Genetic Associations With Carotid Intima-Media Thickness in the Chinese Population and Shared Genetic Architecture With Cardiometabolic Diseases and Traits

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BACKGROUND: Carotid artery intima-media thickness (cIMT) is a highly heritable measure of subclinical atherosclerosis and a predictor of cardiovascular diseases. However, knowledge about its shared genetic basis remains limited. The majority of genome-wide association studies have been conducted in individuals of European ancestry, leaving the genetic determinants of cIMT in non-European ancestry populations largely understudied. METHODS: A single-trait genome-wide association study was performed in 22 370 participants from the China Kadoorie Biobank to identify new genetic variants associated with cIMT. We then leveraged cIMT and cardiometabolic disease and trait data from populations of European and East Asian ancestries, to conduct linkage disequilibrium score regression and genome-wide cross-trait analysis, followed by gene-based analysis and Mendelian randomization. RESULTS: . cIMT showed significant positive genetic correlations with coronary artery disease, type 2 diabetes, body mass index, and systolic blood pressure in both European and East Asian populations. Pleiotropic analysis found 110 and 699 significant pleiotropic variants in 4 trait pairs for East Asian and European populations, respectively, with 27 and 186 colocalized loci detected. Gene-based analysis highlighted important biological pathways involving lipid metabolism and carbohydrate metabolism. Mendelian randomization estimates indicated that higher systolic blood pressure and body mass index, and coronary artery disease and type 2 diabetes, were causal for cIMT, and a reverse effect was observed between cIMT and systolic blood pressure. CONCLUSIONS: Our large-scale genome-wide association study of cIMT identified novel loci in the Chinese population and shared genetic underpinnings and causal relationships with cardiometabolic diseases and traits. These findings potentially provide targets for intervention that may allow the development of new strategies targeting this aspect of atherosclerosis.

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