Genetic ancestry-smoking interactions and lung function in African Americans: a cohort study

Abstract

Background: Smoking tobacco reduces lung function. African Americans have both lower lung function and decreased metabolism of tobacco smoke compared to European Americans. African ancestry is also associated with lower pulmonary function in African Americans. We aimed to determine whether African ancestry modifies the association between smoking and lung function and its rate of decline in African Americans.

Methodology/principal findings: We evaluated a prospective ongoing cohort of 1,281 African Americans participating in the Health, Aging, and Body Composition (Health ABC) Study initiated in 1997. We also examined an ongoing prospective cohort initiated in 1985 of 1,223 African Americans in the Coronary Artery Disease in Young Adults (CARDIA) Study. Pulmonary function and tobacco smoking exposure were measured at baseline and repeatedly over the follow-up period. Individual genetic ancestry proportions were estimated using ancestry informative markers selected to distinguish European and West African ancestry. African Americans with a high proportion of African ancestry had lower baseline forced expiratory volume in one second (FEV₁) per pack-year of smoking (-5.7 ml FEV₁/ smoking pack-year) compared with smokers with lower African ancestry (-4.6 ml in FEV₁/ smoking pack-year) (interaction P value = 0.17). Longitudinal analyses revealed a suggestive interaction between smoking, and African ancestry on the rate of FEV(1) decline in Health ABC and independently replicated in CARDIA.

Conclusions/significance: African American individuals with a high proportion of African ancestry are at greater risk for losing lung function while smoking.

Figure 1. Predicted FEV₁ decline (in milliliters) by smoking-ancestry strata derived from a mixed effects model.

Health ABC (A) and CARDIA (B). Current smokers are represented by the ▴ symbol and former smokers by the • symbol. Low African ancestry groups are represented by a solid line and high African ancestry by a dashed line. The groups are as follows: low African current smokers (solid line with ▴ symbol), high African current smokers (dashed line with ▴ symbol), low African former smokers (solid line with • symbol), and high African former smokers (dashed line with • symbol).