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Mekić S, Pardo LM, Gunn DA, Jacobs LC, Hamer MA, Ikram MA, Vinke EJ, Vernooij MW, Haarman AEG, Thee EF, Vergroesen JE, Klaver CCW, Croll PH, Goedegebure A, Trajanoska K, Rivadeneira F, van Meurs JBJ, Arshi B, Kavousi M, de Roos EW, Brusselle GGO, Kayser M, Nijsten T. Younger facial looks are associate with a lower likelihood of several age-related morbidities in the middle-aged to elderly. Br J Dermatol 2023; 188:390-395. [PMID: 36763776 DOI: 10.1093/bjd/ljac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Looking older for one's chronological age is associated with a higher mortality rate. Yet it remains unclear how perceived facial age relates to morbidity and the degree to which facial ageing reflects systemic ageing of the human body. OBJECTIVES To investigate the association between ΔPA and age-related morbidities of different organ systems, where ΔPA represents the difference between perceived age (PA) and chronological age. METHODS We performed a cross-sectional analysis on data from the Rotterdam Study, a population-based cohort study in the Netherlands. High-resolution facial photographs of 2679 men and women aged 51.5-87.8 years of European descent were used to assess PA. PA was estimated and scored in 5-year categories using these photographs by a panel of men and women who were blinded for chronological age and medical history. A linear mixed model was used to generate the mean PAs. The difference between the mean PA and chronological age was calculated (ΔPA), where a higher (positive) ΔPA means that the person looks younger for their age and a lower (negative) ΔPA that the person looks older. ΔPA was tested as a continuous variable for association with ageing-related morbidities including cardiovascular, pulmonary, ophthalmological, neurocognitive, renal, skeletal and auditory morbidities in separate regression analyses, adjusted for age and sex (model 1) and additionally for body mass index, smoking and sun exposure (model 2). RESULTS We observed 5-year higher ΔPA (i.e. looking younger by 5 years for one's age) to be associated with less osteoporosis [odds ratio (OR) 0.76, 95% confidence interval (CI) 0.62-0.93], less chronic obstructive pulmonary disease (OR 0.85, 95% CI 0.77-0.95), less age-related hearing loss (model 2; B = -0.76, 95% CI -1.35 to -0.17) and fewer cataracts (OR 0.84, 95% CI 0.73-0.97), but with better global cognitive functioning (g-factor; model 2; B = 0.07, 95% CI 0.04-0.10). CONCLUSIONS PA is associated with multiple morbidities and better cognitive function, suggesting that systemic ageing and cognitive ageing are, to an extent, externally visible in the human face.
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Affiliation(s)
- Selma Mekić
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook MK44 1LQ, UK
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Merel A Hamer
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Eline J Vinke
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Annet E G Haarman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Eric F Thee
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joelle E Vergroesen
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Pauline H Croll
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Andre Goedegebure
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Katerina Trajanoska
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joyce B J van Meurs
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Banafsheh Arshi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Emmely W de Roos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Guy G O Brusselle
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Manfred Kayser
- Department of Genetic Identification, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Mekić S, Gunn DA, Jacobs LC, Hijnen D, Ikram MA, Mayes AE, Nijsten T, Pardo LM. Genetic Susceptibility to Dry Skin in a General Middle-Aged to Elderly Population: A GWAS. J Invest Dermatol 2021; 141:2077-2079.e5. [PMID: 33640410 DOI: 10.1016/j.jid.2020.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Selma Mekić
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook, United Kingdom
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - DirkJan Hijnen
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrew E Mayes
- Unilever Research and Development, Colworth Science Park, Sharnbrook, United Kingdom
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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3
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Mekić S, Wigmann C, Gunn DA, Jacobs LC, Kayser M, Schikowski T, Nijsten T, Pardo LM. Genetics of facial telangiectasia in the Rotterdam Study: a genome-wide association study and candidate gene approach. J Eur Acad Dermatol Venereol 2020; 35:749-754. [PMID: 33095951 DOI: 10.1111/jdv.17014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/05/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The severity of facial telangiectasia or red veins is associated with many lifestyle factors. However, the genetic predisposition remains unclear. OBJECTIVES We performed a genome-wide association study (GWAS) on facial telangiectasia in the Rotterdam Study (RS) and tested for replication in two independent cohorts. Additionally, a candidate gene approach with known pigmentation genes was performed. METHODS Facial telangiectasia were extracted from standardized facial photographs (collected from 2010-2013) of 2842 northwestern European participants (median age 66.9, 56.8% female) from the RS. Our GWAS top hits (P-value <10-6 ) were tested for replication in 460 elderly women of the SALIA cohort and in 576 additional men and women of the RS. Associations of top single nucleotide polymorphisms (SNPs) with expression quantitative trait loci (eQTL) in various tissues were reviewed (GTEx database) alongside phenotype associations in the UK biobank database. SNP-based associations between known pigmentation genes and facial telangiectasia were tested. Conditional analysis on skin colour was additionally performed. RESULTS Our most significant GWAS signal was rs4417318 (P-value 5.38*10-7 ), an intergenic SNP on chromosome 12 mapping to the SLC16A7 gene. Other suggestive SNPs tagged genes ZNF211, ZSCAN4, ICOS and KCNN3; SNP eQTLs and phenotype associations tagged links to the vascular system. However, the top signals did not pass significance in the two replication cohorts. The pigmentation genes KIAA0930, SLCA45A2 and MC1R, were significantly associated with telangiectasia in a candidate gene approach but not independently of skin colour. CONCLUSION In this GWAS on telangiectasia in a northwestern European population, no genome-wide significant SNPs were found, although suggestive signals indicate genes involved in the vascular system might be involved in telangiectasia. Significantly associated pigmentation genes underline the link between skin colour and telangiectasia.
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Affiliation(s)
- S Mekić
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C Wigmann
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - D A Gunn
- Colworth Science Park, Unilever Research and Development, Sharnbrook, UK
| | - L C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Kayser
- Department of Genetic Identification, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T Schikowski
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - T Nijsten
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Mekić S, Jacobs LC, Hamer MA, Ikram MA, Schoufour JD, Gunn DA, Kiefte-de Jong JC, Nijsten T. A healthy diet in women is associated with less facial wrinkles in a large Dutch population-based cohort. J Am Acad Dermatol 2019; 80:1358-1363.e2. [DOI: 10.1016/j.jaad.2018.03.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/12/2018] [Accepted: 03/15/2018] [Indexed: 12/01/2022]
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Duffy DL, Zhu G, Li X, Sanna M, Iles MM, Jacobs LC, Evans DM, Yazar S, Beesley J, Law MH, Kraft P, Visconti A, Taylor JC, Liu F, Wright MJ, Henders AK, Bowdler L, Glass D, Ikram MA, Uitterlinden AG, Madden PA, Heath AC, Nelson EC, Green AC, Chanock S, Barrett JH, Brown MA, Hayward NK, MacGregor S, Sturm RA, Hewitt AW, Kayser M, Hunter DJ, Newton Bishop JA, Spector TD, Montgomery GW, Mackey DA, Smith GD, Nijsten TE, Bishop DT, Bataille V, Falchi M, Han J, Martin NG. Publisher Correction: Novel pleiotropic risk loci for melanoma and nevus density implicate multiple biological pathways. Nat Commun 2019; 10:299. [PMID: 30643134 PMCID: PMC6331636 DOI: 10.1038/s41467-018-08078-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The original version of this Article contained errors in the spelling of the authors Fan Liu and M. Arfan Ikram, which were incorrectly given as Fan Lui and Arfan M. Ikram. In addition, the original version of this Article also contained errors in the author affiliations which are detailed in the associated Publisher Correction.
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Affiliation(s)
- David L Duffy
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Gu Zhu
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, 63110, USA
| | - Marianna Sanna
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Mark M Iles
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David M Evans
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | | | - Matthew H Law
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Alessia Visconti
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - John C Taylor
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Fan Liu
- Department of Genetic Identification, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - Anjali K Henders
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Lisa Bowdler
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Dan Glass
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands
| | - Pamela A Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Molecular Oncology Group, CRUK Manchester Institute, University of Manchester, Manchester, UK
| | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer H Barrett
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Matthew A Brown
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | | | | | - Richard A Sturm
- Dermatology Research Centre, University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | - Manfred Kayser
- Department of Genetic Identification, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Julia A Newton Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Timothy D Spector
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - David A Mackey
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | | | - Tamar E Nijsten
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - D Timothy Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Veronique Bataille
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Mario Falchi
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, 63110, USA
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Mekić S, Jacobs LC, Gunn DA, Mayes AE, Ikram MA, Pardo LM, Nijsten T. Prevalence and determinants for xerosis cutis in the middle-aged and elderly population: A cross-sectional study. J Am Acad Dermatol 2018; 81:963-969.e2. [PMID: 30586613 DOI: 10.1016/j.jaad.2018.12.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/03/2018] [Accepted: 12/10/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Determinants and the extent of dry skin in healthy middle-aged and elderly populations have not been well established. OBJECTIVE We aimed to identify the prevalence and determinants for generalized dry skin (GDS) and localized dry skin (LDS) within a large prospective population-based cohort of middle-aged and elderly individuals of the Rotterdam Study. METHODS Dry skin was physician-graded as none, localized, or generalized. For GDS and LDS, separate multivariable logistic regression analyses were performed to search for association with participant characteristics, lifestyle factors, environmental factors, several comorbidities, and drug exposure. RESULTS Among the 5547 eligible participants, 60% had dry skin, of whom a fifth had GDS. Age, female sex, skin color, body mass index, outside temperature, eczema, and chemotherapy in the past were significant determinants for both GDS and LDS. Smoking, the use of statins and diuretics, poorer self-perceived health, and several dermatologic conditions increased the likelihood of having GDS only. Daily cream use was associated with less LDS. LIMITATIONS Interobserver variability and residual confounding could have influenced our results. Because of our cross-sectional design, we could not infer causality. CONCLUSION We identified factors significantly associated with dry skin in a general middle-aged and elderly population, with health parameters more strongly associated with GDS.
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Affiliation(s)
- Selma Mekić
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook, Bedfordshire, United Kingdom
| | - Andrew E Mayes
- Unilever Research and Development, Colworth Science Park, Sharnbrook, Bedfordshire, United Kingdom
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Duffy DL, Zhu G, Li X, Sanna M, Iles MM, Jacobs LC, Evans DM, Yazar S, Beesley J, Law MH, Kraft P, Visconti A, Taylor JC, Liu F, Wright MJ, Henders AK, Bowdler L, Glass D, Ikram MA, Uitterlinden AG, Madden PA, Heath AC, Nelson EC, Green AC, Chanock S, Barrett JH, Brown MA, Hayward NK, MacGregor S, Sturm RA, Hewitt AW, Kayser M, Hunter DJ, Newton Bishop JA, Spector TD, Montgomery GW, Mackey DA, Smith GD, Nijsten TE, Bishop DT, Bataille V, Falchi M, Han J, Martin NG. Novel pleiotropic risk loci for melanoma and nevus density implicate multiple biological pathways. Nat Commun 2018; 9:4774. [PMID: 30429480 PMCID: PMC6235897 DOI: 10.1038/s41467-018-06649-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/13/2018] [Indexed: 11/09/2022] Open
Abstract
The total number of acquired melanocytic nevi on the skin is strongly correlated with melanoma risk. Here we report a meta-analysis of 11 nevus GWAS from Australia, Netherlands, UK, and USA comprising 52,506 individuals. We confirm known loci including MTAP, PLA2G6, and IRF4, and detect novel SNPs in KITLG and a region of 9q32. In a bivariate analysis combining the nevus results with a recent melanoma GWAS meta-analysis (12,874 cases, 23,203 controls), SNPs near GPRC5A, CYP1B1, PPARGC1B, HDAC4, FAM208B, DOCK8, and SYNE2 reached global significance, and other loci, including MIR146A and OBFC1, reached a suggestive level. Overall, we conclude that most nevus genes affect melanoma risk (KITLG an exception), while many melanoma risk loci do not alter nevus count. For example, variants in TERC and OBFC1 affect both traits, but other telomere length maintenance genes seem to affect melanoma risk only. Our findings implicate multiple pathways in nevogenesis.
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Affiliation(s)
- David L Duffy
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Gu Zhu
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, 63110, USA
| | - Marianna Sanna
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Mark M Iles
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David M Evans
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | | | - Matthew H Law
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Alessia Visconti
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - John C Taylor
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Fan Liu
- Department of Genetic Identification, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - Anjali K Henders
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Lisa Bowdler
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Dan Glass
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands
| | - Pamela A Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Molecular Oncology Group, CRUK Manchester Institute, University of Manchester, Manchester, UK
| | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer H Barrett
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Matthew A Brown
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | | | | | - Richard A Sturm
- Dermatology Research Centre, University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | - Manfred Kayser
- Department of Genetic Identification, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Julia A Newton Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Timothy D Spector
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - David A Mackey
- Centre for Ophthalmology and Vision Science, University of Western Australia and the Lions Eye Institute, Perth, Australia
| | | | - Tamar E Nijsten
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - D Timothy Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Veronique Bataille
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Mario Falchi
- Department of Twin Research & Genetic Epidemiology, St Thomas Hospital Campus, Kings College, London, UK
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, 63110, USA
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Jacobs LC, Nijsten T. Commentary on: "A genome-wide association study in Caucasian women suggests the involvement of HLA genes in the severity of facial solar lentigines" by Laville et al., 2016. Pigment Cell Melanoma Res 2018; 30:72-73. [PMID: 27801553 DOI: 10.1111/pcmr.12550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Leonie C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Hamer MA, Pardo LM, Jacobs LC, Ikram MA, Laven JS, Kayser M, Hollestein LM, Gunn DA, Nijsten T. Lifestyle and Physiological Factors Associated with Facial Wrinkling in Men and Women. J Invest Dermatol 2017; 137:1692-1699. [PMID: 28392345 DOI: 10.1016/j.jid.2017.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/07/2017] [Accepted: 03/02/2017] [Indexed: 11/19/2022]
Abstract
Facial wrinkling is one of the most notable signs of skin aging. Men and women show different wrinkling patterns yet the lifestyle and physiological factors underlying these sex-specific patterns are relatively unknown. Here, we investigated sex-specific determinants for facial wrinkles. Wrinkle area was quantified digitally using facial photographs of 3,831 northwestern Europeans (51-98 years, 58% female). Effect estimates from multivariable linear regressions are presented as the percentage difference in the mean value of wrinkle area per unit increase of a determinant (%Δ). Wrinkle area was higher in men (median 4.5%, interquartile range: 2.9-6.3) than in women (3.6%, interquartile range: 2.2-5.6). Age was the strongest determinant, and current smoking (men: 15.5%Δ; women: 30.9%Δ) and lower body mass index (men: 1.7%Δ; women: 1.8%Δ) were also statistically significantly associated with increased wrinkling. Pale skin color showed a protective effect (men: -21.0%Δ; women: -28.5%Δ) and, in men, sunburn tendency was associated with less wrinkling. In women, low educational levels and alcohol use were associated with more wrinkling, whereas female pattern hair loss and a higher free androgen index were associated with less wrinkling. In summary, we validated known and identified additional determinants for wrinkling. Skin aging-reducing strategies should incorporate the sex differences found in this study.
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Affiliation(s)
- Merel A Hamer
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Leonie C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Joop S Laven
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Manfred Kayser
- Department of Genetic Identification, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Loes M Hollestein
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook, Bedfordshire, UK
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Zhong K, Verkouteren JA, Jacobs LC, Uitterlinden AG, Hofman A, Liu F, Nijsten T, Kayser M. Pigmentation-Independent Susceptibility Loci for Actinic Keratosis Highlighted by Compound Heterozygosity Analysis. J Invest Dermatol 2017; 137:77-84. [DOI: 10.1016/j.jid.2016.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/29/2016] [Accepted: 09/02/2016] [Indexed: 10/21/2022]
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Jacobs LC, Hamer MA, Verkouteren JAC, Pardo LM, Liu F, Nijsten T. Perceived skin colour seems a swift, valid and reliable measurement. Br J Dermatol 2015; 173:1084-6. [PMID: 25940018 DOI: 10.1111/bjd.13888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L C Jacobs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - M A Hamer
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - J A C Verkouteren
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - F Liu
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
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de Kruijf M, Peters MJ, C. Jacobs L, Tiemeier H, Nijsten T, Hofman A, Uitterlinden AG, Huygen FJPM, van Meurs JBJ. Determinants for Quantitative Sensory Testing and the Association with Chronic Musculoskeletal Pain in the General Elderly Population. Pain Pract 2015. [DOI: 10.1111/papr.12335] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Marjolein de Kruijf
- Department of Internal Medicine; Erasmus MC Rotterdam; Rotterdam The Netherlands
- Department of Anesthesiology; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Marjolein J. Peters
- Department of Internal Medicine; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Leonie C. Jacobs
- Department of Dermatology; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Henning Tiemeier
- Department of Psychiatry; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Tamar Nijsten
- Department of Dermatology; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Albert Hofman
- Department of Epidemiology; Erasmus MC Rotterdam; Rotterdam The Netherlands
| | - Andre G. Uitterlinden
- Department of Internal Medicine; Erasmus MC Rotterdam; Rotterdam The Netherlands
- Department of Epidemiology; Erasmus MC Rotterdam; Rotterdam The Netherlands
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Liu F, Visser M, Duffy DL, Hysi PG, Jacobs LC, Lao O, Zhong K, Walsh S, Chaitanya L, Wollstein A, Zhu G, Montgomery GW, Henders AK, Mangino M, Glass D, Bataille V, Sturm RA, Rivadeneira F, Hofman A, van IJcken WFJ, Uitterlinden AG, Palstra RJTS, Spector TD, Martin NG, Nijsten TEC, Kayser M. Genetics of skin color variation in Europeans: genome-wide association studies with functional follow-up. Hum Genet 2015; 134:823-35. [PMID: 25963972 PMCID: PMC4495261 DOI: 10.1007/s00439-015-1559-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/20/2015] [Indexed: 02/05/2023]
Abstract
In the International Visible Trait Genetics (VisiGen) Consortium, we investigated the genetics of human skin color by combining a series of genome-wide association studies (GWAS) in a total of 17,262 Europeans with functional follow-up of discovered loci. Our GWAS provide the first genome-wide significant evidence for chromosome 20q11.22 harboring the ASIP gene being explicitly associated with skin color in Europeans. In addition, genomic loci at 5p13.2 (SLC45A2), 6p25.3 (IRF4), 15q13.1 (HERC2/OCA2), and 16q24.3 (MC1R) were confirmed to be involved in skin coloration in Europeans. In follow-up gene expression and regulation studies of 22 genes in 20q11.22, we highlighted two novel genes EIF2S2 and GSS, serving as competing functional candidates in this region and providing future research lines. A genetically inferred skin color score obtained from the 9 top-associated SNPs from 9 genes in 940 worldwide samples (HGDP-CEPH) showed a clear gradual pattern in Western Eurasians similar to the distribution of physical skin color, suggesting the used 9 SNPs as suitable markers for DNA prediction of skin color in Europeans and neighboring populations, relevant in future forensic and anthropological
investigations.
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Affiliation(s)
- Fan Liu
- Department of Forensic Molecular Biology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands,
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Jacobs LC, Liu F, Pardo LM, Hofman A, Uitterlinden AG, Kayser M, Nijsten T. IRF4, MC1R and TYR genes are risk factors for actinic keratosis independent of skin color. Hum Mol Genet 2015; 24:3296-303. [PMID: 25724930 DOI: 10.1093/hmg/ddv076] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/24/2015] [Indexed: 12/13/2022] Open
Abstract
Actinic keratosis (AK) is a pre-malignant skin disease, highly prevalent in elderly Europeans. This study investigates genetic susceptibility to AK with a genome-wide association study (GWAS). A full body skin examination was performed in 3194 elderly individuals from the Rotterdam Study (RS) of exclusive north-western European origin (aged 51-99 years, 45% male). Physicians graded the number of AK into four severity levels: none (76%), 1-3 (14%), 4-9 (6%) and ≥10 (5%), and skin color was quantified using a spectrophotometer on sun-unexposed skin. A GWAS for AK severity was conducted, where promising signals at IRF4 and MC1R (P < 4.2 × 10(-7)) were successfully replicated in an additional cohort of 623 RS individuals (IRF4, rs12203592, Pcombined = 6.5 × 10(-13) and MC1R, rs139810560, Pcombined = 4.1 × 10(-9)). Further, in an analysis of ten additional well-known human pigmentation genes, TYR also showed significant association with AK (rs1393350, P = 5.3 × 10(-4)) after correction for multiple testing. Interestingly, the strength and significance of above-mentioned associations retained largely the same level after skin color adjustment. Overall, our data strongly suggest that IRF4, MC1R and TYR genes likely have pleiotropic effects, a combination of pigmentation and oncogenic functions, resulting in an increased risk of AK.
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Affiliation(s)
| | - Fan Liu
- Department of Forensic Molecular Biology
| | | | | | - André G Uitterlinden
- Department of Epidemiology and Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Jacobs LC, Liu F, Bleyen I, Gunn DA, Hofman A, Klaver CCW, Uitterlinden AG, Neumann HAM, Bataille V, Spector TD, Kayser M, Nijsten T. Intrinsic and extrinsic risk factors for sagging eyelids. JAMA Dermatol 2014; 150:836-43. [PMID: 24869959 DOI: 10.1001/jamadermatol.2014.27] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Sagging eyelids, or dermatochalasis, are a frequent concern in older adults. It is considered a feature of skin aging, but risk factors other than aging are largely unknown. OBJECTIVE To study nongenetic and genetic risk factors for sagging eyelids. DESIGN Upper eyelid sagging was graded in 4 categories of severity using digital photographs. Dermatochalasis was defined as the eyelid hanging over the eyelashes. Age, sex, skin color, tanning ability, hormonal status in women, current smoking, body mass index, and sun protection behavior were analyzed in a multivariable multinomial logistic regression model. Genetic predisposition was assessed using heritability analysis and a genome-wide association study. SETTING AND PARTICIPANTS The study was performed in 2 independent population-based cohorts. The Rotterdam Study included older adults from one district in Rotterdam, the Netherlands, and the UK Adult Twin Registry (TwinsUK) included twins from all over the United Kingdom. Participants were 5578 unrelated Dutch Europeans (mean age, 67.1 years; 44.0% male) from the Rotterdam Study and 2186 twins (mean age, 53.1 years; 10.4% male) from the TwinsUK. MAIN OUTCOMES AND MEASURES Sagging eyelid severity levels, ranging from 1 (normal control) to 4 (severe sagging). RESULTS Among 5578 individuals from the Rotterdam Study, 17.8% showed dermatochalasis (moderate and severe sagging eyelids). Significant and independent risk factors for sagging eyelids included age, male sex, lighter skin color, and higher body mass index. In addition, current smoking was borderline significantly associated. Heritability of sagging eyelids was estimated to be 61% among 1052 twin pairs from the TwinsUK (15.6% showed dermatochalasis). A meta-analysis of genome-wide association study results from 5578 Rotterdam Study and 1053 TwinsUK participants showed a genome-wide significant recessive protective effect of the C allele of rs11876749 (P = 1.7 × 10(-8)). This variant is located close to TGIF1 (an inducer of transforming growth factor β), which is a known gene associated with skin aging. CONCLUSIONS AND RELEVANCE This is the first observational study to date demonstrating that other risk factors (male sex, genetic variants, lighter skin color, high body mass index, and possibly current smoking) in addition to aging are involved in the origin of sagging eyelids.
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Affiliation(s)
- Leonie C Jacobs
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Fan Liu
- Department of Forensic Molecular Biology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Isabel Bleyen
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook, England
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands5Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands6Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - H A Martino Neumann
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Veronique Bataille
- Department of Twin Research and Genetic Epidemiology, King's College London, London, England8Department of Dermatology, West Hertfordshire Hospitals National Health Service Trust, Hertfordshire, England
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, England
| | - Manfred Kayser
- Department of Forensic Molecular Biology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
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16
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Kilpeläinen TO, Zillikens MC, Stančáková A, Finucane FM, Ried JS, Langenberg C, Zhang W, Beckmann JS, Luan J, Vandenput L, Styrkarsdottir U, Zhou Y, Smith AV, Zhao JH, Amin N, Vedantam S, Shin SY, Haritunians T, Fu M, Feitosa MF, Kumari M, Halldorsson BV, Tikkanen E, Mangino M, Hayward C, Song C, Arnold AM, Aulchenko YS, Oostra BA, Campbell H, Cupples LA, Davis KE, Döring A, Eiriksdottir G, Estrada K, Fernández-Real JM, Garcia M, Gieger C, Glazer NL, Guiducci C, Hofman A, Humphries SE, Isomaa B, Jacobs LC, Jula A, Karasik D, Karlsson MK, Khaw KT, Kim LJ, Kivimäki M, Klopp N, Kühnel B, Kuusisto J, Liu Y, Ljunggren Ö, Lorentzon M, Luben RN, McKnight B, Mellström D, Mitchell BD, Mooser V, Moreno JM, Männistö S, O’Connell JR, Pascoe L, Peltonen L, Peral B, Perola M, Psaty BM, Salomaa V, Savage DB, Semple RK, Skaric-Juric T, Sigurdsson G, Song KS, Spector TD, Syvänen AC, Talmud PJ, Thorleifsson G, Thorsteinsdottir U, Uitterlinden AG, van Duijn CM, Vidal-Puig A, Wild SH, Wright AF, Clegg DJ, Schadt E, Wilson JF, Rudan I, Ripatti S, Borecki IB, Shuldiner AR, Ingelsson E, Jansson JO, Kaplan RC, Gudnason V, Harris TB, Groop L, Kiel DP, Rivadeneira F, Walker M, Barroso I, Vollenweider P, Waeber G, Chambers JC, Kooner JS, Soranzo N, Hirschhorn JN, Stefansson K, Wichmann HE, Ohlsson C, O’Rahilly S, Wareham NJ, Speliotes EK, Fox CS, Laakso M, Loos RJF. Genetic variation near IRS1 associates with reduced adiposity and an impaired metabolic profile. Nat Genet 2011; 43:753-60. [PMID: 21706003 PMCID: PMC3262230 DOI: 10.1038/ng.866] [Citation(s) in RCA: 245] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 05/25/2011] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio 70211, Finland
| | - Francis M Finucane
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Janina S Ried
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Jacques S Beckmann
- Department of Medical Genetics, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Jian’an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | | | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
| | - Albert Vernon Smith
- Icelandic Heart Association, Heart Preventive Clinic and Research Institute, IS-201 Kopavogur, Iceland
| | - Jing-Hua Zhao
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Najaf Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Sailaja Vedantam
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts 02142, USA
- Divisions of Genetics and Endocrinology and Program in Genomics, Children’s Hospital, Boston, Massachusetts 02115, USA
| | - So Youn Shin
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Talin Haritunians
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
| | - Mao Fu
- Division of Endocrinology, Diabetes & Nutrition, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri 63108, USA
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology, UCL, London, WC1E6 BT, UK
| | - Bjarni V Halldorsson
- deCODE Genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
- Reykjavik University, Menntavegur 1, IS-101 Reykjavik, Iceland
| | - Emmi Tikkanen
- Institute for Molecular Medicine Finland FIMM, 00014 University of Helsinki, Finland
- Public Health Genomics, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, Edinburgh, EH4 2XU, UK
| | - Ci Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Alice M Arnold
- Department of Biostatistics, University of Washington, Seattle, Washington 98195, USA
| | - Yurii S Aulchenko
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Ben A Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Harry Campbell
- Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
- Framingham Heart Study, Framingham, Massachusetts 01702-5827, USA
| | - Kathryn E Davis
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8854, USA
| | - Angela Döring
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Gudny Eiriksdottir
- Icelandic Heart Association, Heart Preventive Clinic and Research Institute, IS-201 Kopavogur, Iceland
| | - Karol Estrada
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - José Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomédica de Girona, CIBEROBN (CB06/03/0010), 17007 Girona, Spain
| | - Melissa Garcia
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892-9205, USA
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Nicole L Glazer
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington 98101, USA
- Department of Medicine, University of Washington, Seattle, Washington 98195, USA
| | - Candace Guiducci
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts 02142, USA
| | - Albert Hofman
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, London WC1E 6JF, UK
| | - Bo Isomaa
- Folkhälsan Research Centre, 00014 Helsinki, Finland
- Department of Social Services and Health Care, 68601 Jakobstad, Finland
| | - Leonie C Jacobs
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Antti Jula
- Population Studies Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - David Karasik
- Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School, Boston, Massachusetts 02131, USA
| | - Magnus K Karlsson
- Department of Clinical Sciences, Lund University, 205 02 Malmö, Sweden
- Department of Orthopaedics, Malmö University Hospital, 205 02 Malmö, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Institute of Public health, University of Cambridge, Cambridge CB2 2SR, UK
| | - Lauren J Kim
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892-9205, USA
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Norman Klopp
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Brigitte Kühnel
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio 70211, Finland
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Robert N Luben
- Department of Public Health and Primary Care, Institute of Public health, University of Cambridge, Cambridge CB2 2SR, UK
| | - Barbara McKnight
- Department of Biostatistics, University of Washington, Seattle, Washington 98195, USA
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington 98101, USA
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes & Nutrition, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
| | - Vincent Mooser
- Genetic, R&D, GlaxoSmithKline, King of Prussia, Philadelphia 19406, USA
| | - José Maria Moreno
- Department of Diabetes, Endocrinology and Nutrition, Institut d’Investigació Biomédica de Girona, CIBEROBN (CB06/03/0010), 17007 Girona, Spain
| | - Satu Männistö
- Chronic Disease Epidemiology and Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Jeffery R O’Connell
- Division of Endocrinology, Diabetes & Nutrition, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
| | - Laura Pascoe
- Institute of Cell & Molecular Biosciences, Newcastle University, NE2 4HH, Newcastle, UK
| | - Leena Peltonen
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
- Institute for Molecular Medicine Finland FIMM, 00014 University of Helsinki, Finland
- Public Health Genomics, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Belén Peral
- Instituto de Investigaciones Biomédicas, Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC) & Universidad Autónoma de Madrid, E-28029, Madrid, Spain
| | - Markus Perola
- Institute for Molecular Medicine Finland FIMM, 00014 University of Helsinki, Finland
- Public Health Genomics, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington 98101, USA
- Department of Medicine, University of Washington, Seattle, Washington 98195, USA
- Department of Epidemiology, University of Washington, Seattle, Washington 98195, USA
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101, USA
| | - Veikko Salomaa
- Chronic Disease Epidemiology and Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - David B Savage
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - Robert K Semple
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | | | - Gunnar Sigurdsson
- Department of Endocrinology and Metabolism, University Hospital, IS-108 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, IS-101 Reykjavik, Iceland
| | - Kijoung S Song
- Genetic, R&D, GlaxoSmithKline, King of Prussia, Philadelphia 19406, USA
| | | | - Ann-Christine Syvänen
- Department of Medical Sciences, Molecular Medicine, Science for Life Laboratory, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Philippa J Talmud
- Centre for Cardiovascular Genetics, Department of Medicine, University College London, London WC1E 6JF, UK
| | | | - Unnur Thorsteinsdottir
- deCODE Genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, IS-101 Reykjavik, Iceland
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Cornelia M van Duijn
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
- NGI, Centre for Medical Systems Biology (CMSB), Leiden, 2300 RC, The Netherlands
| | - Antonio Vidal-Puig
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - Sarah H Wild
- Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
| | - Alan F Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, Edinburgh, EH4 2XU, UK
| | - Deborah J Clegg
- Touchstone Diabetes Center, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8854, USA
| | - Eric Schadt
- Pacific Biosciences, Menlo Park, California 94025-1451, USA
- Sage Bionetworks, Seattle, Washington 98109, USA
| | - James F Wilson
- Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
| | - Igor Rudan
- Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
- Croatian Centre for Global Health, University of Split Medical School, Split 21000, Croatia
- Gen Info Ltd, Zagreb 10000, Croatia
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland FIMM, 00014 University of Helsinki, Finland
- Public Health Genomics, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Ingrid B Borecki
- Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri 63108, USA
| | - Alan R Shuldiner
- Division of Endocrinology, Diabetes & Nutrition, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
- Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland 21231, USA
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
| | - John-Olov Jansson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Heart Preventive Clinic and Research Institute, IS-201 Kopavogur, Iceland
- University of Iceland, IS-101 Reykjavik, Iceland
| | - Tamara B Harris
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892-9205, USA
| | - Leif Groop
- Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, 205 02 Malmö, Sweden
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School, Boston, Massachusetts 02131, USA
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, 3015GE, The Netherlands
| | - Mark Walker
- Institute of Cell & Molecular Biosciences, Newcastle University, NE2 4HH, Newcastle, UK
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - Peter Vollenweider
- Department of Internal Medicine, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Gérard Waeber
- Department of Internal Medicine, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - John C Chambers
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Jaspal S Kooner
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Rd., London W12 ONN, UK
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Joel N Hirschhorn
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts 02142, USA
- Divisions of Genetics and Endocrinology and Program in Genomics, Children’s Hospital, Boston, Massachusetts 02115, USA
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02142, USA
| | - Kari Stefansson
- deCODE Genetics, Sturlugata 8, IS-101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, IS-101 Reykjavik, Iceland
| | - H-Erich Wichmann
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität and Klinikum Großhadern, 81377 Munich, Germany
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Stephen O’Rahilly
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Elizabeth K Speliotes
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts 02142, USA
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Caroline S Fox
- National Heart, Lung, and Blood Institute and Harvard Medical School, Boston, Massachusetts 01702, USA
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio 70211, Finland
| | - Ruth J F Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
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17
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Lindgren CM, Heid IM, Randall JC, Lamina C, Steinthorsdottir V, Qi L, Speliotes EK, Thorleifsson G, Willer CJ, Herrera BM, Jackson AU, Lim N, Scheet P, Soranzo N, Amin N, Aulchenko YS, Chambers JC, Drong A, Luan J, Lyon HN, Rivadeneira F, Sanna S, Timpson NJ, Zillikens MC, Zhao JH, Almgren P, Bandinelli S, Bennett AJ, Bergman RN, Bonnycastle LL, Bumpstead SJ, Chanock SJ, Cherkas L, Chines P, Coin L, Cooper C, Crawford G, Doering A, Dominiczak A, Doney ASF, Ebrahim S, Elliott P, Erdos MR, Estrada K, Ferrucci L, Fischer G, Forouhi NG, Gieger C, Grallert H, Groves CJ, Grundy S, Guiducci C, Hadley D, Hamsten A, Havulinna AS, Hofman A, Holle R, Holloway JW, Illig T, Isomaa B, Jacobs LC, Jameson K, Jousilahti P, Karpe F, Kuusisto J, Laitinen J, Lathrop GM, Lawlor DA, Mangino M, McArdle WL, Meitinger T, Morken MA, Morris AP, Munroe P, Narisu N, Nordström A, Nordström P, Oostra BA, Palmer CNA, Payne F, Peden JF, Prokopenko I, Renström F, Ruokonen A, Salomaa V, Sandhu MS, Scott LJ, Scuteri A, Silander K, Song K, Yuan X, Stringham HM, Swift AJ, Tuomi T, Uda M, Vollenweider P, Waeber G, Wallace C, Walters GB, Weedon MN, Witteman JCM, Zhang C, Zhang W, Caulfield MJ, Collins FS, Davey Smith G, Day INM, Franks PW, Hattersley AT, Hu FB, Jarvelin MR, Kong A, Kooner JS, Laakso M, Lakatta E, Mooser V, Morris AD, Peltonen L, Samani NJ, Spector TD, Strachan DP, Tanaka T, Tuomilehto J, Uitterlinden AG, van Duijn CM, Wareham NJ, Watkins for the PROCARDIS consortia H, Waterworth DM, Boehnke M, Deloukas P, Groop L, Hunter DJ, Thorsteinsdottir U, Schlessinger D, Wichmann HE, Frayling TM, Abecasis GR, Hirschhorn JN, Loos RJF, Stefansson K, Mohlke KL, Barroso I, McCarthy for the GIANT consortium MI. Genome-wide association scan meta-analysis identifies three Loci influencing adiposity and fat distribution. PLoS Genet 2009; 5:e1000508. [PMID: 19557161 PMCID: PMC2695778 DOI: 10.1371/journal.pgen.1000508] [Citation(s) in RCA: 396] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 05/06/2009] [Indexed: 12/24/2022] Open
Abstract
To identify genetic loci influencing central obesity and fat distribution, we performed a meta-analysis of 16 genome-wide association studies (GWAS, N = 38,580) informative for adult waist circumference (WC) and waist-hip ratio (WHR). We selected 26 SNPs for follow-up, for which the evidence of association with measures of central adiposity (WC and/or WHR) was strong and disproportionate to that for overall adiposity or height. Follow-up studies in a maximum of 70,689 individuals identified two loci strongly associated with measures of central adiposity; these map near TFAP2B (WC, P = 1.9x10(-11)) and MSRA (WC, P = 8.9x10(-9)). A third locus, near LYPLAL1, was associated with WHR in women only (P = 2.6x10(-8)). The variants near TFAP2B appear to influence central adiposity through an effect on overall obesity/fat-mass, whereas LYPLAL1 displays a strong female-only association with fat distribution. By focusing on anthropometric measures of central obesity and fat distribution, we have identified three loci implicated in the regulation of human adiposity.
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Affiliation(s)
- Cecilia M. Lindgren
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
| | - Iris M. Heid
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Joshua C. Randall
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
| | - Claudia Lamina
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth K. Speliotes
- Department of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Boston, Massachusetts, United States of America
| | | | - Cristen J. Willer
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Blanca M. Herrera
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
- Oxford Centre for Diabetes, Department of Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Anne U. Jackson
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Noha Lim
- Medical Genetics, Clinical Pharmacology and Discovery Medicine, King of Prussia, Pennsylvania, United States of America
| | - Paul Scheet
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Nicole Soranzo
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yurii S. Aulchenko
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - John C. Chambers
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Alexander Drong
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
| | - Jian'an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Helen N. Lyon
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Boston, Massachusetts, United States of America
- Divisions of Genetics and Endocrinology, Program in Genomics, Children's Hospital, Boston, Massachusetts, United States of America
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Serena Sanna
- Istituto di Neurogenetica e Neurofarmacologia, Consiglio Nazionale delle Ricerche, Cagliari, Italy
| | - Nicholas J. Timpson
- The MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jing Hua Zhao
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Peter Almgren
- Department of Clinical Sciences, Diabetes, and Endocrinology Research Unit, University Hospital Malmö, Lund University, Malmö, Sweden
| | | | - Amanda J. Bennett
- Oxford Centre for Diabetes, Department of Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Richard N. Bergman
- Physiology and Biophysics, University of Southern California School of Medicine, Los Angeles, California, United States of America
| | - Lori L. Bonnycastle
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | | | - Stephen J. Chanock
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Lynn Cherkas
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Peter Chines
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Lachlan Coin
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Cyrus Cooper
- MRC Epidemiology Resource Centre, University of Southampton, Southampton, United Kingdom
| | - Gabriel Crawford
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Angela Doering
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Anna Dominiczak
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Alex S. F. Doney
- Diabetes Research Group, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Shah Ebrahim
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Paul Elliott
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Michael R. Erdos
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Karol Estrada
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Guido Fischer
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Nita G. Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Harald Grallert
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Christopher J. Groves
- Oxford Centre for Diabetes, Department of Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Scott Grundy
- Centre for Human Nutrition, University of Texas Southwestern Medical Centre, Dallas, Texas, United States of America
| | - Candace Guiducci
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - David Hadley
- Division of Community Health Sciences, St George's University of London, London, United Kingdom
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rolf Holle
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - John W. Holloway
- MRC Epidemiology Resource Centre, University of Southampton, Southampton, United Kingdom
- Division of Human Genetics, University of Southampton, Southampton, United Kingdom
| | - Thomas Illig
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Bo Isomaa
- Folkhälsan Research Center, Malmska Municipal Health Center and Hospital, Jakobstad, Finland
| | - Leonie C. Jacobs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Karen Jameson
- MRC Epidemiology Resource Centre, University of Southampton, Southampton, United Kingdom
| | | | - Fredrik Karpe
- Oxford Centre for Diabetes, Department of Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Johanna Kuusisto
- Department of Medicine, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | | | | | - Debbie A. Lawlor
- The MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Wendy L. McArdle
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Thomas Meitinger
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Mario A. Morken
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Andrew P. Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
| | - Patricia Munroe
- The William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Narisu Narisu
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Anna Nordström
- Department of Surgical and Perioperative Sciences, Section for Sports Medicine, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Geriatrics, Umeå University Hospital, Umeå, Sweden
| | - Peter Nordström
- Department of Surgical and Perioperative Sciences, Section for Sports Medicine, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Geriatrics, Umeå University Hospital, Umeå, Sweden
| | - Ben A. Oostra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Colin N. A. Palmer
- Population Pharmacogenetics Group, Biomedical Research Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Felicity Payne
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - John F. Peden
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
- Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | - Inga Prokopenko
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
| | - Frida Renström
- Genetic Epidemiology and Clinical Research Group, Department of Public Health and Clinical Medicine, Section for Medicine, Umeå University Hospital, Umeå, Sweden
| | - Aimo Ruokonen
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | | | - Manjinder S. Sandhu
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Laura J. Scott
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Angelo Scuteri
- Unita' Operativa Geriatrica, Instituto Nazionale Ricovero e Cura per Anziani (INRCA) IRCCS, Rome, Italy
| | - Kaisa Silander
- Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland
| | - Kijoung Song
- Medical Genetics, Clinical Pharmacology and Discovery Medicine, King of Prussia, Pennsylvania, United States of America
| | - Xin Yuan
- Medical Genetics, Clinical Pharmacology and Discovery Medicine, King of Prussia, Pennsylvania, United States of America
| | - Heather M. Stringham
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Amy J. Swift
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Tiinamaija Tuomi
- Department of Medicine, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
- Research Program of Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Manuela Uda
- Istituto di Neurogenetica e Neurofarmacologia, Consiglio Nazionale delle Ricerche, Cagliari, Italy
| | - Peter Vollenweider
- Department of Medicine and Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Gerard Waeber
- Department of Medicine and Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Chris Wallace
- The William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Michael N. Weedon
- Genetics of Complex Traits, Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, United Kingdom
| | | | | | - Cuilin Zhang
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, Bethesda, Maryland, United States of America
| | - Weihua Zhang
- Ealing Hospital, Ealing Hospital National Health Service Trust, Southall, London, United Kingdom
| | - Mark J. Caulfield
- The William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Francis S. Collins
- National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - George Davey Smith
- The MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Ian N. M. Day
- Bristol Genetic Epidemiology Laboratories, Department of Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Paul W. Franks
- Genetic Epidemiology and Clinical Research Group, Department of Public Health and Clinical Medicine, Section for Medicine, Umeå University Hospital, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Section for Nutritional Research (Umeå Medical Biobank), Umeå University, Umeå, Sweden
| | - Andrew T. Hattersley
- Genetics of Complex Traits, Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, United Kingdom
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Child and Adolescent Health, National Public Health Institute, Oulu, Finland
| | | | - Jaspal S. Kooner
- National Heart and Lung Institute, Imperial College London Hammersmith Hospital, London, United Kingdom
| | - Markku Laakso
- Department of Medicine, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Edward Lakatta
- Gerontology Research Center, National Institute on Aging, Baltimore, Maryland, United States of Ameica
| | - Vincent Mooser
- Medical Genetics, Clinical Pharmacology and Discovery Medicine, King of Prussia, Pennsylvania, United States of America
| | - Andrew D. Morris
- Diabetes Research Group, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Leena Peltonen
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Nilesh J. Samani
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - David P. Strachan
- Division of Community Health Sciences, St George's University of London, London, United Kingdom
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
- Medstar Research Institute, Baltimore, Maryland, United States of America
| | - Jaakko Tuomilehto
- Diabetes Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Hugh Watkins for the PROCARDIS consortia
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
- Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | - Dawn M. Waterworth
- Medical Genetics, Clinical Pharmacology and Discovery Medicine, King of Prussia, Pennsylvania, United States of America
| | - Michael Boehnke
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Panos Deloukas
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, United Kingdom
| | - Leif Groop
- Department of Clinical Sciences, Diabetes, and Endocrinology Research Unit, University Hospital Malmö, Lund University, Malmö, Sweden
- Department of Medicine, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - David J. Hunter
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Program in Molecular and Genetic Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Broad Institute of MIT and Harvard, Boston, Massachusetts, United States of America
| | - Unnur Thorsteinsdottir
- deCODE Genetics, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - David Schlessinger
- Gerontology Research Center, National Institute on Aging, Baltimore, Maryland, United States of Ameica
| | - H.-Erich Wichmann
- Institute of Epidemiology, Helmholtz Zentrum München, National Research Center for Environment and Health, Neuherberg, Germany
| | - Timothy M. Frayling
- Genetics of Complex Traits, Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, United Kingdom
| | - Gonçalo R. Abecasis
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Joel N. Hirschhorn
- Metabolism Initiative and Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Boston, Massachusetts, United States of America
- Divisions of Genetics and Endocrinology, Program in Genomics, Children's Hospital, Boston, Massachusetts, United States of America
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ruth J. F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Kari Stefansson
- deCODE Genetics, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Karen L. Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Mark I. McCarthy for the GIANT consortium
- Wellcome Trust Centre for Human Genetics, University of Oxford, , Oxford, United Kingdom
- Oxford Centre for Diabetes, Department of Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research, Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
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Casper EJ, Jacobs LC. A New Method of Prostatectomy. Cal West Med 1933; 38:263. [PMID: 18742479 PMCID: PMC1658710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC, Epsteen A. BLADDER TUMORS-CLINICAL MANIFESTATIONS: REPORT OF CASES. Cal West Med 1931; 35:207-211. [PMID: 18741877 PMCID: PMC1657988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. THE SURGICAL PROSTATE. Cal West Med 1928; 28:486-490. [PMID: 18740664 PMCID: PMC1655951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. UNUSUAL PROBLEMS OF THE SURGICAL PROSTATE: CHAIRMAN'S ADDRESS: SECTION ON UROLOGY. Cal West Med 1924; 22:326-328. [PMID: 18739358 PMCID: PMC1654344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. A SIMPLE APPARATUS FOR HOLDING CYSTOSCOPE AND COLLECTING TUBES. Cal State J Med 1922; 20:252. [PMID: 18738763 PMCID: PMC1517277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. MANIFESTATIONS OF LESIONS IN THE POSTERIOR URETHRA. Cal State J Med 1921; 19:370-371. [PMID: 18738566 PMCID: PMC1517029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. Vesico-Intestinal Fistula. Cal State J Med 1921; 19:19-21. [PMID: 18738356 PMCID: PMC1516755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. DIAGNOSIS AND TREATMENT OF GLANDULAR OBSTRUCTION AT THE NECK OF BLADDER. Cal State J Med 1919; 17:56-58. [PMID: 18737815 PMCID: PMC1593686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Jacobs LC. TWO CASES OF POISONING FROM THE USE OF ALYPIN IN THE URETHRA. Cal State J Med 1917; 15:268-270. [PMID: 18737364 PMCID: PMC1592953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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