Coronary Artery Disease Risk Elevated With Genetic Hyperglycemia

HealthDay News — Genetic predisposition to hyperglycemia raises the odds of coronary artery disease (CAD), independent of type 2 diabetes and other CAD risk factors, according to research published online March 15 in Diabetes Care.

Jordi Merino, PhD, from Massachusetts General Hospital in Boston, and colleagues conducted a discovery and validation genetic instrumental analysis to test the hypothesis that of all the potential metabolic contributors to type 2 diabetes and its metabolic consequences, genetically driven hyperglycemia alone has an effect on CAD risk. Analysis relied upon summary-level statistics from the largest published meta-analyses of genome-wide association studies for fasting glucose (FG; 133,010 participants free of diabetes) and CAD (63,746 case subjects and 130,681 control subjects).

The researchers found that using an instrumental variable analysis of 12 FG-raising variants, a 1 mmol/L increase in FG revealed an effect-size estimate of 1.43 CAD odds (95% CI, 1.14-1.79). After excluding variants for heterogeneity and pleiotropic effects on other CAD risk factors, the association remained (odds ratio [OR]: 1.33; 95% CI, 1.02-1.73). The 12 FG-increasing variants did not significantly increase type 2 diabetes risk (OR: 1.05; 95% CI, 0.91-1.23), and its prevalence was constant across FG genetic risk score quintiles (P =.72).

“These findings suggest that modulating glycemia may provide cardiovascular benefit,” the authors write.

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Merino J, Leong A, Posner DC, et al. Genetically driven hyperglycemia increases risk of coronary artery disease separately from type 2 diabetes [published online March 15, 2016]. Diabetes Care. doi: 10.2337/dc16-2625