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Article

LDLR Gene Polymorphisms (rs5925 and rs1529729) Are Associated with Susceptibility to Coronary Artery Disease in a South Indian Population

1
Department of Human Genetics, Punjabi University, Punjab 147002, India
2
Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
3
Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia
4
Sri Jayadeva Institute of Cardiovascular Science and Research, Bangalore 560069, India
*
Author to whom correspondence should be addressed.
Med. Sci. 2019, 7(7), 80; https://doi.org/10.3390/medsci7070080
Submission received: 9 June 2019 / Revised: 7 July 2019 / Accepted: 8 July 2019 / Published: 15 July 2019
(This article belongs to the Section Cardiovascular Disease)

Abstract

:
Cardiovascular diseases (CVD) are a major cause of death in India and worldwide. Atherosclerosis is caused by the interaction of environmental and genetic factors. Hypercholesterolemia is an example of a classical risk factor for CVD. The low-density lipoprotein receptor (LDLR) is one of the regulating mechanisms the liver uses for cholesterol homeostasis. Gene variations in the LDLR have been reported to cause hypercholesterolemia and consequently CVD. We investigated the association of polymorphisms in the LDLR (rs5925 and rs1529729) with coronary artery disease (CAD) in 200 coronary artery disease patients and 200 matched healthy controls using allele-specific PCR (AS-PCR). The results indicated that the CT genotype of the rs1529729 polymorphism was associated a decreased susceptibility to CAD with an odds ratio (OR) = 0.42 (95% confidence interval (CI), 0.23–0.77), risk ratio (RR) = 0.59 (0.39–0.89), P = 0.0047. The TT genotype of the rs1529729 polymorphism was also associated with decreased susceptibility to CAD with an OR = 0.19 (95% CI, 0.076–0.47), RR = 0.57 (0.47–0.69), P = 0.0003. The GA genotype of the rs5925 polymorphism was associated with decreased susceptibility to CAD with an OR = 0.45 (95% CI, 0.27–0.75), RR = 0.65 (0.47–0.88), P = 0.002. We concluded that the CT and TT genotypes of the rs1529729 polymorphism and the GA genotype of the rs5925 polymorphism are probably associated with decreased susceptibility to CAD. The simplicity of AS-PCR makes it particularly suitable for the rapid, large-scale screening of gene variabilities in the LDLR. AS-PCR could provide significant benefits in clinical applications with its ability to amplify a lower quantity of samples in a cost-saving manner. Nevertheless, these findings need to be validated in well-designed studies with larger sample sizes and in different populations.

1. Introduction

Coronary artery disease (CAD) is a complex disease resulting from the interaction of genetic and environmental factors. Traditional risk factors for atherosclerosis include obesity, hypercholesterolemia, smoking, hypertension, and hyperglycemia [1]. These factors lead to an excessive accumulation of cholesterol, which results in hardening of and accumulation of thrombotic debris in the artery wall [2]. The steps involved in the formation of an atherosclerotic lesion begin with an injury to the endothelial wall, after which the retention of lipid particles occurs, followed by inflammation. These steps lead to the generation of a necrotic core (containing cell debris and lipids) covered by a fibrous cap, eventually leading to the formation of an atheromatous plaque [3]. Hypercholesterolemia is one of the important risk factors involved in the formation of atherosclerotic plaques [4]. It has been reported that the deposition of cholesterol particles in the endothelial wall initiates the inflammatory response, which involves the activation of macrophages and lymphocytes, as well as the production of cytokines (including tumor necrosis factor-alpha, interleukin-6, and interferon-gamma) [5], and enhances the development of atheroma [4]. Cholesterol is pooled in the liver from the diet or from cholesterol that is synthesized by cells. The liver is the primary organ for the regulation of cholesterol homeostasis, and the low-density lipoprotein receptor (LDLR) is one of the regulating mechanisms [6]. The LDLR is a transmembrane glycoprotein that plays an important role in the uptake of low-density lipoprotein (LDL) from the blood circulation in a process that is mediated by apolipoprotein B [7,8]. The LDLR binds at neutral pH specifically and with a high affinity to extracellular lipoprotein particles [9]. The LDLR and LDL–cholesterol complex is then brought into the cell by endocytosis [10]. LDL–cholesterol is then released by the LDLR at an acidic pH for degradation by a lysosome which results in the release of free cholesterol and the return of the LDLR to the cell surface [9]. Genome-wide association studies (GWASs) have discovered certain novel gene loci that reproducibly associate with diseases [11,12,13], including CAD [14,15,16,17,18,19,20] and atherosclerosis [21,22]. Mutations in the LDLR gene have been reported to cause familial hypercholesterolemia [18,23]. In the present study, we investigated the association of polymorphisms in the LDLR (rs5925 and rs1529729) and CAD in a cohort from the Bangalore population.

2. Subjects and Methods

This project has been approved by the institutional ethics committee (IEC), Punjabi University, Patiala, project No. 268/DLS/HG. We conducted a population-based case–control study including 200 patients with clinically confirmed CAD and 200 healthy controls (HC) with no history of CAD and no familial relationship to the CAD patients. We excluded any patient with a previous history of chronic disease from this study.

2.1. Collection of Blood Samples and Clinical History

About 3 mL of peripheral blood was collected in an EDTA-containing vial from each patient and healthy control after they completed a questionnaire. We collected information as well as an informed written consent form from both CAD patients and healthy controls regarding personal information such as name, gender, and age. Additionally, information regarding a history of sexually transmitted diseases and addiction, such as smoking and alcohol, were collected. We also collected laboratory and clinical data.

2.2. Extraction of DNA

DNA was extracted from the blood using the modified glass bead method, as described in a previous study [24]. The extracted DNA was dissolved in 100 μL of 10 mM Tris-Cl (pH 8.0) buffer and stored at 4 °C until use. The quality of the DNA was assessed by gel electrophoresis.

2.3. Genotyping of the LDLR Polymorphisms (rs5925 and rs1529729)

Gene polymorphisms were detected using allele-specific PCR (AS-PCR). AS-PCR is based on the use of sequence-specific PCR primers that allow for amplification of the template DNA when the target allele is contained within the sample. Primers were designed using primer 3 software (Table 1, Figure 1). For rs5925, AS-PCR was performed in two tubes with each of the tubes containing a common forward primer and a different reverse primer. The reaction mixtures for the rs5925 AS-PCR contained template DNA, 3–4 μL (50 ng); the common forward primer, 0.3 μL (25 pmol); a reverse primer, 0.3 μL (25 pmol); Coral load dye, 2.5 μL; 12.5 μL of TopTaq Master Mix (Qiagen, Germany); and enough nuclease free ddH2O to bring the final volume to 25 μL. The AS-PCR for rs1529729 was performed in two tubes, each containing a different primer set. The reaction mixture for the rs152972 AS-PCR contained DNA template, 3–4 μL (50 ng); either the F1/R2 or the F2/R1 primer combinations, 0.3 μL of each primer (25 pmol); Coral load dye, 2.5μL; 12.5 μL of TopTaq Master Mix (Qiagen, Germany); and enough nuclease free ddH2O to bring the final volume to 25 μL. The PCR conditions used were as follows: initial denaturation for 10 min at 95 °C, 35 cycles of 30 s at 95 °C (denaturation), 30 s at 57 °C (the rs5925 AS-PCR) or 61 °C (the rs1529729 AS-PCR) (annealing), and 1 min at 72 °C (elongation), followed by 10 min at 72 °C (final elongation). The PCR products were visualized using electrophoresis via 2% agarose gel stained with ethidium bromide (Figure 2). The lengths of the PCR products for rs1529729 were 212 bp for F1/R1, and 175 bp for F2/R2 PCR products, and 176 bp for the rs5925 (Figure 2).

2.4. Statistical Analysis

Group differences were compared using a Student’s two-sample t-test or a one-way analysis of variance (ANOVA) for continuous variables, and a Chi-square test for categorical variables. Differences in both the single nucleotide polymorphism SNP allele and in the genotype frequencies between groups were evaluated using the Chi-square test. The associations between both SNP genotypes and the risk of CAD were estimated by computing the odds ratios (ORs), risk ratios (RRs), and risk differences (RDs) with 95% confidence intervals (CIs). Allele frequencies among cases, as well as controls, were evaluated using the Chi-square test. P < 0.05 was considered significant. All statistical analyses were performed using SPSS 16.0 (IBM, Chicago, IL, USA).

3. Results

A total of 200 CAD patients and 200 healthy controls were included in this study. The demographic characteristics of CAD patients and controls are shown in Table 2. The ratios of gender and age differences in CAD patients are comparable to those of the control group. The clinical characteristics of the CAD patients are shown in Table 3.

3.1. The Genotype Frequency of the LDLR Polymorphisms rs1529729 and rs5925

The genotype frequency of the rs1529729 polymorphisms CC, CT, TT in patients were 9, 77, and 14%, respectively, whereas they were 21, 76, and 3% in controls, respectively. The differences in the proportions of the genotype frequencies were significantly different (P = 0.0001, Table 4). The genotype frequency of the rs5925 polymorphisms GG, GA, AA in patients were 27, 62, and 11% respectively, whereas they were 15, 76, and 9% in controls, respectively. The differences in the proportions of the genotype frequencies were significantly different (P = 0.006, Table 4).

3.2. rs1529729 C > T and rs5925 G > A Polymorphisms Were Associated with CAD

The results of the present study indicated that in the codominant model the CT genotype of the rs1529729 polymorphism was associated with a decreased susceptibility to CAD with an OR = 0.42 (95% CI, 0.23–0.77), RR = 0.59 (0.39–0.89), P = 0.0047. The TT genotype was also associated with a reduced risk for CAD with an OR = 0.09 (95% CI, 0.03–0.26), RR = 0.36 (0.24–0.55), P = 0.0001 (Table 5). In the dominant model the CT + TT genotype was associated with a decreased susceptibility to CAD with an OR = 0.37 (95% CI, 0.21–0.67), RR = 0.56 (0.38–0.84), P = 0.001. The TT genotype was associated with decreased susceptibility to CAD with OR = 0.19 (95% CI, 0.076–0.47), RR = 0.57 (0.47–0.69), P = 0.0003 (Table 5).
Our results also showed that in the codominant model the GA genotype of the rs5925 polymorphism was associated with a decreased susceptibility to CAD, OR = 0.45 (95% CI, 0.27–0.75), RR = 0.65 (0.47–0.88), P = 0.002. In the dominant model the GA + AA genotype was associated with a reduced risk of CAD with OR = 0.477 (95% CI, 0.28–0.78), RR = 0.66 (0.48–0.9), P = 0.003 (Table 5). Our results also showed that covariates such as gender, age, blood levels of random sugar, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were non-significantly different (P > 0.05) among the genotypes of both the SNPs in the patient group. We also did not see significant effects (P > 0.05) of diabetes, hypertension, intake of alcohol, smoking, and pan masala on either the rs5925 or the rs1529729 polymorphisms (Table 6). These results were unexpected and might be due to the limited sample size used in this research.

4. Discussion

4.1. Association of rs1529729 C > T and rs5925 G > A Genotypes with CAD

Cardiovascular disease (CVD) represents an economic and health burden all over the world [25]. CVD has become a leading cause of death in all parts of India. In India, CVD has increased by 59%, from 23.2 million (1990) to 37 million (2010) [26]. One thousand and seven hundred mutations in the LDLR gene have been associated with familial hypercholesterolemia [23], which is one of the traditional risk factors for CVD [27]. This fact has prompted us to examine the association of the LDLR rs1529729 C > T and rs5925 G > A gene variations with CAD. Our results indicated that the rs1529729 C > T genotype distribution is different between the cases and the control (P-value = 0.0001, Table 4). Moreover, our results showed that the CT and TT genotypes of rs1529729 C > T are associated with decreased susceptibility to CAD with an OR = 0.42 (95% CI, 0.23–0.77), RR = 0.59 (0.39–0.89), P = 0.0047, and an OR = 0.09 (95% CI, 0.03–0.26), RR = 0.36 (0.24–0.55), P = 0.0001, respectively (Table 5). At the allelic level, the T allele is associated with a reduced susceptibility to CAD with an OR = 0.63 (95% CI, 0.47–0.83), RR = 0.79 (0.69–0.91), P = 0.0011 (Table 5). We did not see significant differences in the random blood sugar (RBS), triglyceride, cholesterol, HDL-C, and LDL-C levels between the rs1529729 genotypes in CAD patients (P-value > 0.05, Table 6). This may be due to the relatively small sample size taken in this study. These results may be in good agreement with the study by Kathiresan et al., 2008 [28].
The results showed that the rs5925 G > A genotype distribution is different between the cases and the control (P-value = 0.006, Table 4). It was indicated that the GA genotype of the rs5925 polymorphism is associated with decreased susceptibility to CAD with an OR = 0.45 (95% CI, 0.27–0.75), RR = 0.65 (0.47–0.88), P = 0.002. The rs5925 polymorphism (in cooperation with the rs688 polymorphism) has been shown to regulate the splicing efficiency of the LDLR gene [29]. This result may be consistent with a study that showed that the rs5925 polymorphism is associated with the thickness of the carotid-intima media in Slovenian type 2 diabetes T2D patients [30]. Furthermore, the rs5925 polymorphism has been predicted to be one of the SNPs that cause familial hypercholesterolemia in the Malaysian population [31].
Our results also showed that there are no significant differences (P > 0.05) between the rs5925 genotype distribution and RBS, triglycerides, cholesterol, HDL-C, and LDL-C levels (Table 6). Again, these results may be due to the small sample size, or perhaps some of the CAD patients had been treated with hypolipidemic agents. LDLR is a transmembrane glycoprotein at the hepatocyte surface that plays an important role in cholesterol homeostasis [8]. We suggest that the T allele of the rs1529729 polymorphism and the GA genotype of the rs5925 polymorphism protect against CAD by increasing the expression of LDLR at the hepatocyte surface such that LDL-C uptake and metabolism is enhanced. In support of this suggestion, the rs5925 polymorphism has been described as an exon-splicing enhancer [29]. However, the effect of rs1529729 and rs5925 polymorphisms on LDLR expression should be to be elucidated in a future study.
To our knowledge, this is the first study that has shown the potential associations of the rs5925 and rs1529729 polymorphisms with CAD in a South Indian population. The limitations of this study include a relatively small sample size and the fact that the study population contained a high percentage of males compared to females (Table 2).

4.2. The Frequency of the rs5925 and rs1529729 Polymorphisms in Different Populations

The frequency of the rs5925 genotypes GG, GA, and AA has been studied in different populations (Table 7). The frequency of the rs1529729 genotypes CC, CT, and TT have been reported in an Iranian population as 28.43, 42.16, and 29.41%, respectively (Table 7). In the present study, the rs1529729 genotype distributions were 21, 76, and 3% (Table 7). This difference may be due to the different sample size or different ethnicity.
The results showed that the lowest percentage of the GG genotype in controls was (4%) in the Taiwanese population, while the highest was (56.5%) in the Chinese population (Table 7). Our study found that the GG genotype in controls was 15%, which is consistent with previous findings (Table 7). The GA genotype ranged from 51 to 34% in Mexican and Taiwanese populations, respectively. The GA genotype in our study was relatively high (76%). In this study, the AA genotype in the control group was 9%, which is within the range of previous findings (8 to 62%) in Chinese and Taiwanese populations, respectively (Table 7).

5. Conclusions

Taken together, the results of the present study indicated that the CT and TT genotypes of the rs1529729 polymorphism and the GA genotype of the rs5925 polymorphism are associated with decreased susceptibility to CAD in a South Indian population. However, these results must await further validation in future studies with larger sample sizes and in different populations. Moreover, a proteomic study on the effect of the rs1529729 and rs5925 polymorphisms on the LDLR protein is recommended.

Author Contributions

Conceptualization, all authors; Methodology, C.K.J., R.M. and I.E.; sample collection, C.K.J. and S.B.; Investigation C.K.J., R.M., and S.B. Analyses, C.K.J., R.M. and I.E.; Validation, R.M. and S.M.S.C.; Supervision, S.M.S.C.; Visualization, all authors; Original draft preparation C.K.J.; Writing—Review and Editing I.E. and R.M.

Funding

C.K.J was funded by a scholarship from UGC.

Acknowledgments

We thank the patients and the healthy control for their participation in this project.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. De Rosa, S.; Arcidiacono, B.; Chiefari, E.; Brunetti, A.; Indolfi, C.; Foti, D.P. Type 2 Diabetes Mellitus and Cardiovascular Disease: Genetic and Epigenetic Links. Front. Endocrinol. (Lausanne) 2018, 9, 2. [Google Scholar] [CrossRef] [PubMed]
  2. Fioranelli, M.; Bottaccioli, A.G.; Bottaccioli, F.; Bianchi, M.; Rovesti, M.; Roccia, M.G. Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based. Front. Immunol. 2018, 9, 2031. [Google Scholar] [CrossRef] [PubMed]
  3. Lusis, A.J. Genetics of atherosclerosis. Trends Genet. 2012, 28, 267–275. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  4. Manduteanu, I.; Simionescu, M. Inflammation in atherosclerosis: A cause or a result of vascular disorders? J. Cell. Mol. Med. 2012, 16, 1978–1990. [Google Scholar] [CrossRef] [PubMed]
  5. Tousoulis, D.; Oikonomou, E.; Economou, E.K.; Crea, F.; Kaski, J.C. Inflammatory cytokines in atherosclerosis: Current therapeutic approaches. Eur. Heart J. 2016, 37, 1723–1732. [Google Scholar] [CrossRef] [PubMed]
  6. Van De Sluis, B.; Wijers, M.; Herz, J. News on the molecular regulation and function of hepatic low-density lipoprotein receptor and LDLR-related protein 1. Curr. Opin. Lipidol. 2017, 28, 241–247. [Google Scholar] [CrossRef]
  7. Abisambra, J.F.; Fiorelli, T.; Padmanabhan, J.; Neame, P.; Wefes, I.; Potter, H. LDLR expression and localization are altered in mouse and human cell culture models of Alzheimer’s disease. PLoS ONE 2010, 5, e8556. [Google Scholar] [CrossRef]
  8. Zhang, Y.; Ma, K.L.; Ruan, X.Z.; Liu, B.C. Dysregulation of the Low-Density Lipoprotein Receptor Pathway Is Involved in Lipid Disorder-Mediated Organ Injury. Int. J. Biol. Sci. 2016, 12, 569–579. [Google Scholar] [CrossRef] [Green Version]
  9. Nikolic, J.; Belot, L.; Raux, H.; Legrand, P.; Gaudin, Y.; Albertini, A.A. Structural basis for the recognition of LDL-receptor family members by VSV glycoprotein. Nat. Commun. 2018, 9, 1029. [Google Scholar] [CrossRef]
  10. Litvinov, D.Y.; Savushkin, E.V.; Dergunov, A.D. Intracellular and Plasma Membrane Events in Cholesterol Transport and Homeostasis. J. Lipids 2018, 2018, 22. [Google Scholar] [CrossRef]
  11. Elfaki, I.; Almutairi, F.M.; Mir, R.; Khan, R.; Abu-Duhier, F. Cytochrome P450 CYP1B1*2 gene and its Association with T2D in Tabuk Population, Northwestern Region of Saudi Arabia. Asian J. Pharm. Clin. Res. 2018, 11, 55–59. [Google Scholar] [CrossRef]
  12. Dadaev, T.; Saunders, E.J.; Newcombe, P.J.; Anokian, E.; Leongamornlert, D.A.; Brook, M.N.; Cieza-Borrella, C.; Mijuskovic, M.; Wakerell, S.; Al Olama, A.A.; et al. Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants. Nat. Commun. 2018, 9, 2256. [Google Scholar] [CrossRef]
  13. Almutairi, F.M.; Mir, R.; Abu-Duhier, F.; Khan, R.; Harby, K.; Elfaki, I. SLC2A2 Gene (Glucose Transporter 2) Variation is Associated with an Increased Risk of Developing T2d in an Ethnic Population of Saudi Arabia. Indian J. Public Health Res. Dev. 2019, 10, 600–605. [Google Scholar] [CrossRef]
  14. Van der Harst, P.; Verweij, N. Identification of 64 Novel Genetic Loci Provides an Expanded View on the Genetic Architecture of Coronary Artery Disease. Circ. Res. 2018, 122, 433–443. [Google Scholar] [CrossRef] [PubMed]
  15. Mir, R.; Jha, C.K.; Elfaki, I.; Rehman, S.; Javid, J.; Khullar, N.; Banu, S.; Chahal, S.M.S. MicroRNA-224 (rs188519172 A>G) gene variability is associated with a decreased susceptibility to Coronary Artery Disease: A Case-Control Study. Microrna 2018, 8, 198–205. [Google Scholar] [CrossRef] [PubMed]
  16. Jha, C.K.; Mir, R.; Elfaki, I.; Khullar, N.; Rehman, S.; Javid, J.; Banu, S.; Chahal, S.M.S. Potential impact of microRNA-423 gene variability in coronary artery disease. Endocr. Metab. Immune Disord. Drug Targets 2018, 19, 67–74. [Google Scholar] [CrossRef] [PubMed]
  17. Mir, R.; Jha, C.K.; Elfaki, I.; Javid, J.; Rehman, S.; Khullar, N.; Banu, S.; Chahal, S.M.S. Incidence of MicroR-4513C/T Gene Variability in Coronary Artery Disease- A case-Control Study. Endocr. Metab. Immune Disord. Drug Targets 2019. [Google Scholar] [CrossRef] [PubMed]
  18. Jha, C.K.; Mir, R.; Khullar, N.; Banu, S.; Chahal, S.M.S. LDLR rs688 TT Genotype and T Allele Are Associated with Increased Susceptibility to Coronary Artery Disease-A Case-Control Study. J. Cardiovasc. Dev. Dis. 2018, 5, 31. [Google Scholar] [CrossRef]
  19. Jha, C.K.; Mir, R.; Elfaki, I.; Javid, J.; Babakr, A.T.; Banu, S.; Chahal, S.M.S. Evaluation of the Association of Omentin 1 rs2274907 A>T and rs2274908 G<A Gene Polymorphisms with Coronary Artery Disease in Indian Population: A Case Control Study. J. Pers. Med. 2019, 9, 30. [Google Scholar]
  20. Strisciuglio, T.; Franco, D.; Di Gioia, G.; De Biase, C.; Morisco, C.; Trimarco, B.; Barbato, E. Impact of genetic polymorphisms on platelet function and response to anti platelet drugs. Cardiovasc. Diagn. Ther. 2018, 8, 610–620. [Google Scholar] [CrossRef]
  21. Elfaki, I.; Mir, R.; Almutairi, F.M.; Duhier, F.M.A. Cytochrome P450: Polymorphisms and Roles in Cancer, Diabetes and Atherosclerosis. Asian Pac. J. Cancer Prev. 2018, 19, 2057–2070. [Google Scholar] [PubMed]
  22. Galasso, G.; Santulli, G.; Piscione, F.; De Rosa, R.; Trimarco, V.; Piccolo, R.; Cassese, S.; Iaccarino, G.; Trimarco, B.; Chiariello, M. The GPIIIA PlA2 polymorphism is associated with an increased risk of cardiovascular adverse events. BMC Cardiovasc. Disord. 2010, 10, 41. [Google Scholar] [CrossRef] [PubMed]
  23. Strom, T.B.; Tveten, K.; Laerdahl, J.K.; Leren, T.P. Mutation G805R in the transmembrane domain of the LDL receptor gene causes familial hypercholesterolemia by inducing ectodomain cleavage of the LDL receptor in the endoplasmic reticulum. FEBS Open Biol. 2014, 4, 321–327. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  24. Jha, C.K.; Chahal, S.M.S.; Khullar, N.; Banu, S.; Mir, R. High-Quality Genomic DNA Extraction From Long Term Stored (LTS) Whole Blood Samples Using Glass Bead Method. Int. J. Health Sci. Res. 2016, 6, 288–292. [Google Scholar]
  25. Benjamin, E.J.; Blaha, M.J.; Chiuve, S.E.; Cushman, M.; Das, S.R.; Deo, R.; de Ferranti, S.D.; Floyd, J.; Fornage, M.; Gillespie, C.; et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017, 135, e146–e603. [Google Scholar] [CrossRef] [PubMed]
  26. Prabhakaran, D.; Jeemon, P.; Roy, A. Cardiovascular Diseases in India: Current Epidemiology and Future Directions. Circulation 2016, 133, 1605–1620. [Google Scholar] [CrossRef] [PubMed]
  27. Wong, B.; Kruse, G.; Kutikova, L.; Ray, K.K.; Mata, P.; Bruckert, E. Cardiovascular Disease Risk Associated With Familial Hypercholesterolemia: A Systematic Review of the Literature. Clin. Ther. 2016, 38, 1696–1709. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  28. Kathiresan, S.; Melander, O.; Anevski, D.; Guiducci, C.; Burtt, N.P.; Roos, C.; Hirschhorn, J.N.; Berglund, G.; Hedblad, B.; Groop, L.; et al. Polymorphisms associated with cholesterol and risk of cardiovascular events. N. Engl. J. Med. 2008, 358, 1240–1249. [Google Scholar] [CrossRef] [PubMed]
  29. Lee, J.D.; Hsiao, K.M.; Wang, T.C.; Lee, T.H.; Kuo, Y.W.; Huang, Y.C.; Hsu, H.L.; Lin, Y.H.; Wu, C.Y.; Huang, Y.C.; et al. Mutual effect of rs688 and rs5925 in regulating low-density lipoprotein receptor splicing. DNA Cell Biol. 2014, 33, 869–875. [Google Scholar] [CrossRef] [PubMed]
  30. Nikolajević-Starčević, J.; Popović, D.; Letonja, M.Š.; Makuc, J.; Šeruga, M.; Vujkovac, A.C.; Pražnikar, Z.J.; Stare, J.; Petrovič, D. Polymorphism AvaII of the LDL receptor (rs5925) is associated with carotid-intima media thickness in patients with diabetes mellitus type 2. Slov. Med. J. 2014, 83, 5–12. [Google Scholar]
  31. Al-Khateeb, A.; Zahri, M.K.; Mohamed, M.S.; Sasongko, T.H.; Ibrahim, S.; Yusof, Z.; Zilfalil, B.A. Analysis of sequence variations in low-density lipoprotein receptor gene among Malaysian patients with familial hypercholesterolemia. BMC Med. Genet. 2011, 12, 40. [Google Scholar] [CrossRef] [PubMed]
  32. Rios-Gonzalez, B.E.; Ibarra-Cortes, B.; Ramirez-Lopez, G.; Sanchez-Corona, J.; Magana-Torres, M.T. Association of polymorphisms of genes involved in lipid metabolism with blood pressure and lipid values in mexican hypertensive individuals. Dis. Markers 2014, 2014, 9. [Google Scholar] [CrossRef] [PubMed]
  33. Lee, J.D.; Lee, T.H.; Kuo, Y.W.; Huang, Y.C.; Hsu, H.L.; Lin, Y.H.; Wu, C.Y.; Huang, Y.C.; Lee, M.; Hsiao, K.M. Polymorphisms at the LDLR locus may be associated with ischemic cerebrovascular disease independent of lipid profile. Curr. Neurovasc. Res. 2012, 9, 200–206. [Google Scholar] [CrossRef] [PubMed]
  34. Lagos, J.; Zambrano, T.; Rosales, A.; Salazar, L.A. APOE polymorphisms contribute to reduced atorvastatin response in Chilean Amerindian subjects. Int. J. Mol. Sci. 2015, 16, 7890–7899. [Google Scholar] [CrossRef] [PubMed]
  35. Yin, R.X.; Aung, L.H.; Long, X.J.; Yan, T.T.; Cao, X.L.; Huang, F.; Wu, J.Z.; Yang, D.Z.; Lin, W.X.; Pan, S.L. Interactions of several genetic polymorphisms and alcohol consumption on blood pressure levels. Biofactors 2015, 41, 339–351. [Google Scholar] [CrossRef]
  36. Jamaldini, S.H.; Babanejad, M.; Mozaffari, R.; Nikzat, N.; Jalalvand, K.; Badiei, A.; Sanati, H.; Shakerian, F.; Afshari, M.; Kahrizi, K.; et al. Association of polymorphisms at LDLR locus with coronary artery disease independently from lipid profile. Acta. Med. Iran. 2014, 52, 352–359. [Google Scholar] [PubMed]
Figure 1. The annealing sites of the primers used for genotyping rs1529729 (A) and rs5925 (B).
Figure 1. The annealing sites of the primers used for genotyping rs1529729 (A) and rs5925 (B).
Medsci 07 00080 g001
Figure 2. Genotyping of rs1529729 C > T (A) and rs5925 G > A (B) polymorphisms using allele-specific PCR (AS-PCR) assay.
Figure 2. Genotyping of rs1529729 C > T (A) and rs5925 G > A (B) polymorphisms using allele-specific PCR (AS-PCR) assay.
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Table 1. Primers sequences of allele-specific (AS)-PCR used for genotyping the low-density lipoprotein receptor (LDLR) gene polymorphisms rs1529729 and rs5925.
Table 1. Primers sequences of allele-specific (AS)-PCR used for genotyping the low-density lipoprotein receptor (LDLR) gene polymorphisms rs1529729 and rs5925.
SNP Primer SequenceProduct SizeTa
rs1529729F1 Forward primer (C allele)5-GTGGTGCCATGTATAACACCC-3175 bp61 °C
R1 Reverse primer5-CAAGAACCCAAGTTTGGAAAC-3
F2 Forward primer (T allele)5-GTGGTGCCATGTATAACACCT-3212 bp
R2 Reverse primer5-CTATATCTGGAGGCAAGAACCTGA-3
rs5925Reverse primer (G allele)5′-GGGTGAGGTTGTGGAAGACG-3′176 bp57 °C
Reverse primer (A allele)5′-GGGTGAGGTTGTGGAAGACA-3′176 bp
Common Forward primer5′-CAGTGTTTAACGGGATTTGT-3′
Table 2. Demographic characteristics of coronary artery disease (CAD) patients and healthy controls.
Table 2. Demographic characteristics of coronary artery disease (CAD) patients and healthy controls.
VariablesNo. of CAD Cases (n = 200 (100%)No. of Healthy Controls (n = 200 (100%)
No. of cases and controls200 (100%)200 (100%)
Gender difference
Males180 (90%)176 (88%)
Females20 (10%)24 (12%)
Age difference
Age ≤5090 (45%)88 (44%)
Age >50110 (55%)112 (56%)
Table 3. Baseline characteristics of CAD patients.
Table 3. Baseline characteristics of CAD patients.
VariablesCAD Cases (n = 200)(%)
Random blood sugar (RBS)
≤140 mg129(64.5%)
>140 mg71(35.5%)
Cholesterol
≤200 mg176(88%)
>200 mg24(12%)
High-density lipoprotein cholesterol (HDL-C)
≤40 mg166(83%)
>40 mg34(17%)
Low-density lipoprotein cholesterol (LDL-C)
≤100 mg150(75%)
>100 mg50(25%)
Triglycerides (TGL)
≤150 mg105(52.5%)
>150 mg95(47.5%)
Coronary heart disease (CHD) in family
Yes15(7.5%)
No185(92.5%)
Hypertension
Yes29(14.5%)
No171(85.5%)
Type 2 diabetes
Yes39(19.5%)
No161(80.5%)
Smoking
Yes121(60.5%)
No79(39.5%)
Alcohol
Yes71(35.5%)
No129(64.5%)
Pan masala
Yes4(2%)
No196(98%)
Table 4. The genotype frequency of the LDLR polymorphisms of study cohorts (controls and CAD patients).
Table 4. The genotype frequency of the LDLR polymorphisms of study cohorts (controls and CAD patients).
SNPGenotypeC/CC/TT/TChi-SquareDfP-Value
rs1529729CAD patients n = 200 (%)18 (9%)154 (77%)28 (14%)23.8520.0001
Controls n = 200 (%)42 (21%)152 (76%)06 (3%)
rs5925GenotypeG/GG/AA/AChi-squareDfP-value
CAD patients n = 200 (%)54 (27%)124 (62%)22 (11%)10.120.006
Controls n = 200 (%)30 (15%)152 (76%)18 (9%)
Table 5. Association of the LDLR rs1529729 C > T and rs5925 G > A gene variations with CAD.
Table 5. Association of the LDLR rs1529729 C > T and rs5925 G > A gene variations with CAD.
SNPGenotypesHealthy ControlsCAD CasesOdds Ratio (OR) (95% CI)Risk Ratio (RR)P-Value
rs1529729 (n = 200)(n = 200)
Codominant
LDLR-CC42181 (ref.)1 (ref.)
LDLR-CT1521540.42 (0.23–0.77)0.59 (0.39–0.89)0.0047
LDLR-TT06280.09 (0.03–0.26)0.36 (0.24–0.55)0.0001
Dominant
LDLR-CC42181 (ref.)1 (ref.)
LDLR-(CT + TT)1581820.37 (0.21–0.67)0.56 (0.38–0.84)0.001
Recessive
LDLR-(CC + CT)1941721 (ref.)1 (ref.)
LDLR-TT06280.19 (0.076–0.47)0.57 (0.47–0.69)0.0003
Allele
LDLR-C2361901 (ref.)1 (ref.)
LDLR-T1642100.63 (0.47–0.83)0.79 (0.69–0.91)0.0011
rs5925Codominant
LDLR-GG30541 (ref.)1 (ref.)
LDLR-GA1521240.45 (0.27–0.75)0.65 (0.47–0.88)0.002
LDLR-AA18220.67 (0.32–1.46)0.79 (0.50–1.24)0.322
Dominant
LDLR-GG30541 (ref.)1 (ref.)
LDLR-(GA+AA)1701460.477 (0.28–0.78)0.66 (0.48–0.9)0.003
Recessive
LDLR-(GG+GA)1821781 (ref.)1 (ref.)
LDLR-AA18221.24 (0.64–2.4)1.12 (0.78–1.6)0.5
Allele
LDLR-G2122321 (ref.)1 (ref.)
LDLR-A1881680.8 (0.61–1.07)0.9 (0.78–1.03)0.107
Table 6. Correlations of the covariates with rs5925 and rs1529729 genotypes.
Table 6. Correlations of the covariates with rs5925 and rs1529729 genotypes.
rs1529729rs5925
Subjectsn = 200C/CC/TT/TX2DFP valueG/GG/AA/AX2DFP-value
Correlation with gender
Males18015138272.220.3348111210.8320.66
Females20031601 061301
Correlation with age
Age ≤ 50900773101.6120.4472358090.4320.806
Age > 50110118118 316613
Correlation with RBS
RBS ≤ 140 mg1291398180.5220.773383130.8720.647
RBS > 140 mg71055610 214109
Correlation with cholesterol
Cholesterol ≤ 200 mg17614137251.9620.37545114175.3320.069
Cholesterol > 200 mg24041703 091005
Correlation with HDL
HDL ≤ 40 mg16614128240.520.77844104180.1820.913
HDL > 40 mg34042604 102004
Correlation with LDL
LDL ≤ 100 mg15015113221.0720.58574492142.7720.25
LDL > 100 mg50034106 103208
Correlation with TGL
TGL ≤ 150 mg1051079160.420.81872566141.9520.377
TGL > 150 mg95087512 295808
Correlation with hypertension
Hypertension290322040.0720.96560422033.2620.195
No hypertension1711513224 5010219
Correlation with diabetes
Diabetes390430050.1320.93710728042.2420.326
No diabetes1611412423 479618
Correlation with CHD
CHD150211020.3720.83110112023.4120.181
No CHD1851614326 5311220
Correlation with smoking
Smoking1211393151.620.44932645082.3220.313
No smoking79056113 287914
Correlation with alcohol
Alcohol71852111.0120.60351847061.0720.585
No alcohol1291010217 367716
Correlation with pan masala
Pan masala040004001.2220.54340003011.9420.379
No pan masala1961815028 5412121
Table 7. The rs5925 G > A and rs1529729 C > T genotype distributions in different populations.
Table 7. The rs5925 G > A and rs1529729 C > T genotype distributions in different populations.
rs5925
CountryDiseasenHomozygous Wild Type%Heterozygous%Homozygous Mutant%Reference
MexicoHypertension1603622.57345.635131.87[32]
Controls1603421.258251.254427.5
SloveniaType 2 diabetes3996716.818947.414335.8[30]
Controls1962613.39146.47940.3
TaiwanIschemic stroke815526.426232.150161.5[33]
Controls4301741463426762
ChileHypercholesterolemia1162521.67867.21311.2[34]
ControlsNANA NA NA
ChinaBlood pressure60829748.8237397412.2[35]
Controls61634856.521635.1528.4
Present studyCAD2005427124622211
Controls200301515276189
CountryDiseasenHomozygous Wild Type%Heterozygous%Homozygous Mutant%Reference
rs1529729
IranCAD1704325.4410360.362414.2[36]
Controls1042928.434442.163129.41
SwedenCardiovascular5084161031.7248148.899319.5[28]
ControlsNANA NA NA
PresentCAD cases200189154772814
studyControls20042211527663

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MDPI and ACS Style

K. Jha, C.; Mir, R.; Elfaki, I.; Banu, S.; Chahal, S.M.S. LDLR Gene Polymorphisms (rs5925 and rs1529729) Are Associated with Susceptibility to Coronary Artery Disease in a South Indian Population. Med. Sci. 2019, 7, 80. https://doi.org/10.3390/medsci7070080

AMA Style

K. Jha C, Mir R, Elfaki I, Banu S, Chahal SMS. LDLR Gene Polymorphisms (rs5925 and rs1529729) Are Associated with Susceptibility to Coronary Artery Disease in a South Indian Population. Medical Sciences. 2019; 7(7):80. https://doi.org/10.3390/medsci7070080

Chicago/Turabian Style

K. Jha, Chandan, Rashid Mir, Imadeldin Elfaki, Shaheena Banu, and S. M. S. Chahal. 2019. "LDLR Gene Polymorphisms (rs5925 and rs1529729) Are Associated with Susceptibility to Coronary Artery Disease in a South Indian Population" Medical Sciences 7, no. 7: 80. https://doi.org/10.3390/medsci7070080

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