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J Lipid Res. 2017 Nov;58(11):2162-2170. doi: 10.1194/jlr.M079822. Epub 2017 Sep 4.

Polygenic determinants in extremes of high-density lipoprotein cholesterol.

Author information

1
Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
2
Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
3
Montréal Heart Institute et Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada.
4
Departments of Genetics and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
5
Departments of Genetics, Medicine, and Pediatrics, the Cardiovascular Institute, and the Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
6
Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada hegele@robarts.ca.
7
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Abstract

HDL cholesterol (HDL-C) remains a superior biochemical predictor of CVD risk, but its genetic basis is incompletely defined. In patients with extreme HDL-C concentrations, we concurrently evaluated the contributions of multiple large- and small-effect genetic variants. In a discovery cohort of 255 unrelated lipid clinic patients with extreme HDL-C levels, we used a targeted next-generation sequencing panel to evaluate rare variants in known HDL metabolism genes, simultaneously with common variants bundled into a polygenic trait score. Two additional cohorts were used for validation and included 1,746 individuals from the Montréal Heart Institute Biobank and 1,048 individuals from the University of Pennsylvania. Findings were consistent between cohorts: we found rare heterozygous large-effect variants in 18.7% and 10.9% of low- and high-HDL-C patients, respectively. We also found common variant accumulation, indicated by extreme polygenic trait scores, in an additional 12.8% and 19.3% of overall cases of low- and high-HDL-C extremes, respectively. Thus, the genetic basis of extreme HDL-C concentrations encountered clinically is frequently polygenic, with contributions from both rare large-effect and common small-effect variants. Multiple types of genetic variants should be considered as contributing factors in patients with extreme dyslipidemia.

KEYWORDS:

common variants; complex trait; dyslipidemias; genes in lipid dysfunction; genetics; genomics; next-generation sequencing; polygenic risk score; rare variants

PMID:
28870971
PMCID:
PMC5665671
DOI:
10.1194/jlr.M079822
[Indexed for MEDLINE]
Free PMC Article

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