Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
Hum Mol Genet. 2019 Feb 15;28(4):675-687. doi: 10.1093/hmg/ddy387.
Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of cardiovascular disease and mortality. Its prevalence and severity vary across ancestral background. Although OSA traits are heritable, few genetic associations have been identified. To identify genetic regions associated with OSA and improve statistical power, we applied admixture mapping on three primary OSA traits [the apnea hypopnea index (AHI), overnight average oxyhemoglobin saturation (SaO2) and percentage time SaO2 < 90%] and a secondary trait (respiratory event duration) in a Hispanic/Latino American population study of 11 575 individuals with significant variation in ancestral background. Linear mixed models were performed using previously inferred African, European and Amerindian local genetic ancestry markers. Global African ancestry was associated with a lower AHI, higher SaO2 and shorter event duration. Admixture mapping analysis of the primary OSA traits identified local African ancestry at the chromosomal region 2q37 as genome-wide significantly associated with AHI (P < 5.7 × 10-5), and European and Amerindian ancestries at 18q21 suggestively associated with both AHI and percentage time SaO2 < 90% (P < 10-3). Follow-up joint ancestry-SNP association analyses identified novel variants in ferrochelatase (FECH), significantly associated with AHI and percentage time SaO2 < 90% after adjusting for multiple tests (P < 8 × 10-6). These signals contributed to the admixture mapping associations and were replicated in independent cohorts. In this first admixture mapping study of OSA, novel associations with variants in the iron/heme metabolism pathway suggest a role for iron in influencing respiratory traits underlying OSA.
阻塞性睡眠呼吸暂停(OSA)是一种与心血管疾病和死亡率风险增加相关的常见疾病。其患病率和严重程度因祖先背景而异。尽管 OSA 特征具有遗传性,但已确定的遗传相关性很少。为了确定与 OSA 相关的遗传区域并提高统计效力,我们在一个具有重要祖先背景变异的 11575 名西班牙裔/拉丁裔美国人的研究中,应用混合映射方法研究了三个主要 OSA 特征[呼吸暂停低通气指数(AHI)、夜间平均血氧饱和度(SaO2)和 SaO2<90%的时间百分比]和一个次要特征(呼吸事件持续时间)。使用先前推断的非洲、欧洲和美洲原住民局部遗传祖先标记,采用线性混合模型进行分析。全球非洲祖先与较低的 AHI、较高的 SaO2 和较短的事件持续时间相关。主要 OSA 特征的混合映射分析确定了染色体区域 2q37 上的局部非洲祖先与 AHI 呈全基因组显著相关(P<5.7×10-5),18q21 上的欧洲和美洲原住民祖先提示与 AHI 和 SaO2<90%的时间百分比均相关(P<10-3)。后续的联合祖先-SNP 关联分析确定了亚铁螯合酶(FECH)中的新型变体与 AHI 和 SaO2<90%的时间百分比显著相关,调整多重检验后(P<8×10-6)。这些信号有助于混合映射关联,并且在独立队列中得到了复制。在这项 OSA 的首次混合映射研究中,与铁/血红素代谢途径中的变体相关的新关联表明,铁在影响 OSA 下呼吸道特征方面发挥作用。