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Spangler L, Nielson CM, Brookhart MA, Hernandez RK, Stad RK, Lin T. Cardiovascular Safety in Postmenopausal Women and Men With Osteoporosis Treated With Denosumab and Zoledronic Acid: A Post-Authorization Safety Study. JBMR Plus 2023; 7:e10793. [PMID: 37808402 PMCID: PMC10556278 DOI: 10.1002/jbm4.10793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 10/10/2023] Open
Abstract
Osteoporosis and cardiovascular disease are common in older adults. Treatment of osteoporosis reduces the burden of debilitating fractures; however, it is important to understand the benefit versus risk of treatment. This study evaluates the risk of stroke (ischemic or hemorrhagic) and myocardial infarction (MI) among postmenopausal women and men initiating osteoporosis treatment with denosumab (receptor activator of nuclear factor κB ligand [RANKL] inhibitor) or zoledronic acid (bisphosphonate) between October 2010 and June 2019. A retrospective cohort study employing the new user/active comparator design was conducted. Analyses were conducted separately in two national US commercial databases, MarketScan® and Optum® for reproducibility. Inverse probability of treatment and censoring weighting was employed to control for confounding and informative censoring. Cumulative risks at 6-month, 12-month, and 36-month time points were calculated and adjusted risk ratios and differences (with 95% confidence intervals [CIs]) were estimated. In MarketScan® and Optum® databases, 96,611 and 73,127 patients met all study eligibility criteria, respectively. At 36 months, the risk ratio estimates (zoledronic acid referent group) were 1.22 (95% CI, 0.77-1.66) and 0.97 (95% CI, 0.63-1.32) for MI and 1.00 (95% CI, 0.61-1.40) and 0.87 (95% CI, 0.56-1.17) for stroke in MarketScan and Optum, respectively. Most of the treatment associations across the other time periods and outcomes also had 95% CIs including the null value. In these large samples of real-world US patients, no increased risk in MI and stroke were identified for up to 36 months of treatment in denosumab users compared with zoledronic acid users. © 2023 Amgen. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Leslie Spangler
- Center for Observational Research, Amgen Inc.Thousand OaksCAUSA
| | | | - M. Alan Brookhart
- NoviSci, Inc.DurhamNCUSA
- Department of Population Health SciencesDuke UniversityDurhamNCUSA
| | | | - Robert Kees Stad
- Research and Development, Amgen Inc. Europe GmbHRotkreuzSwitzerland
| | - Tzu‐Chieh Lin
- Center for Observational Research, Amgen Inc.Thousand OaksCAUSA
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2
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Levintow SN, Nielson CM, Hernandez RK, Breskin A, Pritchard D, Lash TL, Rothman KJ, Gilbertson D, Muntner P, Critchlow C, Brookhart MA, Bradbury BD. Pragmatic considerations for negative control outcome studies to guide non-randomized comparative analyses: A narrative review. Pharmacoepidemiol Drug Saf 2023; 32:599-606. [PMID: 36965103 DOI: 10.1002/pds.5623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/14/2022] [Revised: 03/02/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
This narrative review describes the application of negative control outcome (NCO) methods to assess potential bias due to unmeasured or mismeasured confounders in non-randomized comparisons of drug effectiveness and safety. An NCO is assumed to have no causal relationship with a treatment under study while subject to the same confounding structure as the treatment and outcome of interest; an association between treatment and NCO then reflects the potential for uncontrolled confounding between treatment and outcome. We focus on two recently completed NCO studies that assessed the comparability of outcome risk for patients initiating different osteoporosis medications and lipid-lowering therapies, illustrating several ways in which confounding may result. In these studies, NCO methods were implemented in claims-based data sources, with the results used to guide the decision to proceed with comparative effectiveness or safety analyses. Based on this research, we provide recommendations for future NCO studies, including considerations for the identification of confounding mechanisms in the target patient population, the selection of NCOs expected to satisfy required assumptions, the interpretation of NCO effect estimates, and the mitigation of uncontrolled confounding detected in NCO analyses. We propose the use of NCO studies prior to initiating comparative effectiveness or safety research, providing information on the potential presence of uncontrolled confounding in those comparative analyses. Given the increasing use of non-randomized designs for regulatory decision-making, the application of NCO methods will strengthen study design, analysis, and interpretation of real-world data and the credibility of the resulting real-world evidence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sara N Levintow
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- NoviSci, a Target RWE Company, Durham, North Carolina
| | - Carrie M Nielson
- Center for Observational Research, Amgen, Thousand Oaks, California
| | | | - Alexander Breskin
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- NoviSci, a Target RWE Company, Durham, North Carolina
| | | | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kenneth J Rothman
- RTI Health Solutions, Research Triangle Institute, Research Triangle Park, North Carolina
| | - David Gilbertson
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Paul Muntner
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Cathy Critchlow
- Center for Observational Research, Amgen, Thousand Oaks, California
| | - M Alan Brookhart
- NoviSci, a Target RWE Company, Durham, North Carolina
- Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Brian D Bradbury
- Center for Observational Research, Amgen, Thousand Oaks, California
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Nielson CM, Bylsma LC, Fryzek JP, Saad HA, Crawford J. Relative Dose Intensity of Chemotherapy and Survival in Patients with Advanced Stage Solid Tumor Cancer: A Systematic Review and Meta-Analysis. Oncologist 2021; 26:e1609-e1618. [PMID: 33973301 PMCID: PMC8417866 DOI: 10.1002/onco.13822] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/30/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Chemotherapy-induced toxicities lead to therapy dose reduction or delay, affecting patient outcomes. This systematic review and meta-analysis evaluated the impact of relative dose intensity (RDI) on survival in adult patients with solid tumor cancer on nonadjuvant-based chemotherapy regimens. METHODS PubMed, Embase, and Web of Science databases were searched for peer-reviewed English journal articles or congress abstracts evaluating association between RDI and survival; observational studies, case series of ≥20 patients, and clinical trials published between 2013 and 2020 were eligible. Meta-analyses were conducted to quantify the association between RDI levels and overall survival (OS) among studies reporting a hazard ratio (HR) for OS by similar tumor types, regimens, and RDI. Forest plots represented summary HR and 95% confidence interval (CI); Cochran's Q and I2 tests evaluated study heterogeneity. RESULTS Overall, 919 articles were reviewed and 22 included; seven were eligible for meta-analysis. Significantly shorter OS at RDI <80% versus ≥80% and <85% versus ≥85% was observed upon meta-analysis of four carboplatin-based studies for breast, non-small cell lung, or ovarian cancer (HR 1.17; 95% CI: 1.07-1.27) and three FOLFOX-, FOLFIRI-, or FOLFIRINOX-based studies for colorectal or pancreatic cancer (HR 1.39; 95% CI: 1.03-1.89). Grade 3 or higher hematologic toxicities were higher for carboplatin-based regimens (thrombocytopenia: 14%-22%; anemia: 15%-19%; neutropenia: 24%-58%) than FOLFOX-, FOLFIRI-, or FOLFIRINOX-based regimens (thrombocytopenia: 1%-4%; anemia: 5%-19%; neutropenia: 19%-47%). CONCLUSION The results suggested longer OS with RDI ≥80% or ≥85% for both regimens, indicating that management of toxicities across treatment modalities may contribute to maintenance of higher RDI and benefit survival for patients with advanced solid tumors. IMPLICATIONS FOR PRACTICE Chemotherapy-induced toxicities lead to dose reduction and/or treatment delay, thus affecting patient outcomes. Results of this systematic review and meta-analysis, evaluating the impact of relative dose intensity (RDI) on survival of patients with solid tumors on nonadjuvant-based chemotherapy regimens, demonstrate a longer overall survival with RDI levels of at least 80% for patients with solid tumors on carboplatin-based and FOLFOX-, FOLFIRI-, or FOLFIRINOX-based chemotherapy regimens, suggesting a protective effect of maintaining RDI ≥80% or ≥ -85%. Although grade 3 or higher hematologic toxicities occurred more in carboplatin-based studies, managing toxicities across treatment regimens may contribute to maintenance of higher RDI and ultimately benefit overall survival.
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Affiliation(s)
| | - Lauren C. Bylsma
- EpidStrategies, A Division of ToxStrategies, Inc.Ann ArborMichiganUSA
| | - Jon P. Fryzek
- EpidStrategies, A Division of ToxStrategies, Inc.RockvilleMarylandUSA
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Snell Taylor SJ, Nielson CM, Breskin A, Saul B, Yu Y, Alam N, Eisen M, Hippenmeyer J, Janssens A, Kozak T, Papadaki HA, Selleslag D, Viallard JF, Feistritzer C, Kaiafa G, Kelsh M, Kilpatrick K, Brookhart MA, McGrath LJ. Effectiveness and Safety of Romiplostim Among Patients with Newly Diagnosed, Persistent and Chronic Immune Thrombocytopenia in European Clinical Practice. Adv Ther 2021; 38:2673-2688. [PMID: 33866516 PMCID: PMC8107157 DOI: 10.1007/s12325-021-01727-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Romiplostim has been approved in Europe since 2009 to treat patients with chronic primary immune thrombocytopenia (ITP). Using real-world data from seven European countries, we measured the effectiveness and safety outcomes within 24 weeks following romiplostim initiation by duration of ITP: less than 3 months ("newly diagnosed"), 3-12 months ("persistent"), and more than 12 months ("chronic"). METHODS Adults with ITP and ≥ 1 romiplostim administration between 2009 and 2012 were included. Endpoints included durable platelet response, median platelet count, rescue therapy, bleeding and adverse events. We used inverse probability of censoring weighted estimators to estimate cumulative risk of each outcome. There were 64 newly diagnosed, 50 persistent, and 226 chronic ITP patients at romiplostim initiation. RESULTS Durable platelet response at 24 weeks ranged from 32% [confidence interval (CI): 18-46%] in newly diagnosed patients to 53% (CI 37-68%) in persistent patients. Median platelet count during follow-up ranged from 88 (CI 80-96) × 109/L in chronic patients to 131 (CI 102-160) × 109/L in newly diagnosed patients. CONCLUSION Regardless of ITP duration, over half of patients discontinued concomitant ITP medications. Few adverse events were observed. Although only approved for chronic patients, estimates of the romiplostim treatment effect were similar across patients being managed in European clinical practice, regardless of ITP duration at romiplostim initiation.
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Affiliation(s)
| | | | - Alexander Breskin
- NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Bradley Saul
- NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA
| | - Ying Yu
- NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA
| | | | | | | | | | | | | | | | | | | | - Georgia Kaiafa
- AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - M Alan Brookhart
- NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA
- Department of Population Health Sciences, Duke University, Durham, UK
| | - Leah J McGrath
- NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA
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5
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Gotschalck MA, Nørgaard M, Risbo N, Christiansen CF, Bahmanyar S, Ghanima W, Alam N, Frederiksen H, Nielson CM, Sørensen HT. Predictors for and outcomes after bone marrow biopsy in Scandinavian patients with chronic immune thrombocytopenia. Eur J Haematol 2021; 107:145-156. [PMID: 33851445 DOI: 10.1111/ejh.13635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/25/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine predictors for bone marrow biopsy (BMB) and the outcome following BMB in patients with chronic immune thrombocytopenia (cITP). METHODS We identified patients diagnosed with cITP during 2009-2017 and obtained information on BMB, cITP treatment and subsequent thrombotic events, hospitalized bleeding, hematological cancer, and death using data from population-based healthcare databases and medical records in Denmark, Norway, and Sweden. RESULTS Among 4471 adults (≥18 years) with cITP, 1683 (37.6%) underwent BMB before cITP diagnosis, while cumulative BMB incidence after cITP diagnosis date was 3.1% at 1 year and 7.5% at 5 years. Predictors of having a BMB after cITP diagnosis included older age, male sex, low baseline platelet count, splenectomy, and number of cITP treatments. Compared with patients without BMB, patients with BMB had higher rates of thrombotic events (1 year adjusted hazard ratio [HR] 1.53 [95% CI, 0.92-2.54]), hospitalized bleeding episodes (1 year adjusted HR 1.72 [95% CI, 1.15-2.58]), hematological cancer (1 year adjusted HR 35.26 [95% CI 17.67-70.34]), and all-cause mortality (1 year adjusted HR 1.97 [95% CI, 1.44-2.68]). CONCLUSION Patients who undergo BMB after cITP diagnosis represent a subset of patients with more severe disease and increased rates of complications as well as hematological malignancies.
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Affiliation(s)
- Madeleine Andersson Gotschalck
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Nickolaj Risbo
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Christian Fynbo Christiansen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Shahram Bahmanyar
- Department of Medicine, Clinical Epidemiology Unit & Center for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden
| | - Waleed Ghanima
- Department of Medicine, Østfold Hospital Trust, Oslo, Norway.,Department of Hematology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Naufil Alam
- Center for Observational Research, Amgen Ltd, Uxbridge, UK
| | - Henrik Frederiksen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Carrie M Nielson
- Center for Observational Research, Amgen Inc, Thousand Oaks, CA, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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Coronado GD, Nielson CM, Keast EM, Petrik AF, Suls JM. The influence of multi-morbidities on colorectal cancer screening recommendations and completion. Cancer Causes Control 2021; 32:555-565. [PMID: 33687606 DOI: 10.1007/s10552-021-01408-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/02/2019] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Patients' chronic disease burden can influence the likelihood that providers will recommend cancer screening and that patients will participate in it. Using data from the STOP CRC pragmatic study, we examined associations between chronic disease burden and colorectal cancer screening recommendation and use. METHODS Participating STOP CRC clinics (n = 26) received either usual care or training to implement a mailed fecal immunochemical test (FIT) outreach program. Selected clinic patients (n = 60,187 patients) were aged 50-74 and overdue for colorectal cancer screening. We used logistic regression to examine the associations between FIT recommendations and completion and patients' chronic disease burden, calculated using the Charlson Comorbidity Index and the Chronic Illness and Disability Payment System. RESULTS For each index, FIT recommendation odds were 8-9% higher among individuals with minimal chronic disease burden and 13-23% lower among individuals with high chronic disease burden (inverted U-shaped association). Among adults who were ordered a FIT, FIT completion odds were 20% lower for individuals with any, versus no, chronic condition and diminished with increasing disease burden (inverse linear association). CONCLUSIONS Analysis showed an inverted U-shaped association between patients' chronic disease burden and providers' recommendation of a FIT and an inverse linear association between patients' chronic disease burden and FIT completion. ClinicalTrials.gov registration: NCT01742065.
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Affiliation(s)
- Gloria D Coronado
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA.
| | - Carrie M Nielson
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Erin M Keast
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Amanda F Petrik
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Jerry M Suls
- Center for Personalized Health, Feinstein Institute for Medical Research, New York, NY, 10022, USA
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Shaw JL, Nielson CM, Park JK, Marongiu A, Soff GA. The incidence of thrombocytopenia in adult patients receiving chemotherapy for solid tumors or hematologic malignancies. Eur J Haematol 2021; 106:662-672. [PMID: 33544940 PMCID: PMC8248430 DOI: 10.1111/ejh.13595] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To estimate the risk of thrombocytopenia in various cancers and chemotherapy regimens. METHODS Structured patient-level data from the Flatiron Health Electronic Health Record database were used to identify adult patients who received chemotherapy for a solid tumor or hematologic malignancy from 2012 to 2017. Three-month cumulative incidence of thrombocytopenia was assessed based on platelet counts, overall and by grade of thrombocytopenia. Co-occurrence of anemia, neutropenia, and leukopenia was evaluated. RESULTS Of 15,521 patients with solid tumors, 13% had thrombocytopenia within 3 months (platelet count < 100 × 109 /L); 4% had grade 3 (25 to < 50 × 109 /L), and 2% grade 4 (<25 × 109 /L) thrombocytopenia. Of 2537 patients with hematologic malignancies, 28% had any thrombocytopenia, 16% with grade 3, and 12% with grade 4. Among patients with thrombocytopenia, it occurred without another cytopenia in 18% of solid tumors and 7% of hematologic malignancies. CONCLUSIONS In a large, US-representative sample of patients undergoing chemotherapy in clinical practice, thrombocytopenia incidence varied across tumor and regimen types. Despite recommendations to alter chemotherapy to avoid severe thrombocytopenia, 4% of patients with solid tumors and 16% with hematologic malignancies experienced grade 3 thrombocytopenia. Prediction and prevention of thrombocytopenia may help oncologists avoid dose modifications and their adverse effects on survival.
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Affiliation(s)
| | | | | | | | - Gerald A Soff
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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8
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Orwoll ES, Wiedrick J, Nielson CM, Jacobs J, Baker ES, Piehowski P, Petyuk V, Gao Y, Shi T, Smith RD, Bauer DC, Cummings SR, Lapidus J. Proteomic assessment of serum biomarkers of longevity in older men. Aging Cell 2020; 19:e13253. [PMID: 33078901 PMCID: PMC7681066 DOI: 10.1111/acel.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/30/2020] [Accepted: 08/30/2020] [Indexed: 12/28/2022] Open
Abstract
The biological bases of longevity are not well understood, and there are limited biomarkers for the prediction of long life. We used a high-throughput, discovery-based proteomics approach to identify serum peptides and proteins that were associated with the attainment of longevity in a longitudinal study of community-dwelling men age ≥65 years. Baseline serum in 1196 men were analyzed using liquid chromatography-ion mobility-mass spectrometry, and lifespan was determined during ~12 years of follow-up. Men who achieved longevity (≥90% expected survival) were compared to those who died earlier. Rigorous statistical methods that controlled for false positivity were utilized to identify 25 proteins that were associated with longevity. All these proteins were in lower abundance in long-lived men and included a variety involved in inflammation or complement activation. Lower levels of longevity-associated proteins were also associated with better health status, but as time to death shortened, levels of these proteins increased. Pathway analyses implicated a number of compounds as important upstream regulators of the proteins and implicated shared networks that underlie the observed associations with longevity. Overall, these results suggest that complex pathways, prominently including inflammation, are linked to the likelihood of attaining longevity. This work may serve to identify novel biomarkers for longevity and to understand the biology underlying lifespan.
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Affiliation(s)
| | | | | | - Jon Jacobs
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Erin S. Baker
- Department of Chemistry North Carolina State University Raleigh NC USA
| | - Paul Piehowski
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Vladislav Petyuk
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Yuqian Gao
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Tujin Shi
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Richard D. Smith
- Biological Science Division Pacific Northwest National Laboratory Richland WA USA
| | - Douglas C. Bauer
- Departments of Medicine and Epidemiology & Biostatistics University of California San Francisco CA USA
| | - Steven R. Cummings
- California Pacific Medical Center Research Institute San Francisco CA USA
| | - Jodi Lapidus
- Oregon Health & Science University Portland OR USA
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Schneider JL, Rivelli JS, Gruss I, Petrik AF, Nielson CM, Green BB, Coronado GD. Barriers and Facilitators to Timely Colonoscopy Completion for Safety Net Clinic Patients. Am J Health Behav 2020; 44:460-472. [PMID: 32553027 DOI: 10.5993/ajhb.44.4.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this study, we conducted telephone interviews with patients in community clinics who had abnormal fecal immunochemical test (FIT) results to identify follow-up colonoscopy challenges. The FIT is an effective colorectal cancer screening method, but its value is contingent on follow-up diagnostic colonoscopy. Methods: We explored barriers at 3 timepoints: (1) abnormal FIT-result communication, (2) scheduling/completion of colonoscopy, and (3) receipt of results. We sought to understand variation in experience by both Spanish and English language patients. Results: We interviewed 32 patients (16 English; 16 Spanish), 66% of whom were women. There were 13 early completers (≤ 2 months after FIT result), 14 later completers (> 2 months after FIT result), and 5 non-completers of the colonoscopy. The greatest challenge was fear of the procedure, expressed more often by Spanish language (SL) participants and later completers. SL participants also cited cost and lack of clear communication about the need for a colonoscopy. English language (EL) participants experienced lack of reliable transportation. Conclusions: Barriers to timely colonoscopy completion following an abnormal FIT can occur at different transitions in care and vary by patient characteristics. Our findings may inform the design of programs to improve colonoscopy completion in safety net clinics.
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Affiliation(s)
- Jennifer L. Schneider
- Jennifer L. Schneider, Senior Research Associate, Center for Health Research, Kaiser Permanente Northwest, Portland, OR;,
| | - Jennifer S. Rivelli
- Jennifer S. Rivelli, Research Associate and Manager, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Inga Gruss
- Inga Gruss, Senior Research Associate, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Amanda F. Petrik
- Amanda F. Petrik, Senior Research Associate, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Carrie M. Nielson
- Carrie M. Nielson, Epidemiologist, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Beverly B. Green
- Beverly B. Green, Investigator, Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Gloria D. Coronado
- Gloria D. Coronado, Distinguished Investigator, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
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Sun J, Gastman BR, McCahon L, Buchbinder EI, Puzanov I, Nanni M, Lewis JM, Carvajal RD, Singh-Kandah S, Desai AM, Raskin L, Nielson CM, Ismail R, Zager JS. Observational study of talimogene laherparepvec use in the anti-PD-1 era for melanoma in the US (COSMUS-2). Melanoma Manag 2020; 7:MMT41. [PMID: 32821373 PMCID: PMC7426742 DOI: 10.2217/mmt-2020-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/28/2020] [Indexed: 12/22/2022] Open
Abstract
AIM Talimogene laherparepvec (T-VEC) is an intralesional therapy for unresectable, metastatic melanoma. T-VEC real-world use in the context of anti-PD1-based therapy requires further characterization. MATERIALS & METHODS A retrospective review of T-VEC use from 1 January 2017 and 31 March 2018 for melanoma patients was conducted at seven US institutions. RESULTS Among 83 patients, three categories of T-VEC and anti-PD-1 therapy were identified: T-VEC used without anti-PD-1 (n = 29, 35%), T-VEC after anti-PD-1-based therapy (n = 22, 27%) and concurrent T-VEC and anti-PD-1-based therapy (n = 32, 39%). 25% of patients discontinued T-VEC therapy due to no remaining injectable lesions, 37% discontinued T-VEC due to progressive disease. Discontinuation of T-VEC did not differ by anti-PD-1-based therapy use or timing. CONCLUSION In real-world settings, T-VEC may be used concurrently with or after anti-PD-1-based therapy.
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Affiliation(s)
- James Sun
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brian R Gastman
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Lucy McCahon
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | | | - Igor Puzanov
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14203, USA
| | - Michele Nanni
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14203, USA
| | - James M Lewis
- Department of Surgical Oncology, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920, USA
| | - Richard D Carvajal
- Department of Medical Oncology, Columbia University Irving Medical Center, New York, NY 37996, USA
| | - Shahnaz Singh-Kandah
- Department of Medical Oncology, Columbia University Irving Medical Center, New York, NY 37996, USA
| | - Anupam M Desai
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | | | | | | | - Jonathan S Zager
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA
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11
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O'Connor EA, Nielson CM, Petrik AF, Green BB, Coronado GD. Prospective Cohort study of Predictors of Follow-Up Diagnostic Colonoscopy from a Pragmatic Trial of FIT Screening. Sci Rep 2020; 10:2441. [PMID: 32051454 PMCID: PMC7016148 DOI: 10.1038/s41598-020-59032-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/23/2020] [Indexed: 01/18/2023] Open
Abstract
The goal of this study was to explore diagnostic colonoscopy completion in adults with abnormal screening fecal immunochemical test (FIT) results. This was a secondary analysis of the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (Stop CRC) study, a cluster-randomized pragmatic trial to increase uptake of CRC screening in federally qualified community health clinics. Diagnostic colonoscopy completion and reasons for non-completion were ascertained through a manual review of electronic health records, and completion was compared across a wide range of individual patient health and sociodemographic characteristics. Among 2,018 adults with an abnormal FIT result, 1066 (52.8%) completed a follow-up colonoscopy within 12 months. Completion was generally similar across a wide range of participant subpopulations; however, completion was higher for participants who were younger, Hispanic, Spanish-speaking, and had zero or one of the Charlson medical comorbidities, compared to their counterparts. Neighborhood-level predictors were not associated with diagnostic colonoscopy completion. Thus, completion of a diagnostic colonoscopy was relatively low in a large sample of community health clinic adults who had an abnormal screening FIT result. While completion was generally similar across a wide range of characteristics, younger, healthier, Hispanic participants tended to have a higher likelihood of completion.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA. Elizabeth.O'
| | - Carrie M Nielson
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Amanda F Petrik
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Beverly B Green
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA
| | - Gloria D Coronado
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
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12
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Abstract
Proteins are an essential part of essentially all biological processes, and there is enormous variation in protein forms and concentrations that is not reflected in DNA or RNA. Recently there have been rapid advances in the ability to measure protein sequence, modification and concentration, particularly with methods based in mass spectrometry. Global measures of proteins in tissues or in the circulation provide a broad assessment of the proteome that can be extremely useful for discovery, and targeted proteomic measures can yield specific and sensitive assessments of specific peptides and proteins. While most proteomic measures are directed at the detection of consensus peptide sequences, mass spectrometry based proteomic methods also allow a detailed examination of the peptide sequence differences that result from genetic variants and that may have important effects on protein function. In evaluating proteomic data, a number of analytical considerations are important, including an understanding of missing data, the challenge of multiple testing and replication, and the use of rapidly evolving methods in systems biology. While proteomics has not yet had a major impact in skeletal research, interesting recent research has used these approaches in the study of bone cell biology and the discovery of biomarkers of skeletal disorders. Proteomics can be expected to have an increasing influence in the study of bone biology and pathophysiology.
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Affiliation(s)
| | - Jon M Jacobs
- Pacific Northwest National Laboratory, Richland, WA, USA
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13
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Nielson CM, Vollmer WM, Petrik AF, Keast EM, Green BB, Coronado GD. Factors Affecting Adherence in a Pragmatic Trial of Annual Fecal Immunochemical Testing for Colorectal Cancer. J Gen Intern Med 2019; 34:978-985. [PMID: 30684199 PMCID: PMC6544723 DOI: 10.1007/s11606-018-4820-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/27/2018] [Accepted: 11/27/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Colorectal cancer screening by fecal immunochemical test (FIT) reduces the burden of colorectal cancer. However, effectiveness relies on annual adherence, which presents challenges for clinic staff and patients. OBJECTIVE Describe FIT return rates and identify factors associated with FIT adherence over 2 years in a mailed FIT outreach program in federally qualified health centers. DESIGN Observational study nested in the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) trial. Five thousand one hundred ninety-five patients had an initial FIT order and were followed for ≥ 2 years (3574 also had a FIT order in the second year). MAIN MEASURES FIT return percent in each year and patient- and neighborhood-level characteristics associated with FIT adherence. KEY RESULTS Overall, the proportion of FIT orders that were completed was 46% in the patients' first year and 41% in the patients' second year. Of the 5195 patients with a FIT order in year 1, 3574 (69%) also had a FIT order in year 2 (71% of year 1 adherers and 67% of year 1 non-adherers, p = 0.009). Among those with a FIT order in the second year, the FIT return rate was about twice as high among those who were adherent in the first year (952/1674, or 57%) as among those who were not (531/1900, or 28%, p < 0.0001). Patient-level characteristics associated with higher odds of FIT return were a history of FIT screening at baseline, age over 65 (vs 50-65), no current tobacco use, recent receipt of a mammogram or flu vaccine, Asian ancestry (compared to non-Hispanic white), and non-English preference. The only neighborhood factor associated with lower FIT return rate was patient's larger residential city size. CONCLUSION Our findings can inform the customization of programs to promote FIT return among patients who receive care at federally qualified health centers. TRIAL REGISTRATION http://www.clinicaltrials.gov.
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Affiliation(s)
- Carrie M Nielson
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - William M Vollmer
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - Amanda F Petrik
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - Erin M Keast
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - Beverly B Green
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Gloria D Coronado
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
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14
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Skeith AE, Stephens CQ, Nielson CM, Caughey AB. History of adolescent birth and diabetes in adulthood: a cross-sectional study of a nationally representative sample of American women. J Matern Fetal Neonatal Med 2019; 34:714-719. [PMID: 31039650 DOI: 10.1080/14767058.2019.1614159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: In the USA, 12-14% have type 2 diabetes mellitus and the incidence is rising. Adolescent birth has been shown to be associated with significant gestational weight gain and obesity in adulthood.Objective: We sought to evaluate the association between the history of adolescent birth and diabetes in adulthood.Study design: We conducted a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) data, examining 2-year cycles from 2005 to 2014. In a population of adult women who had experienced at least one live birth and who were not currently pregnant, we examined the prevalence of type 2 diabetes mellitus by the history of adolescent birth (live birth prior to 20 years of age). Sample characteristics were compared using survey-weighted chi-square tests. Multivariate logistic regression was used to examine the association between diabetes mellitus and adolescent birth history, with progressive adjustments for birth cohort, race/ethnicity, education level, and body mass index (BMI).Results: In a survey sample of 6507 individuals, we found that 38% of the women had experienced adolescent birth. Significant differences were found between those who had experienced adolescent birth and those who had not by birth cohort, race/ethnicity, federal poverty level, education attainment, parity, and BMI (p < .001 for all). The prevalence of type 2 diabetes was higher in women with a history of adolescent birth in adulthood than in women without a history of adolescent birth (17.2 versus 12.1%, p < .001; BMI-adjusted odds ratio = 1.27; 95% confidence interval, 1.03-1.58, p = .03).Conclusion: American women with a history of adolescent birth are at a significantly higher risk of type 2 diabetes mellitus in adulthood. Greater attention must be paid to preventing metabolic disease in women who experience early parity.
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Affiliation(s)
- Ashley E Skeith
- Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Portland, OR, USA
| | - Caroline Q Stephens
- Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Portland, OR, USA
| | - Carrie M Nielson
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, USA
| | - Aaron B Caughey
- Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Portland, OR, USA
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15
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Karasik D, Zillikens MC, Hsu YH, Aghdassi A, Akesson K, Amin N, Barroso I, Bennett DA, Bertram L, Bochud M, Borecki IB, Broer L, Buchman AS, Byberg L, Campbell H, Campos-Obando N, Cauley JA, Cawthon PM, Chambers JC, Chen Z, Cho NH, Choi HJ, Chou WC, Cummings SR, de Groot LCPGM, De Jager PL, Demuth I, Diatchenko L, Econs MJ, Eiriksdottir G, Enneman AW, Eriksson J, Eriksson JG, Estrada K, Evans DS, Feitosa MF, Fu M, Gieger C, Grallert H, Gudnason V, Lenore LJ, Hayward C, Hofman A, Homuth G, Huffman KM, Husted LB, Illig T, Ingelsson E, Ittermann T, Jansson JO, Johnson T, Biffar R, Jordan JM, Jula A, Karlsson M, Khaw KT, Kilpeläinen TO, Klopp N, Kloth JSL, Koller DL, Kooner JS, Kraus WE, Kritchevsky S, Kutalik Z, Kuulasmaa T, Kuusisto J, Laakso M, Lahti J, Lang T, Langdahl BL, Lerch MM, Lewis JR, Lill C, Lind L, Lindgren C, Liu Y, Livshits G, Ljunggren Ö, Loos RJF, Lorentzon M, Luan J, Luben RN, Malkin I, McGuigan FE, Medina-Gomez C, Meitinger T, Melhus H, Mellström D, Michaëlsson K, Mitchell BD, Morris AP, Mosekilde L, Nethander M, Newman AB, O'Connell JR, Oostra BA, Orwoll ES, Palotie A, Peacock M, Perola M, Peters A, Prince RL, Psaty BM, Räikkönen K, Ralston SH, Ripatti S, Rivadeneira F, Robbins JA, Rotter JI, Rudan I, Salomaa V, Satterfield S, Schipf S, Shin CS, Smith AV, Smith SB, Soranzo N, Spector TD, Stančáková A, Stefansson K, Steinhagen-Thiessen E, Stolk L, Streeten EA, Styrkarsdottir U, Swart KMA, Thompson P, Thomson CA, Thorleifsson G, Thorsteinsdottir U, Tikkanen E, Tranah GJ, Uitterlinden AG, van Duijn CM, van Schoor NM, Vandenput L, Vollenweider P, Völzke H, Wactawski-Wende J, Walker M, J Wareham N, Waterworth D, Weedon MN, Wichmann HE, Widen E, Williams FMK, Wilson JF, Wright NC, Yerges-Armstrong LM, Yu L, Zhang W, Zhao JH, Zhou Y, Nielson CM, Harris TB, Demissie S, Kiel DP, Ohlsson C. Disentangling the genetics of lean mass. Am J Clin Nutr 2019; 109:276-287. [PMID: 30721968 PMCID: PMC6500901 DOI: 10.1093/ajcn/nqy272] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background Lean body mass (LM) plays an important role in mobility and metabolic function. We previously identified five loci associated with LM adjusted for fat mass in kilograms. Such an adjustment may reduce the power to identify genetic signals having an association with both lean mass and fat mass. Objectives To determine the impact of different fat mass adjustments on genetic architecture of LM and identify additional LM loci. Methods We performed genome-wide association analyses for whole-body LM (20 cohorts of European ancestry with n = 38,292) measured using dual-energy X-ray absorptiometry) or bioelectrical impedance analysis, adjusted for sex, age, age2, and height with or without fat mass adjustments (Model 1 no fat adjustment; Model 2 adjustment for fat mass as a percentage of body mass; Model 3 adjustment for fat mass in kilograms). Results Seven single-nucleotide polymorphisms (SNPs) in separate loci, including one novel LM locus (TNRC6B), were successfully replicated in an additional 47,227 individuals from 29 cohorts. Based on the strengths of the associations in Model 1 vs Model 3, we divided the LM loci into those with an effect on both lean mass and fat mass in the same direction and refer to those as "sumo wrestler" loci (FTO and MC4R). In contrast, loci with an impact specifically on LM were termed "body builder" loci (VCAN and ADAMTSL3). Using existing available genome-wide association study databases, LM increasing alleles of SNPs in sumo wrestler loci were associated with an adverse metabolic profile, whereas LM increasing alleles of SNPs in "body builder" loci were associated with metabolic protection. Conclusions In conclusion, we identified one novel LM locus (TNRC6B). Our results suggest that a genetically determined increase in lean mass might exert either harmful or protective effects on metabolic traits, depending on its relation to fat mass.
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Affiliation(s)
- David Karasik
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, MA
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative-Sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Yi-Hsiang Hsu
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
- Molecular and Integrative Physiological Sciences Program, Harvard School of Public Health, Boston, MA
| | - Ali Aghdassi
- Department of Medicine A, University of Greifswald, Greifswald, Germany
| | - Kristina Akesson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
- NIHR Cambridge Biomedical Research Centre
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, Lübeck, Germany
| | - Murielle Bochud
- University Institute for Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Ingrid B Borecki
- Division of Statistical Genomics, Department of Genetics
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Linda Broer
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Liisa Byberg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, United Kingdom
| | | | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - John C Chambers
- Cardiology, Ealing Hospital NHS Trust, London, United Kingdom
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, United Kingdom
| | - Zhao Chen
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Youngtong-Gu, Suwon, Korea
| | - Hyung Jin Choi
- Department of Internal Medicine
- Department of Anatomy and Cell Biology, Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Wide River Institute of Immunology, Seoul National University, Hongcheon, Korea
| | - Wen-Chi Chou
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, MA
- Broad Institute, Cambridge, MA
| | - Steven R Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA
| | | | - Phillip L De Jager
- Center for Translational and Computational Neuroimmunology, Neurology, Columbia University Medical Center, New York, NY
- Cell Circuits Program, Broad Institute, Cambridge, MA
| | - Ilja Demuth
- Charité—Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Luda Diatchenko
- Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Michael J Econs
- Department of Medicine and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Anke W Enneman
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Joel Eriksson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Folkhalsan Research Centre, Helsinki, Finland
| | - Karol Estrada
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Translational Biology, Biogen, Cambridge, MA
| | - Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics
| | - Mao Fu
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
| | - Christian Gieger
- Research Unit of Molecular Epidemiology
- Institute of Epidemiology II
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology
- Institute of Epidemiology II
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
- CCG Nutrigenomics and Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
| | - Vilmundur Gudnason
- Icelandic Heart Association Holtasmari, Kopavogur, Iceland
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - Launer J Lenore
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, NIA, Bethesda, MD
| | - Caroline Hayward
- MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh, United Kingdom
| | - Albert Hofman
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative-Sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Kim M Huffman
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Lise B Husted
- Aarhus University Hospital, Endocrinology and Internal Medicine, Aarhus, Denmark
| | - Thomas Illig
- Research Unit of Molecular Epidemiology
- Department of Human Genetics, Hannover Medical School, Hanover, Germany
| | - Erik Ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA
| | - Till Ittermann
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - John-Olov Jansson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Toby Johnson
- University Institute for Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Reiner Biffar
- Centre of Oral Health, Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Antti Jula
- National Institute for Health and Welfare, Helsinki, Finland
| | - Magnus Karlsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Tuomas O Kilpeläinen
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Norman Klopp
- Research Unit of Molecular Epidemiology
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | | | - Daniel L Koller
- Department of Medicine and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Jaspal S Kooner
- Cardiology, Ealing Hospital NHS Trust, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- Faculty of Medicine, National Heart & Lung Institute, Cardiovascular Science, Hammersmith Campus, Hammersmith Hospital, Imperial College London, United Kingdom
| | - William E Kraus
- Duke Molecular Physiology Institute and Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Stephen Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Zoltán Kutalik
- University Institute for Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Teemu Kuulasmaa
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jari Lahti
- Helsinki Collegium Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Thomas Lang
- Department of Radiology and Biomedical Imaging, and School of Dentistry, UC San Francisco, San Francisco, CA
| | - Bente L Langdahl
- Aarhus University Hospital, Endocrinology and Internal Medicine, Aarhus, Denmark
| | - Markus M Lerch
- Department of Medicine A, University of Greifswald, Greifswald, Germany
| | - Joshua R Lewis
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Christina Lill
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Lars Lind
- Department. of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Cecilia Lindgren
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, United Kingdom
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, United Kingdom
| | - Östen Ljunggren
- Department. of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ruth J F Loos
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
- The Charles Bronfman Institute of Personalized Medicine
- Institute of Child Health and Development
- The Genetics of Obesity and Related Traits Program, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mattias Lorentzon
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jian'an Luan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Robert N Luben
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida Malkin
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Fiona E McGuigan
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Thomas Meitinger
- Institute of Human Genetics, MRI, Technische Universität München, Munich, Germany
- Institute of Human Genetics, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Håkan Melhus
- Department. of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dan Mellström
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Braxton D Mitchell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
- Geriatric Research and Education Clinical Center—Veterans Administration Medical Center, Baltimore, MD
| | - Andrew P Morris
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, United Kingdom
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Leif Mosekilde
- Aarhus University Hospital, Endocrinology and Internal Medicine, Aarhus, Denmark
| | - Maria Nethander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Jeffery R O'Connell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
| | - Ben A Oostra
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Centre for Medical Systems Biology & Netherlands Consortium on Healthy Aging, Leiden, The Netherlands
| | | | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | - Munro Peacock
- Department of Medicine and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland
- University of Helsinki, Institute for Molecular Medicine, Finland and Diabetes and Obesity Research Program, Helsinki, Finland
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Annette Peters
- Research Unit of Molecular Epidemiology
- Institute of Epidemiology II
| | - Richard L Prince
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gardiner Hospital, Perth, Australia
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Stuart H Ralston
- Molecular Medicine Centre, MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, United Kingdom
| | - Samuli Ripatti
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative-Sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - John A Robbins
- Department of Medicine, University California at Davis, Sacramento, CA
| | - Jerome I Rotter
- Institute for Translational Genomic and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor UCLA Medical Center, Torrance, CA
| | - Igor Rudan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Sabine Schipf
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | | | - Albert V Smith
- Icelandic Heart Association Holtasmari, Kopavogur, Iceland
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - Shad B Smith
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University, Durham, NC
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, United Kingdom
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Kari Stefansson
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
- deCODE Genetics, Reykjavik, Iceland
| | | | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative-Sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Elizabeth A Streeten
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
- Geriatric Research and Education Clinical Center—Veterans Administration Medical Center, Baltimore, MD
| | | | - Karin M A Swart
- Department of Epidemiology and Biostatistics, and the EMGO+ Institute; VU University Medical Center, Amsterdam, The Netherlands
| | | | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - Unnur Thorsteinsdottir
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
- deCODE Genetics, Reykjavik, Iceland
| | - Emmi Tikkanen
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Gregory J Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative-Sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Centre for Medical Systems Biology & Netherlands Consortium on Healthy Aging, Leiden, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, and the EMGO+ Institute; VU University Medical Center, Amsterdam, The Netherlands
| | - Liesbeth Vandenput
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, SUNY, Buffalo, NY
| | - Mark Walker
- Institute of Cellular Medicine (Diabetes), The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | | | - Michael N Weedon
- Genetics of Complex Traits, Royal Devon & Exeter Hospital, University of Exeter Medical School, Exeter, United Kingdom
| | - H-Erich Wichmann
- Institute of Epidemiology II
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Neuherberg/Munich, Germany
- Institute of Medical Statistics and Epidemiology, Technical University, Munich, Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, United Kingdom
| | - James F Wilson
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, United Kingdom
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Laura M Yerges-Armstrong
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
- Genetics, GlaxoSmithKline, King of Prussia, PA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Weihua Zhang
- Cardiology, Ealing Hospital NHS Trust, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | | | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, NIA, Bethesda, MD
| | - Serkalem Demissie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Douglas P Kiel
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hersh AR, Boulos M, Caughey AB, Nielson CM. 131: Adolescent birth and hypertension in adulthood: evidence from NHANES 2005-2016. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2018.11.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fischer LE, Purnell JQ, Fino N, Nielson CM, Patti M, Wolfe BM. Risk Factors and Predictors of Hypoglycemia after Bariatric Surgery in the LABS Consortium. Surg Obes Relat Dis 2018. [DOI: 10.1016/j.soard.2018.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nielson CM, Rivelli JS, Fuoco MJ, Gawlik VR, Jimenez R, Petrik AF, Coronado GD. Effectiveness of automated and live phone reminders after mailed-FIT outreach in a pilot randomized trial. Prev Med Rep 2018; 12:210-213. [PMID: 30364785 PMCID: PMC6199768 DOI: 10.1016/j.pmedr.2018.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/09/2018] [Accepted: 10/14/2018] [Indexed: 12/28/2022] Open
Abstract
The effectiveness of annual mailed fecal immunochemical testing (FIT) outreach is highest when return rates are optimized, which is aided by patient reminders. In a pilot patient-randomized controlled trial in two western Washington clinics of the Sea Mar Community Health Centers, we compared the effectiveness of two phone-based approaches to mailed FIT outreach reminders. In fall 2016, patients ages 50–75, due for colorectal cancer screening, and with a visit in the previous year at either of two clinics, were mailed an introductory letter and FIT. Those who did not return the FIT within 3 weeks (N = 427) were randomized to receive either: a) a series of up to 6 automated phone reminders; or b) the combination of automated and live phone reminders (up to 6 in total). The sole outcome was FIT return within 6 months after the FIT mailing. FIT completion rates were similar in the groups assigned to receive automated calls vs automated plus live calls (40% vs 39%; p = 0.89). The effectiveness of FIT reminder mode differed by language preference (p for interaction = 0.03): among Spanish-preferring patients (n = 106), FIT return rates were higher in the automated-only group than to the auto- plus live-call group (62% vs 39%, p = 0.02). Among English-preferring patients, no difference in modes was observed (n = 279, 32% vs 34%, p = 0.74). We observed no added benefit of live reminder calls in a mailed FIT plus automated call reminder program; our findings may inform efforts to efficiently optimize mailed-FIT outreach programs. ClinicalTrials.gov identifier NCT01742065
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Affiliation(s)
- Carrie M Nielson
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Jennifer S Rivelli
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Morgan J Fuoco
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | | | | | - Amanda F Petrik
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Gloria D Coronado
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
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Suri P, Palmer MR, Tsepilov YA, Freidin MB, Boer CG, Yau MS, Evans DS, Gelemanovic A, Bartz TM, Nethander M, Arbeeva L, Karssen L, Neogi T, Campbell A, Mellstrom D, Ohlsson C, Marshall LM, Orwoll E, Uitterlinden A, Rotter JI, Lauc G, Psaty BM, Karlsson MK, Lane NE, Jarvik GP, Polasek O, Hochberg M, Jordan JM, Van Meurs JBJ, Jackson R, Nielson CM, Mitchell BD, Smith BH, Hayward C, Smith NL, Aulchenko YS, Williams FMK. Genome-wide meta-analysis of 158,000 individuals of European ancestry identifies three loci associated with chronic back pain. PLoS Genet 2018; 14:e1007601. [PMID: 30261039 PMCID: PMC6159857 DOI: 10.1371/journal.pgen.1007601] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [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: 01/30/2018] [Accepted: 08/02/2018] [Indexed: 01/07/2023] Open
Abstract
Back pain is the #1 cause of years lived with disability worldwide, yet surprisingly little is known regarding the biology underlying this symptom. We conducted a genome-wide association study (GWAS) meta-analysis of chronic back pain (CBP). Adults of European ancestry were included from 15 cohorts in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and from the UK Biobank interim data release. CBP cases were defined as those reporting back pain present for ≥3-6 months; non-cases were included as comparisons ("controls"). Each cohort conducted genotyping using commercially available arrays followed by imputation. GWAS used logistic regression models with additive genetic effects, adjusting for age, sex, study-specific covariates, and population substructure. The threshold for genome-wide significance in the fixed-effect inverse-variance weighted meta-analysis was p<5×10(-8). Suggestive (p<5×10(-7)) and genome-wide significant (p<5×10(-8)) variants were carried forward for replication or further investigation in the remaining UK Biobank participants not included in the discovery sample. The discovery sample comprised 158,025 individuals, including 29,531 CBP cases. A genome-wide significant association was found for the intronic variant rs12310519 in SOX5 (OR 1.08, p = 7.2×10(-10)). This was subsequently replicated in 283,752 UK Biobank participants not included in the discovery sample, including 50,915 cases (OR 1.06, p = 5.3×10(-11)), and exceeded genome-wide significance in joint meta-analysis (OR 1.07, p = 4.5×10(-19)). We found suggestive associations at three other loci in the discovery sample, two of which exceeded genome-wide significance in joint meta-analysis: an intergenic variant, rs7833174, located between CCDC26 and GSDMC (OR 1.05, p = 4.4×10(-13)), and an intronic variant, rs4384683, in DCC (OR 0.97, p = 2.4×10(-10)). In this first reported meta-analysis of GWAS for CBP, we identified and replicated a genetic locus associated with CBP (SOX5). We also identified 2 other loci that reached genome-wide significance in a 2-stage joint meta-analysis (CCDC26/GSDMC and DCC).
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Affiliation(s)
- Pradeep Suri
- Seattle Epidemiologic Research and Information Center (ERIC), Department of Veterans Affairs Office of Research and Development, Seattle, Washington, United States of America
- Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington, United States of America
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America
| | - Melody R. Palmer
- Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Yakov A. Tsepilov
- Polyomica, ‘s-Hertogenbosch, the Netherlands
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, Russia
- Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics SD RAS, Novosibirsk, Russia
| | - Maxim B. Freidin
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Cindy G. Boer
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Michelle S. Yau
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Andrea Gelemanovic
- Department of Public Health, University of Split Medical School, Split, Croatia
| | - Traci M. Bartz
- Cardiovascular Health Research Unit and Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Maria Nethander
- Department of Medicine, University of Göteborg, Göteborg, Sweden
| | - Liubov Arbeeva
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | | | - Tuhina Neogi
- Clinical Epidemiology Unit, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Dan Mellstrom
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Sweden
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Lynn M. Marshall
- Department of Orthopedics and Rehabilitation, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Eric Orwoll
- Department of Medicine, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Andre Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California, United States of America
- Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Gordan Lauc
- Genos Ltd, Osijek, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit and Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Health Services, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, United States of America
| | - Magnus K. Karlsson
- Department of Orthopedics, Skane University Hospital, Lund University, Malmö, Sweden
| | - Nancy E. Lane
- Departments of Medicine and Rheumatology, University of California Davis, Sacramento, California, United States of America
| | - Gail P. Jarvik
- Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Ozren Polasek
- Department of Public Health, University of Split Medical School, Split, Croatia
- Hospital “Sveti Ivan”, Zagreb, Croatia
| | - Marc Hochberg
- Departments of Medicine and Epidemiology, University of Maryland, Baltimore, Maryland, United States of America
| | - Joanne M. Jordan
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | | | - Rebecca Jackson
- Department of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Carrie M. Nielson
- School of Public Health, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Braxton D. Mitchell
- Departments of Medicine and Epidemiology, University of Maryland, Baltimore, Maryland, United States of America
- Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Baltimore, Maryland, United States of America
| | - Blair H. Smith
- Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Caroline Hayward
- MRC Human Genetics Unit, MRC Institute of Genetics & Molecular Medicine, University of Edinburgh, United Kingdom
| | - Nicholas L. Smith
- Seattle Epidemiologic Research and Information Center (ERIC), Department of Veterans Affairs Office of Research and Development, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, United States of America
| | | | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
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Nielson CM, Petrik AF, Jacob L, Vollmer WM, Keast EM, Schneider JL, Rivelli JS, Kapka TJ, Meenan RT, Mummadi RR, Green BB, Coronado GD. Positive predictive values of fecal immunochemical tests used in the STOP CRC pragmatic trial. Cancer Med 2018; 7:4781-4790. [PMID: 30101513 PMCID: PMC6144161 DOI: 10.1002/cam4.1727] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/06/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
Annual fecal immunochemical testing (FIT) is cost-effective for colorectal cancer (CRC) screening. However, FIT positivity rates and positive predictive value (PPV) can vary substantially, with false-positive (FP) results adding to colonoscopy burden without improving cancer detection. Our objective was to describe FIT PPV and the factors associated with FP results among patients undergoing CRC screening. In an ongoing pragmatic clinical trial of mailed-FIT outreach, clinics delivered one of three FIT brands (InSure, OC-Micro, and Hemosure). Patients who had a positive FIT result and a follow-up colonoscopy were included in this analysis (N = 1130). Patients' demographic and medical histories were abstracted from electronic health records (EHR). Associations with a FP result (ie, a positive FIT result with no evidence of advanced neoplasia during follow-up colonoscopy) were evaluated for FIT brand and patient factors using mixed-effects multivariable logistic regression. The mean proportion of FIT-positive results ranged from 8% in centers using the OC-Micro test to 21% for Hemosure. PPVs for advanced neoplasia were 0.30 to 0.17, respectively (P for χ2 = 0.08). In multivariable-adjusted models, use of Hemosure was associated with greater odds of a FP result than OC-Micro (OR = 2.00, 95% CI: 0.47-8.56) or InSure (OR = 1.72, 95% CI: 0.44-6.68). However, only female sex (OR = 1.58, 95% CI: 1.19-2.10) and history of a colorectal condition (OR = 2.17, 95% CI: 1.13-4.15) were significantly associated with FP. In conclusion, FIT positivity varied by brand, and FP results differed by patient factors available through the EHR. These results can be used to minimize the frequency of FP results, reducing patient distress and colonoscopy burden.
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Affiliation(s)
| | | | | | | | - Erin M. Keast
- Kaiser Permanente Center for Health ResearchPortlandOregon
| | | | | | - Tanya J. Kapka
- Kaiser Permanente Center for Health ResearchPortlandOregon
| | | | | | - Beverly B. Green
- Kaiser Permanente Washington Health Research InstituteSeattleWashington
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Wright NC, Hooker ER, Nielson CM, Ensrud KE, Harrison SL, Orwoll ES, Barrett-Connor E. The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int 2018; 29:859-870. [PMID: 29344692 PMCID: PMC5939930 DOI: 10.1007/s00198-017-4349-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023]
Abstract
UNLABELLED There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance. INTRODUCTION To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study. METHODS Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks. RESULTS We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65-69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake. CONCLUSIONS Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney function and the inability to perform the grip strength test.
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Affiliation(s)
- N C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - E R Hooker
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - C M Nielson
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - K E Ensrud
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - S L Harrison
- San Francisco Coordinating Center, University of California, San Francisco, San Francisco, CA, USA
| | - E S Orwoll
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA
| | - E Barrett-Connor
- Division of Epidemiology, Department of Family Medicine and Public Health, University of San Diego School of Medicine, La Jolla, CA, USA.
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Orwoll ES, Wiedrick J, Jacobs J, Baker ES, Piehowski P, Petyuk V, Gao Y, Shi T, Smith RD, Bauer DC, Cummings SR, Nielson CM, Lapidus J. High-throughput serum proteomics for the identification of protein biomarkers of mortality in older men. Aging Cell 2018; 17. [PMID: 29399943 PMCID: PMC5847880 DOI: 10.1111/acel.12717] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2017] [Indexed: 01/17/2023] Open
Abstract
The biological perturbations associated with incident mortality are not well elucidated, and there are limited biomarkers for the prediction of mortality. We used a novel high‐throughput proteomics approach to identify serum peptides and proteins associated with 5‐year mortality in community‐dwelling men age ≥65 years who participated in a longitudinal observational study of musculoskeletal aging (Osteoporotic Fractures in Men: MrOS). In a discovery phase, serum specimens collected at baseline in 2473 men were analyzed using liquid chromatography–ion mobility–mass spectrometry, and incident mortality in the subsequent 5 years was ascertained by tri‐annual questionnaire. Rigorous statistical methods were utilized to identify 56 peptides (31 proteins) that were associated with 5‐year mortality. In an independent replication phase, selected reaction monitoring was used to examine 21 of those peptides in baseline serum from 750 additional men; 81% of those peptides remained significantly associated with mortality. Mortality‐associated proteins included a variety involved in inflammation or complement activation; several have been previously linked to mortality (e.g., C‐reactive protein, alpha 1‐antichymotrypsin) and others are not previously known to be associated with mortality. Other novel proteins of interest included pregnancy‐associated plasma protein, VE‐cadherin, leucine‐rich α‐2 glycoprotein 1, vinculin, vitronectin, mast/stem cell growth factor receptor, and Saa4. A panel of peptides improved the predictive value of a commonly used clinical predictor of mortality. Overall, these results suggest that complex inflammatory pathways, and proteins in other pathways, are linked to 5‐year mortality risk. This work may serve to identify novel biomarkers for near‐term mortality.
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Affiliation(s)
| | | | - Jon Jacobs
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Erin S. Baker
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Paul Piehowski
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Vladislav Petyuk
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Yuqian Gao
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Tujin Shi
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Richard D. Smith
- Biological Science Division; Pacific Northwest National Laboratory; Richland WA USA
| | - Douglas C. Bauer
- Department of Medicine; University of California; San Francisco CA USA
| | - Steven R Cummings
- California Pacific Medical Center Research Institute; San Francisco CA USA
| | | | - Jodi Lapidus
- Oregon Health & Science University; Portland OR USA
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Eriksson AL, Perry JRB, Coviello AD, Delgado GE, Ferrucci L, Hoffman AR, Huhtaniemi IT, Ikram MA, Karlsson MK, Kleber ME, Laughlin GA, Liu Y, Lorentzon M, Lunetta KL, Mellström D, Murabito JM, Murray A, Nethander M, Nielson CM, Prokopenko I, Pye SR, Raffel LJ, Rivadeneira F, Srikanth P, Stolk L, Teumer A, Travison TG, Uitterlinden AG, Vaidya D, Vanderschueren D, Zmuda JM, März W, Orwoll ES, Ouyang P, Vandenput L, Wu FCW, de Jong FH, Bhasin S, Kiel DP, Ohlsson C. Genetic Determinants of Circulating Estrogen Levels and Evidence of a Causal Effect of Estradiol on Bone Density in Men. J Clin Endocrinol Metab 2018; 103:991-1004. [PMID: 29325096 PMCID: PMC5868407 DOI: 10.1210/jc.2017-02060] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/04/2018] [Indexed: 12/24/2022]
Abstract
Context Serum estradiol (E2) and estrone (E1) levels exhibit substantial heritability. Objective To investigate the genetic regulation of serum E2 and E1 in men. Design, Setting, and Participants Genome-wide association study in 11,097 men of European origin from nine epidemiological cohorts. Main Outcome Measures Genetic determinants of serum E2 and E1 levels. Results Variants in/near CYP19A1 demonstrated the strongest evidence for association with E2, resolving to three independent signals. Two additional independent signals were found on the X chromosome; FAMily with sequence similarity 9, member B (FAM9B), rs5934505 (P = 3.4 × 10-8) and Xq27.3, rs5951794 (P = 3.1 × 10-10). E1 signals were found in CYP19A1 (rs2899472, P = 5.5 × 10-23), in Tripartite motif containing 4 (TRIM4; rs17277546, P = 5.8 × 10-14), and CYP11B1/B2 (rs10093796, P = 1.2 × 10-8). E2 signals in CYP19A1 and FAM9B were associated with bone mineral density (BMD). Mendelian randomization analysis suggested a causal effect of serum E2 on BMD in men. A 1 pg/mL genetically increased E2 was associated with a 0.048 standard deviation increase in lumbar spine BMD (P = 2.8 × 10-12). In men and women combined, CYP19A1 alleles associated with higher E2 levels were associated with lower degrees of insulin resistance. Conclusions Our findings confirm that CYP19A1 is an important genetic regulator of E2 and E1 levels and strengthen the causal importance of E2 for bone health in men. We also report two independent loci on the X-chromosome for E2, and one locus each in TRIM4 and CYP11B1/B2, for E1.
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Affiliation(s)
- Anna L Eriksson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - John R B Perry
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | | | - Graciela E Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland
| | - Andrew R Hoffman
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California
| | - Ilpo T Huhtaniemi
- Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Magnus K Karlsson
- Department of Orthopaedics and Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Marcus E Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gail A Laughlin
- Family Medicine and Public Health, University of California-San Diego, San Diego, California
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg and Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kathryn L Lunetta
- Boston University School of Public Health, Boston, Massachusetts
- Framingham Heart Study, Framingham, Massachusetts
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg and Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Joanne M Murabito
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Anna Murray
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Maria Nethander
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Carrie M Nielson
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | - Inga Prokopenko
- Department of Genomics of Common Disease, School of Public Health, Imperial College London, London, United Kingdom
- Hammersmith Hospital, London, United Kingdom
| | - Stephen R Pye
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Leslie J Raffel
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of California, Irvine, California
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Priya Srikanth
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Thomas G Travison
- Institute for Aging Research, Hebrew Senior Life and Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - André G Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Dhananjay Vaidya
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dirk Vanderschueren
- Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Laboratory of Clinical and Experimental Endocrinology, Leuven, Belgium
| | - Joseph M Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Winfried März
- Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Eric S Orwoll
- Bone & Mineral Unit, Oregon Health & Science University, Portland, Oregon
| | - Pamela Ouyang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Frederick C W Wu
- Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, Faculty of Medical and Human Sciences, The University of Manchester, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Frank H de Jong
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas P Kiel
- Framingham Heart Study, Framingham, Massachusetts
- Institute for Aging Research, Hebrew Senior Life and Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Alonso N, Estrada K, Albagha OME, Herrera L, Reppe S, Olstad OK, Gautvik KM, Ryan NM, Evans KL, Nielson CM, Hsu YH, Kiel DP, Markozannes G, Ntzani EE, Evangelou E, Feenstra B, Liu X, Melbye M, Masi L, Brandi ML, Riches P, Daroszewska A, Olmos JM, Valero C, Castillo J, Riancho JA, Husted LB, Langdahl BL, Brown MA, Duncan EL, Kaptoge S, Khaw KT, Usategui-Martín R, Del Pino-Montes J, González-Sarmiento R, Lewis JR, Prince RL, D’Amelio P, García-Giralt N, NoguéS X, Mencej-Bedrac S, Marc J, Wolstein O, Eisman JA, Oei L, Medina-Gómez C, Schraut KE, Navarro P, Wilson JF, Davies G, Starr J, Deary I, Tanaka T, Ferrucci L, Gianfrancesco F, Gennari L, Lucas G, Elosua R, Uitterlinden AG, Rivadeneira F, Ralston SH. Identification of a novel locus on chromosome 2q13, which predisposes to clinical vertebral fractures independently of bone density. Ann Rheum Dis 2018; 77:378-385. [PMID: 29170203 PMCID: PMC5912156 DOI: 10.1136/annrheumdis-2017-212469] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/01/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To identify genetic determinants of susceptibility to clinical vertebral fractures, which is an important complication of osteoporosis. METHODS Here we conduct a genome-wide association study in 1553 postmenopausal women with clinical vertebral fractures and 4340 controls, with a two-stage replication involving 1028 cases and 3762 controls. Potentially causal variants were identified using expression quantitative trait loci (eQTL) data from transiliac bone biopsies and bioinformatic studies. RESULTS A locus tagged by rs10190845 was identified on chromosome 2q13, which was significantly associated with clinical vertebral fracture (P=1.04×10-9) with a large effect size (OR 1.74, 95% CI 1.06 to 2.6). Bioinformatic analysis of this locus identified several potentially functional SNPs that are associated with expression of the positional candidate genes TTL (tubulin tyrosine ligase) and SLC20A1 (solute carrier family 20 member 1). Three other suggestive loci were identified on chromosomes 1p31, 11q12 and 15q11. All these loci were novel and had not previously been associated with bone mineral density or clinical fractures. CONCLUSION We have identified a novel genetic variant that is associated with clinical vertebral fractures by mechanisms that are independent of BMD. Further studies are now in progress to validate this association and evaluate the underlying mechanism.
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Affiliation(s)
- Nerea Alonso
- Rheumatology and Bone disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Karol Estrada
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Omar M E Albagha
- Rheumatology and Bone disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Doha, Qatar
| | - Lizbeth Herrera
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Sjur Reppe
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Clinical Biochemistry, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ole K Olstad
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Kaare M Gautvik
- Department of Clinical Biochemistry, Lovisenberg Diakonale Hospital, Oslo, Norway
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Niamh M Ryan
- Centre for Genomic and Experimental Medicine, IGMM, University of Edinburgh, Edinburgh, UK
| | - Kathryn L Evans
- Centre for Genomic and Experimental Medicine, IGMM, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Carrie M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Yi-Hsiang Hsu
- Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
- BROAD Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Musculoskeletal Research Center, Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA
| | - Douglas P Kiel
- BROAD Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Musculoskeletal Research Center, Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - George Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Evangelia E Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Centre for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Rhode Island, USA
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Bjarke Feenstra
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Xueping Liu
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mads Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Stanford School of Medicine, Stanford, California, USA
| | - Laura Masi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Philip Riches
- Rheumatology and Bone disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Anna Daroszewska
- Rheumatology and Bone disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Institute of Ageing and Chronic Disease, The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, Liverpool, UK
| | - José Manuel Olmos
- Department of Internal Medicine, Hospital UM Valdecilla, University of Cantabria, IDIVAL, RETICEF, Santander, Spain
| | - Carmen Valero
- Department of Internal Medicine, Hospital UM Valdecilla, University of Cantabria, IDIVAL, RETICEF, Santander, Spain
| | - Jesús Castillo
- Department of Internal Medicine, Hospital UM Valdecilla, University of Cantabria, IDIVAL, RETICEF, Santander, Spain
| | - José A Riancho
- Department of Internal Medicine, Hospital UM Valdecilla, University of Cantabria, IDIVAL, RETICEF, Santander, Spain
| | - Lise B Husted
- Department of Endocrinology and Internal Medicine THG, Aarhus University Hospital, Aarhus, Denmark
| | - Bente L Langdahl
- Department of Endocrinology and Internal Medicine THG, Aarhus University Hospital, Aarhus, Denmark
| | - Matthew A Brown
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Emma L Duncan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Endocrinology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Stephen Kaptoge
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, School of Medicine, University of Cambridge, Cambridge, UK
| | - Ricardo Usategui-Martín
- Molecular Medicine Unit, Department of Medicine and Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, University of Salamanca – CSIC, Salamanca, Spain
| | - Javier Del Pino-Montes
- Molecular Medicine Unit, Department of Medicine and Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, University of Salamanca – CSIC, Salamanca, Spain
| | - Rogelio González-Sarmiento
- Molecular Medicine Unit, Department of Medicine and Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, University of Salamanca – CSIC, Salamanca, Spain
| | - Joshua R Lewis
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Centre for Kidney Research, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Richard L Prince
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Patrizia D’Amelio
- Gerontology and Bone Metabolic Diseases Unit, Department of Medical Science, University of Torino, Torino, Italy
| | - Natalia García-Giralt
- Department of Internal Medicine, Hospital del Mar-IMIM, RETICEF, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Xavier NoguéS
- Department of Internal Medicine, Hospital del Mar-IMIM, RETICEF, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Simona Mencej-Bedrac
- Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Marc
- Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Orit Wolstein
- Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - John A Eisman
- Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Ling Oei
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Carolina Medina-Gómez
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Katharina E Schraut
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Edinburgh/British Heart Foundation Centre for Cardiovascular Science, QMRI, University of Edinburgh, Edinburgh, UK
| | - Pau Navarro
- MRC Human Genetics Unit, MRC, IGMM, University of Edinburgh, Edinburgh, UK
| | - James F Wilson
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- MRC Human Genetics Unit, MRC, IGMM, University of Edinburgh, Edinburgh, UK
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - John Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Ian Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, Maryland, USA
| | - Fernando Gianfrancesco
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council of Italy, Naples, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Gavin Lucas
- Grup de Recerca en Genètica i Epidemiologia Cardiovascular, IMIM, Barcelona, Spain
| | - Roberto Elosua
- Grup de Recerca en Genètica i Epidemiologia Cardiovascular, IMIM, Barcelona, Spain
| | - André G Uitterlinden
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Departments of Internal Medicine and Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Stuart H Ralston
- Rheumatology and Bone disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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Skeith AE, Stephens CQ, Nielson CM, Caughey AB. 143: Adolescent birth and diabetes in adulthood. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.10.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
UNLABELLED Cannabis use is rising in the USA. Its relationship to cannabinoid signaling in bone cells implies its use could affect bone mineral density (BMD) in the population. In a national survey of people ages 20-59, we found no association between self-reported cannabis use and BMD of the hip or spine. INTRODUCTION Cannabis is the most widely used illegal drug in the USA, and its recreational use has recently been approved in several US states. Cannabinoids play a role in bone homeostasis. We aimed to determine the association between cannabis use and BMD in US adults. METHODS In the National Health and Nutrition Examination Survey 2007-2010, 4743 participants between 20 and 59 years old, history of cannabis use was categorized into never, former (previous use, but not in last 30 days), light (1-4 days of use in last 30 days), and heavy (≥5 days of use in last 30 days). Multivariable linear regression was used to test the association between cannabis use and DXA BMD of the proximal femur and lumbar spine with adjustment for age, sex, BMI, and race/ethnicity among other BMD determinants. RESULTS Sixty percent of the population reported ever using cannabis; 47% were former users, 5% were light users, and 7% were heavy users. Heavy cannabis users were more likely to be male, have a lower BMI, increased daily alcohol intake, increased tobacco pack-years, and were more likely to have used other illegal drugs (cocaine, heroin, or methamphetamines). No association between cannabis and BMD was observed for any level of use (p ≥ 0.28). CONCLUSIONS A history of cannabis use, although highly prevalent and related to other risk factors for low BMD, was not independently associated with BMD in this cross-sectional study of American men and women.
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Affiliation(s)
- Donald Bourne
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA
| | - Wesley Plinke
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA
| | - Elizabeth R Hooker
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA
| | - Carrie M Nielson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.
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27
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Zillikens MC, Demissie S, Hsu YH, Yerges-Armstrong LM, Chou WC, Stolk L, Livshits G, Broer L, Johnson T, Koller DL, Kutalik Z, Luan J, Malkin I, Ried JS, Smith AV, Thorleifsson G, Vandenput L, Hua Zhao J, Zhang W, Aghdassi A, Åkesson K, Amin N, Baier LJ, Barroso I, Bennett DA, Bertram L, Biffar R, Bochud M, Boehnke M, Borecki IB, Buchman AS, Byberg L, Campbell H, Campos Obanda N, Cauley JA, Cawthon PM, Cederberg H, Chen Z, Cho NH, Jin Choi H, Claussnitzer M, Collins F, Cummings SR, De Jager PL, Demuth I, Dhonukshe-Rutten RAM, Diatchenko L, Eiriksdottir G, Enneman AW, Erdos M, Eriksson JG, Eriksson J, Estrada K, Evans DS, Feitosa MF, Fu M, Garcia M, Gieger C, Girke T, Glazer NL, Grallert H, Grewal J, Han BG, Hanson RL, Hayward C, Hofman A, Hoffman EP, Homuth G, Hsueh WC, Hubal MJ, Hubbard A, Huffman KM, Husted LB, Illig T, Ingelsson E, Ittermann T, Jansson JO, Jordan JM, Jula A, Karlsson M, Khaw KT, Kilpeläinen TO, Klopp N, Kloth JSL, Koistinen HA, Kraus WE, Kritchevsky S, Kuulasmaa T, Kuusisto J, Laakso M, Lahti J, Lang T, Langdahl BL, Launer LJ, Lee JY, Lerch MM, Lewis JR, Lind L, Lindgren C, Liu Y, Liu T, Liu Y, Ljunggren Ö, Lorentzon M, Luben RN, Maixner W, McGuigan FE, Medina-Gomez C, Meitinger T, Melhus H, Mellström D, Melov S, Michaëlsson K, Mitchell BD, Morris AP, Mosekilde L, Newman A, Nielson CM, O'Connell JR, Oostra BA, Orwoll ES, Palotie A, Parker SCJ, Peacock M, Perola M, Peters A, Polasek O, Prince RL, Räikkönen K, Ralston SH, Ripatti S, Robbins JA, Rotter JI, Rudan I, Salomaa V, Satterfield S, Schadt EE, Schipf S, Scott L, Sehmi J, Shen J, Soo Shin C, Sigurdsson G, Smith S, Soranzo N, Stančáková A, Steinhagen-Thiessen E, Streeten EA, Styrkarsdottir U, Swart KMA, Tan ST, Tarnopolsky MA, Thompson P, Thomson CA, Thorsteinsdottir U, Tikkanen E, Tranah GJ, Tuomilehto J, van Schoor NM, Verma A, Vollenweider P, Völzke H, Wactawski-Wende J, Walker M, Weedon MN, Welch R, Wichmann HE, Widen E, Williams FMK, Wilson JF, Wright NC, Xie W, Yu L, Zhou Y, Chambers JC, Döring A, van Duijn CM, Econs MJ, Gudnason V, Kooner JS, Psaty BM, Spector TD, Stefansson K, Rivadeneira F, Uitterlinden AG, Wareham NJ, Ossowski V, Waterworth D, Loos RJF, Karasik D, Harris TB, Ohlsson C, Kiel DP. Erratum: Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. Nat Commun 2017; 8:1414. [PMID: 29116125 PMCID: PMC5676783 DOI: 10.1038/s41467-017-01008-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands
| | - Serkalem Demissie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Yi-Hsiang Hsu
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Molecular and Integrative Physiological Sciences Program, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Laura M Yerges-Armstrong
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Wen-Chi Chou
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Broad Institute, Cambridge, MA, 02142, USA
| | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands
| | - Gregory Livshits
- Sackler Faculty of Medicine, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, 6997801, Israel.,Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - Linda Broer
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Toby Johnson
- Department of Medical Genetics, University of Lausanne, Lausanne, 1011, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland.,Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Daniel L Koller
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Zoltán Kutalik
- Department of Medical Genetics, University of Lausanne, Lausanne, 1011, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland.,Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Jian'an Luan
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Ida Malkin
- Sackler Faculty of Medicine, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Janina S Ried
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, 201, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | | | - Liesbeth Vandenput
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Weihua Zhang
- Department Epidemiology and Biostatistics, School of Public Health, Imperial College, London, SW7 2AZ, UK.,Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK
| | - Ali Aghdassi
- Department of Medicine A, University of Greifswald, Greifswald, 17489, Germany
| | - Kristina Åkesson
- Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden.,Department of Orthopedics, Skåne University Hospital, Malmö, S-205 02, Sweden
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Leslie J Baier
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK.,NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, CB2 OQQ, UK.,Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge Metabolic Research Laboratories, Cambridge, CB2 OQQ, UK
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Experimental & Integrative Genomics, University of Lübeck, Lübeck, 23562, Germany.,School of Public Health, Faculty of Medicine, Imperial College London, London, W6 8RP, UK
| | - Rainer Biffar
- Centre of Oral Health, Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, 17489, Germany
| | - Murielle Bochud
- Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ingrid B Borecki
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA.,Division of Biostatistics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Liisa Byberg
- Department of Surgical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Harry Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK
| | | | - Jane A Cauley
- Department of Epidemiology Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Henna Cederberg
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Zhao Chen
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85714, USA
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Youngtong-Gu, Suwon, 16499, Korea
| | - Hyung Jin Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea.,Department of Internal Medicine, Chungbuk National University Hospital, Cheongju Si, Korea
| | - Melina Claussnitzer
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Broad Institute, Cambridge, MA, 02142, USA.,Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA, 02139, USA.,Institute of Human Genetics, MRI, Technische Universität München, Munich, 81675, Germany.,Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Francis Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, MD, 20892, USA
| | - Steven R Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Philip L De Jager
- Harvard Medical School, Boston, MA, 02115, USA.,Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, 02142, USA
| | - Ilja Demuth
- Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 13353, Germany.,Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Berlin, 13353, Germany
| | | | - Luda Diatchenko
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, H3A 0G1, Canada.,Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | | | - Anke W Enneman
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Mike Erdos
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, MD, 20892, USA
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, 00014, Finland.,Unit of General Practice, Helsinki University Central Hospital, Helsinki, 00014, Finland.,Folkhalsan Research Centre, Helsinki, 00250, Finland.,Vasa Central Hospital, Vasa, 65130, Finland.,National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Joel Eriksson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Karol Estrada
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Mao Fu
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Melissa Garcia
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Christian Gieger
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Thomas Girke
- Institute for Integrative Genome Biology, University of California, Riverside, CA, 92521, USA.,Department of Botany and Plant Sciences, University of California, Riverside, CA, 92521, USA
| | - Nicole L Glazer
- Departments of Medicine and Epidemiology, Boston University School of Medicine and Public Health, Boston, MA, 02118, USA
| | - Harald Grallert
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Department of Botany and Plant Sciences, University of California, Riverside, CA, 92521, USA.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,CCG Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, 85764, Germany.,CCG Nutrigenomics and Type 2 Diabetes. Helmholtz Zentrum München, Neuherberg, 85764, Germany
| | - Jagvir Grewal
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Bok-Ghee Han
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Chungcheongbuk-do, 28159, Korea
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Caroline Hayward
- MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh, Scotland, EH4 2XU, UK
| | - Albert Hofman
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Eric P Hoffman
- Department of Pharmaceutical Sciences, SUNY Binghamton, Binghamton, NY, 13902, USA
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, 17487, Germany
| | - Wen-Chi Hsueh
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Monica J Hubal
- Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC, 20052, USA.,Research Center for Genetic Medicine, Children's National Medical Center, Washington, DC, 20052, USA
| | - Alan Hubbard
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Kim M Huffman
- Division of Rheumatology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Lise B Husted
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Department of Human Genetics, Hannover Medical School, Hannover, 30625, Germany.,Hannover Unified Biobank, Hannover Medical School, Hannover, 30625, Germany
| | - Erik Ingelsson
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden.,Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Till Ittermann
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - John-Olov Jansson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 405 30, Sweden
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA
| | - Antti Jula
- National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Magnus Karlsson
- Department of Clinical Sciences and Orthopaedics, Lund University, Skåne University Hospital SUS, Malmö, 22362, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Tuomas O Kilpeläinen
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, 2100, Denmark.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Norman Klopp
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Hannover Unified Biobank, Hannover Medical School, Hannover, 30625, Germany
| | | | - Heikki A Koistinen
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland.,Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, 00271, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, 00290, Finland
| | - William E Kraus
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Stephen Kritchevsky
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Teemu Kuulasmaa
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, FI00014, Finland
| | - Thomas Lang
- University of California San Francisco, San Francisco, CA, 94143, USA
| | - Bente L Langdahl
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Jong-Young Lee
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Chungcheongbuk-do, 28159, Korea
| | - Markus M Lerch
- Department of Medicine A, University of Greifswald, Greifswald, 17489, Germany
| | - Joshua R Lewis
- School of Medicine and Pharmacology, University of Western Australia, Perth, 6009, Australia.,Centre for Kidney Research, School of Public Health, University of Sydney, Sydney, 2006, Australia
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Cecilia Lindgren
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, OX3 7BN, UK
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, 27517, USA
| | - Tian Liu
- Max Planck Institute for Molecular Genetics, Berlin, 14195, Germany.,Max Planck Institute for Human Development, Berlin, 14195, Germany
| | - Youfang Liu
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA
| | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Mattias Lorentzon
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Robert N Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - William Maixner
- Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Fiona E McGuigan
- Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Thomas Meitinger
- Institute of Human Genetics, MRI, Technische Universität München, Munich, 81675, Germany.,Institute of Human Genetics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Håkan Melhus
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Dan Mellström
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Simon Melov
- Buck Institute for Research on Aging, Novato, CA, 94945, USA.,Leonard Davis School of Gerontology, University of Southern California, LA, CA, 90089, USA
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Braxton D Mitchell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, 21201, USA
| | - Andrew P Morris
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, OX3 7BN, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK
| | - Leif Mosekilde
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Anne Newman
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | | | - Jeffrey R O'Connell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Ben A Oostra
- Department of Clinical Genetics, Erasmus MC, Rotterdam, 300 CA, The Netherlands.,Centre for Medical Systems Biology and Netherlands Consortium on Healthy Aging, Leiden, RC2300, The Netherlands
| | - Eric S Orwoll
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, FI00014, Finland
| | - Stephen C J Parker
- Human Genetics and Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Munro Peacock
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, 00271, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Diabetes and Obesity Research Program, University of Helsinki, Helsinki, FI00014, Finland.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Ozren Polasek
- Faculty of Medicine, Department of Public Health, University of Split, Split, 21000, Croatia
| | - Richard L Prince
- School of Medicine and Pharmacology, University of Western Australia, Perth, 6009, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gardiner Hospital, Perth, 6009, Australia
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, FI00014, Finland
| | - Stuart H Ralston
- Molecular Medicine Centre, MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, Scotland, EH4 2XU, UK
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Hjelt Institute, University of Helsinki, Helsinki, Finland.,Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK
| | - John A Robbins
- Department of Medicine, University of California at Davis, Sacramento, CA, 95817, USA
| | - Jerome I Rotter
- Institute for Translational Genomic and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor UCLA Medical Center, Torrance, CA, 90502, USA
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Eric E Schadt
- Department of Genetics and Genomic Science, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sabine Schipf
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - Laura Scott
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Joban Sehmi
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Jian Shen
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Gunnar Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,Department of Endocrinology and Metabolism, Landspitali, The National University Hospital of Iceland, Reykjavik, 101, Iceland
| | - Shad Smith
- Center for Translational Pain Medicine, Department of Anesthiology, Duke University Medical Center, Durham, NC, 27110, USA
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Elisabeth Steinhagen-Thiessen
- Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 13353, Germany
| | - Elizabeth A Streeten
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Geriatric Research and Education Clinical Center (GRECC) - Veterans Administration Medical Center, Baltimore, MD, 21201, USA
| | | | - Karin M A Swart
- Department of Epidemiology and Biostatistics, and the EMGO Institute, VU University Medical Center, Amsterdam, BT1081, The Netherlands
| | - Sian-Tsung Tan
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Mark A Tarnopolsky
- Department of Medicine, McMaster University Medical Center, Hamilton, ON, Canada, L8N 3Z5
| | - Patricia Thompson
- Department of Pathology, Stony Brook School of Medicine, Stony Brook, NY, 11794, USA
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85714, USA
| | - Unnur Thorsteinsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,deCODE Genetics, Reykjavik, 101, Iceland
| | - Emmi Tikkanen
- National Institute for Health and Welfare, Helsinki, 00271, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Molecular Medicine Centre, MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, Scotland, EH4 2XU, UK
| | - Gregory J Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Jaakko Tuomilehto
- Vasa Central Hospital, Vasa, 65130, Finland.,Department of Neuroscience and Preventive Medicine, Danube-University Krems, Krems, 3500, Austria.,Diabetes Research Group, King Abdulaziz University, Jeddah, 12589, Saudi Arabia.,Dasman Diabetes Institute, Dasman, 15462, Kuwait
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, and the EMGO Institute, VU University Medical Center, Amsterdam, BT1081, The Netherlands
| | - Arjun Verma
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK
| | - Peter Vollenweider
- Department of Medicine and Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, CH-1011, Switzerland
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - Mark Walker
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, EX1 2LU, UK
| | - Ryan Welch
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - H-Erich Wichmann
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology, Ludwig-Maximilians-Universität, Munich, 81377, Germany.,Institute of Medical Statistics and Epidemiology, Technical University, Munich, 81675, Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - James F Wilson
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK.,MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh, Scotland, EH4 2XU, UK
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Weijia Xie
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, EX1 2LU, UK
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - John C Chambers
- Department Epidemiology and Biostatistics, School of Public Health, Imperial College, London, SW7 2AZ, UK.,Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, SW3 6NP, UK.,Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Angela Döring
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands.,Centre for Medical Systems Biology and Netherlands Consortium on Healthy Aging, Leiden, RC2300, The Netherlands
| | - Michael J Econs
- Department of Medicine and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, 201, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Jaspal S Kooner
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK.,Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Bruce M Psaty
- Departments of Medicine, Epidemiology, and Health Services, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98101, USA.,Kaiser Permanente Washington Health Research Institute, Washington, Seattle, WA, 98101, USA
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - Kari Stefansson
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,deCODE Genetics, Reykjavik, 101, Iceland
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Vicky Ossowski
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Dawn Waterworth
- Medical Genetics, GlaxoSmithKline, Philadelphia, PA, 19112, USA
| | - Ruth J F Loos
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK.,The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Institute of Child Health and Development, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,The Genetics of Obesity and Related Traits Program, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - David Karasik
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, 1311502, Israel
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Claes Ohlsson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Douglas P Kiel
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA. .,Harvard Medical School, Boston, MA, 02115, USA. .,Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
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Zillikens MC, Demissie S, Hsu YH, Yerges-Armstrong LM, Chou WC, Stolk L, Livshits G, Broer L, Johnson T, Koller DL, Kutalik Z, Luan J, Malkin I, Ried JS, Smith AV, Thorleifsson G, Vandenput L, Hua Zhao J, Zhang W, Aghdassi A, Åkesson K, Amin N, Baier LJ, Barroso I, Bennett DA, Bertram L, Biffar R, Bochud M, Boehnke M, Borecki IB, Buchman AS, Byberg L, Campbell H, Campos Obanda N, Cauley JA, Cawthon PM, Cederberg H, Chen Z, Cho NH, Jin Choi H, Claussnitzer M, Collins F, Cummings SR, De Jager PL, Demuth I, Dhonukshe-Rutten RAM, Diatchenko L, Eiriksdottir G, Enneman AW, Erdos M, Eriksson JG, Eriksson J, Estrada K, Evans DS, Feitosa MF, Fu M, Garcia M, Gieger C, Girke T, Glazer NL, Grallert H, Grewal J, Han BG, Hanson RL, Hayward C, Hofman A, Hoffman EP, Homuth G, Hsueh WC, Hubal MJ, Hubbard A, Huffman KM, Husted LB, Illig T, Ingelsson E, Ittermann T, Jansson JO, Jordan JM, Jula A, Karlsson M, Khaw KT, Kilpeläinen TO, Klopp N, Kloth JSL, Koistinen HA, Kraus WE, Kritchevsky S, Kuulasmaa T, Kuusisto J, Laakso M, Lahti J, Lang T, Langdahl BL, Launer LJ, Lee JY, Lerch MM, Lewis JR, Lind L, Lindgren C, Liu Y, Liu T, Liu Y, Ljunggren Ö, Lorentzon M, Luben RN, Maixner W, McGuigan FE, Medina-Gomez C, Meitinger T, Melhus H, Mellström D, Melov S, Michaëlsson K, Mitchell BD, Morris AP, Mosekilde L, Newman A, Nielson CM, O'Connell JR, Oostra BA, Orwoll ES, Palotie A, Parker SCJ, Peacock M, Perola M, Peters A, Polasek O, Prince RL, Räikkönen K, Ralston SH, Ripatti S, Robbins JA, Rotter JI, Rudan I, Salomaa V, Satterfield S, Schadt EE, Schipf S, Scott L, Sehmi J, Shen J, Soo Shin C, Sigurdsson G, Smith S, Soranzo N, Stančáková A, Steinhagen-Thiessen E, Streeten EA, Styrkarsdottir U, Swart KMA, Tan ST, Tarnopolsky MA, Thompson P, Thomson CA, Thorsteinsdottir U, Tikkanen E, Tranah GJ, Tuomilehto J, van Schoor NM, Verma A, Vollenweider P, Völzke H, Wactawski-Wende J, Walker M, Weedon MN, Welch R, Wichmann HE, Widen E, Williams FMK, Wilson JF, Wright NC, Xie W, Yu L, Zhou Y, Chambers JC, Döring A, van Duijn CM, Econs MJ, Gudnason V, Kooner JS, Psaty BM, Spector TD, Stefansson K, Rivadeneira F, Uitterlinden AG, Wareham NJ, Ossowski V, Waterworth D, Loos RJF, Karasik D, Harris TB, Ohlsson C, Kiel DP. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. Nat Commun 2017; 8:80. [PMID: 28724990 PMCID: PMC5517526 DOI: 10.1038/s41467-017-00031-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 05/02/2017] [Indexed: 12/25/2022] Open
Abstract
Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p < 5 × 10−8) or suggestively genome wide (p < 2.3 × 10−6). Replication in 63,475 (47,227 of European ancestry) individuals from 33 cohorts for whole body lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass. Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.
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Affiliation(s)
- M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands
| | - Serkalem Demissie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Yi-Hsiang Hsu
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Molecular and Integrative Physiological Sciences Program, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Laura M Yerges-Armstrong
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Wen-Chi Chou
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Broad Institute, Cambridge, MA, 02142, USA
| | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands
| | - Gregory Livshits
- Sackler Faculty of Medicine, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, 6997801, Israel.,Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - Linda Broer
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Toby Johnson
- Department of Medical Genetics, University of Lausanne, Lausanne, 1011, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland.,Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Daniel L Koller
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Zoltán Kutalik
- Department of Medical Genetics, University of Lausanne, Lausanne, 1011, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland.,Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Jian'an Luan
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Ida Malkin
- Sackler Faculty of Medicine, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Janina S Ried
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur, 201, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | | | - Liesbeth Vandenput
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Weihua Zhang
- Department Epidemiology and Biostatistics, School of Public Health, Imperial College, London, SW7 2AZ, UK.,Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK
| | - Ali Aghdassi
- Department of Medicine A, University of Greifswald, Greifswald, 17489, Germany
| | - Kristina Åkesson
- Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden.,Department of Orthopedics, Skåne University Hospital, Malmö, S-205 02, Sweden
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Leslie J Baier
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK.,NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, CB2 OQQ, UK.,Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge Metabolic Research Laboratories, Cambridge, CB2 OQQ, UK
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics and Experimental & Integrative Genomics, University of Lübeck, Lübeck, 23562, Germany.,School of Public Health, Faculty of Medicine, Imperial College London, London, W6 8RP, UK
| | - Rainer Biffar
- Centre of Oral Health, Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University of Greifswald, Greifswald, 17489, Germany
| | - Murielle Bochud
- Centre Hospitalier Universitaire (CHUV), University Institute for Social and Preventive Medicine, Lausanne, 1010, Switzerland
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ingrid B Borecki
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA.,Division of Biostatistics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Liisa Byberg
- Department of Surgical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Harry Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK
| | | | - Jane A Cauley
- Department of Epidemiology Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Henna Cederberg
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Zhao Chen
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85714, USA
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Youngtong-Gu, Suwon, 16499, Korea
| | - Hyung Jin Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea.,Department of Internal Medicine, Chungbuk National University Hospital, Cheongju Si, Korea
| | - Melina Claussnitzer
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Broad Institute, Cambridge, MA, 02142, USA.,Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, MA, 02139, USA.,Institute of Human Genetics, MRI, Technische Universität München, Munich, 81675, Germany.,Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Francis Collins
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, MD, 20892, USA
| | - Steven R Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Philip L De Jager
- Harvard Medical School, Boston, MA, 02115, USA.,Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, 02142, USA
| | - Ilja Demuth
- Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 13353, Germany.,Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Berlin, 13353, Germany
| | | | - Luda Diatchenko
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, H3A 0G1, Canada.,Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | | | - Anke W Enneman
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Mike Erdos
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, MD, 20892, USA
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, 00014, Finland.,Unit of General Practice, Helsinki University Central Hospital, Helsinki, 00014, Finland.,Folkhalsan Research Centre, Helsinki, 00250, Finland.,Vasa Central Hospital, Vasa, 65130, Finland.,National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Joel Eriksson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Karol Estrada
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Mao Fu
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Melissa Garcia
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Christian Gieger
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Thomas Girke
- Institute for Integrative Genome Biology, University of California, Riverside, CA, 92521, USA.,Department of Botany and Plant Sciences, University of California, Riverside, CA, 92521, USA
| | - Nicole L Glazer
- Departments of Medicine and Epidemiology, Boston University School of Medicine and Public Health, Boston, MA, 02118, USA
| | - Harald Grallert
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Department of Botany and Plant Sciences, University of California, Riverside, CA, 92521, USA.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,CCG Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, 85764, Germany.,CCG Nutrigenomics and Type 2 Diabetes. Helmholtz Zentrum München, Neuherberg, 85764, Germany
| | - Jagvir Grewal
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Bok-Ghee Han
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Chungcheongbuk-do, 28159, Korea
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Caroline Hayward
- MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh, Scotland, EH4 2XU, UK
| | - Albert Hofman
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Eric P Hoffman
- Department of Pharmaceutical Sciences, SUNY Binghamton, Binghamton, NY, 13902, USA
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, 17487, Germany
| | - Wen-Chi Hsueh
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Monica J Hubal
- Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC, 20052, USA.,Research Center for Genetic Medicine, Children's National Medical Center, Washington, DC, 20052, USA
| | - Alan Hubbard
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Kim M Huffman
- Division of Rheumatology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Lise B Husted
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Department of Human Genetics, Hannover Medical School, Hannover, 30625, Germany.,Hannover Unified Biobank, Hannover Medical School, Hannover, 30625, Germany
| | - Erik Ingelsson
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden.,Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Till Ittermann
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - John-Olov Jansson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 405 30, Sweden
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA
| | - Antti Jula
- National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Magnus Karlsson
- Department of Clinical Sciences and Orthopaedics, Lund University, Skåne University Hospital SUS, Malmö, 22362, Sweden
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - Tuomas O Kilpeläinen
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, 2100, Denmark.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Norman Klopp
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Hannover Unified Biobank, Hannover Medical School, Hannover, 30625, Germany
| | | | - Heikki A Koistinen
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland.,Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, 00271, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, 00290, Finland
| | - William E Kraus
- Division of Cardiology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Stephen Kritchevsky
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Teemu Kuulasmaa
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, FI00014, Finland
| | - Thomas Lang
- University of California San Francisco, San Francisco, CA, 94143, USA
| | - Bente L Langdahl
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Jong-Young Lee
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Chungcheongbuk-do, 28159, Korea
| | - Markus M Lerch
- Department of Medicine A, University of Greifswald, Greifswald, 17489, Germany
| | - Joshua R Lewis
- School of Medicine and Pharmacology, University of Western Australia, Perth, 6009, Australia.,Centre for Kidney Research, School of Public Health, University of Sydney, Sydney, 2006, Australia
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Cecilia Lindgren
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, OX3 7BN, UK
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, 27517, USA
| | - Tian Liu
- Max Planck Institute for Molecular Genetics, Berlin, 14195, Germany.,Max Planck Institute for Human Development, Berlin, 14195, Germany
| | - Youfang Liu
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27517, USA
| | - Östen Ljunggren
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Mattias Lorentzon
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Robert N Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK
| | - William Maixner
- Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Fiona E McGuigan
- Department of Clinical Sciences, Lund University, Malmö, 22362, Sweden
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Thomas Meitinger
- Institute of Human Genetics, MRI, Technische Universität München, Munich, 81675, Germany.,Institute of Human Genetics, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Håkan Melhus
- Department of Medical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Dan Mellström
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Simon Melov
- Buck Institute for Research on Aging, Novato, CA, 94945, USA.,Leonard Davis School of Gerontology, University of Southern California, LA, CA, 90089, USA
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, 75185, Sweden
| | - Braxton D Mitchell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, 21201, USA
| | - Andrew P Morris
- Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, OX3 7BN, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK
| | - Leif Mosekilde
- Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DK 8000, Denmark
| | - Anne Newman
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | | | - Jeffrey R O'Connell
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Ben A Oostra
- Department of Clinical Genetics, Erasmus MC, Rotterdam, 300 CA, The Netherlands.,Centre for Medical Systems Biology and Netherlands Consortium on Healthy Aging, Leiden, RC2300, The Netherlands
| | - Eric S Orwoll
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, FI00014, Finland
| | - Stephen C J Parker
- Human Genetics and Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Munro Peacock
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, 00271, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Diabetes and Obesity Research Program, University of Helsinki, Helsinki, FI00014, Finland.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Ozren Polasek
- Faculty of Medicine, Department of Public Health, University of Split, Split, 21000, Croatia
| | - Richard L Prince
- School of Medicine and Pharmacology, University of Western Australia, Perth, 6009, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gardiner Hospital, Perth, 6009, Australia
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, FI00014, Finland
| | - Stuart H Ralston
- Molecular Medicine Centre, MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, Scotland, EH4 2XU, UK
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Hjelt Institute, University of Helsinki, Helsinki, Finland.,Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK
| | - John A Robbins
- Department of Medicine, University of California at Davis, Sacramento, CA, 95817, USA
| | - Jerome I Rotter
- Institute for Translational Genomic and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor UCLA Medical Center, Torrance, CA, 90502, USA
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Eric E Schadt
- Department of Genetics and Genomic Science, Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sabine Schipf
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - Laura Scott
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Joban Sehmi
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Jian Shen
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Gunnar Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,Department of Endocrinology and Metabolism, Landspitali, The National University Hospital of Iceland, Reykjavik, 101, Iceland
| | - Shad Smith
- Center for Translational Pain Medicine, Department of Anesthiology, Duke University Medical Center, Durham, NC, 27110, USA
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA, UK
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, 70210, Finland
| | - Elisabeth Steinhagen-Thiessen
- Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 13353, Germany
| | - Elizabeth A Streeten
- Program in Personalized and Genomic Medicine, and Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.,Geriatric Research and Education Clinical Center (GRECC) - Veterans Administration Medical Center, Baltimore, MD, 21201, USA
| | | | - Karin M A Swart
- Department of Epidemiology and Biostatistics, and the EMGO Institute, VU University Medical Center, Amsterdam, BT1081, The Netherlands
| | - Sian-Tsung Tan
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Mark A Tarnopolsky
- Department of Medicine, McMaster University Medical Center, Hamilton, ON, Canada, L8N 3Z5
| | - Patricia Thompson
- Department of Pathology, Stony Brook School of Medicine, Stony Brook, NY, 11794, USA
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85714, USA
| | - Unnur Thorsteinsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,deCODE Genetics, Reykjavik, 101, Iceland
| | - Emmi Tikkanen
- National Institute for Health and Welfare, Helsinki, 00271, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland.,Molecular Medicine Centre, MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, Scotland, EH4 2XU, UK
| | - Gregory J Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA
| | - Jaakko Tuomilehto
- Vasa Central Hospital, Vasa, 65130, Finland.,Department of Neuroscience and Preventive Medicine, Danube-University Krems, Krems, 3500, Austria.,Diabetes Research Group, King Abdulaziz University, Jeddah, 12589, Saudi Arabia.,Dasman Diabetes Institute, Dasman, 15462, Kuwait
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, and the EMGO Institute, VU University Medical Center, Amsterdam, BT1081, The Netherlands
| | - Arjun Verma
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK
| | - Peter Vollenweider
- Department of Medicine and Internal Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, CH-1011, Switzerland
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, 17489, Germany
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - Mark Walker
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, EX1 2LU, UK
| | - Ryan Welch
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - H-Erich Wichmann
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology, Ludwig-Maximilians-Universität, Munich, 81377, Germany.,Institute of Medical Statistics and Epidemiology, Technical University, Munich, 81675, Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, 00251, Finland
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - James F Wilson
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK.,MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh, Scotland, EH4 2XU, UK
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Weijia Xie
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, EX1 2LU, UK
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - John C Chambers
- Department Epidemiology and Biostatistics, School of Public Health, Imperial College, London, SW7 2AZ, UK.,Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, SW3 6NP, UK.,Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Angela Döring
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany.,Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands.,Centre for Medical Systems Biology and Netherlands Consortium on Healthy Aging, Leiden, RC2300, The Netherlands
| | - Michael J Econs
- Department of Medicine and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, 201, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Jaspal S Kooner
- Cardiology Department, Ealing Hospital NHS Trust, Middlesex, UB1 3HW, UK.,National Heart and Lung Institute, Imperial College London, London, SW3 6LY, UK.,Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Bruce M Psaty
- Departments of Medicine, Epidemiology, and Health Services, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98101, USA.,Kaiser Permanente Washington Health Research Institute, Washington, Seattle, WA, 98101, USA
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Campus, London, WC2R 2LS, UK
| | - Kari Stefansson
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,deCODE Genetics, Reykjavik, 101, Iceland
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, 3000, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, 2593, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, 3000, The Netherlands
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK
| | - Vicky Ossowski
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Phoenix, AZ, 85014, USA
| | - Dawn Waterworth
- Medical Genetics, GlaxoSmithKline, Philadelphia, PA, 19112, USA
| | - Ruth J F Loos
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 OQQ, UK.,The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Institute of Child Health and Development, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,The Genetics of Obesity and Related Traits Program, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - David Karasik
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA.,Harvard Medical School, Boston, MA, 02115, USA.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, 1311502, Israel
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute for Aging, Bethesda, MD, 20892, USA
| | - Claes Ohlsson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden
| | - Douglas P Kiel
- Hebrew SeniorLife, Institute for Aging Research, Roslindale, MA, 02131, USA. .,Harvard Medical School, Boston, MA, 02115, USA. .,Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
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29
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Nielson CM, Wiedrick J, Shen J, Jacobs J, Baker ES, Baraff A, Piehowski P, Lee CG, Baratt A, Petyuk V, McWeeney S, Lim JY, Bauer DC, Lane NE, Cawthon PM, Smith RD, Lapidus J, Orwoll ES. Identification of Hip BMD Loss and Fracture Risk Markers Through Population-Based Serum Proteomics. J Bone Miner Res 2017; 32:1559-1567. [PMID: 28316103 PMCID: PMC5489383 DOI: 10.1002/jbmr.3125] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/22/2017] [Accepted: 03/06/2017] [Indexed: 01/16/2023]
Abstract
Serum proteomics analysis may lead to the discovery of novel osteoporosis biomarkers. The Osteoporotic Fractures in Men (MrOS) study comprises men ≥65 years old in the US who have had repeated BMD measures and have been followed for incident fracture. High-throughput quantitative proteomic analysis was performed on baseline fasting serum samples from non-Hispanic white men using a multidimensional approach coupling liquid chromatography, ion-mobility separation, and mass spectrometry (LC-IMS-MS). We followed the participants for a mean of 4.6 years for changes in femoral neck bone mineral density (BMD) and for incident hip fracture. Change in BMD was determined from mixed effects regression models taking age and weight into account. Participants were categorized into three groups: BMD maintenance (no decline; estimated change ≥0 g/cm2 , n = 453); expected loss (estimated change 0 to 1 SD below the estimated mean change, -0.034 g/cm2 for femoral neck, n = 1184); and accelerated loss (estimated change ≥1 SD below mean change, n = 237). Differential abundance values of 3946 peptides were summarized by meta-analysis to determine differential abundance of each of 339 corresponding proteins for accelerated BMD loss versus maintenance. Using this meta-analytic standardized fold change at cutoffs of ≥1.1 or ≤0.9 (p < 0.10), 20 proteins were associated with accelerated BMD loss. Associations of those 20 proteins with incident hip fracture were tested using Cox proportional hazards models with age and BMI adjustment in 2473 men. Five proteins were associated with incident hip fracture (HR between 1.29 and 1.41 per SD increase in estimated protein abundance). Some proteins have been previously associated with fracture risk (eg, CD14 and SHBG), whereas others have roles in cellular senescence and aging (B2MG and TIMP1) and complement activation and innate immunity (CO7, CO9, CFAD). These findings may inform development of biomarkers for future research in bone biology and fracture prediction. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Carrie M Nielson
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Jack Wiedrick
- Biostatistics and Design Program, OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Jian Shen
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Jon Jacobs
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Erin S Baker
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Aaron Baraff
- Division of Biostatistics, Oregon Health & Science University, Portland, OR, USA
| | - Paul Piehowski
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Christine G Lee
- Research Service, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Arie Baratt
- Division of Bioinformatics and Computational Biology, Oregon Health & Science University, Portland, OR, USA
| | - Vladislav Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Shannon McWeeney
- Division of Bioinformatics and Computational Biology, Oregon Health & Science University, Portland, OR, USA
| | - Jeong Youn Lim
- Division of Biostatistics, Oregon Health & Science University, Portland, OR, USA
| | - Douglas C Bauer
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Nancy E Lane
- Department of Internal Medicine, University of California at Davis, Sacramento, CA, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Richard D Smith
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Jodi Lapidus
- Biostatistics and Design Program, OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Eric S Orwoll
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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30
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Campos-Obando N, Koek WNH, Hooker ER, van der Eerden BC, Pols HA, Hofman A, van Leeuwen JP, Uitterlinden AG, Nielson CM, Zillikens MC. Serum Phosphate Is Associated With Fracture Risk: The Rotterdam Study and MrOS. J Bone Miner Res 2017; 32:1182-1193. [PMID: 28177140 PMCID: PMC5466477 DOI: 10.1002/jbmr.3094] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/26/2017] [Accepted: 02/05/2017] [Indexed: 01/31/2023]
Abstract
Extreme phosphate levels (P) have been associated with mineralization defects and increased fracture risk. Whether P within normal range is related to bone health in the general population is not well understood. To investigate the association of P with bone mineral density (BMD) and fracture risk, we assessed two population-based cohorts: the Dutch Rotterdam Study (RS-I, RS-II, RS-III; n = 6791) and the US Osteoporotic Fractures in Men (MrOS; n = 5425) study. The relationship of P with lumbar spine (LS) and femoral neck (FN) BMD was tested in all cohorts via linear models; fracture risk was tested in RS-I, RS-II, and MrOS through Cox models, after follow-up of 8.6, 6.6, and 10.9 years, respectively. Adjustments were made for age, body mass index, smoking, serum levels of calcium, potassium, 25-hydroxyvitamin D, estimated glomerular filtration rate (eGFR), FN-BMD, prevalent diabetes, and cardiovascular disease. Additional adjustments were made for phosphate intake, parathyroid hormone, and fibroblast growth factor 23 levels in MrOS. We further stratified by eGFR. Results were pooled through study-level meta-analyses. Hazard ratios (HR) and betas (β) (from meta-analyses) are expressed per 1 mg/dL P increase. P was positively associated with fracture risk in men and women from RS, and findings were replicated in MrOS (pooled HR all [95% CI]: 1.47 [1.31-1.65]). P was associated with fracture risk in subjects without chronic kidney disease (CKD): all (1.44 [1.26-1.63]) and in men with CKD (1.93 [1.42-2.62]). P was inversely related to LS-BMD in men (β: -0.06 [-0.11 to -0.02]) and not to FN-BMD in either sex. In summary, serum P was positively related to fracture risk independently from BMD and phosphate intake after adjustments for potential confounders. P and LS-BMD were negatively related in men. Our findings suggest that increased P levels even within normal range might be deleterious for bone health in the normal population. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
| | - W Nadia H Koek
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Elizabeth R Hooker
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | | | - Huibert A Pols
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Carrie M Nielson
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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31
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Böger CA, Gorski M, McMahon GM, Xu H, Chang YPC, van der Most PJ, Navis G, Nolte IM, de Borst MH, Zhang W, Lehne B, Loh M, Tan ST, Boerwinkle E, Grams ME, Sekula P, Li M, Wilmot B, Moon JG, Scheet P, Cucca F, Xiao X, Lyytikäinen LP, Delgado G, Grammer TB, Kleber ME, Sedaghat S, Rivadeneira F, Corre T, Kutalik Z, Bergmann S, Nielson CM, Srikanth P, Teumer A, Müller-Nurasyid M, Brockhaus AC, Pfeufer A, Rathmann W, Peters A, Matsumoto M, de Andrade M, Atkinson EJ, Robinson-Cohen C, de Boer IH, Hwang SJ, Heid IM, Gögele M, Concas MP, Tanaka T, Bandinelli S, Nalls MA, Singleton A, Tajuddin SM, Adeyemo A, Zhou J, Doumatey A, McWeeney S, Murabito J, Franceschini N, Flessner M, Shlipak M, Wilson JG, Chen G, Rotimi CN, Zonderman AB, Evans MK, Ferrucci L, Devuyst O, Pirastu M, Shuldiner A, Hicks AA, Pramstaller PP, Kestenbaum B, Kardia SLR, Turner ST, Study LC, Briske TE, Gieger C, Strauch K, Meisinger C, Meitinger T, Völker U, Nauck M, Völzke H, Vollenweider P, Bochud M, Waeber G, Kähönen M, Lehtimäki T, März W, Dehghan A, Franco OH, Uitterlinden AG, Hofman A, Taylor HA, Chambers JC, Kooner JS, Fox CS, Hitzemann R, Orwoll ES, Pattaro C, Schlessinger D, Köttgen A, Snieder H, Parsa A, Cohen DM. NFAT5 and SLC4A10 Loci Associate with Plasma Osmolality. J Am Soc Nephrol 2017; 28:2311-2321. [PMID: 28360221 DOI: 10.1681/asn.2016080892] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 08/19/2016] [Accepted: 02/02/2017] [Indexed: 12/20/2022] Open
Abstract
Disorders of water balance, an excess or deficit of total body water relative to body electrolyte content, are common and ascertained by plasma hypo- or hypernatremia, respectively. We performed a two-stage genome-wide association study meta-analysis on plasma sodium concentration in 45,889 individuals of European descent (stage 1 discovery) and 17,637 additional individuals of European descent (stage 2 replication), and a transethnic meta-analysis of replicated single-nucleotide polymorphisms in 79,506 individuals (63,526 individuals of European descent, 8765 individuals of Asian Indian descent, and 7215 individuals of African descent). In stage 1, we identified eight loci associated with plasma sodium concentration at P<5.0 × 10-6 Of these, rs9980 at NFAT5 replicated in stage 2 meta-analysis (P=3.1 × 10-5), with combined stages 1 and 2 genome-wide significance of P=5.6 × 10-10 Transethnic meta-analysis further supported the association at rs9980 (P=5.9 × 10-12). Additionally, rs16846053 at SLC4A10 showed nominally, but not genome-wide, significant association in combined stages 1 and 2 meta-analysis (P=6.7 × 10-8). NFAT5 encodes a ubiquitously expressed transcription factor that coordinates the intracellular response to hypertonic stress but was not previously implicated in the regulation of systemic water balance. SLC4A10 encodes a sodium bicarbonate transporter with a brain-restricted expression pattern, and variant rs16846053 affects a putative intronic NFAT5 DNA binding motif. The lead variants for NFAT5 and SLC4A10 are cis expression quantitative trait loci in tissues of the central nervous system and relevant to transcriptional regulation. Thus, genetic variation in NFAT5 and SLC4A10 expression and function in the central nervous system may affect the regulation of systemic water balance.
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Affiliation(s)
- Carsten A Böger
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Mathias Gorski
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Gearoid M McMahon
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Huichun Xu
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Yen-Pei C Chang
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Peter J van der Most
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Gerjan Navis
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Ilja M Nolte
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Martin H de Borst
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Weihua Zhang
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Benjamin Lehne
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Marie Loh
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Sian-Tsung Tan
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Eric Boerwinkle
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Morgan E Grams
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Peggy Sekula
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Man Li
- Due to the number of contributing authors, the affiliations are listed in the supplemental material.
| | - Beth Wilmot
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - James G Moon
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Paul Scheet
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Francesco Cucca
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Xiangjun Xiao
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Leo-Pekka Lyytikäinen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Graciela Delgado
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Tanja B Grammer
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Marcus E Kleber
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Sanaz Sedaghat
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Fernando Rivadeneira
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Tanguy Corre
- Due to the number of contributing authors, the affiliations are listed in the supplemental material.
| | - Zoltan Kutalik
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Sven Bergmann
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Carrie M Nielson
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Priya Srikanth
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Alexander Teumer
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Martina Müller-Nurasyid
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Anne Catharina Brockhaus
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Arne Pfeufer
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Wolfgang Rathmann
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Annette Peters
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Martha Matsumoto
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Mariza de Andrade
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Elizabeth J Atkinson
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Cassianne Robinson-Cohen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Ian H de Boer
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Shih-Jen Hwang
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Iris M Heid
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Martin Gögele
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Maria Pina Concas
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Toshiko Tanaka
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Stefania Bandinelli
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Mike A Nalls
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Andrew Singleton
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Salman M Tajuddin
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Adebowale Adeyemo
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Jie Zhou
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Ayo Doumatey
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Shannon McWeeney
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Joanne Murabito
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Nora Franceschini
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Michael Flessner
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Michael Shlipak
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - James G Wilson
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Guanjie Chen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Charles N Rotimi
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Alan B Zonderman
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Michele K Evans
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Luigi Ferrucci
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Olivier Devuyst
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Mario Pirastu
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Alan Shuldiner
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Andrew A Hicks
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Peter Paul Pramstaller
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Bryan Kestenbaum
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Sharon L R Kardia
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Stephen T Turner
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - LifeLines Cohort Study
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Tamara Ellefson Briske
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Christian Gieger
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Konstantin Strauch
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Christa Meisinger
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Thomas Meitinger
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Uwe Völker
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Matthias Nauck
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Henry Völzke
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Peter Vollenweider
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Murielle Bochud
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Gerard Waeber
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Mika Kähönen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Terho Lehtimäki
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Winfried März
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Abbas Dehghan
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Oscar H Franco
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Andre G Uitterlinden
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Albert Hofman
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Herman A Taylor
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - John C Chambers
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Jaspal S Kooner
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Caroline S Fox
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Robert Hitzemann
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Eric S Orwoll
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Cristian Pattaro
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - David Schlessinger
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Anna Köttgen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Harold Snieder
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - Afshin Parsa
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
| | - David M Cohen
- Due to the number of contributing authors, the affiliations are listed in the supplemental material
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Robinson-Cohen C, Lutsey PL, Kleber ME, Nielson CM, Mitchell BD, Bis JC, Eny KM, Portas L, Eriksson J, Lorentzon M, Koller DL, Milaneschi Y, Teumer A, Pilz S, Nethander M, Selvin E, Tang W, Weng LC, Wong HS, Lai D, Peacock M, Hannemann A, Völker U, Homuth G, Nauk M, Murgia F, Pattee JW, Orwoll E, Zmuda JM, Riancho JA, Wolf M, Williams F, Penninx B, Econs MJ, Ryan KA, Ohlsson C, Paterson AD, Psaty BM, Siscovick DS, Rotter JI, Pirastu M, Streeten E, März W, Fox C, Coresh J, Wallaschofski H, Pankow JS, de Boer IH, Kestenbaum B. Genetic Variants Associated with Circulating Parathyroid Hormone. J Am Soc Nephrol 2016; 28:1553-1565. [PMID: 27927781 DOI: 10.1681/asn.2016010069] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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: 01/19/2016] [Accepted: 10/13/2016] [Indexed: 12/19/2022] Open
Abstract
Parathyroid hormone (PTH) is a primary calcium regulatory hormone. Elevated serum PTH concentrations in primary and secondary hyperparathyroidism have been associated with bone disease, hypertension, and in some studies, cardiovascular mortality. Genetic causes of variation in circulating PTH concentrations are incompletely understood. We performed a genome-wide association study of serum PTH concentrations among 29,155 participants of European ancestry from 13 cohort studies (n=22,653 and n=6502 in discovery and replication analyses, respectively). We evaluated the association of single nucleotide polymorphisms (SNPs) with natural log-transformed PTH concentration adjusted for age, sex, season, study site, and principal components of ancestry. We discovered associations of SNPs from five independent regions with serum PTH concentration, including the strongest association with rs6127099 upstream of CYP24A1 (P=4.2 × 10-53), a gene that encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-dihydroxyvitamin D. Each additional copy of the minor allele at this SNP associated with 7% higher serum PTH concentration. The other SNPs associated with serum PTH concentration included rs4074995 within RGS14 (P=6.6 × 10-17), rs219779 adjacent to CLDN14 (P=3.5 × 10-16), rs4443100 near RTDR1 (P=8.7 × 10-9), and rs73186030 near CASR (P=4.8 × 10-8). Of these five SNPs, rs6127099, rs4074995, and rs219779 replicated. Thus, common genetic variants located near genes involved in vitamin D metabolism and calcium and renal phosphate transport associated with differences in circulating PTH concentrations. Future studies could identify the causal variants at these loci, and the clinical and functional relevance of these variants should be pursued.
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Affiliation(s)
- Cassianne Robinson-Cohen
- Division of Nephrology, Department of Medicine, Kidney Research Institute, .,Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
| | | | - Marcus E Kleber
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Carrie M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon
| | - Braxton D Mitchell
- Department of Medicine and Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, and
| | - Karen M Eny
- Program in Genetics & Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Portas
- Institute of Population Genetics, National Research Council of Italy, Rome, Italy
| | - Joel Eriksson
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, and
| | - Mattias Lorentzon
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, and
| | | | - Yuri Milaneschi
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, Vrije Universiteit Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Alexander Teumer
- Institutes for Community Medicine, Department Study of Health in Pomerania - Klinisch-Epidemiologische Forschung (SHIP-KEF), and
| | - Stefan Pilz
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Endocrinology and Nuclear Medicine, and
| | - Maria Nethander
- Bioinformatics Core Facility, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elizabeth Selvin
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Weihong Tang
- Divisions of Epidemiology and Community Health and
| | - Lu-Chen Weng
- Divisions of Epidemiology and Community Health and
| | - Hoi Suen Wong
- Program in Genetics & Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dongbing Lai
- Departments of Medical and Molecular Genetics and
| | | | | | - Uwe Völker
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | | | - Federico Murgia
- Institute of Population Genetics, National Research Council of Italy, Rome, Italy
| | - Jack W Pattee
- Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Eric Orwoll
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon
| | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jose Antonio Riancho
- Department of Medicine, University of Cantabria, and Hospital Universitario Marques de Valdecilla, Insituto de Investigacion Sanitaria, Santander, Spain
| | - Myles Wolf
- Division of Nephrology and Hypertension, Department of Medicine and.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, Division of Genetics & Molecular Medicine, King's College, London, United Kingdom
| | - Brenda Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, Vrije Universiteit Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - Michael J Econs
- Departments of Medical and Molecular Genetics and.,Medicine, Indiana University, Indianapolis, Indiana
| | - Kathleen A Ryan
- Department of Medicine and Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, and
| | - Andrew D Paterson
- Program in Genetics & Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bruce M Psaty
- Institutes for Community Medicine, Department Study of Health in Pomerania - Klinisch-Epidemiologische Forschung (SHIP-KEF), and.,Departments of Health Services and.,Group Health Research Institute, Group Health Cooperative, Seattle, Washington
| | - David S Siscovick
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.,The New York Academy of Medicine, New York, New York.,Medicine, University of Washington, Seattle, Washington
| | - Jerome I Rotter
- Department of Pediatrics and Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles, Medical Center, Institute for Translational Genomics and Population Sciences, Torrance, California
| | - Mario Pirastu
- Institute of Population Genetics, National Research Council of Italy, Rome, Italy
| | - Elizabeth Streeten
- Department of Medicine and Program for Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Winfried März
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany.,Synlab Academy, Synlab Services GmbH, Mannheim, Germany; and.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Caroline Fox
- Department of Genetics and Pharmacogenomics, Merck Research, Whitehouse Station, New Jersey
| | - Josef Coresh
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Ian H de Boer
- Division of Nephrology, Department of Medicine, Kidney Research Institute.,Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
| | - Bryan Kestenbaum
- Division of Nephrology, Department of Medicine, Kidney Research Institute.,Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
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Nielson CM, Liu CT, Smith AV, Ackert-Bicknell CL, Reppe S, Jakobsdottir J, Wassel C, Register TC, Oei L, Alonso N, Oei EH, Parimi N, Samelson EJ, Nalls MA, Zmuda J, Lang T, Bouxsein M, Latourelle J, Claussnitzer M, Siggeirsdottir K, Srikanth P, Lorentzen E, Vandenput L, Langefeld C, Raffield L, Terry G, Cox AJ, Allison MA, Criqui MH, Bowden D, Ikram MA, Mellström D, Karlsson MK, Carr J, Budoff M, Phillips C, Cupples LA, Chou WC, Myers RH, Ralston SH, Gautvik KM, Cawthon PM, Cummings S, Karasik D, Rivadeneira F, Gudnason V, Orwoll ES, Harris TB, Ohlsson C, Kiel DP, Hsu YH. Novel Genetic Variants Associated With Increased Vertebral Volumetric BMD, Reduced Vertebral Fracture Risk, and Increased Expression of SLC1A3 and EPHB2. J Bone Miner Res 2016; 31:2085-2097. [PMID: 27476799 PMCID: PMC5477772 DOI: 10.1002/jbmr.2913] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/22/2016] [Accepted: 07/08/2016] [Indexed: 12/26/2022]
Abstract
Genome-wide association studies (GWASs) have revealed numerous loci for areal bone mineral density (aBMD). We completed the first GWAS meta-analysis (n = 15,275) of lumbar spine volumetric BMD (vBMD) measured by quantitative computed tomography (QCT), allowing for examination of the trabecular bone compartment. SNPs that were significantly associated with vBMD were also examined in two GWAS meta-analyses to determine associations with morphometric vertebral fracture (n = 21,701) and clinical vertebral fracture (n = 5893). Expression quantitative trait locus (eQTL) analyses of iliac crest biopsies were performed in 84 postmenopausal women, and murine osteoblast expression of genes implicated by eQTL or by proximity to vBMD-associated SNPs was examined. We identified significant vBMD associations with five loci, including: 1p36.12, containing WNT4 and ZBTB40; 8q24, containing TNFRSF11B; and 13q14, containing AKAP11 and TNFSF11. Two loci (5p13 and 1p36.12) also contained associations with radiographic and clinical vertebral fracture, respectively. In 5p13, rs2468531 (minor allele frequency [MAF] = 3%) was associated with higher vBMD (β = 0.22, p = 1.9 × 10-8 ) and decreased risk of radiographic vertebral fracture (odds ratio [OR] = 0.75; false discovery rate [FDR] p = 0.01). In 1p36.12, rs12742784 (MAF = 21%) was associated with higher vBMD (β = 0.09, p = 1.2 × 10-10 ) and decreased risk of clinical vertebral fracture (OR = 0.82; FDR p = 7.4 × 10-4 ). Both SNPs are noncoding and were associated with increased mRNA expression levels in human bone biopsies: rs2468531 with SLC1A3 (β = 0.28, FDR p = 0.01, involved in glutamate signaling and osteogenic response to mechanical loading) and rs12742784 with EPHB2 (β = 0.12, FDR p = 1.7 × 10-3 , functions in bone-related ephrin signaling). Both genes are expressed in murine osteoblasts. This is the first study to link SLC1A3 and EPHB2 to clinically relevant vertebral osteoporosis phenotypes. These results may help elucidate vertebral bone biology and novel approaches to reducing vertebral fracture incidence. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Carrie M Nielson
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Albert V Smith
- Icelandic Heart Association, Kópavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | - Sjur Reppe
- Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Oslo, Norway.,Lovisenberg Diakonale Hospital, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Christina Wassel
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Thomas C Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ling Oei
- Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden, The Netherlands
| | - Nerea Alonso
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland, UK
| | - Edwin H Oei
- Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Neeta Parimi
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA
| | - Mike A Nalls
- National Institute on Aging (NIA), National Institutes of Health, Bethesda, MD, USA
| | - Joseph Zmuda
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Thomas Lang
- Department of Radiology, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Mary Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard University Medical School, Boston, MA, USA
| | | | - Melina Claussnitzer
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Technical University Munich, Munich, Germany
| | | | - Priya Srikanth
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Erik Lorentzen
- Department of Bioinformatics, Gothenburg University, Gothenburg, Sweden
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Langefeld
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Laura Raffield
- Center for Human Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Greg Terry
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Amanda J Cox
- Center for Diabetes Research, Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Matthew A Allison
- Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA
| | - Michael H Criqui
- Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA
| | - Don Bowden
- Center for Diabetes Research, Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Internal Medicine/Endocrinology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus K Karlsson
- Department of Orthopaedics and Clinical Sciences, Malmö University Hospital, Lund University, Malmö, Sweden
| | - John Carr
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Caroline Phillips
- National Institute on Aging (NIA), National Institutes of Health, Bethesda, MD, USA
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Wen-Chi Chou
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Stuart H Ralston
- Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland, UK
| | - Kaare M Gautvik
- Lovisenberg Diakonale Hospital, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Steven Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - David Karasik
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kópavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Eric S Orwoll
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA
| | - Tamara B Harris
- National Institute on Aging (NIA), National Institutes of Health, Bethesda, MD, USA
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University Medical School, Boston, MA, USA
| | - Yi-Hsiang Hsu
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, MA, USA
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Abstract
Introduction The development of functional limitations among adults aged 65 or older has profound effects on individual and population resources. Improved understanding of the relationship between functional limitations and co-occurring chronic diseases (multimorbidity) is an emerging area of interest. The objective of this study was to investigate the association between multimorbidity and functional limitations among community-dwelling adults 65 or older in the United States and explore factors that modify this association. Methods We conducted a cross-sectional analysis of adults aged 65 or older using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2012. We used negative binomial regression to estimate the association between multimorbidity (≥2 concurrent diseases) and functional limitations and to determine whether the association differed by sex or age. Results The prevalence of multimorbidity in this population was 67% (95% confidence interval [CI], 65%–68%). Each additional chronic condition was associated with an increase in the number of functional limitations, and the association was stronger among those aged 75 or older than among those aged 65 to 74. For those aged 65 to 74, each additional chronic condition was associated with 1.35 (95% CI, 1.27–1.43) times the number of functional limitations for men and 1.62 times (95% CI, 1.31–2.02) the number of functional limitations for women. For those 75 or older, the associations increased to 1.71 (95% CI, 1.35–2.16) for men and 2.06 (95% CI, 1.51–2.81) for women for each additional chronic condition. Conclusion Multimorbidity was associated with increases in functional limitations, and the associations were stronger among women than among men and among adults aged 75 or older than among those aged 65 to 74. These findings underscore the importance of addressing age and sex differences when formulating prevention strategies.
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Affiliation(s)
- Kazuaki Jindai
- School of Public Health, Oregon Health & Science University, Portland, Oregon, and VA Portland Health Care System, Portland, Oregon
| | - Carrie M Nielson
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | | | - Ana R Quiñones
- School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CB669, Portland, OR 97239. . Dr Quiñones is also affiliated with VA Portland Health Care System, Portland, Oregon. Dr Vorderstrasse is now affiliated with Health Promotion and Chronic Disease Prevention, Oregon Health Authority, Portland, Oregon
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Hooker ER, Shrestha S, Lee CG, Cawthon PM, Abrahamson M, Ensrud K, Stefanick ML, Dam TT, Marshall LM, Orwoll ES, Nielson CM. Obesity and Falls in a Prospective Study of Older Men: The Osteoporotic Fractures in Men Study. J Aging Health 2016; 29:1235-1250. [PMID: 27469600 DOI: 10.1177/0898264316660412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate fall rates across body mass index (BMI) categories by age group, considering physical performance and comorbidities. METHOD In the Osteoporotic Fractures in Men (MrOS) study, 5,834 men aged ≥65 reported falls every 4 months over 4.8 (±0.8) years. Adjusted associations between BMI and an incident fall were tested using mixed-effects models. RESULTS The fall rate (0.66/man-year overall, 95% confidence interval [CI] = [0.65, 0.67]) was lowest in the youngest, normal weight men (0.44/man-year, 95% CI = [0.41, 0.47]) and greatest in the oldest, highest BMI men (1.47 falls/man-year, 95% CI = [1.22, 1.76]). Obesity was associated with a 24% to 92% increased fall risk in men below 80 ( ptrend ≤ .0001, p for interaction by age = .03). Only adjustment for dynamic balance test altered the BMI-falls association substantially. DISCUSSION Obesity was independently associated with higher fall rates in men 65 to 80 years old. Narrow walk time, a measure of gait stability, may mediate the association.
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Affiliation(s)
| | - Smriti Shrestha
- 1 Oregon Health & Science University, Portland, USA.,2 North Carolina Agricultural and Technical State University, Greensboro, USA
| | | | - Peggy M Cawthon
- 4 California Pacific Medical Center Research Institute, San Francisco, USA.,5 University of California, San Francisco, USA
| | | | | | | | - Thuy-Tien Dam
- 8 Columbia University Medical Center, New York, NY, USA
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Srikanth P, Chun RF, Hewison M, Adams JS, Bouillon R, Vanderschueren D, Lane N, Cawthon PM, Dam T, Barrett-Connor E, Daniels LB, Shikany JM, Stefanick ML, Cauley JA, Orwoll ES, Nielson CM. Associations of total and free 25OHD and 1,25(OH)2D with serum markers of inflammation in older men. Osteoporos Int 2016; 27:2291-2300. [PMID: 26905270 PMCID: PMC4902735 DOI: 10.1007/s00198-016-3537-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/10/2016] [Indexed: 01/08/2023]
Abstract
UNLABELLED Vitamin D is hypothesized to suppress inflammation. We tested total and free vitamin D metabolites and their association with inflammatory markers. Interleukin-6 levels were lower with higher 25-hydroxyvitamin D. 1,25-dihydroxyvitamin D and free 25OHD associations mirrored those of 25OHD. However, associations for the two metabolites diverged for tumor necrosis factor alpha (TNF-α) soluble receptors. INTRODUCTION Vitamin D is hypothesized to suppress inflammation, and circulating 25-hydroxyvitamin D (25OHD) and inflammatory markers are inversely correlated. However, total serum 25OHD may not be the best indicator of biologically active vitamin D. METHODS We tested serum total 25OHD, total 1,25(OH)2D, vitamin D binding protein (DBP), and estimated free 25OHD and free 1,25(OH)2D associations with inflammatory markers serum interleukin-6 (IL-6), TNF-α and their soluble receptors, interleukin-10 (IL-10), and C-reactive protein (CRP) as continuous outcomes and the presence of ≥2 inflammatory markers in the highest quartile as a dichotomous outcome, in a random subcohort of 679 men in the Osteoporotic Fractures in Men (MrOS) study. RESULTS IL-6 was lower in men with higher 25OHD (-0.23 μg/mL per standard deviation (SD) increase in 25OHD, 95 % confidence intervals (CI) -0.07 to -0.38 μg/mL) and with higher 1,25(OH)2D (-0.20 μg/mL, 95 % CI -0.0004 to -0.39 μg/mL); free D associations were slightly stronger. 25OHD and DBP, but not 1,25(OH)2D, were independently associated with IL-6. TNF-α soluble receptors were inversely associated with 1,25(OH)2D but positively associated with 25OHD, and each had independent effects. The strongest association with ≥2 inflammatory markers in the highest quartile was for free 1,25(OH)2D (odds ratios (OR) 0.70, 95 % CI 0.54 to 0.89 per SD increase in free 1,25(OH)2D). CONCLUSIONS Associations of 1,25(OH)2D and free 25OHD with IL-6 mirrored those of 25OHD, suggesting that 1,25(OH)2D and free D do not improve upon 25OHD in population-based IL-6 studies. However, associations for the two metabolites diverged for TNF-α soluble receptor, warranting examination of both metabolites in studies of TNF-α and its antagonists.
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Affiliation(s)
- P Srikanth
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
| | - R F Chun
- Department of Orthopaedic Surgery and Orthopaedic Hospital Research Center, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - M Hewison
- Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK
| | - J S Adams
- Department of Orthopaedic Surgery and Orthopaedic Hospital Research Center, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - R Bouillon
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospital, Leuven, Belgium
| | - D Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospital, Leuven, Belgium
| | - N Lane
- Division of Rheumatology, University of California Davis, Davis, CA, USA
| | - P M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - T Dam
- Department of Medicine, Division of Geriatric Medicine and Aging, Columbia University, New York, NY, USA
| | - E Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, CA, USA
| | - L B Daniels
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, CA, USA
- Division of Cardiology, Department of Medicine, University of California, San Diego, CA, USA
| | - J M Shikany
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - M L Stefanick
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - E S Orwoll
- Bone and Mineral Unit, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CR113, Portland, OR, 97239, USA.
| | - C M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
- Bone and Mineral Unit, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CR113, Portland, OR, 97239, USA
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Gourlay ML, Overman RA, Fine JP, Filteau G, Cawthon PM, Schousboe JT, Orwoll ES, Wilt TJ, Nguyen TV, Lane NE, Szulc P, Taylor BC, Dam TT, Nielson CM, Cauley JA, Barrett-Connor E, Fink HA, Lapidus JA, Kado DM, Diem SJ, Ensrud KE. Time to Osteoporosis and Major Fracture in Older Men: The MrOS Study. Am J Prev Med 2016; 50:727-736. [PMID: 26821835 PMCID: PMC4875888 DOI: 10.1016/j.amepre.2015.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 01/13/2023]
Abstract
INTRODUCTION For older men who undergo bone mineral density (BMD) testing, the optimal osteoporosis screening schedule is unknown. Time-to-disease estimates are necessary to inform screening intervals. METHODS A prospective cohort study of 5,415 community-dwelling men aged ≥65 years without hip or clinical vertebral fracture or antifracture treatment at baseline was conducted. Participants had concurrent BMD and fracture follow-up between 2000 and 2009, and additional fracture follow-up through 2014. Data were analyzed in 2015. Time to incident osteoporosis (lowest T-score ≤ -2.50) for men without baseline osteoporosis, and time to hip or clinical vertebral fracture or major osteoporotic fracture for men without or with baseline osteoporosis, were estimated. RESULTS Nine men (0.2%) with BMD T-scores >-1.50 at baseline developed osteoporosis during follow-up. The adjusted estimated time for 10% to develop osteoporosis was 8.5 (95% CI=6.7, 10.9) years for those with moderate osteopenia (lowest T-score, -1.50 to -1.99) and 2.7 (95% CI=2.1, 3.4) years for those with advanced osteopenia (lowest T-score, -2.00 to -2.49) at baseline. The adjusted times for 3% to develop a first hip or clinical vertebral fracture ranged from 7.1 (95% CI=6.0, 8.3) years in men with baseline T-scores > -1.50 to 1.7 (95% CI=1.0, 3.1) years in men with baseline osteoporosis. CONCLUSIONS Men aged 65 years and older with femoral neck, total hip, and lumbar spine BMD T-scores >-1.50 on a first BMD test were very unlikely to develop osteoporosis during follow-up. Additional BMD testing may be most informative in older men with T-scores ≤-1.50.
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Affiliation(s)
- Margaret L Gourlay
- Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina.
| | - Robert A Overman
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina
| | - Jason P Fine
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Guillaume Filteau
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, California
| | - John T Schousboe
- Department of Rheumatology, Park Nicollet Health Services, Minneapolis, Minnesota; Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota
| | - Eric S Orwoll
- Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon
| | - Timothy J Wilt
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota
| | - Tuan V Nguyen
- Garvan Institute of Medical Research, UNSW School of Public Health and Community Medicine, New South Wales, Australia; Centre for Health Technologies, University of Technology, Sydney, Australia
| | - Nancy E Lane
- Departments of Medicine and Division of Rheumatology, Center for Musculoskeletal Health, UC Davis Health System, Sacramento, California
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Lyon, France
| | - Brent C Taylor
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Thuy-Tien Dam
- Department of Medicine, Columbia University, New York, New York
| | - Carrie M Nielson
- Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon; School of Public Health, Oregon Health and Science University, Portland, Oregon
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elizabeth Barrett-Connor
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - Howard A Fink
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minnesota
| | - Jodi A Lapidus
- School of Public Health, Oregon Health and Science University, Portland, Oregon
| | - Deborah M Kado
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California; Department of Medicine, University of California, San Diego, La Jolla, California
| | - Susan J Diem
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Kristine E Ensrud
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Nielson CM, Jones KS, Chun RF, Jacobs JM, Wang Y, Hewison M, Adams JS, Swanson CM, Lee CG, Vanderschueren D, Pauwels S, Prentice A, Smith RD, Shi T, Gao Y, Schepmoes AA, Zmuda JM, Lapidus J, Cauley JA, Bouillon R, Schoenmakers I, Orwoll ES. Free 25-Hydroxyvitamin D: Impact of Vitamin D Binding Protein Assays on Racial-Genotypic Associations. J Clin Endocrinol Metab 2016; 101:2226-34. [PMID: 27007693 PMCID: PMC4870848 DOI: 10.1210/jc.2016-1104] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Total 25-hydroxyvitamin D (25OHD) is a marker of vitamin D status and is lower in African Americans than in whites. Whether this difference holds for free 25OHOD (f25OHD) is unclear, considering reported genetic-racial differences in vitamin D binding protein (DBP) used to calculate f25OHD. OBJECTIVES Our objective was to assess racial-geographic differences in f25OHD and to understand inconsistencies in racial associations with DBP and calculated f25OHD. DESIGN This study used a cross-sectional design. SETTING The general community in the United States, United Kingdom, and The Gambia were included in this study. PARTICIPANTS Men in Osteoporotic Fractures in Men and Medical Research Council studies (N = 1057) were included. EXPOSURES Total 25OHD concentration, race, and DBP (GC) genotype exposures were included. OUTCOME MEASURES Directly measured f25OHD, DBP assessed by proteomics, monoclonal and polyclonal immunoassays, and calculated f25OHD were the outcome measures. RESULTS Total 25OHD correlated strongly with directly measured f25OHD (Spearman r = 0.84). Measured by monoclonal assay, mean DBP in African-ancestry subjects was approximately 50% lower than in whites, whereas DBP measured by polyclonal DBP antibodies or proteomic methods was not lower in African-ancestry. Calculated f25OHD (using polyclonal DBP assays) correlated strongly with directly measured f25OHD (r = 0.80-0.83). Free 25OHD, measured or calculated from polyclonal DBP assays, reflected total 25OHD concentration irrespective of race and was lower in African Americans than in US whites. CONCLUSIONS Previously reported racial differences in DBP concentration are likely from monoclonal assay bias, as there was no racial difference in DBP concentration by other methods. This confirms the poor vitamin D status of many African-Americans and the utility of total 25OHD in assessing vitamin D in the general population.
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Nielson CM, Jones KS, Bouillon R, Chun RF, Jacobs J, Wang Y, Hewison M, Adams JS, Swanson CM, Lee CG, Vanderschueren D, Pauwels S, Prentice A, Smith RD, Shi T, Gao Y, Zmuda JM, Lapidus J, Cauley JA, Schoenmakers I, Orwoll ES. Role of Assay Type in Determining Free 25-Hydroxyvitamin D Levels in Diverse Populations. N Engl J Med 2016; 374:1695-6. [PMID: 27007809 PMCID: PMC4870041 DOI: 10.1056/nejmc1513502] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Kerry S Jones
- Medical Research Council Human Nutrition Research, Cambridge, United Kingdom
| | | | - Rene F Chun
- University of California, Los Angeles, Los Angeles, CA
| | - Jon Jacobs
- Pacific Northwest National Laboratory, Richland, WA
| | - Ying Wang
- Oregon Health and Science University, Portland, OR
| | | | - John S Adams
- University of California, Los Angeles, Los Angeles, CA
| | | | | | | | | | - Ann Prentice
- Medical Research Council Human Nutrition Research, Cambridge, United Kingdom
| | | | - Tujin Shi
- Pacific Northwest National Laboratory, Richland, WA
| | - Yuqian Gao
- Pacific Northwest National Laboratory, Richland, WA
| | | | - Jodi Lapidus
- Oregon Health and Science University, Portland, OR
| | | | - Inez Schoenmakers
- Medical Research Council Human Nutrition Research, Cambridge, United Kingdom
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40
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Cawthon PM, Schousboe JT, Harrison SL, Ensrud KE, Black D, Cauley JA, Cummings SR, LeBlanc ES, Laughlin GA, Nielson CM, Broughton A, Kado DM, Hoffman AR, Jamal SA, Barrett-Connor E, Orwoll ES. Sex hormones, sex hormone binding globulin, and vertebral fractures in older men. Bone 2016; 84:271-278. [PMID: 26778261 PMCID: PMC4755786 DOI: 10.1016/j.bone.2016.01.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/01/2015] [Accepted: 01/07/2016] [Indexed: 11/18/2022]
Abstract
The association between sex hormones and sex hormone binding globin (SHBG) with vertebral fractures in men is not well studied. In these analyses, we determined whether sex hormones and SHBG were associated with greater likelihood of vertebral fractures in a prospective cohort study of community dwelling older men. We included data from participants in MrOS who had been randomly selected for hormone measurement (N=1463, including 1054 with follow-up data 4.6years later). Major outcomes included prevalent vertebral fracture (semi-quantitative grade≥2, N=140, 9.6%) and new or worsening vertebral fracture (change in SQ grade≥1, N=55, 5.2%). Odds ratios per SD decrease in sex hormones and per SD increase in SHBG were estimated with logistic regression adjusted for potentially confounding factors, including age, bone mineral density, and other sex hormones. Higher SHBG was associated with a greater likelihood of prevalent vertebral fractures (OR: 1.38 per SD increase, 95% CI: 1.11, 1.72). Total estradiol analyzed as a continuous variable was not associated with prevalent vertebral fractures (OR per SD decrease: 0.86, 95% CI: 0.68 to 1.10). Men with total estradiol values ≤17pg/ml had a borderline higher likelihood of prevalent fracture than men with higher values (OR: 1.46, 95% CI: 0.99, 2.16). There was no association between total testosterone and prevalent fracture. In longitudinal analyses, SHBG (OR: 1.42 per SD increase, 95% CI: 1.03, 1.95) was associated with new or worsening vertebral fracture, but there was no association with total estradiol or total testosterone. In conclusion, higher SHBG (but not testosterone or estradiol) is an independent risk factor for vertebral fractures in older men.
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Affiliation(s)
- Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA.
| | - John T Schousboe
- Park Nicollet Institute for Research and Education, University of Minnesota, Minneapolis, MN, USA
| | | | - Kristine E Ensrud
- Minneapolis Veterans Affairs Health Care System, and University of Minnesota, Minneapolis, MN, USA
| | - Dennis Black
- University of California, San Francisco, CA, USA
| | | | - Steven R Cummings
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR, USA
| | | | | | - Augusta Broughton
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | | | | | | | | | - Eric S Orwoll
- Oregon Health and Science University, Portland, OR, USA
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41
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Shen J, Leslie WD, Nielson CM, Majumdar SR, Morin SN, Orwoll ES. Associations of Body Mass Index With Incident Fractures and Hip Structural Parameters in a Large Canadian Cohort. J Clin Endocrinol Metab 2016; 101:476-84. [PMID: 26670128 PMCID: PMC5393587 DOI: 10.1210/jc.2015-3123] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Fractures in obese individuals are of public health importance, but the relationship between obesity and fracture is complex and remains poorly understood. OBJECTIVE The study examined the association of body mass index (BMI) with bone structural and strength parameters and incident fracture. DESIGN AND SETTING We performed cross-sectional and longitudinal analyses using data from the Manitoba Bone Density Program. PARTICIPANTS We included 51 313 women and 4689 men aged 50 years or older referred for dual-energy X-ray absorptiometry scans. For 41 919 women and 4085 men, we were able to derive hip structural parameters. MAIN OUTCOME MEASURE Cross-sectional moment of inertia, cross-sectional area, and femoral strength index were derived from dual-energy X-ray absorptiometry. Health service records were assessed for incident major osteoporotic fractures (MOFs) (mean follow-up 6.2 y in women and 4.7 y in men). RESULTS Among individuals with a BMI of less than 30 kg/m(2), increasing BMI was associated with progressive increases in bone mineral density (BMD), cross-sectional moment of inertia, and cross-sectional area. The relationship reached a plateau around a BMI of 30 kg/m(2), with little additional increment with further increases in BMI (all P for interaction < .0001, obese vs nonobese). Increasing BMI was linearly associated with decreases in strength index in both women and men. MOFs were ascertained in 3721 women and 276 men (1027 female and 75 male hip fractures). Higher BMI was associated with a lower risk of MOF in women in multivariable models, but this association was largely explained by their higher BMD. Protective association of higher BMI with hip fracture were stronger and only partially explained by BMD (hazard ratio [95% confidence interval] 0.79 [0.73-0.99] for obese I and 0.67 [0.46-0.98] for obese II). Higher BMI was not significantly associated with a risk of MOF or hip fracture in men. CONCLUSIONS Despite structural and biomechanical disadvantages, obese women were at lower risk of fracture.
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Affiliation(s)
- Jian Shen
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
| | - William D Leslie
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
| | - Carrie M Nielson
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
| | - Sumit R Majumdar
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
| | - Suzanne N Morin
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
| | - Eric S Orwoll
- Department of Medicine (J.S., C.M.N., E.S.O.), Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239; University of Manitoba (W.D.L.), Winnipeg, Canada R3T 2N2; University of Alberta (S.R.M.), Edmonton, Alberta, Canada T6G 2H7; and McGill University (S.N.M.), Montreal, Québec, Canada H9X 3V9
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Lu Y, Day FR, Gustafsson S, Buchkovich ML, Na J, Bataille V, Cousminer DL, Dastani Z, Drong AW, Esko T, Evans DM, Falchi M, Feitosa MF, Ferreira T, Hedman ÅK, Haring R, Hysi PG, Iles MM, Justice AE, Kanoni S, Lagou V, Li R, Li X, Locke A, Lu C, Mägi R, Perry JRB, Pers TH, Qi Q, Sanna M, Schmidt EM, Scott WR, Shungin D, Teumer A, Vinkhuyzen AAE, Walker RW, Westra HJ, Zhang M, Zhang W, Zhao JH, Zhu Z, Afzal U, Ahluwalia TS, Bakker SJL, Bellis C, Bonnefond A, Borodulin K, Buchman AS, Cederholm T, Choh AC, Choi HJ, Curran JE, de Groot LCPGM, De Jager PL, Dhonukshe-Rutten RAM, Enneman AW, Eury E, Evans DS, Forsen T, Friedrich N, Fumeron F, Garcia ME, Gärtner S, Han BG, Havulinna AS, Hayward C, Hernandez D, Hillege H, Ittermann T, Kent JW, Kolcic I, Laatikainen T, Lahti J, Leach IM, Lee CG, Lee JY, Liu T, Liu Y, Lobbens S, Loh M, Lyytikäinen LP, Medina-Gomez C, Michaëlsson K, Nalls MA, Nielson CM, Oozageer L, Pascoe L, Paternoster L, Polašek O, Ripatti S, Sarzynski MA, Shin CS, Narančić NS, Spira D, Srikanth P, Steinhagen-Thiessen E, Sung YJ, Swart KMA, Taittonen L, Tanaka T, Tikkanen E, van der Velde N, van Schoor NM, Verweij N, Wright AF, Yu L, Zmuda JM, Eklund N, Forrester T, Grarup N, Jackson AU, Kristiansson K, Kuulasmaa T, Kuusisto J, Lichtner P, Luan J, Mahajan A, Männistö S, Palmer CD, Ried JS, Scott RA, Stancáková A, Wagner PJ, Demirkan A, Döring A, Gudnason V, Kiel DP, Kühnel B, Mangino M, Mcknight B, Menni C, O'Connell JR, Oostra BA, Shuldiner AR, Song K, Vandenput L, van Duijn CM, Vollenweider P, White CC, Boehnke M, Boettcher Y, Cooper RS, Forouhi NG, Gieger C, Grallert H, Hingorani A, Jørgensen T, Jousilahti P, Kivimaki M, Kumari M, Laakso M, Langenberg C, Linneberg A, Luke A, Mckenzie CA, Palotie A, Pedersen O, Peters A, Strauch K, Tayo BO, Wareham NJ, Bennett DA, Bertram L, Blangero J, Blüher M, Bouchard C, Campbell H, Cho NH, Cummings SR, Czerwinski SA, Demuth I, Eckardt R, Eriksson JG, Ferrucci L, Franco OH, Froguel P, Gansevoort RT, Hansen T, Harris TB, Hastie N, Heliövaara M, Hofman A, Jordan JM, Jula A, Kähönen M, Kajantie E, Knekt PB, Koskinen S, Kovacs P, Lehtimäki T, Lind L, Liu Y, Orwoll ES, Osmond C, Perola M, Pérusse L, Raitakari OT, Rankinen T, Rao DC, Rice TK, Rivadeneira F, Rudan I, Salomaa V, Sørensen TIA, Stumvoll M, Tönjes A, Towne B, Tranah GJ, Tremblay A, Uitterlinden AG, van der Harst P, Vartiainen E, Viikari JS, Vitart V, Vohl MC, Völzke H, Walker M, Wallaschofski H, Wild S, Wilson JF, Yengo L, Bishop DT, Borecki IB, Chambers JC, Cupples LA, Dehghan A, Deloukas P, Fatemifar G, Fox C, Furey TS, Franke L, Han J, Hunter DJ, Karjalainen J, Karpe F, Kaplan RC, Kooner JS, McCarthy MI, Murabito JM, Morris AP, Bishop JAN, North KE, Ohlsson C, Ong KK, Prokopenko I, Richards JB, Schadt EE, Spector TD, Widén E, Willer CJ, Yang J, Ingelsson E, Mohlke KL, Hirschhorn JN, Pospisilik JA, Zillikens MC, Lindgren C, Kilpeläinen TO, Loos RJF. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk. Nat Commun 2016; 7:10495. [PMID: 26833246 PMCID: PMC4740398 DOI: 10.1038/ncomms10495] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [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: 06/15/2015] [Accepted: 12/16/2015] [Indexed: 12/24/2022] Open
Abstract
To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eight were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk.
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Affiliation(s)
- Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, The
Icahn School of Medicine at Mount Sinai, New York, New
York
10029, USA
- The Department of Preventive Medicine, The Icahn School of
Medicine at Mount Sinai, New York, New York
10029, USA
| | - Felix R. Day
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Stefan Gustafsson
- Science for Life Laboratory, Uppsala University, 750
85
Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala
University, 751 85
Uppsala, Sweden
| | - Martin L. Buchkovich
- Department of Genetics, University of North Carolina,
Chapel Hill, North Carolina
27599, USA
| | - Jianbo Na
- Department of Developmental and Regenerative Biology, The Icahn
School of Medicine at Mount Sinai, New York, New York
10029, USA
| | - Veronique Bataille
- West Herts NHS Trust, Herts
HP2 4AD, UK
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
| | - Diana L. Cousminer
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
| | - Zari Dastani
- Department Epidemiology, Biostatistics and Human Genetics, Lady
Davis Institute, Jewish General Hospital, McGill University,
Montréal, Quebec, Canada
H3T1E2
| | - Alexander W. Drong
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
| | - Tõnu Esko
- Estonian Genome Center, Univeristy of Tartu,
Tartu, 51010, Estonia
- Broad Institute of the Massachusetts Institute of Technology
and Harvard University, Cambridge
2142, USA
- Divisions of Endocrinology and Genetics and Center for Basic
and Translational Obesity Research, Boston Children's Hospital,
Boston, Massachusetts
02115, USA
- Department of Genetics, Harvard Medical School,
Boston, Massachusetts
02115, USA
| | - David M. Evans
- University of Queensland Diamantina Institute, Translational
Research Institute, Brisbane, Queensland
4102, Australia
- MRC Integrative Epidemiology Unit, School of Social and
Community Medicine, University of Bristol, Bristol
BS82BN, UKnited
| | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
- Department of Genomics of Common Disease, School of Public
Health, Imperial College London, London
W12 0NN, UK
| | - Mary F. Feitosa
- Division of Statistical Genomics, Department of Genetics,
Washington University School of Medicine, St Louis,
Missouri
63108, USA
| | - Teresa Ferreira
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
| | - Åsa K. Hedman
- Science for Life Laboratory, Uppsala University, 750
85
Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala
University, 751 85
Uppsala, Sweden
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine,
University Medicine Greifswald, 17475
Greifswald, Germany
- European University of Applied Sciences, Faculty of Applied
Public Health, 18055
Rostock, Germany
| | - Pirro G. Hysi
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
| | - Mark M. Iles
- Leeds Institute of Cancer and Pathology, Cancer Research UK
Leeds Centre, University of Leeds, Leeds
LS9 7TF, UK
| | - Anne E. Justice
- Department of Epidemiology, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina
27599, USA
| | - Stavroula Kanoni
- William Harvey Research Institute, Barts and The London School
of Medicine and Dentistry, Queen Mary University of London,
London
EC1M 6BQ, UK
- Wellcome Trust Sanger Institute, Human Genetics,
Hinxton, Cambridge
CB10 1SA, UK
| | - Vasiliki Lagou
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism,
University of Oxford, Churchill Hospital, Oxford
OX3 7LJ, UK
| | - Rui Li
- Department Epidemiology, Biostatistics and Human Genetics, Lady
Davis Institute, Jewish General Hospital, McGill University,
Montréal, Quebec, Canada
H3T1E2
| | - Xin Li
- Department of Epidemiology, Harvard School of Public
Health, Boston, Massachusetts
02115, USA
| | - Adam Locke
- Center for Statistical Genetics, Department of Biostatistics,
University of Michigan, Ann Arbor, Michigan
48109, USA
| | - Chen Lu
- Department of Biostatistics, Boston University School of Public
Health, Boston, Massachusetts
02118, USA
| | - Reedik Mägi
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Estonian Genome Center, Univeristy of Tartu,
Tartu, 51010, Estonia
| | - John R. B. Perry
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Tune H. Pers
- Divisions of Endocrinology and Genetics and Center for Basic
and Translational Obesity Research, Boston Children's Hospital,
Boston, Massachusetts
02115, USA
- Department of Genetics, Harvard Medical School,
Boston, Massachusetts
02115, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
- Medical and Population Genetics Program, Broad Institute of MIT
and Harvard, Cambridge
02142, USA
- Department of Epidemiology Research, Statens Serum
Institut, 2100
Copenhagen, Denmark
| | - Qibin Qi
- Department of Epidemiology and Popualtion Health, Albert
Einstein College of Medicine, Bronx, New York
10461, USA
| | - Marianna Sanna
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
- Department of Genomics of Common Disease, School of Public
Health, Imperial College London, London
W12 0NN, UK
| | - Ellen M. Schmidt
- Department of Computational Medicine and Bioinformatics,
University of Michigan, Ann Arbor, Michigan
48109, USA
| | - William R. Scott
- Department of Epidemiology and Biostatistics, Imperial College
London, London
W2 1PG, UK
- Ealing Hospital NHS Trust, Middlesex
UB1 3HW, UK
| | - Dmitry Shungin
- Lund University Diabetes Centre, Department of Clinical
Science, Genetic and Molecular Epidemiology Unit, Skåne University
Hosptial, 205 02
Malmö, Sweden
- Department of Public Health and Clinical Medicine, Unit of
Medicine, Umeå University, 901 87
Umeå, Sweden
- Department of Odontology, Umeå University,
901 85
Umeå, Sweden
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine
Greifswald, 17475
Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics,
University Medicine Greifswald, 17475
Greifswald, Germany
| | | | - Ryan W. Walker
- The Charles Bronfman Institute for Personalized Medicine, The
Icahn School of Medicine at Mount Sinai, New York, New
York
10029, USA
- The Department of Preventive Medicine, The Icahn School of
Medicine at Mount Sinai, New York, New York
10029, USA
| | - Harm-Jan Westra
- Program in Medical and Population Genetics, Broad Institute of
Harvard and Massachusetts Institute of Technology, Cambridge,
Massachusetts
02142, USA
- Divisions of Genetics and Rheumatology, Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School,
Boston, Massachusetts
02446, USA
- Partners Center for Personalized Genetic Medicine,
Boston, Massachusetts
02446, USA
| | - Mingfeng Zhang
- Department of Dermatology, Brigham and Women's
Hospital, Boston, Massachusetts
02115, USA
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College
London, London
W2 1PG, UK
- Ealing Hospital NHS Trust, Middlesex
UB1 3HW, UK
| | - Jing Hua Zhao
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Zhihong Zhu
- Queensland Brain Institute, The University of Queensland,
Brisbane
4072, Australia
| | - Uzma Afzal
- Department of Epidemiology and Biostatistics, Imperial College
London, London
W2 1PG, UK
- Ealing Hospital NHS Trust, Middlesex
UB1 3HW, UK
| | - Tarunveer Singh Ahluwalia
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty
of Health and Medical Sceinces, University of Copenhagen, 2200
Copenhagen, Denmark
- Danish Pediatric Asthma Center, Gentofte Hospital, The Capital
Region, 2200
Copenhagen, Denmark
- Steno Diabetes Center A/S, DK-2820
Gentofte, Denmark
| | - Stephan J. L. Bakker
- University of Groningen, University Medical Center Groningen,
Department of Medicine, 9700 RB
Groningen, The Netherlands
| | - Claire Bellis
- Department of Genetics, Texas Biomedical Research
Institute, San Antonio, Texas
78245, USA
| | - Amélie Bonnefond
- CNRS UMR 8199, F-59019
Lille, France
- European Genomic Institute for Diabetes, 59000
Lille, France
- Université de Lille 2, 59000
Lille, France
| | - Katja Borodulin
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Aron S. Buchman
- Rush Alzheimer's Disease Center, Rush University
Medical Center, Chicago, Illinois
60612, USA
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical
Nutrition and Metabolism, Uppsala University, 751 85
Uppsala, Sweden
| | - Audrey C. Choh
- Lifespan Health Research Center, Wright State University
Boonshoft School of Medicine, Dayton, Ohio
45420, USA
| | - Hyung Jin Choi
- Department of Anatomy, Seoul National University College of
Medicine, Seoul
03080, Korea
| | - Joanne E. Curran
- South Texas Diabetes and Obesity Institute, University of Texas
Rio Grande Valley, Brownsville, Texas
78520
| | | | - Philip L. De Jager
- Program in Medical and Population Genetics, Broad Institute of
Harvard and Massachusetts Institute of Technology, Cambridge,
Massachusetts
02142, USA
- Harvard Medical School, Boston,
Massachusetts
02115, USA
- Program in Translational NeuroPsychiatric Genomics, Department
of Neurology, Brigham and Women's Hospital, Boston,
Massachusetts
02115, USA
| | | | - Anke W. Enneman
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Elodie Eury
- CNRS UMR 8199, F-59019
Lille, France
- European Genomic Institute for Diabetes, 59000
Lille, France
- Université de Lille 2, 59000
Lille, France
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute,
San Francisco, California
94107, USA
| | - Tom Forsen
- Department of General Practice and Primary Health Care,
University of Helsinki, FI-00014
Helsinki, Finland
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine,
University Medicine Greifswald, 17475
Greifswald, Germany
| | - Frédéric Fumeron
- INSERM, UMR_S 1138, Centre de Recherche des Cordeliers,
F-75006
Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S
1138, Centre de Recherche des Cordeliers, F-75006
Paris, France
- Université Paris Descartes, Sorbonne Paris
Cité, UMR_S 1138, Centre de Recherche des Cordeliers,
F-75006
Paris, France
- Univ Paris Diderot, Sorbonne Paris Cité, UMR_S 1138,
Centre de Recherche des Cordeliers, F-75006
Paris, France
| | - Melissa E. Garcia
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, Maryland
20892, USA
| | - Simone Gärtner
- Department of Medicine A, University Medicine Greifswald,
17475
Greifswald, Germany
| | - Bok-Ghee Han
- Center for Genome Science, National Institute of Health, Osong
Health Technology Administration Complex, Chungcheongbuk-do
370914, Korea
| | - Aki S. Havulinna
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh
EH4 2XU, UK
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging,
National Institutes of Health, Bethesda, Maryland
20892, USA
| | - Hans Hillege
- University of Groningen, University Medical Center Groningen,
Department of Cardiology, 9700 RB
Groningen, The Netherlands
| | - Till Ittermann
- Institute for Community Medicine, University Medicine
Greifswald, 17475
Greifswald, Germany
| | - Jack W. Kent
- Department of Genetics, Texas Biomedical Research
Institute, San Antonio, Texas
78245, USA
| | - Ivana Kolcic
- Department of Public Health, Faculty of Medicine, University of
Split, Split
21000, Croatia
| | - Tiina Laatikainen
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
- Hospital District of North Karelia, FI-80210
Joensuu, Finland
- Institute of Public Health and Clinical Nutrition, University
of Eastern Finland, FI-70211
Kuopio, Finland
| | - Jari Lahti
- Folkhälsan Research Centre, FI-00290
Helsinki, Finland
- Institute of Behavioural Sciences, University of
Helsinki, FI-00014
Helsinki, Finland
| | - Irene Mateo Leach
- University of Groningen, University Medical Center Groningen,
Department of Cardiology, 9700 RB
Groningen, The Netherlands
| | - Christine G. Lee
- Department of Medicine, Oregon Health and Science
University, Portland, Oregon
97239, USA
- Research Service, Veterans Affairs Medical Center,
Portland, Oregon
97239, USA
| | - Jong-Young Lee
- Center for Genome Science, National Institute of Health, Osong
Health Technology Administration Complex, Chungcheongbuk-do
370914, Korea
| | - Tian Liu
- Max Planck Institute for Molecular Genetics, Department of
Vertebrate Genomics, 14195
Berlin, Germany
- Max Planck Institute for Human Development,
14194
Berlin, Germany
| | - Youfang Liu
- Thurston Arthritis Research Center, University of North
Carolina at Chapel Hill, Chaper Hill, North Carolina
27599-7280, USA
| | - Stéphane Lobbens
- CNRS UMR 8199, F-59019
Lille, France
- European Genomic Institute for Diabetes, 59000
Lille, France
- Université de Lille 2, 59000
Lille, France
| | - Marie Loh
- Department of Epidemiology and Biostatistics, Imperial College
London, London
W2 1PG, UK
- Translational Laboratory in Genetic Medicine (TLGM), Agency for
Science, Technology and Research (A*STAR), 8A Biomedical
Grove, Immunos, Level 5, Singapore
138648, Singapore
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, University of Tampere School
of Medicine, FI-33014
Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories and
School of Medicine, University of Tampere, FI-33520
Tampere, Finland
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Department of Epidemiology, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Karl Michaëlsson
- Department of Surgical Sciences, Orthopedics, Uppsala
University, 751 85
Uppsala, Sweden
| | - Mike A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging,
National Institutes of Health, Bethesda, Maryland
20892, USA
| | - Carrie M. Nielson
- School of Public Health, Oregon Health & Science
University, Portland, Oregon
97239, USA
- Bone & Mineral Unit, Oregon Health & Science
University, Portland, Oregon
97239, USA
| | | | - Laura Pascoe
- Institute of Cell & Molecular Biosciences, Newcastle
University, Newcastle
NE1 7RU, UK
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, School of Social and
Community Medicine, University of Bristol, Bristol
BS82BN, UKnited
| | - Ozren Polašek
- Department of Public Health, Faculty of Medicine, University of
Split, Split
21000, Croatia
- Centre for Global Health Research, Usher Institute of
Population Health Sciences and Informatics, University of Edinburgh, Teviot
Place, Edinburgh
EH8 9AG, UK
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- Wellcome Trust Sanger Institute, Human Genetics,
Hinxton, Cambridge
CB10 1SA, UK
- Hjelt Institute, University of Helsinki,
FI-00014
Helsinki, Finland
| | - Mark A. Sarzynski
- Human Genomics Laboratory, Pennington Biomedical Research
Center, Baton Rouge, Los Angeles
70808, USA
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University
College of Medicine, Seoul
03080, Korea
| | | | - Dominik Spira
- The Berlin Aging Study II; Research Group on Geriatrics;
Charité—Universitätsmedizin Berlin,
13347
Berlin, Germany
- Lipid Clinic at the Interdisciplinary Metabolism Center,
Charité-Universitätsmedizin Berlin, 13353
Berlin, Germany
| | - Priya Srikanth
- School of Public Health, Oregon Health & Science
University, Portland, Oregon
97239, USA
- Bone & Mineral Unit, Oregon Health & Science
University, Portland, Oregon
97239, USA
| | - Elisabeth Steinhagen-Thiessen
- The Berlin Aging Study II; Research Group on Geriatrics;
Charité—Universitätsmedizin Berlin,
13347
Berlin, Germany
- Lipid Clinic at the Interdisciplinary Metabolism Center,
Charité-Universitätsmedizin Berlin, 13353
Berlin, Germany
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of
Medicine, St Louis, Missouri
63110, USA
| | - Karin M. A. Swart
- EMGO Institute for Health and Care Research, VU University
Medical Center, 1081 BT
Amsterdam, The Netherlands
- VUMC, Department of Epidemiology and Biostatistics,
1081 BT
Amsterdam, The Netherlands
| | - Leena Taittonen
- Department of Pediatrics, University of Oulu,
FI-90014
Oulu, Finland
- Department of Pediatrics, Vaasa Central Hospital,
FI-65100
Vaasa, Finland
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on
Aging, Baltimore, Maryland
21225, USA
| | - Emmi Tikkanen
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- Hjelt Institute, University of Helsinki,
FI-00014
Helsinki, Finland
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Natasja M. van Schoor
- EMGO Institute for Health and Care Research, VU University
Medical Center, 1081 BT
Amsterdam, The Netherlands
- VUMC, Department of Epidemiology and Biostatistics,
1081 BT
Amsterdam, The Netherlands
| | - Niek Verweij
- University of Groningen, University Medical Center Groningen,
Department of Cardiology, 9700 RB
Groningen, The Netherlands
| | - Alan F. Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh
EH4 2XU, UK
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University
Medical Center, Chicago, Illinois
60612, USA
| | - Joseph M. Zmuda
- Department of Epidemiology; University of Pittsburgh,
Pittsburgh, Pennsylvania
15261, USA
| | - Niina Eklund
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Terrence Forrester
- Tropical Metabolism Research Unit, Tropical Medicine Research
Institute, University of the West Indies, Mona
JMAAW15, Jamaica
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
| | - Anne U. Jackson
- Center for Statistical Genetics, Department of Biostatistics,
University of Michigan, Ann Arbor, Michigan
48109, USA
| | - Kati Kristiansson
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Teemu Kuulasmaa
- Faculty of Health Sciences, Institute of Clinical Medicine,
Internal Medicine, University of Eastern Finland, 70210
Kuopio, Finland
| | - Johanna Kuusisto
- Faculty of Health Sciences, Institute of Clinical Medicine,
Internal Medicine, University of Eastern Finland, 70210
Kuopio, Finland
- Department of Medicine, University of Eastern Finland,
70210
Kuopio, Finland
- Kuopio University Hospital, 70029
Kuopio, Finland
| | - Peter Lichtner
- Institute of Human Genetics, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Jian'an Luan
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
| | - Satu Männistö
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Cameron D. Palmer
- Broad Institute of the Massachusetts Institute of Technology
and Harvard University, Cambridge
2142, USA
- Divisions of Endocrinology and Genetics and Center for Basic
and Translational Obesity Research, Boston Children's Hospital,
Boston, Massachusetts
02115, USA
| | - Janina S. Ried
- Institute of Genetic Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Robert A. Scott
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Alena Stancáková
- Department of Medicine, University of Eastern Finland and
Kuopio University Hospital, 70210
Kuopio, Finland
| | - Peter J. Wagner
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Ayse Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, 3015GE
Rotterdam, The Netherlands
| | - Angela Döring
- Institute of Epidemiology I, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur
201, Iceland
- University of Iceland, Faculty of Medicine,
Reykjavik
101, Iceland
| | - Douglas P. Kiel
- Department of Medicine Beth Israel Deaconess Medical Center
and Harvard Medical School, Boston, Massachusetts
02115
- Institute for Aging Research Hebrew Senior Life,
Boston, Massachusetts
02131, USA
| | - Brigitte Kühnel
- Institute of Genetic Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
| | - Barbara Mcknight
- Cardiovascular Health Research Unit, University of
Washington, Seattle, Washington
98101, USA
- Program in Biostatistics and Biomathematics, Divison of Public
Health Sciences, Fred Hutchinson Cancer Research Center,
Seattle, Washington
98109, USA
- Department of Biostatistics, University of Washington,
Seattle, Washington
98195, USA
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
| | - Jeffrey R. O'Connell
- Program for Personalized and Genomic Medicine, Division of
Endocrinology, Diabetes and Nutrition, Department of Medicine, University of
Maryland School of Medicine, Baltimore, Maryland
21201, USA
| | - Ben A. Oostra
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, 3015GE
Rotterdam, The Netherlands
| | - Alan R. Shuldiner
- Program for Personalized and Genomic Medicine, Division of
Endocrinology, Diabetes and Nutrition, Department of Medicine, University of
Maryland School of Medicine, Baltimore, Maryland
21201, USA
- Geriatric Research and Education Clinical Center, Vetrans
Administration Medical Center, Baltimore, Maryland
21042, USA
| | - Kijoung Song
- Genetics, Projects Clinical Platforms and Sciences,
GlaxoSmithKline, Philadelphia, Pennsylvania
19112, USA
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Department of Internal
Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy,
University of Gothenburg, 413 45
Gothenburg, Sweden
| | - Cornelia M. van Duijn
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus
University Medical Center, 3015GE
Rotterdam, The Netherlands
- Center for Medical Systems Biology, 2300
Leiden, The Netherlands
| | - Peter Vollenweider
- Department of Internal Medicine, University Hospital Lausanne
(CHUV) and University of Lausanne, 1011
Lausanne, Switzerland
| | - Charles C. White
- Department of Biostatistics, Boston University School of Public
Health, Boston, Massachusetts
02118, USA
| | - Michael Boehnke
- Center for Statistical Genetics, Department of Biostatistics,
University of Michigan, Ann Arbor, Michigan
48109, USA
| | - Yvonne Boettcher
- University of Leipzig, IFB Adiposity Diseases,
04103
Leipzig, Germany
- University of Leipzig, Department of Medicine,
04103
Leipzig, Germany
| | - Richard S. Cooper
- Department of Public Health Sciences, Stritch School of
Medicine, Loyola University Chicago, Maywood, Illinois
61053, USA
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Harald Grallert
- Institute of Epidemiology II, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- German Center for Diabetes Research (DZD),
85764
Neuherberg, Germany
| | - Aroon Hingorani
- Institute of Cardiovascular Science, University College
London, London
WC1E 6BT, UK
| | - Torben Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, 2200
Copenhagen, Denmark
- Faculty of Medicine, University of Aalborg,
9220
Aalborg, Denmark
- Research Centre for Prevention and Health,
DK2600
Capital Region of Denmark, Denmark
| | - Pekka Jousilahti
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, UCL,
London
WC1E 6BT, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, UCL,
London
WC1E 6BT, UK
| | - Markku Laakso
- Faculty of Health Sciences, Institute of Clinical Medicine,
Internal Medicine, University of Eastern Finland, 70210
Kuopio, Finland
- Department of Medicine, University of Eastern Finland,
70210
Kuopio, Finland
- Kuopio University Hospital, 70029
Kuopio, Finland
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
- Department of Epidemiology and Public Health, UCL,
London
WC1E 6BT, UK
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup
Hospital, 2600
Glostrup, Denmark
| | - Amy Luke
- Department of Public Health Sciences, Stritch School of
Medicine, Loyola University Chicago, Maywood, Illinois
61053, USA
| | - Colin A. Mckenzie
- Tropical Metabolism Research Unit, Tropical Medicine Research
Institute, University of the West Indies, Mona
JMAAW15, Jamaica
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- Wellcome Trust Sanger Institute, Human Genetics,
Hinxton, Cambridge
CB10 1SA, UK
- Massachusetts General Hospital, Center for Human Genetic
Research, Psychiatric and Neurodevelopmental Genetics Unit,
Boston, Massachusetts
02114, USA
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum
München—German Research Center for Environmental
Health, 85764
Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology,
Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität,
81377
Munich, Germany
| | - Bamidele O. Tayo
- Department of Public Health Sciences, Stritch School of
Medicine, Loyola University Chicago, Maywood, Illinois
61053, USA
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
| | - David A. Bennett
- Rush Alzheimer's Disease Center, Rush University
Medical Center, Chicago, Illinois
60612, USA
| | - Lars Bertram
- School of Public Health, Faculty of Medicine, Imperial College
London, London
W6 8RP, UK
- Lübeck Interdisciplinary Platform for Genome
Analytics, Institutes of Neurogenetics and Integrative and Experimental
Genomics, University of Lübeck, 23562
Lübeck, Germany
| | - John Blangero
- South Texas Diabetes and Obesity Institute, University of Texas
Rio Grande Valley, Brownsville, Texas
78520
| | - Matthias Blüher
- University of Leipzig, IFB Adiposity Diseases,
04103
Leipzig, Germany
- University of Leipzig, Department of Medicine,
04103
Leipzig, Germany
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research
Center, Baton Rouge, Los Angeles
70808, USA
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of
Population Health Sciences and Informatics, University of Edinburgh, Teviot
Place, Edinburgh
EH8 9AG, UK
| | - Nam H. Cho
- Ajou University School of Medicine, Department of Preventive
Medicine, Suwon Kyoung-gi
443-721, Korea
| | - Steven R. Cummings
- California Pacific Medical Center Research Institute,
San Francisco, California
94107, USA
| | - Stefan A. Czerwinski
- Lifespan Health Research Center, Wright State University
Boonshoft School of Medicine, Dayton, Ohio
45420, USA
| | - Ilja Demuth
- The Berlin Aging Study II; Research Group on Geriatrics;
Charité—Universitätsmedizin Berlin,
13347
Berlin, Germany
- Institute of Medical and Human Genetics,
Charité—Universitätsmedizin Berlin,
13353
Berlin, Germany
| | - Rahel Eckardt
- The Berlin Aging Study II; Research Group on Geriatrics;
Charité—Universitätsmedizin Berlin,
13347
Berlin, Germany
| | - Johan G. Eriksson
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
- Department of General Practice and Primary Health Care,
University of Helsinki, FI-00014
Helsinki, Finland
- Folkhälsan Research Centre, FI-00290
Helsinki, Finland
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on
Aging, Baltimore, Maryland
21225, USA
| | - Oscar H. Franco
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Department of Epidemiology, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Philippe Froguel
- CNRS UMR 8199, F-59019
Lille, France
- European Genomic Institute for Diabetes, 59000
Lille, France
- Université de Lille 2, 59000
Lille, France
| | - Ron T. Gansevoort
- University of Groningen, University Medical Center Groningen,
Department of Medicine, 9700 RB
Groningen, The Netherlands
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern
Denmark, 5000
Odense, Denmark
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, National
Institute on Aging, Bethesda, Maryland
20892, USA
| | - Nicholas Hastie
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh
EH4 2XU, UK
| | - Markku Heliövaara
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Albert Hofman
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Department of Epidemiology, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North
Carolina at Chapel Hill, Chaper Hill, North Carolina
27599-7280, USA
| | - Antti Jula
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University
Hospital, FI-33521
Tampere, Finland
- Department of Clinical Physiology, University of Tampere
School of Medicine, FI-33014
Tampere, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
- Children's Hospital, Helsinki University Hospital and
University of Helsinki, FI-00029
Helsinki, Finland
- Department of Obstetrics and Gynecology, MRC Oulu, Oulu
University Hospital and University of Oulu, FI-90029
Oulu, Finland
| | - Paul B. Knekt
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Peter Kovacs
- University of Leipzig, IFB Adiposity Diseases,
04103
Leipzig, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, University of Tampere School
of Medicine, FI-33014
Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories and
School of Medicine, University of Tampere, FI-33520
Tampere, Finland
| | - Lars Lind
- Department of Medical Sciences, Uppsala University,
751 85
Uppsala, Sweden
| | - Yongmei Liu
- Center for Human Genetics, Division of Public Health Sciences,
Wake Forest School of Medicine, Winston-Salem, North
Carolina
27157, USA
| | - Eric S. Orwoll
- Bone & Mineral Unit, Oregon Health & Science
University, Portland, Oregon
97239, USA
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton General Hospital, Southampton
SO16 6YD, UK
| | - Markus Perola
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
- Estonian Genome Center, Univeristy of Tartu,
Tartu, 51010, Estonia
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Louis Pérusse
- Department of Kinesiology, Laval University,
Québec City, Quebec, Canada
G1V 0A6
- Institute of Nutrition and Functional Foods, Laval
University, Québec City, Quebec,
Canada
G1V 0A6
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku
University Hospital, FI-20521
Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular
Medicine, University of Turku, FI-20520
Turku, Finland
| | - Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research
Center, Baton Rouge, Los Angeles
70808, USA
| | - D. C. Rao
- Division of Statistical Genomics, Department of Genetics,
Washington University School of Medicine, St Louis,
Missouri
63108, USA
- Division of Biostatistics, Washington University School of
Medicine, St Louis, Missouri
63110, USA
- Department of Psychiatry, Washington University School of
Medicine, St Louis, Missouri
63110, USA
| | - Treva K. Rice
- Division of Biostatistics, Washington University School of
Medicine, St Louis, Missouri
63110, USA
- Department of Psychiatry, Washington University School of
Medicine, St Louis, Missouri
63110, USA
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Department of Epidemiology, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of
Population Health Sciences and Informatics, University of Edinburgh, Teviot
Place, Edinburgh
EH8 9AG, UK
| | - Veikko Salomaa
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Thorkild I. A. Sørensen
- MRC Integrative Epidemiology Unit, School of Social and
Community Medicine, University of Bristol, Bristol
BS82BN, UKnited
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg
Hospital, The Capital Region, 2000
Frederiksberg, Denmark
| | - Michael Stumvoll
- University of Leipzig, IFB Adiposity Diseases,
04103
Leipzig, Germany
- University of Leipzig, Department of Medicine,
04103
Leipzig, Germany
| | - Anke Tönjes
- University of Leipzig, Department of Medicine,
04103
Leipzig, Germany
| | - Bradford Towne
- Lifespan Health Research Center, Wright State University
Boonshoft School of Medicine, Dayton, Ohio
45420, USA
| | - Gregory J. Tranah
- California Pacific Medical Center Research Institute,
San Francisco, California
94107, USA
| | - Angelo Tremblay
- Department of Kinesiology, Laval University,
Québec City, Quebec, Canada
G1V 0A6
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
- Department of Epidemiology, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen,
Department of Cardiology, 9700 RB
Groningen, The Netherlands
- Durrer Center for Cardiogenetic Research, Interuniversity
Cardiology Institute Netherlands-Netherlands Heart Institute, 3501
DG
Utrecht, The Netherlands
- Department of Genetics, University Medical Center Groningen,
University of Groningen, 9700 RB
Groningen, The Netherlands
| | - Erkki Vartiainen
- National Institute for Health and Welfare,
FI-00271
Helsinki, Finland
| | - Jorma S. Viikari
- Department of Medicine, University of Turku,
FI-20521
Turku, Finland
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh
EH4 2XU, UK
| | - Marie-Claude Vohl
- Institute of Nutrition and Functional Foods, Laval
University, Québec City, Quebec,
Canada
G1V 0A6
- School of Nutrition, Laval University,
Québec City, Quebec, Canada
G1V 0A6
| | - Henry Völzke
- Institute for Community Medicine, University Medicine
Greifswald, 17475
Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site
Greifswald, 17475
Greifswald, Germany
- DZD (German Centre for Diabetes Research), partner site
Greifswald, 17475
Greifswald, Germany
| | - Mark Walker
- Program in Medical and Population Genetics, Broad Institute of
Harvard and Massachusetts Institute of Technology, Cambridge,
Massachusetts
02142, USA
- Institute of Cellular Medicine, Newcastle University,
Newcastle
NE2 4HH, UK
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine,
University Medicine Greifswald, 17475
Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site
Greifswald, 17475
Greifswald, Germany
| | - Sarah Wild
- Centre for Population Health Sciences, Usher Institute of
Population Health Sciences and Informatics, University of Edinburgh,
Edinburgh
EH8 9AG, UK
| | - James F. Wilson
- MRC Human Genetics Unit, Institute of Genetics and Molecular
Medicine, University of Edinburgh, Edinburgh
EH4 2XU, UK
- Centre for Global Health Research, Usher Institute of
Population Health Sciences and Informatics, University of Edinburgh, Teviot
Place, Edinburgh
EH8 9AG, UK
| | - Loïc Yengo
- CNRS UMR 8199, F-59019
Lille, France
- European Genomic Institute for Diabetes, 59000
Lille, France
- Université de Lille 2, 59000
Lille, France
| | - D. Timothy Bishop
- Leeds Institute of Cancer and Pathology, Cancer Research UK
Leeds Centre, University of Leeds, Leeds
LS9 7TF, UK
| | - Ingrid B. Borecki
- Division of Statistical Genomics, Department of Genetics,
Washington University School of Medicine, St Louis,
Missouri
63108, USA
- Analytical Genetics Group, Regeneron Genetics Center,
Regeneron Pharmaceuticals, Inc., Tarrytown, New York
10591, USA
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, Imperial College
London, London
W2 1PG, UK
- Ealing Hospital NHS Trust, Middlesex
UB1 3HW, UK
- Imperial College Healthcare NHS Trust, London
W12 0HS, UK
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public
Health, Boston, Massachusetts
02118, USA
- National Heart, Lung, and Blood Institute, the Framingham
Heart Study, Framingham, Massachusetts
01702, USA
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center,
3000CA
Rotterdam/Zuidholland, The Netherlands
| | - Panos Deloukas
- William Harvey Research Institute, Barts and The London School
of Medicine and Dentistry, Queen Mary University of London,
London
EC1M 6BQ, UK
- Wellcome Trust Sanger Institute, Human Genetics,
Hinxton, Cambridge
CB10 1SA, UK
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research
of Hereditary Disorders (PACER-HD), King Abdulaziz University,
Jeddah
21589, Saudi Arabia
| | - Ghazaleh Fatemifar
- MRC Integrative Epidemiology Unit, School of Social and
Community Medicine, University of Bristol, Bristol
BS82BN, UKnited
| | - Caroline Fox
- Harvard Medical School, Boston,
Massachusetts
02115, USA
- National Heart, Lung, and Blood Institute, the Framingham
Heart Study, Framingham, Massachusetts
01702, USA
| | - Terrence S. Furey
- Department of Genetics, University of North Carolina,
Chapel Hill, North Carolina
27599, USA
- Department of Biology, University of North Carolina,
Chapel Hill, North Carolina
27599, USA
| | - Lude Franke
- University of Groningen, University Medical Center Groningen,
Department of Cardiology, 9700 RB
Groningen, The Netherlands
- Department of Genetics, University Medical Center Groningen,
University of Groningen, 9700 RB
Groningen, The Netherlands
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of
Public Health, Melvin and Bren Simon Cancer Center,
Indianapolis, Indiana
46202, USA
| | - David J. Hunter
- Broad Institute of the Massachusetts Institute of Technology
and Harvard University, Cambridge
2142, USA
- Department of Epidemiology, Harvard School of Public
Health, Boston, Massachusetts
02115, USA
- Channing Division of Network Medicine, Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School,
Boston, Massachusetts
02115, USA
- Department of Nutrition, Harvard School of Public
Health, Boston, Massachusetts
02115, USA
| | - Juha Karjalainen
- Department of Genetics, University Medical Center Groningen,
University of Groningen, 9700 RB
Groningen, The Netherlands
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism,
University of Oxford, Churchill Hospital, Oxford
OX3 7LJ, UK
- Oxford NIHR Biomedical Research Centre,
Oxford
OX3 7LJ, UK
| | - Robert C. Kaplan
- Department of Epidemiology and Popualtion Health, Albert
Einstein College of Medicine, Bronx, New York
10461, USA
| | - Jaspal S. Kooner
- Ealing Hospital NHS Trust, Middlesex
UB1 3HW, UK
- Imperial College Healthcare NHS Trust, London
W12 0HS, UK
- National Heart and Lung Institute, Imperial College
London, London
W12 0NN, UK
| | - Mark I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism,
University of Oxford, Churchill Hospital, Oxford
OX3 7LJ, UK
- Oxford NIHR Biomedical Research Centre,
Oxford
OX3 7LJ, UK
| | - Joanne M. Murabito
- Boston University School of Medicine, Department of Medicine,
Section of General Internal Medicine, Boston,
Massachusetts
02118, USA
- NHLBI's and Boston University's Framingham
Heart Study, Framingham, Massachusetts
01702, USA
| | - Andrew P. Morris
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Department of Biostatistics, University of Liverpool,
Liverpool
L69 3GA, UK
| | - Julia A. N. Bishop
- Leeds Institute of Cancer and Pathology, Cancer Research UK
Leeds Centre, University of Leeds, Leeds
LS9 7TF, UK
| | - Kari E. North
- Carolina Center for Genome Sciences and Department of
Epidemiology, University of North Carolina at Chapel Hill, Chapel
Hill, North Carolina
27599-7400, USA
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal
Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy,
University of Gothenburg, 413 45
Gothenburg, Sweden
| | - Ken K. Ong
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
- MRC Unit for Lifelong Health and Ageing at UCL,
London
WC1B 5JU, UK
- Department of Paediatrics, University of Cambridge,
Cambridge
CB2 0QQ, UK
| | - Inga Prokopenko
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Department of Genomics of Common Disease, School of Public
Health, Imperial College London, London
W12 0NN, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism,
University of Oxford, Churchill Hospital, Oxford
OX3 7LJ, UK
| | - J. Brent Richards
- Department Epidemiology, Biostatistics and Human Genetics, Lady
Davis Institute, Jewish General Hospital, McGill University,
Montréal, Quebec, Canada
H3T1E2
- Department of Medicine, Lady Davis Institute, Jewish General
Hospital, McGill University, Montréal,
Quebec, Canada
H3T1E2
- Department of Twin Research, King's College
London, London
SE1 1E7, UK
- Division of Endocrinology, Lady Davis Institute, Jewish
General Hospital, McGill University, Montréal,
Quebec, Canada
H3T1E2
| | - Eric E. Schadt
- Icahn Institute for Genomics and Multiscale Biology, Icahn
School of Medicine at Mount Sinai, New York, New York
10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of
Medicine at Mount Sinai, New York, New York
10029, USA
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology,
King's College London, London
SE1 7EH, UK
| | - Elisabeth Widén
- Institute for Molecular Medicine Finland, University of
Helsinki, FI-00290
Helsinki, Finland
| | - Cristen J. Willer
- Department of Computational Medicine and Bioinformatics,
University of Michigan, Ann Arbor, Michigan
48109, USA
- Department of Human Genetics, University of Michigan,
Ann Arbor, Michigan
48109, USA
- Department of Internal Medicine, Division of Cardiovascular
Medicine, University of Michigan, Ann Arbor, Michigan
48109, USA
| | - Jian Yang
- Queensland Brain Institute, The University of Queensland,
Brisbane
4072, Australia
| | - Erik Ingelsson
- Science for Life Laboratory, Uppsala University, 750
85
Uppsala, Sweden
- Department of Medical Sciences, Molecular Epidemiology, Uppsala
University, 751 85
Uppsala, Sweden
- Department of Medicine, Division of Cardiovascular Medicine,
Stanford University School of Medicine, Stanford,
California
94305, USA
| | - Karen L. Mohlke
- Department of Genetics, University of North Carolina,
Chapel Hill, North Carolina
27599, USA
| | - Joel N. Hirschhorn
- Broad Institute of the Massachusetts Institute of Technology
and Harvard University, Cambridge
2142, USA
- Divisions of Endocrinology and Genetics and Center for Basic
and Translational Obesity Research, Boston Children's Hospital,
Boston, Massachusetts
02115, USA
- Department of Genetics, Harvard Medical School,
Boston, Massachusetts
02115, USA
| | - John Andrew Pospisilik
- Department of Epigenetics, Max Planck Institute of
Immunobiology and Epigenetics, D-76108
Freiburg, Germany
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center,
3015GE
Rotterdam, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands
Consortium for Healthy Aging (NCHA), Rotterdam
The Netherlands
| | - Cecilia Lindgren
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford
OX3 7BN, UK
- Broad Institute of the Massachusetts Institute of Technology
and Harvard University, Cambridge
2142, USA
- The Big Data Institute, University of Oxford,
Oxford
OX3 7LJ, UK
| | - Tuomas Oskari Kilpeläinen
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
- Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen, 2100
Copenhagen, Denmark
| | - Ruth J. F. Loos
- The Charles Bronfman Institute for Personalized Medicine, The
Icahn School of Medicine at Mount Sinai, New York, New
York
10029, USA
- The Department of Preventive Medicine, The Icahn School of
Medicine at Mount Sinai, New York, New York
10029, USA
- MRC Epidemiology Unit, University of Cambridge School of
Clinical Medicine, Institute of Metabolic Science, University of Cambridge,
Cambridge Biomedical Campus, Cambridge
CB2 0QQ, UK
- The Genetics of Obesity and Related Metabolic Traits Program,
The Icahn School of Medicine at Mount Sinai, New York, New
York, 10029, USA
- The Mindich Child Health and Development Institute, The Icahn
School of Medicine at Mount Sinai, New York, New York
10029, USA
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Zheng HF, Forgetta V, Hsu YH, Estrada K, Rosello-Diez A, Leo PJ, Dahia CL, Park-Min KH, Tobias JH, Kooperberg C, Kleinman A, Styrkarsdottir U, Liu CT, Uggla C, Evans DS, Nielson CM, Walter K, Pettersson-Kymmer U, McCarthy S, Eriksson J, Kwan T, Jhamai M, Trajanoska K, Memari Y, Min J, Huang J, Danecek P, Wilmot B, Li R, Chou WC, Mokry LE, Moayyeri A, Claussnitzer M, Cheng CH, Cheung W, Medina-Gómez C, Ge B, Chen SH, Choi K, Oei L, Fraser J, Kraaij R, Hibbs MA, Gregson CL, Paquette D, Hofman A, Wibom C, Tranah GJ, Marshall M, Gardiner BB, Cremin K, Auer P, Hsu L, Ring S, Tung JY, Thorleifsson G, Enneman AW, van Schoor NM, de Groot LCPGM, van der Velde N, Melin B, Kemp JP, Christiansen C, Sayers A, Zhou Y, Calderari S, van Rooij J, Carlson C, Peters U, Berlivet S, Dostie J, Uitterlinden AG, Williams SR, Farber C, Grinberg D, LaCroix AZ, Haessler J, Chasman DI, Giulianini F, Rose LM, Ridker PM, Eisman JA, Nguyen TV, Center JR, Nogues X, Garcia-Giralt N, Launer LL, Gudnason V, Mellström D, Vandenput L, Amin N, van Duijn CM, Karlsson MK, Ljunggren Ö, Svensson O, Hallmans G, Rousseau F, Giroux S, Bussière J, Arp PP, Koromani F, Prince RL, Lewis JR, Langdahl BL, Hermann AP, Jensen JEB, Kaptoge S, Khaw KT, Reeve J, Formosa MM, Xuereb-Anastasi A, Åkesson K, McGuigan FE, Garg G, Olmos JM, Zarrabeitia MT, Riancho JA, Ralston SH, Alonso N, Jiang X, Goltzman D, Pastinen T, Grundberg E, Gauguier D, Orwoll ES, Karasik D, Davey-Smith G, Smith AV, Siggeirsdottir K, Harris TB, Zillikens MC, van Meurs JBJ, Thorsteinsdottir U, Maurano MT, Timpson NJ, Soranzo N, Durbin R, Wilson SG, Ntzani EE, Brown MA, Stefansson K, Hinds DA, Spector T, Cupples LA, Ohlsson C, Greenwood CMT, Jackson RD, Rowe DW, Loomis CA, Evans DM, Ackert-Bicknell CL, Joyner AL, Duncan EL, Kiel DP, Rivadeneira F, Richards JB. Whole-genome sequencing identifies EN1 as a determinant of bone density and fracture. Nature 2015; 526:112-117. [PMID: 26367794 PMCID: PMC4755714 DOI: 10.1038/nature14878 10.1016/j.ajhg.2017.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/28/2014] [Accepted: 06/30/2015] [Indexed: 04/02/2024]
Abstract
The extent to which low-frequency (minor allele frequency (MAF) between 1-5%) and rare (MAF ≤ 1%) variants contribute to complex traits and disease in the general population is mainly unknown. Bone mineral density (BMD) is highly heritable, a major predictor of osteoporotic fractures, and has been previously associated with common genetic variants, as well as rare, population-specific, coding variants. Here we identify novel non-coding genetic variants with large effects on BMD (ntotal = 53,236) and fracture (ntotal = 508,253) in individuals of European ancestry from the general population. Associations for BMD were derived from whole-genome sequencing (n = 2,882 from UK10K (ref. 10); a population-based genome sequencing consortium), whole-exome sequencing (n = 3,549), deep imputation of genotyped samples using a combined UK10K/1000 Genomes reference panel (n = 26,534), and de novo replication genotyping (n = 20,271). We identified a low-frequency non-coding variant near a novel locus, EN1, with an effect size fourfold larger than the mean of previously reported common variants for lumbar spine BMD (rs11692564(T), MAF = 1.6%, replication effect size = +0.20 s.d., Pmeta = 2 × 10(-14)), which was also associated with a decreased risk of fracture (odds ratio = 0.85; P = 2 × 10(-11); ncases = 98,742 and ncontrols = 409,511). Using an En1(cre/flox) mouse model, we observed that conditional loss of En1 results in low bone mass, probably as a consequence of high bone turnover. We also identified a novel low-frequency non-coding variant with large effects on BMD near WNT16 (rs148771817(T), MAF = 1.2%, replication effect size = +0.41 s.d., Pmeta = 1 × 10(-11)). In general, there was an excess of association signals arising from deleterious coding and conserved non-coding variants. These findings provide evidence that low-frequency non-coding variants have large effects on BMD and fracture, thereby providing rationale for whole-genome sequencing and improved imputation reference panels to study the genetic architecture of complex traits and disease in the general population.
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Affiliation(s)
- Hou-Feng Zheng
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montréal H3A 1A2, Canada
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
| | - Vincenzo Forgetta
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montréal H3A 1A2, Canada
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
| | - Yi-Hsiang Hsu
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of MIT and Harvard, Boston, Massachusetts 02115, USA
| | - Karol Estrada
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of MIT and Harvard, Boston, Massachusetts 02115, USA
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Alberto Rosello-Diez
- Developmental Biology Program, Sloan Kettering Institute, New York, New York 10065, USA
| | - Paul J Leo
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Chitra L Dahia
- Department of Cell and Developmental Biology, Weill Cornell Medical College, New York, New York 10065, USA
- Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, New York 10021, USA
| | - Kyung Hyun Park-Min
- Rheumatology Divison, Hospital for Special Surgery New York, New York 10021, USA
| | - Jonathan H Tobias
- School of Clinical Science, University of Bristol, Bristol BS10 5NB, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | | | - Aaron Kleinman
- Department of Research, 23andMe, Mountain View, California 94041, USA
| | | | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
| | - Charlotta Uggla
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
| | - Daniel S Evans
- California Pacific Medical Center Research Institute, San Francisco, California 94158, USA
| | - Carrie M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health &Science University, Portland, Oregon 97239, USA
- Bone &Mineral Unit, Oregon Health &Science University, Portland, Oregon 97239, USA
| | - Klaudia Walter
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Ulrika Pettersson-Kymmer
- Departments of Pharmacology and Clinical Neurosciences, Umeå University, Umeå S-901 87, Sweden
- Department of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, Sweden
| | - Shane McCarthy
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Joel Eriksson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
| | - Tony Kwan
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
| | - Mila Jhamai
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Katerina Trajanoska
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Yasin Memari
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Josine Min
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | - Jie Huang
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Petr Danecek
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Beth Wilmot
- Oregon Clinical and Translational Research Institute, Oregon Health &Science University, Portland, Oregon 97239, USA
- Department of Medical and Clinical Informatics, Oregon Health &Science University, Portland, Oregon 97239, USA
| | - Rui Li
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montréal H3A 1A2, Canada
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
| | - Wen-Chi Chou
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Lauren E Mokry
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
| | - Alireza Moayyeri
- Farr Institute of Health Informatics Research, University College London, London NW1 2DA, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK
| | - Melina Claussnitzer
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of MIT and Harvard, Boston, Massachusetts 02115, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Chia-Ho Cheng
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
| | - Warren Cheung
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
- Department of Human Genetics, McGill University, Montréal H3A 1B1, Canada
| | - Carolina Medina-Gómez
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - Bing Ge
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
| | - Shu-Huang Chen
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
| | - Kwangbom Choi
- Center for Musculoskeletal Research, University of Rochester, Rochester, New York 14642, USA
| | - Ling Oei
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - James Fraser
- Department of Biochemistry and Goodman Cancer Research Center, McGill University, Montréal H3G 1Y6, Canada
| | - Robert Kraaij
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - Matthew A Hibbs
- Center for Musculoskeletal Research, University of Rochester, Rochester, New York 14642, USA
- Department of Computer Science, Trinity University, San Antonio, Texas 78212, USA
| | - Celia L Gregson
- Musculoskeletal Research Unit, University of Bristol, Bristol BS10 5NB, UK
| | - Denis Paquette
- Department of Biochemistry and Goodman Cancer Research Center, McGill University, Montréal H3G 1Y6, Canada
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - Carl Wibom
- Department of Radiation Sciences, Umeå University, Umeå S-901 87, Sweden
| | - Gregory J Tranah
- Department of Public Health and Preventive Medicine, Oregon Health &Science University, Portland, Oregon 97239, USA
- Bone &Mineral Unit, Oregon Health &Science University, Portland, Oregon 97239, USA
| | - Mhairi Marshall
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Brooke B Gardiner
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Katie Cremin
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Paul Auer
- School of Public Health, University of Wisconsin, Milwaukee, Wisconsin 53726, USA
| | - Li Hsu
- Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Sue Ring
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
| | - Joyce Y Tung
- Department of Research, 23andMe, Mountain View, California 94041, USA
| | | | - Anke W Enneman
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | | | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Internal Medicine, Section Geriatrics, Academic Medical Center, Amsterdam 1105, The Netherlands
| | - Beatrice Melin
- Department of Radiation Sciences, Umeå University, Umeå S-901 87, Sweden
| | - John P Kemp
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | | | - Adrian Sayers
- Musculoskeletal Research Unit, University of Bristol, Bristol BS10 5NB, UK
| | - Yanhua Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
| | - Sophie Calderari
- Cordeliers Research Centre, INSERM UMRS 1138, Paris 75006, France
- Institute of Cardiometabolism and Nutrition, University Pierre &Marie Curie, Paris 75013, France
| | - Jeroen van Rooij
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - Chris Carlson
- Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Ulrike Peters
- Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Soizik Berlivet
- Department of Biochemistry and Goodman Cancer Research Center, McGill University, Montréal H3G 1Y6, Canada
| | - Josée Dostie
- Department of Biochemistry and Goodman Cancer Research Center, McGill University, Montréal H3G 1Y6, Canada
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - Stephen R Williams
- Departments of Medicine (Cardiovascular Medicine), Centre for Public Health Genomics, University of Virginia, Charlottesville, Virginia 22908, USA
| | - Charles Farber
- Departments of Medicine (Cardiovascular Medicine), Centre for Public Health Genomics, University of Virginia, Charlottesville, Virginia 22908, USA
| | - Daniel Grinberg
- Department of Genetics, University of Barcelona, Barcelona 08028, Spain
- U-720, Centre for Biomedical Network Research on Rare Diseases (CIBERER), Barcelona 28029, Spain
- Department of Human Molecular Genetics, The Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona 08028, Spain
| | - Andrea Z LaCroix
- Women's Health Center of Excellence Family Medicine and Public Health, University of California - San Diego, San Diego, California 92093, USA
| | - Jeff Haessler
- Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA
| | - Daniel I Chasman
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA
| | - Lynda M Rose
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA
| | - Paul M Ridker
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA
| | - John A Eisman
- Osteoporosis &Bone Biology Program, Garvan Institute of Medical Research, Sydney 2010, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney 6959, Australia
- St. Vincent's Hospital &Clinical School, NSW University, Sydney 2010, Australia
| | - Tuan V Nguyen
- Osteoporosis &Bone Biology Program, Garvan Institute of Medical Research, Sydney 2010, Australia
- St. Vincent's Hospital &Clinical School, NSW University, Sydney 2010, Australia
| | - Jacqueline R Center
- Osteoporosis &Bone Biology Program, Garvan Institute of Medical Research, Sydney 2010, Australia
- St. Vincent's Hospital &Clinical School, NSW University, Sydney 2010, Australia
| | - Xavier Nogues
- Musculoskeletal Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
- Cooperative Research Network on Aging and Fragility (RETICEF), Institute of Health Carlos III, 28029, Spain
- Department of Internal Medicine, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona 08193, Spain
| | - Natalia Garcia-Giralt
- Musculoskeletal Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
- Cooperative Research Network on Aging and Fragility (RETICEF), Institute of Health Carlos III, 28029, Spain
| | - Lenore L Launer
- Neuroepidemiology Section, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Vilmunder Gudnason
- Icelandic Heart Association, Kopavogur IS-201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik IS-101, Iceland
| | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
| | - Najaf Amin
- Genetic epidemiology unit, Department of Epidemiology, Erasmus MC, Rotterdam 3000CA, The Netherlands
| | - Cornelia M van Duijn
- Genetic epidemiology unit, Department of Epidemiology, Erasmus MC, Rotterdam 3000CA, The Netherlands
| | - Magnus K Karlsson
- Department of Orthopaedics, Skåne University Hospital Malmö 205 02, Sweden
| | - Östen Ljunggren
- Department of Medical Sciences, University of Uppsala, Uppsala 751 85, Sweden
| | - Olle Svensson
- Department of Surgical and Perioperative Sciences, Umeå Unviersity, Umeå 901 85, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, Sweden
| | - François Rousseau
- Department of Molecular Biology, Medical Biochemistry and Pathology, Université Laval, Québec City G1V 0A6, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec, Québec City G1V 4G2, Canada
| | - Sylvie Giroux
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec, Québec City G1V 4G2, Canada
| | - Johanne Bussière
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec, Québec City G1V 4G2, Canada
| | - Pascal P Arp
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Richard L Prince
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands 6009, Australia
- Department of Medicine, University of Western Australia, Perth 6009, Australia
| | - Joshua R Lewis
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands 6009, Australia
- Department of Medicine, University of Western Australia, Perth 6009, Australia
| | - Bente L Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C 8000, Denmark
| | - A Pernille Hermann
- Department of Endocrinology, Odense University Hospital, Odense C 5000, Denmark
| | - Jens-Erik B Jensen
- Department of Endocrinology, Hvidovre University Hospital, Hvidovre 2650, Denmark
| | - Stephen Kaptoge
- Farr Institute of Health Informatics Research, University College London, London NW1 2DA, UK
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Jonathan Reeve
- Medicine and Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Institute of Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford OX3 7LD, UK
| | - Melissa M Formosa
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Angela Xuereb-Anastasi
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Kristina Åkesson
- Department of Orthopaedics, Skåne University Hospital Malmö 205 02, Sweden
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, 205 02, Sweden
| | - Fiona E McGuigan
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, 205 02, Sweden
| | - Gaurav Garg
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, 205 02, Sweden
| | - Jose M Olmos
- Department of Medicine and Psychiatry, University of Cantabria, Santander 39011, Spain
- Department of Internal Medicine, Hospital U.M. Valdecilla- IDIVAL, Santander 39008, Spain
| | - Maria T Zarrabeitia
- Department of Legal Medicine, University of Cantabria, Santander 39011, Spain
| | - Jose A Riancho
- Department of Medicine and Psychiatry, University of Cantabria, Santander 39011, Spain
- Department of Internal Medicine, Hospital U.M. Valdecilla- IDIVAL, Santander 39008, Spain
| | - Stuart H Ralston
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Nerea Alonso
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Xi Jiang
- Department of Reconstructive Sciences, College of Dental Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
| | - David Goltzman
- Department of Medicine and Physiology, McGill University, Montréal H4A 3J1, Canada
| | - Tomi Pastinen
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
- Department of Human Genetics, McGill University, Montréal H3A 1B1, Canada
| | - Elin Grundberg
- McGill University and Genome Quebec Innovation Centre, Montréal H3A 0G1, Canada
- Department of Human Genetics, McGill University, Montréal H3A 1B1, Canada
| | - Dominique Gauguier
- Cordeliers Research Centre, INSERM UMRS 1138, Paris 75006, France
- Institute of Cardiometabolism and Nutrition, University Pierre &Marie Curie, Paris 75013, France
| | - Eric S Orwoll
- Bone &Mineral Unit, Oregon Health &Science University, Portland, Oregon 97239, USA
- Department of Medicine, Oregon Health &Science University, Portland, Oregon 97239, USA
| | - David Karasik
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13010, Israel
| | - George Davey-Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | - Albert V Smith
- Icelandic Heart Association, Kopavogur IS-201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik IS-101, Iceland
| | | | - Tamara B Harris
- Laboratory of Epidemiology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Joyce B J van Meurs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
| | - Unnur Thorsteinsdottir
- Department of Population Genomics, deCODE Genetics, Reykjavik IS-101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik IS-101, Iceland
| | - Matthew T Maurano
- Department of Genome Sciences, University of Washington, Seattle, Washington 98195, USA
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Richard Durbin
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, UK
| | - Scott G Wilson
- Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands 6009, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley 6009, Australia
| | - Evangelia E Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island 02903, USA
| | - Matthew A Brown
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
| | - Kari Stefansson
- Faculty of Medicine, University of Iceland, Reykjavik IS-101, Iceland
- deCODE Genetics, Reykjavik IS-101, Iceland
| | - David A Hinds
- Department of Research, 23andMe, Mountain View, California 94041, USA
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK
| | - L Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
- Framingham Heart Study, Framingham, Massachusetts 01702, USA
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden
| | - Celia M T Greenwood
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
- Department of Human Genetics, McGill University, Montréal H3A 1B1, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal H3A 1A2, Canada
- Department of Oncology, Gerald Bronfman Centre, McGill University, Montréal H2W 1S6, Canada
| | - Rebecca D Jackson
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, Ohio 43210, USA
| | - David W Rowe
- Department of Reconstructive Sciences, College of Dental Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
| | - Cynthia A Loomis
- The Ronald O. Perelman Department of Dermatology and Department of Cell Biology, New York University School of Medicine, New York, New York 10016, USA
| | - David M Evans
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | | | - Alexandra L Joyner
- Developmental Biology Program, Sloan Kettering Institute, New York, New York 10065, USA
| | - Emma L Duncan
- The University of Queensland Diamantina Institute, Translational Research Institute, Princess Alexandra Hospital, Brisbane 4102, Australia
- Department of Diabetes and Endocrinology, Royal Brisbane and Women's Hospital, Brisbane 4029, Australia
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
- Broad Institute of MIT and Harvard, Boston, Massachusetts 02115, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam 3015GE, The Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging (NCHA), Leiden 2300RC, The Netherlands
| | - J Brent Richards
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montréal H3A 1A2, Canada
- Department of Medicine, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal H3T 1E2, Canada
- Department of Twin Research and Genetic Epidemiology, King's College London, London SE1 7EH, UK
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Swanson CM, Srikanth P, Lee CG, Cummings SR, Jans I, Cauley JA, Bouillon R, Vanderschueren D, Orwoll ES, Nielson CM. Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. J Bone Miner Res 2015; 30:1403-13. [PMID: 25707402 PMCID: PMC4506713 DOI: 10.1002/jbmr.2487] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 12/22/2022]
Abstract
Relationships between 1,25-dihydroxyvitamin D (1,25(OH)2 D) and skeletal outcomes are uncertain. We examined the associations of 1,25(OH)2 D with bone mineral density (BMD), BMD change, and incident non-vertebral fractures in a cohort of older men and compared them with those of 25-hydroxyvitamin D (25OHD). The study population included 1000 men (aged 74.6 ± 6.2 years) in the Osteoporotic Fractures in Men (MrOS) study, of which 537 men had longitudinal dual-energy X-ray absorptiometry (DXA) data (4.5 years of follow-up). A case-cohort design and Cox proportional hazards models were used to test the association between vitamin D metabolite levels and incident nonvertebral and hip fractures. Linear regression models were used to estimate the association between vitamin D measures and baseline BMD and BMD change. Interactions between 25OHD and 1,25(OH)2 D were tested for each outcome. Over an average follow-up of 5.1 years, 432 men experienced incident nonvertebral fractures, including 81 hip fractures. Higher 25OHD was associated with higher baseline BMD, slower BMD loss, and lower hip fracture risk. Conversely, men with higher 1,25(OH)2 D had lower baseline BMD. 1,25(OH)2 D was not associated with BMD loss or nonvertebral fracture. Compared with higher levels of calcitriol, the risk of hip fracture was higher in men with the lowest 1,25(OH)2 D levels (8.70 to 51.60 pg/mL) after adjustment for baseline hip BMD (hazard ratio [HR] = 1.99, 95% confidence interval [CI] 1.19-3.33). Adjustment of 1,25(OH)2 D data for 25OHD (and vice versa) had little effect on the associations observed but did attenuate the hip fracture association of both vitamin D metabolites. In older men, higher 1,25(OH)2 D was associated with lower baseline BMD but was not related to the rate of bone loss or nonvertebral fracture risk. However, with BMD adjustment, a protective association for hip fracture was found with higher 1,25(OH)2 D. The associations of 25OHD with skeletal outcomes were generally stronger than those for 1,25(OH)2 D. These results do not support the hypothesis that measures of 1,25(OH)2 D improve the ability to predict adverse skeletal outcomes when 25OHD measures are available. © 2015 American Society for Bone and Mineral Research.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Priya Srikanth
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christine G Lee
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,Research Service, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Steven R Cummings
- California Pacific Medical Research Institute, San Francisco, CA, USA
| | - Ivo Jans
- Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium.,Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Eric S Orwoll
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Carrie M Nielson
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
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45
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Shen J, Nielson CM, Marshall LM, Lee DC, Keaveny TM, Orwoll ES. The Association Between BMI and QCT-Derived Proximal Hip Structure and Strength in Older Men: A Cross-Sectional Study. J Bone Miner Res 2015; 30:1301-8. [PMID: 25565555 PMCID: PMC4755511 DOI: 10.1002/jbmr.2450] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/23/2014] [Accepted: 12/31/2014] [Indexed: 01/28/2023]
Abstract
Although higher body mass index (BMI) is associated with higher bone mineral density, recent evidence indicates that increased BMI may not be consistently associated with reduced hip fracture risk. Moreover, substantial proportions of hip fractures occur among overweight and obese men and women. The role of increased BMI and obesity on bone density, structure, and strength at the hip is not well understood. We conducted cross-sectional analyses between BMI and various density and structure measures derived from quantitative computed tomography (QCT)-scans of the proximal femur, in 3067 men (mean age: 73 y) from the Osteoporotic Fractures in Men Study (MrOS). Finite element (FE) analysis of hip QCT scans was performed for a subcohort of 672 men to provide a measure of femoral strength for a simulated sideways fall. The impact force was estimated using patient-specific weight and height information. Multivariable general linear models were used to examine the associations between BMI and hip QCT measures. The relationship of BMI with hip QCT measures was significantly different between men categorized as non-obese and obese (P for interaction ≤ 0.014). For non-obese men (BMI < 30), increasing BMI was associated with higher integral, cortical and trabecular vBMD, integral volume, cross-sectional area, and percent cortical volume (all p < 0.001). For obese men (BMI ≥30), increasing BMI was not associated with any of those parameters. In addition, compared to non-obese men, obese men had a higher hip strength, but also a higher ratio of impact force to strength (P < 0.0001), in theory increasing their risk of hip fracture despite their increased strength. These results provide a better understanding of hip fracture risk in obese men.
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Affiliation(s)
- Jian Shen
- Department of Medicine, Bone and Mineral Unit, Oregon Health and Science University, Portland, OR
| | - Carrie M Nielson
- Department of Medicine, Bone and Mineral Unit, Oregon Health and Science University, Portland, OR
| | - Lynn M Marshall
- Departments of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR
| | | | - Tony M Keaveny
- O.N. Diagnostics, Berkeley, CA.,Department of Mechanical Engineering, University of California, Berkeley, Berkeley, CA
| | - Eric S Orwoll
- Department of Medicine, Bone and Mineral Unit, Oregon Health and Science University, Portland, OR
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46
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Eriksson J, Evans DS, Nielson CM, Shen J, Srikanth P, Hochberg M, McWeeney S, Cawthon PM, Wilmot B, Zmuda J, Tranah G, Mirel DB, Challa S, Mooney M, Crenshaw A, Karlsson M, Mellström D, Vandenput L, Orwoll E, Ohlsson C. Limited clinical utility of a genetic risk score for the prediction of fracture risk in elderly subjects. J Bone Miner Res 2015; 30:184-94. [PMID: 25043339 PMCID: PMC4281709 DOI: 10.1002/jbmr.2314] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/25/2014] [Accepted: 07/05/2014] [Indexed: 01/03/2023]
Abstract
It is important to identify the patients at highest risk of fractures. A recent large-scale meta-analysis identified 63 autosomal single-nucleotide polymorphisms (SNPs) associated with bone mineral density (BMD), of which 16 were also associated with fracture risk. Based on these findings, two genetic risk scores (GRS63 and GRS16) were developed. Our aim was to determine the clinical usefulness of these GRSs for the prediction of BMD, BMD change, and fracture risk in elderly subjects. We studied two male (Osteoporotic Fractures in Men Study [MrOS] US, MrOS Sweden) and one female (Study of Osteoporotic Fractures [SOF]) large prospective cohorts of older subjects, looking at BMD, BMD change, and radiographically and/or medically confirmed incident fractures (8067 subjects, 2185 incident nonvertebral or vertebral fractures). GRS63 was associated with BMD (≅3% of the variation explained) but not with BMD change. Both GRS63 and GRS16 were associated with fractures. After BMD adjustment, the effect sizes for these associations were substantially reduced. Similar results were found using an unweighted GRS63 and an unweighted GRS16 compared with those found using the corresponding weighted risk scores. Only minor improvements in C-statistics (AUC) for fractures were found when the GRSs were added to a base model (age, weight, and height), and no significant improvements in C-statistics were found when they were added to a model further adjusted for BMD. Net reclassification improvements with the addition of the GRSs to a base model were modest and substantially attenuated in BMD-adjusted models. GRS63 is associated with BMD, but not BMD change, suggesting that the genetic determinants of BMD differ from those of BMD change. When BMD is known, the clinical utility of the two GRSs for fracture prediction is limited in elderly subjects.
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Affiliation(s)
- Joel Eriksson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Leslie WD, Orwoll ES, Nielson CM, Morin SN, Majumdar SR, Johansson H, Odén A, McCloskey EV, Kanis JA. Estimated lean mass and fat mass differentially affect femoral bone density and strength index but are not FRAX independent risk factors for fracture. J Bone Miner Res 2014; 29:2511-9. [PMID: 24825359 DOI: 10.1002/jbmr.2280] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/26/2014] [Accepted: 05/04/2014] [Indexed: 11/07/2022]
Abstract
Although increasing body weight has been regarded as protective against osteoporosis and fractures, there is accumulating evidence that fat mass adversely affects skeletal health compared with lean mass. We examined skeletal health as a function of estimated total body lean and fat mass in 40,050 women and 3600 men age ≥50 years at the time of baseline dual-energy X-ray absorptiometry (DXA) testing from a clinical registry from Manitoba, Canada. Femoral neck bone mineral density (BMD), strength index (SI), cross-sectional area (CSA), and cross-sectional moment of inertia (CSMI) were derived from DXA. Multivariable models showed that increasing lean mass was associated with near-linear increases in femoral BMD, CSA, and CSMI in both women and men, whereas increasing fat mass showed a small initial increase in these measurements followed by a plateau. In contrast, femoral SI was relatively unaffected by increasing lean mass but was associated with a continuous linear decline with increasing fat mass, which should predict higher fracture risk. During mean 5-year follow-up, incident major osteoporosis fractures and hip fractures were observed in 2505 women and 180 men (626 and 45 hip fractures, respectively). After adjustment for fracture risk assessment tool (FRAX) scores (with or without BMD), we found no evidence that lean mass, fat mass, or femoral SI affected prediction of major osteoporosis fractures or hip fractures. Findings were similar in men and women, without significant interactions with sex or obesity. In conclusion, skeletal adaptation to increasing lean mass was positively associated with BMD but had no effect on femoral SI, whereas increasing fat mass had no effect on BMD but adversely affected femoral SI. Greater fat mass was not independently associated with a greater risk of fractures over 5-year follow-up. FRAX robustly predicts fractures and was not affected by variations in body composition.
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Chun RF, Peercy BE, Orwoll ES, Nielson CM, Adams JS, Hewison M. Vitamin D and DBP: the free hormone hypothesis revisited. J Steroid Biochem Mol Biol 2014; 144 Pt A:132-7. [PMID: 24095930 PMCID: PMC3976473 DOI: 10.1016/j.jsbmb.2013.09.012] [Citation(s) in RCA: 298] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/20/2013] [Accepted: 09/24/2013] [Indexed: 12/21/2022]
Abstract
The last five years have witnessed a remarkable renaissance in vitamin D research and a complete re-evaluation of its benefits to human health. Two key factors have catalyzed these changes. First, it now seems likely that localized, tissue-specific, conversion of 25-hydroxyvitamin D (25OHD) to 1,25-dihydroxyvitamin D (1,25(OH)2D) drives many of the newly recognized effects of vitamin D on human health. The second key factor concerns the ongoing discussion as to what constitutes adequate or optimal serum vitamin D (25OHD) status, with the possibility that vitamin D-deficiency is common to communities across the globe. These two concepts appear to be directly linked when low serum concentrations of 25OHD compromise intracrine generation of 1,25(OH)2D within target tissues. But, is this an over-simplification? Pro-hormone 25OHD is a lipophilic molecule that is transported in the circulation bound primarily to vitamin D binding protein (DBP). While the association between 25OHD and DBP is pivotal for renal handling of 25OHD and endocrine synthesis of 1,25(OH)2D, what is the role of DBP for extra-renal synthesis of 1,25(OH)2D? We hypothesize that binding to DBP impairs delivery of 25OHD to the vitamin D-activating enzyme 1α-hydroxylase in some target cells. Specifically, it is unbound, 'free' 25OHD that drives many of the non-classical actions of vitamin D. Levels of 'free' 25OHD are dependent on the concentration of DBP and alternative serum binding proteins such as albumin, but will also be influenced by variations in DBP binding affinity for specific vitamin D metabolites. The aim of this review will be to discuss the merits of 'free 25OHD' as an alternative marker of vitamin D status, particularly in the context of non-classical responses to vitamin D. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.
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Affiliation(s)
- Rene F Chun
- Orthopaedic Hospital Research Center, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Bradford E Peercy
- Department of Mathematics and Statistics, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - Eric S Orwoll
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Carrie M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - John S Adams
- Orthopaedic Hospital Research Center, University of California Los Angeles, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Martin Hewison
- Orthopaedic Hospital Research Center, University of California Los Angeles, Los Angeles, CA 90095, USA; Molecular Biology Institute, University of California Los Angeles, Los Angeles, CA 90095, USA.
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Lee DSH, Markwardt S, Goeres L, Lee CG, Eckstrom E, Williams C, Fu R, Orwoll E, Cawthon PM, Stefanick ML, Mackey D, Bauer DC, Nielson CM. Statins and physical activity in older men: the osteoporotic fractures in men study. JAMA Intern Med 2014; 174:1263-70. [PMID: 24911216 PMCID: PMC4346343 DOI: 10.1001/jamainternmed.2014.2266] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Muscle pain, fatigue, and weakness are common adverse effects of statin medications and may decrease physical activity in older men. OBJECTIVE To determine whether statin use is associated with physical activity, longitudinally and cross-sectionally. DESIGN, SETTING, AND PARTICIPANTS Men participating in the Osteoporotic Fractures in Men Study (N = 5994), a multicenter prospective cohort study of community-living men 65 years and older, enrolled between March 2000 and April 2002. Follow-up was conducted through 2009. EXPOSURES Statin use as determined by an inventory of medications (taken within the last 30 days). In cross-sectional analyses (n = 4137), statin use categories were users and nonusers. In longitudinal analyses (n = 3039), categories were prevalent users (baseline use and throughout the study), new users (initiated use during the study), and nonusers (never used). MAIN OUTCOMES AND MEASURES Self-reported physical activity at baseline and 2 follow-up visits using the Physical Activity Scale for the Elderly (PASE). At the third visit, an accelerometer measured metabolic equivalents (METs [kilocalories per kilogram per hour]) and minutes of moderate activity (METs ≥3.0), vigorous activity (METs ≥6.0), and sedentary behavior (METs ≤1.5). RESULTS At baseline, 989 men (24%) were users and 3148 (76%) were nonusers. The adjusted difference in baseline PASE between users and nonusers was -5.8 points (95% CI, -10.9 to -0.7 points). A total of 3039 men met the inclusion criteria for longitudinal analysis: 727 (24%) prevalent users, 845 (28%) new users, and 1467 (48%) nonusers. PASE score declined by a mean (95% CI) of 2.5 (2.0 to 3.0) points per year for nonusers and 2.8 (2.1 to 3.5) points per year for prevalent users, a nonstatistical difference (0.3 [-0.5 to 1.0] points). For new users, annual PASE score declined at a faster rate than nonusers (difference of 0.9 [95% CI, 0.1 to 1.7] points). A total of 3071 men had adequate accelerometry data, 1542 (50%) were statin users. Statin users expended less METs (0.03 [95% CI, 0.02-0.04] METs less) and engaged in less moderate physical activity (5.4 [95% CI, 1.9-8.8] fewer minutes per day), less vigorous activity (0.6 [95% CI, 0.1-1.1] fewer minutes per day), and more sedentary behavior (7.6 [95% CI, 2.6-12.4] greater minutes per day). CONCLUSIONS AND RELEVANCE Statin use was associated with modestly lower physical activity among community-living men, even after accounting for medical history and other potentially confounding factors. The clinical significance of these findings deserves further investigation.
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Affiliation(s)
- David S H Lee
- Department of Pharmacy Practice, Oregon State University/Oregon Health and Science University College of Pharmacy, Portland
| | - Sheila Markwardt
- Department of Pharmacy Practice, Oregon State University/Oregon Health and Science University College of Pharmacy, Portland
| | - Leah Goeres
- Department of Pharmacy Practice, Oregon State University/Oregon Health and Science University College of Pharmacy, Portland
| | - Christine G Lee
- Research Service, Department of Veterans Affairs Medical Center, Portland, Oregon3Division of Endocrinology, Department of Medicine, Diabetes and Clinical Nutrition, Oregon Health and Science University School of Medicine, Portland
| | - Elizabeth Eckstrom
- Division of General Medicine and Geriatrics, Oregon Health and Science University School of Medicine, Portland
| | - Craig Williams
- Department of Pharmacy Practice, Oregon State University/Oregon Health and Science University College of Pharmacy, Portland
| | - Rongwei Fu
- Department of Public Health and Preventive Medicine, Oregon Health and Science University School of Medicine, Portland
| | - Eric Orwoll
- Division of Endocrinology, Department of Medicine, Diabetes and Clinical Nutrition, Oregon Health and Science University School of Medicine, Portland
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco
| | - Marcia L Stefanick
- Prevention Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California
| | - Dawn Mackey
- California Pacific Medical Center Research Institute, San Francisco
| | - Douglas C Bauer
- Department of Medicine, University of California, San Francisco
| | - Carrie M Nielson
- Department of Public Health and Preventive Medicine, Oregon Health and Science University School of Medicine, Portland
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50
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Swanson CM, Nielson CM, Shrestha S, Lee CG, Barrett-Connor E, Jans I, Cauley JA, Boonen S, Bouillon R, Vanderschueren D, Orwoll ES. Higher 25(OH)D2 is associated with lower 25(OH)D3 and 1,25(OH)2D3. J Clin Endocrinol Metab 2014; 99:2736-44. [PMID: 24828488 PMCID: PMC4121037 DOI: 10.1210/jc.2014-1069] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Despite common use of supplemental vitamin D2 in clinical practice, the associations of serum vitamin D2 concentrations with other vitamin D metabolites and total vitamin D are unclear. OBJECTIVE The aim of the study was to measure vitamin D2 and D3 levels and examine their associations with each other and with total vitamin D. DESIGN We performed a cross-sectional analysis of 679 randomly selected participants from the Osteoporotic Fractures in Men Study. 25-Hydroxyvitamin D2 [25(OH)D2], 25(OH)D3, 1,25-dihydroxyvitamin D2 [1,25(OH)2D2], and 1,25(OH)2D3 were measured using liquid chromatography-tandem mass spectrometry and were summed to obtain total 25(OH)D and 1,25(OH)2D. Associations between all metabolites (D2, D3, and total levels) were examined using Wilcoxon rank-sum tests and Spearman correlations. RESULTS 25(OH)D2 and 1,25(OH)2D2 were detectable in 189 (27.8%) and 178 (26.2%) of the men, respectively. Higher 25(OH)D2 levels did not correlate with higher total 25(OH)D (r = 0.10; P = .17), although median total 25(OH)D was slightly higher in those with detectable vs undetectable 25(OH)D2 (25.8 vs 24.3 ng/mL; P < .001). 25(OH)D2 was not positively associated with total 1,25(OH)2D levels (r = -0.11; P = .13), and median 1,25(OH)2D level was not higher in those with detectable vs undetectable 25(OH)D2. Higher 25(OH)D2 was associated with lower 25(OH)D3 (r = -0.35; P < .001) and 1,25(OH)2D3 (r = -0.32; P < .001), with median levels of both D3 metabolites 18-35% higher when D2 metabolites were undetectable. CONCLUSIONS In a cohort of older men, 25(OH)D2 is associated with lower levels of 25(OH)D3 and 1,25(OH)2D3, suggesting that vitamin D2 may decrease the availability of D3 and may not increase calcitriol levels.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology (C.M.S., C.G.L., E.S.O.), Bone and Mineral Unit (C.M.S., C.M.N., S.S., C.G.L., E.S.O.), and Department of Public Health and Preventive Medicine (C.M.N.), Oregon Health & Science University, Portland, Oregon 97239; Research Service (C.G.L.), Portland Veterans Affairs Medical Center, Portland, Oregon 97239; Division of Epidemiology (E.B.-C.), Department of Family & Preventive Medicine, University California San Diego, La Jolla, California 92093-0607; Laboratory of Diagnostic Medicine (I.J., D.V.), KU Leuven, University of Leuven, 3000 Leuven, Belgium; Department of Epidemiology (J.A.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; and Division of Geriatric Medicine and Centre for Metabolic Bone Diseases (S.B.), and Laboratory of Clinical and Experimental Endocrinology (R.B., D.V.), KU Leuven, University of Leuven, 3000 Leuven, Belgium
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