Document Detail


Physiogenomic analysis of statin-treated patients: domain-specific counter effects within the ACACB gene on low-density lipoprotein cholesterol?
MedLine Citation:
PMID:  20602615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Administered at maximal dosages, the most common statins--atorvastatin, simvastatin and rosuvastatin--lower low-density lipoprotein cholesterol (LDLC) by an average of 37-57% in patients with primary hypercholesterolemia. We hypothesized novel genetic underpinnings for variation in LDLC levels in the context of statin therapy.
MATERIALS & METHODS: Genotyping of 384 SNPs in 202 volunteers from a lipid outpatient clinic was accomplished and LDLC levels obtained from chart records. The SNPs were distributed across 222 genes representing physiological pathways such as general metabolism, cholesterol biochemistry, cardiovascular function, inflammation, neurobiology and cell proliferation. We discovered significant associations with LDLC levels for the rs34274 SNP (p < 0.0002) and for rs2241220 (p < 0.008) in the acetyl-coenzyme A carboxylase beta (ACACB) gene. When corrected for multiple testing, the false-discovery rate associated with rs34274 was 0.076 (significance threshold: 0.10) and for rs2241220 the false-discovery rate was 0.93 (not significant). The acetyl coenzyme A carboxylase beta enzyme synthesizes malonyl coenzyme A, an essential substrate for hepatic fatty acid synthesis and an inhibitor of fatty acid oxidation.
RESULTS: The SNPs were in weak linkage disequilibrium (D = 0.302). Minor alleles at these sites demonstrate opposing influences on LDLC; the C>T substitution at rs34724 is a risk marker and the C>T substitution at rs2241220 a protective marker for LDLC levels. These SNPs hypothetically influence enzymatic activity through different mechanisms, rs34274 through the PII promoter and rs2241220 via alteration of the protein's responsiveness to allosteric influence.
CONCLUSION: Physiogenomic evidence suggests a novel link between LDLC levels and the regulation of fatty acid metabolism. The findings complement previously discovered novel SNP relationships to myalgia (pain) and myositis (serum creatine kinase activity). By genotyping for myositis, myalgia and LDLC levels, a physiogenomic model may be developed to help clinicians maximize effectiveness and minimize side effects in prescribing statins.
Authors:
Gualberto Ruaño; Paul D Thompson; John P Kane; Clive R Pullinger; Andreas Windemuth; Richard L Seip; Mohan Kocherla; Theodore R Holford; Alan H B Wu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pharmacogenomics     Volume:  11     ISSN:  1744-8042     ISO Abbreviation:  Pharmacogenomics     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-06     Completed Date:  2011-01-06     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  100897350     Medline TA:  Pharmacogenomics     Country:  England    
Other Details:
Languages:  eng     Pagination:  959-71     Citation Subset:  IM    
Affiliation:
Genomas, Inc, 67 Jefferson Street, Hartford, CT 06106, USA. g.ruano@genomas.net
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MeSH Terms
Descriptor/Qualifier:
Acetyl-CoA Carboxylase / genetics
Aged
Anticholesteremic Agents / therapeutic use*
Cholesterol / blood
Cholesterol, LDL / blood*
Cross-Sectional Studies
Female
Fluorobenzenes / therapeutic use
Genotype
Heptanoic Acids / therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage,  adverse effects,  therapeutic use*
Hypercholesterolemia / chemically induced,  drug therapy
Male
Middle Aged
Polymorphism, Single Nucleotide*
Pyrimidines / therapeutic use
Pyrroles / therapeutic use
Simvastatin / therapeutic use
Sulfonamides / therapeutic use
Grant Support
ID/Acronym/Agency:
4R 44GM085201-02/GM/NIGMS NIH HHS; R44 GM085201-03/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, LDL; 0/Fluorobenzenes; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Pyrimidines; 0/Pyrroles; 0/Sulfonamides; 110862-48-1/atorvastatin; 287714-41-4/rosuvastatin; 57-88-5/Cholesterol; 79902-63-9/Simvastatin; EC 6.4.1.2/Acetyl-CoA Carboxylase
Comments/Corrections

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