Associations of Self-Reported Race, Social Determinants of Health, and Polygenic Risk With Coronary Heart Disease
Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD). This study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S. In 67,256 All of Us (AoU) particip...
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| Veröffentlicht in: | Journal of the American College of Cardiology Jg. 84; H. 22; S. 2157 |
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| Sprache: | Englisch |
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26.11.2024
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| ISSN: | 1558-3597, 1558-3597 |
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| Abstract | Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).
This study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S.
In 67,256 All of Us (AoU) participants with available SDOH and whole-genome sequencing data, we ascertained self-reported race/ethnicity and 22 SDOH measures across 5 SDOH domains, and we calculated a PRS for CHD (PRS
, PGS004696). We developed an SDOH score for CHD (SDOH
). We tested the associations of SDOH and PRS
with CHD in regression models that included clinical risk factors.
SDOH across 5 domains, including food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness, were associated with CHD. SDOH
was highest in self-reported Black and Hispanic people. Self-reporting as Blacks had higher odds of having CHD than Whites but not after adjustment for SDOH
. SDOH
and PRS
were weakly correlated. In the test set (n = 33,628), 1-SD increases in SDOH
and PRS
were associated with CHD in models that adjusted for clinical risk factors (OR: 1.32; 95% CI: 1.23-1.41 and OR: 1.36; 95% CI: 1.28-1.44, respectively). SDOH
and PRS
were associated with incident CHD events (n = 52) over a median follow-up of 214 days (Q1-Q3: 88 days).
Increased odds of CHD in people who self-report as Black are likely due to a higher SDOH burden. SDOH and PRS were independently associated with CHD. Our findings suggest that including both PRS and SDOH in CHD risk models could improve their accuracy. |
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| AbstractList | Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).BACKGROUNDSocial determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).This study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S.OBJECTIVESThis study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S.In 67,256 All of Us (AoU) participants with available SDOH and whole-genome sequencing data, we ascertained self-reported race/ethnicity and 22 SDOH measures across 5 SDOH domains, and we calculated a PRS for CHD (PRSCHD, PGS004696). We developed an SDOH score for CHD (SDOHCHD). We tested the associations of SDOH and PRSCHD with CHD in regression models that included clinical risk factors.METHODSIn 67,256 All of Us (AoU) participants with available SDOH and whole-genome sequencing data, we ascertained self-reported race/ethnicity and 22 SDOH measures across 5 SDOH domains, and we calculated a PRS for CHD (PRSCHD, PGS004696). We developed an SDOH score for CHD (SDOHCHD). We tested the associations of SDOH and PRSCHD with CHD in regression models that included clinical risk factors.SDOH across 5 domains, including food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness, were associated with CHD. SDOHCHD was highest in self-reported Black and Hispanic people. Self-reporting as Blacks had higher odds of having CHD than Whites but not after adjustment for SDOHCHD. SDOHCHD and PRSCHD were weakly correlated. In the test set (n = 33,628), 1-SD increases in SDOHCHD and PRSCHD were associated with CHD in models that adjusted for clinical risk factors (OR: 1.32; 95% CI: 1.23-1.41 and OR: 1.36; 95% CI: 1.28-1.44, respectively). SDOHCHD and PRSCHD were associated with incident CHD events (n = 52) over a median follow-up of 214 days (Q1-Q3: 88 days).RESULTSSDOH across 5 domains, including food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness, were associated with CHD. SDOHCHD was highest in self-reported Black and Hispanic people. Self-reporting as Blacks had higher odds of having CHD than Whites but not after adjustment for SDOHCHD. SDOHCHD and PRSCHD were weakly correlated. In the test set (n = 33,628), 1-SD increases in SDOHCHD and PRSCHD were associated with CHD in models that adjusted for clinical risk factors (OR: 1.32; 95% CI: 1.23-1.41 and OR: 1.36; 95% CI: 1.28-1.44, respectively). SDOHCHD and PRSCHD were associated with incident CHD events (n = 52) over a median follow-up of 214 days (Q1-Q3: 88 days).Increased odds of CHD in people who self-report as Black are likely due to a higher SDOH burden. SDOH and PRS were independently associated with CHD. Our findings suggest that including both PRS and SDOH in CHD risk models could improve their accuracy.CONCLUSIONSIncreased odds of CHD in people who self-report as Black are likely due to a higher SDOH burden. SDOH and PRS were independently associated with CHD. Our findings suggest that including both PRS and SDOH in CHD risk models could improve their accuracy. Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD). This study sought to test the associations of self-reported race/ethnicity, SDOH, and a polygenic risk score (PRS), with CHD in a large and diverse U.S. In 67,256 All of Us (AoU) participants with available SDOH and whole-genome sequencing data, we ascertained self-reported race/ethnicity and 22 SDOH measures across 5 SDOH domains, and we calculated a PRS for CHD (PRS , PGS004696). We developed an SDOH score for CHD (SDOH ). We tested the associations of SDOH and PRS with CHD in regression models that included clinical risk factors. SDOH across 5 domains, including food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness, were associated with CHD. SDOH was highest in self-reported Black and Hispanic people. Self-reporting as Blacks had higher odds of having CHD than Whites but not after adjustment for SDOH . SDOH and PRS were weakly correlated. In the test set (n = 33,628), 1-SD increases in SDOH and PRS were associated with CHD in models that adjusted for clinical risk factors (OR: 1.32; 95% CI: 1.23-1.41 and OR: 1.36; 95% CI: 1.28-1.44, respectively). SDOH and PRS were associated with incident CHD events (n = 52) over a median follow-up of 214 days (Q1-Q3: 88 days). Increased odds of CHD in people who self-report as Black are likely due to a higher SDOH burden. SDOH and PRS were independently associated with CHD. Our findings suggest that including both PRS and SDOH in CHD risk models could improve their accuracy. |
| Author | Na, Jie Kullo, Iftikhar J Schaid, Daniel J Naderian, Mohammadreza Norland, Kristjan |
| Author_xml | – sequence: 1 givenname: Kristjan surname: Norland fullname: Norland, Kristjan organization: Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA – sequence: 2 givenname: Daniel J surname: Schaid fullname: Schaid, Daniel J organization: Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA – sequence: 3 givenname: Mohammadreza surname: Naderian fullname: Naderian, Mohammadreza organization: Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA – sequence: 4 givenname: Jie surname: Na fullname: Na, Jie organization: Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA – sequence: 5 givenname: Iftikhar J surname: Kullo fullname: Kullo, Iftikhar J email: kullo.iftikhar@mayo.edu organization: Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: kullo.iftikhar@mayo.edu |
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| Keywords | social determinants of health coronary heart disease polygenic risk scores |
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| References | 38260263 - medRxiv. 2024 Jan 11:2024.01.10.24301105. doi: 10.1101/2024.01.10.24301105. |
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| Snippet | Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).
This study sought to test the associations of... Social determinants of health (SDOH) influence the risk of common diseases such as coronary heart disease (CHD).BACKGROUNDSocial determinants of health (SDOH)... |
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| SubjectTerms | Adult Aged Cohort Studies Coronary Disease - epidemiology Coronary Disease - ethnology Coronary Disease - genetics Female Humans Male Middle Aged Multifactorial Inheritance - genetics Racial Groups Risk Assessment - methods Risk Factors Self Report Social Determinants of Health United States - epidemiology |
| Title | Associations of Self-Reported Race, Social Determinants of Health, and Polygenic Risk With Coronary Heart Disease |
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