A study recently published in Science on the impact of VA Million Veterans Program (MVP) It underscores the importance of diverse representation in genetics research and paves the way for advancements in tailored health care to meet the individual needs of veterans and the veteran population.
MVP is a national research program that examines how genes, lifestyle, military experiences, and exposures affect the health and well-being of veterans.
Since its launch in 2011, one million veterans have joined MVP. It is the VA’s largest research effort to improve health care for veterans and one of the largest research programs in the world studying genes and health. More than 250,000 minority veterans and 100,000 women veterans have joined the program, and MVP includes more people of African descent than any other research program in the world. This allows researchers to learn more about and ultimately treat populations that have historically been underrepresented in research.
Led by VA physicians Scott Damrauer and Katherine Liao and a team of VA researchers, in partnership with researchers from the U.S. Department of Energy and the National Library of Medicine at the National Institutes of Health (NIH), the latest MVP study included 635,969 veterans and represented one of the largest studies of its kind to analyze genetic associations with health-related traits and diseases among a diverse population.
According to the VA, a persistent limitation of clinical research is the lack of diversity among study participants. The implications are that research findings may not apply to all populations. For example, certain genetic traits and their associated diseases may be more common in some populations than others. When study participants are similar in their demographics, these important differences go unnoticed. In contrast, when studies include individuals from diverse backgrounds, researchers can identify these unique differences and tailor study implications accordingly.
This is what distinguishes the study published today from others. Nearly one-third (n=186,927) of the veteran participants were of non-European ancestry. By comparison, in all genome-wide association studies published to date, nearly 94% of participants were of European ancestry. The diversity of this study allowed the identification of nearly 3,500 associations, which were possible only because non-European populations were included.
Diversity is what makes MVP such a powerful tool, as it drives its ability to generate research results that will improve care for all veterans. Of the more than one million MVP participants, more than a quarter represent a racial or ethnic minority. This makes MVP one of the most diverse genetic databases in the world.
A primary goal of this study was to assess the relationship between genetic variations (i.e., differences in genes between individuals) and various health and disease traits (e.g., diabetes, blood cell counts, etc.). By assessing veteran participants’ DNA and linking the findings to VA medical records and additional research questionnaires, the research team identified a total of 26,049 associations between genetic variations and traits across a total of 1,270 health traits. Overall, the researchers identified that disease-causing genes are more similar than different among veterans of all backgrounds. In particular, a method called fine mapping identified causal variants in 6,318 signals across 613 traits. Of these, one-third of the associations (n = 2,069) identified were unique to non-European ancestry populations largely due to diseases that are more prevalent or genetic variants that are more common in one group than another.
Some of the key findings include:
• Identification of 101 traits in veterans of African ancestry that exhibit a prevalence at least twice that observed in veterans of European ancestry, including hereditary hemolytic anemias, sarcoidosis, and keloid scars.
• Discovery of a new signal in veterans of African descent associated with increased risk of gout.
• Identification of new genes associated with alopecia based on the higher prevalence of this condition in the Hispanic veteran population.
Associations such as those identified in this study may represent genetic predispositions to certain health conditions. They may also provide clues as to why one veteran may respond differently than another to the same treatment for the same condition. The findings may also help identify new uses for FDA-approved drugs for various diseases and health conditions.
Over the past year, results from more than 100 studies have been published highlighting new discoveries about conditions such as tinnitus, Alzheimer’s disease, prostate cancer, PTSD, endometriosis, and more. These research findings continue to improve the VA’s understanding of and ability to address Veterans’ most pressing health concerns and needs.
