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Ala-Korpela, M.

Publications and source records attributed to Ala-Korpela, M..

12 recordsLinked to original sources

Direct estimation of HDL-mediated cholesterol efflux capacity from serum

High-density lipoprotein mediated cholesterol efflux capacity (HDL-CEC) is a functional attribute that may have a protective role in atherogenesis. However, the estimation of HDL-CEC is based on in vitro cell assays that are laborious and hamper large-scale phenotyping. Here, we present a cost-effective high-throughput nuclear magnetic resonance (NMR) spectroscopy method to estimate HDL-CEC directly from serum. We applied the new method in a population-based study of 7,603 individuals including 574 who developed incident coronary heart disease (CHD) during 15 years of follow-up, making this the largest quantitative study for HDL-CEC. As estimated by NMR-spectroscopy, a 1-SD higher HDL-CEC was associated with a lower risk of incident CHD (hazards ratio 0.86; 95%CI 0.79-0.93, adjusted for traditional risk factors and HDL-C). These findings are consistent with published associations based on in vitro cell assays. These corroborative large-scale findings provide further support for a potential protective role of HDL-CEC in CHD, and substantiate this new method and its future applications.

epidemiology

Genetic and environmental perturbations lead to regulatory decoherence

Correlation among traits is a fundamental feature of biological systems. From morphological characters, to transcriptional or metabolic networks, the correlations we routinely observe between traits reflect a shared regulation that remains poorly understood and difficult to study. To address this problem, we developed a new and flexible approach that allows us to identify factors associated with variation in correlation between individuals. Here, we use data from three large human cohorts to study the effects of genetic variation and environmental perturbation on correlations among mRNA transcripts and among NMR metabolites. We first show that environmental exposures (namely, infection and disease) lead to a systematic loss of correlation, which we define as decoherence. Using longitudinal data, we show that decoherent metabolites are better predictors of whether someone will develop metabolic syndrome than metabolites commonly used as biomarkers of this disease. Finally, we show that correlation itself is a trait under genetic control: specifically, we mapped and replicated hundreds of correlation QTLs, which often involve transcription factors or their known target genes. Together, this work furthers our understanding of how and why coordinated biological processes break down, and highlights the role of decoherence in disease emergence.

genomics

Machine Learning in Multi-Omics Data to Assess Longitudinal Predictors of Glycaemic Trait Levels

Type 2 diabetes (T2D) is a global health burden that will benefit from personalised risk prediction and targeted prevention programmes. Omics data have enabled more detailed risk prediction; however, most studies have focussed on directly on the ability of DNA variants predicting T2D onset with less attention given to epigenetic regulation and glycaemic trait variability. By applying machine learning to the longitudinal Northern Finland Birth Cohort 1966 (NFBC 1966) at 31 (T1) and 46 (T2) years old, we predicted fasting glucose (FG) and insulin (FI), glycated haemoglobin (HbA1c) and 2-hour glucose and insulin from oral glucose tolerance test (2hGlu, 2hIns) at T2 in 513 individuals from 1,001 variables at T1 and T2, including anthropometric, metabolic, metabolomic and epigenetic variables. We further tested whether the information obtained by the machine learning models in NFBC could be used to predict glycaemic traits in the independent French study with 48 matching predictors (DESIR, N=769, age range 30-65 years at recruitment, interval between data collections: 9 years). In this study, FG and FI were best predicted, with average R2 values of 0.38 and 0.53. Sex, branched-chain and aromatic amino acids, HDL-cholesterol, glycerol, ketone bodies, blood pressure at T2 and measurements of adiposity at T1, as well as multiple methylation marks at both time points were amongst the top predictors. In the validation analysis, we reached R2 values of 0.41/0.55 for FG/FI when trained and tested in NFBC1966 and 0.17/0.30 when trained in NFBC1966 and tested in DESIR. We identified clinically relevant sets of predictors from a large multi-omics dataset and highlighted the potential of methylation markers and longitudinal changes in prediction.

genomics

Elevated alpha 1 antitrypsin is a major component of GlycA-associated risk for future morbidity and mortality

Integration of electronic health records with systems-level biomolecular data has led to the discovery that GlycA, a complex nuclear magnetic resonance (NMR) spectroscopy biomarker, predicts long-term risk of disease onset and death from myriad causes. To determine the molecular underpinnings of the disease risk of the heterogeneous GlycA signal, we used machine learning to build imputation models for GlycAs constituent glycoproteins, then estimated glycoprotein levels in 11,861 adults across two population-based cohorts with long-term follow-up. While alpha-1-acid glycoprotein had the strongest correlation with GlycA, our analysis revealed that alpha-1 antitrypsin (AAT) was the most predictive of morbidity and mortality for the widest range of diseases, including heart failure (HR=1.60 per s.d., P=1x10-10), influenza and pneumonia (HR=1.37, P=6x10-10), and liver diseases (HR=1.81, P=1x10-6). Despite emerging evidence of AAT's role in suppressing inflammation, transcriptional analyses revealed elevated expression of diverse inflammatory immune pathways with elevated AAT levels, suggesting AAT is elevating to compensate for low-grade chronic inflammation. This study clarifies the molecular underpinnings of the GlycA biomarker and its associated disease risk, and indicates a previously unrecognised association between elevated AAT and severe disease onset and mortality.

systems biology

Lipoprotein Signatures of Cholesteryl Ester Transfer Protein and HMG-CoA Reductase Inhibition

BackgroundCETP inhibition reduces vascular event rates but confusion surrounds its low-density lipoprotein (LDL)-cholesterol effects. We sought to clarify associations of genetic inhibition of CETP on detailed lipoproteins.\n\nMethods and ResultsWe used variants associated with CETP (rs247617) and HMGCR (rs12916) expression in 62,400 Europeans with detailed lipoprotein profiling from nuclear magnetic resonance spectroscopy. Genetic associations were scaled to 10% lower risk of coronary heart disease (CHD). Associations of lipoprotein measures with risk of incident CHD in three population-based cohorts (770 cases) were examined.\n\nCETP and HMGCR had near-identical associations with LDL-cholesterol concentration estimated by Friedewald-equation. HMGCR had a relatively consistent effect on cholesterol concentrations across all apolipoprotein B-containing lipoproteins. CETP had stronger effects on remnant and very-low-density lipoprotein cholesterol but no effect on cholesterol concentrations in LDL defined by particle size (diameter 18-26 nm) (-0.02SD 95%CI: -0.10, 0.05 for CETP versus -0.24SD, 95%CI -0.30, -0.18 for HMGCR). CETP had profound effects on lipid compositions of lipoproteins, with strong reductions in the triglyceride content of all highdensity lipoprotein (HDL) particles. These alterations in triglyceride composition within HDL subclasses were observationally associated with risk of CHD, independently of total cholesterol and triglycerides (strongest HR per 1-SD higher triglyceride composition in very-large HDL 1.35; 95%CI: 1.18, 1.54).\n\nConclusionCETP inhibition does not affect size-specific LDL cholesterol but may lower CHD risk by lowering cholesterol in other apolipoprotein-B containing lipoproteins and lowering triglyceride content of HDL particles. Conventional composite lipid assays may mask heterogeneous effects of lipid-altering therapies.

genetics

Proof of concept for quantitative urine NMR metabolomics pipeline for large-scale epidemiology and genetics

BackgroundQuantitative molecular data from urine are rare in epidemiology and genetics. NMR spectroscopy could provide these data in high-throughput, and it has already been applied in epidemiological settings to analyse urine samples. However, quantitative protocols for large-scale applications are not available.\n\nMethodsWe describe in detail how to prepare urine samples and perform NMR experiments to obtain quantitative metabolic information. Semi-automated quantitative lineshape fitting analyses were set up for 43 metabolites and applied to data from various analytical test samples and from 1,004 individuals from a population-based epidemiological cohort. Novel analyses on how urine metabolites associate with quantitative serum NMR metabolomics data (61 metabolic measures; n=995) were performed. In addition, confirmatory genome-wide analyses of urine metabolites were conducted (n=578). The fully automated quantitative regression-based spectral analysis is demonstrated for creatinine and glucose (n= 4,548).\n\nResultsIntra-assay metabolite variations were mostly <5% indicating high robustness and accuracy of the urine NMR spectroscopy methodology per se. Intra-individual metabolite variations were large, ranging from 6% to 194%. However, population-based inter-individual metabolite variations were even larger (from 14% to 1655%), providing a sound base for epidemiological applications. Metabolic associations between urine and serum were found clearly weaker than those within serum and within urine, indicating that urinary metabolomics data provide independent metabolic information. Two previous genome-wide hits for formate and 2-hydroxyisobutyrate were replicated at genome-wide significance.\n\nConclusionsQuantitative urine metabolomics data suggest broad novelty for systems epidemiology. A roadmap for an open access methodology is provided.

epidemiology

Metabolomic consequences of genetic inhibition of PCSK9 compared with statin treatment

BackgroundBoth statins and PCSK9 inhibitors lower blood low-density lipoprotein cholesterol (LDL-C) levels to reduce risk of cardiovascular events. To assess potential differences between metabolic effects of these two lipid-lowering therapies, we performed detailed lipid and metabolite profiling of a large randomized statin trial, and compared the results with the effects of genetic inhibition of PCSK9, acting as a naturally occurring trial.\n\nMethods228 circulating metabolic measures were quantified by nuclear magnetic resonance spectroscopy, including lipoprotein subclass concentrations and their lipid composition, fatty acids, and amino acids, for 5,359 individuals (2,659 on treatment) in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial at 6-months post-randomization. The corresponding metabolic measures were analyzed in eight population cohorts (N=72,185) using PCSK9 rs11591147 as an unconfounded proxy to mimic the therapeutic effects of PCSK9 inhibitors.\n\nResultsScaled to an equivalent lowering of LDL-C, the effects of genetic inhibition of PCSK9 on 228 metabolic markers were generally consistent with those of statin therapy (R2=0.88). Alterations in lipoprotein lipid composition and fatty acid balance were similar. However, discrepancies were observed for very-low-density lipoprotein (VLDL) lipid measures. For instance, genetic inhibition of PCSK9 showed weaker effects on lowering of VLDL-cholesterol compared with statin therapy (54% vs. 77% reduction, relative to the lowering effect on LDL-C; P=2 x 10-7 for heterogeneity). Genetic inhibition of PCSK9 showed no robust effects on amino acids, ketones, and a marker of inflammation (GlycA); in contrast, statin treatment lowered GlycA levels.\n\nConclusionsGenetic inhibition of PCSK9 results in similar metabolic effects as statin therapy across a detailed lipid and metabolite profile. However, for the same lowering of LDL-C, PCSK9 inhibitors are predicted to be less efficacious than statins at lowering VLDL lipids, which could potentially translate into subtle differences in cardiovascular risk reduction.

epidemiology

The landscape of incident disease risk for the biomarker GlycA and its mortality stratification in angiography patients

Integration of systems-level biomolecular information with electronic health records has led to the discovery of robust blood-based biomarkers predictive of future health and disease. Of recent intense interest is the GlycA biomarker, a complex nuclear magnetic resonance (NMR) spectroscopy signal reflective of acute and chronic inflammation, which predicts long term risk of diverse outcomes including cardiovascular disease, type 2 diabetes, and all-cause mortality. To systematically explore the specificity of the disease burden indicated by GlycA we analysed the risk for 468 common incident hospitalization and mortality outcomes occurring during an 8-year follow-up of 11,861 adults from Finland. Our analyses of GlycA replicated known associations, identified associations with specific cardiovascular disease outcomes, and uncovered new associations with risk of alcoholic liver disease (meta-analysed hazard ratio 2.94 per 1-SD, P=5x10-6), chronic renal failure (HR=2.47, P=3x10-6), glomerular diseases (HR=1.95, P=1x10-6), chronic obstructive pulmonary disease (HR=1.58, P=3x10-5), inflammatory polyarthropathies (HR=1.46, P=4x10-8), and hypertension (HR=1.21, P=5x10-5). We further evaluated GlycA as a biomarker in secondary prevention of 12-year cardiovascular mortality in 900 angiography patients with suspected coronary artery disease. We observed hazard ratios of 4.87 and 5.00 for 12-year mortality in angiography patients in the fourth and fifth quintiles by GlycA levels demonstrating the prognostic potential of GlycA for identification of high mortality-risk individuals. Both GlycA and C-reactive protein had shared as well as independent contributions to mortality hazard, emphasising the importance of chronic inflammation in secondary prevention of cardiovascular disease.

epidemiology

Metabolic characterization of menopause: cross-sectional and longitudinal evidence

BackgroundIt remains elusive whether the changes in cardiometabolic biomarkers during the menopausal transition are due to ovarian aging or chronological aging. Well-conducted longitudinal studies are required to determine this. The aim of this study was to explore the cross-sectional and longitudinal associations of reproductive status defined according to the 2012 Stages of Reproductive Aging Workshop criteria with 74 metabolic biomarkers, and establish whether any associations are independent of age related changes.\n\nMethodsWe determined cross-sectional associations of reproductive status with metabolic profiling in 3,312 UK midlife women. In a subgroup of 1,492 women who had repeat assessments after 2.5 years, we assessed how change in reproductive status was associated with the changes in metabolic biomarkers. Metabolic profiles were measured by high-throughput quantitative serum NMR metabolomics. In longitudinal analyses, we compared the change in metabolic biomarkers for each reproductive status category change to that in the reference of being pre-menopausal at both time points. As all women aged by a similar amount during follow-up, these analyses contribute to distinguish age related changes from those related to change in reproductive status.\n\nResultsConsistent cross-sectional and longitudinal associations of menopause with a wide range of metabolic biomarkers were observed, suggesting transition to menopause induces multiple metabolic changes independent of chronological aging. The metabolic changes included increased concentrations of very small VLDL, IDL and LDL subclasses, remnant and LDL cholesterol, and reduced LDL particle size, all towards an atherogenic lipoprotein profile. Increased inflammation was suggested via an inflammatory biomarker, glycoprotein acetyls, but not via C-reactive protein. Also, levels of glutamine and albumin were increased during the transition. Most of these metabolic changes seen at the time of becoming post-menopausal remained or became slightly stronger during the post-menopausal years.\n\nConclusionsTransition to post-menopause has effects on multiple circulating metabolic biomarkers, over and above the underlying age trajectory. The adverse changes in multiple apolipoprotein-B containing lipoprotein subclasses and increased inflammation may underlie womens increased cardiometabolic risk in post-menopausal years.\n\nAbbreviations

epidemiology

Metabolic Effects Of Risk Alleles In PNPLA3, TM6SF2, GCKR, And LYPLAL1 Inform About Heterogeneity Of Non-Alcoholic Fatty Liver Disease

Fatty liver has been associated with unfavourable metabolic changes in circulation and is considered as a risk factor for cardiometabolic complications such as type 2 diabetes and cardiovascular disease. We aimed to provide insights in fatty liver related metabolic deviations by studying the resemblance between the metabolic profile associated with fatty liver observationally and metabolic profiles of non-alcoholic fatty liver disease (NAFLD) risk increasing genotypes. We determined cross-sectional associations of ultrasound-ascertained fatty liver status with 123 metabolic traits in 1,810 individuals aged 34-49 years from The Cardiovascular Risk in Young Finns Study. The cross-sectional associations were compared with the association profiles of NAFLD risk alleles in PNPLA3, TM6SF2, GCKR, and LYPLAL1 with the corresponding metabolic traits obtained from a publicly available genome-wide association study including up to 24,925 European individuals. The analysis revealed substantially different metabolic effects of the risk alleles. PNPLA3 rs738409-G, the strongest genetic risk factor to NAFLD, did not associate with metabolic changes. GCKR rs1260326-T resulted in an association profile similar to the observational fatty liver associations. Metabolic effects of LYPLAL1 rs12137855-C were similar, but statistically less robust, to the effects of GCKR rs1260326-T. In contrast, NAFLD risk allele TM6SF2 rs58542926-T displayed opposite metabolic associations when compared with the observational association pattern.\n\nConclusionThe divergent effects of the risk alleles on circulating lipids and metabolites underline involvement of several metabolic pathways in NAFLD and suggest that there are pathogenically different subtypes of NAFLD with alternate metabolic consequences. NAFLD risk alleles may have neutral or even cardioprotective effect on circulating lipids and metabolites providing evidence that hepatic lipid accumulation by itself would not necessarily cause the metabolic deviations associated observationally with fatty liver.

epidemiology

Association of pre-pregnancy body mass index with future offspring metabolic profile: findings from three independent European birth cohorts

BackgroundA high proportion of women start pregnancy overweight/obese. According to the developmental overnutrition hypothesis, this could lead offspring to have metabolic disruption throughout their lives, and, thus perpetuate the obesity epidemic across generations. Concerns about this hypothesis are influencing antenatal care. However, it is unknown whether maternal pregnancy adiposity is associated with long-term risk of adverse metabolic profiles in offspring, and if so, whether this association is causal, via intrauterine mechanisms, or explained by shared familial (genetic, lifestyle, socioeconomic) characteristics. We aimed to determine if associations between maternal body mass index (BMI) with offspring systemic metabolite profile are causal via intrauterine mechanisms or familial factors.\n\nMethods and FindingsWe used one and two-stage individual participant data (IPD) metaanalysis, and a negative-control (paternal BMI) to examine the association between maternal prepregnancy BMI and offspring serum metabolome from three European birth cohorts (offspring age at metabolite assessment 16, 17 and 31 years). Circulating metabolites were quantified by high-throughput nuclear magnetic resonance metabolomics. Results from one-stage IPD meta-analysis (N=5327 to 5377 mother-father-offspring trios) showed that increasing maternal and paternal BMI was associated with an adverse cardio-metabolic profile in offspring. We observed strong positive associations with VLDL-lipoproteins, VLDL-C, VLDL-triglycerides, VLDL-diameter, branched/aromatic amino acids, glycoprotein acetyls, and triglycerides, and strong negative associations with HDL-lipoprotein, HDL-diameter, HDL-C, HDL2-C and HDL3-C (all P<0.003). Stronger magnitudes of associations were present for maternal compared with paternal BMI across these associations, however there was no strong statistical evidence for heterogeneity between them (all bootstrap P >0.003, equivalent to 0.05 after accounting for multiple testing). Results were similar in each individual cohort, and in the two-stage analysis. Offspring BMI showed similar patterns of crosssectional association with metabolic profiles as for parental pre-pregnancy BMI associations, but with greater magnitudes. Adjustment of the parent BMI-offspring metabolite associations for offspring BMI suggested the parental associations were largely due to the association of parental BMI measures with offspring BMI.\n\nConclusionOur findings suggest that maternal BMI-offspring metabolome associations are likely to be largely due to shared genetic or familial lifestyle confounding, rather than intrauterine programming mechanisms. They do not support the introduction of measures to reduce maternal BMI in order to prevent adverse offspring cardio-metabolic health.

epidemiology

An interaction map of circulating metabolites, immune gene networks and their genetic regulation

The interaction between metabolism and the immune system plays a central role in many cardiometabolic diseases. We integrated blood transcriptomic, metabolomic, and genomic profiles from two population-based cohorts, including a subset with 7-year follow-up sampling. We identified topologically robust gene networks enriched for diverse immune functions including cytotoxicity, viral response, B cell, platelet, neutrophil, and mast cell/basophil activity. These immune gene modules showed complex patterns of association with 158 circulating metabolites, including lipoprotein subclasses, lipids, fatty acids, amino acids, and CRP. Genome-wide scans for module expression quantitative trait loci (mQTLs) revealed five modules with mQTLs of both cis and trans effects. The strongest mQTL was in ARHGEF3 (rs1354034) and affected a module enriched for platelet function. Mast cell/basophil and neutrophil function modules maintained their metabolite associations during 7-year follow-up, while our strongest mQTL in ARHGEF3 also displayed clear temporal stability. This study provides a detailed map of natural variation at the blood immuno-metabolic interface and its genetic basis, and facilitates subsequent studies to explain inter-individual variation in cardiometabolic disease.

genomics