A common variant in PNPLA3 is associated with age at diagnosis of NAFLD in patients from a multi-ethnic biobank.

TitleA common variant in PNPLA3 is associated with age at diagnosis of NAFLD in patients from a multi-ethnic biobank.
Publication TypeJournal Article
Year of Publication2020
AuthorsWalker, RW, Belbin, GM, Sorokin, EP, Van Vleck, T, Wojcik, GL, Moscati, A, Gignoux, CR, Cho, J, Abul-Husn, NS, Nadkarni, G, Kenny, EE, Loos, RJF
JournalJ Hepatol
Volume72
Issue6
Pagination1070-1081
Date Published2020 06
ISSN1600-0641
Abstract

BACKGROUND & AIMS: The Ile138Met variant (rs738409) in the PNPLA3 gene has the largest effect on non-alcoholic fatty liver disease (NAFLD), increasing the risk of progression to severe forms of liver disease. It remains unknown if the variant plays a role in age of NAFLD onset. We aimed to determine if rs738409 impacts on the age of NAFLD diagnosis.

METHODS: We applied a novel natural language processing (NLP) algorithm to a longitudinal electronic health records (EHR) dataset of >27,000 individuals with genetic data from a multi-ethnic biobank, defining NAFLD cases (n = 1,703) and confirming controls (n = 8,119). We conducted i) a survival analysis to determine if age at diagnosis differed by rs738409 genotype, ii) a receiver operating characteristics analysis to assess the utility of the rs738409 genotype in discriminating NAFLD cases from controls, and iii) a phenome-wide association study (PheWAS) between rs738409 and 10,095 EHR-derived disease diagnoses.

RESULTS: The PNPLA3 G risk allele was associated with: i) earlier age of NAFLD diagnosis, with the strongest effect in Hispanics (hazard ratio 1.33; 95% CI 1.15-1.53; p

CONCLUSION: Given the role of the rs738409 in NAFLD diagnosis age, our results suggest that stratifying risk within populations known to have an enhanced risk of liver disease, such as Hispanic carriers of the rs738409 variant, would be effective in earlier identification of those who would benefit most from early NAFLD prevention and treatment strategies.

LAY SUMMARY: Despite clear associations between the PNPLA3 rs738409 variant and elevated risk of progression from non-alcoholic fatty liver disease (NAFLD) to more severe forms of liver disease, it remains unknown if PNPLA3 rs738409 plays a role in the age of NAFLD onset. Herein, we found that this risk variant is associated with an earlier age of NAFLD and other liver disease diagnoses; an observation most pronounced in Hispanic Americans. We conclude that PNPLA3 rs738409 could be used to better understand liver disease risk within vulnerable populations and identify patients that may benefit from early prevention strategies.

DOI10.1016/j.jhep.2020.01.029
Alternate JournalJ Hepatol
PubMed ID32145261
PubMed Central IDPMC7840172
Grant ListU01 HG007417 / HG / NHGRI NIH HHS / United States
U01 HG009610 / HG / NHGRI NIH HHS / United States
R01 DK075787 / DK / NIDDK NIH HHS / United States
R01 HL104608 / HL / NHLBI NIH HHS / United States
U01 HG009080 / HG / NHGRI NIH HHS / United States
R01 HG010297 / HG / NHGRI NIH HHS / United States
R01 HL142302 / HL / NHLBI NIH HHS / United States
R01 DK110113 / DK / NIDDK NIH HHS / United States
UM1 HG008901 / HG / NHGRI NIH HHS / United States
R01 DK107786 / DK / NIDDK NIH HHS / United States
S10 OD018522 / OD / NIH HHS / United States
S10 OD026880 / OD / NIH HHS / United States
R01 DK101855 / DK / NIDDK NIH HHS / United States
P30 ES023515 / ES / NIEHS NIH HHS / United States
R56 HG010297 / HG / NHGRI NIH HHS / United States
T32 HD049311 / HD / NICHD NIH HHS / United States