Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Oct 8;18(1):131.
doi: 10.1186/s12933-019-0930-1.

Genetic predisposition to type 2 diabetes is associated with severity of coronary artery disease in patients with acute coronary syndromes

Qiwen Zheng  1 , Jie Jiang  2 , Yong Huo  3 , Dafang Chen  4
Affiliations
Observational Study

Genetic predisposition to type 2 diabetes is associated with severity of coronary artery disease in patients with acute coronary syndromes

Qiwen Zheng et al. Cardiovasc Diabetol. .

Abstract

Background: Accumulating evidence has shown that type 2 diabetes (T2D) and coronary artery disease (CAD) may stem from a 'common soil'. The aim of our study was to examine the association between genetic predisposition to T2D and the risk of severe CAD among patients with acute coronary syndromes (ACS) undergoing angiography.

Methods: The current case-control study included 1414 ACS patients with at least one major epicardial vessel stenosis > 50% enrolled in the ACS Genetic Study. The severity of CAD was quantified by the number of coronary arteries involved. Genetic risk score (GRS) was calculated using 41 common variants that robustly associated with increased risk of T2D in East Asians. Logistic regression models were used to estimate the association between GRS and the severity of CAD.

Results: In the age-, sex- and BMI-adjusted model, each additional risk allele was associated with a 6% increased risk of multi-vessel disease (OR = 1.06, 95% CI 1.02-1.09). The OR was 1.43 (95% CI 1.08-1.89) for the risk of severe CAD when comparing the extreme tertiles of T2D-GRS. The association was not reduced after further adjustment for conventional cardiovascular risk factors. Additional adjustment for T2D status in our regression model attenuated the association by approximately one quarter. In subgroup analysis, the strengths of the associations between GRS and the severity of CAD were broadly similar in terms of baseline demographic information and disease characteristics.

Conclusions: Our data indicated that genetic predisposition to T2D is associated with elevated risk of severe CAD. This association revealed a possible causal relationship and is partially mediated through diabetic status.

Keywords: Acute coronary syndromes; Atherosclerosis; Coronary artery disease; Genetic risk score; Severity; Type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Linear relationship between T2D-GRS and risk of multi-vessel disease. Data are OR (solid lines) and 95% CI (dashed lines), adjusted for age, sex, BMI, current smoker, hypertension, and hypercholesterolemia
Fig. 2
Fig. 2
Triangular relationship among GRS, T2D and multi-vessel disease. ORG represented the association between GRS and T2D risk after adjustment for age, sex, and BMI; ORD represented the association between T2D and multi-vessel disease; ORO represented the observed association of GRS with multi-vessel disease; and ORE represented the expected association of GRS with multi-vessel disease. ORD, ORO, and ORE were calculated after adjustment for age, sex, BMI, smoking status, hypertension, and hypercholesterolemia
Fig. 3
Fig. 3
Association between GRS and severe CAD in subgroups of the participants with and without demographic characteristics, lifestyle factors, and comorbidities. All ORs were calculated per SD increase in GRS. All analyses were adjusted for age and sex, except for age and sex subgroup. Prior CVD included prior myocardial infarction, prior revascularization, heart failure, stroke/transient ischemic arrack, chronic angina and peripheral vascular disease
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7. - DOI - PMC - PubMed
    1. GBD 2017 Causes of Death Collaborators Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392(10159):1736–1888. doi: 10.1016/S0140-6736(18)32203-7. - DOI - PMC - PubMed
    1. Stern MP. Diabetes and cardiovascular disease. The “common soil” hypothesis. Diabetes. 1995;44(4):369–374. doi: 10.2337/diab.44.4.369. - DOI - PubMed
    1. Almdal T, Scharling H, Jensen JS, Vestergaard H. The independent effect of type 2 diabetes mellitus on ischemic heart disease, stroke, and death: a population-based study of 13,000 men and women with 20 years of follow-up. Arch Intern Med. 2004;164(13):1422–1426. doi: 10.1001/archinte.164.13.1422. - DOI - PubMed
    1. Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC, Jr, Sowers JR. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100(10):1134–1146. doi: 10.1161/01.CIR.100.10.1134. - DOI - PubMed

Publication types

MeSH terms