Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China

Background: Previous genome-wide association studies revealed that the chromosome 9p21.3 locus is associated with an increased risk of myocardial infarction (MI) and diabetes mellitus (DM). However, it is unclear whether the 9p21.3-MI association is direct or mediated by pathways related to DM.Study...

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Main Authors: Zhijun Wu, Haihui Sheng, Xiuxiu Su, Xiang Gao, Lin Lu, Wei Jin
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-07-01
Series:Frontiers in Endocrinology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fendo.2018.00362/full
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author Zhijun Wu
Haihui Sheng
Xiuxiu Su
Xiang Gao
Lin Lu
Wei Jin
author_facet Zhijun Wu
Haihui Sheng
Xiuxiu Su
Xiang Gao
Lin Lu
Wei Jin
author_sort Zhijun Wu
collection DOAJ
description Background: Previous genome-wide association studies revealed that the chromosome 9p21.3 locus is associated with an increased risk of myocardial infarction (MI) and diabetes mellitus (DM). However, it is unclear whether the 9p21.3-MI association is direct or mediated by pathways related to DM.Study Design: We applied mediation analysis to examine the potential mediating effect of DM on the association between the 9p21.3 genetic risk score (GRS; ranged from 0 to 8) and MI in a case-control study of 865 MI patients and 927 controls without coronary artery disease (CAD). The GRS combining 4 lead 9p21.3 single nucleotide polymorphisms (rs1333040, rs4987574, rs2383207, and rs1333049) was constructed.Results: Each 1 unit increase in weighted 9p21.3 GRS was associated with a 9% increased DM risk (95% confidence interval (CI) 1.00, 1.19) in the control group and a 14% increased MI risk (95% CI 1.09, 1.20). Mediation analyses yielded a direct-effect odds ratio (OR) of 1.06 (95% CI 1.04, 1.08) and an indirect-effect OR of 1.00 (95% CI 0.99, 1.01) for weighted GRS. DM mediated 4.40% (95% CI 3.42, 6.52) of the total association between the weighted GRS and MI risk. Individuals with the highest quartile of 9p21.3 GRS and DM had a 6-fold higher MI risk than those with the lowest quartile of 9p21.3 GRS and non-DM (OR 6.03, 95% CI 3.48, 10.5).Conclusion: DM is a weak mediator that explains a small fraction of the 9p21. 3-MI association in Chinese adults. Nevertheless, there is a strong synergistic effect between DM and the 9p21.3 GRS on MI risk.
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spelling doaj.art-3f7ffd70083d473bab6309b9b51b51012022-12-21T23:27:50ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-07-01910.3389/fendo.2018.00362377385Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, ChinaZhijun Wu0Haihui Sheng1Xiuxiu Su2Xiang Gao3Lin Lu4Wei Jin5Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaNational Engineering Center for Biochip at Shanghai, Shanghai, ChinaDepartment of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Nutritional Sciences, Pennsylvania State University, State College, PA, United StatesDepartment of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackground: Previous genome-wide association studies revealed that the chromosome 9p21.3 locus is associated with an increased risk of myocardial infarction (MI) and diabetes mellitus (DM). However, it is unclear whether the 9p21.3-MI association is direct or mediated by pathways related to DM.Study Design: We applied mediation analysis to examine the potential mediating effect of DM on the association between the 9p21.3 genetic risk score (GRS; ranged from 0 to 8) and MI in a case-control study of 865 MI patients and 927 controls without coronary artery disease (CAD). The GRS combining 4 lead 9p21.3 single nucleotide polymorphisms (rs1333040, rs4987574, rs2383207, and rs1333049) was constructed.Results: Each 1 unit increase in weighted 9p21.3 GRS was associated with a 9% increased DM risk (95% confidence interval (CI) 1.00, 1.19) in the control group and a 14% increased MI risk (95% CI 1.09, 1.20). Mediation analyses yielded a direct-effect odds ratio (OR) of 1.06 (95% CI 1.04, 1.08) and an indirect-effect OR of 1.00 (95% CI 0.99, 1.01) for weighted GRS. DM mediated 4.40% (95% CI 3.42, 6.52) of the total association between the weighted GRS and MI risk. Individuals with the highest quartile of 9p21.3 GRS and DM had a 6-fold higher MI risk than those with the lowest quartile of 9p21.3 GRS and non-DM (OR 6.03, 95% CI 3.48, 10.5).Conclusion: DM is a weak mediator that explains a small fraction of the 9p21. 3-MI association in Chinese adults. Nevertheless, there is a strong synergistic effect between DM and the 9p21.3 GRS on MI risk.https://www.frontiersin.org/article/10.3389/fendo.2018.00362/fullmediation analysismyocardial infarctiondiabetes mellitusgenetic risk scoremetabolic disease
spellingShingle Zhijun Wu
Haihui Sheng
Xiuxiu Su
Xiang Gao
Lin Lu
Wei Jin
Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
Frontiers in Endocrinology
mediation analysis
myocardial infarction
diabetes mellitus
genetic risk score
metabolic disease
title Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
title_full Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
title_fullStr Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
title_full_unstemmed Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
title_short Mediating Effect of Diabetes Mellitus on the Association Between Chromosome 9p21.3 Locus and Myocardial Infarction Risk: A Case-Control Study in Shanghai, China
title_sort mediating effect of diabetes mellitus on the association between chromosome 9p21 3 locus and myocardial infarction risk a case control study in shanghai china
topic mediation analysis
myocardial infarction
diabetes mellitus
genetic risk score
metabolic disease
url https://www.frontiersin.org/article/10.3389/fendo.2018.00362/full
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