Frontiers in Genetics (Jul 2022)

Do Biobank Recall Studies Matter? Long-Term Follow-Up of Research Participants With Familial Hypercholesterolemia

  • Miriam Nurm,
  • Miriam Nurm,
  • Anu Reigo,
  • Margit Nõukas,
  • Margit Nõukas,
  • Liis Leitsalu,
  • Tiit Nikopensius,
  • Marili Palover,
  • Marili Palover,
  • Tarmo Annilo,
  • Maris Alver,
  • Maris Alver,
  • Aet Saar,
  • Aet Saar,
  • Toomas Marandi,
  • Toomas Marandi,
  • Tiia Ainla,
  • Tiia Ainla,
  • Andres Metspalu,
  • Andres Metspalu,
  • Tõnu Esko,
  • Neeme Tõnisson,
  • Neeme Tõnisson

DOI
https://doi.org/10.3389/fgene.2022.936131
Journal volume & issue
Vol. 13

Abstract

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Recall-by-genotype (RbG) studies conducted with population-based biobank data remain urgently needed, and follow-up RbG studies, which add substance to this research approach, remain solitary. In such studies, potentially disease-related genotypes are identified and individuals with those genotypes are recalled for consultation to gather more detailed clinical phenotypic information and explain to them the meaning of their genetic findings. Familial hypercholesterolemia (FH) is among the most common autosomal-dominant single-gene disorders, with a global prevalence of 1 in 500 (Nordestgaard et al., Eur. Heart J., 2013, 34 (45), 3478–3490). Untreated FH leads to lifelong elevated LDL cholesterol levels, which can cause ischemic heart disease, with potentially fatal consequences at a relatively early age. In most cases, the pathogenesis of FH is based on a defect in one of three LDL receptor-related genes–APOB, LDLR, and PCSK9. We present our first long-term follow-up RbG study of FH, conducted within the Estonian Biobank (34 recalled participants from a pilot RbG study and 291 controls harboring the same APOB, LDLR, and PCSK9 variants that were included in the pilot study). The participants’ electronic health record data (FH-related diagnoses, lipid-lowering treatment prescriptions) and pharmacogenomic risk of developing statin-induced myopathy were assessed. A survey was administered to recalled participants to discern the impact of the knowledge of their genetic findings on their lives 4–6 years later. Significant differences in FH diagnoses and lipid-lowering treatment prescriptions were found between the recalled participants and controls (34 and 291 participants respectively). Our study highlights the need for more consistent lipid-lowering treatment adherence checkups and encourage more follow-up RbG studies to be performed.

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