Healthy Lifestyle and Clonal Hematopoiesis of Indeterminate Potential: Results From the Women's Health Initiative.
Healthy Lifestyle and Clonal Hematopoiesis of Indeterminate Potential: Results From the Women's Health Initiative.
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DOI：
10.1161/jaha.120.018789
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发表时间：
2021-03
影响因子：
5.4
通讯作者：
Manson JE
中科院分区：
文献类型：
--
作者：
Haring B;Reiner AP;Liu J;Tobias DK;Whitsel E;Berger JS;Desai P;Wassertheil-Smoller S;LaMonte MJ;Hayden KM;Bick AG;Natarajan P;Weinstock JS;Nguyen PK;Stefanick M;Simon MS;Eaton CB;Kooperberg C;Manson JE
潜在不确定克隆造血（CHIP）的存在与动脉粥样硬化性心血管疾病、癌症和死亡率的高风险相关。健康的生活方式与CHIP之间的关系尚不清楚。该分析纳入了参加WHI（妇女健康倡议）的8709名绝经后妇女（平均年龄66.5岁），无癌症或心血管疾病，具有深度覆盖的全基因组测序数据。获得了有关生活方式因素（体重指数、吸烟、体育活动和饮食质量）的信息，并根据满足的健康标准（0分[最不健康]到4分[最健康]）创建了健康生活方式评分。CHIP是在预先指定的白血病驱动突变列表的基础上得出的。CHIP患病率为8.6%。较高的健康生活方式评分与CHIP无关（多变量调整比值比[OR] [95% CI]，分别为0.99[0.80-1.23]和1.13[0.93-1.37]），分别为高（3或4分）和中（2分），而参照（0或1分）。在评分组成部分中，与肥胖相比，正常和超重的体重指数与CHIP的低几率显著相关（OR分别为0.71 [95% CI, 0.57-0.88]和0.83 [95% CI, 0.68-1.01]； P‐趋势为0.0015）。与当前吸烟者相比，从未吸烟的人患CHIP的几率更低。基于综合评分的健康生活方式与绝经后妇女的CHIP无关。然而，在个人生活方式因素中，拥有正常的体重指数与较低的CHIP患病率密切相关。这些发现支持了这样一种观点，即某些健康的生活方式因素与较低的CHIP频率有关。
Presence of clonal hematopoiesis of indeterminate potential (CHIP) is associated with a higher risk of atherosclerotic cardiovascular disease, cancer, and mortality. The relationship between a healthy lifestyle and CHIP is unknown. This analysis included 8709 postmenopausal women (mean age, 66.5 years) enrolled in the WHI (Women's Health Initiative), free of cancer or cardiovascular disease, with deep‐coverage whole genome sequencing data available. Information on lifestyle factors (body mass index, smoking, physical activity, and diet quality) was obtained, and a healthy lifestyle score was created on the basis of healthy criteria met (0 point [least healthy] to 4 points [most healthy]). CHIP was derived on the basis of a prespecified list of leukemogenic driver mutations. The prevalence of CHIP was 8.6%. A higher healthy lifestyle score was not associated with CHIP (multivariable‐adjusted odds ratio [OR] [95% CI], 0.99 [0.80–1.23] and 1.13 [0.93–1.37]) for the upper (3 or 4 points) and middle category (2 points), respectively, versus referent (0 or 1 point). Across score components, a normal and overweight body mass index compared with obese was significantly associated with a lower odds for CHIP (OR, 0.71 [95% CI, 0.57–0.88] and 0.83 [95% CI, 0.68–1.01], respectively; P‐trend 0.0015). Having never smoked compared with being a current smoker tended to be associated with lower odds for CHIP. A healthy lifestyle, based on a composite score, was not related to CHIP among postmenopausal women. However, across individual lifestyle factors, having a normal body mass index was strongly associated with a lower prevalence of CHIP. These findings support the idea that certain healthy lifestyle factors are associated with a lower frequency of CHIP.