Transethnic meta-analysis suggests genetic variation in the HEME pathway influences potassium response in patients treated with hydrochlorothiazide

Pharmacogenomics J. 2015 Apr;15(2):153-7. doi: 10.1038/tpj.2014.46. Epub 2014 Sep 9.

Abstract

Hypokalemia is a recognized adverse effect of thiazide diuretic treatment. This phenomenon, which may impair insulin secretion, has been suggested to be a reason for the adverse effects on glucose metabolism associated with thiazide diuretic treatment of hypertension. However, the mechanisms underlying thiazide diuretic-induced hypokalemia are not well understood. In an effort to identify genes or genomic regions associated with potassium response to hydrochlorothiazide, without a priori knowledge of biologic effects, we performed a genome-wide association study and a multiethnic meta-analysis in 718 European- and African-American hypertensive participants from two different pharmacogenetic studies. Single-nucleotide polymorphisms rs10845697 (Bayes factor=5.560) on chromosome 12, near to the HEME binding protein 1 gene, and rs11135740 (Bayes factor=5.258) on chromosome 8, near to the Mitoferrin-1 gene, reached genome-wide association study significance (Bayes factor >5). These results, if replicated, suggest a novel mechanism involving effects of genes in the HEME pathway influencing hydrochlorothiazide-induced renal potassium loss.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Bayes Theorem
  • Black or African American / genetics
  • Carrier Proteins / genetics*
  • Cation Transport Proteins / genetics
  • Chromosomes, Human, Pair 12 / genetics
  • Chromosomes, Human, Pair 8 / genetics
  • Female
  • Genome-Wide Association Study / methods
  • Heme / genetics*
  • Heme-Binding Proteins
  • Hemeproteins / genetics*
  • Humans
  • Hydrochlorothiazide / metabolism
  • Hydrochlorothiazide / therapeutic use*
  • Hypertension / drug therapy
  • Hypertension / genetics
  • Hypertension / metabolism
  • Hypokalemia / drug therapy
  • Hypokalemia / genetics
  • Hypokalemia / metabolism
  • Male
  • Middle Aged
  • Mitochondrial Proteins / genetics
  • Polymorphism, Single Nucleotide / genetics*
  • Potassium / metabolism*
  • White People / genetics

Substances

  • Antihypertensive Agents
  • Carrier Proteins
  • Cation Transport Proteins
  • HEBP1 protein, human
  • Heme-Binding Proteins
  • Hemeproteins
  • Mitochondrial Proteins
  • Slc25a37 protein, human
  • Hydrochlorothiazide
  • Heme
  • Potassium