Bradley J Willcox1,2, Brian J Morris1,2,3, Gregory J Tranah4, Randi Chen1, Kamal H Masaki1,2, Qimei He1, D Craig Willcox1,2,5, Richard C Allsopp6, Stefan Moisyadi6, Mariana Gerschenson7, Philip M C Davy6, Leonard W Poon8, Beatriz Rodriguez1,2, Anne B Newman9, Tamara B Harris10, Steven R Cummings4, Yongmei Liu11, Neeta Parimi4, Daniel S Evans4, Timothy A Donlon1,7,12. 1. Department of Research, Kuakini Medical Center, Honolulu, Hawaii. 2. Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu. 3. School of Medical Sciences and Bosch Institute, University of Sydney, New South Wales, Australia. 4. California Pacific Medical Center Research Institute, San Francisco. 5. Department of Human Welfare, Okinawa International University, Ginowan, Japan. 6. Institute for Biogenesis Research, University of Hawaii, Honolulu. 7. Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Honolulu. 8. Institute of Gerontology, University of Georgia, Athens. 9. Department of Epidemiology, University of Pittsburgh, Pennsylvania. 10. Laboratory of Neurogenetics, Intramural Research Program, National Institute on Aging, Bethesda, Maryland. 11. Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina. 12. Department of Pathology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
Abstract
BACKGROUND: We recently reported that protection against coronary artery disease (CAD) mortality is the major contributor to longer life associated with FOXO3 genotype. The present study examined this relation in more detail. METHODS: We performed a 15-year observational study of 3,584 older American men of Japanese ancestry from the Kuakini Honolulu Heart Program cohort and 1,595 White and 1,067 Black elderly individuals from the Health Aging and Body Composition study. RESULTS: Multivariate Cox regression models demonstrated that carriage of the longevity-associated G allele of FOXO3 single nucleotide polymorphisms rs2802292 was a protective factor against CAD mortality in all three populations. In Japanese and Whites, but not in Blacks, the protective effect of the G allele was little changed in models adjusted for other major risk factors. Population-attributable risk (PAR) models found that the nonprotective TT genotype contributed 15%, 9%, and 3% to CAD mortality risk in Japanese, White, and Black Americans, respectively, and was one of the top three contributing factors to CAD mortality. In Japanese, this effect size was comparable with hypertension (15%), but in Whites and Blacks PAR for hypertension was higher (29% and 26%, respectively). G-allele carriers had lower plasma TNF-α than noncarriers, suggesting inflammation as a potential mediating factor for CAD mortality risk. CONCLUSION: FOXO3 genotype is an important risk factor for CAD mortality in older populations. More research is needed to identify potential mechanisms and targets for intervention.
BACKGROUND: We recently reported that protection against coronary artery disease (CAD) mortality is the major contributor to longer life associated with FOXO3 genotype. The present study examined this relation in more detail. METHODS: We performed a 15-year observational study of 3,584 older American men of Japanese ancestry from the Kuakini Honolulu Heart Program cohort and 1,595 White and 1,067 Black elderly individuals from the Health Aging and Body Composition study. RESULTS: Multivariate Cox regression models demonstrated that carriage of the longevity-associated G allele of FOXO3 single nucleotide polymorphisms rs2802292 was a protective factor against CAD mortality in all three populations. In Japanese and Whites, but not in Blacks, the protective effect of the G allele was little changed in models adjusted for other major risk factors. Population-attributable risk (PAR) models found that the nonprotective TT genotype contributed 15%, 9%, and 3% to CAD mortality risk in Japanese, White, and Black Americans, respectively, and was one of the top three contributing factors to CAD mortality. In Japanese, this effect size was comparable with hypertension (15%), but in Whites and Blacks PAR for hypertension was higher (29% and 26%, respectively). G-allele carriers had lower plasma TNF-α than noncarriers, suggesting inflammation as a potential mediating factor for CAD mortality risk. CONCLUSION: FOXO3 genotype is an important risk factor for CAD mortality in older populations. More research is needed to identify potential mechanisms and targets for intervention.
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