Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany The Charles Bronfman Institute for Personalized Medicine, Genetics of Obesity & Related Metabolic Traits Program, Icahn School of Medicine at Mount Sinai, New York, USA.
Gut. 2015 Apr;64(4):646-56. doi: 10.1136/gutjnl-2014-306930. Epub 2014 Jul 15.
Serum lipase activities above the threefold upper reference limit indicate acute pancreatitis. We investigated whether high lipase activity-within the reference range and in the absence of pancreatitis-are associated with genetic single nucleotide polymorphisms (SNP), and whether these identified SNPs are also associated with clinical pancreatitis.
Genome-wide association studies (GWAS) on phenotypes 'serum lipase activity' and 'high serum lipase activity' were conducted including 3966 German volunteers from the population-based Study-of-Health-in-Pomerania (SHIP). Lead SNPs associated on a genome-wide significance level were replicated in two cohorts, 1444 blood donors and 1042 pancreatitis patients.
Initial discovery GWAS detected SNPs within or near genes encoding the ABO blood group specifying transferases A/B (ABO), Fucosyltransferase-2 (FUT2), and Chymotrypsinogen-B2 (CTRB2), to be significantly associated with lipase activity levels in asymptomatic subjects. Replication analyses in blood donors confirmed the association of FUT-2 non-secretor status (OR=1.49; p=0.012) and ABO blood-type-B (OR=2.48; p=7.29×10(-8)) with high lipase activity levels. In pancreatitis patients, significant associations were found for FUT-2 non-secretor status (OR=1.53; p=8.56×10(-4)) and ABO-B (OR=1.69, p=1.0×10(-4)) with chronic pancreatitis, but not with acute pancreatitis. Conversely, carriers of blood group O were less frequently affected by chronic pancreatitis (OR=0.62; p=1.22×10(-05)) and less likely to have high lipase activity levels (OR=0.59; p=8.14×10(-05)).
These are the first results indicating that ABO blood type-B as well as FUT2 non-secretor status are common population-wide risk factors for developing chronic pancreatitis. They also imply that, even within the reference range, elevated lipase activities may indicate subclinical pancreatic injury in asymptomatic subjects.
血清脂肪酶活性超过三倍参考上限提示急性胰腺炎。我们研究了脂肪酶活性在参考范围内且无胰腺炎时的高活性是否与遗传单核苷酸多态性(SNP)相关,以及这些鉴定出的 SNP 是否也与临床胰腺炎相关。
对表型“血清脂肪酶活性”和“高血清脂肪酶活性”进行全基因组关联研究(GWAS),包括来自基于人群的波罗的海健康研究(SHIP)的 3966 名德国志愿者。在两个队列中,1444 名献血者和 1042 名胰腺炎患者中,对具有全基因组显著意义水平的主要 SNP 进行了复制。
初步发现 GWAS 检测到在编码 ABO 血型指定转移酶 A/B(ABO)、岩藻糖基转移酶-2(FUT2)和糜蛋白酶原-B2(CTRB2)的基因内或附近的 SNP 与无症状受试者的脂肪酶活性水平显著相关。在献血者中的复制分析证实了 FUT-2 非分泌状态(OR=1.49;p=0.012)和 ABO 血型-B(OR=2.48;p=7.29×10(-8))与高脂肪酶活性水平相关。在胰腺炎患者中,发现 FUT-2 非分泌状态(OR=1.53;p=8.56×10(-4))和 ABO-B(OR=1.69,p=1.0×10(-4))与慢性胰腺炎显著相关,但与急性胰腺炎无关。相反,携带血型 O 的患者患慢性胰腺炎的频率较低(OR=0.62;p=1.22×10(-05)),且高水平脂肪酶活性的可能性较低(OR=0.59;p=8.14×10(-05))。
这些是第一个表明 ABO 血型-B 以及 FUT2 非分泌状态是慢性胰腺炎的常见人群风险因素的结果。它们还表明,即使在参考范围内,升高的脂肪酶活性也可能表明无症状受试者的亚临床胰腺损伤。