Associations of Self-Reported Race, Social Determinants of Health, and Polygenic Risk With Coronary Heart Disease.

Autor: Norland K; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Schaid DJ; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA., Naderian M; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA., Na J; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA., Kullo IJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: kullo.iftikhar@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of the American College of Cardiology [J Am Coll Cardiol] 2024 Nov 26; Vol. 84 (22), pp. 2157-2166.
DOI: 10.1016/j.jacc.2024.06.052
Abstrakt: Background: Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).
Objectives: This study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S.
Methods: In 67,256 All of Us (AoU) participants with available SDOH and whole-genome sequencing data, we ascertained self-reported race/ethnicity and 22 SDOH measures across 5 SDOH domains, and we calculated a PRS for CHD (PRS CHD , PGS004696). We developed an SDOH score for CHD (SDOH CHD ). We tested the associations of SDOH and PRS CHD with CHD in regression models that included clinical risk factors.
Results: SDOH across 5 domains, including food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness, were associated with CHD. SDOH CHD was highest in self-reported Black and Hispanic people. Self-reporting as Blacks had higher odds of having CHD than Whites but not after adjustment for SDOH CHD . SDOH CHD and PRS CHD were weakly correlated. In the test set (n = 33,628), 1-SD increases in SDOH CHD and PRS CHD were associated with CHD in models that adjusted for clinical risk factors (OR: 1.32; 95% CI: 1.23-1.41 and OR: 1.36; 95% CI: 1.28-1.44, respectively). SDOH CHD and PRS CHD were associated with incident CHD events (n = 52) over a median follow-up of 214 days (Q1-Q3: 88 days).
Conclusions: Increased odds of CHD in people who self-report as Black are likely due to a higher SDOH burden. SDOH and PRS were independently associated with CHD. Our findings suggest that including both PRS and SDOH in CHD risk models could improve their accuracy.
Competing Interests: Funding Support and Author Disclosures This work was supported by grants from the Polygenic Risk Methods in Diverse Populations (PRIMED) Consortium through the National Human Genome Research Institute grant U01 HG11710, the electronic Medical Records and Genomics (eMERGE) Network funded by the National Human Genome Research Institute grant U01 HG06379, and National Heart, Lung, and Blood Institute grants K24 HL137010 and GM065450. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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