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Metabolic profiling of angiopoietin-like protein 3 and 4 inhibition: a drug-target Mendelian randomization analysis.

Accepted version
Peer-reviewed

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Type

Article

Change log

Authors

Wang, Qin 
Oliver-Williams, Clare 
Raitakari, Olli T 
Viikari, Jorma 
Lehtimäki, Terho 

Abstract

AIMS: Angiopoietin-like protein 3 (ANGPTL3) and 4 (ANGPTL4) inhibit lipoprotein lipase (LPL) and represent emerging drug targets to lower circulating triglycerides and reduce cardiovascular risk. To investigate the molecular effects of genetic mimicry of ANGPTL3 and ANGPTL4 inhibition and compare them to the effects of genetic mimicry of LPL enhancement. METHODS AND RESULTS: Associations of genetic variants in ANGPTL3 (rs11207977-T), ANGPTL4 (rs116843064-A), and LPL (rs115849089-A) with an extensive serum lipid and metabolite profile (208 measures) were characterized in six cohorts of up to 61 240 participants. Genetic associations with anthropometric measures, glucose-insulin metabolism, blood pressure, markers of kidney function, and cardiometabolic endpoints via genome-wide summary data were also explored. ANGPTL4 rs116843064-A and LPL rs115849089-A displayed a strikingly similar pattern of associations across the lipoprotein and lipid measures. However, the corresponding associations with ANGPTL3 rs11207977-T differed, including those for low-density lipoprotein and high-density lipoprotein particle concentrations and compositions. All three genotypes associated with lower concentrations of an inflammatory biomarker glycoprotein acetyls and genetic mimicry of ANGPTL3 inhibition and LPL enhancement were also associated with lower C-reactive protein. Genetic mimicry of ANGPTL4 inhibition and LPL enhancement were associated with a lower waist-to-hip ratio, improved insulin-glucose metabolism, and lower risk of coronary heart disease and type 2 diabetes, whilst genetic mimicry of ANGPTL3 was associated with improved kidney function. CONCLUSIONS: Genetic mimicry of ANGPTL4 inhibition and LPL enhancement have very similar systemic metabolic effects, whereas genetic mimicry of ANGPTL3 inhibition showed differing metabolic effects, suggesting potential involvement of pathways independent of LPL. Genetic mimicry of ANGPTL4 inhibition and LPL enhancement were associated with a lower risk of coronary heart disease and type 2 diabetes. These findings reinforce evidence that enhancing LPL activity (either directly or via upstream effects) through pharmacological approaches is likely to yield benefits to human health.

Description

Keywords

ANGPTL3, ANGPTL4, Amino acids, Drug targets, Glycoprotein acetyls, LPL, Lipoprotein lipids, Lipoprotein subclasses, Mendelian randomization, Angiopoietin-Like Protein 3, Angiopoietin-Like Protein 4, Angiopoietin-like Proteins, Angiopoietins, Diabetes Mellitus, Type 2, Humans, Mendelian Randomization Analysis, Pharmaceutical Preparations

Journal Title

Eur Heart J

Conference Name

Journal ISSN

0195-668X
1522-9645

Volume Title

42

Publisher

Oxford University Press (OUP)

Rights

All rights reserved
Sponsorship
This work was supported by Academy of Finland (grant no. 297338, 307247, 322098, 286284, 134309, 126925, 121584, 124282, 129378, 117787, and 41071), Novo Nordisk foundation (NNF17OC0027034 and NNF17OC0026062), Oulu Health and Wellfare Center, Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, ERDF European Regional Development Fund (grant no. 539/2010:A31592), EU Horizon 2020 (grant no. 633595 and 755320), EU Research Council (grant no. 742927) and following foundations: Sigrid Juselius, Finnish Cardiovascular Research, Juho Vainio, Paavo Nurmi, Finnish Cultural, Tampere Tuberculosis, Emil Aaltonen, Yrjö Jahnsson, Signe and Ane Gyllenberg, and Finnish Diabetes Research. Dr Holmes is supported by a British Heart Foundation Intermediate Clinical Research Fellowship (FS/18/23/33512) and the National Institute for Health Research Oxford Biomedical Research Centre.