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Polymorphism in the CETP Gene Region, HDL Cholesterol, and Risk of Future Myocardial Infarction

作者:Paul M. Ridker, Guillaume Paré, Alex N. Parker, Robert Y.L. Zee, Joseph P. Miletich, Daniel I. Chasman · 发表于:Circulation Cardiovascular Genetics · 年份:2009 · DOI:10.1161/circgenetics.108.817304 · 被引用次数:199 · 研究领域:Diabetes, Cardiovascular Risks, and Lipoproteins、Genetic Associations and Epidemiology、Lipoproteins and Cardiovascular Health

BACKGROUND: Recent trial data have challenged the hypothesis that cholesteryl ester transfer protein (CETP) and high-density lipoprotein cholesterol (HDL-C) have causal roles in atherothrombosis. One method to evaluate this issue is to examine whether polymorphisms in the CETP gene that impact on HDL-C levels also impact on the future development of myocardial infarction. METHODS AND RESULTS: In a prospective cohort of 18 245 initially healthy American women, we examined over 350 000 singe-nucleotide polymorphisms (SNPs) first to identify loci associated with HDL-C and then to evaluate whether significant SNPs within these loci also impact on rates of incident myocardial infarction during an average 10-year follow-up period. Nine loci on 9 chromosomes had 1 or more SNPs associated with HDL-C at genome-wide statistical significance (P<5x10(-8)). However, only SNPs near or in the CETP gene at 16q13 were associated with both HDL-C and risk of incident myocardial infarction (198 events). For example, SNP rs708272 in the CETP gene was associated with a per-allele increase in HDL-C levels of 3.1 mg/dL and a concordant 24% lower risk of future myocardial infarction (age-adjusted hazard ratio, 0.76; 95% CI, 0.62 to 0.94), consistent with recent meta-analysis. Independent and again concordant effects on HDL-C and incident myocardial infarction were also observed at the CETP locus for rs4329913 and rs7202364. Adjustment for HDL-C attenuated but did not eliminate these effects. CONCLUSI...