title: Functional variants in the lymphotoxin-alpha gene predict cardiovascular disease in dialysis patients.
abstract: TNF-beta that is encoded by lymphotoxin-alpha gene (LTA) regulates adhesion molecules and IL-6. Previously, a genome-wide case-control study showed that LTA gene variants predisposed to cardiovascular disease (CVD). In a prospective study of 775 dialysis patients, LTA and IL-6 gene variants were tested as independent predictors of CVD risk. Four polymorphisms in the LTA gene and one in the IL-6 gene were genotyped. CVD events were ascertained from medical records. During a mean follow-up of 2.6 yr, 294 first-incident CVD events occurred. The LTA 26Asn variant predicted higher adjusted CVD risk (hazard ratio HR 1.33 for each additional copy of Asn allele; 95% confidence interval 1.14 to 1.55; P = 0.0003). Two other nonsynonymous polymorphisms in the LTA, 13Agr and 51Pro, were associated with lower inflammatory activity and CVD risk. LTA haplotypes (based on all four single-nucleotide polymorphisms) were associated with inflammatory markers and predicted CVD risk (P = 0.005) after adjustment. These LTA genotype associations were independent of the IL-6 -174G/C genotype association that was reported recently. LTA and IL-6 gene variants independently predicted risk for CVD among dialysis patients, suggesting that susceptibility in multiple inflammatory pathways contribute to the development of CVD.
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Liu
authors.forename: Yvette
authors.initials: Y
authors.lastname: Berthier-Schaad
authors.forename: Laura
authors.initials: L
authors.lastname: Plantinga
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Fink
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Wen Hong
authors.initials: WH
authors.lastname: Kao
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Klag
authors.forename: Michael W
authors.initials: MW
authors.lastname: Smith
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008233:Lymphotoxin-alpha / Q000235:genetics* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors
chemical_list: D008233:Lymphotoxin-alpha