A genetic risk score and diabetes predict development of alcohol-related cirrhosis in drinkers

Background & Aims - Only a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk. - Methods - Three cohorts (GenomALC-1: n = 1,690, GenomALC-2: n = 3,037, UK Biobank: relevant n = 6,898) with a history of he...

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Hauptverfasser: Whitfield, John B. (VerfasserIn) , Schwantes-An, Tae-Hwi (VerfasserIn) , Darlay, Rebecca (VerfasserIn) , Aithal, Guruprasad P. (VerfasserIn) , Atkinson, Stephen R. (VerfasserIn) , Bataller, Ramon (VerfasserIn) , Botwin, Greg (VerfasserIn) , Chalasani, Naga P. (VerfasserIn) , Cordell, Heather J. (VerfasserIn) , Daly, Ann K. (VerfasserIn) , Day, Christopher P. (VerfasserIn) , Eyer, Florian (VerfasserIn) , Foroud, Tatiana (VerfasserIn) , Gleeson, Dermot (VerfasserIn) , Goldman, David (VerfasserIn) , Haber, Paul S. (VerfasserIn) , Jacquet, Jean-Marc (VerfasserIn) , Liang, Tiebing (VerfasserIn) , Liangpunsakul, Suthat (VerfasserIn) , Masson, Steven (VerfasserIn) , Mathurin, Philippe (VerfasserIn) , Moirand, Romain (VerfasserIn) , McQuillin, Andrew (VerfasserIn) , Moreno, Christophe (VerfasserIn) , Morgan, Marsha Y. (VerfasserIn) , Mueller, Sebastian (VerfasserIn) , Müllhaupt, Beat (VerfasserIn) , Nagy, Laura E. (VerfasserIn) , Nahon, Pierre (VerfasserIn) , Nalpas, Bertrand (VerfasserIn) , Naveau, Sylvie (VerfasserIn) , Perney, Pascal (VerfasserIn) , Pirmohamed, Munir (VerfasserIn) , Seitz, Helmut K. (VerfasserIn) , Soyka, Michael (VerfasserIn) , Stickel, Felix (VerfasserIn) , Thompson, Andrew (VerfasserIn) , Thursz, Mark R. (VerfasserIn) , Trépo, Eric (VerfasserIn) , Morgan, Timothy R. (VerfasserIn) , Seth, Devanshi (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2022
In: Journal of hepatology
Year: 2022, Jahrgang: 76, Heft: 2, Pages: 275-282
ISSN:1600-0641
DOI:10.1016/j.jhep.2021.10.005
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jhep.2021.10.005
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0168827821021115
Volltext
Verfasserangaben:John B. Whitfield, Tae-Hwi Schwantes-An, Rebecca Darlay, Guruprasad P. Aithal, Stephen R. Atkinson, Ramon Bataller, Greg Botwin, Naga P. Chalasani, Heather J. Cordell, Ann K. Daly, Christopher P. Day, Florian Eyer, Tatiana Foroud, Dermot Gleeson, David Goldman, Paul S. Haber, Jean-Marc Jacquet, Tiebing Liang, Suthat Liangpunsakul, Steven Masson, Philippe Mathurin, Romain Moirand, Andrew McQuillin, Christophe Moreno, Marsha Y. Morgan, Sebastian Mueller, Beat Müllhaupt, Laura E. Nagy, Pierre Nahon, Bertrand Nalpas, Sylvie Naveau, Pascal Perney, Munir Pirmohamed, Helmut K. Seitz, Michael Soyka, Felix Stickel, Andrew Thompson, Mark R. Thursz, Eric Trépo, Timothy R. Morgan, Devanshi Seth, for the GenomALC Consortium

MARC

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245 1 2 |a A genetic risk score and diabetes predict development of alcohol-related cirrhosis in drinkers  |c John B. Whitfield, Tae-Hwi Schwantes-An, Rebecca Darlay, Guruprasad P. Aithal, Stephen R. Atkinson, Ramon Bataller, Greg Botwin, Naga P. Chalasani, Heather J. Cordell, Ann K. Daly, Christopher P. Day, Florian Eyer, Tatiana Foroud, Dermot Gleeson, David Goldman, Paul S. Haber, Jean-Marc Jacquet, Tiebing Liang, Suthat Liangpunsakul, Steven Masson, Philippe Mathurin, Romain Moirand, Andrew McQuillin, Christophe Moreno, Marsha Y. Morgan, Sebastian Mueller, Beat Müllhaupt, Laura E. Nagy, Pierre Nahon, Bertrand Nalpas, Sylvie Naveau, Pascal Perney, Munir Pirmohamed, Helmut K. Seitz, Michael Soyka, Felix Stickel, Andrew Thompson, Mark R. Thursz, Eric Trépo, Timothy R. Morgan, Devanshi Seth, for the GenomALC Consortium 
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520 |a Background & Aims - Only a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk. - Methods - Three cohorts (GenomALC-1: n = 1,690, GenomALC-2: n = 3,037, UK Biobank: relevant n = 6,898) with a history of heavy alcohol consumption (≥80 g/day (men), ≥50 g/day (women), for ≥10 years) were included. Cases were participants with alcohol-related cirrhosis. Controls had a history of similar alcohol consumption but no evidence of liver disease. Risk scores were computed from up to 8 genetic loci identified previously as associated with alcohol-related cirrhosis and 3 clinical risk factors. Score performance for the stratification of alcohol-related cirrhosis risk was assessed and compared across the alcohol-related liver disease spectrum, including hepatocellular carcinoma (HCC). - Results - A combination of 3 single nucleotide polymorphisms (SNPs) (PNPLA3:rs738409, SUGP1-TM6SF2:rs10401969, HSD17B13:rs6834314) and diabetes status best discriminated cirrhosis risk. The odds ratios (ORs) and (95% CIs) between the lowest (Q1) and highest (Q5) score quintiles of the 3-SNP score, based on independent allelic effect size estimates, were 5.99 (4.18-8.60) (GenomALC-1), 2.81 (2.03-3.89) (GenomALC-2), and 3.10 (2.32-4.14) (UK Biobank). Patients with diabetes and high risk scores had ORs of 14.7 (7.69-28.1) (GenomALC-1) and 17.1 (11.3-25.7) (UK Biobank) compared to those without diabetes and with low risk scores. Patients with cirrhosis and HCC had significantly higher mean risk scores than patients with cirrhosis alone (0.76 ± 0.06 vs. 0.61 ± 0.02, p = 0.007). Score performance was not significantly enhanced by information on additional genetic risk variants, body mass index or coffee consumption. - Conclusions - A risk score based on 3 genetic risk variants and diabetes status enables the stratification of heavy drinkers based on their risk of cirrhosis, allowing for the provision of earlier preventative interventions. - Lay summary - Excessive chronic drinking leads to cirrhosis in some people, but so far there is no way to identify those at high risk of developing this debilitating disease. We developed a genetic risk score that can identify patients at high risk. The risk of cirrhosis is increased >10-fold with just two risk factors - diabetes and a high genetic risk score. Risk assessment using this test could enable the early and personalised management of this disease in high-risk patients. 
650 4 |a chronic alcohol use 
650 4 |a coffee 
650 4 |a genome-wide association 
650 4 |a Hepatocellular carcinoma 
650 4 |a risk stratification 
650 4 |a single nucleotide polymorphism 
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700 1 |a Cordell, Heather J.  |e VerfasserIn  |4 aut 
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