Cumulative association of 22 genetic variants with seropositive rheumatoid arthritis risk.

Cumulative association of 22 genetic variants with seropositive rheumatoid arthritis risk.
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DOI:
10.1136/ard.2009.120170
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发表时间:
2010-06
影响因子:
27.4
通讯作者:
Plenge RM
Plenge RM
中科院分区:
医学1区
文献类型:
--
作者:
Karlson EW;Chibnik LB;Kraft P;Cui J;Keenan BT;Ding B;Raychaudhuri S;Klareskog L;Alfredsson L;Plenge RM

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最近风险等位基因的发现使得定义类风湿性关节炎 (RA) 患者的遗传风险概况成为可能。我们研究了基于 22 个经验证的血清阳性 RA 遗传风险等位基因的累积评分是否能够识别出可能受益于预防性干预措施的高风险、无症状个体。我们对(1)来自美国护士健康研究(NHS)的 289 名白人血清阳性病例和 481 名对照者,以及(2)来自瑞典 RA 流行病学调查(EIRA)的 629 名白人 CCP 抗体阳性病例和 623 名对照者的 13 个经验证的 RA 风险位点和 8 个 HLA 等位基因的 14 个单核苷酸多态性(SNP)进行了基因分型。我们创建了加权遗传风险评分(GRS),其中每个风险等位基因的权重是已发布的比值比的对数。我们使用逻辑回归来研究与 RA 事件的关联。我们比较了每个队列中纯临床模型和临床+遗传模型的 AUC。 GRS > 平均值标准差 1.25 的患者在 NHS(OR=2.9,95% CI 1.8-4.6)和 EIRA(OR=3.4,95% CI 2.3-5.0)中血清阳性 RA 的 OR 显着高于人群平均值。在 NHS 中,临床模型的 AUC 为 0.57,临床 + 遗传模型的 AUC 为 0.66,在 EIRA 中分别为 0.63 和 0.75。将 22 个风险等位基因组合成加权遗传风险评分,可显着对个体的 RA 风险进行分层,而不仅仅是临床风险因素。然而,鉴于 RA 的发病率较低,加权遗传风险评分在普通人群中的临床效用有限。
Recent discoveries of risk alleles have made it possible to define genetic risk profiles for patients with rheumatoid arthritis (RA). We examined whether a cumulative score based on 22 validated genetic risk alleles for seropositive RA would identify high-risk, asymptomatic individuals who might benefit from preventive interventions. We genotyped 14 single nucleotide polymorphisms (SNPs) at 13 validated RA risk loci and 8 HLA alleles among (1) 289 Caucasian seropositive cases and 481 controls from the US Nurses' Health Studies (NHS), and (2) 629 Caucasian CCP antibody positive cases and 623 controls from the Swedish Epidemiologic Investigation of RA (EIRA). We created a weighted genetic risk score (GRS), where the weight for each risk allele is the log of the published odds ratio. We used logistic regression to study associations with incident RA. We compared AUCs from a clinical-only model and clinical + genetic model in each cohort. Patients with GRS > 1.25 standard deviations of the mean had a significantly higher OR of seropositive RA in both NHS (OR=2.9, 95%CI 1.8–4.6) and EIRA (OR=3.4, 95% CI 2.3–5.0) referent to the population average. In NHS, the AUC for a clinical model was 0.57 and for a clinical + genetic model was 0.66, and in EIRA was 0.63 and 0.75, respectively. The combination of 22 risk alleles into a weighted genetic risk score significantly stratifies individuals for RA risk beyond clinical risk factors alone. However, given the low incidence of RA, the clinical utility of a weighted genetic risk score is limited in the general population.
DOI: 10.1002/art.24328
发表时间: 2009-03-01
影响因子: --
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