Edmond K. Kabagambe

Genetic loci associated with plasma phospholipid N-3 fatty acids: A Meta-Analysis of Genome-Wide association studies from the charge consortium

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 = 3×10−64) and lower levels of eicosapentaenoic acid (EPA, p = 5×10−58) and docosapentaenoic acid (DPA, p = 4×10−154). Minor alleles of SNPs in ELOVL2 (elongase) were associated with higher EPA (p = 2×10−12) and DPA (p = 1×10−43) and lower docosahexaenoic acid (DHA, p = 1×10−15). In addition to genes in the n-3 pathway, we identified a novel association of DPA with several SNPs in GCKR (glucokinase regulator, p = 1×10−8). 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.

Adipose Tissue α-Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica

Background—&agr;-Linolenic acid may protect against cardiovascular disease. We examined the association between adipose tissue &agr;-linolenic acid and nonfatal acute myocardial infarction (MI) in a population-based case-control study in Costa Rica. Methods and Results—The 482 case patients with a first nonfatal acute MI and 482 population control subjects were matched by age, sex, and area of residence. Fatty acids were assessed by gas-liquid chromatography in adipose tissue samples collected from all subjects. ORs and 95% CIs were calculated from multivariate conditional logistic regression models. Subjects in the top quintiles of adipose tissue &agr;-linolenic acid had a lower risk of MI than those in the lowest quintile: OR (95% CI), 1.00; 0.80 (0.52 to 1.24); 0.53 (0.34 to 0.82); 0.44 (0.28 to 0.67); and 0.37 (0.24 to 0.59); test for trend, P <0.0001. This association was strengthened after adjustment for established MI risk factors, including smoking, physical activity, income, and adipose tissue linoleic acid and trans fatty acids (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.50; test for trend, P <0.0001). Further adjustment for the intake of saturated fat, fiber, alcohol, and vitamin E did not change this association (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.55; test for trend, P <0.0001). Conclusions—The inverse association observed between &agr;-linolenic acid and nonfatal acute MI suggests that consumption of vegetable oils rich in &agr;-linolenic acid confers important protection against cardiovascular disease.

Genome-Wide Association of Body Fat Distribution in African Ancestry Populations Suggests New Loci

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.

A High Intake of Saturated Fatty Acids Strengthens the Association between the Fat Mass and Obesity-Associated Gene and BMI

Evidence that physical activity (PA) modulates the association between the fat mass and obesity-associated gene (FTO) and BMI is emerging; however, information about dietary factors modulating this association is scarce. We investigated whether fat and carbohydrate intake modified the association of FTO gene variation with BMI in two populations, including participants in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study (n = 1069) and in the Boston Puerto Rican Health (BPRHS) study (n = 1094). We assessed energy, nutrient intake, and PA using validated questionnaires. Genetic variability at the FTO locus was characterized by polymorphisms rs9939609 (in the GOLDN) and rs1121980 (in the GOLDN and BPRHS). We found significant interactions between PA and FTO on BMI in the GOLDN but not in the BPRHS. We found a significant interaction between SFA intake and FTO on BMI, which was stronger than that of total fat and was present in both populations (P-interaction = 0.007 in the GOLDN and P-interaction = 0.014 in BPRHS for categorical; and P-interaction = 0.028 in the GOLDN and P-interaction = 0.041 in BPRHS for continuous SFA). Thus, homozygous participants for the FTO-risk allele had a higher mean BMI than the other genotypes only when they had a high-SFA intake (above the population mean: 29.7 ± 0.7 vs. 28.1 ± 0.5 kg/m²; P = 0.037 in the GOLDN and 33.6. ± 0.8 vs. 31.2 ± 0.4 kg/m²; P = 0.006 in BPRHS). No associations with BMI were found at lower SFA intakes. We found no significant interactions with carbohydrate intake. In conclusion, SFA intake modulates the association between FTO and BMI in American populations.

Epigenome-Wide Association Study of Fasting Measures of Glucose, Insulin, and HOMA-IR in the Genetics of Lipid Lowering Drugs and Diet Network Study

Known genetic susceptibility loci for type 2 diabetes (T2D) explain only a small proportion of heritable T2D risk. We hypothesize that DNA methylation patterns may contribute to variation in diabetes-related risk factors, and this epigenetic variation across the genome can contribute to the missing heritability in T2D and related metabolic traits. We conducted an epigenome-wide association study for fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) among 837 nondiabetic participants in the Genetics of Lipid Lowering Drugs and Diet Network study, divided into discovery (N = 544) and replication (N = 293) stages. Cytosine guanine dinucleotide (CpG) methylation at ∼470,000 CpG sites was assayed in CD4+ T cells using the Illumina Infinium HumanMethylation 450 Beadchip. We fit a mixed model with the methylation status of each CpG as the dependent variable, adjusting for age, sex, study site, and T-cell purity as fixed-effects and family structure as a random-effect. A Bonferroni corrected P value of 1.1 × 10−7 was considered significant in the discovery stage. Significant associations were tested in the replication stage using identical models. Methylation of a CpG site in ABCG1 on chromosome 21 was significantly associated with insulin (P = 1.83 × 10−7) and HOMA-IR (P = 1.60 × 10−9). Another site in the same gene was significant for HOMA-IR and of borderline significance for insulin (P = 1.29 × 10−7 and P = 3.36 × 10−6, respectively). Associations with the top two signals replicated for insulin and HOMA-IR (P = 5.75 × 10−3 and P = 3.35 × 10−2, respectively). Our findings suggest that methylation of a CpG site within ABCG1 is associated with fasting insulin and merits further evaluation as a novel disease risk marker.

Transient exposure to coffee as a trigger of a first nonfatal myocardial infarction

Background: The effects of coffee on myocardial infarction are uncertain. We hypothesize that coffee in the presence of predisposing factors can induce a cascade of events that, through sympathetic nervous activation, can induce the onset of myocardial infarction. Methods: We recruited 503 incident cases of nonfatal myocardial infarction between 1994 and 1998 in Costa Rica. We used a case-crossover design to calculate relative risks (RRs) and 95% confidence intervals (95% CIs). Results: The RR of myocardial infarction in the hour after coffee intake was 1.49 (95% CI = 1.17–1.89). Occasional coffee drinkers (≤1 cup/day, n = 103) had a RR of myocardial infarction of 4.14 (2.03–8.42), moderate coffee drinkers (2–3 cups/day, n = 280) had a RR of 1.60 (1.16–2.21), and heavy coffee drinkers (≥4 cups/d, n = 120) had a RR of 1.06 (0.69–1.63; P = 0.006, test of homogeneity). Patients with 3 or more risk factors (n = 101) had a RR of myocardial infarction of 2.10 (1.30–3.39), whereas patients with fewer than 3 risk factors (n = 396) had a RR of 1.39 (1.04–1.82; P = 0.15, test of homogeneity); and RR was 1.72 (1.30–2.30) among sedentary patients compared with 1.07 (0.66–1.72) among nonsedentary (P = 0.10, test of homogeneity). Conclusions: The findings indicate that coffee intake may trigger myocardial infarction. The association is particularly strong among people with light/occasional intake of coffee (≤1 cup/day), with sedentary lifestyle, or with 3 or more risk factors for coronary heart disease.

ADIPOQ Polymorphisms, Monounsaturated Fatty Acids, and Obesity Risk : The GOLDN Study

Serum adiponectin levels have been positively associated with insulin sensitivity and are decreased in type 2 diabetes (T2D) and obesity. Genetic and environmental factors influence serum adiponectin and may contribute to risk of metabolic syndrome and T2D. Therefore, we investigated the effect of ADIPOQ single‐nucleotide polymorphisms (SNPs), −11377C>G and −11391G>A, on metabolic‐related traits, and their modulation by dietary fat in white Americans. Data were collected from 1,083 subjects participating in the Genetics of Lipid Lowering Drugs and Diet Network study. Mean serum adiponectin concentration was higher for carriers of the −11391A allele (P = 0.001) but lower for the −11377G allele carriers (P = 0.017). Moreover, we found a significant association with obesity traits for the −11391G>A SNP. Carriers of the −11391A allele had significantly lower weight (P = 0.029), BMI (P = 0.019), waist (P = 0.003), and hip circumferences (P = 0.004) compared to noncarriers. Interestingly, the associations of the −11391G>A with BMI and obesity risk were modified by monounsaturated fatty acids (MUFAs) intake (P‐interaction = 0.021 and 0.034 for BMI and obesity risk, respectively). In subjects with MUFA intake above the median (≥13% of energy intake), −11391A carriers had lower BMI (27.1 kg/m2 for GA+AA vs. 29.1 kg/m2 for GG, P = 0.002) and decreased obesity risk (odds ratio for −11391A = 0.52, 95% confidence interval (CI); 0.28–0.96; P = 0.031). However, we did not detect genotype‐related differences for BMI or obesity in subjects with MUFA intake <13%. Our findings support a significant association between the −11391G>A SNPs and obesity‐related traits and the potential to moderate such effects using dietary modification.

Individual saturated fatty acids and nonfatal acute myocardial infarction in Costa Rica.

Background: Epidemiological studies on the effect of individual saturated fatty acids (SFAs) on cardiovascular disease, especially in developing countries with different dietary patterns, are scarce.Objective: To determine the risk of nonfatal acute myocardial infarction (MI) associated with consumption of individual SFAs and their food sources in Costa Rica.Design: The cases (n=485) were survivors of a first acute MI and were matched by age, sex and area of residence to population controls (n=508). Data on anthropometrical measurements, lifestyle and diet were collected using interviewer-administered questionnaires.Results: In analyses adjusted for confounders, consumption of total and individual SFAs was associated with an increased risk of MI. The odds ratio (OR) (95% confidence intervals) for 1% increase in energy from total saturated fat was 1.12 (1.03–1.21) while it was 1.51 (1.03–2.22) for lauric acid+myristic acid, 1.14 (1.01–1.30) for palmitic acid and 2.00 (1.34–3.00) for stearic acid. Although lauric and myristic acids were associated with increased risk of MI, they were consumed in small amounts and most of the saturated fat (87%) came from palmitic and stearic acids, which derived mainly from red meat and fried foods. Consumption of cheese (1–2 vs 0 servings/day) was associated with increased risk of MI (OR=3.07; 95% confidence interval: 1.74–5.39; P for trend <0.0001), while consumption of low-fat milk was not.Conclusions: Increased consumption of total and individual SFAs is associated with increased risk of MI. Lauric, myristic and stearic acids were more potent than palmitic acid.Sponsorship: National Institutes of Health Grant HL 49086 and HL 60692.

Risk factors for Brucella seropositivity in goat herds in eastern and western Uganda.

Cross-sectional prevalences and risk factors for Brucella seropositivity in goats in eastern and western Uganda were investigated. Serum was collected from 1518 goats randomly selected from 145 herds which had been identified using multistage sampling. The brucellosis card test (CT) and the Brucella melitensis tube-agglutination test (TAT) were used in parallel to detect antibodies against B. abortus and B. melitensis, respectively. Interviewer-administered questionnaires were used to collect information on goat health and management. This information was used in multivariable logistic-regression models to determine the risk factors for Brucella seropositivity in goat herds. For each analysis, a herd was considered positive if at least one goat in the herd tested positive for antibodies against Brucella and negative if none was positive. Four percent (55/1480) of the goats screened with the CT had antibodies against Brucella. The reactors were distributed in 13% (19/145) of the herds. The most-important herd-level risk factors identified were use of a hired caretaker as the primary manager of the operation compared to owner/family members (adjusted odds ratio (OR)=8.1; 95% CI 1.6, 39.7), keeping sheep in addition to goats (OR=6.0; CI 1.5, 23.7) compared to having no sheep, and free browsing (OR=4.7; 95% CI 1.0, 20.7) when compared to tethering or zero-grazing. Using the TAT, 10% (141/1446) of the goats tested positive. The positives were distributed in 43% (63/145) of the herds. Free browsing (OR=6.7; 95% CI 2.7, 16.9) when compared to tethering or zero-grazing and lack of veterinary care (OR=2.9; CI 1.3, 6.7) were the most-important factors identified in the multivariable model for B. melitensis herd seropositivity. To explore/reduce the risk of misclassification in a secondary analysis, herds were reclassified as positive if at least one goat tested positive on both tests and negative if none of the goats was positive on any of the two tests. Using this classification, 2% (30/1320; 95% CI 2, 3%) of the goats tested positive resulting in 13% (12/93) of the herds being positive. The distribution of the above risk factors by brucellosis herd-status (as defined by the second criterion) is also presented.

ADIPOQ polymorphisms, monounsaturated fatty acids, and obesity risk

Serum adiponectin levels have been positively associated with insulin sensitivity and are decreased in type 2 diabetes (T2D) and obesity. Genetic and environmental factors influence serum adiponectin and may contribute to risk of metabolic syndrome and T2D. Therefore, we investigated the effect of ADIPOQ single‐nucleotide polymorphisms (SNPs), −11377C>G and −11391G>A, on metabolic‐related traits, and their modulation by dietary fat in white Americans. Data were collected from 1,083 subjects participating in the Genetics of Lipid Lowering Drugs and Diet Network study. Mean serum adiponectin concentration was higher for carriers of the −11391A allele (P = 0.001) but lower for the −11377G allele carriers (P = 0.017). Moreover, we found a significant association with obesity traits for the −11391G>A SNP. Carriers of the −11391A allele had significantly lower weight (P = 0.029), BMI (P = 0.019), waist (P = 0.003), and hip circumferences (P = 0.004) compared to noncarriers. Interestingly, the associations of the −11391G>A with BMI and obesity risk were modified by monounsaturated fatty acids (MUFAs) intake (P‐interaction = 0.021 and 0.034 for BMI and obesity risk, respectively). In subjects with MUFA intake above the median (≥13% of energy intake), −11391A carriers had lower BMI (27.1 kg/m2 for GA+AA vs. 29.1 kg/m2 for GG, P = 0.002) and decreased obesity risk (odds ratio for −11391A = 0.52, 95% confidence interval (CI); 0.28–0.96; P = 0.031). However, we did not detect genotype‐related differences for BMI or obesity in subjects with MUFA intake <13%. Our findings support a significant association between the −11391G>A SNPs and obesity‐related traits and the potential to moderate such effects using dietary modification.