DNA Methylation Variants at HIF3A Locus, B-Vitamin Intake, and Long-Term Weight Change: Gene-Diet Interactions in Two U.S
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3146 Diabetes Volume 64, September 2015 Tao Huang,1 Yan Zheng,1 Qibin Qi,2 Min Xu,3 Sylvia H. Ley,1 Yanping Li,1 Jae H. Kang,4 Janey Wiggs,5 Louis R. Pasquale,4,5 Andrew T. Chan,6 Eric B. Rimm,1,4,7 David J. Hunter,1,7 JoAnn E. Manson,4,7,8 Walter C. Willett,1,4,7 Frank B. Hu,1,4,7 and Lu Qi1,4 DNA Methylation Variants at HIF3A Locus, B-Vitamin Intake, and Long-term Weight Change: Gene-Diet Interactions in Two U.S. Cohorts Diabetes 2015;64:3146–3154 | DOI: 10.2337/db15-0264 The first epigenome-wide association study of BMI not induced by changes in the DNA sequence (1). Increasing identified DNA methylation at an HIF3A locus associated evidence indicates that DNA methylation plays a pivotal role with BMI. We tested the hypothesis that DNA methylation in regulating body adiposity (2–5). In a recent large-scale variants are associated with BMI according to intake of epigenome-wide association study, Dick et al. (4) found B vitamins. In two large cohorts, we found significant inter- that DNA methylation at HIF3A was associated with BMI. actions between the DNA methylation–associated HIF3A However, genetic variants in this locus were not associated single nucleotide polymorphism (SNP) rs3826795 and in- with BMI, although they were associated with HIF3A meth- take of B vitamins on 10-year changes in BMI. The asso- ylationlevelsinbloodandadiposeandskintissues.The ciation between rs3826795 and BMI changes consistently authors suggested that the association between HIF3A meth- increased across the tertiles of total vitamin B and B 2 12 ylation and BMI might not be operating by the Mendelian intake (all P for interaction <0.01). The differences in the randomization theory (4), but the study did not consider BMI changes per increment of minor allele were 20.10 OBESITY STUDIES potential modifying effects of environmental factors on the (SE 0.06), 20.01 (SE 0.06), and 0.12 (SE 0.07) within sub- genetic associations. Previous evidence supports the impor- groups defined by increasing tertiles of total vitamin B2 intake and 20.10 (SE 0.06), 20.01 (SE 0.06), and 0.10 (SE tance of considering interactions between genetic and diet/ – 0.07) within subgroups defined by increasing tertiles of lifestyle factors in the development of adiposity (6 10). It has long been acknowledged that DNA methylation total vitamin B12 intake. In two independent cohorts, a DNA methylation variant in HIF3A was associated with levels are subject to modulation by environmental factors BMI changes through interactions with total or supple- such as diet and lifestyle. Methylation of DNA is a bio- mental vitamin B2, vitamin B12, and folate. These findings chemical process in which a methyl group is added to suggest a potential causal relation between DNA methyl- DNA nucleotides. Several B vitamins, including folate, ation and adiposity. riboflavin (B2), pyridoxine (B6), and B12, act as key en- zyme cofactors and play essential roles in methyl group metabolism and DNA methylation in particular (11,12). DNA methylation is one of the major epigenetic events Previous studies have associated B-vitamin intake with ad- that affect gene expression through a mechanism that is iposity in humans (13,14). Therefore, we hypothesized that 1Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 8Division of Preventive Medicine, Department of Medicine, Brigham and Women’s 2Department of Epidemiology and Population Health, Albert Einstein College of Hospital and Harvard Medical School, Boston, MA Medicine, Bronx, NY Corresponding author: Lu Qi, [email protected]. 3Shanghai Clinical Center for Endocrine and Metabolic Diseases and Shanghai Received 25 February 2015 and accepted 14 May 2015. Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China This article contains Supplementary Data online at http://diabetes 4Channing Division of Network Medicine, Department of Medicine, Brigham and .diabetesjournals.org/lookup/suppl/doi:10.2337/db15-0264/-/DC1. Women’s Hospital and Harvard Medical School, Boston, MA © 2015 by the American Diabetes Association. Readers may use this article as 5Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and long as the work is properly cited, the use is educational and not for profit, and Ear Infirmary, Boston, MA the work is not altered. 6Division of Gastroenterology, Massachusetts General Hospital, Boston, MA 7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA diabetes.diabetesjournals.org Huang and Associates 3147 B vitamins modify the relation between the methylation- with a BMI $30 kg/m2 were defined as obese, and those associated genetic variants at HIF3A and BMI. To test this with a BMI $25 kg/m2 were defined as overweight. The hypothesis, we examined interactions between intake of epidemic of obesity occurred during a relatively short pe- B vitamins and DNA methylation variants at the HIF3A riod of time in the U.S. between ;1980 and 2000 (28,29), locus in relation to BMI and 10-year changes in BMI in paralleling a dramatic transition from traditional to obe- two prospective cohorts: the Nurses’ Health Study (NHS) sogenic diet/lifestyle patterns (9,10,30). Obesity traits and the Health Professionals Follow-Up Study (HPFS). measured at a single time point cannot capture the vari- ance in gradual changes, whereas changes in BMI/body RESEARCH DESIGN AND METHODS weight during the period of the obesity epidemic more Study Population likely reflect the long-term, dynamic response to gene- The NHS is a prospective cohort study of 121,700 female environment interactions. Furthermore, considerable in- registered nurses aged 30–55 years at study inception in terindividual variations of weight change in response to 1976 (15). The HPFS is a prospective cohort study of diet interventions have long been noted (10); therefore, 51,529 U.S. male health professionals aged 40–75 years the present study mainly focused on 10-year changes in at study inception in 1986 (16). The human subjects com- BMI. We defined the 10-year period for changes in BMI as mittees at the Harvard School of Public Health and Brigham 1980–1990 in the NHS cohort and 1986–1996 in the and Women’s Hospital approved these studies. Informed HPFS cohort. consent was obtained from all participants. In both cohorts, Single Nucleotide Polymorphism Selection and information about medical history, lifestyle, and health con- Genotyping ditions has been collected by self-administered question- The HIF3A variants rs3826795 and rs8102595 were se- naires every 2 years since inception. The current analysis lected because they had independent associations with baseline was set in 1980 for the NHS and 1986 for the methylation at a specific CpG site (cg22891070) within fi HPFS when the rst data on intake of B vitamins were intron 1 of HIF3A in adipose tissue and skin DNA asso- collected. We included 8,109 women and 6,761 men of ciated with BMI (4). The single nucleotide polymorphisms European ancestry. Both case and control participants (SNPs) were genotyped and had a high imputation quality with genotyping data available based on previous genome- score (r2 $ 0.8) as assessed with the use of MACH version – wide association studies were included (17 22). 1.0.16 software (Center for Statistical Genetics, Univer- Assessment of Dietary Factors and Covariates sity of Michigan). DNA extraction methods, quality con- Questionnaires were sent every 2 years to update in- trol measures, SNP genotyping, and imputations are formation on medical history and lifestyle factors. The described in detail elsewhere (17–22,31). The minor allele cohorts had follow-up rates of .85%. Dietary intake of frequencies (MAFs) of rs3826795 and rs8102595 are 0.09 various nutrients at baseline, including folate and vita- and 0.18, respectively. mins B2,B6, and B12, as well as daily consumption of Statistical Analyses alcohol, sugar-sweetened beverages, fried food, and total We examined the association of genetic variants with meat were assessed by validated semiquantitative food adiposity measures, baseline B-vitamin intake, and 10- frequency questionnaires every 4 years (23,24). All con- year changes in BMI or body weight using general linear tributions, including those from food and supplements, models. Interactions between the genetic variants and were summed to derive the total intake of specific intake of baseline nutrients (e.g., intake of total B vitamins, nutrients (23). The validity and reliability of the food intake of B vitamins from supplements or food frequency questionnaire has been established previously sources) on body weight, BMI, and 10-year changes in (23,24). Physical activity was expressed as metabolic body weight or BMI were tested by including a multi- equivalents per week by incorporating the reported time plicative interaction term in the models. Potential spent on various activities and the intensity level of each confounders considered in multivariable models were age activity. The validity of the self-reported physical activity (years, continuous), baseline physical activity (MET-h/week, data has been described previously (25). The Alternate continuous), baseline television watching (0–1, 2–5, 6–20, Healthy Eating Index was calculated previously in the 21–40, .40 h/week), baseline smoking (never, past, cur- NHS and HPFS (26). rent), baseline alcohol intake (0, 0.1–4.9, 5.0–9.9, 10– Assessment of Adiposity and 10-Year Changes in BMI 14.9, $15 g/day), baseline Alternate Healthy Eating Index Height and body weight were assessed by questionnaire at (in quintiles), and baseline total energy intake (in quin- baseline, and weight was requested on each follow-up tiles). Sugar-sweetened beverage, fried food, and total questionnaire. Body weight at a young age (18 years old in meat consumption were further adjusted in sensitivity the NHS and 21 years old in the HPFS) was also collected analyses.