Variation in the SERPINA6/SERPINA1 locus alters morning plasma cortisol, hepatic corticosteroid binding globulin expression, gene expression in peripheral tissues, and risk of cardiovascular disease.


Journal

Journal of human genetics
ISSN: 1435-232X
Titre abrégé: J Hum Genet
Pays: England
ID NLM: 9808008

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 03 11 2020
accepted: 14 12 2020
revised: 14 12 2020
pubmed: 21 1 2021
medline: 3 9 2021
entrez: 20 1 2021
Statut: ppublish

Résumé

The stress hormone cortisol modulates fuel metabolism, cardiovascular homoeostasis, mood, inflammation and cognition. The CORtisol NETwork (CORNET) consortium previously identified a single locus associated with morning plasma cortisol. Identifying additional genetic variants that explain more of the variance in cortisol could provide new insights into cortisol biology and provide statistical power to test the causative role of cortisol in common diseases. The CORNET consortium extended its genome-wide association meta-analysis for morning plasma cortisol from 12,597 to 25,314 subjects and from ~2.2 M to ~7 M SNPs, in 17 population-based cohorts of European ancestries. We confirmed the genetic association with SERPINA6/SERPINA1. This locus contains genes encoding corticosteroid binding globulin (CBG) and α1-antitrypsin. Expression quantitative trait loci (eQTL) analyses undertaken in the STARNET cohort of 600 individuals showed that specific genetic variants within the SERPINA6/SERPINA1 locus influence expression of SERPINA6 rather than SERPINA1 in the liver. Moreover, trans-eQTL analysis demonstrated effects on adipose tissue gene expression, suggesting that variations in CBG levels have an effect on delivery of cortisol to peripheral tissues. Two-sample Mendelian randomisation analyses provided evidence that each genetically-determined standard deviation (SD) increase in morning plasma cortisol was associated with increased odds of chronic ischaemic heart disease (0.32, 95% CI 0.06-0.59) and myocardial infarction (0.21, 95% CI 0.00-0.43) in UK Biobank and similarly in CARDIoGRAMplusC4D. These findings reveal a causative pathway for CBG in determining cortisol action in peripheral tissues and thereby contributing to the aetiology of cardiovascular disease.

Identifiants

pubmed: 33469137
doi: 10.1038/s10038-020-00895-6
pii: 10.1038/s10038-020-00895-6
pmc: PMC8144017
mid: EMS114696
doi:

Substances chimiques

Adrenal Cortex Hormones 0
SERPINA1 protein, human 0
SERPINA6 protein, human 0
alpha 1-Antitrypsin 0
Transcortin 9010-38-2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

625-636

Subventions

Organisme : Chief Scientist Office
ID : CZB/4/733
Pays : United Kingdom
Organisme : British Heart Foundation (BHF)
ID : RG/11/4/28734
Organisme : Medical Research Council
ID : MC_UU_00011/1
Pays : United Kingdom
Organisme : Wellcome Trust (Wellcome)
ID : 107049/Z/15/Z
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 202802/Z/16/Z
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RG/11/4/28734
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_17228
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 098017
Pays : United Kingdom
Organisme : NIH HHS
ID : S10 OD018522
Pays : United States
Organisme : NIH HHS
ID : S10 OD026880
Pays : United States
Organisme : Wellcome Trust
ID : 090532
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 107049
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 064890
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00007/10
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_QA137853
Pays : United Kingdom
Organisme : RCUK | Medical Research Council (MRC)
ID : 1938124

Investigateurs

Dan Mellström (D)

Références

Walker BR. Glucocorticoids and cardiovascular disease. Eur J Endocrinol. 2007;157:545–59.
pubmed: 17984234 doi: 10.1530/EJE-07-0455
Ragnarsson O, Olsson DS, Papakokkinou E, Chantzichristos D, Dahlqvist P, Segerstedt E, et al. Overall and disease-specific mortality in patients with cushing disease: a Swedish Nationwide Study. J Clin Endocrinol Metab. 2019;104:2375–84.
pubmed: 30715394 doi: 10.1210/jc.2018-02524
Phillips DIW, Barker DJP, Fall CHD, Seckl JR, Whorwood CB, Wood PJ, et al. Elevated plasma cortisol concentrations: a link between low birth weight and the insulin resistance syndrome? J Clin Endocrinol Metab. 1998;83:757–60.
pubmed: 9506721
Filipovsky J, Ducimetiere P, Eschwege E, Richard JL, Rosselin G, Claude JR. The relationship of blood pressure with glucose, insulin, heart rate, free fatty acids and plasma cortisol levels according to degree of obesity in middle-aged men. J Hypertens. 1996;14:229–35.
pubmed: 8728301 doi: 10.1097/00004872-199602000-00012
Fraser Robert, Ingram Mary C, Anderson Niall H, Morrison Caroline, Davies Eleanor, Connell John MC. Cortisol effects on body mass, blood pressure, and cholesterol in the general population. Hypertension. 1999;33:1364–8.
pubmed: 10373217 doi: 10.1161/01.HYP.33.6.1364
Reynolds RM, Walker BR, Syddall HE, Andrew R, Wood PJ, Whorwood CB, et al. Altered control of cortisol secretion in adult men with low birth weight and cardiovascular risk factors. J Clin Endocrinol Metab. 2001;86:245–50.
pubmed: 11232008
Lupien SJ, de Leon M, de Santi S, Convit A, Tarshish C, Nair NPV, et al. Cortisol levels during human aging predict hippocampal atrophy and memory deficits. Nat Neurosci. 1998;1:69–73.
pubmed: 10195112 doi: 10.1038/271
Holsboer F. Stress, hypercortisolism and corticosteroid receptors in depression: implicatons for therapy. J Affect Disord. 2001;62:77–91.
pubmed: 11172875 doi: 10.1016/S0165-0327(00)00352-9
Seckl JR, Meaney MJ. Glucocorticoid “Programming” and PTSD risk. Ann NY Acad Sci. 2006;1071:351–78.
pubmed: 16891583 doi: 10.1196/annals.1364.027
Ball TM. Cortisol circadian rhythms and stress responses in infants at risk of allergic disease. NIM. 2006;13:294–300.
Bolton JL, Hayward C, Direk N, Lewis JG, Hammond GL, Hill LA, et al. Genome wide association identifies common variants at the SERPINA6/SERPINA1 locus influencing plasma cortisol and corticosteroid binding globulin. PLOS Genet. 2014;10:e1004474.
pubmed: 25010111 pmcid: 4091794 doi: 10.1371/journal.pgen.1004474
Hammond GL, Smith CL, Paterson NAM, Sibbald WJ. A role for corticosteroid-binding globulin in delivery of cortisol to activated neutrophils. J Clin Endocrinol Metab. 1990;71:34–9.
pubmed: 2370299 doi: 10.1210/jcem-71-1-34
Crawford AA, Soderberg S, Kirschbaum C, Murphy L, Eliasson M, Ebrahim S, et al. Morning plasma cortisol as a cardiovascular risk factor: findings from prospective cohort and Mendelian randomization studies. Eur J Endocrinol. 2019;181:429–38.
pubmed: 31325907 pmcid: 6733337 doi: 10.1530/EJE-19-0161
Pott J, Bae YJ, Horn K, Teren A, Kühnapfel A, Kirsten H, et al. Genetic association study of eight steroid hormones and implications for sexual dimorphism of coronary artery disease. J Clin Endocrinol Metab. 2019;104:5008–23.
pubmed: 31169883 doi: 10.1210/jc.2019-00757
Neumann A, Direk N, Crawford AA, Mirza S, Adams H, Bolton J, et al. The low single nucleotide polymorphism heritability of plasma and saliva cortisol levels. Psychoneuroendocrinology. 2017;85:88–95.
pubmed: 28843169 doi: 10.1016/j.psyneuen.2017.08.011
Winkler TW, Day FR, Croteau-Chonka DC, Wood AR, Locke AE, Mägi R, et al. Quality control and conduct of genome-wide association meta-analyses. Nat Protoc. 2014;9:1192–212.
pubmed: 24762786 pmcid: 4083217 doi: 10.1038/nprot.2014.071
Willer CJ, Li Y, Abecasis GR. METAL: fast and efficient meta-analysis of genomewide association scans. Bioinformatics. 2010;26:2190–1.
pubmed: 20616382 pmcid: 2922887 doi: 10.1093/bioinformatics/btq340
Winkler TW, Kutalik Z, Gorski M, Lottaz C, Kronenberg F, Heid IM. EasyStrata: evaluation and visualization of stratified genome-wide association meta-analysis data. Bioinformatics. 2015;31:259–61.
pubmed: 25260699 doi: 10.1093/bioinformatics/btu621
Bulik-Sullivan BK, Loh P-R, Finucane HK, Ripke S, Yang J, Patterson N, et al. LD Score regression distinguishes confounding from polygenicity in genome-wide association studies. Nat Genet. 2015;47:291–5.
pubmed: 25642630 pmcid: 4495769 doi: 10.1038/ng.3211
Finucane HK, Bulik-Sullivan B, Gusev A, Trynka G, Reshef Y, Loh P-R, et al. Partitioning heritability by functional annotation using genome-wide association summary statistics. Nat Genet. 2015;47:1228–35.
pubmed: 26414678 pmcid: 4626285 doi: 10.1038/ng.3404
Bulik-Sullivan B, Finucane HK, Anttila V, Gusev A, Day FR, Loh P-R, et al. An atlas of genetic correlations across human diseases and traits. Nat Genet. 2015;47:1236–41.
pubmed: 26414676 pmcid: 4797329 doi: 10.1038/ng.3406
Zheng J, Erzurumluoglu AM, Elsworth BL, Kemp JP, Howe L, Haycock PC, et al. LD Hub: a centralized database and web interface to perform LD score regression that maximizes the potential of summary level GWAS data for SNP heritability and genetic correlation analysis. Bioinformatics. 2017;33:272–9.
pubmed: 27663502 doi: 10.1093/bioinformatics/btw613
Leeuw CA, de, Mooij JM, Heskes T, Posthuma D. MAGMA: Generalized Gene-Set Analysis of GWAS Data. PLOS Comput Biol. 2015;11:e1004219.
pubmed: 25885710 pmcid: 4401657 doi: 10.1371/journal.pcbi.1004219
Watanabe K, Taskesen E, Bochoven Avan, Posthuma D. Functional mapping and annotation of genetic associations with FUMA. Nat Commun. 2017;8:1–11.
doi: 10.1038/s41467-017-01261-5
Franzén O, Ermel R, Cohain A, Akers NK, Narzo AD, Talukdar HA, et al. Cardiometabolic risk loci share downstream cis- and trans-gene regulation across tissues and diseases. Science. 2016;353:827–30.
pubmed: 27540175 pmcid: 5534139 doi: 10.1126/science.aad6970
Schadt EE, Molony C, Chudin E, Hao K, Yang X, Lum PY, et al. Mapping the Genetic Architecture of Gene Expression in Human Liver. PLOS Biol. 2008;6:e107.
pubmed: 18462017 pmcid: 2365981 doi: 10.1371/journal.pbio.0060107
Qi J, Asl HF, Björkegren J, Michoel T. kruX: matrix-based non-parametric eQTL discovery. BMC Bioinform. 2014;15:11.
doi: 10.1186/1471-2105-15-11
Storey JD, Tibshirani R. Statistical significance for genomewide studies. PNAS. 2003;100:9440–5.
pubmed: 12883005 doi: 10.1073/pnas.1530509100 pmcid: 170937
Pruim RJ, Welch RP, Sanna S, Teslovich TM, Chines PS, Gliedt TP, et al. LocusZoom: regional visualization of genome-wide association scan results. Bioinformatics. 2010;26:2336–7.
pubmed: 20634204 pmcid: 2935401 doi: 10.1093/bioinformatics/btq419
Giambartolomei C, Vukcevic D, Schadt EE, Franke L, Hingorani AD, Wallace C, et al. Bayesian test for colocalisation between pairs of genetic association studies using summary statistics. PLOS Genet. 2014;10:e1004383.
pubmed: 24830394 pmcid: 4022491 doi: 10.1371/journal.pgen.1004383
Shabalin AA. Matrix eQTL: ultra fast eQTL analysis via large matrix operations. Bioinformatics. 2012;28:1353–8.
pubmed: 22492648 pmcid: 3348564 doi: 10.1093/bioinformatics/bts163
Machiela MJ, Chanock SJ. LDlink: a web-based application for exploring population-specific haplotype structure and linking correlated alleles of possible functional variants. Bioinformatics. 2015;31:3555–7.
pubmed: 26139635 pmcid: 4626747 doi: 10.1093/bioinformatics/btv402
Burgess S, Scott RA, Timpson NJ, Davey Smith G, Thompson SG, EPIC- InterAct Consortium. Using published data in Mendelian randomization: a blueprint for efficient identification of causal risk factors. Eur J Epidemiol. 2015;30:543–52.
pubmed: 25773750 pmcid: 4516908 doi: 10.1007/s10654-015-0011-z
Hemani G, Zheng J, Elsworth B, Wade KH, Haberland V, Baird D, et al. The MR-Base platform supports systematic causal inference across the human phenome. ELife. 2018;7:e34408.
pubmed: 29846171 pmcid: 5976434 doi: 10.7554/eLife.34408
Halperin M. Fitting of straight lines and prediction when both variables are subject to error. J Am Stat Assoc. 1961;56:657–69.
doi: 10.1080/01621459.1961.10480651
Inglis GC, Ingram MC, Holloway CD, Swan L, Birnie D, Hillis WS, et al. Familial pattern of corticosteroids and their metabolism in adult human subjects—the Scottish Adult Twin Study. J Clin Endocrinol Metab. 1999;84:4132–7.
pubmed: 10566661
Meikle AW, Stringham JD, Woodward MG, Bishop DT. Heritability of variation of plasma cortisol levels. Metab Clin Exp. 1988;37:514–7.
pubmed: 2967419 doi: 10.1016/0026-0495(88)90164-3
Froehlich JC, Zink RW, Li T-K, Christian JC. Analysis of heritability of hormonal responses to alcohol in twins: beta-endorphin as a potential biomarker of genetic risk for alcoholism. Alcohol Clin Exp Res. 2000;24:265–77.
pubmed: 10776662 doi: 10.1111/j.1530-0277.2000.tb04607.x
Meyer EJ, Nenke MA, Rankin W, Lewis JG, Torpy DJ. Corticosteroid-binding globulin: a review of basic and clinical advances. Horm Metab Res. 2016;48:359–71.
pubmed: 27214312 doi: 10.1055/s-0042-108071
Hill LA, Vassiliadi DA, Dimopoulou I, Anderson AJ, Boyle LD, Kilgour AHM, et al. Neutrophil elastase-cleaved corticosteroid-binding globulin is absent in human plasma. J Endocrinol. 2019;240:27–39.
pubmed: 30452386 doi: 10.1530/JOE-18-0479
Wester VL, Rossum EFCvan. Clinical applications of cortisol measurements in hair. Eur J Endocrinol. 2015;173:M1–0.
pubmed: 25924811 doi: 10.1530/EJE-15-0313

Auteurs

Andrew A Crawford (AA)

BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Sean Bankier (S)

BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
Division of Genetics and Genomics, The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK.

Elisabeth Altmaier (E)

Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.

Catriona L K Barnes (CLK)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

David W Clark (DW)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

Raili Ermel (R)

Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia.

Nele Friedrich (N)

Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany.
German Center for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, 17475, Greifswald, Germany.

Pim van der Harst (P)

Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, PO box 30.001, 9700 RB, The Netherlands.

Peter K Joshi (PK)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

Ville Karhunen (V)

Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England Centre for Environment and Health, Imperial College London, London, UK.
Centre for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.

Jari Lahti (J)

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
Turku Institute of Advanced Studies, University of Turku, Turku, Finland.

Anubha Mahajan (A)

Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.
Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.

Massimo Mangino (M)

Department of Twin Research and Genetic Epidemiology, King's College, Lambeth Palace Road, London, SE1 7EH, UK.
NIHR Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, UK.

Maria Nethander (M)

Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Alexander Neumann (A)

Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.

Maik Pietzner (M)

Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany.
German Center for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, 17475, Greifswald, Germany.

Katyayani Sukhavasi (K)

Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia.

Carol A Wang (CA)

School of Medicine and Public Health, Faculty of Medicine and Health, University of Newcastle, Newcastle, NSW, 2308, Australia.

Stephan J L Bakker (SJL)

Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Johan L M Bjorkegren (JLM)

Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden.
Department of Genetics & Genomic Sciences, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Clinical Gene Networks AB, Stockholm, Sweden.

Harry Campbell (H)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

Johan Eriksson (J)

Folkhälsan Research Center, Helsinki, Finland.
Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Helsinki, Singapore.

Christian Gieger (C)

Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
German Center for Diabetes Research (DZD), Neuherberg, Germany.

Caroline Hayward (C)

MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, Western General Hospital University of Edinburgh, Edinburgh, EH4 2XU, Scotland.

Marjo-Riitta Jarvelin (MR)

Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England Centre for Environment and Health, Imperial College London, London, UK.
Centre for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
Unit of Primary Health Care and Medical Research Center, Oulu University Hospital, Oulu, Finland.

Stela McLachlan (S)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

Andrew P Morris (AP)

Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
Department of Biostatistics, University of Liverpool, Liverpool, UK.
Wellcome Centre for Human genetics, University of Oxford, Oxford, UK.

Claes Ohlsson (C)

Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Drug Treatment, Sahlgrenska University Hospital, Gothenburg, Sweden.

Craig E Pennell (CE)

School of Medicine and Public Health, Faculty of Medicine and Health, University of Newcastle, Newcastle, NSW, 2308, Australia.

Jackie Price (J)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.

Igor Rudan (I)

Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.

Arno Ruusalepp (A)

Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia.
Clinical Gene Networks AB, Stockholm, Sweden.

Tim Spector (T)

NIHR Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, UK.

Henning Tiemeier (H)

Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Social and Behavioural Science, Harvard TH Chan School of Public Health, Boston, MA, USA.

Henry Völzke (H)

Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17489, Greifswald, Germany.

James F Wilson (JF)

Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland.
MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, Western General Hospital University of Edinburgh, Edinburgh, EH4 2XU, Scotland.

Tom Michoel (T)

Division of Genetics and Genomics, The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK.
Computational Biology Unit, Department of Informatics, University of Bergen, PO Box 7803, 5020, Bergen, Norway.

Nicolas J Timpson (NJ)

MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

George Davey Smith (GD)

MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Brian R Walker (BR)

BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK. Brian.Walker@ncl.ac.uk.
Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK. Brian.Walker@ncl.ac.uk.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH