Abstract Text |
Polygenic risk scores (PRS) are a promising tool for improving health outcomes through personalized medicine, however there is a well-documented need to improve diversity in the populations through which PRS are generated to not further exacerbate health disparities among underrepresented populations. Specifically for Low-Density Lipoprotein Cholesterol (LDL-C), a known risk factor for cardiovascular disease, recent efforts have been made to diversify PRS to represent non-European ancestral groups, including African, East Asian, South Asian, and Hispanic populations. However, there are several other minority populations for which the transferability of PRS has not yet been examined. Specifically, the transferability of these ‘multiethnic’ PRS has not been studied in Pacific Islanders, who have a disproportionate burden of cardiovascular disease and are underrepresented in health research.
Thus, we sought to assess the performance of a recent multiethnic PRS for LDL-C, constructed using over 1 million individuals of African, East Asian, European, Hispanic, and South Asian (Graham et. al 2021), in a cohort of n=2,816 Samoan adults.
The genetic variant information and corresponding weights for the multiethnic LDL-C PRS were downloaded from the Polygenic Score Catalog, and WGS data from 2,816 Samoans were aligned to the scoring file to assign individual-level risk scores. Of the 9,009 variants in the PRS, 8,653 (96%) were available in the Samoan samples, although 20% (1,747/8,653) of variants were monomorphic in the Samoan samples. The distribution of the PRS in Samoans ranged from 43.6 to 49.3 risk alleles, with a mean of 46.8. The utility of the PRS was evaluated using a multivariable linear regression model adjusted for age, sex, and principal components of ancestry. The PRS was associated with higher LDL-C (β = 13.7 mg/dL, 95% CI 12.2 – 15.3 mg/dL, p = 4.3e-66). The partial r2 for the PRS was 10.17% (95% bootstrap CI 8.23 – 12.42%), values that are similar to the published performance of the PRS in other non-European ancestral groups (r2 10-16%), despite there being no Pacific Islanders represented in the PRS construction. While there is still much work to do to improve the representation of minority populations in health research, these results show that, at least for LDL-C, a PRS derived from multiple diverse ancestries performs similarly in Samoans as to other minority populations. Further work is needed to characterize the performance of PRS for other traits in this population to see if they are equally transferable and to compare performance to a PRS derived in a Pacific Islander population. However, this work highlights the importance of including several diverse populations in the construction of PRS as a first step in improving the accuracy and transferability to minority populations.
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