Associations of combined polygenic risk score and glycemic status with atrial fibrillation, coronary artery disease and ischemic stroke

被引:2
|
作者
Kim, Juntae [1 ]
Kim, Dongmin [1 ]
Bae, Han-Joon [2 ]
Park, Byoung-Eun [1 ]
Kang, Tae Soo [1 ]
Lim, Seong-Hoon [1 ]
Lee, Su Yeon [1 ]
Chung, Young Hak [1 ]
Ryu, Ji Wung [1 ]
Lee, Myung-Yong [1 ]
Yang, Pil-Sung [3 ]
Joung, Boyoung [4 ]
机构
[1] Dankook Univ, Coll Med, Dept Internal Med, Div Cardiol, 119 Dandae Ro, Cheonan Si 31116, Chungnam, South Korea
[2] Daegu Catholic Univ, Med Ctr, Dept Cardiol, 33 Duryugongwonro 17 Gil, Daegu 42472, South Korea
[3] CHA Univ, CHA Bundang Med Ctr, Dept Cardiol, 59 Yatap Ro, Seongnam 13496, Gyeonggi Do, South Korea
[4] Yonsei Univ, Coll Med, Dept Internal Med, Div Cardiol, 50 Yonseiro, Seoul 03722, South Korea
关键词
Polygenic risk score; Diabetes Mellitus; Hemoglobin A1c; Cardiovascular Disease; Atrial fibrillation; Coronary artery Disease; Ischemic Stroke; DIABETES-MELLITUS; HEMOGLOBIN A(1C); MORTALITY; INSULIN; GLUCOSE; ADULTS; PREVALENCE; OUTCOMES; A1C;
D O I
10.1186/s12933-023-02021-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background It is unknown whether high hemoglobin A1c (HbA1c) is associated with increases in the risk of cardiovascular disease among individuals with elevated genetic susceptibility. We aimed to investigate the association between HbA1c and atrial fibrillation (AF), coronary artery disease (CAD), and ischemic stroke according to the polygenic risk score (PRS).Methods The UK Biobank cohort included 502,442 participants aged 40-70 years who were recruited from 22 assessment centers across the United Kingdom from 2006 to 2010. This study included 305,605 unrelated individuals with available PRS and assessed new-onset AF, CAD, and ischemic stroke. The participants were divided into tertiles based on the validated PRS for each outcome. Within each PRS tertiles, the risks of incident events associated with HbA1c levels were investigated and compared with HbA1c < 5.7% and low PRS. Data were analyzed from November 2022 to May 2023.Results Of 305,605 individuals, 161,605 (52.9%) were female, and the mean (SD) age was 56.6 (8.1) years. During a median follow-up of 11.9 (interquartile range 11.1-12.6) years, the incidences of AF, CAD, and ischemic stroke were 4.6, 2.9 and 1.1 per 100 person-years, respectively. Compared to individuals with HbA1c < 5.7% and low PRS, individuals with HbA1c >= 6.5% and high PRS had a 2.67-times higher risk for AF (hazard ratio [HR], 2.67; 95% confidence interval (CI), 2.43-2.94), 5.71-times higher risk for CAD (HR, 5.71; 95% CI, 5.14-6.33) and 2.94-times higher risk for ischemic stroke (HR, 2.94; 95% CI, 2.47-3.50). In the restricted cubic spline models, while a U-shaped trend was observed between HbA1c and the risk of AF, dose-dependent increases were observed between HbA1c and the risk of CAD and ischemic stroke regardless PRS tertile.Conclusions Our results suggest that the nature of the dose-dependent relationship between HbA1c levels and cardiovascular disease in individuals with different PRS is outcome-specific. This adds to the evidence that PRS may play a role together with glycemic status in the development of cardiovascular disease.
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页数:10
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