Soluble Urokinase Plasminogen Activator Receptor: Genetic Variation and Cardiovascular Disease Risk in Black Adults
Open accessAbstract
Background: suPAR (Soluble urokinase plasminogen activator receptor) has emerged as an important biomarker of coagulation, inflammation, and cardiovascular disease (CVD) risk. The contribution of suPAR to CVD risk and its genetic influence in Black populations have not been evaluated. Methods: We measured suPAR in 3492 Black adults from the prospective, community-based JHS (Jackson Heart Study). Cross-sectional associations of suPAR with lifestyle and CVD risk factors were assessed, whole-genome sequence data were used to evaluate genetic associations of suPAR, and relationships of suPAR with incident CVD outcomes and overall mortality were estimated over follow-up. Results: In Cox models adjusted for traditional CVD risk factors, estimated glomerular filtration rate, and CRP (C-reactive protein), each 1-SD higher suPAR was associated with a 21% to 31% increased risk of incident coronary heart disease, heart failure, stroke, and mortality. In the genome-wide association study, 2 missense (rs399145 encoding p.Thr86Ala, rs4760 encoding p.Phe272Leu) and 2 noncoding regulatory variants (rs73935023 within an enhancer element and rs4251805 within the promoter) of PLAUR on chromosome 19 were each independently associated with suPAR and together explained 14% of suPAR phenotypic variation. The allele frequencies of each of the four suPAR-associated genetic variants differ considerably across African and European populations. We further show that PLAUR rs73935023 can alter transcriptional activity in vitro. We did not find any association between genetically determined suPAR and CVD in JHS or a larger electronic medical record-based analyses of Blacks or Whites. Conclusions: Our results demonstrate the importance of ancestry-differentiated genetic variation on suPAR levels and indicate suPAR is a CVD biomarker in Black adults.
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As genetic variants may vary in frequency across populations, such variants could drive systematic differences in protein measures.
“As these genetic variants may vary in frequency across populations, such variants could drive systematic differences in protein measures20.”
From Cross-ancestry comparison of aptamer and antibody protein measures (2026) · cites this paper as [20]
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Cross-ancestry comparison of aptamer and antibody protein measures
Nicholas, J. C., Katz, D. H., Tahir, U. A., Debban, C. L., Aguet, F., Blackwell, T., Bowler, R. P., Broadaway, K. A., Chen, J., Clish, C. B., et al. (2026) · Nature Communications · doi:10.1038/s41467-025-67814-1 · Cited by 13 · see citing works
Self-citation
- Authors
- Olson, N. C., Raffield, L. M., Moxley, A. H., Miller-Fleming, T. W., Auer, P. L., Franceschini, N., Ngo, D., Thornton, T. A., Lange, E. M., Li, Y., Nickerson, D. A., Zakai, N. A., Gerszten, R. E., Cox, N. J., Correa, A., Mohlke, K. L., & Reiner, A. P.
- Affiliations
- University of Vermont (US)
- University of North Carolina at Chapel Hill (US)
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.W.M.-F., N.J.C.).
- University of Wisconsin–Milwaukee (US)
- Beth Israel Deaconess Medical Center (US)
- University of Washington (US)
- University of Colorado Anschutz (US)
- Vanderbilt University Medical Center (US)
- University of Mississippi Medical Center (US)
- Epidemiology (A.P.R.), University of Washington, Seattle.
- ORCID
- Venue
- Circulation: Genomic and Precision Medicine
- Published
- 2021-12
- Volume
- 14
- Issue
- 6
- Pages
- e003421-e003421
- ISSN
- 2574-8300 (ISSN-L)
- PMC
- PMC8692389
- OpenAlex
- W3208658984
- Cited by
- 16
- References
- 4
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 5
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Genomic and Precision Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- U.S. Department of Health and Human Services
- Jackson State University
- Georgia Clinical and Translational Science Alliance
- Mississippi State Department of Health
- National Institutes of Health (1r01hl120393-01a1, 1s10od017985-01, KL2TR002490, UL1TR000445, UL1TR002243)
- National Heart, Lung, and Blood Institute (HHSN268201100037C, U19HL065962, HHSN268201800012C, R01-HL120393, HHSN268201800010 I, R01HL132947, HHSN268201800014 I, HHSN268201800001C, HHSN268201800012 I, U01HL120393, HHSN268201800014C, HHSN268201800015I, HHSN268201800011C, HHSN268201800011I, R00HL129045, R01HL117626, T32HL129982)
- National Human Genome Research Institute (U01HG006378, U01HG004798, T32HG008341, U01HG011720)
- National Institute of General Medical Sciences (P50GM115305, RC2GM092618)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK072193, R01DK117445)
- National Institute of Neurological Disorders and Stroke (R01NS032830)
- National Center for Research Resources (S10RR025141, UL1RR024975)
- National Center for Advancing Translational Sciences
- National Institute on Minority Health and Health Disparities (R01MD012765, HHSN268201800013I)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD074711)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Paraoxonase enzyme and polymorphisms
- Keywords
- soluble urokinase plasminogen activator receptor, suPAR, PLAUR, cardiovascular risk, Black people, genetic variants, coronary artery disease, heart failure, stroke, mortality, transcriptional activity, biomarkers, Jackson Heart Study
- MeSH terms
- Adult, Cardiovascular Diseases, Cross-Sectional Studies, Humans, Prospective Studies, Genetic Variation, Genome-Wide Association Study, Receptors, Urokinase Plasminogen Activator
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