학술논문

Interaction Between Type 2 Diabetes Prevention Strategies and Genetic Determinants of Coronary Artery Disease on Cardiometabolic Risk Factors
Document Type
article
Author
Merino, JordiJablonski, Kathleen AMercader, Josep MKahn, Steven EChen, LingHarden, MaeganDelahanty, Linda MAraneta, Maria Rosario GWalford, Geoffrey AJacobs, Suzanne BRIbebuogu, Uzoma NFranks, Paul WKnowler, William CFlorez, Jose CBray, George AGadde, KishoreChatellier, AnnieArceneaux, JenniferDragg, AmberDuncan, CrystalGreenway, Frank LHsia, DanielLevy, ErmaLockett, MonicaRyan, Donna HEhrmann, DavidMatulik, Margaret JCzech, KirstenDeSandre, CatherineGoldstein, Barry JFurlong, KevinSmith, Kellie AWildman, WendiPepe, ConstanceGoldberg, Ronald BCalles, JeanetteOjito, JulietCastillo-Florez, SumayaFlorez, Hermes JGiannella, AnnaLara, OlgaVeciana, BethHaffner, Steven MHazuda, Helen PMontez, Maria GHattaway, KathyLorenzo, CarlosMartinez, ArleneWalker, TatianaHamman, Richard FDabelea, DanaTestaverde, LisaAnderson, DeniseBouffard, AlexisJenkins, TonyaLenz, DionePerreault, LeighPrice, David WSteinke, Sheila CHorton, Edward SPoirier, Catherine SSwift, KatiCaballero, EnriqueFargnoli, BarbaraGuidi, AshleyGuido, MathewJackson, Sharon DLambert, LoriLawton, Kathleen ELedbury, SarahSansoucy, JessicaSpellman, JeanneMontgomery, Brenda KFujimoto, WilfredKnopp, Robert HLipkin, Edward WMorgan-Taggart, IvyMurillo, AnneTaylor, LonneseThomas, AprilTsai, Elaine CTrence, DaceKitabchi, Abbas EDagogo-Jack, SamuelMurphy, Mary ETaylor, LauraDolgoff, JenniferClark, DebraIbebuogu, UzomaLambeth, HelenRicks, HarrietRutledge, Lily MKSoberman, Judith EMolitch, Mark EMetzger, Boyd EJohnson, Mariana KGiles, Mimi MLarsen, DianePen, Samsam C
Source
Diabetes. 69(1)
Subject
Biomedical and Clinical Sciences
Diabetes
Clinical Research
Atherosclerosis
Clinical Trials and Supportive Activities
Cardiovascular
Heart Disease
Prevention
Heart Disease - Coronary Heart Disease
Nutrition
Obesity
Metabolic and endocrine
Good Health and Well Being
Adult
Cardiovascular Diseases
Coronary Artery Disease
Diabetes Mellitus
Type 2
Exercise
Exercise Therapy
Female
Gene-Environment Interaction
Genetic Predisposition to Disease
Humans
Life Style
Male
Metabolic Syndrome
Metformin
Middle Aged
Prediabetic State
Preventive Health Services
Risk Factors
United States
Diabetes Prevention Program Research Group
Medical and Health Sciences
Endocrinology & Metabolism
Biomedical and clinical sciences
Language
Abstract
Coronary artery disease (CAD) is more frequent among individuals with dysglycemia. Preventive interventions for diabetes can improve cardiometabolic risk factors (CRFs), but it is unclear whether the benefits on CRFs are similar for individuals at different genetic risk for CAD. We built a 201-variant polygenic risk score (PRS) for CAD and tested for interaction with diabetes prevention strategies on 1-year changes in CRFs in 2,658 Diabetes Prevention Program (DPP) participants. We also examined whether separate lifestyle behaviors interact with PRS and affect changes in CRFs in each intervention group. Participants in both the lifestyle and metformin interventions had greater improvement in the majority of recognized CRFs compared with placebo (P < 0.001) irrespective of CAD genetic risk (P interaction > 0.05). We detected nominal significant interactions between PRS and dietary quality and physical activity on 1-year change in BMI, fasting glucose, triglycerides, and HDL cholesterol in individuals randomized to metformin or placebo, but none of them achieved the multiple-testing correction for significance. This study confirms that diabetes preventive interventions improve CRFs regardless of CAD genetic risk and delivers hypothesis-generating data on the varying benefit of increasing physical activity and improving diet on intermediate cardiovascular risk factors depending on individual CAD genetic risk profile.