机译
心血管连续性合并症的基因组研究
摘要:Comorbidity or a combination of several diseases in the same individual is a common and widely investigated phenomenon. However, the genetic background for non–random disease combinations is not fully understood. Modern technologies and approaches to genomic data analysis enable the investigation of the genetic profile of patients burdened with several diseases (polypathia, disease conglomerates) and its comparison with the profiles of patients with single diseases. An association study featuring three groups of patients with various combinations of cardiovascular disorders and a control group of relatively healthy individuals was conducted. Patients were selected as follows: presence of only one disease, ischemic heart disease (IHD); a combination of two diseases, IHD and arterial hypertension (AH); and a combination of several diseases, including IHD, AH, type 2 diabetes mellitus (T2DM), and hypercholesterolemia (HC). Genotyping was performed using the “My Gene” genomic service (www.i–gene.ru). An analysis of 1,400 polymorphic genetic variants and their associations with the studied phenotypes are presented. A total of 14 polymorphic variants were associatedwith the phenotype “IHD only,” including those in theAPOB, CD226, NKX2–5,TLR2, DPP6, KLRB1,VDR, SCARB1, NEDD4L, andSREBF2 genes, and intragenic variants rs12487066, rs7807268,rs10896449, and rs944289. A total of 13 genetic markers were associated withthe “IHD and AH” phenotype, including variants in theBTNL2, EGFR, CNTNAP2,SCARB1, and HNF1A genes, and intragenicpolymorphisms rs801114, rs10499194, rs13207033, rs2398162, rs6501455, andrs1160312. A total of 14 genetic variants were associated with a combination ofseveral diseases of cardiovascular continuum (CVC), including those in theTAS2R38, SEZ6L, APOA2, KLF7,CETP, ITGA4, RAD54B,LDLR, and MTAP genes, along with intragenicvariants rs1333048, rs1333049, and rs6501455. One common genetic marker wasidentified for the “IHD only” and “IHD and AH”phenotypes: rs4765623 in the SCARB1 gene; two common geneticmarkers, rs663048 in SEZ6L and intragenic rs6501455, wereidentified for the “IHD and AH” phenotype and a combination ofseveral diseases (syntropy); there were no common genetic markers for the“syntropy” and “IHD only” phenotypes. Classificatoryanalysis of the relationships between the associated genes and metabolicpathways revealed that lipid–metabolizing genes are involved in thedevelopment of all three CVC variants, whereas immunity-response genes arespecific to the “IHD only” phenotype. The study demonstrated thatcomorbidity presents additional challenges in association studies of diseasepredisposition, since the genetic profile of combined forms of pathology can bemarkedly different from those for isolated “single” forms of adisease.