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Lifelong reduction of LDL-cholesterol related to a common variant in the LDL-receptor gene decreases the risk of coronary artery disease--a Mendelian Randomisation study
Authors:Linsel-Nitschke Patrick  Götz Anika  Erdmann Jeanette  Braenne Ingrid  Braund Peter  Hengstenberg Christian  Stark Klaus  Fischer Marcus  Schreiber Stefan  El Mokhtari Nour Eddine  Schaefer Arne  Schrezenmeir Jürgen  Schrezenmeier Jürgen  Rubin Diana  Hinney Anke  Reinehr Thomas  Roth Christian  Ortlepp Jan  Hanrath Peter  Hall Alistair S  Mangino Massimo  Lieb Wolfgang  Lamina Claudia  Heid Iris M  Doering Angela  Gieger Christian  Peters Annette  Meitinger Thomas  Wichmann H-Erich  König Inke R  Ziegler Andreas  Kronenberg Florian  Samani Nilesh J
Institution:Medizinische Klinik II, Universit?t zu Lübeck, Lübeck, Germany.
Abstract:

Background

Rare mutations of the low-density lipoprotein receptor gene (LDLR) cause familial hypercholesterolemia, which increases the risk for coronary artery disease (CAD). Less is known about the implications of common genetic variation in the LDLR gene regarding the variability of cholesterol levels and risk of CAD.

Methods

Imputed genotype data at the LDLR locus on 1 644 individuals of a population-based sample were explored for association with LDL-C level. Replication of association with LDL-C level was sought for the most significant single nucleotide polymorphism (SNP) within the LDLR gene in three European samples comprising 6 642 adults and 533 children. Association of this SNP with CAD was examined in six case-control studies involving more than 15 000 individuals.

Findings

Each copy of the minor T allele of SNP rs2228671 within LDLR (frequency 11%) was related to a decrease of LDL-C levels by 0.19 mmol/L (95% confidence interval (CI) 0.13–0.24] mmol/L, p?=?1.5×10?10). This association with LDL-C was uniformly found in children, men, and women of all samples studied. In parallel, the T allele of rs2228671 was associated with a significantly lower risk of CAD (Odds Ratio per copy of the T allele: 0.82, 95% CI 0.76–0.89], p?=?2.1×10?7). Adjustment for LDL-C levels by logistic regression or Mendelian Randomisation models abolished the significant association between rs2228671 with CAD completely, indicating a functional link between the genetic variant at the LDLR gene locus, change in LDL-C and risk of CAD.

Conclusion

A common variant at the LDLR gene locus affects LDL-C levels and, thereby, the risk for CAD.
Keywords:
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