Abstract

Flavin containing monooxygenase 3 [FMO3] encodes dimethylaniline monooxygenase [N-oxide-forming] 3, which breaks down nitrogen-containing compounds, and has been implicated in blood pressure regulation. Studies have reported conflicting results of the association of a common nonsynonymous variant, E158K (rs2266782), with hypertension. We examined the associations of E158K, along with rare and low frequency exonic variants (minor allele frequency [MAF]<5%) in FMO3 with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP). We included 7,350 European Americans and 2,814 African Americans in the Atherosclerosis Risk in Communities (ARIC) study with exome sequencing of FMO3. The association of FMO3 variants with SBP and DBP was tested using single variant and gene-based tests followed by the replication or interrogation of significant variants in ancestry-specific cohorts based on Bonferroni corrected thresholds. E158K had significant association with higher SBP in African Americans in ARIC (p=0.03), and two low frequency variants had significant association with higher SBP in African Americans (rs200985584, MAF 0.1%, p=0.0003) and European Americans (rs75904274, MAF 1.7%, p=0.006). These associations were not significant with additional samples: E158K in a meta-analysis of SBP of African ancestry (N=30,841, p=0.43) that included ARIC participants and the two low frequency variants in an independent ancestry-specific exome sequencing study of blood pressure (rs200985584, p=0.94; rs75904274, p=0.81). Our study does not support the association of E158K and low frequency variants in FMO3 with blood pressure and demonstrates the importance of replication in genetic studies.

Highlights

  • IntroductionHigh levels of trimethylamine N-oxide (TMAO) have been associated with atherosclerotic lesions in mice and various cardiovascular disease (CVD) outcomes (cerebrovascular accident, myocardial infarction, and CVD related mortality) in humans [1]

  • High levels of trimethylamine N-oxide (TMAO) have been associated with atherosclerotic lesions in mice and various cardiovascular disease (CVD) outcomes in humans [1]

  • We examined the associations of E158K, along with rare and low frequency exonic variants in Flavin Containing Monooxygenase 3 (FMO) with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP)

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Summary

Introduction

High levels of trimethylamine N-oxide (TMAO) have been associated with atherosclerotic lesions in mice and various cardiovascular disease (CVD) outcomes (cerebrovascular accident, myocardial infarction, and CVD related mortality) in humans [1]. Loss-of-function variants in FMO , such as N61S and P153L, have been found to cause trimethylaminuria (TMAU), a condition characterized by an accumulation of TMA in the blood, due to the decreased catalytic efficiency of FMO3 [3]. Those who have rare variants in FMO causing trimethylaminuria commonly have hypertension [4]. A study in a population of 1,649 Irish participants found no significant association of E158K (minor allele frequency [MAF] = 36%) with hypertension [5]. Another study in a Russian population with 2,995 unrelated participants found that among cigarette smokers, there was an increased risk of hypertension (odds ratio of 1.38) in E158K homozygous individuals (MAF = 45%) [6]

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