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PCSK9 genetic variants and risk of type 2 diabetes: a mendelian randomisation study

AF. Schmidt, DI. Swerdlow, MV. Holmes, RS. Patel, Z. Fairhurst-Hunter, DM. Lyall, FP. Hartwig, BL. Horta, E. Hyppönen, C. Power, M. Moldovan, E. van Iperen, GK. Hovingh, I. Demuth, K. Norman, E. Steinhagen-Thiessen, J. Demuth, L. Bertram, T. Liu,...

. 2017 ; 5 (2) : 97-105. [pub] 20161129

Language English Country England, Great Britain

Document type Journal Article

BACKGROUND: Statin treatment and variants in the gene encoding HMG-CoA reductase are associated with reductions in both the concentration of LDL cholesterol and the risk of coronary heart disease, but also with modest hyperglycaemia, increased bodyweight, and modestly increased risk of type 2 diabetes, which in no way offsets their substantial benefits. We sought to investigate the associations of LDL cholesterol-lowering PCSK9 variants with type 2 diabetes and related biomarkers to gauge the likely effects of PCSK9 inhibitors on diabetes risk. METHODS: In this mendelian randomisation study, we used data from cohort studies, randomised controlled trials, case control studies, and genetic consortia to estimate associations of PCSK9 genetic variants with LDL cholesterol, fasting blood glucose, HbA1c, fasting insulin, bodyweight, waist-to-hip ratio, BMI, and risk of type 2 diabetes, using a standardised analysis plan, meta-analyses, and weighted gene-centric scores. FINDINGS: Data were available for more than 550 000 individuals and 51 623 cases of type 2 diabetes. Combined analyses of four independent PCSK9 variants (rs11583680, rs11591147, rs2479409, and rs11206510) scaled to 1 mmol/L lower LDL cholesterol showed associations with increased fasting glucose (0·09 mmol/L, 95% CI 0·02 to 0·15), bodyweight (1·03 kg, 0·24 to 1·82), waist-to-hip ratio (0·006, 0·003 to 0·010), and an odds ratio for type diabetes of 1·29 (1·11 to 1·50). Based on the collected data, we did not identify associations with HbA1c (0·03%, -0·01 to 0·08), fasting insulin (0·00%, -0·06 to 0·07), and BMI (0·11 kg/m2, -0·09 to 0·30). INTERPRETATION: PCSK9 variants associated with lower LDL cholesterol were also associated with circulating higher fasting glucose concentration, bodyweight, and waist-to-hip ratio, and an increased risk of type 2 diabetes. In trials of PCSK9 inhibitor drugs, investigators should carefully assess these safety outcomes and quantify the risks and benefits of PCSK9 inhibitor treatment, as was previously done for statins. FUNDING: British Heart Foundation, and University College London Hospitals NHS Foundation Trust (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre.

Anschutz Medical Campus University of Colorado Denver Denver CO USA

Biomedical and Translational Informatics Geisinger Health System Danville PA USA

Bradford Institute for Health Research Bradford Royal Infirmary Bradford UK

Cancer Epidemiology Unit San Giovanni Battista Hospital Turin Italy

Center for Health Research Geisinger Clinic Danville PA USA

Center for Human Genetics Marshfield Clinic Research Foundation Marshfield WI USA

Centre for Cardiovascular Genetics University College London UK

Centre for Oncology Prevention CPO Piemonte Turin Italy

Centre for Population Health Research Sansom Institute for Health Research University of South Australia Adelaide SA Australia

Centre for Population Health Sciences Usher Institute of Population Health Sciences and Informatics University of Edinburgh Edinburgh UK

Charité Research Group on Geriatrics Charité Universitätsmedizin Berlin Berlin Germany

Children's Hospital of Philadelphia Philadelphia PA USA

Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford Oxford UK

CNRS UMR 8199 European Genomic Institute for Diabetes Institut Pasteur de Lille University of Lille Lille France

Cyprus International Institute for Environmental and Public Health Cyprus University of Technology Limassol Cyprus

Department of Biochemistry and Molecular Biology Huck Institutes of the Life Sciences Pennsylvania State University University Park PA USA

Department of Biomedical Informatics Vanderbilt University School of Medicine Nashville TN USA

Department of Cardiology Division Heart and Lungs University Medical Center Utrecht Utrecht Netherlands

Department of Cardiology University Medical Center Groningen University of Groningen Groningen Netherlands

Department of Clinical Epidemiology Biostatistics and Bioinformatics Academic Medical Center Amsterdam Netherlands

Department of Clinical Epidemiology Leiden University Medical Center Leiden Netherlands

Department of Clinical Experimental Research Rigshospitalet Copenhagen Denmark

Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Department of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany

Department of Epidemiology and Public Health UCL Institute of Epidemiology and Health Care University College London UK

Department of Epidemiology Erasmus University Medical Center Rotterdam Netherlands

Department of Epidemiology Fred Hutchinson Cancer Research Center University of Washington Seattle WA USA

Department of Epidemiology University Medical Center Groningen University of Groningen Groningen Netherlands

Department of Genetics University Medical Center Groningen University of Groningen Groningen Netherlands

Department of Genomics of Common Disease Imperial College London London UK

Department of Internal Medicine B University Medicine Greifswald Greifswald Germany

Department of Internal Medicine Erasmus University Medical Center Rotterdam Netherlands

Department of Medical Sciences University of Turin Turin Italy

Department of Medicine A University Medicine Greifswald Greifswald Germany

Department of Medicine Imperial College London London UK

Department of Neurology Medical University of Innsbruck Innsbruck Austria

Department of Non Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine London UK

Department of Primary Care and Population Health University College London UK

Department of Respiratory Medicine Academic Medical Center Amsterdam Netherlands

Department of Surgery Nicosia Medical School University of Nicosia Nicosia Cyprus

Department of Surgery University of Pennsylvania Philadelphia PA USA

Department of Vascular Medicine Academic Medical Center Amsterdam Netherlands

Department of Vascular Surgery Imperial College London London UK

Departments of Medicine and Pharmacology Vanderbilt University School of Medicine Nashville TN USA

Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN USA

Division of Cardiovascular Medicine Department of Medicine Stanford University School of Medicine Stanford CA USA

Division of Genetic Epidemiology Innsbruck Department of Medical Genetics Molecular and Clinical Pharmacology Medical University of Innsbruck Innsbruck Austria

Division of Pharmacoepidemiology and Clinical Pharmacology Utrecht Institute of Pharmaceutical Sciences Faculty of Science Utrecht University Utrecht Netherlands

Durrer Center for Cardiovascular Research Netherlands Heart Institute Utrecht Netherlands

E CA Economics GmbH Berlin Germany

Essentia Institute of Rural Health Duluth MN USA

Faculty of Medicine and Department of Biostatistics and Epidemiology MRC PHE Centre for Environment and Health School of Public Health Imperial College London London UK

Farr Institute of Health Informatics Research UCL Institute of Health Informatics University College London UK

George Washington University Washington DC USA

German Centre for Cardiovascular Research Greifswald Germany

Group Health Research Institute in Seattle WA USA

Group Health Research Institute Seattle WA USA

Harvard Medical School Center for Cardiovascular Disease Prevention Brigham and Women's Hospital Boston MA USA

Human Genetics Foundation HuGeF Turin Italy

I'institut du Thorax INSERM CNRS University of Nantes CHU de Nantes Nantes France

Institute for Community Medicine University Medicine Greifswald Greifswald Germany

Institute for Social and Economic Research University of Essex Colchester Essex UK

Institute of Cardiovascular and Medical Sciences University of Glasgow Glasgow UK

Institute of Cardiovascular Science University College London UK

Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh UK

Institute of Health and Wellbeing University of Glasgow Glasgow UK

Institute of Internal and Preventive Medicine Siberian Branch of the Russian Academy of Medical Sciences Novosibirsk Russia

Institute of Medical and Human Genetics Charité Universitätsmedizin Berlin Berlin Germany

Interfaculty Institute of Genetics and Functional Genomics University Medicine Greifswald Greifswald Germany

Internal Medicine Unit Department of Medicine Lausanne University Hospital Lausanne Switzerland

Jagiellonian University Collegium Medicum Krakow Poland

Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht Netherlands

Lithuanian University of Health Sciences Kaunas Lithuania

Lübeck Interdisciplinary Platform for Genome Analytics Institutes of Neurogenetics and Integrative and Experimental Genomics University of Lübeck Lübeck Germany

Max Planck Institute for Human Development Berlin Germany

Max Planck Institute for Molecular Genetics Berlin Germany

Medical Research Council Population Health Research Unit at the University of Oxford University of Oxford Oxford UK

Molecular Epidemiology Department of Medical Sciences Uppsala University Uppsala Sweden

MRC Epidemiology Unit Institute of Metabolic Science University of Cambridge School of Clinical Medicine Cambridge UK

National Institute of Public Health Prague Czech Republic

Neuroepidemiology and Ageing Research Unit Imperial College London London UK

Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Novosibirsk State Medical University Novosibirsk Russia

Population Health Research Institute Hamilton ON Canada

Population Health Research Institute St George's University of London London UK

Population Policy and Practice UCL Great Ormond Street Institute of Child Health London UK

Postgraduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil

Renal and Cardiovascular Epidemiology Centre de Recherche en Epidémiologie et Santé des Populations INSERM U1018 Villejuif France

Research Centre for Prevention and Health Capital Region of Denmark Denmark

Robertson Centre for Biostatistics University of Glasgow Glasgow UK

School of Health Sciences University of South Australia Adelaide SA Australia

School of Social and Community Medicine University of Bristol Bristol UK

Science for Life Laboratory Department of Medical Sciences Uppsala University Uppsala Sweden

South Australian Health and Medical Research Institute Adelaide SA Australia

South Australian Health and Medical Research Institute EMBL Australia Adelaide SA Australia

The Barts Heart Centre St Bartholomew's Hospital London UK

University of Newcastle Newcastle NSW Australia

Wellcome Trust Centre for Human Genetics University of Oxford Oxford UK

References provided by Crossref.org

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$a Schmidt, Amand F $u Institute of Cardiovascular Science, University College London, UK; Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, UK. Electronic address: amand.schmidt@ucl.ac.uk.
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$a PCSK9 genetic variants and risk of type 2 diabetes: a mendelian randomisation study / $c AF. Schmidt, DI. Swerdlow, MV. Holmes, RS. Patel, Z. Fairhurst-Hunter, DM. Lyall, FP. Hartwig, BL. Horta, E. Hyppönen, C. Power, M. Moldovan, E. van Iperen, GK. Hovingh, I. Demuth, K. Norman, E. Steinhagen-Thiessen, J. Demuth, L. Bertram, T. Liu, S. Coassin, J. Willeit, S. Kiechl, K. Willeit, D. Mason, J. Wright, R. Morris, G. Wanamethee, P. Whincup, Y. Ben-Shlomo, S. McLachlan, JF. Price, M. Kivimaki, C. Welch, A. Sanchez-Galvez, P. Marques-Vidal, A. Nicolaides, AG. Panayiotou, NC. Onland-Moret, YT. van der Schouw, G. Matullo, G. Fiorito, S. Guarrera, C. Sacerdote, NJ. Wareham, C. Langenberg, R. Scott, J. Luan, M. Bobak, S. Malyutina, A. Pająk, R. Kubinova, A. Tamosiunas, H. Pikhart, LL. Husemoen, N. Grarup, O. Pedersen, T. Hansen, A. Linneberg, KS. Simonsen, J. Cooper, SE. Humphries, M. Brilliant, T. Kitchner, H. Hakonarson, DS. Carrell, CA. McCarty, HL. Kirchner, EB. Larson, DR. Crosslin, M. de Andrade, DM. Roden, JC. Denny, C. Carty, S. Hancock, J. Attia, E. Holliday, M. O'Donnell, S. Yusuf, M. Chong, G. Pare, P. van der Harst, MA. Said, RN. Eppinga, N. Verweij, H. Snieder, . , T. Christen, DO. Mook-Kanamori, S. Gustafsson, L. Lind, E. Ingelsson, R. Pazoki, O. Franco, A. Hofman, A. Uitterlinden, A. Dehghan, A. Teumer, S. Baumeister, M. Dörr, MM. Lerch, U. Völker, H. Völzke, J. Ward, JP. Pell, DJ. Smith, T. Meade, AH. Maitland-van der Zee, EV. Baranova, R. Young, I. Ford, A. Campbell, S. Padmanabhan, ML. Bots, DE. Grobbee, P. Froguel, D. Thuillier, B. Balkau, A. Bonnefond, B. Cariou, M. Smart, Y. Bao, M. Kumari, A. Mahajan, PM. Ridker, DI. Chasman, AP. Reiner, LA. Lange, MD. Ritchie, FW. Asselbergs, JP. Casas, BJ. Keating, D. Preiss, AD. Hingorani, . , N. Sattar,
520    9_
$a BACKGROUND: Statin treatment and variants in the gene encoding HMG-CoA reductase are associated with reductions in both the concentration of LDL cholesterol and the risk of coronary heart disease, but also with modest hyperglycaemia, increased bodyweight, and modestly increased risk of type 2 diabetes, which in no way offsets their substantial benefits. We sought to investigate the associations of LDL cholesterol-lowering PCSK9 variants with type 2 diabetes and related biomarkers to gauge the likely effects of PCSK9 inhibitors on diabetes risk. METHODS: In this mendelian randomisation study, we used data from cohort studies, randomised controlled trials, case control studies, and genetic consortia to estimate associations of PCSK9 genetic variants with LDL cholesterol, fasting blood glucose, HbA1c, fasting insulin, bodyweight, waist-to-hip ratio, BMI, and risk of type 2 diabetes, using a standardised analysis plan, meta-analyses, and weighted gene-centric scores. FINDINGS: Data were available for more than 550 000 individuals and 51 623 cases of type 2 diabetes. Combined analyses of four independent PCSK9 variants (rs11583680, rs11591147, rs2479409, and rs11206510) scaled to 1 mmol/L lower LDL cholesterol showed associations with increased fasting glucose (0·09 mmol/L, 95% CI 0·02 to 0·15), bodyweight (1·03 kg, 0·24 to 1·82), waist-to-hip ratio (0·006, 0·003 to 0·010), and an odds ratio for type diabetes of 1·29 (1·11 to 1·50). Based on the collected data, we did not identify associations with HbA1c (0·03%, -0·01 to 0·08), fasting insulin (0·00%, -0·06 to 0·07), and BMI (0·11 kg/m2, -0·09 to 0·30). INTERPRETATION: PCSK9 variants associated with lower LDL cholesterol were also associated with circulating higher fasting glucose concentration, bodyweight, and waist-to-hip ratio, and an increased risk of type 2 diabetes. In trials of PCSK9 inhibitor drugs, investigators should carefully assess these safety outcomes and quantify the risks and benefits of PCSK9 inhibitor treatment, as was previously done for statins. FUNDING: British Heart Foundation, and University College London Hospitals NHS Foundation Trust (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre.
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$a Swerdlow, Daniel I $u Institute of Cardiovascular Science, University College London, UK; Department of Medicine, Imperial College London, London, UK.
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$a Holmes, Michael V $u Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Population Health Research Unit at the University of Oxford, University of Oxford, Oxford, UK.
700    1_
$a Patel, Riyaz S $u Institute of Cardiovascular Science, University College London, UK; Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, UK; The Barts Heart Centre, St Bartholomew's Hospital, London, UK.
700    1_
$a Fairhurst-Hunter, Zammy $u Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
700    1_
$a Lyall, Donald M $u Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
700    1_
$a Hartwig, Fernando Pires $u Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
700    1_
$a Horta, Bernardo Lessa $u Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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$a Hyppönen, Elina $u Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia; Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK; South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
700    1_
$a Power, Christine $u Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK.
700    1_
$a Moldovan, Max $u School of Health Sciences, University of South Australia, Adelaide, SA, Australia; South Australian Health and Medical Research Institute-EMBL Australia, Adelaide, SA, Australia.
700    1_
$a van Iperen, Erik $u Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, Netherlands.
700    1_
$a Hovingh, G Kees $u Department of Vascular Medicine, Academic Medical Center Amsterdam, Netherlands.
700    1_
$a Demuth, Ilja $u Charité Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
700    1_
$a Norman, Kristina $u Charité Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
700    1_
$a Steinhagen-Thiessen, Elisabeth $u Charité Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
700    1_
$a Demuth, Juri $u E.CA Economics GmbH, Berlin, Germany.
700    1_
$a Bertram, Lars $u Neuroepidemiology and Ageing Research Unit, Imperial College London, London, UK; Lübeck Interdisciplinary Platform for Genome Analytics (LIGA), Institutes of Neurogenetics and Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany.
700    1_
$a Liu, Tian $u Max Planck Institute for Human Development, Berlin, Germany; Max Planck Institute for Molecular Genetics, Berlin, Germany.
700    1_
$a Coassin, Stefan $u Division of Genetic Epidemiology Innsbruck, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
700    1_
$a Willeit, Johann $u Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
700    1_
$a Kiechl, Stefan $u Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
700    1_
$a Willeit, Karin $u Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
700    1_
$a Mason, Dan $u Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
700    1_
$a Wright, John $u Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
700    1_
$a Morris, Richard $u School of Social and Community Medicine, University of Bristol, Bristol, UK.
700    1_
$a Wanamethee, Goya $u Department of Primary Care & Population Health, University College London, UK.
700    1_
$a Whincup, Peter $u Population Health Research Institute, St George's, University of London, London, UK.
700    1_
$a Ben-Shlomo, Yoav $u School of Social and Community Medicine, University of Bristol, Bristol, UK.
700    1_
$a McLachlan, Stela $u Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
700    1_
$a Price, Jackie F $u Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
700    1_
$a Kivimaki, Mika $u Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, UK.
700    1_
$a Welch, Catherine $u Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, UK.
700    1_
$a Sanchez-Galvez, Adelaida $u Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, UK.
700    1_
$a Marques-Vidal, Pedro $u Internal Medicine Unit, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
700    1_
$a Nicolaides, Andrew $u Department of Vascular Surgery, Imperial College London, London, UK; Department of Surgery, Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.
700    1_
$a Panayiotou, Andrie G $u Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
700    1_
$a Onland-Moret, N Charlotte $u Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
700    1_
$a van der Schouw, Yvonne T $u Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
700    1_
$a Matullo, Giuseppe $u Human Genetics Foundation, HuGeF, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy.
700    1_
$a Fiorito, Giovanni $u Human Genetics Foundation, HuGeF, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy.
700    1_
$a Guarrera, Simonetta $u Human Genetics Foundation, HuGeF, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy.
700    1_
$a Sacerdote, Carlotta $u Cancer Epidemiology Unit, San Giovanni Battista Hospital, Turin, Italy; Centre for Oncology Prevention, CPO Piemonte, Turin, Italy.
700    1_
$a Wareham, Nicholas J $u MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
700    1_
$a Langenberg, Claudia $u MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
700    1_
$a Scott, Robert $u MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
700    1_
$a Luan, Jian'an $u MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
700    1_
$a Bobak, Martin $u Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, UK.
700    1_
$a Malyutina, Sofia $u Novosibirsk State Medical University, Novosibirsk, Russia; Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia.
700    1_
$a Pająk, Andrzej $u Jagiellonian University Collegium Medicum, Krakow, Poland.
700    1_
$a Kubinova, Ruzena $u National Institute of Public Health, Prague, Czech Republic.
700    1_
$a Tamosiunas, Abdonas $u Lithuanian University of Health Sciences, Kaunas, Lithuania.
700    1_
$a Pikhart, Hynek $u Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, UK.
700    1_
$a Husemoen, Lise Lotte Nystrup $u Research Centre for Prevention and Health, Capital Region of Denmark, Denmark.
700    1_
$a Grarup, Niels $u Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
700    1_
$a Pedersen, Oluf $u Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
700    1_
$a Hansen, Torben $u Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
700    1_
$a Linneberg, Allan $u Research Centre for Prevention and Health, Capital Region of Denmark, Denmark; Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
700    1_
$a Simonsen, Kenneth Starup $u Research Centre for Prevention and Health, Capital Region of Denmark, Denmark.
700    1_
$a Cooper, Jackie $u Centre for Cardiovascular Genetics, University College London, UK.
700    1_
$a Humphries, Steve E $u Centre for Cardiovascular Genetics, University College London, UK.
700    1_
$a Brilliant, Murray $u Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, WI, USA.
700    1_
$a Kitchner, Terrie $u Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, WI, USA.
700    1_
$a Hakonarson, Hakon $u Children's Hospital of Philadelphia, Philadelphia, PA, USA.
700    1_
$a Carrell, David S $u Group Health Research Institute in Seattle, WA, USA.
700    1_
$a McCarty, Catherine A $u Essentia Institute of Rural Health, Duluth, MN, USA.
700    1_
$a Kirchner, H Lester $u Center for Health Research, Geisinger Clinic, Danville, PA, USA.
700    1_
$a Larson, Eric B $u Group Health Research Institute, Seattle, WA, USA.
700    1_
$a Crosslin, David R $u Group Health Research Institute, Seattle, WA, USA.
700    1_
$a de Andrade, Mariza $u Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
700    1_
$a Roden, Dan M $u Departments of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA.
700    1_
$a Denny, Joshua C $u Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA.
700    1_
$a Carty, Cara $u George Washington University, Washington, DC, USA.
700    1_
$a Hancock, Stephen $u University of Newcastle, Newcastle, NSW, Australia.
700    1_
$a Attia, John $u University of Newcastle, Newcastle, NSW, Australia.
700    1_
$a Holliday, Elizabeth $u University of Newcastle, Newcastle, NSW, Australia.
700    1_
$a O'Donnell, Martin $u Population Health Research Institute, Hamilton, ON, Canada.
700    1_
$a Yusuf, Salim $u Population Health Research Institute, Hamilton, ON, Canada.
700    1_
$a Chong, Michael $u Population Health Research Institute, Hamilton, ON, Canada.
700    1_
$a Pare, Guillaume $u Population Health Research Institute, Hamilton, ON, Canada.
700    1_
$a van der Harst, Pim $u Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, Netherlands; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
700    1_
$a Said, M Abdullah $u Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
700    1_
$a Eppinga, Ruben N $u Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
700    1_
$a Verweij, Niek $u Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
700    1_
$a Snieder, Harold $u Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
700    1_
$a ,
700    1_
$a Christen, Tim $u Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
700    1_
$a Mook-Kanamori, Dennis O $u Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
700    1_
$a Gustafsson, Stefan $u Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
700    1_
$a Lind, Lars $u Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
700    1_
$a Ingelsson, Erik $u Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
700    1_
$a Pazoki, Raha $u Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
700    1_
$a Franco, Oscar $u Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
700    1_
$a Hofman, Albert $u Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
700    1_
$a Uitterlinden, Andre $u Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.
700    1_
$a Dehghan, Abbas $u Faculty of Medicine, and Department of Biostatistics and Epidemiology, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
700    1_
$a Teumer, Alexander $u Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany.
700    1_
$a Baumeister, Sebastian $u Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
700    1_
$a Dörr, Marcus $u Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany.
700    1_
$a Lerch, Markus M $u Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
700    1_
$a Völker, Uwe $u Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany.
700    1_
$a Völzke, Henry $u Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany.
700    1_
$a Ward, Joey $u Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
700    1_
$a Pell, Jill P $u Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
700    1_
$a Smith, Daniel J $u Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
700    1_
$a Meade, Tom $u Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
700    1_
$a Maitland-van der Zee, Anke H $u Department of Respiratory Medicine, Academic Medical Center Amsterdam, Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.
700    1_
$a Baranova, Ekaterina V $u Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.
700    1_
$a Young, Robin $u Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
700    1_
$a Ford, Ian $u Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
700    1_
$a Campbell, Archie $u Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
700    1_
$a Padmanabhan, Sandosh $u Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
700    1_
$a Bots, Michiel L $u Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
700    1_
$a Grobbee, Diederick E $u Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
700    1_
$a Froguel, Philippe $u Department of Genomics of Common Disease, Imperial College London, London, UK; CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France.
700    1_
$a Thuillier, Dorothée $u CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France.
700    1_
$a Balkau, Beverley $u Renal and Cardiovascular Epidemiology, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), INSERM U1018, Villejuif, France.
700    1_
$a Bonnefond, Amélie $u Department of Genomics of Common Disease, Imperial College London, London, UK; CNRS UMR 8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille, France.
700    1_
$a Cariou, Bertrand $u I'institut du Thorax, INSERM, CNRS, University of Nantes, CHU de Nantes, Nantes, France.
700    1_
$a Smart, Melissa $u Institute for Social and Economic Research, University of Essex, Colchester, Essex, UK.
700    1_
$a Bao, Yanchun $u Institute for Social and Economic Research, University of Essex, Colchester, Essex, UK.
700    1_
$a Kumari, Meena $u Institute for Social and Economic Research, University of Essex, Colchester, Essex, UK.
700    1_
$a Mahajan, Anubha $u Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
700    1_
$a Ridker, Paul M $u Harvard Medical School Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, MA, USA.
700    1_
$a Chasman, Daniel I $u Harvard Medical School Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, MA, USA.
700    1_
$a Reiner, Alex P $u Department of Epidemiology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA.
700    1_
$a Lange, Leslie A $u Anschutz Medical Campus, University of Colorado Denver, Denver, CO, USA.
700    1_
$a Ritchie, Marylyn D $u Biomedical and Translational Informatics, Geisinger Health System, Danville, PA, USA; Department of Biochemistry and Molecular Biology, Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, USA.
700    1_
$a Asselbergs, Folkert W $u Institute of Cardiovascular Science, University College London, UK; Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, UK; Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, Netherlands.
700    1_
$a Casas, Juan-Pablo $u Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, UK.
700    1_
$a Keating, Brendan J $u Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
700    1_
$a Preiss, David $u Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Population Health Research Unit at the University of Oxford, University of Oxford, Oxford, UK.
700    1_
$a Hingorani, Aroon D $u Institute of Cardiovascular Science, University College London, UK; Farr Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, UK.
700    1_
$a ,
700    1_
$a Sattar, Naveed $u Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. Electronic address: naveed.sattar@glasgow.ac.uk.
773    0_
$w MED00186388 $t The lancet. Diabetes & endocrinology $x 2213-8595 $g Roč. 5, č. 2 (2017), s. 97-105
856    41
$u https://pubmed.ncbi.nlm.nih.gov/27908689 $y Pubmed
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