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Melander, O.

Publications and source records attributed to Melander, O..

5 recordsLinked to original sources

Copeptin response to acute physical stress during hypohydration: An exploratory secondary analysis

PurposePlasma copeptin (a surrogate marker of arginine vasopressin) is increasingly being used as a marker of stress in several research and clinical contexts. However, the response to an acute physical stressor in healthy adults has not yet been tested meaning it is unclear whether copeptin reflects dynamic changes in stress or whether this is moderated by different basal copeptin concentrations and how this relates to other stress hormones. MethodsSecondary data analysis in a subsample of participants (n = 7; n = 1 woman) who opted-in for muscle biopsies in a randomised crossover study investigating the effects of acute hypohydration (HYPO) versus rehydration (RE) on metabolism. ResultsPlasma copeptin responded to the muscle biopsy stress stimulus, with a similar magnitude of difference according to basal concentrations during HYPO and RE; however, the peak was higher and concentrations typically took longer to return to baseline during HYPO. Despite large differences in copeptin concentrations, adrenocorticotropin hormone (ACTH) and cortisol showed a similar trends in response to the biopsies, regardless of hydration status. ConclusionCopeptin responded dynamically to an acute physical stressor (muscle biopsy). HYPO induced higher basal copeptin concentrations compared to RE, and resulted in a higher and prolonged copeptin response. Further research should investigate the mechanisms underlying the lack of differences in ACTH and cortisol according to hydration status.

physiology↗

A new pipeline for the normalization and pooling of metabolomics data

Pooling metabolomics data across studies is often desirable to increase the statistical power of the analysis. However, this can raise methodological challenges as several preanalytical and analytical factors could introduce differences in measured concentrations and variability between datasets. Specifically, different studies may use variable sample types (e.g., serum versus plasma) collected, treated and stored according to different protocols, and assayed in different laboratories using different instruments. To address these issues, a new pipeline was developed to normalize and pool metabolomics data through a set of sequential steps: (i) exclusions of the least informative observations and metabolites and removal of outliers; imputation of missing data; (ii) identification of the main sources of variability through PC-PR2 analysis; (iii) application of linear mixed models to remove unwanted variability, including samples originating study and batch, and preserve biological variations while accounting for potential differences in the residual variances across studies. This pipeline was applied to targeted metabolomics data acquired using Biocrates AbsoluteIDQ kits in eight case-control studies nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Comprehensive examination of metabolomics measurements indicated that the pipeline improved the comparability of data across the studies. Our pipeline can be adapted to normalize other molecular data, including biomarkers as well as proteomics data, and could be used for pooling molecular datasets, for example in international consortia, to limit biases introduced by inter-study variability. This versatility of the pipeline makes our work of potential interest to molecular epidemiologists.

bioinformatics↗

Exome-wide association study on Albuminuria identifies a novel rare variant in CUBN and additional genes, in 33,985 Europeans with and without diabetes

Identifying rare coding variants associated with albuminuria may open new avenues for preventing chronic kidney disease (CKD) and end-stage renal disease which are highly prevalent in patients with diabetes. Efforts to identify genetic susceptibility variants for albuminuria have so far been limited with the majority of studies focusing on common variants.\n\nWe performed an exome-wide association study to identify coding variants in a two phase (discovery and replication) approach, totaling to 33,985 individuals of European ancestry (15,872 with and 18,113 without diabetes) and further testing in Greenlanders (n = 2,605). We identify a rare (MAF: 0.8%) missense (A1690V) variant in CUBN (rs141640975, {beta}=0.27, p=1.3 x 10-11) associated with albuminuria as a continuous measure in the combined European meta-analyses. Presence of each rare allele of the variant was associated with a 6.4% increase in albuminuria. The rare CUBN variant had 3 times stronger effect in individuals with diabetes compared to those without (pinteraction: 5.4 x 10-4, {beta}DM: 0.69, {beta}nonDM: 0.20) in the discovery meta-analyses. Geneaggregate tests based on rare and common variants identify three additional genes associated with albuminuria (HES1, CDC73, and GRM5) after multiple testing correction (P_bonferroni<2.7 x 10-6).\n\nThe current study identifies a rare coding variant in the CUBN locus and other potential genes associated with albuminuria in individuals with and without diabetes. These genes have been implicated in renal and cardiovascular dysfunction. These findings provide new insights into the genetic architecture of albuminuria and highlight novel target genes and pathways for prevention of diabetes-related kidney disease.\n\nSignificance statementIncreased albuminuria is a key manifestation of major health burdens, including chronic kidney disease and/or cardiovascular disease. Although being partially heritable, there is a lack of knowledge on rare genetic variants that contribute to albuminuria. The current study describes the discovery and validation, of a new rare gene mutation (~1%) in the CUBN gene which associates with increased albuminuria. Its effect multiplies 3 folds among diabetes cases compared to non diabetic individuals. The study further uncovers 3 additional genes modulating albuminuria levels in humans. Thus the current study findings provide new insights into the genetic architecture of albuminuria and highlight novel genes/pathways for prevention of diabetes related kidney disease.

genetics↗

Genome-wide analysis yields new loci associating with aortic valve stenosis

Aortic valve stenosis (AS) is the most common valvular heart disease, characterized by a thickened and calcified valve causing left ventricular outflow obstruction. Severe AS is a significant cause of morbidity and mortality, affecting approximately 5% of those over 70 years of age1,2,3. Little is known about the genetics of AS, although recently a variant at the LPA locus4 and a rare MYH6 missense variant were found to associate with AS5. We report a large genome-wide association study (GWAS) with a follow-up in up to 7,307 AS cases and 801,073 controls. We identified two new AS loci, on chromosome 1p21 near PALMD (rs7543130; OR=1.20, P=1.2x10-22) and on chromosome 2q22 in TEX41 (rs1830321; OR=1.15, P=1.8x10-13). Rs7543130 also associates with bicuspid aortic valve (BAV) (OR=1.28, P=6.6x10-10) and aortic root diameter (P=1.30x10-8) and rs1830321 associates with BAV (OR=1.12, P=5.3x10-3 and coronary artery disease (CAD) (OR=1.05, P=9.3x10-5). These results indicate that AS is partly rooted in the same processes as cardiac development and atherosclerosis.

genetics↗

Clustering of adult-onset diabetes into novel subgroups guides therapy and improves prediction of outcome

BackgroundDiabetes is presently classified into two main forms, type 1 (T1D) and type 2 diabetes (T2D), but especially T2D is highly heterogeneous. A refined classification could provide a powerful tool individualize treatment regimes and identify individuals with increased risk of complications already at diagnosis.\n\nMethodsWe applied data-driven cluster analysis (k-means and hierarchical clustering) in newly diagnosed diabetic patients (N=8,980) from the Swedish ANDIS (All New Diabetics in Scania) cohort, using five variables (GAD-antibodies, BMI, HbA1c, HOMA2-B and HOMA2-IR), and related to prospective data on development of complications and prescription of medication from patient records. Replication was performed in three independent cohorts: the Scania Diabetes Registry (SDR, N=1466), ANDIU (All New Diabetics in Uppsala, N=844) and DIREVA (Diabetes Registry Vaasa, N=3485). Cox regression and logistic regression was used to compare time to medication, time to reaching the treatment goal and risk of diabetic complications and genetic associations.\n\nFindingsWe identified 5 replicable clusters of diabetes patients, with significantly different patient characteristics and risk of diabetic complications. Particularly, individuals in the most insulin-resistant cluster 3 had significantly higher risk of diabetic kidney disease, but had been prescribed similar diabetes treatment compared to the less susceptible individuals in clusters 4 and 5. The insulin deficient cluster 2 had the highest risk of retinopathy. In support of the clustering, genetic associations to the clusters differed from those seen in traditional T2D.\n\nInterpretationWe could stratify patients into five subgroups predicting disease progression and development of diabetic complications more precisely than the current classification. This new substratificationn may help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes.\n\nFundingThe funders of the study had no role in study design, data collection, analysis, interpretation or writing of the report.\n\nResearch in contextEvidence before this study\n\nThe current diabetes classification into T1D and T2D relies primarily on presence (T1D) or absence (T2D) of autoantibodies against pancreatic islet beta cell autoantigens and age at diagnosis (earlier for T1D). With this approach 75-85% of patients are classified as T2D. A third subgroup, Latent Autoimmune Diabetes in Adults (LADA,<10%), is defined by presence of autoantibodies against glutamate decarboxylase (GADA) with onset in adult age. In addition, several rare monogenic forms of diabetes have been described, including Maturity Onset Diabetes of the Young (MODY) and neonatal diabetes. This information is provided by national guidelines (ADA,WHO, IDF, Diabetes UK etc) but has not been much updated during the past 20 years and very few attempts have been made to explore heterogeneity of T2D. A topological analysis of potential T2D subgroups using electronic health records was published in 2015 but this information has not been implemented in the clinic.\n\nAdded value of this study\n\nHere we applied a data-driven cluster analysis of 5 simple variables measured at diagnosis in 4 independent cohorts of newly-diagnosed diabetic patients (N=14755) and identified 5 replicable clusters of diabetes patients, with significantly different patient characteristics and risk of diabetic complications. Particularly, individuals in the most insulin-resistant cluster 3 had significantly higher risk of diabetic kidney disease.\n\nImplications of the available evidence\n\nThis new sub-stratification may help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes

epidemiology↗