RT Journal Article SR Electronic T1 Systems medicine links microbial inflammatory response with glycoprotein-associated mortality risk JF bioRxiv FD Cold Spring Harbor Laboratory SP 018655 DO 10.1101/018655 A1 Scott C Ritchie A1 Peter Würtz A1 Artika P Nath A1 Gad Abraham A1 Aki S Havulinna A1 Antti J Kangas A1 Pasi Soininen A1 Kristiina Aalto A1 Ilkka Seppälä A1 Emma Raitoharju A1 Marko Salmi A1 Mikael Maksimow A1 Satu Männistö A1 Mika Kähönen A1 Markus Juonala A1 Terho Lehtimäki A1 Sirpa Jalkanen A1 Markus Perola A1 Olli Raitakari A1 Veikko Salomaa A1 Mika Ala-Korpela A1 Johannes Kettunen A1 Michael Inouye YR 2015 UL http://biorxiv.org/content/early/2015/04/28/018655.abstract AB Integrative analyses of high-throughput omics data have elucidated the aetiology and pathogenesis for complex traits and diseases1–4, and the linking of omics information to electronic health records promises new insights into human health and disease. Recent nuclear magnetic resonance (NMR) spectroscopy biomarker profiling has implicated glycoprotein acetyls (GlycA) as a biomarker for cardiovascular risk5 and all-cause mortality6. To elucidate biological processes contributing to GlycA-associated mortality risk, we leveraged human omics data from three population-based cohorts together with nation-wide Finnish hospital and mortality records. Elevated GlycA was associated with myriad infection-related inflammatory processes. Within individuals, elevated GlycA levels were stable over long time periods, up to a decade, and chronically elevated GlycA was also associated with modest elevation of numerous cytokines. Individuals with elevated GlycA also showed increased expression of a transcriptional sub-network, the Neutrophil Degranulation Module (NDM), suggesting an increased activity of microbe-driven immune response. Subsequent analysis of nation-wide hospitalisation and death records was consistent with a microbial basis for GlycA-associated mortality, with each standard deviation increase in GlycA raising an individual’s future risk of hospitalization and death from non-localized infection by 40% and 136%, respectively. These results show that, beyond its established role in acute-phase response7–9, elevated GlycA is more broadly a biomarker for low-grade chronic inflammation and increased neutrophil activity. Further, increased risk of susceptibility to severe microbial-infection events in healthy individuals suggests this inflammation is a contributor to mortality risk. Taken together, this study demonstrates the power of an integrative approach that combines omics data and health records to delineate the biological processes underlying a newly discovered biomarker, providing a model strategy for future systems medicine studies.