The Cyclin D1 (CCND1) A870G polymorphism predicts clinical outcome to lapatinib and capecitabine in HER2-positive metastatic breast cancer

BACKGROUND: Lapatinib plus capecitabine emerged as an efficacious therapy in metastatic breast cancer (mBC). We aimed to identify germline single-nucleotide polymorphisms (SNPs) in genes involved in capecitabine catabolism and human epidermal receptor signaling that were associated with clinical outcome to assist in selecting patients likely to benefit from this combination.

PATIENTS AND METHODS: DNA was extracted from 240 of 399 patients enrolled in EGF100151 clinical trial (NCT00078572; clinicaltrials.gov) and SNPs were successfully evaluated in 234 patients. The associations between SNPs and clinical outcome were analyzed using Fisher's exact test, Kaplan-Meier curves, log-rank tests, likelihood ratio test within logistic or Cox regression model, as appropriate.

RESULTS: There were significant interactions between CCND1 A870G and clinical outcome. Patients carrying the A-allele were more likely to benefit from lapatinib plus capecitabine versus capecitabine when compared with patients harboring G/G (P = 0.022, 0.024 and 0.04, respectively). In patients with the A-allele, the response rate (RR) was significantly higher with lapatinib plus capecitabine (35%) compared with capecitabine (11%; P = 0.001) but not between treatments in patients with G/G (RR = 24% and 32%, respectively; P = 0.85). Time to tumor progression (TTP) was longer in patients with the A-allele treated with lapatinib plus capecitabine compared with capecitabine (median TTP = 7.9 and 3.4 months; P < 0.001), but not in patients with G/G (median TTP = 6.1 and 6.6 months; P = 0.92).

CONCLUSION: Our findings suggest that CCND1A870G may be useful in predicting clinical outcome in HER2-positive mBC patients treated with lapatinib plus capecitabine.

Prognostic role of lemur tyrosine kinase-3 germline polymorphisms in adjuvant gastric cancer in Japan and the United States

Lemur tyrosine kinase-3 (LMTK3) was recently identified as an estrogen receptor (ER)-α modulator related to endocrine therapy resistance, and its polymorphisms rs9989661 (T>C) T/T genotype and rs8108419 (G>A) G/G or A/G genotype predicted improved outcomes in breast cancer. Because different predominant ER distributions link to breast and gastric cancer and little is known of the prognostic role of LMTK3 in gastric cancer, this study was carried out to clarify the prognostic role of these polymorphisms in gastric cancer. One-hundred and sixty-nine Japanese and 137 U.S. patients with localized gastric adenocarcinoma were enrolled. Genomic DNA was extracted from blood or tissue, and all samples were analyzed by PCR-based direct DNA sequencing. Overall, these polymorphisms were not associated with survival in both cohorts. When gender was considered, in multivariate analysis, harboring rs9989661 T/T genotype was associated with disease-free survival [HR, 4.37; 95% confidence interval (CI), 2.08-9.18; P < 0.0001] and overall survival (OS; HR, 3.69; 95% CI, 1.65-8.24; P = 0.0014) in the Japanese males and time to recurrence (HR, 7.29; 95% CI, 1.07-49.80; P = 0.043) in the U.S. females. Meanwhile, harboring rs8108419 G/G genotype was associated with OS in the Japanese females (HR, 3.04; 95% CI, 1.08-8.56; P = 0.035) and the U.S. males (HR, 3.39; 95% CI, 1.31-8.80; P = 0.012). The prognostic role of these polymorphisms may be negative in gastric cancer. These findings suggest that the estrogen pathway may play a prognostic role in patients with gastric cancer but this may be dependent on the regional differences both in physiology and genetic alterations of gastric cancer.

Meta-analysis of Positive and Negative Symptoms Reveals Schizophrenia Modifier Genes

BACKGROUND: Evidence suggests that genetic factors may influence both schizophrenia (Scz) and its clinical presentation. In recent years, genome-wide association studies (GWAS) have demonstrated considerable success in identifying risk loci. Detection of "modifier loci" has the potential to further elucidate underlying disease processes.

METHODS: We performed GWAS of empirically derived positive and negative symptom scales in Irish cases from multiply affected pedigrees and a larger, independent case-control sample, subsequently combining these into a large Irish meta-analysis. In addition to single-SNP associations, we considered gene-based and pathway analyses to better capture convergent genetic effects, and to facilitate biological interpretation of these findings. Replication and testing of aggregate genetic effects was conducted using an independent European-American sample.

RESULTS: Though no single marker met the genome-wide significance threshold, genes and ontologies/pathways were significantly associated with negative and positive symptoms; notably, NKAIN2 and NRG1, respectively. We observed limited overlap in ontologies/pathways associated with different symptom profiles, with immune-related categories over-represented for negative symptoms, and addiction-related categories for positive symptoms. Replication analyses suggested that genes associated with clinical presentation are generalizable to non-Irish samples.

CONCLUSIONS: These findings strongly support the hypothesis that modifier loci contribute to the etiology of distinct Scz symptom profiles. The finding that previously implicated "risk loci" actually influence particular symptom dimensions has the potential to better delineate the roles of these genes in Scz etiology. Furthermore, the over-representation of distinct gene ontologies/pathways across symptom profiles suggests that the clinical heterogeneity of Scz is due in part to complex and diverse genetic factors.

Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci

Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity.

Pleiotropic analysis of cancer risk loci on esophageal adenocarcinoma risk

Background: Several cancer-associated loci identified from genome-wide association studies (GWAS) have been associated with risks of multiple cancer sites, suggesting pleiotropic effects. We investigated whether GWAS-identified risk variants for other common cancers are associated with risk of esophageal adenocarcinoma (EA) or its precursor, Barrett's esophagus. 

Methods: We examined the associations between risks of EA and Barrett's esophagus and 387 SNPs that have been associated with risks of other cancers, by using genotype imputation data on 2,163 control participants and 3,885 (1,501 EA and 2,384 Barrett's esophagus) case patients from the Barrett's and Esophageal Adenocarcinoma Genetic Susceptibility Study, and investigated effect modification by smoking history, body mass index (BMI), and reflux/heartburn. 

Results: After correcting for multiple testing, none of the tested 387 SNPs were statistically significantly associated with risk of EA or Barrett's esophagus. No evidence of effect modification by smoking, BMI, or reflux/heartburn was observed. 

Conclusions: Genetic risk variants for common cancers identified from GWAS appear not to be associated with risks of EA or Barrett's esophagus. 

Impact: To our knowledge, this is the first investigation of pleiotropic genetic associations with risks of EA and Barrett's esophagus.

SNP discovery using Next Generation Transcriptomic Sequencing in Atlantic herring (Clupea harengus)

The introduction of Next Generation Sequencing (NGS) has revolutionised population genetics, providing studies of non-model species with unprecedented genomic coverage, allowing evolutionary biologists to address questions previously far beyond the reach of available resources. Furthermore, the simple mutation model of Single Nucleotide Polymorphisms (SNPs) permits cost-effective high-throughput genotyping in thousands of individuals simultaneously. Genomic resources are scarce for the Atlantic herring (Clupea harengus), a small pelagic species that sustains high revenue fisheries. This paper details the development of 578 SNPs using a combined NGS and high-throughput genotyping approach. Eight individuals covering the species distribution in the eastern Atlantic were bar-coded and multiplexed into a single cDNA library and sequenced using the 454 GS FLX platform. SNP discovery was performed by de novo sequence clustering and contig assembly, followed by the mapping of reads against consensus contig sequences. Selection of candidate SNPs for genotyping was conducted using an in silico approach. SNP validation and genotyping were performed simultaneously using an Illumina 1,536 GoldenGate assay. Although the conversion rate of candidate SNPs in the genotyping assay cannot be predicted in advance, this approach has the potential to maximise cost and time efficiencies by avoiding expensive and time-consuming laboratory stages of SNP validation. Additionally, the in silico approach leads to lower ascertainment bias in the resulting SNP panel as marker selection is based only on the ability to design primers and the predicted presence of intron-exon boundaries. Consequently SNPs with a wider spectrum of minor allele frequencies (MAFs) will be genotyped in the final panel. The genomic resources presented here represent a valuable multi-purpose resource for developing informative marker panels for population discrimination, microarray development and for population genomic studies in the wild.

Reduced risk of pancreatic cancer associated with asthma and nasal allergies

OBJECTIVE: Studies indicate an inverse association between ductal adenocarcinoma of the pancreas (PDAC) and nasal allergies. However, controversial findings are reported for the association with asthma. Understanding PDAC risk factors will help us to implement appropriate strategies to prevent, treat and diagnose this cancer. This study assessed and characterised the association between PDAC and asthma and corroborated existing reports regarding the association between allergies and PDAC risk.

DESIGN: Information about asthma and allergies was collated from 1297 PDAC cases and 1024 controls included in the PanGenEU case-control study. Associations between PDAC and atopic diseases were studied using multilevel logistic regression analysis. Meta-analyses of association studies on these diseases and PDAC risk were performed applying random-effects model.

RESULTS: Asthma was associated with lower risk of PDAC (OR 0.64, 95% CI 0.47 to 0.88), particularly long-standing asthma (>=17 years, OR 0.39, 95% CI 0.24 to 0.65). Meta-analysis of 10 case-control studies sustained our results (metaOR 0.73, 95% CI 0.59 to 0.89). Nasal allergies and related symptoms were associated with lower risk of PDAC (OR 0.66, 95% CI 0.52 to 0.83 and OR 0.59, 95% CI 0.46 to 0.77, respectively). These results were supported by a meta-analysis of nasal allergy studies (metaOR 0.6, 95% CI 0.5 to 0.72). Skin allergies were not associated with PDAC risk.

CONCLUSIONS: This study shows a consistent inverse association between PDAC and asthma and nasal allergies, supporting the notion that atopic diseases are associated with reduced cancer risk. These results point to the involvement of immune and/or inflammatory factors that may either foster or restrain pancreas carcinogenesis warranting further research to understand the molecular mechanisms driving this association.

Síntese de azacalixarenos para o reconhecimento molecular de aniões

No âmbito desta dissertação são apresentados novos recetores sintéticos baseados na plataforma macrocíclica tetraazacalix[2]areno[2]triazina incorporando bases de purina ou unidades de aminoácidos naturais. Estes recetores foram preparados tendo como objectivo o reconhecimento seletivo de fármacos e aniões biologicamente relevantes. No primeiro capítulo é apresentada uma revisão bibliográfica sobre recetores derivados de tetraazacalix[2]areno[2]triazina demonstrando-se que a funcionalização desta plataforma, nos anéis de triazina ou nos anéis benzénicos, encontra-se ainda na infância bem como a investigação das suas afinidades para aniões. Subsequentemente, considerando os aniões principais estudados nesta tese, aniões carboxilatos alifáticos, aromáticos e aminoácidos é apresentada uma revisão bibliográfica sobre os estudos de reconhecimento molecular reportados na literatura, entre derivados de calix[4]areno e este tipo de aniões. No segundo capítulo descrevem-se as sínteses de recetores com uma ou duas unidades de aminoácido, L-alanina (AC1A, AC2A) e L-triptofano (AC2T), ancoradas nos anéis benzénicos da plataforma tetraazacalix[2]areno[2]triazina. Como demostrado no capítulo 3, os grupos N-H dos azotos em ponte são locais de reconhecimento de aniões. Neste contexto, estes macrociclos foram também metilados nos azotos em ponte (Me4AC2A e Me4AC2T) de modo a direcionar o reconhecimento cooperativo de aniões exclusivamente através dos grupos N-H das unidades de aminoácidos. A lipofilicidade destas moléculas foi alterada por substituição dos átomos de cloro das triazinas por dihexilamina. Os compostos sintetizados foram caracterizados através de técnicas espetroscópicas complementadas em alguns compostos por difração de raios X de cristal único. No capítulo 3 apresentam-se os estudos de reconhecimento molecular entre os recetores sintetizados e aniões derivados de ácidos carboxílicos (mono, di e tricarboxílicos) alifáticos, aromáticos, isoméricos e aniões inorgânicos. Estes estudos foram efetuados em DMSO-d6 ou em CDCl3 por titulações de RMN de 1H com determinação das respetivas constantes de associação. Para os recetores AC1A e AC2A o reconhecimento da maioria dos aniões estudados ocorre simultaneamente através dos grupos N-H dos azotos em ponte e do N-H da amida do braço da L-alanina. Contudo, no caso do isoftalato e tricarboxilato, com dois e três grupos carboxilato em posição meta, ocorre preferencialmente através dos dois braços de L-alanina como sugerido por estudos de dinâmica molecular em DMSO. Os estudos de associação realizados para os macrociclos que contêm unidades de L-triptofano, AC2T e Me4AC2T, mostraram que o reconhecimento de aniões é efetuado preferencialmente através de ligações de hidrogénio estabelecidas com os grupos amida e amina do grupo indole dos braços de aminoácido em detrimento das aminas em ponte como em AC1A e AC2A. Para a série dos carboxilatos alifáticos verifica-se que o recetor Me4AC2A tem maior afinidade com o anião glutarato (K= 389 M-1, DMSO-d6) enquanto o recetor Me4AC2T associa-se mais fortemente com o anião oxalato (K= 776 M-1, CDCl3). Todas as Job plots efetuadas confirmaram que as entidades estudadas obedeciam a uma estequiometria recetor/anião de 1:1.

Receptores de aniões baseados em azacalix[4]arenos e isoftalamidas

Nesta tese, desenvolvida no âmbito do Programa Doutoral em Química da Universidade de Aveiro, foram desenvolvidos novos receptores sintéticos construídos a partir da plataforma macrocíclica tetraazacalix[2]areno[2]triazina ou do fragmento de isoftalamida. Ambas as unidades estruturais foram decora-das com grupos de reconhecimento molecular baseados em grupos amida e/ou ureia com o objectivo de actuarem como receptores selectivos de aniões com importância biológica ou farmacológica, incluindo acetato, oxalato, malo-nato, succinato, glutarato, diglicolato, L- e D-NHBoc-alanina, (S)- e (R)-fenilpro-panoato, (S,S)- e (R,R)-tartarato, fumarato, maleato, Cl-, HCO3-, H2PO4-, HSO4- e SO42-. No Capítulo 1 é efectuada uma revisão bibliográfica dos desenvolvimentos recentes na síntese, caracterização estrutural e aplicações de receptores fun-cionais relacionados com os desenvolvidos no âmbito desta tese, com especial incidência para aqueles que foram estudados como receptores de aniões. Neste domínio, enquanto que receptores derivados da isoftalamida têm sido bastante estudados ao longo das últimas décadas, o desenvolvimento de receptores de aniões inspirados em heteracalix[2]areno[2]triazinas ainda se encontra a dar os primeiros passos. No Capítulo 2 é apresentada a síntese de quatro novos macrociclos derivados de tetraazacalix[2]areno[2]triazina incorporando um ou dois braços de L-alanina (A1, A2) ou de L-leucina (L1, L2) nos anéis benzénicos, e derivados com grupos amida como unidades de reconhecimento. Adicionalmente, são também apresentados dois novos azacalix[2]areno[2]triazinas contendo um (U1) ou dois (U2) braços com grupos ureia substituídos com um grupo (S)-metilbenzílico. Foram ainda preparados os macrociclos A2Me4 e U2Me4 por metilação dos átomos de azoto em ponte de A2 e U2, os quais foram posterior-mente utilizados em estudos de associação. Os compostos sintetizados foram caracterizados através de técnicas espectroscópicas, complementadas por difracção de raios X de cristal único no caso de U2Me4. O Capítulo 3 contempla os estudos de reconhecimento molecular entre os macrociclos A2Me4 e U2Me4 e os aniões derivados de ácidos mono- e dicarbo-xílicos alifáticos, ácidos carboxílicos isoméricos (enantiómeros e isómeros geométricos), aminoácidos e polioxaniões acima referidos, excepto HCO3-. Os estudos de associação foram realizados através de técnicas de titulação por RMN 1H com determinação das respectivas constantes de afinidade. Todas as associações estudadas apresentaram uma estequiometria receptor-substrato 1:1 com excepção das associações formadas entre A2Me4 e U2Me4 com H2PO4- (1:2). Os complexos A2Me4∙SO42- e U2Me4∙(H2PO4-)2 são os mais estáveis com constantes de associação de 7,4 × 104 M-1 e superior a 105 M-2, respectivamente. O reconhecimento dos dicarboxilatos ocorreu através dos dois braços do macrociclo, com os aniões com grupos carboxilato separados por cadeias alifáticas mais compridas (glutarato e diglicolato) apresentando um melhor ajuste aos braços de A2Me4 e U2Me4. Não foi observado reconheci-mento enantiosselectivo de aniões. Em contraste, as constantes de afinidade para as associações com os aniões dos isómeros cis (maleato) e trans (fumarato) do ácido but-2-enodióico, de 89 e 4920 M-1 para A2Me4 e 481 e 4007 M-1 para U2Me4, respectivamente, sugerem selectividade de ambos os receptores para o fumarato. No Capítulo 4 é descrita a síntese de nove receptores acíclicos incorporando a unidade de isoftalamida (Iso-1 a Iso-9) e braços laterais com grupos de reconhecimento de aniões. Enquanto que o receptor Iso-1 possui como unida-des de reconhecimento apenas grupos amida, os receptores Iso-2, Iso-3, Iso-5, Iso-6, Iso-7 e Iso-9 possuem grupos amida e ureia, e os derivados Iso-4 e Iso-8 grupos amida e sulfonilureia. Em cada um destes compostos, os grupos de reconhecimento estão separados por uma cadeia etilénica cuja flexibilidade confere um melhor ajuste com os aniões. Os derivados de isoftalamida preparados foram caracterizados através de técnicas espectroscópicas. No Capítulo 5 são apresentados os estudos de associação realizados por técnicas de titulação por RMN 1H entre Iso-1, Iso-2, Iso-4, Iso-6 e Iso-8 com os aniões H2PO4-, HCO3-, Cl- e oxalato. Os receptores Iso-1, Iso-2 e Iso-6 apresentaram maior afinidade para o dianião, com valores de Kass de 6100, 7800 e 9800 M-1 respectivamente, e menor para Cl- (17 < Kass < 19 M-1). Foram sempre formadas associações mais estáveis com H2PO4- (294 < Kass < 427 M-1) comparativamente a HCO3-, sendo que a associação mais forte com este últi-mo foi determinada com Iso-2 (Kass = 95 M-1). As moléculas de Iso-4 e Iso-8 sofreram desprotonação dos grupos sulfonilureia na presença de todos os aniões excepto de Cl-. No Capítulo 6 apresentam-se as conclusões gerais e no Capítulo 7 descrevem-se os procedimentos experimentais e também os dados espectroscópicos dos produtos obtidos.

Quantifying diet-induced metabolic changes of the human gut microbiome

The human gut microbiome is known to be associated with various human disorders, but a major challenge is to go beyond association studies and elucidate causalities. Mathematical modeling of the human gut microbiome at a genome scale is a useful tool to decipher microbe-microbe, diet-microbe and microbe-host interactions. Here, we describe the CASINO (Community And Systems-level INteractive Optimization) toolbox, a comprehensive computational platform for analysis of microbial communities through metabolic modeling. We first validated the toolbox by simulating and testing the performance of single bacteria and whole communities in vitro. Focusing on metabolic interactions between the diet, gut microbiota, and host metabolism, we demonstrated the predictive power of the toolbox in a diet-intervention study of 45 obese and overweight individuals and validated our predictions by fecal and blood metabolomics data. Thus, modeling could quantitatively describe altered fecal and serum amino acid levels in response to diet intervention.

IFN stimulated gene expression in the liver is a better predictor of treatment response in chronic hepatitis c than the IL28b (IFN lambda 3) genotype

Background: Therapy of chronic hepatitis C (CHC) with pegIFNa/ribavirin achieves sustained virologic response (SVR) in ~55%. Pre-activation of the endogenous interferon system in the liver is associated non-response (NR). Recently, genome-wide association studies described associations of allelic variants near the IL28B (IFNλ3) gene with treatment response and with spontaneous clearance of the virus. We investigated if the IL28B genotype determines the constitutive expression of IFN stimulated genes (ISGs) in the liver of patients with CHC. Methods: We genotyped 93 patients with CHC for 3 IL28B single nucleotide polymorphisms (SNPs, rs12979860, rs8099917, rs12980275), extracted RNA from their liver biopsies and quantified the expression of IL28B and of 8 previously identified classifier genes which discriminate between SVR and NR (IFI44L, RSAD2, ISG15, IFI22, LAMP3, OAS3, LGALS3BP and HTATIP2). Decision tree ensembles in the form of a random forest classifier were used to calculate the relative predictive power of these different variables in a multivariate analysis. Results: The minor IL28B allele (bad risk for treatment response) was significantly associated with increased expression of ISGs, and, unexpectedly, with decreased expression of IL28B. Stratification of the patients into SVR and NR revealed that ISG expression was conditionally independent from the IL28B genotype, i.e. there was an increased expression of ISGs in NR compared to SVR irrespective of the IL28B genotype. The random forest feature score (RFFS) identified IFI27 (RFFS = 2.93), RSAD2 (1.88) and HTATIP2 (1.50) expression and the HCV genotype (1.62) as the strongest predictors of treatment response. ROC curves of the IL28B SNPs showed an AUC of 0.66 with an error rate (ERR) of 0.38. A classifier with the 3 best classifying genes showed an excellent test performance with an AUC of 0.94 and ERR of 0.15. The addition of IL28B genotype information did not improve the predictive power of the 3-gene classifier. Conclusions: IL28B genotype and hepatic ISG expression are conditionally independent predictors of treatment response in CHC. There is no direct link between altered IFNλ3 expression and pre-activation of the endogenous system in the liver. Hepatic ISG expression is by far the better predictor for treatment response than IL28B genotype.

Clinical and genetic investigation of a large Tunisian family with complete achromatopsia: identification of a new nonsense mutation in GNAT2 gene.

Complete achromatopsia is a rare autosomal recessive disease associated with CNGA3, CNGB3, GNAT2 and PDE6C mutations. This retinal disorder is characterized by complete loss of color discrimination due to the absence or alteration of the cones function. The purpose of the present study was the clinical and the genetic characterization of achromatopsia in a large consanguineous Tunisian family. Ophthalmic evaluation included a full clinical examination, color vision testing and electroretinography. Linkage analysis using microsatellite markers flanking CNGA3, CNGB3, GNAT2 and PDE6C genes was performed. Mutations were screened by direct sequencing. A total of 12 individuals were diagnosed with congenital complete achromatopsia. They are members of six nuclear consanguineous families belonging to the same large consanguineous family. Linkage analysis revealed linkage to GNAT2. Mutational screening of GNAT2 revealed three intronic variations c.119-69G>C, c.161+66A>T and c.875-31G>C that co-segregated with a novel mutation p.R313X. An identical GNAT2 haplotype segregating with this mutation was identified, indicating a founder mutation. All patients were homozygous for the p.R313X mutation. This is the first report of the clinical and genetic investigation of complete achromatopsia in North Africa and the largest family with recessive achromatopsia involving GNAT2; thus, providing a unique opportunity for genotype-phenotype correlation for this extremely rare condition.

Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk.

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or  ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure (GUCY1A3-GUCY1B3, NPR3-C5orf23, ADM, FURIN-FES, GOSR2, GNAS-EDN3); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention.

Novel loci for adiponectin levels and their influence on type 2 diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals.

Circulating levels of adiponectin, a hormone produced predominantly by adipocytes, are highly heritable and are inversely associated with type 2 diabetes mellitus (T2D) and other metabolic traits. We conducted a meta-analysis of genome-wide association studies in 39,883 individuals of European ancestry to identify genes associated with metabolic disease. We identified 8 novel loci associated with adiponectin levels and confirmed 2 previously reported loci (P = 4.5×10(-8)-1.2×10(-43)). Using a novel method to combine data across ethnicities (N = 4,232 African Americans, N = 1,776 Asians, and N = 29,347 Europeans), we identified two additional novel loci. Expression analyses of 436 human adipocyte samples revealed that mRNA levels of 18 genes at candidate regions were associated with adiponectin concentrations after accounting for multiple testing (p<3×10(-4)). We next developed a multi-SNP genotypic risk score to test the association of adiponectin decreasing risk alleles on metabolic traits and diseases using consortia-level meta-analytic data. This risk score was associated with increased risk of T2D (p = 4.3×10(-3), n = 22,044), increased triglycerides (p = 2.6×10(-14), n = 93,440), increased waist-to-hip ratio (p = 1.8×10(-5), n = 77,167), increased glucose two hours post oral glucose tolerance testing (p = 4.4×10(-3), n = 15,234), increased fasting insulin (p = 0.015, n = 48,238), but with lower in HDL-cholesterol concentrations (p = 4.5×10(-13), n = 96,748) and decreased BMI (p = 1.4×10(-4), n = 121,335). These findings identify novel genetic determinants of adiponectin levels, which, taken together, influence risk of T2D and markers of insulin resistance.

Genetic variation near IRS1 associates with reduced adiposity and an impaired metabolic profile.

Genome-wide association studies have identified 32 loci influencing body mass index, but this measure does not distinguish lean from fat mass. To identify adiposity loci, we meta-analyzed associations between ∼2.5 million SNPs and body fat percentage from 36,626 individuals and followed up the 14 most significant (P < 10(-6)) independent loci in 39,576 individuals. We confirmed a previously established adiposity locus in FTO (P = 3 × 10(-26)) and identified two new loci associated with body fat percentage, one near IRS1 (P = 4 × 10(-11)) and one near SPRY2 (P = 3 × 10(-8)). Both loci contain genes with potential links to adipocyte physiology. Notably, the body-fat-decreasing allele near IRS1 is associated with decreased IRS1 expression and with an impaired metabolic profile, including an increased visceral to subcutaneous fat ratio, insulin resistance, dyslipidemia, risk of diabetes and coronary artery disease and decreased adiponectin levels. Our findings provide new insights into adiposity and insulin resistance.