Clonal hematopoiesis is associated with future diseases and mortality.

BACKGROUND

Clonal hematopoiesis is a proposed marker of aging. Clonal hematopoiesis of indeterminate potential (CHIP) is a candidate risk factor for atherosclerotic cardiovascular diseases, hematological malignancies, and all-cause mortality, while its associations with the diseases of other systems and cause-specific mortality remain inconclusive.

METHODS

We estimated the longitudinal risk for CHIP with 70 common diseases, all-cause, and cause-specific mortality among 431,546 participants in the UK Biobank. Two-sample Mendelian randomization analyses were performed to test the causal associations of CHIP with incident diseases. Cox proportional hazard regression model was used to generate the hazard ratio [HR] and 95% confidence interval [CI] for each CHIP phenotype with the common health-related outcomes. Also evaluated the joint associations between CHIP and telomere length for diseases and mortalities.

RESULTS

This study included 431,546 participants (mean age, 56.49 years; 45.7% male), of whom 20,274 had CHIP. CHIP at baseline was associated with increased risk of cancers (HR = 1.14, 95% CI 1.10-1.17), infections (HR = 1.12, 95% CI 1.07-1.16), ischemic heart diseases (HR = 1.07, 95% CI 1.02-1.12), diseases of the blood (HR = 1.31, 95% CI 1.26-1.37), nervous (HR = 1.05, 95% CI 1.01-1.10), respiratory (HR = 1.10, 95% CI 1.06-1.13), and genitourinary systems (HR = 1.10, 95% CI 1.07-1.14), and related mortality (false discovery rate <0.05). CHIP carriers were also at elevated risk of incident mental (HR = 1.07, 95% CI 1.03-1.12) and dermatological (HR = 1.07, 95% CI 1.03-1.11) disorders and mortality due to circulatory system (HR = 1.19, 95% CI 1.11-1.28). Most of the associations between CHIP and diseases or mortalities were robust after adjustment for inflammatory parameters. Large clone size CHIP had higher longitudinal risks compared with small clone size or overall CHIP. CHIP due to TET2 mutation was associated with more outcomes than other common CHIP driver genes. Significant interactions were observed between CHIP and short telomere length, the additive and multiplicative effects on the risk of diseases and mortalities were more obvious among large clone size CHIP.

CONCLUSION

This study showed that CHIP was associated with diseases and mortalities of multiple systems, suggesting CHIP was a candidate risk factor for human health.