A new study reveals that 4% of Icelanders carry genotypes linked to serious diseases, impacting their lifespan. The study, which analyzed 58,000 whole-genome sequenced Icelanders, found that actionable genotypes, particularly those predisposing individuals to cancer and cardiovascular diseases, significantly shorten life expectancy. These findings have led to a national precision medicine initiative in Iceland, underscoring the potential of genomic data in improving healthcare and patient outcomes.
Scientists at deCODE genetics, a subsidiary of Amgen, have published a study exploring the relationship between specific genotypes found in the Icelandic population and their impact on lifespan. This study has inspired the Icelandic government to initiate a comprehensive precision medicine program. Precision medicine delivery relies heavily on extensive data in genomics, transcriptomics, and proteomics, areas where Icelanders have a unique advantage because they behold an unprecedented amount of such data.
The study, recently published in the New England Journal of Medicine, focuses on genotypes that increase the risk of a disease for which preventive or therapeutic measures have been established. These genotypes are termed actionable genotypes. The scientists used a population-based data set, consisting of 58,000 whole-genome sequenced Icelanders, to assess the fraction of individuals carrying actionable genotypes.
Utilizing a list of 73 actionable genes from the guidelines from the American College of Medical Genetics and Genomics (ACMG), the scientists found that 4% of Icelanders carry an actionable genotype in one or more of these genes. The diseases caused by these genotypes include cardiovascular, cancer, and metabolic diseases.
Impact of Actionable Genotypes on Lifespan
The study assessed the relationship between actionable genotypes and the lifespan of their carriers. The largest effect was observed among carriers of cancer-predisposing genotypes, which had three years shorter median survival than non-carriers. A pathogenic variant in BRCA2, predisposing to breast, ovarian, and pancreatic cancer, shortened lifespan by seven years, and a variant in LDLR, which causes high levels of cholesterol and cardiovascular disease, shortened lifespan by six years. “Our results suggest that the actionable genotypes identified in our study, which are all predicted to cause serious disease, may have a drastic effect on lifespan,” said Patrick Sulem author on the paper and scientist at, deCODE genetics.
Three authors on the paper, Kari Stefansson, Patrick Sulem, and Brynjar O Jensson. Credit: deCODE Genetics
The results showed that carriers of particular actionable genotypes were more likely to have died from the disease caused by these genotypes. Individuals with a pathogenic variant in BRCA2, have a seven-fold risk of dying from breast, ovarian, or pancreatic cancer.
Furthermore, they are 3.5 times more likely to develop prostate cancer and 7 times more likely to die from prostate cancer than those who do not carry the variant.
The researchers determined that 1 in 25 individuals carried an actionable genotype and have, on average, a shortened lifespan. “The identification and disclosure of actionable genotypes to participants can guide clinical decision-making, which may result in improved patient outcomes. This knowledge therefore has significant potential to mitigate disease burden for individuals and society as a whole” said Kari Stefansson, author of the paper and CEO of deCODE genetics.
Reference: “Actionable Genotypes and Their Association with Life Span in Iceland” by Brynjar O. Jensson, Gudny A. Arnadottir, Hildigunnur Katrinardottir, Run Fridriksdottir, Hannes Helgason, Asmundur Oddsson, Gardar Sveinbjornsson, Hannes P. Eggertsson, Gisli H. Halldorsson, Bjarni A. Atlason, Hakon Jonsson, Gudjon R. Oskarsson, Arni Sturluson, Sigurjon A. Gudjonsson, Gudmundur A. Thorisson, Florian Zink, Kristjan H.S. Moore, Gunnar Palsson, Asgeir Sigurdsson, Adalbjorg Jonasdottir, Aslaug Jonasdottir, Magnus K. Magnusson, Anna Helgadottir, Valgerdur Steinthorsdottir, Julius Gudmundsson, Simon N. Stacey, Rafn Hilmarsson, Isleifur Olafsson, Oskar T. Johannsson, David O. Arnar, Jona Saemundsdottir, Olafur T. Magnusson, Gisli Masson, Bjarni V. Halldorsson, Agnar Helgason, Hreinn Stefansson, Ingileif Jonsdottir, Hilma Holm, Thorunn Rafnar, Unnur Thorsteinsdottir, Daniel F. Gudbjartsson, Kari Stefansson and Patrick Sulem, 7 November 2023, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2300792
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