interactions with age, sex, black race, body mass index, or baseline coronary heart disease were detected. Similar associations were observed for heart failure with preserved (n=529) or reduced (n=348) ejection fraction.

CONCLUSIONS: This study shows associations of higher plasma levels of Cer-16 and SM-16 with increased risk of heart failure and higher levels of Cer-22, SM-20, SM-22, and SM-24 with decreased risk of heart failure.

CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00005133.

%B Circ Heart Fail %V 12 %P e005708 %8 2019 Jul %G eng %N 7 %R 10.1161/CIRCHEARTFAILURE.118.005708 %0 Journal Article %J BMJ %D 2019 %T {Quality of dietary fat and genetic risk of type 2 diabetes: individual participant data meta-analysis %A Merino, J. %A Guasch-Ferr?, M. %A Ellervik, C. %A Dashti, H. S. %A Sharp, S. J. %A Wu, P. %A Overvad, K. %A Sarnowski, C. %A Kuokkanen, M. %A Lemaitre, R. N. %A Justice, A. E. %A Ericson, U. %A Braun, K. V. E. %A Mahendran, Y. %A Frazier-Wood, A. C. %A Sun, D. %A Chu, A. Y. %A Tanaka, T. %A Luan, J. %A Hong, J. %A Tj?nneland, A. %A Ding, M. %A Lundqvist, A. %A Mukamal, K. %A Rohde, R. %A Schulz, C. A. %A Franco, O. H. %A Grarup, N. %A Chen, Y. I. %A Bazzano, L. %A Franks, P. W. %A Buring, J. E. %A Langenberg, C. %A Liu, C. T. %A Hansen, T. %A Jensen, M. K. %A S??ksj?rvi, K. %A Psaty, B. M. %A Young, K. L. %A Hindy, G. %A Sandholt, C. H. %A Ridker, P. M. %A Ordovas, J. M. %A Meigs, J. B. %A Pedersen, O. %A Kraft, P. %A Perola, M. %A North, K. E. %A Orho-Melander, M. %A Voortman, T. %A Toft, U. %A Rotter, J. I. %A Qi, L. %A Forouhi, N. G. %A Mozaffarian, D. %A S?rensen, T. I. A. %A Stampfer, M. J. %A M?nnist?, S. %A Selvin, E. %A Imamura, F. %A Salomaa, V. %A Hu, F. B. %A Wareham, N. J. %A Dupuis, J. %A Smith, C. E. %A Kilpel?inen, T. O. %A Chasman, D. I. %A Florez, J. C. %X {To investigate whether the genetic burden of type 2 diabetes modifies the association between the quality of dietary fat and the incidence of type 2 diabetes.\ Individual participant data meta-analysis.\ Eligible prospective cohort studies were systematically sourced from studies published between January 1970 and February 2017 through electronic searches in major medical databases (Medline, Embase, and Scopus) and discussion with investigators.\ Data from cohort studies or multicohort consortia with available genome-wide genetic data and information about the quality of dietary fat and the incidence of type 2 diabetes in participants of European descent was sought. Prospective cohorts that had accrued five or more years of follow-up were included. The type 2 diabetes genetic risk profile was characterized by a 68-variant polygenic risk score weighted by published effect sizes. Diet was recorded by using validated cohort-specific dietary assessment tools. Outcome measures were summary adjusted hazard ratios of incident type 2 diabetes for polygenic risk score, isocaloric replacement of carbohydrate (refined starch and sugars) with types of fat, and the interaction of types of fat with polygenic risk score.\ Of 102 305 participants from 15 prospective cohort studies, 20 015 type 2 diabetes cases were documented after a median follow-up of 12 years (interquartile range 9.4-14.2). The hazard ratio of type 2 diabetes per increment of 10 risk alleles in the polygenic risk score was 1.64 (95% confidence interval 1.54 to 1.75 %B BMJ %V 366 %P l4292 %8 07 %G eng %0 Journal Article %J Alzheimers Dement %D 2019 %T A rare missense variant of CASP7 is associated with familial late-onset Alzheimer's disease. %A Zhang, Xiaoling %A Zhu, Congcong %A Beecham, Gary %A Vardarajan, Badri N %A Ma, Yiyi %A Lancour, Daniel %A Farrell, John J %A Chung, Jaeyoon %A Mayeux, Richard %A Haines, Jonathan L %A Schellenberg, Gerard D %A Pericak-Vance, Margaret A %A Lunetta, Kathryn L %A Farrer, Lindsay A %X

INTRODUCTION: The genetic architecture of Alzheimer's disease (AD) is only partially understood.

METHODS: We conducted an association study for AD using whole sequence data from 507 genetically enriched AD cases (i.e., cases having close relatives affected by AD) and 4917 cognitively healthy controls of European ancestry (EA) and 172 enriched cases and 179 controls of Caribbean Hispanic ancestry. Confirmation of top findings from stage 1 was sought in two family-based genome-wide association study data sets and in a whole genome-sequencing data set comprising members from 42 EA and 115 Caribbean Hispanic families.

RESULTS: We identified associations in EAs with variants in 12 novel loci. The most robust finding is a rare CASP7 missense variant (rs116437863; P = 2.44 × 10) which improved when combined with results from stage 2 data sets (P = 1.92 × 10).

DISCUSSION: Our study demonstrated that an enriched case design can strengthen genetic signals, thus allowing detection of associations that would otherwise be missed in a traditional case-control study.

%B Alzheimers Dement %8 2019 Jan 03 %G eng %R 10.1016/j.jalz.2018.10.005 %0 Journal Article %J Am J Kidney Dis %D 2019 %T {Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium %A Inker, L. A. %A Grams, M. E. %A Levey, A. S. %A Coresh, J. %A Cirillo, M. %A Collins, J. F. %A Gansevoort, R. T. %A Gutierrez, O. M. %A Hamano, T. %A Heine, G. H. %A Ishikawa, S. %A Jee, S. H. %A Kronenberg, F. %A Landray, M. J. %A Miura, K. %A Nadkarni, G. N. %A Peralta, C. A. %A Rothenbacher, D. %A Schaeffner, E. %A Sedaghat, S. %A Shlipak, M. G. %A Zhang, L. %A van Zuilen, A. D. %A Hallan, S. I. %A Kovesdy, C. P. %A Woodward, M. %A Levin, A. %A Astor, B. %A Appel, L. %A Greene, T. %A Chen, T. %A Chalmers, J. %A Woodward, M. %A Arima, H. %A Perkovic, V. %A Yatsuya, H. %A Tamakoshi, K. %A Li, Y. %A Hirakawa, Y. %A Coresh, J. %A Matsushita, K. %A Grams, M. %A Sang, Y. %A Polkinghorne, K. %A Chadban, S. %A Atkins, R. %A Levin, A. %A Djurdjev, O. %A Zhang, L. %A Liu, L. %A Zhao, M. %A Wang, F. %A Wang, J. %A Schaeffner, E. %A Ebert, N. %A Martus, P. %A Levin, A. %A Djurdjev, O. %A Tang, M. %A Heine, G. %A Emrich, I. %A Seiler, S. %A Zawada, A. %A Nally, J. %A Navaneethan, S. %A Schold, J. %A Zhang, L. %A Zhao, M. %A Wang, F. %A Wang, J. %A Shlipak, M. %A Sarnak, M. %A Katz, R. %A Hiramoto, J. %A Iso, H. %A Yamagishi, K. %A Umesawa, M. %A Muraki, I. %A Fukagawa, M. %A Maruyama, S. %A Hamano, T. %A Hasegawa, T. %A Fujii, N. %A Wheeler, D. %A Emberson, J. %A Townend, J. %A Landray, M. %A Brenner, H. %A Sch?ttker, B. %A Saum, K. U. %A Rothenbacher, D. %A Fox, C. %A Hwang, S. J. %A K?ttgen, A. %A Kronenberg, F. %A Schneider, M. P. %A Eckardt, K. U. %A Green, J. %A Kirchner, H. L. %A Chang, A. R. %A Ho, K. %A Ito, S. %A Miyazaki, M. %A Nakayama, M. %A Yamada, G. %A Cirillo, M. %A Irie, F. %A Sairenchi, T. %A Ishikawa, S. %A Yano, Y. %A Kotani, K. %A Nakamura, T. %A Jee, S. H. %A Kimm, H. %A Mok, Y. %A Chodick, G. %A Shalev, V. %A Wetzels, J. F. M. %A Blankestijn, P. J. %A van Zuilen, A. D. %A van den Brand, J. %A Sarnak, M. %A Inker, L. %A Peralta, C. %A Hiramoto, J. %A Katz, R. %A Sarnak, M. %A Kronenberg, F. %A Kollerits, B. %A Ritz, E. %A Nitsch, D. %A Roderick, P. %A Fletcher, A. %A Bottinger, E. %A Nadkarni, G. N. %A Ellis, S. B. %A Nadukuru, R. %A Sang, Y. %A Ueshima, H. %A Okayama, A. %A Miura, K. %A Tanaka, S. %A Ueshima, H. %A Okamura, T. %A Miura, K. %A Tanaka, S. %A Miura, K. %A Okayama, A. %A Kadota, A. %A Tanaka, S. %A Kenealy, T. %A Elley, C. R. %A Collins, J. F. %A Drury, P. L. %A Ohkubo, T. %A Asayama, K. %A Metoki, H. %A Kikuya, M. %A Nakayama, M. %A Nelson, R. G. %A Knowler, W. C. %A Gansevoort, R. T. %A Bakker, S. J. %A Hak, E. %A Heerspink, H. J. L. %A Brunskill, N. %A Major, R. %A Shepherd, D. %A Medcalf, J. %A Jassal, S. K. %A Bergstrom, J. %A Ix, J. H. %A Barrett-Connor, E. %A Kovesdy, C. %A Kalantar-Zadeh, K. %A Sumida, K. %A Gutierrez, O. M. %A Muntner, P. %A Warnock, D. %A McClellan, W. %A Heerspink, H. J. L. %A de Zeeuw, D. %A Brenner, B. %A Sedaghat, S. %A Ikram, M. A. %A Hoorn, E. J. %A Dehghan, A. %A Carrero, J. J. %A Gasparini, A. %A Wettermark, B. %A Elinder, C. G. %A Wong, T. Y. %A Sabanayagam, C. %A Cheng, C. Y. %A Visseren, F. L. J. %A Evans, M. %A Segelmark, M. %A Stendahl, M. %A Sch?n, S. %A Tangri, N. %A Sud, M. %A Naimark, D. %A Wen, C. P. %A Tsao, C. K. %A Tsai, M. K. %A Chen, C. H. %A Konta, T. %A Hirayama, A. %A Ichikawa, K. %A Lannfelt, L. %A Larsson, A. %A ?rnl?v, J. %A Bilo, H. J. G. %A Landman, G. W. D. %A van Hateren, K. J. J. %A Kleefstra, N. %A Coresh Chair, J. %A Gansevoort, R. T. %A Grams, M. E. %A Hallan, S. %A Kovesdy, C. P. %A Levey, A. S. %A Matsushita, K. %A Shalev, V. %A Woodward, M. %A Ballew, S. H. %A Chen, J. %A Coresh, J. %A Grams, M. E. %A Kwak, L. %A Matsushita, K. %A Sang, Y. %A Surapaneni, A. %A Woodward, M. %X Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.\ Cross-sectional individual participant-level analyses in a global consortium.\ 17 CKD and 38 general population and high-risk cohorts.\ Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.\ Data were obtained and analyzed between July 2015 and January 2018.\ We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.\ The CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).\ Variations in study era, health care delivery system, typical diet, and laboratory assays.\ Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD. %B Am J Kidney Dis %V 73 %P 206–217 %8 02 %G eng %0 Journal Article %J Am J Hum Genet %D 2019 %T Sequencing Analysis at 8p23 Identifies Multiple Rare Variants in DLC1 Associated with Sleep-Related Oxyhemoglobin Saturation Level. %A Liang, Jingjing %A Cade, Brian E %A He, Karen Y %A Wang, Heming %A Lee, Jiwon %A Sofer, Tamar %A Williams, Stephanie %A Li, Ruitong %A Chen, Han %A Gottlieb, Daniel J %A Evans, Daniel S %A Guo, Xiuqing %A Gharib, Sina A %A Hale, Lauren %A Hillman, David R %A Lutsey, Pamela L %A Mukherjee, Sutapa %A Ochs-Balcom, Heather M %A Palmer, Lyle J %A Rhodes, Jessica %A Purcell, Shaun %A Patel, Sanjay R %A Saxena, Richa %A Stone, Katie L %A Tang, Weihong %A Tranah, Gregory J %A Boerwinkle, Eric %A Lin, Xihong %A Liu, Yongmei %A Psaty, Bruce M %A Vasan, Ramachandran S %A Cho, Michael H %A Manichaikul, Ani %A Silverman, Edwin K %A Barr, R Graham %A Rich, Stephen S %A Rotter, Jerome I %A Wilson, James G %A Redline, Susan %A Zhu, Xiaofeng %X

Average arterial oxyhemoglobin saturation during sleep (AvSpOS) is a clinically relevant measure of physiological stress associated with sleep-disordered breathing, and this measure predicts incident cardiovascular disease and mortality. Using high-depth whole-genome sequencing data from the National Heart, Lung, and Blood Institute (NHLBI) Trans-Omics for Precision Medicine (TOPMed) project and focusing on genes with linkage evidence on chromosome 8p23, we observed that six coding and 51 noncoding variants in a gene that encodes the GTPase-activating protein (DLC1) are significantly associated with AvSpOS and replicated in independent subjects. The combined DLC1 association evidence of discovery and replication cohorts reaches genome-wide significance in European Americans (p = 7.9 × 10). A risk score for these variants, built on an independent dataset, explains 0.97% of the AvSpOS variation and contributes to the linkage evidence. The 51 noncoding variants are enriched in regulatory features in a human lung fibroblast cell line and contribute to DLC1 expression variation. Mendelian randomization analysis using these variants indicates a significant causal effect of DLC1 expression in fibroblasts on AvSpOS. Multiple sources of information, including genetic variants, gene expression, and methylation, consistently suggest that DLC1 is a gene associated with AvSpOS.

%B Am J Hum Genet %V 105 %P 1057-1068 %8 2019 Nov 07 %G eng %N 5 %R 10.1016/j.ajhg.2019.10.002 %0 Journal Article %J J Am Heart Assoc %D 2019 %T Serial Plasma Phospholipid Fatty Acids in the De Novo Lipogenesis Pathway and Total Mortality, Cause-Specific Mortality, and Cardiovascular Diseases in the Cardiovascular Health Study. %A Lai, Heidi T M %A de Oliveira Otto, Marcia C %A Lee, Yujin %A Wu, Jason H Y %A Song, Xiaoling %A King, Irena B %A Psaty, Bruce M %A Lemaitre, Rozenn N %A McKnight, Barbara %A Siscovick, David S %A Mozaffarian, Dariush %X

Background Synthesized fatty acids (FAs) from de novo lipogenesis may affect cardiometabolic health, but longitudinal associations between serially measured de novo lipogenesis-related fatty acid biomarkers and mortality or cardiovascular disease (CVD) are not well established. Methods and Results We investigated longitudinal associations between de novo lipogenesis-related fatty acids with all-cause mortality, cause-specific mortality, and incident CVD among 3869 older US adults, mean (SD) age 75 (5) years and free of prevalent CVD at baseline. Levels of plasma phospholipid palmitic (16:0), palmitoleic (16:1n-7), stearic (18:0), oleic acid (18:1n-9), and other risk factors were serially measured at baseline, 6 years, and 13 years. All-cause mortality, cause-specific mortality, and incident fatal and nonfatal CVD were centrally adjudicated. Risk was assessed in multivariable-adjusted Cox models with time-varying FAs and covariates. During 13 years, median follow-up (maximum 22.4 years), participants experienced 3227 deaths (1131 CVD, 2096 non-CVD) and 1753 incident CVD events. After multivariable adjustment, higher cumulative levels of 16:0, 16:1n-7, and 18:1n-9 were associated with higher all-cause mortality, with extreme-quintile hazard ratios (95% CIs) of 1.35 (1.17-1.56), 1.40 (1.21-1.62), and 1.56 (1.35-1.80), respectively, whereas higher levels of 18:0 were associated with lower mortality (hazard ratio=0.76; 95% CI=0.66-0.88). Associations were generally similar for CVD mortality versus non-CVD mortality, as well as total incident CVD. Changes in levels of 16:0 were positively, and 18:0 inversely, associated with all-cause mortality (hazard ratio=1.23, 95% CI=1.08-1.41; and hazard ratio=0.78, 95% CI=0.68-0.90). Conclusions Higher long-term levels of 16:0, 16:1n-7, and 18:1n-9 and changes in 16:0 were positively, whereas long-term levels and changes in 18:0 were inversely, associated with all-cause mortality in older adults.

%B J Am Heart Assoc %V 8 %P e012881 %8 2019 Nov 19 %G eng %N 22 %R 10.1161/JAHA.119.012881 %0 Journal Article %J Neurology %D 2019 %T Serum magnesium and calcium levels in relation to ischemic stroke: Mendelian randomization study. %A Larsson, Susanna C %A Traylor, Matthew %A Burgess, Stephen %A Boncoraglio, Giorgio B %A Jern, Christina %A Michaëlsson, Karl %A Markus, Hugh S %X

OBJECTIVE: To determine whether serum magnesium and calcium concentrations are causally associated with ischemic stroke or any of its subtypes using the mendelian randomization approach.

METHODS: Analyses were conducted using summary statistics data for 13 single-nucleotide polymorphisms robustly associated with serum magnesium (n = 6) or serum calcium (n = 7) concentrations. The corresponding data for ischemic stroke were obtained from the MEGASTROKE consortium (34,217 cases and 404,630 noncases).

RESULTS: In standard mendelian randomization analysis, the odds ratios for each 0.1 mmol/L (about 1 SD) increase in genetically predicted serum magnesium concentrations were 0.78 (95% confidence interval [CI] 0.69-0.89; = 1.3 × 10) for all ischemic stroke, 0.63 (95% CI 0.50-0.80; = 1.6 × 10) for cardioembolic stroke, and 0.60 (95% CI 0.44-0.82; = 0.001) for large artery stroke; there was no association with small vessel stroke (odds ratio 0.90, 95% CI 0.67-1.20; = 0.46). Only the association with cardioembolic stroke was robust in sensitivity analyses. There was no association of genetically predicted serum calcium concentrations with all ischemic stroke (per 0.5 mg/dL [about 1 SD] increase in serum calcium: odds ratio 1.03, 95% CI 0.88-1.21) or with any subtype.

CONCLUSIONS: This study found that genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke but found no significant association of genetically higher serum calcium concentrations with any ischemic stroke subtype.

%B Neurology %V 92 %P e944-e950 %8 2019 Feb 26 %G eng %N 9 %R 10.1212/WNL.0000000000007001 %0 Journal Article %J J. Gerontol. A Biol. Sci. Med. Sci. %D 2019 %T {Sex Differences in the Association Between Pentraxin 3 and Cognitive Decline: The Cardiovascular Health Study %A Miller, L. M. %A Jenny, N. S. %A Rawlings, A. M. %A Arnold, A. M. %A Fitzpatrick, A. L. %A Lopez, O. L. %A Odden, M. C. %X The importance of systemic inflammation, measured by C-reactive protein, in cognitive decline has been demonstrated; however, the role of vascular inflammation is less understood. Pentraxin 3 (PTX3) is a novel marker of vascular inflammation.\ We followed adults 65 and older, free of cardiovascular disease (CVD) for up to 9 years (n = 1,547) in the Cardiovascular Health Study. We evaluated the relationship between PTX3 and change in cognitive function, measured using the Modified Mini-Mental State Examination (3MSE), and incident cognitive impairment (3MSE < 80). Mediation by CVD events, and effect modification by sex and apolipoprotein E ɛ4 allele (APOE4) were also examined.\ The average decline in 3MSE was 0.77 points per year. The association between PTX3 and change in 3MSE differed between women and men (p = .02). In the adjusted model, each standard deviation higher in PTX3 was associated with a 0.20 greater decline in 3MSE score per year in women over follow-up (95% CI: -0. 37, -0.03; p = .02), compared to no change in men (β = 0.07; 95% CI: -0.08, 0.22). CVD events had a minor effect on the associations. No effect modification by APOE4 was found, although we observed the association of PTX3 and cognitive impairment in women was attenuated and nonsignificant after adjustment for APOE4. There was a paradoxical protective association between PTX3 and reduced cognitive impairment in men, even after adjustment for APOE4.\ We found that vascular inflammation was significantly associated with cognitive decline in older women, but not men. %B J. Gerontol. A Biol. Sci. Med. Sci. %8 Dec %G eng %0 Journal Article %J Pharmacogenomics J %D 2019 %T Statin-induced LDL cholesterol response and type 2 diabetes: a bidirectional two-sample Mendelian randomization study. %A Smit, Roelof A J %A Trompet, Stella %A Leong, Aaron %A Goodarzi, Mark O %A Postmus, Iris %A Warren, Helen %A Theusch, Elizabeth %A Barnes, Michael R %A Arsenault, Benoit J %A Li, Xiaohui %A Feng, QiPing %A Chasman, Daniel I %A Cupples, L Adrienne %A Hitman, Graham A %A Krauss, Ronald M %A Psaty, Bruce M %A Rotter, Jerome I %A Cessie, Saskia le %A Stein, C Michael %A Jukema, J Wouter %X

It remains unclear whether the increased risk of new-onset type 2 diabetes (T2D) seen in statin users is due to low LDL-C concentrations, or due to the statin-induced proportional change in LDL-C. In addition, genetic instruments have not been proposed before to examine whether liability to T2D might cause greater proportional statin-induced LDL-C lowering. Using summary-level statistics from the Genomic Investigation of Statin Therapy (GIST, n = 40,914) and DIAGRAM (n = 159,208) consortia, we found a positive genetic correlation between LDL-C statin response and T2D using LD score regression (r = 0.36, s.e. = 0.13). However, mendelian randomization analyses did not provide support for statin response having a causal effect on T2D risk (OR 1.00 (95% CI: 0.97, 1.03) per 10% increase in statin response), nor that liability to T2D has a causal effect on statin-induced LDL-C response (0.20% increase in response (95% CI: -0.40, 0.80) per doubling of odds of liability to T2D). Although we found no evidence to suggest that proportional statin response influences T2D risk, a definitive assessment should be made in populations comprised exclusively of statin users, as the presence of nonstatin users in the DIAGRAM dataset may have substantially diluted our effect estimate.

%B Pharmacogenomics J %8 2019 Dec 05 %G eng %R 10.1038/s41397-019-0125-x %0 Journal Article %J Genome Biol %D 2019 %T Systematic analysis of dark and camouflaged genes reveals disease-relevant genes hiding in plain sight. %A Ebbert, Mark T W %A Jensen, Tanner D %A Jansen-West, Karen %A Sens, Jonathon P %A Reddy, Joseph S %A Ridge, Perry G %A Kauwe, John S K %A Belzil, Veronique %A Pregent, Luc %A Carrasquillo, Minerva M %A Keene, Dirk %A Larson, Eric %A Crane, Paul %A Asmann, Yan W %A Ertekin-Taner, Nilufer %A Younkin, Steven G %A Ross, Owen A %A Rademakers, Rosa %A Petrucelli, Leonard %A Fryer, John D %K Genetic Predisposition to Disease %K Genome, Human %K Humans %K Mutation %X

BACKGROUND: The human genome contains "dark" gene regions that cannot be adequately assembled or aligned using standard short-read sequencing technologies, preventing researchers from identifying mutations within these gene regions that may be relevant to human disease. Here, we identify regions with few mappable reads that we call dark by depth, and others that have ambiguous alignment, called camouflaged. We assess how well long-read or linked-read technologies resolve these regions.

RESULTS: Based on standard whole-genome Illumina sequencing data, we identify 36,794 dark regions in 6054 gene bodies from pathways important to human health, development, and reproduction. Of these gene bodies, 8.7% are completely dark and 35.2% are ≥ 5% dark. We identify dark regions that are present in protein-coding exons across 748 genes. Linked-read or long-read sequencing technologies from 10x Genomics, PacBio, and Oxford Nanopore Technologies reduce dark protein-coding regions to approximately 50.5%, 35.6%, and 9.6%, respectively. We present an algorithm to resolve most camouflaged regions and apply it to the Alzheimer's Disease Sequencing Project. We rescue a rare ten-nucleotide frameshift deletion in CR1, a top Alzheimer's disease gene, found in disease cases but not in controls.

CONCLUSIONS: While we could not formally assess the association of the CR1 frameshift mutation with Alzheimer's disease due to insufficient sample-size, we believe it merits investigating in a larger cohort. There remain thousands of potentially important genomic regions overlooked by short-read sequencing that are largely resolved by long-read technologies.

%B Genome Biol %V 20 %P 97 %8 2019 05 20 %G eng %N 1 %R 10.1186/s13059-019-1707-2 %0 Journal Article %J Nat Genet %D 2019 %T Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels. %A Tin, Adrienne %A Marten, Jonathan %A Halperin Kuhns, Victoria L %A Li, Yong %A Wuttke, Matthias %A Kirsten, Holger %A Sieber, Karsten B %A Qiu, Chengxiang %A Gorski, Mathias %A Yu, Zhi %A Giri, Ayush %A Sveinbjornsson, Gardar %A Li, Man %A Chu, Audrey Y %A Hoppmann, Anselm %A O'Connor, Luke J %A Prins, Bram %A Nutile, Teresa %A Noce, Damia %A Akiyama, Masato %A Cocca, Massimiliano %A Ghasemi, Sahar %A van der Most, Peter J %A Horn, Katrin %A Xu, Yizhe %A Fuchsberger, Christian %A Sedaghat, Sanaz %A Afaq, Saima %A Amin, Najaf %A Arnlöv, Johan %A Bakker, Stephan J L %A Bansal, Nisha %A Baptista, Daniela %A Bergmann, Sven %A Biggs, Mary L %A Biino, Ginevra %A Boerwinkle, Eric %A Bottinger, Erwin P %A Boutin, Thibaud S %A Brumat, Marco %A Burkhardt, Ralph %A Campana, Eric %A Campbell, Archie %A Campbell, Harry %A Carroll, Robert J %A Catamo, Eulalia %A Chambers, John C %A Ciullo, Marina %A Concas, Maria Pina %A Coresh, Josef %A Corre, Tanguy %A Cusi, Daniele %A Felicita, Sala Cinzia %A de Borst, Martin H %A De Grandi, Alessandro %A de Mutsert, Renée %A de Vries, Aiko P J %A Delgado, Graciela %A Demirkan, Ayse %A Devuyst, Olivier %A Dittrich, Katalin %A Eckardt, Kai-Uwe %A Ehret, Georg %A Endlich, Karlhans %A Evans, Michele K %A Gansevoort, Ron T %A Gasparini, Paolo %A Giedraitis, Vilmantas %A Gieger, Christian %A Girotto, Giorgia %A Gögele, Martin %A Gordon, Scott D %A Gudbjartsson, Daniel F %A Gudnason, Vilmundur %A Haller, Toomas %A Hamet, Pavel %A Harris, Tamara B %A Hayward, Caroline %A Hicks, Andrew A %A Hofer, Edith %A Holm, Hilma %A Huang, Wei %A Hutri-Kähönen, Nina %A Hwang, Shih-Jen %A Ikram, M Arfan %A Lewis, Raychel M %A Ingelsson, Erik %A Jakobsdottir, Johanna %A Jonsdottir, Ingileif %A Jonsson, Helgi %A Joshi, Peter K %A Josyula, Navya Shilpa %A Jung, Bettina %A Kähönen, Mika %A Kamatani, Yoichiro %A Kanai, Masahiro %A Kerr, Shona M %A Kiess, Wieland %A Kleber, Marcus E %A Koenig, Wolfgang %A Kooner, Jaspal S %A Körner, Antje %A Kovacs, Peter %A Krämer, Bernhard K %A Kronenberg, Florian %A Kubo, Michiaki %A Kuhnel, Brigitte %A La Bianca, Martina %A Lange, Leslie A %A Lehne, Benjamin %A Lehtimäki, Terho %A Liu, Jun %A Loeffler, Markus %A Loos, Ruth J F %A Lyytikäinen, Leo-Pekka %A Mägi, Reedik %A Mahajan, Anubha %A Martin, Nicholas G %A März, Winfried %A Mascalzoni, Deborah %A Matsuda, Koichi %A Meisinger, Christa %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A O'Donnell, Christopher J %A Wilson, Otis D %A Gaziano, J Michael %A Mishra, Pashupati P %A Mohlke, Karen L %A Mononen, Nina %A Montgomery, Grant W %A Mook-Kanamori, Dennis O %A Müller-Nurasyid, Martina %A Nadkarni, Girish N %A Nalls, Mike A %A Nauck, Matthias %A Nikus, Kjell %A Ning, Boting %A Nolte, Ilja M %A Noordam, Raymond %A O'Connell, Jeffrey R %A Olafsson, Isleifur %A Padmanabhan, Sandosh %A Penninx, Brenda W J H %A Perls, Thomas %A Peters, Annette %A Pirastu, Mario %A Pirastu, Nicola %A Pistis, Giorgio %A Polasek, Ozren %A Ponte, Belen %A Porteous, David J %A Poulain, Tanja %A Preuss, Michael H %A Rabelink, Ton J %A Raffield, Laura M %A Raitakari, Olli T %A Rettig, Rainer %A Rheinberger, Myriam %A Rice, Kenneth M %A Rizzi, Federica %A Robino, Antonietta %A Rudan, Igor %A Krajcoviechova, Alena %A Cifkova, Renata %A Rueedi, Rico %A Ruggiero, Daniela %A Ryan, Kathleen A %A Saba, Yasaman %A Salvi, Erika %A Schmidt, Helena %A Schmidt, Reinhold %A Shaffer, Christian M %A Smith, Albert V %A Smith, Blair H %A Spracklen, Cassandra N %A Strauch, Konstantin %A Stumvoll, Michael %A Sulem, Patrick %A Tajuddin, Salman M %A Teren, Andrej %A Thiery, Joachim %A Thio, Chris H L %A Thorsteinsdottir, Unnur %A Toniolo, Daniela %A Tönjes, Anke %A Tremblay, Johanne %A Uitterlinden, André G %A Vaccargiu, Simona %A van der Harst, Pim %A van Duijn, Cornelia M %A Verweij, Niek %A Völker, Uwe %A Vollenweider, Peter %A Waeber, Gérard %A Waldenberger, Melanie %A Whitfield, John B %A Wild, Sarah H %A Wilson, James F %A Yang, Qiong %A Zhang, Weihua %A Zonderman, Alan B %A Bochud, Murielle %A Wilson, James G %A Pendergrass, Sarah A %A Ho, Kevin %A Parsa, Afshin %A Pramstaller, Peter P %A Psaty, Bruce M %A Böger, Carsten A %A Snieder, Harold %A Butterworth, Adam S %A Okada, Yukinori %A Edwards, Todd L %A Stefansson, Kari %A Susztak, Katalin %A Scholz, Markus %A Heid, Iris M %A Hung, Adriana M %A Teumer, Alexander %A Pattaro, Cristian %A Woodward, Owen M %A Vitart, Veronique %A Köttgen, Anna %X

Elevated serum urate levels cause gout and correlate with cardiometabolic diseases via poorly understood mechanisms. We performed a trans-ancestry genome-wide association study of serum urate in 457,690 individuals, identifying 183 loci (147 previously unknown) that improve the prediction of gout in an independent cohort of 334,880 individuals. Serum urate showed significant genetic correlations with many cardiometabolic traits, with genetic causality analyses supporting a substantial role for pleiotropy. Enrichment analysis, fine-mapping of urate-associated loci and colocalization with gene expression in 47 tissues implicated the kidney and liver as the main target organs and prioritized potentially causal genes and variants, including the transcriptional master regulators in the liver and kidney, HNF1A and HNF4A. Experimental validation showed that HNF4A transactivated the promoter of ABCG2, encoding a major urate transporter, in kidney cells, and that HNF4A p.Thr139Ile is a functional variant. Transcriptional coregulation within and across organs may be a general mechanism underlying the observed pleiotropy between urate and cardiometabolic traits.

%B Nat Genet %V 51 %P 1459-1474 %8 2019 Oct %G eng %N 10 %R 10.1038/s41588-019-0504-x %0 Journal Article %J Nat Genet %D 2019 %T Trans-ethnic association study of blood pressure determinants in over 750,000 individuals. %A Giri, Ayush %A Hellwege, Jacklyn N %A Keaton, Jacob M %A Park, Jihwan %A Qiu, Chengxiang %A Warren, Helen R %A Torstenson, Eric S %A Kovesdy, Csaba P %A Sun, Yan V %A Wilson, Otis D %A Robinson-Cohen, Cassianne %A Roumie, Christianne L %A Chung, Cecilia P %A Birdwell, Kelly A %A Damrauer, Scott M %A DuVall, Scott L %A Klarin, Derek %A Cho, Kelly %A Wang, Yu %A Evangelou, Evangelos %A Cabrera, Claudia P %A Wain, Louise V %A Shrestha, Rojesh %A Mautz, Brian S %A Akwo, Elvis A %A Sargurupremraj, Muralidharan %A Debette, Stephanie %A Boehnke, Michael %A Scott, Laura J %A Luan, Jian'an %A Zhao, Jing-Hua %A Willems, Sara M %A Thériault, Sébastien %A Shah, Nabi %A Oldmeadow, Christopher %A Almgren, Peter %A Li-Gao, Ruifang %A Verweij, Niek %A Boutin, Thibaud S %A Mangino, Massimo %A Ntalla, Ioanna %A Feofanova, Elena %A Surendran, Praveen %A Cook, James P %A Karthikeyan, Savita %A Lahrouchi, Najim %A Liu, Chunyu %A Sepúlveda, Nuno %A Richardson, Tom G %A Kraja, Aldi %A Amouyel, Philippe %A Farrall, Martin %A Poulter, Neil R %A Laakso, Markku %A Zeggini, Eleftheria %A Sever, Peter %A Scott, Robert A %A Langenberg, Claudia %A Wareham, Nicholas J %A Conen, David %A Palmer, Colin Neil Alexander %A Attia, John %A Chasman, Daniel I %A Ridker, Paul M %A Melander, Olle %A Mook-Kanamori, Dennis Owen %A Harst, Pim van der %A Cucca, Francesco %A Schlessinger, David %A Hayward, Caroline %A Spector, Tim D %A Jarvelin, Marjo-Riitta %A Hennig, Branwen J %A Timpson, Nicholas J %A Wei, Wei-Qi %A Smith, Joshua C %A Xu, Yaomin %A Matheny, Michael E %A Siew, Edward E %A Lindgren, Cecilia %A Herzig, Karl-Heinz %A Dedoussis, George %A Denny, Joshua C %A Psaty, Bruce M %A Howson, Joanna M M %A Munroe, Patricia B %A Newton-Cheh, Christopher %A Caulfield, Mark J %A Elliott, Paul %A Gaziano, J Michael %A Concato, John %A Wilson, Peter W F %A Tsao, Philip S %A Velez Edwards, Digna R %A Susztak, Katalin %A O'Donnell, Christopher J %A Hung, Adriana M %A Edwards, Todd L %X

In this trans-ethnic multi-omic study, we reinterpret the genetic architecture of blood pressure to identify genes, tissues, phenomes and medication contexts of blood pressure homeostasis. We discovered 208 novel common blood pressure SNPs and 53 rare variants in genome-wide association studies of systolic, diastolic and pulse pressure in up to 776,078 participants from the Million Veteran Program (MVP) and collaborating studies, with analysis of the blood pressure clinical phenome in MVP. Our transcriptome-wide association study detected 4,043 blood pressure associations with genetically predicted gene expression of 840 genes in 45 tissues, and mouse renal single-cell RNA sequencing identified upregulated blood pressure genes in kidney tubule cells.

%B Nat Genet %V 51 %P 51-62 %8 2019 Jan %G eng %N 1 %R 10.1038/s41588-018-0303-9 %0 Journal Article %J Sci Rep %D 2019 %T {Variants Associated with the Ankle Brachial Index Differ by Hispanic/Latino Ethnic Group: a genome-wide association study in the Hispanic Community Health Study/Study of Latinos %A Sofer, T. %A Emery, L. %A Jain, D. %A Ellis, A. M. %A Laurie, C. C. %A Allison, M. A. %A Lee, J. %A Kurniansyah, N. %A Kerr, K. F. %A Gonz?lez, H. M. %A Tarraf, W. %A Criqui, M. H. %A Lange, L. A. %A Palmas, W. R. %A Franceschini, N. %A Wassel, C. L. %X Lower extremity peripheral artery disease (PAD) burden differs by race/ethnicity. Although familial aggregation and heritability studies suggest a genetic basis, little is known about the genetic susceptibility to PAD, especially in non-European descent populations. Genome-wide association studies (GWAS) of the ankle brachial index (ABI) and PAD (defined as an ABI < 0.90) have not been conducted in Hispanics/Latinos. We performed a GWAS of PAD and the ABI in 7,589 participants aged >45 years from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We also performed GWAS for ABI stratified by Hispanic/Latino ethnic subgroups: Central American, Mexican, and South American (Mainland group), and Cuban, Dominican, and Puerto Rican (Caribbean group). We detected two genome-wide significant associations for the ABI in COMMD10 in Puerto Ricans, and at SYBU in the Caribbean group. The lead SNP rs4466200 in the COMMD10 gene had a replication p = 0.02 for the ABI in Multi-Ethnic Study of Atherosclerosis (MESA) African Americans, but it did not replicate in African Americans from the Cardiovascular Health Study (CHS). In a regional look-up, a nearby SNP rs12520838 had Bonferroni adjusted p = 0.05 (unadjusted p = 7.5 × 10-5) for PAD in MESA Hispanics. Among three suggestive associations (p < 10-7) in subgroup-specific analyses, DMD on chromosome X, identified in Central Americans, replicated in MESA Hispanics (p = 2.2 × 10-4). None of the previously reported ABI and PAD associations in whites generalized to Hispanics/Latinos. %B Sci Rep %V 9 %P 11410 %8 08 %G eng %0 Journal Article %J J Am Geriatr Soc %D 2020 %T Accelerometer-Measured Sedentary Patterns are Associated with Incident Falls in Older Women. %A Rosenberg, Dori E %A Rillamas-Sun, Eileen %A Bellettiere, John %A LaMonte, Michael %A Buchner, David M %A Di, Chongzhi %A Hunt, Julie %A Marshall, Stephen %A Stefanick, Marcia %A Zhang, Yuzheng %A LaCroix, Andrea Z %X

BACKGROUND/OBJECTIVE: Falls cause significant problems for older adults. Sedentary time is associated with lower physical function and could increase the risk for falls.

DESIGN: Prospective study.

SETTING: Sites across the United States.

PARTICIPANTS: Older women (N = 5,545, mean age 79 years) from the Women' Health Initiative Objective Physical Activity and Cardiovascular Health study.

MEASUREMENTS: Accelerometers worn at the hip for up to 1 week collected measures of daily sedentary time and the mean sedentary bout duration, a commonly used metric for sedentary accumulation patterns. For up to 13 months after accelerometer wear, women reported daily whether they had fallen on monthly calendars.

RESULTS: In fully adjusted models, the incident rate ratios (95% confidence interval) for quartiles 1 (lowest), 2, 3, and 4 of sedentary time respectively were 1.0 (ref.), 1.07 (0.93-1.24), 1.07 (0.91-1.25), and 1.14 (0.96-1.35; P-trend = .65) and for mean sedentary bout duration was 1.0 (ref.), 1.05 (0.92-1.21), 1.02 (0.88-1.17), and 1.17 (1.01-1.37; P-trend = .01), respectively. Women with a history of two or more falls had stronger associations between sedentary time and falls incidence compared with women with a history of no or one fall (P for interaction = .046).

CONCLUSIONS: Older women in the highest quartile of mean sedentary bout duration had a significantly increased risk of falling. Women with a history of frequent falling may be at higher risk for falling if they have high sedentary time. Interventions testing whether shortening total sedentary time and/or sedentary bouts lowers fall risk are needed to confirm these observational findings.

%B J Am Geriatr Soc %8 2020 Nov 30 %G eng %R 10.1111/jgs.16923 %0 Journal Article %J JAMA Neurol %D 2020 %T Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals. %A Levine, Deborah A %A Gross, Alden L %A Briceño, Emily M %A Tilton, Nicholas %A Kabeto, Mohammed U %A Hingtgen, Stephanie M %A Giordani, Bruno J %A Sussman, Jeremy B %A Hayward, Rodney A %A Burke, James F %A Elkind, Mitchell S V %A Manly, Jennifer J %A Moran, Andrew E %A Kulick, Erin R %A Gottesman, Rebecca F %A Walker, Keenan A %A Yano, Yuichiro %A Gaskin, Darrell J %A Sidney, Stephen %A Yaffe, Kristine %A Sacco, Ralph L %A Wright, Clinton B %A Roger, Veronique L %A Allen, Norrina Bai %A Galecki, Andrzej T %X

Importance: Black individuals are more likely than white individuals to develop dementia. Whether higher blood pressure (BP) levels in black individuals explain differences between black and white individuals in dementia risk is uncertain.

Objective: To determine whether cumulative BP levels explain racial differences in cognitive decline.

Design, Setting, and Participants: Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018.

Main Outcomes and Measures: The primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function.

Exposures: Race (black vs white).

Results: Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (-0.03 points per year faster [95% CI, -0.05 to -0.01]; P = .004) and memory (-0.08 points per year faster [95% CI, -0.11 to -0.06]; P < .001) but significantly slower declines in executive function (0.09 points per year slower [95% CI, 0.08-0.10]; P < .001). Time-dependent cumulative mean systolic BP level was associated with significantly faster declines in global cognition (-0.018 points per year faster per each 10-mm Hg increase [95% CI, -0.023 to -0.014]; P < .001), memory (-0.028 points per year faster per each 10-mm Hg increase [95% CI, -0.035 to -0.021]; P < .001), and executive function (-0.01 points per year faster per each 10-mm Hg increase [95% CI, -0.014 to -0.007]; P < .001). After adjusting for cumulative mean systolic BP, differences between black and white individuals in cognitive slopes were attenuated for global cognition (-0.01 points per year [95% CI, -0.03 to 0.01]; P = .56) and memory (-0.06 points per year [95% CI, -0.08 to -0.03]; P < .001) but not executive function (0.10 points per year [95% CI, 0.09-0.11]; P < .001).

Conclusions and Relevance: These results suggest that black individuals' higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.

%B JAMA Neurol %8 2020 Apr 13 %G eng %R 10.1001/jamaneurol.2020.0568 %0 Journal Article %J Neurology %D 2020 %T Association of CD14 with incident dementia and markers of brain aging and injury. %A Pase, Matthew P %A Himali, Jayandra J %A Beiser, Alexa S %A DeCarli, Charles %A McGrath, Emer R %A Satizabal, Claudia L %A Aparicio, Hugo J %A Adams, Hieab H H %A Reiner, Alexander P %A Longstreth, W T %A Fornage, Myriam %A Tracy, Russell P %A Lopez, Oscar %A Psaty, Bruce M %A Levy, Daniel %A Seshadri, Sudha %A Bis, Joshua C %X

OBJECTIVE: To test the hypothesis that the inflammatory marker plasma soluble CD14 (sCD14) associates with incident dementia and related endophenotypes in 2 community-based cohorts.

METHODS: Our samples included the prospective community-based Framingham Heart Study (FHS) and Cardiovascular Health Study (CHS) cohorts. Plasma sCD14 was measured at baseline and related to the incidence of dementia, domains of cognitive function, and MRI-defined brain volumes. Follow-up for dementia occurred over a mean of 10 years (SD 4) in the FHS and a mean of 6 years (SD 3) in the CHS.

RESULTS: We studied 1,588 participants from the FHS (mean age 69 ± 6 years, 47% male, 131 incident events) and 3,129 participants from the CHS (mean age 72 ± 5 years, 41% male, 724 incident events) for the risk of incident dementia. Meta-analysis across the 2 cohorts showed that each SD unit increase in sCD14 was associated with a 12% increase in the risk of incident dementia (95% confidence interval 1.03-1.23; = 0.01) following adjustments for age, sex, ε4 status, and vascular risk factors. Higher levels of sCD14 were associated with various cognitive and MRI markers of accelerated brain aging in both cohorts and with a greater progression of brain atrophy and a decline in executive function in the FHS.

CONCLUSION: sCD14 is an inflammatory marker related to brain atrophy, cognitive decline, and incident dementia.

%B Neurology %V 94 %P e254-e266 %8 2020 01 21 %G eng %N 3 %R 10.1212/WNL.0000000000008682 %0 Journal Article %J JAMA Ophthalmol %D 2020 %T Association of Genetic Variation With Keratoconus. %A McComish, Bennet J %A Sahebjada, Srujana %A Bykhovskaya, Yelena %A Willoughby, Colin E %A Richardson, Andrea J %A Tenen, Abi %A Charlesworth, Jac C %A Macgregor, Stuart %A Mitchell, Paul %A Lucas, Sionne E M %A Mills, Richard A %A Mackey, David A %A Li, Xiaohui %A Wang, Jie Jin %A Jensen, Richard A %A Rotter, Jerome I %A Taylor, Kent D %A Hewitt, Alex W %A Rabinowitz, Yaron S %A Baird, Paul N %A Craig, Jamie E %A Burdon, Kathryn P %K Adult %K Female %K Fuchs' Endothelial Dystrophy %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Keratoconus %K Lipase %K Logistic Models %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %X

Importance: Keratoconus is a condition in which the cornea progressively thins and protrudes in a conical shape, severely affecting refraction and vision. It is a major indication for corneal transplant. To discover new genetic loci associated with keratoconus and better understand the causative mechanism of this disease, we performed a genome-wide association study on patients with keratoconus.

Objective: To identify genetic susceptibility regions for keratoconus in the human genome.

Design, Setting, and Participants: This study was conducted with data from eye clinics in Australia, the United States, and Northern Ireland. The discovery cohort of individuals with keratoconus and control participants from Australia was genotyped using the Illumina HumanCoreExome single-nucleotide polymorphism array. After quality control and data cleaning, genotypes were imputed against the 1000 Genomes Project reference panel (phase III; version 5), and association analyses were completed using PLINK version 1.90. Single-nucleotide polymorphisms with P < 1.00 × 10-6 were assessed for replication in 3 additional cohorts. Control participants were drawn from the cohorts of the Blue Mountains Eye Study and a previous study of glaucoma. Replication cohorts were from a previous keratoconus genome-wide association study data set from the United States, a cohort of affected and control participants from Australia and Northern Ireland, and a case-control cohort from Victoria, Australia. Data were collected from January 2006 to March 2019.

Main Outcomes and Measures: Associations between keratoconus and 6 252 612 genetic variants were estimated using logistic regression after adjusting for ancestry using the first 3 principal components.

Results: The discovery cohort included 522 affected individuals and 655 control participants, while the replication cohorts included 818 affected individuals (222 from the United States, 331 from Australia and Northern Ireland, and 265 from Victoria, Australia) and 3858 control participants (2927 from the United States, 229 from Australia and Northern Ireland, and 702 from Victoria, Australia). Two novel loci reached genome-wide significance (defined as P < 5.00 × 10-8), with a P value of 7.46 × 10-9 at rs61876744 in patatin-like phospholipase domain-containing 2 gene (PNPLA2) on chromosome 11 and a P value of 6.35 × 10-12 at rs138380, 2.2 kb upstream of casein kinase I isoform epsilon gene (CSNK1E) on chromosome 22. One additional locus was identified with a P value less than 1.00 × 10-6 in mastermind-like transcriptional coactivator 2 (MAML2) on chromosome 11 (P = 3.91 × 10-7). The novel locus in PNPLA2 reached genome-wide significance in an analysis of all 4 cohorts (P = 2.45 × 10-8).

Conclusions and Relevance: In this relatively large keratoconus genome-wide association study, we identified a genome-wide significant locus for keratoconus in the region of PNPLA2 on chromosome 11.

%B JAMA Ophthalmol %V 138 %P 174-181 %8 2020 02 01 %G eng %N 2 %R 10.1001/jamaophthalmol.2019.5293 %0 Journal Article %J JAMA Netw Open %D 2020 %T Association of Leukocyte Telomere Length With Mortality Among Adult Participants in 3 Longitudinal Studies. %A Arbeev, Konstantin G %A Verhulst, Simon %A Steenstrup, Troels %A Kark, Jeremy D %A Bagley, Olivia %A Kooperberg, Charles %A Reiner, Alexander P %A Hwang, Shih-Jen %A Levy, Daniel %A Fitzpatrick, Annette L %A Christensen, Kaare %A Yashin, Anatoliy I %A Aviv, Abraham %X

Importance: Leukocyte telomere length (LTL) is a trait associated with risk of cardiovascular disease and cancer, the 2 major disease categories that largely define longevity in the United States. However, it remains unclear whether LTL is associated with the human life span.

Objective: To examine whether LTL is associated with the life span of contemporary humans.

Design, Setting, and Participants: This cohort study included 3259 adults of European ancestry from the Cardiovascular Health Study (CHS), Framingham Heart Study (FHS), and Women's Health Initiative (WHI). Leukocyte telomere length was measured in 1992 and 1997 in the CHS, from 1995 to 1998 in the FHS, and from 1993 to 1998 in the WHI. Data analysis was conducted from February 2017 to December 2019.

Main Outcomes and Measures: Death and LTL, measured by Southern blots of the terminal restriction fragments, were the main outcomes. Cause of death was adjudicated by end point committees.

Results: The analyzed sample included 3259 participants (2342 [71.9%] women), with a median (range) age of 69.0 (50.0-98.0) years at blood collection. The median (range) follow-up until death was 10.9 (0.2-23.0) years in CHS, 19.7 (3.4-23.0) years in FHS, and 16.6 (0.5-20.0) years in WHI. During follow-up, there were 1525 deaths (482 [31.6%] of cardiovascular disease; 373 [24.5%] of cancer, and 670 [43.9%] of other or unknown causes). Short LTL, expressed in residual LTL, was associated with increased mortality risk. Overall, the hazard ratio for all-cause mortality for a 1-kilobase decrease in LTL was 1.34 (95% CI, 1.21-1.47). This association was stronger for noncancer causes of death (cardiovascular death: hazard ratio, 1.28; 95% CI, 1.08-1.52; cancer: hazard ratio, 1.13; 95% CI, 0.93-1.36; and other causes: hazard ratio, 1.53; 95% CI, 1.32-1.77).

Conclusions and Relevance: The results of this study indicate that LTL is associated with a natural life span limit in contemporary humans.

%B JAMA Netw Open %V 3 %P e200023 %8 2020 Feb 05 %G eng %N 2 %R 10.1001/jamanetworkopen.2020.0023 %0 Journal Article %J JAMA Intern Med %D 2020 %T Association of Nonobstructive Chronic Bronchitis With Respiratory Health Outcomes in Adults. %A Balte, Pallavi P %A Chaves, Paulo H M %A Couper, David J %A Enright, Paul %A Jacobs, David R %A Kalhan, Ravi %A Kronmal, Richard A %A Loehr, Laura R %A London, Stephanie J %A Newman, Anne B %A O'Connor, George T %A Schwartz, Joseph E %A Smith, Benjamin M %A Smith, Lewis J %A White, Wendy B %A Yende, Sachin %A Oelsner, Elizabeth C %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Asthma %K Bronchitis, Chronic %K Female %K Humans %K Lung %K Male %K Middle Aged %K Prospective Studies %K Respiratory Function Tests %K Smokers %K Smoking %K Young Adult %X

Importance: Chronic bronchitis has been associated with cigarette smoking as well as with e-cigarette use among young adults, but the association of chronic bronchitis in persons without airflow obstruction or clinical asthma, described as nonobstructive chronic bronchitis, with respiratory health outcomes remains uncertain.

Objective: To assess whether nonobstructive chronic bronchitis is associated with adverse respiratory health outcomes in adult ever smokers and never smokers.

Design, Setting, and Participants: This prospective cohort study included 22 325 adults without initial airflow obstruction (defined as the ratio of forced expiratory volume in the first second [FEV1] to forced vital capacity [FVC] of <0.70) or clinical asthma at baseline. The National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study harmonized and pooled data from 9 US general population-based cohorts. Thus present study is based on data from 5 of these cohorts. Participants were enrolled from August 1971 through May 2007 and were followed up through December 2018.

Exposures: Nonobstructive chronic bronchitis was defined by questionnaire at baseline as both cough and phlegm for at least 3 months for at least 2 consecutive years.

Main Outcomes and Measures: Lung function was measured by prebronchodilator spirometry. Hospitalizations and deaths due to chronic lower respiratory disease and respiratory disease-related mortality were defined by events adjudication and administrative criteria. Models were stratified by smoking status and adjusted for anthropometric, sociodemographic, and smoking-related factors. The comparison group was participants without nonobstructive chronic bronchitis.

Results: Among 22 325 adults included in the analysis, mean (SD) age was 53.0 (16.3) years (range, 18.0-95.0 years), 58.2% were female, 65.9% were non-Hispanic white, and 49.6% were ever smokers. Among 11 082 ever smokers with 99 869 person-years of follow-up, participants with nonobstructive chronic bronchitis (300 [2.7%]) had accelerated decreases in FEV1 (4.1 mL/y; 95% CI, 2.1-6.1 mL/y) and FVC (4.7 mL/y; 95% CI, 2.2-7.2 mL/y), increased risks of chronic lower respiratory disease-related hospitalization or mortality (hazard ratio [HR], 2.2; 95% CI, 1.7-2.7), and greater respiratory disease-related (HR, 2.0; 95% CI, 1.1-3.8) and all-cause mortality (HR, 1.5; 95% CI, 1.3-1.8) compared with ever smokers without nonobstructive chronic bronchitis. Among 11 243 never smokers with 120 004 person-years of follow-up, participants with nonobstructive chronic bronchitis (151 [1.3%]) had greater rates of chronic lower respiratory disease-related hospitalization or mortality (HR, 3.1; 95% CI, 2.1-4.5) compared with never smokers without nonobstructive chronic bronchitis. Nonobstructive chronic bronchitis was not associated with FEV1:FVC decline or incident airflow obstruction. The presence of at least 1 of the component symptoms of nonobstructive chronic bronchitis (ie, chronic cough or phlegm), which was common in both ever smokers (11.0%) and never smokers (6.7%), was associated with adverse respiratory health outcomes.

Conclusions and Relevance: The findings suggest that nonobstructive chronic bronchitis is associated with adverse respiratory health outcomes, particularly in ever smokers, and may be a high-risk phenotype suitable for risk stratification and targeted therapies.

%B JAMA Intern Med %V 180 %P 676-686 %8 2020 05 01 %G eng %N 5 %R 10.1001/jamainternmed.2020.0104 %0 Journal Article %J Alzheimers Dement %D 2020 %T Associations of body composition with incident dementia in older adults: Cardiovascular Health Study-Cognition Study. %A Cui, Chendi %A Mackey, Rachel H %A Shaaban, C Elizabeth %A Kuller, Lewis H %A Lopez, Oscar L %A Sekikawa, Akira %X

INTRODUCTION: A body of literature reported associations between late-life general adiposity measures (eg, body mass index) and dementia. Little is known about the association of late-life body composition with dementia risk.

METHODS: We determined this association among cognitively normal participants from the Cardiovascular Health Study- Cognition Study. Body composition was assessed by dual-energy x-ray absorptiometry in 1994-1995. Dementia was ascertained at annual follow-up from 1998-1999 to 2013. Associations of body composition with incident dementia were assessed by the Fine-Gray model.

RESULT: Among 344 participants (mean age 78, 62.2% women), body composition was significantly different between men and women, despite similar body mass indexes (BMIs). Increased dementia risk was significantly associated with lower lean mass in men and marginally with low appendicular lean mass in women.

DISCUSSION: Decreased lean mass was an indicator of increased dementia risk in older adults. Studies should test whether preventing lean mass loss in older adults reduces dementia risk.

%B Alzheimers Dement %8 2020 Aug 17 %G eng %R 10.1002/alz.12125 %0 Journal Article %J Alzheimer Dis Assoc Disord %D 2020 %T Brachial Flow-mediated Dilation and Risk of Dementia: The Cardiovascular Health Study. %A Garg, Parveen K %A Tan, Annabel X %A Odden, Michelle C %A Gardin, Julius M %A Lopez, Oscar L %A Newman, Anne B %A Rawlings, Andreea M %A Mukamal, Kenneth J %X

INTRODUCTION: Brachial flow-mediated dilation (FMD) is a physiologic measure of endothelial function. We determined the prospective association of brachial FMD with incident dementia among older adults.

METHODS: We included 2777 Cardiovascular Health Study participants who underwent brachial FMD measurement. Incident dementia was ascertained by medication use, International Classification of Diseases-9 codes, requirement for a proxy, and death certificates and calibrated to gold-standard assessments performed in a subset of the cohort.

RESULTS: Mean participant age at time of brachial FMD measurement was 77.9 years. We identified 1650 incident dementia cases (median follow-up=10.5 y). After adjusting for age, race, sex, education, clinic site, and baseline arterial diameter, risk of dementia for participants in the highest quartile of percent brachial FMD did not differ from those in lowest quartile (hazard ratio=0.89, 95% confidence interval: 0.77, 1.03).

CONCLUSIONS: Brachial FMD, measured late in life, is not associated with an increased risk of incident dementia.

%B Alzheimer Dis Assoc Disord %V 34 %P 272-274 %8 2020 Jul-Sep %G eng %N 3 %R 10.1097/WAD.0000000000000394 %0 Journal Article %J J Alzheimers Dis %D 2020 %T Cerebral Blood Flow Is Associated with Diagnostic Class and Cognitive Decline in Alzheimer's Disease. %A Duan, Wenna %A Sehrawat, Parshant %A Balachandrasekaran, Arvind %A Bhumkar, Ashish B %A Boraste, Paresh B %A Becker, James T %A Kuller, Lewis H %A Lopez, Oscar L %A Gach, H Michael %A Dai, Weiying %X

BACKGROUND: Reliable cerebral blood flow (CBF) biomarkers using a noninvasive imaging technique are sought to facilitate early diagnosis and intervention in early Alzheimer's disease (AD).

OBJECTIVE: We aim to identify brain regions in which CBF values are affected and related to cognitive decline in early AD using a large cohort.

METHODS: Perfusion MRIs using continuous arterial spin labeling were acquired at 1.5 T in 58 normal controls (NC), 50 mild cognitive impairments (MCI), and 40 AD subjects from the Cardiovascular Health Study Cognition Study. Regional absolute CBF and normalized CBF (nCBF) values, without and with correction of partial volume effects, were compared across three groups. Association between regional CBF values and Modified Mini-Mental State Examination (3MSE) were investigated by multiple linear regression analyses adjusted for cardiovascular risk factors.

RESULTS: After correcting for partial volume effects and cardiovascular risk factors, ADs exhibited decreased nCBF with the strongest reduction in the bilateral posterior cingulate & precuneus region (p < 0.001) compared to NCs, and the strongest reduction in the bilateral superior medial frontal region (p < 0.001) compared to MCIs. MCIs exhibited the strongest nCBF decrease in the left hippocampus and nCBF increase in the right inferior frontal and insular region. The 3MSE scores within the symptomatic subjects were significantly associated with nCBF in the bilateral posterior and middle cingulate and parietal (p < 0.001), bilateral superior medial frontal (p < 0.001), bilateral temporoparietal (p < 0.02), and right hippocampus (p = 0.02) regions.

CONCLUSION: Noninvasive perfusion MRI can detect functional changes across diagnostic class and serve as a staging biomarker of cognitive status.

%B J Alzheimers Dis %V 76 %P 1103-1120 %8 2020 %G eng %N 3 %R 10.3233/JAD-200034 %0 Journal Article %J Nat Commun %D 2020 %T {Cerebral small vessel disease genomics and its implications across the lifespan %A Sargurupremraj, M. %A Suzuki, H. %A Jian, X. %A Sarnowski, C. %A Evans, T. E. %A Bis, J. C. %A Eiriksdottir, G. %A Sakaue, S. %A Terzikhan, N. %A Habes, M. %A Zhao, W. %A Armstrong, N. J. %A Hofer, E. %A Yanek, L. R. %A Hagenaars, S. P. %A Kumar, R. B. %A van den Akker, E. B. %A McWhirter, R. E. %A Trompet, S. %A Mishra, A. %A Saba, Y. %A Satizabal, C. L. %A Beaudet, G. %A Petit, L. %A Tsuchida, A. %A Zago, L. %A Schilling, S. %A Sigurdsson, S. %A Gottesman, R. F. %A Lewis, C. E. %A Aggarwal, N. T. %A Lopez, O. L. %A Smith, J. A. %A Vald?s Hern?ndez, M. C. %A van der Grond, J. %A Wright, M. J. %A Knol, M. J. %A D?rr, M. %A Thomson, R. J. %A Bordes, C. %A Le Grand, Q. %A Duperron, M. G. %A Smith, A. V. %A Knopman, D. S. %A Schreiner, P. J. %A Evans, D. A. %A Rotter, J. I. %A Beiser, A. S. %A Maniega, S. M. %A Beekman, M. %A Trollor, J. %A Stott, D. J. %A Vernooij, M. W. %A Wittfeld, K. %A Niessen, W. J. %A Soumar?, A. %A Boerwinkle, E. %A Sidney, S. %A Turner, S. T. %A Davies, G. %A Thalamuthu, A. %A V?lker, U. %A van Buchem, M. A. %A Bryan, R. N. %A Dupuis, J. %A Bastin, M. E. %A Ames, D. %A Teumer, A. %A Amouyel, P. %A Kwok, J. B. %A B?low, R. %A Deary, I. J. %A Schofield, P. R. %A Brodaty, H. %A Jiang, J. %A Tabara, Y. %A Setoh, K. %A Miyamoto, S. %A Yoshida, K. %A Nagata, M. %A Kamatani, Y. %A Matsuda, F. %A Psaty, B. M. %A Bennett, D. A. %A De Jager, P. L. %A Mosley, T. H. %A Sachdev, P. S. %A Schmidt, R. %A Warren, H. R. %A Evangelou, E. %A Tr?gou?t, D. A. %A Ikram, M. A. %A Wen, W. %A DeCarli, C. %A Srikanth, V. K. %A Jukema, J. W. %A Slagboom, E. P. %A Kardia, S. L. R. %A Okada, Y. %A Mazoyer, B. %A Wardlaw, J. M. %A Nyquist, P. A. %A Mather, K. A. %A Grabe, H. J. %A Schmidt, H. %A van Duijn, C. M. %A Gudnason, V. %A Longstreth, W. T. %A Launer, L. J. %A Lathrop, M. %A Seshadri, S. %A Tzourio, C. %A Adams, H. H. %A Matthews, P. M. %A Fornage, M. %A Debette, S. %A Amouyel, P. %A de Andrade, M. %A Basu, S. %A Berr, C. %A Brody, J. A. %A Chasman, D. I. %A Dartigues, J. F. %A Folsom, A. R. %A Germain, M. %A de Haan, H. %A Heit, J. %A Houwing-Duitermaat, J. %A Kabrhel, C. %A Kraft, P. %A Legal, G. %A Lindstr?m, S. %A Monajemi, R. %A Morange, P. E. %A Psaty, B. M. %A Reitsma, P. H. %A Ridker, P. M. %A Rose, L. M. %A Rosendaal, F. R. %A Saut, N. %A Slagboom, E. %A Smadja, D. %A Smith, N. L. %A Suchon, P. %A Tang, W. %A Taylor, K. D. %A Tr?gou?t, D. A. %A Tzourio, C. %A de Visser, M. C. H. %A van Hylckama Vlieg, A. %A Weng, L. C. %A Wiggins, K. L. %A Gormley, P. %A Anttila, V. %A Winsvold, B. S. %A Palta, P. %A Esko, T. %A Pers, T. H. %A Farh, K. H. %A Cuenca-Leon, E. %A Muona, M. %A Furlotte, N. A. %A Kurth, T. %A Ingason, A. %A McMahon, G. %A Ligthart, L. %A Terwindt, G. M. %A Kallela, M. %A Freilinger, T. M. %A Ran, C. %A Gordon, S. G. %A Stam, A. H. %A Steinberg, S. %A Borck, G. %A Koiranen, M. %A Quaye, L. %A Adams, H. H. H. %A Lehtim?ki, T. %A Sarin, A. P. %A Wedenoja, J. %A Hinds, D. A. %A Buring, J. E. %A Sch?rks, M. %A Ridker, P. M. %A Gudlaug Hrafnsdottir, M. %A Stefansson, H. %A Ring, S. M. %A Hottenga, J. J. %A Penninx, B. W. J. H. %A F?rkkil?, M. %A Artto, V. %A Kaunisto, M. %A Veps?l?inen, S. %A Malik, R. %A Heath, A. C. %A Madden, P. A. F. %A Martin, N. G. %A Montgomery, G. W. %A Kurki, M. %A Kals, M. %A M?gi, R. %A P?rn, K. %A H?m?l?inen, E. %A Huang, H. %A Byrnes, A. E. %A Franke, L. %A Huang, J. %A Stergiakouli, E. %A Lee, P. H. %A Sandor, C. %A Webber, C. %A Cader, Z. %A Muller-Myhsok, B. %A Schreiber, S. %A Meitinger, T. %A Eriksson, J. G. %A Salomaa, V. %A Heikkil?, K. %A Loehrer, E. %A Uitterlinden, A. G. %A Hofman, A. %A van Duijn, C. M. %A Cherkas, L. %A Pedersen, L. M. %A Stubhaug, A. %A Nielsen, C. S. %A M?nnikk?, M. %A Mihailov, E. %A Milani, L. %A G?bel, H. %A Esserlind, A. L. %A Francke Christensen, A. %A Folkmann Hansen, T. %A Werge, T. %A Kaprio, J. %A Aromaa, A. J. %A Raitakari, O. %A Ikram, M. A. %A Spector, T. %A J?rvelin, M. R. %A Metspalu, A. %A Kubisch, C. %A Strachan, D. P. %A Ferrari, M. D. %A Belin, A. C. %A Dichgans, M. %A Wessman, M. %A van den Maagdenberg, A. M. J. M. %A Zwart, J. A. %A Boomsma, D. I. %A Davey Smith, G. %A Stefansson, K. %A Eriksson, N. %A Daly, M. J. %A Neale, B. M. %A Olesen, J. %A Chasman, D. I. %A Nyholt, D. R. %A Palotie, A. %X White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (p = 2.5×10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials. %B Nat Commun %V 11 %P 6285 %8 12 %G eng %0 Journal Article %J Stroke %D 2020 %T Cholesterol Variability and Cranial Magnetic Resonance Imaging Findings in Older Adults: The Cardiovascular Health Study. %A Kalani, Rizwan %A Bartz, Traci M %A Suchy-Dicey, Astrid %A Elkind, Mitchell S V %A Psaty, Bruce M %A Leung, Lester Y %A Rice, Kenneth %A Tirschwell, David %A Longstreth, W T %X

Background and Purpose- Serum cholesterol variability, independent of mean, has been associated with stroke, white matter hyperintensities on cranial magnetic resonance imaging (MRI), and other cardiovascular events. We sought to assess the relationship between total serum cholesterol (TC) variability and cranial MRI findings of subclinical or covert vascular brain injury in a longitudinal, population-based cohort study of older adults. Methods- In the Cardiovascular Health Study, we assessed associations between intraindividual TC mean, trend, and variability over ≈5 years with covert brain infarction (CBI) and white matter grade (WMG) on cranial MRI. Mean TC was calculated for each study participant from 4 annual TC measurements between 2 MRI scans. TC trend was calculated as the slope of the linear regression of the TC measurements, and TC variability was calculated as the SD of the residuals from the linear regression. We evaluated the association of intraindividual TC variability with incident CBI and worsening WMG between 2 MRI scans in primary analyses and with prevalent CBI number and WMG on the follow-up MRI scan in secondary analyses. Results- Among participants who were eligible for the study and free of clinical stroke before the follow-up MRI, 17.9% of 1098 had incident CBI, and 27.8% of 1351 had worsening WMG on the follow-up MRI. Mean, trend, and variability of TC were not associated with these outcomes. TC variability, independent of mean and trend, was significantly associated with the number of CBI (β=0.009 [95% CI, 0.003-0.016] =0.004; N=1604) and was associated with WMG (β, 0.009 [95% CI, -0.0002 to 0.019] =0.055; N=1602) on the follow-up MRI. Conclusions- Among older adults, TC variability was not associated with incident CBI or worsening WMG but was associated with the number of prevalent CBI on cranial MRI. More work is needed to validate and to clarify the mechanisms underlying such associations.

%B Stroke %V 51 %P 69-74 %8 2020 Jan %G eng %N 1 %R 10.1161/STROKEAHA.119.026698 %0 Journal Article %J Lancet Respir Med %D 2020 %T Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population-based and case-control cohorts. %A Moll, Matthew %A Sakornsakolpat, Phuwanat %A Shrine, Nick %A Hobbs, Brian D %A DeMeo, Dawn L %A John, Catherine %A Guyatt, Anna L %A McGeachie, Michael J %A Gharib, Sina A %A Obeidat, Ma'en %A Lahousse, Lies %A Wijnant, Sara R A %A Brusselle, Guy %A Meyers, Deborah A %A Bleecker, Eugene R %A Li, Xingnan %A Tal-Singer, Ruth %A Manichaikul, Ani %A Rich, Stephen S %A Won, Sungho %A Kim, Woo Jin %A Do, Ah Ra %A Washko, George R %A Barr, R Graham %A Psaty, Bruce M %A Bartz, Traci M %A Hansel, Nadia N %A Barnes, Kathleen %A Hokanson, John E %A Crapo, James D %A Lynch, David %A Bakke, Per %A Gulsvik, Amund %A Hall, Ian P %A Wain, Louise %A Weiss, Scott T %A Silverman, Edwin K %A Dudbridge, Frank %A Tobin, Martin D %A Cho, Michael H %K Adult %K Case-Control Studies %K Cohort Studies %K Female %K Forced Expiratory Volume %K Genome-Wide Association Study %K Humans %K Male %K Middle Aged %K Phenotype %K Pulmonary Disease, Chronic Obstructive %K Risk Factors %K Vital Capacity %X

BACKGROUND: Genetic factors influence chronic obstructive pulmonary disease (COPD) risk, but the individual variants that have been identified have small effects. We hypothesised that a polygenic risk score using additional variants would predict COPD and associated phenotypes.

METHODS: We constructed a polygenic risk score using a genome-wide association study of lung function (FEV and FEV/forced vital capacity [FVC]) from the UK Biobank and SpiroMeta. We tested this polygenic risk score in nine cohorts of multiple ethnicities for an association with moderate-to-severe COPD (defined as FEV/FVC <0·7 and FEV <80% of predicted). Associations were tested using logistic regression models, adjusting for age, sex, height, smoking pack-years, and principal components of genetic ancestry. We assessed predictive performance of models by area under the curve. In a subset of studies, we also studied quantitative and qualitative CT imaging phenotypes that reflect parenchymal and airway pathology, and patterns of reduced lung growth.

FINDINGS: The polygenic risk score was associated with COPD in European (odds ratio [OR] per SD 1·81 [95% CI 1·74-1·88] and non-European (1·42 [1·34-1·51]) populations. Compared with the first decile, the tenth decile of the polygenic risk score was associated with COPD, with an OR of 7·99 (6·56-9·72) in European ancestry and 4·83 (3·45-6·77) in non-European ancestry cohorts. The polygenic risk score was superior to previously described genetic risk scores and, when combined with clinical risk factors (ie, age, sex, and smoking pack-years), showed improved prediction for COPD compared with a model comprising clinical risk factors alone (AUC 0·80 [0·79-0·81] vs 0·76 [0·75-0·76]). The polygenic risk score was associated with CT imaging phenotypes, including wall area percent, quantitative and qualitative measures of emphysema, local histogram emphysema patterns, and destructive emphysema subtypes. The polygenic risk score was associated with a reduced lung growth pattern.

INTERPRETATION: A risk score comprised of genetic variants can identify a small subset of individuals at markedly increased risk for moderate-to-severe COPD, emphysema subtypes associated with cigarette smoking, and patterns of reduced lung growth.

FUNDING: US National Institutes of Health, Wellcome Trust.

%B Lancet Respir Med %V 8 %P 696-708 %8 2020 07 %G eng %N 7 %R 10.1016/S2213-2600(20)30101-6 %0 Journal Article %J PLoS One %D 2020 %T Coagulation factor VIII, white matter hyperintensities and cognitive function: Results from the Cardiovascular Health Study. %A Rohmann, Jessica L %A Longstreth, W T %A Cushman, Mary %A Fitzpatrick, Annette L %A Heckbert, Susan R %A Rice, Kenneth %A Rosendaal, Frits R %A Sitlani, Colleen M %A Psaty, Bruce M %A Siegerink, Bob %K Aged %K Blood Coagulation %K Cognition %K Cross-Sectional Studies %K Factor VIII %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Magnetic Resonance Imaging %K Male %K Mental Status and Dementia Tests %K Up-Regulation %K White Matter %X

OBJECTIVE: To investigate the relationship between high FVIII clotting activity (FVIII:C), MRI-defined white matter hyperintensities (WMH) and cognitive function over time.

METHODS: Data from the population-based Cardiovascular Health Study (n = 5,888, aged ≥65) were used. FVIII:C was measured in blood samples taken at baseline. WMH burden was assessed on two cranial MRI scans taken roughly 5 years apart. Cognitive function was assessed annually using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST). We used ordinal logistic regression models adjusted for demographic and cardiovascular factors in cross-sectional and longitudinal WMH analyses, and adjusted linear regression and linear mixed models in the analyses of cognitive function.

RESULTS: After adjustment for confounding, higher levels of FVIII:C were not strongly associated with the burden of WMH on the initial MRI scan (OR>p75 = 1.20, 95% CI 0.99-1.45; N = 2,735) nor with WMH burden worsening over time (OR>p75 = 1.18, 95% CI 0.87-1.59; N = 1,527). High FVIII:C showed no strong association with cognitive scores cross-sectionally (3MSE>p75 β = -0.06, 95%CI -0.45 to 0.32, N = 4,005; DSST>p75 β = -0.69, 95%CI -1.52 to 0.13, N = 3,954) or over time (3MSE>p75 β = -0.07,95% CI -0.58 to 0.44, N = 2,764; DSST>p75 β = -0.22, 95% CI -0.97 to 0.53, N = 2,306) after confounding adjustment.

INTERPRETATION: The results from this cohort study of older adult participants indicate no strong relationships between higher FVIII:C levels and WMH burden or cognitive function in cross-sectional and longitudinal analyses.

%B PLoS One %V 15 %P e0242062 %8 2020 %G eng %N 11 %R 10.1371/journal.pone.0242062 %0 Journal Article %J Nat Genet %D 2020 %T {Discovery of rare variants associated with blood pressure regulation through meta-analysis of 1.3 million individuals %A Surendran, P. %A Feofanova, E. V. %A Lahrouchi, N. %A Ntalla, I. %A Karthikeyan, S. %A Cook, J. %A Chen, L. %A Mifsud, B. %A Yao, C. %A Kraja, A. T. %A Cartwright, J. H. %A Hellwege, J. N. %A Giri, A. %A Tragante, V. %A Thorleifsson, G. %A Liu, D. J. %A Prins, B. P. %A Stewart, I. D. %A Cabrera, C. P. %A Eales, J. M. %A Akbarov, A. %A Auer, P. L. %A Bielak, L. F. %A Bis, J. C. %A Braithwaite, V. S. %A Brody, J. A. %A Daw, E. W. %A Warren, H. R. %A Drenos, F. %A Nielsen, S. F. %A Faul, J. D. %A Fauman, E. B. %A Fava, C. %A Ferreira, T. %A Foley, C. N. %A Franceschini, N. %A Gao, H. %A Giannakopoulou, O. %A Giulianini, F. %A Gudbjartsson, D. F. %A Guo, X. %A Harris, S. E. %A Havulinna, A. S. %A Helgadottir, A. %A Huffman, J. E. %A Hwang, S. J. %A Kanoni, S. %A Kontto, J. %A Larson, M. G. %A Li-Gao, R. %A Lindstr?m, J. %A Lotta, L. A. %A Lu, Y. %A Luan, J. %A Mahajan, A. %A Malerba, G. %A Masca, N. G. D. %A Mei, H. %A Menni, C. %A Mook-Kanamori, D. O. %A Mosen-Ansorena, D. %A M?ller-Nurasyid, M. %A Par?, G. %A Paul, D. S. %A Perola, M. %A Poveda, A. %A Rauramaa, R. %A Richard, M. %A Richardson, T. G. %A Sep?lveda, N. %A Sim, X. %A Smith, A. V. %A Smith, J. A. %A Staley, J. R. %A Stan?kov?, A. %A Sulem, P. %A Th?riault, S. %A Thorsteinsdottir, U. %A Trompet, S. %A Varga, T. V. %A Velez Edwards, D. R. %A Veronesi, G. %A Weiss, S. %A Willems, S. M. %A Yao, J. %A Young, R. %A Yu, B. %A Zhang, W. %A Zhao, J. H. %A Zhao, W. %A Zhao, W. %A Evangelou, E. %A Aeschbacher, S. %A Asllanaj, E. %A Blankenberg, S. %A Bonnycastle, L. L. %A Bork-Jensen, J. %A Brandslund, I. %A Braund, P. S. %A Burgess, S. %A Cho, K. %A Christensen, C. %A Connell, J. %A Mutsert, R. %A Dominiczak, A. F. %A D?rr, M. %A Eiriksdottir, G. %A Farmaki, A. E. %A Gaziano, J. M. %A Grarup, N. %A Grove, M. L. %A Hallmans, G. %A Hansen, T. %A Have, C. T. %A Heiss, G. %A J?rgensen, M. E. %A Jousilahti, P. %A Kajantie, E. %A Kamat, M. %A K?r?j?m?ki, A. %A Karpe, F. %A Koistinen, H. A. %A Kovesdy, C. P. %A Kuulasmaa, K. %A Laatikainen, T. %A Lannfelt, L. %A Lee, I. T. %A Lee, W. J. %A Linneberg, A. %A Martin, L. W. %A Moitry, M. %A Nadkarni, G. %A Neville, M. J. %A Palmer, C. N. A. %A Papanicolaou, G. J. %A Pedersen, O. %A Peters, J. %A Poulter, N. %A Rasheed, A. %A Rasmussen, K. L. %A Rayner, N. W. %A M?gi, R. %A Renstr?m, F. %A Rettig, R. %A Rossouw, J. %A Schreiner, P. J. %A Sever, P. S. %A Sigurdsson, E. L. %A Skaaby, T. %A Sun, Y. V. %A Sundstrom, J. %A Thorgeirsson, G. %A Esko, T. %A Trabetti, E. %A Tsao, P. S. %A Tuomi, T. %A Turner, S. T. %A Tzoulaki, I. %A Vaartjes, I. %A Vergnaud, A. C. %A Willer, C. J. %A Wilson, P. W. F. %A Witte, D. R. %A Yonova-Doing, E. %A Zhang, H. %A Aliya, N. %A Almgren, P. %A Amouyel, P. %A Asselbergs, F. W. %A Barnes, M. R. %A Blakemore, A. I. %A Boehnke, M. %A Bots, M. L. %A Bottinger, E. P. %A Buring, J. E. %A Chambers, J. C. %A Chen, Y. I. %A Chowdhury, R. %A Conen, D. %A Correa, A. %A Davey Smith, G. %A Boer, R. A. %A Deary, I. J. %A Dedoussis, G. %A Deloukas, P. %A Di Angelantonio, E. %A Elliott, P. %A Felix, S. B. %A Ferri?res, J. %A Ford, I. %A Fornage, M. %A Franks, P. W. %A Franks, S. %A Frossard, P. %A Gambaro, G. %A Gaunt, T. R. %A Groop, L. %A Gudnason, V. %A Harris, T. B. %A Hayward, C. %A Hennig, B. J. %A Herzig, K. H. %A Ingelsson, E. %A Tuomilehto, J. %A J?rvelin, M. R. %A Jukema, J. W. %A Kardia, S. L. R. %A Kee, F. %A Kooner, J. S. %A Kooperberg, C. %A Launer, L. J. %A Lind, L. %A Loos, R. J. F. %A Majumder, A. A. S. %A Laakso, M. %A McCarthy, M. I. %A Melander, O. %A Mohlke, K. L. %A Murray, A. D. %A Nordestgaard, B. G. %A Orho-Melander, M. %A Packard, C. J. %A Padmanabhan, S. %A Palmas, W. %A Polasek, O. %A Porteous, D. J. %A Prentice, A. M. %A Province, M. A. %A Relton, C. L. %A Rice, K. %A Ridker, P. M. %A Rolandsson, O. %A Rosendaal, F. R. %A Rotter, J. I. %A Rudan, I. %A Salomaa, V. %A Samani, N. J. %A Sattar, N. %A Sheu, W. H. %A Smith, B. H. %A Soranzo, N. %A Spector, T. D. %A Starr, J. M. %A Sebert, S. %A Taylor, K. D. %A Lakka, T. A. %A Timpson, N. J. %A Tobin, M. D. %A van der Harst, P. %A van der Meer, P. %A Ramachandran, V. S. %A Verweij, N. %A Virtamo, J. %A V?lker, U. %A Weir, D. R. %A Zeggini, E. %A Charchar, F. J. %A Wareham, N. J. %A Langenberg, C. %A Tomaszewski, M. %A Butterworth, A. S. %A Caulfield, M. J. %A Danesh, J. %A Edwards, T. L. %A Holm, H. %A Hung, A. M. %A Lindgren, C. M. %A Liu, C. %A Manning, A. K. %A Morris, A. P. %A Morrison, A. C. %A O'Donnell, C. J. %A Psaty, B. M. %A Saleheen, D. %A Stefansson, K. %A Boerwinkle, E. %A Chasman, D. I. %A Levy, D. %A Newton-Cheh, C. %A Munroe, P. B. %A Howson, J. M. M. %A de Boer, R. A. %A van der Harst, P. %A van der Meer, P. %A Verweij, N. %A Butterworth, A. S. %A Danesh, J. %A Langenberg, C. %A Deloukas, P. %A McCarthy, M. I. %A Franks, P. W. %A Rolandsson, O. %A Wareham, N. J. %A Prins, B. P. %A Zeggini, E. %A Hellwege, J. N. %A Giri, A. %A Edwards, D. R. V. %A Cho, K. %A Gaziano, J. M. %A Kovesdy, C. P. %A Sun, Y. V. %A Tsao, P. S. %A Wilson, P. W. F. %A Edwards, T. L. %A Hung, A. M. %A O'Donnell, C. J. %X Genetic studies of blood pressure (BP) to date have mainly analyzed common variants (minor allele frequency > 0.05). In a meta-analysis of up to 1.3 million participants, we discovered 106 new BP-associated genomic regions and 87 rare (minor allele frequency ≤ 0.01) variant BP associations (P < 5 × 10-8), of which 32 were in new BP-associated loci and 55 were independent BP-associated single-nucleotide variants within known BP-associated regions. Average effects of rare variants (44% coding) were 8 times larger than common variant effects and indicate potential candidate causal genes at new and known loci (for example, GATA5 and PLCB3). BP-associated variants (including rare and common) were enriched in regions of active chromatin in fetal tissues, potentially linking fetal development with BP regulation in later life. Multivariable Mendelian randomization suggested possible inverse effects of elevated systolic and diastolic BP on large artery stroke. Our study demonstrates the utility of rare-variant analyses for identifying candidate genes and the results highlight potential therapeutic targets. %B Nat Genet %V 52 %P 1314–1332 %8 12 %G eng %0 Journal Article %J Am J Epidemiol %D 2020 %T A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline. %A Cornelius, Talea %A Schwartz, Joseph E %A Balte, Pallavi %A Bhatt, Surya P %A Cassano, Patricia A %A Currow, David %A Jacobs, David R %A Johnson, Miriam %A Kalhan, Ravi %A Kronmal, Richard %A Loehr, Laura %A O'Connor, George T %A Smith, Benjamin %A White, Wendy B %A Yende, Sachin %A Oelsner, Elizabeth C %K Adult %K Aged %K Body Mass Index %K Cohort Studies %K Humans %K Linear Models %K Lung %K Middle Aged %K Respiratory Function Tests %K Weight Gain %X

The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983-2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year, -25.50 mL/year, -21.99 mL/year, and -0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r = -0.16) and FVC (r = -0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.

%B Am J Epidemiol %V 189 %P 1173-1184 %8 2020 10 01 %G eng %N 10 %R 10.1093/aje/kwaa059 %0 Journal Article %J Nat Genet %D 2020 %T {Dynamic incorporation of multiple in silico functional annotations empowers rare variant association analysis of large whole-genome sequencing studies at scale %A Li, X. %A Li, Z. %A Zhou, H. %A Gaynor, S. M. %A Liu, Y. %A Chen, H. %A Sun, R. %A Dey, R. %A Arnett, D. K. %A Aslibekyan, S. %A Ballantyne, C. M. %A Bielak, L. F. %A Blangero, J. %A Boerwinkle, E. %A Bowden, D. W. %A Broome, J. G. %A Conomos, M. P. %A Correa, A. %A Cupples, L. A. %A Curran, J. E. %A Freedman, B. I. %A Guo, X. %A Hindy, G. %A Irvin, M. R. %A Kardia, S. L. R. %A Kathiresan, S. %A Khan, A. T. %A Kooperberg, C. L. %A Laurie, C. C. %A Liu, X. S. %A Mahaney, M. C. %A Manichaikul, A. W. %A Martin, L. W. %A Mathias, R. A. %A McGarvey, S. T. %A Mitchell, B. D. %A Montasser, M. E. %A Moore, J. E. %A Morrison, A. C. %A O'Connell, J. R. %A Palmer, N. D. %A Pampana, A. %A Peralta, J. M. %A Peyser, P. A. %A Psaty, B. M. %A Redline, S. %A Rice, K. M. %A Rich, S. S. %A Smith, J. A. %A Tiwari, H. K. %A Tsai, M. Y. %A Vasan, R. S. %A Wang, F. F. %A Weeks, D. E. %A Weng, Z. %A Wilson, J. G. %A Yanek, L. R. %A Neale, B. M. %A Sunyaev, S. R. %A Abecasis, G. R. %A Rotter, J. I. %A Willer, C. J. %A Peloso, G. M. %A Natarajan, P. %A Lin, X. %A Abe, N. %A Abecasis, G. R. %A Aguet, F. %A Albert, C. %A Almasy, L. %A Alonso, A. %A Ament, S. %A Anderson, P. %A Anugu, P. %A Applebaum-Bowden, D. %A Ardlie, K. %A Arking, D. %A Arnett, D. K. %A Ashley-Koch, A. %A Aslibekyan, S. %A Assimes, T. %A Auer, P. %A Avramopoulos, D. %A Barnard, J. %A Barnes, K. %A Barr, R. G. %A Barron-Casella, E. %A Barwick, L. %A Beaty, T. %A Beck, G. %A Becker, D. %A Becker, L. %A Beer, R. %A Beitelshees, A. %A Benjamin, E. %A Benos, T. %A Bezerra, M. %A Bielak, L. F. %A Bis, J. %A Blackwell, T. %A Blangero, J. %A Boerwinkle, E. %A Bowden, D. W. %A Bowler, R. %A Brody, J. %A Broeckel, U. %A Broome, J. G. %A Bunting, K. %A Burchard, E. %A Bustamante, C. %A Buth, E. %A Cade, B. %A Cardwell, J. %A Carey, V. %A Carty, C. %A Casaburi, R. %A Casella, J. %A Castaldi, P. %A Chaffin, M. %A Chang, C. %A Chang, Y. C. %A Chasman, D. %A Chavan, S. %A Chen, B. J. %A Chen, W. M. %A Chen, Y. I. %A Cho, M. %A Choi, S. H. %A Chuang, L. M. %A Chung, M. %A Chung, R. H. %A Clish, C. %A Comhair, S. %A Conomos, M. P. %A Cornell, E. %A Correa, A. %A Crandall, C. %A Crapo, J. %A Cupples, L. A. %A Curran, J. E. %A Curtis, J. %A Custer, B. %A Damcott, C. %A Darbar, D. %A Das, S. %A David, S. %A Davis, C. %A Daya, M. %A de Andrade, M. %A Fuentes, L. L. %A DeBaun, M. %A Deka, R. %A DeMeo, D. %A Devine, S. %A Duan, Q. %A Duggirala, R. %A Durda, J. P. %A Dutcher, S. %A Eaton, C. %A Ekunwe, L. %A El Boueiz, A. %A Ellinor, P. %A Emery, L. %A Erzurum, S. %A Farber, C. %A Fingerlin, T. %A Flickinger, M. %A Fornage, M. %A Franceschini, N. %A Frazar, C. %A Fu, M. %A Fullerton, S. M. %A Fulton, L. %A Gabriel, S. %A Gan, W. %A Gao, S. %A Gao, Y. %A Gass, M. %A Gelb, B. %A Geng, X. P. %A Geraci, M. %A Germer, S. %A Gerszten, R. %A Ghosh, A. %A Gibbs, R. %A Gignoux, C. %A Gladwin, M. %A Glahn, D. %A Gogarten, S. %A Gong, D. W. %A Goring, H. %A Graw, S. %A Grine, D. %A Gu, C. C. %A Guan, Y. %A Guo, X. %A Gupta, N. %A Haessler, J. %A Hall, M. %A Harris, D. %A Hawley, N. L. %A He, J. %A Heckbert, S. %A Hernandez, R. %A Herrington, D. %A Hersh, C. %A Hidalgo, B. %A Hixson, J. %A Hobbs, B. %A Hokanson, J. %A Hong, E. %A Hoth, K. %A Hsiung, C. A. %A Hung, Y. J. %A Huston, H. %A Hwu, C. M. %A Irvin, M. R. %A Jackson, R. %A Jain, D. %A Jaquish, C. %A Jhun, M. A. %A Johnsen, J. %A Johnson, A. %A Johnson, C. %A Johnston, R. %A Jones, K. %A Kang, H. M. %A Kaplan, R. %A Kardia, S. L. R. %A Kathiresan, S. %A Kelly, S. %A Kenny, E. %A Kessler, M. %A Khan, A. T. %A Kim, W. %A Kinney, G. %A Konkle, B. %A Kooperberg, C. L. %A Kramer, H. %A Lange, C. %A Lange, E. %A Lange, L. %A Laurie, C. C. %A Laurie, C. %A LeBoff, M. %A Lee, J. %A Lee, S. S. %A Lee, W. J. %A LeFaive, J. %A Levine, D. %A Levy, D. %A Lewis, J. %A Li, X. %A Li, Y. %A Lin, H. %A Lin, H. %A Lin, K. H. %A Lin, X. %A Liu, S. %A Liu, Y. %A Liu, Y. %A Loos, R. J. F. %A Lubitz, S. %A Lunetta, K. %A Luo, J. %A Mahaney, M. C. %A Make, B. %A Manichaikul, A. W. %A Manson, J. %A Margolin, L. %A Martin, L. W. %A Mathai, S. %A Mathias, R. A. %A May, S. %A McArdle, P. %A McDonald, M. L. %A McFarland, S. %A McGarvey, S. T. %A McGoldrick, D. %A McHugh, C. %A Mei, H. %A Mestroni, L. %A Meyers, D. A. %A Mikulla, J. %A Min, N. %A Minear, M. %A Minster, R. L. %A Mitchell, B. D. %A Moll, M. %A Montasser, M. E. %A Montgomery, C. %A Moscati, A. %A Musani, S. %A Mwasongwe, S. %A Mychaleckyj, J. C. %A Nadkarni, G. %A Naik, R. %A Naseri, T. %A Natarajan, P. %A Nekhai, S. %A Nelson, S. C. %A Neltner, B. %A Nickerson, D. %A North, K. %A O'Connell, J. R. %A O'Connor, T. %A Ochs-Balcom, H. %A Paik, D. %A Palmer, N. D. %A Pankow, J. %A Papanicolaou, G. %A Parsa, A. %A Peralta, J. M. %A Perez, M. %A Perry, J. %A Peters, U. %A Peyser, P. A. %A Phillips, L. S. %A Pollin, T. %A Post, W. %A Becker, J. P. %A Boorgula, M. P. %A Preuss, M. %A Psaty, B. M. %A Qasba, P. %A Qiao, D. %A Qin, Z. %A Rafaels, N. %A Raffield, L. %A Vasan, R. S. %A Rao, D. C. %A Rasmussen-Torvik, L. %A Ratan, A. %A Redline, S. %A Reed, R. %A Regan, E. %A Reiner, A. %A Reupena, M. S. %A Rice, K. M. %A Rich, S. S. %A Roden, D. %A Roselli, C. %A Rotter, J. I. %A Ruczinski, I. %A Russell, P. %A Ruuska, S. %A Ryan, K. %A Sabino, E. C. %A Saleheen, D. %A Salimi, S. %A Salzberg, S. %A Sandow, K. %A Sankaran, V. G. %A Scheller, C. %A Schmidt, E. %A Schwander, K. %A Schwartz, D. %A Sciurba, F. %A Seidman, C. %A Seidman, J. %A Sheehan, V. %A Sherman, S. L. %A Shetty, A. %A Shetty, A. %A Sheu, W. H. %A Shoemaker, M. B. %A Silver, B. %A Silverman, E. %A Smith, J. A. %A Smith, J. %A Smith, N. %A Smith, T. %A Smoller, S. %A Snively, B. %A Snyder, M. %A Sofer, T. %A Sotoodehnia, N. %A Stilp, A. M. %A Storm, G. %A Streeten, E. %A Su, J. L. %A Sung, Y. J. %A Sylvia, J. %A Szpiro, A. %A Sztalryd, C. %A Taliun, D. %A Tang, H. %A Taub, M. %A Taylor, K. D. %A Taylor, M. %A Taylor, S. %A Telen, M. %A Thornton, T. A. %A Threlkeld, M. %A Tinker, L. %A Tirschwell, D. %A Tishkoff, S. %A Tiwari, H. K. %A Tong, C. %A Tracy, R. %A Tsai, M. Y. %A Vaidya, D. %A Van Den Berg, D. %A VandeHaar, P. %A Vrieze, S. %A Walker, T. %A Wallace, R. %A Walts, A. %A Wang, F. F. %A Wang, H. %A Watson, K. %A Weeks, D. E. %A Weir, B. %A Weiss, S. %A Weng, L. C. %A Wessel, J. %A Willer, C. J. %A Williams, K. %A Williams, L. K. %A Wilson, C. %A Wilson, J. G. %A Wong, Q. %A Wu, J. %A Xu, H. %A Yanek, L. R. %A Yang, I. %A Yang, R. %A Zaghloul, N. %A Zekavat, M. %A Zhang, Y. %A Zhao, S. X. %A Zhao, W. %A Zhi, D. %A Zhou, X. %A Zhu, X. %A Zody, M. %A Zoellner, S. %A Abdalla, M. %A Abecasis, G. R. %A Arnett, D. K. %A Aslibekyan, S. %A Assimes, T. %A Atkinson, E. %A Ballantyne, C. M. %A Beitelshees, A. %A Bielak, L. F. %A Bis, J. %A Bodea, C. %A Boerwinkle, E. %A Bowden, D. W. %A Brody, J. %A Cade, B. %A Carlson, J. %A Chang, I. S. %A Chen, Y. I. %A Chun, S. %A Chung, R. H. %A Conomos, M. P. %A Correa, A. %A Cupples, L. A. %A Damcott, C. %A de Vries, P. %A Do, R. %A Elliott, A. %A Fu, M. %A Ganna, A. %A Gong, D. W. %A Graham, S. %A Haas, M. %A Haring, B. %A He, J. %A Heckbert, S. %A Himes, B. %A Hixson, J. %A Irvin, M. R. %A Jain, D. %A Jarvik, G. %A Jhun, M. A. %A Jiang, J. %A Jun, G. %A Kalyani, R. %A Kardia, S. L. R. %A Kathiresan, S. %A Khera, A. %A Klarin, D. %A Kooperberg, C. L. %A Kral, B. %A Lange, L. %A Laurie, C. C. %A Laurie, C. %A Lemaitre, R. %A Li, Z. %A Li, X. %A Lin, X. %A Mahaney, M. C. %A Manichaikul, A. W. %A Martin, L. W. %A Mathias, R. A. %A Mathur, R. %A McGarvey, S. T. %A McHugh, C. %A McLenithan, J. %A Mikulla, J. %A Mitchell, B. D. %A Montasser, M. E. %A Moran, A. %A Morrison, A. C. %A Nakao, T. %A Natarajan, P. %A Nickerson, D. %A North, K. %A O'Connell, J. R. %A O'Donnell, C. %A Palmer, N. D. %A Pampana, A. %A Patel, A. %A Peloso, G. M. %A Perry, J. %A Peters, U. %A Peyser, P. A. %A Pirruccello, J. %A Pollin, T. %A Preuss, M. %A Psaty, B. M. %A Rao, D. C. %A Redline, S. %A Reed, R. %A Reiner, A. %A Rich, S. S. %A Rosenthal, S. %A Rotter, J. I. %A Schoenberg, J. %A Selvaraj, M. S. %A Sheu, W. H. %A Smith, J. A. %A Sofer, T. %A Stilp, A. M. %A Sunyaev, S. R. %A Surakka, I. %A Sztalryd, C. %A Tang, H. %A Taylor, K. D. %A Tsai, M. Y. %A Uddin, M. M. %A Urbut, S. %A Verbanck, M. %A Von Holle, A. %A Wang, H. %A Wang, F. F. %A Wiggins, K. %A Willer, C. J. %A Wilson, J. G. %A Wolford, B. %A Xu, H. %A Yanek, L. R. %A Zaghloul, N. %A Zekavat, M. %A Zhang, J. %X Large-scale whole-genome sequencing studies have enabled the analysis of rare variants (RVs) associated with complex phenotypes. Commonly used RV association tests have limited scope to leverage variant functions. We propose STAAR (variant-set test for association using annotation information), a scalable and powerful RV association test method that effectively incorporates both variant categories and multiple complementary annotations using a dynamic weighting scheme. For the latter, we introduce 'annotation principal components', multidimensional summaries of in silico variant annotations. STAAR accounts for population structure and relatedness and is scalable for analyzing very large cohort and biobank whole-genome sequencing studies of continuous and dichotomous traits. We applied STAAR to identify RVs associated with four lipid traits in 12,316 discovery and 17,822 replication samples from the Trans-Omics for Precision Medicine Program. We discovered and replicated new RV associations, including disruptive missense RVs of NPC1L1 and an intergenic region near APOC1P1 associated with low-density lipoprotein cholesterol. %B Nat Genet %V 52 %P 969–983 %8 Sep %G eng %0 Journal Article %J Hum Brain Mapp %D 2020 %T Estrogen, brain structure, and cognition in postmenopausal women. %A Boyle, Christina P %A Raji, Cyrus A %A Erickson, Kirk I %A Lopez, Oscar L %A Becker, James T %A Gach, H Michael %A Kuller, Lewis H %A Longstreth, William %A Carmichael, Owen T %A Riedel, Brandalyn C %A Thompson, Paul M %X

Declining estrogen levels before, during, and after menopause can affect memory and risk for Alzheimer's disease. Undesirable side effects of hormone variations emphasize a role for hormone therapy (HT) where possible benefits include a delay in the onset of dementia-yet findings are inconsistent. Effects of HT may be mediated by estrogen receptors found throughout the brain. Effects may also depend on lifestyle factors, timing of use, and genetic risk. We studied the impact of self-reported HT use on brain volume in 562 elderly women (71-94 years) with mixed cognitive status while adjusting for aforementioned factors. Covariate-adjusted voxelwise linear regression analyses using a model with 16 predictors showed HT use as positively associated with regional brain volumes, regardless of cognitive status. Examinations of other factors related to menopause, oophorectomy and hysterectomy status independently yielded positive effects on brain volume when added to our model. One interaction term, HTxBMI, out of several examined, revealed significant negative association with overall brain volume, suggesting a greater reduction in brain volume than BMI alone. Our main findings relating HT to regional brain volume were as hypothesized, but some exploratory analyses were not in line with existing hypotheses. Studies suggest lower levels of estrogen resulting from oophorectomy and hysterectomy affect brain volume negatively, and the addition of HT modifies the relation between BMI and brain volume positively. Effects of HT may depend on the age range assessed, motivating studies with a wider age range as well as a randomized design.

%B Hum Brain Mapp %8 2020 Sep 10 %G eng %R 10.1002/hbm.25200 %0 Journal Article %J J R Stat Soc Ser A Stat Soc %D 2020 %T Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study. %A Andrews, Ryan M %A Shpitser, Ilya %A Lopez, Oscar %A Longstreth, William T %A Chaves, Paulo H M %A Kuller, Lewis %A Carlson, Michelle C %X

The paper examines whether leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular-related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.

%B J R Stat Soc Ser A Stat Soc %V 183 %P 1705-1726 %8 2020 Oct %G eng %N 4 %R 10.1111/rssa.12570 %0 Journal Article %J J Am Heart Assoc %D 2020 %T Fatty Acid Binding Protein-4 and Risk of Cardiovascular Disease: The Cardiovascular Health Study. %A Egbuche, Obiora %A Biggs, Mary L %A Ix, Joachim H %A Kizer, Jorge R %A Lyles, Mary F %A Siscovick, David S %A Djoussé, Luc %A Mukamal, Kenneth J %X

Background FABP-4 (fatty acid binding protein-4) is a lipid chaperone in adipocytes and has been associated with prognosis in selected clinical populations. We investigated the associations between circulating FABP-4, risk of incident cardiovascular disease (CVD), and risk of CVD mortality among older adults with and without established CVD. Methods and Results In the Cardiovascular Health Study, we measured FABP4 levels in stored specimens from the 1992-993 visit and followed participants for incident CVD if they were free of prevalent CVD at baseline and for CVD mortality through June 2015. We used Cox regression to estimate hazard ratios for incident CVD and CVD mortality per doubling in serum FABP-4 adjusted for age, sex, race, field center, waist circumference, blood pressure, lipids, fasting glucose, and C-reactive protein. Among 4026 participants free of CVD and 681 with prevalent CVD, we documented 1878 cases of incident CVD and 331 CVD deaths, respectively. In adjusted analyses, FABP-4 was modestly associated with risk of incident CVD (mean, 34.24; SD, 18.90; HR, 1.10 per doubling in FABP-4, 95% CI, 1.00-1.21). In contrast, FABP-4 was more clearly associated with risk of CVD mortality among participants without (HR hazard ratio 1.24, 95% CI, 1.10-1.40) or with prevalent CVD (HR hazard ratio 1.57, 95% CI, 1.24-1.98). These associations were not significantly modified by sex, age, and waist circumference. Conclusions Serum FABP-4 is modestly associated with risk of incident CVD even after adjustment for standard risk factors, but more strongly associated with CVD mortality among older adults with and without established CVD.

%B J Am Heart Assoc %V 9 %P e014070 %8 2020 Apr 07 %G eng %N 7 %R 10.1161/JAHA.119.014070 %0 Journal Article %J PLoS Med %D 2020 %T {Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies %A Imamura, F. %A Fretts, A. M. %A Marklund, M. %A Ardisson Korat, A. V. %A Yang, W. S. %A Lankinen, M. %A Qureshi, W. %A Helmer, C. %A Chen, T. A. %A Virtanen, J. K. %A Wong, K. %A Bassett, J. K. %A Murphy, R. %A Tintle, N. %A Yu, C. I. %A Brouwer, I. A. %A Chien, K. L. %A Chen, Y. Y. %A Wood, A. C. %A Del Gobbo, L. C. %A Djousse, L. %A Geleijnse, J. M. %A Giles, G. G. %A de Goede, J. %A Gudnason, V. %A Harris, W. S. %A Hodge, A. %A Hu, F. %A Koulman, A. %A Laakso, M. %A Lind, L. %A Lin, H. J. %A McKnight, B. %A Rajaobelina, K. %A Riserus, U. %A Robinson, J. G. %A Samieri, C. %A Senn, M. %A Siscovick, D. S. %A Soedamah-Muthu, S. S. %A Sotoodehnia, N. %A Sun, Q. %A Tsai, M. Y. %A Tuomainen, T. P. %A Uusitupa, M. %A Wagenknecht, L. E. %A Wareham, N. J. %A Wu, J. H. Y. %A Micha, R. %A Lemaitre, R. N. %A Mozaffarian, D. %A Forouhi, N. G. %X De novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D).\ Seventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970-1973 to 2006-2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3-75.5 years; % women = 20.4%-62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41-1.66; p < 0.001) for 16:0, 1.40 (1.33-1.48; p < 0.001) for 16:1n-7, 1.14 (1.05-1.22; p = 0.001) for 18:0, and 1.16 (1.07-1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%-73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94-1.13). These findings had limitations in potential reverse causation and residual confounding by imprecisely measured or unmeasured factors.\ Concentrations of fatty acids in the DNL were positively associated with T2D incidence. Our findings support further work to investigate a possible role of DNL and individual fatty acids in the development of T2D. %B PLoS Med %V 17 %P e1003102 %8 06 %G eng %0 Journal Article %J Mol Psychiatry %D 2020 %T Gene-educational attainment interactions in a multi-ancestry genome-wide meta-analysis identify novel blood pressure loci. %A de Las Fuentes, Lisa %A Sung, Yun Ju %A Noordam, Raymond %A Winkler, Thomas %A Feitosa, Mary F %A Schwander, Karen %A Bentley, Amy R %A Brown, Michael R %A Guo, Xiuqing %A Manning, Alisa %A Chasman, Daniel I %A Aschard, Hugues %A Bartz, Traci M %A Bielak, Lawrence F %A Campbell, Archie %A Cheng, Ching-Yu %A Dorajoo, Rajkumar %A Hartwig, Fernando P %A Horimoto, A R V R %A Li, Changwei %A Li-Gao, Ruifang %A Liu, Yongmei %A Marten, Jonathan %A Musani, Solomon K %A Ntalla, Ioanna %A Rankinen, Tuomo %A Richard, Melissa %A Sim, Xueling %A Smith, Albert V %A Tajuddin, Salman M %A Tayo, Bamidele O %A Vojinovic, Dina %A Warren, Helen R %A Xuan, Deng %A Alver, Maris %A Boissel, Mathilde %A Chai, Jin-Fang %A Chen, Xu %A Christensen, Kaare %A Divers, Jasmin %A Evangelou, Evangelos %A Gao, Chuan %A Girotto, Giorgia %A Harris, Sarah E %A He, Meian %A Hsu, Fang-Chi %A Kuhnel, Brigitte %A Laguzzi, Federica %A Li, Xiaoyin %A Lyytikäinen, Leo-Pekka %A Nolte, Ilja M %A Poveda, Alaitz %A Rauramaa, Rainer %A Riaz, Muhammad %A Rueedi, Rico %A Shu, Xiao-Ou %A Snieder, Harold %A Sofer, Tamar %A Takeuchi, Fumihiko %A Verweij, Niek %A Ware, Erin B %A Weiss, Stefan %A Yanek, Lisa R %A Amin, Najaf %A Arking, Dan E %A Arnett, Donna K %A Bergmann, Sven %A Boerwinkle, Eric %A Brody, Jennifer A %A Broeckel, Ulrich %A Brumat, Marco %A Burke, Gregory %A Cabrera, Claudia P %A Canouil, Mickaël %A Chee, Miao Li %A Chen, Yii-Der Ida %A Cocca, Massimiliano %A Connell, John %A de Silva, H Janaka %A de Vries, Paul S %A Eiriksdottir, Gudny %A Faul, Jessica D %A Fisher, Virginia %A Forrester, Terrence %A Fox, Ervin F %A Friedlander, Yechiel %A Gao, He %A Gigante, Bruna %A Giulianini, Franco %A Gu, Chi Charles %A Gu, Dongfeng %A Harris, Tamara B %A He, Jiang %A Heikkinen, Sami %A Heng, Chew-Kiat %A Hunt, Steven %A Ikram, M Arfan %A Irvin, Marguerite R %A Kähönen, Mika %A Kavousi, Maryam %A Khor, Chiea Chuen %A Kilpeläinen, Tuomas O %A Koh, Woon-Puay %A Komulainen, Pirjo %A Kraja, Aldi T %A Krieger, J E %A Langefeld, Carl D %A Li, Yize %A Liang, Jingjing %A Liewald, David C M %A Liu, Ching-Ti %A Liu, Jianjun %A Lohman, Kurt K %A Mägi, Reedik %A McKenzie, Colin A %A Meitinger, Thomas %A Metspalu, Andres %A Milaneschi, Yuri %A Milani, Lili %A Mook-Kanamori, Dennis O %A Nalls, Mike A %A Nelson, Christopher P %A Norris, Jill M %A O'Connell, Jeff %A Ogunniyi, Adesola %A Padmanabhan, Sandosh %A Palmer, Nicholette D %A Pedersen, Nancy L %A Perls, Thomas %A Peters, Annette %A Petersmann, Astrid %A Peyser, Patricia A %A Polasek, Ozren %A Porteous, David J %A Raffel, Leslie J %A Rice, Treva K %A Rotter, Jerome I %A Rudan, Igor %A Rueda-Ochoa, Oscar-Leonel %A Sabanayagam, Charumathi %A Salako, Babatunde L %A Schreiner, Pamela J %A Shikany, James M %A Sidney, Stephen S %A Sims, Mario %A Sitlani, Colleen M %A Smith, Jennifer A %A Starr, John M %A Strauch, Konstantin %A Swertz, Morris A %A Teumer, Alexander %A Tham, Yih Chung %A Uitterlinden, André G %A Vaidya, Dhananjay %A van der Ende, M Yldau %A Waldenberger, Melanie %A Wang, Lihua %A Wang, Ya-Xing %A Wei, Wen-Bin %A Weir, David R %A Wen, Wanqing %A Yao, Jie %A Yu, Bing %A Yu, Caizheng %A Yuan, Jian-Min %A Zhao, Wei %A Zonderman, Alan B %A Becker, Diane M %A Bowden, Donald W %A Deary, Ian J %A Dörr, Marcus %A Esko, Tõnu %A Freedman, Barry I %A Froguel, Philippe %A Gasparini, Paolo %A Gieger, Christian %A Jonas, Jost Bruno %A Kammerer, Candace M %A Kato, Norihiro %A Lakka, Timo A %A Leander, Karin %A Lehtimäki, Terho %A Magnusson, Patrik K E %A Marques-Vidal, Pedro %A Penninx, Brenda W J H %A Samani, Nilesh J %A van der Harst, Pim %A Wagenknecht, Lynne E %A Wu, Tangchun %A Zheng, Wei %A Zhu, Xiaofeng %A Bouchard, Claude %A Cooper, Richard S %A Correa, Adolfo %A Evans, Michele K %A Gudnason, Vilmundur %A Hayward, Caroline %A Horta, Bernardo L %A Kelly, Tanika N %A Kritchevsky, Stephen B %A Levy, Daniel %A Palmas, Walter R %A Pereira, A C %A Province, Michael M %A Psaty, Bruce M %A Ridker, Paul M %A Rotimi, Charles N %A Tai, E Shyong %A van Dam, Rob M %A van Duijn, Cornelia M %A Wong, Tien Yin %A Rice, Kenneth %A Gauderman, W James %A Morrison, Alanna C %A North, Kari E %A Kardia, Sharon L R %A Caulfield, Mark J %A Elliott, Paul %A Munroe, Patricia B %A Franks, Paul W %A Rao, Dabeeru C %A Fornage, Myriam %X

Educational attainment is widely used as a surrogate for socioeconomic status (SES). Low SES is a risk factor for hypertension and high blood pressure (BP). To identify novel BP loci, we performed multi-ancestry meta-analyses accounting for gene-educational attainment interactions using two variables, "Some College" (yes/no) and "Graduated College" (yes/no). Interactions were evaluated using both a 1 degree of freedom (DF) interaction term and a 2DF joint test of genetic and interaction effects. Analyses were performed for systolic BP, diastolic BP, mean arterial pressure, and pulse pressure. We pursued genome-wide interrogation in Stage 1 studies (N = 117 438) and follow-up on promising variants in Stage 2 studies (N = 293 787) in five ancestry groups. Through combined meta-analyses of Stages 1 and 2, we identified 84 known and 18 novel BP loci at genome-wide significance level (P < 5 × 10). Two novel loci were identified based on the 1DF test of interaction with educational attainment, while the remaining 16 loci were identified through the 2DF joint test of genetic and interaction effects. Ten novel loci were identified in individuals of African ancestry. Several novel loci show strong biological plausibility since they involve physiologic systems implicated in BP regulation. They include genes involved in the central nervous system-adrenal signaling axis (ZDHHC17, CADPS, PIK3C2G), vascular structure and function (GNB3, CDON), and renal function (HAS2 and HAS2-AS1, SLIT3). Collectively, these findings suggest a role of educational attainment or SES in further dissection of the genetic architecture of BP.

%B Mol Psychiatry %8 2020 May 05 %G eng %R 10.1038/s41380-020-0719-3 %0 Journal Article %J Alzheimers Dement (Amst) %D 2020 %T Genetic and regulatory architecture of Alzheimer's disease in the region. %A Kulminski, Alexander M %A Shu, Leonardo %A Loika, Yury %A He, Liang %A Nazarian, Alireza %A Arbeev, Konstantin %A Ukraintseva, Svetlana %A Yashin, Anatoliy %A Culminskaya, Irina %X

Introduction: Apolipoprotein E () ε2 and ε4 alleles encoded by rs7412 and rs429358 polymorphisms, respectively, are landmark contra and pro "risk" factors for Alzheimer's disease (AD).

Methods: We examined differences in linkage disequilibrium (LD) structures between (1) AD-affected and unaffected subjects and (2) older AD-unaffected and younger subjects in the 19q13.3 region harboring rs7412 and rs429358.

Results: AD is associated with sex-nonspecific heterogeneous patterns of decreased and increased LD of rs7412 and rs429358, respectively, with other polymorphisms from five genes in this region in AD-affected subjects. The LD patterns in older AD-unaffected subjects resembled those in younger individuals. Polarization of the ε4- and ε2 allele-related heterogeneous LD clusters differentiated cell types and implicated specific tissues in AD pathogenesis.

Discussion: Protection and predisposition to AD is characterized by an interplay of rs7412 and rs429358, with multiple polymorphisms in the 19q13.3 region in a tissue-specific manner, which is not driven by common evolutionary forces.

%B Alzheimers Dement (Amst) %V 12 %P e12008 %8 2020 %G eng %N 1 %R 10.1002/dad2.12008 %0 Journal Article %J Science %D 2020 %T The genetic architecture of the human cerebral cortex %A Grasby, Katrina L. %A Jahanshad, Neda %A Painter, Jodie N. %A Colodro-Conde, Lucía %A Bralten, Janita %A Hibar, Derrek P. %A Lind, Penelope A. %A Pizzagalli, Fabrizio %A Ching, Christopher R. K. %A McMahon, Mary Agnes B. %A Shatokhina, Natalia %A Zsembik, Leo C. P. %A Thomopoulos, Sophia I. %A Zhu, Alyssa H. %A Strike, Lachlan T. %A Agartz, Ingrid %A Alhusaini, Saud %A Almeida, Marcio A. A. %A Alnæs, Dag %A Amlien, Inge K. %A Andersson, Micael %A Ard, Tyler %A Armstrong, Nicola J. %A Ashley-Koch, Allison %A Atkins, Joshua R. %A Bernard, Manon %A Brouwer, Rachel M. %A Buimer, Elizabeth E. L. %A Bülow, Robin %A Bürger, Christian %A Cannon, Dara M. %A Chakravarty, Mallar %A Chen, Qiang %A Cheung, Joshua W. %A Couvy-Duchesne, Baptiste %A Dale, Anders M. %A Dalvie, Shareefa %A de Araujo, Tânia K. %A de Zubicaray, Greig I. %A de Zwarte, Sonja M. C. %A den Braber, Anouk %A Doan, Nhat Trung %A Dohm, Katharina %A Ehrlich, Stefan %A Engelbrecht, Hannah-Ruth %A Erk, Susanne %A Fan, Chun Chieh %A Fedko, Iryna O. %A Foley, Sonya F. %A Ford, Judith M. %A Fukunaga, Masaki %A Garrett, Melanie E. %A Ge, Tian %A Giddaluru, Sudheer %A Goldman, Aaron L. %A Green, Melissa J. %A Groenewold, Nynke A. %A Grotegerd, Dominik %A Gurholt, Tiril P. %A Gutman, Boris A. %A Hansell, Narelle K. %A Harris, Mathew A. %A Harrison, Marc B. %A Haswell, Courtney C. %A Hauser, Michael %A Herms, Stefan %A Heslenfeld, Dirk J. %A Ho, New Fei %A Hoehn, David %A Hoffmann, Per %A Holleran, Laurena %A Hoogman, Martine %A Hottenga, Jouke-Jan %A Ikeda, Masashi %A Janowitz, Deborah %A Jansen, Iris E. %A Jia, Tianye %A Jockwitz, Christiane %A Kanai, Ryota %A Karama, Sherif %A Kasperaviciute, Dalia %A Kaufmann, Tobias %A Kelly, Sinead %A Kikuchi, Masataka %A Klein, Marieke %A Knapp, Michael %A Knodt, Annchen R. %A Krämer, Bernd %A Lam, Max %A Lancaster, Thomas M. %A Lee, Phil H. %A Lett, Tristram A. %A Lewis, Lindsay B. %A Lopes-Cendes, Iscia %A Luciano, Michelle %A Macciardi, Fabio %A Marquand, Andre F. %A Mathias, Samuel R. %A Melzer, Tracy R. %A Milaneschi, Yuri %A Mirza-Schreiber, Nazanin %A Moreira, Jose C. V. %A Mühleisen, Thomas W. %A Müller-Myhsok, Bertram %A Najt, Pablo %A Nakahara, Soichiro %A Nho, Kwangsik %A Olde Loohuis, Loes M. %A Orfanos, Dimitri Papadopoulos %A Pearson, John F. %A Pitcher, Toni L. %A Pütz, Benno %A Quidé, Yann %A Ragothaman, Anjanibhargavi %A Rashid, Faisal M. %A Reay, William R. %A Redlich, Ronny %A Reinbold, Céline S. %A Repple, Jonathan %A Richard, Geneviève %A Riedel, Brandalyn C. %A Risacher, Shannon L. %A Rocha, Cristiane S. %A Mota, Nina Roth %A Salminen, Lauren %A Saremi, Arvin %A Saykin, Andrew J. %A Schlag, Fenja %A Schmaal, Lianne %A Schofield, Peter R. %A Secolin, Rodrigo %A Shapland, Chin Yang %A Shen, Li %A Shin, Jean %A Shumskaya, Elena %A Sønderby, Ida E. %A Sprooten, Emma %A Tansey, Katherine E. %A Teumer, Alexander %A Thalamuthu, Anbupalam %A Tordesillas-Gutierrez, Diana %A Turner, Jessica A. %A Uhlmann, Anne %A Vallerga, Costanza Ludovica %A van der Meer, Dennis %A van Donkelaar, Marjolein M. J. %A van Eijk, Liza %A van Erp, Theo G. M. %A van Haren, Neeltje E. M. %A van Rooij, Daan %A van Tol, Marie-Jose %A Veldink, Jan H. %A Verhoef, Ellen %A Walton, Esther %A Wang, Mingyuan %A Wang, Yunpeng %A Wardlaw, Joanna M. %A Wen, Wei %A Westlye, Lars T. %A Whelan, Christopher D. %A Witt, Stephanie H. %A Wittfeld, Katharina %A Wolf, Christiane %A Wolfers, Thomas %A Wu, Jing Qin %A Yasuda, Clarissa L. %A Zaremba, Dario %A Zhang, Zuo %A Zwiers, Marcel P. %A Artiges, Eric %A Assareh, Amelia A. %A Ayesa-Arriola, Rosa %A Belger, Aysenil %A Brandt, Christine L. %A Brown, Gregory G. %A Cichon, Sven %A Curran, Joanne E. %A Davies, Gareth E. %A Degenhardt, Franziska %A Dennis, Michelle F. %A Dietsche, Bruno %A Djurovic, Srdjan %A Doherty, Colin P. %A Espiritu, Ryan %A Garijo, Daniel %A Gil, Yolanda %A Gowland, Penny A. %A Green, Robert C. %A Häusler, Alexander N. %A Heindel, Walter %A Ho, Beng-Choon %A Hoffmann, Wolfgang U. %A Holsboer, Florian %A Homuth, Georg %A Hosten, Norbert %A Jack, Clifford R. %A Jang, MiHyun %A Jansen, Andreas %A Kimbrel, Nathan A. %A Kolskår, Knut %A Koops, Sanne %A Krug, Axel %A Lim, Kelvin O. %A Luykx, Jurjen J. %A Mathalon, Daniel H. %A Mather, Karen A. %A Mattay, Venkata S. %A Matthews, Sarah %A Mayoral Van Son, Jaqueline %A McEwen, Sarah C. %A Melle, Ingrid %A Morris, Derek W. %A Mueller, Bryon A. %A Nauck, Matthias %A Nordvik, Jan E. %A Nöthen, Markus M. %A O’Leary, Daniel S. %A Opel, Nils %A Martinot, Marie-Laure Paillère %A Pike, G. Bruce %A Preda, Adrian %A Quinlan, Erin B. %A Rasser, Paul E. %A Ratnakar, Varun %A Reppermund, Simone %A Steen, Vidar M. %A Tooney, Paul A. %A Torres, Fábio R. %A Veltman, Dick J. %A Voyvodic, James T. %A Whelan, Robert %A White, Tonya %A Yamamori, Hidenaga %A Adams, Hieab H. H. %A Bis, Joshua C. %A Debette, Stephanie %A DeCarli, Charles %A Fornage, Myriam %A Gudnason, Vilmundur %A Hofer, Edith %A Ikram, M. Arfan %A Launer, Lenore %A Longstreth, W. T. %A Lopez, Oscar L. %A Mazoyer, Bernard %A Mosley, Thomas H. %A Roshchupkin, Gennady V. %A Satizabal, Claudia L. %A Schmidt, Reinhold %A Seshadri, Sudha %A Yang, Qiong %A Alvim, Marina K. M. %A Ames, David %A Anderson, Tim J. %A Andreassen, Ole A. %A Arias-Vasquez, Alejandro %A Bastin, Mark E. %A Baune, Bernhard T. %A Beckham, Jean C. %A Blangero, John %A Boomsma, Dorret I. %A Brodaty, Henry %A Brunner, Han G. %A Buckner, Randy L. %A Buitelaar, Jan K. %A Bustillo, Juan R. %A Cahn, Wiepke %A Cairns, Murray J. %A Calhoun, Vince %A Carr, Vaughan J. %A Caseras, Xavier %A Caspers, Svenja %A Cavalleri, Gianpiero L. %A Cendes, Fernando %A Corvin, Aiden %A Crespo-Facorro, Benedicto %A Dalrymple-Alford, John C. %A Dannlowski, Udo %A de Geus, Eco J. C. %A Deary, Ian J. %A Delanty, Norman %A Depondt, Chantal %A Desrivières, Sylvane %A Donohoe, Gary %A Espeseth, Thomas %A Fernández, Guillén %A Fisher, Simon E. %A Flor, Herta %A Forstner, Andreas J. %A Francks, Clyde %A Franke, Barbara %A Glahn, David C. %A Gollub, Randy L. %A Grabe, Hans J. %A Gruber, Oliver %A Håberg, Asta K. %A Hariri, Ahmad R. %A Hartman, Catharina A. %A Hashimoto, Ryota %A Heinz, Andreas %A Henskens, Frans A. %A Hillegers, Manon H. J. %A Hoekstra, Pieter J. %A Holmes, Avram J. %A Hong, L. Elliot %A Hopkins, William D. %A Hulshoff Pol, Hilleke E. %A Jernigan, Terry L. %A Jönsson, Erik G. %A Kahn, René S. %A Kennedy, Martin A. %A Kircher, Tilo T. J. %A Kochunov, Peter %A Kwok, John B. J. %A Le Hellard, Stephanie %A Loughland, Carmel M. %A Martin, Nicholas G. %A Martinot, Jean-Luc %A McDonald, Colm %A McMahon, Katie L. %A Meyer-Lindenberg, Andreas %A Michie, Patricia T. %A Morey, Rajendra A. %A Mowry, Bryan %A Nyberg, Lars %A Oosterlaan, Jaap %A Ophoff, Roel A. %A Pantelis, Christos %A Paus, Tomáš %A Pausova, Zdenka %A Penninx, Brenda W. J. H. %A Polderman, Tinca J. C. %A Posthuma, Danielle %A Rietschel, Marcella %A Roffman, Joshua L. %A Rowland, Laura M. %A Sachdev, Perminder S. %A Sämann, Philipp G. %A Schall, Ulrich %A Schumann, Gunter %A Scott, Rodney J. %A Sim, Kang %A Sisodiya, Sanjay M. %A Smoller, Jordan W. %A Sommer, Iris E. %A St Pourcain, Beate %A Stein, Dan J. %A Toga, Arthur W. %A Trollor, Julian N. %A Van der Wee, Nic J. A. %A van ’t Ent, Dennis %A Völzke, Henry %A Walter, Henrik %A Weber, Bernd %A Weinberger, Daniel R. %A Wright, Margaret J. %A Zhou, Juan %A Stein, Jason L. %A Thompson, Paul M. %A Medland, Sarah E. %B Science %V 367 %P eaay6690 %8 Aug-03-2021 %G eng %U https://www.sciencemag.org/lookup/doi/10.1126/science.aay6690https://syndication.highwire.org/content/doi/10.1126/science.aay6690https://syndication.highwire.org/content/doi/10.1126/science.aay6690 %N 6484 %! Science %R 10.1126/science.aay6690 %0 Journal Article %J Nat Commun %D 2020 %T {Genetic correlations and genome-wide associations of cortical structure in general population samples of 22,824 adults %A Hofer, E. %A Roshchupkin, G. V. %A Adams, H. H. H. %A Knol, M. J. %A Lin, H. %A Li, S. %A Zare, H. %A Ahmad, S. %A Armstrong, N. J. %A Satizabal, C. L. %A Bernard, M. %A Bis, J. C. %A Gillespie, N. A. %A Luciano, M. %A Mishra, A. %A Scholz, M. %A Teumer, A. %A Xia, R. %A Jian, X. %A Mosley, T. H. %A Saba, Y. %A Pirpamer, L. %A Seiler, S. %A Becker, J. T. %A Carmichael, O. %A Rotter, J. I. %A Psaty, B. M. %A Lopez, O. L. %A Amin, N. %A van der Lee, S. J. %A Yang, Q. %A Himali, J. J. %A Maillard, P. %A Beiser, A. S. %A DeCarli, C. %A Karama, S. %A Lewis, L. %A Harris, M. %A Bastin, M. E. %A Deary, I. J. %A Veronica Witte, A. %A Beyer, F. %A Loeffler, M. %A Mather, K. A. %A Schofield, P. R. %A Thalamuthu, A. %A Kwok, J. B. %A Wright, M. J. %A Ames, D. %A Trollor, J. %A Jiang, J. %A Brodaty, H. %A Wen, W. %A Vernooij, M. W. %A Hofman, A. %A Uitterlinden, A. G. %A Niessen, W. J. %A Wittfeld, K. %A B?low, R. %A V?lker, U. %A Pausova, Z. %A Bruce Pike, G. %A Maingault, S. %A Crivello, F. %A Tzourio, C. %A Amouyel, P. %A Mazoyer, B. %A Neale, M. C. %A Franz, C. E. %A Lyons, M. J. %A Panizzon, M. S. %A Andreassen, O. A. %A Dale, A. M. %A Logue, M. %A Grasby, K. L. %A Jahanshad, N. %A Painter, J. N. %A Colodro-Conde, L. %A Bralten, J. %A Hibar, D. P. %A Lind, P. A. %A Pizzagalli, F. %A Stein, J. L. %A Thompson, P. M. %A Medland, S. E. %A Sachdev, P. S. %A Kremen, W. S. %A Wardlaw, J. M. %A Villringer, A. %A van Duijn, C. M. %A Grabe, H. J. %A Longstreth, W. T. %A Fornage, M. %A Paus, T. %A Debette, S. %A Arfan Ikram, M. %A Schmidt, H. %A Schmidt, R. %A Seshadri, S. %A Grasby, K. L. %A Jahanshad, N. %A Painter, J. N. %A Colodro-Conde, L. %A Bralten, J. %A Hibar, D. P. %A Lind, P. A. %A Pizzagalli, F. %A Ching, C. R. K. %A McMahon, M. A. B. %A Shatokhina, N. %A Zsembik, L. C. P. %A Agartz, I. %A Alhusaini, S. %A Almeida, M. A. A. %A Aln?s, D. %A Amlien, I. K. %A Andersson, M. %A Ard, T. %A Armstrong, N. J. %A Ashley-Koch, A. %A Bernard, M. %A Brouwer, R. M. %A Buimer, E. E. L. %A B?low, R. %A B?rger, C. %A Cannon, D. M. %A Chakravarty, M. %A Chen, Q. %A Cheung, J. W. %A Couvy-Duchesne, B. %A Dale, A. M. %A Dalvie, S. %A de Araujo, T. K. %A de Zubicaray, G. I. %A de Zwarte, S. M. C. %A den Braber, A. %A Doan, N. T. %A Dohm, K. %A Ehrlich, S. %A Engelbrecht, H. R. %A Erk, S. %A Fan, C. C. %A Fedko, I. O. %A Foley, S. F. %A Ford, J. M. %A Fukunaga, M. %A Garrett, M. E. %A Ge, T. %A Giddaluru, S. %A Goldman, A. L. %A Groenewold, N. A. %A Grotegerd, D. %A Gurholt, T. P. %A Gutman, B. A. %A Hansell, N. K. %A Harris, M. A. %A Harrison, M. B. %A Haswell, C. C. %A Hauser, M. %A Herms, S. %A Heslenfeld, D. J. %A Ho, N. F. %A Hoehn, D. %A Hoffmann, P. %A Holleran, L. %A Hoogman, M. %A Hottenga, J. J. %A Ikeda, M. %A Janowitz, D. %A Jansen, I. E. %A Jia, T. %A Jockwitz, C. %A Kanai, R. %A Karama, S. %A Kasperaviciute, D. %A Kaufmann, T. %A Kelly, S. %A Kikuchi, M. %A Klein, M. %A Knapp, M. %A Knodt, A. R. %A Kr?mer, B. %A Lam, M. %A Lancaster, T. M. %A Lee, P. H. %A Lett, T. A. %A Lewis, L. B. %A Lopes-Cendes, I. %A Luciano, M. %A Macciardi, F. %A Marquand, A. F. %A Mathias, S. R. %A Melzer, T. R. %A Milaneschi, Y. %A Mirza-Schreiber, N. %A Moreira, J. C. V. %A M?hleisen, T. W. %A M?ller-Myhsok, B. %A Najt, P. %A Nakahara, S. %A Nho, K. %A Olde Loohuis, L. M. %A Orfanos, D. P. %A Pearson, J. F. %A Pitcher, T. L. %A P?tz, B. %A Ragothaman, A. %A Rashid, F. M. %A Redlich, R. %A Reinbold, C. S. %A Repple, J. %A Richard, G. %A Riedel, B. C. %A Risacher, S. L. %A Rocha, C. S. %A Mota, N. R. %A Salminen, L. %A Saremi, A. %A Saykin, A. J. %A Schlag, F. %A Schmaal, L. %A Schofield, P. R. %A Secolin, R. %A Shapland, C. Y. %A Shen, L. %A Shin, J. %A Shumskaya, E. %A S?nderby, I. E. %A Sprooten, E. %A Strike, L. T. %A Tansey, K. E. %A Teumer, A. %A Thalamuthu, A. %A Thomopoulos, S. I. %A Tordesillas-Guti?rrez, D. %A Turner, J. A. %A Uhlmann, A. %A Vallerga, C. L. %A van der Meer, D. %A van Donkelaar, M. M. J. %A van Eijk, L. %A van Erp, T. G. M. %A van Haren, N. E. M. %A van Rooij, D. %A van Tol, M. J. %A Veldink, J. H. %A Verhoef, E. %A Walton, E. %A Wang, M. %A Wang, Y. %A Wardlaw, J. M. %A Wen, W. %A Westlye, L. T. %A Whelan, C. D. %A Witt, S. H. %A Wittfeld, K. %A Wolf, C. %A Wolfers, T. %A Yasuda, C. L. %A Zaremba, D. %A Zhang, Z. %A Zhu, A. H. %A Zwiers, M. P. %A Artiges, E. %A Assareh, A. A. %A Ayesa-Arriola, R. %A Belger, A. %A Brandt, C. L. %A Brown, G. G. %A Cichon, S. %A Curran, J. E. %A Davies, G. E. %A Degenhardt, F. %A Dietsche, B. %A Djurovic, S. %A Doherty, C. P. %A Espiritu, R. %A Garijo, D. %A Gil, Y. %A Gowland, P. A. %A Green, R. C. %A H?usler, A. N. %A Heindel, W. %A Ho, B. C. %A Hoffmann, W. U. %A Holsboer, F. %A Homuth, G. %A Hosten, N. %A Jack, C. R. %A Jang, M. %A Jansen, A. %A Kolsk?r, K. %A Koops, S. %A Krug, A. %A Lim, K. O. %A Luykx, J. J. %A Mathalon, D. H. %A Mather, K. A. %A Mattay, V. S. %A Matthews, S. %A Son, J. M. V. %A McEwen, S. C. %A Melle, I. %A Morris, D. W. %A Mueller, B. A. %A Nauck, M. %A Nordvik, J. E. %A N?then, M. M. %A O'Leary, D. S. %A Opel, N. %A Martinot, M. -P. %A Pike, G. B. %A Preda, A. %A Quinlan, E. B. %A Ratnakar, V. %A Reppermund, S. %A Steen, V. M. %A Torres, F. R. %A Veltman, D. J. %A Voyvodic, J. T. %A Whelan, R. %A White, T. %A Yamamori, H. %A Alvim, M. K. M. %A Ames, D. %A Anderson, T. J. %A Andreassen, O. A. %A Arias-Vasquez, A. %A Bastin, M. E. %A Baune, B. T. %A Blangero, J. %A Boomsma, D. I. %A Brodaty, H. %A Brunner, H. G. %A Buckner, R. L. %A Buitelaar, J. K. %A Bustillo, J. R. %A Cahn, W. %A Calhoun, V. %A Caseras, X. %A Caspers, S. %A Cavalleri, G. L. %A Cendes, F. %A Corvin, A. %A Crespo-Facorro, B. %A Dalrymple-Alford, J. C. %A Dannlowski, U. %A de Geus, E. J. C. %A Deary, I. J. %A Delanty, N. %A Depondt, C. %A Desrivi?res, S. %A Donohoe, G. %A Espeseth, T. %A Fern?ndez, G. %A Fisher, S. E. %A Flor, H. %A Forstner, A. J. %A Francks, C. %A Franke, B. %A Glahn, D. C. %A Gollub, R. L. %A Grabe, H. J. %A Gruber, O. %A H?berg, A. K. %A Hariri, A. R. %A Hartman, C. A. %A Hashimoto, R. %A Heinz, A. %A Hillegers, M. H. J. %A Hoekstra, P. J. %A Holmes, A. J. %A Hong, L. E. %A Hopkins, W. D. %A Hulshoff Pol, H. E. %A Jernigan, T. L. %A J?nsson, E. G. %A Kahn, R. S. %A Kennedy, M. A. %A Kircher, T. T. J. %A Kochunov, P. %A Kwok, J. B. J. %A Hellard, S. L. %A Martin, N. G. %A Martinot, J. - %A McDonald, C. %A McMahon, K. L. %A Meyer-Lindenberg, A. %A Morey, R. A. %A Nyberg, L. %A Oosterlaan, J. %A Ophoff, R. A. %A Paus, T. %A Pausova, Z. %A Penninx, B. W. J. H. %A Polderman, T. J. C. %A Posthuma, D. %A Rietschel, M. %A Roffman, J. L. %A Rowland, L. M. %A Sachdev, P. S. %A S?mann, P. G. %A Schumann, G. %A Sim, K. %A Sisodiya, S. M. %A Smoller, J. W. %A Sommer, I. E. %A Pourcain, B. S. %A Stein, D. J. %A Toga, A. W. %A Trollor, J. N. %A Van der Wee, N. J. A. %A van 't Ent, D. %A V?lzke, H. %A Walter, H. %A Weber, B. %A Weinberger, D. R. %A Wright, M. J. %A Zhou, J. %A Stein, J. L. %A Thompson, P. M. %A Medland, S. E. %X Cortical thickness, surface area and volumes vary with age and cognitive function, and in neurological and psychiatric diseases. Here we report heritability, genetic correlations and genome-wide associations of these cortical measures across the whole cortex, and in 34 anatomically predefined regions. Our discovery sample comprises 22,824 individuals from 20 cohorts within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium and the UK Biobank. We identify genetic heterogeneity between cortical measures and brain regions, and 160 genome-wide significant associations pointing to wnt/β-catenin, TGF-β and sonic hedgehog pathways. There is enrichment for genes involved in anthropometric traits, hindbrain development, vascular and neurodegenerative disease and psychiatric conditions. These data are a rich resource for studies of the biological mechanisms behind cortical development and aging. %B Nat Commun %V 11 %P 4796 %8 09 %G eng %0 Journal Article %J Circ Genom Precis Med %D 2020 %T {Genetic Determinants of Electrocardiographic P-wave Duration and Relation to Atrial Fibrillation %A Weng, L. C. %A Hall, A. W. %A Choi, S. H. %A Jurgens, S. J. %A Haessler, J. %A Bihlmeyer, N. A. %A Grarup, N. %A Lin, H. %A Teumer, A. %A Li-Gao, R. %A Yao, J. %A Guo, X. %A Brody, J. A. %A M?ller-Nurasyid, M. %A Schramm, K. %A Verweij, N. %A van den Berg, M. E. %A van Setten, J. %A Isaacs, A. %A Ram?rez, J. %A Warren, H. R. %A Padmanabhan, S. %A Kors, J. A. %A de Boer, R. A. %A van der Meer, P. %A Sinner, M. F. %A Waldenberger, M. %A Psaty, B. M. %A Taylor, K. D. %A V?lker, U. %A Kanters, J. K. %A Li, M. %A Alonso, A. %A Perez, M. V. %A Vaartjes, I. %A Bots, M. L. %A Huang, P. L. %A Heckbert, S. R. %A Lin, H. J. %A Kornej, J. %A Munroe, P. B. %A van Duijn, C. M. %A Asselbergs, F. W. %A Stricker, B. H. %A van der Harst, P. %A K??b, S. %A Peters, A. %A Sotoodehnia, N. %A Rotter, J. I. %A Mook-Kanamori, D. O. %A D?rr, M. %A Felix, S. B. %A Linneberg, A. %A Hansen, T. %A Arking, D. E. %A Kooperberg, C. %A Benjamin, E. J. %A Lunetta, K. L. %A Ellinor, P. T. %A Lubitz, S. A. %X Background - The P-wave duration (PWD) is an electrocardiographic (ECG) measurement that represents cardiac conduction in the atria. Shortened or prolonged PWD is associated with atrial fibrillation (AF). We used exome chip data to examine the associations between common and rare variants with PWD. Methods - Fifteen studies comprising 64,440 individuals (56,943 European, 5,681 African, 1,186 Hispanic, 630 Asian), and 230,000 variants were used to examine associations with maximum PWD across the 12-lead ECG. Meta-analyses summarized association results for common variants; gene-based burden and SKAT tests examined low-frequency variant-PWD associations. Additionally, we examined the associations between PWD loci and AF using previous AF GWAS. Results - We identified 21 common and low-frequency genetic loci (14 novel) associated with maximum PWD, including several AF loci (TTN, CAND2, SCN10A, PITX2, CAV1, SYNPO2L, SOX5, TBX5, MYH6, RPL3L). The top variants at known sarcomere genes (TTN, MYH6) were associated with longer PWD and increased AF risk. However, top variants at other loci (e.g., PITX2 and SCN10A) were associated with longer PWD but lower AF risk. Conclusions - Our results highlight multiple novel genetic loci associated with PWD, and underscore the shared mechanisms of atrial conduction and AF. Prolonged PWD may be an endophenotype for several different genetic mechanisms of AF. %B Circ Genom Precis Med %8 Aug %G eng %0 Journal Article %J PLoS One %D 2020 %T Genetic loci associated with prevalent and incident myocardial infarction and coronary heart disease in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. %A Hahn, Julie %A Fu, Yi-Ping %A Brown, Michael R %A Bis, Joshua C %A de Vries, Paul S %A Feitosa, Mary F %A Yanek, Lisa R %A Weiss, Stefan %A Giulianini, Franco %A Smith, Albert Vernon %A Guo, Xiuqing %A Bartz, Traci M %A Becker, Diane M %A Becker, Lewis C %A Boerwinkle, Eric %A Brody, Jennifer A %A Chen, Yii-Der Ida %A Franco, Oscar H %A Grove, Megan %A Harris, Tamara B %A Hofman, Albert %A Hwang, Shih-Jen %A Kral, Brian G %A Launer, Lenore J %A Markus, Marcello R P %A Rice, Kenneth M %A Rich, Stephen S %A Ridker, Paul M %A Rivadeneira, Fernando %A Rotter, Jerome I %A Sotoodehnia, Nona %A Taylor, Kent D %A Uitterlinden, André G %A Völker, Uwe %A Völzke, Henry %A Yao, Jie %A Chasman, Daniel I %A Dörr, Marcus %A Gudnason, Vilmundur %A Mathias, Rasika A %A Post, Wendy %A Psaty, Bruce M %A Dehghan, Abbas %A O'Donnell, Christopher J %A Morrison, Alanna C %K Aging %K Coronary Artery Disease %K Cross-Sectional Studies %K Europe %K European Continental Ancestry Group %K Genetic Loci %K Genome-Wide Association Study %K Humans %K Myocardial Infarction %K Polymorphism, Single Nucleotide %K Prospective Studies %X

BACKGROUND: Genome-wide association studies have identified multiple genomic loci associated with coronary artery disease, but most are common variants in non-coding regions that provide limited information on causal genes and etiology of the disease. To overcome the limited scope that common variants provide, we focused our investigation on low-frequency and rare sequence variations primarily residing in coding regions of the genome.

METHODS AND RESULTS: Using samples of individuals of European ancestry from ten cohorts within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, both cross-sectional and prospective analyses were conducted to examine associations between genetic variants and myocardial infarction (MI), coronary heart disease (CHD), and all-cause mortality following these events. For prevalent events, a total of 27,349 participants of European ancestry, including 1831 prevalent MI cases and 2518 prevalent CHD cases were used. For incident cases, a total of 55,736 participants of European ancestry were included (3,031 incident MI cases and 5,425 incident CHD cases). There were 1,860 all-cause deaths among the 3,751 MI and CHD cases from six cohorts that contributed to the analysis of all-cause mortality. Single variant and gene-based analyses were performed separately in each cohort and then meta-analyzed for each outcome. A low-frequency intronic variant (rs988583) in PLCL1 was significantly associated with prevalent MI (OR = 1.80, 95% confidence interval: 1.43, 2.27; P = 7.12 × 10-7). We conducted gene-based burden tests for genes with a cumulative minor allele count (cMAC) ≥ 5 and variants with minor allele frequency (MAF) < 5%. TMPRSS5 and LDLRAD1 were significantly associated with prevalent MI and CHD, respectively, and RC3H2 and ANGPTL4 were significantly associated with incident MI and CHD, respectively. No loci were significantly associated with all-cause mortality following a MI or CHD event.

CONCLUSION: This study identified one known locus (ANGPTL4) and four new loci (PLCL1, RC3H2, TMPRSS5, and LDLRAD1) associated with cardiovascular disease risk that warrant further investigation.

%B PLoS One %V 15 %P e0230035 %8 2020 %G eng %N 11 %R 10.1371/journal.pone.0230035 %0 Journal Article %J Diabetes %D 2020 %T Genetic Studies of Leptin Concentrations Implicate Leptin in the Regulation of Early Adiposity. %A Yaghootkar, Hanieh %A Zhang, Yiying %A Spracklen, Cassandra N %A Karaderi, Tugce %A Huang, Lam Opal %A Bradfield, Jonathan %A Schurmann, Claudia %A Fine, Rebecca S %A Preuss, Michael H %A Kutalik, Zoltán %A Wittemans, Laura Bl %A Lu, Yingchang %A Metz, Sophia %A Willems, Sara M %A Li-Gao, Ruifang %A Grarup, Niels %A Wang, Shuai %A Molnos, Sophie %A Sandoval-Zárate, América A %A Nalls, Mike A %A Lange, Leslie A %A Haesser, Jeffrey %A Guo, Xiuqing %A Lyytikäinen, Leo-Pekka %A Feitosa, Mary F %A Sitlani, Colleen M %A Venturini, Cristina %A Mahajan, Anubha %A Kacprowski, Tim %A Wang, Carol A %A Chasman, Daniel I %A Amin, Najaf %A Broer, Linda %A Robertson, Neil %A Young, Kristin L %A Allison, Matthew %A Auer, Paul L %A Blüher, Matthias %A Borja, Judith B %A Bork-Jensen, Jette %A Carrasquilla, Germán D %A Christofidou, Paraskevi %A Demirkan, Ayse %A Doege, Claudia A %A Garcia, Melissa E %A Graff, Mariaelisa %A Guo, Kaiying %A Hakonarson, Hakon %A Hong, Jaeyoung %A Ida Chen, Yii-Der %A Jackson, Rebecca %A Jakupović, Hermina %A Jousilahti, Pekka %A Justice, Anne E %A Kähönen, Mika %A Kizer, Jorge R %A Kriebel, Jennifer %A LeDuc, Charles A %A Li, Jin %A Lind, Lars %A Luan, Jian'an %A Mackey, David %A Mangino, Massimo %A Männistö, Satu %A Martin Carli, Jayne F %A Medina-Gómez, Carolina %A Mook-Kanamori, Dennis O %A Morris, Andrew P %A de Mutsert, Renée %A Nauck, Matthias %A Nedeljkovic, Ivana %A Pennell, Craig E %A Pradhan, Arund D %A Psaty, Bruce M %A Raitakari, Olli T %A Scott, Robert A %A Skaaby, Tea %A Strauch, Konstantin %A Taylor, Kent D %A Teumer, Alexander %A Uitterlinden, André G %A Wu, Ying %A Yao, Jie %A Walker, Mark %A North, Kari E %A Kovacs, Peter %A Ikram, M Arfan %A van Duijn, Cornelia M %A Ridker, Paul M %A Lye, Stephen %A Homuth, Georg %A Ingelsson, Erik %A Spector, Tim D %A McKnight, Barbara %A Province, Michael A %A Lehtimäki, Terho %A Adair, Linda S %A Rotter, Jerome I %A Reiner, Alexander P %A Wilson, James G %A Harris, Tamara B %A Ripatti, Samuli %A Grallert, Harald %A Meigs, James B %A Salomaa, Veikko %A Hansen, Torben %A Willems van Dijk, Ko %A Wareham, Nicholas J %A Grant, Struan Fa %A Langenberg, Claudia %A Frayling, Timothy M %A Lindgren, Cecilia M %A Mohlke, Karen L %A Leibel, Rudolph L %A Loos, Ruth Jf %A Kilpeläinen, Tuomas O %X

Leptin influences food intake by informing the brain about the status of body fat stores. Rare mutations associated with congenital leptin deficiency cause severe early-onset obesity that can be mitigated by administering leptin. However, the role of genetic regulation of leptin in polygenic obesity remains poorly understood. We performed an exome-based analysis in up to 57,232 individuals of diverse ancestries to identify genetic variants that influence adiposity-adjusted leptin concentrations. We identify five novel variants, including four missense variants, in , and , and one intergenic variant near The missense variant Val94Met (rs17151919) in was common in individuals of African ancestry only and its association with lower leptin concentrations was specific to this ancestry (P=2x10, n=3,901). Using analyses, we show that the Met94 allele decreases leptin secretion. We also show that the Met94 allele is associated with higher BMI in young African-ancestry children but not in adults, suggesting leptin regulates early adiposity.

%B Diabetes %8 2020 Sep 11 %G eng %R 10.2337/db20-0070 %0 Journal Article %J Nat Commun %D 2020 %T {Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure %A Shah, S. %A Henry, A. %A Roselli, C. %A Lin, H. %A Sveinbj?rnsson, G. %A Fatemifar, G. %A Hedman, ?. K. %A Wilk, J. B. %A Morley, M. P. %A Chaffin, M. D. %A Helgadottir, A. %A Verweij, N. %A Dehghan, A. %A Almgren, P. %A Andersson, C. %A Aragam, K. G. %A ?rnl?v, J. %A Backman, J. D. %A Biggs, M. L. %A Bloom, H. L. %A Brandimarto, J. %A Brown, M. R. %A Buckbinder, L. %A Carey, D. J. %A Chasman, D. I. %A Chen, X. %A Chen, X. %A Chung, J. %A Chutkow, W. %A Cook, J. P. %A Delgado, G. E. %A Denaxas, S. %A Doney, A. S. %A D?rr, M. %A Dudley, S. C. %A Dunn, M. E. %A Engstr?m, G. %A Esko, T. %A Felix, S. B. %A Finan, C. %A Ford, I. %A Ghanbari, M. %A Ghasemi, S. %A Giedraitis, V. %A Giulianini, F. %A Gottdiener, J. S. %A Gross, S. %A Gu?bjartsson, D. F. %A Gutmann, R. %A Haggerty, C. M. %A van der Harst, P. %A Hyde, C. L. %A Ingelsson, E. %A Jukema, J. W. %A Kavousi, M. %A Khaw, K. T. %A Kleber, M. E. %A K?ber, L. %A Koekemoer, A. %A Langenberg, C. %A Lind, L. %A Lindgren, C. M. %A London, B. %A Lotta, L. A. %A Lovering, R. C. %A Luan, J. %A Magnusson, P. %A Mahajan, A. %A Margulies, K. B. %A M?rz, W. %A Melander, O. %A Mordi, I. R. %A Morgan, T. %A Morris, A. D. %A Morris, A. P. %A Morrison, A. C. %A Nagle, M. W. %A Nelson, C. P. %A Niessner, A. %A Niiranen, T. %A O'Donoghue, M. L. %A Owens, A. T. %A Palmer, C. N. A. %A Parry, H. M. %A Perola, M. %A Portilla-Fernandez, E. %A Psaty, B. M. %A Rice, K. M. %A Ridker, P. M. %A Romaine, S. P. R. %A Rotter, J. I. %A Salo, P. %A Salomaa, V. %A van Setten, J. %A Shalaby, A. A. %A Smelser, D. T. %A Smith, N. L. %A Stender, S. %A Stott, D. J. %A Svensson, P. %A Tammesoo, M. L. %A Taylor, K. D. %A Teder-Laving, M. %A Teumer, A. %A Thorgeirsson, G. %A Thorsteinsdottir, U. %A Torp-Pedersen, C. %A Trompet, S. %A Tyl, B. %A Uitterlinden, A. G. %A Veluchamy, A. %A V?lker, U. %A Voors, A. A. %A Wang, X. %A Wareham, N. J. %A Waterworth, D. %A Weeke, P. E. %A Weiss, R. %A Wiggins, K. L. %A Xing, H. %A Yerges-Armstrong, L. M. %A Yu, B. %A Zannad, F. %A Zhao, J. H. %A Hemingway, H. %A Samani, N. J. %A McMurray, J. J. V. %A Yang, J. %A Visscher, P. M. %A Newton-Cheh, C. %A Malarstig, A. %A Holm, H. %A Lubitz, S. A. %A Sattar, N. %A Holmes, M. V. %A Cappola, T. P. %A Asselbergs, F. W. %A Hingorani, A. D. %A Kuchenbaecker, K. %A Ellinor, P. T. %A Lang, C. C. %A Stefansson, K. %A Smith, J. G. %A Vasan, R. S. %A Swerdlow, D. I. %A Lumbers, R. T. %A Abecasis, G. %A Backman, J. %A Bai, X. %A Balasubramanian, S. %A Banerjee, N. %A Baras, A. %A Barnard, L. %A Beechert, C. %A Blumenfeld, A. %A Cantor, M. %A Chai, Y. %A Chung, J. %A Coppola, G. %A Damask, A. %A Dewey, F. %A Economides, A. %A Eom, G. %A Forsythe, C. %A Fuller, E. D. %A Gu, Z. %A Gurski, L. %A Guzzardo, P. M. %A Habegger, L. %A Hahn, Y. %A Hawes, A. %A van Hout, C. %A Jones, M. B. %A Khalid, S. %A Lattari, M. %A Li, A. %A Lin, N. %A Liu, D. %A Lopez, A. %A Manoochehri, K. %A Marchini, J. %A Marcketta, A. %A Maxwell, E. K. %A McCarthy, S. %A Mitnaul, L. J. %A O'Dushlaine, C. %A Overton, J. D. %A Padilla, M. S. %A Paulding, C. %A Penn, J. %A Pradhan, M. %A Reid, J. G. %A Schleicher, T. D. %A Schurmann, C. %A Shuldiner, A. %A Staples, J. C. %A Sun, D. %A Toledo, K. %A Ulloa, R. H. %A Widom, L. %A Wolf, S. E. %A Yadav, A. %A Ye, B. %X Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies. %B Nat Commun %V 11 %P 163 %8 01 %G eng %0 Journal Article %J Stroke %D 2020 %T {Genome-Wide Association Study Meta-Analysis of Stroke in 22 000 Individuals of African Descent Identifies Novel Associations With Stroke %A Keene, K. L. %A Hyacinth, H. I. %A Bis, J. C. %A Kittner, S. J. %A Mitchell, B. D. %A Cheng, Y. C. %A Pare, G. %A Chong, M. %A O'Donnell, M. %A Meschia, J. F. %A Chen, W. M. %A Sale, M. M. %A Rich, S. S. %A Nalls, M. A. %A Zonderman, A. B. %A Evans, M. K. %A Wilson, J. G. %A Correa, A. %A Markus, H. S. %A Traylor, M. %A Lewis, C. M. %A Carty, C. L. %A Reiner, A. %A Haessler, J. %A Langefeld, C. D. %A Gottesman, R. %A Mosley, T. H. %A Woo, D. %A Yaffe, K. %A Liu, Y. %A Longstreth, W. T. %A Psaty, B. M. %A Kooperberg, C. %A Lange, L. A. %A Sacco, R. %A Rundek, T. %A Lee, J. M. %A Cruchaga, C. %A Furie, K. L. %A Arnett, D. K. %A Benavente, O. R. %A Grewal, R. P. %A Peddareddygari, L. R. %A Dichgans, M. %A Malik, R. %A Worrall, B. B. %A Fornage, M. %X Stroke is a complex disease with multiple genetic and environmental risk factors. Blacks endure a nearly 2-fold greater risk of stroke and are 2× to 3× more likely to die from stroke than European Americans.\ The COMPASS (Consortium of Minority Population Genome-Wide Association Studies of Stroke) has conducted a genome-wide association meta-analysis of stroke in >22 000 individuals of African ancestry (3734 cases, 18 317 controls) from 13 cohorts.\ In meta-analyses, we identified one single nucleotide polymorphism (rs55931441) near the HNF1A gene that reached genome-wide significance (P=4.62×10-8) and an additional 29 variants with suggestive evidence of association (P<1×10-6), representing 24 unique loci. For validation, a look-up analysis for a 100 kb region flanking the COMPASS single nucleotide polymorphism was performed in SiGN (Stroke Genetics Network) Europeans, SiGN Hispanics, and METASTROKE (Europeans). Using a stringent Bonferroni correction P value of 2.08×10-3 (0.05/24 unique loci), we were able to validate associations at the HNF1A locus in both SiGN (P=8.18×10-4) and METASTROKE (P=1.72×10-3) European populations. Overall, 16 of 24 loci showed evidence for validation across multiple populations. Previous studies have reported associations between variants in the HNF1A gene and lipids, C-reactive protein, and risk of coronary artery disease and stroke. Suggestive associations with variants in the SFXN4 and TMEM108 genes represent potential novel ischemic stroke loci.\ These findings represent the most thorough investigation of genetic determinants of stroke in individuals of African descent, to date. %B Stroke %V 51 %P 2454–2463 %8 Aug %G eng %0 Journal Article %J BMC Med Res Methodol %D 2020 %T Incorporating sampling weights into robust estimation of Cox proportional hazards regression model, with illustration in the Multi-Ethnic Study of Atherosclerosis. %A Sitlani, Colleen M %A Lumley, Thomas %A McKnight, Barbara %A Rice, Kenneth M %A Olson, Nels C %A Doyle, Margaret F %A Huber, Sally A %A Tracy, Russell P %A Psaty, Bruce M %A C Delaney, Joseph A %X

BACKGROUND: Cox proportional hazards regression models are used to evaluate associations between exposures of interest and time-to-event outcomes in observational data. When exposures are measured on only a sample of participants, as they are in a case-cohort design, the sampling weights must be incorporated into the regression model to obtain unbiased estimating equations.

METHODS: Robust Cox methods have been developed to better estimate associations when there are influential outliers in the exposure of interest, but these robust methods do not incorporate sampling weights. In this paper, we extend these robust methods, which already incorporate influence weights, so that they also accommodate sampling weights.

RESULTS: Simulations illustrate that in the presence of influential outliers, the association estimate from the weighted robust method is closer to the true value than the estimate from traditional weighted Cox regression. As expected, in the absence of outliers, the use of robust methods yields a small loss of efficiency. Using data from a case-cohort study that is nested within the Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study, we illustrate differences between traditional and robust weighted Cox association estimates for the relationships between immune cell traits and risk of stroke.

CONCLUSIONS: Robust weighted Cox regression methods are a new tool to analyze time-to-event data with sampling, e.g. case-cohort data, when exposures of interest contain outliers.

%B BMC Med Res Methodol %V 20 %P 62 %8 2020 03 14 %G eng %N 1 %R 10.1186/s12874-020-00945-9 %0 Journal Article %J Nature %D 2020 %T Inherited causes of clonal haematopoiesis in 97,691 whole genomes. %A Bick, Alexander G %A Weinstock, Joshua S %A Nandakumar, Satish K %A Fulco, Charles P %A Bao, Erik L %A Zekavat, Seyedeh M %A Szeto, Mindy D %A Liao, Xiaotian %A Leventhal, Matthew J %A Nasser, Joseph %A Chang, Kyle %A Laurie, Cecelia %A Burugula, Bala Bharathi %A Gibson, Christopher J %A Lin, Amy E %A Taub, Margaret A %A Aguet, Francois %A Ardlie, Kristin %A Mitchell, Braxton D %A Barnes, Kathleen C %A Moscati, Arden %A Fornage, Myriam %A Redline, Susan %A Psaty, Bruce M %A Silverman, Edwin K %A Weiss, Scott T %A Palmer, Nicholette D %A Vasan, Ramachandran S %A Burchard, Esteban G %A Kardia, Sharon L R %A He, Jiang %A Kaplan, Robert C %A Smith, Nicholas L %A Arnett, Donna K %A Schwartz, David A %A Correa, Adolfo %A de Andrade, Mariza %A Guo, Xiuqing %A Konkle, Barbara A %A Custer, Brian %A Peralta, Juan M %A Gui, Hongsheng %A Meyers, Deborah A %A McGarvey, Stephen T %A Chen, Ida Yii-Der %A Shoemaker, M Benjamin %A Peyser, Patricia A %A Broome, Jai G %A Gogarten, Stephanie M %A Wang, Fei Fei %A Wong, Quenna %A Montasser, May E %A Daya, Michelle %A Kenny, Eimear E %A North, Kari E %A Launer, Lenore J %A Cade, Brian E %A Bis, Joshua C %A Cho, Michael H %A Lasky-Su, Jessica %A Bowden, Donald W %A Cupples, L Adrienne %A Mak, Angel C Y %A Becker, Lewis C %A Smith, Jennifer A %A Kelly, Tanika N %A Aslibekyan, Stella %A Heckbert, Susan R %A Tiwari, Hemant K %A Yang, Ivana V %A Heit, John A %A Lubitz, Steven A %A Johnsen, Jill M %A Curran, Joanne E %A Wenzel, Sally E %A Weeks, Daniel E %A Rao, Dabeeru C %A Darbar, Dawood %A Moon, Jee-Young %A Tracy, Russell P %A Buth, Erin J %A Rafaels, Nicholas %A Loos, Ruth J F %A Durda, Peter %A Liu, Yongmei %A Hou, Lifang %A Lee, Jiwon %A Kachroo, Priyadarshini %A Freedman, Barry I %A Levy, Daniel %A Bielak, Lawrence F %A Hixson, James E %A Floyd, James S %A Whitsel, Eric A %A Ellinor, Patrick T %A Irvin, Marguerite R %A Fingerlin, Tasha E %A Raffield, Laura M %A Armasu, Sebastian M %A Wheeler, Marsha M %A Sabino, Ester C %A Blangero, John %A Williams, L Keoki %A Levy, Bruce D %A Sheu, Wayne Huey-Herng %A Roden, Dan M %A Boerwinkle, Eric %A Manson, JoAnn E %A Mathias, Rasika A %A Desai, Pinkal %A Taylor, Kent D %A Johnson, Andrew D %A Auer, Paul L %A Kooperberg, Charles %A Laurie, Cathy C %A Blackwell, Thomas W %A Smith, Albert V %A Zhao, Hongyu %A Lange, Ethan %A Lange, Leslie %A Rich, Stephen S %A Rotter, Jerome I %A Wilson, James G %A Scheet, Paul %A Kitzman, Jacob O %A Lander, Eric S %A Engreitz, Jesse M %A Ebert, Benjamin L %A Reiner, Alexander P %A Jaiswal, Siddhartha %A Abecasis, Goncalo %A Sankaran, Vijay G %A Kathiresan, Sekar %A Natarajan, Pradeep %X

Age is the dominant risk factor for most chronic human diseases, but the mechanisms through which ageing confers this risk are largely unknown. The age-related acquisition of somatic mutations that lead to clonal expansion in regenerating haematopoietic stem cell populations has recently been associated with both haematological cancer and coronary heart disease-this phenomenon is termed clonal haematopoiesis of indeterminate potential (CHIP). Simultaneous analyses of germline and somatic whole-genome sequences provide the opportunity to identify root causes of CHIP. Here we analyse high-coverage whole-genome sequences from 97,691 participants of diverse ancestries in the National Heart, Lung, and Blood Institute Trans-omics for Precision Medicine (TOPMed) programme, and identify 4,229 individuals with CHIP. We identify associations with blood cell, lipid and inflammatory traits that are specific to different CHIP driver genes. Association of a genome-wide set of germline genetic variants enabled the identification of three genetic loci associated with CHIP status, including one locus at TET2 that was specific to individuals of African ancestry. In silico-informed in vitro evaluation of the TET2 germline locus enabled the identification of a causal variant that disrupts a TET2 distal enhancer, resulting in increased self-renewal of haematopoietic stem cells. Overall, we observe that germline genetic variation shapes haematopoietic stem cell function, leading to CHIP through mechanisms that are specific to clonal haematopoiesis as well as shared mechanisms that lead to somatic mutations across tissues.

%B Nature %V 586 %P 763-768 %8 2020 10 %G eng %N 7831 %R 10.1038/s41586-020-2819-2 %0 Journal Article %J Atherosclerosis %D 2020 %T Innate and adaptive immune cell subsets as risk factors for coronary heart disease in two population-based cohorts. %A Olson, Nels C %A Sitlani, Colleen M %A Doyle, Margaret F %A Huber, Sally A %A Landay, Alan L %A Tracy, Russell P %A Psaty, Bruce M %A Delaney, Joseph A %X

BACKGROUND AND AIMS: Cell-mediated immunity is implicated in atherosclerosis. We evaluated whether innate and adaptive immune cell subsets in peripheral blood are risk factors for coronary heart disease.

METHODS: A nested case-cohort study (n = 2155) was performed within the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS). Cases of incident myocardial infarction (MI) and incident angina (n = 880 total cases) were compared with a cohort random sample (n = 1275). Immune cell phenotypes (n = 34, including CD14 monocytes, natural killer cells, γδ T cells, CD4, CD8 and CD19 lymphocyte subsets) were measured from cryopreserved cells by flow cytometry. Cox proportional hazards models with adjustment for cardiovascular disease risk factors were used to evaluate associations of cell phenotypes with incident MI and a composite phenotype of incident MI or incident angina (MI-angina) over a median 9.3 years of follow-up. Th1, Th2, Th17, T regulatory (CD4CD25CD127), naive (CD4CD45RA), memory (CD4CD45RO), and CD4CD28 cells were specified as primary hypotheses. In secondary analyses, 27 additional cell phenotypes were investigated.

RESULTS: After correction for multiple testing, there were no statistically significant associations of CD4 naive, memory, CD28, or T helper cell subsets with MI or MI-angina in MESA, CHS, or combined-cohort meta analyses. Null associations were also observed for monocyte subsets, natural killer cells, γδ T cells, CD19 B cell and differentiated CD4 and CD8 cell subsets.

CONCLUSIONS: The proportions of peripheral blood monocyte and lymphocyte subsets are not strongly related to the future occurrence of MI or angina in adults free of autoimmune disease.

%B Atherosclerosis %V 300 %P 47-53 %8 2020 05 %G eng %R 10.1016/j.atherosclerosis.2020.03.011 %0 Journal Article %J Clin Neurol Neurosurg %D 2020 %T Long-term cognitive decline and mortality after carotid endarterectomy. %A Thirumala, Parthasarathy D %A Reddy, Rajiv P %A Lopez, Oscar L %A Chang, Yue-Fang %A Becker, James T %A Kuller, Lewis H %X

OBJECTIVES: To date no studies have evaluated long term cognitive decline after carotid endarterectomy (CEA). We evaluated whether participants who had CEA were at increased risk of cognitive decline over participants who didn't undergo CEA.

PATIENTS AND METHODS: The patients in the study were participants in the Cardiovascular Health Study (CHS), a study of 5201 men and women over the age of 65 who were recruited from four communities (Pittsburgh, Pennsylvania; Sacramento, California; Winston-Salem, North Carolina; Hagerstown, Maryland) in 1988-89. The outcomes measured were 1) Decline in 3MSE and digit symbol substitution test (DSST) scores after CEA compared to before CEA. 2) All-cause mortality in CHS cohort among participants who did and did not have CEA.

RESULTS: CEA patients had significantly greater annual decrease in the DSST scores -2.43 (SD 4.21) compared to those who did not have a CEA -1.1 (SD 2.57) (p < 0.001) but this was not seen in the 3MSE scores. CEA patients had increased the risk of decline in DSST (OR 2.41, 95 % CI 1.49, 3.88) and 3MSE (OR 2.17, 95 % CI 1.35, 3.48) scores after adjusting for age, gender, race and educational status. CEA was associated with all-cause mortality in the long term with a HR of 2.72 (95 % CI 2.22, 3.34) after adjusting for covariates. Participants with lower baseline 3MSE scores HR 1.39 (1.27, 1.51), lower DSST scores <34 HR 1.69(1.54, 1.85) were more likely deceased.

CONCLUSIONS: CEA patients are at increased risk of lower scores on 3MSE and DSST testing in the long term. Mortality in the CHS cohort was higher in participants who underwent CEA. Further, lower 3MSE and DSST scores increased the risk of mortality.

%B Clin Neurol Neurosurg %V 194 %P 105823 %8 2020 Jul %G eng %R 10.1016/j.clineuro.2020.105823 %0 Journal Article %J Lancet Respir Med %D 2020 %T Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. %A Oelsner, Elizabeth C %A Balte, Pallavi P %A Bhatt, Surya P %A Cassano, Patricia A %A Couper, David %A Folsom, Aaron R %A Freedman, Neal D %A Jacobs, David R %A Kalhan, Ravi %A Mathew, Amanda R %A Kronmal, Richard A %A Loehr, Laura R %A London, Stephanie J %A Newman, Anne B %A O'Connor, George T %A Schwartz, Joseph E %A Smith, Lewis J %A White, Wendy B %A Yende, Sachin %K Adult %K Aged %K Case-Control Studies %K Ex-Smokers %K Female %K Follow-Up Studies %K Humans %K Lung %K Male %K Middle Aged %K National Heart, Lung, and Blood Institute (U.S.) %K Non-Smokers %K Respiratory Physiological Phenomena %K Smokers %K Smoking %K Spirometry %K United States %K Young Adult %X

BACKGROUND: Former smokers now outnumber current smokers in many developed countries, and current smokers are smoking fewer cigarettes per day. Some data suggest that lung function decline normalises with smoking cessation; however, mechanistic studies suggest that lung function decline could continue. We hypothesised that former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers, including among those without prevalent lung disease.

METHODS: We used data on six US population-based cohorts included in the NHLBI Pooled Cohort Study. We restricted the sample to participants with valid spirometry at two or more exams. Two cohorts recruited younger adults (≥17 years), two recruited middle-aged and older adults (≥45 years), and two recruited only elderly adults (≥65 years) with examinations done between 1983 and 2014. FEV decline in sustained former smokers and current smokers was compared to that of never-smokers by use of mixed models adjusted for sociodemographic and anthropometric factors. Differential FEV decline was also evaluated according to duration of smoking cessation and cumulative (number of pack-years) and current (number of cigarettes per day) cigarette consumption.

FINDINGS: 25 352 participants (ages 17-93 years) completed 70 228 valid spirometry exams. Over a median follow-up of 7 years (IQR 3-20), FEV decline at the median age (57 years) was 31·01 mL per year (95% CI 30·66-31·37) in sustained never-smokers, 34·97 mL per year (34·36-35·57) in former smokers, and 39·92 mL per year (38·92-40·92) in current smokers. With adjustment, former smokers showed an accelerated FEV decline of 1·82 mL per year (95% CI 1·24-2·40) compared to never-smokers, which was approximately 20% of the effect estimate for current smokers (9·21 mL per year; 95% CI 8·35-10·08). Compared to never-smokers, accelerated FEV decline was observed in former smokers for decades after smoking cessation and in current smokers with low cumulative cigarette consumption (<10 pack-years). With respect to current cigarette consumption, the effect estimate for FEV decline in current smokers consuming less than five cigarettes per day (7·65 mL per year; 95% CI 6·21-9·09) was 68% of that in current smokers consuming 30 or more cigarettes per day (11·24 mL per year; 9·86-12·62), and around five times greater than in former smokers (1·57 mL per year; 1·00-2·14). Among participants without prevalent lung disease, associations were attenuated but were consistent with the main results.

INTERPRETATION: Former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers. These results suggest that all levels of smoking exposure are likely to be associated with lasting and progressive lung damage.

FUNDING: National Institutes of Health, National Heart Lung and Blood Institute, and US Environmental Protection Agency.

%B Lancet Respir Med %V 8 %P 34-44 %8 2020 01 %G eng %N 1 %R 10.1016/S2213-2600(19)30276-0 %0 Journal Article %J Eur J Epidemiol %D 2020 %T Mendelian randomization analysis does not support causal associations of birth weight with hypertension risk and blood pressure in adulthood. %A Zheng, Yan %A Huang, Tao %A Wang, Tiange %A Mei, Zhendong %A Sun, Zhonghan %A Zhang, Tao %A Ellervik, Christina %A Chai, Jin-Fang %A Sim, Xueling %A van Dam, Rob M %A Tai, E-Shyong %A Koh, Woon-Puay %A Dorajoo, Rajkumar %A Saw, Seang-Mei %A Sabanayagam, Charumathi %A Wong, Tien Yin %A Gupta, Preeti %A Rossing, Peter %A Ahluwalia, Tarunveer S %A Vinding, Rebecca K %A Bisgaard, Hans %A Bønnelykke, Klaus %A Wang, Yujie %A Graff, Mariaelisa %A Voortman, Trudy %A van Rooij, Frank J A %A Hofman, Albert %A van Heemst, Diana %A Noordam, Raymond %A Estampador, Angela C %A Varga, Tibor V %A Enzenbach, Cornelia %A Scholz, Markus %A Thiery, Joachim %A Burkhardt, Ralph %A Orho-Melander, Marju %A Schulz, Christina-Alexandra %A Ericson, Ulrika %A Sonestedt, Emily %A Kubo, Michiaki %A Akiyama, Masato %A Zhou, Ang %A Kilpeläinen, Tuomas O %A Hansen, Torben %A Kleber, Marcus E %A Delgado, Graciela %A McCarthy, Mark %A Lemaitre, Rozenn N %A Felix, Janine F %A Jaddoe, Vincent W V %A Wu, Ying %A Mohlke, Karen L %A Lehtimäki, Terho %A Wang, Carol A %A Pennell, Craig E %A Schunkert, Heribert %A Kessler, Thorsten %A Zeng, Lingyao %A Willenborg, Christina %A Peters, Annette %A Lieb, Wolfgang %A Grote, Veit %A Rzehak, Peter %A Koletzko, Berthold %A Erdmann, Jeanette %A Munz, Matthias %A Wu, Tangchun %A He, Meian %A Yu, Caizheng %A Lecoeur, Cécile %A Froguel, Philippe %A Corella, Dolores %A Moreno, Luis A %A Lai, Chao-Qiang %A Pitkänen, Niina %A Boreham, Colin A %A Ridker, Paul M %A Rosendaal, Frits R %A de Mutsert, Renée %A Power, Chris %A Paternoster, Lavinia %A Sørensen, Thorkild I A %A Tjønneland, Anne %A Overvad, Kim %A Djoussé, Luc %A Rivadeneira, Fernando %A Lee, Nanette R %A Raitakari, Olli T %A Kähönen, Mika %A Viikari, Jorma %A Langhendries, Jean-Paul %A Escribano, Joaquin %A Verduci, Elvira %A Dedoussis, George %A König, Inke %A Balkau, Beverley %A Coltell, Oscar %A Dallongeville, Jean %A Meirhaeghe, Aline %A Amouyel, Philippe %A Gottrand, Frédéric %A Pahkala, Katja %A Niinikoski, Harri %A Hyppönen, Elina %A März, Winfried %A Mackey, David A %A Gruszfeld, Dariusz %A Tucker, Katherine L %A Fumeron, Frédéric %A Estruch, Ramon %A Ordovas, Jose M %A Arnett, Donna K %A Mook-Kanamori, Dennis O %A Mozaffarian, Dariush %A Psaty, Bruce M %A North, Kari E %A Chasman, Daniel I %A Qi, Lu %X

Epidemiology studies suggested that low birthweight was associated with a higher risk of hypertension in later life. However, little is known about the causality of such associations. In our study, we evaluated the causal association of low birthweight with adulthood hypertension following a standard analytic protocol using the study-level data of 183,433 participants from 60 studies (CHARGE-BIG consortium), as well as that with blood pressure using publicly available summary-level genome-wide association data from EGG consortium of 153,781 participants, ICBP consortium and UK Biobank cohort together of 757,601 participants. We used seven SNPs as the instrumental variable in the study-level analysis and 47 SNPs in the summary-level analysis. In the study-level analyses, decreased birthweight was associated with a higher risk of hypertension in adults (the odds ratio per 1 standard deviation (SD) lower birthweight, 1.22; 95% CI 1.16 to 1.28), while no association was found between genetically instrumented birthweight and hypertension risk (instrumental odds ratio for causal effect per 1 SD lower birthweight, 0.97; 95% CI 0.68 to 1.41). Such results were consistent with that from the summary-level analyses, where the genetically determined low birthweight was not associated with blood pressure measurements either. One SD lower genetically determined birthweight was not associated with systolic blood pressure (β = - 0.76, 95% CI - 2.45 to 1.08 mmHg), 0.06 mmHg lower diastolic blood pressure (β = - 0.06, 95% CI - 0.93 to 0.87 mmHg), or pulse pressure (β = - 0.65, 95% CI - 1.38 to 0.69 mmHg, all p > 0.05). Our findings suggest that the inverse association of birthweight with hypertension risk from observational studies was not supported by large Mendelian randomization analyses.

%B Eur J Epidemiol %V 35 %P 685-697 %8 2020 Jul %G eng %N 7 %R 10.1007/s10654-020-00638-z %0 Journal Article %J Kidney Int %D 2020 %T Meta-analysis uncovers genome-wide significant variants for rapid kidney function decline. %A Gorski, Mathias %A Jung, Bettina %A Li, Yong %A Matias-Garcia, Pamela R %A Wuttke, Matthias %A Coassin, Stefan %A Thio, Chris H L %A Kleber, Marcus E %A Winkler, Thomas W %A Wanner, Veronika %A Chai, Jin-Fang %A Chu, Audrey Y %A Cocca, Massimiliano %A Feitosa, Mary F %A Ghasemi, Sahar %A Hoppmann, Anselm %A Horn, Katrin %A Li, Man %A Nutile, Teresa %A Scholz, Markus %A Sieber, Karsten B %A Teumer, Alexander %A Tin, Adrienne %A Wang, Judy %A Tayo, Bamidele O %A Ahluwalia, Tarunveer S %A Almgren, Peter %A Bakker, Stephan J L %A Banas, Bernhard %A Bansal, Nisha %A Biggs, Mary L %A Boerwinkle, Eric %A Bottinger, Erwin P %A Brenner, Hermann %A Carroll, Robert J %A Chalmers, John %A Chee, Miao-Li %A Chee, Miao-Ling %A Cheng, Ching-Yu %A Coresh, Josef %A de Borst, Martin H %A Degenhardt, Frauke %A Eckardt, Kai-Uwe %A Endlich, Karlhans %A Franke, Andre %A Freitag-Wolf, Sandra %A Gampawar, Piyush %A Gansevoort, Ron T %A Ghanbari, Mohsen %A Gieger, Christian %A Hamet, Pavel %A Ho, Kevin %A Hofer, Edith %A Holleczek, Bernd %A Xian Foo, Valencia Hui %A Hutri-Kähönen, Nina %A Hwang, Shih-Jen %A Ikram, M Arfan %A Josyula, Navya Shilpa %A Kähönen, Mika %A Khor, Chiea-Chuen %A Koenig, Wolfgang %A Kramer, Holly %A Krämer, Bernhard K %A Kuhnel, Brigitte %A Lange, Leslie A %A Lehtimäki, Terho %A Lieb, Wolfgang %A Loos, Ruth J F %A Lukas, Mary Ann %A Lyytikäinen, Leo-Pekka %A Meisinger, Christa %A Meitinger, Thomas %A Melander, Olle %A Milaneschi, Yuri %A Mishra, Pashupati P %A Mononen, Nina %A Mychaleckyj, Josyf C %A Nadkarni, Girish N %A Nauck, Matthias %A Nikus, Kjell %A Ning, Boting %A Nolte, Ilja M %A O'Donoghue, Michelle L %A Orho-Melander, Marju %A Pendergrass, Sarah A %A Penninx, Brenda W J H %A Preuss, Michael H %A Psaty, Bruce M %A Raffield, Laura M %A Raitakari, Olli T %A Rettig, Rainer %A Rheinberger, Myriam %A Rice, Kenneth M %A Rosenkranz, Alexander R %A Rossing, Peter %A Rotter, Jerome I %A Sabanayagam, Charumathi %A Schmidt, Helena %A Schmidt, Reinhold %A Schöttker, Ben %A Schulz, Christina-Alexandra %A Sedaghat, Sanaz %A Shaffer, Christian M %A Strauch, Konstantin %A Szymczak, Silke %A Taylor, Kent D %A Tremblay, Johanne %A Chaker, Layal %A van der Harst, Pim %A van der Most, Peter J %A Verweij, Niek %A Völker, Uwe %A Waldenberger, Melanie %A Wallentin, Lars %A Waterworth, Dawn M %A White, Harvey D %A Wilson, James G %A Wong, Tien-Yin %A Woodward, Mark %A Yang, Qiong %A Yasuda, Masayuki %A Yerges-Armstrong, Laura M %A Zhang, Yan %A Snieder, Harold %A Wanner, Christoph %A Böger, Carsten A %A Köttgen, Anna %A Kronenberg, Florian %A Pattaro, Cristian %A Heid, Iris M %X

Rapid decline of glomerular filtration rate estimated from creatinine (eGFRcrea) is associated with severe clinical endpoints. In contrast to cross-sectionally assessed eGFRcrea, the genetic basis for rapid eGFRcrea decline is largely unknown. To help define this, we meta-analyzed 42 genome-wide association studies from the Chronic Kidney Diseases Genetics Consortium and United Kingdom Biobank to identify genetic loci for rapid eGFRcrea decline. Two definitions of eGFRcrea decline were used: 3 mL/min/1.73m/year or more ("Rapid3"; encompassing 34,874 cases, 107,090 controls) and eGFRcrea decline 25% or more and eGFRcrea under 60 mL/min/1.73m at follow-up among those with eGFRcrea 60 mL/min/1.73m or more at baseline ("CKDi25"; encompassing 19,901 cases, 175,244 controls). Seven independent variants were identified across six loci for Rapid3 and/or CKDi25: consisting of five variants at four loci with genome-wide significance (near UMOD-PDILT (2), PRKAG2, WDR72, OR2S2) and two variants among 265 known eGFRcrea variants (near GATM, LARP4B). All these loci were novel for Rapid3 and/or CKDi25 and our bioinformatic follow-up prioritized variants and genes underneath these loci. The OR2S2 locus is novel for any eGFRcrea trait including interesting candidates. For the five genome-wide significant lead variants, we found supporting effects for annual change in blood urea nitrogen or cystatin-based eGFR, but not for GATM or LARP4B. Individuals at high compared to those at low genetic risk (8-14 vs 0-5 adverse alleles) had a 1.20-fold increased risk of acute kidney injury (95% confidence interval 1.08-1.33). Thus, our identified loci for rapid kidney function decline may help prioritize therapeutic targets and identify mechanisms and individuals at risk for sustained deterioration of kidney function.

%B Kidney Int %8 2020 Oct 30 %G eng %R 10.1016/j.kint.2020.09.030 %0 Journal Article %J BMC Med %D 2020 %T {Mitochondrial DNA copy number and incident atrial fibrillation %A Zhao, D. %A Bartz, T. M. %A Sotoodehnia, N. %A Post, W. S. %A Heckbert, S. R. %A Alonso, A. %A Longchamps, R. J. %A Castellani, C. A. %A Hong, Y. S. %A Rotter, J. I. %A Lin, H. J. %A O'Rourke, B. %A Pankratz, N. %A Lane, J. A. %A Yang, S. Y. %A Guallar, E. %A Arking, D. E. %X Mechanistic studies suggest that mitochondria DNA (mtDNA) dysfunction may be associated with increased risk of atrial fibrillation (AF). The association between mtDNA copy number (mtDNA-CN) and incident AF in the general population, however, remains unknown.\ We conducted prospective analyses of 19,709 participants from the Atherosclerosis Risk in Communities Study (ARIC), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Cardiovascular Health Study (CHS). mtDNA-CN from the peripheral blood was calculated from probe intensities on the Affymetrix Genome-Wide Human single nucleotide polymorphisms (SNP) Array 6.0 in ARIC and MESA and from multiplexed real-time quantitative polymerase chain reaction (qPCR) in CHS. Incident AF cases were identified through electrocardiograms, review of hospital discharge codes, Medicare claims, and death certificates.\ The median follow-up time was 21.4 years in ARIC, 12.9 years in MESA, and 11.0 years in CHS, during which 4021 participants developed incident atrial fibrillation (1761 in ARIC, 790 in MESA, and 1470 in CHS). In fully adjusted models, participants with the lowest quintile of mitochondria DNA copy number had an overall 13% increased risk (95% CI 1 to 27%) of incident atrial fibrillation compared to those with the highest quintile. Dose-response spline analysis also showed an inverse association between mitochondria DNA copy number and hazard for atrial fibrillation for all three cohorts. These associations were consistent across subgroups.\ Mitochondria DNA copy number was inversely associated with the risk of AF independent of traditional cardiovascular risk factors. These findings implicate mitochondria DNA copy number as a novel risk factor for atrial fibrillation. Further research is warranted to understand the underlying mechanisms and to evaluate the role of mitochondria DNA copy number in the management of atrial fibrillation risk. %B BMC Med %V 18 %P 246 %8 Sep %G eng %0 Journal Article %J Genome Med %D 2020 %T Mitochondrial DNA copy number can influence mortality and cardiovascular disease via methylation of nuclear DNA CpGs. %A Castellani, Christina A %A Longchamps, Ryan J %A Sumpter, Jason A %A Newcomb, Charles E %A Lane, John A %A Grove, Megan L %A Bressler, Jan %A Brody, Jennifer A %A Floyd, James S %A Bartz, Traci M %A Taylor, Kent D %A Wang, Penglong %A Tin, Adrienne %A Coresh, Josef %A Pankow, James S %A Fornage, Myriam %A Guallar, Eliseo %A O'Rourke, Brian %A Pankratz, Nathan %A Liu, Chunyu %A Levy, Daniel %A Sotoodehnia, Nona %A Boerwinkle, Eric %A Arking, Dan E %X

BACKGROUND: Mitochondrial DNA copy number (mtDNA-CN) has been associated with a variety of aging-related diseases, including all-cause mortality. However, the mechanism by which mtDNA-CN influences disease is not currently understood. One such mechanism may be through regulation of nuclear gene expression via the modification of nuclear DNA (nDNA) methylation.

METHODS: To investigate this hypothesis, we assessed the relationship between mtDNA-CN and nDNA methylation in 2507 African American (AA) and European American (EA) participants from the Atherosclerosis Risk in Communities (ARIC) study. To validate our findings, we assayed an additional 2528 participants from the Cardiovascular Health Study (CHS) (N = 533) and Framingham Heart Study (FHS) (N = 1995). We further assessed the effect of experimental modification of mtDNA-CN through knockout of TFAM, a regulator of mtDNA replication, via CRISPR-Cas9.

RESULTS: Thirty-four independent CpGs were associated with mtDNA-CN at genome-wide significance (P < 5 × 10). Meta-analysis across all cohorts identified six mtDNA-CN-associated CpGs at genome-wide significance (P < 5 × 10). Additionally, over half of these CpGs were associated with phenotypes known to be associated with mtDNA-CN, including coronary heart disease, cardiovascular disease, and mortality. Experimental modification of mtDNA-CN demonstrated that modulation of mtDNA-CN results in changes in nDNA methylation and gene expression of specific CpGs and nearby transcripts. Strikingly, the "neuroactive ligand receptor interaction" KEGG pathway was found to be highly overrepresented in the ARIC cohort (P = 5.24 × 10), as well as the TFAM knockout methylation (P = 4.41 × 10) and expression (P = 4.30 × 10) studies.

CONCLUSIONS: These results demonstrate that changes in mtDNA-CN influence nDNA methylation at specific loci and result in differential expression of specific genes that may impact human health and disease via altered cell signaling.

%B Genome Med %V 12 %P 84 %8 2020 Sep 28 %G eng %N 1 %R 10.1186/s13073-020-00778-7 %0 Journal Article %J Nat Commun %D 2020 %T Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction. %A Ntalla, Ioanna %A Weng, Lu-Chen %A Cartwright, James H %A Hall, Amelia Weber %A Sveinbjornsson, Gardar %A Tucker, Nathan R %A Choi, Seung Hoan %A Chaffin, Mark D %A Roselli, Carolina %A Barnes, Michael R %A Mifsud, Borbala %A Warren, Helen R %A Hayward, Caroline %A Marten, Jonathan %A Cranley, James J %A Concas, Maria Pina %A Gasparini, Paolo %A Boutin, Thibaud %A Kolcic, Ivana %A Polasek, Ozren %A Rudan, Igor %A Araujo, Nathalia M %A Lima-Costa, Maria Fernanda %A Ribeiro, Antonio Luiz P %A Souza, Renan P %A Tarazona-Santos, Eduardo %A Giedraitis, Vilmantas %A Ingelsson, Erik %A Mahajan, Anubha %A Morris, Andrew P %A del Greco M, Fabiola %A Foco, Luisa %A Gögele, Martin %A Hicks, Andrew A %A Cook, James P %A Lind, Lars %A Lindgren, Cecilia M %A Sundström, Johan %A Nelson, Christopher P %A Riaz, Muhammad B %A Samani, Nilesh J %A Sinagra, Gianfranco %A Ulivi, Sheila %A Kähönen, Mika %A Mishra, Pashupati P %A Mononen, Nina %A Nikus, Kjell %A Caulfield, Mark J %A Dominiczak, Anna %A Padmanabhan, Sandosh %A Montasser, May E %A O'Connell, Jeff R %A Ryan, Kathleen %A Shuldiner, Alan R %A Aeschbacher, Stefanie %A Conen, David %A Risch, Lorenz %A Thériault, Sébastien %A Hutri-Kähönen, Nina %A Lehtimäki, Terho %A Lyytikäinen, Leo-Pekka %A Raitakari, Olli T %A Barnes, Catriona L K %A Campbell, Harry %A Joshi, Peter K %A Wilson, James F %A Isaacs, Aaron %A Kors, Jan A %A van Duijn, Cornelia M %A Huang, Paul L %A Gudnason, Vilmundur %A Harris, Tamara B %A Launer, Lenore J %A Smith, Albert V %A Bottinger, Erwin P %A Loos, Ruth J F %A Nadkarni, Girish N %A Preuss, Michael H %A Correa, Adolfo %A Mei, Hao %A Wilson, James %A Meitinger, Thomas %A Müller-Nurasyid, Martina %A Peters, Annette %A Waldenberger, Melanie %A Mangino, Massimo %A Spector, Timothy D %A Rienstra, Michiel %A van de Vegte, Yordi J %A van der Harst, Pim %A Verweij, Niek %A Kääb, Stefan %A Schramm, Katharina %A Sinner, Moritz F %A Strauch, Konstantin %A Cutler, Michael J %A Fatkin, Diane %A London, Barry %A Olesen, Morten %A Roden, Dan M %A Benjamin Shoemaker, M %A Gustav Smith, J %A Biggs, Mary L %A Bis, Joshua C %A Brody, Jennifer A %A Psaty, Bruce M %A Rice, Kenneth %A Sotoodehnia, Nona %A De Grandi, Alessandro %A Fuchsberger, Christian %A Pattaro, Cristian %A Pramstaller, Peter P %A Ford, Ian %A Wouter Jukema, J %A Macfarlane, Peter W %A Trompet, Stella %A Dörr, Marcus %A Felix, Stephan B %A Völker, Uwe %A Weiss, Stefan %A Havulinna, Aki S %A Jula, Antti %A Sääksjärvi, Katri %A Salomaa, Veikko %A Guo, Xiuqing %A Heckbert, Susan R %A Lin, Henry J %A Rotter, Jerome I %A Taylor, Kent D %A Yao, Jie %A de Mutsert, Renée %A Maan, Arie C %A Mook-Kanamori, Dennis O %A Noordam, Raymond %A Cucca, Francesco %A Ding, Jun %A Lakatta, Edward G %A Qian, Yong %A Tarasov, Kirill V %A Levy, Daniel %A Lin, Honghuang %A Newton-Cheh, Christopher H %A Lunetta, Kathryn L %A Murray, Alison D %A Porteous, David J %A Smith, Blair H %A Stricker, Bruno H %A Uitterlinden, Andre %A van den Berg, Marten E %A Haessler, Jeffrey %A Jackson, Rebecca D %A Kooperberg, Charles %A Peters, Ulrike %A Reiner, Alexander P %A Whitsel, Eric A %A Alonso, Alvaro %A Arking, Dan E %A Boerwinkle, Eric %A Ehret, Georg B %A Soliman, Elsayed Z %A Avery, Christy L %A Gogarten, Stephanie M %A Kerr, Kathleen F %A Laurie, Cathy C %A Seyerle, Amanda A %A Stilp, Adrienne %A Assa, Solmaz %A Abdullah Said, M %A Yldau van der Ende, M %A Lambiase, Pier D %A Orini, Michele %A Ramirez, Julia %A Van Duijvenboden, Stefan %A Arnar, David O %A Gudbjartsson, Daniel F %A Holm, Hilma %A Sulem, Patrick %A Thorleifsson, Gudmar %A Thorolfsdottir, Rosa B %A Thorsteinsdottir, Unnur %A Benjamin, Emelia J %A Tinker, Andrew %A Stefansson, Kari %A Ellinor, Patrick T %A Jamshidi, Yalda %A Lubitz, Steven A %A Munroe, Patricia B %X

The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N = 293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.5% to 62.6%. We observe enrichment for cardiac muscle developmental/contractile and cytoskeletal genes, highlighting key regulation processes for atrioventricular conduction. Additionally, 8 loci not previously reported harbor genes underlying inherited arrhythmic syndromes and/or cardiomyopathies suggesting a role for these genes in cardiovascular pathology in the general population. We show that polygenic predisposition to PR interval duration is an endophenotype for cardiovascular disease, including distal conduction disease, AF, and atrioventricular pre-excitation. These findings advance our understanding of the polygenic basis of cardiac conduction, and the genetic relationship between PR interval duration and cardiovascular disease.

%B Nat Commun %V 11 %P 2542 %8 2020 May 21 %G eng %N 1 %R 10.1038/s41467-020-15706-x %0 Journal Article %J Neurology %D 2020 %T Orthostatic Hypotension, Dizziness, Neurology Outcomes, and Death in Older Adults. %A Juraschek, Stephen P %A Longstreth, W T %A Lopez, Oscar L %A Gottdiener, John S %A Lipsitz, Lewis A %A Kuller, Lewis H %A Mukamal, Kenneth J %X

OBJECTIVE: To test the hypothesis that orthostatic hypotension (OH) might cause cerebral hypoperfusion and injury, we examined the longitudinal relationship between orthostatic hypotension (OH) or orthostatic symptoms and incident neurologic outcomes in a community population of older adults.

METHODS: Cardiovascular Health Study (CHS) participants (≥65yrs) without dementia or stroke had blood pressure (BP) measured after lying 20-minutes and after standing 3-minutes. Participants reported dizziness immediately upon standing and any dizziness in the past 2wks. OH was defined as a drop in standing systolic/diastolic BP ≥20/≥10mmHg. We determined the association between OH or dizziness with (1) MRI brain findings (ventricular size, white matter hyperintensities, brain infarcts) using linear or logistic regression, (2) cognitive function (baseline and over time) using generalized estimating equations, and (3) prospective adjudicated events (dementia, stroke, death) using Cox models. Models were adjusted for demographic characteristics and OH risk factors. We used multiple imputation to account for missing OH or dizziness (N=534).

RESULTS: Prior to imputation, there were 5,007 participants (mean age 72.7±5.5yrs, 57.6% women, 10.9% black, 16% with OH). OH was modestly associated with death (HR=1.11; 95%CI:1.02,1.20), but not MRI findings, cognition, dementia, or stroke. In contrast, dizziness upon standing was associated with lower baseline cognition (β=-1.20;-1.94,-0.47), incident dementia (HR=1.32;1.04,1.62), incident stroke (HR=1.22;1.06,1.41), and death (HR=1.13; 1.06,1.21). Similarly, dizziness over the past two weeks was associated with higher white matter grade (β=0.16;0.03,0.30), brain infarcts (OR=1.31;1.06,1.63), lower baseline cognition (β=-1.18;-2.01,-0.34), and death (HR=1.13;1.04,1.22).

CONCLUSIONS: Dizziness was more consistently associated with neurologic outcomes than OH 3-minutes after standing. Delayed OH assessments may miss pathologic information related to cerebral injury.

%B Neurology %8 2020 Jul 30 %G eng %R 10.1212/WNL.0000000000010456 %0 Journal Article %J JAMA Netw Open %D 2020 %T Performance of the Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Body Mass Index. %A Khera, Rohan %A Pandey, Ambarish %A Ayers, Colby R %A Carnethon, Mercedes R %A Greenland, Philip %A Ndumele, Chiadi E %A Nambi, Vijay %A Seliger, Stephen L %A Chaves, Paulo H M %A Safford, Monika M %A Cushman, Mary %A Xanthakis, Vanessa %A Vasan, Ramachandran S %A Mentz, Robert J %A Correa, Adolfo %A Lloyd-Jones, Donald M %A Berry, Jarett D %A de Lemos, James A %A Neeland, Ian J %K Adult %K Aged %K Body Mass Index %K Cardiovascular Diseases %K Cohort Studies %K Correlation of Data %K Female %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Proportional Hazards Models %K Prospective Studies %K Risk Assessment %K Risk Factors %X

Importance: Obesity is a global health challenge and a risk factor for atherosclerotic cardiovascular disease (ASVCD). Performance of the pooled cohort equations (PCE) for ASCVD risk by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) is unknown.

Objective: To assess performance of the PCE across clinical BMI categories.

Design, Setting, and Participants: This cohort study used pooled individual-level data from 8 community-based, prospective, longitudinal cohort studies with 10-year ASCVD event follow-up from 1996 to 2016. We included all adults ages 40 to 79 years without baseline ASCVD or statin use, resulting in a sample size of 37 311 participants. Data were analyzed from August 2017 to July 2020.

Exposures: Participant BMI category: underweight (<18.5), normal weight (18.5 to <25), overweight (25 to <30), mild obesity (30 to <35), and moderate to severe obesity (≥35).

Main Outcomes and Measures: Discrimination (Harrell C statistic) and calibration (Nam-D'Agostino χ2 goodness-of-fit test) of the PCE across BMI categories. Improvement in discrimination and net reclassification with addition of BMI, waist circumference, and high-sensitivity C-reactive protein (hsCRP) to the PCE.

Results: Among 37 311 participants (mean [SD] age, 58.6 [11.8] years; 21 897 [58.7%] women), 380 604 person-years of follow-up were conducted. Mean (SD) baseline BMI was 29.0 (6.2), and 360 individuals (1.0%) were in the underweight category, 9937 individuals (26.6%) were in the normal weight category, 13 601 individuals (36.4%) were in the overweight category, 7783 individuals (20.9%) were in the mild obesity category, and 5630 individuals (15.1%) were in the moderate to severe obesity category. Median (interquartile range [IQR]) 10-year estimated ASCVD risk was 7.1% (2.5%-15.4%), and 3709 individuals (9.9%) developed ASCVD over a median (IQR) 10.8 [8.5-12.6] years. The PCE overestimated ASCVD risk in the overall cohort (estimated/observed [E/O] risk ratio, 1.22; 95% CI, 1.18-1.26) and across all BMI categories except the underweight category. Calibration was better near the clinical decision threshold in all BMI groups but worse among individuals with moderate or severe obesity (E/O risk ratio, 1.36; 95% CI, 1.25-1.47) and among those with the highest estimated ASCVD risk ≥20%. The PCE C statistic overall was 0.760 (95% CI, 0.753-0.767), with lower discrimination in the moderate or severe obesity group (C statistic, 0.742; 95% CI, 0.721-0.763) compared with the normal-range BMI group (C statistic, 0.785; 95% CI, 0.772-0.798). Waist circumference (hazard ratio, 1.07 per 1-SD increase; 95% CI, 1.03-1.11) and hsCRP (hazard ratio, 1.07 per 1-SD increase; 95% CI, 1.05-1.09), but not BMI, were associated with increased ASCVD risk when added to the PCE. However, these factors did not improve model performance (C statistic, 0.760; 95% CI, 0.753-0.767) with or without added metrics.

Conclusions and Relevance: These findings suggest that the PCE had acceptable model discrimination and were well calibrated at clinical decision thresholds but overestimated risk of ASCVD for individuals in overweight and obese categories, particularly individuals with high estimated risk. Incorporation of the usual clinical measures of obesity did not improve risk estimation of the PCE. Future research is needed to determine whether incorporation of alternative high-risk obesity markers (eg, weight trajectory or measures of visceral or ectopic fat) into the PCE may improve risk prediction.

%B JAMA Netw Open %V 3 %P e2023242 %8 2020 10 01 %G eng %N 10 %R 10.1001/jamanetworkopen.2020.23242 %0 Journal Article %J J Am Heart Assoc %D 2020 %T Plasma Ceramides and Sphingomyelins in Relation to Atrial Fibrillation Risk: The Cardiovascular Health Study. %A Jensen, Paul N %A Fretts, Amanda M %A Hoofnagle, Andrew N %A Sitlani, Colleen M %A McKnight, Barbara %A King, Irena B %A Siscovick, David S %A Psaty, Bruce M %A Heckbert, Susan R %A Mozaffarian, Dariush %A Sotoodehnia, Nona %A Lemaitre, Rozenn N %X

Background Ceramides exhibit multiple biological activities that may influence the pathophysiological characteristics of atrial fibrillation (AF). Whether the length of the saturated fatty acid carried by the ceramide or their sphingomyelin precursors are associated with AF risk is not known. Methods and Results Among 4206 CHS (Cardiovascular Health Study) participants (mean age, 76 years; 40% men) who were free of prevalent AF at baseline, we identified 1198 incident AF cases over a median 8.7 years of follow-up. We examined 8 sphingolipid species: ceramide and sphingomyelin species with palmitic acid and species with very-long-chain saturated fatty acids: arachidic; behenic; and lignoceric. In adjusted Cox regression analyses, ceramides and sphingomyelins with very-long-chain saturated fatty acids were associated with reduced AF risk (ie, per 2-fold higher ceramide with behenic acid hazard ratio, 0.71; 95% CI, 0.59-0.86; sphingomyelin with behenic acid hazard ratio, 0.60; 95% CI, 0.46-0.77). In contrast, ceramides and sphingomyelins with palmitic acid were associated with increased AF risk (ceramide with palmitic acid hazard ratio, 1.31; 95% CI, 1.03-1.66; sphingomyelin with palmitic acid hazard ratio, 1.73; 95% CI, 1.18-2.55). Associations were attenuated with adjustment for NT-proBNP (N-terminal pro-B-type natriuretic peptide), but did not differ significantly by age, sex, race, body mass index, or history of coronary heart disease. Conclusions Our findings suggest that several ceramide and sphingomyelin species are associated with incident AF, and that these associations differ on the basis of the fatty acid. Ceramides and sphingomyelins with palmitic acid were associated with increased AF risk, whereas ceramides and sphingomyelins with very-long-chain saturated fatty acids were associated with reduced AF risk.

%B J Am Heart Assoc %V 9 %P e012853 %8 2020 Feb 18 %G eng %N 4 %R 10.1161/JAHA.119.012853 %0 Journal Article %J Cell %D 2020 %T The Polygenic and Monogenic Basis of Blood Traits and Diseases. %A Vuckovic, Dragana %A Bao, Erik L %A Akbari, Parsa %A Lareau, Caleb A %A Mousas, Abdou %A Jiang, Tao %A Chen, Ming-Huei %A Raffield, Laura M %A Tardaguila, Manuel %A Huffman, Jennifer E %A Ritchie, Scott C %A Megy, Karyn %A Ponstingl, Hannes %A Penkett, Christopher J %A Albers, Patrick K %A Wigdor, Emilie M %A Sakaue, Saori %A Moscati, Arden %A Manansala, Regina %A Lo, Ken Sin %A Qian, Huijun %A Akiyama, Masato %A Bartz, Traci M %A Ben-Shlomo, Yoav %A Beswick, Andrew %A Bork-Jensen, Jette %A Bottinger, Erwin P %A Brody, Jennifer A %A van Rooij, Frank J A %A Chitrala, Kumaraswamy N %A Wilson, Peter W F %A Choquet, Helene %A Danesh, John %A Di Angelantonio, Emanuele %A Dimou, Niki %A Ding, Jingzhong %A Elliott, Paul %A Esko, Tõnu %A Evans, Michele K %A Felix, Stephan B %A Floyd, James S %A Broer, Linda %A Grarup, Niels %A Guo, Michael H %A Guo, Qi %A Greinacher, Andreas %A Haessler, Jeff %A Hansen, Torben %A Howson, Joanna M M %A Huang, Wei %A Jorgenson, Eric %A Kacprowski, Tim %A Kähönen, Mika %A Kamatani, Yoichiro %A Kanai, Masahiro %A Karthikeyan, Savita %A Koskeridis, Fotios %A Lange, Leslie A %A Lehtimäki, Terho %A Linneberg, Allan %A Liu, Yongmei %A Lyytikäinen, Leo-Pekka %A Manichaikul, Ani %A Matsuda, Koichi %A Mohlke, Karen L %A Mononen, Nina %A Murakami, Yoshinori %A Nadkarni, Girish N %A Nikus, Kjell %A Pankratz, Nathan %A Pedersen, Oluf %A Preuss, Michael %A Psaty, Bruce M %A Raitakari, Olli T %A Rich, Stephen S %A Rodriguez, Benjamin A T %A Rosen, Jonathan D %A Rotter, Jerome I %A Schubert, Petra %A Spracklen, Cassandra N %A Surendran, Praveen %A Tang, Hua %A Tardif, Jean-Claude %A Ghanbari, Mohsen %A Völker, Uwe %A Völzke, Henry %A Watkins, Nicholas A %A Weiss, Stefan %A Cai, Na %A Kundu, Kousik %A Watt, Stephen B %A Walter, Klaudia %A Zonderman, Alan B %A Cho, Kelly %A Li, Yun %A Loos, Ruth J F %A Knight, Julian C %A Georges, Michel %A Stegle, Oliver %A Evangelou, Evangelos %A Okada, Yukinori %A Roberts, David J %A Inouye, Michael %A Johnson, Andrew D %A Auer, Paul L %A Astle, William J %A Reiner, Alexander P %A Butterworth, Adam S %A Ouwehand, Willem H %A Lettre, Guillaume %A Sankaran, Vijay G %A Soranzo, Nicole %X

Blood cells play essential roles in human health, underpinning physiological processes such as immunity, oxygen transport, and clotting, which when perturbed cause a significant global health burden. Here we integrate data from UK Biobank and a large-scale international collaborative effort, including data for 563,085 European ancestry participants, and discover 5,106 new genetic variants independently associated with 29 blood cell phenotypes covering a range of variation impacting hematopoiesis. We holistically characterize the genetic architecture of hematopoiesis, assess the relevance of the omnigenic model to blood cell phenotypes, delineate relevant hematopoietic cell states influenced by regulatory genetic variants and gene networks, identify novel splice-altering variants mediating the associations, and assess the polygenic prediction potential for blood traits and clinical disorders at the interface of complex and Mendelian genetics. These results show the power of large-scale blood cell trait GWAS to interrogate clinically meaningful variants across a wide allelic spectrum of human variation.

%B Cell %V 182 %P 1214-1231.e11 %8 2020 Sep 03 %G eng %N 5 %R 10.1016/j.cell.2020.08.008 %0 Journal Article %J Circ Genom Precis Med %D 2020 %T Role of Rare and Low-Frequency Variants in Gene-Alcohol Interactions on Plasma Lipid Levels. %A Wang, Zhe %A Chen, Han %A Bartz, Traci M %A Bielak, Lawrence F %A Chasman, Daniel I %A Feitosa, Mary F %A Franceschini, Nora %A Guo, Xiuqing %A Lim, Elise %A Noordam, Raymond %A Richard, Melissa A %A Wang, Heming %A Cade, Brian %A Cupples, L Adrienne %A de Vries, Paul S %A Giulanini, Franco %A Lee, Jiwon %A Lemaitre, Rozenn N %A Martin, Lisa W %A Reiner, Alex P %A Rich, Stephen S %A Schreiner, Pamela J %A Sidney, Stephen %A Sitlani, Colleen M %A Smith, Jennifer A %A Willems van Dijk, Ko %A Yao, Jie %A Zhao, Wei %A Fornage, Myriam %A Kardia, Sharon L R %A Kooperberg, Charles %A Liu, Ching-Ti %A Mook-Kanamori, Dennis O %A Province, Michael A %A Psaty, Bruce M %A Redline, Susan %A Ridker, Paul M %A Rotter, Jerome I %A Boerwinkle, Eric %A Morrison, Alanna C %X

BACKGROUND: Alcohol intake influences plasma lipid levels, and such effects may be moderated by genetic variants. We aimed to characterize the role of aggregated rare and low-frequency protein-coding variants in gene by alcohol consumption interactions associated with fasting plasma lipid levels.

METHODS: In the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, fasting plasma triglycerides and high- and low-density lipoprotein cholesterol were measured in 34 153 individuals with European ancestry from 5 discovery studies and 32 277 individuals from 6 replication studies. Rare and low-frequency functional protein-coding variants (minor allele frequency, ≤5%) measured by an exome array were aggregated by genes and evaluated by a gene-environment interaction test and a joint test of genetic main and gene-environment interaction effects. Two dichotomous self-reported alcohol consumption variables, current drinker, defined as any recurrent drinking behavior, and regular drinker, defined as the subset of current drinkers who consume at least 2 drinks per week, were considered.

RESULTS: We discovered and replicated 21 gene-lipid associations at 13 known lipid loci through the joint test. Eight loci (, , , , , , , and ) remained significant after conditioning on the common index single-nucleotide polymorphism identified by previous genome-wide association studies, suggesting an independent role for rare and low-frequency variants at these loci. One significant gene-alcohol interaction on triglycerides in a novel locus was significantly discovered (=6.65×10 for the interaction test) and replicated at nominal significance level (=0.013) in .

CONCLUSIONS: In conclusion, this study applied new gene-based statistical approaches and suggested that rare and low-frequency genetic variants interacted with alcohol consumption on lipid levels.

%B Circ Genom Precis Med %V 13 %P e002772 %8 2020 Aug %G eng %N 4 %R 10.1161/CIRCGEN.119.002772 %0 Journal Article %J J Am Heart Assoc %D 2020 %T Serial Biomarkers of De Novo Lipogenesis Fatty Acids and Incident Heart Failure in Older Adults: The Cardiovascular Health Study. %A Lee, Yujin %A Lai, Heidi T M %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A McKnight, Barbara %A King, Irena B %A Song, Xiaoling %A Huggins, Gordon S %A Vest, Amanda R %A Siscovick, David S %A Mozaffarian, Dariush %X

Background De novo lipogenesis (DNL) is an endogenous pathway that converts excess dietary starch, sugar, protein, and alcohol into specific fatty acids (FAs). Although elevated DNL is linked to several metabolic abnormalities, little is known about how long-term habitual levels and changes in levels of FAs in the DNL pathway relate to incident heart failure (HF). Methods and Results We investigated whether habitual levels and changes in serial measures of FAs in the DNL pathway were associated with incident HF among 4249 participants free of HF at baseline. Plasma phospholipid FAs were measured at baseline, 6 years, and 13 years using gas chromatography, and risk factors for HF were measured using standardized methods. Incident HF was centrally adjudicated using medical records. We prospectively evaluated associations with HF risk of (1) habitual FA levels, using cumulative updating to assess long-term exposure, and (2) changes in FA levels over time. During 22.1 years of follow-up, 1304 HF cases occurred. After multivariable adjustment, habitual levels and changes in levels of palmitic acid (16:0) were positively associated with incident HF (interquintile hazard ratio [95% CI]=1.17 [1.00-1.36] and 1.26 [1.03-1.55], respectively). Changes in levels of 7-hexadecenoic acid (16:1n-9) and vaccenic acid (18:1n-7) were each positively associated with risk of HF (1.36 [1.13-1.62], and 1.43 [1.18-1.72], respectively). Habitual levels and changes in levels of myristic acid (14:0), palmitoleic acid (16:1n-7), stearic acid (18:0), and oleic acid (18:1n-9) were not associated with incident HF. Conclusions Both habitual levels and changes in levels of 16:0 were positively associated with incident HF in older adults. Changes in 16:1n-9 and 18:1n-7 were also positively associated with incident HF. These findings support a potential role of DNL or these DNL-related FAs in the development of HF.

%B J Am Heart Assoc %V 9 %P e014119 %8 2020 Feb 18 %G eng %N 4 %R 10.1161/JAHA.119.014119 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2020 %T Sex Differences in the Association Between Pentraxin 3 and Cognitive Decline: The Cardiovascular Health Study. %A Miller, Lindsay M %A Jenny, Nancy S %A Rawlings, Andreea M %A Arnold, Alice M %A Fitzpatrick, Annette L %A Lopez, Oscar L %A Odden, Michelle C %X

BACKGROUND: The importance of systemic inflammation, measured by C-reactive protein, in cognitive decline has been demonstrated; however, the role of vascular inflammation is less understood. Pentraxin 3 (PTX3) is a novel marker of vascular inflammation.

METHODS: We followed adults 65 and older, free of cardiovascular disease (CVD) for up to 9 years (n = 1,547) in the Cardiovascular Health Study. We evaluated the relationship between PTX3 and change in cognitive function, measured using the Modified Mini-Mental State Examination (3MSE), and incident cognitive impairment (3MSE < 80). Mediation by CVD events, and effect modification by sex and apolipoprotein E ɛ4 allele (APOE4) were also examined.

RESULTS: The average decline in 3MSE was 0.77 points per year. The association between PTX3 and change in 3MSE differed between women and men (p = .02). In the adjusted model, each standard deviation higher in PTX3 was associated with a 0.20 greater decline in 3MSE score per year in women over follow-up (95% CI: -0. 37, -0.03; p = .02), compared to no change in men (β = 0.07; 95% CI: -0.08, 0.22). CVD events had a minor effect on the associations. No effect modification by APOE4 was found, although we observed the association of PTX3 and cognitive impairment in women was attenuated and nonsignificant after adjustment for APOE4. There was a paradoxical protective association between PTX3 and reduced cognitive impairment in men, even after adjustment for APOE4.

CONCLUSIONS: We found that vascular inflammation was significantly associated with cognitive decline in older women, but not men.

%B J Gerontol A Biol Sci Med Sci %V 75 %P 1523-1529 %8 2020 Jul 13 %G eng %N 8 %R 10.1093/gerona/glz217 %0 Journal Article %J J Am Coll Cardiol %D 2020 %T Sex-Specific Associations of Cardiovascular Risk Factors and Biomarkers With Incident Heart Failure. %A Suthahar, Navin %A Lau, Emily S %A Blaha, Michael J %A Paniagua, Samantha M %A Larson, Martin G %A Psaty, Bruce M %A Benjamin, Emelia J %A Allison, Matthew A %A Bartz, Traci M %A Januzzi, James L %A Levy, Daniel %A Meems, Laura M G %A Bakker, Stephan J L %A Lima, João A C %A Cushman, Mary %A Lee, Douglas S %A Wang, Thomas J %A deFilippi, Christopher R %A Herrington, David M %A Nayor, Matthew %A Vasan, Ramachandran S %A Gardin, Julius M %A Kizer, Jorge R %A Bertoni, Alain G %A Allen, Norrina B %A Gansevoort, Ron T %A Shah, Sanjiv J %A Gottdiener, John S %A Ho, Jennifer E %A de Boer, Rudolf A %X

BACKGROUND: Whether cardiovascular (CV) disease risk factors and biomarkers associate differentially with heart failure (HF) risk in men and women is unclear.

OBJECTIVES: The purpose of this study was to evaluate sex-specific associations of CV risk factors and biomarkers with incident HF.

METHODS: The analysis was performed using data from 4 community-based cohorts with 12.5 years of follow-up. Participants (recruited between 1989 and 2002) were free of HF at baseline. Biomarker measurements included natriuretic peptides, cardiac troponins, plasminogen activator inhibitor-1, D-dimer, fibrinogen, C-reactive protein, sST2, galectin-3, cystatin-C, and urinary albumin-to-creatinine ratio.

RESULTS: Among 22,756 participants (mean age 60 ± 13 years, 53% women), HF occurred in 2,095 participants (47% women). Age, smoking, type 2 diabetes mellitus, hypertension, body mass index, atrial fibrillation, myocardial infarction, left ventricular hypertrophy, and left bundle branch block were strongly associated with HF in both sexes (p < 0.001), and the combined clinical model had good discrimination in men (C-statistic = 0.80) and in women (C-statistic = 0.83). The majority of biomarkers were strongly and similarly associated with HF in both sexes. The clinical model improved modestly after adding natriuretic peptides in men (ΔC-statistic = 0.006; likelihood ratio chi-square = 146; p < 0.001), and after adding cardiac troponins in women (ΔC-statistic = 0.003; likelihood ratio chi-square = 73; p < 0.001).

CONCLUSIONS: CV risk factors are strongly and similarly associated with incident HF in both sexes, highlighting the similar importance of risk factor control in reducing HF risk in the community. There are subtle sex-related differences in the predictive value of individual biomarkers, but the overall improvement in HF risk estimation when included in a clinical HF risk prediction model is limited in both sexes.

%B J Am Coll Cardiol %V 76 %P 1455-1465 %8 2020 Sep 22 %G eng %N 12 %R 10.1016/j.jacc.2020.07.044 %0 Journal Article %J Kidney Int %D 2020 %T A systematic review and participant-level meta-analysis found little association of retinal microvascular caliber and reduced kidney function. %A Lye, Weng Kit %A Paterson, Euan %A Patterson, Christopher C %A Maxwell, Alexander P %A Binte Mohammed Abdul, Riswana Banu %A Tai, E Shyong %A Cheng, Ching Yu %A Kayama, Takamasa %A Yamashita, Hidetoshi %A Sarnak, Mark %A Shlipak, Michael %A Matsushita, Kunihiro %A Mutlu, Unal %A Ikram, Mohammad A %A Klaver, Caroline %A Kifley, Annette %A Mitchell, Paul %A Myers, Chelsea %A Klein, Barbara E %A Klein, Ronald %A Wong, Tien Y %A Sabanayagam, Charumathi %A McKay, Gareth J %X

Previously, variation in retinal vascular caliber has been reported in association with chronic kidney disease (CKD) but findings remain inconsistent. To help clarify this we conducted individual participant data meta-analysis and aggregate data meta-analysis on summary estimates to evaluate cross-sectional associations between retinal vascular caliber and CKD. A systematic review was performed using Medline and EMBASE for articles published until October 2018. The aggregate analysis used a two-stage approach combining summary estimates from eleven studies (44,803 patients) while the individual participant analysis used a one-stage approach combining raw data from nine studies (33,222 patients). CKD stages 3-5 was defined as an estimated glomerular filtration rate under 60 mL/min/1.73m. Retinal arteriolar and venular caliber (central retinal arteriolar and venular equivalent) were assessed from retinal photographs using computer-assisted methods. Logistic regression estimated relative risk of CKD stages 3-5 associated with a 20 μm decrease (approximately one standard deviation) in central retinal arteriolar and venular equivalent. Prevalence of CKD stages 3-5 was 11.2 % of 33,222 and 11.3 % of 44,803 patients in the individual participant and aggregate data analysis, respectively. No significant associations were detected in adjusted analyses between central retinal arteriolar and venular equivalent and CKD stages 3-5 in the aggregate analysis for central retinal arteriolar relative risk (0.98, 95% confidence interval 0.94-1.03); venular equivalent (0.99, 0.95- 1.04) or individual participant central retinal arteriolar (0.99, 0.95-1.04) or venular equivalent (1.01, 0.97-1.05). Thus, meta-analysis provided little evidence to suggest that cross sectional direct measurements of retinal vascular caliber was associated with CKD stages 3-5 in the general population. Hence, meta-analyses of longitudinal studies evaluating the association between retinal parameters and CKD stages 3-5 may be warranted.

%B Kidney Int %8 2020 Aug 15 %G eng %R 10.1016/j.kint.2020.06.033 %0 Journal Article %J Cell %D 2020 %T Trans-ethnic and Ancestry-Specific Blood-Cell Genetics in 746,667 Individuals from 5 Global Populations. %A Chen, Ming-Huei %A Raffield, Laura M %A Mousas, Abdou %A Sakaue, Saori %A Huffman, Jennifer E %A Moscati, Arden %A Trivedi, Bhavi %A Jiang, Tao %A Akbari, Parsa %A Vuckovic, Dragana %A Bao, Erik L %A Zhong, Xue %A Manansala, Regina %A Laplante, Véronique %A Chen, Minhui %A Lo, Ken Sin %A Qian, Huijun %A Lareau, Caleb A %A Beaudoin, Mélissa %A Hunt, Karen A %A Akiyama, Masato %A Bartz, Traci M %A Ben-Shlomo, Yoav %A Beswick, Andrew %A Bork-Jensen, Jette %A Bottinger, Erwin P %A Brody, Jennifer A %A van Rooij, Frank J A %A Chitrala, Kumaraswamynaidu %A Cho, Kelly %A Choquet, Helene %A Correa, Adolfo %A Danesh, John %A Di Angelantonio, Emanuele %A Dimou, Niki %A Ding, Jingzhong %A Elliott, Paul %A Esko, Tõnu %A Evans, Michele K %A Floyd, James S %A Broer, Linda %A Grarup, Niels %A Guo, Michael H %A Greinacher, Andreas %A Haessler, Jeff %A Hansen, Torben %A Howson, Joanna M M %A Huang, Qin Qin %A Huang, Wei %A Jorgenson, Eric %A Kacprowski, Tim %A Kähönen, Mika %A Kamatani, Yoichiro %A Kanai, Masahiro %A Karthikeyan, Savita %A Koskeridis, Fotis %A Lange, Leslie A %A Lehtimäki, Terho %A Lerch, Markus M %A Linneberg, Allan %A Liu, Yongmei %A Lyytikäinen, Leo-Pekka %A Manichaikul, Ani %A Martin, Hilary C %A Matsuda, Koichi %A Mohlke, Karen L %A Mononen, Nina %A Murakami, Yoshinori %A Nadkarni, Girish N %A Nauck, Matthias %A Nikus, Kjell %A Ouwehand, Willem H %A Pankratz, Nathan %A Pedersen, Oluf %A Preuss, Michael %A Psaty, Bruce M %A Raitakari, Olli T %A Roberts, David J %A Rich, Stephen S %A Rodriguez, Benjamin A T %A Rosen, Jonathan D %A Rotter, Jerome I %A Schubert, Petra %A Spracklen, Cassandra N %A Surendran, Praveen %A Tang, Hua %A Tardif, Jean-Claude %A Trembath, Richard C %A Ghanbari, Mohsen %A Völker, Uwe %A Völzke, Henry %A Watkins, Nicholas A %A Zonderman, Alan B %A Wilson, Peter W F %A Li, Yun %A Butterworth, Adam S %A Gauchat, Jean-François %A Chiang, Charleston W K %A Li, Bingshan %A Loos, Ruth J F %A Astle, William J %A Evangelou, Evangelos %A van Heel, David A %A Sankaran, Vijay G %A Okada, Yukinori %A Soranzo, Nicole %A Johnson, Andrew D %A Reiner, Alexander P %A Auer, Paul L %A Lettre, Guillaume %X

Most loci identified by GWASs have been found in populations of European ancestry (EUR). In trans-ethnic meta-analyses for 15 hematological traits in 746,667 participants, including 184,535 non-EUR individuals, we identified 5,552 trait-variant associations at p < 5 × 10, including 71 novel associations not found in EUR populations. We also identified 28 additional novel variants in ancestry-specific, non-EUR meta-analyses, including an IL7 missense variant in South Asians associated with lymphocyte count in vivo and IL-7 secretion levels in vitro. Fine-mapping prioritized variants annotated as functional and generated 95% credible sets that were 30% smaller when using the trans-ethnic as opposed to the EUR-only results. We explored the clinical significance and predictive value of trans-ethnic variants in multiple populations and compared genetic architecture and the effect of natural selection on these blood phenotypes between populations. Altogether, our results for hematological traits highlight the value of a more global representation of populations in genetic studies.

%B Cell %V 182 %P 1198-1213.e14 %8 2020 Sep 03 %G eng %N 5 %R 10.1016/j.cell.2020.06.045 %0 Journal Article %J Circ Genom Precis Med %D 2020 %T Whole Blood DNA Methylation Signatures of Diet Are Associated With Cardiovascular Disease Risk Factors and All-Cause Mortality. %A Ma, Jiantao %A Rebholz, Casey M %A Braun, Kim V E %A Reynolds, Lindsay M %A Aslibekyan, Stella %A Xia, Rui %A Biligowda, Niranjan G %A Huan, Tianxiao %A Liu, Chunyu %A Mendelson, Michael M %A Joehanes, Roby %A Hu, Emily A %A Vitolins, Mara Z %A Wood, Alexis C %A Lohman, Kurt %A Ochoa-Rosales, Carolina %A van Meurs, Joyce %A Uitterlinden, Andre %A Liu, Yongmei %A Elhadad, Mohamed A %A Heier, Margit %A Waldenberger, Melanie %A Peters, Annette %A Colicino, Elena %A Whitsel, Eric A %A Baldassari, Antoine %A Gharib, Sina A %A Sotoodehnia, Nona %A Brody, Jennifer A %A Sitlani, Colleen M %A Tanaka, Toshiko %A Hill, W David %A Corley, Janie %A Deary, Ian J %A Zhang, Yan %A Schöttker, Ben %A Brenner, Hermann %A Walker, Maura E %A Ye, Shumao %A Nguyen, Steve %A Pankow, Jim %A Demerath, Ellen W %A Zheng, Yinan %A Hou, Lifang %A Liang, Liming %A Lichtenstein, Alice H %A Hu, Frank B %A Fornage, Myriam %A Voortman, Trudy %A Levy, Daniel %X

BACKGROUND: DNA methylation patterns associated with habitual diet have not been well studied.

METHODS: Diet quality was characterized using a Mediterranean-style diet score and the Alternative Healthy Eating Index score. We conducted ethnicity-specific and trans-ethnic epigenome-wide association analyses for diet quality and leukocyte-derived DNA methylation at over 400 000 CpGs (cytosine-guanine dinucleotides) in 5 population-based cohorts including 6662 European ancestry, 2702 African ancestry, and 360 Hispanic ancestry participants. For diet-associated CpGs identified in epigenome-wide analyses, we conducted Mendelian randomization (MR) analysis to examine their relations to cardiovascular disease risk factors and examined their longitudinal associations with all-cause mortality.

RESULTS: We identified 30 CpGs associated with either Mediterranean-style diet score or Alternative Healthy Eating Index, or both, in European ancestry participants. Among these CpGs, 12 CpGs were significantly associated with all-cause mortality (Bonferroni corrected <1.6×10). Hypermethylation of cg18181703 () was associated with higher scores of both Mediterranean-style diet score and Alternative Healthy Eating Index and lower risk for all-cause mortality (=5.7×10). Ten additional diet-associated CpGs were nominally associated with all-cause mortality (<0.05). MR analysis revealed 8 putatively causal associations for 6 CpGs with 4 cardiovascular disease risk factors (body mass index, triglycerides, high-density lipoprotein cholesterol concentrations, and type 2 diabetes mellitus; Bonferroni corrected MR <4.5×10). For example, hypermethylation of cg11250194 () was associated with lower triglyceride concentrations (MR, =1.5×10).and hypermethylation of cg02079413 (; ) was associated with body mass index (corrected MR, =1×10).

CONCLUSIONS: Habitual diet quality was associated with differential peripheral leukocyte DNA methylation levels of 30 CpGs, most of which were also associated with multiple health outcomes, in European ancestry individuals. These findings demonstrate that integrative genomic analysis of dietary information may reveal molecular targets for disease prevention and treatment.

%B Circ Genom Precis Med %V 13 %P e002766 %8 2020 Aug %G eng %N 4 %R 10.1161/CIRCGEN.119.002766 %0 Journal Article %J Nat Commun %D 2020 %T Whole genome sequence analysis of pulmonary function and COPD in 19,996 multi-ethnic participants. %A Zhao, Xutong %A Qiao, Dandi %A Yang, Chaojie %A Kasela, Silva %A Kim, Wonji %A Ma, Yanlin %A Shrine, Nick %A Batini, Chiara %A Sofer, Tamar %A Taliun, Sarah A Gagliano %A Sakornsakolpat, Phuwanat %A Balte, Pallavi P %A Prokopenko, Dmitry %A Yu, Bing %A Lange, Leslie A %A Dupuis, Josée %A Cade, Brian E %A Lee, Jiwon %A Gharib, Sina A %A Daya, Michelle %A Laurie, Cecelia A %A Ruczinski, Ingo %A Cupples, L Adrienne %A Loehr, Laura R %A Bartz, Traci M %A Morrison, Alanna C %A Psaty, Bruce M %A Vasan, Ramachandran S %A Wilson, James G %A Taylor, Kent D %A Durda, Peter %A Johnson, W Craig %A Cornell, Elaine %A Guo, Xiuqing %A Liu, Yongmei %A Tracy, Russell P %A Ardlie, Kristin G %A Aguet, Francois %A VanDenBerg, David J %A Papanicolaou, George J %A Rotter, Jerome I %A Barnes, Kathleen C %A Jain, Deepti %A Nickerson, Deborah A %A Muzny, Donna M %A Metcalf, Ginger A %A Doddapaneni, Harshavardhan %A Dugan-Perez, Shannon %A Gupta, Namrata %A Gabriel, Stacey %A Rich, Stephen S %A O'Connor, George T %A Redline, Susan %A Reed, Robert M %A Laurie, Cathy C %A Daviglus, Martha L %A Preudhomme, Liana K %A Burkart, Kristin M %A Kaplan, Robert C %A Wain, Louise V %A Tobin, Martin D %A London, Stephanie J %A Lappalainen, Tuuli %A Oelsner, Elizabeth C %A Abecasis, Goncalo R %A Silverman, Edwin K %A Barr, R Graham %A Cho, Michael H %A Manichaikul, Ani %K Adult %K African Americans %K Aged %K Aged, 80 and over %K Alpha-Ketoglutarate-Dependent Dioxygenase FTO %K Calcium-Binding Proteins %K Feasibility Studies %K Female %K Follow-Up Studies %K Genetic Loci %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Intracellular Signaling Peptides and Proteins %K Lung %K Male %K Middle Aged %K Polymorphism, Single Nucleotide %K Protein Inhibitors of Activated STAT %K Pulmonary Disease, Chronic Obstructive %K Respiratory Physiological Phenomena %K Small Ubiquitin-Related Modifier Proteins %K Whole Genome Sequencing %X

Chronic obstructive pulmonary disease (COPD), diagnosed by reduced lung function, is a leading cause of morbidity and mortality. We performed whole genome sequence (WGS) analysis of lung function and COPD in a multi-ethnic sample of 11,497 participants from population- and family-based studies, and 8499 individuals from COPD-enriched studies in the NHLBI Trans-Omics for Precision Medicine (TOPMed) Program. We identify at genome-wide significance 10 known GWAS loci and 22 distinct, previously unreported loci, including two common variant signals from stratified analysis of African Americans. Four novel common variants within the regions of PIAS1, RGN (two variants) and FTO show evidence of replication in the UK Biobank (European ancestry n ~ 320,000), while colocalization analyses leveraging multi-omic data from GTEx and TOPMed identify potential molecular mechanisms underlying four of the 22 novel loci. Our study demonstrates the value of performing WGS analyses and multi-omic follow-up in cohorts of diverse ancestry.

%B Nat Commun %V 11 %P 5182 %8 2020 10 14 %G eng %N 1 %R 10.1038/s41467-020-18334-7 %0 Journal Article %J JAMA Netw Open %D 2021 %T Assessment of Plasma Phospholipid Very-Long-Chain Saturated Fatty Acid Levels and Healthy Aging. %A Bockus, Lee B %A Biggs, Mary L %A Lai, Heidi T M %A de Olivera Otto, Marcia C %A Fretts, Amanda M %A McKnight, Barbara %A Sotoodehnia, Nona %A King, Irena B %A Song, Xiaoling %A Siscovick, David S %A Mozaffarian, Dariush %A Lemaitre, Rozenn N %X

Importance: Identifying novel factors that protect against age-related diseases and promote healthy aging is critical to public health. Higher levels of circulating very-long-chain saturated fatty acids (VLSFAs) are integrated biomarkers of diet and metabolism shown to have beneficial associations in cardiovascular disease and total mortality, but whether they are associated with overall healthy aging is unknown.

Objective: To examine the association of circulating levels of 3 VLSFAs with unhealthy aging events, including incident chronic disease (cardiovascular disease, cancer, lung disease or severe kidney disease), physical dysfunction, and cognitive decline.

Design, Setting, and Participants: This cohort study used 1992 to 2014 data from the Cardiovascular Health Study (CHS). The CHS is a multicenter, population-based study of cardiovascular disease among older adults. Among the 4559 CHS participants with available fatty acid data, 1879 participants who had an age-related event before their first measurement were excluded. Data analysis was performed in 2020.

Main Outcomes and Measures: Plasma phospholipid VLSFA levels were measured by thin-layer chromatography followed by gas chromatography. The main outcome was the hazard ratio (HR) of an incident unhealthy aging event associated with serial measures of plasma arachidic acid, behenic acid, and lignoceric acid.

Results: Among the 2680 study participants (976 men [36.4%]), the mean (SD) age was 74.7 (4.8) years old at entry. During a median (interquartile range) of 6.4 (2.9-12.9) years of follow-up, 2484 participants experienced an unhealthy event. Compared with the lowest quintile, levels of behenic acid in the highest quintile of the fatty acid distribution were associated with 15% lower risk of an unhealthy event (HR, 0.85; 95% CI, 0.74-0.97; P for trend = .01) after adjustment for demographic characteristics, lifestyle factors, and clinical conditions. In analogous comparisons, levels of lignoceric acid were similarly associated with 16% lower risk of an unhealthy event (HR, 0.84; 95% CI, 0.73-0.95; P for trend = .001).

Conclusions and Relevance: These findings suggest that higher levels of circulating behenic acid and lignoceric acid are associated with lower risk of unhealthy aging events. These results highlight the need to explore determinants of circulating VLSFAs for potential novel efforts to promote healthy aging.

%B JAMA Netw Open %V 4 %P e2120616 %8 2021 Aug 02 %G eng %N 8 %R 10.1001/jamanetworkopen.2021.20616 %0 Journal Article %J Blood %D 2021 %T {Association between ABO haplotypes and the risk of venous thrombosis: impact on disease risk estimation %A Goumidi, L. %A Thibord, F. %A Wiggins, K. L. %A Li-Gao, R. %A Brown, M. R. %A van Hylckama Vlieg, A. %A Souto, J. C. %A Soria, J. M. %A Ibrahim-Kosta, M. %A Saut, N. %A Daian, D. %A Olaso, R. %A Amouyel, P. %A Debette, S. %A Boland, A. %A Bailly, P. %A Morrison, A. C. %A Mook-Kanamori, D. O. %A Deleuze, J. F. %A Johnson, A. %A de Vries, P. S. %A Sabater-Lleal, M. %A Chiaroni, J. %A Smith, N. L. %A Rosendaal, F. R. %A Chasman, D. I. %A Trégouët, D. A. %A Morange, P. E. %X 10.1182/blood.2020008997Genetic risk score (GRS) analysis is a popular approach to derive individual risk prediction models for complex diseases. In venous thrombosis (VT), such type of analysis shall integrate information at the ABO blood group locus, which is one of the major susceptibility loci. However, there is no consensus about which single nucleotide polymorphisms (SNPs) must be investigated when properly assessing association between ABO locus and VT risk. Using comprehensive haplotype analyses of ABO blood group tagging SNPs in 5425 cases and 8445 controls from 6 studies, we demonstrate that using only rs8176719 (tagging O1) to correctly assess the impact of ABO locus on VT risk is suboptimal, because 5% of rs8176719-delG carriers do not have an increased risk of developing VT. Instead, we recommend the use of 4 SNPs, rs2519093 (tagging A1), rs1053878 (A2), rs8176743 (B), and rs41302905 (O2), when assessing the impact of ABO locus on VT risk to avoid any risk misestimation. Compared with the O1 haplotype, the A2 haplotype is associated with a modest increase in VT risk (odds ratio, ∼1.2), the A1 and B haplotypes are associated with an ∼1.8-fold increased risk, whereas the O2 haplotype tends to be slightly protective (odds ratio, ∼0.80). In addition, although the A1 and B blood groups are associated with increased von Willebrand factor and factor VIII plasma levels, only the A1 blood group is associated with ICAM levels, but in an opposite direction, leaving additional avenues to be explored to fully understand the spectrum of biological effects mediated by ABO locus on cardiovascular traits. %B Blood %V 137 %P 2394–2402 %8 Apr %G eng %0 Journal Article %J JAMA Neurol %D 2021 %T Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events in Participants From 4 Population-Based Cohort Studies. %A Murthy, Santosh B %A Zhang, Cenai %A Diaz, Ivan %A Levitan, Emily B %A Koton, Silvia %A Bartz, Traci M %A DeRosa, Janet T %A Strobino, Kevin %A Colantonio, Lisandro D %A Iadecola, Costantino %A Safford, Monika M %A Howard, Virginia J %A Longstreth, W T %A Gottesman, Rebecca F %A Sacco, Ralph L %A Elkind, Mitchell S V %A Howard, George %A Kamel, Hooman %X

Importance: Intracerebral hemorrhage and arterial ischemic disease share risk factors, to our knowledge, but the association between the 2 conditions remains unknown.

Objective: To evaluate whether intracerebral hemorrhage was associated with an increased risk of incident ischemic stroke and myocardial infarction.

Design, Setting, and Participants: An analysis was conducted of pooled longitudinal participant-level data from 4 population-based cohort studies in the United States: the Atherosclerosis Risk in Communities (ARIC) study, the Cardiovascular Health Study (CHS), the Northern Manhattan Study (NOMAS), and the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Patients were enrolled from 1987 to 2007, and the last available follow-up was December 31, 2018. Data were analyzed from September 1, 2019, to March 31, 2020.

Exposure: Intracerebral hemorrhage, as assessed by an adjudication committee based on predefined clinical and radiologic criteria.

Main Outcomes and Measures: The primary outcome was an arterial ischemic event, defined as a composite of ischemic stroke or myocardial infarction, centrally adjudicated within each study. Secondary outcomes were ischemic stroke and myocardial infarction. Participants with prevalent intracerebral hemorrhage, ischemic stroke, or myocardial infarction at their baseline study visit were excluded. Cox proportional hazards regression was used to examine the association between intracerebral hemorrhage and subsequent arterial ischemic events after adjustment for baseline age, sex, race/ethnicity, vascular comorbidities, and antithrombotic medications.

Results: Of 55 131 participants, 47 866 (27 639 women [57.7%]; mean [SD] age, 62.2 [10.2] years) were eligible for analysis. During a median follow-up of 12.7 years (interquartile range, 7.7-19.5 years), there were 318 intracerebral hemorrhages and 7648 arterial ischemic events. The incidence of an arterial ischemic event was 3.6 events per 100 person-years (95% CI, 2.7-5.0 events per 100 person-years) after intracerebral hemorrhage vs 1.1 events per 100 person-years (95% CI, 1.1-1.2 events per 100 person-years) among those without intracerebral hemorrhage. In adjusted models, intracerebral hemorrhage was associated with arterial ischemic events (hazard ratio [HR], 2.3; 95% CI, 1.7-3.1), ischemic stroke (HR, 3.1; 95% CI, 2.1-4.5), and myocardial infarction (HR, 1.9; 95% CI, 1.2-2.9). In sensitivity analyses, intracerebral hemorrhage was associated with arterial ischemic events when updating covariates in a time-varying manner (HR, 2.2; 95% CI, 1.6-3.0); when using incidence density matching (odds ratio, 2.3; 95% CI, 1.3-4.2); when including participants with prevalent intracerebral hemorrhage, ischemic stroke, or myocardial infarction (HR, 2.2; 95% CI, 1.6-2.9); and when using death as a competing risk (subdistribution HR, 1.6; 95% CI, 1.1-2.1).

Conclusions and Relevance: This study found that intracerebral hemorrhage was associated with an increased risk of ischemic stroke and myocardial infarction. These findings suggest that intracerebral hemorrhage may be a novel risk marker for arterial ischemic events.

%B JAMA Neurol %V 78 %P 809-816 %8 2021 Jul 01 %G eng %N 7 %R 10.1001/jamaneurol.2021.0925 %0 Journal Article %J JAMA %D 2021 %T Association Between Preserved Ratio Impaired Spirometry and Clinical Outcomes in US Adults. %A Wan, Emily S %A Balte, Pallavi %A Schwartz, Joseph E %A Bhatt, Surya P %A Cassano, Patricia A %A Couper, David %A Daviglus, Martha L %A Dransfield, Mark T %A Gharib, Sina A %A Jacobs, David R %A Kalhan, Ravi %A London, Stephanie J %A Navas-Acien, Ana %A O'Connor, George T %A Sanders, Jason L %A Smith, Benjamin M %A White, Wendy %A Yende, Sachin %A Oelsner, Elizabeth C %K Adult %K Aged %K Aged, 80 and over %K Cardiovascular Diseases %K Female %K Forced Expiratory Volume %K Humans %K Lung %K Lung Diseases %K Male %K Middle Aged %K Prevalence %K Retrospective Studies %K Spirometry %K United States %K Vital Capacity %X

Importance: Chronic lung diseases are a leading cause of morbidity and mortality. Unlike chronic obstructive pulmonary disease, clinical outcomes associated with proportional reductions in expiratory lung volumes without obstruction, otherwise known as preserved ratio impaired spirometry (PRISm), are poorly understood.

Objective: To examine the prevalence, correlates, and clinical outcomes associated with PRISm in US adults.

Design, Setting, and Participants: The National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study was a retrospective study with harmonized pooled data from 9 US general population-based cohorts (enrollment, 65 251 participants aged 18 to 102 years of whom 53 701 participants had valid baseline lung function) conducted from 1971-2011 (final follow-up, December 2018).

Exposures: Participants were categorized into mutually exclusive groups by baseline lung function. PRISm was defined as the ratio of forced expiratory volume in the first second to forced vital capacity (FEV1:FVC) greater than or equal to 0.70 and FEV1 less than 80% predicted; obstructive spirometry FEV1:FVC ratio of less than 0.70; and normal spirometry FEV1:FVC ratio greater than or equal to 0.7 and FEV1 greater than or equal to 80% predicted.

Main Outcomes and Measures: Main outcomes were all-cause mortality, respiratory-related mortality, coronary heart disease (CHD)-related mortality, respiratory-related events (hospitalizations and mortality), and CHD-related events (hospitalizations and mortality) classified by adjudication or validated administrative criteria. Absolute risks were adjusted for age and smoking status. Poisson and Cox proportional hazards models comparing PRISm vs normal spirometry were adjusted for age, sex, race and ethnicity, education, body mass index, smoking status, cohort, and comorbidities.

Results: Among all participants (mean [SD] age, 53.2 [15.8] years, 56.4% women, 48.5% never-smokers), 4582 (8.5%) had PRISm. The presence of PRISm relative to normal spirometry was significantly associated with obesity (prevalence, 48.3% vs 31.4%; prevalence ratio [PR], 1.68 [95% CI, 1.55-1.82]), underweight (prevalence, 1.4% vs 1.0%; PR, 2.20 [95% CI, 1.72-2.82]), female sex (prevalence, 60.3% vs 59.0%; PR, 1.07 [95% CI, 1.01-1.13]), and current smoking (prevalence, 25.2% vs 17.5%; PR, 1.33 [95% CI, 1.22-1.45]). PRISm, compared with normal spirometry, was significantly associated with greater all-cause mortality (29.6/1000 person-years vs 18.0/1000 person-years; difference, 11.6/1000 person-years [95% CI, 10.0-13.1]; adjusted hazard ratio [HR], 1.50 [95% CI, 1.42-1.59]), respiratory-related mortality (2.1/1000 person-years vs 1.0/1000 person-years; difference, 1.1/1000 person-years [95% CI, 0.7-1.6]; adjusted HR, 1.95 [95% CI, 1.54-2.48]), CHD-related mortality (5.4/1000 person-years vs 2.6/1000 person-years; difference, 2.7/1000 person-years [95% CI, 2.1-3.4]; adjusted HR, 1.55 [95% CI, 1.36-1.77]), respiratory-related events (12.2/1000 person-years vs 6.0/1000 person-years; difference, 6.2/1000 person-years [95% CI, 4.9-7.5]; adjusted HR, 1.90 [95% CI, 1.69-2.14]), and CHD-related events (11.7/1000 person-years vs 7.0/1000 person-years; difference, 4.7/1000 person-years [95% CI, 3.7-5.8]; adjusted HR, 1.30 [95% CI, 1.18-1.42]).

Conclusions and Relevance: In a large, population-based sample of US adults, baseline PRISm, compared with normal spirometry, was associated with a small but statistically significant increased risk for mortality and adverse cardiovascular and respiratory outcomes. Further research is needed to explore whether this association is causal.

%B JAMA %V 326 %P 2287-2298 %8 2021 12 14 %G eng %N 22 %R 10.1001/jama.2021.20939 %0 Journal Article %J Transl Psychiatry %D 2021 %T Association of low-frequency and rare coding variants with information processing speed. %A Bressler, Jan %A Davies, Gail %A Smith, Albert V %A Saba, Yasaman %A Bis, Joshua C %A Jian, Xueqiu %A Hayward, Caroline %A Yanek, Lisa %A Smith, Jennifer A %A Mirza, Saira S %A Wang, Ruiqi %A Adams, Hieab H H %A Becker, Diane %A Boerwinkle, Eric %A Campbell, Archie %A Cox, Simon R %A Eiriksdottir, Gudny %A Fawns-Ritchie, Chloe %A Gottesman, Rebecca F %A Grove, Megan L %A Guo, Xiuqing %A Hofer, Edith %A Kardia, Sharon L R %A Knol, Maria J %A Koini, Marisa %A Lopez, Oscar L %A Marioni, Riccardo E %A Nyquist, Paul %A Pattie, Alison %A Polasek, Ozren %A Porteous, David J %A Rudan, Igor %A Satizabal, Claudia L %A Schmidt, Helena %A Schmidt, Reinhold %A Sidney, Stephen %A Simino, Jeannette %A Smith, Blair H %A Turner, Stephen T %A van der Lee, Sven J %A Ware, Erin B %A Whitmer, Rachel A %A Yaffe, Kristine %A Yang, Qiong %A Zhao, Wei %A Gudnason, Vilmundur %A Launer, Lenore J %A Fitzpatrick, Annette L %A Psaty, Bruce M %A Fornage, Myriam %A Arfan Ikram, M %A van Duijn, Cornelia M %A Seshadri, Sudha %A Mosley, Thomas H %A Deary, Ian J %K Adult %K Aging %K Cognition %K Genome-Wide Association Study %K Geroscience %K Humans %K Polymorphism, Single Nucleotide %K Ubiquitin-Protein Ligases %X

Measures of information processing speed vary between individuals and decline with age. Studies of aging twins suggest heritability may be as high as 67%. The Illumina HumanExome Bead Chip genotyping array was used to examine the association of rare coding variants with performance on the Digit-Symbol Substitution Test (DSST) in community-dwelling adults participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. DSST scores were available for 30,576 individuals of European ancestry from nine cohorts and for 5758 individuals of African ancestry from four cohorts who were older than 45 years and free of dementia and clinical stroke. Linear regression models adjusted for age and gender were used for analysis of single genetic variants, and the T5, T1, and T01 burden tests that aggregate the number of rare alleles by gene were also applied. Secondary analyses included further adjustment for education. Meta-analyses to combine cohort-specific results were carried out separately for each ancestry group. Variants in RNF19A reached the threshold for statistical significance (p = 2.01 × 10) using the T01 test in individuals of European descent. RNF19A belongs to the class of E3 ubiquitin ligases that confer substrate specificity when proteins are ubiquitinated and targeted for degradation through the 26S proteasome. Variants in SLC22A7 and OR51A7 were suggestively associated with DSST scores after adjustment for education for African-American participants and in the European cohorts, respectively. Further functional characterization of its substrates will be required to confirm the role of RNF19A in cognitive function.

%B Transl Psychiatry %V 11 %P 613 %8 2021 12 04 %G eng %N 1 %R 10.1038/s41398-021-01736-6 %0 Journal Article %J Cell Genom %D 2021 %T Association of mitochondrial DNA copy number with cardiometabolic diseases. %A Liu, Xue %A Longchamps, Ryan J %A Wiggins, Kerri L %A Raffield, Laura M %A Bielak, Lawrence F %A Zhao, Wei %A Pitsillides, Achilleas %A Blackwell, Thomas W %A Yao, Jie %A Guo, Xiuqing %A Kurniansyah, Nuzulul %A Thyagarajan, Bharat %A Pankratz, Nathan %A Rich, Stephen S %A Taylor, Kent D %A Peyser, Patricia A %A Heckbert, Susan R %A Seshadri, Sudha %A Cupples, L Adrienne %A Boerwinkle, Eric %A Grove, Megan L %A Larson, Nicholas B %A Smith, Jennifer A %A Vasan, Ramachandran S %A Sofer, Tamar %A Fitzpatrick, Annette L %A Fornage, Myriam %A Ding, Jun %A Correa, Adolfo %A Abecasis, Goncalo %A Psaty, Bruce M %A Wilson, James G %A Levy, Daniel %A Rotter, Jerome I %A Bis, Joshua C %A Satizabal, Claudia L %A Arking, Dan E %A Liu, Chunyu %X

Mitochondrial DNA (mtDNA) is present in multiple copies in human cells. We evaluated cross-sectional associations of whole blood mtDNA copy number (CN) with several cardiometabolic disease traits in 408,361 participants of multiple ancestries in TOPMed and UK Biobank. Age showed a threshold association with mtDNA CN: among younger participants (<65 years of age), each additional 10 years of age was associated with 0.03 standard deviation (s.d.) higher level of mtDNA CN ( = 0.0014) versus a 0.14 s.d. lower level of mtDNA CN ( = 1.82 × 10) among older participants (≥65 years). At lower mtDNA CN levels, we found age-independent associations with increased odds of obesity ( = 5.6 × 10), hypertension ( = 2.8 × 10), diabetes ( = 3.6 × 10), and hyperlipidemia ( = 6.3 × 10). The observed decline in mtDNA CN after 65 years of age may be a key to understanding age-related diseases.

%B Cell Genom %V 1 %8 2021 Oct 13 %G eng %N 1 %R 10.1016/j.xgen.2021.100006 %0 Journal Article %J Alzheimers Dement %D 2021 %T Association of mitochondrial variants and haplogroups identified by whole exome sequencing with Alzheimer's disease. %A Zhang, Xiaoling %A Farrell, John J %A Tong, Tong %A Hu, Junming %A Zhu, Congcong %A Wang, Li-San %A Mayeux, Richard %A Haines, Jonathan L %A Pericak-Vance, Margaret A %A Schellenberg, Gerard D %A Lunetta, Kathryn L %A Farrer, Lindsay A %X

INTRODUCTION: Findings regarding the association between mitochondrial DNA (mtDNA) variants and Alzheimer's disease (AD) are inconsistent.

METHODS: We developed a pipeline for accurate assembly and variant calling in mitochondrial genomes embedded within whole exome sequences (WES) from 10,831 participants from the Alzheimer's Disease Sequencing Project (ADSP). Association of AD risk was evaluated with each mtDNA variant and variants located in 1158 nuclear genes related to mitochondrial function using the SCORE test. Gene-based tests were performed using SKAT-O.

RESULTS: Analysis of 4220 mtDNA variants revealed study-wide significant association of AD with a rare MT-ND4L missense variant (rs28709356; minor allele frequency = 0.002; P = 7.3 × 10 ) as well as with MT-ND4L in a gene-based test (P = 6.71 × 10 ). Significant association was also observed with a MT-related nuclear gene, TAMM41, in a gene-based test (P = 2.7 × 10 ). The expression of TAMM41 was lower in AD cases than controls (P = .00046) or mild cognitive impairment cases (P = .03).

DISCUSSION: Significant findings in MT-ND4L and TAMM41 provide evidence for a role of mitochondria in AD.

%B Alzheimers Dement %8 2021 Jun 20 %G eng %R 10.1002/alz.12396 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2021 %T Association of Retail Environment and Neighborhood Socioeconomic Status with Mortality among Community-dwelling Older Adults in the US: Cardiovascular Health Study. %A Zhang, Kehan %A Lovasi, Gina S %A Odden, Michelle C %A Michael, Yvonne L %A Newman, Anne B %A Arnold, Alice M %A Kim, Dae Hyun %A Wu, Chenkai %X

BACKGROUND: Few studies have examined the association of neighborhood environment and mortality among community-dwelling older populations. Geographic Information Systems (GIS)-based measures of neighborhood physical environment may provide new insights on the health effects of the social and built environment.

METHODS: We studied 4,379 community-dwelling older adults in the US aged ≥65 years from the Cardiovascular Health Study. Principal component analysis was used to identify neighborhood components from 48 variables assessing facilities and establishments, demographic composition, socio-economic status, and economic prosperity. We used a Cox model to evaluate the association of neighborhood components with five-year mortality. Age, sex, race, education, income, marital status, body mass index, smoking status, disability, coronary heart disease, and diabetes were included as covariates. We also examined the interactions between neighborhood components and sex and race (Black vs. white or other).

RESULTS: We identified five neighborhood components, representing facilities and resources, immigrant communities, community-level economic deprivation, resident-level socio-economic status and residents' age. Communities' economic deprivation and residents' socio-economic status were significantly associated with five-year mortality. We did not find interactions between sex or race and any of the five neighborhood components. The results were similar in a sensitivity analysis where we used ten-year mortality as the outcome.

CONCLUSIONS: We found that communities' economic status but not facilities in communities was associated with mortality among older adults. These findings revealed the importance and benefits living in a socio-economically advantaged neighborhood could have on health among older residents with different demographic backgrounds.

%B J Gerontol A Biol Sci Med Sci %8 2021 Oct 20 %G eng %R 10.1093/gerona/glab319 %0 Journal Article %J JAMA Netw Open %D 2021 %T Association of Trimethylamine N-Oxide and Related Metabolites in Plasma and Incident Type 2 Diabetes: The Cardiovascular Health Study. %A Lemaitre, Rozenn N %A Jensen, Paul N %A Wang, Zeneng %A Fretts, Amanda M %A McKnight, Barbara %A Nemet, Ina %A Biggs, Mary L %A Sotoodehnia, Nona %A de Oliveira Otto, Marcia C %A Psaty, Bruce M %A Siscovick, David S %A Hazen, Stanley L %A Mozaffarian, Dariush %X

Importance: Although rodent studies suggest that trimethylamine N-oxide (TMAO) influences glucose homeostasis and risk of type 2 diabetes, evidence in humans is limited.

Objective: To examine the associations of serial measures of plasma TMAO and related metabolite concentrations with incident type 2 diabetes, fasting plasma insulin and glucose levels, and the Gutt insulin sensitivity index (ISI).

Design, Setting, and Participants: This prospective cohort design assessed the association of plasma TMAO and related metabolite concentrations with diabetes outcome, whereas a cross-sectional design assessed the association with insulin and glucose levels and Gutt ISI. The participants were a cohort of older US adults from the Cardiovascular Health Study (CHS). Data from June 1989 to May 1990, from November 1992 to June 1993, and from June 1995 to June 1997 were included, with follow-up through June 2010. Levels of TMAO and related metabolites were measured in CHS plasma samples. Data were analyzed from July 2019 to September 2020.

Exposures: Plasma concentrations of TMAO, carnitine, betaine, choline, crotonobetaine, and γ-butyrobetaine, measured by high-performance liquid chromatography and mass spectrometry.

Main Outcomes and Measures: Linear regression for associations of TMAO and related metabolites with insulin and glucose levels and Gutt ISI, and proportional hazards regression for associations with diabetes.

Results: The study included 4442 participants without diabetes at baseline (mean [SD] age, 73 [6] years at entry; 2710 [61%] women). In multivariable analyses, plasma TMAO, carnitine, crotonobetaine, and γ-butyrobetaine concentrations were positively associated with fasting insulin level (insulin mean geometric ratio comparing fifth with first quintiles of metabolite concentration: 1.07 [95% CI, 1.04-1.10] for TMAO; 1.07 [95% CI, 1.03-1.10] for carnitine; 1.05 [95% CI, 1.02-1.08] for crotonobetaine; and 1.06 [95% CI, 1.02-1.09] for γ-butyrobetaine). In contrast, betaine and choline concentrations were associated with greater insulin sensitivity (mean difference in Gutt ISI comparing fifth with first quintiles: 6.46 [95% CI, 4.32-8.60] and 2.27 [95% CI, 0.16-4.38], respectively). Incident diabetes was identified in 661 participants during a median 12.1 (interquartile range, 6.9-17.1) years of follow-up. In multivariable analyses, TMAO and metabolites were not significantly associated with type 2 diabetes risk (hazard ratios of diabetes comparing fifth with first quintile: 1.20 [95% CI, 0.94-1.55] for TMAO; 0.96 [95% CI, 0.74-1.24] for choline; 0.88 [95% CI, 0.67-1.15] for betaine; 1.07 [95% CI, 0.83-1.37] for carnitine; 0.79 [95% CI, 0.60-1.04] for γ-butyrobetaine; and 1.06 [95% CI, 0.83-1.35] for crotonobetaine).

Conclusions and Relevance: Plasma TMAO and related metabolites were not significantly associated with type 2 diabetes among older adults. The metabolites TMAO, carnitine, γ-butyrobetaine, and crotonobetaine may be associated with insulin resistance, and betaine and choline may be associated with greater insulin sensitivity, but temporality of the associations was not established.

%B JAMA Netw Open %V 4 %P e2122844 %8 2021 Aug 02 %G eng %N 8 %R 10.1001/jamanetworkopen.2021.22844 %0 Journal Article %J Soc Psychiatry Psychiatr Epidemiol %D 2021 %T Associations between neighborhood greenspace and brain imaging measures in non-demented older adults: the Cardiovascular Health Study. %A Besser, Lilah M %A Lovasi, Gina S %A Michael, Yvonne L %A Garg, Parveen %A Hirsch, Jana A %A Siscovick, David %A Hurvitz, Phil %A Biggs, Mary L %A Galvin, James E %A Bartz, Traci M %A Longstreth, W T %X

PURPOSE: Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer's disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer's disease.

METHODS: We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, population-based Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989-1999) were obtained/analyzed in 2020.

RESULTS: Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: - 0.30; 95% confidence interval: - 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex.

CONCLUSION: This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.

%B Soc Psychiatry Psychiatr Epidemiol %8 2021 Jan 03 %G eng %R 10.1007/s00127-020-02000-w %0 Journal Article %J J Clin Endocrinol Metab %D 2021 %T Associations of Body Mass Index and Waist Circumference in Young Adulthood with Later Life Incident Diabetes. %A Nair, Nandini %A Vittinghoff, Eric %A Pletcher, Mark J %A Oelsner, Elizabeth C %A Allen, Norrina B %A Ndumele, Chiadi E %A West, Nancy A %A Strotmeyer, Elsa S %A Mukamal, Kenneth J %A Siscovick, David S %A Biggs, Mary L %A Laferrère, Blandine %A Moran, Andrew E %A Zhang, Yiyi %K Adolescent %K Adult %K Biomarkers %K Body Mass Index %K Diabetes Mellitus %K Female %K Follow-Up Studies %K Humans %K Male %K Obesity %K Overweight %K Prognosis %K Prospective Studies %K Risk Factors %K United States %K Waist Circumference %K Young Adult %X

CONTEXT: The independent contribution of young adult exposure to overweight and obesity to later-life incident diabetes is not well studied.

OBJECTIVE: To assess the associations of exposures to elevated body mass index (BMI) and waist circumference (WC) in young adulthood (ages 18-39 years) with incident diabetes later in life (≥40 years).

DESIGN: Pooled data from 6 US prospective cohorts (Atherosclerosis Risk in Communities Study, Cardiovascular Risk Development in Young Adults Study, Cardiovascular Health Study, (4) Framingham Heart Study Offspring Cohort, (5) Health, Aging and Body Composition Study, and (6) Multi-Ethnic Study of Atherosclerosis.

SETTING: Population-based cohort studies.

PARTICIPANTS: 30 780 participants (56.1% female, 69.8% non-Hispanic white) without a diagnosis of diabetes by age 40.

INTERVENTIONS: We imputed BMI and WC trajectories from age 18 for every participant and estimated time-weighted average exposures to BMI or WC during young adulthood and later life.

MAIN OUTCOME MEASURE(S): Incident diabetes defined as fasting glucose ≥126 mg/dL, nonfasting glucose ≥200 mg/dL, or use of diabetes medications.

RESULTS: During a 9-year median follow-up, 4323 participants developed incident diabetes. Young adult BMI and WC were associated with later-life incident diabetes after controlling for later-life exposures [hazard ratios (HR) 1.99 for BMI ≥ 30 kg/m2 and 2.13 for WC > 88cm (women)/>102cm (men) compared to normal ranges]. Young adult homeostatic model of insulin resistance mediated 49% and 44% of the association between BMI and WC with later-life incident diabetes. High-density lipoproteins and triglycerides mediated a smaller proportion of these associations.

CONCLUSIONS: Elevated BMI and WC during young adulthood were independently associated with later-life incident diabetes. Insulin resistance may be a key mediator.

%B J Clin Endocrinol Metab %V 106 %P e5011-e5020 %8 2021 11 19 %G eng %N 12 %R 10.1210/clinem/dgab551 %0 Journal Article %J Osteoporos Int %D 2021 %T Associations of hemoglobin and change in hemoglobin with risk of incident hip fracture in older men and women: the cardiovascular health study. %A Valderrábano, R J %A Bůžková, P %A Chang, P-Y %A Zakai, N A %A Fink, H A %A Robbins, J A %A Wu, J Y %A Lee, J S %X

In a multi-site longitudinal cohort study, decreasing hemoglobin was associated with increased hip fracture risk in men. Anemia was associated with hip fracture in men and in African American women. Decreasing hemoglobin may be a marker of progressing bone fragility, making its serial measurement useful for fracture risk stratification.

INTRODUCTION: Hematopoiesis and bone health are interdependent. Anemia has been associated with risk of fracture in humans. To further elucidate this relationship, we hypothesized that decreasing hemoglobin could indicate defective hematopoiesis and would also predict fracture risk.

METHODS: We performed a prospective analysis from study baseline (1992) of the Cardiovascular Health Study, a multi-site longitudinal cohort study. A total of 4670 men and women, ages >65 years, who were able to consent and not institutionalized or wheelchair bound, had hemoglobin (Hb) measured in 1992. For 4006 subjects, Hb change from 1989 to 1992 was annualized and divided into sex-specific quartiles. Incident hip fractures were verified against Medicare claims data during a median follow-up of 11.8 years.

RESULTS: Nested Cox proportional-hazard models estimated association of hip fracture with anemia (men Hb <13 g/dL, women Hb <12 g/dL) and separately, greatest Hb decrease (versus others). Anemia was associated with increased hip fracture risk in all men (HR 1.59; 95% CI 1.01-2.50) and African American women (HR 3.21; 95% CI 1.07-9.63). In men, an annualized Hb loss of >0.36 g/dL/year was associated with a higher risk of hip fracture (HR 1.67; 95% CI 1.10-2.54), which was lessened by anemia at the start of fracture follow-up (HR 1.53; 95% CI 0.99-2.39).

CONCLUSIONS: Decreasing Hb may be an early marker for subsequent hip fracture risk in men, which may be less informative once an anemia threshold is crossed. Only African American women with anemia had increased hip fracture risk, suggesting a race difference in this relationship.

%B Osteoporos Int %8 2021 Feb 12 %G eng %R 10.1007/s00198-021-05873-y %0 Journal Article %J J Am Heart Assoc %D 2021 %T Associations of Serum Nonesterified Fatty Acids With Coronary Heart Disease Mortality and Nonfatal Myocardial Infarction: The CHS (Cardiovascular Health Study) Cohort. %A Huang, Neil K %A Bůzková, Petra %A Matthan, Nirupa R %A Djoussé, Luc %A Hirsch, Calvin H %A Kizer, Jorge R %A Longstreth, W T %A Mukamal, Kenneth J %A Lichtenstein, Alice H %X

Background Significant associations have been reported between serum total nonesterified fatty acid (NEFA) concentrations and coronary heart disease (CHD) mortality and incident nonfatal myocardial infarction (MI) in some prospective cohort studies. Little is known about whether individual or subclasses (saturated, polyunsaturated [n-6 and n-3], and fatty acids) of serum NEFAs relate to CHD mortality and nonfatal MI. Methods and Results CHS (Cardiovascular Health Study) participants (N=1681) who had no history of MI, angina, or revascularization or were free of MI at baseline (1996-1997) were included. NEFAs were quantified using gas chromatography. Cox regression analysis was used to evaluate associations of 5 subclasses and individual NEFAs with CHD composite (CHD mortality and nonfatal MI), CHD mortality, and incident nonfatal MI. During a median follow-up of 11.7 years, 266 cases of CHD death and 271 cases of nonfatal MI occurred. In the fully adjusted model, no significant associations were identified between individual NEFA and CHD composite. Exploratory analyses indicated that lauric acid (12:0) was negatively associated (hazard ratio [HR], 0.76; 95% CI, 0.59-0.98; =0.0328) and dihomo-γ-linolenic acid (20:3n-6) was positively associated with CHD mortality (HR, 1.34; 95% CI, 1.02-1.76; =0.0351). Elaidic acid (18:1n-7) was positively associated with incident nonfatal MI (HR, 1.46; 95% CI, 1.01-2.12; =0.0445). No significant associations were observed for NEFA subclass and any outcomes. Conclusions In CHS participants, 2 NEFAs, dihomo-γ-linolenic and elaidic acids, were positively associated with CHD mortality and nonfatal MI, respectively, suggesting potential susceptibility biomarkers for risks of CHD mortality and nonfatal MI.

%B J Am Heart Assoc %V 10 %P e019135 %8 2021 Mar 16 %G eng %N 6 %R 10.1161/JAHA.120.019135 %0 Journal Article %J HGG Adv %D 2021 %T BinomiRare: A robust test for association of a rare genetic variant with a binary outcome for mixed models and any case-control proportion. %A Sofer, Tamar %A Lee, Jiwon %A Kurniansyah, Nuzulul %A Jain, Deepti %A Laurie, Cecelia A %A Gogarten, Stephanie M %A Conomos, Matthew P %A Heavner, Ben %A Hu, Yao %A Kooperberg, Charles %A Haessler, Jeffrey %A Vasan, Ramachandran S %A Cupples, L Adrienne %A Coombes, Brandon J %A Seyerle, Amanda %A Gharib, Sina A %A Chen, Han %A O'Connell, Jeffrey R %A Zhang, Man %A Gottlieb, Daniel J %A Psaty, Bruce M %A Longstreth, W T %A Rotter, Jerome I %A Taylor, Kent D %A Rich, Stephen S %A Guo, Xiuqing %A Boerwinkle, Eric %A Morrison, Alanna C %A Pankow, James S %A Johnson, Andrew D %A Pankratz, Nathan %A Reiner, Alex P %A Redline, Susan %A Smith, Nicholas L %A Rice, Kenneth M %A Schifano, Elizabeth D %X

Whole-genome sequencing (WGS) and whole-exome sequencing studies have become increasingly available and are being used to identify rare genetic variants associated with health and disease outcomes. Investigators routinely use mixed models to account for genetic relatedness or other clustering variables (e.g., family or household) when testing genetic associations. However, no existing tests of the association of a rare variant with a binary outcome in the presence of correlated data control the type 1 error where there are (1) few individuals harboring the rare allele, (2) a small proportion of cases relative to controls, and (3) covariates to adjust for. Here, we address all three issues in developing a framework for testing rare variant association with a binary trait in individuals harboring at least one risk allele. In this framework, we estimate outcome probabilities under the null hypothesis and then use them, within the individuals with at least one risk allele, to test variant associations. We extend the BinomiRare test, which was previously proposed for independent observations, and develop the Conway-Maxwell-Poisson (CMP) test and study their properties in simulations. We show that the BinomiRare test always controls the type 1 error, while the CMP test sometimes does not. We then use the BinomiRare test to test the association of rare genetic variants in target genes with small-vessel disease (SVD) stroke, short sleep, and venous thromboembolism (VTE), in whole-genome sequence data from the Trans-Omics for Precision Medicine (TOPMed) program.

%B HGG Adv %V 2 %8 2021 Jul 08 %G eng %N 3 %R 10.1016/j.xhgg.2021.100040 %0 Journal Article %J Nat Commun %D 2021 %T Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies. %A Harris, William S %A Tintle, Nathan L %A Imamura, Fumiaki %A Qian, Frank %A Korat, Andres V Ardisson %A Marklund, Matti %A Djoussé, Luc %A Bassett, Julie K %A Carmichael, Pierre-Hugues %A Chen, Yun-Yu %A Hirakawa, Yoichiro %A Küpers, Leanne K %A Laguzzi, Federica %A Lankinen, Maria %A Murphy, Rachel A %A Samieri, Cecilia %A Senn, Mackenzie K %A Shi, Peilin %A Virtanen, Jyrki K %A Brouwer, Ingeborg A %A Chien, Kuo-Liong %A Eiriksdottir, Gudny %A Forouhi, Nita G %A Geleijnse, Johanna M %A Giles, Graham G %A Gudnason, Vilmundur %A Helmer, Catherine %A Hodge, Allison %A Jackson, Rebecca %A Khaw, Kay-Tee %A Laakso, Markku %A Lai, Heidi %A Laurin, Danielle %A Leander, Karin %A Lindsay, Joan %A Micha, Renata %A Mursu, Jaako %A Ninomiya, Toshiharu %A Post, Wendy %A Psaty, Bruce M %A Riserus, Ulf %A Robinson, Jennifer G %A Shadyab, Aladdin H %A Snetselaar, Linda %A Sala-Vila, Aleix %A Sun, Yangbo %A Steffen, Lyn M %A Tsai, Michael Y %A Wareham, Nicholas J %A Wood, Alexis C %A Wu, Jason H Y %A Hu, Frank %A Sun, Qi %A Siscovick, David S %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %K Aged %K Aged, 80 and over %K Cause of Death %K Fatty Acids, Omega-3 %K Female %K Follow-Up Studies %K Humans %K Male %K Middle Aged %K Mortality, Premature %K Prospective Studies %K Protective Factors %K Risk Factors %X

The health effects of omega-3 fatty acids have been controversial. Here we report the results of a de novo pooled analysis conducted with data from 17 prospective cohort studies examining the associations between blood omega-3 fatty acid levels and risk for all-cause mortality. Over a median of 16 years of follow-up, 15,720 deaths occurred among 42,466 individuals. We found that, after multivariable adjustment for relevant risk factors, risk for death from all causes was significantly lower (by 15-18%, at least p < 0.003) in the highest vs the lowest quintile for circulating long chain (20-22 carbon) omega-3 fatty acids (eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids). Similar relationships were seen for death from cardiovascular disease, cancer and other causes. No associations were seen with the 18-carbon omega-3, alpha-linolenic acid. These findings suggest that higher circulating levels of marine n-3 PUFA are associated with a lower risk of premature death.

%B Nat Commun %V 12 %P 2329 %8 2021 04 22 %G eng %N 1 %R 10.1038/s41467-021-22370-2 %0 Journal Article %J Ann Epidemiol %D 2021 %T Cardiovascular damage phenotypes and all-cause and CVD mortality in older adults. %A Miller, Lindsay M %A Wu, Chenkai %A Hirsch, Calvin H %A Lopez, Oscar L %A Cushman, Mary %A Odden, Michelle C %X

PURPOSE: The association between CVD risk factors and mortality is well established, however, current tools for addressing subgroups have focused on the overall burden of disease. The identification of risky combinations of characteristics may lead to a better understanding of physiologic pathways that underlie morbidity and mortality in older adults.

METHODS: Participants included 5067 older adults from the Cardiovascular Health Study, followed for up to 6 years. Using latent class analysis (LCA), we created CV damage phenotypes based on probabilities of abnormal brain infarctions, major echocardiogram abnormalities, N-terminal probrain natriuretic peptide, troponin T, interleukin-6, c reactive-protein, galectin-3, cystatin C. We assigned class descriptions based on the probability of having an abnormality among risk factors, such that a healthy phenotype would have low probabilities in all risk factors. Participants were assigned to phenotypes based on the maximum probability of membership. We used Cox-proportional hazards regression to evaluate the association between the categorical CV damage phenotype and all-cause and CVD-mortality.

RESULTS: The analysis yielded 5 CV damage phenotypes consistent with the following descriptions: healthy (59%), cardio-renal (11%), cardiac (15%), multisystem morbidity (6%), and inflammatory (9%). All four phenotypes were statistically associated with a greater risk of all-cause mortality when compared with the healthy phenotype. The multisystem morbidity phenotype had the greatest risk of all-cause death (HR: 4.02; 95% CI: 3.44, 4.70), and CVD-mortality (HR: 4.90, 95% CI: 3.95, 6.06).

CONCLUSIONS: Five CV damage phenotypes emerged from CVD risk factor measures. CV damage across multiple systems confers a greater mortality risk compared to damage in any single domain.

%B Ann Epidemiol %V 63 %P 35-40 %8 2021 Jul 30 %G eng %R 10.1016/j.annepidem.2021.07.012 %0 Journal Article %J J Alzheimers Dis %D 2021 %T Cerebral Blood Flow Predicts Conversion of Mild Cognitive Impairment into Alzheimer's Disease and Cognitive Decline: An Arterial Spin Labeling Follow-up Study. %A Duan, Wenna %A Zhou, Grace D %A Balachandrasekaran, Arvind %A Bhumkar, Ashish B %A Boraste, Paresh B %A Becker, James T %A Kuller, Lewis H %A Lopez, Oscar L %A Gach, H Michael %A Dai, Weiying %X

BACKGROUND: This is the first longitudinal study to assess regional cerebral blood flow (rCBF) changes during the progression from normal control (NC) through mild cognitive impairment (MCI) and Alzheimer's disease (AD).

OBJECTIVE: We aim to determine if perfusion MRI biomarkers, derived from our prior cross-sectional study, can predict the onset and cognitive decline of AD.

METHODS: Perfusion MRIs using arterial spin labeling (ASL) were acquired in 15 stable-NC, 14 NC-to-MCI, 16 stable-MCI, and 18 MCI/AD-to-AD participants from the Cardiovascular Health Study (CHS) cognition study. Group comparisons, predictions of AD conversion and time to conversion, and Modified Mini-Mental State Examination (3MSE) from rCBF were performed.

RESULTS: Compared to the stable-NC group: 1) the stable-MCI group exhibited rCBF decreases in the right temporoparietal (p = 0.00010) and right inferior frontal and insula (p = 0.0094) regions; and 2) the MCI/AD-to-AD group exhibited rCBF decreases in the bilateral temporoparietal regions (p = 0.00062 and 0.0035). Compared to the NC-to-MCI group, the stable-MCI group exhibited a rCBF decrease in the right hippocampus region (p = 0.0053). The baseline rCBF values in the posterior cingulate cortex (PCC) (p = 0.0043), bilateral superior medial frontal regions (BSMF) (p = 0.012), and left inferior frontal (p = 0.010) regions predicted the 3MSE scores for all the participants at follow-up. The baseline rCBF in the PCC and BSMF regions predicted the conversion and time to conversion from MCI to AD (p < 0.05; not significant after multiple corrections).

CONCLUSION: We demonstrated the feasibility of ASL in detecting rCBF changes in the typical AD-affected regions and the predictive value of baseline rCBF on AD conversion and cognitive decline.

%B J Alzheimers Dis %V 82 %P 293-305 %8 2021 %G eng %N 1 %R 10.3233/JAD-210199 %0 Journal Article %J Nat Commun %D 2021 %T Chromosome Xq23 is associated with lower atherogenic lipid concentrations and favorable cardiometabolic indices. %A Natarajan, Pradeep %A Pampana, Akhil %A Graham, Sarah E %A Ruotsalainen, Sanni E %A Perry, James A %A de Vries, Paul S %A Broome, Jai G %A Pirruccello, James P %A Honigberg, Michael C %A Aragam, Krishna %A Wolford, Brooke %A Brody, Jennifer A %A Antonacci-Fulton, Lucinda %A Arden, Moscati %A Aslibekyan, Stella %A Assimes, Themistocles L %A Ballantyne, Christie M %A Bielak, Lawrence F %A Bis, Joshua C %A Cade, Brian E %A Do, Ron %A Doddapaneni, Harsha %A Emery, Leslie S %A Hung, Yi-Jen %A Irvin, Marguerite R %A Khan, Alyna T %A Lange, Leslie %A Lee, Jiwon %A Lemaitre, Rozenn N %A Martin, Lisa W %A Metcalf, Ginger %A Montasser, May E %A Moon, Jee-Young %A Muzny, Donna %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Peralta, Juan M %A Peyser, Patricia A %A Stilp, Adrienne M %A Tsai, Michael %A Wang, Fei Fei %A Weeks, Daniel E %A Yanek, Lisa R %A Wilson, James G %A Abecasis, Goncalo %A Arnett, Donna K %A Becker, Lewis C %A Blangero, John %A Boerwinkle, Eric %A Bowden, Donald W %A Chang, Yi-Cheng %A Chen, Yii-der I %A Choi, Won Jung %A Correa, Adolfo %A Curran, Joanne E %A Daly, Mark J %A Dutcher, Susan K %A Ellinor, Patrick T %A Fornage, Myriam %A Freedman, Barry I %A Gabriel, Stacey %A Germer, Soren %A Gibbs, Richard A %A He, Jiang %A Hveem, Kristian %A Jarvik, Gail P %A Kaplan, Robert C %A Kardia, Sharon L R %A Kenny, Eimear %A Kim, Ryan W %A Kooperberg, Charles %A Laurie, Cathy C %A Lee, Seonwook %A Lloyd-Jones, Don M %A Loos, Ruth J F %A Lubitz, Steven A %A Mathias, Rasika A %A Martinez, Karine A Viaud %A McGarvey, Stephen T %A Mitchell, Braxton D %A Nickerson, Deborah A %A North, Kari E %A Palotie, Aarno %A Park, Cheol Joo %A Psaty, Bruce M %A Rao, D C %A Redline, Susan %A Reiner, Alexander P %A Seo, Daekwan %A Seo, Jeong-Sun %A Smith, Albert V %A Tracy, Russell P %A Vasan, Ramachandran S %A Kathiresan, Sekar %A Cupples, L Adrienne %A Rotter, Jerome I %A Morrison, Alanna C %A Rich, Stephen S %A Ripatti, Samuli %A Willer, Cristen %A Peloso, Gina M %X

Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and 591,247 controls (P = 1.7 × 10), and reduced odds for diabetes mellitus type 2 among 54,095 cases and 573,885 controls (P = 1.4 × 10). Although we observe an association with increased BMI, waist-to-hip ratio adjusted for BMI is reduced, bioimpedance analyses indicate increased gluteofemoral fat, and abdominal MRI analyses indicate reduced visceral adiposity. Co-localization analyses strongly correlate increased CHRDL1 gene expression, particularly in adipose tissue, with reduced concentrations of blood lipids.

%B Nat Commun %V 12 %P 2182 %8 2021 04 12 %G eng %N 1 %R 10.1038/s41467-021-22339-1 %0 Journal Article %J Clin Chem %D 2021 %T Circulating Ceramides and Sphingomyelins and Risk of Mortality: The Cardiovascular Health Study. %A Fretts, Amanda M %A Jensen, Paul N %A Hoofnagle, Andrew N %A McKnight, Barbara %A Sitlani, Colleen M %A Siscovick, David S %A King, Irena B %A Psaty, Bruce M %A Sotoodehnia, Nona %A Lemaitre, Rozenn N %X

BACKGROUND: Recent studies suggest that associations of ceramides (Cer) and sphingomyelins (SM) with health outcomes differ according to the fatty acid acylated to the sphingoid backbone. The purpose of this study was to assess associations of Cer and SM species with mortality.

METHODS: The study population included participants from the Cardiovascular Health Study (CHS), a community-based cohort of adults aged ≥65 years who were followed from 1992-2015 (n = 4612). Associations of plasma Cer and SM species carrying long-chain (i.e., 16:0) and very-long-chain (i.e., 20:0, 22:0, 24:0) saturated fatty acids with mortality were assessed using Cox proportional hazards models.

RESULTS: During a median follow-up of 10.2 years, 4099 deaths occurred. High concentrations of Cer and SM carrying fatty acid 16:0 were each associated with an increased risk of mortality. Conversely, high concentrations of several ceramide and sphingomyelin species carrying longer fatty acids were each associated with a decreased risk of mortality. The hazard ratios for total mortality per 2-fold difference in each Cer and SM species were: 1.89 (95% CI), 1.65-2.17 for Cer-16, 0.79 (95% CI, 0.70-0.88) for Cer-22, 0.74 (95% CI, 0.65-0.84) for Cer-24, 2.51 (95% CI, 2.01-3.14) for SM-16, 0.68 (95% CI, 0.58-0.79) for SM-20, 0.57 (95% CI, 0.49-0.67) for SM-22, and 0.66 (0.57-0.75) for SM-24. We found no association of Cer-20 with risk of death.

CONCLUSIONS: Associations of Cer and SM with the risk of death differ according to the length of their acylated saturated fatty acid. Future studies are needed to explore mechanisms underlying these relationships.

%B Clin Chem %V 67 %P 1650-1659 %8 2021 Nov 26 %G eng %N 12 %R 10.1093/clinchem/hvab182 %0 Journal Article %J Epilepsia %D 2021 %T Cognitive decline in older adults with epilepsy: The Cardiovascular Health Study. %A Choi, Hyunmi %A Thacker, Evan L %A Longstreth, William T %A Elkind, Mitchell S V %A Boehme, Amelia K %X

OBJECTIVE: Cognitive decline is a major concern for older adults with epilepsy. Whether and how much faster older adults with epilepsy experience cognitive decline beyond expected age-related cognitive change remain unclear. We sought to estimate and compare rates of cognitive decline in older adults with and without epilepsy.

METHODS: The Cardiovascular Health Study is a population-based longitudinal cohort study of 5888 US adults aged 65+. Cognitive function was assessed annually with Modified Mini-Mental State Exam (3MS) and Digit Symbol Substitution Test (DSST). We used linear mixed models to estimate average rates of decline in 3MS and DSST scores by epilepsy status (prevalent, incident, or no epilepsy), adjusted for risk factors associated with cognitive decline.

RESULTS: The rate of decline in 3MS was significantly faster in prevalent epilepsy (P < .001) and after incident epilepsy (P = .002) compared with no epilepsy. Prevalent epilepsy and apolipoprotein E gene (APOE) ε4 (ApoE4) had a synergistic interaction, whereby prevalent epilepsy and ApoE4 together were associated with 1.51 points faster annual decline in 3MS than would be expected if prevalent epilepsy and ApoE4 did not interact (P < .001). Older adults with prevalent epilepsy had a significantly lower initial DSST score and faster rate of decline compared to those with no epilepsy (P < .001).

SIGNIFICANCE: Faster decline in global cognitive ability seen in this study validates concerns of patients. ApoE4 allele status was an effect modifier of the relationship between cognitive decline and prevalent epilepsy. Further research is warranted to explore biological mechanisms and possible interventions to mitigate cognitive decline.

%B Epilepsia %V 62 %P 85-97 %8 2021 Jan %G eng %N 1 %R 10.1111/epi.16748 %0 Journal Article %J Nat Commun %D 2021 %T Determinants of penetrance and variable expressivity in monogenic metabolic conditions across 77,184 exomes. %A Goodrich, Julia K %A Singer-Berk, Moriel %A Son, Rachel %A Sveden, Abigail %A Wood, Jordan %A England, Eleina %A Cole, Joanne B %A Weisburd, Ben %A Watts, Nick %A Caulkins, Lizz %A Dornbos, Peter %A Koesterer, Ryan %A Zappala, Zachary %A Zhang, Haichen %A Maloney, Kristin A %A Dahl, Andy %A Aguilar-Salinas, Carlos A %A Atzmon, Gil %A Barajas-Olmos, Francisco %A Barzilai, Nir %A Blangero, John %A Boerwinkle, Eric %A Bonnycastle, Lori L %A Bottinger, Erwin %A Bowden, Donald W %A Centeno-Cruz, Federico %A Chambers, John C %A Chami, Nathalie %A Chan, Edmund %A Chan, Juliana %A Cheng, Ching-Yu %A Cho, Yoon Shin %A Contreras-Cubas, Cecilia %A Córdova, Emilio %A Correa, Adolfo %A DeFronzo, Ralph A %A Duggirala, Ravindranath %A Dupuis, Josée %A Garay-Sevilla, Ma Eugenia %A García-Ortiz, Humberto %A Gieger, Christian %A Glaser, Benjamin %A González-Villalpando, Clicerio %A Gonzalez, Ma Elena %A Grarup, Niels %A Groop, Leif %A Gross, Myron %A Haiman, Christopher %A Han, Sohee %A Hanis, Craig L %A Hansen, Torben %A Heard-Costa, Nancy L %A Henderson, Brian E %A Hernandez, Juan Manuel Malacara %A Hwang, Mi Yeong %A Islas-Andrade, Sergio %A Jørgensen, Marit E %A Kang, Hyun Min %A Kim, Bong-Jo %A Kim, Young Jin %A Koistinen, Heikki A %A Kooner, Jaspal Singh %A Kuusisto, Johanna %A Kwak, Soo-Heon %A Laakso, Markku %A Lange, Leslie %A Lee, Jong-Young %A Lee, Juyoung %A Lehman, Donna M %A Linneberg, Allan %A Liu, Jianjun %A Loos, Ruth J F %A Lyssenko, Valeriya %A Ma, Ronald C W %A Martínez-Hernández, Angélica %A Meigs, James B %A Meitinger, Thomas %A Mendoza-Caamal, Elvia %A Mohlke, Karen L %A Morris, Andrew D %A Morrison, Alanna C %A Ng, Maggie C Y %A Nilsson, Peter M %A O'Donnell, Christopher J %A Orozco, Lorena %A Palmer, Colin N A %A Park, Kyong Soo %A Post, Wendy S %A Pedersen, Oluf %A Preuss, Michael %A Psaty, Bruce M %A Reiner, Alexander P %A Revilla-Monsalve, Cristina %A Rich, Stephen S %A Rotter, Jerome I %A Saleheen, Danish %A Schurmann, Claudia %A Sim, Xueling %A Sladek, Rob %A Small, Kerrin S %A So, Wing Yee %A Spector, Timothy D %A Strauch, Konstantin %A Strom, Tim M %A Tai, E Shyong %A Tam, Claudia H T %A Teo, Yik Ying %A Thameem, Farook %A Tomlinson, Brian %A Tracy, Russell P %A Tuomi, Tiinamaija %A Tuomilehto, Jaakko %A Tusié-Luna, Teresa %A van Dam, Rob M %A Vasan, Ramachandran S %A Wilson, James G %A Witte, Daniel R %A Wong, Tien-Yin %A Burtt, Noel P %A Zaitlen, Noah %A McCarthy, Mark I %A Boehnke, Michael %A Pollin, Toni I %A Flannick, Jason %A Mercader, Josep M %A O'Donnell-Luria, Anne %A Baxter, Samantha %A Florez, Jose C %A MacArthur, Daniel G %A Udler, Miriam S %K Adult %K Biological Variation, Population %K Biomarkers %K Diabetes Mellitus, Type 2 %K Dyslipidemias %K Exome %K Genetic Predisposition to Disease %K Genotype %K Humans %K Multifactorial Inheritance %K Penetrance %K Risk Assessment %X

Hundreds of thousands of genetic variants have been reported to cause severe monogenic diseases, but the probability that a variant carrier develops the disease (termed penetrance) is unknown for virtually all of them. Additionally, the clinical utility of common polygenetic variation remains uncertain. Using exome sequencing from 77,184 adult individuals (38,618 multi-ancestral individuals from a type 2 diabetes case-control study and 38,566 participants from the UK Biobank, for whom genotype array data were also available), we apply clinical standard-of-care gene variant curation for eight monogenic metabolic conditions. Rare variants causing monogenic diabetes and dyslipidemias display effect sizes significantly larger than the top 1% of the corresponding polygenic scores. Nevertheless, penetrance estimates for monogenic variant carriers average 60% or lower for most conditions. We assess epidemiologic and genetic factors contributing to risk prediction in monogenic variant carriers, demonstrating that inclusion of polygenic variation significantly improves biomarker estimation for two monogenic dyslipidemias.

%B Nat Commun %V 12 %P 3505 %8 2021 06 09 %G eng %N 1 %R 10.1038/s41467-021-23556-4 %0 Journal Article %J Am J Hum Genet %D 2021 %T Discovery and fine-mapping of height loci via high-density imputation of GWASs in individuals of African ancestry. %A Graff, Mariaelisa %A Justice, Anne E %A Young, Kristin L %A Marouli, Eirini %A Zhang, Xinruo %A Fine, Rebecca S %A Lim, Elise %A Buchanan, Victoria %A Rand, Kristin %A Feitosa, Mary F %A Wojczynski, Mary K %A Yanek, Lisa R %A Shao, Yaming %A Rohde, Rebecca %A Adeyemo, Adebowale A %A Aldrich, Melinda C %A Allison, Matthew A %A Ambrosone, Christine B %A Ambs, Stefan %A Amos, Christopher %A Arnett, Donna K %A Atwood, Larry %A Bandera, Elisa V %A Bartz, Traci %A Becker, Diane M %A Berndt, Sonja I %A Bernstein, Leslie %A Bielak, Lawrence F %A Blot, William J %A Bottinger, Erwin P %A Bowden, Donald W %A Bradfield, Jonathan P %A Brody, Jennifer A %A Broeckel, Ulrich %A Burke, Gregory %A Cade, Brian E %A Cai, Qiuyin %A Caporaso, Neil %A Carlson, Chris %A Carpten, John %A Casey, Graham %A Chanock, Stephen J %A Chen, Guanjie %A Chen, Minhui %A Chen, Yii-der I %A Chen, Wei-Min %A Chesi, Alessandra %A Chiang, Charleston W K %A Chu, Lisa %A Coetzee, Gerry A %A Conti, David V %A Cooper, Richard S %A Cushman, Mary %A Demerath, Ellen %A Deming, Sandra L %A Dimitrov, Latchezar %A Ding, Jingzhong %A Diver, W Ryan %A Duan, Qing %A Evans, Michele K %A Falusi, Adeyinka G %A Faul, Jessica D %A Fornage, Myriam %A Fox, Caroline %A Freedman, Barry I %A Garcia, Melissa %A Gillanders, Elizabeth M %A Goodman, Phyllis %A Gottesman, Omri %A Grant, Struan F A %A Guo, Xiuqing %A Hakonarson, Hakon %A Haritunians, Talin %A Harris, Tamara B %A Harris, Curtis C %A Henderson, Brian E %A Hennis, Anselm %A Hernandez, Dena G %A Hirschhorn, Joel N %A McNeill, Lorna Haughton %A Howard, Timothy D %A Howard, Barbara %A Hsing, Ann W %A Hsu, Yu-Han H %A Hu, Jennifer J %A Huff, Chad D %A Huo, Dezheng %A Ingles, Sue A %A Irvin, Marguerite R %A John, Esther M %A Johnson, Karen C %A Jordan, Joanne M %A Kabagambe, Edmond K %A Kang, Sun J %A Kardia, Sharon L %A Keating, Brendan J %A Kittles, Rick A %A Klein, Eric A %A Kolb, Suzanne %A Kolonel, Laurence N %A Kooperberg, Charles %A Kuller, Lewis %A Kutlar, Abdullah %A Lange, Leslie %A Langefeld, Carl D %A Le Marchand, Loïc %A Leonard, Hampton %A Lettre, Guillaume %A Levin, Albert M %A Li, Yun %A Li, Jin %A Liu, Yongmei %A Liu, Youfang %A Liu, Simin %A Lohman, Kurt %A Lotay, Vaneet %A Lu, Yingchang %A Maixner, William %A Manson, JoAnn E %A McKnight, Barbara %A Meng, Yan %A Monda, Keri L %A Monroe, Kris %A Moore, Jason H %A Mosley, Thomas H %A Mudgal, Poorva %A Murphy, Adam B %A Nadukuru, Rajiv %A Nalls, Mike A %A Nathanson, Katherine L %A Nayak, Uma %A N'diaye, Amidou %A Nemesure, Barbara %A Neslund-Dudas, Christine %A Neuhouser, Marian L %A Nyante, Sarah %A Ochs-Balcom, Heather %A Ogundiran, Temidayo O %A Ogunniyi, Adesola %A Ojengbede, Oladosu %A Okut, Hayrettin %A Olopade, Olufunmilayo I %A Olshan, Andrew %A Padhukasahasram, Badri %A Palmer, Julie %A Palmer, Cameron D %A Palmer, Nicholette D %A Papanicolaou, George %A Patel, Sanjay R %A Pettaway, Curtis A %A Peyser, Patricia A %A Press, Michael F %A Rao, D C %A Rasmussen-Torvik, Laura J %A Redline, Susan %A Reiner, Alex P %A Rhie, Suhn K %A Rodriguez-Gil, Jorge L %A Rotimi, Charles N %A Rotter, Jerome I %A Ruiz-Narvaez, Edward A %A Rybicki, Benjamin A %A Salako, Babatunde %A Sale, Michèle M %A Sanderson, Maureen %A Schadt, Eric %A Schreiner, Pamela J %A Schurmann, Claudia %A Schwartz, Ann G %A Shriner, Daniel A %A Signorello, Lisa B %A Singleton, Andrew B %A Siscovick, David S %A Smith, Jennifer A %A Smith, Shad %A Speliotes, Elizabeth %A Spitz, Margaret %A Stanford, Janet L %A Stevens, Victoria L %A Stram, Alex %A Strom, Sara S %A Sucheston, Lara %A Sun, Yan V %A Tajuddin, Salman M %A Taylor, Herman %A Taylor, Kira %A Tayo, Bamidele O %A Thun, Michael J %A Tucker, Margaret A %A Vaidya, Dhananjay %A Van Den Berg, David J %A Vedantam, Sailaja %A Vitolins, Mara %A Wang, Zhaoming %A Ware, Erin B %A Wassertheil-Smoller, Sylvia %A Weir, David R %A Wiencke, John K %A Williams, Scott M %A Williams, L Keoki %A Wilson, James G %A Witte, John S %A Wrensch, Margaret %A Wu, Xifeng %A Yao, Jie %A Zakai, Neil %A Zanetti, Krista %A Zemel, Babette S %A Zhao, Wei %A Zhao, Jing Hua %A Zheng, Wei %A Zhi, Degui %A Zhou, Jie %A Zhu, Xiaofeng %A Ziegler, Regina G %A Zmuda, Joe %A Zonderman, Alan B %A Psaty, Bruce M %A Borecki, Ingrid B %A Cupples, L Adrienne %A Liu, Ching-Ti %A Haiman, Christopher A %A Loos, Ruth %A Ng, Maggie C Y %A North, Kari E %X

Although many loci have been associated with height in European ancestry populations, very few have been identified in African ancestry individuals. Furthermore, many of the known loci have yet to be generalized to and fine-mapped within a large-scale African ancestry sample. We performed sex-combined and sex-stratified meta-analyses in up to 52,764 individuals with height and genome-wide genotyping data from the African Ancestry Anthropometry Genetics Consortium (AAAGC). We additionally combined our African ancestry meta-analysis results with published European genome-wide association study (GWAS) data. In the African ancestry analyses, we identified three novel loci (SLC4A3, NCOA2, ECD/FAM149B1) in sex-combined results and two loci (CRB1, KLF6) in women only. In the African plus European sex-combined GWAS, we identified an additional three novel loci (RCCD1, G6PC3, CEP95) which were equally driven by AAAGC and European results. Among 39 genome-wide significant signals at known loci, conditioning index SNPs from European studies identified 20 secondary signals. Two of the 20 new secondary signals and none of the 8 novel loci had minor allele frequencies (MAF) < 5%. Of 802 known European height signals, 643 displayed directionally consistent associations with height, of which 205 were nominally significant (p < 0.05) in the African ancestry sex-combined sample. Furthermore, 148 of 241 loci contained ≤20 variants in the credible sets that jointly account for 99% of the posterior probability of driving the associations. In summary, trans-ethnic meta-analyses revealed novel signals and further improved fine-mapping of putative causal variants in loci shared between African and European ancestry populations.

%B Am J Hum Genet %V 108 %P 564-582 %8 2021 Apr 01 %G eng %N 4 %R 10.1016/j.ajhg.2021.02.011 %0 Journal Article %J Clin Nutr %D 2021 %T Egg consumption, overall diet quality, and risk of type 2 diabetes and coronary heart disease: A pooling project of US prospective cohorts. %A Djoussé, Luc %A Zhou, Guohai %A McClelland, Robyn L %A Ma, Nanxun %A Zhou, Xia %A Kabagambe, Edmond K %A Talegawkar, Sameera A %A Judd, Suzanne E %A Biggs, Mary L %A Fitzpatrick, Annette L %A Clark, Cheryl R %A Gagnon, David R %A Steffen, Lyn M %A Gaziano, J Michael %A Lee, I-Min %A Buring, Julie E %A Manson, JoAnn E %K Adult %K Aged %K Cohort Studies %K Coronary Disease %K Diabetes Mellitus, Type 2 %K Diet %K Eggs %K Humans %K Middle Aged %K Prospective Studies %K Risk Factors %K United States %X

BACKGROUND AND AIMS: Data on the relation of egg consumption with risk of type 2 diabetes (T2D) and coronary heart disease (CHD) are limited and inconsistent. Few studies have controlled for overall dietary patterns in egg-T2D or egg-CHD analyses, and it is unclear whether any observed elevated risks of T2D and CHD with frequent egg consumption is real or due to confounding by dietary habits. We tested the hypothesis that frequent egg consumption is associated with a higher risk of T2D and CHD risk after adjustment for overall dietary patterns among adults.

DESIGN: We used prospective cohort design to complete time-to-event analyses.

METHODS: We pooled de novo, harmonized, individual-level analyses from nine US cohorts (n = 103,811). Cox regression was used to estimate hazard ratios separately in each cohort adjusting for age, ethnicity, body mass index (BMI), exercise, smoking, alcohol intake, and dietary patterns. We pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks.

RESULTS: Median age ranged from 25 to 72 years. Median egg consumption was 1 egg per week in most of the cohorts. While egg consumption up to one per week was not associated with T2D risk, consumption of ≥2 eggs per week was associated with elevated risk [27% elevated risk of T2D comparing 7+ eggs/week with none (95% CI: 16%-37%)]. There was little evidence for heterogeneity across cohorts and we observed similar conclusions when stratified by BMI. Overall, egg consumption was not associated with the risk of CHD. However, in a sensitivity analysis, there was a 30% higher risk of CHD (95% CI: 3%-56%) restricted to older adults consuming 5-6 eggs/week.

CONCLUSIONS: Our data showed an elevated risk of T2D with egg consumption of ≥2 eggs per week but not with <2 eggs/week. While there was no overall association of egg consumption with CHD risk, the elevated CHD observed with consumption of 5-6 eggs/week in older cohorts merits further investigation.

%B Clin Nutr %V 40 %P 2475-2482 %8 2021 05 %G eng %N 5 %R 10.1016/j.clnu.2021.03.003 %0 Journal Article %J Circulation %D 2021 %T Epigenetic Age and the Risk of Incident Atrial Fibrillation. %A Roberts, Jason D %A Vittinghoff, Eric %A Lu, Ake T %A Alonso, Alvaro %A Wang, Biqi %A Sitlani, Colleen M %A Mohammadi-Shemirani, Pedrum %A Fornage, Myriam %A Kornej, Jelena %A Brody, Jennifer A %A Arking, Dan E %A Lin, Honghuang %A Heckbert, Susan R %A Prokic, Ivana %A Ghanbari, Mohsen %A Skanes, Allan C %A Bartz, Traci M %A Perez, Marco V %A Taylor, Kent D %A Lubitz, Steven A %A Ellinor, Patrick T %A Lunetta, Kathryn L %A Pankow, James S %A Paré, Guillaume %A Sotoodehnia, Nona %A Benjamin, Emelia J %A Horvath, Steve %A Marcus, Gregory M %K Aged %K Aging %K Atrial Fibrillation %K DNA Methylation %K Epigenesis, Genetic %K Epigenomics %K Female %K Follow-Up Studies %K Humans %K Incidence %K Male %K Mendelian Randomization Analysis %K Middle Aged %K Models, Cardiovascular %K Models, Genetic %X

BACKGROUND: The most prominent risk factor for atrial fibrillation (AF) is chronological age; however, underlying mechanisms are unexplained. Algorithms using epigenetic modifications to the human genome effectively predict chronological age. Chronological and epigenetic predicted ages may diverge in a phenomenon referred to as epigenetic age acceleration (EAA), which may reflect accelerated biological aging. We sought to evaluate for associations between epigenetic age measures and incident AF.

METHODS: Measures for 4 epigenetic clocks (Horvath, Hannum, DNA methylation [DNAm] PhenoAge, and DNAm GrimAge) and an epigenetic predictor of PAI-1 (plasminogen activator inhibitor-1) levels (ie, DNAm PAI-1) were determined for study participants from 3 population-based cohort studies. Cox models evaluated for associations with incident AF and results were combined via random-effects meta-analyses. Two-sample summary-level Mendelian randomization analyses evaluated for associations between genetic instruments of the EAA measures and AF.

RESULTS: Among 5600 participants (mean age, 65.5 years; female, 60.1%; Black, 50.7%), there were 905 incident AF cases during a mean follow-up of 12.9 years. Unadjusted analyses revealed all 4 epigenetic clocks and the DNAm PAI-1 predictor were associated with statistically significant higher hazards of incident AF, though the magnitudes of their point estimates were smaller relative to the associations observed for chronological age. The pooled EAA estimates for each epigenetic measure, with the exception of Horvath EAA, were associated with incident AF in models adjusted for chronological age, race, sex, and smoking variables. After multivariable adjustment for additional known AF risk factors that could also potentially function as mediators, pooled EAA measures for 2 clocks remained statistically significant. Five-year increases in EAA measures for DNAm GrimAge and DNAm PhenoAge were associated with 19% (adjusted hazard ratio [HR], 1.19 [95% CI, 1.09-1.31]; <0.01) and 15% (adjusted HR, 1.15 [95% CI, 1.05-1.25]; <0.01) higher hazards of incident AF, respectively. Mendelian randomization analyses for the 5 EAA measures did not reveal statistically significant associations with AF.

CONCLUSIONS: Our study identified adjusted associations between EAA measures and incident AF, suggesting that biological aging plays an important role independent of chronological age, though a potential underlying causal relationship remains unclear. These aging processes may be modifiable and not constrained by the immutable factor of time.

%B Circulation %V 144 %P 1899-1911 %8 2021 12 14 %G eng %N 24 %R 10.1161/CIRCULATIONAHA.121.056456 %0 Journal Article %J Nat Commun %D 2021 %T {Epigenome-wide association meta-analysis of DNA methylation with coffee and tea consumption %A Karabegović, I. %A Portilla-Fernandez, E. %A Li, Y. %A Ma, J. %A Maas, S. C. E. %A Sun, D. %A Hu, E. A. %A Kühnel, B. %A Zhang, Y. %A Ambatipudi, S. %A Fiorito, G. %A Huang, J. %A Castillo-Fernandez, J. E. %A Wiggins, K. L. %A de Klein, N. %A Grioni, S. %A Swenson, B. R. %A Polidoro, S. %A Treur, J. L. %A Cuenin, C. %A Tsai, P. C. %A Costeira, R. %A Chajes, V. %A Braun, K. %A Verweij, N. %A Kretschmer, A. %A Franke, L. %A van Meurs, J. B. J. %A Uitterlinden, A. G. %A de Knegt, R. J. %A Ikram, M. A. %A Dehghan, A. %A Peters, A. %A Schöttker, B. %A Gharib, S. A. %A Sotoodehnia, N. %A Bell, J. T. %A Elliott, P. %A Vineis, P. %A Relton, C. %A Herceg, Z. %A Brenner, H. %A Waldenberger, M. %A Rebholz, C. M. %A Voortman, T. %A Pan, Q. %A Fornage, M. %A Levy, D. %A Kayser, M. %A Ghanbari, M. %X 10.1038/s41467-021-22752-6Coffee and tea are extensively consumed beverages worldwide which have received considerable attention regarding health. Intake of these beverages is consistently linked to, among others, reduced risk of diabetes and liver diseases; however, the mechanisms of action remain elusive. Epigenetics is suggested as a mechanism mediating the effects of dietary and lifestyle factors on disease onset. Here we report the results from epigenome-wide association studies (EWAS) on coffee and tea consumption in 15,789 participants of European and African-American ancestries from 15 cohorts. EWAS meta-analysis of coffee consumption reveals 11 CpGs surpassing the epigenome-wide significance threshold (P-value <1.1×10-7), which annotated to the AHRR, F2RL3, FLJ43663, HDAC4, GFI1 and PHGDH genes. Among them, cg14476101 is significantly associated with expression of the PHGDH and risk of fatty liver disease. Knockdown of PHGDH expression in liver cells shows a correlation with expression levels of genes associated with circulating lipids, suggesting a role of PHGDH in hepatic-lipid metabolism. EWAS meta-analysis on tea consumption reveals no significant association, only two CpGs annotated to CACNA1A and PRDM16 genes show suggestive association (P-value <5.0×10-6). These findings indicate that coffee-associated changes in DNA methylation levels may explain the mechanism of action of coffee consumption in conferring risk of diseases. %B Nat Commun %V 12 %P 2830 %8 05 %G eng %0 Journal Article %J Nat Commun %D 2021 %T Epigenome-wide association study of serum urate reveals insights into urate co-regulation and the SLC2A9 locus. %A Tin, Adrienne %A Schlosser, Pascal %A Matias-Garcia, Pamela R %A Thio, Chris H L %A Joehanes, Roby %A Liu, Hongbo %A Yu, Zhi %A Weihs, Antoine %A Hoppmann, Anselm %A Grundner-Culemann, Franziska %A Min, Josine L %A Kuhns, Victoria L Halperin %A Adeyemo, Adebowale A %A Agyemang, Charles %A Arnlöv, Johan %A Aziz, Nasir A %A Baccarelli, Andrea %A Bochud, Murielle %A Brenner, Hermann %A Bressler, Jan %A Breteler, Monique M B %A Carmeli, Cristian %A Chaker, Layal %A Coresh, Josef %A Corre, Tanguy %A Correa, Adolfo %A Cox, Simon R %A Delgado, Graciela E %A Eckardt, Kai-Uwe %A Ekici, Arif B %A Endlich, Karlhans %A Floyd, James S %A Fraszczyk, Eliza %A Gao, Xu %A Gào, Xīn %A Gelber, Allan C %A Ghanbari, Mohsen %A Ghasemi, Sahar %A Gieger, Christian %A Greenland, Philip %A Grove, Megan L %A Harris, Sarah E %A Hemani, Gibran %A Henneman, Peter %A Herder, Christian %A Horvath, Steve %A Hou, Lifang %A Hurme, Mikko A %A Hwang, Shih-Jen %A Kardia, Sharon L R %A Kasela, Silva %A Kleber, Marcus E %A Koenig, Wolfgang %A Kooner, Jaspal S %A Kronenberg, Florian %A Kuhnel, Brigitte %A Ladd-Acosta, Christine %A Lehtimäki, Terho %A Lind, Lars %A Liu, Dan %A Lloyd-Jones, Donald M %A Lorkowski, Stefan %A Lu, Ake T %A Marioni, Riccardo E %A März, Winfried %A McCartney, Daniel L %A Meeks, Karlijn A C %A Milani, Lili %A Mishra, Pashupati P %A Nauck, Matthias %A Nowak, Christoph %A Peters, Annette %A Prokisch, Holger %A Psaty, Bruce M %A Raitakari, Olli T %A Ratliff, Scott M %A Reiner, Alex P %A Schöttker, Ben %A Schwartz, Joel %A Sedaghat, Sanaz %A Smith, Jennifer A %A Sotoodehnia, Nona %A Stocker, Hannah R %A Stringhini, Silvia %A Sundström, Johan %A Swenson, Brenton R %A van Meurs, Joyce B J %A van Vliet-Ostaptchouk, Jana V %A Venema, Andrea %A Völker, Uwe %A Winkelmann, Juliane %A Wolffenbuttel, Bruce H R %A Zhao, Wei %A Zheng, Yinan %A Loh, Marie %A Snieder, Harold %A Waldenberger, Melanie %A Levy, Daniel %A Akilesh, Shreeram %A Woodward, Owen M %A Susztak, Katalin %A Teumer, Alexander %A Köttgen, Anna %K Amino Acid Transport System y+ %K Cohort Studies %K CpG Islands %K DNA Methylation %K Epigenome %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Glucose Transport Proteins, Facilitative %K Gout %K Humans %K Male %K Uric Acid %X

Elevated serum urate levels, a complex trait and major risk factor for incident gout, are correlated with cardiometabolic traits via incompletely understood mechanisms. DNA methylation in whole blood captures genetic and environmental influences and is assessed in transethnic meta-analysis of epigenome-wide association studies (EWAS) of serum urate (discovery, n = 12,474, replication, n = 5522). The 100 replicated, epigenome-wide significant (p < 1.1E-7) CpGs explain 11.6% of the serum urate variance. At SLC2A9, the serum urate locus with the largest effect in genome-wide association studies (GWAS), five CpGs are associated with SLC2A9 gene expression. Four CpGs at SLC2A9 have significant causal effects on serum urate levels and/or gout, and two of these partly mediate the effects of urate-associated GWAS variants. In other genes, including SLC7A11 and PHGDH, 17 urate-associated CpGs are associated with conditions defining metabolic syndrome, suggesting that these CpGs may represent a blood DNA methylation signature of cardiometabolic risk factors. This study demonstrates that EWAS can provide new insights into GWAS loci and the correlation of serum urate with other complex traits.

%B Nat Commun %V 12 %P 7173 %8 2021 12 09 %G eng %N 1 %R 10.1038/s41467-021-27198-4 %0 Journal Article %J J Am Heart Assoc %D 2021 %T Estimating Systolic Blood Pressure Intervention Trial Participant Posttrial Survival Using Pooled Epidemiologic Cohort Data. %A Bellows, Brandon K %A Zhang, Yiyi %A Zhang, Zugui %A Lloyd-Jones, Donald M %A Bress, Adam P %A King, Jordan B %A Kolm, Paul %A Cushman, William C %A Johnson, Karen C %A Tamariz, Leonardo %A Oelsner, Elizabeth C %A Shea, Steven %A Newman, Anne B %A Ives, Diane G %A Couper, David %A Moran, Andrew E %A Weintraub, William S %X

Background Intensive systolic blood pressure treatment (<120 mm Hg) in SPRINT (Systolic Blood Pressure Intervention Trial) improved survival compared with standard treatment (<140 mm Hg) over a median follow-up of 3.3 years. We projected life expectancy after observed follow-up in SPRINT using SPRINT-eligible participants in the NHLBI-PCS (National Heart, Lung, and Blood Institute Pooled Cohorts Study). Methods and Results We used propensity scores to weight SPRINT-eligible NHLBI-PCS participants to resemble SPRINT participants. In SPRINT participants, we estimated in-trial survival (<4 years) using a time-based flexible parametric survival model. In SPRINT-eligible NHLBI-PCS participants, we estimated posttrial survival (≥4 years) using an age-based flexible parametric survival model and applied the formula to SPRINT participants to predict posttrial survival. We projected overall life expectancy for each SPRINT participant and compared it to parametric regression (eg, Gompertz) projections based on SPRINT data alone. We included 8584 SPRINT and 10 593 SPRINT-eligible NHLBI-PCS participants. After propensity weighting, mean (SD) age was 67.9 (9.4) and 68.2 (8.8) years, and 35.5% and 37.6% were women in SPRINT and NHLBI-PCS, respectively. Using the NHLBI-PCS-based method, projected mean life expectancy from randomization was 21.0 (7.4) years with intensive and 19.1 (7.2) years with standard treatment. Using the Gompertz regression, life expectancy was 11.2 (2.3) years with intensive and 10.5 (2.2) years with standard treatment. Conclusions Combining SPRINT and NHLBI-PCS observed data likely offers a more realistic estimate of life expectancy than parametrically extrapolating SPRINT data alone. These results offer insight into the potential long-term effectiveness of intensive SBP goals.

%B J Am Heart Assoc %V 10 %P e020361 %8 2021 May 18 %G eng %N 10 %R 10.1161/JAHA.120.020361 %0 Journal Article %J J Thromb Haemost %D 2021 %T FGL1 as a modulator of plasma D-dimer levels: Exome-wide marker analysis of plasma tPA, PAI-1, and D-dimer. %A Thibord, Florian %A Song, Ci %A Pattee, Jack %A Rodriguez, Benjamin A T %A Chen, Ming-Huei %A O'Donnell, Christopher J %A Kleber, Marcus E %A Delgado, Graciela E %A Guo, Xiuqing %A Yao, Jie %A Taylor, Kent D %A Ozel, Ayse Bilge %A Brody, Jennifer A %A McKnight, Barbara %A Gyorgy, Beata %A Simonsick, Eleanor %A Leonard, Hampton L %A Carrasquilla, Germán D %A Guindo-Martinez, Marta %A Silveira, Angela %A Temprano-Sagrera, Gerard %A Yanek, Lisa R %A Becker, Diane M %A Mathias, Rasika A %A Becker, Lewis C %A Raffield, Laura M %A Kilpeläinen, Tuomas O %A Grarup, Niels %A Pedersen, Oluf %A Hansen, Torben %A Linneberg, Allan %A Hamsten, Anders %A Watkins, Hugh %A Sabater-Lleal, Maria %A Nalls, Mike A %A Trégouët, David-Alexandre %A Morange, Pierre-Emmanuel %A Psaty, Bruce M %A Tracy, Russel P %A Smith, Nicholas L %A Desch, Karl C %A Cushman, Mary %A Rotter, Jerome I %A de Vries, Paul S %A Pankratz, Nathan D %A Folsom, Aaron R %A Morrison, Alanna C %A März, Winfried %A Tang, Weihong %A Johnson, Andrew D %X

BACKGROUND: Use of targeted exome-arrays with common, rare variants and functionally enriched variation has led to discovery of new genes contributing to population variation in risk factors. Plasminogen activator-inhibitor 1 (PAI-1), tissue plasminogen activator (tPA), and the plasma product D-dimer are important components of the fibrinolytic system. There have been few large-scale genome-wide or exome-wide studies of PAI-1, tPA, and D-dimer.

OBJECTIVES: We sought to discover new genetic loci contributing to variation in these traits using an exome-array approach.

METHODS: Cohort-level analyses and fixed effects meta-analyses of PAI-1 (n = 15 603), tPA (n = 6876,) and D-dimer (n = 19 306) from 12 cohorts of European ancestry with diverse study design were conducted, including single-variant analyses and gene-based burden testing.

RESULTS: Five variants located in NME7, FGL1, and the fibrinogen locus, all associated with D-dimer levels, achieved genome-wide significance (P < 5 × 10 ). Replication was sought for these 5 variants, as well as 45 well-imputed variants with P < 1 × 10 in the discovery using an independent cohort. Replication was observed for three out of the five significant associations, including a novel and uncommon (0.013 allele frequency) coding variant p.Trp256Leu in FGL1 (fibrinogen-like-1) with increased plasma D-dimer levels. Additionally, a candidate-gene approach revealed a suggestive association for a coding variant (rs143202684-C) in SERPINB2, and suggestive associations with consistent effect in the replication analysis include an intronic variant (rs11057830-A) in SCARB1 associated with increased D-dimer levels.

CONCLUSION: This work provides new evidence for a role of FGL1 in hemostasis.

%B J Thromb Haemost %8 2021 Apr 20 %G eng %R 10.1111/jth.15345 %0 Journal Article %J Nature %D 2021 %T Genetic insights into biological mechanisms governing human ovarian ageing. %A Ruth, Katherine S %A Day, Felix R %A Hussain, Jazib %A Martínez-Marchal, Ana %A Aiken, Catherine E %A Azad, Ajuna %A Thompson, Deborah J %A Knoblochova, Lucie %A Abe, Hironori %A Tarry-Adkins, Jane L %A Gonzalez, Javier Martin %A Fontanillas, Pierre %A Claringbould, Annique %A Bakker, Olivier B %A Sulem, Patrick %A Walters, Robin G %A Terao, Chikashi %A Turon, Sandra %A Horikoshi, Momoko %A Lin, Kuang %A Onland-Moret, N Charlotte %A Sankar, Aditya %A Hertz, Emil Peter Thrane %A Timshel, Pascal N %A Shukla, Vallari %A Borup, Rehannah %A Olsen, Kristina W %A Aguilera, Paula %A Ferrer-Roda, Mònica %A Huang, Yan %A Stankovic, Stasa %A Timmers, Paul R H J %A Ahearn, Thomas U %A Alizadeh, Behrooz Z %A Naderi, Elnaz %A Andrulis, Irene L %A Arnold, Alice M %A Aronson, Kristan J %A Augustinsson, Annelie %A Bandinelli, Stefania %A Barbieri, Caterina M %A Beaumont, Robin N %A Becher, Heiko %A Beckmann, Matthias W %A Benonisdottir, Stefania %A Bergmann, Sven %A Bochud, Murielle %A Boerwinkle, Eric %A Bojesen, Stig E %A Bolla, Manjeet K %A Boomsma, Dorret I %A Bowker, Nicholas %A Brody, Jennifer A %A Broer, Linda %A Buring, Julie E %A Campbell, Archie %A Campbell, Harry %A Castelao, Jose E %A Catamo, Eulalia %A Chanock, Stephen J %A Chenevix-Trench, Georgia %A Ciullo, Marina %A Corre, Tanguy %A Couch, Fergus J %A Cox, Angela %A Crisponi, Laura %A Cross, Simon S %A Cucca, Francesco %A Czene, Kamila %A Smith, George Davey %A de Geus, Eco J C N %A de Mutsert, Renée %A De Vivo, Immaculata %A Demerath, Ellen W %A Dennis, Joe %A Dunning, Alison M %A Dwek, Miriam %A Eriksson, Mikael %A Esko, Tõnu %A Fasching, Peter A %A Faul, Jessica D %A Ferrucci, Luigi %A Franceschini, Nora %A Frayling, Timothy M %A Gago-Dominguez, Manuela %A Mezzavilla, Massimo %A García-Closas, Montserrat %A Gieger, Christian %A Giles, Graham G %A Grallert, Harald %A Gudbjartsson, Daniel F %A Gudnason, Vilmundur %A Guénel, Pascal %A Haiman, Christopher A %A Håkansson, Niclas %A Hall, Per %A Hayward, Caroline %A He, Chunyan %A He, Wei %A Heiss, Gerardo %A Høffding, Miya K %A Hopper, John L %A Hottenga, Jouke J %A Hu, Frank %A Hunter, David %A Ikram, Mohammad A %A Jackson, Rebecca D %A Joaquim, Micaella D R %A John, Esther M %A Joshi, Peter K %A Karasik, David %A Kardia, Sharon L R %A Kartsonaki, Christiana %A Karlsson, Robert %A Kitahara, Cari M %A Kolcic, Ivana %A Kooperberg, Charles %A Kraft, Peter %A Kurian, Allison W %A Kutalik, Zoltán %A La Bianca, Martina %A Lachance, Genevieve %A Langenberg, Claudia %A Launer, Lenore J %A Laven, Joop S E %A Lawlor, Deborah A %A Le Marchand, Loïc %A Li, Jingmei %A Lindblom, Annika %A Lindström, Sara %A Lindstrom, Tricia %A Linet, Martha %A Liu, Yongmei %A Liu, Simin %A Luan, Jian'an %A Mägi, Reedik %A Magnusson, Patrik K E %A Mangino, Massimo %A Mannermaa, Arto %A Marco, Brumat %A Marten, Jonathan %A Martin, Nicholas G %A Mbarek, Hamdi %A McKnight, Barbara %A Medland, Sarah E %A Meisinger, Christa %A Meitinger, Thomas %A Menni, Cristina %A Metspalu, Andres %A Milani, Lili %A Milne, Roger L %A Montgomery, Grant W %A Mook-Kanamori, Dennis O %A Mulas, Antonella %A Mulligan, Anna M %A Murray, Alison %A Nalls, Mike A %A Newman, Anne %A Noordam, Raymond %A Nutile, Teresa %A Nyholt, Dale R %A Olshan, Andrew F %A Olsson, Håkan %A Painter, Jodie N %A Patel, Alpa V %A Pedersen, Nancy L %A Perjakova, Natalia %A Peters, Annette %A Peters, Ulrike %A Pharoah, Paul D P %A Polasek, Ozren %A Porcu, Eleonora %A Psaty, Bruce M %A Rahman, Iffat %A Rennert, Gad %A Rennert, Hedy S %A Ridker, Paul M %A Ring, Susan M %A Robino, Antonietta %A Rose, Lynda M %A Rosendaal, Frits R %A Rossouw, Jacques %A Rudan, Igor %A Rueedi, Rico %A Ruggiero, Daniela %A Sala, Cinzia F %A Saloustros, Emmanouil %A Sandler, Dale P %A Sanna, Serena %A Sawyer, Elinor J %A Sarnowski, Chloe %A Schlessinger, David %A Schmidt, Marjanka K %A Schoemaker, Minouk J %A Schraut, Katharina E %A Scott, Christopher %A Shekari, Saleh %A Shrikhande, Amruta %A Smith, Albert V %A Smith, Blair H %A Smith, Jennifer A %A Sorice, Rossella %A Southey, Melissa C %A Spector, Tim D %A Spinelli, John J %A Stampfer, Meir %A Stöckl, Doris %A van Meurs, Joyce B J %A Strauch, Konstantin %A Styrkarsdottir, Unnur %A Swerdlow, Anthony J %A Tanaka, Toshiko %A Teras, Lauren R %A Teumer, Alexander %A Þorsteinsdottir, Unnur %A Timpson, Nicholas J %A Toniolo, Daniela %A Traglia, Michela %A Troester, Melissa A %A Truong, Thérèse %A Tyrrell, Jessica %A Uitterlinden, André G %A Ulivi, Sheila %A Vachon, Celine M %A Vitart, Veronique %A Völker, Uwe %A Vollenweider, Peter %A Völzke, Henry %A Wang, Qin %A Wareham, Nicholas J %A Weinberg, Clarice R %A Weir, David R %A Wilcox, Amber N %A van Dijk, Ko Willems %A Willemsen, Gonneke %A Wilson, James F %A Wolffenbuttel, Bruce H R %A Wolk, Alicja %A Wood, Andrew R %A Zhao, Wei %A Zygmunt, Marek %A Chen, Zhengming %A Li, Liming %A Franke, Lude %A Burgess, Stephen %A Deelen, Patrick %A Pers, Tune H %A Grøndahl, Marie Louise %A Andersen, Claus Yding %A Pujol, Anna %A Lopez-Contreras, Andres J %A Daniel, Jeremy A %A Stefansson, Kari %A Chang-Claude, Jenny %A van der Schouw, Yvonne T %A Lunetta, Kathryn L %A Chasman, Daniel I %A Easton, Douglas F %A Visser, Jenny A %A Ozanne, Susan E %A Namekawa, Satoshi H %A Solc, Petr %A Murabito, Joanne M %A Ong, Ken K %A Hoffmann, Eva R %A Murray, Anna %A Roig, Ignasi %A Perry, John R B %X

Reproductive longevity is essential for fertility and influences healthy ageing in women, but insights into its underlying biological mechanisms and treatments to preserve it are limited. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. Integration with experimental models demonstrates that these DDR processes act across the life-course to shape the ovarian reserve and its rate of depletion. Furthermore, we demonstrate that experimental manipulation of DDR pathways highlighted by human genetics increases fertility and extends reproductive life in mice. Causal inference analyses using the identified genetic variants indicate that extending reproductive life in women improves bone health and reduces risk of type 2 diabetes, but increases the risk of hormone-sensitive cancers. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease.

%B Nature %V 596 %P 393-397 %8 2021 Aug %G eng %N 7872 %R 10.1038/s41586-021-03779-7 %0 Journal Article %J Hum Mol Genet %D 2021 %T {Genome-Wide Association Study of Circulating Interleukin 6 Levels Identifies Novel Loci %A Ahluwalia, T. S. %A Prins, B. P. %A Abdollahi, M. %A Armstrong, N. J. %A Aslibekyan, S. %A Bain, L. %A Jefferis, B. %A Baumert, J. %A Beekman, M. %A Ben-Shlomo, Y. %A Bis, J. C. %A Mitchell, B. D. %A de Geus, E. %A Delgado, G. E. %A Marek, D. %A Eriksson, J. %A Kajantie, E. %A Kanoni, S. %A Kemp, J. P. %A Lu, C. %A Marioni, R. E. %A McLachlan, S. %A Milaneschi, Y. %A Nolte, I. M. %A Petrelis, A. M. %A Porcu, E. %A Sabater-Lleal, M. %A Naderi, E. %A Seppälä, I. %A Shah, T. %A Singhal, G. %A Standl, M. %A Teumer, A. %A Thalamuthu, A. %A Thiering, E. %A Trompet, S. %A Ballantyne, C. M. %A Benjamin, E. J. %A Casas, J. P. %A Toben, C. %A Dedoussis, G. %A Deelen, J. %A Durda, P. %A Engmann, J. %A Feitosa, M. F. %A Grallert, H. %A Hammarstedt, A. %A Harris, S. E. %A Homuth, G. %A Hottenga, J. J. %A Jalkanen, S. %A Jamshidi, Y. %A Jawahar, M. C. %A Jess, T. %A Kivimaki, M. %A Kleber, M. E. %A Lahti, J. %A Liu, Y. %A Marques-Vidal, P. %A Mellström, D. %A Mooijaart, S. P. %A Müller-Nurasyid, M. %A Penninx, B. %A Revez, J. A. %A Rossing, P. %A Räikkönen, K. %A Sattar, N. %A Scharnagl, H. %A Sennblad, B. %A Silveira, A. %A Pourcain, B. S. %A Timpson, N. J. %A Trollor, J. %A van Dongen, J. %A van Heemst, D. %A Visvikis-Siest, S. %A Vollenweider, P. %A Völker, U. %A Waldenberger, M. %A Willemsen, G. %A Zabaneh, D. %A Morris, R. W. %A Arnett, D. K. %A Baune, B. T. %A Boomsma, D. I. %A Chang, Y. C. %A Deary, I. J. %A Deloukas, P. %A Eriksson, J. G. %A Evans, D. M. %A Ferreira, M. A. %A Gaunt, T. %A Gudnason, V. %A Hamsten, A. %A Heinrich, J. %A Hingorani, A. %A Humphries, S. E. %A Jukema, J. W. %A Koeing, W. %A Kumari, M. %A Kutalik, Z. %A Lawlor, D. A. %A Lehtimäki, T. %A März, W. %A Mather, K. %A Naitza, S. %A Nauck, M. %A Ohlsson, C. %A Price, J. F. %A Raitakari, O. %A Rice, K. %A Sachdev, P. S. %A Slagboom, E. %A Sørensen, T. I. A. %A Spector, T. %A Stacey, D. %A Stathopoulou, M. G. %A Tanaka, T. %A Wannamethee, S. G. %A Whincup, P. %A Rotter, J. I. %A Dehghan, A. %A Boerwinkle, E. %A Psaty, B. M. %A Snieder, H. %A Alizadeh, B. Z. %X Interleukin-6 (IL-6) is a multifunctional cytokine with both pro- and anti-inflammatory properties with a heritability estimate of up to 61%. The circulating levels of IL-6 in blood have been associated with an increased risk of complex disease pathogenesis. We conducted a two-staged, discovery, and replication meta genome-wide association study (GWAS) of circulating serum IL-6 levels comprising up to 67 428 (ndiscovery = 52 654 and nreplication = 14 774) individuals of European ancestry. The inverse variance fixed-effects based discovery meta-analysis, followed by replication led to the identification of two independent loci, IL1F10/IL1RN rs6734238 on Chromosome (Chr) 2q14, (pcombined = 1.8 × 10-11), HLA-DRB1/DRB5 rs660895 on Chr6p21 (pcombined = 1.5 × 10-10) in the combined meta-analyses of all samples. We also replicated the IL6R rs4537545 locus on Chr1q21 (pcombined = 1.2 × 10-122). Our study identifies novel loci for circulating IL-6 levels uncovering new immunological and inflammatory pathways that may influence IL-6 pathobiology. %B Hum Mol Genet %8 Jan %G eng %0 Journal Article %J Nat Commun %D 2021 %T {Genome-wide meta-analysis of muscle weakness identifies 15 susceptibility loci in older men and women %A Jones, G. %A Trajanoska, K. %A Santanasto, A. J. %A Stringa, N. %A Kuo, C. L. %A Atkins, J. L. %A Lewis, J. R. %A Duong, T. %A Hong, S. %A Biggs, M. L. %A Luan, J. %A Sarnowski, C. %A Lunetta, K. L. %A Tanaka, T. %A Wojczynski, M. K. %A Cvejkus, R. %A Nethander, M. %A Ghasemi, S. %A Yang, J. %A Zillikens, M. C. %A Walter, S. %A Sicinski, K. %A Kague, E. %A Ackert-Bicknell, C. L. %A Arking, D. E. %A Windham, B. G. %A Boerwinkle, E. %A Grove, M. L. %A Graff, M. %A Spira, D. %A Demuth, I. %A Van der Velde, N. %A de Groot, L. C. P. G. M. %A Psaty, B. M. %A Odden, M. C. %A Fohner, A. E. %A Langenberg, C. %A Wareham, N. J. %A Bandinelli, S. %A van Schoor, N. M. %A Huisman, M. %A Tan, Q. %A Zmuda, J. %A Mellström, D. %A Karlsson, M. %A Bennett, D. A. %A Buchman, A. S. %A De Jager, P. L. %A Uitterlinden, A. G. %A Völker, U. %A Kocher, T. %A Teumer, A. %A Rodriguéz-Mañas, L. %A García, F. J. %A Carnicero, J. A. %A Herd, P. %A Bertram, L. %A Ohlsson, C. %A Murabito, J. M. %A Melzer, D. %A Kuchel, G. A. %A Ferrucci, L. %A Karasik, D. %A Rivadeneira, F. %A Kiel, D. P. %A Pilling, L. C. %X Low muscle strength is an important heritable indicator of poor health linked to morbidity and mortality in older people. In a genome-wide association study meta-analysis of 256,523 Europeans aged 60 years and over from 22 cohorts we identify 15 loci associated with muscle weakness (European Working Group on Sarcopenia in Older People definition: n = 48,596 cases, 18.9% of total), including 12 loci not implicated in previous analyses of continuous measures of grip strength. Loci include genes reportedly involved in autoimmune disease (HLA-DQA1 p = 4 × 10-17), arthritis (GDF5 p = 4 × 10-13), cell cycle control and cancer protection, regulation of transcription, and others involved in the development and maintenance of the musculoskeletal system. Using Mendelian randomization we report possible overlapping causal pathways, including diabetes susceptibility, haematological parameters, and the immune system. We conclude that muscle weakness in older adults has distinct mechanisms from continuous strength, including several pathways considered to be hallmarks of ageing. %B Nat Commun %V 12 %P 654 %8 01 %G eng %0 Journal Article %J ESC Heart Fail %D 2021 %T {The genomics of heart failure: design and rationale of the HERMES consortium %A Lumbers, R. T. %A Shah, S. %A Lin, H. %A Czuba, T. %A Henry, A. %A Swerdlow, D. I. %A Malarstig, A. %A Andersson, C. %A Verweij, N. %A Holmes, M. V. %A Ärnlöv, J. %A Svensson, P. %A Hemingway, H. %A Sallah, N. %A Almgren, P. %A Aragam, K. G. %A Asselin, G. %A Backman, J. D. %A Biggs, M. L. %A Bloom, H. L. %A Boersma, E. %A Brandimarto, J. %A Brown, M. R. %A Brunner-La Rocca, H. P. %A Carey, D. J. %A Chaffin, M. D. %A Chasman, D. I. %A Chazara, O. %A Chen, X. %A Chen, X. %A Chung, J. H. %A Chutkow, W. %A Cleland, J. G. F. %A Cook, J. P. %A de Denus, S. %A Dehghan, A. %A Delgado, G. E. %A Denaxas, S. %A Doney, A. S. %A Dörr, M. %A Dudley, S. C. %A Engström, G. %A Esko, T. %A Fatemifar, G. %A Felix, S. B. %A Finan, C. %A Ford, I. %A Fougerousse, F. %A Fouodjio, R. %A Ghanbari, M. %A Ghasemi, S. %A Giedraitis, V. %A Giulianini, F. %A Gottdiener, J. S. %A Gross, S. %A Guðbjartsson, D. F. %A Gui, H. %A Gutmann, R. %A Haggerty, C. M. %A van der Harst, P. %A Hedman, Å. K. %A Helgadottir, A. %A Hillege, H. %A Hyde, C. L. %A Jacob, J. %A Jukema, J. W. %A Kamanu, F. %A Kardys, I. %A Kavousi, M. %A Khaw, K. T. %A Kleber, M. E. %A Køber, L. %A Koekemoer, A. %A Kraus, B. %A Kuchenbaecker, K. %A Langenberg, C. %A Lind, L. %A Lindgren, C. M. %A London, B. %A Lotta, L. A. %A Lovering, R. C. %A Luan, J. %A Magnusson, P. %A Mahajan, A. %A Mann, D. %A Margulies, K. B. %A Marston, N. A. %A März, W. %A McMurray, J. J. V. %A Melander, O. %A Melloni, G. %A Mordi, I. R. %A Morley, M. P. %A Morris, A. D. %A Morris, A. P. %A Morrison, A. C. %A Nagle, M. W. %A Nelson, C. P. %A Newton-Cheh, C. %A Niessner, A. %A Niiranen, T. %A Nowak, C. %A O'Donoghue, M. L. %A Owens, A. T. %A Palmer, C. N. A. %A Pare, G. %A Perola, M. %A Perreault, L. L. %A Portilla-Fernandez, E. %A Psaty, B. M. %A Rice, K. M. %A Ridker, P. M. %A Romaine, S. P. R. %A Roselli, C. %A Rotter, J. I. %A Ruff, C. T. %A Sabatine, M. S. %A Salo, P. %A Salomaa, V. %A van Setten, J. %A Shalaby, A. A. %A Smelser, D. T. %A Smith, N. L. %A Stefansson, K. %A Stender, S. %A Stott, D. J. %A Sveinbjornsson, G. %A Tammesoo, M. L. %A Tardif, J. C. %A Taylor, K. D. %A Teder-Laving, M. %A Teumer, A. %A Thorgeirsson, G. %A Thorsteinsdottir, U. %A Torp-Pedersen, C. %A Trompet, S. %A Tuckwell, D. %A Tyl, B. %A Uitterlinden, A. G. %A Vaura, F. %A Veluchamy, A. %A Visscher, P. M. %A Völker, U. %A Voors, A. A. %A Wang, X. %A Wareham, N. J. %A Weeke, P. E. %A Weiss, R. %A White, H. D. %A Wiggins, K. L. %A Xing, H. %A Yang, J. %A Yang, Y. %A Yerges-Armstrong, L. M. %A Yu, B. %A Zannad, F. %A Zhao, F. %A Wilk, J. B. %A Holm, H. %A Sattar, N. %A Lubitz, S. A. %A Lanfear, D. E. %A Shah, S. %A Dunn, M. E. %A Wells, Q. S. %A Asselbergs, F. W. %A Hingorani, A. D. %A Dubé, M. P. %A Samani, N. J. %A Lang, C. C. %A Cappola, T. P. %A Ellinor, P. T. %A Vasan, R. S. %A Smith, J. G. %X The HERMES (HEart failure Molecular Epidemiology for Therapeutic targetS) consortium aims to identify the genomic and molecular basis of heart failure.\ under an additive genetic model.\ HERMES is a global collaboration aiming to (i) identify the genetic determinants of heart failure; (ii) generate insights into the causal pathways leading to heart failure and enable genetic approaches to target prioritization; and (iii) develop genomic tools for disease stratification and risk prediction. %B ESC Heart Fail %8 Sep %G eng %0 Journal Article %J Stroke %D 2021 %T HDL (High-Density Lipoprotein) Subspecies, Prevalent Covert Brain Infarcts, and Incident Overt Ischemic Stroke: Cardiovascular Health Study. %A Koch, Manja %A Aroner, Sarah A %A Fitzpatrick, Annette L %A Longstreth, W T %A Furtado, Jeremy D %A Mukamal, Kenneth J %A Jensen, Majken K %X

BACKGROUND AND PURPOSE: Whether HDL (high-density lipoprotein) is associated with risk of vascular brain injury is unclear. HDL is comprised of many apo (apolipoprotein) species, creating distinct subtypes of HDL.

METHODS: We utilized sandwich ELISA to determine HDL subspecies from plasma collected in 1998/1999 from 2001 CHS (Cardiovascular Health Study) participants (mean age, 80 years).

RESULTS: In cross-sectional analyses, participants with higher apoA1 in plasma and lower apoE in HDL were less likely to have prevalent covert magnetic resonance imaging-defined infarcts: odds ratio for apoA1 Q4 versus Q1, 0.68 (95% CI, 0.50-0.93), and odds ratio for apoE Q4 versus Q1, 1.36 (95% CI, 1.01-1.84). Similarly, apoA1 in the subspecies of HDL that lacked apoC3, apoJ, or apoE was inversely related to covert infarcts, and apoE in the subspecies of HDL that lacked apoC3 or apoJ was directly related to covert infarcts in prospective analyses. In contrast, the concentrations of apoA1 and apoE in the complementary subspecies of HDL that contained these apos were unrelated to covert infarcts. Patterns of associations between incident overt ischemic stroke and apoA1, apoE, and apoA1 and apoE in subspecies of HDL were similar to those observed for covert infarcts but less pronounced.

CONCLUSIONS: This study highlights HDL subspecies defined by apo content as relevant biomarkers of covert and overt vascular brain injury.

%B Stroke %P STROKEAHA121034299 %8 2021 Oct 14 %G eng %R 10.1161/STROKEAHA.121.034299 %0 Journal Article %J J Thromb Haemost %D 2021 %T Hemostatic factor levels and cognitive decline in older adults: The Cardiovascular Health Study. %A Harrington, Laura B %A Ehlert, Alexa N %A Thacker, Evan L %A Jenny, Nancy S %A Lopez, Oscar %A Cushman, Mary %A Fitzpatrick, Annette %A Mukamal, Kenneth J %A Jensen, Majken K %X

BACKGROUND: Hemostasis is a key factor in cerebrovascular disease, but the association of hemostatic factors with cognitive decline is unclear.

OBJECTIVE: To prospectively evaluate associations of 20 hemostatic factor levels with changes in cognition during ≥8 years of follow-up in the Cardiovascular Health Study (CHS) of older adults.

METHODS: We included participants of an existing CHS cross-sectional substudy (n = 400) with hemostatic factors measured in 1989-1990. Between 1989-1990 and 1998-1999, cognitive function was measured using the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Tests. Mixed-effects linear regression models estimated change in cognitive function over time, adjusting for sociodemographic and clinical factors and APOE genotype, using Bonferroni adjustment. We also derived principal components to account for the interrelationship among factors.

RESULTS: Of 20 factors evaluated individually, only higher levels of plasmin-α -antiplasmin complex (PAP), tissue factor pathway inhibitor (TFPI), and lower factor X (FXc) levels were associated with faster cognitive decline, estimated by annual change in 3MSE points (1 standard deviation PAP β = -0.65, 95% confidence interval [CI]: -1.08 to -0.21; TFPI β = -0.55, 95% CI: -0.90 to -0.19; FXc β = 0.52, 95% CI: 0.21-0.84). One of four principal components, loading positively on D-dimer, prothrombin fragment 1.2 (F1.2), and PAP was significantly associated with change in 3MSE.

CONCLUSIONS: Levels of PAP, TPFI, and FXc and a combination of factors driven by PAP, D-dimer, and F1.2 were associated with cognitive decline. Whether these findings can be used to improve dementia prevention or prediction requires further study.

%B J Thromb Haemost %8 2021 Mar 16 %G eng %R 10.1111/jth.15300 %0 Journal Article %J Circ Genom Precis Med %D 2021 %T Identification of Functional Genetic Determinants of Cardiac Troponin T and I in a Multiethnic Population and Causal Associations With Atrial Fibrillation. %A Yang, Yunju %A Bartz, Traci M %A Brown, Michael R %A Guo, Xiuqing %A Zilhão, Nuno R %A Trompet, Stella %A Weiss, Stefan %A Yao, Jie %A Brody, Jennifer A %A deFilippi, Christopher R %A Hoogeveen, Ron C %A Lin, Henry J %A Gudnason, Vilmundur %A Ballantyne, Christie M %A Dörr, Marcus %A Jukema, J Wouter %A Petersmann, Astrid %A Psaty, Bruce M %A Rotter, Jerome I %A Boerwinkle, Eric %A Fornage, Myriam %A Jun, Goo %A Yu, Bing %X

BACKGROUND: Elevated cardiac troponin levels in blood are associated with increased risk of cardiovascular diseases and mortality. Cardiac troponin levels are heritable, but their genetic architecture remains elusive.

METHODS: We conducted a transethnic genome-wide association analysis on high-sensitivity cTnT (cardiac troponin T; hs-cTnT) and high-sensitivity cTnI (cardiac troponin I; hs-cTnI) levels in 24 617 and 14 336 participants free of coronary heart disease and heart failure from 6 population-based cohorts, followed by a series of bioinformatic analyses to decipher the genetic architecture of hs-cTnT and hs-cTnI.

RESULTS: We identified 4 genome-wide significant loci for hs-cTnT including a novel locus rs3737882 in and 3 previously reported loci at , , and . One known locus at was replicated for hs-cTnI. One copy of C allele for rs3737882 was associated with a 6% increase in hs-cTnT levels (minor allele frequency, 0.18; =2.80×10). We observed pleiotropic loci located at and . The proportions of variances explained by single-nucleotide polymorphisms were 10.15% and 7.74% for hs-cTnT and hs-cTnI, respectively. Single-nucleotide polymorphisms were colocalized with expression in heart tissues and hs-cTnT and with expression in artery, heart tissues, and whole blood and both troponins. Mendelian randomization analyses showed that genetically increased hs-cTnT and hs-cTnI levels were associated with higher odds of atrial fibrillation (odds ratio, 1.38 [95% CI, 1.25-1.54] for hs-cTnT and 1.21 [95% CI, 1.06-1.37] for hs-cTnI).

CONCLUSIONS: We identified a novel genetic locus associated with hs-cTnT in a multiethnic population and found that genetically regulated troponin levels were associated with atrial fibrillation.

%B Circ Genom Precis Med %V 14 %P e003460 %8 2021 12 %G eng %N 6 %R 10.1161/CIRCGEN.121.003460 %0 Journal Article %J PLoS One %D 2021 %T Identification of novel and rare variants associated with handgrip strength using whole genome sequence data from the NHLBI Trans-Omics in Precision Medicine (TOPMed) Program. %A Sarnowski, Chloe %A Chen, Han %A Biggs, Mary L %A Wassertheil-Smoller, Sylvia %A Bressler, Jan %A Irvin, Marguerite R %A Ryan, Kathleen A %A Karasik, David %A Arnett, Donna K %A Cupples, L Adrienne %A Fardo, David W %A Gogarten, Stephanie M %A Heavner, Benjamin D %A Jain, Deepti %A Kang, Hyun Min %A Kooperberg, Charles %A Mainous, Arch G %A Mitchell, Braxton D %A Morrison, Alanna C %A O'Connell, Jeffrey R %A Psaty, Bruce M %A Rice, Kenneth %A Smith, Albert V %A Vasan, Ramachandran S %A Windham, B Gwen %A Kiel, Douglas P %A Murabito, Joanne M %A Lunetta, Kathryn L %X

Handgrip strength is a widely used measure of muscle strength and a predictor of a range of morbidities including cardiovascular diseases and all-cause mortality. Previous genome-wide association studies of handgrip strength have focused on common variants primarily in persons of European descent. We aimed to identify rare and ancestry-specific genetic variants associated with handgrip strength by conducting whole-genome sequence association analyses using 13,552 participants from six studies representing diverse population groups from the Trans-Omics in Precision Medicine (TOPMed) Program. By leveraging multiple handgrip strength measures performed in study participants over time, we increased our effective sample size by 7-12%. Single-variant analyses identified ten handgrip strength loci among African-Americans: four rare variants, five low-frequency variants, and one common variant. One significant and four suggestive genes were identified associated with handgrip strength when aggregating rare and functional variants; all associations were ancestry-specific. We additionally leveraged the different ancestries available in the UK Biobank to further explore the ancestry-specific association signals from the single-variant association analyses. In conclusion, our study identified 11 new loci associated with handgrip strength with rare and/or ancestry-specific genetic variations, highlighting the added value of whole-genome sequencing in diverse samples. Several of the associations identified using single-variant or aggregate analyses lie in genes with a function relevant to the brain or muscle or were reported to be associated with muscle or age-related traits. Further studies in samples with sequence data and diverse ancestries are needed to confirm these findings.

%B PLoS One %V 16 %P e0253611 %8 2021 %G eng %N 7 %R 10.1371/journal.pone.0253611 %0 Journal Article %J Nat Commun %D 2021 %T Identification of putative causal loci in whole-genome sequencing data via knockoff statistics. %A He, Zihuai %A Liu, Linxi %A Wang, Chen %A Le Guen, Yann %A Lee, Justin %A Gogarten, Stephanie %A Lu, Fred %A Montgomery, Stephen %A Tang, Hua %A Silverman, Edwin K %A Cho, Michael H %A Greicius, Michael %A Ionita-Laza, Iuliana %K Algorithms %K Causality %K Computer Simulation %K Data Interpretation, Statistical %K Datasets as Topic %K Genetic Loci %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Linkage Disequilibrium %K Markov Chains %K Models, Genetic %K Polymorphism, Single Nucleotide %K Reproducibility of Results %K Whole Genome Sequencing %X

The analysis of whole-genome sequencing studies is challenging due to the large number of rare variants in noncoding regions and the lack of natural units for testing. We propose a statistical method to detect and localize rare and common risk variants in whole-genome sequencing studies based on a recently developed knockoff framework. It can (1) prioritize causal variants over associations due to linkage disequilibrium thereby improving interpretability; (2) help distinguish the signal due to rare variants from shadow effects of significant common variants nearby; (3) integrate multiple knockoffs for improved power, stability, and reproducibility; and (4) flexibly incorporate state-of-the-art and future association tests to achieve the benefits proposed here. In applications to whole-genome sequencing data from the Alzheimer's Disease Sequencing Project (ADSP) and COPDGene samples from NHLBI Trans-Omics for Precision Medicine (TOPMed) Program we show that our method compared with conventional association tests can lead to substantially more discoveries.

%B Nat Commun %V 12 %P 3152 %8 2021 05 25 %G eng %N 1 %R 10.1038/s41467-021-22889-4 %0 Journal Article %J Am J Cardiol %D 2021 %T Incidence, Determinants and Mortality of Heart Failure Associated With Medical-Surgical Procedures in Patients ≥ 65 Years of Age (from the Cardiovascular Health Study). %A Shah, Monali %A Rodriguez, Carlos J %A Bartz, Traci M %A Lyles, Mary F %A Kizer, Jorge R %A Aurigemma, Gerard P %A Gardin, Julius M %A Gottdiener, John S %X

Heart failure (HF) and myocardial infarction are serious complications of major noncardiac surgery in older adults. Many factors can contribute to the development of HF during the postoperative period. The incidence of, and risk factors for, procedure-associated heart failure (PHF) occurring at the time of, or shortly after, medical procedures in a population-based sample ≥ 65 years of age have not been fully characterized, particularly in comparison with HF not proximate to medical procedures. This analysis comprises 5,121 men and women free of HF at baseline from the Cardiovascular Health Study who were followed up for 12.0 years (median). HF events were documented by self-report at semi-annual contacts and confirmed by a formal adjudication committee using a review of the participants' medical records and standardized criteria for HF. Incident HF events were additionally adjudicated as either being related or unrelated to a medical procedure (PHF and non-PHF, respectively). We estimated cause-specific hazards ratios for the association of covariates with PHF and non-PHF. There were 1,728 incident HF events in the primary analysis: 168 (10%) classified as PHF, 1,526 (88%) as non-PHF, and 34 unclassified (2%). For those 1,045 participants in whom LV ejection fraction was known at the time of the HF event, it was ≥45% in 89 of 118 participants (75%) with PHF, compared to 517 of 927 participants (55%) with non-PHF (p < 0.001). Increased age, male gender, diabetes, and angina at baseline were associated with both PHF and non-PHF (range of hazard ratios (HR): 1.04-2.05]. Being Black was inversely associated with PHF [HR: 0.46, 95% confidence interval: 0.25-0.86]. Participants with increased age, without baseline angina, and with baseline LVEF<55% were at a significantly lower risk for PHF compared to non-PHF. Among those with PHF, surgical procedures-including cardiac, orthopedic, gastrointestinal, vascular, and urologic-comprised 83.3%, while percutaneous procedures comprised 8.9% (including 6.5% represented by cardiac catheterizations and pacemaker placements). Another group composed of a variety of procedures commonly requiring large fluid volume administration comprised 7.7%. There was a lower all-cause 30-day mortality in the PHF versus the non-PHF group (2.2% vs 5.7%), with a nonsignificant odds ratio of 0.39 in a minimally adjusted model. When individuals with prior myocardial infarction (MI) were excluded in a sensitivity analysis, the proportion of incident HF with concurrent MI was greater for PHF (32.9%) than for non-PHF (19.8%). In conclusion, PHF in older adults is a common entity with relatively low 30-day mortality. Baseline angina, lower age, and LVEF ≥ 55% were associated with a higher risk of PHF compared to non-PHF. Being Black was associated with a lower risk of PHF and PHF as a proportion of HF was lower in Black than in non-Black participants. Compared to non-PHF, PHF more frequently presented with concurrent MI and with preserved LV ejection fraction.

%B Am J Cardiol %V 153 %P 71-78 %8 2021 Aug 15 %G eng %R 10.1016/j.amjcard.2021.05.017 %0 Journal Article %J Heart %D 2021 %T Individual non-esterified fatty acids and incident atrial fibrillation late in life. %A Pellegrini, Cara N %A Bůzková, Petra %A Lichtenstein, Alice H %A Matthan, Nirupa R %A Ix, Joachim H %A Siscovick, David S %A Heckbert, Susan R %A Tracy, Russell P %A Mukamal, Kenneth J %A Djoussé, Luc %A Kizer, Jorge R %X

OBJECTIVE: Obesity and dysmetabolism are major risk factors for atrial fibrillation (AF). Expansion of fat depots is associated with increased circulating total non-esterified fatty acids (NEFAs), elevated levels of which are associated with incident AF. We undertook comprehensive serum measurement of individual NEFA to identify specific associations with new-onset AF late in life.

METHODS: The present study focused on participants with available serum and free of AF selected from the Cardiovascular Health Study, a community-based longitudinal investigation of older US adults. Thirty-five individual NEFAs were measured by gas chromatography. Cox regression was used to evaluate the association of individual NEFAs with incident AF.

RESULTS: The study sample included 1872 participants (age 77.7±4.4). During median follow-up of 11.3 years, 715 cases of incident AF occurred. After concurrent adjustment of all NEFAs and full adjustment for potential confounders, higher serum concentration of nervonic acid (24:1 n-9), a long-chain monounsaturated fatty acid, was associated with higher risk of AF (HR per SD: 1.18, 95% CI 1.08 to 1.29; p<0.001). Conversely, higher serum concentration of gamma-linolenic acid (GLA) (18:3 n-6), a polyunsaturated n-6 fatty acid, was associated with lower risk of AF (HR per SD: 0.81, 95% CI 0.71 to 0.94; p=0.004). None of the remaining NEFAs was significantly associated with AF.

CONCLUSIONS: Among older adults, serum levels of non-esterified nervonic acid were positively associated, while serum levels of non-esterified GLA were inversely associated, with incident AF. If confirmed, these results could offer new strategies for AF prevention and early intervention in this segment of the population at highest risk.

%B Heart %8 2021 Jan 22 %G eng %R 10.1136/heartjnl-2020-317929 %0 Journal Article %J J Am Heart Assoc %D 2021 %T Longitudinal Plasma Measures of Trimethylamine N-Oxide and Risk of Atherosclerotic Cardiovascular Disease Events in Community-Based Older Adults. %A Lee, Yujin %A Nemet, Ina %A Wang, Zeneng %A Lai, Heidi T M %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A Fretts, Amanda M %A Sotoodehnia, Nona %A Budoff, Matthew %A DiDonato, Joseph A %A McKnight, Barbara %A Tang, W H Wilson %A Psaty, Bruce M %A Siscovick, David S %A Hazen, Stanley L %A Mozaffarian, Dariush %X

Background Trimethylamine N-oxide (TMAO) is a gut microbiota-dependent metabolite of dietary choline, L-carnitine, and phosphatidylcholine-rich foods. On the basis of experimental studies and patients with prevalent disease, elevated plasma TMAO may increase risk of atherosclerotic cardiovascular disease (ASCVD). TMAO is also renally cleared and may interact with and causally contribute to renal dysfunction. Yet, how serial TMAO levels relate to incident and recurrent ASCVD in community-based populations and the potential mediating or modifying role of renal function are not established. Methods and Results We investigated associations of serial measures of plasma TMAO, assessed at baseline and 7 years, with incident and recurrent ASCVD in a community-based cohort of 4131 (incident) and 1449 (recurrent) older US adults. TMAO was measured using stable isotope dilution liquid chromatography-tandem mass spectrometry (laboratory coefficient of variation, <6%). Incident ASCVD (myocardial infarction, fatal coronary heart disease, stroke, sudden cardiac death, or other atherosclerotic death) was centrally adjudicated using medical records. Risk was assessed by multivariable Cox proportional hazards regression, including time-varying demographics, lifestyle factors, medical history, laboratory measures, and dietary habits. Potential mediating effects and interaction by estimated glomerular filtration rate (eGFR) were assessed. During prospective follow-up, 1766 incident and 897 recurrent ASCVD events occurred. After multivariable adjustment, higher levels of TMAO were associated with a higher risk of incident ASCVD, with extreme quintile hazard ratio (HR) compared with the lowest quintile=1.21 (95% CI, 1.02-1.42; -trend=0.029). This relationship appeared mediated or confounded by eGFR (eGFR-adjusted HR, 1.07; 95% CI, 0.90-1.27), as well as modified by eGFR (-interaction <0.001). High levels of TMAO were associated with higher incidence of ASCVD in the presence of impaired renal function (eGFR <60 mL/min per 1.73 m: HR, 1.56 [95% CI, 1.13-2.14]; -trend=0.007), but not normal or mildly reduced renal function (eGFR ≥60 mL/min per 1.73 m: HR, 1.03 [95% CI, 0.85-1.25]; -trend=0.668). Among individuals with prior ASCVD, TMAO associated with higher risk of recurrent ASCVD (HR, 1.25 [95% CI, 1.01-1.56]; -trend=0.009), without significant modification by eGFR. Conclusions In this large community-based cohort of older US adults, serial measures of TMAO were associated with higher risk of incident ASCVD, with apparent modification by presence of impaired renal function and with higher risk of recurrent ASCVD.

%B J Am Heart Assoc %P e020646 %8 2021 Aug 16 %G eng %R 10.1161/JAHA.120.020646 %0 Journal Article %J Nat Commun %D 2021 %T Meta-analyses identify DNA methylation associated with kidney function and damage. %A Schlosser, Pascal %A Tin, Adrienne %A Matias-Garcia, Pamela R %A Thio, Chris H L %A Joehanes, Roby %A Liu, Hongbo %A Weihs, Antoine %A Yu, Zhi %A Hoppmann, Anselm %A Grundner-Culemann, Franziska %A Min, Josine L %A Adeyemo, Adebowale A %A Agyemang, Charles %A Arnlöv, Johan %A Aziz, Nasir A %A Baccarelli, Andrea %A Bochud, Murielle %A Brenner, Hermann %A Breteler, Monique M B %A Carmeli, Cristian %A Chaker, Layal %A Chambers, John C %A Cole, Shelley A %A Coresh, Josef %A Corre, Tanguy %A Correa, Adolfo %A Cox, Simon R %A de Klein, Niek %A Delgado, Graciela E %A Domingo-Relloso, Arce %A Eckardt, Kai-Uwe %A Ekici, Arif B %A Endlich, Karlhans %A Evans, Kathryn L %A Floyd, James S %A Fornage, Myriam %A Franke, Lude %A Fraszczyk, Eliza %A Gao, Xu %A Gào, Xīn %A Ghanbari, Mohsen %A Ghasemi, Sahar %A Gieger, Christian %A Greenland, Philip %A Grove, Megan L %A Harris, Sarah E %A Hemani, Gibran %A Henneman, Peter %A Herder, Christian %A Horvath, Steve %A Hou, Lifang %A Hurme, Mikko A %A Hwang, Shih-Jen %A Jarvelin, Marjo-Riitta %A Kardia, Sharon L R %A Kasela, Silva %A Kleber, Marcus E %A Koenig, Wolfgang %A Kooner, Jaspal S %A Kramer, Holly %A Kronenberg, Florian %A Kuhnel, Brigitte %A Lehtimäki, Terho %A Lind, Lars %A Liu, Dan %A Liu, Yongmei %A Lloyd-Jones, Donald M %A Lohman, Kurt %A Lorkowski, Stefan %A Lu, Ake T %A Marioni, Riccardo E %A März, Winfried %A McCartney, Daniel L %A Meeks, Karlijn A C %A Milani, Lili %A Mishra, Pashupati P %A Nauck, Matthias %A Navas-Acien, Ana %A Nowak, Christoph %A Peters, Annette %A Prokisch, Holger %A Psaty, Bruce M %A Raitakari, Olli T %A Ratliff, Scott M %A Reiner, Alex P %A Rosas, Sylvia E %A Schöttker, Ben %A Schwartz, Joel %A Sedaghat, Sanaz %A Smith, Jennifer A %A Sotoodehnia, Nona %A Stocker, Hannah R %A Stringhini, Silvia %A Sundström, Johan %A Swenson, Brenton R %A Tellez-Plaza, Maria %A van Meurs, Joyce B J %A van Vliet-Ostaptchouk, Jana V %A Venema, Andrea %A Verweij, Niek %A Walker, Rosie M %A Wielscher, Matthias %A Winkelmann, Juliane %A Wolffenbuttel, Bruce H R %A Zhao, Wei %A Zheng, Yinan %A Loh, Marie %A Snieder, Harold %A Levy, Daniel %A Waldenberger, Melanie %A Susztak, Katalin %A Köttgen, Anna %A Teumer, Alexander %K Adult %K Aged %K CpG Islands %K DNA Methylation %K Female %K Glomerular Filtration Rate %K Humans %K Interferon Regulatory Factors %K Kidney %K Kidney Function Tests %K LIM Domain Proteins %K Male %K Membrane Proteins %K Middle Aged %K Renal Insufficiency, Chronic %K Transcription Factors %X

Chronic kidney disease is a major public health burden. Elevated urinary albumin-to-creatinine ratio is a measure of kidney damage, and used to diagnose and stage chronic kidney disease. To extend the knowledge on regulatory mechanisms related to kidney function and disease, we conducted a blood-based epigenome-wide association study for estimated glomerular filtration rate (n = 33,605) and urinary albumin-to-creatinine ratio (n = 15,068) and detected 69 and seven CpG sites where DNA methylation was associated with the respective trait. The majority of these findings showed directionally consistent associations with the respective clinical outcomes chronic kidney disease and moderately increased albuminuria. Associations of DNA methylation with kidney function, such as CpGs at JAZF1, PELI1 and CHD2 were validated in kidney tissue. Methylation at PHRF1, LDB2, CSRNP1 and IRF5 indicated causal effects on kidney function. Enrichment analyses revealed pathways related to hemostasis and blood cell migration for estimated glomerular filtration rate, and immune cell activation and response for urinary albumin-to-creatinineratio-associated CpGs.

%B Nat Commun %V 12 %P 7174 %8 2021 12 09 %G eng %N 1 %R 10.1038/s41467-021-27234-3 %0 Journal Article %J Eur J Epidemiol %D 2021 %T Meta-analysis of epigenome-wide association studies of carotid intima-media thickness. %A Portilla-Fernández, Eliana %A Hwang, Shih-Jen %A Wilson, Rory %A Maddock, Jane %A Hill, W David %A Teumer, Alexander %A Mishra, Pashupati P %A Brody, Jennifer A %A Joehanes, Roby %A Ligthart, Symen %A Ghanbari, Mohsen %A Kavousi, Maryam %A Roks, Anton J M %A Danser, A H Jan %A Levy, Daniel %A Peters, Annette %A Ghasemi, Sahar %A Schminke, Ulf %A Dörr, Marcus %A Grabe, Hans J %A Lehtimäki, Terho %A Kähönen, Mika %A Hurme, Mikko A %A Bartz, Traci M %A Sotoodehnia, Nona %A Bis, Joshua C %A Thiery, Joachim %A Koenig, Wolfgang %A Ong, Ken K %A Bell, Jordana T %A Meisinger, Christine %A Wardlaw, Joanna M %A Starr, John M %A Seissler, Jochen %A Then, Cornelia %A Rathmann, Wolfgang %A Ikram, M Arfan %A Psaty, Bruce M %A Raitakari, Olli T %A Völzke, Henry %A Deary, Ian J %A Wong, Andrew %A Waldenberger, Melanie %A O'Donnell, Christopher J %A Dehghan, Abbas %X

Common carotid intima-media thickness (cIMT) is an index of subclinical atherosclerosis that is associated with ischemic stroke and coronary artery disease (CAD). We undertook a cross-sectional epigenome-wide association study (EWAS) of measures of cIMT in 6400 individuals. Mendelian randomization analysis was applied to investigate the potential causal role of DNA methylation in the link between atherosclerotic cardiovascular risk factors and cIMT or clinical cardiovascular disease. The CpG site cg05575921 was associated with cIMT (beta = -0.0264, p value = 3.5 × 10) in the discovery panel and was replicated in replication panel (beta = -0.07, p value = 0.005). This CpG is located at chr5:81649347 in the intron 3 of the aryl hydrocarbon receptor repressor gene (AHRR). Our results indicate that DNA methylation at cg05575921 might be in the pathway between smoking, cIMT and stroke. Moreover, in a region-based analysis, 34 differentially methylated regions (DMRs) were identified of which a DMR upstream of ALOX12 showed the strongest association with cIMT (p value = 1.4 × 10). In conclusion, our study suggests that DNA methylation may play a role in the link between cardiovascular risk factors, cIMT and clinical cardiovascular disease.

%B Eur J Epidemiol %8 2021 Jun 06 %G eng %R 10.1007/s10654-021-00759-z %0 Journal Article %J HGG Adv %D 2021 %T Multi-Ancestry Genome-wide Association Study Accounting for Gene-Psychosocial Factor Interactions Identifies Novel Loci for Blood Pressure Traits. %A Sun, Daokun %A Richard, Melissa %A Musani, Solomon K %A Sung, Yun Ju %A Winkler, Thomas W %A Schwander, Karen %A Chai, Jin Fang %A Guo, Xiuqing %A Kilpeläinen, Tuomas O %A Vojinovic, Dina %A Aschard, Hugues %A Bartz, Traci M %A Bielak, Lawrence F %A Brown, Michael R %A Chitrala, Kumaraswamy %A Hartwig, Fernando P %A Horimoto, Andrea R V R %A Liu, Yongmei %A Manning, Alisa K %A Noordam, Raymond %A Smith, Albert V %A Harris, Sarah E %A Kuhnel, Brigitte %A Lyytikäinen, Leo-Pekka %A Nolte, Ilja M %A Rauramaa, Rainer %A van der Most, Peter J %A Wang, Rujia %A Ware, Erin B %A Weiss, Stefan %A Wen, Wanqing %A Yanek, Lisa R %A Arking, Dan E %A Arnett, Donna K %A Barac, Ana %A Boerwinkle, Eric %A Broeckel, Ulrich %A Chakravarti, Aravinda %A Chen, Yii-Der Ida %A Cupples, L Adrienne %A Davigulus, Martha L %A de Las Fuentes, Lisa %A de Mutsert, Renée %A de Vries, Paul S %A Delaney, Joseph A C %A Roux, Ana V Diez %A Dörr, Marcus %A Faul, Jessica D %A Fretts, Amanda M %A Gallo, Linda C %A Grabe, Hans Jörgen %A Gu, C Charles %A Harris, Tamara B %A Hartman, Catharina C A %A Heikkinen, Sami %A Ikram, M Arfan %A Isasi, Carmen %A Johnson, W Craig %A Jonas, Jost Bruno %A Kaplan, Robert C %A Komulainen, Pirjo %A Krieger, Jose E %A Levy, Daniel %A Liu, Jianjun %A Lohman, Kurt %A Luik, Annemarie I %A Martin, Lisa W %A Meitinger, Thomas %A Milaneschi, Yuri %A O'Connell, Jeff R %A Palmas, Walter R %A Peters, Annette %A Peyser, Patricia A %A Pulkki-Råback, Laura %A Raffel, Leslie J %A Reiner, Alex P %A Rice, Kenneth %A Robinson, Jennifer G %A Rosendaal, Frits R %A Schmidt, Carsten Oliver %A Schreiner, Pamela J %A Schwettmann, Lars %A Shikany, James M %A Shu, Xiao-Ou %A Sidney, Stephen %A Sims, Mario %A Smith, Jennifer A %A Sotoodehnia, Nona %A Strauch, Konstantin %A Tai, E Shyong %A Taylor, Kent %A Uitterlinden, André G %A van Duijn, Cornelia M %A Waldenberger, Melanie %A Wee, Hwee-Lin %A Wei, Wen-Bin %A Wilson, Gregory %A Xuan, Deng %A Yao, Jie %A Zeng, Donglin %A Zhao, Wei %A Zhu, Xiaofeng %A Zonderman, Alan B %A Becker, Diane M %A Deary, Ian J %A Gieger, Christian %A Lakka, Timo A %A Lehtimäki, Terho %A North, Kari E %A Oldehinkel, Albertine J %A Penninx, Brenda W J H %A Snieder, Harold %A Wang, Ya-Xing %A Weir, David R %A Zheng, Wei %A Evans, Michele K %A Gauderman, W James %A Gudnason, Vilmundur %A Horta, Bernardo L %A Liu, Ching-Ti %A Mook-Kanamori, Dennis O %A Morrison, Alanna C %A Pereira, Alexandre C %A Psaty, Bruce M %A Amin, Najaf %A Fox, Ervin R %A Kooperberg, Charles %A Sim, Xueling %A Bierut, Laura %A Rotter, Jerome I %A Kardia, Sharon L R %A Franceschini, Nora %A Rao, Dabeeru C %A Fornage, Myriam %X

Psychological and social factors are known to influence blood pressure (BP) and risk of hypertension and associated cardiovascular diseases. To identify novel BP loci, we carried out genome-wide association meta-analyses of systolic, diastolic, pulse, and mean arterial BP taking into account the interaction effects of genetic variants with three psychosocial factors: depressive symptoms, anxiety symptoms, and social support. Analyses were performed using a two-stage design in a sample of up to 128,894 adults from 5 ancestry groups. In the combined meta-analyses of Stages 1 and 2, we identified 59 loci (p value <5e-8), including nine novel BP loci. The novel associations were observed mostly with pulse pressure, with fewer observed with mean arterial pressure. Five novel loci were identified in African ancestry, and all but one showed patterns of interaction with at least one psychosocial factor. Functional annotation of the novel loci supports a major role for genes implicated in the immune response (), synaptic function and neurotransmission (), as well as genes previously implicated in neuropsychiatric or stress-related disorders (). These findings underscore the importance of considering psychological and social factors in gene discovery for BP, especially in non-European populations.

%B HGG Adv %V 2 %8 2021 Jan 14 %G eng %N 1 %R 10.1016/j.xhgg.2020.100013 %0 Journal Article %J Mol Psychiatry %D 2021 %T Multi-ancestry genome-wide gene-sleep interactions identify novel loci for blood pressure. %A Wang, Heming %A Noordam, Raymond %A Cade, Brian E %A Schwander, Karen %A Winkler, Thomas W %A Lee, Jiwon %A Sung, Yun Ju %A Bentley, Amy R %A Manning, Alisa K %A Aschard, Hugues %A Kilpeläinen, Tuomas O %A Ilkov, Marjan %A Brown, Michael R %A Horimoto, Andrea R %A Richard, Melissa %A Bartz, Traci M %A Vojinovic, Dina %A Lim, Elise %A Nierenberg, Jovia L %A Liu, Yongmei %A Chitrala, Kumaraswamynaidu %A Rankinen, Tuomo %A Musani, Solomon K %A Franceschini, Nora %A Rauramaa, Rainer %A Alver, Maris %A Zee, Phyllis C %A Harris, Sarah E %A van der Most, Peter J %A Nolte, Ilja M %A Munroe, Patricia B %A Palmer, Nicholette D %A Kuhnel, Brigitte %A Weiss, Stefan %A Wen, Wanqing %A Hall, Kelly A %A Lyytikäinen, Leo-Pekka %A O'Connell, Jeff %A Eiriksdottir, Gudny %A Launer, Lenore J %A de Vries, Paul S %A Arking, Dan E %A Chen, Han %A Boerwinkle, Eric %A Krieger, Jose E %A Schreiner, Pamela J %A Sidney, Stephen %A Shikany, James M %A Rice, Kenneth %A Chen, Yii-Der Ida %A Gharib, Sina A %A Bis, Joshua C %A Luik, Annemarie I %A Ikram, M Arfan %A Uitterlinden, André G %A Amin, Najaf %A Xu, Hanfei %A Levy, Daniel %A He, Jiang %A Lohman, Kurt K %A Zonderman, Alan B %A Rice, Treva K %A Sims, Mario %A Wilson, Gregory %A Sofer, Tamar %A Rich, Stephen S %A Palmas, Walter %A Yao, Jie %A Guo, Xiuqing %A Rotter, Jerome I %A Biermasz, Nienke R %A Mook-Kanamori, Dennis O %A Martin, Lisa W %A Barac, Ana %A Wallace, Robert B %A Gottlieb, Daniel J %A Komulainen, Pirjo %A Heikkinen, Sami %A Mägi, Reedik %A Milani, Lili %A Metspalu, Andres %A Starr, John M %A Milaneschi, Yuri %A Waken, R J %A Gao, Chuan %A Waldenberger, Melanie %A Peters, Annette %A Strauch, Konstantin %A Meitinger, Thomas %A Roenneberg, Till %A Völker, Uwe %A Dörr, Marcus %A Shu, Xiao-Ou %A Mukherjee, Sutapa %A Hillman, David R %A Kähönen, Mika %A Wagenknecht, Lynne E %A Gieger, Christian %A Grabe, Hans J %A Zheng, Wei %A Palmer, Lyle J %A Lehtimäki, Terho %A Gudnason, Vilmundur %A Morrison, Alanna C %A Pereira, Alexandre C %A Fornage, Myriam %A Psaty, Bruce M %A van Duijn, Cornelia M %A Liu, Ching-Ti %A Kelly, Tanika N %A Evans, Michele K %A Bouchard, Claude %A Fox, Ervin R %A Kooperberg, Charles %A Zhu, Xiaofeng %A Lakka, Timo A %A Esko, Tõnu %A North, Kari E %A Deary, Ian J %A Snieder, Harold %A Penninx, Brenda W J H %A Gauderman, W James %A Rao, Dabeeru C %A Redline, Susan %A van Heemst, Diana %X

Long and short sleep duration are associated with elevated blood pressure (BP), possibly through effects on molecular pathways that influence neuroendocrine and vascular systems. To gain new insights into the genetic basis of sleep-related BP variation, we performed genome-wide gene by short or long sleep duration interaction analyses on four BP traits (systolic BP, diastolic BP, mean arterial pressure, and pulse pressure) across five ancestry groups in two stages using 2 degree of freedom (df) joint test followed by 1df test of interaction effects. Primary multi-ancestry analysis in 62,969 individuals in stage 1 identified three novel gene by sleep interactions that were replicated in an additional 59,296 individuals in stage 2 (stage 1 + 2 P < 5 × 10), including rs7955964 (FIGNL2/ANKRD33) that increases BP among long sleepers, and rs73493041 (SNORA26/C9orf170) and rs10406644 (KCTD15/LSM14A) that increase BP among short sleepers (P < 5 × 10). Secondary ancestry-specific analysis identified another novel gene by long sleep interaction at rs111887471 (TRPC3/KIAA1109) in individuals of African ancestry (P = 2 × 10). Combined stage 1 and 2 analyses additionally identified significant gene by long sleep interactions at 10 loci including MKLN1 and RGL3/ELAVL3 previously associated with BP, and significant gene by short sleep interactions at 10 loci including C2orf43 previously associated with BP (P < 10). 2df test also identified novel loci for BP after modeling sleep that has known functions in sleep-wake regulation, nervous and cardiometabolic systems. This study indicates that sleep and primary mechanisms regulating BP may interact to elevate BP level, suggesting novel insights into sleep-related BP regulation.

%B Mol Psychiatry %8 2021 Apr 15 %G eng %R 10.1038/s41380-021-01087-0 %0 Journal Article %J Nat Commun %D 2021 %T {A multi-ethnic epigenome-wide association study of leukocyte DNA methylation and blood lipids %A Jhun, M. A. %A Mendelson, M. %A Wilson, R. %A Gondalia, R. %A Joehanes, R. %A Salfati, E. %A Zhao, X. %A Braun, K. V. E. %A Do, A. N. %A Hedman, Å. K. %A Zhang, T. %A Carnero-Montoro, E. %A Shen, J. %A Bartz, T. M. %A Brody, J. A. %A Montasser, M. E. %A O'Connell, J. R. %A Yao, C. %A Xia, R. %A Boerwinkle, E. %A Grove, M. %A Guan, W. %A Liliane, P. %A Singmann, P. %A Müller-Nurasyid, M. %A Meitinger, T. %A Gieger, C. %A Peters, A. %A Zhao, W. %A Ware, E. B. %A Smith, J. A. %A Dhana, K. %A van Meurs, J. %A Uitterlinden, A. %A Ikram, M. A. %A Ghanbari, M. %A Zhi, D. %A Gustafsson, S. %A Lind, L. %A Li, S. %A Sun, D. %A Spector, T. D. %A Chen, Y. I. %A Damcott, C. %A Shuldiner, A. R. %A Absher, D. M. %A Horvath, S. %A Tsao, P. S. %A Kardia, S. %A Psaty, B. M. %A Sotoodehnia, N. %A Bell, J. T. %A Ingelsson, E. %A Chen, W. %A Dehghan, A. %A Arnett, D. K. %A Waldenberger, M. %A Hou, L. %A Whitsel, E. A. %A Baccarelli, A. %A Levy, D. %A Fornage, M. %A Irvin, M. R. %A Assimes, T. L. %X 10.1038/s41467-021-23899-yHere we examine the association between DNA methylation in circulating leukocytes and blood lipids in a multi-ethnic sample of 16,265 subjects. We identify 148, 35, and 4 novel associations among Europeans, African Americans, and Hispanics, respectively, and an additional 186 novel associations through a trans-ethnic meta-analysis. We observe a high concordance in the direction of effects across racial/ethnic groups, a high correlation of effect sizes between high-density lipoprotein and triglycerides, a modest overlap of associations with epigenome-wide association studies of other cardio-metabolic traits, and a largely non-overlap with lipid loci identified to date through genome-wide association studies. Thirty CpGs reached significance in at least 2 racial/ethnic groups including 7 that showed association with the expression of an annotated gene. CpGs annotated to CPT1A showed evidence of being influenced by triglycerides levels. DNA methylation levels of circulating leukocytes show robust and consistent association with blood lipid levels across multiple racial/ethnic groups. %B Nat Commun %V 12 %P 3987 %8 06 %G eng %0 Journal Article %J Circ Genom Precis Med %D 2021 %T Multiethnic Genome-Wide Association Study of Subclinical Atherosclerosis in Individuals With Type 2 Diabetes. %A Lu, Yingchang %A Dimitrov, Latchezar %A Chen, Shyh-Huei %A Bielak, Lawrence F %A Bis, Joshua C %A Feitosa, Mary F %A Lu, Lingyi %A Kavousi, Maryam %A Raffield, Laura M %A Smith, Albert V %A Wang, Lihua %A Weiss, Stefan %A Yao, Jie %A Zhu, Jiaxi %A Gudmundsson, Elias F %A Gudmundsdottir, Valborg %A Bos, Daniel %A Ghanbari, Mohsen %A Ikram, M Arfan %A Hwang, Shih-Jen %A Taylor, Kent D %A Budoff, Matthew J %A Gislason, Gauti K %A O'Donnell, Christopher J %A An, Ping %A Franceschini, Nora %A Freedman, Barry I %A Fu, Yi-Ping %A Guo, Xiuqing %A Heiss, Gerardo %A Kardia, Sharon L R %A Wilson, James G %A Langefeld, Carl D %A Schminke, Ulf %A Uitterlinden, André G %A Lange, Leslie A %A Peyser, Patricia A %A Gudnason, Vilmundur G %A Psaty, Bruce M %A Rotter, Jerome I %A Bowden, Donald W %A Ng, Maggie C Y %X

BACKGROUND: Coronary artery calcification (CAC) and carotid artery intima-media thickness (cIMT) are measures of subclinical atherosclerosis in asymptomatic individuals and strong risk factors for cardiovascular disease. Type 2 diabetes (T2D) is an independent cardiovascular disease risk factor that accelerates atherosclerosis.

METHODS: We performed meta-analyses of genome-wide association studies in up to 2500 T2D individuals of European ancestry (EA) and 1590 T2D individuals of African ancestry with or without exclusion of prevalent cardiovascular disease, for CAC measured by cardiac computed tomography, and 3608 individuals of EA and 838 individuals of African ancestry with T2D for cIMT measured by ultrasonography within the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium.

RESULTS: We replicated 2 loci (rs9369640 and rs9349379 near and rs10757278 near ) for CAC and one locus for cIMT (rs7412 and rs445925 near ) that were previously reported in the general EA populations. We identified one novel CAC locus (rs8000449 near at 13q13.3) at =2.0×10 in EA. No additional loci were identified with the meta-analyses of EA and African ancestry. The expression quantitative trait loci analysis with nearby expressed genes derived from arterial wall and metabolic tissues from the Genotype-Tissue Expression project pinpoints , encoding a matricellular protein involved in bone formation and bone matrix organization, as the potential candidate gene at this locus. In addition, we found significant associations (<3.1×10) for 3 previously reported coronary artery disease loci for these subclinical atherosclerotic phenotypes (rs2891168 near and rs11170820 near for CAC, and rs7412 near for cIMT).

CONCLUSIONS: Our results provide potential biological mechanisms that could link CAC and cIMT to increased cardiovascular disease risk in individuals with T2D.

%B Circ Genom Precis Med %V 14 %P e003258 %8 2021 Aug %G eng %N 4 %R 10.1161/CIRCGEN.120.003258 %0 Journal Article %J Blood Cancer Discov %D 2021 %T is mutated in clonal hematopoiesis and myelodysplastic syndromes and impacts RNA splicing. %A Beauchamp, Ellen M %A Leventhal, Matthew %A Bernard, Elsa %A Hoppe, Emma R %A Todisco, Gabriele %A Creignou, Maria %A Gallì, Anna %A Castellano, Cecilia A %A McConkey, Marie %A Tarun, Akansha %A Wong, Waihay %A Schenone, Monica %A Stanclift, Caroline %A Tanenbaum, Benjamin %A Malolepsza, Edyta %A Nilsson, Björn %A Bick, Alexander G %A Weinstock, Joshua S %A Miller, Mendy %A Niroula, Abhishek %A Dunford, Andrew %A Taylor-Weiner, Amaro %A Wood, Timothy %A Barbera, Alex %A Anand, Shankara %A Psaty, Bruce M %A Desai, Pinkal %A Cho, Michael H %A Johnson, Andrew D %A Loos, Ruth %A MacArthur, Daniel G %A Lek, Monkol %A Neuberg, Donna S %A Lage, Kasper %A Carr, Steven A %A Hellstrom-Lindberg, Eva %A Malcovati, Luca %A Papaemmanuil, Elli %A Stewart, Chip %A Getz, Gad %A Bradley, Robert K %A Jaiswal, Siddhartha %A Ebert, Benjamin L %X

Clonal hematopoiesis results from somatic mutations in cancer driver genes in hematopoietic stem cells. We sought to identify novel drivers of clonal expansion using an unbiased analysis of sequencing data from 84,683 persons and identified common mutations in the 5-methylcytosine reader, , as well as in , , and . We also identified these mutations at low frequency in myelodysplastic syndrome patients. edited mouse hematopoietic stem and progenitor cells exhibited a competitive advantage and increased genome-wide intron retention. mutations potentially link DNA methylation and RNA splicing, the two most commonly mutated pathways in clonal hematopoiesis and MDS.

%B Blood Cancer Discov %V 2 %P 500-517 %8 2021 Sep %G eng %N 5 %R 10.1158/2643-3230.BCD-20-0224 %0 Journal Article %J Diabetes Care %D 2021 %T n-3 Fatty Acid Biomarkers and Incident Type 2 Diabetes: An Individual Participant-Level Pooling Project of 20 Prospective Cohort Studies %A Qian, F. %A Ardisson Korat, A. V. %A Imamura, F. %A Marklund, M. %A Tintle, N. %A Virtanen, J. K. %A Zhou, X. %A Bassett, J. K. %A Lai, H. %A Hirakawa, Y. %A Chien, K. L. %A Wood, A. C. %A Lankinen, M. %A Murphy, R. A. %A Samieri, C. %A Pertiwi, K. %A de Mello, V. D. %A Guan, W. %A Forouhi, N. G. %A Wareham, N. %A Hu, I. C. F. B. %A Riserus, U. %A Lind, L. %A Harris, W. S. %A Shadyab, A. H. %A Robinson, J. G. %A Steffen, L. M. %A Hodge, A. %A Giles, G. G. %A Ninomiya, T. %A Uusitupa, M. %A Tuomilehto, J. %A m, J. %A Laakso, M. %A Siscovick, D. S. %A Helmer, C. %A Geleijnse, J. M. %A Wu, J. H. Y. %A Fretts, A. %A Lemaitre, R. N. %A Micha, R. %A Mozaffarian, D. %A Sun, Q. %X -linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with T2D risk through an individual participant-level pooled analysis.\ For our analysis we incorporated data from a global consortium of 20 prospective studies from 14 countries. We included 65,147 participants who had blood measurements of ALA, EPA, DPA, or DHA and were free of diabetes at baseline. De novo harmonized analyses were performed in each cohort following a prespecified protocol, and cohort-specific associations were pooled using inverse variance-weighted meta-analysis.\ 0.001). ALA was not associated with T2D (HR 0.97 [95% CI 0.92, 1.02]) per interquintile range. Associations were robust across prespecified subgroups as well as in sensitivity analyses.\ Higher circulating biomarkers of seafood-derived n-3 fatty acids, including EPA, DPA, DHA, and their sum, were associated with lower risk of T2D in a global consortium of prospective studies. The biomarker of plant-derived ALA was not significantly associated with T2D risk. %B Diabetes Care %V 44 %P 1133–1142 %8 May %G eng %0 Journal Article %J BMC Cardiovasc Disord %D 2021 %T Natural killer cells, gamma delta T cells and classical monocytes are associated with systolic blood pressure in the multi-ethnic study of atherosclerosis (MESA). %A Delaney, Joseph A C %A Olson, Nels C %A Sitlani, Colleen M %A Fohner, Alison E %A Huber, Sally A %A Landay, Alan L %A Heckbert, Susan R %A Tracy, Russell P %A Psaty, Bruce M %A Feinstein, Matt %A Doyle, Margaret F %X

BACKGROUND: Hypertension is a major source of cardiovascular morbidity and mortality. Recent evidence from mouse models, genetic, and cross-sectional human studies suggest increased proportions of selected immune cell subsets may be associated with levels of systolic blood pressure (SBP).

METHODS: We assayed immune cells from cryopreserved samples collected at the baseline examination (2000-2002) from 1195 participants from the multi-ethnic study of atherosclerosis (MESA). We used linear mixed models, with adjustment for age, sex, race/ethnicity, smoking, exercise, body mass index, education, diabetes, and cytomegalovirus titers, to estimate the associations between 30 immune cell subsets (4 of which were a priori hypotheses) and repeated measures of SBP (baseline and up to four follow-up measures) over 10 years. The analysis provides estimates of the association with blood pressure level.

RESULTS: The mean age of the MESA participants at baseline was 64 ± 10 years and 53% were male. A one standard deviation (1-SD) increment in the proportion of γδ T cells was associated with 2.40 mmHg [95% confidence interval (CI) 1.34-3.42] higher average systolic blood pressure; and for natural killer cells, a 1-SD increment was associated with 1.88 mmHg (95% CI 0.82-2.94) higher average level of systolic blood pressure. A 1-SD increment in classical monocytes (CD14CD16) was associated with 2.01 mmHG (95% CI 0.79-3.24) lower average systolic blood pressure. There were no associations of CD4 T helper cell subsets with average systolic blood pressure.

CONCLUSION: These findings suggest that the innate immune system plays a role in levels of SBP whereas there were no associations with adaptive immune cells.

%B BMC Cardiovasc Disord %V 21 %P 45 %8 2021 Jan 22 %G eng %N 1 %R 10.1186/s12872-021-01857-2 %0 Journal Article %J Alzheimers Dement %D 2021 %T Ophthalmic conditions associated with dementia risk: The Cardiovascular Health Study. %A Hwang, Phillip H %A Longstreth, Will T %A Thielke, Stephen M %A Francis, Courtney E %A Carone, Marco %A Kuller, Lewis H %A Fitzpatrick, Annette L %X

INTRODUCTION: Ophthalmic conditions and dementia appear to overlap and may share common pathways, but research has not differentiated dementia subtypes.

METHODS: Diagnoses of cataracts, age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma were based on medical histories and International Classification of Diseases, Ninth Revision (ICD-9) codes for 3375 participants from the Cardiovascular Health Study. Dementia, including Alzheimer's disease (AD) and vascular dementia (VaD), was classified using standardized research criteria.

RESULTS: Cataracts were associated with AD (hazard ratio [HR] = 1.34; 95% confidence interval [CI] = 1.01-1.80) and VaD/mixed dementia (HR = 1.41; 95% CI = 1.02-1.95). AMD was associated with AD only (HR = 1.87; 95% CI = 1.13-3.09), whereas DR was associated with VaD/mixed dementia only (HR = 2.63; 95% CI = 1.10-6.27).

DISCUSSION: Differential associations between specific ophthalmic conditions and dementia subtypes may elucidate pathophysiologic pathways. Lack of association between glaucoma and dementia was most surprising from these analyses.

%B Alzheimers Dement %8 2021 Mar 31 %G eng %R 10.1002/alz.12313 %0 Journal Article %J JAMA Cardiol %D 2021 %T Performance of the American Heart Association/American College of Cardiology Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Self-reported Physical Activity Levels. %A Pandey, Ambarish %A Mehta, Anurag %A Paluch, Amanda %A Ning, Hongyan %A Carnethon, Mercedes R %A Allen, Norrina B %A Michos, Erin D %A Berry, Jarett D %A Lloyd-Jones, Donald M %A Wilkins, John T %X

Importance: The American Heart Association/American College of Cardiology pooled cohort equations (PCEs) are used for predicting 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Pooled cohort equation risk prediction capabilities across self-reported leisure-time physical activity (LTPA) levels and the change in model performance with addition of LTPA to the PCE are unclear.

Objective: To evaluate PCE risk prediction performance across self-reported LTPA levels and the change in model performance by adding LTPA to the existing PCE model.

Design, Setting, and Participants: Individual-level pooling of data from 3 longitudinal cohort studies-Atherosclerosis Risk in Communities, Multi-Ethnic Study of Atherosclerosis, and Cardiovascular Health Study-was performed. A total of 18 824 participants were stratified into 4 groups based on self-reported LTPA levels: inactive (0 metabolic equivalent of task [MET]-min/wk), less than guideline-recommended (<500 MET-min/wk), guideline-recommended (500-1000 MET-min/week), and greater than guideline-recommended (>1000 MET-min/wk). Pooled cohort equation risk discrimination was studied using the C statistic and reclassification capabilities were studied using the Greenwood Nam-D'Agostino χ2 goodness-of-fit test. Change in risk discrimination and reclassification on adding LTPA to PCEs was evaluated using change in C statistic, integrated discrimination index, and categorical net reclassification index.

Main Outcomes and Measures: Adjudicated ASCVD events during 10-year follow-up.

Results: Among 18 824 participants studied, 10 302 were women (54.7%); mean (SD) age was 57.6 (8.2) years. A total of 5868 participants (31.2%) were inactive, 3849 (20.4%) had less than guideline-recommended LTPA, 3372 (17.9%) had guideline-recommended LTPA, and 5735 (30.5%) had greater than guideline-recommended LTPA level. Higher LTPA levels were associated with a lower risk of ASCVD after adjustment for risk factors (hazard ratio [HR] per 1-SD higher LTPA, 0.91; 95% CI, 0.86-0.96). Across LTPA groups, PCE risk discrimination (C statistic, 0.76-0.78) and risk calibration (all χ2 P > .10) was similar. Addition of LTPA to the PCE model resulted in no significant change in the C statistic (0.0005; 95% CI, -0.0004 to 0.0015; P = .28) and categorical net reclassification index (-0.003; 95% CI, -0.010 to 0.010; P = .95), but a minimal improvement in the integrated discrimination index (0.0008; 95% CI, 0.0002-0.0013; P = .005) was observed. Similar results were noted when cohort-specific coefficients were used for creating the baseline model.

Conclusions and Relevance: Higher self-reported LTPA levels appear to be associated with lower ASCVD risk and increasing LTPA promotes cardiovascular wellness. These findings suggest the American Heart Association/American College of Cardiology PCEs are accurate at estimating the probability of 10-year ASCVD risk regardless of LTPA level. The addition of self-reported LTPA to PCEs does not appear to be associated with improvement in risk prediction model performance.

%B JAMA Cardiol %V 6 %P 690-696 %8 2021 Jun 01 %G eng %N 6 %R 10.1001/jamacardio.2021.0948 %0 Journal Article %J Front Pharmacol %D 2021 %T The Pharmacogenetics of Statin Therapy on Clinical Events: No Evidence that Genetic Variation Affects Statin Response on Myocardial Infarction. %A Trompet, Stella %A Postmus, Iris %A Warren, Helen R %A Noordam, Raymond %A Smit, Roelof A J %A Theusch, Elizabeth %A Li, Xiaohui %A Arsenault, Benoit %A Chasman, Daniel I %A Hitman, Graham A %A Munroe, Patricia B %A Rotter, Jerome I %A Psaty, Bruce M %A Caulfield, Mark J %A Krauss, Ron M %A Cupples, Adrienne L %A Jukema, Wouter J %X

The pharmacogenetic effect on cardiovascular disease reduction in response to statin treatment has only been assessed in small studies. In a pharmacogenetic genome wide association study (GWAS) analysis within the Genomic Investigation of Statin Therapy (GIST) consortium, we investigated whether genetic variation was associated with the response of statins on cardiovascular disease risk reduction. The investigated endpoint was incident myocardial infarction (MI) defined as coronary heart disease death and definite and suspect non-fatal MI. For imputed single nucleotide polymorphisms (SNPs), regression analysis was performed on expected allelic dosage and meta-analysed with a fixed-effects model, inverse variance weighted meta-analysis. All SNPs with -values <5.0 × 10 in stage 1 GWAS meta-analysis were selected for further investigation in stage-2. As a secondary analysis, we extracted SNPs from the Stage-1 GWAS meta-analysis results based on predefined hypotheses to possibly modifying the effect of statin therapy on MI. In stage-1 meta-analysis (eight studies, = 10,769, 4,212 cases), we observed no genome-wide significant results ( < 5.0 × 10). A total of 144 genetic variants were followed-up in the second stage (three studies, = 1,525, 180 cases). In the combined meta-analysis, no genome-wide significant hits were identified. Moreover, none of the look-ups of SNPs known to be associated with either CHD or with statin response to cholesterol levels reached Bonferroni level of significance within our stage-1 meta-analysis. This GWAS analysis did not provide evidence that genetic variation affects statin response on cardiovascular risk reduction. It does not appear likely that genetic testing for predicting effects of statins on clinical events will become a useful tool in clinical practice.

%B Front Pharmacol %V 12 %P 679857 %8 2021 %G eng %R 10.3389/fphar.2021.679857 %0 Journal Article %J J Lipid Res %D 2021 %T Plasma Ceramides containing Saturated Fatty Acids are Associated with Risk of Type 2 Diabetes. %A Fretts, Amanda M %A Jensen, Paul N %A Hoofnagle, Andrew N %A McKnight, Barbara %A Howard, Barbara V %A Umans, Jason %A Sitlani, Colleen M %A Siscovick, David S %A King, Irena B %A Djoussé, Luc %A Sotoodehnia, Nona %A Lemaitre, Rozenn N %X

Recent studies suggest that the type of saturated fatty acid bound to sphingolipids influences the biological activity of those sphingolipids. However, it is unknown whether associations of sphingolipids with diabetes may differ by the identity of bound lipid species. Here we investigated associations of 15 ceramide and sphingomyelin species (i.e., all sphingolipids, measured with coefficient of variation less than 20%) with incident type 2 diabetes in the Cardiovascular Health Study (n = 3,645), a large cohort study of cardiovascular disease (CVD) among elderly adults who were followed from 1989-2015. Diabetes incidence was defined as fasting glucose ≥126 mg/dL or non-fasting glucose ≥200 mg/dL; reported use of insulin or oral hypoglycemic medication; or documentation of diabetes diagnosis through the Centers for Medicare and Medicaid Services records. Associations of each sphingolipid with incident diabetes were assessed using a Cox proportional hazards regression model. We found that higher circulating levels of ceramide with acylated palmitic acid (Cer-16), stearic acid containing ceramide (Cer-18), arachidic acid containing ceramide (Cer-20), and behenic acid containing ceramide (Cer-22) were each associated with a higher risk of diabetes. The hazard ratios for incident diabetes per 1 SD higher log levels of each ceramide species were: 1.21 (95% CI 1.09-1.34) for Cer-16, 1.23 (95% CI 1.10-1.37) for Cer-18, 1.14 (95% CI 1.02-1.26) for Cer-20, and 1.18 (95% CI 1.06-1.32) for Cer-22. In conclusion, higher levels of Cer-16, Cer-18, Cer-20, and Cer-22 were associated with a higher risk of diabetes.

%B J Lipid Res %P 100119 %8 2021 Sep 20 %G eng %R 10.1016/j.jlr.2021.100119 %0 Journal Article %J Nature %D 2021 %T {The power of genetic diversity in genome-wide association studies of lipids %A Graham, S. E. %A Clarke, S. L. %A Wu, K. H. %A Kanoni, S. %A Zajac, G. J. M. %A Ramdas, S. %A Surakka, I. %A Ntalla, I. %A Vedantam, S. %A Winkler, T. W. %A Locke, A. E. %A Marouli, E. %A Hwang, M. Y. %A Han, S. %A Narita, A. %A Choudhury, A. %A Bentley, A. R. %A Ekoru, K. %A Verma, A. %A Trivedi, B. %A Martin, H. C. %A Hunt, K. A. %A Hui, Q. %A Klarin, D. %A Zhu, X. %A Thorleifsson, G. %A Helgadottir, A. %A Gudbjartsson, D. F. %A Holm, H. %A Olafsson, I. %A Akiyama, M. %A Sakaue, S. %A Terao, C. %A Kanai, M. %A Zhou, W. %A Brumpton, B. M. %A Rasheed, H. %A Ruotsalainen, S. E. %A Havulinna, A. S. %A Veturi, Y. %A Feng, Q. %A Rosenthal, E. A. %A Lingren, T. %A Pacheco, J. A. %A Pendergrass, S. A. %A Haessler, J. %A Giulianini, F. %A Bradford, Y. %A Miller, J. E. %A Campbell, A. %A Lin, K. %A Millwood, I. Y. %A Hindy, G. %A Rasheed, A. %A Faul, J. D. %A Zhao, W. %A Weir, D. R. %A Turman, C. %A Huang, H. %A Graff, M. %A Mahajan, A. %A Brown, M. R. %A Zhang, W. %A Yu, K. %A Schmidt, E. M. %A Pandit, A. %A Gustafsson, S. %A Yin, X. %A Luan, J. %A Zhao, J. H. %A Matsuda, F. %A Jang, H. M. %A Yoon, K. %A Medina-Gomez, C. %A Pitsillides, A. %A Hottenga, J. J. %A Willemsen, G. %A Wood, A. R. %A Ji, Y. %A Gao, Z. %A Haworth, S. %A Mitchell, R. E. %A Chai, J. F. %A Aadahl, M. %A Yao, J. %A Manichaikul, A. %A Warren, H. R. %A Ramirez, J. %A Bork-Jensen, J. %A Kårhus, L. L. %A Goel, A. %A Sabater-Lleal, M. %A Noordam, R. %A Sidore, C. %A Fiorillo, E. %A McDaid, A. F. %A Marques-Vidal, P. %A Wielscher, M. %A Trompet, S. %A Sattar, N. %A Møllehave, L. T. %A Thuesen, B. H. %A Munz, M. %A Zeng, L. %A Huang, J. %A Yang, B. %A Poveda, A. %A Kurbasic, A. %A Lamina, C. %A Forer, L. %A Scholz, M. %A Galesloot, T. E. %A Bradfield, J. P. %A Daw, E. W. %A Zmuda, J. M. %A Mitchell, J. S. %A Fuchsberger, C. %A Christensen, H. %A Brody, J. A. %A Feitosa, M. F. %A Wojczynski, M. K. %A Preuss, M. %A Mangino, M. %A Christofidou, P. %A Verweij, N. %A Benjamins, J. W. %A Engmann, J. %A Kember, R. L. %A Slieker, R. C. %A Lo, K. S. %A Zilhao, N. R. %A Le, P. %A Kleber, M. E. %A Delgado, G. E. %A Huo, S. %A Ikeda, D. D. %A Iha, H. %A Yang, J. %A Liu, J. %A Leonard, H. L. %A Marten, J. %A Schmidt, B. %A Arendt, M. %A Smyth, L. J. %A Cañadas-Garre, M. %A Wang, C. %A Nakatochi, M. %A Wong, A. %A Hutri-Kähönen, N. %A Sim, X. %A Xia, R. %A Huerta-Chagoya, A. %A Fernandez-Lopez, J. C. %A Lyssenko, V. %A Ahmed, M. %A Jackson, A. U. %A Irvin, M. R. %A Oldmeadow, C. %A Kim, H. N. %A Ryu, S. %A Timmers, P. R. H. J. %A Arbeeva, L. %A Dorajoo, R. %A Lange, L. A. %A Chai, X. %A Prasad, G. %A Lorés-Motta, L. %A Pauper, M. %A Long, J. %A Li, X. %A Theusch, E. %A Takeuchi, F. %A Spracklen, C. N. %A Loukola, A. %A Bollepalli, S. %A Warner, S. C. %A Wang, Y. X. %A Wei, W. B. %A Nutile, T. %A Ruggiero, D. %A Sung, Y. J. %A Hung, Y. J. %A Chen, S. %A Liu, F. %A Yang, J. %A Kentistou, K. A. %A Gorski, M. %A Brumat, M. %A Meidtner, K. %A Bielak, L. F. %A Smith, J. A. %A Hebbar, P. %A Farmaki, A. E. %A Hofer, E. %A Lin, M. %A Xue, C. %A Zhang, J. %A Concas, M. P. %A Vaccargiu, S. %A van der Most, P. J. %A Pitkänen, N. %A Cade, B. E. %A Lee, J. %A van der Laan, S. W. %A Chitrala, K. N. %A Weiss, S. %A Zimmermann, M. E. %A Lee, J. Y. %A Choi, H. S. %A Nethander, M. %A Freitag-Wolf, S. %A Southam, L. %A Rayner, N. W. %A Wang, C. A. %A Lin, S. Y. %A Wang, J. S. %A Couture, C. %A Lyytikäinen, L. P. %A Nikus, K. %A Cuellar-Partida, G. %A Vestergaard, H. %A Hildalgo, B. %A Giannakopoulou, O. %A Cai, Q. %A Obura, M. O. %A van Setten, J. %A Li, X. %A Schwander, K. %A Terzikhan, N. %A Shin, J. H. %A Jackson, R. D. %A Reiner, A. P. %A Martin, L. W. %A Chen, Z. %A Li, L. %A Highland, H. M. %A Young, K. L. %A Kawaguchi, T. %A Thiery, J. %A Bis, J. C. %A Nadkarni, G. N. %A Launer, L. J. %A Li, H. %A Nalls, M. A. %A Raitakari, O. T. %A Ichihara, S. %A Wild, S. H. %A Nelson, C. P. %A Campbell, H. %A Jäger, S. %A Nabika, T. %A Al-Mulla, F. %A Niinikoski, H. %A Braund, P. S. %A Kolcic, I. %A Kovacs, P. %A Giardoglou, T. %A Katsuya, T. %A Bhatti, K. F. %A de Kleijn, D. %A de Borst, G. J. %A Kim, E. K. %A Adams, H. H. H. %A Ikram, M. A. %A Zhu, X. %A Asselbergs, F. W. %A Kraaijeveld, A. O. %A Beulens, J. W. J. %A Shu, X. O. %A Rallidis, L. S. %A Pedersen, O. %A Hansen, T. %A Mitchell, P. %A Hewitt, A. W. %A Kähönen, M. %A Pérusse, L. %A Bouchard, C. %A Tonjes, A. %A Chen, Y. I. %A Pennell, C. E. %A Mori, T. A. %A Lieb, W. %A Franke, A. %A Ohlsson, C. %A Mellström, D. %A Cho, Y. S. %A Lee, H. %A Yuan, J. M. %A Koh, W. P. %A Rhee, S. Y. %A Woo, J. T. %A Heid, I. M. %A Stark, K. J. %A Völzke, H. %A Homuth, G. %A Evans, M. K. %A Zonderman, A. B. %A Polasek, O. %A Pasterkamp, G. %A Hoefer, I. E. %A Redline, S. %A Pahkala, K. %A Oldehinkel, A. J. %A Snieder, H. %A Biino, G. %A Schmidt, R. %A Schmidt, H. %A Chen, Y. E. %A Bandinelli, S. %A Dedoussis, G. %A Thanaraj, T. A. %A Kardia, S. L. R. %A Kato, N. %A Schulze, M. B. %A Girotto, G. %A Jung, B. %A Böger, C. A. %A Joshi, P. K. %A Bennett, D. A. %A De Jager, P. L. %A Lu, X. %A Mamakou, V. %A Brown, M. %A Caulfield, M. J. %A Munroe, P. B. %A Guo, X. %A Ciullo, M. %A Jonas, J. B. %A Samani, N. J. %A Kaprio, J. %A Pajukanta, P. %A Adair, L. S. %A Bechayda, S. A. %A de Silva, H. J. %A Wickremasinghe, A. R. %A Krauss, R. M. %A Wu, J. Y. %A Zheng, W. %A den Hollander, A. I. %A Bharadwaj, D. %A Correa, A. %A Wilson, J. G. %A Lind, L. %A Heng, C. K. %A Nelson, A. E. %A Golightly, Y. M. %A Wilson, J. F. %A Penninx, B. %A Kim, H. L. %A Attia, J. %A Scott, R. J. %A Rao, D. C. %A Arnett, D. K. %A Walker, M. %A Koistinen, H. A. %A Chandak, G. R. %A Yajnik, C. S. %A Mercader, J. M. %A Tusié-Luna, T. %A Aguilar-Salinas, C. A. %A Villalpando, C. G. %A Orozco, L. %A Fornage, M. %A Tai, E. S. %A van Dam, R. M. %A Lehtimäki, T. %A Chaturvedi, N. %A Yokota, M. %A Liu, J. %A Reilly, D. F. %A McKnight, A. J. %A Kee, F. %A Jöckel, K. H. %A McCarthy, M. I. %A Palmer, C. N. A. %A Vitart, V. %A Hayward, C. %A Simonsick, E. %A van Duijn, C. M. %A Lu, F. %A Qu, J. %A Hishigaki, H. %A Lin, X. %A März, W. %A Parra, E. J. %A Cruz, M. %A Gudnason, V. %A Tardif, J. C. %A Lettre, G. %A 't Hart, L. M. %A Elders, P. J. M. %A Damrauer, S. M. %A Kumari, M. %A Kivimaki, M. %A van der Harst, P. %A Spector, T. D. %A Loos, R. J. F. %A Province, M. A. %A Psaty, B. M. %A Brandslund, I. %A Pramstaller, P. P. %A Christensen, K. %A Ripatti, S. %A Widén, E. %A Hakonarson, H. %A Grant, S. F. A. %A Kiemeney, L. A. L. M. %A de Graaf, J. %A Loeffler, M. %A Kronenberg, F. %A Gu, D. %A Erdmann, J. %A Schunkert, H. %A Franks, P. W. %A Linneberg, A. %A Jukema, J. W. %A Khera, A. V. %A Männikkö, M. %A Jarvelin, M. R. %A Kutalik, Z. %A Cucca, F. %A Mook-Kanamori, D. O. %A van Dijk, K. W. %A Watkins, H. %A Strachan, D. P. %A Grarup, N. %A Sever, P. %A Poulter, N. %A Rotter, J. I. %A Dantoft, T. M. %A Karpe, F. %A Neville, M. J. %A Timpson, N. J. %A Cheng, C. Y. %A Wong, T. Y. %A Khor, C. C. %A Sabanayagam, C. %A Peters, A. %A Gieger, C. %A Hattersley, A. T. %A Pedersen, N. L. %A Magnusson, P. K. E. %A Boomsma, D. I. %A de Geus, E. J. C. %A Cupples, L. A. %A van Meurs, J. B. J. %A Ghanbari, M. %A Gordon-Larsen, P. %A Huang, W. %A Kim, Y. J. %A Tabara, Y. %A Wareham, N. J. %A Langenberg, C. %A Zeggini, E. %A Kuusisto, J. %A Laakso, M. %A Ingelsson, E. %A Abecasis, G. %A Chambers, J. C. %A Kooner, J. S. %A de Vries, P. S. %A Morrison, A. C. %A North, K. E. %A Daviglus, M. %A Kraft, P. %A Martin, N. G. %A Whitfield, J. B. %A Abbas, S. %A Saleheen, D. %A Walters, R. G. %A Holmes, M. V. %A Black, C. %A Smith, B. H. %A Justice, A. E. %A Baras, A. %A Buring, J. E. %A Ridker, P. M. %A Chasman, D. I. %A Kooperberg, C. %A Wei, W. Q. %A Jarvik, G. P. %A Namjou, B. %A Hayes, M. G. %A Ritchie, M. D. %A Jousilahti, P. %A Salomaa, V. %A Hveem, K. %A Åsvold, B. O. %A Kubo, M. %A Kamatani, Y. %A Okada, Y. %A Murakami, Y. %A Thorsteinsdottir, U. %A Stefansson, K. %A Ho, Y. L. %A Lynch, J. A. %A Rader, D. J. %A Tsao, P. S. %A Chang, K. M. %A Cho, K. %A O'Donnell, C. J. %A Gaziano, J. M. %A Wilson, P. %A Rotimi, C. N. %A Hazelhurst, S. %A Ramsay, M. %A Trembath, R. C. %A van Heel, D. A. %A Tamiya, G. %A Yamamoto, M. %A Kim, B. J. %A Mohlke, K. L. %A Frayling, T. M. %A Hirschhorn, J. N. %A Kathiresan, S. %A Boehnke, M. %A Natarajan, P. %A Peloso, G. M. %A Brown, C. D. %A Morris, A. P. %A Assimes, T. L. %A Deloukas, P. %A Sun, Y. V. %A Willer, C. J. %X application of polygenic scores in clinical practice. %B Nature %V 600 %P 675–679 %8 Dec %G eng %0 Journal Article %J Heart %D 2021 %T Premature ventricular complexes and development of heart failure in a community-based population. %A Limpitikul, Worawan B %A Dewland, Thomas A %A Vittinghoff, Eric %A Soliman, Elsayed %A Nah, Gregory %A Fang, Christina %A Siscovick, David S %A Psaty, Bruce M %A Sotoodehnia, Nona %A Heckbert, Susan %A Stein, Phyllis K %A Gottdiener, John %A Hu, Xiao %A Hempfling, Ralf %A Marcus, Gregory M %X

OBJECTIVE: A higher premature ventricular complex (PVC) frequency is associated with incident congestive heart failure (CHF) and death. While certain PVC characteristics may contribute to that risk, the current literature stems from patients in medical settings and is therefore prone to referral bias. This study aims to identify PVC characteristics associated with incident CHF in a community-based setting.

METHODS: The Cardiovascular Health Study is a cohort of community-dwelling individuals who underwent prospective evaluation and follow-up. We analysed 24-hour Holter data to assess PVC characteristics and used multivariable logistic and Cox proportional hazards models to identify predictors of a left ventricular ejection fraction (LVEF) decline and incident CHF, respectively.

RESULTS: Of 871 analysed participants, 316 participants exhibited at least 10 PVCs during the 24-hour recording. For participants with PVCs, the average age was 72±5 years, 41% were women and 93% were white. Over a median follow-up of 11 years, 34% developed CHF. After adjusting for demographics, cardiovascular comorbidities, antiarrhythmic drug use and PVC frequency, a greater heterogeneity of the PVC coupling interval was associated with an increased risk of LVEF decline and incident CHF. Of note, neither PVC duration nor coupling interval duration exhibited a statistically significant relationship with either outcome.

CONCLUSIONS: In this first community-based study to identify Holter-based features of PVCs that are associated with LVEF reduction and incident CHF, the fact that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure.

%B Heart %8 2021 Sep 07 %G eng %R 10.1136/heartjnl-2021-319473 %0 Journal Article %J J Alzheimers Dis %D 2021 %T Pre-Statistical Considerations for Harmonization of Cognitive Instruments: Harmonization of ARIC, CARDIA, CHS, FHS, MESA, and NOMAS. %A Briceño, Emily M %A Gross, Alden L %A Giordani, Bruno J %A Manly, Jennifer J %A Gottesman, Rebecca F %A Elkind, Mitchell S V %A Sidney, Stephen %A Hingtgen, Stephanie %A Sacco, Ralph L %A Wright, Clinton B %A Fitzpatrick, Annette %A Fohner, Alison E %A Mosley, Thomas H %A Yaffe, Kristine %A Levine, Deborah A %X

BACKGROUND: Meta-analyses of individuals' cognitive data are increasing to investigate the biomedical, lifestyle, and sociocultural factors that influence cognitive decline and dementia risk. Pre-statistical harmonization of cognitive instruments is a critical methodological step for accurate cognitive data harmonization, yet specific approaches for this process are unclear.

OBJECTIVE: To describe pre-statistical harmonization of cognitive instruments for an individual-level meta-analysis in the blood pressure and cognition (BP COG) study.

METHODS: We identified cognitive instruments from six cohorts (the Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Coronary Artery Risk Development in Young Adults study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study) and conducted an extensive review of each item's administration and scoring procedures, and score distributions.

RESULTS: We included 153 cognitive instrument items from 34 instruments across the six cohorts. Of these items, 42%were common across ≥2 cohorts. 86%of common items showed differences across cohorts. We found administration, scoring, and coding differences for seemingly equivalent items. These differences corresponded to variability across cohorts in score distributions and ranges. We performed data augmentation to adjust for differences.

CONCLUSION: Cross-cohort administration, scoring, and procedural differences for cognitive instruments are frequent and need to be assessed to address potential impact on meta-analyses and cognitive data interpretation. Detecting and accounting for these differences is critical for accurate attributions of cognitive health across cohort studies.

%B J Alzheimers Dis %V 83 %P 1803-1813 %8 2021 %G eng %N 4 %R 10.3233/JAD-210459 %0 Journal Article %J Sci Rep %D 2021 %T {Rare and low-frequency exonic variants and gene-by-smoking interactions in pulmonary function %A Yang, T. %A Jackson, V. E. %A Smith, A. V. %A Chen, H. %A Bartz, T. M. %A Sitlani, C. M. %A Psaty, B. M. %A Gharib, S. A. %A O'Connor, G. T. %A Dupuis, J. %A Xu, J. %A Lohman, K. %A Liu, Y. %A Kritchevsky, S. B. %A Cassano, P. A. %A Flexeder, C. %A Gieger, C. %A Karrasch, S. %A Peters, A. %A Schulz, H. %A Harris, S. E. %A Starr, J. M. %A Deary, I. J. %A Manichaikul, A. %A Oelsner, E. C. %A Barr, R. G. %A Taylor, K. D. %A Rich, S. S. %A Bonten, T. N. %A Mook-Kanamori, D. O. %A Noordam, R. %A Li-Gao, R. %A Jarvelin, M. R. %A Wielscher, M. %A Terzikhan, N. %A Lahousse, L. %A Brusselle, G. %A Weiss, S. %A Ewert, R. %A Gläser, S. %A Homuth, G. %A Shrine, N. %A Hall, I. P. %A Tobin, M. %A London, S. J. %A Wei, P. %A Morrison, A. C. %X . This study investigates the utility of assessing gene-by-smoking interactions and underscores their effects on potential pulmonary function. %B Sci Rep %V 11 %P 19365 %8 09 %G eng %0 Journal Article %J Circ Genom Precis Med %D 2021 %T {Rare Coding Variants Associated With Electrocardiographic Intervals Identify Monogenic Arrhythmia Susceptibility Genes: A Multi-Ancestry Analysis %A Choi, S. H. %A Jurgens, S. J. %A Haggerty, C. M. %A Hall, A. W. %A Halford, J. L. %A Morrill, V. N. %A Weng, L. C. %A Lagerman, B. %A Mirshahi, T. %A Pettinger, M. %A Guo, X. %A Lin, H. J. %A Alonso, A. %A Soliman, E. Z. %A Kornej, J. %A Lin, H. %A Moscati, A. %A Nadkarni, G. N. %A Brody, J. A. %A Wiggins, K. L. %A Cade, B. E. %A Lee, J. %A Austin-Tse, C. %A Blackwell, T. %A Chaffin, M. D. %A Lee, C. J. %A Rehm, H. L. %A Roselli, C. %A Redline, S. %A Mitchell, B. D. %A Sotoodehnia, N. %A Psaty, B. M. %A Heckbert, S. R. %A Loos, R. J. F. %A Vasan, R. S. %A Benjamin, E. J. %A Correa, A. %A Boerwinkle, E. %A Arking, D. E. %A Rotter, J. I. %A Rich, S. S. %A Whitsel, E. A. %A Perez, M. %A Kooperberg, C. %A Fornwalt, B. K. %A Lunetta, K. L. %A Ellinor, P. T. %A Lubitz, S. A. %X Alterations in electrocardiographic (ECG) intervals are well-known markers for arrhythmia and sudden cardiac death (SCD) risk. While the genetics of arrhythmia syndromes have been studied, relations between electrocardiographic intervals and rare genetic variation at a population level are poorly understood.\ Using a discovery sample of 29 000 individuals with whole-genome sequencing from Trans-Omics in Precision Medicine and replication in nearly 100 000 with whole-exome sequencing from the UK Biobank and MyCode, we examined associations between low-frequency and rare coding variants with 5 routinely measured electrocardiographic traits (RR, P-wave, PR, and QRS intervals and corrected QT interval).\ ), a marker of SCD risk. Incomplete penetrance of such deleterious variation was common as over 70% of carriers had normal electrocardiographic intervals.\ Our findings indicate that large-scale high-depth sequence data and electrocardiographic analysis identifies monogenic arrhythmia susceptibility genes and rare variants with large effects. Known pathogenic variation in conventional arrhythmia and SCD genes exhibited incomplete penetrance and accounted for only a small fraction of marked electrocardiographic interval prolongation. %B Circ Genom Precis Med %V 14 %P e003300 %8 Aug %G eng %0 Journal Article %J PLoS Genet %D 2021 %T Rare variants in the endocytic pathway are associated with Alzheimer's disease, its related phenotypes, and functional consequences. %A Zhan, Lingyu %A Li, Jiajin %A Jew, Brandon %A Sul, Jae Hoon %K Alzheimer Disease %K Endocytosis %K Genome-Wide Association Study %K Humans %K Phenotype %K Polymorphism, Single Nucleotide %K Whole Genome Sequencing %X

Late-onset Alzheimer's disease (LOAD) is the most common type of dementia causing irreversible brain damage to the elderly and presents a major public health challenge. Clinical research and genome-wide association studies have suggested a potential contribution of the endocytic pathway to AD, with an emphasis on common loci. However, the contribution of rare variants in this pathway to AD has not been thoroughly investigated. In this study, we focused on the effect of rare variants on AD by first applying a rare-variant gene-set burden analysis using genes in the endocytic pathway on over 3,000 individuals with European ancestry from three large whole-genome sequencing (WGS) studies. We identified significant associations of rare-variant burden within the endocytic pathway with AD, which were successfully replicated in independent datasets. We further demonstrated that this endocytic rare-variant enrichment is associated with neurofibrillary tangles (NFTs) and age-related phenotypes, increasing the risk of obtaining severer brain damage, earlier age-at-onset, and earlier age-of-death. Next, by aggregating rare variants within each gene, we sought to identify single endocytic genes associated with AD and NFTs. Careful examination using NFTs revealed one significantly associated gene, ANKRD13D. To identify functional associations, we integrated bulk RNA-Seq data from over 600 brain tissues and found two endocytic expression genes (eGenes), HLA-A and SLC26A7, that displayed significant influences on their gene expressions. Differential expressions between AD patients and controls of these three identified genes were further examined by incorporating scRNA-Seq data from 48 post-mortem brain samples and demonstrated distinct expression patterns across cell types. Taken together, our results demonstrated strong rare-variant effect in the endocytic pathway on AD risk and progression and functional effect of gene expression alteration in both bulk and single-cell resolution, which may bring more insight and serve as valuable resources for future AD genetic studies, clinical research, and therapeutic targeting.

%B PLoS Genet %V 17 %P e1009772 %8 2021 09 %G eng %N 9 %R 10.1371/journal.pgen.1009772 %0 Journal Article %J Nature %D 2021 %T Sequencing of 53,831 diverse genomes from the NHLBI TOPMed Program. %A Taliun, Daniel %A Harris, Daniel N %A Kessler, Michael D %A Carlson, Jedidiah %A Szpiech, Zachary A %A Torres, Raul %A Taliun, Sarah A Gagliano %A Corvelo, André %A Gogarten, Stephanie M %A Kang, Hyun Min %A Pitsillides, Achilleas N %A LeFaive, Jonathon %A Lee, Seung-Been %A Tian, Xiaowen %A Browning, Brian L %A Das, Sayantan %A Emde, Anne-Katrin %A Clarke, Wayne E %A Loesch, Douglas P %A Shetty, Amol C %A Blackwell, Thomas W %A Smith, Albert V %A Wong, Quenna %A Liu, Xiaoming %A Conomos, Matthew P %A Bobo, Dean M %A Aguet, Francois %A Albert, Christine %A Alonso, Alvaro %A Ardlie, Kristin G %A Arking, Dan E %A Aslibekyan, Stella %A Auer, Paul L %A Barnard, John %A Barr, R Graham %A Barwick, Lucas %A Becker, Lewis C %A Beer, Rebecca L %A Benjamin, Emelia J %A Bielak, Lawrence F %A Blangero, John %A Boehnke, Michael %A Bowden, Donald W %A Brody, Jennifer A %A Burchard, Esteban G %A Cade, Brian E %A Casella, James F %A Chalazan, Brandon %A Chasman, Daniel I %A Chen, Yii-Der Ida %A Cho, Michael H %A Choi, Seung Hoan %A Chung, Mina K %A Clish, Clary B %A Correa, Adolfo %A Curran, Joanne E %A Custer, Brian %A Darbar, Dawood %A Daya, Michelle %A de Andrade, Mariza %A DeMeo, Dawn L %A Dutcher, Susan K %A Ellinor, Patrick T %A Emery, Leslie S %A Eng, Celeste %A Fatkin, Diane %A Fingerlin, Tasha %A Forer, Lukas %A Fornage, Myriam %A Franceschini, Nora %A Fuchsberger, Christian %A Fullerton, Stephanie M %A Germer, Soren %A Gladwin, Mark T %A Gottlieb, Daniel J %A Guo, Xiuqing %A Hall, Michael E %A He, Jiang %A Heard-Costa, Nancy L %A Heckbert, Susan R %A Irvin, Marguerite R %A Johnsen, Jill M %A Johnson, Andrew D %A Kaplan, Robert %A Kardia, Sharon L R %A Kelly, Tanika %A Kelly, Shannon %A Kenny, Eimear E %A Kiel, Douglas P %A Klemmer, Robert %A Konkle, Barbara A %A Kooperberg, Charles %A Köttgen, Anna %A Lange, Leslie A %A Lasky-Su, Jessica %A Levy, Daniel %A Lin, Xihong %A Lin, Keng-Han %A Liu, Chunyu %A Loos, Ruth J F %A Garman, Lori %A Gerszten, Robert %A Lubitz, Steven A %A Lunetta, Kathryn L %A Mak, Angel C Y %A Manichaikul, Ani %A Manning, Alisa K %A Mathias, Rasika A %A McManus, David D %A McGarvey, Stephen T %A Meigs, James B %A Meyers, Deborah A %A Mikulla, Julie L %A Minear, Mollie A %A Mitchell, Braxton D %A Mohanty, Sanghamitra %A Montasser, May E %A Montgomery, Courtney %A Morrison, Alanna C %A Murabito, Joanne M %A Natale, Andrea %A Natarajan, Pradeep %A Nelson, Sarah C %A North, Kari E %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Pankratz, Nathan %A Peloso, Gina M %A Peyser, Patricia A %A Pleiness, Jacob %A Post, Wendy S %A Psaty, Bruce M %A Rao, D C %A Redline, Susan %A Reiner, Alexander P %A Roden, Dan %A Rotter, Jerome I %A Ruczinski, Ingo %A Sarnowski, Chloe %A Schoenherr, Sebastian %A Schwartz, David A %A Seo, Jeong-Sun %A Seshadri, Sudha %A Sheehan, Vivien A %A Sheu, Wayne H %A Shoemaker, M Benjamin %A Smith, Nicholas L %A Smith, Jennifer A %A Sotoodehnia, Nona %A Stilp, Adrienne M %A Tang, Weihong %A Taylor, Kent D %A Telen, Marilyn %A Thornton, Timothy A %A Tracy, Russell P %A Van Den Berg, David J %A Vasan, Ramachandran S %A Viaud-Martinez, Karine A %A Vrieze, Scott %A Weeks, Daniel E %A Weir, Bruce S %A Weiss, Scott T %A Weng, Lu-Chen %A Willer, Cristen J %A Zhang, Yingze %A Zhao, Xutong %A Arnett, Donna K %A Ashley-Koch, Allison E %A Barnes, Kathleen C %A Boerwinkle, Eric %A Gabriel, Stacey %A Gibbs, Richard %A Rice, Kenneth M %A Rich, Stephen S %A Silverman, Edwin K %A Qasba, Pankaj %A Gan, Weiniu %A Papanicolaou, George J %A Nickerson, Deborah A %A Browning, Sharon R %A Zody, Michael C %A Zöllner, Sebastian %A Wilson, James G %A Cupples, L Adrienne %A Laurie, Cathy C %A Jaquish, Cashell E %A Hernandez, Ryan D %A O'Connor, Timothy D %A Abecasis, Goncalo R %X

The Trans-Omics for Precision Medicine (TOPMed) programme seeks to elucidate the genetic architecture and biology of heart, lung, blood and sleep disorders, with the ultimate goal of improving diagnosis, treatment and prevention of these diseases. The initial phases of the programme focused on whole-genome sequencing of individuals with rich phenotypic data and diverse backgrounds. Here we describe the TOPMed goals and design as well as the available resources and early insights obtained from the sequence data. The resources include a variant browser, a genotype imputation server, and genomic and phenotypic data that are available through dbGaP (Database of Genotypes and Phenotypes). In the first 53,831 TOPMed samples, we detected more than 400 million single-nucleotide and insertion or deletion variants after alignment with the reference genome. Additional previously undescribed variants were detected through assembly of unmapped reads and customized analysis in highly variable loci. Among the more than 400 million detected variants, 97% have frequencies of less than 1% and 46% are singletons that are present in only one individual (53% among unrelated individuals). These rare variants provide insights into mutational processes and recent human evolutionary history. The extensive catalogue of genetic variation in TOPMed studies provides unique opportunities for exploring the contributions of rare and noncoding sequence variants to phenotypic variation. Furthermore, combining TOPMed haplotypes with modern imputation methods improves the power and reach of genome-wide association studies to include variants down to a frequency of approximately 0.01%.

%B Nature %V 590 %P 290-299 %8 2021 02 %G eng %N 7845 %R 10.1038/s41586-021-03205-y %0 Journal Article %J Cardiology %D 2021 %T Serum Individual Nonesterified Fatty Acids and Risk of Heart Failure in Older Adults. %A Djoussé, Luc %A Biggs, Mary L %A Matthan, Nirupa R %A Ix, Joachim H %A Fitzpatrick, Annette L %A King, Irena %A Lemaitre, Rozenn N %A McKnight, Barbara %A Kizer, Jorge R %A Lichtenstein, Alice H %A Mukamal, Kenneth J %A Siscovick, David S %X

BACKGROUND: Heart failure (HF) is highly prevalent among older adults and is associated with high costs. Although serum total nonesterified fatty acids (NEFAs) have been positively associated with HF risk, the contribution of each individual NEFA to HF risk has not been examined.

OBJECTIVE: The aim of this study was to examine the association of individual fasting NEFAs with HF risk in older adults.

METHODS: In this prospective cohort study of older adults, we measured 35 individual NEFAs in 2,140 participants of the Cardiovascular Health Study using gas chromatography. HF was ascertained using review of medical records by an endpoint committee.

RESULTS: The mean age was 77.7 ± 4.4 years, and 38.8% were male. During a median follow-up of 9.7 (maximum 19.0) years, 655 new cases of HF occurred. In a multivariable Cox regression model controlling for demographic and anthropometric variables, field center, education, serum albumin, glomerular filtration rate, physical activity, alcohol consumption, smoking, hormone replacement therapy, unintentional weight loss, and all other measured NEFAs, we observed inverse associations (HR [95% CI] per standard deviation) of nonesterified pentadecanoic (15:0) (0.73 [0.57-0.94]), γ-linolenic acid (GLA) (0.87 [0.75-1.00]), and docosahexaenoic acid (DHA) (0.73 [0.61-0.88]) acids with HF, and positive associations of nonesterified stearic (18:0) (1.30 [1.04-1.63]) and nervonic (24:1n-9) (1.17 [1.06-1.29]) acids with HF.

CONCLUSION: Our data are consistent with a higher risk of HF with nonesterified stearic and nervonic acids and a lower risk with nonesterified 15:0, GLA, and DHA in older adults. If confirmed in other studies, specific NEFAs may provide new targets for HF prevention.

%B Cardiology %P 1-8 %8 2021 Feb 25 %G eng %R 10.1159/000513917 %0 Journal Article %J Osteoporos Int %D 2021 %T Serum non-esterified fatty acid levels and hip fracture risk: The Cardiovascular Health Study. %A Barzilay, J I %A Bůžková, P %A Djoussé, L %A Ix, J %A Kizer, J %A Cauley, J %A Matthan, N %A Lichtenstein, A H %A Mukamal, K J %X

Among elderly participants from the Cardiovascular Health Study, we found that non-esterified trans fatty acid levels had a significant prospective association with hip fracture risk. Other non-esterified fatty acid classes were not associated with hip fracture risk.

INTRODUCTION: Serum non-esterified fatty acids (NEFAs) are bioactive metabolic intermediates that can be taken up by bone tissue. Their associations with hip fracture risk have not been previously examined.

METHODS: Thirty-five individual NEFAs in five classes (saturated [SFA], mono-un-saturated [MUFA], poly-unsaturated n-6 and n-3 [PUFA], and trans-FA) were measured in Cardiovascular Health Study participants (n = 2139, mean age 77.8 years) without known diabetes. The multivariable associations of NEFA levels with hip fracture risk were evaluated in Cox hazards models.

RESULTS: We documented 303 incident hip fractures during 11.1 years of follow-up. Among the five NEFA classes, total trans FA levels were positively associated with higher hip fracture risk (HR 1.17 [95% CI, 1.04, 1.31; p = 0.01] per one standard deviation higher level). The SFA lignoceric acid (24:0) was positively associated with higher risk (HR 1.09 [1.04, 1.1]; p < 0.001), while behenic (22:0) and docosatetraenoic (22:4 n6) acids were associated with lower risk (HR 0.76 [0.61, 0.94]; p = 0.01; 0.84 [0.70, 1.00]; p = 0.05, respectively).

CONCLUSION: Total plasma trans NEFA levels are related to hip fracture risk, suggesting an unrecognized benefit of their systematic removal from food. Novel associations of individual NEFAs with hip fracture risk require confirmation in other cohort studies.

%B Osteoporos Int %8 2021 Mar 02 %G eng %R 10.1007/s00198-021-05897-4 %0 Journal Article %J J Am Heart Assoc %D 2021 %T Serum Nonesterified Fatty Acids and Incident Stroke: The CHS. %A Huang, Neil K %A Biggs, Mary L %A Matthan, Nirupa R %A Djoussé, Luc %A Longstreth, W T %A Mukamal, Kenneth J %A Siscovick, David S %A Lichtenstein, Alice H %K 8,11,14-Eicosatrienoic Acid %K Fatty Acids, Nonesterified %K Fatty Acids, Omega-3 %K Hemorrhagic Stroke %K Humans %K Prospective Studies %K Risk Factors %K Stroke %K Trans Fatty Acids %X

Background Significant associations between total nonesterified fatty acid (NEFA) concentrations and incident stroke have been reported in some prospective cohort studies. We evaluated the associations between incident stroke and serum concentrations of nonesterified saturated, monounsaturated, polyunsaturated, and fatty acids. Methods and Results CHS (Cardiovascular Health Study) participants (N=2028) who were free of stroke at baseline (1996-1997) and had an archived fasting serum sample were included in this study. A total of 35 NEFAs were quantified using gas chromatography. Cox proportional hazards regression models were used to evaluate associations of 5 subclasses (nonesterified saturated, monounsaturated, omega (n)-6 polyunsaturated, n-3 polyunsaturated, and fatty acids) of NEFAs and individual NEFAs with incident stroke. Sensitivity analysis was conducted by excluding cases with hemorrhagic stroke (n=45). A total of 338 cases of incident stroke occurred during the median 10.5-year follow-up period. Total n-3 (hazard ratio [HR], 0.77 [95% CI, 0.61-0.97]) and n-6 (HR, 1.32 [95% CI, 1.01-1.73]) subclasses of NEFA were negatively and positively associated with incident stroke, respectively. Among individual NEFAs, dihomo-γ-linolenic acid (20:3n-6) was associated with higher risk (HR, 1.29 [95% CI, 1.02-1.63]), whereas -7-hexadecenoic acid (16:1n-9) and arachidonic acid (20:4n-6) were associated with a lower risk (HR, 0.67 [95% CI, 0.47-0.97]; HR, 0.81 [95% CI. 0.65-1.00], respectively) of incident stroke per standard deviation increment. After the exclusion of cases with hemorrhagic stroke, these associations did not remain significant. Conclusions A total of 2 NEFA subclasses and 3 individual NEFAs were associated with incident stroke. Of these, the NEFA n-3 subclass and dihomo-γ-linolenic acid are diet derived and may be potential biomarkers for total stroke risk.

%B J Am Heart Assoc %V 10 %P e022725 %8 2021 11 16 %G eng %N 22 %R 10.1161/JAHA.121.022725 %0 Journal Article %J Nutrients %D 2021 %T Serum Non-Esterified Fatty Acids, Carotid Artery Intima-Media Thickness and Flow-Mediated Dilation in Older Adults: The Cardiovascular Health Study (CHS). %A Huang, Neil K %A Bůzková, Petra %A Matthan, Nirupa R %A Djoussé, Luc %A Kizer, Jorge R %A Mukamal, Kenneth J %A Polak, Joseph F %A Lichtenstein, Alice H %K Aged %K Aged, 80 and over %K Atherosclerosis %K Biomarkers %K Brachial Artery %K Carotid Artery, Common %K Carotid Intima-Media Thickness %K Dilatation %K Fatty Acids, Monounsaturated %K Fatty Acids, Nonesterified %K Female %K Humans %K Linoleic Acid %K Male %K Regional Blood Flow %K Risk Factors %K Ultrasonography %X

Elevated common carotid artery intima-media thickness (carotid IMT) and diminished flow-mediated dilation (FMD) are early subclinical indicators of atherosclerosis. Serum total non-esterified fatty acid (NEFA) concentrations have been positively associated with subclinical atherosclerosis. The relations between individual NEFA, carotid IMT and FMD have as yet to be assessed. We investigated the associations between fasting serum individual NEFA, carotid IMT and FMD among Cardiovascular Health Study (CHS) participants with ( = 255 for carotid IMT, 301 for FMD) or without ( = 1314 for carotid IMT, 1462 for FMD) known atherosclerotic cardiovascular disease (ASCVD). Using archived samples (fasting) collected from 1996-1997 (baseline), 35 individual NEFAs were measured using gas chromatography. Carotid IMT and estimated plaque thickness (mean of maximum internal carotid IMT) were determined in 1998-1999. FMD was measured in 1997-1998. Linear regression adjusted by the Holm-Bonferroni method was used to assess relations between individual NEFA, carotid IMT and FMD. In multivariable adjusted linear regression models per SD increment, the non-esterified fatty acid conjugated linoleic acid (-18:2 CLA) was positively associated with carotid IMT [β (95% CI): 44.8 (19.2, 70.4), = 0.025] among participants with, but not without, ASCVD [2.16 (-6.74, 11.5), = 1.000]. Non-esterified -palmitoleic acid (16:1n-7) was positively associated with FMD [19.7 (8.34, 31.0), = 0.024] among participants without, but not with ASCVD. No significant associations between NEFAs and estimated plaque thickness were observed. In older adults, serum non-esterified CLA and palmitoleic acid were positively associated with carotid IMT and FMD, respectively, suggesting potential modifiable biomarkers for arteriopathy.

%B Nutrients %V 13 %8 2021 Aug 31 %G eng %N 9 %R 10.3390/nu13093052 %0 Journal Article %J JAMA Netw Open %D 2021 %T Sex Differences in Cognitive Decline Among US Adults. %A Levine, Deborah A %A Gross, Alden L %A Briceño, Emily M %A Tilton, Nicholas %A Giordani, Bruno J %A Sussman, Jeremy B %A Hayward, Rodney A %A Burke, James F %A Hingtgen, Stephanie %A Elkind, Mitchell S V %A Manly, Jennifer J %A Gottesman, Rebecca F %A Gaskin, Darrell J %A Sidney, Stephen %A Sacco, Ralph L %A Tom, Sarah E %A Wright, Clinton B %A Yaffe, Kristine %A Galecki, Andrzej T %K Aged %K Cognitive Dysfunction %K Cognitive Reserve %K Cohort Studies %K Executive Function %K Humans %K Memory %K Middle Aged %K Risk %K Sex Factors %K Time Factors %K United States %X

Importance: Sex differences in dementia risk are unclear, but some studies have found greater risk for women.

Objective: To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.

Design, Setting, and Participants: This cohort study used pooled analysis of individual participant data from 5 cohort studies for years 1971 to 2017: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Linear mixed-effects models were used to estimate changes in each continuous cognitive outcome over time by sex. Data analysis was completed from March 2019 to October 2020.

Exposure: Sex.

Main Outcomes and Measures: The primary outcome was change in global cognition. Secondary outcomes were change in memory and executive function. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition.

Results: Among 34 349 participants, 26 088 who self-reported Black or White race, were free of stroke and dementia, and had covariate data at or before the first cognitive assessment were included for analysis. Median (interquartile range) follow-up was 7.9 (5.3-20.5) years. There were 11 775 (44.7%) men (median [interquartile range] age, 58 [51-66] years at first cognitive assessment; 2229 [18.9%] Black) and 14 313 women (median [interquartile range] age, 58 [51-67] years at first cognitive assessment; 3636 [25.4%] Black). Women had significantly higher baseline performance than men in global cognition (2.20 points higher; 95% CI, 2.04 to 2.35 points; P < .001), executive function (2.13 points higher; 95% CI, 1.98 to 2.29 points; P < .001), and memory (1.89 points higher; 95% CI, 1.72 to 2.06 points; P < .001). Compared with men, women had significantly faster declines in global cognition (-0.07 points/y faster; 95% CI, -0.08 to -0.05 points/y; P < .001) and executive function (-0.06 points/y faster; 95% CI, -0.07 to -0.05 points/y; P < .001). Men and women had similar declines in memory (-0.004 points/y faster; 95% CI, -0.023 to 0.014; P = .61).

Conclusions and Relevance: The results of this cohort study suggest that women may have greater cognitive reserve but faster cognitive decline than men, which could contribute to sex differences in late-life dementia.

%B JAMA Netw Open %V 4 %P e210169 %8 2021 02 01 %G eng %N 2 %R 10.1001/jamanetworkopen.2021.0169 %0 Journal Article %J Nat Commun %D 2021 %T {Sex-dimorphic genetic effects and novel loci for fasting glucose and insulin variability %A Lagou, V. %A M?gi, R. %A Hottenga, J. J. %A Grallert, H. %A Perry, J. R. B. %A Bouatia-Naji, N. %A Marullo, L. %A Rybin, D. %A Jansen, R. %A Min, J. L. %A Dimas, A. S. %A Ulrich, A. %A Zudina, L. %A G?din, J. R. %A Jiang, L. %A Faggian, A. %A Bonnefond, A. %A Fadista, J. %A Stathopoulou, M. G. %A Isaacs, A. %A Willems, S. M. %A Navarro, P. %A Tanaka, T. %A Jackson, A. U. %A Montasser, M. E. %A O'Connell, J. R. %A Bielak, L. F. %A Webster, R. J. %A Saxena, R. %A Stafford, J. M. %A Pourcain, B. S. %A Timpson, N. J. %A Salo, P. %A Shin, S. Y. %A Amin, N. %A Smith, A. V. %A Li, G. %A Verweij, N. %A Goel, A. %A Ford, I. %A Johnson, P. C. D. %A Johnson, T. %A Kapur, K. %A Thorleifsson, G. %A Strawbridge, R. J. %A Rasmussen-Torvik, L. J. %A Esko, T. %A Mihailov, E. %A Fall, T. %A Fraser, R. M. %A Mahajan, A. %A Kanoni, S. %A Giedraitis, V. %A Kleber, M. E. %A Silbernagel, G. %A Meyer, J. %A M?ller-Nurasyid, M. %A Ganna, A. %A Sarin, A. P. %A Yengo, L. %A Shungin, D. %A Luan, J. %A Horikoshi, M. %A An, P. %A Sanna, S. %A Boettcher, Y. %A Rayner, N. W. %A Nolte, I. M. %A Zemunik, T. %A Iperen, E. V. %A Kovacs, P. %A Hastie, N. D. %A Wild, S. H. %A McLachlan, S. %A Campbell, S. %A Polasek, O. %A Carlson, O. %A Egan, J. %A Kiess, W. %A Willemsen, G. %A Kuusisto, J. %A Laakso, M. %A Dimitriou, M. %A Hicks, A. A. %A Rauramaa, R. %A Bandinelli, S. %A Thorand, B. %A Liu, Y. %A Miljkovic, I. %A Lind, L. %A Doney, A. %A Perola, M. %A Hingorani, A. %A Kivimaki, M. %A Kumari, M. %A Bennett, A. J. %A Groves, C. J. %A Herder, C. %A Koistinen, H. A. %A Kinnunen, L. %A Faire, U. %A Bakker, S. J. L. %A Uusitupa, M. %A Palmer, C. N. A. %A Jukema, J. W. %A Sattar, N. %A Pouta, A. %A Snieder, H. %A Boerwinkle, E. %A Pankow, J. S. %A Magnusson, P. K. %A Krus, U. %A Scapoli, C. %A de Geus, E. J. C. N. %A Bl?her, M. %A Wolffenbuttel, B. H. R. %A Province, M. A. %A Abecasis, G. R. %A Meigs, J. B. %A Hovingh, G. K. %A Lindstr?m, J. %A Wilson, J. F. %A Wright, A. F. %A Dedoussis, G. V. %A Bornstein, S. R. %A Schwarz, P. E. H. %A T?njes, A. %A Winkelmann, B. R. %A Boehm, B. O. %A M?rz, W. %A Metspalu, A. %A Price, J. F. %A Deloukas, P. %A K?rner, A. %A Lakka, T. A. %A Keinanen-Kiukaanniemi, S. M. %A Saaristo, T. E. %A Bergman, R. N. %A Tuomilehto, J. %A Wareham, N. J. %A Langenberg, C. %A M?nnist?, S. %A Franks, P. W. %A Hayward, C. %A Vitart, V. %A Kaprio, J. %A Visvikis-Siest, S. %A Balkau, B. %A Altshuler, D. %A Rudan, I. %A Stumvoll, M. %A Campbell, H. %A van Duijn, C. M. %A Gieger, C. %A Illig, T. %A Ferrucci, L. %A Pedersen, N. L. %A Pramstaller, P. P. %A Boehnke, M. %A Frayling, T. M. %A Shuldiner, A. R. %A Peyser, P. A. %A Kardia, S. L. R. %A Palmer, L. J. %A Penninx, B. W. %A Meneton, P. %A Harris, T. B. %A Navis, G. %A Harst, P. V. %A Smith, G. D. %A Forouhi, N. G. %A Loos, R. J. F. %A Salomaa, V. %A Soranzo, N. %A Boomsma, D. I. %A Groop, L. %A Tuomi, T. %A Hofman, A. %A Munroe, P. B. %A Gudnason, V. %A Siscovick, D. S. %A Watkins, H. %A Lecoeur, C. %A Vollenweider, P. %A Franco-Cereceda, A. %A Eriksson, P. %A Jarvelin, M. R. %A Stefansson, K. %A Hamsten, A. %A Nicholson, G. %A Karpe, F. %A Dermitzakis, E. T. %A Lindgren, C. M. %A McCarthy, M. I. %A Froguel, P. %A Kaakinen, M. A. %A Lyssenko, V. %A Watanabe, R. M. %A Ingelsson, E. %A Florez, J. C. %A Dupuis, J. %A Barroso, I. %A Morris, A. P. %A Prokopenko, I. %X Differences between sexes contribute to variation in the levels of fasting glucose and insulin. Epidemiological studies established a higher prevalence of impaired fasting glucose in men and impaired glucose tolerance in women, however, the genetic component underlying this phenomenon is not established. We assess sex-dimorphic (73,089/50,404 women and 67,506/47,806 men) and sex-combined (151,188/105,056 individuals) fasting glucose/fasting insulin genetic effects via genome-wide association study meta-analyses in individuals of European descent without diabetes. Here we report sex dimorphism in allelic effects on fasting insulin at IRS1 and ZNF12 loci, the latter showing higher RNA expression in whole blood in women compared to men. We also observe sex-homogeneous effects on fasting glucose at seven novel loci. Fasting insulin in women shows stronger genetic correlations than in men with waist-to-hip ratio and anorexia nervosa. Furthermore, waist-to-hip ratio is causally related to insulin resistance in women, but not in men. These results position dissection of metabolic and glycemic health sex dimorphism as a steppingstone for understanding differences in genetic effects between women and men in related phenotypes. %B Nat Commun %V 12 %P 24 %8 01 %G eng %0 Journal Article %J Nat Commun %D 2021 %T {Sex-dimorphic genetic effects and novel loci for fasting glucose and insulin variability %A Lagou, V. %A Mägi, R. %A Hottenga, J. J. %A Grallert, H. %A Perry, J. R. B. %A Bouatia-Naji, N. %A Marullo, L. %A Rybin, D. %A Jansen, R. %A Min, J. L. %A Dimas, A. S. %A Ulrich, A. %A Zudina, L. %A Gådin, J. R. %A Jiang, L. %A Faggian, A. %A Bonnefond, A. %A Fadista, J. %A Stathopoulou, M. G. %A Isaacs, A. %A Willems, S. M. %A Navarro, P. %A Tanaka, T. %A Jackson, A. U. %A Montasser, M. E. %A O'Connell, J. R. %A Bielak, L. F. %A Webster, R. J. %A Saxena, R. %A Stafford, J. M. %A Pourcain, B. S. %A Timpson, N. J. %A Salo, P. %A Shin, S. Y. %A Amin, N. %A Smith, A. V. %A Li, G. %A Verweij, N. %A Goel, A. %A Ford, I. %A Johnson, P. C. D. %A Johnson, T. %A Kapur, K. %A Thorleifsson, G. %A Strawbridge, R. J. %A Rasmussen-Torvik, L. J. %A Esko, T. %A Mihailov, E. %A Fall, T. %A Fraser, R. M. %A Mahajan, A. %A Kanoni, S. %A Giedraitis, V. %A Kleber, M. E. %A Silbernagel, G. %A Meyer, J. %A Müller-Nurasyid, M. %A Ganna, A. %A Sarin, A. P. %A Yengo, L. %A Shungin, D. %A Luan, J. %A Horikoshi, M. %A An, P. %A Sanna, S. %A Boettcher, Y. %A Rayner, N. W. %A Nolte, I. M. %A Zemunik, T. %A Iperen, E. V. %A Kovacs, P. %A Hastie, N. D. %A Wild, S. H. %A McLachlan, S. %A Campbell, S. %A Polasek, O. %A Carlson, O. %A Egan, J. %A Kiess, W. %A Willemsen, G. %A Kuusisto, J. %A Laakso, M. %A Dimitriou, M. %A Hicks, A. A. %A Rauramaa, R. %A Bandinelli, S. %A Thorand, B. %A Liu, Y. %A Miljkovic, I. %A Lind, L. %A Doney, A. %A Perola, M. %A Hingorani, A. %A Kivimaki, M. %A Kumari, M. %A Bennett, A. J. %A Groves, C. J. %A Herder, C. %A Koistinen, H. A. %A Kinnunen, L. %A Faire, U. %A Bakker, S. J. L. %A Uusitupa, M. %A Palmer, C. N. A. %A Jukema, J. W. %A Sattar, N. %A Pouta, A. %A Snieder, H. %A Boerwinkle, E. %A Pankow, J. S. %A Magnusson, P. K. %A Krus, U. %A Scapoli, C. %A de Geus, E. J. C. N. %A Blüher, M. %A Wolffenbuttel, B. H. R. %A Province, M. A. %A Abecasis, G. R. %A Meigs, J. B. %A Hovingh, G. K. %A Lindström, J. %A Wilson, J. F. %A Wright, A. F. %A Dedoussis, G. V. %A Bornstein, S. R. %A Schwarz, P. E. H. %A Tonjes, A. %A Winkelmann, B. R. %A Boehm, B. O. %A März, W. %A Metspalu, A. %A Price, J. F. %A Deloukas, P. %A Körner, A. %A Lakka, T. A. %A Keinanen-Kiukaanniemi, S. M. %A Saaristo, T. E. %A Bergman, R. N. %A Tuomilehto, J. %A Wareham, N. J. %A Langenberg, C. %A Männistö, S. %A Franks, P. W. %A Hayward, C. %A Vitart, V. %A Kaprio, J. %A Visvikis-Siest, S. %A Balkau, B. %A Altshuler, D. %A Rudan, I. %A Stumvoll, M. %A Campbell, H. %A van Duijn, C. M. %A Gieger, C. %A Illig, T. %A Ferrucci, L. %A Pedersen, N. L. %A Pramstaller, P. P. %A Boehnke, M. %A Frayling, T. M. %A Shuldiner, A. R. %A Peyser, P. A. %A Kardia, S. L. R. %A Palmer, L. J. %A Penninx, B. W. %A Meneton, P. %A Harris, T. B. %A Navis, G. %A Harst, P. V. %A Smith, G. D. %A Forouhi, N. G. %A Loos, R. J. F. %A Salomaa, V. %A Soranzo, N. %A Boomsma, D. I. %A Groop, L. %A Tuomi, T. %A Hofman, A. %A Munroe, P. B. %A Gudnason, V. %A Siscovick, D. S. %A Watkins, H. %A Lecoeur, C. %A Vollenweider, P. %A Franco-Cereceda, A. %A Eriksson, P. %A Jarvelin, M. R. %A Stefansson, K. %A Hamsten, A. %A Nicholson, G. %A Karpe, F. %A Dermitzakis, E. T. %A Lindgren, C. M. %A McCarthy, M. I. %A Froguel, P. %A Kaakinen, M. A. %A Lyssenko, V. %A Watanabe, R. M. %A Ingelsson, E. %A Florez, J. C. %A Dupuis, J. %A Barroso, I. %A Morris, A. P. %A Prokopenko, I. %X Differences between sexes contribute to variation in the levels of fasting glucose and insulin. Epidemiological studies established a higher prevalence of impaired fasting glucose in men and impaired glucose tolerance in women, however, the genetic component underlying this phenomenon is not established. We assess sex-dimorphic (73,089/50,404 women and 67,506/47,806 men) and sex-combined (151,188/105,056 individuals) fasting glucose/fasting insulin genetic effects via genome-wide association study meta-analyses in individuals of European descent without diabetes. Here we report sex dimorphism in allelic effects on fasting insulin at IRS1 and ZNF12 loci, the latter showing higher RNA expression in whole blood in women compared to men. We also observe sex-homogeneous effects on fasting glucose at seven novel loci. Fasting insulin in women shows stronger genetic correlations than in men with waist-to-hip ratio and anorexia nervosa. Furthermore, waist-to-hip ratio is causally related to insulin resistance in women, but not in men. These results position dissection of metabolic and glycemic health sex dimorphism as a steppingstone for understanding differences in genetic effects between women and men in related phenotypes. %B Nat Commun %V 12 %P 24 %8 01 %G eng %0 Journal Article %J Neurology %D 2021 %T Silent Myocardial Infarction and Subsequent Ischemic Stroke in the Cardiovascular Health Study. %A Merkler, Alexander E %A Bartz, Traci M %A Kamel, Hooman %A Soliman, Elsayed Z %A Howard, Virginia %A Psaty, Bruce M %A Okin, Peter M %A Safford, Monika M %A Elkind, Mitchell S V %A Longstreth, W T %X

OBJECTIVE: To test the hypothesis that silent MI is a risk factor for ischemic stroke, we evaluated the association between silent MI and subsequent ischemic stroke in the Cardiovascular Health Study.

METHODS: The Cardiovascular Health Study prospectively enrolled community-dwelling individuals ≥65 years of age. We included participants without prevalent stroke or baseline evidence of MI. Our exposures were silent and clinically apparent, overt MI. Silent MI was defined as new evidence of Q-wave MI, without clinical symptoms of MI, on ECGs performed during annual study visits from 1989-1999. The primary outcome was incident ischemic stroke. Secondary outcomes were ischemic stroke subtypes: non-lacunar, lacunar, and other/unknown. Cox proportional hazards analysis was used to model the association between time-varying MI status (silent, overt, or no MI) and stroke after adjustment for baseline demographics and vascular risk factors.

RESULTS: Among 4,224 participants, 362 (8.6%) had an incident silent MI, 421 (10.0%) an incident overt MI, and 377 (8.9%) an incident ischemic stroke during a median follow-up of 9.8 years. After adjustment for demographics and comorbidities, silent MI was independently associated with subsequent ischemic stroke (HR, 1.51; 95% CI, 1.03-2.21). Overt MI was associated with ischemic stroke both in the short term (HR, 80; 95% CI, 53-119) and long term (HR, 1.60; 95% CI, 1.04-2.44). In secondary analyses, the association between silent MI and stroke was limited to non-lacunar ischemic stroke (HR 2.40; 95% CI, 1.36-4.22).

CONCLUSION: In a community-based sample, we found an association between silent MI and ischemic stroke.

%B Neurology %8 2021 May 24 %G eng %R 10.1212/WNL.0000000000012249 %0 Journal Article %J Circ Genom Precis Med %D 2021 %T Sugar-Sweetened Beverage Consumption May Modify Associations Between Genetic Variants in the CHREBP (Carbohydrate Responsive Element Binding Protein) Locus and HDL-C (High-Density Lipoprotein Cholesterol) and Triglyceride Concentrations. %A Haslam, Danielle E %A Peloso, Gina M %A Guirette, Melanie %A Imamura, Fumiaki %A Bartz, Traci M %A Pitsillides, Achilleas N %A Wang, Carol A %A Li-Gao, Ruifang %A Westra, Jason M %A Pitkänen, Niina %A Young, Kristin L %A Graff, Mariaelisa %A Wood, Alexis C %A Braun, Kim V E %A Luan, Jian'an %A Kähönen, Mika %A Kiefte-de Jong, Jessica C %A Ghanbari, Mohsen %A Tintle, Nathan %A Lemaitre, Rozenn N %A Mook-Kanamori, Dennis O %A North, Kari %A Helminen, Mika %A Mossavar-Rahmani, Yasmin %A Snetselaar, Linda %A Martin, Lisa W %A Viikari, Jorma S %A Oddy, Wendy H %A Pennell, Craig E %A Rosendall, Frits R %A Ikram, M Arfan %A Uitterlinden, André G %A Psaty, Bruce M %A Mozaffarian, Dariush %A Rotter, Jerome I %A Taylor, Kent D %A Lehtimäki, Terho %A Raitakari, Olli T %A Livingston, Kara A %A Voortman, Trudy %A Forouhi, Nita G %A Wareham, Nick J %A de Mutsert, Renée %A Rich, Steven S %A Manson, JoAnn E %A Mora, Samia %A Ridker, Paul M %A Merino, Jordi %A Meigs, James B %A Dashti, Hassan S %A Chasman, Daniel I %A Lichtenstein, Alice H %A Smith, Caren E %A Dupuis, Josée %A Herman, Mark A %A McKeown, Nicola M %X

BACKGROUND: ChREBP (carbohydrate responsive element binding protein) is a transcription factor that responds to sugar consumption. Sugar-sweetened beverage (SSB) consumption and genetic variants in the locus have separately been linked to HDL-C (high-density lipoprotein cholesterol) and triglyceride concentrations. We hypothesized that SSB consumption would modify the association between genetic variants in the locus and dyslipidemia.

METHODS: Data from 11 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (N=63 599) and the UK Biobank (N=59 220) were used to quantify associations of SSB consumption, genetic variants, and their interaction on HDL-C and triglyceride concentrations using linear regression models. A total of 1606 single nucleotide polymorphisms within or near were considered. SSB consumption was estimated from validated questionnaires, and participants were grouped by their estimated intake.

RESULTS: In a meta-analysis, rs71556729 was significantly associated with higher HDL-C concentrations only among the highest SSB consumers (β, 2.12 [95% CI, 1.16-3.07] mg/dL per allele; <0.0001), but not significantly among the lowest SSB consumers (=0.81; <0.0001). Similar results were observed for 2 additional variants (rs35709627 and rs71556736). For triglyceride, rs55673514 was positively associated with triglyceride concentrations only among the highest SSB consumers (β, 0.06 [95% CI, 0.02-0.09] ln-mg/dL per allele, =0.001) but not the lowest SSB consumers (=0.84; =0.0005).

CONCLUSIONS: Our results identified genetic variants in the locus that may protect against SSB-associated reductions in HDL-C and other variants that may exacerbate SSB-associated increases in triglyceride concentrations. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005133, NCT00005121, NCT00005487, and NCT00000479.

%B Circ Genom Precis Med %V 14 %P e003288 %8 2021 Aug %G eng %N 4 %R 10.1161/CIRCGEN.120.003288 %0 Journal Article %J Am J Epidemiol %D 2021 %T A System for Phenotype Harmonization in the NHLBI Trans-Omics for Precision Medicine (TOPMed) Program. %A Stilp, Adrienne M %A Emery, Leslie S %A Broome, Jai G %A Buth, Erin J %A Khan, Alyna T %A Laurie, Cecelia A %A Wang, Fei Fei %A Wong, Quenna %A Chen, Dongquan %A D'Augustine, Catherine M %A Heard-Costa, Nancy L %A Hohensee, Chancellor R %A Johnson, William Craig %A Juarez, Lucia D %A Liu, Jingmin %A Mutalik, Karen M %A Raffield, Laura M %A Wiggins, Kerri L %A de Vries, Paul S %A Kelly, Tanika N %A Kooperberg, Charles %A Natarajan, Pradeep %A Peloso, Gina M %A Peyser, Patricia A %A Reiner, Alex P %A Arnett, Donna K %A Aslibekyan, Stella %A Barnes, Kathleen C %A Bielak, Lawrence F %A Bis, Joshua C %A Cade, Brian E %A Chen, Ming-Huei %A Correa, Adolfo %A Cupples, L Adrienne %A de Andrade, Mariza %A Ellinor, Patrick T %A Fornage, Myriam %A Franceschini, Nora %A Gan, Weiniu %A Ganesh, Santhi K %A Graffelman, Jan %A Grove, Megan L %A Guo, Xiuqing %A Hawley, Nicola L %A Hsu, Wan-Ling %A Jackson, Rebecca D %A Jaquish, Cashell E %A Johnson, Andrew D %A Kardia, Sharon L R %A Kelly, Shannon %A Lee, Jiwon %A Mathias, Rasika A %A McGarvey, Stephen T %A Mitchell, Braxton D %A Montasser, May E %A Morrison, Alanna C %A North, Kari E %A Nouraie, Seyed Mehdi %A Oelsner, Elizabeth C %A Pankratz, Nathan %A Rich, Stephen S %A Rotter, Jerome I %A Smith, Jennifer A %A Taylor, Kent D %A Vasan, Ramachandran S %A Weeks, Daniel E %A Weiss, Scott T %A Wilson, Carla G %A Yanek, Lisa R %A Psaty, Bruce M %A Heckbert, Susan R %A Laurie, Cathy C %X

Genotype-phenotype association studies often combine phenotype data from multiple studies to increase power. Harmonization of the data usually requires substantial effort due to heterogeneity in phenotype definitions, study design, data collection procedures, and data set organization. Here we describe a centralized system for phenotype harmonization that includes input from phenotype domain and study experts, quality control, documentation, reproducible results, and data sharing mechanisms. This system was developed for the National Heart, Lung and Blood Institute's Trans-Omics for Precision Medicine program, which is generating genomic and other omics data for >80 studies with extensive phenotype data. To date, 63 phenotypes have been harmonized across thousands of participants from up to 17 studies per phenotype (participants recruited 1948-2012). We discuss challenges in this undertaking and how they were addressed. The harmonized phenotype data and associated documentation have been submitted to National Institutes of Health data repositories for controlled-access by the scientific community. We also provide materials to facilitate future harmonization efforts by the community, which include (1) the code used to generate the 63 harmonized phenotypes, enabling others to reproduce, modify or extend these harmonizations to additional studies; and (2) results of labeling thousands of phenotype variables with controlled vocabulary terms.

%B Am J Epidemiol %8 2021 Apr 16 %G eng %R 10.1093/aje/kwab115 %0 Journal Article %J Nat Genet %D 2021 %T {The trans-ancestral genomic architecture of glycemic traits %A Chen, J. %A Spracklen, C. N. %A Marenne, G. %A Varshney, A. %A Corbin, L. J. %A Luan, J. %A Willems, S. M. %A Wu, Y. %A Zhang, X. %A Horikoshi, M. %A Boutin, T. S. %A Mägi, R. %A Waage, J. %A Li-Gao, R. %A Chan, K. H. K. %A Yao, J. %A Anasanti, M. D. %A Chu, A. Y. %A Claringbould, A. %A Heikkinen, J. %A Hong, J. %A Hottenga, J. J. %A Huo, S. %A Kaakinen, M. A. %A Louie, T. %A März, W. %A Moreno-Macias, H. %A Ndungu, A. %A Nelson, S. C. %A Nolte, I. M. %A North, K. E. %A Raulerson, C. K. %A Ray, D. %A Rohde, R. %A Rybin, D. %A Schurmann, C. %A Sim, X. %A Southam, L. %A Stewart, I. D. %A Wang, C. A. %A Wang, Y. %A Wu, P. %A Zhang, W. %A Ahluwalia, T. S. %A Appel, E. V. R. %A Bielak, L. F. %A Brody, J. A. %A Burtt, N. P. %A Cabrera, C. P. %A Cade, B. E. %A Chai, J. F. %A Chai, X. %A Chang, L. C. %A Chen, C. H. %A Chen, B. H. %A Chitrala, K. N. %A Chiu, Y. F. %A de Haan, H. G. %A Delgado, G. E. %A Demirkan, A. %A Duan, Q. %A Engmann, J. %A Fatumo, S. A. %A Gayán, J. %A Giulianini, F. %A Gong, J. H. %A Gustafsson, S. %A Hai, Y. %A Hartwig, F. P. %A He, J. %A Heianza, Y. %A Huang, T. %A Huerta-Chagoya, A. %A Hwang, M. Y. %A Jensen, R. A. %A Kawaguchi, T. %A Kentistou, K. A. %A Kim, Y. J. %A Kleber, M. E. %A Kooner, I. K. %A Lai, S. %A Lange, L. A. %A Langefeld, C. D. %A Lauzon, M. %A Li, M. %A Ligthart, S. %A Liu, J. %A Loh, M. %A Long, J. %A Lyssenko, V. %A Mangino, M. %A Marzi, C. %A Montasser, M. E. %A Nag, A. %A Nakatochi, M. %A Noce, D. %A Noordam, R. %A Pistis, G. %A Preuss, M. %A Raffield, L. %A Rasmussen-Torvik, L. J. %A Rich, S. S. %A Robertson, N. R. %A Rueedi, R. %A Ryan, K. %A Sanna, S. %A Saxena, R. %A Schraut, K. E. %A Sennblad, B. %A Setoh, K. %A Smith, A. V. %A Sparsø, T. %A Strawbridge, R. J. %A Takeuchi, F. %A Tan, J. %A Trompet, S. %A van den Akker, E. %A van der Most, P. J. %A Verweij, N. %A Vogel, M. %A Wang, H. %A Wang, C. %A Wang, N. %A Warren, H. R. %A Wen, W. %A Wilsgaard, T. %A Wong, A. %A Wood, A. R. %A Xie, T. %A Zafarmand, M. H. %A Zhao, J. H. %A Zhao, W. %A Amin, N. %A Arzumanyan, Z. %A Astrup, A. %A Bakker, S. J. L. %A Baldassarre, D. %A Beekman, M. %A Bergman, R. N. %A Bertoni, A. %A Blüher, M. %A Bonnycastle, L. L. %A Bornstein, S. R. %A Bowden, D. W. %A Cai, Q. %A Campbell, A. %A Campbell, H. %A Chang, Y. C. %A de Geus, E. J. C. %A Dehghan, A. %A Du, S. %A Eiriksdottir, G. %A Farmaki, A. E. %A Frånberg, M. %A Fuchsberger, C. %A Gao, Y. %A Gjesing, A. P. %A Goel, A. %A Han, S. %A Hartman, C. A. %A Herder, C. %A Hicks, A. A. %A Hsieh, C. H. %A Hsueh, W. A. %A Ichihara, S. %A Igase, M. %A Ikram, M. A. %A Johnson, W. C. %A Jørgensen, M. E. %A Joshi, P. K. %A Kalyani, R. R. %A Kandeel, F. R. %A Katsuya, T. %A Khor, C. C. %A Kiess, W. %A Kolcic, I. %A Kuulasmaa, T. %A Kuusisto, J. %A Läll, K. %A Lam, K. %A Lawlor, D. A. %A Lee, N. R. %A Lemaitre, R. N. %A Li, H. %A Lin, S. Y. %A Lindström, J. %A Linneberg, A. %A Liu, J. %A Lorenzo, C. %A Matsubara, T. %A Matsuda, F. %A Mingrone, G. %A Mooijaart, S. %A Moon, S. %A Nabika, T. %A Nadkarni, G. N. %A Nadler, J. L. %A Nelis, M. %A Neville, M. J. %A Norris, J. M. %A Ohyagi, Y. %A Peters, A. %A Peyser, P. A. %A Polasek, O. %A Qi, Q. %A Raven, D. %A Reilly, D. F. %A Reiner, A. %A Rivideneira, F. %A Roll, K. %A Rudan, I. %A Sabanayagam, C. %A Sandow, K. %A Sattar, N. %A Schürmann, A. %A Shi, J. %A Stringham, H. M. %A Taylor, K. D. %A Teslovich, T. M. %A Thuesen, B. %A Timmers, P. R. H. J. %A Tremoli, E. %A Tsai, M. Y. %A Uitterlinden, A. %A van Dam, R. M. %A van Heemst, D. %A van Hylckama Vlieg, A. %A Van Vliet-Ostaptchouk, J. V. %A Vangipurapu, J. %A Vestergaard, H. %A Wang, T. %A Willems van Dijk, K. %A Zemunik, T. %A Abecasis, G. R. %A Adair, L. S. %A Aguilar-Salinas, C. A. %A Alarcón-Riquelme, M. E. %A An, P. %A Aviles-Santa, L. %A Becker, D. M. %A Beilin, L. J. %A Bergmann, S. %A Bisgaard, H. %A Black, C. %A Boehnke, M. %A Boerwinkle, E. %A Böhm, B. O. %A Bønnelykke, K. %A Boomsma, D. I. %A Bottinger, E. P. %A Buchanan, T. A. %A Canouil, M. %A Caulfield, M. J. %A Chambers, J. C. %A Chasman, D. I. %A Chen, Y. I. %A Cheng, C. Y. %A Collins, F. S. %A Correa, A. %A Cucca, F. %A de Silva, H. J. %A Dedoussis, G. %A Elmståhl, S. %A Evans, M. K. %A Ferrannini, E. %A Ferrucci, L. %A Florez, J. C. %A Franks, P. W. %A Frayling, T. M. %A Froguel, P. %A Gigante, B. %A Goodarzi, M. O. %A Gordon-Larsen, P. %A Grallert, H. %A Grarup, N. %A Grimsgaard, S. %A Groop, L. %A Gudnason, V. %A Guo, X. %A Hamsten, A. %A Hansen, T. %A Hayward, C. %A Heckbert, S. R. %A Horta, B. L. %A Huang, W. %A Ingelsson, E. %A James, P. S. %A Jarvelin, M. R. %A Jonas, J. B. %A Jukema, J. W. %A Kaleebu, P. %A Kaplan, R. %A Kardia, S. L. R. %A Kato, N. %A Keinanen-Kiukaanniemi, S. M. %A Kim, B. J. %A Kivimaki, M. %A Koistinen, H. A. %A Kooner, J. S. %A Körner, A. %A Kovacs, P. %A Kuh, D. %A Kumari, M. %A Kutalik, Z. %A Laakso, M. %A Lakka, T. A. %A Launer, L. J. %A Leander, K. %A Li, H. %A Lin, X. %A Lind, L. %A Lindgren, C. %A Liu, S. %A Loos, R. J. F. %A Magnusson, P. K. E. %A Mahajan, A. %A Metspalu, A. %A Mook-Kanamori, D. O. %A Mori, T. A. %A Munroe, P. B. %A Njølstad, I. %A O'Connell, J. R. %A Oldehinkel, A. J. %A Ong, K. K. %A Padmanabhan, S. %A Palmer, C. N. A. %A Palmer, N. D. %A Pedersen, O. %A Pennell, C. E. %A Porteous, D. J. %A Pramstaller, P. P. %A Province, M. A. %A Psaty, B. M. %A Qi, L. %A Raffel, L. J. %A Rauramaa, R. %A Redline, S. %A Ridker, P. M. %A Rosendaal, F. R. %A Saaristo, T. E. %A Sandhu, M. %A Saramies, J. %A Schneiderman, N. %A Schwarz, P. %A Scott, L. J. %A Selvin, E. %A Sever, P. %A Shu, X. O. %A Slagboom, P. E. %A Small, K. S. %A Smith, B. H. %A Snieder, H. %A Sofer, T. %A Sørensen, T. I. A. %A Spector, T. D. %A Stanton, A. %A Steves, C. J. %A Stumvoll, M. %A Sun, L. %A Tabara, Y. %A Tai, E. S. %A Timpson, N. J. %A Tonjes, A. %A Tuomilehto, J. %A Tusie, T. %A Uusitupa, M. %A van der Harst, P. %A van Duijn, C. %A Vitart, V. %A Vollenweider, P. %A Vrijkotte, T. G. M. %A Wagenknecht, L. E. %A Walker, M. %A Wang, Y. X. %A Wareham, N. J. %A Watanabe, R. M. %A Watkins, H. %A Wei, W. B. %A Wickremasinghe, A. R. %A Willemsen, G. %A Wilson, J. F. %A Wong, T. Y. %A Wu, J. Y. %A Xiang, A. H. %A Yanek, L. R. %A Yengo, L. %A Yokota, M. %A Zeggini, E. %A Zheng, W. %A Zonderman, A. B. %A Rotter, J. I. %A Gloyn, A. L. %A McCarthy, M. I. %A Dupuis, J. %A Meigs, J. B. %A Scott, R. A. %A Prokopenko, I. %A Leong, A. %A Liu, C. T. %A Parker, S. C. J. %A Mohlke, K. L. %A Langenberg, C. %A Wheeler, E. %A Morris, A. P. %A Barroso, I. %A de Haan, H. G. %A van den Akker, E. %A van der Most, P. J. %A de Geus, E. J. C. %A van Dam, R. M. %A van Heemst, D. %A van Hylckama Vlieg, A. %A van Willems van Dijk, K. %A de Silva, H. J. %A van der Harst, P. %A van Duijn, C. %X 10.1038/s41588-021-00852-9Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 × 10-8), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution. %B Nat Genet %V 53 %P 840–860 %8 06 %G eng %0 Journal Article %J J Am Geriatr Soc %D 2021 %T Urine creatinine concentration and clinical outcomes in older adults: The Cardiovascular Health Study. %A Barzilay, Joshua I %A Bůzková, Petra %A Shlipak, Michael G %A Lyles, Mary F %A Bansal, Nisha %A Garimella, Pranav S %A Ix, Joachim H %A Kizer, Jorge R %A Strotmeyer, Elsa S %A Djoussé, Luc %A Biggs, Mary L %A Siscovick, David %A Mukamal, Kenneth J %X

PURPOSE: Loss of muscle mass and strength are associated with long-term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults.

METHODS: We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996-1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub-cohort, 1331 participants underwent dual energy X-ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus.

RESULTS: In linear regression analysis, a one standard deviation higher Ucr concentration (64.6 mg/dl) was associated with greater grip strength (kg force) β = 0.44 [0.16, 0.72]; p = 0.002) and higher lean muscle mass (kg) (β = 0.43 [0.08, 0.78]; p = 0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p = 0.65).

CONCLUSION: A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community-living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults.

%B J Am Geriatr Soc %8 2021 Aug 07 %G eng %R 10.1111/jgs.17388 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2021 %T What Cut-Point in Gait Speed Best Discriminates Community-Dwelling Older Adults With Mobility Complaints From Those Without? A Pooled Analysis From the Sarcopenia Definitions and Outcomes Consortium. %A Cawthon, Peggy M %A Patel, Sheena M %A Kritchevsky, Stephen B %A Newman, Anne B %A Santanasto, Adam %A Kiel, Douglas P %A Travison, Thomas G %A Lane, Nancy %A Cummings, Steven R %A Orwoll, Eric S %A Duchowny, Kate A %A Kwok, Timothy %A Hirani, Vasant %A Schousboe, John %A Karlsson, Magnus K %A Mellström, Dan %A Ohlsson, Claes %A Ljunggren, Osten %A Xue, Qian-Li %A Shardell, Michelle %A Jordan, Joanne M %A Pencina, Karol M %A Fielding, Roger A %A Magaziner, Jay %A Correa-de-Araujo, Rosaly %A Bhasin, Shalender %A Manini, Todd M %K Aged %K Female %K Gait %K Humans %K Independent Living %K Male %K Mobility Limitation %K Sarcopenia %K Walking %K Walking Speed %X

BACKGROUND: Cut-points to define slow walking speed have largely been derived from expert opinion.

METHODS: Study participants (13 589 men and 5043 women aged ≥65years) had walking speed (m/s) measured over 4-6 m (mean ± SD: 1.20 ± 0.27 m/s in men and 0.94 ± 0.24 m/s in women.) Mobility limitation was defined as any self-reported difficulty with walking approximately 1/4 mile (prevalence: 12.6% men, 26.4% women). Sex-stratified classification and regression tree (CART) models with 10-fold cross-validation identified walking speed cut-points that optimally discriminated those who reported mobility limitation from those who did not.

RESULTS: Among 5043 women, CART analysis identified 2 cut-points, classifying 4144 (82.2%) with walking speed ≥0.75 m/s, which we labeled as "fast"; 478 (9.5%) as "intermediate" (walking speed ≥0.62 m/s but <0.75 m/s); and 421 (8.3%) as "slow" (walking speed <0.62 m/s). Among 13 589 men, CART analysis identified 3 cut-points, classifying 10 001 (73.6%) with walking speed ≥1.00 m/s ("very fast"); 2901 (21.3%) as "fast" (walking speed ≥0.74 m/s but <1.00 m/s); 497 (3.7%) as "intermediate" (walking speed ≥0.57 m/s but <0.74 m/s); and 190 (1.4%) as "slow" (walking speed <0.57 m/s). Prevalence of self-reported mobility limitation was lowest in the "fast" or "very fast" (11% for men and 19% for women) and highest in the "slow" (60.5% in men and 71.0% in women). Rounding the 2 slower cut-points to 0.60 m/s and 0.75 m/s reclassified very few participants.

CONCLUSIONS: Cut-points in walking speed of approximately 0.60 m/s and 0.75 m/s discriminate those with self-reported mobility limitation from those without.

%B J Gerontol A Biol Sci Med Sci %V 76 %P e321-e327 %8 2021 09 13 %G eng %N 10 %R 10.1093/gerona/glab183 %0 Journal Article %J EBioMedicine %D 2021 %T Whole genome sequence analyses of eGFR in 23,732 people representing multiple ancestries in the NHLBI trans-omics for precision medicine (TOPMed) consortium. %A Lin, Bridget M %A Grinde, Kelsey E %A Brody, Jennifer A %A Breeze, Charles E %A Raffield, Laura M %A Mychaleckyj, Josyf C %A Thornton, Timothy A %A Perry, James A %A Baier, Leslie J %A de Las Fuentes, Lisa %A Guo, Xiuqing %A Heavner, Benjamin D %A Hanson, Robert L %A Hung, Yi-Jen %A Qian, Huijun %A Hsiung, Chao A %A Hwang, Shih-Jen %A Irvin, Margaret R %A Jain, Deepti %A Kelly, Tanika N %A Kobes, Sayuko %A Lange, Leslie %A Lash, James P %A Li, Yun %A Liu, Xiaoming %A Mi, Xuenan %A Musani, Solomon K %A Papanicolaou, George J %A Parsa, Afshin %A Reiner, Alex P %A Salimi, Shabnam %A Sheu, Wayne H-H %A Shuldiner, Alan R %A Taylor, Kent D %A Smith, Albert V %A Smith, Jennifer A %A Tin, Adrienne %A Vaidya, Dhananjay %A Wallace, Robert B %A Yamamoto, Kenichi %A Sakaue, Saori %A Matsuda, Koichi %A Kamatani, Yoichiro %A Momozawa, Yukihide %A Yanek, Lisa R %A Young, Betsi A %A Zhao, Wei %A Okada, Yukinori %A Abecasis, Gonzalo %A Psaty, Bruce M %A Arnett, Donna K %A Boerwinkle, Eric %A Cai, Jianwen %A Yii-Der Chen, Ida %A Correa, Adolfo %A Cupples, L Adrienne %A He, Jiang %A Kardia, Sharon Lr %A Kooperberg, Charles %A Mathias, Rasika A %A Mitchell, Braxton D %A Nickerson, Deborah A %A Turner, Steve T %A Vasan, Ramachandran S %A Rotter, Jerome I %A Levy, Daniel %A Kramer, Holly J %A Köttgen, Anna %A Rich, Stephen S %A Lin, Dan-Yu %A Browning, Sharon R %A Franceschini, Nora %X

BACKGROUND: Genetic factors that influence kidney traits have been understudied for low frequency and ancestry-specific variants.

METHODS: We combined whole genome sequencing (WGS) data from 23,732 participants from 10 NHLBI Trans-Omics for Precision Medicine (TOPMed) Program multi-ethnic studies to identify novel loci for estimated glomerular filtration rate (eGFR). Participants included European, African, East Asian, and Hispanic ancestries. We applied linear mixed models using a genetic relationship matrix estimated from the WGS data and adjusted for age, sex, study, and ethnicity.

FINDINGS: When testing single variants, we identified three novel loci driven by low frequency variants more commonly observed in non-European ancestry (PRKAA2, rs180996919, minor allele frequency [MAF] 0.04%, P = 6.1 × 10; METTL8, rs116951054, MAF 0.09%, P = 4.5 × 10; and MATK, rs539182790, MAF 0.05%, P = 3.4 × 10). We also replicated two known loci for common variants (rs2461702, MAF=0.49, P = 1.2 × 10, nearest gene GATM, and rs71147340, MAF=0.34, P = 3.3 × 10, CDK12). Testing aggregated variants within a gene identified the MAF gene. A statistical approach based on local ancestry helped to identify replication samples for ancestry-specific variants.

INTERPRETATION: This study highlights challenges in studying variants influencing kidney traits that are low frequency in populations and more common in non-European ancestry.

%B EBioMedicine %V 63 %P 103157 %8 2021 Jan %G eng %R 10.1016/j.ebiom.2020.103157 %0 Journal Article %J Hum Mol Genet %D 2021 %T Whole genome sequence analysis of platelet traits in the NHLBI trans-omics for precision medicine initiative. %A Little, Amarise %A Hu, Yao %A Sun, Quan %A Jain, Deepti %A Broome, Jai %A Chen, Ming-Huei %A Thibord, Florian %A McHugh, Caitlin %A Surendran, Praveen %A Blackwell, Thomas W %A Brody, Jennifer A %A Bhan, Arunoday %A Chami, Nathalie %A Vries, Paul S %A Ekunwe, Lynette %A Heard-Costa, Nancy %A Hobbs, Brian D %A Manichaikul, Ani %A Moon, Jee-Young %A Preuss, Michael H %A Ryan, Kathleen %A Wang, Zhe %A Wheeler, Marsha %A Yanek, Lisa R %A Abecasis, Goncalo R %A Almasy, Laura %A Beaty, Terri H %A Becker, Lewis C %A Blangero, John %A Boerwinkle, Eric %A Butterworth, Adam S %A Choquet, Helene %A Correa, Adolfo %A Curran, Joanne E %A Faraday, Nauder %A Fornage, Myriam %A Glahn, David C %A Hou, Lifang %A Jorgenson, Eric %A Kooperberg, Charles %A Lewis, Joshua P %A Lloyd-Jones, Donald M %A Loos, Ruth J F %A Min, Nancy %A Mitchell, Braxton D %A Morrison, Alanna C %A Nickerson, Debbie %A North, Kari E %A O'Connell, Jeffrey R %A Pankratz, Nathan %A Psaty, Bruce M %A Vasan, Ramachandran S %A Rich, Stephen S %A Rotter, Jerome I %A Smith, Albert V %A Smith, Nicholas L %A Tang, Hua %A Tracy, Russell P %A Conomos, Matthew P %A Laurie, Cecelia A %A Mathias, Rasika A %A Li, Yun %A Auer, Paul L %A Thornton, Timothy %A Reiner, Alexander P %A Johnson, Andrew D %A Raffield, Laura M %X

Platelets play a key role in thrombosis and hemostasis. Platelet count (PLT) and mean platelet volume (MPV) are highly heritable quantitative traits, with hundreds of genetic signals previously identified, mostly in European ancestry populations. We here utilize whole genome sequencing from NHLBI's Trans-Omics for Precision Medicine Initiative (TOPMed) in a large multi-ethnic sample to further explore common and rare variation contributing to PLT (n = 61 200) and MPV (n = 23 485). We identified and replicated secondary signals at MPL (rs532784633) and PECAM1 (rs73345162), both more common in African ancestry populations. We also observed rare variation in Mendelian platelet related disorder genes influencing variation in platelet traits in TOPMed cohorts (not enriched for blood disorders). For example, association of GP9 with lower PLT and higher MPV was partly driven by a pathogenic Bernard-Soulier syndrome variant (rs5030764, p.Asn61Ser), and the signals at TUBB1 and CD36 were partly driven by loss of function variants not annotated as pathogenic in ClinVar (rs199948010 and rs571975065). However, residual signal remained for these gene-based signals after adjusting for lead variants, suggesting that additional variants in Mendelian genes with impacts in general population cohorts remain to be identified. Gene-based signals were also identified at several GWAS identified loci for genes not annotated for Mendelian platelet disorders (PTPRH, TET2, CHEK2), with somatic variation driving the result at TET2. These results highlight the value of whole genome sequencing in populations of diverse genetic ancestry to identify novel regulatory and coding signals, even for well-studied traits like platelet traits.

%B Hum Mol Genet %8 2021 Sep 06 %G eng %R 10.1093/hmg/ddab252 %0 Journal Article %J Genome Med %D 2021 %T Whole-genome association analyses of sleep-disordered breathing phenotypes in the NHLBI TOPMed program. %A Cade, Brian E %A Lee, Jiwon %A Sofer, Tamar %A Wang, Heming %A Zhang, Man %A Chen, Han %A Gharib, Sina A %A Gottlieb, Daniel J %A Guo, Xiuqing %A Lane, Jacqueline M %A Liang, Jingjing %A Lin, Xihong %A Mei, Hao %A Patel, Sanjay R %A Purcell, Shaun M %A Saxena, Richa %A Shah, Neomi A %A Evans, Daniel S %A Hanis, Craig L %A Hillman, David R %A Mukherjee, Sutapa %A Palmer, Lyle J %A Stone, Katie L %A Tranah, Gregory J %A Abecasis, Goncalo R %A Boerwinkle, Eric A %A Correa, Adolfo %A Cupples, L Adrienne %A Kaplan, Robert C %A Nickerson, Deborah A %A North, Kari E %A Psaty, Bruce M %A Rotter, Jerome I %A Rich, Stephen S %A Tracy, Russell P %A Vasan, Ramachandran S %A Wilson, James G %A Zhu, Xiaofeng %A Redline, Susan %X

BACKGROUND: Sleep-disordered breathing is a common disorder associated with significant morbidity. The genetic architecture of sleep-disordered breathing remains poorly understood. Through the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, we performed the first whole-genome sequence analysis of sleep-disordered breathing.

METHODS: The study sample was comprised of 7988 individuals of diverse ancestry. Common-variant and pathway analyses included an additional 13,257 individuals. We examined five complementary traits describing different aspects of sleep-disordered breathing: the apnea-hypopnea index, average oxyhemoglobin desaturation per event, average and minimum oxyhemoglobin saturation across the sleep episode, and the percentage of sleep with oxyhemoglobin saturation < 90%. We adjusted for age, sex, BMI, study, and family structure using MMSKAT and EMMAX mixed linear model approaches. Additional bioinformatics analyses were performed with MetaXcan, GIGSEA, and ReMap.

RESULTS: We identified a multi-ethnic set-based rare-variant association (p = 3.48 × 10) on chromosome X with ARMCX3. Additional rare-variant associations include ARMCX3-AS1, MRPS33, and C16orf90. Novel common-variant loci were identified in the NRG1 and SLC45A2 regions, and previously associated loci in the IL18RAP and ATP2B4 regions were associated with novel phenotypes. Transcription factor binding site enrichment identified associations with genes implicated with respiratory and craniofacial traits. Additional analyses identified significantly associated pathways.

CONCLUSIONS: We have identified the first gene-based rare-variant associations with objectively measured sleep-disordered breathing traits. Our results increase the understanding of the genetic architecture of sleep-disordered breathing and highlight associations in genes that modulate lung development, inflammation, respiratory rhythmogenesis, and HIF1A-mediated hypoxic response.

%B Genome Med %V 13 %P 136 %8 2021 08 26 %G eng %N 1 %R 10.1186/s13073-021-00917-8 %0 Journal Article %J Am J Hum Genet %D 2021 %T Whole-genome sequencing association analysis of quantitative red blood cell phenotypes: The NHLBI TOPMed program. %A Hu, Yao %A Stilp, Adrienne M %A McHugh, Caitlin P %A Rao, Shuquan %A Jain, Deepti %A Zheng, Xiuwen %A Lane, John %A Méric de Bellefon, Sébastian %A Raffield, Laura M %A Chen, Ming-Huei %A Yanek, Lisa R %A Wheeler, Marsha %A Yao, Yao %A Ren, Chunyan %A Broome, Jai %A Moon, Jee-Young %A de Vries, Paul S %A Hobbs, Brian D %A Sun, Quan %A Surendran, Praveen %A Brody, Jennifer A %A Blackwell, Thomas W %A Choquet, Helene %A Ryan, Kathleen %A Duggirala, Ravindranath %A Heard-Costa, Nancy %A Wang, Zhe %A Chami, Nathalie %A Preuss, Michael H %A Min, Nancy %A Ekunwe, Lynette %A Lange, Leslie A %A Cushman, Mary %A Faraday, Nauder %A Curran, Joanne E %A Almasy, Laura %A Kundu, Kousik %A Smith, Albert V %A Gabriel, Stacey %A Rotter, Jerome I %A Fornage, Myriam %A Lloyd-Jones, Donald M %A Vasan, Ramachandran S %A Smith, Nicholas L %A North, Kari E %A Boerwinkle, Eric %A Becker, Lewis C %A Lewis, Joshua P %A Abecasis, Goncalo R %A Hou, Lifang %A O'Connell, Jeffrey R %A Morrison, Alanna C %A Beaty, Terri H %A Kaplan, Robert %A Correa, Adolfo %A Blangero, John %A Jorgenson, Eric %A Psaty, Bruce M %A Kooperberg, Charles %A Walton, Russell T %A Kleinstiver, Benjamin P %A Tang, Hua %A Loos, Ruth J F %A Soranzo, Nicole %A Butterworth, Adam S %A Nickerson, Debbie %A Rich, Stephen S %A Mitchell, Braxton D %A Johnson, Andrew D %A Auer, Paul L %A Li, Yun %A Mathias, Rasika A %A Lettre, Guillaume %A Pankratz, Nathan %A Laurie, Cathy C %A Laurie, Cecelia A %A Bauer, Daniel E %A Conomos, Matthew P %A Reiner, Alexander P %K Adult %K Aged %K Chromosomes, Human, Pair 16 %K Datasets as Topic %K Erythrocytes %K Female %K Gene Editing %K Genetic Variation %K Genome-Wide Association Study %K HEK293 Cells %K Humans %K Male %K Middle Aged %K National Heart, Lung, and Blood Institute (U.S.) %K Phenotype %K Quality Control %K Reproducibility of Results %K United States %X

Whole-genome sequencing (WGS), a powerful tool for detecting novel coding and non-coding disease-causing variants, has largely been applied to clinical diagnosis of inherited disorders. Here we leveraged WGS data in up to 62,653 ethnically diverse participants from the NHLBI Trans-Omics for Precision Medicine (TOPMed) program and assessed statistical association of variants with seven red blood cell (RBC) quantitative traits. We discovered 14 single variant-RBC trait associations at 12 genomic loci, which have not been reported previously. Several of the RBC trait-variant associations (RPN1, ELL2, MIDN, HBB, HBA1, PIEZO1, and G6PD) were replicated in independent GWAS datasets imputed to the TOPMed reference panel. Most of these discovered variants are rare/low frequency, and several are observed disproportionately among non-European Ancestry (African, Hispanic/Latino, or East Asian) populations. We identified a 3 bp indel p.Lys2169del (g.88717175_88717177TCT[4]) (common only in the Ashkenazi Jewish population) of PIEZO1, a gene responsible for the Mendelian red cell disorder hereditary xerocytosis (MIM: 194380), associated with higher mean corpuscular hemoglobin concentration (MCHC). In stepwise conditional analysis and in gene-based rare variant aggregated association analysis, we identified several of the variants in HBB, HBA1, TMPRSS6, and G6PD that represent the carrier state for known coding, promoter, or splice site loss-of-function variants that cause inherited RBC disorders. Finally, we applied base and nuclease editing to demonstrate that the sentinel variant rs112097551 (nearest gene RPN1) acts through a cis-regulatory element that exerts long-range control of the gene RUVBL1 which is essential for hematopoiesis. Together, these results demonstrate the utility of WGS in ethnically diverse population-based samples and gene editing for expanding knowledge of the genetic architecture of quantitative hematologic traits and suggest a continuum between complex trait and Mendelian red cell disorders.

%B Am J Hum Genet %V 108 %P 874-893 %8 2021 05 06 %G eng %N 5 %R 10.1016/j.ajhg.2021.04.003 %0 Journal Article %J Am J Hum Genet %D 2021 %T Whole-genome sequencing in diverse subjects identifies genetic correlates of leukocyte traits: The NHLBI TOPMed program. %A Mikhaylova, Anna V %A McHugh, Caitlin P %A Polfus, Linda M %A Raffield, Laura M %A Boorgula, Meher Preethi %A Blackwell, Thomas W %A Brody, Jennifer A %A Broome, Jai %A Chami, Nathalie %A Chen, Ming-Huei %A Conomos, Matthew P %A Cox, Corey %A Curran, Joanne E %A Daya, Michelle %A Ekunwe, Lynette %A Glahn, David C %A Heard-Costa, Nancy %A Highland, Heather M %A Hobbs, Brian D %A Ilboudo, Yann %A Jain, Deepti %A Lange, Leslie A %A Miller-Fleming, Tyne W %A Min, Nancy %A Moon, Jee-Young %A Preuss, Michael H %A Rosen, Jonathon %A Ryan, Kathleen %A Smith, Albert V %A Sun, Quan %A Surendran, Praveen %A de Vries, Paul S %A Walter, Klaudia %A Wang, Zhe %A Wheeler, Marsha %A Yanek, Lisa R %A Zhong, Xue %A Abecasis, Goncalo R %A Almasy, Laura %A Barnes, Kathleen C %A Beaty, Terri H %A Becker, Lewis C %A Blangero, John %A Boerwinkle, Eric %A Butterworth, Adam S %A Chavan, Sameer %A Cho, Michael H %A Choquet, Helene %A Correa, Adolfo %A Cox, Nancy %A DeMeo, Dawn L %A Faraday, Nauder %A Fornage, Myriam %A Gerszten, Robert E %A Hou, Lifang %A Johnson, Andrew D %A Jorgenson, Eric %A Kaplan, Robert %A Kooperberg, Charles %A Kundu, Kousik %A Laurie, Cecelia A %A Lettre, Guillaume %A Lewis, Joshua P %A Li, Bingshan %A Li, Yun %A Lloyd-Jones, Donald M %A Loos, Ruth J F %A Manichaikul, Ani %A Meyers, Deborah A %A Mitchell, Braxton D %A Morrison, Alanna C %A Ngo, Debby %A Nickerson, Deborah A %A Nongmaithem, Suraj %A North, Kari E %A O'Connell, Jeffrey R %A Ortega, Victor E %A Pankratz, Nathan %A Perry, James A %A Psaty, Bruce M %A Rich, Stephen S %A Soranzo, Nicole %A Rotter, Jerome I %A Silverman, Edwin K %A Smith, Nicholas L %A Tang, Hua %A Tracy, Russell P %A Thornton, Timothy A %A Vasan, Ramachandran S %A Zein, Joe %A Mathias, Rasika A %A Reiner, Alexander P %A Auer, Paul L %K Asthma %K Biomarkers %K Dermatitis, Atopic %K Genetic Predisposition to Disease %K Genome, Human %K Genome-Wide Association Study %K Humans %K Leukocytes %K National Heart, Lung, and Blood Institute (U.S.) %K Phenotype %K Polymorphism, Single Nucleotide %K Prognosis %K Proteome %K Pulmonary Disease, Chronic Obstructive %K Quantitative Trait Loci %K United Kingdom %K United States %K Whole Genome Sequencing %X

Many common and rare variants associated with hematologic traits have been discovered through imputation on large-scale reference panels. However, the majority of genome-wide association studies (GWASs) have been conducted in Europeans, and determining causal variants has proved challenging. We performed a GWAS of total leukocyte, neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts generated from 109,563,748 variants in the autosomes and the X chromosome in the Trans-Omics for Precision Medicine (TOPMed) program, which included data from 61,802 individuals of diverse ancestry. We discovered and replicated 7 leukocyte trait associations, including (1) the association between a chromosome X, pseudo-autosomal region (PAR), noncoding variant located between cytokine receptor genes (CSF2RA and CLRF2) and lower eosinophil count; and (2) associations between single variants found predominantly among African Americans at the S1PR3 (9q22.1) and HBB (11p15.4) loci and monocyte and lymphocyte counts, respectively. We further provide evidence indicating that the newly discovered eosinophil-lowering chromosome X PAR variant might be associated with reduced susceptibility to common allergic diseases such as atopic dermatitis and asthma. Additionally, we found a burden of very rare FLT3 (13q12.2) variants associated with monocyte counts. Together, these results emphasize the utility of whole-genome sequencing in diverse samples in identifying associations missed by European-ancestry-driven GWASs.

%B Am J Hum Genet %V 108 %P 1836-1851 %8 2021 10 07 %G eng %N 10 %R 10.1016/j.ajhg.2021.08.007 %0 Journal Article %J Nat Genet %D 2022 %T Assessing the contribution of rare variants to complex trait heritability from whole-genome sequence data. %A Wainschtein, Pierrick %A Jain, Deepti %A Zheng, Zhili %A Cupples, L Adrienne %A Shadyab, Aladdin H %A McKnight, Barbara %A Shoemaker, Benjamin M %A Mitchell, Braxton D %A Psaty, Bruce M %A Kooperberg, Charles %A Liu, Ching-Ti %A Albert, Christine M %A Roden, Dan %A Chasman, Daniel I %A Darbar, Dawood %A Lloyd-Jones, Donald M %A Arnett, Donna K %A Regan, Elizabeth A %A Boerwinkle, Eric %A Rotter, Jerome I %A O'Connell, Jeffrey R %A Yanek, Lisa R %A de Andrade, Mariza %A Allison, Matthew A %A McDonald, Merry-Lynn N %A Chung, Mina K %A Fornage, Myriam %A Chami, Nathalie %A Smith, Nicholas L %A Ellinor, Patrick T %A Vasan, Ramachandran S %A Mathias, Rasika A %A Loos, Ruth J F %A Rich, Stephen S %A Lubitz, Steven A %A Heckbert, Susan R %A Redline, Susan %A Guo, Xiuqing %A Chen, Y -D Ida %A Laurie, Cecelia A %A Hernandez, Ryan D %A McGarvey, Stephen T %A Goddard, Michael E %A Laurie, Cathy C %A North, Kari E %A Lange, Leslie A %A Weir, Bruce S %A Yengo, Loic %A Yang, Jian %A Visscher, Peter M %X

Analyses of data from genome-wide association studies on unrelated individuals have shown that, for human traits and diseases, approximately one-third to two-thirds of heritability is captured by common SNPs. However, it is not known whether the remaining heritability is due to the imperfect tagging of causal variants by common SNPs, in particular whether the causal variants are rare, or whether it is overestimated due to bias in inference from pedigree data. Here we estimated heritability for height and body mass index (BMI) from whole-genome sequence data on 25,465 unrelated individuals of European ancestry. The estimated heritability was 0.68 (standard error 0.10) for height and 0.30 (standard error 0.10) for body mass index. Low minor allele frequency variants in low linkage disequilibrium (LD) with neighboring variants were enriched for heritability, to a greater extent for protein-altering variants, consistent with negative selection. Our results imply that rare variants, in particular those in regions of low linkage disequilibrium, are a major source of the still missing heritability of complex traits and disease.

%B Nat Genet %V 54 %P 263-273 %8 2022 Mar %G eng %N 3 %R 10.1038/s41588-021-00997-7 %0 Journal Article %J Neurology %D 2022 %T Association of Serum Neurofilament Light Chain Concentration and MRI Findings in Older Adults: The Cardiovascular Health Study. %A Fohner, Alison E %A Bartz, Traci M %A Tracy, Russell P %A Adams, Hieab H H %A Bis, Joshua C %A Djoussé, Luc %A Satizabal, Claudia L %A Lopez, Oscar L %A Seshadri, Sudha %A Mukamal, Kenneth J %A Kuller, Lewis H %A Psaty, Bruce M %A Longstreth, W T %X

BACKGROUND AND OBJECTIVES: Neurofilament light chain (NfL) in blood is a sensitive but nonspecific marker of brain injury. This study sought to evaluate associations between NfL concentration and MRI findings of vascular brain injury in older adults.

METHODS: A longitudinal cohort study included 2 cranial MRI scans performed about 5 years apart and assessed for white matter hyperintensities (WMH) and infarcts. About 1 year before their second MRI, 1,362 participants (median age 77 years, 61.4% women) without a history of TIA or stroke had measurement of 4 biomarkers: NfL, total tau, glial fibrillary acidic protein (GFAP), and ubiquitin carboxyl-terminal hydrolase L1. Most (n = 1,279) also had the first MRI scan, and some (n = 633) had quantitative measurements of hippocampal and WMH. In primary analyses, we assessed associations of NfL with a 10-point white matter grade (WMG) and prevalent infarcts on second MRI and with worsening WMG and incident infarct comparing the 2 scans. A value <0.0125 (0.05/4) was considered significant for these analyses. We also assessed associations with hippocampal and WMH volume.

RESULTS: In fully adjusted models, log(NfL) concentration was associated with WMG (β = 0.27; = 2.3 × 10) and worsening WMG (relative risk [RR] 1.24; = 0.0022), but less strongly with prevalent brain infarcts (RR 1.18; = 0.013) and not with incident brain infarcts (RR 1.18; = 0.18). Associations were also present with WMH volume (β = 2,242.9, = 0.0036). For the other 3 biomarkers, the associations for log (GFAP) concentration with WMG and worsening WMG were significant.

DISCUSSION: Among older adults without a history of stroke, higher serum NfL concentration was associated with covert MRI findings of vascular brain injury, especially the burden of WMH and its worsening. Whether these results offer opportunities for the use of NfL as a noninvasive biomarker of WMH or to control vascular risk factors remains to be determined.

%B Neurology %V 98 %P e903-e911 %8 2022 Mar 01 %G eng %N 9 %R 10.1212/WNL.0000000000013229 %0 Journal Article %J JAMA Netw Open %D 2022 %T Association of Trimethylamine N-Oxide and Metabolites With Mortality in Older Adults. %A Fretts, Amanda M %A Hazen, Stanley L %A Jensen, Paul %A Budoff, Matthew %A Sitlani, Colleen M %A Wang, Meng %A de Oliveira Otto, Marcia C %A DiDonato, Joseph A %A Lee, Yujin %A Psaty, Bruce M %A Siscovick, David S %A Sotoodehnia, Nona %A Tang, W H Wilson %A Lai, Heidi %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %K Aged %K Betaine %K Cardiovascular Diseases %K Carnitine %K Choline %K Cohort Studies %K Female %K Humans %K Male %K Methylamines %K Prospective Studies %X

Importance: Little is known about the association of trimethylamine N-oxide (TMAO), a novel plasma metabolite derived from L-carnitine and phosphatidylcholine, and related metabolites (ie, choline, betaine, carnitine, and butyrobetaine) with risk of death among older adults in the general population.

Objective: To investigate the associations of serial measures of plasma TMAO and related metabolites with risk of total and cause-specific death (ie, deaths from cardiovascular diseases [CVDs] and non-CVDs) among older adults in the US.

Design, Setting, and Participants: This prospective cohort study involved 5333 participants from the Cardiovascular Health Study-a community-based longitudinal cohort of adults aged 65 years or older-who were followed up from June 1, 1989, to December 31, 2015. Participants were from 4 communities in the US (Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania). Data were analyzed from March 17 to June 23, 2021.

Exposures: Plasma TMAO, choline, betaine, carnitine, and butyrobetaine levels were measured using stored samples from baseline (June 1, 1989, to May 31, 1990, or November 1, 1992, to June 31, 1993) and follow-up examination (June 1, 1996, to May 31, 1997). Measurements were performed through stable-isotope dilution liquid chromatography with tandem mass spectrometry using high-performance liquid chromatography with online electrospray ionization tandem mass spectrometry.

Main Outcomes and Measures: Deaths (total and cause specific) were adjudicated by a centralized Cardiovascular Health Study events committee based on information from medical records, laboratory and diagnostic reports, death certificates, and/or interviews with next of kin. The associations of each metabolite with mortality were assessed using Cox proportional hazards regression models.

Results: Among 5333 participants in the analytic sample, the mean (SD) age was 73 (6) years; 2149 participants (40.3%) were male, 3184 (59.7%) were female, 848 (15.9%) were African American, 4450 (83.4%) were White, and 35 (0.01%) were of other races (12 were American Indian or Alaska Native, 4 were Asian or Pacific Islander, and 19 were of other races or ethnicities). During a median follow-up of 13.2 years (range, 0-26.9 years), 4791 deaths occurred. After adjustment for potential confounders, the hazard ratios for death from any cause (ie, total mortality) comparing extreme quintiles (fifth vs first) of plasma concentrations were 1.30 (95% CI, 1.17-1.44) for TMAO, 1.19 (95% CI, 1.08-1.32) for choline, 1.26 (95% CI, 1.15-1.40) for carnitine, and 1.26 (95% CI, 1.13-1.40) for butyrobetaine. Plasma betaine was not associated with risk of death. The extent of risk estimates was similar for CVD and non-CVD mortality.

Conclusions and Relevance: In this cohort study, plasma concentrations of TMAO and related metabolites were positively associated with risk of death. These findings suggest that circulating TMAO is an important novel risk factor associated with death among older adults.

%B JAMA Netw Open %V 5 %P e2213242 %8 2022 05 02 %G eng %N 5 %R 10.1001/jamanetworkopen.2022.13242 %0 Journal Article %J Genome Res %D 2022 %T {An association test of the spatial distribution of rare missense variants within protein structures identifies Alzheimer's disease-related patterns %A Jin, B. %A Capra, J. A. %A Benchek, P. %A Wheeler, N. %A Naj, A. C. %A Hamilton-Nelson, K. L. %A Farrell, J. J. %A Leung, Y. Y. %A Kunkle, B. %A Vadarajan, B. %A Schellenberg, G. D. %A Mayeux, R. %A Wang, L. S. %A Farrer, L. A. %A Pericak-Vance, M. A. %A Martin, E. R. %A Haines, J. L. %A Crawford, D. C. %A Bush, W. S. %X is a novel AD risk gene that has a cluster of variants primarily shared by case subjects around the Sec6 domain. This cluster is also validated in an independent replication data set and a validation data set with a larger sample size. %B Genome Res %V 32 %P 778–790 %8 04 %G eng %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2022 %T The Associations of Individual and Subclasses of Non-Esterified Fatty Acids with Disability, and Mobility Limitation in Older Adults: the Cardiovascular Health Study. %A Ahiawodzi, Peter %A Bůzková, Petra %A Lichtenstein, Alice H %A Matthan, Nirupa R %A Ix, Joachim H %A Kizer, Jorge R %A Tracy, Russell P %A Arnold, Alice %A Newman, Anne B %A Siscovick, David %A Djoussé, Luc %A Mukamal, Kenneth J %X

BACKGROUND: We sought to determine the associations between individual non-esterified fatty acids (NEFAs) and disability and mobility limitation.

METHODS: We studied 1734 participants in the Cardiovascular Health Study (CHS), an ongoing population-based cohort study of community-living older American adults. We measured 35 individual NEFA species in fasting serum samples obtained at the 1996-1997 clinic visit. Using yearly assessments of activities of daily living and self-reported mobility, we identified participants with incident disability or mobility limitation during 15 years of follow-up. Cox proportional hazards regression models were used to determine the associations between per-SD increment in the individual NEFAs and incident disability and mobility limitations with adjustment for potential confounding factors.

RESULTS: Higher concentrations of total and a broad range of individual NEFA species were associated with risk of disability and mobility limitation [disability: HR per SD of total NEFA (SD=174.70) =1.11, 95%CI=1.04-1.18, p=0.001; mobility limitation: HR per SD of total NEFA=1.09, 95%CI=1.02-1.16, p=0.01). Among individual saturated NEFAs (SFAs), myristic (14:0) and palmitic (16:0) acids were significantly associated with higher risk of both disability and mobility limitations, but longer-chain FAs were not. Most individual monounsaturated (MUFA), n-6 polyunsaturated fatty acids (PUFAs), and trans FAs were positively significantly associated with higher risks of both disability and mobility limitation. In contrast, most n-3 PUFA species were not associated with disability or mobility limitation.

CONCLUSIONS: Higher risks of disability and mobility limitation were observed for pro-inflammatory intermediate-chain SFAs, MUFAs, n-6 PUFAs, and trans FAs. Our findings indicated no significant association for anti-inflammatory n-3 PUFAs.

%B J Gerontol A Biol Sci Med Sci %8 2022 Sep 26 %G eng %R 10.1093/gerona/glac206 %0 Journal Article %J J Alzheimers Dis %D 2022 %T Associations of Pulmonary Function with MRI Brain Volumes: A Coordinated Multi-Study Analysis. %A Frenzel, Stefan %A Bis, Josh C %A Gudmundsson, Elias F %A O'Donnell, Adrienne %A Simino, Jeannette %A Yaqub, Amber %A Bartz, Traci M %A Brusselle, Guy G O %A Bülow, Robin %A DeCarli, Charles S %A Ewert, Ralf %A Gharib, Sina A %A Ghosh, Saptaparni %A Gireud-Goss, Monica %A Gottesman, Rebecca F %A Ikram, M Arfan %A Knopman, David S %A Launer, Lenore J %A London, Stephanie J %A Longstreth, W T %A Lopez, Oscar L %A Melo van Lent, Debora %A O'Connor, George %A Satizabal, Claudia L %A Shrestha, Srishti %A Sigurdsson, Sigurdur %A Stubbe, Beate %A Talluri, Rajesh %A Vasan, Ramachandran S %A Vernooij, Meike W %A Völzke, Henry %A Wiggins, Kerri L %A Yu, Bing %A Beiser, Alexa S %A Gudnason, Vilmundur %A Mosley, Thomas %A Psaty, Bruce M %A Wolters, Frank J %A Grabe, Hans J %A Seshadri, Sudha %X

BACKGROUND: Previous studies suggest poor pulmonary function is associated with increased burden of cerebral white matter hyperintensities and brain atrophy among elderly individuals, but the results are inconsistent.

OBJECTIVE: To study the cross-sectional associations of pulmonary function with structural brain variables.

METHODS: Data from six large community-based samples (N = 11,091) were analyzed. Spirometric measurements were standardized with respect to age, sex, height, and ethnicity using reference equations of the Global Lung Function Initiative. Associations of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and their ratio FEV1/FVC with brain volume, gray matter volume, hippocampal volume, and volume of white matter hyperintensities were investigated using multivariable linear regressions for each study separately and then combined using random-effect meta-analyses.

RESULTS: FEV1 and FVC were positively associated with brain volume, gray matter volume, and hippocampal volume, and negatively associated with white matter hyperintensities volume after multiple testing correction, with little heterogeneity present between the studies. For instance, an increase of FVC by one unit was associated with 3.5 ml higher brain volume (95% CI: [2.2, 4.9]). In contrast, results for FEV1/FVC were more heterogeneous across studies, with significant positive associations with brain volume, gray matter volume, and hippocampal volume, but not white matter hyperintensities volume. Associations of brain variables with both FEV1 and FVC were consistently stronger than with FEV1/FVC, specifically with brain volume and white matter hyperintensities volume.

CONCLUSION: In cross-sectional analyses, worse pulmonary function is associated with smaller brain volumes and higher white matter hyperintensities burden.

%B J Alzheimers Dis %8 2022 Oct 03 %G eng %R 10.3233/JAD-220667 %0 Journal Article %J J Nucl Med %D 2022 %T CD133 as a Biomarker for an Autoantibody-to-ImmunoPET Paradigm for the Early Detection of Small Cell Lung Cancer. %A Kunihiro, Andrew G %A Sarrett, Samantha M %A Lastwika, Kristin J %A Solan, Joell L %A Pisarenko, Tatyana %A Keinänen, Outi %A Rodriguez, Cindy %A Taverne, Lydia R %A Fitzpatrick, Annette L %A Li, Christopher I %A Houghton, A McGarry %A Zeglis, Brian M %A Lampe, Paul D %K Animals %K Autoantibodies %K Biomarkers %K Cell Line, Tumor %K Disease Models, Animal %K Early Detection of Cancer %K Humans %K Lung Neoplasms %K Mice %K Mice, Nude %K Neuroendocrine Tumors %K Positron-Emission Tomography %K RNA, Messenger %K Small Cell Lung Carcinoma %X

Small cell lung cancer (SCLC) is a deadly neuroendocrine tumor for which there are no screening methods sensitive enough to facilitate early, effective intervention. We propose targeting the neuroendocrine tumor neoantigen CD133 via antibody-based early detection and PET (immunoPET) to facilitate earlier and more accurate detection of SCLC. RNA sequencing datasets, immunohistochemistry, flow cytometry, and Western blots were used to quantify CD133 expression in healthy and SCLC patients. CD133 was imaged using near-infrared fluorescence (NIRF) immunoimaging, and Zr immunoPET. Anti(α)-CD133 autoantibody levels were measured in SCLC patient plasma using antibody microarrays. Across 6 publicly available datasets, CD133 messenger RNA was found to be higher in SCLC tumors than in other tissues, including healthy or normal adjacent lung and non-SCLC samples. Critically, the upregulation of CD133 messenger RNA in SCLC was associated with a significant increase (hazard ratio, 2.62) in death. CD133 protein was expressed in primary human SCLC, in SCLC patient-derived xenografts, and in both SCLC cell lines tested (H82 and H69). Using an H82 xenograft mouse model, we first imaged CD133 expression with NIRF. Both and NIRF clearly showed that a fluorophore-tagged αCD133 homed to lung tumors. Next, we validated the noninvasive visualization of subcutaneous and orthotopic H82 xenografts via immunoPET. An αCD133 antibody labeled with the positron-emitting radiometal Zr demonstrated significant accumulation in tumor tissue while producing minimal uptake in healthy organs. Finally, plasma αCD133 autoantibodies were found in subjects from cohort studies up to 1 year before SCLC diagnosis. In light of these findings, we conclude that the presence of αCD133 autoantibodies in a blood sample followed by CD133-targeted Zr-immunoPET could be an effective early detection screening strategy for SCLC.

%B J Nucl Med %V 63 %P 1701-1707 %8 2022 Nov %G eng %N 11 %R 10.2967/jnumed.121.263511 %0 Journal Article %J J Am Heart Assoc %D 2022 %T Circulating Soluble CD163, Associations With Cardiovascular Outcomes and Mortality, and Identification of Genetic Variants in Older Individuals: The Cardiovascular Health Study. %A Durda, Peter %A Raffield, Laura M %A Lange, Ethan M %A Olson, Nels C %A Jenny, Nancy Swords %A Cushman, Mary %A Deichgraeber, Pia %A Grarup, Niels %A Jonsson, Anna %A Hansen, Torben %A Mychaleckyj, Josyf C %A Psaty, Bruce M %A Reiner, Alex P %A Tracy, Russell P %A Lange, Leslie A %K Aged %K Antigens, CD %K Antigens, Differentiation, Myelomonocytic %K Asialoglycoprotein Receptor %K Biomarkers %K Cardiovascular Diseases %K Female %K Genome-Wide Association Study %K Heart Failure %K Humans %K Longitudinal Studies %K Male %X

Background Monocytes/macrophages participate in cardiovascular disease. CD163 (cluster of differentiation 163) is a monocyte/macrophage receptor, and the shed sCD163 (soluble CD163) reflects monocyte/macrophage activation. We examined the association of sCD163 with incident cardiovascular disease events and performed a genome-wide association study to identify sCD163-associated variants. Methods and Results We measured plasma sCD163 in 5214 adults (aged ≥65 years, 58.7% women, 16.2% Black) of the CHS (Cardiovascular Health Study). We used Cox regression models (associations of sCD163 with incident events and mortality); median follow-up was 26 years. Genome-wide association study analyses were stratified on race. Adjusted for age, sex, and race and ethnicity, sCD163 levels were associated with all-cause mortality (hazard ratio [HR], 1.08 [95% CI, 1.04-1.12] per SD increase), cardiovascular disease mortality (HR, 1.15 [95% CI, 1.09-1.21]), incident coronary heart disease (HR, 1.10 [95% CI, 1.04-1.16]), and incident heart failure (HR, 1.18 [95% CI, 1.12-1.25]). When further adjusted (eg, cardiovascular disease risk factors), only incident coronary heart disease lost significance. In European American individuals, genome-wide association studies identified 38 variants on chromosome 2 near (top result rs62165726, =3.3×10),19 variants near chromosome 17 gene (rs55714927, =1.5×10), and 18 variants near chromosome 11 gene . These regions replicated in the European ancestry ADDITION-PRO cohort, a longitudinal cohort study nested in the Danish arm of the Anglo-Danish-Dutch study of Intensive Treatment Intensive Treatment In peOple with screeNdetcted Diabetes in Primary Care. In Black individuals, we identified 9 variants on chromosome 6 (rs3129781 =7.1×10) in the region, and 3 variants (rs115391969 =4.3×10) near the chromosome 16 gene Conclusions Monocyte function, as measured by sCD163, may be predictive of overall and cardiovascular-specific mortality and incident heart failure.

%B J Am Heart Assoc %V 11 %P e024374 %8 2022 Nov %G eng %N 21 %R 10.1161/JAHA.121.024374 %0 Journal Article %J Stroke %D 2022 %T Clonal Hematopoiesis Is Associated With Higher Risk of Stroke. %A Bhattacharya, Romit %A Zekavat, Seyedeh M %A Haessler, Jeffrey %A Fornage, Myriam %A Raffield, Laura %A Uddin, Md Mesbah %A Bick, Alexander G %A Niroula, Abhishek %A Yu, Bing %A Gibson, Christopher %A Griffin, Gabriel %A Morrison, Alanna C %A Psaty, Bruce M %A Longstreth, William T %A Bis, Joshua C %A Rich, Stephen S %A Rotter, Jerome I %A Tracy, Russell P %A Correa, Adolfo %A Seshadri, Sudha %A Johnson, Andrew %A Collins, Jason M %A Hayden, Kathleen M %A Madsen, Tracy E %A Ballantyne, Christie M %A Jaiswal, Siddhartha %A Ebert, Benjamin L %A Kooperberg, Charles %A Manson, JoAnn E %A Whitsel, Eric A %A Natarajan, Pradeep %A Reiner, Alexander P %X

BACKGROUND AND PURPOSE: Clonal hematopoiesis of indeterminate potential (CHIP) is a novel age-related risk factor for cardiovascular disease-related morbidity and mortality. The association of CHIP with risk of incident ischemic stroke was reported previously in an exploratory analysis including a small number of incident stroke cases without replication and lack of stroke subphenotyping. The purpose of this study was to discover whether CHIP is a risk factor for ischemic or hemorrhagic stroke.

METHODS: We utilized plasma genome sequence data of blood DNA to identify CHIP in 78 752 individuals from 8 prospective cohorts and biobanks. We then assessed the association of CHIP and commonly mutated individual CHIP driver genes (, , and ) with any stroke, ischemic stroke, and hemorrhagic stroke.

RESULTS: CHIP was associated with an increased risk of total stroke (hazard ratio, 1.14 [95% CI, 1.03-1.27]; =0.01) after adjustment for age, sex, and race. We observed associations with CHIP with risk of hemorrhagic stroke (hazard ratio, 1.24 [95% CI, 1.01-1.51]; =0.04) and with small vessel ischemic stroke subtypes. In gene-specific association results, showed the strongest association with total stroke and ischemic stroke, whereas and were each associated with increased risk of hemorrhagic stroke.

CONCLUSIONS: CHIP is associated with an increased risk of stroke, particularly with hemorrhagic and small vessel ischemic stroke. Future studies clarifying the relationship between CHIP and subtypes of stroke are needed.

%B Stroke %V 53 %P 788-797 %8 2022 Mar %G eng %N 3 %R 10.1161/STROKEAHA.121.037388 %0 Journal Article %J Am J Kidney Dis %D 2022 %T Clonal Hematopoiesis of Indeterminate Potential and Kidney Function Decline in the General Population. %A Kestenbaum, Bryan %A Bick, Alexander G %A Vlasschaert, Caitlyn %A Rauh, Michael J %A Lanktree, Matthew B %A Franceschini, Nora %A Shoemaker, Moore B %A Harris, Raymond C %A Psaty, Bruce M %A Köttgen, Anna %A Natarajan, Pradeep %A Robinson-Cohen, Cassianne %X

RATIONALE & OBJECTIVE: Clonal hematopoiesis of indeterminate potential (CHIP), defined by the age-related ontogenesis of expanded leukemogenic variants indicative of a genetically distinct clonal leukocyte population, is associated with risk of hematologic malignancy and cardiovascular disease. In experimental models, recapitulation of CHIP promotes kidney interstitial fibrosis with direct tissue infiltration of donor macrophages. We tested the hypothesis that CHIP is associated with kidney function decline in the general population.

STUDY DESIGN: Cohort study.

SETTING & PARTICIPANTS: 12,004 individuals from 3 community-based cohorts in the TOPMed Consortium.

EXPOSURE: CHIP status from whole-genome sequences obtained from DNA extracted from peripheral blood.

OUTCOME: Risk of 30% decline in estimated glomerular filtration rate (eGFR) and percent eGFR decline per year during the follow-up period.

ANALYTICAL APPROACH: Cox proportional hazards models for 30% eGFR decline end point and generalized estimating equations for annualized relative change in eGFR with meta-analysis. Study-specific estimates were combined using fixed-effect meta-analysis.

RESULTS: The median baseline eGFR was 84mL/min/1.73m. The prevalence of CHIP was 6.6%, 9.0%, and 12.2% in persons aged 50-60, 60-70, and>70 years, respectively. Over a median follow-up period of 8 years, for the 30% eGFR outcome 205 events occurred among 1,002 CHIP carriers (2.1 events per 100 person-years) and 2,041 events in persons without CHIP (1.7 events per 100 person-years). In meta-analysis, CHIP was associated with greater risk of a 30% eGFR decline (17% [95% CI, 1%-36%] higher; P=0.04). Differences were not observed between those with baseline eGFR above or below 60mL/min/1.73m, of age above or below 60 years, or with or without diabetes.

LIMITATIONS: Small number of participants with moderate-to-advanced kidney disease and restricted set of CHIP driver variants.

CONCLUSIONS: We report an association between CHIP and eGFR decline in 3 general population cohorts without known kidney disease. Further studies are needed to investigate this novel condition and its potential impact among individuals with overt kidney disease.

%B Am J Kidney Dis %8 2022 Oct 11 %G eng %R 10.1053/j.ajkd.2022.08.014 %0 Journal Article %J Nat Commun %D 2022 %T {Clonal hematopoiesis of indeterminate potential, DNA methylation, and risk for coronary artery disease %A Uddin, M. D. M. %A Nguyen, N. Q. H. %A Yu, B. %A Brody, J. A. %A Pampana, A. %A Nakao, T. %A Fornage, M. %A Bressler, J. %A Sotoodehnia, N. %A Weinstock, J. S. %A Honigberg, M. C. %A Nachun, D. %A Bhattacharya, R. %A Griffin, G. K. %A Chander, V. %A Gibbs, R. A. %A Rotter, J. I. %A Liu, C. %A Baccarelli, A. A. %A Chasman, D. I. %A Whitsel, E. A. %A Kiel, D. P. %A Murabito, J. M. %A Boerwinkle, E. %A Ebert, B. L. %A Jaiswal, S. %A Floyd, J. S. %A Bick, A. G. %A Ballantyne, C. M. %A Psaty, B. M. %A Natarajan, P. %A Conneely, K. N. %X Age-related changes to the genome-wide DNA methylation (DNAm) pattern observed in blood are well-documented. Clonal hematopoiesis of indeterminate potential (CHIP), characterized by the age-related acquisition and expansion of leukemogenic mutations in hematopoietic stem cells (HSCs), is associated with blood cancer and coronary artery disease (CAD). Epigenetic regulators DNMT3A and TET2 are the two most frequently mutated CHIP genes. Here, we present results from an epigenome-wide association study for CHIP in 582 Cardiovascular Health Study (CHS) participants, with replication in 2655 Atherosclerosis Risk in Communities (ARIC) Study participants. We show that DNMT3A and TET2 CHIP have distinct and directionally opposing genome-wide DNAm association patterns consistent with their regulatory roles, albeit both promoting self-renewal of HSCs. Mendelian randomization analyses indicate that a subset of DNAm alterations associated with these two leading CHIP genes may promote the risk for CAD. %B Nat Commun %V 13 %P 5350 %8 Sep %G eng %0 Journal Article %J Cell Rep Med %D 2022 %T Correlations between complex human phenotypes vary by genetic background, gender, and environment. %A Elgart, Michael %A Goodman, Matthew O %A Isasi, Carmen %A Chen, Han %A Morrison, Alanna C %A de Vries, Paul S %A Xu, Huichun %A Manichaikul, Ani W %A Guo, Xiuqing %A Franceschini, Nora %A Psaty, Bruce M %A Rich, Stephen S %A Rotter, Jerome I %A Lloyd-Jones, Donald M %A Fornage, Myriam %A Correa, Adolfo %A Heard-Costa, Nancy L %A Vasan, Ramachandran S %A Hernandez, Ryan %A Kaplan, Robert C %A Redline, Susan %A Sofer, Tamar %K Female %K Genetic Background %K Humans %K Male %K Phenotype %X

We develop a closed-form Haseman-Elston estimator for genetic and environmental correlation coefficients between complex phenotypes, which we term HEc, that is as precise as GCTA yet ∼20× faster. We estimate genetic and environmental correlations between over 7,000 phenotype pairs in subgroups from the Trans-Omics in Precision Medicine (TOPMed) program. We demonstrate substantial differences in both heritabilities and genetic correlations for multiple phenotypes and phenotype pairs between individuals of self-reported Black, Hispanic/Latino, and White backgrounds. We similarly observe differences in many of the genetic and environmental correlations between genders. To estimate the contribution of genetics to the observed phenotypic correlation, we introduce "fractional genetic correlation" as the fraction of phenotypic correlation explained by genetics. Finally, we quantify the enrichment of correlations between phenotypic domains, each of which is comprised of multiple phenotypes. Altogether, we demonstrate that the observed correlations between complex human phenotypes depend on the genetic background of the individuals, their gender, and their environment.

%B Cell Rep Med %V 3 %P 100844 %8 2022 Dec 20 %G eng %N 12 %R 10.1016/j.xcrm.2022.100844 %0 Journal Article %J Circulation %D 2022 %T Cross-Ancestry Investigation of Venous Thromboembolism Genomic Predictors. %A Thibord, Florian %A Klarin, Derek %A Brody, Jennifer A %A Chen, Ming-Huei %A Levin, Michael G %A Chasman, Daniel I %A Goode, Ellen L %A Hveem, Kristian %A Teder-Laving, Maris %A Martinez-Perez, Angel %A Aïssi, Dylan %A Daian-Bacq, Delphine %A Ito, Kaoru %A Natarajan, Pradeep %A Lutsey, Pamela L %A Nadkarni, Girish N %A de Vries, Paul S %A Cuellar-Partida, Gabriel %A Wolford, Brooke N %A Pattee, Jack W %A Kooperberg, Charles %A Braekkan, Sigrid K %A Li-Gao, Ruifang %A Saut, Noémie %A Sept, Corriene %A Germain, Marine %A Judy, Renae L %A Wiggins, Kerri L %A Ko, Darae %A O'Donnell, Christopher J %A Taylor, Kent D %A Giulianini, Franco %A de Andrade, Mariza %A Nøst, Therese H %A Boland, Anne %A Empana, Jean-Philippe %A Koyama, Satoshi %A Gilliland, Thomas %A Do, Ron %A Huffman, Jennifer E %A Wang, Xin %A Zhou, Wei %A Manuel Soria, Jose %A Carlos Souto, Juan %A Pankratz, Nathan %A Haessler, Jeffery %A Hindberg, Kristian %A Rosendaal, Frits R %A Turman, Constance %A Olaso, Robert %A Kember, Rachel L %A Bartz, Traci M %A Lynch, Julie A %A Heckbert, Susan R %A Armasu, Sebastian M %A Brumpton, Ben %A Smadja, David M %A Jouven, Xavier %A Komuro, Issei %A Clapham, Katharine R %A Loos, Ruth J F %A Willer, Cristen J %A Sabater-Lleal, Maria %A Pankow, James S %A Reiner, Alexander P %A Morelli, Vania M %A Ridker, Paul M %A Vlieg, Astrid van Hylckama %A Deleuze, Jean-Francois %A Kraft, Peter %A Rader, Daniel J %A Min Lee, Kyung %A Psaty, Bruce M %A Heidi Skogholt, Anne %A Emmerich, Joseph %A Suchon, Pierre %A Rich, Stephen S %A Vy, Ha My T %A Tang, Weihong %A Jackson, Rebecca D %A Hansen, John-Bjarne %A Morange, Pierre-Emmanuel %A Kabrhel, Christopher %A Trégouët, David-Alexandre %A Damrauer, Scott M %A Johnson, Andrew D %A Smith, Nicholas L %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Genomics %K Humans %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %K Thrombosis %K Venous Thromboembolism %X

BACKGROUND: Venous thromboembolism (VTE) is a life-threatening vascular event with environmental and genetic determinants. Recent VTE genome-wide association studies (GWAS) meta-analyses involved nearly 30 000 VTE cases and identified up to 40 genetic loci associated with VTE risk, including loci not previously suspected to play a role in hemostasis. The aim of our research was to expand discovery of new genetic loci associated with VTE by using cross-ancestry genomic resources.

METHODS: We present new cross-ancestry meta-analyzed GWAS results involving up to 81 669 VTE cases from 30 studies, with replication of novel loci in independent populations and loci characterization through in silico genomic interrogations.

RESULTS: In our genetic discovery effort that included 55 330 participants with VTE (47 822 European, 6320 African, and 1188 Hispanic ancestry), we identified 48 novel associations, of which 34 were replicated after correction for multiple testing. In our combined discovery-replication analysis (81 669 VTE participants) and ancestry-stratified meta-analyses (European, African, and Hispanic), we identified another 44 novel associations, which are new candidate VTE-associated loci requiring replication. In total, across all GWAS meta-analyses, we identified 135 independent genomic loci significantly associated with VTE risk. A genetic risk score of the significantly associated loci in Europeans identified a 6-fold increase in risk for those in the top 1% of scores compared with those with average scores. We also identified 31 novel transcript associations in transcriptome-wide association studies and 8 novel candidate genes with protein quantitative-trait locus Mendelian randomization analyses. In silico interrogations of hemostasis and hematology traits and a large phenome-wide association analysis of the 135 GWAS loci provided insights to biological pathways contributing to VTE, with some loci contributing to VTE through well-characterized coagulation pathways and others providing new data on the role of hematology traits, particularly platelet function. Many of the replicated loci are outside of known or currently hypothesized pathways to thrombosis.

CONCLUSIONS: Our cross-ancestry GWAS meta-analyses identified new loci associated with VTE. These findings highlight new pathways to thrombosis and provide novel molecules that may be useful in the development of improved antithrombosis treatments.

%B Circulation %V 146 %P 1225-1242 %8 2022 Oct 18 %G eng %N 16 %R 10.1161/CIRCULATIONAHA.122.059675 %0 Journal Article %J Circulation %D 2022 %T Diabetes Status Modifies the Association Between Different Measures of Obesity and Heart Failure Risk Among Older Adults: A Pooled Analysis of Community-Based NHLBI Cohorts. %A Patel, Kershaw V %A Segar, Matthew W %A Lavie, Carl J %A Kondamudi, Nitin %A Neeland, Ian J %A Almandoz, Jaime P %A Martin, Corby K %A Carbone, Salvatore %A Butler, Javed %A Powell-Wiley, Tiffany M %A Pandey, Ambarish %K Aged %K Cohort Studies %K Diabetes Mellitus %K Female %K Heart Failure %K Humans %K Male %K National Heart, Lung, and Blood Institute (U.S.) %K Obesity %K Risk Factors %K United States %X

BACKGROUND: Obesity and diabetes are associated with a higher risk of heart failure (HF). The interrelationships between different measures of adiposity-overall obesity, central obesity, fat mass (FM)-and diabetes status for HF risk are not well-established.

METHODS: Participant-level data from the ARIC study (Atherosclerosis Risk in Communities; visit 5) and the CHS (Cardiovascular Health Study; visit 1) cohorts were obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center, harmonized, and pooled for the present analysis, excluding individuals with prevalent HF. FM was estimated in all participants using established anthropometric prediction equations additionally validated using the bioelectrical impedance-based FM in the ARIC subgroup. Incident HF events on follow-up were captured across both cohorts using similar adjudication methods. Multivariable-adjusted Fine-Gray models were created to evaluate the associations of body mass index (BMI), waist circumference (WC), and FM with risk of HF in the overall cohort as well as among those with versus without diabetes at baseline. The population attributable risk of overall obesity (BMI≥30 kg/m), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF was evaluated among participants with and without diabetes.

RESULTS: The study included 10 387 participants (52.9% ARIC; 25.1% diabetes; median age, 74 years). The correlation between predicted and bioelectrical impedance-based FM was high (=0.90; n=5038). During a 5-year follow-up, 447 participants developed HF (4.3%). Higher levels of each adiposity measure were significantly associated with higher HF risk (hazard ratio [95% CI] per 1 SD higher BMI=1.15 [1.05, 1.27], WC=1.22 [1.10, 1.36]; FM=1.13 [1.02, 1.25]). A significant interaction was noted between diabetes status and measures of BMI ( interaction=0.04) and WC ( interaction=0.004) for the risk of HF. In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (hazard ratio [95% CI] per 1 SD higher BMI=1.29 [1.14-1.47]; WC=1.48 [1.29-1.70]; FM=1.25 [1.09-1.43]) but not those without diabetes, including participants with prediabetes and euglycemia. The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, and 13.7%, respectively) versus those without diabetes (≤1% for each).

CONCLUSIONS: Higher BMI, WC, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes.

%B Circulation %V 145 %P 268-278 %8 2022 01 25 %G eng %N 4 %R 10.1161/CIRCULATIONAHA.121.055830 %0 Journal Article %J Arterioscler Thromb Vasc Biol %D 2022 %T Dietary Meat, Trimethylamine N-Oxide-Related Metabolites, and Incident Cardiovascular Disease Among Older Adults: The Cardiovascular Health Study. %A Wang, Meng %A Wang, Zeneng %A Lee, Yujin %A Lai, Heidi T M %A de Oliveira Otto, Marcia C %A Lemaitre, Rozenn N %A Fretts, Amanda %A Sotoodehnia, Nona %A Budoff, Matthew %A DiDonato, Joseph A %A McKnight, Barbara %A Tang, W H Wilson %A Psaty, Bruce M %A Siscovick, David S %A Hazen, Stanley L %A Mozaffarian, Dariush %K Animals %K Atherosclerosis %K Cardiovascular Diseases %K Carnitine %K Humans %K Meat %K Methylamines %K Risk Factors %X

BACKGROUND: Effects of animal source foods (ASF) on atherosclerotic cardiovascular disease (ASCVD) and underlying mechanisms remain controversial. We investigated prospective associations of different ASF with incident ASCVD and potential mediation by gut microbiota-generated trimethylamine N-oxide, its L-carnitine-derived intermediates γ-butyrobetaine and crotonobetaine, and traditional ASCVD risk pathways.

METHODS: Among 3931 participants from a community-based US cohort aged 65+ years, ASF intakes and trimethylamine N-oxide-related metabolites were measured serially over time. Incident ASCVD (myocardial infarction, fatal coronary heart disease, stroke, other atherosclerotic death) was adjudicated over 12.5 years median follow-up. Cox proportional hazards models with time-varying exposures and covariates examined ASF-ASCVD associations; and additive hazard models, mediation proportions by different risk pathways.

RESULTS: After multivariable-adjustment, higher intakes of unprocessed red meat, total meat, and total ASF associated with higher ASCVD risk, with hazard ratios (95% CI) per interquintile range of 1.15 (1.01-1.30), 1.22 (1.07-1.39), and 1.18 (1.03-1.34), respectively. Trimethylamine N-oxide-related metabolites together significantly mediated these associations, with mediation proportions (95% CI) of 10.6% (1.0-114.5), 7.8% (1.0-32.7), and 9.2% (2.2-44.5), respectively. Processed meat intake associated with a nonsignificant trend toward higher ASCVD (1.11 [0.98-1.25]); intakes of fish, poultry, and eggs were not significantly associated. Among other risk pathways, blood glucose, insulin, and C-reactive protein, but not blood pressure or blood cholesterol, each significantly mediated the total meat-ASCVD association.

CONCLUSIONS: In this large, community-based cohort, higher meat intake associated with incident ASCVD, partly mediated by microbiota-derived metabolites of L-carnitine, abundant in red meat. These novel findings support biochemical links between dietary meat, gut microbiome pathways, and ASCVD.

%B Arterioscler Thromb Vasc Biol %V 42 %P e273-e288 %8 2022 09 %G eng %N 9 %R 10.1161/ATVBAHA.121.316533 %0 Journal Article %J Commun Biol %D 2022 %T Differential and shared genetic effects on kidney function between diabetic and non-diabetic individuals. %A Winkler, Thomas W %A Rasheed, Humaira %A Teumer, Alexander %A Gorski, Mathias %A Rowan, Bryce X %A Stanzick, Kira J %A Thomas, Laurent F %A Tin, Adrienne %A Hoppmann, Anselm %A Chu, Audrey Y %A Tayo, Bamidele %A Thio, Chris H L %A Cusi, Daniele %A Chai, Jin-Fang %A Sieber, Karsten B %A Horn, Katrin %A Li, Man %A Scholz, Markus %A Cocca, Massimiliano %A Wuttke, Matthias %A van der Most, Peter J %A Yang, Qiong %A Ghasemi, Sahar %A Nutile, Teresa %A Li, Yong %A Pontali, Giulia %A Günther, Felix %A Dehghan, Abbas %A Correa, Adolfo %A Parsa, Afshin %A Feresin, Agnese %A de Vries, Aiko P J %A Zonderman, Alan B %A Smith, Albert V %A Oldehinkel, Albertine J %A De Grandi, Alessandro %A Rosenkranz, Alexander R %A Franke, Andre %A Teren, Andrej %A Metspalu, Andres %A Hicks, Andrew A %A Morris, Andrew P %A Tönjes, Anke %A Morgan, Anna %A Podgornaia, Anna I %A Peters, Annette %A Körner, Antje %A Mahajan, Anubha %A Campbell, Archie %A Freedman, Barry I %A Spedicati, Beatrice %A Ponte, Belen %A Schöttker, Ben %A Brumpton, Ben %A Banas, Bernhard %A Krämer, Bernhard K %A Jung, Bettina %A Åsvold, Bjørn Olav %A Smith, Blair H %A Ning, Boting %A Penninx, Brenda W J H %A Vanderwerff, Brett R %A Psaty, Bruce M %A Kammerer, Candace M %A Langefeld, Carl D %A Hayward, Caroline %A Spracklen, Cassandra N %A Robinson-Cohen, Cassianne %A Hartman, Catharina A %A Lindgren, Cecilia M %A Wang, Chaolong %A Sabanayagam, Charumathi %A Heng, Chew-Kiat %A Lanzani, Chiara %A Khor, Chiea-Chuen %A Cheng, Ching-Yu %A Fuchsberger, Christian %A Gieger, Christian %A Shaffer, Christian M %A Schulz, Christina-Alexandra %A Willer, Cristen J %A Chasman, Daniel I %A Gudbjartsson, Daniel F %A Ruggiero, Daniela %A Toniolo, Daniela %A Czamara, Darina %A Porteous, David J %A Waterworth, Dawn M %A Mascalzoni, Deborah %A Mook-Kanamori, Dennis O %A Reilly, Dermot F %A Daw, E Warwick %A Hofer, Edith %A Boerwinkle, Eric %A Salvi, Erika %A Bottinger, Erwin P %A Tai, E-Shyong %A Catamo, Eulalia %A Rizzi, Federica %A Guo, Feng %A Rivadeneira, Fernando %A Guilianini, Franco %A Sveinbjornsson, Gardar %A Ehret, Georg %A Waeber, Gérard %A Biino, Ginevra %A Girotto, Giorgia %A Pistis, Giorgio %A Nadkarni, Girish N %A Delgado, Graciela E %A Montgomery, Grant W %A Snieder, Harold %A Campbell, Harry %A White, Harvey D %A Gao, He %A Stringham, Heather M %A Schmidt, Helena %A Li, Hengtong %A Brenner, Hermann %A Holm, Hilma %A Kirsten, Holgen %A Kramer, Holly %A Rudan, Igor %A Nolte, Ilja M %A Tzoulaki, Ioanna %A Olafsson, Isleifur %A Martins, Jade %A Cook, James P %A Wilson, James F %A Halbritter, Jan %A Felix, Janine F %A Divers, Jasmin %A Kooner, Jaspal S %A Lee, Jeannette Jen-Mai %A O'Connell, Jeffrey %A Rotter, Jerome I %A Liu, Jianjun %A Xu, Jie %A Thiery, Joachim %A Arnlöv, Johan %A Kuusisto, Johanna %A Jakobsdottir, Johanna %A Tremblay, Johanne %A Chambers, John C %A Whitfield, John B %A Gaziano, John M %A Marten, Jonathan %A Coresh, Josef %A Jonas, Jost B %A Mychaleckyj, Josyf C %A Christensen, Kaare %A Eckardt, Kai-Uwe %A Mohlke, Karen L %A Endlich, Karlhans %A Dittrich, Katalin %A Ryan, Kathleen A %A Rice, Kenneth M %A Taylor, Kent D %A Ho, Kevin %A Nikus, Kjell %A Matsuda, Koichi %A Strauch, Konstantin %A Miliku, Kozeta %A Hveem, Kristian %A Lind, Lars %A Wallentin, Lars %A Yerges-Armstrong, Laura M %A Raffield, Laura M %A Phillips, Lawrence S %A Launer, Lenore J %A Lyytikäinen, Leo-Pekka %A Lange, Leslie A %A Citterio, Lorena %A Klaric, Lucija %A Ikram, M Arfan %A Ising, Marcus %A Kleber, Marcus E %A Francescatto, Margherita %A Concas, Maria Pina %A Ciullo, Marina %A Piratsu, Mario %A Orho-Melander, Marju %A Laakso, Markku %A Loeffler, Markus %A Perola, Markus %A de Borst, Martin H %A Gögele, Martin %A Bianca, Martina La %A Lukas, Mary Ann %A Feitosa, Mary F %A Biggs, Mary L %A Wojczynski, Mary K %A Kavousi, Maryam %A Kanai, Masahiro %A Akiyama, Masato %A Yasuda, Masayuki %A Nauck, Matthias %A Waldenberger, Melanie %A Chee, Miao-Li %A Chee, Miao-Ling %A Boehnke, Michael %A Preuss, Michael H %A Stumvoll, Michael %A Province, Michael A %A Evans, Michele K %A O'Donoghue, Michelle L %A Kubo, Michiaki %A Kähönen, Mika %A Kastarinen, Mika %A Nalls, Mike A %A Kuokkanen, Mikko %A Ghanbari, Mohsen %A Bochud, Murielle %A Josyula, Navya Shilpa %A Martin, Nicholas G %A Tan, Nicholas Y Q %A Palmer, Nicholette D %A Pirastu, Nicola %A Schupf, Nicole %A Verweij, Niek %A Hutri-Kähönen, Nina %A Mononen, Nina %A Bansal, Nisha %A Devuyst, Olivier %A Melander, Olle %A Raitakari, Olli T %A Polasek, Ozren %A Manunta, Paolo %A Gasparini, Paolo %A Mishra, Pashupati P %A Sulem, Patrick %A Magnusson, Patrik K E %A Elliott, Paul %A Ridker, Paul M %A Hamet, Pavel %A Svensson, Per O %A Joshi, Peter K %A Kovacs, Peter %A Pramstaller, Peter P %A Rossing, Peter %A Vollenweider, Peter %A van der Harst, Pim %A Dorajoo, Rajkumar %A Sim, Ralene Z H %A Burkhardt, Ralph %A Tao, Ran %A Noordam, Raymond %A Mägi, Reedik %A Schmidt, Reinhold %A de Mutsert, Renée %A Rueedi, Rico %A van Dam, Rob M %A Carroll, Robert J %A Gansevoort, Ron T %A Loos, Ruth J F %A Felicita, Sala Cinzia %A Sedaghat, Sanaz %A Padmanabhan, Sandosh %A Freitag-Wolf, Sandra %A Pendergrass, Sarah A %A Graham, Sarah E %A Gordon, Scott D %A Hwang, Shih-Jen %A Kerr, Shona M %A Vaccargiu, Simona %A Patil, Snehal B %A Hallan, Stein %A Bakker, Stephan J L %A Lim, Su-Chi %A Lucae, Susanne %A Vogelezang, Suzanne %A Bergmann, Sven %A Corre, Tanguy %A Ahluwalia, Tarunveer S %A Lehtimäki, Terho %A Boutin, Thibaud S %A Meitinger, Thomas %A Wong, Tien-Yin %A Bergler, Tobias %A Rabelink, Ton J %A Esko, Tõnu %A Haller, Toomas %A Thorsteinsdottir, Unnur %A Völker, Uwe %A Foo, Valencia Hui Xian %A Salomaa, Veikko %A Vitart, Veronique %A Giedraitis, Vilmantas %A Gudnason, Vilmundur %A Jaddoe, Vincent W V %A Huang, Wei %A Zhang, Weihua %A Wei, Wen Bin %A Kiess, Wieland %A März, Winfried %A Koenig, Wolfgang %A Lieb, Wolfgang %A Gào, Xīn %A Sim, Xueling %A Wang, Ya Xing %A Friedlander, Yechiel %A Tham, Yih-Chung %A Kamatani, Yoichiro %A Okada, Yukinori %A Milaneschi, Yuri %A Yu, Zhi %A Stark, Klaus J %A Stefansson, Kari %A Böger, Carsten A %A Hung, Adriana M %A Kronenberg, Florian %A Köttgen, Anna %A Pattaro, Cristian %A Heid, Iris M %K Creatinine %K Diabetes Mellitus %K Diabetic Nephropathies %K Genome-Wide Association Study %K Glomerular Filtration Rate %K Humans %K Kidney %X

Reduced glomerular filtration rate (GFR) can progress to kidney failure. Risk factors include genetics and diabetes mellitus (DM), but little is known about their interaction. We conducted genome-wide association meta-analyses for estimated GFR based on serum creatinine (eGFR), separately for individuals with or without DM (n = 178,691, n = 1,296,113). Our genome-wide searches identified (i) seven eGFR loci with significant DM/noDM-difference, (ii) four additional novel loci with suggestive difference and (iii) 28 further novel loci (including CUBN) by allowing for potential difference. GWAS on eGFR among DM individuals identified 2 known and 27 potentially responsible loci for diabetic kidney disease. Gene prioritization highlighted 18 genes that may inform reno-protective drug development. We highlight the existence of DM-only and noDM-only effects, which can inform about the target group, if respective genes are advanced as drug targets. Largely shared effects suggest that most drug interventions to alter eGFR should be effective in DM and noDM.

%B Commun Biol %V 5 %P 580 %8 2022 Jun 13 %G eng %N 1 %R 10.1038/s42003-022-03448-z %0 Journal Article %J Nat Commun %D 2022 %T {DNA methylation signature of chronic low-grade inflammation and its role in cardio-respiratory diseases %A Wielscher, M. %A Mandaviya, P. R. %A Kuehnel, B. %A Joehanes, R. %A Mustafa, R. %A Robinson, O. %A Zhang, Y. %A Bodinier, B. %A Walton, E. %A Mishra, P. P. %A Schlosser, P. %A Wilson, R. %A Tsai, P. C. %A Palaniswamy, S. %A Marioni, R. E. %A Fiorito, G. %A Cugliari, G. %A Karhunen, V. %A Ghanbari, M. %A Psaty, B. M. %A Loh, M. %A Bis, J. C. %A Lehne, B. %A Sotoodehnia, N. %A Deary, I. J. %A Chadeau-Hyam, M. %A Brody, J. A. %A Cardona, A. %A Selvin, E. %A Smith, A. K. %A Miller, A. H. %A Torres, M. A. %A Marouli, E. %A Gào, X. %A van Meurs, J. B. J. %A Graf-Schindler, J. %A Rathmann, W. %A Koenig, W. %A Peters, A. %A Weninger, W. %A Farlik, M. %A Zhang, T. %A Chen, W. %A Xia, Y. %A Teumer, A. %A Nauck, M. %A Grabe, H. J. %A Doerr, M. %A Lehtimäki, T. %A Guan, W. %A Milani, L. %A Tanaka, T. %A Fisher, K. %A Waite, L. L. %A Kasela, S. %A Vineis, P. %A Verweij, N. %A van der Harst, P. %A Iacoviello, L. %A Sacerdote, C. %A Panico, S. %A Krogh, V. %A Tumino, R. %A Tzala, E. %A Matullo, G. %A Hurme, M. A. %A Raitakari, O. T. %A Colicino, E. %A Baccarelli, A. A. %A Kähönen, M. %A Herzig, K. H. %A Li, S. %A Conneely, K. N. %A Kooner, J. S. %A Köttgen, A. %A Heijmans, B. T. %A Deloukas, P. %A Relton, C. %A Ong, K. K. %A Bell, J. T. %A Boerwinkle, E. %A Elliott, P. %A Brenner, H. %A Beekman, M. %A Levy, D. %A Waldenberger, M. %A Chambers, J. C. %A Dehghan, A. %A Jarvelin, M. R. %X We performed a multi-ethnic Epigenome Wide Association study on 22,774 individuals to describe the DNA methylation signature of chronic low-grade inflammation as measured by C-Reactive protein (CRP). We find 1,511 independent differentially methylated loci associated with CRP. These CpG sites show correlation structures across chromosomes, and are primarily situated in euchromatin, depleted in CpG islands. These genomic loci are predominantly situated in transcription factor binding sites and genomic enhancer regions. Mendelian randomization analysis suggests altered CpG methylation is a consequence of increased blood CRP levels. Mediation analysis reveals obesity and smoking as important underlying driving factors for changed CpG methylation. Finally, we find that an activated CpG signature significantly increases the risk for cardiometabolic diseases and COPD. %B Nat Commun %V 13 %P 2408 %8 05 %G eng %0 Journal Article %J Nat Commun %D 2022 %T Endophenotype effect sizes support variant pathogenicity in monogenic disease susceptibility genes. %A Halford, Jennifer L %A Morrill, Valerie N %A Choi, Seung Hoan %A Jurgens, Sean J %A Melloni, Giorgio %A Marston, Nicholas A %A Weng, Lu-Chen %A Nauffal, Victor %A Hall, Amelia W %A Gunn, Sophia %A Austin-Tse, Christina A %A Pirruccello, James P %A Khurshid, Shaan %A Rehm, Heidi L %A Benjamin, Emelia J %A Boerwinkle, Eric %A Brody, Jennifer A %A Correa, Adolfo %A Fornwalt, Brandon K %A Gupta, Namrata %A Haggerty, Christopher M %A Harris, Stephanie %A Heckbert, Susan R %A Hong, Charles C %A Kooperberg, Charles %A Lin, Henry J %A Loos, Ruth J F %A Mitchell, Braxton D %A Morrison, Alanna C %A Post, Wendy %A Psaty, Bruce M %A Redline, Susan %A Rice, Kenneth M %A Rich, Stephen S %A Rotter, Jerome I %A Schnatz, Peter F %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Wong, Eugene K %A Sabatine, Marc S %A Ruff, Christian T %A Lunetta, Kathryn L %A Ellinor, Patrick T %A Lubitz, Steven A %K Disease Susceptibility %K Endophenotypes %K Humans %K Long QT Syndrome %K Virulence %X

Accurate and efficient classification of variant pathogenicity is critical for research and clinical care. Using data from three large studies, we demonstrate that population-based associations between rare variants and quantitative endophenotypes for three monogenic diseases (low-density-lipoprotein cholesterol for familial hypercholesterolemia, electrocardiographic QTc interval for long QT syndrome, and glycosylated hemoglobin for maturity-onset diabetes of the young) provide evidence for variant pathogenicity. Effect sizes are associated with pathogenic ClinVar assertions (P < 0.001 for each trait) and discriminate pathogenic from non-pathogenic variants (area under the curve 0.82-0.84 across endophenotypes). An effect size threshold of ≥ 0.5 times the endophenotype standard deviation nominates up to 35% of rare variants of uncertain significance or not in ClinVar in disease susceptibility genes with pathogenic potential. We propose that variant associations with quantitative endophenotypes for monogenic diseases can provide evidence supporting pathogenicity.

%B Nat Commun %V 13 %P 5106 %8 2022 08 30 %G eng %N 1 %R 10.1038/s41467-022-32009-5 %0 Journal Article %J Brain %D 2022 %T Epigenetic and integrative cross-omics analyses of cerebral white matter hyperintensities on MRI. %A Yang, Yunju %A Knol, Maria J %A Wang, Ruiqi %A Mishra, Aniket %A Liu, Dan %A Luciano, Michelle %A Teumer, Alexander %A Armstrong, Nicola %A Bis, Joshua C %A Jhun, Min A %A Li, Shuo %A Adams, Hieab H H %A Aziz, Nasir Ahmad %A Bastin, Mark E %A Bourgey, Mathieu %A Brody, Jennifer A %A Frenzel, Stefan %A Gottesman, Rebecca F %A Hosten, Norbert %A Hou, Lifang %A Kardia, Sharon L R %A Lohner, Valerie %A Marquis, Pascale %A Maniega, Susana Muñoz %A Satizabal, Claudia L %A Sorond, Farzaneh A %A Valdés Hernández, Maria C %A van Duijn, Cornelia M %A Vernooij, Meike W %A Wittfeld, Katharina %A Yang, Qiong %A Zhao, Wei %A Boerwinkle, Eric %A Levy, Daniel %A Deary, Ian J %A Jiang, Jiyang %A Mather, Karen A %A Mosley, Thomas H %A Psaty, Bruce M %A Sachdev, Perminder S %A Smith, Jennifer A %A Sotoodehnia, Nona %A DeCarli, Charles S %A Breteler, Monique M B %A Arfan Ikram, M %A Grabe, Hans J %A Wardlaw, Joanna %A Longstreth, W T %A Launer, Lenore J %A Seshadri, Sudha %A Debette, Stephanie %A Fornage, Myriam %X

Cerebral white matter hyperintensities on MRI are markers of cerebral small vessel disease, a major risk factor for dementia and stroke. Despite the successful identification of multiple genetic variants associated with this highly heritable condition, its genetic architecture remains incompletely understood. More specifically, the role of DNA methylation has received little attention. We investigated the association between white matter hyperintensity burden and DNA methylation in blood at approximately 450,000 CpG sites in 9,732 middle-aged to older adults from 14 community-based studies. Single-CpG and region-based association analyses were carried out. Functional annotation and integrative cross-omics analyses were performed to identify novel genes underlying the relationship between DNA methylation and white matter hyperintensities. We identified 12 single-CpG and 46 region-based DNA methylation associations with white matter hyperintensity burden. Our top discovery single CpG, cg24202936 (P = 7.6 × 10-8), was associated with F2 expression in blood (P = 6.4 × 10-5), and colocalized with FOLH1 expression in brain (posterior probability =0.75). Our top differentially methylated regions were in PRMT1 and in CCDC144NL-AS1, which were also represented in single-CpG associations (cg17417856 and cg06809326, respectively). Through Mendelian randomization analyses cg06809326 was putatively associated with white matter hyperintensity burden (P = 0.03) and expression of CCDC144NL-AS1 possibly mediated this association. Differentially methylated region analysis, joint epigenetic association analysis, and multi-omics colocalization analysis consistently identified a role of DNA methylation near SH3PXD2A, a locus previously identified in genome-wide association studies of white matter hyperintensities. Gene set enrichment analyses revealed functions of the identified DNA methylation loci in the blood-brain barrier and in the immune response. Integrative cross-omics analysis identified 19 key regulatory genes in two networks related to extracellular matrix organization, and lipid and lipoprotein metabolism. A drug repositioning analysis indicated antihyperlipidemic agents, more specifically peroxisome proliferator-activated receptor alpha, as possible target drugs for white matter hyperintensities. Our epigenome-wide association study and integrative cross-omics analyses implicate novel genes influencing white matter hyperintensity burden, which converged on pathways related to the immune response and to a compromised blood brain barrier possibly due to disrupted cell-cell and cell-extracellular matrix interactions. The results also suggest that antihyperlipidemic therapy may contribute to lowering risk for white matter hyperintensities possibly through protection against blood brain barrier disruption.

%B Brain %8 2022 Aug 09 %G eng %R 10.1093/brain/awac290 %0 Journal Article %J Neurology %D 2022 %T Epilepsy, Vascular Risk Factors, and Cognitive Decline in Older Adults: The Cardiovascular Health Study. %A Choi, Hyunmi %A Elkind, Mitchell S V %A Longstreth, W T %A Boehme, Amelia K %A Hafen, Rebekah %A Hoyt, Emma J %A Thacker, Evan L %K Aged %K Cognition %K Cognitive Dysfunction %K Epilepsy %K Humans %K Longitudinal Studies %K Neuropsychological Tests %K Risk Factors %X

BACKGROUND AND OBJECTIVES: Recent studies have shown that global cognitive ability tends to decline faster over time in older adults (≥65 years) with epilepsy compared with older adults without epilepsy. Scarce data exist about the role of vascular risk factors (VRFs) on cognitive course in epilepsy. We assessed whether the associations of individual VRFs with cognitive trajectory differed depending on the presence of prevalent epilepsy.

METHODS: The Cardiovascular Health Study is a population-based longitudinal cohort study of 5,888 US adults aged ≥65 years. Cognitive function was assessed annually with modified Mini-Mental State Examination (3MS; global cognitive ability) and Digit Symbol Substitution Test (DSST; information processing speed). We used linear mixed models to estimate the individual and joint associations of epilepsy and VRFs with cognitive decline by modeling epilepsy × VRF interactions one by one, each adjusted for all other VRFs considered, including demographics, health behaviors, clinical characteristics, and comorbid diagnoses. From these models, we estimated excess mean cognitive decline due to interaction of epilepsy with each VRF.

RESULTS: We observed excess mean decline in global cognitive ability (3MS) due to interactions of epilepsy with hypertension (6.6 points greater mean 8-year decline than expected if no interaction; 95% CI 1.3-12.0) and with abstaining from alcohol (5.8 points greater than expected; 95% CI 0.3-11.3). We also observed excess mean decline in information processing speed (DSST) due to interactions of epilepsy with prior stroke (18.1 points greater mean 9-year decline than expected; 95% CI 7.6-28.5), with abstaining from alcohol (6.1 points greater than expected; 95% CI 2.5-9.8), and with higher triglyceride levels (2.4 points greater than expected per SD; 95% CI 0.4-4.3).

DISCUSSION: Associations of some VRFs with cognitive decline in older adults are stronger in the presence of epilepsy, suggesting a need for greater attention to vascular protection for preserving brain health in older adults with epilepsy.

%B Neurology %V 99 %P e2346-e2358 %8 2022 Nov 22 %G eng %N 21 %R 10.1212/WNL.0000000000201187 %0 Journal Article %J Brief Bioinform %D 2022 %T eSCAN: scan regulatory regions for aggregate association testing using whole-genome sequencing data. %A Yang, Yingxi %A Sun, Quan %A Huang, Le %A Broome, Jai G %A Correa, Adolfo %A Reiner, Alexander %A Raffield, Laura M %A Yang, Yuchen %A Li, Yun %K Genome %K Genome-Wide Association Study %K Genomics %K Regulatory Sequences, Nucleic Acid %K Whole Genome Sequencing %X

Multiple statistical methods for aggregate association testing have been developed for whole-genome sequencing (WGS) data. Many aggregate variants in a given genomic window and ignore existing knowledge to define test regions, resulting in many identified regions not clearly linked to genes, and thus, limiting biological understanding. Functional information from new technologies (such as Hi-C and its derivatives), which can help link enhancers to their effector genes, can be leveraged to predefine variant sets for aggregate testing in WGS data. Here, we propose the eSCAN (scan the enhancers) method for genome-wide assessment of enhancer regions in sequencing studies, combining the advantages of dynamic window selection in SCANG (SCAN the Genome), a previously developed method, with the advantages of incorporating putative regulatory regions from annotation. eSCAN, by searching in putative enhancers, increases statistical power and aids mechanistic interpretation, as demonstrated by extensive simulation studies. We also apply eSCAN for blood cell traits using NHLBI Trans-Omics for Precision Medicine WGS data. Results from real data analysis show that eSCAN is able to capture more significant signals, and these signals are of shorter length (indicating higher resolution fine-mapping capability) and drive association of larger regions detected by other methods.

%B Brief Bioinform %V 23 %8 2022 01 17 %G eng %N 1 %R 10.1093/bib/bbab497 %0 Journal Article %J Nutr Metab Cardiovasc Dis %D 2022 %T Fishing for health: Neighborhood variation in fish intake, fish quality and association with stroke risk among older adults in the Cardiovascular Health Study. %A Liang, Li-Jung %A Casillas, Alejandra %A Longstreth, W T %A PhanVo, Lynn %A Vassar, Stefanie D %A Brown, Arleen F %X

BACKGROUND AND AIMS: Fish consumption has been associated with better health outcomes. Dietary patterns may vary substantially by neighborhood of residence. However, it is unclear if the benefits of a healthy diet are equivalent in different communities. This study examines associations of fish consumption with stroke incidence and stroke risk factors, and whether these differ by neighborhood socioeconomic status (NSES).

METHODS AND RESULTS: We studied 4007 participants in the Cardiovascular Health Study who were 65 years or older and recruited between 1989 and 1990 from 4 US communities. Outcomes included fish consumption type (bakes/broiled vs. fried) and frequency, stroke incidence, and stroke risk factors. Multilevel regressions models were used to estimate fish consumption associations with clinical outcomes. Lower NSES was associated with higher consumption of fried fish (aOR = 1.47, 95% CI: 1.10-1.98) and lower consumption of non-fried fish (0.64, 0.47-0.86). Frequent fried fish (11.9 vs. 9.2 person-years for at least once weekly vs. less than once a month, respectively) and less frequent non-fried fish (17.7 vs. 9.6 person-years for less than once a month vs. at least once weekly, respectively) were independently associated with an increased risk of stroke (p-values < 0.05). However, among those with similar levels of healthy fish consumption, residents with low NSES had less benefit on stroke risk reduction, compared with high NSES.

CONCLUSION: Fish consumption type and frequency both impact stroke risk. Benefits of healthy fish consumption differ by neighborhood socioeconomic status.

%B Nutr Metab Cardiovasc Dis %8 2022 Mar 12 %G eng %R 10.1016/j.numecd.2022.03.005 %0 Journal Article %J Nat Methods %D 2022 %T A framework for detecting noncoding rare-variant associations of large-scale whole-genome sequencing studies. %A Li, Zilin %A Li, Xihao %A Zhou, Hufeng %A Gaynor, Sheila M %A Selvaraj, Margaret Sunitha %A Arapoglou, Theodore %A Quick, Corbin %A Liu, Yaowu %A Chen, Han %A Sun, Ryan %A Dey, Rounak %A Arnett, Donna K %A Auer, Paul L %A Bielak, Lawrence F %A Bis, Joshua C %A Blackwell, Thomas W %A Blangero, John %A Boerwinkle, Eric %A Bowden, Donald W %A Brody, Jennifer A %A Cade, Brian E %A Conomos, Matthew P %A Correa, Adolfo %A Cupples, L Adrienne %A Curran, Joanne E %A de Vries, Paul S %A Duggirala, Ravindranath %A Franceschini, Nora %A Freedman, Barry I %A Göring, Harald H H %A Guo, Xiuqing %A Kalyani, Rita R %A Kooperberg, Charles %A Kral, Brian G %A Lange, Leslie A %A Lin, Bridget M %A Manichaikul, Ani %A Manning, Alisa K %A Martin, Lisa W %A Mathias, Rasika A %A Meigs, James B %A Mitchell, Braxton D %A Montasser, May E %A Morrison, Alanna C %A Naseri, Take %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Peyser, Patricia A %A Psaty, Bruce M %A Raffield, Laura M %A Redline, Susan %A Reiner, Alexander P %A Reupena, Muagututi'a Sefuiva %A Rice, Kenneth M %A Rich, Stephen S %A Smith, Jennifer A %A Taylor, Kent D %A Taub, Margaret A %A Vasan, Ramachandran S %A Weeks, Daniel E %A Wilson, James G %A Yanek, Lisa R %A Zhao, Wei %A Rotter, Jerome I %A Willer, Cristen J %A Natarajan, Pradeep %A Peloso, Gina M %A Lin, Xihong %K Genetic Variation %K Genome %K Genome-Wide Association Study %K Humans %K Phenotype %K Whole Genome Sequencing %X

Large-scale whole-genome sequencing studies have enabled analysis of noncoding rare-variant (RV) associations with complex human diseases and traits. Variant-set analysis is a powerful approach to study RV association. However, existing methods have limited ability in analyzing the noncoding genome. We propose a computationally efficient and robust noncoding RV association detection framework, STAARpipeline, to automatically annotate a whole-genome sequencing study and perform flexible noncoding RV association analysis, including gene-centric analysis and fixed window-based and dynamic window-based non-gene-centric analysis by incorporating variant functional annotations. In gene-centric analysis, STAARpipeline uses STAAR to group noncoding variants based on functional categories of genes and incorporate multiple functional annotations. In non-gene-centric analysis, STAARpipeline uses SCANG-STAAR to incorporate dynamic window sizes and multiple functional annotations. We apply STAARpipeline to identify noncoding RV sets associated with four lipid traits in 21,015 discovery samples from the Trans-Omics for Precision Medicine (TOPMed) program and replicate several of them in an additional 9,123 TOPMed samples. We also analyze five non-lipid TOPMed traits.

%B Nat Methods %V 19 %P 1599-1611 %8 2022 Dec %G eng %N 12 %R 10.1038/s41592-022-01640-x %0 Journal Article %J Am J Ophthalmol %D 2022 %T {Gene Set Enrichment Analsyes Identify Pathways Involved in Genetic Risk for Diabetic Retinopathy %A Sobrin, L. %A Susarla, G. %A Stanwyck, L. %A Rouhana, J. M. %A Li, A. %A Pollack, S. %A Igo, R. P. %A Jensen, R. A. %A Li, X. %A Ng, M. C. Y. %A Smith, A. V. %A Kuo, J. Z. %A Taylor, K. D. %A Freedman, B. I. %A Bowden, D. W. %A Penman, A. %A Chen, C. J. %A Craig, J. E. %A Adler, S. G. %A Chew, E. Y. %A Cotch, M. F. %A Yaspan, B. %A Mitchell, P. %A Wang, J. J. %A Klein, B. E. K. %A Wong, T. Y. %A Rotter, J. I. %A Burdon, K. P. %A Iyengar, S. K. %A Segrè, A. V. %X {To identify functionally related genes associated with diabetic retinopathy (DR) risk using gene set enrichment analyses applied to genome-wide association study meta-analyses.\ .05.\ .05) in the other method. These pathways were regulation of the lipid catabolic process (2-fold enrichment %B Am J Ophthalmol %V 233 %P 111–123 %8 01 %G eng %0 Journal Article %J Brain %D 2022 %T {Gene-mapping study of extremes of cerebral small vessel disease reveals TRIM47 as a strong candidate %A Mishra, A. %A Duplaà, C. %A Vojinovic, D. %A Suzuki, H. %A Sargurupremraj, M. %A Zilhao, N. R. %A Li, S. %A Bartz, T. M. %A Jian, X. %A Zhao, W. %A Hofer, E. %A Wittfeld, K. %A Harris, S. E. %A van der Auwera-Palitschka, S. %A Luciano, M. %A Bis, J. C. %A Adams, H. H. H. %A Satizabal, C. L. %A Gottesman, R. F. %A Gampawar, P. G. %A Bülow, R. %A Weiss, S. %A Yu, M. %A Bastin, M. E. %A Lopez, O. L. %A Vernooij, M. W. %A Beiser, A. S. %A Völker, U. %A Kacprowski, T. %A Soumare, A. %A Smith, J. A. %A Knopman, D. S. %A Morris, Z. %A Zhu, Y. %A Rotter, J. I. %A Dufouil, C. %A Valdés Hernández, M. %A Muñoz Maniega, S. %A Lathrop, M. %A Boerwinkle, E. %A Schmidt, R. %A Ihara, M. %A Mazoyer, B. %A Yang, Q. %A Joutel, A. %A Tournier-Lasserve, E. %A Launer, L. J. %A Deary, I. J. %A Mosley, T. H. %A Amouyel, P. %A DeCarli, C. S. %A Psaty, B. M. %A Tzourio, C. %A Kardia, S. L. R. %A Grabe, H. J. %A Teumer, A. %A van Duijn, C. M. %A Schmidt, H. %A Wardlaw, J. M. %A Ikram, M. A. %A Fornage, M. %A Gudnason, V. %A Seshadri, S. %A Matthews, P. M. %A Longstreth, W. T. %A Couffinhal, T. %A Debette, S. %X Cerebral small vessel disease is a leading cause of stroke and a major contributor to cognitive decline and dementia, but our understanding of specific genes underlying the cause of sporadic cerebral small vessel disease is limited. We report a genome-wide association study and a whole-exome association study on a composite extreme phenotype of cerebral small vessel disease derived from its most common MRI features: white matter hyperintensities and lacunes. Seventeen population-based cohorts of older persons with MRI measurements and genome-wide genotyping (n = 41 326), whole-exome sequencing (n = 15 965), or exome chip (n = 5249) data contributed 13 776 and 7079 extreme small vessel disease samples for the genome-wide association study and whole-exome association study, respectively. The genome-wide association study identified significant association of common variants in 11 loci with extreme small vessel disease, of which the chr12q24.11 locus was not previously reported to be associated with any MRI marker of cerebral small vessel disease. The whole-exome association study identified significant associations of extreme small vessel disease with common variants in the 5' UTR region of EFEMP1 (chr2p16.1) and one probably damaging common missense variant in TRIM47 (chr17q25.1). Mendelian randomization supports the causal association of extensive small vessel disease severity with increased risk of stroke and Alzheimer's disease. Combined evidence from summary-based Mendelian randomization studies and profiling of human loss-of-function allele carriers showed an inverse relation between TRIM47 expression in the brain and blood vessels and extensive small vessel disease severity. We observed significant enrichment of Trim47 in isolated brain vessel preparations compared to total brain fraction in mice, in line with the literature showing Trim47 enrichment in brain endothelial cells at single cell level. Functional evaluation of TRIM47 by small interfering RNAs-mediated knockdown in human brain endothelial cells showed increased endothelial permeability, an important hallmark of cerebral small vessel disease pathology. Overall, our comprehensive gene-mapping study and preliminary functional evaluation suggests a putative role of TRIM47 in the pathophysiology of cerebral small vessel disease, making it an important candidate for extensive in vivo explorations and future translational work. %B Brain %V 145 %P 1992–2007 %8 Jun %G eng %0 Journal Article %J Nat Commun %D 2022 %T {Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways %A Young, W. J. %A Lahrouchi, N. %A Isaacs, A. %A Duong, T. %A Foco, L. %A Ahmed, F. %A Brody, J. A. %A Salman, R. %A Noordam, R. %A Benjamins, J. W. %A Haessler, J. %A Lyytikäinen, L. P. %A Repetto, L. %A Concas, M. P. %A van den Berg, M. E. %A Weiss, S. %A Baldassari, A. R. %A Bartz, T. M. %A Cook, J. P. %A Evans, D. S. %A Freudling, R. %A Hines, O. %A Isaksen, J. L. %A Lin, H. %A Mei, H. %A Moscati, A. %A Müller-Nurasyid, M. %A Nursyifa, C. %A Qian, Y. %A Richmond, A. %A Roselli, C. %A Ryan, K. A. %A Tarazona-Santos, E. %A Thériault, S. %A van Duijvenboden, S. %A Warren, H. R. %A Yao, J. %A Raza, D. %A Aeschbacher, S. %A Ahlberg, G. %A Alonso, A. %A Andreasen, L. %A Bis, J. C. %A Boerwinkle, E. %A Campbell, A. %A Catamo, E. %A Cocca, M. %A Cutler, M. J. %A Darbar, D. %A De Grandi, A. %A De Luca, A. %A Ding, J. %A Ellervik, C. %A Ellinor, P. T. %A Felix, S. B. %A Froguel, P. %A Fuchsberger, C. %A Gögele, M. %A Graff, C. %A Graff, M. %A Guo, X. %A Hansen, T. %A Heckbert, S. R. %A Huang, P. L. %A Huikuri, H. V. %A Hutri-Kähönen, N. %A Ikram, M. A. %A Jackson, R. D. %A Junttila, J. %A Kavousi, M. %A Kors, J. A. %A Leal, T. P. %A Lemaitre, R. N. %A Lin, H. J. %A Lind, L. %A Linneberg, A. %A Liu, S. %A Macfarlane, P. W. %A Mangino, M. %A Meitinger, T. %A Mezzavilla, M. %A Mishra, P. P. %A Mitchell, R. N. %A Mononen, N. %A Montasser, M. E. %A Morrison, A. C. %A Nauck, M. %A Nauffal, V. %A Navarro, P. %A Nikus, K. %A Pare, G. %A Patton, K. K. %A Pelliccione, G. %A Pittman, A. %A Porteous, D. J. %A Pramstaller, P. P. %A Preuss, M. H. %A Raitakari, O. T. %A Reiner, A. P. %A Ribeiro, A. L. P. %A Rice, K. M. %A Risch, L. %A Schlessinger, D. %A Schotten, U. %A Schurmann, C. %A Shen, X. %A Shoemaker, M. B. %A Sinagra, G. %A Sinner, M. F. %A Soliman, E. Z. %A Stoll, M. %A Strauch, K. %A Tarasov, K. %A Taylor, K. D. %A Tinker, A. %A Trompet, S. %A Uitterlinden, A. %A Völker, U. %A Völzke, H. %A Waldenberger, M. %A Weng, L. C. %A Whitsel, E. A. %A Wilson, J. G. %A Avery, C. L. %A Conen, D. %A Correa, A. %A Cucca, F. %A Dörr, M. %A Gharib, S. A. %A Girotto, G. %A Grarup, N. %A Hayward, C. %A Jamshidi, Y. %A Jarvelin, M. R. %A Jukema, J. W. %A Kääb, S. %A Kähönen, M. %A Kanters, J. K. %A Kooperberg, C. %A Lehtimäki, T. %A Lima-Costa, M. F. %A Liu, Y. %A Loos, R. J. F. %A Lubitz, S. A. %A Mook-Kanamori, D. O. %A Morris, A. P. %A O'Connell, J. R. %A Olesen, M. S. %A Orini, M. %A Padmanabhan, S. %A Pattaro, C. %A Peters, A. %A Psaty, B. M. %A Rotter, J. I. %A Stricker, B. %A van der Harst, P. %A van Duijn, C. M. %A Verweij, N. %A Wilson, J. F. %A Arking, D. E. %A Ramirez, J. %A Lambiase, P. D. %A Sotoodehnia, N. %A Mifsud, B. %A Newton-Cheh, C. %A Munroe, P. B. %X 250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization. %B Nat Commun %V 13 %P 5144 %8 09 %G eng %0 Journal Article %J Hum Mol Genet %D 2022 %T {Genetic and clinical determinants of abdominal aortic diameter: genome-wide association studies, exome array data and Mendelian randomization study %A Portilla-Fernandez, E. %A Klarin, D. %A Hwang, S. J. %A Biggs, M. L. %A Bis, J. C. %A Weiss, S. %A Rospleszcz, S. %A Natarajan, P. %A Hoffmann, U. %A Rogers, I. S. %A Truong, Q. A. %A lker, U. %A rr, M. %A low, R. %A Criqui, M. H. %A Allison, M. %A Ganesh, S. K. %A Yao, J. %A Waldenberger, M. %A Bamberg, F. %A Rice, K. M. %A Essers, J. %A Kapteijn, D. M. C. %A van der Laan, S. W. %A de Knegt, R. J. %A Ghanbari, M. %A Felix, J. F. %A Ikram, M. A. %A Kavousi, M. %A Uitterlinden, A. G. %A Roks, A. J. M. %A Danser, A. H. J. %A Tsao, P. S. %A Damrauer, S. M. %A Guo, X. %A Rotter, J. I. %A Psaty, B. M. %A Kathiresan, S. %A lzke, H. %A Peters, A. %A Johnson, C. %A Strauch, K. %A Meitinger, T. %A O'Donnell, C. J. %A Dehghan, A. %X 0.0001), known risk factors for AAA, consistent with a causal association with AAD. Our findings point to new biology as well as highlighting gene regions in mechanisms that have previously been implicated in the genetics of other vascular diseases. %B Hum Mol Genet %V 31 %P 3566–3579 %8 Oct %G eng %0 Journal Article %J Kidney Int %D 2022 %T Genetic loci and prioritization of genes for kidney function decline derived from a meta-analysis of 62 longitudinal genome-wide association studies. %A Gorski, Mathias %A Rasheed, Humaira %A Teumer, Alexander %A Thomas, Laurent F %A Graham, Sarah E %A Sveinbjornsson, Gardar %A Winkler, Thomas W %A Günther, Felix %A Stark, Klaus J %A Chai, Jin-Fang %A Tayo, Bamidele O %A Wuttke, Matthias %A Li, Yong %A Tin, Adrienne %A Ahluwalia, Tarunveer S %A Arnlöv, Johan %A Åsvold, Bjørn Olav %A Bakker, Stephan J L %A Banas, Bernhard %A Bansal, Nisha %A Biggs, Mary L %A Biino, Ginevra %A Böhnke, Michael %A Boerwinkle, Eric %A Bottinger, Erwin P %A Brenner, Hermann %A Brumpton, Ben %A Carroll, Robert J %A Chaker, Layal %A Chalmers, John %A Chee, Miao-Li %A Chee, Miao-Ling %A Cheng, Ching-Yu %A Chu, Audrey Y %A Ciullo, Marina %A Cocca, Massimiliano %A Cook, James P %A Coresh, Josef %A Cusi, Daniele %A de Borst, Martin H %A Degenhardt, Frauke %A Eckardt, Kai-Uwe %A Endlich, Karlhans %A Evans, Michele K %A Feitosa, Mary F %A Franke, Andre %A Freitag-Wolf, Sandra %A Fuchsberger, Christian %A Gampawar, Piyush %A Gansevoort, Ron T %A Ghanbari, Mohsen %A Ghasemi, Sahar %A Giedraitis, Vilmantas %A Gieger, Christian %A Gudbjartsson, Daniel F %A Hallan, Stein %A Hamet, Pavel %A Hishida, Asahi %A Ho, Kevin %A Hofer, Edith %A Holleczek, Bernd %A Holm, Hilma %A Hoppmann, Anselm %A Horn, Katrin %A Hutri-Kähönen, Nina %A Hveem, Kristian %A Hwang, Shih-Jen %A Ikram, M Arfan %A Josyula, Navya Shilpa %A Jung, Bettina %A Kähönen, Mika %A Karabegović, Irma %A Khor, Chiea-Chuen %A Koenig, Wolfgang %A Kramer, Holly %A Krämer, Bernhard K %A Kuhnel, Brigitte %A Kuusisto, Johanna %A Laakso, Markku %A Lange, Leslie A %A Lehtimäki, Terho %A Li, Man %A Lieb, Wolfgang %A Lind, Lars %A Lindgren, Cecilia M %A Loos, Ruth J F %A Lukas, Mary Ann %A Lyytikäinen, Leo-Pekka %A Mahajan, Anubha %A Matias-Garcia, Pamela R %A Meisinger, Christa %A Meitinger, Thomas %A Melander, Olle %A Milaneschi, Yuri %A Mishra, Pashupati P %A Mononen, Nina %A Morris, Andrew P %A Mychaleckyj, Josyf C %A Nadkarni, Girish N %A Naito, Mariko %A Nakatochi, Masahiro %A Nalls, Mike A %A Nauck, Matthias %A Nikus, Kjell %A Ning, Boting %A Nolte, Ilja M %A Nutile, Teresa %A O'Donoghue, Michelle L %A O'Connell, Jeffrey %A Olafsson, Isleifur %A Orho-Melander, Marju %A Parsa, Afshin %A Pendergrass, Sarah A %A Penninx, Brenda W J H %A Pirastu, Mario %A Preuss, Michael H %A Psaty, Bruce M %A Raffield, Laura M %A Raitakari, Olli T %A Rheinberger, Myriam %A Rice, Kenneth M %A Rizzi, Federica %A Rosenkranz, Alexander R %A Rossing, Peter %A Rotter, Jerome I %A Ruggiero, Daniela %A Ryan, Kathleen A %A Sabanayagam, Charumathi %A Salvi, Erika %A Schmidt, Helena %A Schmidt, Reinhold %A Scholz, Markus %A Schöttker, Ben %A Schulz, Christina-Alexandra %A Sedaghat, Sanaz %A Shaffer, Christian M %A Sieber, Karsten B %A Sim, Xueling %A Sims, Mario %A Snieder, Harold %A Stanzick, Kira J %A Thorsteinsdottir, Unnur %A Stocker, Hannah %A Strauch, Konstantin %A Stringham, Heather M %A Sulem, Patrick %A Szymczak, Silke %A Taylor, Kent D %A Thio, Chris H L %A Tremblay, Johanne %A Vaccargiu, Simona %A van der Harst, Pim %A van der Most, Peter J %A Verweij, Niek %A Völker, Uwe %A Wakai, Kenji %A Waldenberger, Melanie %A Wallentin, Lars %A Wallner, Stefan %A Wang, Judy %A Waterworth, Dawn M %A White, Harvey D %A Willer, Cristen J %A Wong, Tien-Yin %A Woodward, Mark %A Yang, Qiong %A Yerges-Armstrong, Laura M %A Zimmermann, Martina %A Zonderman, Alan B %A Bergler, Tobias %A Stefansson, Kari %A Böger, Carsten A %A Pattaro, Cristian %A Köttgen, Anna %A Kronenberg, Florian %A Heid, Iris M %X

Estimated glomerular filtration rate (eGFR) reflects kidney function. Progressive eGFR-decline can lead to kidney failure, necessitating dialysis or transplantation. Hundreds of loci from genome-wide association studies (GWAS) for eGFR help explain population cross section variability. Since the contribution of these or other loci to eGFR-decline remains largely unknown, we derived GWAS for annual eGFR-decline and meta-analyzed 62 longitudinal studies with eGFR assessed twice over time in all 343,339 individuals and in high-risk groups. We also explored different covariate adjustment. Twelve genome-wide significant independent variants for eGFR-decline unadjusted or adjusted for eGFR-baseline (11 novel, one known for this phenotype), including nine variants robustly associated across models were identified. All loci for eGFR-decline were known for cross-sectional eGFR and thus distinguished a subgroup of eGFR loci. Seven of the nine variants showed variant-by-age interaction on eGFR cross section (further about 350,000 individuals), which linked genetic associations for eGFR-decline with age-dependency of genetic cross-section associations. Clinically important were two to four-fold greater genetic effects on eGFR-decline in high-risk subgroups. Five variants associated also with chronic kidney disease progression mapped to genes with functional in-silico evidence (UMOD, SPATA7, GALNTL5, TPPP). An unfavorable versus favorable nine-variant genetic profile showed increased risk odds ratios of 1.35 for kidney failure (95% confidence intervals 1.03-1.77) and 1.27 for acute kidney injury (95% confidence intervals 1.08-1.50) in over 2000 cases each, with matched controls). Thus, we provide a large data resource, genetic loci, and prioritized genes for kidney function decline, which help inform drug development pipelines revealing important insights into the age-dependency of kidney function genetics.

%B Kidney Int %8 2022 Jun 16 %G eng %R 10.1016/j.kint.2022.05.021 %0 Journal Article %J Circ Res %D 2022 %T Genome Wide Association Studies of Variant-by-Thiazide Interaction on Lipids Identifies a Novel Low-Density Lipoprotein Cholesterol Locus. %A Downie, Carolina G %A Highland, Heather M %A Lee, Moa P %A Raffield, Laura M %A Preuss, Michael %A Whitsel, Eric A %A Psaty, Bruce M %A Sitlani, Colleen M %A Graff, Mariaelisa %A Avery, Christy L %K Cholesterol, HDL %K Cholesterol, LDL %K Diuretics %K Genome-Wide Association Study %K Sodium Chloride Symporter Inhibitors %K Thiazides %K Triglycerides %B Circ Res %V 131 %P 277-279 %8 2022 Jul 22 %G eng %N 3 %R 10.1161/CIRCRESAHA.122.321120 %0 Journal Article %J iScience %D 2022 %T Genome-wide analyses identify as a susceptibility locus for premature atrial contraction frequency. %A Thériault, Sébastien %A Imboden, Medea %A Biggs, Mary L %A Austin, Thomas R %A Aeschbacher, Stefanie %A Schaffner, Emmanuel %A Brody, Jennifer A %A Bartz, Traci M %A Risch, Martin %A Grossmann, Kirsten %A Lin, Henry J %A Soliman, Elsayed Z %A Post, Wendy S %A Risch, Lorenz %A Krieger, Jose E %A Pereira, Alexandre C %A Heckbert, Susan R %A Sotoodehnia, Nona %A Probst-Hensch, Nicole M %A Conen, David %X

Premature atrial contractions (PACs) are frequently observed on electrocardiograms and are associated with increased risks of atrial fibrillation (AF), stroke, and mortality. In this study, we aimed to identify genetic susceptibility loci for PAC frequency. We performed a genome-wide association study meta-analysis with PAC frequency obtained from ambulatory cardiac monitoring in 4,831 individuals of European ancestry. We identified a genome-wide significant locus at the gene. The lead variant, rs7373862, located in an intron of , was associated with an increase of 0.12 [95% CI 0.08-0.16] standard deviations of the normalized PAC frequency per risk allele. Among genetic variants previously associated with AF, there was a significant enrichment in concordance of effect for PAC frequency (n = 73/106, p = 5.1 × 10). However, several AF risk loci, including , were not associated with PAC frequency. These findings suggest the existence of both shared and distinct genetic mechanisms for PAC frequency and AF.

%B iScience %V 25 %P 105210 %8 2022 Oct 21 %G eng %N 10 %R 10.1016/j.isci.2022.105210 %0 Journal Article %J Hum Genet %D 2022 %T {Genome-wide analysis of mitochondrial DNA copy number reveals loci implicated in nucleotide metabolism, platelet activation, and megakaryocyte proliferation %A Longchamps, R. J. %A Yang, S. Y. %A Castellani, C. A. %A Shi, W. %A Lane, J. %A Grove, M. L. %A Bartz, T. M. %A Sarnowski, C. %A Liu, C. %A Burrows, K. %A Guyatt, A. L. %A Gaunt, T. R. %A Kacprowski, T. %A Yang, J. %A De Jager, P. L. %A Yu, L. %A Bergman, A. %A Xia, R. %A Fornage, M. %A Feitosa, M. F. %A Wojczynski, M. K. %A Kraja, A. T. %A Province, M. A. %A Amin, N. %A Rivadeneira, F. %A Tiemeier, H. %A Uitterlinden, A. G. %A Broer, L. %A van Meurs, J. B. J. %A van Duijn, C. M. %A Raffield, L. M. %A Lange, L. %A Rich, S. S. %A Lemaitre, R. N. %A Goodarzi, M. O. %A Sitlani, C. M. %A Mak, A. C. Y. %A Bennett, D. A. %A Rodriguez, S. %A Murabito, J. M. %A Lunetta, K. L. %A Sotoodehnia, N. %A Atzmon, G. %A Ye, K. %A Barzilai, N. %A Brody, J. A. %A Psaty, B. M. %A Taylor, K. D. %A Rotter, J. I. %A Boerwinkle, E. %A Pankratz, N. %A Arking, D. E. %X ). %B Hum Genet %V 141 %P 127–146 %8 Jan %G eng %0 Journal Article %J Mol Psychiatry %D 2022 %T Genome-wide meta-analyses reveal novel loci for verbal short-term memory and learning. %A Lahti, Jari %A Tuominen, Samuli %A Yang, Qiong %A Pergola, Giulio %A Ahmad, Shahzad %A Amin, Najaf %A Armstrong, Nicola J %A Beiser, Alexa %A Bey, Katharina %A Bis, Joshua C %A Boerwinkle, Eric %A Bressler, Jan %A Campbell, Archie %A Campbell, Harry %A Chen, Qiang %A Corley, Janie %A Cox, Simon R %A Davies, Gail %A De Jager, Philip L %A Derks, Eske M %A Faul, Jessica D %A Fitzpatrick, Annette L %A Fohner, Alison E %A Ford, Ian %A Fornage, Myriam %A Gerring, Zachary %A Grabe, Hans J %A Grodstein, Francine %A Gudnason, Vilmundur %A Simonsick, Eleanor %A Holliday, Elizabeth G %A Joshi, Peter K %A Kajantie, Eero %A Kaprio, Jaakko %A Karell, Pauliina %A Kleineidam, Luca %A Knol, Maria J %A Kochan, Nicole A %A Kwok, John B %A Leber, Markus %A Lam, Max %A Lee, Teresa %A Li, Shuo %A Loukola, Anu %A Luck, Tobias %A Marioni, Riccardo E %A Mather, Karen A %A Medland, Sarah %A Mirza, Saira S %A Nalls, Mike A %A Nho, Kwangsik %A O'Donnell, Adrienne %A Oldmeadow, Christopher %A Painter, Jodie %A Pattie, Alison %A Reppermund, Simone %A Risacher, Shannon L %A Rose, Richard J %A Sadashivaiah, Vijay %A Scholz, Markus %A Satizabal, Claudia L %A Schofield, Peter W %A Schraut, Katharina E %A Scott, Rodney J %A Simino, Jeannette %A Smith, Albert V %A Smith, Jennifer A %A Stott, David J %A Surakka, Ida %A Teumer, Alexander %A Thalamuthu, Anbupalam %A Trompet, Stella %A Turner, Stephen T %A van der Lee, Sven J %A Villringer, Arno %A Völker, Uwe %A Wilson, Robert S %A Wittfeld, Katharina %A Vuoksimaa, Eero %A Xia, Rui %A Yaffe, Kristine %A Yu, Lei %A Zare, Habil %A Zhao, Wei %A Ames, David %A Attia, John %A Bennett, David A %A Brodaty, Henry %A Chasman, Daniel I %A Goldman, Aaron L %A Hayward, Caroline %A Ikram, M Arfan %A Jukema, J Wouter %A Kardia, Sharon L R %A Lencz, Todd %A Loeffler, Markus %A Mattay, Venkata S %A Palotie, Aarno %A Psaty, Bruce M %A Ramirez, Alfredo %A Ridker, Paul M %A Riedel-Heller, Steffi G %A Sachdev, Perminder S %A Saykin, Andrew J %A Scherer, Martin %A Schofield, Peter R %A Sidney, Stephen %A Starr, John M %A Trollor, Julian %A Ulrich, William %A Wagner, Michael %A Weir, David R %A Wilson, James F %A Wright, Margaret J %A Weinberger, Daniel R %A Debette, Stephanie %A Eriksson, Johan G %A Mosley, Thomas H %A Launer, Lenore J %A van Duijn, Cornelia M %A Deary, Ian J %A Seshadri, Sudha %A Räikkönen, Katri %X

Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1, as well as an expected signal in the APOE/APOC1/TOMM40 region. These results replicated in an independent sample. Functional and bioinformatic analyses supported many of these loci and further implicated POC1. We showed that polygenic score for verbal learning associated with brain activation in right parieto-occipital region during working memory task. Finally, we showed genetic correlations of these memory traits with several neurocognitive and health outcomes. Our findings suggest a role of several genomic loci in verbal memory processes.

%B Mol Psychiatry %8 2022 Aug 16 %G eng %R 10.1038/s41380-022-01710-8 %0 Journal Article %J JCI Insight %D 2022 %T {Genome-wide studies reveal factors associated with circulating uromodulin and its relationships to complex diseases %A Li, Y. %A Cheng, Y. %A Consolato, F. %A Schiano, G. %A Chong, M. R. %A Pietzner, M. %A Nguyen, N. Q. H. %A Scherer, N. %A Biggs, M. L. %A Kleber, M. E. %A Haug, S. %A Göçmen, B. %A Pigeyre, M. %A Sekula, P. %A Steinbrenner, I. %A Schlosser, P. %A Joseph, C. B. %A Brody, J. A. %A Grams, M. E. %A Hayward, C. %A Schultheiss, U. T. %A Krämer, B. K. %A Kronenberg, F. %A Peters, A. %A Seissler, J. %A Steubl, D. %A Then, C. %A Wuttke, M. %A März, W. %A Eckardt, K. U. %A Gieger, C. %A Boerwinkle, E. %A Psaty, B. M. %A Coresh, J. %A Oefner, P. J. %A Pare, G. %A Langenberg, C. %A Scherberich, J. E. %A Yu, B. %A Akilesh, S. %A Devuyst, O. %A Rampoldi, L. %A Köttgen, A. %X Uromodulin (UMOD) is a major risk gene for monogenic and complex forms of kidney disease. The encoded kidney-specific protein uromodulin is highly abundant in urine and related to chronic kidney disease, hypertension, and pathogen defense. To gain insights into potential systemic roles, we performed genome-wide screens of circulating uromodulin using complementary antibody-based and aptamer-based assays. We detected 3 and 10 distinct significant loci, respectively. Integration of antibody-based results at the UMOD locus with functional genomics data (RNA-Seq, ATAC-Seq, Hi-C) of primary human kidney tissue highlighted an upstream variant with differential accessibility and transcription in uromodulin-synthesizing kidney cells as underlying the observed cis effect. Shared association patterns with complex traits, including chronic kidney disease and blood pressure, placed the PRKAG2 locus in the same pathway as UMOD. Experimental validation of the third antibody-based locus, B4GALNT2, showed that the p.Cys466Arg variant of the encoded N-acetylgalactosaminyltransferase had a loss-of-function effect leading to higher serum uromodulin levels. Aptamer-based results pointed to enzymes writing glycan marks present on uromodulin and to their receptors in the circulation, suggesting that this assay permits investigating uromodulin's complex glycosylation rather than its quantitative levels. Overall, our study provides insights into circulating uromodulin and its emerging functions. %B JCI Insight %V 7 %8 05 %G eng %0 Journal Article %J JMIR Cardio %D 2022 %T The Impact of Time Horizon on Classification Accuracy: Application of Machine Learning to Prediction of Incident Coronary Heart Disease. %A Simon, Steven %A Mandair, Divneet %A Albakri, Abdel %A Fohner, Alison %A Simon, Noah %A Lange, Leslie %A Biggs, Mary %A Mukamal, Kenneth %A Psaty, Bruce %A Rosenberg, Michael %X

BACKGROUND: Many machine learning approaches are limited to classification of outcomes rather than longitudinal prediction. One strategy to use machine learning in clinical risk prediction is to classify outcomes over a given time horizon. However, it is not well-known how to identify the optimal time horizon for risk prediction.

OBJECTIVE: In this study, we aim to identify an optimal time horizon for classification of incident myocardial infarction (MI) using machine learning approaches looped over outcomes with increasing time horizons. Additionally, we sought to compare the performance of these models with the traditional Framingham Heart Study (FHS) coronary heart disease gender-specific Cox proportional hazards regression model.

METHODS: We analyzed data from a single clinic visit of 5201 participants of a cardiovascular health study. We examined 61 variables collected from this baseline exam, including demographic and biologic data, medical history, medications, serum biomarkers, electrocardiographic, and echocardiographic data. We compared several machine learning methods (eg, random forest, L1 regression, gradient boosted decision tree, support vector machine, and k-nearest neighbor) trained to predict incident MI that occurred within time horizons ranging from 500-10,000 days of follow-up. Models were compared on a 20% held-out testing set using area under the receiver operating characteristic curve (AUROC). Variable importance was performed for random forest and L1 regression models across time points. We compared results with the FHS coronary heart disease gender-specific Cox proportional hazards regression functions.

RESULTS: There were 4190 participants included in the analysis, with 2522 (60.2%) female participants and an average age of 72.6 years. Over 10,000 days of follow-up, there were 813 incident MI events. The machine learning models were most predictive over moderate follow-up time horizons (ie, 1500-2500 days). Overall, the L1 (Lasso) logistic regression demonstrated the strongest classification accuracy across all time horizons. This model was most predictive at 1500 days follow-up, with an AUROC of 0.71. The most influential variables differed by follow-up time and model, with gender being the most important feature for the L1 regression and weight for the random forest model across all time frames. Compared with the Framingham Cox function, the L1 and random forest models performed better across all time frames beyond 1500 days.

CONCLUSIONS: In a population free of coronary heart disease, machine learning techniques can be used to predict incident MI at varying time horizons with reasonable accuracy, with the strongest prediction accuracy in moderate follow-up periods. Validation across additional populations is needed to confirm the validity of this approach in risk prediction.

%B JMIR Cardio %V 6 %P e38040 %8 2022 Nov 02 %G eng %N 2 %R 10.2196/38040 %0 Journal Article %J Genome Biol %D 2022 %T {Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis %A Kanoni, S. %A Graham, S. E. %A Wang, Y. %A Surakka, I. %A Ramdas, S. %A Zhu, X. %A Clarke, S. L. %A Bhatti, K. F. %A Vedantam, S. %A Winkler, T. W. %A Locke, A. E. %A Marouli, E. %A Zajac, G. J. M. %A Wu, K. H. %A Ntalla, I. %A Hui, Q. %A Klarin, D. %A Hilliard, A. T. %A Wang, Z. %A Xue, C. %A Thorleifsson, G. %A Helgadottir, A. %A Gudbjartsson, D. F. %A Holm, H. %A Olafsson, I. %A Hwang, M. Y. %A Han, S. %A Akiyama, M. %A Sakaue, S. %A Terao, C. %A Kanai, M. %A Zhou, W. %A Brumpton, B. M. %A Rasheed, H. %A Havulinna, A. S. %A Veturi, Y. %A Pacheco, J. A. %A Rosenthal, E. A. %A Lingren, T. %A Feng, Q. %A Kullo, I. J. %A Narita, A. %A Takayama, J. %A Martin, H. C. %A Hunt, K. A. %A Trivedi, B. %A Haessler, J. %A Giulianini, F. %A Bradford, Y. %A Miller, J. E. %A Campbell, A. %A Lin, K. %A Millwood, I. Y. %A Rasheed, A. %A Hindy, G. %A Faul, J. D. %A Zhao, W. %A Weir, D. R. %A Turman, C. %A Huang, H. %A Graff, M. %A Choudhury, A. %A Sengupta, D. %A Mahajan, A. %A Brown, M. R. %A Zhang, W. %A Yu, K. %A Schmidt, E. M. %A Pandit, A. %A Gustafsson, S. %A Yin, X. %A Luan, J. %A Zhao, J. H. %A Matsuda, F. %A Jang, H. M. %A Yoon, K. %A Medina-Gomez, C. %A Pitsillides, A. %A Hottenga, J. J. %A Wood, A. R. %A Ji, Y. %A Gao, Z. %A Haworth, S. %A Yousri, N. A. %A Mitchell, R. E. %A Chai, J. F. %A Aadahl, M. %A Bjerregaard, A. A. %A Yao, J. %A Manichaikul, A. %A Hwu, C. M. %A Hung, Y. J. %A Warren, H. R. %A Ramirez, J. %A Bork-Jensen, J. %A rhus, L. L. %A Goel, A. %A Sabater-Lleal, M. %A Noordam, R. %A Mauro, P. %A Matteo, F. %A McDaid, A. F. %A Marques-Vidal, P. %A Wielscher, M. %A Trompet, S. %A Sattar, N. %A llehave, L. T. %A Munz, M. %A Zeng, L. %A Huang, J. %A Yang, B. %A Poveda, A. %A Kurbasic, A. %A Lamina, C. %A Forer, L. %A Scholz, M. %A Galesloot, T. E. %A Bradfield, J. P. %A Ruotsalainen, S. E. %A Daw, E. %A Zmuda, J. M. %A Mitchell, J. S. %A Fuchsberger, C. %A Christensen, H. %A Brody, J. A. %A Vazquez-Moreno, M. %A Feitosa, M. F. %A Wojczynski, M. K. %A Wang, Z. %A Preuss, M. H. %A Mangino, M. %A Christofidou, P. %A Verweij, N. %A Benjamins, J. W. %A Engmann, J. %A Tsao, N. L. %A Verma, A. %A Slieker, R. C. %A Lo, K. S. %A Zilhao, N. R. %A Le, P. %A Kleber, M. E. %A Delgado, G. E. %A Huo, S. %A Ikeda, D. D. %A Iha, H. %A Yang, J. %A Liu, J. %A Demirkan, A. %A Leonard, H. L. %A Marten, J. %A Frank, M. %A Schmidt, B. %A Smyth, L. J. %A adas-Garre, M. %A Wang, C. %A Nakatochi, M. %A Wong, A. %A nen, N. %A Sim, X. %A Xia, R. %A Huerta-Chagoya, A. %A Fernandez-Lopez, J. C. %A Lyssenko, V. %A Nongmaithem, S. S. %A Bayyana, S. %A Stringham, H. M. %A Irvin, M. R. %A Oldmeadow, C. %A Kim, H. N. %A Ryu, S. %A Timmers, P. R. H. J. %A Arbeeva, L. %A Dorajoo, R. %A Lange, L. A. %A Prasad, G. %A s-Motta, L. %A Pauper, M. %A Long, J. %A Li, X. %A Theusch, E. %A Takeuchi, F. %A Spracklen, C. N. %A Loukola, A. %A Bollepalli, S. %A Warner, S. C. %A Wang, Y. X. %A Wei, W. B. %A Nutile, T. %A Ruggiero, D. %A Sung, Y. J. %A Chen, S. %A Liu, F. %A Yang, J. %A Kentistou, K. A. %A Banas, B. %A Nardone, G. G. %A Meidtner, K. %A Bielak, L. F. %A Smith, J. A. %A Hebbar, P. %A Farmaki, A. E. %A Hofer, E. %A Lin, M. %A Concas, M. P. %A Vaccargiu, S. %A van der Most, P. J. %A nen, N. %A Cade, B. E. %A van der Laan, S. W. %A Chitrala, K. N. %A Weiss, S. %A Bentley, A. R. %A Doumatey, A. P. %A Adeyemo, A. A. %A Lee, J. Y. %A Petersen, E. R. B. %A Nielsen, A. A. %A Choi, H. S. %A Nethander, M. %A Freitag-Wolf, S. %A Southam, L. %A Rayner, N. W. %A Wang, C. A. %A Lin, S. Y. %A Wang, J. S. %A Couture, C. %A inen, L. P. %A Nikus, K. %A Cuellar-Partida, G. %A Vestergaard, H. %A Hidalgo, B. %A Giannakopoulou, O. %A Cai, Q. %A Obura, M. O. %A van Setten, J. %A Li, X. %A Liang, J. %A Tang, H. %A Terzikhan, N. %A Shin, J. H. %A Jackson, R. D. %A Reiner, A. P. %A Martin, L. W. %A Chen, Z. %A Li, L. %A Kawaguchi, T. %A Thiery, J. %A Bis, J. C. %A Launer, L. J. %A Li, H. %A Nalls, M. A. %A Raitakari, O. T. %A Ichihara, S. %A Wild, S. H. %A Nelson, C. P. %A Campbell, H. %A ger, S. %A Nabika, T. %A Al-Mulla, F. %A Niinikoski, H. %A Braund, P. S. %A Kolcic, I. %A Kovacs, P. %A Giardoglou, T. %A Katsuya, T. %A de Kleijn, D. %A de Borst, G. J. %A Kim, E. K. %A Adams, H. H. H. %A Ikram, M. A. %A Zhu, X. %A Asselbergs, F. W. %A Kraaijeveld, A. O. %A Beulens, J. W. J. %A Shu, X. O. %A Rallidis, L. S. %A Pedersen, O. %A Hansen, T. %A Mitchell, P. %A Hewitt, A. W. %A nen, M. %A russe, L. %A Bouchard, C. %A njes, A. %A Chen, Y. I. %A Pennell, C. E. %A Mori, T. A. %A Lieb, W. %A Franke, A. %A Ohlsson, C. %A m, D. %A Cho, Y. S. %A Lee, H. %A Yuan, J. M. %A Koh, W. P. %A Rhee, S. Y. %A Woo, J. T. %A Heid, I. M. %A Stark, K. J. %A Zimmermann, M. E. %A lzke, H. %A Homuth, G. %A Evans, M. K. %A Zonderman, A. B. %A Polasek, O. %A Pasterkamp, G. %A Hoefer, I. E. %A Redline, S. %A Pahkala, K. %A Oldehinkel, A. J. %A Snieder, H. %A Biino, G. %A Schmidt, R. %A Schmidt, H. %A Bandinelli, S. %A Dedoussis, G. %A Thanaraj, T. A. %A Kardia, S. L. R. %A Peyser, P. A. %A Kato, N. %A Schulze, M. B. %A Girotto, G. %A ger, C. A. %A Jung, B. %A Joshi, P. K. %A Bennett, D. A. %A De Jager, P. L. %A Lu, X. %A Mamakou, V. %A Brown, M. %A Caulfield, M. J. %A Munroe, P. B. %A Guo, X. %A Ciullo, M. %A Jonas, J. B. %A Samani, N. J. %A Kaprio, J. %A Pajukanta, P. %A -Luna, T. %A Aguilar-Salinas, C. A. %A Adair, L. S. %A Bechayda, S. A. %A de Silva, H. J. %A Wickremasinghe, A. R. %A Krauss, R. M. %A Wu, J. Y. %A Zheng, W. %A Hollander, A. I. %A Bharadwaj, D. %A Correa, A. %A Wilson, J. G. %A Lind, L. %A Heng, C. K. %A Nelson, A. E. %A Golightly, Y. M. %A Wilson, J. F. %A Penninx, B. %A Kim, H. L. %A Attia, J. %A Scott, R. J. %A Rao, D. C. %A Arnett, D. K. %A Hunt, S. C. %A Walker, M. %A Koistinen, H. A. %A Chandak, G. R. %A Mercader, J. M. %A Costanzo, M. C. %A Jang, D. %A Burtt, N. P. %A Villalpando, C. G. %A Orozco, L. %A Fornage, M. %A Tai, E. %A van Dam, R. M. %A ki, T. %A Chaturvedi, N. %A Yokota, M. %A Liu, J. %A Reilly, D. F. %A McKnight, A. J. %A Kee, F. %A ckel, K. H. %A McCarthy, M. I. %A Palmer, C. N. A. %A Vitart, V. %A Hayward, C. %A Simonsick, E. %A van Duijn, C. M. %A Jin, Z. B. %A Qu, J. %A Hishigaki, H. %A Lin, X. %A rz, W. %A Gudnason, V. %A Tardif, J. C. %A Lettre, G. %A Hart, L. M. ' %A Elders, P. J. M. %A Damrauer, S. M. %A Kumari, M. %A Kivimaki, M. %A van der Harst, P. %A Spector, T. D. %A Loos, R. J. F. %A Province, M. A. %A Parra, E. J. %A Cruz, M. %A Psaty, B. M. %A Brandslund, I. %A Pramstaller, P. P. %A Rotimi, C. N. %A Christensen, K. %A Ripatti, S. %A n, E. %A Hakonarson, H. %A Grant, S. F. A. %A Kiemeney, L. A. L. M. %A de Graaf, J. %A Loeffler, M. %A Kronenberg, F. %A Gu, D. %A Erdmann, J. %A Schunkert, H. %A Franks, P. W. %A Linneberg, A. %A Jukema, J. W. %A Khera, A. V. %A ö, M. %A Jarvelin, M. R. %A Kutalik, Z. %A Francesco, C. %A Mook-Kanamori, D. O. %A van Dijk, K. W. %A Watkins, H. %A Strachan, D. P. %A Grarup, N. %A Sever, P. %A Poulter, N. %A Chuang, L. M. %A Rotter, J. I. %A Dantoft, T. M. %A Karpe, F. %A Neville, M. J. %A Timpson, N. J. %A Cheng, C. Y. %A Wong, T. Y. %A Khor, C. C. %A Li, H. %A Sabanayagam, C. %A Peters, A. %A Gieger, C. %A Hattersley, A. T. %A Pedersen, N. L. %A Magnusson, P. K. E. %A Boomsma, D. I. %A Willemsen, A. H. M. %A Cupples, L. %A van Meurs, J. B. J. %A Ghanbari, M. %A Gordon-Larsen, P. %A Huang, W. %A Kim, Y. J. %A Tabara, Y. %A Wareham, N. J. %A Langenberg, C. %A Zeggini, E. %A Kuusisto, J. %A Laakso, M. %A Ingelsson, E. %A Abecasis, G. %A Chambers, J. C. %A Kooner, J. S. %A de Vries, P. S. %A Morrison, A. C. %A Hazelhurst, S. %A Ramsay, M. %A North, K. E. %A Daviglus, M. %A Kraft, P. %A Martin, N. G. %A Whitfield, J. B. %A Abbas, S. %A Saleheen, D. %A Walters, R. G. %A Holmes, M. V. %A Black, C. %A Smith, B. H. %A Baras, A. %A Justice, A. E. %A Buring, J. E. %A Ridker, P. M. %A Chasman, D. I. %A Kooperberg, C. %A Tamiya, G. %A Yamamoto, M. %A van Heel, D. A. %A Trembath, R. C. %A Wei, W. Q. %A Jarvik, G. P. %A Namjou, B. %A Hayes, M. G. %A Ritchie, M. D. %A Jousilahti, P. %A Salomaa, V. %A Hveem, K. %A svold, B. O. %A Kubo, M. %A Kamatani, Y. %A Okada, Y. %A Murakami, Y. %A Kim, B. J. %A Thorsteinsdottir, U. %A Stefansson, K. %A Zhang, J. %A Chen, Y. %A Ho, Y. L. %A Lynch, J. A. %A Rader, D. J. %A Tsao, P. S. %A Chang, K. M. %A Cho, K. %A O'Donnell, C. J. %A Gaziano, J. M. %A Wilson, P. W. F. %A Frayling, T. M. %A Hirschhorn, J. N. %A Kathiresan, S. %A Mohlke, K. L. %A Sun, Y. V. %A Morris, A. P. %A Boehnke, M. %A Brown, C. D. %A Natarajan, P. %A Deloukas, P. %A Willer, C. J. %A Assimes, T. L. %A Peloso, G. M. %X Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery.\ 1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3-5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism.\ Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk. %B Genome Biol %V 23 %P 268 %8 Dec %G eng %0 Journal Article %J Hypertension %D 2022 %T Insights From a Large-Scale Whole-Genome Sequencing Study of Systolic Blood Pressure, Diastolic Blood Pressure, and Hypertension. %A Kelly, Tanika N %A Sun, Xiao %A He, Karen Y %A Brown, Michael R %A Taliun, Sarah A Gagliano %A Hellwege, Jacklyn N %A Irvin, Marguerite R %A Mi, Xuenan %A Brody, Jennifer A %A Franceschini, Nora %A Guo, Xiuqing %A Hwang, Shih-Jen %A de Vries, Paul S %A Gao, Yan %A Moscati, Arden %A Nadkarni, Girish N %A Yanek, Lisa R %A Elfassy, Tali %A Smith, Jennifer A %A Chung, Ren-Hua %A Beitelshees, Amber L %A Patki, Amit %A Aslibekyan, Stella %A Blobner, Brandon M %A Peralta, Juan M %A Assimes, Themistocles L %A Palmas, Walter R %A Liu, Chunyu %A Bress, Adam P %A Huang, Zhijie %A Becker, Lewis C %A Hwa, Chii-Min %A O'Connell, Jeffrey R %A Carlson, Jenna C %A Warren, Helen R %A Das, Sayantan %A Giri, Ayush %A Martin, Lisa W %A Craig Johnson, W %A Fox, Ervin R %A Bottinger, Erwin P %A Razavi, Alexander C %A Vaidya, Dhananjay %A Chuang, Lee-Ming %A Chang, Yen-Pei C %A Naseri, Take %A Jain, Deepti %A Kang, Hyun Min %A Hung, Adriana M %A Srinivasasainagendra, Vinodh %A Snively, Beverly M %A Gu, Dongfeng %A Montasser, May E %A Reupena, Muagututi'a Sefuiva %A Heavner, Benjamin D %A LeFaive, Jonathon %A Hixson, James E %A Rice, Kenneth M %A Wang, Fei Fei %A Nielsen, Jonas B %A Huang, Jianfeng %A Khan, Alyna T %A Zhou, Wei %A Nierenberg, Jovia L %A Laurie, Cathy C %A Armstrong, Nicole D %A Shi, Mengyao %A Pan, Yang %A Stilp, Adrienne M %A Emery, Leslie %A Wong, Quenna %A Hawley, Nicola L %A Minster, Ryan L %A Curran, Joanne E %A Munroe, Patricia B %A Weeks, Daniel E %A North, Kari E %A Tracy, Russell P %A Kenny, Eimear E %A Shimbo, Daichi %A Chakravarti, Aravinda %A Rich, Stephen S %A Reiner, Alex P %A Blangero, John %A Redline, Susan %A Mitchell, Braxton D %A Rao, Dabeeru C %A Ida Chen, Yii-Der %A Kardia, Sharon L R %A Kaplan, Robert C %A Mathias, Rasika A %A He, Jiang %A Psaty, Bruce M %A Fornage, Myriam %A Loos, Ruth J F %A Correa, Adolfo %A Boerwinkle, Eric %A Rotter, Jerome I %A Kooperberg, Charles %A Edwards, Todd L %A Abecasis, Goncalo R %A Zhu, Xiaofeng %A Levy, Daniel %A Arnett, Donna K %A Morrison, Alanna C %X

BACKGROUND: The availability of whole-genome sequencing data in large studies has enabled the assessment of coding and noncoding variants across the allele frequency spectrum for their associations with blood pressure.

METHODS: We conducted a multiancestry whole-genome sequencing analysis of blood pressure among 51 456 Trans-Omics for Precision Medicine and Centers for Common Disease Genomics program participants (stage-1). Stage-2 analyses leveraged array data from UK Biobank (N=383 145), Million Veteran Program (N=318 891), and Reasons for Geographic and Racial Differences in Stroke (N=10 643) participants, along with whole-exome sequencing data from UK Biobank (N=199 631) participants.

RESULTS: Two blood pressure signals achieved genome-wide significance in meta-analyses of stage-1 and stage-2 single variant findings (<5×10). Among them, a rare intergenic variant at novel locus, , was associated with lower systolic blood pressure in stage-1 (beta [SE]=-32.6 [6.0]; =4.99×10) but not stage-2 analysis (=0.11). Furthermore, a novel common variant at the known locus was suggestively associated with diastolic blood pressure in stage-1 (beta [SE]=-0.36 [0.07]; =4.18×10) and attained genome-wide significance in stage-2 (beta [SE]=-0.29 [0.03]; =7.28×10). Nineteen additional signals suggestively associated with blood pressure in meta-analysis of single and aggregate rare variant findings (<1×10 and <1×10, respectively).

DISCUSSION: We report one promising but unconfirmed rare variant for blood pressure and, more importantly, contribute insights for future blood pressure sequencing studies. Our findings suggest promise of aggregate analyses to complement single variant analysis strategies and the need for larger, diverse samples, and family studies to enable robust rare variant identification.

%B Hypertension %P 101161HYPERTENSIONAHA12219324 %8 2022 Jun 02 %G eng %R 10.1161/HYPERTENSIONAHA.122.19324 %0 Journal Article %J Aging Cell %D 2022 %T Integrative analysis of clinical and epigenetic biomarkers of mortality. %A Huan, Tianxiao %A Nguyen, Steve %A Colicino, Elena %A Ochoa-Rosales, Carolina %A Hill, W David %A Brody, Jennifer A %A Soerensen, Mette %A Zhang, Yan %A Baldassari, Antoine %A Elhadad, Mohamed Ahmed %A Toshiko, Tanaka %A Zheng, Yinan %A Domingo-Relloso, Arce %A Lee, Dong Heon %A Ma, Jiantao %A Yao, Chen %A Liu, Chunyu %A Hwang, Shih-Jen %A Joehanes, Roby %A Fornage, Myriam %A Bressler, Jan %A van Meurs, Joyce B J %A Debrabant, Birgit %A Mengel-From, Jonas %A Hjelmborg, Jacob %A Christensen, Kaare %A Vokonas, Pantel %A Schwartz, Joel %A Gahrib, Sina A %A Sotoodehnia, Nona %A Sitlani, Colleen M %A Kunze, Sonja %A Gieger, Christian %A Peters, Annette %A Waldenberger, Melanie %A Deary, Ian J %A Ferrucci, Luigi %A Qu, Yishu %A Greenland, Philip %A Lloyd-Jones, Donald M %A Hou, Lifang %A Bandinelli, Stefania %A Voortman, Trudy %A Hermann, Brenner %A Baccarelli, Andrea %A Whitsel, Eric %A Pankow, James S %A Levy, Daniel %K Biomarkers %K Cardiovascular Diseases %K DNA Methylation %K Epigenesis, Genetic %K Epigenomics %K Humans %K Male %K Neoplasms %X

DNA methylation (DNAm) has been reported to be associated with many diseases and with mortality. We hypothesized that the integration of DNAm with clinical risk factors would improve mortality prediction. We performed an epigenome-wide association study of whole blood DNAm in relation to mortality in 15 cohorts (n = 15,013). During a mean follow-up of 10 years, there were 4314 deaths from all causes including 1235 cardiovascular disease (CVD) deaths and 868 cancer deaths. Ancestry-stratified meta-analysis of all-cause mortality identified 163 CpGs in European ancestry (EA) and 17 in African ancestry (AA) participants at p < 1 × 10 , of which 41 (EA) and 16 (AA) were also associated with CVD death, and 15 (EA) and 9 (AA) with cancer death. We built DNAm-based prediction models for all-cause mortality that predicted mortality risk after adjusting for clinical risk factors. The mortality prediction model trained by integrating DNAm with clinical risk factors showed an improvement in prediction of cancer death with 5% increase in the C-index in a replication cohort, compared with the model including clinical risk factors alone. Mendelian randomization identified 15 putatively causal CpGs in relation to longevity, CVD, or cancer risk. For example, cg06885782 (in KCNQ4) was positively associated with risk for prostate cancer (Beta = 1.2, P  = 4.1 × 10 ) and negatively associated with longevity (Beta = -1.9, P  = 0.02). Pathway analysis revealed that genes associated with mortality-related CpGs are enriched for immune- and cancer-related pathways. We identified replicable DNAm signatures of mortality and demonstrated the potential utility of CpGs as informative biomarkers for prediction of mortality risk.

%B Aging Cell %V 21 %P e13608 %8 2022 Jun %G eng %N 6 %R 10.1111/acel.13608 %0 Journal Article %J Nat Med %D 2022 %T Large-scale genome-wide association study of coronary artery disease in genetically diverse populations. %A Tcheandjieu, Catherine %A Zhu, Xiang %A Hilliard, Austin T %A Clarke, Shoa L %A Napolioni, Valerio %A Ma, Shining %A Lee, Kyung Min %A Fang, Huaying %A Chen, Fei %A Lu, Yingchang %A Tsao, Noah L %A Raghavan, Sridharan %A Koyama, Satoshi %A Gorman, Bryan R %A Vujkovic, Marijana %A Klarin, Derek %A Levin, Michael G %A Sinnott-Armstrong, Nasa %A Wojcik, Genevieve L %A Plomondon, Mary E %A Maddox, Thomas M %A Waldo, Stephen W %A Bick, Alexander G %A Pyarajan, Saiju %A Huang, Jie %A Song, Rebecca %A Ho, Yuk-Lam %A Buyske, Steven %A Kooperberg, Charles %A Haessler, Jeffrey %A Loos, Ruth J F %A Do, Ron %A Verbanck, Marie %A Chaudhary, Kumardeep %A North, Kari E %A Avery, Christy L %A Graff, Mariaelisa %A Haiman, Christopher A %A Le Marchand, Loïc %A Wilkens, Lynne R %A Bis, Joshua C %A Leonard, Hampton %A Shen, Botong %A Lange, Leslie A %A Giri, Ayush %A Dikilitas, Ozan %A Kullo, Iftikhar J %A Stanaway, Ian B %A Jarvik, Gail P %A Gordon, Adam S %A Hebbring, Scott %A Namjou, Bahram %A Kaufman, Kenneth M %A Ito, Kaoru %A Ishigaki, Kazuyoshi %A Kamatani, Yoichiro %A Verma, Shefali S %A Ritchie, Marylyn D %A Kember, Rachel L %A Baras, Aris %A Lotta, Luca A %A Kathiresan, Sekar %A Hauser, Elizabeth R %A Miller, Donald R %A Lee, Jennifer S %A Saleheen, Danish %A Reaven, Peter D %A Cho, Kelly %A Gaziano, J Michael %A Natarajan, Pradeep %A Huffman, Jennifer E %A Voight, Benjamin F %A Rader, Daniel J %A Chang, Kyong-Mi %A Lynch, Julie A %A Damrauer, Scott M %A Wilson, Peter W F %A Tang, Hua %A Sun, Yan V %A Tsao, Philip S %A O'Donnell, Christopher J %A Assimes, Themistocles L %K Coronary Artery Disease %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Polymorphism, Single Nucleotide %K Risk Factors %X

We report a genome-wide association study (GWAS) of coronary artery disease (CAD) incorporating nearly a quarter of a million cases, in which existing studies are integrated with data from cohorts of white, Black and Hispanic individuals from the Million Veteran Program. We document near equivalent heritability of CAD across multiple ancestral groups, identify 95 novel loci, including nine on the X chromosome, detect eight loci of genome-wide significance in Black and Hispanic individuals, and demonstrate that two common haplotypes at the 9p21 locus are responsible for risk stratification in all populations except those of African origin, in which these haplotypes are virtually absent. Moreover, in the largest GWAS for angiographically derived coronary atherosclerosis performed to date, we find 15 loci of genome-wide significance that robustly overlap with established loci for clinical CAD. Phenome-wide association analyses of novel loci and polygenic risk scores (PRSs) augment signals related to insulin resistance, extend pleiotropic associations of these loci to include smoking and family history, and precisely document the markedly reduced transferability of existing PRSs to Black individuals. Downstream integrative analyses reinforce the critical roles of vascular endothelial, fibroblast, and smooth muscle cells in CAD susceptibility, but also point to a shared biology between atherosclerosis and oncogenesis. This study highlights the value of diverse populations in further characterizing the genetic architecture of CAD.

%B Nat Med %V 28 %P 1679-1692 %8 2022 08 %G eng %N 8 %R 10.1038/s41591-022-01891-3 %0 Journal Article %J J Alzheimers Dis %D 2022 %T Longitudinal Associations of Plasma TMAO and Related Metabolites with Cognitive Impairment and Dementia in Older Adults: The Cardiovascular Health Study. %A de Oliveira Otto, Marcia C %A Li, Xinmin S %A Wang, Zeneng %A Siscovick, David %A Newman, Anne B %A Lai, Heidi Tsz Mung %A Nemet, Ina %A Lee, Yujin %A Wang, Meng %A Fretts, Amanda %A Lemaitre, Rozenn N %A Tang, W H Wilson %A Lopez, Oscar %A Hazen, Stanley L %A Mozaffarian, Dariush %X

BACKGROUND: Animal studies suggest that gut microbiome metabolites such as trimethylamine N-oxide (TMAO) may influence cognitive function and dementia risk. However potential health effects of TMAO and related metabolites remain unclear.

OBJECTIVE: We examined prospective associations of TMAO, γ-butyrobetaine, crotonobetaine, carnitine, choline, and betaine with risk of cognitive impairment and dementia among older adults aged 65 years and older in the Cardiovascular Health Study (CHS).

METHODS: TMAO and metabolites were measured in stored plasma specimens collected at baseline. Incident cognitive impairment was assessed using the 100-point Modified Mini-Mental State Examination administered serially up to 7 times. Clinical dementia was identified using neuropsychological tests adjudicated by CHS Cognition Study investigators, and by ICD-9 codes from linked Medicare data. Associations of each metabolite with cognitive outcomes were assessed using Cox proportional hazards models.

RESULTS: Over a median of 13 years of follow-up, 529 cases of cognitive impairment, and 522 of dementia were identified. After multivariable adjustment for relevant risk factors, no associations were seen with TMAO, carnitine, choline, or betaine. In contrast, higher crotonobetaine was associated with 20-32% higher risk of cognitive impairment and dementia per interquintile range (IQR), while γ-butyrobetaine was associated with ∼25% lower risk of the same cognitive outcomes per IQR.∥Conclusion:These findings suggest that γ-butyrobetaine, crotonobetaine, two gut microbe and host metabolites, are associated with risk of cognitive impairment and dementia. Our results indicate a need for mechanistic studies evaluating potential effects of these metabolites, and their interconversion on brain health, especially later in life.

%B J Alzheimers Dis %8 2022 Sep 02 %G eng %R 10.3233/JAD-220477 %0 Journal Article %J JAMA Netw Open %D 2022 %T Longitudinal Changes in Hearing and Visual Impairments and Risk of Dementia in Older Adults in the United States. %A Hwang, Phillip H %A Longstreth, W T %A Thielke, Stephen M %A Francis, Courtney E %A Carone, Marco %A Kuller, Lewis H %A Fitzpatrick, Annette L %K Aged %K Alzheimer Disease %K Cohort Studies %K Female %K Hearing %K Hearing Loss %K Humans %K Male %K Medicare %K Prospective Studies %K United States %K Vision Disorders %X

Importance: Hearing and vision problems are individually associated with increased dementia risk, but the impact of having concurrent hearing and vision deficits, ie, dual sensory impairment (DSI), on risk of dementia, including its major subtypes Alzheimer disease (AD) and vascular dementia (VaD), is not well known.

Objective: To evaluate whether DSI is associated with incident dementia in older adults.

Design, Setting, and Participants: This prospective cohort study from the Cardiovascular Health Study (CHS) was conducted between 1992 and 1999, with as many as 8 years of follow-up. The multicenter, population-based sample was recruited from Medicare eligibility files in 4 US communities with academic medical centers. Of 5888 participants aged 65 years and older in CHS, 3602 underwent cranial magnetic resonance imaging and completed the modified Mini-Mental State Examination in 1992 to 1994 as part of the CHS Cognition Study. A total of 227 participants were excluded due to prevalent dementia, leaving a total of 3375 participants without dementia at study baseline. The study hypothesis was that DSI would be associated with increased risk of dementia compared with no sensory impairment. The association between the duration of DSI with risk of dementia was also evaluated. Data analysis was conducted from November 2019 to February 2020.

Exposures: Hearing and vision impairments were collected via self-report at baseline and as many as 5 follow-up visits.

Main Outcomes and Measures: All-cause dementia, AD, and VaD, classified by a multidisciplinary committee using standardized criteria.

Results: A total of 2927 participants with information on hearing and vision at all available study visits were included in the analysis (mean [SD] age, 74.6 [4.8] years; 1704 [58.2%] women; 455 [15.5%] African American or Black; 2472 [85.5%] White). Compared with no sensory impairment, DSI was associated with increased risk of all-cause dementia (hazard ratio [HR], 2.60; 95% CI, 1.66-2.06; P < .001), AD (HR, 3.67; 95% CI, 2.04-6.60; P < .001) but not VaD (HR, 2.03; 95% CI, 1.00-4.09; P = .05).

Conclusions and Relevance: In this cohort study, DSI was associated with increased risk of dementia, particularly AD. Evaluation of hearing and vision in older adults may help to identify those at high risk of developing dementia.

%B JAMA Netw Open %V 5 %P e2210734 %8 2022 05 02 %G eng %N 5 %R 10.1001/jamanetworkopen.2022.10734 %0 Journal Article %J Eur Heart J %D 2022 %T Lung function impairment and risk of incident heart failure: the NHLBI Pooled Cohorts Study. %A Eckhardt, Christina M %A Balte, Pallavi P %A Barr, Robert Graham %A Bertoni, Alain G %A Bhatt, Surya P %A Cuttica, Michael %A Cassano, Patricia A %A Chaves, Paolo %A Couper, David %A Jacobs, David R %A Kalhan, Ravi %A Kronmal, Richard %A Lange, Leslie %A Loehr, Laura %A London, Stephanie J %A O'Connor, George T %A Rosamond, Wayne %A Sanders, Jason %A Schwartz, Joseph E %A Shah, Amil %A Shah, Sanjiv J %A Smith, Lewis %A White, Wendy %A Yende, Sachin %A Oelsner, Elizabeth C %K Adult %K Heart Failure %K Hospitalization %K Humans %K Lung %K National Heart, Lung, and Blood Institute (U.S.) %K Prognosis %K Risk Factors %K Stroke Volume %K United States %X

AIMS: The aim is to evaluate associations of lung function impairment with risk of incident heart failure (HF).

METHODS AND RESULTS: Data were pooled across eight US population-based cohorts that enrolled participants from 1987 to 2004. Participants with self-reported baseline cardiovascular disease were excluded. Spirometry was used to define obstructive [forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70] or restrictive (FEV1/FVC ≥0.70, FVC <80%) lung physiology. The incident HF was defined as hospitalization or death caused by HF. In a sub-set, HF events were sub-classified as HF with reduced ejection fraction (HFrEF; EF <50%) or preserved EF (HFpEF; EF ≥50%). The Fine-Gray proportional sub-distribution hazards models were adjusted for sociodemographic factors, smoking, and cardiovascular risk factors. In models of incident HF sub-types, HFrEF, HFpEF, and non-HF mortality were treated as competing risks. Among 31 677 adults, there were 3344 incident HF events over a median follow-up of 21.0 years. Of 2066 classifiable HF events, 1030 were classified as HFrEF and 1036 as HFpEF. Obstructive [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07-1.27] and restrictive physiology (adjusted HR 1.43, 95% CI 1.27-1.62) were associated with incident HF. Obstructive and restrictive ventilatory defects were associated with HFpEF but not HFrEF. The magnitude of the association between restrictive physiology and HFpEF was similar to associations with hypertension, diabetes, and smoking.

CONCLUSION: Lung function impairment was associated with increased risk of incident HF, and particularly incident HFpEF, independent of and to a similar extent as major known cardiovascular risk factors.

%B Eur Heart J %V 43 %P 2196-2208 %8 2022 06 14 %G eng %N 23 %R 10.1093/eurheartj/ehac205 %0 Journal Article %J Atherosclerosis %D 2022 %T Monocyte subsets, T cell activation profiles, and stroke in men and women: The Multi-Ethnic Study of Atherosclerosis and Cardiovascular Health Study. %A Feinstein, Matthew J %A Bůzková, Petra %A Olson, Nels C %A Doyle, Margaret F %A Sitlani, Colleen M %A Fohner, Alison E %A Huber, Sally A %A Floyd, James %A Sinha, Arjun %A Thorp, Edward B %A Landay, Alan %A Freiberg, Matthew S %A Longstreth, William T %A Tracy, Russell P %A Psaty, Bruce M %A Delaney, Joseph Ac %K Atherosclerosis %K CD4-Positive T-Lymphocytes %K CD8-Positive T-Lymphocytes %K Cytokines %K Female %K Follow-Up Studies %K Humans %K Incidence %K Inflammation %K Interleukin-4 %K Ischemic Stroke %K Lymphocyte Activation %K Male %K Monocytes %K Stroke %K T-Lymphocyte Subsets %X

BACKGROUND AND AIMS: Despite mechanistic data implicating unresolving inflammation in stroke pathogenesis, data regarding circulating immune cell phenotypes - key determinants of inflammation propagation versus resolution - and incident stroke are lacking. Therefore, we aimed to comprehensively define associations of circulating immune phenotypes and activation profiles with incident stroke.

METHODS: We investigated circulating leukocyte phenotypes and activation profiles with incident adjudicated stroke in 2104 diverse adults from the Multi-Ethnic Study of Atherosclerosis (MESA) followed over a median of 16.6 years. Cryopreserved cells from the MESA baseline examination were thawed and myeloid and lymphoid lineage cell subsets were measured using polychromatic flow cytometry and intracellular cytokine activation staining. We analyzed multivariable-adjusted associations of cell phenotypes, as a proportion of parent cell subsets, with incident stroke (overall) and ischemic stroke using Cox regression models.

RESULTS: We observed associations of intermediate monocytes, early-activated CD4 T cells, and both CD4 and CD8 T cells producing interleukin-4 after cytokine stimulation (T and T, respectively) with higher risk for incident stroke; effect sizes ranged from 35% to 62% relative increases in risk for stroke. Meanwhile, differentiated and memory T cell phenotypes were associated with lower risk for incident stroke. In sex-stratified analyses, positive and negative associations were especially strong among men but null among women.

CONCLUSIONS: Circulating IL-4 producing T cells and intermediate monocytes were significantly associated with incident stroke over nearly two decades of follow-up. These associations were stronger among men and not among women. Further translational studies are warranted to define more precise targets for prognosis and intervention.

%B Atherosclerosis %V 351 %P 18-25 %8 2022 06 %G eng %R 10.1016/j.atherosclerosis.2022.05.007 %0 Journal Article %J Circulation %D 2022 %T Monogenic and Polygenic Contributions to QTc Prolongation in the Population. %A Nauffal, Victor %A Morrill, Valerie N %A Jurgens, Sean J %A Choi, Seung Hoan %A Hall, Amelia W %A Weng, Lu-Chen %A Halford, Jennifer L %A Austin-Tse, Christina %A Haggerty, Christopher M %A Harris, Stephanie L %A Wong, Eugene K %A Alonso, Alvaro %A Arking, Dan E %A Benjamin, Emelia J %A Boerwinkle, Eric %A Min, Yuan-I %A Correa, Adolfo %A Fornwalt, Brandon K %A Heckbert, Susan R %A Kooperberg, Charles %A Lin, Henry J %A Loos, Ruth J F %A Rice, Kenneth M %A Gupta, Namrata %A Blackwell, Thomas W %A Mitchell, Braxton D %A Morrison, Alanna C %A Psaty, Bruce M %A Post, Wendy S %A Redline, Susan %A Rehm, Heidi L %A Rich, Stephen S %A Rotter, Jerome I %A Soliman, Elsayed Z %A Sotoodehnia, Nona %A Lunetta, Kathryn L %A Ellinor, Patrick T %A Lubitz, Steven A %X

Rare sequence variation in genes underlying cardiac repolarization and common polygenic variation influence QT interval duration. However, current clinical genetic testing of individuals with unexplained QT prolongation is restricted to examination of monogenic rare variants. The recent emergence of large-scale biorepositories with sequence data enables examination of the joint contribution of rare and common variation to the QT interval in the population. We performed a genome wide association study (GWAS) of the QTc in 84,630 United Kingdom Biobank (UKB) participants and created a polygenic risk score (PRS). Among 26,976 participants with whole genome sequencing and electrocardiogram data in the Trans-Omics for Precision Medicine (TOPMed) program, we identified 160 carriers of putative pathogenic rare variants in 10 genes known to be associated with the QT interval. We examined QTc associations with the PRS and with rare variants in TOPMed. Fifty-four independent loci were identified by GWAS in the UKB. Twenty-one loci were novel, of which 12 were replicated in TOPMed. The PRS comprising 1,110,494 common variants was significantly associated with the QTc in TOPMed (ΔQTc/ = 1.4 ms, 95% CI 1.3 -1.5; p-value=1.1×10). Carriers of putative pathogenic rare variants had longer QTc than non-carriers (ΔQTc=10.9 ms [7.4-14.4]). 23.7% of individuals with QTc>480 ms carried either a monogenic rare variant or had a PRS in the top decile (3.4% monogenic, 21% top decile of PRS). QTc duration in the population is influenced by both rare variants in genes underlying cardiac repolarization and polygenic risk, with a sizeable contribution from polygenic risk. Comprehensive assessment of the genetic determinants of QTc prolongation includes incorporation of both polygenic and monogenic risk.

%B Circulation %8 2022 Apr 07 %G eng %R 10.1161/CIRCULATIONAHA.121.057261 %0 Journal Article %J Nat Genet %D 2022 %T Multi-ancestry genetic study of type 2 diabetes highlights the power of diverse populations for discovery and translation. %A Mahajan, Anubha %A Spracklen, Cassandra N %A Zhang, Weihua %A Ng, Maggie C Y %A Petty, Lauren E %A Kitajima, Hidetoshi %A Yu, Grace Z %A Rüeger, Sina %A Speidel, Leo %A Kim, Young Jin %A Horikoshi, Momoko %A Mercader, Josep M %A Taliun, Daniel %A Moon, Sanghoon %A Kwak, Soo-Heon %A Robertson, Neil R %A Rayner, Nigel W %A Loh, Marie %A Kim, Bong-Jo %A Chiou, Joshua %A Miguel-Escalada, Irene %A Della Briotta Parolo, Pietro %A Lin, Kuang %A Bragg, Fiona %A Preuss, Michael H %A Takeuchi, Fumihiko %A Nano, Jana %A Guo, Xiuqing %A Lamri, Amel %A Nakatochi, Masahiro %A Scott, Robert A %A Lee, Jung-Jin %A Huerta-Chagoya, Alicia %A Graff, Mariaelisa %A Chai, Jin-Fang %A Parra, Esteban J %A Yao, Jie %A Bielak, Lawrence F %A Tabara, Yasuharu %A Hai, Yang %A Steinthorsdottir, Valgerdur %A Cook, James P %A Kals, Mart %A Grarup, Niels %A Schmidt, Ellen M %A Pan, Ian %A Sofer, Tamar %A Wuttke, Matthias %A Sarnowski, Chloe %A Gieger, Christian %A Nousome, Darryl %A Trompet, Stella %A Long, Jirong %A Sun, Meng %A Tong, Lin %A Chen, Wei-Min %A Ahmad, Meraj %A Noordam, Raymond %A Lim, Victor J Y %A Tam, Claudia H T %A Joo, Yoonjung Yoonie %A Chen, Chien-Hsiun %A Raffield, Laura M %A Lecoeur, Cécile %A Prins, Bram Peter %A Nicolas, Aude %A Yanek, Lisa R %A Chen, Guanjie %A Jensen, Richard A %A Tajuddin, Salman %A Kabagambe, Edmond K %A An, Ping %A Xiang, Anny H %A Choi, Hyeok Sun %A Cade, Brian E %A Tan, Jingyi %A Flanagan, Jack %A Abaitua, Fernando %A Adair, Linda S %A Adeyemo, Adebowale %A Aguilar-Salinas, Carlos A %A Akiyama, Masato %A Anand, Sonia S %A Bertoni, Alain %A Bian, Zheng %A Bork-Jensen, Jette %A Brandslund, Ivan %A Brody, Jennifer A %A Brummett, Chad M %A Buchanan, Thomas A %A Canouil, Mickaël %A Chan, Juliana C N %A Chang, Li-Ching %A Chee, Miao-Li %A Chen, Ji %A Chen, Shyh-Huei %A Chen, Yuan-Tsong %A Chen, Zhengming %A Chuang, Lee-Ming %A Cushman, Mary %A Das, Swapan K %A de Silva, H Janaka %A Dedoussis, George %A Dimitrov, Latchezar %A Doumatey, Ayo P %A Du, Shufa %A Duan, Qing %A Eckardt, Kai-Uwe %A Emery, Leslie S %A Evans, Daniel S %A Evans, Michele K %A Fischer, Krista %A Floyd, James S %A Ford, Ian %A Fornage, Myriam %A Franco, Oscar H %A Frayling, Timothy M %A Freedman, Barry I %A Fuchsberger, Christian %A Genter, Pauline %A Gerstein, Hertzel C %A Giedraitis, Vilmantas %A González-Villalpando, Clicerio %A Gonzalez-Villalpando, Maria Elena %A Goodarzi, Mark O %A Gordon-Larsen, Penny %A Gorkin, David %A Gross, Myron %A Guo, Yu %A Hackinger, Sophie %A Han, Sohee %A Hattersley, Andrew T %A Herder, Christian %A Howard, Annie-Green %A Hsueh, Willa %A Huang, Mengna %A Huang, Wei %A Hung, Yi-Jen %A Hwang, Mi Yeong %A Hwu, Chii-Min %A Ichihara, Sahoko %A Ikram, Mohammad Arfan %A Ingelsson, Martin %A Islam, Md Tariqul %A Isono, Masato %A Jang, Hye-Mi %A Jasmine, Farzana %A Jiang, Guozhi %A Jonas, Jost B %A Jørgensen, Marit E %A Jørgensen, Torben %A Kamatani, Yoichiro %A Kandeel, Fouad R %A Kasturiratne, Anuradhani %A Katsuya, Tomohiro %A Kaur, Varinderpal %A Kawaguchi, Takahisa %A Keaton, Jacob M %A Kho, Abel N %A Khor, Chiea-Chuen %A Kibriya, Muhammad G %A Kim, Duk-Hwan %A Kohara, Katsuhiko %A Kriebel, Jennifer %A Kronenberg, Florian %A Kuusisto, Johanna %A Läll, Kristi %A Lange, Leslie A %A Lee, Myung-Shik %A Lee, Nanette R %A Leong, Aaron %A Li, Liming %A Li, Yun %A Li-Gao, Ruifang %A Ligthart, Symen %A Lindgren, Cecilia M %A Linneberg, Allan %A Liu, Ching-Ti %A Liu, Jianjun %A Locke, Adam E %A Louie, Tin %A Luan, Jian'an %A Luk, Andrea O %A Luo, Xi %A Lv, Jun %A Lyssenko, Valeriya %A Mamakou, Vasiliki %A Mani, K Radha %A Meitinger, Thomas %A Metspalu, Andres %A Morris, Andrew D %A Nadkarni, Girish N %A Nadler, Jerry L %A Nalls, Michael A %A Nayak, Uma %A Nongmaithem, Suraj S %A Ntalla, Ioanna %A Okada, Yukinori %A Orozco, Lorena %A Patel, Sanjay R %A Pereira, Mark A %A Peters, Annette %A Pirie, Fraser J %A Porneala, Bianca %A Prasad, Gauri %A Preissl, Sebastian %A Rasmussen-Torvik, Laura J %A Reiner, Alexander P %A Roden, Michael %A Rohde, Rebecca %A Roll, Kathryn %A Sabanayagam, Charumathi %A Sander, Maike %A Sandow, Kevin %A Sattar, Naveed %A Schönherr, Sebastian %A Schurmann, Claudia %A Shahriar, Mohammad %A Shi, Jinxiu %A Shin, Dong Mun %A Shriner, Daniel %A Smith, Jennifer A %A So, Wing Yee %A Stančáková, Alena %A Stilp, Adrienne M %A Strauch, Konstantin %A Suzuki, Ken %A Takahashi, Atsushi %A Taylor, Kent D %A Thorand, Barbara %A Thorleifsson, Gudmar %A Thorsteinsdottir, Unnur %A Tomlinson, Brian %A Torres, Jason M %A Tsai, Fuu-Jen %A Tuomilehto, Jaakko %A Tusié-Luna, Teresa %A Udler, Miriam S %A Valladares-Salgado, Adan %A van Dam, Rob M %A van Klinken, Jan B %A Varma, Rohit %A Vujkovic, Marijana %A Wacher-Rodarte, Niels %A Wheeler, Eleanor %A Whitsel, Eric A %A Wickremasinghe, Ananda R %A van Dijk, Ko Willems %A Witte, Daniel R %A Yajnik, Chittaranjan S %A Yamamoto, Ken %A Yamauchi, Toshimasa %A Yengo, Loic %A Yoon, Kyungheon %A Yu, Canqing %A Yuan, Jian-Min %A Yusuf, Salim %A Zhang, Liang %A Zheng, Wei %A Raffel, Leslie J %A Igase, Michiya %A Ipp, Eli %A Redline, Susan %A Cho, Yoon Shin %A Lind, Lars %A Province, Michael A %A Hanis, Craig L %A Peyser, Patricia A %A Ingelsson, Erik %A Zonderman, Alan B %A Psaty, Bruce M %A Wang, Ya-Xing %A Rotimi, Charles N %A Becker, Diane M %A Matsuda, Fumihiko %A Liu, Yongmei %A Zeggini, Eleftheria %A Yokota, Mitsuhiro %A Rich, Stephen S %A Kooperberg, Charles %A Pankow, James S %A Engert, James C %A Chen, Yii-Der Ida %A Froguel, Philippe %A Wilson, James G %A Sheu, Wayne H H %A Kardia, Sharon L R %A Wu, Jer-Yuarn %A Hayes, M Geoffrey %A Ma, Ronald C W %A Wong, Tien-Yin %A Groop, Leif %A Mook-Kanamori, Dennis O %A Chandak, Giriraj R %A Collins, Francis S %A Bharadwaj, Dwaipayan %A Paré, Guillaume %A Sale, Michèle M %A Ahsan, Habibul %A Motala, Ayesha A %A Shu, Xiao-Ou %A Park, Kyong-Soo %A Jukema, J Wouter %A Cruz, Miguel %A McKean-Cowdin, Roberta %A Grallert, Harald %A Cheng, Ching-Yu %A Bottinger, Erwin P %A Dehghan, Abbas %A Tai, E-Shyong %A Dupuis, Josée %A Kato, Norihiro %A Laakso, Markku %A Köttgen, Anna %A Koh, Woon-Puay %A Palmer, Colin N A %A Liu, Simin %A Abecasis, Goncalo %A Kooner, Jaspal S %A Loos, Ruth J F %A North, Kari E %A Haiman, Christopher A %A Florez, Jose C %A Saleheen, Danish %A Hansen, Torben %A Pedersen, Oluf %A Mägi, Reedik %A Langenberg, Claudia %A Wareham, Nicholas J %A Maeda, Shiro %A Kadowaki, Takashi %A Lee, Juyoung %A Millwood, Iona Y %A Walters, Robin G %A Stefansson, Kari %A Myers, Simon R %A Ferrer, Jorge %A Gaulton, Kyle J %A Meigs, James B %A Mohlke, Karen L %A Gloyn, Anna L %A Bowden, Donald W %A Below, Jennifer E %A Chambers, John C %A Sim, Xueling %A Boehnke, Michael %A Rotter, Jerome I %A McCarthy, Mark I %A Morris, Andrew P %K Diabetes Mellitus, Type 2 %K Ethnicity %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Polymorphism, Single Nucleotide %K Risk Factors %X

We assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent) through the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. Multi-ancestry GWAS meta-analysis identified 237 loci attaining stringent genome-wide significance (P < 5 × 10), which were delineated to 338 distinct association signals. Fine-mapping of these signals was enhanced by the increased sample size and expanded population diversity of the multi-ancestry meta-analysis, which localized 54.4% of T2D associations to a single variant with >50% posterior probability. This improved fine-mapping enabled systematic assessment of candidate causal genes and molecular mechanisms through which T2D associations are mediated, laying the foundations for functional investigations. Multi-ancestry genetic risk scores enhanced transferability of T2D prediction across diverse populations. Our study provides a step toward more effective clinical translation of T2D GWAS to improve global health for all, irrespective of genetic background.

%B Nat Genet %V 54 %P 560-572 %8 2022 May %G eng %N 5 %R 10.1038/s41588-022-01058-3 %0 Journal Article %J Nat Commun %D 2022 %T A multi-ethnic polygenic risk score is associated with hypertension prevalence and progression throughout adulthood. %A Kurniansyah, Nuzulul %A Goodman, Matthew O %A Kelly, Tanika N %A Elfassy, Tali %A Wiggins, Kerri L %A Bis, Joshua C %A Guo, Xiuqing %A Palmas, Walter %A Taylor, Kent D %A Lin, Henry J %A Haessler, Jeffrey %A Gao, Yan %A Shimbo, Daichi %A Smith, Jennifer A %A Yu, Bing %A Feofanova, Elena V %A Smit, Roelof A J %A Wang, Zhe %A Hwang, Shih-Jen %A Liu, Simin %A Wassertheil-Smoller, Sylvia %A Manson, JoAnn E %A Lloyd-Jones, Donald M %A Rich, Stephen S %A Loos, Ruth J F %A Redline, Susan %A Correa, Adolfo %A Kooperberg, Charles %A Fornage, Myriam %A Kaplan, Robert C %A Psaty, Bruce M %A Rotter, Jerome I %A Arnett, Donna K %A Morrison, Alanna C %A Franceschini, Nora %A Levy, Daniel %A Sofer, Tamar %K Adult %K Diabetes Mellitus, Type 2 %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Hypertension %K Multifactorial Inheritance %K Prevalence %K Risk Factors %X

In a multi-stage analysis of 52,436 individuals aged 17-90 across diverse cohorts and biobanks, we train, test, and evaluate a polygenic risk score (PRS) for hypertension risk and progression. The PRS is trained using genome-wide association studies (GWAS) for systolic, diastolic blood pressure, and hypertension, respectively. For each trait, PRS is selected by optimizing the coefficient of variation (CV) across estimated effect sizes from multiple potential PRS using the same GWAS, after which the 3 trait-specific PRSs are combined via an unweighted sum called "PRSsum", forming the HTN-PRS. The HTN-PRS is associated with both prevalent and incident hypertension at 4-6 years of follow up. This association is further confirmed in age-stratified analysis. In an independent biobank of 40,201 individuals, the HTN-PRS is confirmed to be predictive of increased risk for coronary artery disease, ischemic stroke, type 2 diabetes, and chronic kidney disease.

%B Nat Commun %V 13 %P 3549 %8 2022 Jun 21 %G eng %N 1 %R 10.1038/s41467-022-31080-2 %0 Journal Article %J Diabetes %D 2022 %T Multi-Scalar Data Integration Links Glomerular Angiopoietin-Tie Signaling Pathway Activation With Progression of Diabetic Kidney Disease. %A Liu, Jiahao %A Nair, Viji %A Zhao, Yi-Yang %A Chang, Dong-Yuan %A Limonte, Christine %A Bansal, Nisha %A Fermin, Damian %A Eichinger, Felix %A Tanner, Emily C %A Bellovich, Keith A %A Steigerwalt, Susan %A Bhat, Zeenat %A Hawkins, Jennifer J %A Subramanian, Lalita %A Rosas, Sylvia E %A Sedor, John R %A Vasquez, Miguel A %A Waikar, Sushrut S %A Bitzer, Markus %A Pennathur, Subramaniam %A Brosius, Frank C %A de Boer, Ian %A Chen, Min %A Kretzler, Matthias %A Ju, Wenjun %K Angiopoietin-1 %K Angiopoietin-2 %K Angiopoietins %K Biomarkers %K Cohort Studies %K Diabetes Mellitus %K Diabetic Nephropathies %K Disease Progression %K Endothelial Cells %K Humans %K Kidney Failure, Chronic %K Receptor, TIE-2 %K Signal Transduction %X

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD). Prognostic biomarkers reflective of underlying molecular mechanisms are critically needed for effective management of DKD. A three-marker panel was derived from a proteomics analysis of plasma samples by an unbiased machine learning approach from participants (N = 58) in the Clinical Phenotyping and Resource Biobank study. In combination with standard clinical parameters, this panel improved prediction of the composite outcome of ESKD or a 40% decline in glomerular filtration rate. The panel was validated in an independent group (N = 68), who also had kidney transcriptomic profiles. One marker, plasma angiopoietin 2 (ANGPT2), was significantly associated with outcomes in cohorts from the Cardiovascular Health Study (N = 3,183) and the Chinese Cohort Study of Chronic Kidney Disease (N = 210). Glomerular transcriptional angiopoietin/Tie (ANG-TIE) pathway scores, derived from the expression of 154 ANG-TIE signaling mediators, correlated positively with plasma ANGPT2 levels and kidney outcomes. Higher receptor expression in glomeruli and higher ANG-TIE pathway scores in endothelial cells corroborated potential functional effects in the kidney from elevated plasma ANGPT2 levels. Our work suggests that ANGPT2 is a promising prognostic endothelial biomarker with likely functional impact on glomerular pathogenesis in DKD.

%B Diabetes %V 71 %P 2664-2676 %8 2022 Dec 01 %G eng %N 12 %R 10.2337/db22-0169 %0 Journal Article %J Nat Genet %D 2022 %T New insights into the genetic etiology of Alzheimer's disease and related dementias. %A Bellenguez, Céline %A Küçükali, Fahri %A Jansen, Iris E %A Kleineidam, Luca %A Moreno-Grau, Sonia %A Amin, Najaf %A Naj, Adam C %A Campos-Martin, Rafael %A Grenier-Boley, Benjamin %A Andrade, Victor %A Holmans, Peter A %A Boland, Anne %A Damotte, Vincent %A van der Lee, Sven J %A Costa, Marcos R %A Kuulasmaa, Teemu %A Yang, Qiong %A de Rojas, Itziar %A Bis, Joshua C %A Yaqub, Amber %A Prokic, Ivana %A Chapuis, Julien %A Ahmad, Shahzad %A Giedraitis, Vilmantas %A Aarsland, Dag %A Garcia-Gonzalez, Pablo %A Abdelnour, Carla %A Alarcón-Martín, Emilio %A Alcolea, Daniel %A Alegret, Montserrat %A Alvarez, Ignacio %A Alvarez, Victoria %A Armstrong, Nicola J %A Tsolaki, Anthoula %A Antunez, Carmen %A Appollonio, Ildebrando %A Arcaro, Marina %A Archetti, Silvana %A Pastor, Alfonso Arias %A Arosio, Beatrice %A Athanasiu, Lavinia %A Bailly, Henri %A Banaj, Nerisa %A Baquero, Miquel %A Barral, Sandra %A Beiser, Alexa %A Pastor, Ana Belén %A Below, Jennifer E %A Benchek, Penelope %A Benussi, Luisa %A Berr, Claudine %A Besse, Céline %A Bessi, Valentina %A Binetti, Giuliano %A Bizarro, Alessandra %A Blesa, Rafael %A Boada, Merce %A Boerwinkle, Eric %A Borroni, Barbara %A Boschi, Silvia %A Bossù, Paola %A Bråthen, Geir %A Bressler, Jan %A Bresner, Catherine %A Brodaty, Henry %A Brookes, Keeley J %A Brusco, Luis Ignacio %A Buiza-Rueda, Dolores %A Bûrger, Katharina %A Burholt, Vanessa %A Bush, William S %A Calero, Miguel %A Cantwell, Laura B %A Chene, Geneviève %A Chung, Jaeyoon %A Cuccaro, Michael L %A Carracedo, Angel %A Cecchetti, Roberta %A Cervera-Carles, Laura %A Charbonnier, Camille %A Chen, Hung-Hsin %A Chillotti, Caterina %A Ciccone, Simona %A Claassen, Jurgen A H R %A Clark, Christopher %A Conti, Elisa %A Corma-Gómez, Anaïs %A Costantini, Emanuele %A Custodero, Carlo %A Daian, Delphine %A Dalmasso, Maria Carolina %A Daniele, Antonio %A Dardiotis, Efthimios %A Dartigues, Jean-François %A de Deyn, Peter Paul %A de Paiva Lopes, Katia %A de Witte, Lot D %A Debette, Stephanie %A Deckert, Jürgen %A Del Ser, Teodoro %A Denning, Nicola %A DeStefano, Anita %A Dichgans, Martin %A Diehl-Schmid, Janine %A Diez-Fairen, Monica %A Rossi, Paolo Dionigi %A Djurovic, Srdjan %A Duron, Emmanuelle %A Düzel, Emrah %A Dufouil, Carole %A Eiriksdottir, Gudny %A Engelborghs, Sebastiaan %A Escott-Price, Valentina %A Espinosa, Ana %A Ewers, Michael %A Faber, Kelley M %A Fabrizio, Tagliavini %A Nielsen, Sune Fallgaard %A Fardo, David W %A Farotti, Lucia %A Fenoglio, Chiara %A Fernández-Fuertes, Marta %A Ferrari, Raffaele %A Ferreira, Catarina B %A Ferri, Evelyn %A Fin, Bertrand %A Fischer, Peter %A Fladby, Tormod %A Fließbach, Klaus %A Fongang, Bernard %A Fornage, Myriam %A Fortea, Juan %A Foroud, Tatiana M %A Fostinelli, Silvia %A Fox, Nick C %A Franco-Macías, Emlio %A Bullido, María J %A Frank-García, Ana %A Froelich, Lutz %A Fulton-Howard, Brian %A Galimberti, Daniela %A García-Alberca, Jose Maria %A Garcia-Gonzalez, Pablo %A Garcia-Madrona, Sebastian %A Garcia-Ribas, Guillermo %A Ghidoni, Roberta %A Giegling, Ina %A Giorgio, Giaccone %A Goate, Alison M %A Goldhardt, Oliver %A Gomez-Fonseca, Duber %A González-Perez, Antonio %A Graff, Caroline %A Grande, Giulia %A Green, Emma %A Grimmer, Timo %A Grünblatt, Edna %A Grunin, Michelle %A Gudnason, Vilmundur %A Guetta-Baranes, Tamar %A Haapasalo, Annakaisa %A Hadjigeorgiou, Georgios %A Haines, Jonathan L %A Hamilton-Nelson, Kara L %A Hampel, Harald %A Hanon, Olivier %A Hardy, John %A Hartmann, Annette M %A Hausner, Lucrezia %A Harwood, Janet %A Heilmann-Heimbach, Stefanie %A Helisalmi, Seppo %A Heneka, Michael T %A Hernandez, Isabel %A Herrmann, Martin J %A Hoffmann, Per %A Holmes, Clive %A Holstege, Henne %A Vilas, Raquel Huerto %A Hulsman, Marc %A Humphrey, Jack %A Biessels, Geert Jan %A Jian, Xueqiu %A Johansson, Charlotte %A Jun, Gyungah R %A Kastumata, Yuriko %A Kauwe, John %A Kehoe, Patrick G %A Kilander, Lena %A Ståhlbom, Anne Kinhult %A Kivipelto, Miia %A Koivisto, Anne %A Kornhuber, Johannes %A Kosmidis, Mary H %A Kukull, Walter A %A Kuksa, Pavel P %A Kunkle, Brian W %A Kuzma, Amanda B %A Lage, Carmen %A Laukka, Erika J %A Launer, Lenore %A Lauria, Alessandra %A Lee, Chien-Yueh %A Lehtisalo, Jenni %A Lerch, Ondrej %A Lleo, Alberto %A Longstreth, William %A Lopez, Oscar %A de Munain, Adolfo Lopez %A Love, Seth %A Löwemark, Malin %A Luckcuck, Lauren %A Lunetta, Kathryn L %A Ma, Yiyi %A Macías, Juan %A MacLeod, Catherine A %A Maier, Wolfgang %A Mangialasche, Francesca %A Spallazzi, Marco %A Marquié, Marta %A Marshall, Rachel %A Martin, Eden R %A Montes, Angel Martín %A Rodríguez, Carmen Martínez %A Masullo, Carlo %A Mayeux, Richard %A Mead, Simon %A Mecocci, Patrizia %A Medina, Miguel %A Meggy, Alun %A Mehrabian, Shima %A Mendoza, Silvia %A Menéndez-González, Manuel %A Mir, Pablo %A Moebus, Susanne %A Mol, Merel %A Molina-Porcel, Laura %A Montrreal, Laura %A Morelli, Laura %A Moreno, Fermin %A Morgan, Kevin %A Mosley, Thomas %A Nöthen, Markus M %A Muchnik, Carolina %A Mukherjee, Shubhabrata %A Nacmias, Benedetta %A Ngandu, Tiia %A Nicolas, Gaël %A Nordestgaard, Børge G %A Olaso, Robert %A Orellana, Adelina %A Orsini, Michela %A Ortega, Gemma %A Padovani, Alessandro %A Paolo, Caffarra %A Papenberg, Goran %A Parnetti, Lucilla %A Pasquier, Florence %A Pastor, Pau %A Peloso, Gina %A Pérez-Cordón, Alba %A Pérez-Tur, Jordi %A Pericard, Pierre %A Peters, Oliver %A Pijnenburg, Yolande A L %A Pineda, Juan A %A Piñol-Ripoll, Gerard %A Pisanu, Claudia %A Polak, Thomas %A Popp, Julius %A Posthuma, Danielle %A Priller, Josef %A Puerta, Raquel %A Quenez, Olivier %A Quintela, Inés %A Thomassen, Jesper Qvist %A Rábano, Alberto %A Rainero, Innocenzo %A Rajabli, Farid %A Ramakers, Inez %A Real, Luis M %A Reinders, Marcel J T %A Reitz, Christiane %A Reyes-Dumeyer, Dolly %A Ridge, Perry %A Riedel-Heller, Steffi %A Riederer, Peter %A Roberto, Natalia %A Rodriguez-Rodriguez, Eloy %A Rongve, Arvid %A Allende, Irene Rosas %A Rosende-Roca, Maitée %A Royo, Jose Luis %A Rubino, Elisa %A Rujescu, Dan %A Sáez, María Eugenia %A Sakka, Paraskevi %A Saltvedt, Ingvild %A Sanabria, Ángela %A Sánchez-Arjona, María Bernal %A Sanchez-Garcia, Florentino %A Juan, Pascual Sánchez %A Sánchez-Valle, Raquel %A Sando, Sigrid B %A Sarnowski, Chloe %A Satizabal, Claudia L %A Scamosci, Michela %A Scarmeas, Nikolaos %A Scarpini, Elio %A Scheltens, Philip %A Scherbaum, Norbert %A Scherer, Martin %A Schmid, Matthias %A Schneider, Anja %A Schott, Jonathan M %A Selbæk, Geir %A Seripa, Davide %A Serrano, Manuel %A Sha, Jin %A Shadrin, Alexey A %A Skrobot, Olivia %A Slifer, Susan %A Snijders, Gijsje J L %A Soininen, Hilkka %A Solfrizzi, Vincenzo %A Solomon, Alina %A Song, Yeunjoo %A Sorbi, Sandro %A Sotolongo-Grau, Oscar %A Spalletta, Gianfranco %A Spottke, Annika %A Squassina, Alessio %A Stordal, Eystein %A Tartan, Juan Pablo %A Tarraga, Lluis %A Tesí, Niccolo %A Thalamuthu, Anbupalam %A Thomas, Tegos %A Tosto, Giuseppe %A Traykov, Latchezar %A Tremolizzo, Lucio %A Tybjærg-Hansen, Anne %A Uitterlinden, Andre %A Ullgren, Abbe %A Ulstein, Ingun %A Valero, Sergi %A Valladares, Otto %A Broeckhoven, Christine Van %A Vance, Jeffery %A Vardarajan, Badri N %A van der Lugt, Aad %A Dongen, Jasper Van %A van Rooij, Jeroen %A van Swieten, John %A Vandenberghe, Rik %A Verhey, Frans %A Vidal, Jean-Sébastien %A Vogelgsang, Jonathan %A Vyhnalek, Martin %A Wagner, Michael %A Wallon, David %A Wang, Li-San %A Wang, Ruiqi %A Weinhold, Leonie %A Wiltfang, Jens %A Windle, Gill %A Woods, Bob %A Yannakoulia, Mary %A Zare, Habil %A Zhao, Yi %A Zhang, Xiaoling %A Zhu, Congcong %A Zulaica, Miren %A Farrer, Lindsay A %A Psaty, Bruce M %A Ghanbari, Mohsen %A Raj, Towfique %A Sachdev, Perminder %A Mather, Karen %A Jessen, Frank %A Ikram, M Arfan %A de Mendonça, Alexandre %A Hort, Jakub %A Tsolaki, Magda %A Pericak-Vance, Margaret A %A Amouyel, Philippe %A Williams, Julie %A Frikke-Schmidt, Ruth %A Clarimon, Jordi %A Deleuze, Jean-Francois %A Rossi, Giacomina %A Seshadri, Sudha %A Andreassen, Ole A %A Ingelsson, Martin %A Hiltunen, Mikko %A Sleegers, Kristel %A Schellenberg, Gerard D %A van Duijn, Cornelia M %A Sims, Rebecca %A van der Flier, Wiesje M %A Ruiz, Agustin %A Ramirez, Alfredo %A Lambert, Jean-Charles %K Alzheimer Disease %K Cognitive Dysfunction %K Genome-Wide Association Study %K Humans %K tau Proteins %X

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele.

%B Nat Genet %V 54 %P 412-436 %8 2022 Apr %G eng %N 4 %R 10.1038/s41588-022-01024-z %0 Journal Article %J Commun Biol %D 2022 %T Non-linear machine learning models incorporating SNPs and PRS improve polygenic prediction in diverse human populations. %A Elgart, Michael %A Lyons, Genevieve %A Romero-Brufau, Santiago %A Kurniansyah, Nuzulul %A Brody, Jennifer A %A Guo, Xiuqing %A Lin, Henry J %A Raffield, Laura %A Gao, Yan %A Chen, Han %A de Vries, Paul %A Lloyd-Jones, Donald M %A Lange, Leslie A %A Peloso, Gina M %A Fornage, Myriam %A Rotter, Jerome I %A Rich, Stephen S %A Morrison, Alanna C %A Psaty, Bruce M %A Levy, Daniel %A Redline, Susan %A Sofer, Tamar %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Machine Learning %K Multifactorial Inheritance %K Polymorphism, Single Nucleotide %X

Polygenic risk scores (PRS) are commonly used to quantify the inherited susceptibility for a trait, yet they fail to account for non-linear and interaction effects between single nucleotide polymorphisms (SNPs). We address this via a machine learning approach, validated in nine complex phenotypes in a multi-ancestry population. We use an ensemble method of SNP selection followed by gradient boosted trees (XGBoost) to allow for non-linearities and interaction effects. We compare our results to the standard, linear PRS model developed using PRSice, LDpred2, and lassosum2. Combining a PRS as a feature in an XGBoost model results in a relative increase in the percentage variance explained compared to the standard linear PRS model by 22% for height, 27% for HDL cholesterol, 43% for body mass index, 50% for sleep duration, 58% for systolic blood pressure, 64% for total cholesterol, 66% for triglycerides, 77% for LDL cholesterol, and 100% for diastolic blood pressure. Multi-ancestry trained models perform similarly to specific racial/ethnic group trained models and are consistently superior to the standard linear PRS models. This work demonstrates an effective method to account for non-linearities and interaction effects in genetics-based prediction models.

%B Commun Biol %V 5 %P 856 %8 2022 08 22 %G eng %N 1 %R 10.1038/s42003-022-03812-z %0 Journal Article %J Diabetes Care %D 2022 %T {Obesity Partially Mediates the Diabetogenic Effect of Lowering LDL Cholesterol %A Wu, P. %A Moon, J. Y. %A Daghlas, I. %A Franco, G. %A Porneala, B. C. %A Ahmadizar, F. %A Richardson, T. G. %A Isaksen, J. L. %A Hindy, G. %A Yao, J. %A Sitlani, C. M. %A Raffield, L. M. %A Yanek, L. R. %A Feitosa, M. F. %A Cuadrat, R. R. C. %A Qi, Q. %A Arfan Ikram, M. %A Ellervik, C. %A Ericson, U. %A Goodarzi, M. O. %A Brody, J. A. %A Lange, L. %A Mercader, J. M. %A Vaidya, D. %A An, P. %A Schulze, M. B. %A Masana, L. %A Ghanbari, M. %A Olesen, M. S. %A Cai, J. %A Guo, X. %A Floyd, J. S. %A Jäger, S. %A Province, M. A. %A Kalyani, R. R. %A Psaty, B. M. %A Orho-Melander, M. %A Ridker, P. M. %A Kanters, J. K. %A Uitterlinden, A. %A Davey Smith, G. %A Gill, D. %A Kaplan, R. C. %A Kavousi, M. %A Raghavan, S. %A Chasman, D. I. %A Rotter, J. I. %A Meigs, J. B. %A Florez, J. C. %A Dupuis, J. %A Liu, C. T. %A Merino, J. %X LDL cholesterol (LDLc)-lowering drugs modestly increase body weight and type 2 diabetes risk, but the extent to which the diabetogenic effect of lowering LDLc is mediated through increased BMI is unknown.\ We conducted summary-level univariable and multivariable Mendelian randomization (MR) analyses in 921,908 participants to investigate the effect of lowering LDLc on type 2 diabetes risk and the proportion of this effect mediated through BMI. We used data from 92,532 participants from 14 observational studies to replicate findings in individual-level MR analyses.\ A 1-SD decrease in genetically predicted LDLc was associated with increased type 2 diabetes odds (odds ratio [OR] 1.12 [95% CI 1.01, 1.24]) and BMI (β = 0.07 SD units [95% CI 0.02, 0.12]) in univariable MR analyses. The multivariable MR analysis showed evidence of an indirect effect of lowering LDLc on type 2 diabetes through BMI (OR 1.04 [95% CI 1.01, 1.08]) with a proportion mediated of 38% of the total effect (P = 0.03). Total and indirect effect estimates were similar across a number of sensitivity analyses. Individual-level MR analyses confirmed the indirect effect of lowering LDLc on type 2 diabetes through BMI with an estimated proportion mediated of 8% (P = 0.04).\ These findings suggest that the diabetogenic effect attributed to lowering LDLc is partially mediated through increased BMI. Our results could help advance understanding of adipose tissue and lipids in type 2 diabetes pathophysiology and inform strategies to reduce diabetes risk among individuals taking LDLc-lowering medications. %B Diabetes Care %V 45 %P 232–240 %8 Jan %G eng %0 Journal Article %J J Alzheimers Dis %D 2022 %T Pattern of Altered Magnetization Transfer Rate in Alzheimer's Disease. %A Duan, Wenna %A Sehrawat, Parshant %A Zhou, Tony D %A Becker, James T %A Lopez, Oscar L %A Gach, H Michael %A Dai, Weiying %X

BACKGROUND: Biomarkers for Alzheimer's disease (AD) are crucial for early diagnosis and treatment monitoring once disease modifying therapies become available.

OBJECTIVE: This study aims to quantify the forward magnetization transfer rate (kfor) map from brain tissue water to macromolecular protons and use it to identify the brain regions with abnormal kfor in AD and AD progression.

METHODS: From the Cardiovascular Health Study (CHS) cognition study, magnetization transfer imaging (MTI) was acquired at baseline from 63 participants, including 20 normal controls (NC), 18 with mild cognitive impairment (MCI), and 25 AD subjects. Of those, 53 participants completed a follow-up MRI scan and were divided into four groups: 15 stable NC, 12 NC-to-MCI, 12 stable MCI, and 14 MCI/AD-to-AD subjects. kfor maps were compared across NC, MCI, and AD groups at baseline for the cross-sectional study and across four longitudinal groups for the longitudinal study.

RESULTS: We found a lower kfor in the frontal gray matter (GM), parietal GM, frontal corona radiata (CR) white matter (WM) tracts, frontal and parietal superior longitudinal fasciculus (SLF) WM tracts in AD relative to both NC and MCI. Further, we observed progressive decreases of kfor in the frontal GM, parietal GM, frontal and parietal CR WM tracts, and parietal SLF WM tracts in stable MCI. In the parietal GM, parietal CR WM tracts, and parietal SLF WM tracts, we found trend differences between MCI/AD-to-AD and stable NC.

CONCLUSION: Forward magnetization transfer rate is a promising biomarker for AD diagnosis and progression.

%B J Alzheimers Dis %8 2022 Jun 09 %G eng %R 10.3233/JAD-220335 %0 Journal Article %J EBioMedicine %D 2022 %T Plasma epoxyeicosatrienoic acids and diabetes-related cardiovascular disease: The cardiovascular health study. %A Lemaitre, Rozenn N %A Jensen, Paul N %A Zeigler, Maxwell %A Fretts, Amanda M %A Umans, Jason G %A Howard, Barbara V %A Sitlani, Colleen M %A McKnight, Barbara %A Gharib, Sina A %A King, Irena B %A Siscovick, David S %A Psaty, Bruce M %A Sotoodehnia, Nona %A Totah, Rheem A %K Animals %K Arachidonic Acids %K Cardiovascular Diseases %K Diabetes Mellitus, Type 2 %K Eicosanoids %K Humans %K Ischemic Stroke %K Prospective Studies %X

BACKGROUND: Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid that may impact atherosclerosis, and animal experimental studies suggest EETs protect cardiac function. Plasma EETs are mostly esterified to phospholipids and part of an active pool. To address the limited information about EETs and CVD in humans, we conducted a prospective study of total plasma EETs (free + esterified) and diabetes-related CVD in the Cardiovascular Health Study (CHS).

METHODS: We measured 4 EET species and their metabolites, dihydroxyepoxyeicosatrienoic acids (DHETs), in plasma samples from 892 CHS participants with type 2 diabetes. We determined the association of EETs and DHETs with incident myocardial infarction (MI) and ischemic stroke using Cox regression.

FINDINGS: During follow-up (median 7.5 years), we identified 150 MI and 134 ischemic strokes. In primary, multivariable analyses, elevated levels of each EET species were associated with non-significant lower risk of incident MI (for example, hazard ratio for 1 SD higher 14,15-EET: 0.86, 95% CI: 0.72-1.02; p=0.08). The EETs-MI associations became significant in analyses further adjusted for DHETs (hazard ratio for 1 SD higher 14,15-EET adjusted for 14,15-DHET: 0.76, 95% CI: 0.63-0.91; p=0.004). Elevated EET levels were associated with higher risk of ischemic stroke in primary but not secondary analyses. Three DHET species were associated with higher risk of ischemic stroke in all analyses.

INTERPRETATION: Findings from this prospective study complement the extensive studies in animal models showing EETs protect cardiac function and provide new information in humans. Replication is needed to confirm the associations.

FUNDING: US National Institutes of Health.

%B EBioMedicine %V 83 %P 104189 %8 2022 Sep %G eng %R 10.1016/j.ebiom.2022.104189 %0 Journal Article %J J Am Heart Assoc %D 2022 %T Plasma Levels of Advanced Glycation Endproducts and Risk of Cardiovascular Events: Findings From 2 Prospective Cohorts. %A Lamprea-Montealegre, Julio A %A Arnold, Alice M %A McClelland, Robyn L %A Mukamal, Kenneth J %A Djoussé, Luc %A Biggs, Mary L %A Siscovick, David S %A Tracy, Russell P %A Beisswenger, Paul J %A Psaty, Bruce M %A Ix, Joachim H %A Kizer, Jorge R %K Atherosclerosis %K Cardiovascular Diseases %K Cohort Studies %K Glycation End Products, Advanced %K Humans %K Middle Aged %K Risk Factors %X

Background Advanced glycation endproducts (AGEs) have been linked to cardiovascular disease (CVD) in cohorts with and without diabetes. Data are lacking on prospective associations of various α-dicarbonyl-derived AGEs and incident CVD in the general population. We tested the hypothesis that major plasma AGEs are associated with new-onset CVD in 2 population-based cohorts of differing age and comorbidities. Methods and Results Analyses involved a random subcohort (n=466) from the Cardiovascular Health Study and a case-cohort sample (n=1631) from the Multi-Ethnic Study of Atherosclerosis. Five AGEs and 2 oxidative products were measured by liquid chromatography tandem mass spectrometry. Associations with CVD (myocardial infarction and stroke) were evaluated with Cox regression. Participants in the Cardiovascular Health Study were older than the Multi-Ethnic Study of Atherosclerosis, and had more comorbidities, along with higher levels of all AGEs. During median follow-up of 11 years, 439 participants in the Multi-Ethnic Study of Atherosclerosis and 200 in the Cardiovascular Health Study developed CVD. After multivariable adjustment, carboxymethyl-lysine, 3-deoxyglucosone hydroimidazolones and a summary variable of all measured AGEs (principal component 1) were significantly associated with incident CVD in the Cardiovascular Health Study (HRs [95% CI]: 1.20 [1.01, 1.42], 1.45 [1.23, 1.72], and 1.29 [1.06, 1.56], respectively), but not the Multi-Ethnic Study of Atherosclerosis. Oxidative products were not associated with CVD in either cohort. Conclusions We found α-dicarbonyl-derived AGEs to be associated with CVD in an older cohort, but not in a healthier middle-aged/older cohort. Our results suggest that AGEs may exert detrimental cardiovascular effects only under conditions of marked dicarbonyl and oxidative stress. Further investigation of α-dicarbonyl derivatives could lead to potential new strategies for CVD prevention in high-risk older populations.

%B J Am Heart Assoc %V 11 %P e024012 %8 2022 08 02 %G eng %N 15 %R 10.1161/JAHA.121.024012 %0 Journal Article %J Aging Cell %D 2022 %T Plasma proteomic signature of decline in gait speed and grip strength. %A Liu, Xiaojuan %A Pan, Stephanie %A Xanthakis, Vanessa %A Vasan, Ramachandran S %A Psaty, Bruce M %A Austin, Thomas R %A Newman, Anne B %A Sanders, Jason L %A Wu, Chenkai %A Tracy, Russell P %A Gerszten, Robert E %A Odden, Michelle C %K Adult %K Female %K Gait %K Hand Strength %K Humans %K Independent Living %K Male %K Proteomics %K Walking Speed %X

The biological mechanisms underlying decline in physical function with age remain unclear. We examined the plasma proteomic profile associated with longitudinal changes in physical function measured by gait speed and grip strength in community-dwelling adults. We applied an aptamer-based platform to assay 1154 plasma proteins on 2854 participants (60% women, aged 76 years) in the Cardiovascular Health Study (CHS) in 1992-1993 and 1130 participants (55% women, aged 54 years) in the Framingham Offspring Study (FOS) in 1991-1995. Gait speed and grip strength were measured annually for 7 years in CHS and at cycles 7 (1998-2001) and 8 (2005-2008) in FOS. The associations of individual protein levels (log-transformed and standardized) with longitudinal changes in gait speed and grip strength in two populations were examined separately by linear mixed-effects models. Meta-analyses were implemented using random-effects models and corrected for multiple testing. We found that plasma levels of 14 and 18 proteins were associated with changes in gait speed and grip strength, respectively (corrected p < 0.05). The proteins most strongly associated with gait speed decline were GDF-15 (Meta-analytic p = 1.58 × 10 ), pleiotrophin (1.23 × 10 ), and TIMP-1 (5.97 × 10 ). For grip strength decline, the strongest associations were for carbonic anhydrase III (1.09 × 10 ), CDON (2.38 × 10 ), and SMOC1 (7.47 × 10 ). Several statistically significant proteins are involved in the inflammatory responses or antagonism of activin by follistatin pathway. These novel proteomic biomarkers and pathways should be further explored as future mechanisms and targets for age-related functional decline.

%B Aging Cell %V 21 %P e13736 %8 2022 Dec %G eng %N 12 %R 10.1111/acel.13736 %0 Journal Article %J Am J Hum Genet %D 2022 %T Polygenic transcriptome risk scores for COPD and lung function improve cross-ethnic portability of prediction in the NHLBI TOPMed program. %A Hu, Xiaowei %A Qiao, Dandi %A Kim, Wonji %A Moll, Matthew %A Balte, Pallavi P %A Lange, Leslie A %A Bartz, Traci M %A Kumar, Rajesh %A Li, Xingnan %A Yu, Bing %A Cade, Brian E %A Laurie, Cecelia A %A Sofer, Tamar %A Ruczinski, Ingo %A Nickerson, Deborah A %A Muzny, Donna M %A Metcalf, Ginger A %A Doddapaneni, Harshavardhan %A Gabriel, Stacy %A Gupta, Namrata %A Dugan-Perez, Shannon %A Cupples, L Adrienne %A Loehr, Laura R %A Jain, Deepti %A Rotter, Jerome I %A Wilson, James G %A Psaty, Bruce M %A Fornage, Myriam %A Morrison, Alanna C %A Vasan, Ramachandran S %A Washko, George %A Rich, Stephen S %A O'Connor, George T %A Bleecker, Eugene %A Kaplan, Robert C %A Kalhan, Ravi %A Redline, Susan %A Gharib, Sina A %A Meyers, Deborah %A Ortega, Victor %A Dupuis, Josée %A London, Stephanie J %A Lappalainen, Tuuli %A Oelsner, Elizabeth C %A Silverman, Edwin K %A Barr, R Graham %A Thornton, Timothy A %A Wheeler, Heather E %A Cho, Michael H %A Im, Hae Kyung %A Manichaikul, Ani %X

While polygenic risk scores (PRSs) enable early identification of genetic risk for chronic obstructive pulmonary disease (COPD), predictive performance is limited when the discovery and target populations are not well matched. Hypothesizing that the biological mechanisms of disease are shared across ancestry groups, we introduce a PrediXcan-derived polygenic transcriptome risk score (PTRS) to improve cross-ethnic portability of risk prediction. We constructed the PTRS using summary statistics from application of PrediXcan on large-scale GWASs of lung function (forced expiratory volume in 1 s [FEV] and its ratio to forced vital capacity [FEV/FVC]) in the UK Biobank. We examined prediction performance and cross-ethnic portability of PTRS through smoking-stratified analyses both on 29,381 multi-ethnic participants from TOPMed population/family-based cohorts and on 11,771 multi-ethnic participants from TOPMed COPD-enriched studies. Analyses were carried out for two dichotomous COPD traits (moderate-to-severe and severe COPD) and two quantitative lung function traits (FEV and FEV/FVC). While the proposed PTRS showed weaker associations with disease than PRS for European ancestry, the PTRS showed stronger association with COPD than PRS for African Americans (e.g., odds ratio [OR] = 1.24 [95% confidence interval [CI]: 1.08-1.43] for PTRS versus 1.10 [0.96-1.26] for PRS among heavy smokers with ≥ 40 pack-years of smoking) for moderate-to-severe COPD. Cross-ethnic portability of the PTRS was significantly higher than the PRS (paired t test p < 2.2 × 10 with portability gains ranging from 5% to 28%) for both dichotomous COPD traits and across all smoking strata. Our study demonstrates the value of PTRS for improved cross-ethnic portability compared to PRS in predicting COPD risk.

%B Am J Hum Genet %8 2022 Mar 31 %G eng %R 10.1016/j.ajhg.2022.03.007 %0 Journal Article %J Ann Am Thorac Soc %D 2022 %T Pooled Cohort Probability Score for Subclinical Airflow Obstruction. %A Bhatt, Surya P %A Balte, Pallavi P %A Schwartz, Joseph E %A Jaeger, Byron C %A Cassano, Patricia A %A Chaves, Paulo H %A Couper, David %A Jacobs, David R %A Kalhan, Ravi %A Kaplan, Robert %A Lloyd-Jones, Donald %A Newman, Anne B %A O'Connor, George %A Sanders, Jason L %A Smith, Benjamin M %A Sun, Yifei %A Umans, Jason G %A White, Wendy B %A Yende, Sachin %A Oelsner, Elizabeth C %K Adult %K Female %K Forced Expiratory Volume %K Humans %K Lung %K Male %K Middle Aged %K Nutrition Surveys %K Pulmonary Disease, Chronic Obstructive %K Risk Factors %K Spirometry %K Vital Capacity %X

Early detection of chronic obstructive pulmonary disease (COPD) is a public health priority. Airflow obstruction is the single most important risk factor for adverse COPD outcomes, but spirometry is not routinely recommended for screening. To describe the burden of subclinical airflow obstruction (SAO) and to develop a probability score for SAO to inform potential detection and prevention programs. Lung function and clinical data were harmonized and pooled across nine U.S. general population cohorts. Adults with respiratory symptoms, inhaler use, or prior diagnosis of COPD or asthma were excluded. A probability score for prevalent SAO (forced expiratory volume in 1 second/forced vital capacity < 0.70) was developed via hierarchical group-lasso regularization from clinical variables in strata of sex and smoking status, and its discriminative accuracy for SAO was assessed in the pooled cohort as well as in an external validation cohort (NHANES [National Health and Nutrition Examination Survey] 2011-2012). Incident hospitalizations and deaths due to COPD (respiratory events) were defined by adjudication or administrative criteria in four of nine cohorts. Of 33,546 participants (mean age 52 yr, 54% female, 44% non-Hispanic White), 4,424 (13.2%) had prevalent SAO. The incidence of respiratory events ( = 14,024) was threefold higher in participants with SAO versus those without (152 vs. 39 events/10,000 person-years). The probability score, which was based on six commonly available variables (age, sex, race and/or ethnicity, body mass index, smoking status, and smoking pack-years) was well calibrated and showed excellent discrimination in both the testing sample (C-statistic, 0.81; 95% confidence interval [CI], 0.80-0.82) and in NHANES (C-statistic, 0.83; 95% CI, 0.80-0.86). Among participants with predicted probabilities ⩾ 15%, 3.2 would need to undergo spirometry to detect one case of SAO. Adults with SAO demonstrate excess respiratory hospitalization and mortality. A probability score for SAO using commonly available clinical risk factors may be suitable for targeting screening and primary prevention strategies.

%B Ann Am Thorac Soc %V 19 %P 1294-1304 %8 2022 08 %G eng %N 8 %R 10.1513/AnnalsATS.202109-1020OC %0 Journal Article %J Ann Clin Transl Neurol %D 2022 %T {A population-based meta-analysis of circulating GFAP for cognition and dementia risk %A Gonzales, M. M. %A Wiedner, C. %A Wang, C. P. %A Liu, Q. %A Bis, J. C. %A Li, Z. %A Himali, J. J. %A Ghosh, S. %A Thomas, E. A. %A Parent, D. M. %A Kautz, T. F. %A Pase, M. P. %A Aparicio, H. J. %A Djousse, L. %A Mukamal, K. J. %A Psaty, B. M. %A Longstreth, W. T. %A Mosley, T. H. %A Gudnason, V. %A Mbangdadji, D. %A Lopez, O. L. %A Yaffe, K. %A Sidney, S. %A Bryan, R. N. %A Nasrallah, I. M. %A DeCarli, C. S. %A Beiser, A. S. %A Launer, L. J. %A Fornage, M. %A Tracy, R. P. %A Seshadri, S. %A Satizabal, C. L. %X Expression of glial fibrillary acidic protein (GFAP), a marker of reactive astrocytosis, colocalizes with neuropathology in the brain. Blood levels of GFAP have been associated with cognitive decline and dementia status. However, further examinations at a population-based level are necessary to broaden generalizability to community settings.\ Circulating GFAP levels were assayed using a Simoa HD-1 analyzer in 4338 adults without prevalent dementia from four longitudinal community-based cohort studies. The associations between GFAP levels with general cognition, total brain volume, and hippocampal volume were evaluated with separate linear regression models in each cohort with adjustment for age, sex, education, race, diabetes, systolic blood pressure, antihypertensive medication, body mass index, apolipoprotein E ε4 status, site, and time between GFAP blood draw and the outcome. Associations with incident all-cause and Alzheimer's disease dementia were evaluated with adjusted Cox proportional hazard models. Meta-analysis was performed on the estimates derived from each cohort using random-effects models.\ 0.05). However, each standard deviation unit increase in log-transformed GFAP levels was significantly associated with a 2.5-fold higher risk of incident all-cause dementia (Hazard Ratio [HR]: 2.47 (95% CI: 1.52-4.01)) and Alzheimer's disease dementia (HR: 2.54 [95% CI: 1.42-4.53]) over up to 15-years of follow-up.\ Results support the potential role of circulating GFAP levels for aiding dementia risk prediction and improving clinical trial stratification in community settings. %B Ann Clin Transl Neurol %V 9 %P 1574–1585 %8 Oct %G eng %0 Journal Article %J Eur J Epidemiol %D 2022 %T Proteomics and Population Biology in the Cardiovascular Health Study (CHS): design of a study with mentored access and active data sharing. %A Austin, Thomas R %A McHugh, Caitlin P %A Brody, Jennifer A %A Bis, Joshua C %A Sitlani, Colleen M %A Bartz, Traci M %A Biggs, Mary L %A Bansal, Nisha %A Bůzková, Petra %A Carr, Steven A %A deFilippi, Christopher R %A Elkind, Mitchell S V %A Fink, Howard A %A Floyd, James S %A Fohner, Alison E %A Gerszten, Robert E %A Heckbert, Susan R %A Katz, Daniel H %A Kizer, Jorge R %A Lemaitre, Rozenn N %A Longstreth, W T %A McKnight, Barbara %A Mei, Hao %A Mukamal, Kenneth J %A Newman, Anne B %A Ngo, Debby %A Odden, Michelle C %A Vasan, Ramachandran S %A Shojaie, Ali %A Simon, Noah %A Smith, George Davey %A Davies, Neil M %A Siscovick, David S %A Sotoodehnia, Nona %A Tracy, Russell P %A Wiggins, Kerri L %A Zheng, Jie %A Psaty, Bruce M %X

BACKGROUND: In the last decade, genomic studies have identified and replicated thousands of genetic associations with measures of health and disease and contributed to the understanding of the etiology of a variety of health conditions. Proteins are key biomarkers in clinical medicine and often drug-therapy targets. Like genomics, proteomics can advance our understanding of biology.

METHODS AND RESULTS: In the setting of the Cardiovascular Health Study (CHS), a cohort study of older adults, an aptamer-based method that has high sensitivity for low-abundance proteins was used to assay 4979 proteins in frozen, stored plasma from 3188 participants (61% women, mean age 74 years). CHS provides active support, including central analysis, for seven phenotype-specific working groups (WGs). Each CHS WG is led by one or two senior investigators and includes 10 to 20 early or mid-career scientists. In this setting of mentored access, the proteomic data and analytic methods are widely shared with the WGs and investigators so that they may evaluate associations between baseline levels of circulating proteins and the incidence of a variety of health outcomes in prospective cohort analyses. We describe the design of CHS, the CHS Proteomics Study, characteristics of participants, quality control measures, and structural characteristics of the data provided to CHS WGs. We additionally highlight plans for validation and replication of novel proteomic associations.

CONCLUSION: The CHS Proteomics Study offers an opportunity for collaborative data sharing to improve our understanding of the etiology of a variety of health conditions in older adults.

%B Eur J Epidemiol %8 2022 Jul 05 %G eng %R 10.1007/s10654-022-00888-z %0 Journal Article %J Am J Clin Nutr %D 2022 %T PUFA ω-3 and ω-6 biomarkers and sleep: a pooled analysis of cohort studies on behalf of the Fatty Acids and Outcomes Research Consortium (FORCE). %A Murphy, Rachel A %A Tintle, Nathan %A Harris, William S %A Darvishian, Maryam %A Marklund, Matti %A Virtanen, Jyrki K %A Hantunen, Sari %A de Mello, Vanessa D %A Tuomilehto, Jaakko %A Lindström, Jaana %A Bolt, Matthew A %A Brouwer, Ingeborg A %A Wood, Alexis C %A Senn, Mackenzie %A Redline, Susan %A Tsai, Michael Y %A Gudnason, Vilmundur %A Eiriksdottir, Gudny %A Lindberg, Eva %A Shadyab, Aladdin H %A Liu, Buyun %A Carnethon, Mercedes %A Uusitupa, Matti %A Djoussé, Luc %A Riserus, Ulf %A Lind, Lars %A van Dam, Rob M %A Koh, Woon-Puay %A Shi, Peilin %A Siscovick, David %A Lemaitre, Rozenn N %A Mozaffarian, Dariush %K Biomarkers %K Cohort Studies %K Cross-Sectional Studies %K Fatty Acids %K Fatty Acids, Omega-3 %K Humans %K Outcome Assessment, Health Care %K Sleep %X

BACKGROUND: n-3 and n-6 PUFAs have physiologic roles in sleep processes, but little is known regarding circulating n-3 and n-6 PUFA and sleep parameters.

OBJECTIVES: We sought to assess associations between biomarkers of n-3 and n-6 PUFA intake with self-reported sleep duration and difficulty falling sleeping in the Fatty Acids and Outcome Research Consortium.

METHODS: Harmonized, de novo, individual-level analyses were performed and pooled across 12 cohorts. Participants were 35-96 y old and from 5 nations. Circulating measures included α-linolenic acid (ALA), EPA, docosapentaenoic acid (DPA), DHA, EPA + DPA + DHA, linoleic acid, and arachidonic acid. Sleep duration (10 cohorts, n = 18,791) was categorized as short (≤6 h), 7-8 h (reference), or long (≥9 h). Difficulty falling asleep (8 cohorts, n = 12,500) was categorized as yes or no. Associations between PUFAs, sleep duration, and difficulty falling sleeping were assessed by cross-sectional multinomial logistic regression using standardized protocols and covariates. Cohort-specific multivariable-adjusted ORs per quintile of PUFAs were pooled with inverse-variance weighted meta-analysis.

RESULTS: In pooled analysis adjusted for sociodemographic characteristics and health status, participants with higher very long-chain n-3 PUFAs were less likely to have long sleep duration. In the top compared with the bottom quintiles, the multivariable-adjusted ORs (95% CIs) for long sleep were 0.78 (95% CI: 0.65, 0.95) for DHA and 0.76 (95% CI: 0.63, 0.93) for EPA + DPA + DHA. Significant associations for ALA and n-6 PUFA with short sleep duration or difficulty falling sleeping were not identified.

CONCLUSIONS: Participants with higher concentrations of very long-chain n-3 PUFAs were less likely to have long sleep duration. While objective biomarkers reduce recall bias and misclassification, the cross-sectional design limits assessment of the temporal nature of this relation. These novel findings across 12 cohorts highlight the need for experimental and biological assessments of very long-chain n-3 PUFAs and sleep duration.

%B Am J Clin Nutr %V 115 %P 864-876 %8 2022 Mar 04 %G eng %N 3 %R 10.1093/ajcn/nqab408 %0 Journal Article %J Am J Hum Genet %D 2022 %T Rare coding variants in 35 genes associate with circulating lipid levels-A multi-ancestry analysis of 170,000 exomes. %A Hindy, George %A Dornbos, Peter %A Chaffin, Mark D %A Liu, Dajiang J %A Wang, Minxian %A Selvaraj, Margaret Sunitha %A Zhang, David %A Park, Joseph %A Aguilar-Salinas, Carlos A %A Antonacci-Fulton, Lucinda %A Ardissino, Diego %A Arnett, Donna K %A Aslibekyan, Stella %A Atzmon, Gil %A Ballantyne, Christie M %A Barajas-Olmos, Francisco %A Barzilai, Nir %A Becker, Lewis C %A Bielak, Lawrence F %A Bis, Joshua C %A Blangero, John %A Boerwinkle, Eric %A Bonnycastle, Lori L %A Bottinger, Erwin %A Bowden, Donald W %A Bown, Matthew J %A Brody, Jennifer A %A Broome, Jai G %A Burtt, Noel P %A Cade, Brian E %A Centeno-Cruz, Federico %A Chan, Edmund %A Chang, Yi-Cheng %A Chen, Yii-der I %A Cheng, Ching-Yu %A Choi, Won Jung %A Chowdhury, Rajiv %A Contreras-Cubas, Cecilia %A Córdova, Emilio J %A Correa, Adolfo %A Cupples, L Adrienne %A Curran, Joanne E %A Danesh, John %A de Vries, Paul S %A DeFronzo, Ralph A %A Doddapaneni, Harsha %A Duggirala, Ravindranath %A Dutcher, Susan K %A Ellinor, Patrick T %A Emery, Leslie S %A Florez, Jose C %A Fornage, Myriam %A Freedman, Barry I %A Fuster, Valentin %A Garay-Sevilla, Ma Eugenia %A García-Ortiz, Humberto %A Germer, Soren %A Gibbs, Richard A %A Gieger, Christian %A Glaser, Benjamin %A Gonzalez, Clicerio %A Gonzalez-Villalpando, Maria Elena %A Graff, Mariaelisa %A Graham, Sarah E %A Grarup, Niels %A Groop, Leif C %A Guo, Xiuqing %A Gupta, Namrata %A Han, Sohee %A Hanis, Craig L %A Hansen, Torben %A He, Jiang %A Heard-Costa, Nancy L %A Hung, Yi-Jen %A Hwang, Mi Yeong %A Irvin, Marguerite R %A Islas-Andrade, Sergio %A Jarvik, Gail P %A Kang, Hyun Min %A Kardia, Sharon L R %A Kelly, Tanika %A Kenny, Eimear E %A Khan, Alyna T %A Kim, Bong-Jo %A Kim, Ryan W %A Kim, Young Jin %A Koistinen, Heikki A %A Kooperberg, Charles %A Kuusisto, Johanna %A Kwak, Soo Heon %A Laakso, Markku %A Lange, Leslie A %A Lee, Jiwon %A Lee, Juyoung %A Lee, Seonwook %A Lehman, Donna M %A Lemaitre, Rozenn N %A Linneberg, Allan %A Liu, Jianjun %A Loos, Ruth J F %A Lubitz, Steven A %A Lyssenko, Valeriya %A Ma, Ronald C W %A Martin, Lisa Warsinger %A Martínez-Hernández, Angélica %A Mathias, Rasika A %A McGarvey, Stephen T %A McPherson, Ruth %A Meigs, James B %A Meitinger, Thomas %A Melander, Olle %A Mendoza-Caamal, Elvia %A Metcalf, Ginger A %A Mi, Xuenan %A Mohlke, Karen L %A Montasser, May E %A Moon, Jee-Young %A Moreno-Macias, Hortensia %A Morrison, Alanna C %A Muzny, Donna M %A Nelson, Sarah C %A Nilsson, Peter M %A O'Connell, Jeffrey R %A Orho-Melander, Marju %A Orozco, Lorena %A Palmer, Colin N A %A Palmer, Nicholette D %A Park, Cheol Joo %A Park, Kyong Soo %A Pedersen, Oluf %A Peralta, Juan M %A Peyser, Patricia A %A Post, Wendy S %A Preuss, Michael %A Psaty, Bruce M %A Qi, Qibin %A Rao, D C %A Redline, Susan %A Reiner, Alexander P %A Revilla-Monsalve, Cristina %A Rich, Stephen S %A Samani, Nilesh %A Schunkert, Heribert %A Schurmann, Claudia %A Seo, Daekwan %A Seo, Jeong-Sun %A Sim, Xueling %A Sladek, Rob %A Small, Kerrin S %A So, Wing Yee %A Stilp, Adrienne M %A Tai, E Shyong %A Tam, Claudia H T %A Taylor, Kent D %A Teo, Yik Ying %A Thameem, Farook %A Tomlinson, Brian %A Tsai, Michael Y %A Tuomi, Tiinamaija %A Tuomilehto, Jaakko %A Tusié-Luna, Teresa %A Udler, Miriam S %A van Dam, Rob M %A Vasan, Ramachandran S %A Viaud Martinez, Karine A %A Wang, Fei Fei %A Wang, Xuzhi %A Watkins, Hugh %A Weeks, Daniel E %A Wilson, James G %A Witte, Daniel R %A Wong, Tien-Yin %A Yanek, Lisa R %A Kathiresan, Sekar %A Rader, Daniel J %A Rotter, Jerome I %A Boehnke, Michael %A McCarthy, Mark I %A Willer, Cristen J %A Natarajan, Pradeep %A Flannick, Jason A %A Khera, Amit V %A Peloso, Gina M %K Alleles %K Blood Glucose %K Case-Control Studies %K Computational Biology %K Databases, Genetic %K Diabetes Mellitus, Type 2 %K Exome %K Genetic Predisposition to Disease %K Genetic Variation %K Genetics, Population %K Genome-Wide Association Study %K Humans %K Lipid Metabolism %K Lipids %K Liver %K Molecular Sequence Annotation %K Multifactorial Inheritance %K Open Reading Frames %K Phenotype %K Polymorphism, Single Nucleotide %X

Large-scale gene sequencing studies for complex traits have the potential to identify causal genes with therapeutic implications. We performed gene-based association testing of blood lipid levels with rare (minor allele frequency < 1%) predicted damaging coding variation by using sequence data from >170,000 individuals from multiple ancestries: 97,493 European, 30,025 South Asian, 16,507 African, 16,440 Hispanic/Latino, 10,420 East Asian, and 1,182 Samoan. We identified 35 genes associated with circulating lipid levels; some of these genes have not been previously associated with lipid levels when using rare coding variation from population-based samples. We prioritize 32 genes in array-based genome-wide association study (GWAS) loci based on aggregations of rare coding variants; three (EVI5, SH2B3, and PLIN1) had no prior association of rare coding variants with lipid levels. Most of our associated genes showed evidence of association among multiple ancestries. Finally, we observed an enrichment of gene-based associations for low-density lipoprotein cholesterol drug target genes and for genes closest to GWAS index single-nucleotide polymorphisms (SNPs). Our results demonstrate that gene-based associations can be beneficial for drug target development and provide evidence that the gene closest to the array-based GWAS index SNP is often the functional gene for blood lipid levels.

%B Am J Hum Genet %V 109 %P 81-96 %8 2022 01 06 %G eng %N 1 %R 10.1016/j.ajhg.2021.11.021 %0 Journal Article %J Nat Hum Behav %D 2022 %T Rare genetic variants explain missing heritability in smoking. %A Jang, Seon-Kyeong %A Evans, Luke %A Fialkowski, Allison %A Arnett, Donna K %A Ashley-Koch, Allison E %A Barnes, Kathleen C %A Becker, Diane M %A Bis, Joshua C %A Blangero, John %A Bleecker, Eugene R %A Boorgula, Meher Preethi %A Bowden, Donald W %A Brody, Jennifer A %A Cade, Brian E %A Jenkins, Brenda W Campbell %A Carson, April P %A Chavan, Sameer %A Cupples, L Adrienne %A Custer, Brian %A Damrauer, Scott M %A David, Sean P %A de Andrade, Mariza %A Dinardo, Carla L %A Fingerlin, Tasha E %A Fornage, Myriam %A Freedman, Barry I %A Garrett, Melanie E %A Gharib, Sina A %A Glahn, David C %A Haessler, Jeffrey %A Heckbert, Susan R %A Hokanson, John E %A Hou, Lifang %A Hwang, Shih-Jen %A Hyman, Matthew C %A Judy, Renae %A Justice, Anne E %A Kaplan, Robert C %A Kardia, Sharon L R %A Kelly, Shannon %A Kim, Wonji %A Kooperberg, Charles %A Levy, Daniel %A Lloyd-Jones, Donald M %A Loos, Ruth J F %A Manichaikul, Ani W %A Gladwin, Mark T %A Martin, Lisa Warsinger %A Nouraie, Mehdi %A Melander, Olle %A Meyers, Deborah A %A Montgomery, Courtney G %A North, Kari E %A Oelsner, Elizabeth C %A Palmer, Nicholette D %A Payton, Marinelle %A Peljto, Anna L %A Peyser, Patricia A %A Preuss, Michael %A Psaty, Bruce M %A Qiao, Dandi %A Rader, Daniel J %A Rafaels, Nicholas %A Redline, Susan %A Reed, Robert M %A Reiner, Alexander P %A Rich, Stephen S %A Rotter, Jerome I %A Schwartz, David A %A Shadyab, Aladdin H %A Silverman, Edwin K %A Smith, Nicholas L %A Smith, J Gustav %A Smith, Albert V %A Smith, Jennifer A %A Tang, Weihong %A Taylor, Kent D %A Telen, Marilyn J %A Vasan, Ramachandran S %A Gordeuk, Victor R %A Wang, Zhe %A Wiggins, Kerri L %A Yanek, Lisa R %A Yang, Ivana V %A Young, Kendra A %A Young, Kristin L %A Zhang, Yingze %A Liu, Dajiang J %A Keller, Matthew C %A Vrieze, Scott %X

Common genetic variants explain less variation in complex phenotypes than inferred from family-based studies, and there is a debate on the source of this 'missing heritability'. We investigated the contribution of rare genetic variants to tobacco use with whole-genome sequences from up to 26,257 unrelated individuals of European ancestries and 11,743 individuals of African ancestries. Across four smoking traits, single-nucleotide-polymorphism-based heritability ([Formula: see text]) was estimated from 0.13 to 0.28 (s.e., 0.10-0.13) in European ancestries, with 35-74% of it attributable to rare variants with minor allele frequencies between 0.01% and 1%. These heritability estimates are 1.5-4 times higher than past estimates based on common variants alone and accounted for 60% to 100% of our pedigree-based estimates of narrow-sense heritability ([Formula: see text], 0.18-0.34). In the African ancestry samples, [Formula: see text] was estimated from 0.03 to 0.33 (s.e., 0.09-0.14) across the four smoking traits. These results suggest that rare variants are important contributors to the heritability of smoking.

%B Nat Hum Behav %8 2022 Aug 04 %G eng %R 10.1038/s41562-022-01408-5 %0 Journal Article %J Alzheimers Dement %D 2022 %T {Replication study of AD-associated rare variants %A Neupane, A. %A Lenny, B. %A Budde, J. P. %A Wang, F. %A Norton, J. %A Morris, J. C. %A Cruchaga, C. %A Fernández, M. V. %B Alzheimers Dement %V 18 %P 858–862 %8 Apr %G eng %0 Journal Article %J Nature %D 2022 %T {A saturated map of common genetic variants associated with human height %A Yengo, L. %A Vedantam, S. %A Marouli, E. %A Sidorenko, J. %A Bartell, E. %A Sakaue, S. %A Graff, M. %A Eliasen, A. U. %A Jiang, Y. %A Raghavan, S. %A Miao, J. %A Arias, J. D. %A Graham, S. E. %A Mukamel, R. E. %A Spracklen, C. N. %A Yin, X. %A Chen, S. H. %A Ferreira, T. %A Highland, H. H. %A Ji, Y. %A Karaderi, T. %A Lin, K. %A ll, K. %A Malden, D. E. %A Medina-Gomez, C. %A Machado, M. %A Moore, A. %A eger, S. %A Sim, X. %A Vrieze, S. %A Ahluwalia, T. S. %A Akiyama, M. %A Allison, M. A. %A Alvarez, M. %A Andersen, M. K. %A Ani, A. %A Appadurai, V. %A Arbeeva, L. %A Bhaskar, S. %A Bielak, L. F. %A Bollepalli, S. %A Bonnycastle, L. L. %A Bork-Jensen, J. %A Bradfield, J. P. %A Bradford, Y. %A Braund, P. S. %A Brody, J. A. %A Burgdorf, K. S. %A Cade, B. E. %A Cai, H. %A Cai, Q. %A Campbell, A. %A adas-Garre, M. %A Catamo, E. %A Chai, J. F. %A Chai, X. %A Chang, L. C. %A Chang, Y. C. %A Chen, C. H. %A Chesi, A. %A Choi, S. H. %A Chung, R. H. %A Cocca, M. %A Concas, M. P. %A Couture, C. %A Cuellar-Partida, G. %A Danning, R. %A Daw, E. W. %A Degenhard, F. %A Delgado, G. E. %A Delitala, A. %A Demirkan, A. %A Deng, X. %A Devineni, P. %A Dietl, A. %A Dimitriou, M. %A Dimitrov, L. %A Dorajoo, R. %A Ekici, A. B. %A Engmann, J. E. %A Fairhurst-Hunter, Z. %A Farmaki, A. E. %A Faul, J. D. %A Fernandez-Lopez, J. C. %A Forer, L. %A Francescatto, M. %A Freitag-Wolf, S. %A Fuchsberger, C. %A Galesloot, T. E. %A Gao, Y. %A Gao, Z. %A Geller, F. %A Giannakopoulou, O. %A Giulianini, F. %A Gjesing, A. P. %A Goel, A. %A Gordon, S. D. %A Gorski, M. %A Grove, J. %A Guo, X. %A Gustafsson, S. %A Haessler, J. %A Hansen, T. F. %A Havulinna, A. S. %A Haworth, S. J. %A He, J. %A Heard-Costa, N. %A Hebbar, P. %A Hindy, G. %A Ho, Y. A. %A Hofer, E. %A Holliday, E. %A Horn, K. %A Hornsby, W. E. %A Hottenga, J. J. %A Huang, H. %A Huang, J. %A Huerta-Chagoya, A. %A Huffman, J. E. %A Hung, Y. J. %A Huo, S. %A Hwang, M. Y. %A Iha, H. %A Ikeda, D. D. %A Isono, M. %A Jackson, A. U. %A ger, S. %A Jansen, I. E. %A Johansson, I. %A Jonas, J. B. %A Jonsson, A. %A rgensen, T. %A Kalafati, I. P. %A Kanai, M. %A Kanoni, S. %A rhus, L. L. %A Kasturiratne, A. %A Katsuya, T. %A Kawaguchi, T. %A Kember, R. L. %A Kentistou, K. A. %A Kim, H. N. %A Kim, Y. J. %A Kleber, M. E. %A Knol, M. J. %A Kurbasic, A. %A Lauzon, M. %A Le, P. %A Lea, R. %A Lee, J. Y. %A Leonard, H. L. %A Li, S. A. %A Li, X. %A Li, X. %A Liang, J. %A Lin, H. %A Lin, S. Y. %A Liu, J. %A Liu, X. %A Lo, K. S. %A Long, J. %A Lorés-Motta, L. %A Luan, J. %A Lyssenko, V. %A inen, L. P. %A Mahajan, A. %A Mamakou, V. %A Mangino, M. %A Manichaikul, A. %A Marten, J. %A Mattheisen, M. %A Mavarani, L. %A McDaid, A. F. %A Meidtner, K. %A Melendez, T. L. %A Mercader, J. M. %A Milaneschi, Y. %A Miller, J. E. %A Millwood, I. Y. %A Mishra, P. P. %A Mitchell, R. E. %A llehave, L. T. %A Morgan, A. %A Mucha, S. %A Munz, M. %A Nakatochi, M. %A Nelson, C. P. %A Nethander, M. %A Nho, C. W. %A Nielsen, A. A. %A Nolte, I. M. %A Nongmaithem, S. S. %A Noordam, R. %A Ntalla, I. %A Nutile, T. %A Pandit, A. %A Christofidou, P. %A rna, K. %A Pauper, M. %A Petersen, E. R. B. %A Petersen, L. V. %A nen, N. %A ek, O. %A Poveda, A. %A Preuss, M. H. %A Pyarajan, S. %A Raffield, L. M. %A Rakugi, H. %A Ramirez, J. %A Rasheed, A. %A Raven, D. %A Rayner, N. W. %A Riveros, C. %A Rohde, R. %A Ruggiero, D. %A Ruotsalainen, S. E. %A Ryan, K. A. %A Sabater-Lleal, M. %A Saxena, R. %A Scholz, M. %A Sendamarai, A. %A Shen, B. %A Shi, J. %A Shin, J. H. %A Sidore, C. %A Sitlani, C. M. %A Slieker, R. C. %A Smit, R. A. J. %A Smith, A. V. %A Smith, J. A. %A Smyth, L. J. %A Southam, L. %A Steinthorsdottir, V. %A Sun, L. %A Takeuchi, F. %A Tallapragada, D. S. P. %A Taylor, K. D. %A Tayo, B. O. %A Tcheandjieu, C. %A Terzikhan, N. %A Tesolin, P. %A Teumer, A. %A Theusch, E. %A Thompson, D. J. %A Thorleifsson, G. %A Timmers, P. R. H. J. %A Trompet, S. %A Turman, C. %A Vaccargiu, S. %A van der Laan, S. W. %A van der Most, P. J. %A van Klinken, J. B. %A van Setten, J. %A Verma, S. S. %A Verweij, N. %A Veturi, Y. %A Wang, C. A. %A Wang, C. %A Wang, L. %A Wang, Z. %A Warren, H. R. %A Bin Wei, W. %A Wickremasinghe, A. R. %A Wielscher, M. %A Wiggins, K. L. %A Winsvold, B. S. %A Wong, A. %A Wu, Y. %A Wuttke, M. %A Xia, R. %A Xie, T. %A Yamamoto, K. %A Yang, J. %A Yao, J. %A Young, H. %A Yousri, N. A. %A Yu, L. %A Zeng, L. %A Zhang, W. %A Zhang, X. %A Zhao, J. H. %A Zhao, W. %A Zhou, W. %A Zimmermann, M. E. %A Zoledziewska, M. %A Adair, L. S. %A Adams, H. H. H. %A Aguilar-Salinas, C. A. %A Al-Mulla, F. %A Arnett, D. K. %A Asselbergs, F. W. %A svold, B. O. %A Attia, J. %A Banas, B. %A Bandinelli, S. %A Bennett, D. A. %A Bergler, T. %A Bharadwaj, D. %A Biino, G. %A Bisgaard, H. %A Boerwinkle, E. %A ger, C. A. %A nnelykke, K. %A Boomsma, D. I. %A rglum, A. D. %A Borja, J. B. %A Bouchard, C. %A Bowden, D. W. %A Brandslund, I. %A Brumpton, B. %A Buring, J. E. %A Caulfield, M. J. %A Chambers, J. C. %A Chandak, G. R. %A Chanock, S. J. %A Chaturvedi, N. %A Chen, Y. I. %A Chen, Z. %A Cheng, C. Y. %A Christophersen, I. E. %A Ciullo, M. %A Cole, J. W. %A Collins, F. S. %A Cooper, R. S. %A Cruz, M. %A Cucca, F. %A Cupples, L. A. %A Cutler, M. J. %A Damrauer, S. M. %A Dantoft, T. M. %A de Borst, G. J. %A de Groot, L. C. P. G. M. %A De Jager, P. L. %A de Kleijn, D. P. V. %A Janaka de Silva, H. %A Dedoussis, G. V. %A den Hollander, A. I. %A Du, S. %A Easton, D. F. %A Elders, P. J. M. %A Eliassen, A. H. %A Ellinor, P. T. %A hl, S. %A Erdmann, J. %A Evans, M. K. %A Fatkin, D. %A Feenstra, B. %A Feitosa, M. F. %A Ferrucci, L. %A Ford, I. %A Fornage, M. %A Franke, A. %A Franks, P. W. %A Freedman, B. I. %A Gasparini, P. %A Gieger, C. %A Girotto, G. %A Goddard, M. E. %A Golightly, Y. M. %A Gonzalez-Villalpando, C. %A Gordon-Larsen, P. %A Grallert, H. %A Grant, S. F. A. %A Grarup, N. %A Griffiths, L. %A Gudnason, V. %A Haiman, C. %A Hakonarson, H. %A Hansen, T. %A Hartman, C. A. %A Hattersley, A. T. %A Hayward, C. %A Heckbert, S. R. %A Heng, C. K. %A Hengstenberg, C. %A Hewitt, A. W. %A Hishigaki, H. %A Hoyng, C. B. %A Huang, P. L. %A Huang, W. %A Hunt, S. C. %A Hveem, K. %A nen, E. %A Iacono, W. G. %A Ichihara, S. %A Ikram, M. A. %A Isasi, C. R. %A Jackson, R. D. %A Jarvelin, M. R. %A Jin, Z. B. %A ckel, K. H. %A Joshi, P. K. %A Jousilahti, P. %A Jukema, J. W. %A nen, M. %A Kamatani, Y. %A Kang, K. D. %A Kaprio, J. %A Kardia, S. L. R. %A Karpe, F. %A Kato, N. %A Kee, F. %A Kessler, T. %A Khera, A. V. %A Khor, C. C. %A Kiemeney, L. A. L. M. %A Kim, B. J. %A Kim, E. K. %A Kim, H. L. %A Kirchhof, P. %A Kivimaki, M. %A Koh, W. P. %A Koistinen, H. A. %A Kolovou, G. D. %A Kooner, J. S. %A Kooperberg, C. %A ttgen, A. %A Kovacs, P. %A Kraaijeveld, A. %A Kraft, P. %A Krauss, R. M. %A Kumari, M. %A Kutalik, Z. %A Laakso, M. %A Lange, L. A. %A Langenberg, C. %A Launer, L. J. %A Le Marchand, L. %A Lee, H. %A Lee, N. R. %A ki, T. %A Li, H. %A Li, L. %A Lieb, W. %A Lin, X. %A Lind, L. %A Linneberg, A. %A Liu, C. T. %A Liu, J. %A Loeffler, M. %A London, B. %A Lubitz, S. A. %A Lye, S. J. %A Mackey, D. A. %A gi, R. %A Magnusson, P. K. E. %A Marcus, G. M. %A Vidal, P. M. %A Martin, N. G. %A rz, W. %A Matsuda, F. %A McGarrah, R. W. %A McGue, M. %A McKnight, A. J. %A Medland, S. E. %A m, D. %A Metspalu, A. %A Mitchell, B. D. %A Mitchell, P. %A Mook-Kanamori, D. O. %A Morris, A. D. %A Mucci, L. A. %A Munroe, P. B. %A Nalls, M. A. %A Nazarian, S. %A Nelson, A. E. %A Neville, M. J. %A Newton-Cheh, C. %A Nielsen, C. S. %A then, M. M. %A Ohlsson, C. %A Oldehinkel, A. J. %A Orozco, L. %A Pahkala, K. %A Pajukanta, P. %A Palmer, C. N. A. %A Parra, E. J. %A Pattaro, C. %A Pedersen, O. %A Pennell, C. E. %A Penninx, B. W. J. H. %A Pérusse, L. %A Peters, A. %A Peyser, P. A. %A Porteous, D. J. %A Posthuma, D. %A Power, C. %A Pramstaller, P. P. %A Province, M. A. %A Qi, Q. %A Qu, J. %A Rader, D. J. %A Raitakari, O. T. %A Ralhan, S. %A Rallidis, L. S. %A Rao, D. C. %A Redline, S. %A Reilly, D. F. %A Reiner, A. P. %A Rhee, S. Y. %A Ridker, P. M. %A Rienstra, M. %A Ripatti, S. %A Ritchie, M. D. %A Roden, D. M. %A Rosendaal, F. R. %A Rotter, J. I. %A Rudan, I. %A Rutters, F. %A Sabanayagam, C. %A Saleheen, D. %A Salomaa, V. %A Samani, N. J. %A Sanghera, D. K. %A Sattar, N. %A Schmidt, B. %A Schmidt, H. %A Schmidt, R. %A Schulze, M. B. %A Schunkert, H. %A Scott, L. J. %A Scott, R. J. %A Sever, P. %A Shiroma, E. J. %A Shoemaker, M. B. %A Shu, X. O. %A Simonsick, E. M. %A Sims, M. %A Singh, J. R. %A Singleton, A. B. %A Sinner, M. F. %A Smith, J. G. %A Snieder, H. %A Spector, T. D. %A Stampfer, M. J. %A Stark, K. J. %A Strachan, D. P. %A 't Hart, L. M. %A Tabara, Y. %A Tang, H. %A Tardif, J. C. %A Thanaraj, T. A. %A Timpson, N. J. %A njes, A. %A Tremblay, A. %A Tuomi, T. %A Tuomilehto, J. %A -Luna, M. T. %A Uitterlinden, A. G. %A van Dam, R. M. %A van der Harst, P. %A Van der Velde, N. %A van Duijn, C. M. %A van Schoor, N. M. %A Vitart, V. %A lker, U. %A Vollenweider, P. %A lzke, H. %A Wacher-Rodarte, N. H. %A Walker, M. %A Wang, Y. X. %A Wareham, N. J. %A Watanabe, R. M. %A Watkins, H. %A Weir, D. R. %A Werge, T. M. %A Widén, E. %A Wilkens, L. R. %A Willemsen, G. %A Willett, W. C. %A Wilson, J. F. %A Wong, T. Y. %A Woo, J. T. %A Wright, A. F. %A Wu, J. Y. %A Xu, H. %A Yajnik, C. S. %A Yokota, M. %A Yuan, J. M. %A Zeggini, E. %A Zemel, B. S. %A Zheng, W. %A Zhu, X. %A Zmuda, J. M. %A Zonderman, A. B. %A Zwart, J. A. %A Chasman, D. I. %A Cho, Y. S. %A Heid, I. M. %A McCarthy, M. I. %A Ng, M. C. Y. %A O'Donnell, C. J. %A Rivadeneira, F. %A Thorsteinsdottir, U. %A Sun, Y. V. %A Tai, E. S. %A Boehnke, M. %A Deloukas, P. %A Justice, A. E. %A Lindgren, C. M. %A Loos, R. J. F. %A Mohlke, K. L. %A North, K. E. %A Stefansson, K. %A Walters, R. G. %A Winkler, T. W. %A Young, K. L. %A Loh, P. R. %A Yang, J. %A Esko, T. %A Assimes, T. L. %A Auton, A. %A Abecasis, G. R. %A Willer, C. J. %A Locke, A. E. %A Berndt, S. I. %A Lettre, G. %A Frayling, T. M. %A Okada, Y. %A Wood, A. R. %A Visscher, P. M. %A Hirschhorn, J. N. %A Partida, G. C. %A Sun, Y. %A Croteau-Chonka, D. %A Vonk, J. M. %A Chanock, S. %A Le Marchand, L. %X ) account for 40% (45%) of phenotypic variance in populations of European ancestry but only around 10-20% (14-24%) in populations of other ancestries. Effect sizes, associated regions and gene prioritization are similar across ancestries, indicating that reduced prediction accuracy is likely to be explained by linkage disequilibrium and differences in allele frequency within associated regions. Finally, we show that the relevant biological pathways are detectable with smaller sample sizes than are needed to implicate causal genes and variants. Overall, this study provides a comprehensive map of specific genomic regions that contain the vast majority of common height-associated variants. Although this map is saturated for populations of European ancestry, further research is needed to achieve equivalent saturation in other ancestries. %B Nature %V 610 %P 704–712 %8 Oct %G eng %0 Journal Article %J Cancer Epidemiol %D 2022 %T Sleep problems and risk of cancer incidence and mortality in an older cohort: The Cardiovascular Health Study (CHS). %A Sillah, Arthur %A Watson, Nathaniel F %A Peters, Ulrike %A Biggs, Mary L %A Nieto, F Javier %A Li, Christopher I %A Gozal, David %A Thornton, Timothy %A Barrie, Sonnah %A Phipps, Amanda I %X

BACKGROUND: Sleep problems (SP) can indicate underlying sleep disorders, such as obstructive sleep apnea, which may adversely impact cancer risk and mortality.

METHODS: We assessed the association of baseline and longitudinal sleep apnea and insomnia symptoms with incident cancer (N = 3930) and cancer mortality (N = 4580) in the Cardiovascular Health Study. We used Cox proportional hazards regression to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the associations.

RESULTS: Overall, 885 incident cancers and 804 cancer deaths were identified over a median follow-up of 12 and 14 years, respectively. Compared to participants who reported no sleep apnea symptoms, the risk of incident cancer was inversely associated [(HR (95%CI)] with snoring [0.84 (0.71, 0.99)]. We noted an elevated prostate cancer incidence for apnea [2.34 (1.32, 4.15)] and snoring [1.69 (1.11, 2.57)]. We also noted an elevated HR for lymphatic or hematopoietic cancers [daytime sleepiness: 1.81 (1.06, 3.08)]. We found an inverse relationship for cancer mortality with respect to snoring [0.73 (0.62, 0.8)] and apnea [(0.69 (0.51, 0.94))]. We noted a significant inverse relationship between difficulty falling asleep and colorectal cancer death [0.32 (0.15, 0.69)] and snoring with lung cancer death [0.56 (0.35, 0.89)].

CONCLUSIONS: The relationship between SP and cancer risk and mortality was heterogeneous. Larger prospective studies addressing more cancer sites, molecular type-specific associations, and better longitudinal SP assessments are needed for improved delineation of SP-cancer risk dyad.

%B Cancer Epidemiol %V 76 %P 102057 %8 2022 Feb %G eng %R 10.1016/j.canep.2021.102057 %0 Journal Article %J Nature %D 2022 %T Stroke genetics informs drug discovery and risk prediction across ancestries. %A Mishra, Aniket %A Malik, Rainer %A Hachiya, Tsuyoshi %A Jürgenson, Tuuli %A Namba, Shinichi %A Posner, Daniel C %A Kamanu, Frederick K %A Koido, Masaru %A Le Grand, Quentin %A Shi, Mingyang %A He, Yunye %A Georgakis, Marios K %A Caro, Ilana %A Krebs, Kristi %A Liaw, Yi-Ching %A Vaura, Felix C %A Lin, Kuang %A Winsvold, Bendik Slagsvold %A Srinivasasainagendra, Vinodh %A Parodi, Livia %A Bae, Hee-Joon %A Chauhan, Ganesh %A Chong, Michael R %A Tomppo, Liisa %A Akinyemi, Rufus %A Roshchupkin, Gennady V %A Habib, Naomi %A Jee, Yon Ho %A Thomassen, Jesper Qvist %A Abedi, Vida %A Cárcel-Márquez, Jara %A Nygaard, Marianne %A Leonard, Hampton L %A Yang, Chaojie %A Yonova-Doing, Ekaterina %A Knol, Maria J %A Lewis, Adam J %A Judy, Renae L %A Ago, Tetsuro %A Amouyel, Philippe %A Armstrong, Nicole D %A Bakker, Mark K %A Bartz, Traci M %A Bennett, David A %A Bis, Joshua C %A Bordes, Constance %A Børte, Sigrid %A Cain, Anael %A Ridker, Paul M %A Cho, Kelly %A Chen, Zhengming %A Cruchaga, Carlos %A Cole, John W %A De Jager, Phil L %A de Cid, Rafael %A Endres, Matthias %A Ferreira, Leslie E %A Geerlings, Mirjam I %A Gasca, Natalie C %A Gudnason, Vilmundur %A Hata, Jun %A He, Jing %A Heath, Alicia K %A Ho, Yuk-Lam %A Havulinna, Aki S %A Hopewell, Jemma C %A Hyacinth, Hyacinth I %A Inouye, Michael %A Jacob, Mina A %A Jeon, Christina E %A Jern, Christina %A Kamouchi, Masahiro %A Keene, Keith L %A Kitazono, Takanari %A Kittner, Steven J %A Konuma, Takahiro %A Kumar, Amit %A Lacaze, Paul %A Launer, Lenore J %A Lee, Keon-Joo %A Lepik, Kaido %A Li, Jiang %A Li, Liming %A Manichaikul, Ani %A Markus, Hugh S %A Marston, Nicholas A %A Meitinger, Thomas %A Mitchell, Braxton D %A Montellano, Felipe A %A Morisaki, Takayuki %A Mosley, Thomas H %A Nalls, Mike A %A Nordestgaard, Børge G %A O'Donnell, Martin J %A Okada, Yukinori %A Onland-Moret, N Charlotte %A Ovbiagele, Bruce %A Peters, Annette %A Psaty, Bruce M %A Rich, Stephen S %A Rosand, Jonathan %A Sabatine, Marc S %A Sacco, Ralph L %A Saleheen, Danish %A Sandset, Else Charlotte %A Salomaa, Veikko %A Sargurupremraj, Muralidharan %A Sasaki, Makoto %A Satizabal, Claudia L %A Schmidt, Carsten O %A Shimizu, Atsushi %A Smith, Nicholas L %A Sloane, Kelly L %A Sutoh, Yoichi %A Sun, Yan V %A Tanno, Kozo %A Tiedt, Steffen %A Tatlisumak, Turgut %A Torres-Aguila, Nuria P %A Tiwari, Hemant K %A Trégouët, David-Alexandre %A Trompet, Stella %A Tuladhar, Anil Man %A Tybjærg-Hansen, Anne %A van Vugt, Marion %A Vibo, Riina %A Verma, Shefali S %A Wiggins, Kerri L %A Wennberg, Patrik %A Woo, Daniel %A Wilson, Peter W F %A Xu, Huichun %A Yang, Qiong %A Yoon, Kyungheon %A Millwood, Iona Y %A Gieger, Christian %A Ninomiya, Toshiharu %A Grabe, Hans J %A Jukema, J Wouter %A Rissanen, Ina L %A Strbian, Daniel %A Kim, Young Jin %A Chen, Pei-Hsin %A Mayerhofer, Ernst %A Howson, Joanna M M %A Irvin, Marguerite R %A Adams, Hieab %A Wassertheil-Smoller, Sylvia %A Christensen, Kaare %A Ikram, Mohammad A %A Rundek, Tatjana %A Worrall, Bradford B %A Lathrop, G Mark %A Riaz, Moeen %A Simonsick, Eleanor M %A Kõrv, Janika %A França, Paulo H C %A Zand, Ramin %A Prasad, Kameshwar %A Frikke-Schmidt, Ruth %A de Leeuw, Frank-Erik %A Liman, Thomas %A Haeusler, Karl Georg %A Ruigrok, Ynte M %A Heuschmann, Peter Ulrich %A Longstreth, W T %A Jung, Keum Ji %A Bastarache, Lisa %A Paré, Guillaume %A Damrauer, Scott M %A Chasman, Daniel I %A Rotter, Jerome I %A Anderson, Christopher D %A Zwart, John-Anker %A Niiranen, Teemu J %A Fornage, Myriam %A Liaw, Yung-Po %A Seshadri, Sudha %A Fernandez-Cadenas, Israel %A Walters, Robin G %A Ruff, Christian T %A Owolabi, Mayowa O %A Huffman, Jennifer E %A Milani, Lili %A Kamatani, Yoichiro %A Dichgans, Martin %A Debette, Stephanie %X

Previous genome-wide association studies (GWASs) of stroke - the second leading cause of death worldwide - were conducted predominantly in populations of European ancestry. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.

%B Nature %8 2022 Sep 30 %G eng %R 10.1038/s41586-022-05165-3 %0 Journal Article %J Am J Respir Crit Care Med %D 2022 %T Targeted Genome Sequencing Identifies Multiple Rare Variants in Caveolin-1 Associated with Obstructive Sleep Apnea. %A Liang, Jingjing %A Wang, Heming %A Cade, Brian E %A Kurniansyah, Nuzulul %A He, Karen Y %A Lee, Jiwon %A Sands, Scott A %A Brody, Jennifer %A Chen, Han %A Gottlieb, Daniel J %A Evans, Daniel S %A Guo, Xiuqing %A Gharib, Sina A %A Hale, Lauren %A Hillman, David R %A Lutsey, Pamela L %A Mukherjee, Sutapa %A Ochs-Balcom, Heather M %A Palmer, Lyle J %A Purcell, Shaun %A Saxena, Richa %A Patel, Sanjay R %A Stone, Katie L %A Tranah, Gregory J %A Boerwinkle, Eric %A Lin, Xihong %A Liu, Yongmei %A Psaty, Bruce M %A Vasan, Ramachandran S %A Manichaikul, Ani %A Rich, Stephen S %A Rotter, Jerome I %A Sofer, Tamar %A Redline, Susan %A Zhu, Xiaofeng %X

INTRODUCTION: Obstructive sleep apnea (OSA) is a common disorder associated with increased risk for cardiovascular disease, diabetes, and premature mortality. There is strong clinical and epi-demiologic evidence supporting the importance of genetic factors influencing OSA, but limited data implicating specific genes.

METHODS: Leveraging high depth genomic sequencing data from the National Heart, Lung, and Blood Institute (NHLBI) Trans-Omics for Precision Medicine (TOPMed) program and imputed genotype data from multiple population-based studies, we performed linkage analysis in the Cleve-land Family Study (CFS) followed by multi-stage gene-based association analyses in independent cohorts to search for rare variants contributing to OSA severity as assessed by the apnea-hypopnea index (AHI) in a total of 7,708 individuals of European ancestry.

RESULTS: Linkage analysis in CFS identified a suggestive linkage peak on chromosome 7q31 (LOD=2.31). Gene-based analysis identified 21 non-coding rare variants in Caveolin-1 (CAV1) associated with lower AHI after accounting for multiple comparisons (p=7.4×10-8). These non-coding variants together significantly contributed to the linkage evidence (p<10-3). Follow-up anal-ysis revealed significant associations between these variants and increased CAV1 expression, and increased CAV1 expression in peripheral monocytes was associated with lower AHI (p=0.024) and higher minimum overnight oxygen saturation (p=0.007).

CONCLUSION: Rare variants in CAV1, a membrane scaffolding protein essential in multiple cellular and metabolic functions, are associated with higher CAV1 gene expression and lower OSA severity, suggesting a novel target for modulating OSA severity.

%B Am J Respir Crit Care Med %8 2022 Jul 13 %G eng %R 10.1164/rccm.202203-0618OC %0 Journal Article %J Diabetes Care %D 2022 %T {Trans Fatty Acid Biomarkers and Incident Type 2 Diabetes: Pooled Analysis of 12 Prospective Cohort Studies in the Fatty Acids and Outcomes Research Consortium (FORCE) %A Lai, H. T. M. %A Imamura, F. %A Korat, A. V. A. %A Murphy, R. A. %A Tintle, N. %A Bassett, J. K. %A Chen, J. %A ger, J. %A Chien, K. L. %A Senn, M. %A Wood, A. C. %A Forouhi, N. G. %A Schulze, M. B. %A Harris, W. S. %A Vasan, R. S. %A Hu, F. %A Giles, G. G. %A Hodge, A. %A Djousse, L. %A Brouwer, I. A. %A Qian, F. %A Sun, Q. %A Wu, J. H. Y. %A Marklund, M. %A Lemaitre, R. N. %A Siscovick, D. S. %A Fretts, A. M. %A Shadyab, A. H. %A Manson, J. E. %A Howard, B. V. %A Robinson, J. G. %A Wallace, R. B. %A Wareham, N. J. %A Chen, Y. I. %A Rotter, J. I. %A Tsai, M. Y. %A Micha, R. %A Mozaffarian, D. %X Trans fatty acids (TFAs) have harmful biologic effects that could increase the risk of type 2 diabetes (T2D), but evidence remains uncertain. We aimed to investigate the prospective associations of TFA biomarkers and T2D by conducting an individual participant-level pooled analysis.\ 18 years without prevalent diabetes. Each cohort conducted de novo harmonized analyses using a prespecified protocol, and findings were pooled using inverse-variance weighted meta-analysis. Heterogeneity was explored by prespecified between-study and within-study characteristics.\ 0.1).\ Circulating individual trans-18:2 TFA biomarkers were not associated with risk of T2D, while trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated. Findings may reflect the influence of mixed TFA sources (industrial vs. natural ruminant), a general decline in TFA exposure due to policy changes during this period, or the relatively limited range of TFA levels. %B Diabetes Care %V 45 %P 854–863 %8 Apr %G eng %0 Journal Article %J Bone %D 2022 %T Trimethylamine N-oxide and hip fracture and bone mineral density in older adults: The cardiovascular health study. %A Elam, Rachel E %A Bůzková, Petra %A Barzilay, Joshua I %A Wang, Zeneng %A Nemet, Ina %A Budoff, Matthew J %A Cauley, Jane A %A Fink, Howard A %A Lee, Yujin %A Robbins, John A %A Wang, Meng %A Hazen, Stanley L %A Mozaffarian, Dariush %A Carbone, Laura D %K Absorptiometry, Photon %K Aged %K Bone Density %K Female %K Hip Fractures %K Humans %K Male %K Methylamines %K Risk Factors %X

CONTEXT: Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) may adversely affect bone by inducing oxidative stress. Whether this translates into increased fracture risk in older adults is uncertain.

OBJECTIVE: Determine the associations of plasma TMAO with hip fracture and bone mineral density (BMD) in older adults.

DESIGN AND SETTING: Cox hazard models and linear regression stratified by sex examined the associations of TMAO with hip fracture and BMD in the longitudinal cohort of the Cardiovascular Health Study.

PARTICIPANTS: 5019 U.S. adults aged ≥65 years.

EXPOSURE: Plasma TMAO.

MAIN OUTCOME MEASURES: Incident hip fractures; total hip BMD dual x-ray absorptiometry in a subset (n = 1400).

RESULTS: Six hundred sixty-six incident hip fractures occurred during up to 26 years of follow-up (67,574 person-years). After multivariable adjustment, TMAO was not significantly associated with hip fracture (women: hazard ratio (HR) [95% confidence interval (CI)] of 1.00[0.92,1.09] per TMAO doubling; men: 1.12[0.95,1.33]). TMAO was also not associated with total hip BMD (women: BMD difference [95% CI] of 0.42 g/cm*100 [-0.34,1.17] per TMAO doubling; men: 0.19[-1.04,1.42]). In exploratory analyses, we found an interaction between body mass index (BMI) and the association of TMAO with hip fracture (P < 0.01). Higher TMAO was significantly associated with risk of hip fracture in adults with overweight or obesity (BMI ≥ 25) (HR [95% CI]:1.17[1.05,1.31]), but not normal or underweight.

CONCLUSIONS: Among older US men and women, TMAO was not significantly associated with risk of hip fracture or BMD overall. Exploratory analyses suggested a significant association between higher TMAO and hip fracture when BMI was elevated, which merits further study.

%B Bone %V 161 %P 116431 %8 2022 08 %G eng %R 10.1016/j.bone.2022.116431 %0 Journal Article %J Front Endocrinol (Lausanne) %D 2022 %T The Value of Rare Genetic Variation in the Prediction of Common Obesity in European Ancestry Populations. %A Wang, Zhe %A Choi, Shing Wan %A Chami, Nathalie %A Boerwinkle, Eric %A Fornage, Myriam %A Redline, Susan %A Bis, Joshua C %A Brody, Jennifer A %A Psaty, Bruce M %A Kim, Wonji %A McDonald, Merry-Lynn N %A Regan, Elizabeth A %A Silverman, Edwin K %A Liu, Ching-Ti %A Vasan, Ramachandran S %A Kalyani, Rita R %A Mathias, Rasika A %A Yanek, Lisa R %A Arnett, Donna K %A Justice, Anne E %A North, Kari E %A Kaplan, Robert %A Heckbert, Susan R %A de Andrade, Mariza %A Guo, Xiuqing %A Lange, Leslie A %A Rich, Stephen S %A Rotter, Jerome I %A Ellinor, Patrick T %A Lubitz, Steven A %A Blangero, John %A Shoemaker, M Benjamin %A Darbar, Dawood %A Gladwin, Mark T %A Albert, Christine M %A Chasman, Daniel I %A Jackson, Rebecca D %A Kooperberg, Charles %A Reiner, Alexander P %A O'Reilly, Paul F %A Loos, Ruth J F %K Gene Frequency %K Genetic Variation %K Genome-Wide Association Study %K Humans %K Obesity %K Whole Genome Sequencing %X

Polygenic risk scores (PRSs) aggregate the effects of genetic variants across the genome and are used to predict risk of complex diseases, such as obesity. Current PRSs only include common variants (minor allele frequency (MAF) ≥1%), whereas the contribution of rare variants in PRSs to predict disease remains unknown. Here, we examine whether augmenting the standard common variant PRS (PRS) with a rare variant PRS (PRS) improves prediction of obesity. We used genome-wide genotyped and imputed data on 451,145 European-ancestry participants of the UK Biobank, as well as whole exome sequencing (WES) data on 184,385 participants. We performed single variant analyses (for both common and rare variants) and gene-based analyses (for rare variants) for association with BMI (kg/m), obesity (BMI ≥ 30 kg/m), and extreme obesity (BMI ≥ 40 kg/m). We built PRSs and PRSs using a range of methods (Clumping+Thresholding [C+T], PRS-CS, lassosum, gene-burden test). We selected the best-performing PRSs and assessed their performance in 36,757 European-ancestry unrelated participants with whole genome sequencing (WGS) data from the Trans-Omics for Precision Medicine (TOPMed) program. The best-performing PRS explained 10.1% of variation in BMI, and 18.3% and 22.5% of the susceptibility to obesity and extreme obesity, respectively, whereas the best-performing PRS explained 1.49%, and 2.97% and 3.68%, respectively. The PRS was associated with an increased risk of obesity and extreme obesity (OR = 1.37 per SD, = 1.7x10; OR = 1.55 per SD, = 3.8x10), which was attenuated, after adjusting for PRS (OR = 1.08 per SD, = 9.8x10; OR= 1.09 per SD, = 0.02). When PRS and PRS are combined, the increase in explained variance attributed to PRS was small (incremental Nagelkerke R = 0.24% for obesity and 0.51% for extreme obesity). Consistently, combining PRS to PRS provided little improvement to the prediction of obesity (PRS AUC = 0.591; PRS AUC = 0.708; PRS AUC = 0.710). In summary, while rare variants show convincing association with BMI, obesity and extreme obesity, the PRS provides limited improvement over PRS in the prediction of obesity risk, based on these large populations.

%B Front Endocrinol (Lausanne) %V 13 %P 863893 %8 2022 %G eng %R 10.3389/fendo.2022.863893 %0 Journal Article %J Commun Biol %D 2022 %T Whole genome sequence association analysis of fasting glucose and fasting insulin levels in diverse cohorts from the NHLBI TOPMed program. %A DiCorpo, Daniel %A Gaynor, Sheila M %A Russell, Emily M %A Westerman, Kenneth E %A Raffield, Laura M %A Majarian, Timothy D %A Wu, Peitao %A Sarnowski, Chloe %A Highland, Heather M %A Jackson, Anne %A Hasbani, Natalie R %A de Vries, Paul S %A Brody, Jennifer A %A Hidalgo, Bertha %A Guo, Xiuqing %A Perry, James A %A O'Connell, Jeffrey R %A Lent, Samantha %A Montasser, May E %A Cade, Brian E %A Jain, Deepti %A Wang, Heming %A D'Oliveira Albanus, Ricardo %A Varshney, Arushi %A Yanek, Lisa R %A Lange, Leslie %A Palmer, Nicholette D %A Almeida, Marcio %A Peralta, Juan M %A Aslibekyan, Stella %A Baldridge, Abigail S %A Bertoni, Alain G %A Bielak, Lawrence F %A Chen, Chung-Shiuan %A Chen, Yii-Der Ida %A Choi, Won Jung %A Goodarzi, Mark O %A Floyd, James S %A Irvin, Marguerite R %A Kalyani, Rita R %A Kelly, Tanika N %A Lee, Seonwook %A Liu, Ching-Ti %A Loesch, Douglas %A Manson, JoAnn E %A Minster, Ryan L %A Naseri, Take %A Pankow, James S %A Rasmussen-Torvik, Laura J %A Reiner, Alexander P %A Reupena, Muagututi'a Sefuiva %A Selvin, Elizabeth %A Smith, Jennifer A %A Weeks, Daniel E %A Xu, Huichun %A Yao, Jie %A Zhao, Wei %A Parker, Stephen %A Alonso, Alvaro %A Arnett, Donna K %A Blangero, John %A Boerwinkle, Eric %A Correa, Adolfo %A Cupples, L Adrienne %A Curran, Joanne E %A Duggirala, Ravindranath %A He, Jiang %A Heckbert, Susan R %A Kardia, Sharon L R %A Kim, Ryan W %A Kooperberg, Charles %A Liu, Simin %A Mathias, Rasika A %A McGarvey, Stephen T %A Mitchell, Braxton D %A Morrison, Alanna C %A Peyser, Patricia A %A Psaty, Bruce M %A Redline, Susan %A Shuldiner, Alan R %A Taylor, Kent D %A Vasan, Ramachandran S %A Viaud-Martinez, Karine A %A Florez, Jose C %A Wilson, James G %A Sladek, Robert %A Rich, Stephen S %A Rotter, Jerome I %A Lin, Xihong %A Dupuis, Josée %A Meigs, James B %A Wessel, Jennifer %A Manning, Alisa K %K Diabetes Mellitus, Type 2 %K Fasting %K Glucose %K Humans %K Insulin %K National Heart, Lung, and Blood Institute (U.S.) %K Nerve Tissue Proteins %K Polymorphism, Single Nucleotide %K Precision Medicine %K Receptors, Immunologic %K United States %X

The genetic determinants of fasting glucose (FG) and fasting insulin (FI) have been studied mostly through genome arrays, resulting in over 100 associated variants. We extended this work with high-coverage whole genome sequencing analyses from fifteen cohorts in NHLBI's Trans-Omics for Precision Medicine (TOPMed) program. Over 23,000 non-diabetic individuals from five race-ethnicities/populations (African, Asian, European, Hispanic and Samoan) were included. Eight variants were significantly associated with FG or FI across previously identified regions MTNR1B, G6PC2, GCK, GCKR and FOXA2. We additionally characterize suggestive associations with FG or FI near previously identified SLC30A8, TCF7L2, and ADCY5 regions as well as APOB, PTPRT, and ROBO1. Functional annotation resources including the Diabetes Epigenome Atlas were compiled for each signal (chromatin states, annotation principal components, and others) to elucidate variant-to-function hypotheses. We provide a catalog of nucleotide-resolution genomic variation spanning intergenic and intronic regions creating a foundation for future sequencing-based investigations of glycemic traits.

%B Commun Biol %V 5 %P 756 %8 2022 07 28 %G eng %N 1 %R 10.1038/s42003-022-03702-4 %0 Journal Article %J Nat Commun %D 2022 %T Whole genome sequencing identifies structural variants contributing to hematologic traits in the NHLBI TOPMed program. %A Wheeler, Marsha M %A Stilp, Adrienne M %A Rao, Shuquan %A Halldorsson, Bjarni V %A Beyter, Doruk %A Wen, Jia %A Mihkaylova, Anna V %A McHugh, Caitlin P %A Lane, John %A Jiang, Min-Zhi %A Raffield, Laura M %A Jun, Goo %A Sedlazeck, Fritz J %A Metcalf, Ginger %A Yao, Yao %A Bis, Joshua B %A Chami, Nathalie %A de Vries, Paul S %A Desai, Pinkal %A Floyd, James S %A Gao, Yan %A Kammers, Kai %A Kim, Wonji %A Moon, Jee-Young %A Ratan, Aakrosh %A Yanek, Lisa R %A Almasy, Laura %A Becker, Lewis C %A Blangero, John %A Cho, Michael H %A Curran, Joanne E %A Fornage, Myriam %A Kaplan, Robert C %A Lewis, Joshua P %A Loos, Ruth J F %A Mitchell, Braxton D %A Morrison, Alanna C %A Preuss, Michael %A Psaty, Bruce M %A Rich, Stephen S %A Rotter, Jerome I %A Tang, Hua %A Tracy, Russell P %A Boerwinkle, Eric %A Abecasis, Goncalo R %A Blackwell, Thomas W %A Smith, Albert V %A Johnson, Andrew D %A Mathias, Rasika A %A Nickerson, Deborah A %A Conomos, Matthew P %A Li, Yun %A Þorsteinsdottir, Unnur %A Magnússon, Magnús K %A Stefansson, Kari %A Pankratz, Nathan D %A Bauer, Daniel E %A Auer, Paul L %A Reiner, Alex P %K Blood Cells %K Genome-Wide Association Study %K Humans %K Whole Genome Sequencing %X

Genome-wide association studies have identified thousands of single nucleotide variants and small indels that contribute to variation in hematologic traits. While structural variants are known to cause rare blood or hematopoietic disorders, the genome-wide contribution of structural variants to quantitative blood cell trait variation is unknown. Here we utilized whole genome sequencing data in ancestrally diverse participants of the NHLBI Trans Omics for Precision Medicine program (N = 50,675) to detect structural variants associated with hematologic traits. Using single variant tests, we assessed the association of common and rare structural variants with red cell-, white cell-, and platelet-related quantitative traits and observed 21 independent signals (12 common and 9 rare) reaching genome-wide significance. The majority of these associations (N = 18) replicated in independent datasets. In genome-editing experiments, we provide evidence that a deletion associated with lower monocyte counts leads to disruption of an S1PR3 monocyte enhancer and decreased S1PR3 expression.

%B Nat Commun %V 13 %P 7592 %8 2022 Dec 08 %G eng %N 1 %R 10.1038/s41467-022-35354-7 %0 Journal Article %J Hum Mol Genet %D 2022 %T Whole-Exome Sequencing Study Identifies Four Novel Gene Loci Associated with Diabetic Kidney Disease. %A Pan, Yang %A Sun, Xiao %A Mi, Xuenan %A Huang, Zhijie %A Hsu, Yenchih %A Hixson, James E %A Munzy, Donna %A Metcalf, Ginger %A Franceschini, Nora %A Tin, Adrienne %A Köttgen, Anna %A Francis, Michael %A Brody, Jennifer A %A Kestenbaum, Bryan %A Sitlani, Colleen M %A Mychaleckyj, Josyf C %A Kramer, Holly %A Lange, Leslie A %A Guo, Xiuqing %A Hwang, Shih-Jen %A Irvin, Marguerite R %A Smith, Jennifer A %A Yanek, Lisa R %A Vaidya, Dhananjay %A Chen, Yii-Der Ida %A Fornage, Myriam %A Lloyd-Jones, Donald M %A Hou, Lifang %A Mathias, Rasika A %A Mitchell, Braxton D %A Peyser, Patricia A %A Kardia, Sharon L R %A Arnett, Donna K %A Correa, Adolfo %A Raffield, Laura M %A Vasan, Ramachandran S %A Cupple, L Adrienne %A Levy, Daniel %A Kaplan, Robert C %A North, Kari E %A Rotter, Jerome I %A Kooperberg, Charles %A Reiner, Alexander P %A Psaty, Bruce M %A Tracy, Russell P %A Gibbs, Richard A %A Morrison, Alanna C %A Feldman, Harold %A Boerwinkle, Eric %A He, Jiang %A Kelly, Tanika N %X

Diabetic kidney disease (DKD) is recognized as an important public health challenge. However, its genomic mechanisms are poorly understood. To identify rare variants for DKD, we conducted a whole-exome sequencing (WES) study leveraging large cohorts well-phenotyped for chronic kidney disease (CKD) and diabetes. Our two-stage whole-exome sequencing study included 4372 European and African ancestry participants from the Chronic Renal Insufficiency Cohort (CRIC) and Atherosclerosis Risk in Communities (ARIC) studies (stage-1) and 11 487 multi-ancestry Trans-Omics for Precision Medicine (TOPMed) participants (stage-2). Generalized linear mixed models, which accounted for genetic relatedness and adjusted for age, sex, and ancestry, were used to test associations between single variants and DKD. Gene-based aggregate rare variant analyses were conducted using an optimized sequence kernel association test (SKAT-O) implemented within our mixed model framework. We identified four novel exome-wide significant DKD-related loci through initiating diabetes. In single variant analyses, participants carrying a rare, in-frame insertion in the DIS3L2 gene (rs141560952) exhibited a 193-fold increased odds (95% confidence interval: 33.6, 1105) of DKD compared with non-carriers (P = 3.59 × 10-9). Likewise, each copy of a low-frequency KRT6B splice-site variant (rs425827) conferred a 5.31-fold higher odds (95% confidence interval: 3.06, 9.21) of DKD (P = 2.72 × 10-9). Aggregate gene-based analyses further identified ERAP2 (P = 4.03 × 10-8) and NPEPPS (P = 1.51 × 10-7), which are both expressed in the kidney and implicated in renin-angiotensin-aldosterone system modulated immune response. In the largest WES study of DKD, we identified novel rare variant loci attaining exome-wide significance. These findings provide new insights into the molecular mechanisms underlying DKD.

%B Hum Mol Genet %8 2022 Nov 29 %G eng %R 10.1093/hmg/ddac290 %0 Journal Article %J Stroke %D 2022 %T {Whole-Genome Sequencing Association Analyses of Stroke and Its Subtypes in Ancestrally Diverse Populations From Trans-Omics for Precision Medicine Project %A Hu, Y. %A Haessler, J. W. %A Manansala, R. %A Wiggins, K. L. %A Moscati, A. %A Beiser, A. %A Heard-Costa, N. L. %A Sarnowski, C. %A Raffield, L. M. %A Chung, J. %A Marini, S. %A Anderson, C. D. %A Rosand, J. %A Xu, H. %A Sun, X. %A Kelly, T. N. %A Wong, Q. %A Lange, L. A. %A Rotter, J. I. %A Correa, A. %A Vasan, R. S. %A Seshadri, S. %A Rich, S. S. %A Do, R. %A Loos, R. J. F. %A Longstreth, W. T. %A Bis, J. C. %A Psaty, B. M. %A Tirschwell, D. L. %A Assimes, T. L. %A Silver, B. %A Liu, S. %A Jackson, R. %A Wassertheil-Smoller, S. %A Mitchell, B. D. %A Fornage, M. %A Auer, P. L. %A Reiner, A. P. %A Kooperberg, C. %X Stroke is the leading cause of death and long-term disability worldwide. Previous genome-wide association studies identified 51 loci associated with stroke (mostly ischemic) and its subtypes among predominantly European populations. Using whole-genome sequencing in ancestrally diverse populations from the Trans-Omics for Precision Medicine (TOPMed) Program, we aimed to identify novel variants, especially low-frequency or ancestry-specific variants, associated with all stroke, ischemic stroke and its subtypes (large artery, cardioembolic, and small vessel), and hemorrhagic stroke and its subtypes (intracerebral and subarachnoid).\ Whole-genome sequencing data were available for 6833 stroke cases and 27 116 controls, including 22 315 European, 7877 Black, 2616 Hispanic/Latino, 850 Asian, 54 Native American, and 237 other ancestry participants. In TOPMed, we performed single variant association analysis examining 40 million common variants and aggregated association analysis focusing on rare variants. We also combined TOPMed European populations with over 28 000 additional European participants from the UK BioBank genome-wide array data through meta-analysis.\ .\ We represent the first association analysis for stroke and its subtypes using whole-genome sequencing data from ancestrally diverse populations. While our findings suggest the potential benefits of combining whole-genome sequencing data with populations of diverse genetic backgrounds to identify possible low-frequency or ancestry-specific variants, they also highlight the need to increase genome coverage and sample sizes. %B Stroke %V 53 %P 875–885 %8 Mar %G eng %0 Journal Article %J Nature %D 2023 %T Aberrant activation of TCL1A promotes stem cell expansion in clonal haematopoiesis. %A Weinstock, Joshua S %A Gopakumar, Jayakrishnan %A Burugula, Bala Bharathi %A Uddin, Md Mesbah %A Jahn, Nikolaus %A Belk, Julia A %A Bouzid, Hind %A Daniel, Bence %A Miao, Zhuang %A Ly, Nghi %A Mack, Taralynn M %A Luna, Sofia E %A Prothro, Katherine P %A Mitchell, Shaneice R %A Laurie, Cecelia A %A Broome, Jai G %A Taylor, Kent D %A Guo, Xiuqing %A Sinner, Moritz F %A von Falkenhausen, Aenne S %A Kääb, Stefan %A Shuldiner, Alan R %A O'Connell, Jeffrey R %A Lewis, Joshua P %A Boerwinkle, Eric %A Barnes, Kathleen C %A Chami, Nathalie %A Kenny, Eimear E %A Loos, Ruth J F %A Fornage, Myriam %A Hou, Lifang %A Lloyd-Jones, Donald M %A Redline, Susan %A Cade, Brian E %A Psaty, Bruce M %A Bis, Joshua C %A Brody, Jennifer A %A Silverman, Edwin K %A Yun, Jeong H %A Qiao, Dandi %A Palmer, Nicholette D %A Freedman, Barry I %A Bowden, Donald W %A Cho, Michael H %A DeMeo, Dawn L %A Vasan, Ramachandran S %A Yanek, Lisa R %A Becker, Lewis C %A Kardia, Sharon L R %A Peyser, Patricia A %A He, Jiang %A Rienstra, Michiel %A van der Harst, Pim %A Kaplan, Robert %A Heckbert, Susan R %A Smith, Nicholas L %A Wiggins, Kerri L %A Arnett, Donna K %A Irvin, Marguerite R %A Tiwari, Hemant %A Cutler, Michael J %A Knight, Stacey %A Muhlestein, J Brent %A Correa, Adolfo %A Raffield, Laura M %A Gao, Yan %A de Andrade, Mariza %A Rotter, Jerome I %A Rich, Stephen S %A Tracy, Russell P %A Konkle, Barbara A %A Johnsen, Jill M %A Wheeler, Marsha M %A Smith, J Gustav %A Melander, Olle %A Nilsson, Peter M %A Custer, Brian S %A Duggirala, Ravindranath %A Curran, Joanne E %A Blangero, John %A McGarvey, Stephen %A Williams, L Keoki %A Xiao, Shujie %A Yang, Mao %A Gu, C Charles %A Chen, Yii-Der Ida %A Lee, Wen-Jane %A Marcus, Gregory M %A Kane, John P %A Pullinger, Clive R %A Shoemaker, M Benjamin %A Darbar, Dawood %A Roden, Dan M %A Albert, Christine %A Kooperberg, Charles %A Zhou, Ying %A Manson, JoAnn E %A Desai, Pinkal %A Johnson, Andrew D %A Mathias, Rasika A %A Blackwell, Thomas W %A Abecasis, Goncalo R %A Smith, Albert V %A Kang, Hyun M %A Satpathy, Ansuman T %A Natarajan, Pradeep %A Kitzman, Jacob O %A Whitsel, Eric A %A Reiner, Alexander P %A Bick, Alexander G %A Jaiswal, Siddhartha %K Alleles %K Animals %K Clonal Hematopoiesis %K Genome-Wide Association Study %K Hematopoiesis %K Hematopoietic Stem Cells %K Humans %K Mice %K Mutation %K Promoter Regions, Genetic %X

Mutations in a diverse set of driver genes increase the fitness of haematopoietic stem cells (HSCs), leading to clonal haematopoiesis. These lesions are precursors for blood cancers, but the basis of their fitness advantage remains largely unknown, partly owing to a paucity of large cohorts in which the clonal expansion rate has been assessed by longitudinal sampling. Here, to circumvent this limitation, we developed a method to infer the expansion rate from data from a single time point. We applied this method to 5,071 people with clonal haematopoiesis. A genome-wide association study revealed that a common inherited polymorphism in the TCL1A promoter was associated with a slower expansion rate in clonal haematopoiesis overall, but the effect varied by driver gene. Those carrying this protective allele exhibited markedly reduced growth rates or prevalence of clones with driver mutations in TET2, ASXL1, SF3B1 and SRSF2, but this effect was not seen in clones with driver mutations in DNMT3A. TCL1A was not expressed in normal or DNMT3A-mutated HSCs, but the introduction of mutations in TET2 or ASXL1 led to the expression of TCL1A protein and the expansion of HSCs in vitro. The protective allele restricted TCL1A expression and expansion of mutant HSCs, as did experimental knockdown of TCL1A expression. Forced expression of TCL1A promoted the expansion of human HSCs in vitro and mouse HSCs in vivo. Our results indicate that the fitness advantage of several commonly mutated driver genes in clonal haematopoiesis may be mediated by TCL1A activation.

%B Nature %V 616 %P 755-763 %8 2023 Apr %G eng %N 7958 %R 10.1038/s41586-023-05806-1 %0 Journal Article %J JAMA Neurol %D 2023 %T Association Between Acute Myocardial Infarction and Cognition. %A Johansen, Michelle C %A Ye, Wen %A Gross, Alden %A Gottesman, Rebecca F %A Han, Dehua %A Whitney, Rachael %A Briceño, Emily M %A Giordani, Bruno J %A Shore, Supriya %A Elkind, Mitchell S V %A Manly, Jennifer J %A Sacco, Ralph L %A Fohner, Alison %A Griswold, Michael %A Psaty, Bruce M %A Sidney, Stephen %A Sussman, Jeremy %A Yaffe, Kristine %A Moran, Andrew E %A Heckbert, Susan %A Hughes, Timothy M %A Galecki, Andrzej %A Levine, Deborah A %X

IMPORTANCE: The magnitude of cognitive change after incident myocardial infarction (MI) is unclear.

OBJECTIVE: To assess whether incident MI is associated with changes in cognitive function after adjusting for pre-MI cognitive trajectories.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included adults without MI, dementia, or stroke and with complete covariates from the following US population-based cohort studies conducted from 1971 to 2019: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study. Data were analyzed from July 2021 to January 2022.

EXPOSURES: Incident MI.

MAIN OUTCOMES AND MEASURES: The main outcome was change in global cognition. Secondary outcomes were changes in memory and executive function. Outcomes were standardized as mean (SD) T scores of 50 (10); a 1-point difference represented a 0.1-SD difference in cognition. Linear mixed-effects models estimated changes in cognition at the time of MI (change in the intercept) and the rate of cognitive change over the years after MI (change in the slope), controlling for pre-MI cognitive trajectories and participant factors, with interaction terms for race and sex.

RESULTS: The study included 30 465 adults (mean [SD] age, 64 [10] years; 56% female), of whom 1033 had 1 or more MI event, and 29 432 did not have an MI event. Median follow-up was 6.4 years (IQR, 4.9-19.7 years). Overall, incident MI was not associated with an acute decrease in global cognition (-0.18 points; 95% CI, -0.52 to 0.17 points), executive function (-0.17 points; 95% CI, -0.53 to 0.18 points), or memory (0.62 points; 95% CI, -0.07 to 1.31 points). However, individuals with incident MI vs those without MI demonstrated faster declines in global cognition (-0.15 points per year; 95% CI, -0.21 to -0.10 points per year), memory (-0.13 points per year; 95% CI, -0.22 to -0.04 points per year), and executive function (-0.14 points per year; 95% CI, -0.20 to -0.08 points per year) over the years after MI compared with pre-MI slopes. The interaction analysis suggested that race and sex modified the degree of change in the decline in global cognition after MI (race × post-MI slope interaction term, P = .02; sex × post-MI slope interaction term, P = .04), with a smaller change in the decline over the years after MI in Black individuals than in White individuals (difference in slope change, 0.22 points per year; 95% CI, 0.04-0.40 points per year) and in females than in males (difference in slope change, 0.12 points per year; 95% CI, 0.01-0.23 points per year).

CONCLUSIONS: This cohort study using pooled data from 6 cohort studies found that incident MI was not associated with a decrease in global cognition, memory, or executive function at the time of the event compared with no MI but was associated with faster declines in global cognition, memory, and executive function over time. These findings suggest that prevention of MI may be important for long-term brain health.

%B JAMA Neurol %8 2023 May 30 %G eng %R 10.1001/jamaneurol.2023.1331 %0 Journal Article %J J Am Heart Assoc %D 2023 %T Association Between Whole Blood-Derived Mitochondrial DNA Copy Number, Low-Density Lipoprotein Cholesterol, and Cardiovascular Disease Risk. %A Liu, Xue %A Sun, Xianbang %A Zhang, Yuankai %A Jiang, Wenqing %A Lai, Meng %A Wiggins, Kerri L %A Raffield, Laura M %A Bielak, Lawrence F %A Zhao, Wei %A Pitsillides, Achilleas %A Haessler, Jeffrey %A Zheng, Yinan %A Blackwell, Thomas W %A Yao, Jie %A Guo, Xiuqing %A Qian, Yong %A Thyagarajan, Bharat %A Pankratz, Nathan %A Rich, Stephen S %A Taylor, Kent D %A Peyser, Patricia A %A Heckbert, Susan R %A Seshadri, Sudha %A Boerwinkle, Eric %A Grove, Megan L %A Larson, Nicholas B %A Smith, Jennifer A %A Vasan, Ramachandran S %A Fitzpatrick, Annette L %A Fornage, Myriam %A Ding, Jun %A Carson, April P %A Abecasis, Goncalo %A Dupuis, Josée %A Reiner, Alexander %A Kooperberg, Charles %A Hou, Lifang %A Psaty, Bruce M %A Wilson, James G %A Levy, Daniel %A Rotter, Jerome I %A Bis, Joshua C %A Satizabal, Claudia L %A Arking, Dan E %A Liu, Chunyu %X

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). <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; <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; =0.11) or in the reverse direction (β=-0.012; =0.076). Additional bidirectional Mendelian randomization analyses revealed that low-density lipoprotein cholesterol had a causal effect on mtDNA CN (β=-0.084; <0.001), but the reverse direction was not significant (=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 (=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; <0.001). Conclusions Our findings indicate that high low-density lipoprotein cholesterol may underlie the complex relationships between mtDNA CN and vascular atherosclerosis.

%B J Am Heart Assoc %P e029090 %8 2023 Oct 07 %G eng %R 10.1161/JAHA.122.029090 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2023 %T Association of a blood-based aging biomarker index with death and chronic disease: Cardiovascular Health Study. %A Zhang, Xiao %A Sanders, Jason L %A Boudreau, Robert M %A Arnold, Alice M %A Justice, Jamie N %A Espeland, Mark A %A Kuchel, George A %A Barzilai, Nir %A Kuller, Lewis H %A Lopez, Oscar L %A Kritchevsky, Stephen B %A Newman, Anne B %X

BACKGROUND: A goal of gerontology is to discover phenotypes that reflect biological aging distinct from disease pathogenesis. Biomarkers that are strongly associated with mortality could be used to define such a phenotype. However, the relation of such an index with multiple chronic conditions warrants further exploration.

METHODS: A Biomarker Index (BI) was constructed in the Cardiovascular Health Study (N=3197), with a mean age of 74 years. The BI incorporated circulating levels of new biomarkers, including insulin-like growth factor-1, interleukin-6, amino-terminal pro-B-type natriuretic peptide, cystatin-C, C-reactive protein, tumor necrosis factor-alpha soluble receptor 1, fasting insulin, and fasting glucose, and was built based on their relationships with mortality. Cox proportional hazards models predicting a composite of death and chronic disease involving cardiovascular disease, dementia, and cancer were calculated with 6 years of follow-up.

RESULTS: The hazard ratio (HR, 95% CI) for the composite outcome of death or chronic disease per category of BI was 1.65 (1.52, 1.80) and 1.75 (1.58, 1.94) in women and men, respectively. The HR (95% CI) per 5 years of age was 1.57 (1.48, 1.67) and 1.55 (1.44, 1.67) in women and men, respectively. Moreover, BI could attenuate the effect of age on the composite outcome by 16.7% and 22.0% in women and men, respectively.

CONCLUSIONS: BI was significantly and independently associated with a composite outcome of death and chronic disease, and attenuated the effect of age. The BI that is composed of plasma biomarkers may be a practical intermediate phenotype for interventions aiming to modify the course of aging.

%B J Gerontol A Biol Sci Med Sci %8 2023 Jul 19 %G eng %R 10.1093/gerona/glad172 %0 Journal Article %J Calcif Tissue Int %D 2023 %T Association of Immune Cell Subsets with Incident Hip Fracture: The Cardiovascular Health Study. %A Elam, Rachel E %A Bůzková, Petra %A Delaney, Joseph A C %A Fink, Howard A %A Barzilay, Joshua I %A Carbone, Laura D %A Saha, Rick %A Robbins, John A %A Mukamal, Kenneth J %A Valderrábano, Rodrigo J %A Psaty, Bruce M %A Tracy, Russell P %A Olson, Nels C %A Huber, Sally A %A Doyle, Margaret F %A Landay, Alan L %A Cauley, Jane A %X

In this study, we aimed to evaluate the association of innate and adaptive immune cell subsets in peripheral blood mononuclear cells (PBMCs) with hip fracture. To conduct this study, we used data from the Cardiovascular Health Study (CHS), a U.S. multicenter observational cohort of community-dwelling men and women aged ≥ 65 years. Twenty-five immune cell phenotypes were measured by flow cytometry from cryopreserved PBMCs of CHS participants collected in 1998-1999. The natural killer (NK), γδ T, T helper 17 (Th17), and differentiated/senescent CD4CD28 T cell subsets were pre-specified as primary subsets of interest. Hip fracture incidence was assessed prospectively by review of hospitalization records. Multivariable Cox hazard models evaluated associations of immune cell phenotypes with incident hip fracture in sex-stratified and combined analyses. Among 1928 persons, 259 hip fractures occurred over a median 9.7 years of follow-up. In women, NK cells were inversely associated with hip fracture [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.60-0.99 per one standard deviation higher value] and Th17 cells were positively associated with hip fracture [HR 1.18, 95% CI 1.01-1.39]. In men, γδ T cells were inversely associated with hip fracture [HR 0.60, 95% CI 0.37-0.98]. None of the measured immune cell phenotypes were significantly associated with hip fracture incidence in combined analyses. In this large prospective cohort of older adults, potentially important sex differences in the associations of immune cell phenotypes and hip fracture were identified. However, immune cell phenotypes had no association with hip fracture in analyses combining men and women.

%B Calcif Tissue Int %8 2023 Aug 31 %G eng %R 10.1007/s00223-023-01126-8 %0 Journal Article %J Neurology %D 2023 %T Association of Mitochondrial DNA Copy Number With Brain MRI Markers and Cognitive Function: A Meta-analysis of Community-Based Cohorts. %A Zhang, Yuankai %A Liu, Xue %A Wiggins, Kerri L %A Kurniansyah, Nuzulul %A Guo, Xiuqing %A Rodrigue, Amanda L %A Zhao, Wei %A Yanek, Lisa R %A Ratliff, Scott M %A Pitsillides, Achilleas %A Aguirre Patiño, Juan Sebastian %A Sofer, Tamar %A Arking, Dan E %A Austin, Thomas R %A Beiser, Alexa S %A Blangero, John %A Boerwinkle, Eric %A Bressler, Jan %A Curran, Joanne E %A Hou, Lifang %A Hughes, Timothy M %A Kardia, Sharon L %A Launer, Lenore %A Levy, Daniel %A Mosley, Tom H %A Nasrallah, Ilya M %A Rich, Stephen S %A Rotter, Jerome I %A Seshadri, Sudha %A Tarraf, Wassim %A González, Kevin A %A Ramachandran, Vasan %A Yaffe, Kristine %A Nyquist, Paul A %A Psaty, Bruce M %A DeCarli, Charles S %A Smith, Jennifer A %A Glahn, David C %A González, Hector M %A Bis, Joshua C %A Fornage, Myriam %A Heckbert, Susan R %A Fitzpatrick, Annette L %A Liu, Chunyu %A Satizabal, Claudia L %X

BACKGROUND AND OBJECTIVES: Previous studies suggest lower mitochondrial DNA (mtDNA) copy number (CN) is associated with neurodegenerative diseases. However, whether mtDNA CN in whole blood is related to endophenotypes of Alzheimer's disease (AD) and AD related dementia (AD/ADRD) needs further investigation. We assessed the association of mtDNA CN with cognitive function and MRI measures in community-based samples of middle-aged to older adults.

METHODS: We included dementia-free participants from nine diverse community-based cohorts with whole-genome sequencing in the Trans-Omics for Precision Medicine (TOPMed) program. Circulating mtDNA CN was estimated as twice the ratio of the average coverage of mtDNA to nuclear DNA. Brain MRI markers included total brain, hippocampal, and white matter hyperintensity volumes. General cognitive function was derived from distinct cognitive domains. We performed cohort-specific association analyses of mtDNA CN with AD/ADRD endophenotypes assessed within ±5 years (i.e., cross-sectional analyses) or 5 to 20 years after blood draw (i.e., prospective analyses) adjusting for potential confounders. We further explored associations stratified by sex and age (<60 vs. ≥60 years). Fixed-effects or sample size-weighted meta-analyses were performed to combine results. Finally, we performed Mendelian randomization (MR) analyses to assess causality.

RESULTS: We included up to 19,152 participants (mean age 59 years, 57% women). Higher mtDNA CN was cross-sectionally associated with better general cognitive function (Beta=0.04; 95% CI 0.02, 0.06) independent of age, sex, batch effects, race/ethnicity, time between blood draw and cognitive evaluation, cohort-specific variables, and education. Additional adjustment for blood cell counts or cardiometabolic traits led to slightly attenuated results. We observed similar significant associations with cognition in prospective analyses, although of reduced magnitude. We found no significant associations between mtDNA CN and brain MRI measures in meta-analyses. MR analyses did not reveal a causal relation between mtDNA CN in blood and cognition.

DISCUSSION: Higher mtDNA CN in blood is associated with better current and future general cognitive function in large and diverse communities across the US. Although MR analyses did not support a causal role, additional research is needed to assess causality. Circulating mtDNA CN could serve nevertheless as a biomarker of current and future cognitive function in the community.

%B Neurology %8 2023 Mar 16 %G eng %R 10.1212/WNL.0000000000207157 %0 Journal Article %J Neurology %D 2023 %T Association of Obesity With Cognitive Decline in Black and White Americans. %A Quaye, Emmanuel %A Galecki, Andrzej T %A Tilton, Nicholas %A Whitney, Rachael %A Briceño, Emily M %A Elkind, Mitchell S V %A Fitzpatrick, Annette L %A Gottesman, Rebecca F %A Griswold, Michael %A Gross, Alden L %A Heckbert, Susan R %A Hughes, Timothy M %A Longstreth, W T %A Sacco, Ralph L %A Sidney, Stephen %A Windham, B Gwen %A Yaffe, Kristine %A Levine, Deborah A %K Aged %K Black or African American %K Cognition %K Cognitive Dysfunction %K Female %K Humans %K Male %K Middle Aged %K Obesity %K Risk Factors %K United States %K White %X

BACKGROUND AND OBJECTIVES: There are disparities in the prevalence of obesity by race, and the relationship between obesity and cognitive decline is unclear. The objective of this study was to determine whether obesity is independently associated with cognitive decline and whether the association between obesity and cognitive decline differs in Black and White adults. We hypothesized that obesity is associated with greater cognitive decline compared with normal weight and that the effect of obesity on cognitive decline is more pronounced in Black adults compared with their White counterparts.

METHODS: We pooled data from 28,867 participants free of stroke and dementia (mean, SD: age 61 [10.7] years at the first cognitive assessment, 55% female, 24% Black, and 29% obese) from 6 cohorts. The primary outcome was the annual change in global cognition. We performed linear mixed-effects models with and without time-varying cumulative mean systolic blood pressure (SBP) and fasting plasma glucose (FPG). Global cognition was set to a t-score metric (mean 50, SD 10) at a participant's first cognitive assessment; a 1-point difference represents a 0.1 SD difference in global cognition across the 6 cohorts. The median follow-up was 6.5 years (25th percentile, 75th percentile: 5.03, 20.15).

RESULTS: Obese participants had lower baseline global cognition than normal-weight participants (difference in intercepts, -0.36 [95% CI, -0.46 to -0.17]; < 0.001). This difference in baseline global cognition was attenuated but was borderline significant after accounting for SBP and FPG (adjusted differences in intercepts, -0.19 [95% CI, -0.39 to 0.002]; = 0.05). There was no difference in the rate of decline in global cognition between obese and normal-weight participants (difference in slope, 0.009 points/year [95% CI, -0.009 to 0.03]; = 0.32). After accounting for SBP and FPG, obese participants had a slower decline in global cognition (adjusted difference in slope, 0.03 points/year slower [95% CI, 0.01 to 0.05]; < 0.001). There was no evidence that race modified the association between body mass index and global cognitive decline ( = 0.34).

DISCUSSION: These results suggest that obesity is associated with lower initial cognitive scores and may potentially attenuate declines in cognition after accounting for BP and FPG.

%B Neurology %V 100 %P e220-e231 %8 2023 Jan 10 %G eng %N 2 %R 10.1212/WNL.0000000000201367 %0 Journal Article %J BMJ %D 2023 %T Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. %A Ong, Kwok Leung %A Marklund, Matti %A Huang, Liping %A Rye, Kerry-Anne %A Hui, Nicholas %A Pan, Xiong-Fei %A Rebholz, Casey M %A Kim, Hyunju %A Steffen, Lyn M %A van Westing, Anniek C %A Geleijnse, Johanna M %A Hoogeveen, Ellen K %A Chen, Yun-Yu %A Chien, Kuo-Liong %A Fretts, Amanda M %A Lemaitre, Rozenn N %A Imamura, Fumiaki %A Forouhi, Nita G %A Wareham, Nicholas J %A Birukov, Anna %A Jäger, Susanne %A Kuxhaus, Olga %A Schulze, Matthias B %A de Mello, Vanessa Derenji %A Tuomilehto, Jaakko %A Uusitupa, Matti %A Lindström, Jaana %A Tintle, Nathan %A Harris, William S %A Yamasaki, Keisuke %A Hirakawa, Yoichiro %A Ninomiya, Toshiharu %A Tanaka, Toshiko %A Ferrucci, Luigi %A Bandinelli, Stefania %A Virtanen, Jyrki K %A Voutilainen, Ari %A Jayasena, Tharusha %A Thalamuthu, Anbupalam %A Poljak, Anne %A Bustamante, Sonia %A Sachdev, Perminder S %A Senn, Mackenzie K %A Rich, Stephen S %A Tsai, Michael Y %A Wood, Alexis C %A Laakso, Markku %A Lankinen, Maria %A Yang, Xiaowei %A Sun, Liang %A Li, Huaixing %A Lin, Xu %A Nowak, Christoph %A Arnlöv, Johan %A Riserus, Ulf %A Lind, Lars %A Le Goff, Mélanie %A Samieri, Cecilia %A Helmer, Catherine %A Qian, Frank %A Micha, Renata %A Tin, Adrienne %A Köttgen, Anna %A de Boer, Ian H %A Siscovick, David S %A Mozaffarian, Dariush %A Wu, Jason HY %K alpha-Linolenic Acid %K Fatty Acids, Omega-3 %K Fatty Acids, Unsaturated %K Humans %K Middle Aged %K Prospective Studies %K Renal Insufficiency, Chronic %K Risk Factors %X

OBJECTIVE: To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived α linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD).

DESIGN: Pooled analysis.

DATA SOURCES: A consortium of 19 studies from 12 countries identified up to May 2020.

STUDY SELECTION: Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate.

DATA EXTRACTION AND SYNTHESIS: Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis.

MAIN OUTCOME MEASURES: Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m and <75% of baseline rate.

RESULTS: 25 570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I=9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I=5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (≥60 <60 years), estimated glomerular filtration rate (60-89 ≥90 mL/min/1.73 m), hypertension, diabetes, and coronary heart disease at baseline.

CONCLUSIONS: Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.

%B BMJ %V 380 %P e072909 %8 2023 Jan 18 %G eng %R 10.1136/bmj-2022-072909 %0 Journal Article %J JAMA Cardiol %D 2023 %T Association of Rare Protein-Truncating DNA Variants in APOB or PCSK9 With Low-density Lipoprotein Cholesterol Level and Risk of Coronary Heart Disease. %A Dron, Jacqueline S %A Patel, Aniruddh P %A Zhang, Yiyi %A Jurgens, Sean J %A Maamari, Dimitri J %A Wang, Minxian %A Boerwinkle, Eric %A Morrison, Alanna C %A de Vries, Paul S %A Fornage, Myriam %A Hou, Lifang %A Lloyd-Jones, Donald M %A Psaty, Bruce M %A Tracy, Russell P %A Bis, Joshua C %A Vasan, Ramachandran S %A Levy, Daniel %A Heard-Costa, Nancy %A Rich, Stephen S %A Guo, Xiuqing %A Taylor, Kent D %A Gibbs, Richard A %A Rotter, Jerome I %A Willer, Cristen J %A Oelsner, Elizabeth C %A Moran, Andrew E %A Peloso, Gina M %A Natarajan, Pradeep %A Khera, Amit V %X

IMPORTANCE: Protein-truncating variants (PTVs) in apolipoprotein B (APOB) and proprotein convertase subtilisin/kexin type 9 (PCSK9) are associated with significantly lower low-density lipoprotein (LDL) cholesterol concentrations. The association of these PTVs with coronary heart disease (CHD) warrants further characterization in large, multiracial prospective cohort studies.

OBJECTIVE: To evaluate the association of PTVs in APOB and PCSK9 with LDL cholesterol concentrations and CHD risk.

DESIGN, SETTING, AND PARTICIPANTS: This studied included participants from 5 National Heart, Lung, and Blood Institute (NHLBI) studies and the UK Biobank. NHLBI study participants aged 5 to 84 years were recruited between 1971 and 2002 across the US and underwent whole-genome sequencing. UK Biobank participants aged 40 to 69 years were recruited between 2006 and 2010 in the UK and underwent whole-exome sequencing. Data were analyzed from June 2021 to October 2022.

EXPOSURES: PTVs in APOB and PCSK9.

MAIN OUTCOMES AND MEASURES: Estimated untreated LDL cholesterol levels and CHD.

RESULTS: Among 19 073 NHLBI participants (10 598 [55.6%] female; mean [SD] age, 52 [17] years), 139 (0.7%) carried an APOB or PCSK9 PTV, which was associated with 49 mg/dL (95% CI, 43-56) lower estimated untreated LDL cholesterol level. Over a median (IQR) follow-up of 21.5 (13.9-29.4) years, incident CHD was observed in 12 of 139 carriers (8.6%) vs 3029 of 18 934 noncarriers (16.0%), corresponding to an adjusted hazard ratio of 0.51 (95% CI, 0.28-0.89; P = .02). Among 190 464 UK Biobank participants (104 831 [55.0%] female; mean [SD] age, 57 [8] years), 662 (0.4%) carried a PTV, which was associated with 45 mg/dL (95% CI, 42-47) lower estimated untreated LDL cholesterol level. Estimated CHD risk by age 75 years was 3.7% (95% CI, 2.0-5.3) in carriers vs 7.0% (95% CI, 6.9-7.2) in noncarriers, corresponding to an adjusted hazard ratio of 0.51 (95% CI, 0.32-0.81; P = .004).

CONCLUSIONS AND RELEVANCE: Among 209 537 individuals in this study, 0.4% carried an APOB or PCSK9 PTV that was associated with less exposure to LDL cholesterol and a 49% lower risk of CHD.

%B JAMA Cardiol %8 2023 Feb 01 %G eng %R 10.1001/jamacardio.2022.5271 %0 Journal Article %J Circulation %D 2023 %T Association of Severe Hypercholesterolemia and Familial Hypercholesterolemia Genotype With Risk of Coronary Heart Disease. %A Zhang, Yiyi %A Dron, Jacqueline S %A Bellows, Brandon K %A Khera, Amit V %A Liu, Junxiu %A Balte, Pallavi P %A Oelsner, Elizabeth C %A Amr, Sami Samir %A Lebo, Matthew S %A Nagy, Anna %A Peloso, Gina M %A Natarajan, Pradeep %A Rotter, Jerome I %A Willer, Cristen %A Boerwinkle, Eric %A Ballantyne, Christie M %A Lutsey, Pamela L %A Fornage, Myriam %A Lloyd-Jones, Donald M %A Hou, Lifang %A Psaty, Bruce M %A Bis, Joshua C %A Floyd, James S %A Vasan, Ramachandran S %A Heard-Costa, Nancy L %A Carson, April P %A Hall, Michael E %A Rich, Stephen S %A Guo, Xiuqing %A Kazi, Dhruv S %A de Ferranti, Sarah D %A Moran, Andrew E %K Coronary Disease %K Genotype %K Humans %K Hypercholesterolemia %K Hyperlipoproteinemia Type II %B Circulation %V 147 %P 1556-1559 %8 2023 May 16 %G eng %N 20 %R 10.1161/CIRCULATIONAHA.123.064168 %0 Journal Article %J JAMA Netw Open %D 2023 %T {Associations Between Vascular Risk Factor Levels and Cognitive Decline Among Stroke Survivors %A Levine, D. A. %A Chen, B. %A Galecki, A. T. %A Gross, A. L. %A o, E. M. %A Whitney, R. T. %A Ploutz-Snyder, R. J. %A Giordani, B. J. %A Sussman, J. B. %A Burke, J. F. %A Lazar, R. M. %A Howard, V. J. %A Aparicio, H. J. %A Beiser, A. S. %A Elkind, M. S. V. %A Gottesman, R. F. %A Koton, S. %A Pendlebury, S. T. %A Sharma, A. %A Springer, M. V. %A Seshadri, S. %A Romero, J. R. %A Hayward, R. A. %X Incident stroke is associated with accelerated cognitive decline. Whether poststroke vascular risk factor levels are associated with faster cognitive decline is uncertain.\ To evaluate associations of poststroke systolic blood pressure (SBP), glucose, and low-density lipoprotein (LDL) cholesterol levels with cognitive decline.\ Individual participant data meta-analysis of 4 US cohort studies (conducted 1971-2019). Linear mixed-effects models estimated changes in cognition after incident stroke. Median (IQR) follow-up was 4.7 (2.6-7.9) years. Analysis began August 2021 and was completed March 2023.\ Time-dependent cumulative mean poststroke SBP, glucose, and LDL cholesterol levels.\ The primary outcome was change in global cognition. Secondary outcomes were change in executive function and memory. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition.\ .002) but not executive function or memory declines.\ In this cohort study, higher poststroke glucose levels were associated with faster global cognitive decline. We found no evidence that poststroke LDL cholesterol and SBP levels were associated with cognitive decline. %B JAMA Netw Open %V 6 %P e2313879 %8 May %G eng %0 Journal Article %J medRxiv %D 2023 %T Carriers of rare damaging genetic variants are at lower risk of atherosclerotic disease. %A Georgakis, Marios K %A Malik, Rainer %A Hasbani, Natalie R %A Shakt, Gabrielle %A Morrison, Alanna C %A Tsao, Noah L %A Judy, Renae %A Mitchell, Braxton D %A Xu, Huichun %A Montasser, May E %A Do, Ron %A Kenny, Eimear E %A Loos, Ruth J F %A Terry, James G %A Carr, John Jeffrey %A Bis, Joshua C %A Psaty, Bruce M %A Longstreth, W T %A Young, Kendra A %A Lutz, Sharon M %A Cho, Michael H %A Broome, Jai %A Khan, Alyna T %A Wang, Fei Fei %A Heard-Costa, Nancy %A Seshadri, Sudha %A Vasan, Ramachandran S %A Palmer, Nicholette D %A Freedman, Barry I %A Bowden, Donald W %A Yanek, Lisa R %A Kral, Brian G %A Becker, Lewis C %A Peyser, Patricia A %A Bielak, Lawrence F %A Ammous, Farah %A Carson, April P %A Hall, Michael E %A Raffield, Laura M %A Rich, Stephen S %A Post, Wendy S %A Tracy, Russel P %A Taylor, Kent D %A Guo, Xiuqing %A Mahaney, Michael C %A Curran, Joanne E %A Blangero, John %A Clarke, Shoa L %A Haessler, Jeffrey W %A Hu, Yao %A Assimes, Themistocles L %A Kooperberg, Charles %A Damrauer, Scott M %A Rotter, Jerome I %A de Vries, Paul S %A Dichgans, Martin %X

BACKGROUND: The CCL2/CCR2 axis governs monocyte trafficking and recruitment to atherosclerotic lesions. Human genetic analyses and population-based studies support an association between circulating CCL2 levels and atherosclerosis. Still, it remains unknown whether pharmacological targeting of CCR2, the main CCL2 receptor, would provide protection against human atherosclerotic disease.

METHODS: In whole-exome sequencing data from 454,775 UK Biobank participants (40-69 years), we identified predicted loss-of-function (LoF) or damaging missense (REVEL score >0.5) variants within the gene. We prioritized variants associated with lower monocyte count (p<0.05) and tested associations with vascular risk factors and risk of atherosclerotic disease over a mean follow-up of 14 years. The results were replicated in a pooled cohort of three independent datasets (TOPMed, deCODE and Penn Medicine BioBank; total n=441,445) and the effect of the most frequent damaging variant was experimentally validated.

RESULTS: A total of 45 predicted LoF or damaging missense variants were identified in the gene, 4 of which were also significantly associated with lower monocyte count, but not with other white blood cell counts. Heterozygous carriers of these variants were at a lower risk of a combined atherosclerosis outcome, showed a lower burden of atherosclerosis across four vascular beds, and were at a lower lifetime risk of coronary artery disease and myocardial infarction. There was no evidence of association with vascular risk factors including LDL-cholesterol, blood pressure, glycemic status, or C-reactive protein. Using a cAMP assay, we found that cells transfected with the most frequent damaging variant (3:46358273:T:A, M249K, 547 carriers, frequency: 0.14%) show a decrease in signaling in response to CCL2. The associations of the M249K variant with myocardial infarction were consistent across cohorts (OR : 0.62 95%CI: 0.39-0.96; OR : 0.64 95%CI: 0.34-1.19; OR : 0.64 95%CI: 0.45-0.90). In a phenome-wide association study, we found no evidence for higher risk of common infections or mortality among carriers of damaging variants.

CONCLUSIONS: Heterozygous carriers of damaging variants have a lower burden of atherosclerosis and lower lifetime risk of myocardial infarction. In conjunction with previous evidence from experimental and epidemiological studies, our findings highlight the translational potential of CCR2-targeting as an atheroprotective approach.

%B medRxiv %8 2023 Aug 16 %G eng %R 10.1101/2023.08.14.23294063 %0 Journal Article %J Curr Cardiol Rev %D 2023 %T CHARGE-AF: A Useful Score For Atrial Fibrillation Prediction? %A Goudis, Christos %A Daios, Stylianos %A Dimitriadis, Fotios %A Liu, Tong %K Atherosclerosis %K Atrial Fibrillation %K Heart Failure %K Humans %K Incidence %K Myocardial Infarction %K Risk Assessment %K Risk Factors %X

Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice and is associated with increased morbidity and mortality. Various predictive scores for new-onset AF have been proposed, but so far, none have been widely used in clinical practice. CHARGE-AF score was developed from a pooled diverse population from three large cohorts (Atherosclerosis Risk in Communities study, Cardiovascular Health Study and Framingham Heart Study). A simple 5-year predictive model includes the variables of age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes mellitus, history of myocardial infarction and heart failure. Recent studies report that the CHARGE-AF score has good discrimination for incident AF and seems to be a promising prediction model for this arrhythmia. New screening tools (smartphone apps, smartwatches) are rapidly developing for AF detection. Therefore, the wide application of the CHARGE-AF score in clinical practice and the upcoming usage of mobile health technologies and smartwatches may result in better AF prediction and adequate stroke prevention, especially in high-risk patients.

%B Curr Cardiol Rev %V 19 %P e010922208402 %8 2023 %G eng %N 2 %R 10.2174/1573403X18666220901102557 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2023 %T Circulating Growth Differentiation Factors 11 and 8, Their Antagonists Follistatin and Follistatin-like-3, and Risk of Heart Failure in Elders. %A Kizer, Jorge R %A Patel, Sheena %A Ganz, Peter %A Newman, Anne B %A Bhasin, Shalender %A Lee, Se-Jin %A Cawthon, Peggy M %A LeBrasseur, Nathan %A Shah, Sanjiv J %A Psaty, Bruce M %A Tracy, Russell P %A Cummings, Steven R %X

BACKGROUND: Heterochronic parabiosis has identified growth differentiation factor (GDF)-11 as a potential means of cardiac rejuvenation, but findings have been inconsistent. A major barrier has been lack of assay specificity for GDF-11 and its homolog GDF-8.

METHODS: We tested the hypothesis that GDF-11 and GDF-8, and their major antagonists follistatin and follistatin-like (FSTL)-3, are associated with incident heart failure (HF) and its subtypes in elders. Based on validation experiments, we used liquid chromatography tandem mass spectrometry to measure total serum GDF-11 and GDF-8, along with follistatin and follistatin-like (FSTL)-3 by immunoassay, in two longitudinal cohorts of older adults.

RESULTS: In 2,599 participants (age 75.2±4.3) followed for 10.8±5.6 years, 721 HF events occurred. After adjustment, neither GDF-11 (HR per doubling: 0.93 [0.67, 1.30]) nor GDF-8 (HR: 1.02 per doubling [0.83, 1.27]) was associated with incident HF or its subtypes. Positive associations with HF were detected for follistatin (HR: 1.15 [1.00, 1.32]) and FLST-3 (HR: 1.38 [1.03, 1.85]), and with HF with preserved ejection fraction for FSTL-3 (HR: 1.77 [1.03, 3.02]). (All HRs per doubling of biomarker.) FSTL-3 associations with HF appeared stronger at higher follistatin levels and vice versa, and also for men, Blacks and lower kidney function.

CONCLUSIONS: Among older adults, serum follistatin and FSTL-3, but not GDF-11 or GDF-8, were associated with incident HF. These findings do not support the concept that low serum levels of total GDF-11 or GDF-8 contribute to HF late in life, but do implicate transforming growth factor-βsuperfamily pathways as potential therapeutic targets.

%B J Gerontol A Biol Sci Med Sci %8 2023 Aug 25 %G eng %R 10.1093/gerona/glad206 %0 Journal Article %J J Alzheimers Dis %D 2023 %T Circulating Omega-3 and Omega-6 Fatty Acids, Cognitive Decline, and Dementia in Older Adults. %A de Oliveira Otto, Marcia C %A Wu, Jason H Y %A Thacker, Evan L %A Lai, Heidi Tsz Mung %A Lemaitre, Rozenn N %A Padhye, Nikhil %A Song, Xiaoling %A King, Irena B %A Lopez, Oscar %A Siscovick, David S %A Mozaffarian, Dariush %X

BACKGROUND: Comprising nearly 35% of brain lipids, polyunsaturated fatty acids (PUFA) are essential for optimal brain function. However, the role of PUFA on cognitive health outcomes later in life is largely unknown.

OBJECTIVE: We investigated prospective associations of plasma phospholipid omega-3 (ALA [18 : 3], EPA [20 : 5], DPA [22 : 5], DHA [22 : 6]) and omega-6 (LA [18 : 2], AA [20 : 4]) PUFA with cognitive decline, risk of cognitive impairment and dementia among adults aged≥65 years in the Cardiovascular Health Study.

METHODS: Circulating fatty acid concentrations were measured serially at baseline (1992/1993), 6 years, and 13 years later. Cognitive decline and impairment were assessed using the 100-point Modified Mini-Mental State Examination (3MSE) up to 7 times. Clinical dementia was identified using adjudicated neuropsychological tests, and ICD-9 codes.

RESULTS: Among 3,564 older adults free of stroke and dementia at baseline, cognitive function declined annually by approximately -0.5 3MSE points; 507 participants developed cognitive impairment and 499 dementia over up to 23 years of follow-up. In multivariable models, higher circulating arachidonic acid (AA) concentrations were associated with slower cognitive decline and lower dementia risk, with associations growing stronger with greater length of follow-up (hazard ratio [HR,95% CI] of dementia per interquintile range, 0.74 [0.56-0.97] at 5 years, and 0.53 [0.37-0.77] at 15 years). Circulating docosapentaenoic (DPA) concentrations were associated with slower cognitive decline and lower risk of cognitive impairment (extreme-quintile HR, 0.72 [95% CI: 0.55, 0.95]). Findings were generally null or inconsistent for other omega-3 or omega-6 PUFA.

CONCLUSION: Circulating AA and DPA, but not other PUFA, are associated with slower rate of cognitive decline and lower risk of dementia or cognitive impairment later in life.

%B J Alzheimers Dis %8 2023 Aug 23 %G eng %R 10.3233/JAD-230083 %0 Journal Article %J Nat Med %D 2023 %T Clonal hematopoiesis is associated with protection from Alzheimer's disease. %A Bouzid, Hind %A Belk, Julia A %A Jan, Max %A Qi, Yanyan %A Sarnowski, Chloe %A Wirth, Sara %A Ma, Lisa %A Chrostek, Matthew R %A Ahmad, Herra %A Nachun, Daniel %A Yao, Winnie %A Beiser, Alexa %A Bick, Alexander G %A Bis, Joshua C %A Fornage, Myriam %A Longstreth, William T %A Lopez, Oscar L %A Natarajan, Pradeep %A Psaty, Bruce M %A Satizabal, Claudia L %A Weinstock, Joshua %A Larson, Eric B %A Crane, Paul K %A Keene, C Dirk %A Seshadri, Sudha %A Satpathy, Ansuman T %A Montine, Thomas J %A Jaiswal, Siddhartha %X

Clonal hematopoiesis of indeterminate potential (CHIP) is a premalignant expansion of mutated hematopoietic stem cells. As CHIP-associated mutations are known to alter the development and function of myeloid cells, we hypothesized that CHIP may also be associated with the risk of Alzheimer's disease (AD), a disease in which brain-resident myeloid cells are thought to have a major role. To perform association tests between CHIP and AD dementia, we analyzed blood DNA sequencing data from 1,362 individuals with AD and 4,368 individuals without AD. Individuals with CHIP had a lower risk of AD dementia (meta-analysis odds ratio (OR) = 0.64, P = 3.8 × 10), and Mendelian randomization analyses supported a potential causal association. We observed that the same mutations found in blood were also detected in microglia-enriched fraction of the brain in seven of eight CHIP carriers. Single-nucleus chromatin accessibility profiling of brain-derived nuclei in six CHIP carriers revealed that the mutated cells comprised a large proportion of the microglial pool in the samples examined. While additional studies are required to validate the mechanistic findings, these results suggest that CHIP may have a role in attenuating the risk of AD.

%B Nat Med %V 29 %P 1662-1670 %8 2023 Jul %G eng %N 7 %R 10.1038/s41591-023-02397-2 %0 Journal Article %J Diabetes Care %D 2023 %T Clonal Hematopoiesis of Indeterminate Potential (CHIP) and Incident Type 2 Diabetes Risk. %A Tobias, Deirdre K %A Manning, Alisa K %A Wessel, Jennifer %A Raghavan, Sridharan %A Westerman, Kenneth E %A Bick, Alexander G %A DiCorpo, Daniel %A Whitsel, Eric A %A Collins, Jason %A Correa, Adolfo %A Cupples, L Adrienne %A Dupuis, Josée %A Goodarzi, Mark O %A Guo, Xiuqing %A Howard, Barbara %A Lange, Leslie A %A Liu, Simin %A Raffield, Laura M %A Reiner, Alex P %A Rich, Stephen S %A Taylor, Kent D %A Tinker, Lesley %A Wilson, James G %A Wu, Peitao %A Carson, April P %A Vasan, Ramachandran S %A Fornage, Myriam %A Psaty, Bruce M %A Kooperberg, Charles %A Rotter, Jerome I %A Meigs, James %A Manson, JoAnn E %X

OBJECTIVE: Clonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in atherosclerotic coronary heart disease (CHD) and all-cause mortality, but its association with incident type 2 diabetes (T2D) is unknown. We hypothesized that CHIP is associated with elevated risk of T2D.

RESEARCH DESIGN AND METHODS: CHIP was derived from whole-genome sequencing of blood DNA in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) prospective cohorts. We performed analysis for 17,637 participants from six cohorts, without prior T2D, cardiovascular disease, or cancer. We evaluated baseline CHIP versus no CHIP prevalence with incident T2D, including associations with DNMT3A, TET2, ASXL1, JAK2, and TP53 variants. We estimated multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for age, sex, BMI, smoking, alcohol, education, self-reported race/ethnicity, and combined cohorts' estimates via fixed-effects meta-analysis.

RESULTS: Mean (SD) age was 63.4 (11.5) years, 76% were female, and CHIP prevalence was 6.0% (n = 1,055) at baseline. T2D was diagnosed in n = 2,467 over mean follow-up of 9.8 years. Participants with CHIP had 23% (CI = 1.04, 1.45) higher risk of T2D than those with no CHIP. Specifically, higher risk was for TET2 (HR 1.48; CI = 1.05, 2.08) and ASXL1 (HR 1.76; CI = 1.03, 2.99) mutations; DNMT3A was nonsignificant (HR 1.15; CI = 0.93, 1.43). Statistical power was limited for JAK2 and TP53 analyses.

CONCLUSIONS: CHIP was associated with higher incidence of T2D. CHIP mutations located on genes implicated in CHD and mortality were also related to T2D, suggesting shared aging-related pathology.

%B Diabetes Care %8 2023 Sep 27 %G eng %R 10.2337/dc23-0805 %0 Journal Article %J medRxiv %D 2023 %T Clonal Hematopoiesis of Indeterminate Potential is Associated with Acute Kidney Injury. %A Vlasschaert, Caitlyn %A Robinson-Cohen, Cassianne %A Kestenbaum, Bryan %A Silver, Samuel A %A Chen, Jian-Chun %A Akwo, Elvis %A Bhatraju, Pavan K %A Zhang, Ming-Zhi %A Cao, Shirong %A Jiang, Ming %A Wang, Yinqiu %A Niu, Aolei %A Siew, Edward %A Kramer, Holly J %A Köttgen, Anna %A Franceschini, Nora %A Psaty, Bruce M %A Tracy, Russell P %A Alonso, Alvaro %A Arking, Dan E %A Coresh, Josef %A Ballantyne, Christie M %A Boerwinkle, Eric %A Grams, Morgan %A Lanktree, Matthew B %A Rauh, Michael J %A Harris, Raymond C %A Bick, Alexander G %X

Age is a predominant risk factor for acute kidney injury (AKI), yet the biological mechanisms underlying this risk are largely unknown and to date no genetic mechanisms for AKI have been established. Clonal hematopoiesis of indeterminate potential (CHIP) is a recently recognized biological mechanism conferring risk of several chronic aging diseases including cardiovascular disease, pulmonary disease and liver disease. In CHIP, blood stem cells acquire mutations in myeloid cancer driver genes such as and and the myeloid progeny of these mutated cells contribute to end-organ damage through inflammatory dysregulation. We sought to establish whether CHIP causes acute kidney injury (AKI). To address this question, we first evaluated associations with incident AKI events in three population-based epidemiology cohorts (N = 442,153). We found that CHIP was associated with a greater risk of AKI (adjusted HR 1.26, 95% CI: 1.19-1.34, p<0.0001), which was more pronounced in patients with AKI requiring dialysis (adjusted HR 1.65, 95% CI: 1.24-2.20, p=0.001). The risk was particularly high in the subset of individuals where CHIP was driven by mutations in genes other than (HR: 1.49, 95% CI: 1.37-1.61, p<0.0001). We then examined the association between CHIP and recovery from AKI in the ASSESS-AKI cohort and identified that non- CHIP was more common among those with a non-resolving pattern of injury (HR 2.3, 95% CI: 1.14-4.64, p = 0.03). To gain mechanistic insight, we evaluated the role of -CHIP to AKI in ischemia-reperfusion injury (IRI) and unilateral ureteral obstruction (UUO) mouse models. In both models, we observed more severe AKI and greater post-AKI kidney fibrosis in -CHIP mice. Kidney macrophage infiltration was markedly increased in -CHIP mice and -CHIP mutant renal macrophages displayed greater pro-inflammatory responses. In summary, this work establishes CHIP as a genetic mechanism conferring risk of AKI and impaired kidney function recovery following AKI via an aberrant inflammatory response in CHIP derived renal macrophages.

%B medRxiv %8 2023 May 17 %G eng %R 10.1101/2023.05.16.23290051 %0 Journal Article %J JAMA Netw Open %D 2023 %T CogDrisk, ANU-ADRI, CAIDE, and LIBRA Risk Scores for Estimating Dementia Risk. %A Huque, Md Hamidul %A Kootar, Scherazad %A Eramudugolla, Ranmalee %A Han, S Duke %A Carlson, Michelle C %A Lopez, Oscar L %A Bennett, David A %A Peters, Ruth %A Anstey, Kaarin J %K Aged %K Aged, 80 and over %K Alzheimer Disease %K Australia %K Cohort Studies %K Female %K Heart Disease Risk Factors %K Humans %K Male %K Risk Factors %X

IMPORTANCE: While the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia (CAIDE), and Lifestyle for Brain Health (LIBRA) dementia risk tools have been widely used, a large body of new evidence has emerged since their publication. Recently, Cognitive Health and Dementia Risk Index (CogDrisk) and CogDrisk for Alzheimer disease (CogDrisk-AD) risk tools have been developed for the assessment of dementia and AD risk, respectively, using contemporary evidence; comparison of the relative performance of these risk tools is limited.

OBJECTIVE: To evaluate the performance of CogDrisk, ANU-ADRI, CAIDE, LIBRA, and modified LIBRA (LIBRA with age and sex estimates from ANU-ADRI) in estimating dementia and AD risks (with CogDrisk-AD and ANU-ADRI).

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study obtained data from the Rush Memory and Aging Project (MAP), the Cardiovascular Health Study Cognition Study (CHS-CS), and the Health and Retirement Study-Aging, Demographics and Memory Study (HRS-ADAMS). Participants who were free of dementia at baseline were included. The factors were component variables in the risk tools that included self-reported baseline demographics, medical risk factors, and lifestyle habits. The study was conducted between November 2021 and March 2023, and statistical analysis was performed from January to June 2023.

MAIN OUTCOMES AND MEASURES: Risk scores were calculated based on available factors in each of these cohorts. Area under the receiver operating characteristic curve (AUC) was calculated to measure the performance of each risk score. Multiple imputation was used to assess whether missing data may have affected estimates for dementia risk.

RESULTS: Among the 6107 participants in 3 validation cohorts included for this study, 2184 participants without dementia at baseline were available from MAP (mean [SD] age, 80.0 [7.6] years; 1606 [73.5%] female), 548 participants without dementia at baseline were available from HRS-ADAMS (mean [SD] age, 79.5 [6.3] years; 288 [52.5%] female), and 3375 participants without dementia at baseline were available from CHS-CS (mean [SD] age, 74.8 [4.9] years; 1994 [59.1%] female). In all 3 cohorts, a similar AUC for dementia was obtained using CogDrisk, ANU-ADRI, and modified LIBRA (MAP cohort: CogDrisk AUC, 0.65 [95% CI, 0.61-0.69]; ANU-ADRI AUC, 0.65 [95% CI, 0.61-0.69]; modified LIBRA AUC, 0.65 [95% CI, 0.61-0.69]; HRS-ADAMS cohort: CogDrisk AUC, 0.75 [95% CI, 0.71-0.79]; ANU-ADRI AUC, 0.74 [95% CI, 0.70-0.78]; modified LIBRA AUC, 0.75 [95% CI, 0.71-0.79]; CHS-CS cohort: CogDrisk AUC, 0.70 [95% CI, 0.67-0.72]; ANU-ADRI AUC, 0.69 [95% CI, 0.66-0.72]; modified LIBRA AUC, 0.70 [95% CI, 0.68-0.73]). The CAIDE and LIBRA also provided similar but lower AUCs than the 3 aforementioned tools (eg, MAP cohort: CAIDE AUC, 0.50 [95% CI, 0.46-0.54]; LIBRA AUC, 0.53 [95% CI, 0.48-0.57]). The performance of CogDrisk-AD and ANU-ADRI in estimating AD risks was also similar.

CONCLUSIONS AND RELEVANCE: CogDrisk and CogDrisk-AD performed similarly to ANU-ADRI in estimating dementia and AD risks. These results suggest that CogDrisk and CogDrisk-AD, with a greater range of modifiable risk factors compared with other risk tools in this study, may be more informative for risk reduction.

%B JAMA Netw Open %V 6 %P e2331460 %8 2023 Aug 01 %G eng %N 8 %R 10.1001/jamanetworkopen.2023.31460 %0 Journal Article %J medRxiv %D 2023 %T Complexities of cerebral small vessel disease, blood pressure, and dementia relationship: new insights from genetics. %A Sargurupremraj, Muralidharan %A Soumaré, Aïcha %A Bis, Joshua C %A Surakka, Ida %A Jürgenson, Tuuli %A Joly, Pierre %A Knol, Maria J %A Wang, Ruiqi %A Yang, Qiong %A Satizabal, Claudia L %A Gudjonsson, Alexander %A Mishra, Aniket %A Bouteloup, Vincent %A Phuah, Chia-Ling %A van Duijn, Cornelia M %A Cruchaga, Carlos %A Dufouil, Carole %A Chene, Geneviève %A Lopez, Oscar %A Psaty, Bruce M %A Tzourio, Christophe %A Amouyel, Philippe %A Adams, Hieab H %A Jacqmin-Gadda, Hélène %A Ikram, Mohammad Arfan %A Gudnason, Vilmundur %A Milani, Lili %A Winsvold, Bendik S %A Hveem, Kristian %A Matthews, Paul M %A Longstreth, W T %A Seshadri, Sudha %A Launer, Lenore J %A Debette, Stephanie %X

IMPORTANCE: There is increasing recognition that vascular disease, which can be treated, is a key contributor to dementia risk. However, the contribution of specific markers of vascular disease is unclear and, as a consequence, optimal prevention strategies remain unclear.

OBJECTIVE: To disentangle the causal relation of several key vascular traits to dementia risk: (i) white matter hyperintensity (WMH) burden, a highly prevalent imaging marker of covert cerebral small vessel disease (cSVD); (ii) clinical stroke; and (iii) blood pressure (BP), the leading risk factor for cSVD and stroke, for which efficient therapies exist. To account for potential epidemiological biases inherent to late-onset conditions like dementia.

DESIGN SETTING AND PARTICIPANTS: This study first explored the association of genetically determined WMH, BP levels and stroke risk with AD using summary-level data from large genome-wide association studies (GWASs) in a two-sample Mendelian randomization (MR) framework. Second, leveraging individual-level data from large longitudinal population-based cohorts and biobanks with prospective dementia surveillance, the association of weighted genetic risk scores (wGRSs) for WMH, BP, and stroke with incident all-cause-dementia was explored using Cox-proportional hazard and multi-state models. The data analysis was performed from July 26, 2020, through July 24, 2022.

EXPOSURES: Genetically determined levels of WMH volume and BP (systolic, diastolic and pulse blood pressures) and genetic liability to stroke.

MAIN OUTCOMES AND MEASURES: The summary-level MR analyses focused on the outcomes from GWAS of clinically diagnosed AD (n-cases=21,982) and GWAS additionally including self-reported parental history of dementia as a proxy for AD diagnosis (AD , n-cases=53,042). For the longitudinal analyses, individual-level data of 157,698 participants with 10,699 incident all-cause-dementia were studied, exploring AD, vascular or mixed dementia in secondary analyses.

RESULTS: In the two-sample MR analyses, WMH showed strong evidence for a causal association with increased risk of AD (OR, 1.16; 95%CI:1.05-1.28; P=.003) and AD (OR, 1.28; 95%CI:1.07-1.53; P=.008), after accounting for genetically determined pulse pressure for the latter. Genetically predicted BP traits showed evidence for a protective association with both clinically defined AD and AD , with evidence for confounding by shared genetic instruments. In longitudinal analyses the wGRSs for WMH, but not BP or stroke, showed suggestive association with incident all-cause-dementia (HR, 1.02; 95%CI:1.00-1.04; P=.06). BP and stroke wGRSs were strongly associated with mortality but there was no evidence for selective survival bias during follow-up. In secondary analyses, polygenic scores with more liberal instrument definition showed association of both WMH and stroke with all-cause-dementia, AD, and vascular or mixed dementia; associations of stroke, but not WMH, with dementia outcomes were markedly attenuated after adjusting for interim stroke.

CONCLUSION: These findings provide converging evidence that WMH is a leading vascular contributor to dementia risk, which may better capture the brain damage caused by BP (and other etiologies) than BP itself and should be targeted in priority for dementia prevention in the population.

KEY POINTS: Do instrumental variable analyses leveraging genetic information provide evidence for a causal association of various vascular traits with Alzheimer's disease (AD) and all-cause-dementia? How do these associations compare for white matter hyperintensity (WMH) burden, a highly prevalent marker of covert cerebral small vessel disease (cSVD), stroke, and blood pressure traits, the strongest known risk factor for cSVD and stroke? Using Mendelian randomization (MR) leveraging large, published genome-wide association studies, this study showed a putative causal association of larger WMH burden with increased AD risk after accounting for pulse pressure effects, and some evidence for association of lower BP with AD risk with possible confounding by shared genetic instruments. Longitudinal analyses on individual-level data also supported association of genetically determined WMH with incident all-cause-dementia and AD, independently of interim stroke. This study using complementary genetic epidemiology approaches, identified increasing WMH burden to be associated with dementia and AD risk, suggesting the association as specific for cSVD and independent of BP and stroke.

%B medRxiv %8 2023 Aug 13 %G eng %R 10.1101/2023.08.08.23293761 %0 Journal Article %J medRxiv %D 2023 %T Determinants of mosaic chromosomal alteration fitness. %A Pershad, Yash %A Mack, Taralynn %A Poisner, Hannah %A Jakubek, Yasminka A %A Stilp, Adrienne M %A Mitchell, Braxton D %A Lewis, Joshua P %A Boerwinkle, Eric %A Loos, Ruth J %A Chami, Nathalie %A Wang, Zhe %A Barnes, Kathleen %A Pankratz, Nathan %A Fornage, Myriam %A Redline, Susan %A Psaty, Bruce M %A Bis, Joshua C %A Shojaie, Ali %A Silverman, Edwin K %A Cho, Michael H %A Yun, Jeong %A DeMeo, Dawn %A Levy, Daniel %A Johnson, Andrew %A Mathias, Rasika %A Taub, Margaret %A Arnett, Donna %A North, Kari %A Raffield, Laura M %A Carson, April %A Doyle, Margaret F %A Rich, Stephen S %A Rotter, Jerome I %A Guo, Xiuqing %A Cox, Nancy %A Roden, Dan M %A Franceschini, Nora %A Desai, Pinkal %A Reiner, Alex %A Auer, Paul L %A Scheet, Paul %A Jaiswal, Siddhartha %A Weinstock, Joshua S %A Bick, Alexander G %X

Clonal hematopoiesis (CH) is characterized by the acquisition of a somatic mutation in a hematopoietic stem cell that results in a clonal expansion. These driver mutations can be single nucleotide variants in cancer driver genes or larger structural rearrangements called mosaic chromosomal alterations (mCAs). The factors that influence the variations in mCA fitness and ultimately result in different clonal expansion rates are not well-understood. We used the Passenger-Approximated Clonal Expansion Rate (PACER) method to estimate clonal expansion rate for 6,381 individuals in the NHLBI TOPMed cohort with gain, loss, and copy-neutral loss of heterozygosity mCAs. Our estimates of mCA fitness were correlated (R = 0.49) with an alternative approach that estimated fitness of mCAs in the UK Biobank using a theoretical probability distribution. Individuals with lymphoid-associated mCAs had a significantly higher white blood cell count and faster clonal expansion rate. In a cross-sectional analysis, genome-wide association study of estimates of mCA expansion rate identified , , and locus variants as modulators of mCA clonal expansion rate.

%B medRxiv %8 2023 Oct 21 %G eng %R 10.1101/2023.10.20.23297280 %0 Journal Article %J J Am Coll Cardiol %D 2023 %T Effect of 2022 ACC/AHA/HFSA Criteria on Stages of Heart Failure in a Pooled Community Cohort. %A Mohebi, Reza %A Wang, Dongyu %A Lau, Emily S %A Parekh, Juhi K %A Allen, Norrina %A Psaty, Bruce M %A Benjamin, Emelia J %A Levy, Daniel %A Wang, Thomas J %A Shah, Sanjiv J %A Gottdiener, John S %A Januzzi, James L %A Ho, Jennifer E %K American Heart Association %K Atherosclerosis %K Cardiology %K Female %K Heart Failure %K Humans %K Longitudinal Studies %K Prognosis %K United States %X

BACKGROUND: The 2022 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) clinical practice guideline proposed an updated definition for heart failure (HF) stages.

OBJECTIVES: This study aimed to compare prevalence and prognosis of HF stages according to classification/definition originally described in 2013 and 2022 ACC/AHA/HFSA definitions.

METHODS: Study participants from 3 longitudinal cohorts (the MESA [Multi-Ethnic Study of Atherosclerosis], CHS [Cardiovascular Health Study], and the FHS [Framingham Heart Study]), were categorized into 4 HF stages according to the 2013 and 2022 criteria. Cox proportional hazards regression was used to assess predictors of progression to symptomatic HF and adverse clinical outcomes associated with each HF stage.

RESULTS: Among 11,618 study participants, according to the 2022 staging, 1,943 (16.7%) were healthy, 4,348 (37.4%) were in stage A (at risk), 5,019 (43.2%) were in stage B (pre-HF), and 308 (2.7%) were in stage C/D (symptomatic HF). Compared to the classification/definition originally described in 2013, the 2022 ACC/AHA/HFSA approach resulted in a higher proportion of individuals with stage B HF (increase from 15.9% to 43.2%); this shift disproportionately involved women as well as Hispanic and Black individuals. Despite the 2022 criteria designating a greater proportion of individuals as stage B, the relative risk of progression to symptomatic HF remained similar (HR: 10.61; 95% CI: 9.00-12.51; P < 0.001).

CONCLUSIONS: New standards for HF staging resulted in a substantial shift of community-based individuals from stage A to stage B. Those with stage B HF in the new system were at high risk for progression to symptomatic HF.

%B J Am Coll Cardiol %V 81 %P 2231-2242 %8 2023 Jun 13 %G eng %N 23 %R 10.1016/j.jacc.2023.04.007 %0 Journal Article %J Nat Commun %D 2023 %T Evaluating the use of blood pressure polygenic risk scores across race/ethnic background groups. %A Kurniansyah, Nuzulul %A Goodman, Matthew O %A Khan, Alyna T %A Wang, Jiongming %A Feofanova, Elena %A Bis, Joshua C %A Wiggins, Kerri L %A Huffman, Jennifer E %A Kelly, Tanika %A Elfassy, Tali %A Guo, Xiuqing %A Palmas, Walter %A Lin, Henry J %A Hwang, Shih-Jen %A Gao, Yan %A Young, Kendra %A Kinney, Gregory L %A Smith, Jennifer A %A Yu, Bing %A Liu, Simin %A Wassertheil-Smoller, Sylvia %A Manson, JoAnn E %A Zhu, Xiaofeng %A Chen, Yii-Der Ida %A Lee, I-Te %A Gu, C Charles %A Lloyd-Jones, Donald M %A Zöllner, Sebastian %A Fornage, Myriam %A Kooperberg, Charles %A Correa, Adolfo %A Psaty, Bruce M %A Arnett, Donna K %A Isasi, Carmen R %A Rich, Stephen S %A Kaplan, Robert C %A Redline, Susan %A Mitchell, Braxton D %A Franceschini, Nora %A Levy, Daniel %A Rotter, Jerome I %A Morrison, Alanna C %A Sofer, Tamar %K Blood Pressure %K Ethnicity %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Male %K Multifactorial Inheritance %K Population Health %K Risk Factors %X

We assess performance and limitations of polygenic risk scores (PRSs) for multiple blood pressure (BP) phenotypes in diverse population groups. We compare "clumping-and-thresholding" (PRSice2) and LD-based (LDPred2) methods to construct PRSs from each of multiple GWAS, as well as multi-PRS approaches that sum PRSs with and without weights, including PRS-CSx. We use datasets from the MGB Biobank, TOPMed study, UK biobank, and from All of Us to train, assess, and validate PRSs in groups defined by self-reported race/ethnic background (Asian, Black, Hispanic/Latino, and White). For both SBP and DBP, the PRS-CSx based PRS, constructed as a weighted sum of PRSs developed from multiple independent GWAS, perform best across all race/ethnic backgrounds. Stratified analysis in All of Us shows that PRSs are better predictive of BP in females compared to males, individuals without obesity, and middle-aged (40-60 years) compared to older and younger individuals.

%B Nat Commun %V 14 %P 3202 %8 2023 Jun 02 %G eng %N 1 %R 10.1038/s41467-023-38990-9 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2023 %T Evaluation of Associations of Growth Differentiation Factor-11, Growth Differentiation Factor-8 and their Binding Proteins Follistatin and Follistatin-like protein-3 with Dementia and Cognition. %A Newman, Anne B %A Patel, Sheena %A Kizer, Jorge %A Lee, Se-Jin %A Bhasin, Shalinder %A Cawthon, Peggy %A LeBrasseur, Nathan %A Tracy, Russel P %A Ganz, Peter %A Cummings, Steve %X

BACKGROUND: Studies using heterochronic parabiosis discovered that circulating factors mediate brain aging in animal models.

METHODS: We assessed Growth Differentiation Factor (GDF)-11 and GDF-8 using mass spectrometry and inhibitors follistatin and follistatin-like protein-3 (FSTL-3) with ELISA in in the Cardiovascular Health Study (N=1506) and the Health ABC study (N=1237). CLL-11 and Beta 2 microglobulin (B2M) were measured with ELISA in a subset of 400 individuals in Health ABC. Associations were assessed with cognitive function, brain magnetic resonance imaging (MRI) findings (CHS only) and incident dementia using correlations, linear regression and Cox proportional hazards models.

RESULTS: In CHS, levels of GDF-11, GDF-8 and follistatin were not correlated cross sectionally with the 3MSE or DSST, brain MRI findings of white matter hyperintensity, atrophy or small infarcts, nor were they associated with incident dementia. FSTL-3 was modestly correlated with poorer cognitive function, greater white matter hyperintensities and atrophy on MRI as well as with incident dementia with an adjusted HR of 1.72 (95% CI=1.13, 2.61) per doubling of FSTL-3. FSTL-3 was not associated with cognition or dementia in Health ABC, but GDF-8 was associated with both. The adjusted HR for incident dementia was 1.50 (95%CI 1.07, 2.10) per doubling of GDF-8.

CONCLUSIONS: Total GDF-11 level was not related to cognition or dementia in older adults. Associations of GDF-8 with cognitive outcomes in Health ABC were not expected, but consistent with animal models. Associations of FSTL-3 with cognition, brain abnormalities, and incident dementia in CHS implicates TGF-B superfamily inhibition in the pathogenesis of dementia.

%B J Gerontol A Biol Sci Med Sci %8 2023 Jan 20 %G eng %R 10.1093/gerona/glad019 %0 Journal Article %J EBioMedicine %D 2023 %T Evaluation of plasma sphingolipids as mediators of the relationship between kidney disease and cardiovascular events. %A Lidgard, Benjamin %A Bansal, Nisha %A Zelnick, Leila R %A Hoofnagle, Andrew N %A Fretts, Amanda M %A Longstreth, William T %A Shlipak, Michael G %A Siscovick, David S %A Umans, Jason G %A Lemaitre, Rozenn N %X

BACKGROUND: Sphingolipids are a family of circulating lipids with regulatory and signaling roles that are strongly associated with both eGFR and cardiovascular disease. Patients with chronic kidney disease (CKD) are at high risk for cardiovascular events, and have different plasma concentrations of certain plasma sphingolipids compared to patients with normal kidney function. We hypothesize that circulating sphingolipids partially mediate the associations between eGFR and cardiovascular events.

METHODS: We measured the circulating concentrations of 8 sphingolipids, including 4 ceramides and 4 sphingomyelins with the fatty acids 16:0, 20:0, 22:0, and 24:0, in plasma from 3,463 participants in a population-based cohort (Cardiovascular Health Study) without prevalent cardiovascular disease. We tested the adjusted mediation effects by these sphingolipids of the associations between eGFR and incident cardiovascular disease via quasi-Bayesian Monte Carlo method with 2,000 simulations, using a Bonferroni correction for significance.

FINDINGS: The mean (±SD) eGFR was 70 (±16) mL/min/1.73 m; 62% of participants were women. Lower eGFR was associated with higher plasma ceramide-16:0 and sphingomyelin-16:0, and lower ceramides and sphingomyelins-20:0 and -22:0. Lower eGFR was associated with risk of incident heart failure and ischemic stroke, but not myocardial infarction. Five of eight sphingolipids partially mediated the association between eGFR and heart failure. The sphingolipids associated with the greatest proportion mediated were ceramide-16:0 (proportion mediated 13%, 95% CI 8-22%) and sphingomyelin-16:0 (proportion mediated 10%, 95% CI 5-17%). No sphingolipids mediated the association between eGFR and ischemic stroke.

INTERPRETATION: Plasma sphingolipids partially mediated the association between lower eGFR and incident heart failure. Altered sphingolipids metabolism may be a novel mechanism for heart failure in patients with CKD.

FUNDING: This study was supported by T32 DK007467 and a KidneyCure Ben J. Lipps Research Fellowship (Dr. Lidgard). Sphingolipid measurements were supported by R01 HL128575 (Dr. Lemaitre) and R01 HL111375 (Dr. Hoofnagle) from the National Heart, Lung, and Blood Institute (NHLBI).

%B EBioMedicine %V 95 %P 104765 %8 2023 Aug 24 %G eng %R 10.1016/j.ebiom.2023.104765 %0 Journal Article %J Front Genet %D 2023 %T Gene-educational attainment interactions in a multi-population genome-wide meta-analysis identify novel lipid loci. %A de Las Fuentes, Lisa %A Schwander, Karen L %A Brown, Michael R %A Bentley, Amy R %A Winkler, Thomas W %A Sung, Yun Ju %A Munroe, Patricia B %A Miller, Clint L %A Aschard, Hugo %A Aslibekyan, Stella %A Bartz, Traci M %A Bielak, Lawrence F %A Chai, Jin Fang %A Cheng, Ching-Yu %A Dorajoo, Rajkumar %A Feitosa, Mary F %A Guo, Xiuqing %A Hartwig, Fernando P %A Horimoto, Andrea %A Kolcic, Ivana %A Lim, Elise %A Liu, Yongmei %A Manning, Alisa K %A Marten, Jonathan %A Musani, Solomon K %A Noordam, Raymond %A Padmanabhan, Sandosh %A Rankinen, Tuomo %A Richard, Melissa A %A Ridker, Paul M %A Smith, Albert V %A Vojinovic, Dina %A Zonderman, Alan B %A Alver, Maris %A Boissel, Mathilde %A Christensen, Kaare %A Freedman, Barry I %A Gao, Chuan %A Giulianini, Franco %A Harris, Sarah E %A He, Meian %A Hsu, Fang-Chi %A Kuhnel, Brigitte %A Laguzzi, Federica %A Li, Xiaoyin %A Lyytikäinen, Leo-Pekka %A Nolte, Ilja M %A Poveda, Alaitz %A Rauramaa, Rainer %A Riaz, Muhammad %A Robino, Antonietta %A Sofer, Tamar %A Takeuchi, Fumihiko %A Tayo, Bamidele O %A van der Most, Peter J %A Verweij, Niek %A Ware, Erin B %A Weiss, Stefan %A Wen, Wanqing %A Yanek, Lisa R %A Zhan, Yiqiang %A Amin, Najaf %A Arking, Dan E %A Ballantyne, Christie %A Boerwinkle, Eric %A Brody, Jennifer A %A Broeckel, Ulrich %A Campbell, Archie %A Canouil, Mickaël %A Chai, Xiaoran %A Chen, Yii-Der Ida %A Chen, Xu %A Chitrala, Kumaraswamy Naidu %A Concas, Maria Pina %A de Faire, Ulf %A de Mutsert, Renée %A de Silva, H Janaka %A de Vries, Paul S %A Do, Ahn %A Faul, Jessica D %A Fisher, Virginia %A Floyd, James S %A Forrester, Terrence %A Friedlander, Yechiel %A Girotto, Giorgia %A Gu, C Charles %A Hallmans, Göran %A Heikkinen, Sami %A Heng, Chew-Kiat %A Homuth, Georg %A Hunt, Steven %A Ikram, M Arfan %A Jacobs, David R %A Kavousi, Maryam %A Khor, Chiea Chuen %A Kilpeläinen, Tuomas O %A Koh, Woon-Puay %A Komulainen, Pirjo %A Langefeld, Carl D %A Liang, Jingjing %A Liu, Kiang %A Liu, Jianjun %A Lohman, Kurt %A Mägi, Reedik %A Manichaikul, Ani W %A McKenzie, Colin A %A Meitinger, Thomas %A Milaneschi, Yuri %A Nauck, Matthias %A Nelson, Christopher P %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Pereira, Alexandre C %A Perls, Thomas %A Peters, Annette %A Polasek, Ozren %A Raitakari, Olli T %A Rice, Kenneth %A Rice, Treva K %A Rich, Stephen S %A Sabanayagam, Charumathi %A Schreiner, Pamela J %A Shu, Xiao-Ou %A Sidney, Stephen %A Sims, Mario %A Smith, Jennifer A %A Starr, John M %A Strauch, Konstantin %A Tai, E Shyong %A Taylor, Kent D %A Tsai, Michael Y %A Uitterlinden, André G %A van Heemst, Diana %A Waldenberger, Melanie %A Wang, Ya-Xing %A Wei, Wen-Bin %A Wilson, Gregory %A Xuan, Deng %A Yao, Jie %A Yu, Caizheng %A Yuan, Jian-Min %A Zhao, Wei %A Becker, Diane M %A Bonnefond, Amélie %A Bowden, Donald W %A Cooper, Richard S %A Deary, Ian J %A Divers, Jasmin %A Esko, Tõnu %A Franks, Paul W %A Froguel, Philippe %A Gieger, Christian %A Jonas, Jost B %A Kato, Norihiro %A Lakka, Timo A %A Leander, Karin %A Lehtimäki, Terho %A Magnusson, Patrik K E %A North, Kari E %A Ntalla, Ioanna %A Penninx, Brenda %A Samani, Nilesh J %A Snieder, Harold %A Spedicati, Beatrice %A van der Harst, Pim %A Völzke, Henry %A Wagenknecht, Lynne E %A Weir, David R %A Wojczynski, Mary K %A Wu, Tangchun %A Zheng, Wei %A Zhu, Xiaofeng %A Bouchard, Claude %A Chasman, Daniel I %A Evans, Michele K %A Fox, Ervin R %A Gudnason, Vilmundur %A Hayward, Caroline %A Horta, Bernardo L %A Kardia, Sharon L R %A Krieger, Jose Eduardo %A Mook-Kanamori, Dennis O %A Peyser, Patricia A %A Province, Michael M %A Psaty, Bruce M %A Rudan, Igor %A Sim, Xueling %A Smith, Blair H %A van Dam, Rob M %A van Duijn, Cornelia M %A Wong, Tien Yin %A Arnett, Donna K %A Rao, Dabeeru C %A Gauderman, James %A Liu, Ching-Ti %A Morrison, Alanna C %A Rotter, Jerome I %A Fornage, Myriam %X

Educational attainment, widely used in epidemiologic studies as a surrogate for socioeconomic status, is a predictor of cardiovascular health outcomes. A two-stage genome-wide meta-analysis of low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) levels was performed while accounting for gene-educational attainment interactions in up to 226,315 individuals from five population groups. We considered two educational attainment variables: "Some College" (yes/no, for any education beyond high school) and "Graduated College" (yes/no, for completing a 4-year college degree). Genome-wide significant ( < 5 × 10) and suggestive ( < 1 × 10) variants were identified in Stage 1 (in up to 108,784 individuals) through genome-wide analysis, and those variants were followed up in Stage 2 studies (in up to 117,531 individuals). In combined analysis of Stages 1 and 2, we identified 18 novel lipid loci (nine for LDL, seven for HDL, and two for TG) by two degree-of-freedom (2 DF) joint tests of main and interaction effects. Four loci showed significant interaction with educational attainment. Two loci were significant only in cross-population analyses. Several loci include genes with known or suggested roles in adipose (), brain (), and liver () biology, highlighting the potential importance of brain-adipose-liver communication in the regulation of lipid metabolism. An investigation of the potential druggability of genes in identified loci resulted in five gene targets shown to interact with drugs approved by the Food and Drug Administration, including genes with roles in adipose and brain tissue. Genome-wide interaction analysis of educational attainment identified novel lipid loci not previously detected by analyses limited to main genetic effects.

%B Front Genet %V 14 %P 1235337 %8 2023 %G eng %R 10.3389/fgene.2023.1235337 %0 Journal Article %J Nat Commun %D 2023 %T Genetic architecture of spatial electrical biomarkers for cardiac arrhythmia and relationship with cardiovascular disease. %A Young, William J %A Haessler, Jeffrey %A Benjamins, Jan-Walter %A Repetto, Linda %A Yao, Jie %A Isaacs, Aaron %A Harper, Andrew R %A Ramirez, Julia %A Garnier, Sophie %A Van Duijvenboden, Stefan %A Baldassari, Antoine R %A Concas, Maria Pina %A Duong, ThuyVy %A Foco, Luisa %A Isaksen, Jonas L %A Mei, Hao %A Noordam, Raymond %A Nursyifa, Casia %A Richmond, Anne %A Santolalla, Meddly L %A Sitlani, Colleen M %A Soroush, Negin %A Thériault, Sébastien %A Trompet, Stella %A Aeschbacher, Stefanie %A Ahmadizar, Fariba %A Alonso, Alvaro %A Brody, Jennifer A %A Campbell, Archie %A Correa, Adolfo %A Darbar, Dawood %A De Luca, Antonio %A Deleuze, Jean-Francois %A Ellervik, Christina %A Fuchsberger, Christian %A Goel, Anuj %A Grace, Christopher %A Guo, Xiuqing %A Hansen, Torben %A Heckbert, Susan R %A Jackson, Rebecca D %A Kors, Jan A %A Lima-Costa, Maria Fernanda %A Linneberg, Allan %A Macfarlane, Peter W %A Morrison, Alanna C %A Navarro, Pau %A Porteous, David J %A Pramstaller, Peter P %A Reiner, Alexander P %A Risch, Lorenz %A Schotten, Ulrich %A Shen, Xia %A Sinagra, Gianfranco %A Soliman, Elsayed Z %A Stoll, Monika %A Tarazona-Santos, Eduardo %A Tinker, Andrew %A Trajanoska, Katerina %A Villard, Eric %A Warren, Helen R %A Whitsel, Eric A %A Wiggins, Kerri L %A Arking, Dan E %A Avery, Christy L %A Conen, David %A Girotto, Giorgia %A Grarup, Niels %A Hayward, Caroline %A Jukema, J Wouter %A Mook-Kanamori, Dennis O %A Olesen, Morten Salling %A Padmanabhan, Sandosh %A Psaty, Bruce M %A Pattaro, Cristian %A Ribeiro, Antonio Luiz P %A Rotter, Jerome I %A Stricker, Bruno H %A van der Harst, Pim %A van Duijn, Cornelia M %A Verweij, Niek %A Wilson, James G %A Orini, Michele %A Charron, Philippe %A Watkins, Hugh %A Kooperberg, Charles %A Lin, Henry J %A Wilson, James F %A Kanters, Jørgen K %A Sotoodehnia, Nona %A Mifsud, Borbala %A Lambiase, Pier D %A Tereshchenko, Larisa G %A Munroe, Patricia B %K Arrhythmias, Cardiac %K Atrioventricular Block %K Biomarkers %K Cardiovascular Diseases %K Electrocardiography %K Genome-Wide Association Study %K Humans %K Risk Factors %X

The 3-dimensional spatial and 2-dimensional frontal QRS-T angles are measures derived from the vectorcardiogram. They are independent risk predictors for arrhythmia, but the underlying biology is unknown. Using multi-ancestry genome-wide association studies we identify 61 (58 previously unreported) loci for the spatial QRS-T angle (N = 118,780) and 11 for the frontal QRS-T angle (N = 159,715). Seven out of the 61 spatial QRS-T angle loci have not been reported for other electrocardiographic measures. Enrichments are observed in pathways related to cardiac and vascular development, muscle contraction, and hypertrophy. Pairwise genome-wide association studies with classical ECG traits identify shared genetic influences with PR interval and QRS duration. Phenome-wide scanning indicate associations with atrial fibrillation, atrioventricular block and arterial embolism and genetically determined QRS-T angle measures are associated with fascicular and bundle branch block (and also atrioventricular block for the frontal QRS-T angle). We identify potential biology involved in the QRS-T angle and their genetic relationships with cardiovascular traits and diseases, may inform future research and risk prediction.

%B Nat Commun %V 14 %P 1411 %8 2023 Mar 14 %G eng %N 1 %R 10.1038/s41467-023-36997-w %0 Journal Article %J bioRxiv %D 2023 %T Genetic control of mRNA splicing as a potential mechanism for incomplete penetrance of rare coding variants. %A Einson, Jonah %A Glinos, Dafni %A Boerwinkle, Eric %A Castaldi, Peter %A Darbar, Dawood %A de Andrade, Mariza %A Ellinor, Patrick %A Fornage, Myriam %A Gabriel, Stacey %A Germer, Soren %A Gibbs, Richard %A Hersh, Craig P %A Johnsen, Jill %A Kaplan, Robert %A Konkle, Barbara A %A Kooperberg, Charles %A Nassir, Rami %A Loos, Ruth J F %A Meyers, Deborah A %A Mitchell, Braxton D %A Psaty, Bruce %A Vasan, Ramachandran S %A Rich, Stephen S %A Rienstra, Michael %A Rotter, Jerome I %A Saferali, Aabida %A Shoemaker, M Benjamin %A Silverman, Edwin %A Smith, Albert Vernon %A Mohammadi, Pejman %A Castel, Stephane E %A Iossifov, Ivan %A Lappalainen, Tuuli %X

Exonic variants present some of the strongest links between genotype and phenotype. However, these variants can have significant inter-individual pathogenicity differences, known as variable penetrance. In this study, we propose a model where genetically controlled mRNA splicing modulates the pathogenicity of exonic variants. By first cataloging exonic inclusion from RNA-seq data in GTEx v8, we find that pathogenic alleles are depleted on highly included exons. Using a large-scale phased WGS data from the TOPMed consortium, we observe that this effect may be driven by common splice-regulatory genetic variants, and that natural selection acts on haplotype configurations that reduce the transcript inclusion of putatively pathogenic variants, especially when limiting to haploinsufficient genes. Finally, we test if this effect may be relevant for autism risk using families from the Simons Simplex Collection, but find that splicing of pathogenic alleles has a penetrance reducing effect here as well. Overall, our results indicate that common splice-regulatory variants may play a role in reducing the damaging effects of rare exonic variants.

%B bioRxiv %8 2023 Jan 31 %G eng %R 10.1101/2023.01.31.526505 %0 Journal Article %J Sci Adv %D 2023 %T The genetic determinants of recurrent somatic mutations in 43,693 blood genomes. %A Weinstock, Joshua S %A Laurie, Cecelia A %A Broome, Jai G %A Taylor, Kent D %A Guo, Xiuqing %A Shuldiner, Alan R %A O'Connell, Jeffrey R %A Lewis, Joshua P %A Boerwinkle, Eric %A Barnes, Kathleen C %A Chami, Nathalie %A Kenny, Eimear E %A Loos, Ruth J F %A Fornage, Myriam %A Redline, Susan %A Cade, Brian E %A Gilliland, Frank D %A Chen, Zhanghua %A Gauderman, W James %A Kumar, Rajesh %A Grammer, Leslie %A Schleimer, Robert P %A Psaty, Bruce M %A Bis, Joshua C %A Brody, Jennifer A %A Silverman, Edwin K %A Yun, Jeong H %A Qiao, Dandi %A Weiss, Scott T %A Lasky-Su, Jessica %A DeMeo, Dawn L %A Palmer, Nicholette D %A Freedman, Barry I %A Bowden, Donald W %A Cho, Michael H %A Vasan, Ramachandran S %A Johnson, Andrew D %A Yanek, Lisa R %A Becker, Lewis C %A Kardia, Sharon %A He, Jiang %A Kaplan, Robert %A Heckbert, Susan R %A Smith, Nicholas L %A Wiggins, Kerri L %A Arnett, Donna K %A Irvin, Marguerite R %A Tiwari, Hemant %A Correa, Adolfo %A Raffield, Laura M %A Gao, Yan %A de Andrade, Mariza %A Rotter, Jerome I %A Rich, Stephen S %A Manichaikul, Ani W %A Konkle, Barbara A %A Johnsen, Jill M %A Wheeler, Marsha M %A Custer, Brian S %A Duggirala, Ravindranath %A Curran, Joanne E %A Blangero, John %A Gui, Hongsheng %A Xiao, Shujie %A Williams, L Keoki %A Meyers, Deborah A %A Li, Xingnan %A Ortega, Victor %A McGarvey, Stephen %A Gu, C Charles %A Chen, Yii-Der Ida %A Lee, Wen-Jane %A Shoemaker, M Benjamin %A Darbar, Dawood %A Roden, Dan %A Albert, Christine %A Kooperberg, Charles %A Desai, Pinkal %A Blackwell, Thomas W %A Abecasis, Goncalo R %A Smith, Albert V %A Kang, Hyun M %A Mathias, Rasika %A Natarajan, Pradeep %A Jaiswal, Siddhartha %A Reiner, Alexander P %A Bick, Alexander G %K Germ-Line Mutation %K Hematopoiesis %K Humans %K Middle Aged %K Mutation %K Mutation, Missense %K Phenotype %X

Nononcogenic somatic mutations are thought to be uncommon and inconsequential. To test this, we analyzed 43,693 National Heart, Lung and Blood Institute Trans-Omics for Precision Medicine blood whole genomes from 37 cohorts and identified 7131 non-missense somatic mutations that are recurrently mutated in at least 50 individuals. These recurrent non-missense somatic mutations (RNMSMs) are not clearly explained by other clonal phenomena such as clonal hematopoiesis. RNMSM prevalence increased with age, with an average 50-year-old having 27 RNMSMs. Inherited germline variation associated with RNMSM acquisition. These variants were found in genes involved in adaptive immune function, proinflammatory cytokine production, and lymphoid lineage commitment. In addition, the presence of eight specific RNMSMs associated with blood cell traits at effect sizes comparable to Mendelian genetic mutations. Overall, we found that somatic mutations in blood are an unexpectedly common phenomenon with ancestry-specific determinants and human health consequences.

%B Sci Adv %V 9 %P eabm4945 %8 2023 Apr 28 %G eng %N 17 %R 10.1126/sciadv.abm4945 %0 Journal Article %J Res Sq %D 2023 %T Genome-Wide Association Studies and fine-mapping of genomic loci for n-3 and n-6 Polyunsaturated Fatty Acids in Hispanic American and African American Cohorts. %A Yang, Chaojie %A Veenstra, Jenna %A Bartz, Traci %A Pahl, Matthew %A Hallmark, Brian %A Chen, Yii-Der Ida %A Westra, Jason %A Steffen, Lyn %A Brown, Christopher %A Siscovick, David %A Tsai, Michael %A Wood, Alexis %A Rich, Stephen %A Smith, Caren %A O'Connor, Timothy %A Mozaffarian, Dariush %A Grant, Struan %A Chilton, Floyd %A Tintle, Nathan %A Lemaitre, Rozenn %A Manichaikul, Ani %X

Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFAs) play critical roles in human health. Prior genome-wide association studies (GWAS) of n-3 and n-6 PUFAs in European Americans from the CHARGE Consortium have documented strong genetic signals in/near the locus on chromosome 11. We performed a GWAS of four n-3 and four n-6 PUFAs in Hispanic American (n = 1454) and African American (n = 2278) participants from three CHARGE cohorts. Applying a genome-wide significance threshold of  < 5 x 10 , we confirmed association of the signal and found evidence of two additional signals (in and ) within 200 kb of the originally reported signal. Outside of the region, we identified novel signals for arachidonic acid (AA) in Hispanic Americans located in/near genes including , , and spanning a > 9 Mb region on chromosome 11 (57.5Mb ~ 67.1Mb). Among these novel signals, we found associations unique to Hispanic Americans, including rs28364240, a missense variant for AA that is common in CHARGE Hispanic Americans but absent in other race/ancestry groups. Our study sheds light on the genetics of PUFAs and the value of investigating complex trait genetics across diverse ancestry populations.

%B Res Sq %8 2023 Feb 24 %G eng %R 10.21203/rs.3.rs-2073736/v1 %0 Journal Article %J medRxiv %D 2023 %T Genome-Wide Interaction Analysis with DASH Diet Score Identified Novel Loci for Systolic Blood Pressure. %A Guirette, Melanie %A Lan, Jessie %A McKeown, Nicola %A Brown, Michael R %A Chen, Han %A de Vries, Paul S %A Kim, Hyunju %A Rebholz, Casey M %A Morrison, Alanna C %A Bartz, Traci M %A Fretts, Amanda M %A Guo, Xiuqing %A Lemaitre, Rozenn N %A Liu, Ching-Ti %A Noordam, Raymond %A de Mutsert, Renée %A Rosendaal, Frits R %A Wang, Carol A %A Beilin, Lawrence %A Mori, Trevor A %A Oddy, Wendy H %A Pennell, Craig E %A Chai, Jin Fang %A Whitton, Clare %A van Dam, Rob M %A Liu, Jianjun %A Tai, E Shyong %A Sim, Xueling %A Neuhouser, Marian L %A Kooperberg, Charles %A Tinker, Lesley %A Franceschini, Nora %A Huan, Tianxiao %A Winkler, Thomas W %A Bentley, Amy R %A Gauderman, W James %A Heerkens, Luc %A Tanaka, Toshiko %A van Rooij, Jeroen %A Munroe, Patricia B %A Warren, Helen R %A Voortman, Trudy %A Chen, Honglei %A Rao, D C %A Levy, Daniel %A Ma, Jiantao %X

OBJECTIVE: We examined interactions between genotype and a Dietary Approaches to Stop Hypertension (DASH) diet score in relation to systolic blood pressure (SBP).

METHODS: We analyzed up to 9,420,585 biallelic imputed single nucleotide polymorphisms (SNPs) in up to 127,282 individuals of six population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (CHARGE; n=35,660) and UK Biobank (n=91,622) and performed European population-specific and cross-population meta-analyses.

RESULTS: We identified three loci in European-specific analyses and an additional four loci in cross-population analyses at P for interaction < 5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency = 0.03) and the DASH diet score (P for interaction = 4e-8; P for heterogeneity = 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (P for interaction = 9.4e-7) and 0.20±0.06 mm Hg (P for interaction = 0.001) in CHARGE and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with -expression quantitative trait loci (eQTL) variants (P = 4e-273) and -DNA methylation quantitative trait loci (mQTL) variants (P = 1e-300). While the closest gene for rs117878928 is , the highest narrow sense heritability accounted by SNPs potentially interacting with the DASH diet score in this locus was for gene at 15q25.1.

CONCLUSION: We demonstrated gene-DASH diet score interaction effects on SBP in several loci. Studies with larger diverse populations are needed to validate our findings.

%B medRxiv %8 2023 Nov 11 %G eng %R 10.1101/2023.11.10.23298402 %0 Journal Article %J Cerebrovasc Dis %D 2023 %T Hospital-Acquired Infection at Time of Stroke and Cognitive Decline: The Cardiovascular Health Study. %A Cole, Kyril L %A Boehme, Amelia K %A Thacker, Evan L %A Longstreth, W T %A Brown, Bruce L %A Gale, Shawn D %A Hedges, Dawson W %A Anderson, Jacqueline K %A Elkind, Mitchell S V %X

Introduction Hospital-acquired infections (HAIs) after stroke are associated with additional morbidity and mortality, but whether HAIs increase long-term cognitive decline in stroke patients is unknown. We hypothesized that older adults with incident stroke with HAI experience faster cognitive decline than those having stroke without HAI and those without stroke. Methods We performed a longitudinal analysis in the population-based prospective Cardiovascular Health Study. Medicare-eligible participants aged >65 years with and without incident stroke had cognition assessed annually. HAIs were assessed by hospital discharge codes. Global cognitive function was assessed annually by Modified Mini-Mental State Examination (3MSE) and executive function by Digit Symbol Substitution Test (DSST). We used linear mixed models to estimate the mean decline and 95% confidence intervals (95% CI) for 3MSE and DSST scores by incident stroke and HAI status, adjusted for demographics and vascular risk factors. Results Among 5,443 participants >65 years without previous history of stroke, 393 participants had stroke with HAI (SI), 766 had a stroke only (SO), and 4,284 had no stroke (NS) throughout a maximum 9-year follow-up. For 3MSE, compared with NS participants, SO participants had a similar adjusted mean decline (additional 0.08 points/year, 95%CI -0.15, 0.31), while SI participants had a more rapid decline (additional 0.28 points/year, 95%CI 0.16, 0.40). Adjusted mean decline was 0.20 points/year faster (95%CI -0.05, 0.45) among SI than SO participants. For DSST, compared with NS participants, SO participants had a faster adjusted mean decline (additional 0.17 points/year (95%CI 0.003, 0.33), as did SI participants (additional 0.27 points/year (95%CI 0.19, 0.35). Conclusion Stroke, when accompanied by HAI, leads to a faster long-term decline in cognitive ability than in those without stroke. The clinical and public health implications of the effect of infection on post-stroke cognitive decline warrant further attention.

%B Cerebrovasc Dis %8 2023 Oct 23 %G eng %R 10.1159/000533568 %0 Journal Article %J Commun Biol %D 2023 %T {Identification of circulating proteins associated with general cognitive function among middle-aged and older adults %A Tin, A. %A Fohner, A. E. %A Yang, Q. %A Brody, J. A. %A Davies, G. %A Yao, J. %A Liu, D. %A Caro, I. %A Lindbohm, J. V. %A Duggan, M. R. %A Meirelles, O. %A Harris, S. E. %A Gudmundsdottir, V. %A Taylor, A. M. %A Henry, A. %A Beiser, A. S. %A Shojaie, A. %A Coors, A. %A Fitzpatrick, A. L. %A Langenberg, C. %A Satizabal, C. L. %A Sitlani, C. M. %A Wheeler, E. %A Tucker-Drob, E. M. %A Bressler, J. %A Coresh, J. %A Bis, J. C. %A Candia, J. %A Jennings, L. L. %A Pietzner, M. %A Lathrop, M. %A Lopez, O. L. %A Redmond, P. %A Gerszten, R. E. %A Rich, S. S. %A Heckbert, S. R. %A Austin, T. R. %A Hughes, T. M. %A Tanaka, T. %A Emilsson, V. %A Vasan, R. S. %A Guo, X. %A Zhu, Y. %A Tzourio, C. %A Rotter, J. I. %A Walker, K. A. %A Ferrucci, L. %A ki, M. %A Breteler, M. M. B. %A Cox, S. R. %A Debette, S. %A Mosley, T. H. %A Gudnason, V. G. %A Launer, L. J. %A Psaty, B. M. %A Seshadri, S. %A Fornage, M. %X 2.0E-4). Proteins implicated as causes or consequences of AD susceptibility may provide new insight into the potential relationship between immunity and AD susceptibility as well as potential therapeutic targets. %B Commun Biol %V 6 %P 1117 %8 Nov %G eng %0 Journal Article %J Neurobiol Aging %D 2023 %T Investigation of the independent role of a rare APOE variant (L28P; APOE*4Pittsburgh) in late-onset Alzheimer disease. %A Fan, KangHsien %A Francis, Lily %A Aslam, M Muaaz %A Bedison, Margret A %A Lawrence, Elizabeth %A Acharya, Vibha %A Snitz, Beth E %A Ganguli, Mary %A DeKosky, Steven T %A Lopez, Oscar L %A Feingold, Eleanor %A Kamboh, M Ilyas %K Alleles %K Alzheimer Disease %K Animals %K Apolipoprotein E3 %K Apolipoprotein E4 %K Apolipoproteins E %K Genotype %K Heterozygote %X

A rare missense APOE variant (L28P; APOE*4Pittsburgh), which is present only in populations with European ancestry, has been reported to be a risk factor for late-onset Alzheimer's disease (LOAD). However, due to the complete linkage disequilibrium of L28P with APOE*4 (C112R), its independent genetic association is uncertain. The original association study implicating L28P with LOAD risk was carried out in a relatively small sample size. In the current study, we have re-evaluated this association in a large case-control sample of 15,762 White U.S. subjects and investigated its independent effect in APOE 3/4 subjects, as L28P has been observed only in the heterozygous state of APOE*4 carriers and 3/4 is the most common genotype containing the APOE*4 allele. The heterozygous carrier frequency of L28P, all with APOE*4, was about 3-fold higher in AD cases than in cognitively intact controls (0.845% vs. 0.277%). The age- and sex-adjusted meta-analysis odds ratio (OR) was 2.87 (95% CI: 1.34 - 6.13; = 0.0066). Among APOE 3/4 subjects, age- and sex-adjusted meta-analysis OR was 1.53 (95% CI: 0.70 - 3.36; p = 0.28), indicating its effect was independent of APOE*4. The lack of statistical significance appears mainly due to the low power of 4138 subjects with the 3/4 genotype (12% power at α= 0.05) compared to the required sample of 139,088 subjects with the 3/4 genotype to detect an OR of 1.5 at α= 0.05 and 80% power. Our data suggesting that L28P has an independent genetic effect on AD risk is reinforced by earlier experimental findings showing that this mutation leads to significant structural and conformational changes in the ApoE4 molecule and can induce functional defects associated with neuronal Aβ42 accumulation and oxidative stress. Additional functional studies in cell-based systems and animal models will help to delineate its functional significance in the etiology of AD.

%B Neurobiol Aging %V 122 %P 107-111 %8 2023 Feb %G eng %R 10.1016/j.neurobiolaging.2022.11.007 %0 Journal Article %J Aging Cell %D 2023 %T Late-life plasma proteins associated with prevalent and incident frailty: A proteomic analysis. %A Liu, Fangyu %A Austin, Thomas R %A Schrack, Jennifer A %A Chen, Jingsha %A Walston, Jeremy %A Mathias, Rasika A %A Grams, Morgan %A Odden, Michelle C %A Newman, Anne %A Psaty, Bruce M %A Ramonfaur, Diego %A Shah, Amil M %A Windham, B Gwen %A Coresh, Josef %A Walker, Keenan A %X

Proteomic approaches have unique advantages in the identification of biological pathways that influence physical frailty, a multifactorial geriatric syndrome predictive of adverse health outcomes in older adults. To date, proteomic studies of frailty are scarce, and few evaluated prefrailty as a separate state or examined predictors of incident frailty. Using plasma proteins measured by 4955 SOMAmers in the Atherosclerosis Risk in Community study, we identified 134 and 179 proteins cross-sectionally associated with prefrailty and frailty, respectively, after Bonferroni correction (p < 1 × 10 ) among 3838 older adults aged ≥65 years, adjusting for demographic and physiologic factors and chronic diseases. Among them, 23 (17%) and 82 (46%) were replicated in the Cardiovascular Health Study using the same models (FDR p < 0.05). Notably, higher odds of prefrailty and frailty were observed with higher levels of growth differentiation factor 15 (GDF15; p  = 1 × 10 , p  = 2 × 10 ), transgelin (TAGLN; p  = 2 × 10 , p  = 6 × 10 ), and insulin-like growth factor-binding protein 2 (IGFBP2; p  = 5 × 10 , p  = 1 × 10 ) and with a lower level of growth hormone receptor (GHR, p  = 3 × 10 , p  = 2 × 10 ). Longitudinally, we identified 4 proteins associated with incident frailty (p < 1 × 10 ). Higher levels of triggering receptor expressed on myeloid cells 1 (TREM1), TAGLN, and heart and adipocyte fatty-acid binding proteins predicted incident frailty. Differentially regulated proteins were enriched in pathways and upstream regulators related to lipid metabolism, angiogenesis, inflammation, and cell senescence. Our findings provide a set of plasma proteins and biological mechanisms that were dysregulated in both the prodromal and the clinical stage of frailty, offering new insights into frailty etiology and targets for intervention.

%B Aging Cell %8 2023 Sep 11 %G eng %R 10.1111/acel.13975 %0 Journal Article %J J Alzheimers Dis %D 2023 %T Longitudinal Patterns of Brain Changes in a Community Sample in Relation to Aging and Cognitive Status. %A Chwa, Won Jong %A Lopez, Oscar L %A Longstreth, W T %A Dai, Weiying %A Raji, Cyrus A %X

BACKGROUND: Aging and Alzheimer's disease (AD) are characterized by widespread cortical and subcortical atrophy. Though atrophy patterns between aging and AD overlap considerably, regional differences between these two conditions may exist. Few studies, however, have investigated these patterns in large community samples.

OBJECTIVE: Elaborate longitudinal changes in brain morphometry in relation to aging and cognitive status in a well-characterized community cohort.

METHODS: Clinical and neuroimaging data were compiled from 72 participants from the Cardiovascular Health Study-Cognition Study, a community cohort of healthy aging and probable AD participants. Two time points were identified for each participant with a mean follow-up time of 5.36 years. MRI post-processing, morphometric measurements, and statistical analyses were performed using FreeSurfer, Version 7.1.1.

RESULTS: Cortical volume was significantly decreased in the bilateral superior frontal, bilateral inferior parietal, and left superior parietal regions, among others. Cortical thickness was significantly reduced in the bilateral superior frontal and left inferior parietal regions, among others. Overall gray and white matter volumes and hippocampal subfields also demonstrated significant reductions. Cortical volume atrophy trajectories between cognitively stable and cognitively declined participants were significantly different in the right postcentral region.

CONCLUSION: Observed volume reductions were consistent with previous studies investigating morphometric brain changes. Patterns of brain atrophy between AD and aging may be different in magnitude but exhibit widespread spatial overlap. These findings help characterize patterns of brain atrophy that may reflect the general population. Larger studies may more definitively establish population norms of aging and AD-related neuroimaging changes.

%B J Alzheimers Dis %8 2023 Jun 20 %G eng %R 10.3233/JAD-230080 %0 Journal Article %J medRxiv %D 2023 %T loss-of-function variants: Compatible with longevity and associated with resistance to Alzheimer's Disease pathology %A Chemparathy, A. %A Guen, Y. L. %A Chen, S. %A Lee, E. G. %A Leong, L. %A Gorzynski, J. %A Xu, G. %A Belloy, M. %A Kasireddy, N. %A Tauber, A. P. %A Williams, K. %A Stewart, I. %A Wingo, T. %A Lah, J. %A Jayadev, S. %A Hales, C. %A Peskind, E. %A Child, D. D. %A Keene, C. D. %A Cong, L. %A Ashley, E. %A Yu, C. E. %A Greicius, M. D. %X 4 or its protein product as a viable therapeutic option. %B medRxiv %8 Jul %G eng %0 Journal Article %J medRxiv %D 2023 %T Machine learning models for blood pressure phenotypes combining multiple polygenic risk scores. %A Hrytsenko, Yana %A Shea, Benjamin %A Elgart, Michael %A Kurniansyah, Nuzulul %A Lyons, Genevieve %A Morrison, Alanna C %A Carson, April P %A Haring, Bernhard %A Mitchel, Braxton D %A Psaty, Bruce M %A Jaeger, Byron C %A Gu, C Charles %A Kooperberg, Charles %A Levy, Daniel %A Lloyd-Jones, Donald %A Choi, Eunhee %A Brody, Jennifer A %A Smith, Jennifer A %A Rotter, Jerome I %A Moll, Matthew %A Fornage, Myriam %A Simon, Noah %A Castaldi, Peter %A Casanova, Ramon %A Chung, Ren-Hua %A Kaplan, Robert %A Loos, Ruth J F %A Kardia, Sharon L R %A Rich, Stephen S %A Redline, Susan %A Kelly, Tanika %A O'Connor, Timothy %A Zhao, Wei %A Kim, Wonji %A Guo, Xiuqing %A Der Ida Chen, Yii %A Sofer, Tamar %X

We construct non-linear machine learning (ML) prediction models for systolic and diastolic blood pressure (SBP, DBP) using demographic and clinical variables and polygenic risk scores (PRSs). We developed a two-model ensemble, consisting of a baseline model, where prediction is based on demographic and clinical variables only, and a genetic model, where we also include PRSs. We evaluate the use of a linear versus a non-linear model at both the baseline and the genetic model levels and assess the improvement in performance when incorporating multiple PRSs. We report the ensemble model's performance as percentage variance explained (PVE) on a held-out test dataset. A non-linear baseline model improved the PVEs from 28.1% to 30.1% (SBP) and 14.3% to 17.4% (DBP) compared with a linear baseline model. Including seven PRSs in the genetic model computed based on the largest available GWAS of SBP/DBP improved the genetic model PVE from 4.8% to 5.1% (SBP) and 4.7% to 5% (DBP) compared to using a single PRS. Adding additional 14 PRSs computed based on two independent GWASs further increased the genetic model PVE to 6.3% (SBP) and 5.7% (DBP). PVE differed across self-reported race/ethnicity groups, with primarily all non-White groups benefitting from the inclusion of additional PRSs.

%B medRxiv %8 2023 Dec 14 %G eng %R 10.1101/2023.12.13.23299909 %0 Journal Article %J Nat Genet %D 2023 %T Mosaic chromosomal alterations in blood across ancestries using whole-genome sequencing. %A Jakubek, Yasminka A %A Zhou, Ying %A Stilp, Adrienne %A Bacon, Jason %A Wong, Justin W %A Ozcan, Zuhal %A Arnett, Donna %A Barnes, Kathleen %A Bis, Joshua C %A Boerwinkle, Eric %A Brody, Jennifer A %A Carson, April P %A Chasman, Daniel I %A Chen, Jiawen %A Cho, Michael %A Conomos, Matthew P %A Cox, Nancy %A Doyle, Margaret F %A Fornage, Myriam %A Guo, Xiuqing %A Kardia, Sharon L R %A Lewis, Joshua P %A Loos, Ruth J F %A Ma, Xiaolong %A Machiela, Mitchell J %A Mack, Taralynn M %A Mathias, Rasika A %A Mitchell, Braxton D %A Mychaleckyj, Josyf C %A North, Kari %A Pankratz, Nathan %A Peyser, Patricia A %A Preuss, Michael H %A Psaty, Bruce %A Raffield, Laura M %A Vasan, Ramachandran S %A Redline, Susan %A Rich, Stephen S %A Rotter, Jerome I %A Silverman, Edwin K %A Smith, Jennifer A %A Smith, Aaron P %A Taub, Margaret %A Taylor, Kent D %A Yun, Jeong %A Li, Yun %A Desai, Pinkal %A Bick, Alexander G %A Reiner, Alexander P %A Scheet, Paul %A Auer, Paul L %K Black People %K Genome, Human %K Genome-Wide Association Study %K Hispanic or Latino %K Humans %K Mosaicism %K Precision Medicine %X

Megabase-scale mosaic chromosomal alterations (mCAs) in blood are prognostic markers for a host of human diseases. Here, to gain a better understanding of mCA rates in genetically diverse populations, we analyzed whole-genome sequencing data from 67,390 individuals from the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine program. We observed higher sensitivity with whole-genome sequencing data, compared with array-based data, in uncovering mCAs at low mutant cell fractions and found that individuals of European ancestry have the highest rates of autosomal mCAs and the lowest rates of chromosome X mCAs, compared with individuals of African or Hispanic ancestry. Although further studies in diverse populations will be needed to replicate our findings, we report three loci associated with loss of chromosome X, associations between autosomal mCAs and rare variants in DCPS, ADM17, PPP1R16B and TET2 and ancestry-specific variants in ATM and MPL with mCAs in cis.

%B Nat Genet %V 55 %P 1912-1919 %8 2023 Nov %G eng %N 11 %R 10.1038/s41588-023-01553-1 %0 Journal Article %J Nat Genet %D 2023 %T Multi-ancestry genome-wide study identifies effector genes and druggable pathways for coronary artery calcification. %A Kavousi, Maryam %A Bos, Maxime M %A Barnes, Hanna J %A Lino Cardenas, Christian L %A Wong, Doris %A Lu, Haojie %A Hodonsky, Chani J %A Landsmeer, Lennart P L %A Turner, Adam W %A Kho, Minjung %A Hasbani, Natalie R %A de Vries, Paul S %A Bowden, Donald W %A Chopade, Sandesh %A Deelen, Joris %A Benavente, Ernest Diez %A Guo, Xiuqing %A Hofer, Edith %A Hwang, Shih-Jen %A Lutz, Sharon M %A Lyytikäinen, Leo-Pekka %A Slenders, Lotte %A Smith, Albert V %A Stanislawski, Maggie A %A van Setten, Jessica %A Wong, Quenna %A Yanek, Lisa R %A Becker, Diane M %A Beekman, Marian %A Budoff, Matthew J %A Feitosa, Mary F %A Finan, Chris %A Hilliard, Austin T %A Kardia, Sharon L R %A Kovacic, Jason C %A Kral, Brian G %A Langefeld, Carl D %A Launer, Lenore J %A Malik, Shaista %A Hoesein, Firdaus A A Mohamed %A Mokry, Michal %A Schmidt, Reinhold %A Smith, Jennifer A %A Taylor, Kent D %A Terry, James G %A van der Grond, Jeroen %A van Meurs, Joyce %A Vliegenthart, Rozemarijn %A Xu, Jianzhao %A Young, Kendra A %A Zilhão, Nuno R %A Zweiker, Robert %A Assimes, Themistocles L %A Becker, Lewis C %A Bos, Daniel %A Carr, J Jeffrey %A Cupples, L Adrienne %A de Kleijn, Dominique P V %A de Winther, Menno %A den Ruijter, Hester M %A Fornage, Myriam %A Freedman, Barry I %A Gudnason, Vilmundur %A Hingorani, Aroon D %A Hokanson, John E %A Ikram, M Arfan %A Išgum, Ivana %A Jacobs, David R %A Kähönen, Mika %A Lange, Leslie A %A Lehtimäki, Terho %A Pasterkamp, Gerard %A Raitakari, Olli T %A Schmidt, Helena %A Slagboom, P Eline %A Uitterlinden, André G %A Vernooij, Meike W %A Bis, Joshua C %A Franceschini, Nora %A Psaty, Bruce M %A Post, Wendy S %A Rotter, Jerome I %A Björkegren, Johan L M %A O'Donnell, Christopher J %A Bielak, Lawrence F %A Peyser, Patricia A %A Malhotra, Rajeev %A van der Laan, Sander W %A Miller, Clint L %X

Coronary artery calcification (CAC), a measure of subclinical atherosclerosis, predicts future symptomatic coronary artery disease (CAD). Identifying genetic risk factors for CAC may point to new therapeutic avenues for prevention. Currently, there are only four known risk loci for CAC identified from genome-wide association studies (GWAS) in the general population. Here we conducted the largest multi-ancestry GWAS meta-analysis of CAC to date, which comprised 26,909 individuals of European ancestry and 8,867 individuals of African ancestry. We identified 11 independent risk loci, of which eight were new for CAC and five had not been reported for CAD. These new CAC loci are related to bone mineralization, phosphate catabolism and hormone metabolic pathways. Several new loci harbor candidate causal genes supported by multiple lines of functional evidence and are regulators of smooth muscle cell-mediated calcification ex vivo and in vitro. Together, these findings help refine the genetic architecture of CAC and extend our understanding of the biological and potential druggable pathways underlying CAC.

%B Nat Genet %V 55 %P 1651-1664 %8 2023 Oct %G eng %N 10 %R 10.1038/s41588-023-01518-4 %0 Journal Article %J medRxiv %D 2023 %T Multi-ancestry genome-wide study in >2.5 million individuals reveals heterogeneity in mechanistic pathways of type 2 diabetes and complications. %A Suzuki, Ken %A Hatzikotoulas, Konstantinos %A Southam, Lorraine %A Taylor, Henry J %A Yin, Xianyong %A Lorenz, Kim M %A Mandla, Ravi %A Huerta-Chagoya, Alicia %A Rayner, Nigel W %A Bocher, Ozvan %A Ana Luiza de, S V Arruda %A Sonehara, Kyuto %A Namba, Shinichi %A Lee, Simon S K %A Preuss, Michael H %A Petty, Lauren E %A Schroeder, Philip %A Vanderwerff, Brett %A Kals, Mart %A Bragg, Fiona %A Lin, Kuang %A Guo, Xiuqing %A Zhang, Weihua %A Yao, Jie %A Kim, Young Jin %A Graff, Mariaelisa %A Takeuchi, Fumihiko %A Nano, Jana %A Lamri, Amel %A Nakatochi, Masahiro %A Moon, Sanghoon %A Scott, Robert A %A Cook, James P %A Lee, Jung-Jin %A Pan, Ian %A Taliun, Daniel %A Parra, Esteban J %A Chai, Jin-Fang %A Bielak, Lawrence F %A Tabara, Yasuharu %A Hai, Yang %A Thorleifsson, Gudmar %A Grarup, Niels %A Sofer, Tamar %A Wuttke, Matthias %A Sarnowski, Chloe %A Gieger, Christian %A Nousome, Darryl %A Trompet, Stella %A Kwak, Soo-Heon %A Long, Jirong %A Sun, Meng %A Tong, Lin %A Chen, Wei-Min %A Nongmaithem, Suraj S %A Noordam, Raymond %A Lim, Victor J Y %A Tam, Claudia H T %A Joo, Yoonjung Yoonie %A Chen, Chien-Hsiun %A Raffield, Laura M %A Prins, Bram Peter %A Nicolas, Aude %A Yanek, Lisa R %A Chen, Guanjie %A Brody, Jennifer A %A Kabagambe, Edmond %A An, Ping %A Xiang, Anny H %A Choi, Hyeok Sun %A Cade, Brian E %A Tan, Jingyi %A Alaine Broadaway, K %A Williamson, Alice %A Kamali, Zoha %A Cui, Jinrui %A Adair, Linda S %A Adeyemo, Adebowale %A Aguilar-Salinas, Carlos A %A Ahluwalia, Tarunveer S %A Anand, Sonia S %A Bertoni, Alain %A Bork-Jensen, Jette %A Brandslund, Ivan %A Buchanan, Thomas A %A Burant, Charles F %A Butterworth, Adam S %A Canouil, Mickaël %A Chan, Juliana C N %A Chang, Li-Ching %A Chee, Miao-Li %A Chen, Ji %A Chen, Shyh-Huei %A Chen, Yuan-Tsong %A Chen, Zhengming %A Chuang, Lee-Ming %A Cushman, Mary %A Danesh, John %A Das, Swapan K %A Janaka de Silva, H %A Dedoussis, George %A Dimitrov, Latchezar %A Doumatey, Ayo P %A Du, Shufa %A Duan, Qing %A Eckardt, Kai-Uwe %A Emery, Leslie S %A Evans, Daniel S %A Evans, Michele K %A Fischer, Krista %A Floyd, James S %A Ford, Ian %A Franco, Oscar H %A Frayling, Timothy M %A Freedman, Barry I %A Genter, Pauline %A Gerstein, Hertzel C %A Giedraitis, Vilmantas %A González-Villalpando, Clicerio %A Gonzalez-Villalpando, Maria Elena %A Gordon-Larsen, Penny %A Gross, Myron %A Guare, Lindsay A %A Hackinger, Sophie %A Han, Sohee %A Hattersley, Andrew T %A Herder, Christian %A Horikoshi, Momoko %A Howard, Annie-Green %A Hsueh, Willa %A Huang, Mengna %A Huang, Wei %A Hung, Yi-Jen %A Hwang, Mi Yeong %A Hwu, Chii-Min %A Ichihara, Sahoko %A Ikram, Mohammad Arfan %A Ingelsson, Martin %A Islam, Md Tariqul %A Isono, Masato %A Jang, Hye-Mi %A Jasmine, Farzana %A Jiang, Guozhi %A Jonas, Jost B %A Jørgensen, Torben %A Kandeel, Fouad R %A Kasturiratne, Anuradhani %A Katsuya, Tomohiro %A Kaur, Varinderpal %A Kawaguchi, Takahisa %A Keaton, Jacob M %A Kho, Abel N %A Khor, Chiea-Chuen %A Kibriya, Muhammad G %A Kim, Duk-Hwan %A Kronenberg, Florian %A Kuusisto, Johanna %A Läll, Kristi %A Lange, Leslie A %A Lee, Kyung Min %A Lee, Myung-Shik %A Lee, Nanette R %A Leong, Aaron %A Li, Liming %A Li, Yun %A Li-Gao, Ruifang %A Lithgart, Symen %A Lindgren, Cecilia M %A Linneberg, Allan %A Liu, Ching-Ti %A Liu, Jianjun %A Locke, Adam E %A Louie, Tin %A Luan, Jian'an %A Luk, Andrea O %A Luo, Xi %A Lv, Jun %A Lynch, Julie A %A Lyssenko, Valeriya %A Maeda, Shiro %A Mamakou, Vasiliki %A Mansuri, Sohail Rafik %A Matsuda, Koichi %A Meitinger, Thomas %A Metspalu, Andres %A Mo, Huan %A Morris, Andrew D %A Nadler, Jerry L %A Nalls, Michael A %A Nayak, Uma %A Ntalla, Ioanna %A Okada, Yukinori %A Orozco, Lorena %A Patel, Sanjay R %A Patil, Snehal %A Pei, Pei %A Pereira, Mark A %A Peters, Annette %A Pirie, Fraser J %A Polikowsky, Hannah G %A Porneala, Bianca %A Prasad, Gauri %A Rasmussen-Torvik, Laura J %A Reiner, Alexander P %A Roden, Michael %A Rohde, Rebecca %A Roll, Katheryn %A Sabanayagam, Charumathi %A Sandow, Kevin %A Sankareswaran, Alagu %A Sattar, Naveed %A Schönherr, Sebastian %A Shahriar, Mohammad %A Shen, Botong %A Shi, Jinxiu %A Shin, Dong Mun %A Shojima, Nobuhiro %A Smith, Jennifer A %A So, Wing Yee %A Stančáková, Alena %A Steinthorsdottir, Valgerdur %A Stilp, Adrienne M %A Strauch, Konstantin %A Taylor, Kent D %A Thorand, Barbara %A Thorsteinsdottir, Unnur %A Tomlinson, Brian %A Tran, Tam C %A Tsai, Fuu-Jen %A Tuomilehto, Jaakko %A Tusié-Luna, Teresa %A Udler, Miriam S %A Valladares-Salgado, Adan %A van Dam, Rob M %A van Klinken, Jan B %A Varma, Rohit %A Wacher-Rodarte, Niels %A Wheeler, Eleanor %A Wickremasinghe, Ananda R %A van Dijk, Ko Willems %A Witte, Daniel R %A Yajnik, Chittaranjan S %A Yamamoto, Ken %A Yamamoto, Kenichi %A Yoon, Kyungheon %A Yu, Canqing %A Yuan, Jian-Min %A Yusuf, Salim %A Zawistowski, Matthew %A Zhang, Liang %A Zheng, Wei %A Project, Biobank Japan %A BioBank, Penn Medicine %A Center, Regeneron Genetics %A Consortium, eMERGE %A Raffel, Leslie J %A Igase, Michiya %A Ipp, Eli %A Redline, Susan %A Cho, Yoon Shin %A Lind, Lars %A Province, Michael A %A Fornage, Myriam %A Hanis, Craig L %A Ingelsson, Erik %A Zonderman, Alan B %A Psaty, Bruce M %A Wang, Ya-Xing %A Rotimi, Charles N %A Becker, Diane M %A Matsuda, Fumihiko %A Liu, Yongmei %A Yokota, Mitsuhiro %A Kardia, Sharon L R %A Peyser, Patricia A %A Pankow, James S %A Engert, James C %A Bonnefond, Amélie %A Froguel, Philippe %A Wilson, James G %A Sheu, Wayne H H %A Wu, Jer-Yuarn %A Geoffrey Hayes, M %A Ma, Ronald C W %A Wong, Tien-Yin %A Mook-Kanamori, Dennis O %A Tuomi, Tiinamaija %A Chandak, Giriraj R %A Collins, Francis S %A Bharadwaj, Dwaipayan %A Paré, Guillaume %A Sale, Michèle M %A Ahsan, Habibul %A Motala, Ayesha A %A Shu, Xiao-Ou %A Park, Kyong-Soo %A Jukema, J Wouter %A Cruz, Miguel %A Chen, Yii-Der Ida %A Rich, Stephen S %A McKean-Cowdin, Roberta %A Grallert, Harald %A Cheng, Ching-Yu %A Ghanbari, Mohsen %A Tai, E-Shyong %A Dupuis, Josée %A Kato, Norihiro %A Laakso, Markku %A Köttgen, Anna %A Koh, Woon-Puay %A Bowden, Donald W %A Palmer, Colin N A %A Kooner, Jaspal S %A Kooperberg, Charles %A Liu, Simin %A North, Kari E %A Saleheen, Danish %A Hansen, Torben %A Pedersen, Oluf %A Wareham, Nicholas J %A Lee, Juyoung %A Kim, Bong-Jo %A Millwood, Iona Y %A Walters, Robin G %A Stefansson, Kari %A Goodarzi, Mark O %A Mohlke, Karen L %A Langenberg, Claudia %A Haiman, Christopher A %A Loos, Ruth J F %A Florez, Jose C %A Rader, Daniel J %A Ritchie, Marylyn D %A Zöllner, Sebastian %A Mägi, Reedik %A Denny, Joshua C %A Yamauchi, Toshimasa %A Kadowaki, Takashi %A Chambers, John C %A Ng, Maggie C Y %A Sim, Xueling %A Below, Jennifer E %A Tsao, Philip S %A Chang, Kyong-Mi %A McCarthy, Mark I %A Meigs, James B %A Mahajan, Anubha %A Spracklen, Cassandra N %A Mercader, Josep M %A Boehnke, Michael %A Rotter, Jerome I %A Vujkovic, Marijana %A Voight, Benjamin F %A Morris, Andrew P %A Zeggini, Eleftheria %X

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes. To characterise the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study (GWAS) data from 2,535,601 individuals (39.7% non-European ancestry), including 428,452 T2D cases. We identify 1,289 independent association signals at genome-wide significance (P<5×10 ) that map to 611 loci, of which 145 loci are previously unreported. We define eight non-overlapping clusters of T2D signals characterised by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial, and enteroendocrine cells. We build cluster-specific partitioned genetic risk scores (GRS) in an additional 137,559 individuals of diverse ancestry, including 10,159 T2D cases, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned GRS are more strongly associated with coronary artery disease and end-stage diabetic nephropathy than an overall T2D GRS across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings demonstrate the value of integrating multi-ancestry GWAS with single-cell epigenomics to disentangle the aetiological heterogeneity driving the development and progression of T2D, which may offer a route to optimise global access to genetically-informed diabetes care.

%B medRxiv %8 2023 Mar 31 %G eng %R 10.1101/2023.03.31.23287839 %0 Journal Article %J Nat Genet %D 2023 %T Multi-ancestry transcriptome-wide association analyses yield insights into tobacco use biology and drug repurposing. %A Chen, Fang %A Wang, Xingyan %A Jang, Seon-Kyeong %A Quach, Bryan C %A Weissenkampen, J Dylan %A Khunsriraksakul, Chachrit %A Yang, Lina %A Sauteraud, Renan %A Albert, Christine M %A Allred, Nicholette D D %A Arnett, Donna K %A Ashley-Koch, Allison E %A Barnes, Kathleen C %A Barr, R Graham %A Becker, Diane M %A Bielak, Lawrence F %A Bis, Joshua C %A Blangero, John %A Boorgula, Meher Preethi %A Chasman, Daniel I %A Chavan, Sameer %A Chen, Yii-der I %A Chuang, Lee-Ming %A Correa, Adolfo %A Curran, Joanne E %A David, Sean P %A Fuentes, Lisa de Las %A Deka, Ranjan %A Duggirala, Ravindranath %A Faul, Jessica D %A Garrett, Melanie E %A Gharib, Sina A %A Guo, Xiuqing %A Hall, Michael E %A Hawley, Nicola L %A He, Jiang %A Hobbs, Brian D %A Hokanson, John E %A Hsiung, Chao A %A Hwang, Shih-Jen %A Hyde, Thomas M %A Irvin, Marguerite R %A Jaffe, Andrew E %A Johnson, Eric O %A Kaplan, Robert %A Kardia, Sharon L R %A Kaufman, Joel D %A Kelly, Tanika N %A Kleinman, Joel E %A Kooperberg, Charles %A Lee, I-Te %A Levy, Daniel %A Lutz, Sharon M %A Manichaikul, Ani W %A Martin, Lisa W %A Marx, Olivia %A McGarvey, Stephen T %A Minster, Ryan L %A Moll, Matthew %A Moussa, Karine A %A Naseri, Take %A North, Kari E %A Oelsner, Elizabeth C %A Peralta, Juan M %A Peyser, Patricia A %A Psaty, Bruce M %A Rafaels, Nicholas %A Raffield, Laura M %A Reupena, Muagututi'a Sefuiva %A Rich, Stephen S %A Rotter, Jerome I %A Schwartz, David A %A Shadyab, Aladdin H %A Sheu, Wayne H-H %A Sims, Mario %A Smith, Jennifer A %A Sun, Xiao %A Taylor, Kent D %A Telen, Marilyn J %A Watson, Harold %A Weeks, Daniel E %A Weir, David R %A Yanek, Lisa R %A Young, Kendra A %A Young, Kristin L %A Zhao, Wei %A Hancock, Dana B %A Jiang, Bibo %A Vrieze, Scott %A Liu, Dajiang J %K Biology %K Drug Repositioning %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Polymorphism, Single Nucleotide %K Tobacco Use %K Transcriptome %X

Most transcriptome-wide association studies (TWASs) so far focus on European ancestry and lack diversity. To overcome this limitation, we aggregated genome-wide association study (GWAS) summary statistics, whole-genome sequences and expression quantitative trait locus (eQTL) data from diverse ancestries. We developed a new approach, TESLA (multi-ancestry integrative study using an optimal linear combination of association statistics), to integrate an eQTL dataset with a multi-ancestry GWAS. By exploiting shared phenotypic effects between ancestries and accommodating potential effect heterogeneities, TESLA improves power over other TWAS methods. When applied to tobacco use phenotypes, TESLA identified 273 new genes, up to 55% more compared with alternative TWAS methods. These hits and subsequent fine mapping using TESLA point to target genes with biological relevance. In silico drug-repurposing analyses highlight several drugs with known efficacy, including dextromethorphan and galantamine, and new drugs such as muscle relaxants that may be repurposed for treating nicotine addiction.

%B Nat Genet %V 55 %P 291-300 %8 2023 Feb %G eng %N 2 %R 10.1038/s41588-022-01282-x %0 Journal Article %J J Card Fail %D 2023 %T Multiple Prior Live Births are Associated with Cardiac Remodeling and Heart Failure Risk in Women. %A Sarma, Amy A %A Paniagua, Samantha M %A Lau, Emily S %A Wang, Dongyu %A Liu, Elizabeth E %A Larson, Martin G %A Hamburg, Naomi M %A Mitchell, Gary F %A Kizer, Jorge %A Psaty, Bruce M %A Allen, Norrina B %A Lely, A Titia %A Gansevoort, Ronald T %A Rosenberg, Emily %A Mukamal, Kenneth %A Benjamin, Emelia J %A Vasan, Ramachandran S %A Cheng, Susan %A Levy, Daniel %A de Boer, Rudolf A %A Gottdiener, John S %A Shah, Sanjiv J %A Ho, Jennifer E %X

INTRODUCTION: Greater parity has been associated with cardiovascular disease risk, though effects on cardiac remodeling and heart failure risk remain unclear.

METHODS: We examined the association of number of live births and echocardiographic measures of cardiac structure and function in participants of the Framingham Heart Study (FHS) using multivariable linear regression. We next examined the association of parity with incident heart failure with preserved (HFpEF) or reduced (HFrEF) ejection fraction using a Fine-Gray subdistribution hazards model in a pooled analysis of n=12,635 participants of FHS, the Cardiovascular Health Study, the Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular Endstage Disease. Secondary analyses included major CVD, MI, and stroke.

RESULTS: Among n=3931 FHS participants (mean age 48 ± 13 years), higher number of live births was associated with worse LV fractional shortening (multivariable β -1.11 (0.31), p= 0.0005 in ≥ 5 live births vs nulliparous women) and worse cardiac mechanics including global circumferential strain and longitudinal and radial dyssynchrony (p< 0.01 for all comparing ≥ 5 live births vs nulliparity). When examining HF subtypes, women with ≥5 live births were at higher risk of developing future HFrEF compared with nulliparous women (HR 1.93, 95% CI 1.19-3.12, p=0.008); by contrast, a lower risk of HFpEF was observed (HR 0.58, 95% CI 0.37-0.91, p=0.02).

CONCLUSIONS: Greater number of live births are associated with worse cardiac structure and function. While there was no association with overall HF, a higher number of live births was associated with greater risk for incident HFrEF.

%B J Card Fail %8 2023 Jan 10 %G eng %R 10.1016/j.cardfail.2022.12.014 %0 Journal Article %J Health Place %D 2023 %T Neighborhood greenspace and cognition: The cardiovascular health study. %A Godina, Sara L %A Rosso, Andrea L %A Hirsch, Jana A %A Besser, Lilah M %A Lovasi, Gina S %A Donovan, Geoffrey H %A Garg, Parveen K %A Platt, Jonathan M %A Fitzpatrick, Annette L %A Lopez, Oscar L %A Carlson, Michelle C %A Michael, Yvonne L %X

OBJECTIVES: We examined whether greenspace measures (overall percent greenspace and forest, and number of greenspace types) were associated with clinically adjudicated dementia status.

METHODS: In a sample of non-demented older adults (n = 2141, average age = 75.3 years) from the Cardiovascular Health and Cognition Study, Cox proportional hazard and logistic regression analyses were used to estimate associations of baseline greenspace with risks of incident dementia and MCI, respectively, while adjusting for demographics, co-morbidities, and other neighborhood factors. We derived quartiles of percent greenness (greenspace), forest (percent tree canopy cover), and tertiles of greenspace diversity (number of greenspace types) for 5-km radial buffers around participant's residences at study entry (1989-1990) from the 1992 National Land Cover Dataset. Dementia status and mild cognitive impairment (MCI) over 10 years was clinically adjudicated.

RESULTS: We observed no significant association between overall percent greenspace and risk of mild cognitive impairment or dementia and mostly null results for forest and greenspace diversity. Forest greenspace was associated with lower odds of MCI (OR quartile 4 versus 1: 0.54, 95% CI: 0.29-0.98) and greenspace diversity was associated with lower hazard of incident dementia (HR tertile 2 versus 1: 0.70, 95% CI = 0.50-0.99).

DISCUSSION: We found divergent results for different types of greenspace and mild cognitive impairment or dementia. Improved greenspace type and diversity measurement could better characterize the association between greenspace and cognition.

%B Health Place %V 79 %P 102960 %8 2023 Jan 03 %G eng %R 10.1016/j.healthplace.2022.102960 %0 Journal Article %J Alzheimers Dement (Amst) %D 2023 %T Neighborhood greenspace and neighborhood income associated with white matter grade worsening: Cardiovascular Health Study. %A Besser, Lilah M %A Lovasi, Gina S %A Zambrano, Joyce Jimenez %A Camacho, Simone %A Dhanekula, Devi %A Michael, Yvonne L %A Garg, Parveen %A Hirsch, Jana A %A Siscovick, David %A Hurvitz, Philip M %A Biggs, Mary L %A Galvin, James E %A Bartz, Traci M %A Longstreth, W T %X

INTRODUCTION: We examined whether a combined measure of neighborhood greenspace and neighborhood median income was associated with white matter hyperintensity (WMH) and ventricle size changes.

METHODS: The sample included 1260 cognitively normal ≥ 65-year-olds with two magnetic resonance images (MRI; ≈ 5 years apart). WMH and ventricular size were graded from 0 (least) to 9 (most) abnormal (worsening = increase of ≥1 grade from initial to follow-up MRI scans). The four-category neighborhood greenspace-income measure was based on median neighborhood greenspace and income values at initial MRI. Multivariable logistic regression tested associations between neighborhood greenspace-income and MRI measures (worsening vs. not).

RESULTS: White matter grade worsening was more likely for those in lower greenspace-lower income neighborhoods than higher greenspace-higher income neighborhoods (odds ratio = 1.73; 95% confidence interval = 1.19-2.51).

DISCUSSION: The combination of lower neighborhood income and lower greenspace may be a risk factor for worsening white matter grade on MRI. However, findings need to be replicated in more diverse cohorts.

HIGHLIGHTS: Population-based cohort of older adults (≥ 65 years) with greenspace and MRI dataCombined measure of neighborhood greenspace and neighborhood income at initial MRIMRI outcomes included white matter hyperintensities (WMH) and ventricular sizeLongitudinal change in MRI outcomes measured approximately 5 years apartWorsening WMH over time more likely for lower greenspace-lower income neighborhoods.

%B Alzheimers Dement (Amst) %V 15 %P e12484 %8 2023 Oct-Dec %G eng %N 4 %R 10.1002/dad2.12484 %0 Journal Article %J JAMA Netw Open %D 2023 %T Plasma Ceramides and Sphingomyelins and Sudden Cardiac Death in the Cardiovascular Health Study. %A Bockus, Lee B %A Jensen, Paul N %A Fretts, Amanda M %A Hoofnagle, Andrew N %A McKnight, Barbara %A Sitlani, Colleen M %A Siscovick, David S %A King, Irena B %A Psaty, Bruce M %A Sotoodehnia, Nona %A Lemaitre, Rozenn N %K Aged %K Ceramides %K Cohort Studies %K Death, Sudden, Cardiac %K Eicosanoic Acids %K Fatty Acids %K Female %K Humans %K Male %K Sphingolipids %K Sphingomyelins %X

IMPORTANCE: Sphingolipids, including ceramides and sphingomyelins, may influence the pathophysiology and risk of sudden cardiac death (SCD) through multiple biological activities. Whether the length of the fatty acid acylated to plasma sphingolipid species is associated with SCD risk is not known.

OBJECTIVE: To determine whether the saturated fatty acid length of plasma ceramides and sphingomyelins influences the association with SCD risk.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, multivariable Cox proportional hazards regression models were used to examine the association of sphingolipid species with SCD risk. The study population included 4612 participants in the Cardiovascular Health Study followed up prospectively for a median of 10.2 (IQR, 5.5-11.6) years. Baseline data were collected from January 1992 to December 1995 during annual examinations. Data were analyzed from February 11, 2020, to September 9, 2023.

EXPOSURES: Eight plasma sphingolipid species (4 ceramides and 4 sphingomyelins) with saturated fatty acids of 16, 20, 22, and 24 carbons.

MAIN OUTCOME AND MEASURE: Association of plasma ceramides and sphingomyelins with saturated fatty acids of different lengths with SCD risk.

RESULTS: Among the 4612 CHS participants included in the analysis (mean [SD] age, 77 [5] years; 2724 [59.1%] women; 6 [0.1%] American Indian; 4 [0.1%] Asian; 718 [15.6%] Black; 3869 [83.9%] White, and 15 [0.3%] Other), 215 SCD cases were identified. In adjusted Cox proportional hazards regression analyses, plasma ceramides and sphingomyelins with palmitic acid (Cer-16 and SM-16) were associated with higher SCD risk per higher SD of log sphingolipid levels (hazard ratio [HR] for Cer-16, 1.34 [95% CI, 1.12-1.59]; HR for SM-16, 1.37 [95% CI, 1.12-1.67]). Associations did not differ by baseline age, sex, race, or body mass index. No significant association of SCD with sphingolipids with very-long-chain saturated fatty acids was observed after correction for multiple testing (HR for ceramide with arachidic acid, 1.06 [95% CI, 0.90-1.24]; HR for ceramide with behenic acid, 0.92 [95% CI, 0.77-1.10]; HR for ceramide with lignoceric acid, 0.92 [95% CI, 0.77-1.09]; HR for sphingomyelin with arachidic acid, 0.83 [95% CI, 0.71-0.98]; HR for sphingomyelin with behenic acid, 0.84 [95% CI, 0.70-1.00]; HR for sphingomyelin with lignoceric acid, 0.86 [95% CI, 0.72-1.03]).

CONCLUSIONS AND RELEVANCE: The findings of this large, population-based cohort study of SCD identified that higher plasma levels of Cer-16 and SM-16 were associated with higher risk of SCD. Future studies are needed to examine the underlying mechanism of these associations.

%B JAMA Netw Open %V 6 %P e2343854 %8 2023 Nov 01 %G eng %N 11 %R 10.1001/jamanetworkopen.2023.43854 %0 Journal Article %J Neurology %D 2023 %T Plasma Proteomic Associations With Incident Ischemic Stroke in Older Adults: The Cardiovascular Health Study. %A Kalani, Rizwan %A Bartz, Traci M %A Psaty, Bruce M %A Elkind, Mitchell S V %A Floyd, James S %A Gerszten, Robert E %A Shojaie, Ali %A Heckbert, Susan R %A Bis, Joshua C %A Austin, Thomas R %A Tirschwell, David L %A Delaney, Joseph A C %A Longstreth, W T %X

BACKGROUND: Plasma proteomics may elucidate novel insights into the pathophysiology of ischemic stroke (IS), identify biomarkers of IS risk, and guide development of nascent prevention strategies. We evaluated the relationship between the plasma proteome and IS risk in the population-based Cardiovascular Health Study (CHS).

METHODS: Eligible CHS participants were free of prevalent stroke and underwent quantification of 1298 plasma proteins using the aptamer-based SOMAScan assay platform from the 1992-1993 study visit. Multivariable Cox proportional hazards regression was used to evaluate associations between a 1-standard deviation increase in the log-2 transformed estimated plasma protein concentrations and incident IS, adjusting for demographics, IS risk factors, and estimated glomerular filtration rate. For proteins independently associated with incident IS, a secondary stratified analysis evaluated associations in subgroups defined by sex and race. Exploratory analyses evaluated plasma proteomic associations with cardioembolic and non-cardioembolic IS as well as proteins associated with IS risk in participants with left atrial dysfunction but without atrial fibrillation.

RESULTS: Of 2983 eligible participants, the mean age was 74.3 (± 4.8) years, 61.2% were women, and 15.4% were Black. Over a median follow-up of 12.6 years, 450 participants experienced an incident IS. N-terminal pro-brain natriuretic peptide (NTproBNP, adjusted HR 1.37, 95% CI 1.23-1.53, P=2.08x10) and macrophage metalloelastase (MMP12, adjusted HR 1.30, 95% CI 1.16-1.45, P=4.55x10) were independently associated with IS risk. These two associations were similar in men and women and in Black and non-Black participants. In exploratory analyses, NTproBNP was independently associated with incident cardioembolic IS, E-selectin with incident non-cardioembolic IS, and secreted frizzled-related protein 1 with IS risk in participants with left atrial dysfunction.

CONCLUSIONS: In a cohort of older adults, NTproBNP and MMP12 were independently associated with IS risk. We identified plasma proteomic determinants of incident cardioembolic and non-cardioembolic IS and found a novel protein associated with IS risk in those with left atrial dysfunction.

%B Neurology %8 2023 Apr 04 %G eng %R 10.1212/WNL.0000000000207242 %0 Journal Article %J ERJ Open Res %D 2023 %T Plasma sphingolipids, lung function and COPD: the Cardiovascular Health Study. %A Gharib, Arya R %A Jensen, Paul N %A Psaty, Bruce M %A Hoofnagle, Andrew N %A Siscovick, David %A Gharib, Sina A %A Sitlani, Colleen M %A Sotoodehnia, Nona %A Lemaitre, Rozenn N %X

RATIONALE: COPD is the third leading cause of death in the United States. Sphingolipids, structural membrane constituents that play a role in cellular stress and apoptosis signalling, may be involved in lung function.

METHODS: In the Cardiovascular Health Study, a prospective cohort of older adults, we cross-sectionally examined the association of plasma levels of 17 sphingolipid species with lung function and COPD. Multivariable linear regression and logistic regression were used to evaluate associations of sphingolipid concentrations with forced expiratory volume in 1 s (FEV) and odds of COPD, respectively.

RESULTS: Of the 17 sphingolipids evaluated, ceramide-18 (Cer-18) and sphingomyelin-18 (SM-18) were associated with lower FEV values (-0.061 L per two-fold higher Cer-18, p=0.001; -0.092 L per two-fold higher SM-18, p=0.002) after correction for multiple testing. Several other associations were significant at a 0.05 level, but did not reach statistical significance after correction for multiple testing. Specifically, Cer-18 and SM-18 were associated with higher odds of COPD (odds ratio per two-fold higher Cer-18 1.29, p=0.03 and SM-18 1.73, p=0.008). Additionally, Cer-16 and SM-16 were associated with lower FEV values, and Cer-14, SM-14 and SM-16 with a higher odds of COPD.

CONCLUSION: In this large cross-sectional study, specific ceramides and sphingomyelins were associated with reduced lung function in a population-based study. Future studies are needed to examine whether these biomarkers are associated with longitudinal change in FEV within individuals or with incident COPD.

%B ERJ Open Res %V 9 %8 2023 Mar %G eng %N 2 %R 10.1183/23120541.00346-2022 %0 Journal Article %J J Am Heart Assoc %D 2023 %T Plasma Trimethylamine--Oxide and Incident Ischemic Stroke: The Cardiovascular Health Study and the Multi-Ethnic Study of Atherosclerosis. %A Lemaitre, Rozenn N %A Jensen, Paul N %A Wang, Zeneng %A Fretts, Amanda M %A Sitlani, Colleen M %A Nemet, Ina %A Sotoodehnia, Nona %A de Oliveira Otto, Marcia C %A Zhu, Weifei %A Budoff, Matt %A Longstreth, W T %A Psaty, Bruce M %A Siscovick, David S %A Hazen, Stanley L %A Mozaffarian, Dariush %K Aged %K Atherosclerosis %K Female %K Humans %K Ischemic Stroke %K Methylamines %K Oxides %K Prospective Studies %K Risk Factors %K Stroke %K United States %X

Background The association of circulating trimethylamine--oxide (TMAO) with stroke has received limited attention. To address this gap, we examined the associations of serial measures of plasma TMAO with incident ischemic stroke. Methods and Results We used a prospective cohort design with data pooled from 2 cohorts. The settings were the CHS (Cardiovascular Health Study), a cohort of older adults, and the MESA (Multi-Ethnic Study of Atherosclerosis), both in the United States. We measured plasma concentrations of TMAO at baseline and again during the follow-up using high-performance liquid chromatography and mass spectrometry. We assessed the association of plasma TMAO with incident ischemic stroke using proportional hazards regression adjusted for risk factors. The combined cohorts included 11 785 participants without a history of stroke, on average 73 (CHS) and 62 (MESA) years old at baseline, including 60% (CHS) and 53% (MESA) women. We identified 1031 total incident ischemic strokes during a median 15-year follow-up in the combined cohorts. In multivariable analyses, TMAO was significantly associated with incident ischemic stroke risk (hazard ratios comparing a doubling of TMAO: 1.11 [1.03-1.18], =0.004). The association was linear over the range of TMAO concentrations and appeared restricted to those without diagnosed coronary heart disease. An association with hemorrhagic stroke was not found. Conclusions Plasma TMAO levels are associated with incident ischemic stroke in a diverse population. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005133.

%B J Am Heart Assoc %V 12 %P e8711 %8 2023 Aug 15 %G eng %N 16 %R 10.1161/JAHA.122.029230 %0 Journal Article %J medRxiv %D 2023 %T {Polygenic burden of short tandem repeat expansions promote risk for Alzheimer's disease %A Guo, M. H. %A Lee, W. P. %A Vardarajan, B. %A Schellenberg, G. D. %A Phillips-Cremins, J. %X 30 STR expansions had 3.62-fold higher odds of having AD and had more severe AD neuropathology. AD STR expansions were highly enriched within active promoters in post-mortem hippocampal brain tissues and particularly within SINE-VNTR-Alu (SVA) retrotransposons. Together, these results demonstrate that expanded STRs within active promoter regions of the genome promote risk of AD. %B medRxiv %8 Nov %G eng %0 Journal Article %J Sci Transl Med %D 2023 %T Posttranslational modifications induce autoantibodies with risk prediction capability in patients with small cell lung cancer. %A Lastwika, Kristin J %A Kunihiro, Andrew %A Solan, Joell L %A Zhang, Yuzheng %A Taverne, Lydia R %A Shelley, David %A Rho, Jung-Hyun %A Randolph, Timothy W %A Li, Christopher I %A Grogan, Eric L %A Massion, Pierre P %A Fitzpatrick, Annette L %A MacPherson, David %A Houghton, A McGarry %A Lampe, Paul D %K Autoantibodies %K Humans %K Lung Neoplasms %K Protein Processing, Post-Translational %K Small Cell Lung Carcinoma %X

Small cell lung cancer (SCLC) elicits the generation of autoantibodies that result in unique paraneoplastic neurological syndromes. The mechanistic basis for the formation of such autoantibodies is largely unknown but is key to understanding their etiology. We developed a high-dimensional technique that enables detection of autoantibodies in complex with native antigens directly from patient plasma. Here, we used our platform to screen 1009 human plasma samples for 3600 autoantibody-antigen complexes, finding that plasma from patients with SCLC harbors, on average, fourfold higher disease-specific autoantibody signals compared with plasma from patients with other cancers. Across three independent SCLC cohorts, we identified a set of common but previously unknown autoantibodies that are produced in response to both intracellular and extracellular tumor antigens. We further characterized several disease-specific posttranslational modifications within extracellular proteins targeted by these autoantibodies, including citrullination, isoaspartylation, and cancer-specific glycosylation. Because most patients with SCLC have metastatic disease at diagnosis, we queried whether these autoantibodies could be used for SCLC early detection. We created a risk prediction model using five autoantibodies with an average area under the curve of 0.84 for the three cohorts that improved to 0.96 by incorporating cigarette smoke consumption in pack years. Together, our findings provide an innovative approach to identify circulating autoantibodies in SCLC with mechanistic insight into disease-specific immunogenicity and clinical utility.

%B Sci Transl Med %V 15 %P eadd8469 %8 2023 Jan 11 %G eng %N 678 %R 10.1126/scitranslmed.add8469 %0 Journal Article %J Nat Genet %D 2023 %T Powerful, scalable and resource-efficient meta-analysis of rare variant associations in large whole genome sequencing studies. %A Li, Xihao %A Quick, Corbin %A Zhou, Hufeng %A Gaynor, Sheila M %A Liu, Yaowu %A Chen, Han %A Selvaraj, Margaret Sunitha %A Sun, Ryan %A Dey, Rounak %A Arnett, Donna K %A Bielak, Lawrence F %A Bis, Joshua C %A Blangero, John %A Boerwinkle, Eric %A Bowden, Donald W %A Brody, Jennifer A %A Cade, Brian E %A Correa, Adolfo %A Cupples, L Adrienne %A Curran, Joanne E %A de Vries, Paul S %A Duggirala, Ravindranath %A Freedman, Barry I %A Göring, Harald H H %A Guo, Xiuqing %A Haessler, Jeffrey %A Kalyani, Rita R %A Kooperberg, Charles %A Kral, Brian G %A Lange, Leslie A %A Manichaikul, Ani %A Martin, Lisa W %A McGarvey, Stephen T %A Mitchell, Braxton D %A Montasser, May E %A Morrison, Alanna C %A Naseri, Take %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Peyser, Patricia A %A Psaty, Bruce M %A Raffield, Laura M %A Redline, Susan %A Reiner, Alexander P %A Reupena, Muagututi'a Sefuiva %A Rice, Kenneth M %A Rich, Stephen S %A Sitlani, Colleen M %A Smith, Jennifer A %A Taylor, Kent D %A Vasan, Ramachandran S %A Willer, Cristen J %A Wilson, James G %A Yanek, Lisa R %A Zhao, Wei %A Rotter, Jerome I %A Natarajan, Pradeep %A Peloso, Gina M %A Li, Zilin %A Lin, Xihong %K Exome Sequencing %K Genome-Wide Association Study %K Lipids %K Phenotype %K Whole Genome Sequencing %X

Meta-analysis of whole genome sequencing/whole exome sequencing (WGS/WES) studies provides an attractive solution to the problem of collecting large sample sizes for discovering rare variants associated with complex phenotypes. Existing rare variant meta-analysis approaches are not scalable to biobank-scale WGS data. Here we present MetaSTAAR, a powerful and resource-efficient rare variant meta-analysis framework for large-scale WGS/WES studies. MetaSTAAR accounts for relatedness and population structure, can analyze both quantitative and dichotomous traits and boosts the power of rare variant tests by incorporating multiple variant functional annotations. Through meta-analysis of four lipid traits in 30,138 ancestrally diverse samples from 14 studies of the Trans Omics for Precision Medicine (TOPMed) Program, we show that MetaSTAAR performs rare variant meta-analysis at scale and produces results comparable to using pooled data. Additionally, we identified several conditionally significant rare variant associations with lipid traits. We further demonstrate that MetaSTAAR is scalable to biobank-scale cohorts through meta-analysis of TOPMed WGS data and UK Biobank WES data of ~200,000 samples.

%B Nat Genet %V 55 %P 154-164 %8 2023 Jan %G eng %N 1 %R 10.1038/s41588-022-01225-6 %0 Journal Article %J medRxiv %D 2023 %T Prediction of Multiple Individual Primary Cardiovascular Events Using Pooled Cohorts. %A Sussman, Jeremy B %A Whitney, Rachael T %A Burke, James F %A Hayward, Rodney A %A Galecki, Andrzej %A Sidney, Stephen %A Allen, Norrina Bai %A Gottesman, Rebecca F %A Heckbert, Susan R %A Longstreth, William T %A Psaty, Bruce M %A Elkind, Mitchell S V %A Levine, Deborah A %X

INTRODUCTION: Most current clinical risk prediction scores for cardiovascular disease prevention use a composite outcome. Risk prediction scores for specific cardiovascular events could identify people who are at higher risk for some events than others informing personalized care and trial recruitment. We sought to predict risk for multiple different events, describe how those risks differ, and examine if these differences could improve treatment priorities.

METHODS: We used participant-level data from five cohort studies. We included participants between 40 and 79 years old who had no history of myocardial infarction (MI), stroke, or heart failure (HF). We made separate models to predict 10-year rates of first atherosclerotic cardiovascular disease (ASCVD), first fatal or nonfatal MI, first fatal or nonfatal stroke, new-onset HF, fatal ASCVD, fatal MI, fatal stroke, and all-cause mortality using established ASCVD risk factors. To limit overfitting, we used elastic net regularization with alpha = 0.75. We assessed the models for calibration, discrimination, and for correlations between predicted risks for different events. We also estimated the potential impact of varying treatment based on patients who are high risk for some ASCVD events, but not others.

RESULTS: Our study included 24,505 people; 55.6% were women, and 20.7% were non-Hispanic Black. Our models had C-statistics between 0.75 for MI and 0.85 for HF, good calibration, and minimal overfitting. The models were least similar for fatal stroke and all MI (0.58). In 1,840 participants whose risk of MI but not stroke or all-cause mortality was in the top quartile, we estimate one blood pressure-lowering medication would have a 2.4% chance of preventing any ASCVD event per 10 years. A moderate-strength statin would have a 2.1% chance. In 1,039 participants who had top quartile risk of stroke but not MI or mortality, a blood pressure-lowering medication would have a 2.5% chance of preventing an event, but a moderate-strength statin, 1.6%.

CONCLUSION: We developed risk scores for eight key clinical events and found that cardiovascular risk varies somewhat for different clinical events. Future work could determine if tailoring decisions by risk of separate events can improve care.

%B medRxiv %8 2023 Aug 02 %G eng %R 10.1101/2023.08.01.23293525 %0 Journal Article %J Aging Dis %D 2023 %T Prospective Longitudinal Perfusion in Probable Alzheimer's Disease Correlated with Atrophy in Temporal Lobe. %A Zhou, Tony D %A Zhang, Zongpai %A Balachandrasekaran, Arvind %A Raji, Cyrus A %A Becker, James T %A Kuller, Lewis H %A Ge, Yulin %A Lopez, Oscar L %A Dai, Weiying %A Gach, H Michael %X

Reduced cerebral blood flow (CBF) in the temporoparietal region and gray matter volumes (GMVs) in the temporal lobe were previously reported in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the temporal relationship between reductions in CBF and GMVs requires further investigation. This study sought to determine if reduced CBF is associated with reduced GMVs, or vice versa. Data came from 148 volunteers of the Cardiovascular Health Study Cognition Study (CHS-CS), including 58 normal controls (NC), 50 MCI, and 40 AD who had perfusion and structural MRIs during 2002-2003 (Time 2). Sixty-three of the 148 volunteers had follow-up perfusion and structural MRIs (Time 3). Forty out of the 63 volunteers received prior structural MRIs during 1997-1999 (Time 1). The relationships between GMVs and subsequent CBF changes, and between CBF and subsequent GMV changes were investigated. At Time 2, we observed smaller GMVs (p<0.05) in the temporal pole region in AD compared to NC and MCI. We also found associations between: (1) temporal pole GMVs at Time 2 and subsequent declines in CBF in this region (p=0.0014) and in the temporoparietal region (p=0.0032); (2) hippocampal GMVs at Time 2 and subsequent declines in CBF in the temporoparietal region (p=0.012); and (3) temporal pole CBF at Time 2 and subsequent changes in GMV in this region (p = 0.011). Therefore, hypoperfusion in the temporal pole may be an early event driving its atrophy. Perfusion declines in the temporoparietal and temporal pole follow atrophy in this temporal pole region.

%B Aging Dis %8 2023 May 09 %G eng %R 10.14336/AD.2023.0430 %0 Journal Article %J Europace %D 2023 %T A proteomic analysis of atrial fibrillation in a prospective longitudinal cohort (AGES-Reykjavik study). %A Jonmundsson, Thorarinn %A Steindorsdottir, Anna E %A Austin, Thomas R %A Frick, Elisabet A %A Axelsson, Gisli T %A Launer, Lenore %A Psaty, Bruce M %A Loureiro, Joseph %A Orth, Anthony P %A Aspelund, Thor %A Emilsson, Valur %A Floyd, James S %A Jennings, Lori %A Gudnason, Vilmundur %A Gudmundsdottir, Valborg %K Atrial Fibrillation %K Biomarkers %K Endosomal Sorting Complexes Required for Transport %K Humans %K Natriuretic Peptide, Brain %K Oxidoreductases Acting on Sulfur Group Donors %K Peptide Fragments %K Prognosis %K Prospective Studies %K Proteomics %K Risk Factors %X

AIMS: Atrial fibrillation (AF) is associated with high risk of comorbidities and mortality. Our aim was to examine causal and predictive relationships between 4137 serum proteins and incident AF in the prospective population-based Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) study.

METHODS AND RESULTS: The study included 4765 participants, of whom 1172 developed AF. Cox proportional hazards regression models were fitted for 4137 baseline protein measurements adjusting for known risk factors. Protein associations were tested for replication in the Cardiovascular Health Study (CHS). Causal relationships were examined in a bidirectional, two-sample Mendelian randomization analysis. The time-dependent area under the receiver operating characteristic curve (AUC)-statistic was examined as protein levels and an AF-polygenic risk score (PRS) were added to clinical risk models. The proteomic signature of incident AF consisted of 76 proteins, of which 63 (83%) were novel and 29 (38%) were replicated in CHS. The signature included both N-terminal prohormone of brain natriuretic peptide (NT-proBNP)-dependent (e.g. CHST15, ATP1B1, and SVEP1) and independent components (e.g. ASPN, AKR1B, and LAMA1/LAMB1/LAMC1). Nine causal candidates were identified (TAGLN, WARS, CHST15, CHMP3, COL15A1, DUSP13, MANBA, QSOX2, and SRL). The reverse causal analysis suggested that most AF-associated proteins were affected by the genetic liability to AF. N-terminal prohormone of brain natriuretic peptide improved the prediction of incident AF events close to baseline with further improvements gained by the AF-PRS at all time points.

CONCLUSION: The AF proteomic signature includes biologically relevant proteins, some of which may be causal. It mainly reflects an NT-proBNP-dependent consequence of the genetic liability to AF. N-terminal prohormone of brain natriuretic peptide is a promising marker for incident AF in the short term, but risk assessment incorporating a PRS may improve long-term risk assessment.

%B Europace %V 25 %8 2023 Nov 02 %G eng %N 11 %R 10.1093/europace/euad320 %0 Journal Article %J Eur J Heart Fail %D 2023 %T Proteomic prediction of incident heart failure and its main subtypes. %A Emilsson, Valur %A Jonsson, Brynjolfur G %A Austin, Thomas R %A Gudmundsdottir, Valborg %A Axelsson, Gisli T %A Frick, Elisabet A %A Jonmundsson, Thorarinn %A Steindorsdottir, Anna E %A Loureiro, Joseph %A Brody, Jennifer A %A Aspelund, Thor %A Launer, Lenore J %A Thorgeirsson, Gudmundur %A Kortekaas, Kirsten A %A Lindeman, Jan H %A Orth, Anthony P %A Lamb, John R %A Psaty, Bruce M %A Kizer, Jorge R %A Jennings, Lori L %A Gudnason, Vilmundur %X

AIM: To examine the ability of serum proteins in predicting future heart failure (HF) events, including HF with reduced or preserved ejection fraction (HFrEF or HFpEF), in relation to event time, and with or without considering established HF-associated clinical variables.

METHODS AND RESULTS: In the prospective population-based Age, Gene/Environment Susceptibility Reykjavik Study (AGES-RS), 440 individuals developed HF after their first visit with a median follow-up of 5.45 years. Among them, 167 were diagnosed with HFrEF and 188 with HFpEF. A least absolute shrinkage and selection operator regression model with nonparametric bootstrap were used to select predictors from an analysis of 4782 serum proteins, and several pre-established clinical parameters linked to HF. A subset of 8-10 distinct or overlapping serum proteins predicted different future HF outcomes, and C-statistics were used to assess discrimination, revealing proteins combined with a C-index of 0.80 for all incident HF, 0.78 and 0.80 for incident HFpEF or HFrEF, respectively. In the AGES-RS, protein panels alone encompassed the risk contained in the clinical information and improved the performance characteristics of prediction models based on NT-proBNP and clinical risk factors. Finally, the protein predictors performed particularly well close to the time of an HF event, an outcome that was replicated in the Cardiovascular Health Study (CHS).

CONCLUSION: A small number of circulating proteins accurately predicted future HF in the AGES-RS cohort of older adults, and they alone encompass the risk information found in a collection of clinical data. Incident HF events were predicted up to eight years, with predictor performance significantly improving for events occurring less than one year ahead, a finding replicated in an external cohort study. This article is protected by copyright. All rights reserved.

%B Eur J Heart Fail %8 2023 Nov 08 %G eng %R 10.1002/ejhf.3086 %0 Journal Article %J medRxiv %D 2023 %T Rare variants in long non-coding RNAs are associated with blood lipid levels in the TOPMed Whole Genome Sequencing Study. %A Wang, Yuxuan %A Selvaraj, Margaret Sunitha %A Li, Xihao %A Li, Zilin %A Holdcraft, Jacob A %A Arnett, Donna K %A Bis, Joshua C %A Blangero, John %A Boerwinkle, Eric %A Bowden, Donald W %A Cade, Brian E %A Carlson, Jenna C %A Carson, April P %A Chen, Yii-Der Ida %A Curran, Joanne E %A de Vries, Paul S %A Dutcher, Susan K %A Ellinor, Patrick T %A Floyd, James S %A Fornage, Myriam %A Freedman, Barry I %A Gabriel, Stacey %A Germer, Soren %A Gibbs, Richard A %A Guo, Xiuqing %A He, Jiang %A Heard-Costa, Nancy %A Hildalgo, Bertha %A Hou, Lifang %A Irvin, Marguerite R %A Joehanes, Roby %A Kaplan, Robert C %A Kardia, Sharon Lr %A Kelly, Tanika N %A Kim, Ryan %A Kooperberg, Charles %A Kral, Brian G %A Levy, Daniel %A Li, Changwei %A Liu, Chunyu %A Lloyd-Jone, Don %A Loos, Ruth Jf %A Mahaney, Michael C %A Martin, Lisa W %A Mathias, Rasika A %A Minster, Ryan L %A Mitchell, Braxton D %A Montasser, May E %A Morrison, Alanna C %A Murabito, Joanne M %A Naseri, Take %A O'Connell, Jeffrey R %A Palmer, Nicholette D %A Preuss, Michael H %A Psaty, Bruce M %A Raffield, Laura M %A Rao, Dabeeru C %A Redline, Susan %A Reiner, Alexander P %A Rich, Stephen S %A Ruepena, Muagututi'a Sefuiva %A Sheu, Wayne H-H %A Smith, Jennifer A %A Smith, Albert %A Tiwari, Hemant K %A Tsai, Michael Y %A Viaud-Martinez, Karine A %A Wang, Zhe %A Yanek, Lisa R %A Zhao, Wei %A Rotter, Jerome I %A Lin, Xihong %A Natarajan, Pradeep %A Peloso, Gina M %X

Long non-coding RNAs (lncRNAs) are known to perform important regulatory functions. Large-scale whole genome sequencing (WGS) studies and new statistical methods for variant set tests now provide an opportunity to assess the associations between rare variants in lncRNA genes and complex traits across the genome. In this study, we used high-coverage WGS from 66,329 participants of diverse ancestries with blood lipid levels (LDL-C, HDL-C, TC, and TG) in the National Heart, Lung, and Blood Institute (NHLBI) Trans-Omics for Precision Medicine (TOPMed) program to investigate the role of lncRNAs in lipid variability. We aggregated rare variants for 165,375 lncRNA genes based on their genomic locations and conducted rare variant aggregate association tests using the STAAR (variant-Set Test for Association using Annotation infoRmation) framework. We performed STAAR conditional analysis adjusting for common variants in known lipid GWAS loci and rare coding variants in nearby protein coding genes. Our analyses revealed 83 rare lncRNA variant sets significantly associated with blood lipid levels, all of which were located in known lipid GWAS loci (in a ±500 kb window of a Global Lipids Genetics Consortium index variant). Notably, 61 out of 83 signals (73%) were conditionally independent of common regulatory variations and rare protein coding variations at the same loci. We replicated 34 out of 61 (56%) conditionally independent associations using the independent UK Biobank WGS data. Our results expand the genetic architecture of blood lipids to rare variants in lncRNA, implicating new therapeutic opportunities.

%B medRxiv %8 2023 Jun 29 %G eng %R 10.1101/2023.06.28.23291966 %0 Journal Article %J Alzheimers Dement %D 2023 %T {Serum NfL and GFAP are associated with incident dementia and dementia mortality in older adults: The cardiovascular health study %A é, H. T. %A Liu, X. %A Odden, M. C. %A Moseholm, K. F. %A Seshadri, S. %A Satizabal, C. L. %A Lopez, O. L. %A Bis, J. C. %A é, L. %A Fohner, A. E. %A Psaty, B. M. %A Tracy, R. P. %A Longstreth, W. T. %A Jensen, M. K. %A Mukamal, K. J. %X Circulating neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have been independently associated with dementia risk. Their additive association, and their associations with dementia-specific mortality, have not been investigated.\ We associated serum NfL, GFAP, total tau ,and ubiquitin carboxyl-terminal hydrolase-L1, measured in 1712 dementia-free adults, with 19-year incident dementia and dementia-specific mortality risk, and with 3-year cognitive decline.\ 2.06 (1.60-2.67) and 9.22 (4.48-18.9). NfL was independently associated with accelerated cognitive decline.\ Circulating NfL and GFAP may, independently and jointly, provide useful clinical insight regarding dementia risk and prognosis. %B Alzheimers Dement %8 Jul %G eng %0 Journal Article %J JAMA Netw Open %D 2023 %T Sleep Architecture, Obstructive Sleep Apnea, and Cognitive Function in Adults. %A Pase, Matthew P %A Harrison, Stephanie %A Misialek, Jeffrey R %A Kline, Christopher E %A Cavuoto, Marina %A Baril, Andree-Ann %A Yiallourou, Stephanie %A Bisson, Alycia %A Himali, Dibya %A Leng, Yue %A Yang, Qiong %A Seshadri, Sudha %A Beiser, Alexa %A Gottesman, Rebecca F %A Redline, Susan %A Lopez, Oscar %A Lutsey, Pamela L %A Yaffe, Kristine %A Stone, Katie L %A Purcell, Shaun M %A Himali, Jayandra J %X

IMPORTANCE: Good sleep is essential for health, yet associations between sleep and dementia risk remain incompletely understood. The Sleep and Dementia Consortium was established to study associations between polysomnography (PSG)-derived sleep and the risk of dementia and related cognitive and brain magnetic resonance imaging endophenotypes.

OBJECTIVE: To investigate association of sleep architecture and obstructive sleep apnea (OSA) with cognitive function in the Sleep and Dementia Consortium.

DESIGN, SETTING, AND PARTICIPANTS: The Sleep and Dementia Consortium curated data from 5 population-based cohorts across the US with methodologically consistent, overnight, home-based type II PSG and neuropsychological assessments over 5 years of follow-up: the Atherosclerosis Risk in Communities study, Cardiovascular Health Study, Framingham Heart Study (FHS), Osteoporotic Fractures in Men Study, and Study of Osteoporotic Fractures. Sleep metrics were harmonized centrally and then distributed to participating cohorts for cohort-specific analysis using linear regression; study-level estimates were pooled in random effects meta-analyses. Results were adjusted for demographic variables, the time between PSG and neuropsychological assessment (0-5 years), body mass index, antidepressant use, and sedative use. There were 5946 participants included in the pooled analyses without stroke or dementia. Data were analyzed from March 2020 to June 2023.

EXPOSURES: Measures of sleep architecture and OSA derived from in-home PSG.

MAIN OUTCOMES AND MEASURES: The main outcomes were global cognitive composite z scores derived from principal component analysis, with cognitive domains investigated as secondary outcomes. Higher scores indicated better performance.

RESULTS: Across cohorts, 5946 adults (1875 females [31.5%]; mean age range, 58-89 years) were included. The median (IQR) wake after sleep onset time ranged from 44 (27-73) to 101 (66-147) minutes, and the prevalence of moderate to severe OSA ranged from 16.9% to 28.9%. Across cohorts, higher sleep maintenance efficiency (pooled β per 1% increase, 0.08; 95% CI, 0.03 to 0.14; P < .01) and lower wake after sleep onset (pooled β per 1-min increase, -0.07; 95% CI, -0.13 to -0.01 per 1-min increase; P = .02) were associated with better global cognition. Mild to severe OSA (apnea-hypopnea index [AHI] ≥5) was associated with poorer global cognition (pooled β, -0.06; 95% CI, -0.11 to -0.01; P = .01) vs AHI less than 5; comparable results were found for moderate to severe OSA (pooled β, -0.06; 95% CI, -0.11 to -0.01; P = .02) vs AHI less than 5. Differences in sleep stages were not associated with cognition.

CONCLUSIONS AND RELEVANCE: This study found that better sleep consolidation and the absence of OSA were associated with better global cognition over 5 years of follow-up. These findings suggest that the role of interventions to improve sleep for maintaining cognitive function requires investigation.

%B JAMA Netw Open %V 6 %P e2325152 %8 2023 Jul 03 %G eng %N 7 %R 10.1001/jamanetworkopen.2023.25152 %0 Journal Article %J bioRxiv %D 2023 %T A statistical framework for powerful multi-trait rare variant analysis in large-scale whole-genome sequencing studies. %A Li, Xihao %A Chen, Han %A Selvaraj, Margaret Sunitha %A Van Buren, Eric %A Zhou, Hufeng %A Wang, Yuxuan %A Sun, Ryan %A McCaw, Zachary R %A Yu, Zhi %A Arnett, Donna K %A Bis, Joshua C %A Blangero, John %A Boerwinkle, Eric %A Bowden, Donald W %A Brody, Jennifer A %A Cade, Brian E %A Carson, April P %A Carlson, Jenna C %A Chami, Nathalie %A Chen, Yii-Der Ida %A Curran, Joanne E %A de Vries, Paul S %A Fornage, Myriam %A Franceschini, Nora %A Freedman, Barry I %A Gu, Charles %A Heard-Costa, Nancy L %A He, Jiang %A Hou, Lifang %A Hung, Yi-Jen %A Irvin, Marguerite R %A Kaplan, Robert C %A Kardia, Sharon L R %A Kelly, Tanika %A Konigsberg, Iain %A Kooperberg, Charles %A Kral, Brian G %A Li, Changwei %A Loos, Ruth J F %A Mahaney, Michael C %A Martin, Lisa W %A Mathias, Rasika A %A Minster, Ryan L %A Mitchell, Braxton D %A Montasser, May E %A Morrison, Alanna C %A Palmer, Nicholette D %A Peyser, Patricia A %A Psaty, Bruce M %A Raffield, Laura M %A Redline, Susan %A Reiner, Alexander P %A Rich, Stephen S %A Sitlani, Colleen M %A Smith, Jennifer A %A Taylor, Kent D %A Tiwari, Hemant %A Vasan, Ramachandran S %A Wang, Zhe %A Yanek, Lisa R %A Yu, Bing %A Rice, Kenneth M %A Rotter, Jerome I %A Peloso, Gina M %A Natarajan, Pradeep %A Li, Zilin %A Liu, Zhonghua %A Lin, Xihong %X

Large-scale whole-genome sequencing (WGS) studies have improved our understanding of the contributions of coding and noncoding rare variants to complex human traits. Leveraging association effect sizes across multiple traits in WGS rare variant association analysis can improve statistical power over single-trait analysis, and also detect pleiotropic genes and regions. Existing multi-trait methods have limited ability to perform rare variant analysis of large-scale WGS data. We propose MultiSTAAR, a statistical framework and computationally-scalable analytical pipeline for functionally-informed multi-trait rare variant analysis in large-scale WGS studies. MultiSTAAR accounts for relatedness, population structure and correlation among phenotypes by jointly analyzing multiple traits, and further empowers rare variant association analysis by incorporating multiple functional annotations. We applied MultiSTAAR to jointly analyze three lipid traits (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides) in 61,861 multi-ethnic samples from the Trans-Omics for Precision Medicine (TOPMed) Program. We discovered new associations with lipid traits missed by single-trait analysis, including rare variants within an enhancer of and an intergenic region on chromosome 1.

%B bioRxiv %8 2023 Nov 02 %G eng %R 10.1101/2023.10.30.564764 %0 Journal Article %J Res Sq %D 2023 %T {Structural Variation Detection and Association Analysis of Whole-Genome-Sequence Data from 16,905 Alzheimer's Diseases Sequencing Project Subjects %A Lee, W. P. %A Wang, H. %A Dombroski, B. %A Cheng, P. L. %A Tucci, A. %A Si, Y. Q. %A Farrell, J. %A Tzeng, J. Y. %A Leung, Y. Y. %A Malamon, J. %A Wang, L. S. %A Vardarajan, B. %A Farrer, L. %A Schellenberg, G. %X . We also identified 16 SVs associated with AD and 13 SVs linked to AD-related pathological/cognitive endophenotypes. This study highlights the pivotal role of SVs in shaping our understanding of AD genetics. %B Res Sq %8 Oct %G eng %0 Journal Article %J medRxiv %D 2023 %T {Structural Variation Detection and Association Analysis of Whole-Genome-Sequence Data from 16,905 Alzheimer's Diseases Sequencing Project Subjects %A Wang, H. %A Dombroski, B. A. %A Cheng, P. L. %A Tucci, A. %A Si, Y. Q. %A Farrell, J. J. %A Tzeng, J. Y. %A Leung, Y. Y. %A Malamon, J. S. %A Wang, L. S. %A Vardarajan, B. N. %A Farrer, L. A. %A Schellenberg, G. D. %A Lee, W. P. %X . We also identified 16 SVs associated with AD and 13 SVs associated with AD-related pathological/cognitive endophenotypes. Our findings demonstrate the broad impact of SVs on AD genetics.\ Alzheimer's disease, Structural variation, Copy number variation. %B medRxiv %8 Sep %G eng %0 Journal Article %J medRxiv %D 2023 %T Time-to-Event Genome-Wide Association Study for Incident Cardiovascular Disease in People with Type 2 Diabetes Mellitus. %A Kwak, Soo Heon %A Hernandez-Cancela, Ryan B %A DiCorpo, Daniel A %A Condon, David E %A Merino, Jordi %A Wu, Peitao %A Brody, Jennifer A %A Yao, Jie %A Guo, Xiuqing %A Ahmadizar, Fariba %A Meyer, Mariah %A Sincan, Murat %A Mercader, Josep M %A Lee, Sujin %A Haessler, Jeffrey %A Vy, Ha My T %A Lin, Zhaotong %A Armstrong, Nicole D %A Gu, Shaopeng %A Tsao, Noah L %A Lange, Leslie A %A Wang, Ningyuan %A Wiggins, Kerri L %A Trompet, Stella %A Liu, Simin %A Loos, Ruth J F %A Judy, Renae %A Schroeder, Philip H %A Hasbani, Natalie R %A Bos, Maxime M %A Morrison, Alanna C %A Jackson, Rebecca D %A Reiner, Alexander P %A Manson, JoAnn E %A Chaudhary, Ninad S %A Carmichael, Lynn K %A Chen, Yii-Der Ida %A Taylor, Kent D %A Ghanbari, Mohsen %A van Meurs, Joyce %A Pitsillides, Achilleas N %A Psaty, Bruce M %A Noordam, Raymond %A Do, Ron %A Park, Kyong Soo %A Jukema, J Wouter %A Kavousi, Maryam %A Correa, Adolfo %A Rich, Stephen S %A Damrauer, Scott M %A Hajek, Catherine %A Cho, Nam H %A Irvin, Marguerite R %A Pankow, James S %A Nadkarni, Girish N %A Sladek, Robert %A Goodarzi, Mark O %A Florez, Jose C %A Chasman, Daniel I %A Heckbert, Susan R %A Kooperberg, Charles %A Dupuis, Josée %A Malhotra, Rajeev %A de Vries, Paul S %A Liu, Ching-Ti %A Rotter, Jerome I %A Meigs, James B %X

BACKGROUND: Type 2 diabetes mellitus (T2D) confers a two- to three-fold increased risk of cardiovascular disease (CVD). However, the mechanisms underlying increased CVD risk among people with T2D are only partially understood. We hypothesized that a genetic association study among people with T2D at risk for developing incident cardiovascular complications could provide insights into molecular genetic aspects underlying CVD.

METHODS: From 16 studies of the Cohorts for Heart & Aging Research in Genomic Epidemiology (CHARGE) Consortium, we conducted a multi-ancestry time-to-event genome-wide association study (GWAS) for incident CVD among people with T2D using Cox proportional hazards models. Incident CVD was defined based on a composite of coronary artery disease (CAD), stroke, and cardiovascular death that occurred at least one year after the diagnosis of T2D. Cohort-level estimated effect sizes were combined using inverse variance weighted fixed effects meta-analysis. We also tested 204 known CAD variants for association with incident CVD among patients with T2D.

RESULTS: A total of 49,230 participants with T2D were included in the analyses (31,118 European ancestries and 18,112 non-European ancestries) which consisted of 8,956 incident CVD cases over a range of mean follow-up duration between 3.2 and 33.7 years (event rate 18.2%). We identified three novel, distinct genetic loci for incident CVD among individuals with T2D that reached the threshold for genome-wide significance ( <5.0×10 ): rs147138607 (intergenic variant between and ) with a hazard ratio (HR) 1.23, 95% confidence interval (CI) 1.15 - 1.32, =3.6×10 , rs11444867 (intergenic variant near ) with HR 1.89, 95% CI 1.52 - 2.35, =9.9×10 , and rs335407 (intergenic variant between and ) HR 1.25, 95% CI 1.16 - 1.35, =1.5×10 . Among 204 known CAD loci, 32 were associated with incident CVD in people with T2D with <0.05, and 5 were significant after Bonferroni correction ( <0.00024, 0.05/204). A polygenic score of these 204 variants was significantly associated with incident CVD with HR 1.14 (95% CI 1.12 - 1.16) per 1 standard deviation increase ( =1.0×10 ).

CONCLUSIONS: The data point to novel and known genomic regions associated with incident CVD among individuals with T2D.

CLINICAL PERSPECTIVE: We conducted a large-scale multi-ancestry time-to-event GWAS to identify genetic variants associated with CVD among people with T2D. Three variants were significantly associated with incident CVD in people with T2D: rs147138607 (intergenic variant between and ), rs11444867 (intergenic variant near ), and rs335407 (intergenic variant between and ). A polygenic score composed of known CAD variants identified in the general population was significantly associated with the risk of CVD in people with T2D. There are genetic risk factors specific to T2D that could at least partially explain the excess risk of CVD in people with T2D.In addition, we show that people with T2D have enrichment of known CAD association signals which could also explain the excess risk of CVD.

%B medRxiv %8 2023 Jul 28 %G eng %R 10.1101/2023.07.25.23293180 %0 Journal Article %J Am J Prev Med %D 2023 %T Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study. %A Lovasi, Gina S %A Boise, Sarah %A Jogi, Siddharth %A Hurvitz, Philip M %A Rundle, Andrew G %A Diez, Julia %A Hirsch, Jana A %A Fitzpatrick, Annette %A Biggs, Mary L %A Siscovick, David S %X

INTRODUCTION: Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food retail presence on incident disease.

METHODS: The Cardiovascular Health Study recruited adults aged 65+ years in 1989-1993. Analyses conducted in 2021-2022 included those in good baseline health, with addresses updated annually through the year of death (restricted to 91% who died during >2 decades of cohort follow-up). Baseline and annually updated presence of 2 combined food retail categories (supermarkets/produce markets and convenience/snack focused) was characterized using establishment-level data for 1-km and 5-km Euclidean buffers. Cox proportional hazards models estimated associations with time to each incident outcome (cardiovascular disease, diabetes), adjusting for individual and area-based confounders.

RESULTS: Among 2,939 participants, 36% with baseline supermarket/produce market presence within 1 km had excess incident cardiovascular disease (hazard ratio=1.12; 95% CI=1.01, 1.24); the association was attenuated and no longer statistically significant after adjustment for sociodemographic characteristics. Adjusted associations were robustly null for time-varying supermarket/produce market or convenience/fast food retail presence across analyses with outcomes of cardiovascular disease or diabetes incidence.

CONCLUSIONS: Food environment changes continue to be studied to provide an evidence base for policy decisions, and null findings in this longitudinal analysis add literature that casts doubt on the sufficiency of strategies targeting food retail presence alone of an elderly cohort for curtailing incident events of clinical importance.

%B Am J Prev Med %8 2023 Mar 05 %G eng %R 10.1016/j.amepre.2023.02.001 %0 Journal Article %J J Endocr Soc %D 2023 %T A Type 1 Diabetes Polygenic Score Is Not Associated With Prevalent Type 2 Diabetes in Large Population Studies. %A Srinivasan, Shylaja %A Wu, Peitao %A Mercader, Josep M %A Udler, Miriam S %A Porneala, Bianca C %A Bartz, Traci M %A Floyd, James S %A Sitlani, Colleen %A Guo, Xiquing %A Haessler, Jeffrey %A Kooperberg, Charles %A Liu, Jun %A Ahmad, Shahzad %A van Duijn, Cornelia %A Liu, Ching-Ti %A Goodarzi, Mark O %A Florez, Jose C %A Meigs, James B %A Rotter, Jerome I %A Rich, Stephen S %A Dupuis, Josée %A Leong, Aaron %X

CONTEXT: Both type 1 diabetes (T1D) and type 2 diabetes (T2D) have significant genetic contributions to risk and understanding their overlap can offer clinical insight.

OBJECTIVE: We examined whether a T1D polygenic score (PS) was associated with a diagnosis of T2D in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium.

METHODS: We constructed a T1D PS using 79 known single nucleotide polymorphisms associated with T1D risk. We analyzed 13 792 T2D cases and 14 169 controls from CHARGE cohorts to determine the association between the T1D PS and T2D prevalence. We validated findings in an independent sample of 2256 T2D cases and 27 052 controls from the Mass General Brigham Biobank (MGB Biobank). As secondary analyses in 5228 T2D cases from CHARGE, we used multivariable regression models to assess the association of the T1D PS with clinical outcomes associated with T1D.

RESULTS: The T1D PS was not associated with T2D both in CHARGE ( = .15) and in the MGB Biobank ( = .87). The partitioned human leukocyte antigens only PS was associated with T2D in CHARGE (OR 1.02 per 1 SD increase in PS, 95% CI 1.01-1.03, = .006) but not in the MGB Biobank. The T1D PS was weakly associated with insulin use (OR 1.007, 95% CI 1.001-1.012, = .03) in CHARGE T2D cases but not with other outcomes.

CONCLUSION: In large biobank samples, a common variant PS for T1D was not consistently associated with prevalent T2D. However, possible heterogeneity in T2D cannot be ruled out and future studies are needed do subphenotyping.

%B J Endocr Soc %V 7 %P bvad123 %8 2023 Oct 09 %G eng %N 11 %R 10.1210/jendso/bvad123 %0 Journal Article %J Circ Genom Precis Med %D 2023 %T Type 2 Diabetes Modifies the Association of CAD Genomic Risk Variants With Subclinical Atherosclerosis. %A Hasbani, Natalie R %A Westerman, Kenneth E %A Heon Kwak, Soo %A Chen, Han %A Li, Xihao %A DiCorpo, Daniel %A Wessel, Jennifer %A Bis, Joshua C %A Sarnowski, Chloe %A Wu, Peitao %A Bielak, Lawrence F %A Guo, Xiuqing %A Heard-Costa, Nancy %A Kinney, Gregory %A Mahaney, Michael C %A Montasser, May E %A Palmer, Nicholette D %A Raffield, Laura M %A Terry, James G %A Yanek, Lisa R %A Bon, Jessica %A Bowden, Donald W %A Brody, Jennifer A %A Duggirala, Ravindranath %A Jacobs, David R %A Kalyani, Rita R %A Lange, Leslie A %A Mitchell, Braxton D %A Smith, Jennifer A %A Taylor, Kent D %A Carson, April %A Curran, Joanne E %A Fornage, Myriam %A Freedman, Barry I %A Gabriel, Stacey %A Gibbs, Richard A %A Gupta, Namrata %A Kardia, Sharon L R %A Kral, Brian G %A Momin, Zeineen %A Newman, Anne B %A Post, Wendy S %A Viaud-Martinez, Karine A %A Young, Kendra A %A Becker, Lewis C %A Bertoni, Alain %A Blangero, John %A Carr, John J %A Pratte, Katherine %A Psaty, Bruce M %A Rich, Stephen S %A Wu, Joseph C %A Malhotra, Rajeev %A Peyser, Patricia A %A Morrison, Alanna C %A Vasan, Ramachandran S %A Lin, Xihong %A Rotter, Jerome I %A Meigs, James B %A Manning, Alisa K %A de Vries, Paul S %X

BACKGROUND: Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D.

METHODS: We compared the common and rare variant associations of known CAD loci from the literature on CAC, carotid intima-media thickness, and carotid plaque in up to 29 670 participants, including up to 24 157 normoglycemic controls and 5513 T2D cases leveraging whole-genome sequencing data from the Trans-Omics for Precision Medicine program. We included first-order T2D interaction terms in each model to determine whether CAD loci were modified by T2D. The genetic main and interaction effects were assessed using a joint test to determine whether a CAD variant, or gene-based rare variant set, was associated with the respective subclinical atherosclerosis measures and then further determined whether these loci had a significant interaction test.

RESULTS: Using a Bonferroni-corrected significance threshold of <1.6×10, we identified 3 genes (, , and ) associated with CAC and 2 genes ( and ) associated with carotid intima-media thickness and carotid plaque, respectively, through gene-based rare variant set analysis. Both and also had significantly different associations for CAC in T2D cases versus controls. No significant interaction tests were identified through the candidate single-variant analysis.

CONCLUSIONS: These results highlight T2D as an important modifier of rare variant associations in CAD loci with CAC.

%B Circ Genom Precis Med %P e004176 %8 2023 Nov 28 %G eng %R 10.1161/CIRCGEN.123.004176 %0 Journal Article %J J Prev Alzheimers Dis %D 2023 %T Validation of the CogDrisk Instrument as Predictive of Dementia in Four General Community-Dwelling Populations. %A Kootar, S %A Huque, M H %A Eramudugolla, R %A Rizzuto, D %A Carlson, M C %A Odden, M C %A Lopez, O L %A Qiu, C %A Fratiglioni, L %A Han, S D %A Bennett, D A %A Peters, R %A Anstey, K J %K Aging %K Alzheimer Disease %K Cohort Studies %K Dementia %K Humans %K Independent Living %X

BACKGROUND: Lack of external validation of dementia risk tools is a major limitation for generalizability and translatability of prediction scores in clinical practice and research.

OBJECTIVES: We aimed to validate a new dementia prediction risk tool called CogDrisk and a version, CogDrisk-AD for predicting Alzheimer's disease (AD) using cohort studies.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Four cohort studies were identified that included majority of the dementia risk factors from the CogDrisk tool. Participants who were free of dementia at baseline were included. The predictors were component variables in the CogDrisk tool that include self-reported demographics, medical risk factors and lifestyle habits. Risk scores for Any Dementia and AD were computed and Area Under the Curve (AUC) was assessed. To examine modifiable risk factors for dementia, the CogDrisk tool was tested by excluding age and sex estimates from the model.

RESULTS: The performance of the tool varied between studies. The overall AUC and 95% CI for predicting dementia was 0.77 (0.57, 0.97) for the Swedish National study on Aging and Care in Kungsholmen, 0.76 (0.70, 0.83) for the Health and Retirement Study - Aging, Demographics and Memory Study, 0.70 (0.67,0.72) for the Cardiovascular Health Study Cognition Study, and 0.66 (0.62,0.70) for the Rush Memory and Aging Project.

CONCLUSIONS: The CogDrisk and CogDrisk-AD performed well in the four studies. Overall, this tool can be used to assess individualized risk factors of dementia and AD in various population settings.

%B J Prev Alzheimers Dis %V 10 %P 478-487 %8 2023 %G eng %N 3 %R 10.14283/jpad.2023.38 %0 Journal Article %J medRxiv %D 2023 %T Whole genome analysis of plasma fibrinogen reveals population-differentiated genetic regulators with putative liver roles. %A Huffman, Jennifer E %A Nicolas, Jayna %A Hahn, Julie %A Heath, Adam S %A Raffield, Laura M %A Yanek, Lisa R %A Brody, Jennifer A %A Thibord, Florian %A Almasy, Laura %A Bartz, Traci M %A Bielak, Lawrence F %A Bowler, Russell P %A Carrasquilla, Germán D %A Chasman, Daniel I %A Chen, Ming-Huei %A Emmert, David B %A Ghanbari, Mohsen %A Haessle, Jeffery %A Hottenga, Jouke-Jan %A Kleber, Marcus E %A Le, Ngoc-Quynh %A Lee, Jiwon %A Lewis, Joshua P %A Li-Gao, Ruifang %A Luan, Jian'an %A Malmberg, Anni %A Mangino, Massimo %A Marioni, Riccardo E %A Martinez-Perez, Angel %A Pankratz, Nathan %A Polasek, Ozren %A Richmond, Anne %A Rodriguez, Benjamin At %A Rotter, Jerome I %A Steri, Maristella %A Suchon, Pierre %A Trompet, Stella %A Weiss, Stefan %A Zare, Marjan %A Auer, Paul %A Cho, Michael H %A Christofidou, Paraskevi %A Davies, Gail %A de Geus, Eco %A Deleuze, Jean-Francois %A Delgado, Graciela E %A Ekunwe, Lynette %A Faraday, Nauder %A Gögele, Martin %A Greinacher, Andreas %A He, Gao %A Howard, Tom %A Joshi, Peter K %A Kilpeläinen, Tuomas O %A Lahti, Jari %A Linneberg, Allan %A Naitza, Silvia %A Noordam, Raymond %A Paüls-Vergés, Ferran %A Rich, Stephen S %A Rosendaal, Frits R %A Rudan, Igor %A Ryan, Kathleen A %A Souto, Juan Carlos %A van Rooij, Frank Ja %A Wang, Heming %A Zhao, Wei %A Becker, Lewis C %A Beswick, Andrew %A Brown, Michael R %A Cade, Brian E %A Campbell, Harry %A Cho, Kelly %A Crapo, James D %A Curran, Joanne E %A de Maat, Moniek Pm %A Doyle, Margaret %A Elliott, Paul %A Floyd, James S %A Fuchsberger, Christian %A Grarup, Niels %A Guo, Xiuqing %A Harris, Sarah E %A Hou, Lifang %A Kolcic, Ivana %A Kooperberg, Charles %A Menni, Cristina %A Nauck, Matthias %A O'Connell, Jeffrey R %A Orrù, Valeria %A Psaty, Bruce M %A Räikkönen, Katri %A Smith, Jennifer A %A Soria, José Manuel %A Stott, David J %A van Hylckama Vlieg, Astrid %A Watkins, Hugh %A Willemsen, Gonneke %A Wilson, Peter %A Ben-Shlomo, Yoav %A Blangero, John %A Boomsma, Dorret %A Cox, Simon R %A Dehghan, Abbas %A Eriksson, Johan G %A Fiorillo, Edoardo %A Fornage, Myriam %A Hansen, Torben %A Hayward, Caroline %A Ikram, M Arfan %A Jukema, J Wouter %A Kardia, Sharon Lr %A Lange, Leslie A %A März, Winfried %A Mathias, Rasika A %A Mitchell, Braxton D %A Mook-Kanamori, Dennis O %A Morange, Pierre-Emmanuel %A Pedersen, Oluf %A Pramstaller, Peter P %A Redline, Susan %A Reiner, Alexander %A Ridker, Paul M %A Silverman, Edwin K %A Spector, Tim D %A Völker, Uwe %A Wareham, Nick %A Wilson, James F %A Yao, Jie %A Trégouët, David-Alexandre %A Johnson, Andrew D %A Wolberg, Alisa S %A de Vries, Paul S %A Sabater-Lleal, Maria %A Morrison, Alanna C %A Smith, Nicholas L %X

UNLABELLED: Genetic studies have identified numerous regions associated with plasma fibrinogen levels in Europeans, yet missing heritability and limited inclusion of non-Europeans necessitates further studies with improved power and sensitivity. Compared with array-based genotyping, whole genome sequencing (WGS) data provides better coverage of the genome and better representation of non-European variants. To better understand the genetic landscape regulating plasma fibrinogen levels, we meta-analyzed WGS data from the NHLBI's Trans-Omics for Precision Medicine (TOPMed) program (n=32,572), with array-based genotype data from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium (n=131,340) imputed to the TOPMed or Haplotype Reference Consortium panel. We identified 18 loci that have not been identified in prior genetic studies of fibrinogen. Of these, four are driven by common variants of small effect with reported MAF at least 10% higher in African populations. Three ( , and signals contain predicted deleterious missense variants. Two loci, and , each harbor two conditionally distinct, non-coding variants. The gene region encoding the protein chain subunits ( ), contains 7 distinct signals, including one novel signal driven by rs28577061, a variant common (MAF=0.180) in African reference panels but extremely rare (MAF=0.008) in Europeans. Through phenome-wide association studies in the VA Million Veteran Program, we found associations between fibrinogen polygenic risk scores and thrombotic and inflammatory disease phenotypes, including an association with gout. Our findings demonstrate the utility of WGS to augment genetic discovery in diverse populations and offer new insights for putative mechanisms of fibrinogen regulation.

KEY POINTS: Largest and most diverse genetic study of plasma fibrinogen identifies 54 regions (18 novel), housing 69 conditionally distinct variants (20 novel).Sufficient power achieved to identify signal driven by African population variant.Links to (1) liver enzyme, blood cell and lipid genetic signals, (2) liver regulatory elements, and (3) thrombotic and inflammatory disease.

%B medRxiv %8 2023 Jun 12 %G eng %R 10.1101/2023.06.07.23291095 %0 Journal Article %J Circ Genom Precis Med %D 2023 %T Whole Genome Analysis of Venous Thromboembolism: the Trans-Omics for Precision Medicine Program. %A Seyerle, Amanda A %A Laurie, Cecelia A %A Coombes, Brandon J %A Jain, Deepti %A Conomos, Matthew P %A Brody, Jennifer %A Chen, Ming-Huei %A Gogarten, Stephanie M %A Beutel, Kathleen M %A Gupta, Namrata %A Heckbert, Susan R %A Jackson, Rebecca D %A Johnson, Andrew D %A Ko, Darae %A Manson, JoAnn E %A McKnight, Barbara %A Metcalf, Ginger A %A Morrison, Alanna C %A Reiner, Alexander P %A Sofer, Tamar %A Tang, Weihong %A Wiggins, Kerri L %A Boerwinkle, Eric %A Andrade, Mariza de %A Gabriel, Stacey B %A Gibbs, Richard A %A Laurie, Cathy C %A Psaty, Bruce M %A Vasan, Ramachandran S %A Rice, Ken %A Kooperberg, Charles %A Pankow, James S %A Smith, Nicholas L %A Pankratz, Nathan %X

Background Risk for venous thromboembolism has a strong genetic component. Whole genome sequencingfrom the Trans-Omics for Precision Medicine program allowed us to look for new associations, particularly rare variants missed by standard genome-wide association studies. Methods The 3793 cases and 7834 controls (11.6% of cases were Black, Hispanic/Latino, or Asian American) were analyzed using a single variant approach and an aggregate gene-based approach using our primary filter (included only loss-of-function and missense variants predicted to be deleterious) and our secondary filter (included all missense variants). Results Single variant analyses identified associations at 5 known loci. Aggregate gene-based analyses identified only (odds ratio, 6.2 for carriers of rare variants; =7.4×10) when using our primary filter. Employing our secondary variant filter led to a smaller effect size at (odds ratio, 3.8; =1.6×10), while excluding variants found only in rare isoforms led to a larger one (odds ratio, 7.5). Different filtering strategies improved the signal for 2 other known genes: became significant (minimum =1.8×10 with the secondary filter), while did not (minimum =4.4×10 with minor allele frequency <0.0005). Results were largely the same when restricting the analyses to include only unprovoked cases; however, one novel gene, , became significant (=4.4×10 using all missense variants with minor allele frequency <0.0005). Conclusions Here, we have demonstrated the importance of using multiple variant filtering strategies, as we detected additional genes when filtering variants based on their predicted deleteriousness, frequency, and presence on the most expressed isoforms. Our primary analyses did not identify new candidate loci; thus larger follow-up studies are needed to replicate the novel locus and to identify additional rare variation associated with venous thromboembolism.

%B Circ Genom Precis Med %P e003532 %8 2023 Mar 24 %G eng %R 10.1161/CIRCGEN.121.003532 %0 Journal Article %J Front Genet %D 2023 %T Whole genome sequence analysis of apparent treatment resistant hypertension status in participants from the Trans-Omics for Precision Medicine program. %A Armstrong, Nicole D %A Srinivasasainagendra, Vinodh %A Ammous, Farah %A Assimes, Themistocles L %A Beitelshees, Amber L %A Brody, Jennifer %A Cade, Brian E %A Ida Chen, Yii-Der %A Chen, Han %A de Vries, Paul S %A Floyd, James S %A Franceschini, Nora %A Guo, Xiuqing %A Hellwege, Jacklyn N %A House, John S %A Hwu, Chii-Min %A Kardia, Sharon L R %A Lange, Ethan M %A Lange, Leslie A %A McDonough, Caitrin W %A Montasser, May E %A O'Connell, Jeffrey R %A Shuey, Megan M %A Sun, Xiao %A Tanner, Rikki M %A Wang, Zhe %A Zhao, Wei %A Carson, April P %A Edwards, Todd L %A Kelly, Tanika N %A Kenny, Eimear E %A Kooperberg, Charles %A Loos, Ruth J F %A Morrison, Alanna C %A Motsinger-Reif, Alison %A Psaty, Bruce M %A Rao, Dabeeru C %A Redline, Susan %A Rich, Stephen S %A Rotter, Jerome I %A Smith, Jennifer A %A Smith, Albert V %A Irvin, Marguerite R %A Arnett, Donna K %X

Apparent treatment-resistant hypertension (aTRH) is characterized by the use of four or more antihypertensive (AHT) classes to achieve blood pressure (BP) control. In the current study, we conducted single-variant and gene-based analyses of aTRH among individuals from 12 Trans-Omics for Precision Medicine cohorts with whole-genome sequencing data. Cases were defined as individuals treated for hypertension (HTN) taking three different AHT classes, with average systolic BP ≥ 140 or diastolic BP ≥ 90 mmHg, or four or more medications regardless of BP ( = 1,705). A normotensive control group was defined as individuals with BP < 140/90 mmHg ( = 22,079), not on AHT medication. A second control group comprised individuals who were treatment responsive on one AHT medication with BP < 140/ 90 mmHg ( = 5,424). Logistic regression with kinship adjustment using the Scalable and Accurate Implementation of Generalized mixed models (SAIGE) was performed, adjusting for age, sex, and genetic ancestry. We assessed variants using SKAT-O in rare-variant analyses. Single-variant and gene-based tests were conducted in a pooled multi-ethnicity stratum, as well as self-reported ethnic/racial strata (European and African American). One variant in the known HTN locus, , was a top finding in the multi-ethnic analysis ( = 8.23E-07) for the normotensive control group [rs12476527, odds ratio (95% confidence interval) = 0.80 (0.74-0.88)]. This variant was replicated in the Vanderbilt University Medical Center's DNA repository data. Aggregate gene-based signals included the genes and . Additional work validating these loci in larger, more diverse populations, is warranted to determine whether these regions influence the pathobiology of aTRH.

%B Front Genet %V 14 %P 1278215 %8 2023 %G eng %R 10.3389/fgene.2023.1278215 %0 Journal Article %J medRxiv %D 2023 %T WHOLE GENOME SEQUENCING ANALYSIS OF BODY MASS INDEX IDENTIFIES NOVEL AFRICAN ANCESTRY-SPECIFIC RISK ALLELE. %A Zhang, Xinruo %A Brody, Jennifer A %A Graff, Mariaelisa %A Highland, Heather M %A Chami, Nathalie %A Xu, Hanfei %A Wang, Zhe %A Ferrier, Kendra %A Chittoor, Geetha %A Josyula, Navya S %A Li, Xihao %A Li, Zilin %A Allison, Matthew A %A Becker, Diane M %A Bielak, Lawrence F %A Bis, Joshua C %A Boorgula, Meher Preethi %A Bowden, Donald W %A Broome, Jai G %A Buth, Erin J %A Carlson, Christopher S %A Chang, Kyong-Mi %A Chavan, Sameer %A Chiu, Yen-Feng %A Chuang, Lee-Ming %A Conomos, Matthew P %A DeMeo, Dawn L %A Du, Margaret %A Duggirala, Ravindranath %A Eng, Celeste %A Fohner, Alison E %A Freedman, Barry I %A Garrett, Melanie E %A Guo, Xiuqing %A Haiman, Chris %A Heavner, Benjamin D %A Hidalgo, Bertha %A Hixson, James E %A Ho, Yuk-Lam %A Hobbs, Brian D %A Hu, Donglei %A Hui, Qin %A Hwu, Chii-Min %A Jackson, Rebecca D %A Jain, Deepti %A Kalyani, Rita R %A Kardia, Sharon L R %A Kelly, Tanika N %A Lange, Ethan M %A LeNoir, Michael %A Li, Changwei %A Marchand, Loic Le %A McDonald, Merry-Lynn N %A McHugh, Caitlin P %A Morrison, Alanna C %A Naseri, Take %A O'Connell, Jeffrey %A O'Donnell, Christopher J %A Palmer, Nicholette D %A Pankow, James S %A Perry, James A %A Peters, Ulrike %A Preuss, Michael H %A Rao, D C %A Regan, Elizabeth A %A Reupena, Sefuiva M %A Roden, Dan M %A Rodriguez-Santana, Jose %A Sitlani, Colleen M %A Smith, Jennifer A %A Tiwari, Hemant K %A Vasan, Ramachandran S %A Wang, Zeyuan %A Weeks, Daniel E %A Wessel, Jennifer %A Wiggins, Kerri L %A Wilkens, Lynne R %A Wilson, Peter W F %A Yanek, Lisa R %A Yoneda, Zachary T %A Zhao, Wei %A Zöllner, Sebastian %A Arnett, Donna K %A Ashley-Koch, Allison E %A Barnes, Kathleen C %A Blangero, John %A Boerwinkle, Eric %A Burchard, Esteban G %A Carson, April P %A Chasman, Daniel I %A Chen, Yii-Der Ida %A Curran, Joanne E %A Fornage, Myriam %A Gordeuk, Victor R %A He, Jiang %A Heckbert, Susan R %A Hou, Lifang %A Irvin, Marguerite R %A Kooperberg, Charles %A Minster, Ryan L %A Mitchell, Braxton D %A Nouraie, Mehdi %A Psaty, Bruce M %A Raffield, Laura M %A Reiner, Alexander P %A Rich, Stephen S %A Rotter, Jerome I %A Shoemaker, M Benjamin %A Smith, Nicholas L %A Taylor, Kent D %A Telen, Marilyn J %A Weiss, Scott T %A Zhang, Yingze %A Costa, Nancy Heard- %A Sun, Yan V %A Lin, Xihong %A Cupples, L Adrienne %A Lange, Leslie A %A Liu, Ching-Ti %A Loos, Ruth J F %A North, Kari E %A Justice, Anne E %X

Obesity is a major public health crisis associated with high mortality rates. Previous genome-wide association studies (GWAS) investigating body mass index (BMI) have largely relied on imputed data from European individuals. This study leveraged whole-genome sequencing (WGS) data from 88,873 participants from the Trans-Omics for Precision Medicine (TOPMed) Program, of which 51% were of non-European population groups. We discovered 18 BMI-associated signals ( < 5 × 10 ). Notably, we identified and replicated a novel low frequency single nucleotide polymorphism (SNP) in that was common in individuals of African descent. Using a diverse study population, we further identified two novel secondary signals in known BMI loci and pinpointed two likely causal variants in the and loci. Our work demonstrates the benefits of combining WGS and diverse cohorts in expanding current catalog of variants and genes confer risk for obesity, bringing us one step closer to personalized medicine.

%B medRxiv %8 2023 Aug 22 %G eng %R 10.1101/2023.08.21.23293271 %0 Journal Article %J bioRxiv %D 2023 %T Whole Genome Sequencing Based Analysis of Inflammation Biomarkers in the Trans-Omics for Precision Medicine (TOPMed) Consortium. %A Jiang, Min-Zhi %A Gaynor, Sheila M %A Li, Xihao %A Van Buren, Eric %A Stilp, Adrienne %A Buth, Erin %A Wang, Fei Fei %A Manansala, Regina %A Gogarten, Stephanie M %A Li, Zilin %A Polfus, Linda M %A Salimi, Shabnam %A Bis, Joshua C %A Pankratz, Nathan %A Yanek, Lisa R %A Durda, Peter %A Tracy, Russell P %A Rich, Stephen S %A Rotter, Jerome I %A Mitchell, Braxton D %A Lewis, Joshua P %A Psaty, Bruce M %A Pratte, Katherine A %A Silverman, Edwin K %A Kaplan, Robert C %A Avery, Christy %A North, Kari %A Mathias, Rasika A %A Faraday, Nauder %A Lin, Honghuang %A Wang, Biqi %A Carson, April P %A Norwood, Arnita F %A Gibbs, Richard A %A Kooperberg, Charles %A Lundin, Jessica %A Peters, Ulrike %A Dupuis, Josée %A Hou, Lifang %A Fornage, Myriam %A Benjamin, Emelia J %A Reiner, Alexander P %A Bowler, Russell P %A Lin, Xihong %A Auer, Paul L %A Raffield, Laura M %X

Inflammation biomarkers can provide valuable insight into the role of inflammatory processes in many diseases and conditions. Sequencing based analyses of such biomarkers can also serve as an exemplar of the genetic architecture of quantitative traits. To evaluate the biological insight, which can be provided by a multi-ancestry, whole-genome based association study, we performed a comprehensive analysis of 21 inflammation biomarkers from up to 38,465 individuals with whole-genome sequencing from the Trans-Omics for Precision Medicine (TOPMed) program. We identified 22 distinct single-variant associations across 6 traits - E-selectin, intercellular adhesion molecule 1, interleukin-6, lipoprotein-associated phospholipase A2 activity and mass, and P-selectin - that remained significant after conditioning on previously identified associations for these inflammatory biomarkers. We further expanded upon known biomarker associations by pairing the single-variant analysis with a rare variant set-based analysis that further identified 19 significant rare variant set-based associations with 5 traits. These signals were distinct from both significant single variant association signals within TOPMed and genetic signals observed in prior studies, demonstrating the complementary value of performing both single and rare variant analyses when analyzing quantitative traits. We also confirm several previously reported signals from semi-quantitative proteomics platforms. Many of these signals demonstrate the extensive allelic heterogeneity and ancestry-differentiated variant-trait associations common for inflammation biomarkers, a characteristic we hypothesize will be increasingly observed with well-powered, large-scale analyses of complex traits.

%B bioRxiv %8 2023 Sep 12 %G eng %R 10.1101/2023.09.10.555215 %0 Journal Article %J Nat Commun %D 2023 %T Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. %A Feofanova, Elena V %A Brown, Michael R %A Alkis, Taryn %A Manuel, Astrid M %A Li, Xihao %A Tahir, Usman A %A Li, Zilin %A Mendez, Kevin M %A Kelly, Rachel S %A Qi, Qibin %A Chen, Han %A Larson, Martin G %A Lemaitre, Rozenn N %A Morrison, Alanna C %A Grieser, Charles %A Wong, Kari E %A Gersztern, Robert E %A Zhao, Zhongming %A Lasky-Su, Jessica %A Yu, Bing %K Ethnicity %K Genome-Wide Association Study %K Humans %K Metabolome %K Polymorphism, Single Nucleotide %K Quantitative Trait Loci %X

Circulating metabolite levels may reflect the state of the human organism in health and disease, however, the genetic architecture of metabolites is not fully understood. We have performed a whole-genome sequencing association analysis of both common and rare variants in up to 11,840 multi-ethnic participants from five studies with up to 1666 circulating metabolites. We have discovered 1985 novel variant-metabolite associations, and validated 761 locus-metabolite associations reported previously. Seventy-nine novel variant-metabolite associations have been replicated, including three genetic loci located on the X chromosome that have demonstrated its involvement in metabolic regulation. Gene-based analysis have provided further support for seven metabolite-replicated loci pairs and their biologically plausible genes. Among those novel replicated variant-metabolite pairs, follow-up analyses have revealed that 26 metabolites have colocalized with 21 tissues, seven metabolite-disease outcome associations have been putatively causal, and 7 metabolites might be regulated by plasma protein levels. Our results have depicted the genetic contribution to circulating metabolite levels, providing additional insights into understanding human disease.

%B Nat Commun %V 14 %P 3111 %8 2023 May 30 %G eng %N 1 %R 10.1038/s41467-023-38800-2 %0 Journal Article %J medRxiv %D 2024 %T Association analysis of mitochondrial DNA heteroplasmic variants: methods and application. %A Sun, Xianbang %A Bulekova, Katia %A Yang, Jian %A Lai, Meng %A Pitsillides, Achilleas N %A Liu, Xue %A Zhang, Yuankai %A Guo, Xiuqing %A Yong, Qian %A Raffield, Laura M %A Rotter, Jerome I %A Rich, Stephen S %A Abecasis, Goncalo %A Carson, April P %A Vasan, Ramachandran S %A Bis, Joshua C %A Psaty, Bruce M %A Boerwinkle, Eric %A Fitzpatrick, Annette L %A Satizabal, Claudia L %A Arking, Dan E %A Ding, Jun %A Levy, Daniel %A Liu, Chunyu %X

We rigorously assessed a comprehensive association testing framework for heteroplasmy, employing both simulated and real-world data. This framework employed a variant allele fraction (VAF) threshold and harnessed multiple gene-based tests for robust identification and association testing of heteroplasmy. Our simulation studies demonstrated that gene-based tests maintained an appropriate type I error rate at α=0.001. Notably, when 5% or more heteroplasmic variants within a target region were linked to an outcome, burden-extension tests (including the adaptive burden test, variable threshold burden test, and z-score weighting burden test) outperformed the sequence kernel association test (SKAT) and the original burden test. Applying this framework, we conducted association analyses on whole-blood derived heteroplasmy in 17,507 individuals of African and European ancestries (31% of African Ancestry, mean age of 62, with 58% women) with whole genome sequencing data. We performed both cohort- and ancestry-specific association analyses, followed by meta-analysis on bothpooled samples and within each ancestry group. Our results suggest that mtDNA-Enco ded genes/regions are likely to exhibit varying rates in somatic aging, with the notably strong associations observed between heteroplasmy in the and genes ( <0.001) and advance aging by the Original Burden test. In contrast, SKAT identified significant associations ( <0.001) between diabetes and the aggregated effects of heteroplasmy in several protein-coding genes. Further research is warranted to validate these findings. In summary, our proposed statistical framework represents a valuable tool for facilitating association testing of heteroplasmy with disease traits in large human populations.

%B medRxiv %8 2024 Jan 13 %G eng %R 10.1101/2024.01.12.24301233 %0 Journal Article %J JAMA Cardiol %D 2024 %T Familial Hypercholesterolemia Variant and Cardiovascular Risk in Individuals With Elevated Cholesterol. %A Zhang, Yiyi %A Dron, Jacqueline S %A Bellows, Brandon K %A Khera, Amit V %A Liu, Junxiu %A Balte, Pallavi P %A Oelsner, Elizabeth C %A Amr, Sami Samir %A Lebo, Matthew S %A Nagy, Anna %A Peloso, Gina M %A Natarajan, Pradeep %A Rotter, Jerome I %A Willer, Cristen %A Boerwinkle, Eric %A Ballantyne, Christie M %A Lutsey, Pamela L %A Fornage, Myriam %A Lloyd-Jones, Donald M %A Hou, Lifang %A Psaty, Bruce M %A Bis, Joshua C %A Floyd, James S %A Vasan, Ramachandran S %A Heard-Costa, Nancy L %A Carson, April P %A Hall, Michael E %A Rich, Stephen S %A Guo, Xiuqing %A Kazi, Dhruv S %A de Ferranti, Sarah D %A Moran, Andrew E %X

IMPORTANCE: Familial hypercholesterolemia (FH) is a genetic disorder that often results in severely high low-density lipoprotein cholesterol (LDL-C) and high risk of premature coronary heart disease (CHD). However, the impact of FH variants on CHD risk among individuals with moderately elevated LDL-C is not well quantified.

OBJECTIVE: To assess CHD risk associated with FH variants among individuals with moderately (130-189 mg/dL) and severely (≥190 mg/dL) elevated LDL-C and to quantify excess CHD deaths attributable to FH variants in US adults.

DESIGN, SETTING, AND PARTICIPANTS: A total of 21 426 individuals without preexisting CHD from 6 US cohort studies (Atherosclerosis Risk in Communities study, Coronary Artery Risk Development in Young Adults study, Cardiovascular Health Study, Framingham Heart Study Offspring cohort, Jackson Heart Study, and Multi-Ethnic Study of Atherosclerosis) were included, 63 of whom had an FH variant. Data were collected from 1971 to 2018, and the median (IQR) follow-up was 18 (13-28) years. Data were analyzed from March to May 2023.

EXPOSURES: LDL-C, cumulative past LDL-C, FH variant status.

MAIN OUTCOMES AND MEASURES: Cox proportional hazards models estimated associations between FH variants and incident CHD. The Cardiovascular Disease Policy Model projected excess CHD deaths associated with FH variants in US adults.

RESULTS: Of the 21 426 individuals without preexisting CHD (mean [SD] age 52.1 [15.5] years; 12 041 [56.2%] female), an FH variant was found in 22 individuals with moderately elevated LDL-C (0.3%) and in 33 individuals with severely elevated LDL-C (2.5%). The adjusted hazard ratios for incident CHD comparing those with and without FH variants were 2.9 (95% CI, 1.4-6.0) and 2.6 (95% CI, 1.4-4.9) among individuals with moderately and severely elevated LDL-C, respectively. The association between FH variants and CHD was slightly attenuated when further adjusting for baseline LDL-C level, whereas the association was no longer statistically significant after adjusting for cumulative past LDL-C exposure. Among US adults 20 years and older with no history of CHD and LDL-C 130 mg/dL or higher, more than 417 000 carry an FH variant and were projected to experience more than 12 000 excess CHD deaths in those with moderately elevated LDL-C and 15 000 in those with severely elevated LDL-C compared with individuals without an FH variant.

CONCLUSIONS AND RELEVANCE: In this pooled cohort study, the presence of FH variants was associated with a 2-fold higher CHD risk, even when LDL-C was only moderately elevated. The increased CHD risk appeared to be largely explained by the higher cumulative LDL-C exposure in individuals with an FH variant compared to those without. Further research is needed to assess the value of adding genetic testing to traditional phenotypic FH screening.

%B JAMA Cardiol %8 2024 Jan 31 %G eng %R 10.1001/jamacardio.2023.5366 %0 Journal Article %J Nature %D 2024 %T Genetic drivers of heterogeneity in type 2 diabetes pathophysiology. %A Suzuki, Ken %A Hatzikotoulas, Konstantinos %A Southam, Lorraine %A Taylor, Henry J %A Yin, Xianyong %A Lorenz, Kim M %A Mandla, Ravi %A Huerta-Chagoya, Alicia %A Melloni, Giorgio E M %A Kanoni, Stavroula %A Rayner, Nigel W %A Bocher, Ozvan %A Arruda, Ana Luiza %A Sonehara, Kyuto %A Namba, Shinichi %A Lee, Simon S K %A Preuss, Michael H %A Petty, Lauren E %A Schroeder, Philip %A Vanderwerff, Brett %A Kals, Mart %A Bragg, Fiona %A Lin, Kuang %A Guo, Xiuqing %A Zhang, Weihua %A Yao, Jie %A Kim, Young Jin %A Graff, Mariaelisa %A Takeuchi, Fumihiko %A Nano, Jana %A Lamri, Amel %A Nakatochi, Masahiro %A Moon, Sanghoon %A Scott, Robert A %A Cook, James P %A Lee, Jung-Jin %A Pan, Ian %A Taliun, Daniel %A Parra, Esteban J %A Chai, Jin-Fang %A Bielak, Lawrence F %A Tabara, Yasuharu %A Hai, Yang %A Thorleifsson, Gudmar %A Grarup, Niels %A Sofer, Tamar %A Wuttke, Matthias %A Sarnowski, Chloe %A Gieger, Christian %A Nousome, Darryl %A Trompet, Stella %A Kwak, Soo-Heon %A Long, Jirong %A Sun, Meng %A Tong, Lin %A Chen, Wei-Min %A Nongmaithem, Suraj S %A Noordam, Raymond %A Lim, Victor J Y %A Tam, Claudia H T %A Joo, Yoonjung Yoonie %A Chen, Chien-Hsiun %A Raffield, Laura M %A Prins, Bram Peter %A Nicolas, Aude %A Yanek, Lisa R %A Chen, Guanjie %A Brody, Jennifer A %A Kabagambe, Edmond %A An, Ping %A Xiang, Anny H %A Choi, Hyeok Sun %A Cade, Brian E %A Tan, Jingyi %A Broadaway, K Alaine %A Williamson, Alice %A Kamali, Zoha %A Cui, Jinrui %A Thangam, Manonanthini %A Adair, Linda S %A Adeyemo, Adebowale %A Aguilar-Salinas, Carlos A %A Ahluwalia, Tarunveer S %A Anand, Sonia S %A Bertoni, Alain %A Bork-Jensen, Jette %A Brandslund, Ivan %A Buchanan, Thomas A %A Burant, Charles F %A Butterworth, Adam S %A Canouil, Mickaël %A Chan, Juliana C N %A Chang, Li-Ching %A Chee, Miao-Li %A Chen, Ji %A Chen, Shyh-Huei %A Chen, Yuan-Tsong %A Chen, Zhengming %A Chuang, Lee-Ming %A Cushman, Mary %A Danesh, John %A Das, Swapan K %A de Silva, H Janaka %A Dedoussis, George %A Dimitrov, Latchezar %A Doumatey, Ayo P %A Du, Shufa %A Duan, Qing %A Eckardt, Kai-Uwe %A Emery, Leslie S %A Evans, Daniel S %A Evans, Michele K %A Fischer, Krista %A Floyd, James S %A Ford, Ian %A Franco, Oscar H %A Frayling, Timothy M %A Freedman, Barry I %A Genter, Pauline %A Gerstein, Hertzel C %A Giedraitis, Vilmantas %A González-Villalpando, Clicerio %A Gonzalez-Villalpando, Maria Elena %A Gordon-Larsen, Penny %A Gross, Myron %A Guare, Lindsay A %A Hackinger, Sophie %A Hakaste, Liisa %A Han, Sohee %A Hattersley, Andrew T %A Herder, Christian %A Horikoshi, Momoko %A Howard, Annie-Green %A Hsueh, Willa %A Huang, Mengna %A Huang, Wei %A Hung, Yi-Jen %A Hwang, Mi Yeong %A Hwu, Chii-Min %A Ichihara, Sahoko %A Ikram, Mohammad Arfan %A Ingelsson, Martin %A Islam, Md Tariqul %A Isono, Masato %A Jang, Hye-Mi %A Jasmine, Farzana %A Jiang, Guozhi %A Jonas, Jost B %A Jørgensen, Torben %A Kamanu, Frederick K %A Kandeel, Fouad R %A Kasturiratne, Anuradhani %A Katsuya, Tomohiro %A Kaur, Varinderpal %A Kawaguchi, Takahisa %A Keaton, Jacob M %A Kho, Abel N %A Khor, Chiea-Chuen %A Kibriya, Muhammad G %A Kim, Duk-Hwan %A Kronenberg, Florian %A Kuusisto, Johanna %A Läll, Kristi %A Lange, Leslie A %A Lee, Kyung Min %A Lee, Myung-Shik %A Lee, Nanette R %A Leong, Aaron %A Li, Liming %A Li, Yun %A Li-Gao, Ruifang %A Ligthart, Symen %A Lindgren, Cecilia M %A Linneberg, Allan %A Liu, Ching-Ti %A Liu, Jianjun %A Locke, Adam E %A Louie, Tin %A Luan, Jian'an %A Luk, Andrea O %A Luo, Xi %A Lv, Jun %A Lynch, Julie A %A Lyssenko, Valeriya %A Maeda, Shiro %A Mamakou, Vasiliki %A Mansuri, Sohail Rafik %A Matsuda, Koichi %A Meitinger, Thomas %A Melander, Olle %A Metspalu, Andres %A Mo, Huan %A Morris, Andrew D %A Moura, Filipe A %A Nadler, Jerry L %A Nalls, Michael A %A Nayak, Uma %A Ntalla, Ioanna %A Okada, Yukinori %A Orozco, Lorena %A Patel, Sanjay R %A Patil, Snehal %A Pei, Pei %A Pereira, Mark A %A Peters, Annette %A Pirie, Fraser J %A Polikowsky, Hannah G %A Porneala, Bianca %A Prasad, Gauri %A Rasmussen-Torvik, Laura J %A Reiner, Alexander P %A Roden, Michael %A Rohde, Rebecca %A Roll, Katheryn %A Sabanayagam, Charumathi %A Sandow, Kevin %A Sankareswaran, Alagu %A Sattar, Naveed %A Schönherr, Sebastian %A Shahriar, Mohammad %A Shen, Botong %A Shi, Jinxiu %A Shin, Dong Mun %A Shojima, Nobuhiro %A Smith, Jennifer A %A So, Wing Yee %A Stančáková, Alena %A Steinthorsdottir, Valgerdur %A Stilp, Adrienne M %A Strauch, Konstantin %A Taylor, Kent D %A Thorand, Barbara %A Thorsteinsdottir, Unnur %A Tomlinson, Brian %A Tran, Tam C %A Tsai, Fuu-Jen %A Tuomilehto, Jaakko %A Tusié-Luna, Teresa %A Udler, Miriam S %A Valladares-Salgado, Adan %A van Dam, Rob M %A van Klinken, Jan B %A Varma, Rohit %A Wacher-Rodarte, Niels %A Wheeler, Eleanor %A Wickremasinghe, Ananda R %A van Dijk, Ko Willems %A Witte, Daniel R %A Yajnik, Chittaranjan S %A Yamamoto, Ken %A Yamamoto, Kenichi %A Yoon, Kyungheon %A Yu, Canqing %A Yuan, Jian-Min %A Yusuf, Salim %A Zawistowski, Matthew %A Zhang, Liang %A Zheng, Wei %A Raffel, Leslie J %A Igase, Michiya %A Ipp, Eli %A Redline, Susan %A Cho, Yoon Shin %A Lind, Lars %A Province, Michael A %A Fornage, Myriam %A Hanis, Craig L %A Ingelsson, Erik %A Zonderman, Alan B %A Psaty, Bruce M %A Wang, Ya-Xing %A Rotimi, Charles N %A Becker, Diane M %A Matsuda, Fumihiko %A Liu, Yongmei %A Yokota, Mitsuhiro %A Kardia, Sharon L R %A Peyser, Patricia A %A Pankow, James S %A Engert, James C %A Bonnefond, Amélie %A Froguel, Philippe %A Wilson, James G %A Sheu, Wayne H H %A Wu, Jer-Yuarn %A Hayes, M Geoffrey %A Ma, Ronald C W %A Wong, Tien-Yin %A Mook-Kanamori, Dennis O %A Tuomi, Tiinamaija %A Chandak, Giriraj R %A Collins, Francis S %A Bharadwaj, Dwaipayan %A Paré, Guillaume %A Sale, Michèle M %A Ahsan, Habibul %A Motala, Ayesha A %A Shu, Xiao-Ou %A Park, Kyong-Soo %A Jukema, J Wouter %A Cruz, Miguel %A Chen, Yii-Der Ida %A Rich, Stephen S %A McKean-Cowdin, Roberta %A Grallert, Harald %A Cheng, Ching-Yu %A Ghanbari, Mohsen %A Tai, E-Shyong %A Dupuis, Josée %A Kato, Norihiro %A Laakso, Markku %A Köttgen, Anna %A Koh, Woon-Puay %A Bowden, Donald W %A Palmer, Colin N A %A Kooner, Jaspal S %A Kooperberg, Charles %A Liu, Simin %A North, Kari E %A Saleheen, Danish %A Hansen, Torben %A Pedersen, Oluf %A Wareham, Nicholas J %A Lee, Juyoung %A Kim, Bong-Jo %A Millwood, Iona Y %A Walters, Robin G %A Stefansson, Kari %A Ahlqvist, Emma %A Goodarzi, Mark O %A Mohlke, Karen L %A Langenberg, Claudia %A Haiman, Christopher A %A Loos, Ruth J F %A Florez, Jose C %A Rader, Daniel J %A Ritchie, Marylyn D %A Zöllner, Sebastian %A Mägi, Reedik %A Marston, Nicholas A %A Ruff, Christian T %A van Heel, David A %A Finer, Sarah %A Denny, Joshua C %A Yamauchi, Toshimasa %A Kadowaki, Takashi %A Chambers, John C %A Ng, Maggie C Y %A Sim, Xueling %A Below, Jennifer E %A Tsao, Philip S %A Chang, Kyong-Mi %A McCarthy, Mark I %A Meigs, James B %A Mahajan, Anubha %A Spracklen, Cassandra N %A Mercader, Josep M %A Boehnke, Michael %A Rotter, Jerome I %A Vujkovic, Marijana %A Voight, Benjamin F %A Morris, Andrew P %A Zeggini, Eleftheria %X

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes and molecular mechanisms that are often specific to cell type. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P < 5 × 10) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.

%B Nature %8 2024 Feb 19 %G eng %R 10.1038/s41586-024-07019-6 %0 Journal Article %J Eur Respir J %D 2024 %T {Genome-wide association study of preserved ratio impaired spirometry (PRISm) %A Higbee, D. H. %A Lirio, A. %A Hamilton, F. %A Granell, R. %A Wyss, A. B. %A London, S. J. %A Bartz, T. M. %A Gharib, S. A. %A Cho, M. H. %A Wan, E. %A Silverman, E. %A Crapo, J. D. %A Lominchar, J. V. T. %A Hansen, T. %A Grarup, N. %A Dantoft, T. %A rhus, L. %A Linneberg, A. %A O'Connor, G. T. %A Dupuis, J. %A Xu, H. %A De Vries, M. M. %A Hu, X. %A Rich, S. S. %A Barr, R. G. %A Manichaikul, A. %A Wijnant, S. R. A. %A Brusselle, G. G. %A Lahousse, L. %A Li, X. %A ndez Cordero, A. I. %A Obeidat, M. %A Sin, D. D. %A Harris, S. E. %A Redmond, P. %A Taylor, A. M. %A Cox, S. R. %A Williams, A. T. %A Shrine, N. %A John, C. %A Guyatt, A. L. %A Hall, I. P. %A Davey Smith, G. %A Tobin, M. D. %A Dodd, J. W. %X {0.70. PRISm is associated with respiratory symptoms and comorbidities. Our objective was to discover novel genetic signals for PRISm and see if they provide insight into the pathogenesis of PRISm and associated comorbidities.\ We undertook a genome-wide association study (GWAS) of PRISm in UK Biobank participants (Stage 1), and selected single nucleotide polymorphisms (SNPs) reaching genome-wide significance for replication in 13 cohorts (Stage 2). A combined meta-analysis of Stage 1 and Stage 2 was done to determine top SNPs. We used cross-trait linkage disequilibrium score regression to estimate genome-wide genetic correlation between PRISm and pulmonary and extrapulmonary traits. Phenome-wide association studies of top SNPs were performed.\ =0.12 %B Eur Respir J %V 63 %8 Jan %G eng %0 Journal Article %J Nat Commun %D 2024 %T Human whole-exome genotype data for Alzheimer's disease. %A Leung, Yuk Yee %A Naj, Adam C %A Chou, Yi-Fan %A Valladares, Otto %A Schmidt, Michael %A Hamilton-Nelson, Kara %A Wheeler, Nicholas %A Lin, Honghuang %A Gangadharan, Prabhakaran %A Qu, Liming %A Clark, Kaylyn %A Kuzma, Amanda B %A Lee, Wan-Ping %A Cantwell, Laura %A Nicaretta, Heather %A Haines, Jonathan %A Farrer, Lindsay %A Seshadri, Sudha %A Brkanac, Zoran %A Cruchaga, Carlos %A Pericak-Vance, Margaret %A Mayeux, Richard P %A Bush, William S %A DeStefano, Anita %A Martin, Eden %A Schellenberg, Gerard D %A Wang, Li-San %K Alzheimer Disease %K Computational Biology %K Data Accuracy %K Exome %K Genotype %K Humans %X

The heterogeneity of the whole-exome sequencing (WES) data generation methods present a challenge to a joint analysis. Here we present a bioinformatics strategy for joint-calling 20,504 WES samples collected across nine studies and sequenced using ten capture kits in fourteen sequencing centers in the Alzheimer's Disease Sequencing Project. The joint-genotype called variant-called format (VCF) file contains only positions within the union of capture kits. The VCF was then processed specifically to account for the batch effects arising from the use of different capture kits from different studies. We identified 8.2 million autosomal variants. 96.82% of the variants are high-quality, and are located in 28,579 Ensembl transcripts. 41% of the variants are intronic and 1.8% of the variants are with CADD > 30, indicating they are of high predicted pathogenicity. Here we show our new strategy can generate high-quality data from processing these diversely generated WES samples. The improved ability to combine data sequenced in different batches benefits the whole genomics research community.

%B Nat Commun %V 15 %P 684 %8 2024 Jan 23 %G eng %N 1 %R 10.1038/s41467-024-44781-7 %0 Journal Article %J Thromb Res %D 2024 %T Levels of procoagulant factors and peak thrombin generation in relation to dementia risk in older adults: The Cardiovascular Health Study. %A Harrington, Laura B %A Ehlert, Alexa N %A Thacker, Evan L %A Jenny, Nancy S %A Lopez, Oscar %A Cushman, Mary %A Olson, Nels C %A Fitzpatrick, Annette %A Mukamal, Kenneth J %A Jensen, Majken K %K Aged %K Anticoagulants %K Antithrombin III %K Antithrombins %K Dementia %K Factor VIIa %K Fibrinogen %K Hemostatics %K Humans %K Prospective Studies %K Thrombin %X

INTRODUCTION: Markers of hemostasis such as procoagulant factors and peak thrombin generation are associated with cardiovascular outcomes, but their associations with dementia risk are unclear. We aimed to evaluate prospective associations of selected procoagulant factors and peak thrombin generation with dementia risk.

METHODS: We measured levels of 7 hemostatic factors (fibrinogen, factor VII coagulant activity [FVIIc], activated factor VII [FVIIa], factor VIIa-antithrombin [FVIIa-AT], factor XI antigen [FXI], peak thrombin generation, and platelet count) among participants in the Cardiovascular Health Study, a cohort of older adults free of dementia in 1992/1993 (n = 3185). Dementia was adjudicated and classified by DSM-IV criteria through 1998/1999. Cox proportional hazards models estimated hazard ratios (HRs) for any dementia associated with 1-standard deviation (SD) differences, adjusting for sociodemographic and clinical factors and APOE genotype. Secondary analyses separately evaluated the risk of vascular dementia, Alzheimer's disease, and mixed dementia.

RESULTS: At baseline, participants had a median age of 73 years. Over 5.4 years of follow-up, we identified 448 dementia cases. There was no evidence of linear associations between levels of these hemostatic factors with any dementia risk (HRs per 1-SD difference ranged from 1.0 to 1.1; 95 % confidence intervals included 1.0). Results of secondary analyses by dementia subtype were similar.

CONCLUSIONS: In this prospective study, there was no strong evidence of linear associations between levels of fibrinogen, FVIIc, FVIIa, FVIIa-AT, FXI, peak thrombin generation, or platelet count with dementia risk. Despite their associations with cardiovascular disease, higher levels of these biomarkers measured among older adults may not reflect dementia risk.

%B Thromb Res %V 235 %P 148-154 %8 2024 Mar %G eng %R 10.1016/j.thromres.2024.01.024 %0 Journal Article %J Alzheimers Res Ther %D 2024 %T Multi-omics and pathway analyses of genome-wide associations implicate regulation and immunity in verbal declarative memory performance. %A Mei, Hao %A Simino, Jeannette %A Li, Lianna %A Jiang, Fan %A Bis, Joshua C %A Davies, Gail %A Hill, W David %A Xia, Charley %A Gudnason, Vilmundur %A Yang, Qiong %A Lahti, Jari %A Smith, Jennifer A %A Kirin, Mirna %A De Jager, Philip %A Armstrong, Nicola J %A Ghanbari, Mohsen %A Kolcic, Ivana %A Moran, Christopher %A Teumer, Alexander %A Sargurupremraj, Murali %A Mahmud, Shamsed %A Fornage, Myriam %A Zhao, Wei %A Satizabal, Claudia L %A Polasek, Ozren %A Räikkönen, Katri %A Liewald, David C %A Homuth, Georg %A Callisaya, Michele %A Mather, Karen A %A Windham, B Gwen %A Zemunik, Tatijana %A Palotie, Aarno %A Pattie, Alison %A van der Auwera, Sandra %A Thalamuthu, Anbupalam %A Knopman, David S %A Rudan, Igor %A Starr, John M %A Wittfeld, Katharina %A Kochan, Nicole A %A Griswold, Michael E %A Vitart, Veronique %A Brodaty, Henry %A Gottesman, Rebecca %A Cox, Simon R %A Psaty, Bruce M %A Boerwinkle, Eric %A Chasman, Daniel I %A Grodstein, Francine %A Sachdev, Perminder S %A Srikanth, Velandai %A Hayward, Caroline %A Wilson, James F %A Eriksson, Johan G %A Kardia, Sharon L R %A Grabe, Hans J %A Bennett, David A %A Ikram, M Arfan %A Deary, Ian J %A van Duijn, Cornelia M %A Launer, Lenore %A Fitzpatrick, Annette L %A Seshadri, Sudha %A Bressler, Jan %A Debette, Stephanie %A Mosley, Thomas H %K Aged %K Cognition %K Genome-Wide Association Study %K Humans %K Memory %K MicroRNAs %K Multiomics %K Polymorphism, Single Nucleotide %X

BACKGROUND: Uncovering the functional relevance underlying verbal declarative memory (VDM) genome-wide association study (GWAS) results may facilitate the development of interventions to reduce age-related memory decline and dementia.

METHODS: We performed multi-omics and pathway enrichment analyses of paragraph (PAR-dr) and word list (WL-dr) delayed recall GWAS from 29,076 older non-demented individuals of European descent. We assessed the relationship between single-variant associations and expression quantitative trait loci (eQTLs) in 44 tissues and methylation quantitative trait loci (meQTLs) in the hippocampus. We determined the relationship between gene associations and transcript levels in 53 tissues, annotation as immune genes, and regulation by transcription factors (TFs) and microRNAs. To identify significant pathways, gene set enrichment was tested in each cohort and meta-analyzed across cohorts. Analyses of differential expression in brain tissues were conducted for pathway component genes.

RESULTS: The single-variant associations of VDM showed significant linkage disequilibrium (LD) with eQTLs across all tissues and meQTLs within the hippocampus. Stronger WL-dr gene associations correlated with reduced expression in four brain tissues, including the hippocampus. More robust PAR-dr and/or WL-dr gene associations were intricately linked with immunity and were influenced by 31 TFs and 2 microRNAs. Six pathways, including type I diabetes, exhibited significant associations with both PAR-dr and WL-dr. These pathways included fifteen MHC genes intricately linked to VDM performance, showing diverse expression patterns based on cognitive status in brain tissues.

CONCLUSIONS: VDM genetic associations influence expression regulation via eQTLs and meQTLs. The involvement of TFs, microRNAs, MHC genes, and immune-related pathways contributes to VDM performance in older individuals.

%B Alzheimers Res Ther %V 16 %P 14 %8 2024 Jan 20 %G eng %N 1 %R 10.1186/s13195-023-01376-6 %0 Journal Article %J Nat Commun %D 2024 %T {Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications %A Sterenborg, R. B. T. M. %A Steinbrenner, I. %A Li, Y. %A Bujnis, M. N. %A Naito, T. %A Marouli, E. %A Galesloot, T. E. %A Babajide, O. %A Andreasen, L. %A Astrup, A. %A svold, B. O. %A Bandinelli, S. %A Beekman, M. %A Beilby, J. P. %A Bork-Jensen, J. %A Boutin, T. %A Brody, J. A. %A Brown, S. J. %A Brumpton, B. %A Campbell, P. J. %A Cappola, A. R. %A Ceresini, G. %A Chaker, L. %A Chasman, D. I. %A Concas, M. P. %A Coutinho de Almeida, R. %A Cross, S. M. %A Cucca, F. %A Deary, I. J. %A Kjaergaard, A. D. %A Echouffo Tcheugui, J. B. %A Ellervik, C. %A Eriksson, J. G. %A Ferrucci, L. %A Freudenberg, J. %A Fuchsberger, C. %A Gieger, C. %A Giulianini, F. %A gele, M. %A Graham, S. E. %A Grarup, N. %A ä, I. %A Hansen, T. %A Harding, B. N. %A Harris, S. E. %A ø, S. %A Hayward, C. %A Hui, J. %A Ittermann, T. %A Jukema, J. W. %A Kajantie, E. %A Kanters, J. K. %A rhus, L. L. %A Kiemeney, L. A. L. M. %A Kloppenburg, M. %A hnel, B. %A Lahti, J. %A Langenberg, C. %A Lapauw, B. %A Leese, G. %A Li, S. %A Liewald, D. C. M. %A Linneberg, A. %A Lominchar, J. V. T. %A Luan, J. %A Martin, N. G. %A Matana, A. %A Meima, M. E. %A Meitinger, T. %A Meulenbelt, I. %A Mitchell, B. D. %A llehave, L. T. %A Mora, S. %A Naitza, S. %A Nauck, M. %A Netea-Maier, R. T. %A Noordam, R. %A Nursyifa, C. %A Okada, Y. %A Onano, S. %A Papadopoulou, A. %A Palmer, C. N. A. %A Pattaro, C. %A Pedersen, O. %A Peters, A. %A Pietzner, M. %A ek, O. %A Pramstaller, P. P. %A Psaty, B. M. %A Punda, A. %A Ray, D. %A Redmond, P. %A Richards, J. B. %A Ridker, P. M. %A Russ, T. C. %A Ryan, K. A. %A Olesen, M. S. %A Schultheiss, U. T. %A Selvin, E. %A Siddiqui, M. K. %A Sidore, C. %A Slagboom, P. E. %A rensen, T. I. A. %A Soto-Pedre, E. %A Spector, T. D. %A Spedicati, B. %A Srinivasan, S. %A Starr, J. M. %A Stott, D. J. %A Tanaka, T. %A Torlak, V. %A Trompet, S. %A Tuhkanen, J. %A Uitterlinden, A. G. %A van den Akker, E. B. %A van den Eynde, T. %A van der Klauw, M. M. %A van Heemst, D. %A Verroken, C. %A Visser, W. E. %A Vojinovic, D. %A lzke, H. %A Waldenberger, M. %A Walsh, J. P. %A Wareham, N. J. %A Weiss, S. %A Willer, C. J. %A Wilson, S. G. %A Wolffenbuttel, B. H. R. %A Wouters, H. J. C. M. %A Wright, M. J. %A Yang, Q. %A Zemunik, T. %A Zhou, W. %A Zhu, G. %A llner, S. %A Smit, J. W. A. %A Peeters, R. P. %A ttgen, A. %A Teumer, A. %A Medici, M. %X T3, whereas the FT4 associations represent the thyroid hormone metabolism. Polygenic risk score and Mendelian randomization analyses showed the effects of genetically determined variation in thyroid function on various clinical outcomes, including cardiovascular risk factors and diseases, autoimmune diseases, and cancer. In conclusion, our results improve the understanding of thyroid hormone physiology and highlight the pleiotropic effects of thyroid function on various diseases. %B Nat Commun %V 15 %P 888 %8 Jan %G eng %0 Journal Article %J ESC Heart Fail %D 2024 %T A polygenic risk score of atrial fibrillation improves prediction of lifetime risk for heart failure. %A Alkis, Taryn %A Luo, Xi %A Wall, Katherine %A Brody, Jennifer %A Bartz, Traci %A Chang, Patricia P %A Norby, Faye L %A Hoogeveen, Ron C %A Morrison, Alanna C %A Ballantyne, Christie M %A Coresh, Josef %A Boerwinkle, Eric %A Psaty, Bruce M %A Shah, Amil M %A Yu, Bing %X

AIMS: Heart failure (HF) has shared genetic architecture with its risk factors: atrial fibrillation (AF), body mass index (BMI), coronary heart disease (CHD), systolic blood pressure (SBP), and type 2 diabetes (T2D). We aim to assess the association and risk prediction performance of risk-factor polygenic risk scores (PRSs) for incident HF and its subtypes in bi-racial populations.

METHODS AND RESULTS: Five PRSs were constructed for AF, BMI, CHD, SBP, and T2D in White participants of the Atherosclerosis Risk in Communities (ARIC) study. The associations between PRSs and incident HF and its subtypes were assessed using Cox models, and the risk prediction performance of PRSs was assessed using C statistics. Replication was performed in the ARIC study Black and Cardiovascular Health Study (CHS) White participants. In 8624 ARIC study Whites, 1922 (31% cumulative incidence) HF cases developed over 30 years of follow-up. PRSs of AF, BMI, and CHD were associated with incident HF (P < 0.001), where PRS showed the strongest association [hazard ratio (HR): 1.47, 95% confidence interval (CI): 1.41-1.53]. Only the addition of PRS to the ARIC study HF risk equation improved C statistics for 10 year risk prediction from 0.812 to 0.829 (∆C: 0.017, 95% CI: 0.009-0.026). The PRS was associated with both incident HF with reduced ejection fraction (HR: 1.43, 95% CI: 1.27-1.60) and incident HF with preserved ejection fraction (HR: 1.46, 95% CI: 1.33-1.62). The associations between PRS and incident HF and its subtypes, as well as the improved risk prediction, were replicated in the ARIC study Blacks and the CHS Whites (P < 0.050). Protein analyses revealed that N-terminal pro-brain natriuretic peptide and other 98 proteins were associated with PRS .

CONCLUSIONS: The PRS was associated with incident HF and its subtypes and had significant incremental value over an established HF risk prediction equation.

%B ESC Heart Fail %8 2024 Jan 22 %G eng %R 10.1002/ehf2.14665 %0 Journal Article %J Circulation %D 2024 %T Role of Polyunsaturated Fat in Modifying Cardiovascular Risk Associated With Family History of Cardiovascular Disease: Pooled De Novo Results From 15 Observational Studies. %A Laguzzi, Federica %A Åkesson, Agneta %A Marklund, Matti %A Qian, Frank %A Gigante, Bruna %A Bartz, Traci M %A Bassett, Julie K %A Birukov, Anna %A Campos, Hannia %A Hirakawa, Yoichiro %A Imamura, Fumiaki %A Jäger, Susanne %A Lankinen, Maria %A Murphy, Rachel A %A Senn, Mackenzie %A Tanaka, Toshiko %A Tintle, Nathan %A Virtanen, Jyrki K %A Yamagishi, Kazumasa %A Allison, Matthew %A Brouwer, Ingeborg A %A de Faire, Ulf %A Eiriksdottir, Gudny %A Ferrucci, Luigi %A Forouhi, Nita G %A Geleijnse, Johanna M %A Hodge, Allison M %A Kimura, Hitomi %A Laakso, Markku %A Riserus, Ulf %A van Westing, Anniek C %A Bandinelli, Stefania %A Baylin, Ana %A Giles, Graham G %A Gudnason, Vilmundur %A Iso, Hiroyasu %A Lemaitre, Rozenn N %A Ninomiya, Toshiharu %A Post, Wendy S %A Psaty, Bruce M %A Salonen, Jukka T %A Schulze, Matthias B %A Tsai, Michael Y %A Uusitupa, Matti %A Wareham, Nicholas J %A Oh, Seung-Won %A Wood, Alexis C %A Harris, William S %A Siscovick, David %A Mozaffarian, Dariush %A Leander, Karin %K Animals %K Biomarkers %K Cardiovascular Diseases %K Docosahexaenoic Acids %K Fatty Acids, Omega-3 %K Risk Factors %X

BACKGROUND: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium.

METHODS: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels ≤25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having ≥1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction.

RESULTS: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02-1.16]; =0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30-1.54), whereas it was 1.25 (95% CI, 1.16-1.33) for family history alone and 1.06 (95% CI, 0.98-1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions.

CONCLUSIONS: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD.

%B Circulation %V 149 %P 305-316 %8 2024 Jan 23 %G eng %N 4 %R 10.1161/CIRCULATIONAHA.123.065530 %0 Journal Article %J medRxiv %D 2024 %T Trajectory of Cognitive Function After Incident Heart Failure. %A Shore, Supriya %A Li, Hanyu %A Zhang, Min %A Whitney, Rachael %A Gross, Alden L %A Bhatt, Ankeet S %A Nallamothu, Brahmajee K %A Giordani, Bruno %A Briceño, Emily M %A Sussman, Jeremy B %A Gutierrez, Jose %A Yaffe, Kristine %A Griswold, Michael %A Johansen, Michelle C %A Lopez, Oscar L %A Gottesman, Rebecca F %A Sidney, Stephen %A Heckbert, Susan R %A Rundek, Tatjana %A Hughes, Timothy M %A Longstreth, William T %A Levine, Deborah A %X

BACKGROUND: The size/magnitude of cognitive changes after incident heart failure (HF) are unclear. We assessed whether incident HF is associated with changes in cognitive function after accounting for pre-HF cognitive trajectories and known determinants of cognition.

METHODS: This pooled cohort study included adults without HF, stroke, or dementia from six US population-based cohort studies from 1971-2019: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study. Linear mixed-effects models estimated changes in cognition at the time of HF (change in the intercept) and the rate of cognitive change over the years after HF (change in the slope), controlling for pre-HF cognitive trajectories and participant factors. Change in global cognition was the primary outcome. Change in executive function and memory were secondary outcomes. Cognitive outcomes were standardized to a -score metric (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition.

RESULTS: The study included 29,614 adults (mean [SD] age was 61.1 [10.5] years, 55% female, 70.3% White, 22.2% Black 7.5% Hispanic). During a median follow-up of 6.6 (Q1-Q3: 5-19.8) years, 1,407 (4.7%) adults developed incident HF. Incident HF was associated with an acute decrease in global cognition (-1.08 points; 95% CI -1.36, -0.80) and executive function (-0.65 points; 95% CI -0.96, -0.34) but not memory (-0.51 points; 95% CI -1.37, 0.35) at the time of the event. Greater acute decreases in global cognition after HF were seen in those with older age, female sex and White race. Individuals with incident HF, compared to HF-free individuals, demonstrated faster declines in global cognition (-0.15 points per year; 95% CI, -0.21, -0.09) and executive function (-0.16 points per year; 95% CI -0.23, -0.09) but not memory ( -0.11 points per year; 95% CI -0.26, 0.04) compared with pre-HF slopes.

CONCLUSIONS: In this pooled cohort study, incident HF was associated with an acute decrease in global cognition and executive function at the time of the event and faster declines in global cognition and executive function over the following years.

%B medRxiv %8 2024 Feb 11 %G eng %R 10.1101/2024.02.09.24302608 %0 Journal Article %J Nat Commun %D 2024 %T X-chromosome and kidney function: evidence from a multi-trait genetic analysis of 908,697 individuals reveals sex-specific and sex-differential findings in genes regulated by androgen response elements. %A Scholz, Markus %A Horn, Katrin %A Pott, Janne %A Wuttke, Matthias %A Kühnapfel, Andreas %A Nasr, M Kamal %A Kirsten, Holger %A Li, Yong %A Hoppmann, Anselm %A Gorski, Mathias %A Ghasemi, Sahar %A Li, Man %A Tin, Adrienne %A Chai, Jin-Fang %A Cocca, Massimiliano %A Wang, Judy %A Nutile, Teresa %A Akiyama, Masato %A Åsvold, Bjørn Olav %A Bansal, Nisha %A Biggs, Mary L %A Boutin, Thibaud %A Brenner, Hermann %A Brumpton, Ben %A Burkhardt, Ralph %A Cai, Jianwen %A Campbell, Archie %A Campbell, Harry %A Chalmers, John %A Chasman, Daniel I %A Chee, Miao Ling %A Chee, Miao Li %A Chen, Xu %A Cheng, Ching-Yu %A Cifkova, Renata %A Daviglus, Martha %A Delgado, Graciela %A Dittrich, Katalin %A Edwards, Todd L %A Endlich, Karlhans %A Michael Gaziano, J %A Giri, Ayush %A Giulianini, Franco %A Gordon, Scott D %A Gudbjartsson, Daniel F %A Hallan, Stein %A Hamet, Pavel %A Hartman, Catharina A %A Hayward, Caroline %A Heid, Iris M %A Hellwege, Jacklyn N %A Holleczek, Bernd %A Holm, Hilma %A Hutri-Kähönen, Nina %A Hveem, Kristian %A Isermann, Berend %A Jonas, Jost B %A Joshi, Peter K %A Kamatani, Yoichiro %A Kanai, Masahiro %A Kastarinen, Mika %A Khor, Chiea Chuen %A Kiess, Wieland %A Kleber, Marcus E %A Körner, Antje %A Kovacs, Peter %A Krajcoviechova, Alena %A Kramer, Holly %A Krämer, Bernhard K %A Kuokkanen, Mikko %A Kähönen, Mika %A Lange, Leslie A %A Lash, James P %A Lehtimäki, Terho %A Li, Hengtong %A Lin, Bridget M %A Liu, Jianjun %A Loeffler, Markus %A Lyytikäinen, Leo-Pekka %A Magnusson, Patrik K E %A Martin, Nicholas G %A Matsuda, Koichi %A Milaneschi, Yuri %A Mishra, Pashupati P %A Mononen, Nina %A Montgomery, Grant W %A Mook-Kanamori, Dennis O %A Mychaleckyj, Josyf C %A März, Winfried %A Nauck, Matthias %A Nikus, Kjell %A Nolte, Ilja M %A Noordam, Raymond %A Okada, Yukinori %A Olafsson, Isleifur %A Oldehinkel, Albertine J %A Penninx, Brenda W J H %A Perola, Markus %A Pirastu, Nicola %A Polasek, Ozren %A Porteous, David J %A Poulain, Tanja %A Psaty, Bruce M %A Rabelink, Ton J %A Raffield, Laura M %A Raitakari, Olli T %A Rasheed, Humaira %A Reilly, Dermot F %A Rice, Kenneth M %A Richmond, Anne %A Ridker, Paul M %A Rotter, Jerome I %A Rudan, Igor %A Sabanayagam, Charumathi %A Salomaa, Veikko %A Schneiderman, Neil %A Schöttker, Ben %A Sims, Mario %A Snieder, Harold %A Stark, Klaus J %A Stefansson, Kari %A Stocker, Hannah %A Stumvoll, Michael %A Sulem, Patrick %A Sveinbjornsson, Gardar %A Svensson, Per O %A Tai, E-Shyong %A Taylor, Kent D %A Tayo, Bamidele O %A Teren, Andrej %A Tham, Yih-Chung %A Thiery, Joachim %A Thio, Chris H L %A Thomas, Laurent F %A Tremblay, Johanne %A Tönjes, Anke %A van der Most, Peter J %A Vitart, Veronique %A Völker, Uwe %A Wang, Ya Xing %A Wang, Chaolong %A Wei, Wen Bin %A Whitfield, John B %A Wild, Sarah H %A Wilson, James F %A Winkler, Thomas W %A Wong, Tien-Yin %A Woodward, Mark %A Sim, Xueling %A Chu, Audrey Y %A Feitosa, Mary F %A Thorsteinsdottir, Unnur %A Hung, Adriana M %A Teumer, Alexander %A Franceschini, Nora %A Parsa, Afshin %A Köttgen, Anna %A Schlosser, Pascal %A Pattaro, Cristian %K Androgens %K Chromosomes, Human, X %K Female %K Genetic Predisposition to Disease %K Genome-Wide Association Study %K Humans %K Kidney %K Male %K Polymorphism, Single Nucleotide %K Response Elements %K Tetraspanins %X

X-chromosomal genetic variants are understudied but can yield valuable insights into sexually dimorphic human traits and diseases. We performed a sex-stratified cross-ancestry X-chromosome-wide association meta-analysis of seven kidney-related traits (n = 908,697), identifying 23 loci genome-wide significantly associated with two of the traits: 7 for uric acid and 16 for estimated glomerular filtration rate (eGFR), including four novel eGFR loci containing the functionally plausible prioritized genes ACSL4, CLDN2, TSPAN6 and the female-specific DRP2. Further, we identified five novel sex-interactions, comprising male-specific effects at FAM9B and AR/EDA2R, and three sex-differential findings with larger genetic effect sizes in males at DCAF12L1 and MST4 and larger effect sizes in females at HPRT1. All prioritized genes in loci showing significant sex-interactions were located next to androgen response elements (ARE). Five ARE genes showed sex-differential expressions. This study contributes new insights into sex-dimorphisms of kidney traits along with new prioritized gene targets for further molecular research.

%B Nat Commun %V 15 %P 586 %8 2024 Jan 18 %G eng %N 1 %R 10.1038/s41467-024-44709-1