Fibromuscular Dysplasia and Abdominal Aortic Aneurysms Are Dimorphic Sex-Specific Diseases With Shared Complex Genetic Architecture

Author:

Katz Alexander E.123ORCID,Yang Min-Lee124ORCID,Levin Michael G.56ORCID,Tcheandjieu Catherine7ORCID,Mathis Michael8ORCID,Hunker Kristina12ORCID,Blackburn Susan9,Eliason Jonathan L.9,Coleman Dawn M.9ORCID,Fendrikova-Mahlay Natalia10ORCID,Gornik Heather L.11ORCID,Karmakar Monita9,Hill Hannah12,Xu Chang12ORCID,Zawistowski Matthew12ORCID,Brummett Chad M.8,Zoellner Sebastian12ORCID,Zhou Xiang12ORCID,O’Donnell Christopher J.1314ORCID,Douglas Julie A.2,Assimes Themistocles L.1516ORCID,Tsao Phillip S.15ORCID,Li Jun Z.2,Damrauer Scott M.517ORCID,Stanley James C.9ORCID,Ganesh Santhi K.12ORCID,Gaziano J. Michael,Muralidhar Sumitra,Ramoni Rachel,Beckham Jean,Chang Kyong-Mi,O’Donnell Christopher J.,Tsao Philip S.ORCID,Breeling James,Huang Grant,Casas Juan P.,Muralidhar Sumitra,Moser Jennifer,Whitbourne Stacey B.,Brewer Jessica V.,Aslan Mihaela,Connor Todd,Argyres Dean P.,Tsao Philip S.ORCID,Gaziano J. Michael,Stephens Brady,Brophy Mary T.,Humphries Donald E.,Selva Luis E.,Do Nhan,Shayan Shahpoor (Alex),Cho Kelly,Churby Lori,O’Donnell Christopher J.,O’Donnell Christopher J.,Pyarajan Saiju,Tsao Philip S.ORCID,Cho Kelly,DuVall Scott L.,Pyarajan Saiju,Hauser Elizabeth,Sun Yan,Zhao Hongyu,Wilson Peter,McArdle Rachel,Dellitalia Louis,Mattocks Kristin,Harley John,Whittle Jeffrey,Jacono Frank,Beckham Jean,Wells John,Gutierrez Salvador,Gibson Gretchen,Hammer Kimberly,Kaminsky Laurence,Villareal Gerardo,Kinlay Scott,Xu Junzhe,Hamner Mark,Mathew Roy,Bhushan Sujata,Iruvanti Pran,Godschalk Michael,Ballas Zuhair,Ivins Douglas,Mastorides Stephen,Moorman Jonathan,Gappy Saib,Klein Jon,Ratcliffe Nora,Florez Hermes,Okusaga Olaoluwa,Murdoch Maureen,Sriram Peruvemba,Yeh Shing Shing,Tandon Neeraj,Jhala Darshana,Aguayo Samuel,Cohen David,Sharma Satish,Liangpunsakul Suthat,Oursler Kris Ann,Whooley Mary,Ahuja Sunil,Constans Joseph,Meyer Paul,Greco Jennifer,Rauchman Michael,Servatius Richard,Gaddy Melinda,Wallbom Agnes,Morgan Timothy,Stapley Todd,Sherman Scott,Ross George,Tsao PhilipORCID,Strollo Patrick,Boyko Edward,Meyer Laurence,Gupta Samir,Huq Mostaqul,Fayad Joseph,Hung Adriana,Lichy Jack,Hurley Robin,Robey Brooks,Striker Robert

Affiliation:

1. Department of Internal Medicine, Division of Cardiovascular Medicine (A.E.K., M.-L.Y., K.H., H.H., S.K.G.), University of Michigan, Ann Arbor.

2. Department of Human Genetics (A.E.K., M.-L.Y., K.H., H.H., J.A.D., J.Z.L., S.K.G.), University of Michigan, Ann Arbor.

3. Medical Genomics & Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (A.E.K.).

4. Department of Computational Medicine and Bioinformatics (M.-L.Y.), University of Michigan, Ann Arbor.

5. Corporal Michael J. Crescenz Philadelphia VA Medical Center (M.G.L., S.M.D.)

6. Division of Cardiovascular Medicine, Department of Medicine (M.G.L.)

7. Gladstone Institute of data science and Biotechnology, Gladstone Institutes; and Department of epidemiology and biostatistics, University of California at San Francisco, CA. (C.T.)

8. Department of Anesthesiology, Michigan Medicine (M.M., C.M.B.), University of Michigan, Ann Arbor.

9. Department of Surgery, Section of Vascular Surgery (S.B., J.L.E., D.M.C., M.K., J.C.S.), University of Michigan, Ann Arbor.

10. Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH (N.F.-M.).

11. Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH (H.L.G.).

12. Department of Biostatistics and Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor (C.X., M.Z., S.Z., X.Z.).

13. VA Boston Healthcare System (C.O.)

14. Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA (C.O.).

15. VA Palo Alto Health Care System (T.L.A., P.S.T.).

16. Division of Cardiovascular Medicine, Department of Medicine (T.L.A.), Stanford University School of Medicine, CA.

17. Department of Surgery and Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia (S.M.D.).

Abstract

Background: The risk of arterial diseases may be elevated among family members of individuals having multifocal fibromuscular dysplasia (FMD). We sought to investigate the risk of arterial diseases in families of individuals with FMD. Methods: Family histories for 73 probands with FMD were obtained, which included an analysis of 463 total first-degree relatives focusing on FMD and related arterial disorders. A polygenic risk score for FMD (PRS FMD ) was constructed from prior genome-wide association findings of 584 FMD cases and 7139 controls and evaluated for association with an abdominal aortic aneurysm (AAA) in a cohort of 9693 AAA cases and 294 049 controls. A previously published PRS AAA was also assessed among the FMD cases and controls. Results: Of all first degree relatives of probands, 9.3% were diagnosed with FMD, aneurysms, and dissections. Aneurysmal disease occurred in 60.5% of affected relatives and 5.6% of all relatives. Among 227 female first-degree relatives of probands, 4.8% (11) had FMD, representing a relative risk (RR) FMD of 1.5 ([95% CI, 0.75–2.8]; P =0.19) compared with the estimated population prevalence of 3.3%, though not of statistical significance. Of all fathers of FMD probands, 11% had AAAs resulting in a RR AAA of 2.3 ([95% CI, 1.12–4.6]; P =0.014) compared with population estimates. The PRS FMD was found to be associated with an AAA (odds ratio, 1.03 [95% CI, 1.01–1.05]; P =2.6×10 −3 ), and the PRS AAA was found to be associated with FMD (odds ratio, 1.53 [95% CI, 1.2–1.9]; P =9.0×10 −5 ) as well. Conclusions: FMD and AAAs seem to be sex-dimorphic manifestations of a heritable arterial disease with a partially shared complex genetic architecture. Excess risk of having an AAA according to a family history of FMD may justify screening in family members of individuals having FMD.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine

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