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      Genetic pleiotropy between age-related macular degeneration and 16 complex diseases and traits

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          Abstract

          Background

          Age-related macular degeneration (AMD) is a common condition of vision loss with disease development strongly influenced by environmental and genetic factors. Recently, 34 loci were associated with AMD at genome-wide significance. So far, little is known about a genetic overlap between AMD and other complex diseases or disease-relevant traits.

          Methods

          For each of 60 complex diseases/traits with publicly available genome-wide significant association data, the lead genetic variant per independent locus was extracted and a genetic score was calculated for each disease/trait as the weighted sum of risk alleles. The association with AMD was estimated based on 16,144 AMD cases and 17,832 controls using logistic regression.

          Results

          Of the respective disease/trait variance, the 60 genetic scores explained on average 4.8% (0.27–20.69%) and 16 of them were found to be significantly associated with AMD (Q-values < 0.01, p values from < 1.0 × 10 –16 to 1.9 × 10 –3). Notably, an increased risk for AMD was associated with reduced risk for cardiovascular diseases, increased risk for autoimmune diseases, higher HDL and lower LDL levels in serum, lower bone-mineral density as well as an increased risk for skin cancer. By restricting the analysis to 1824 variants initially used to compute the 60 genetic scores, we identified 28 novel AMD risk variants (Q-values < 0.01, p values from 1.1 × 10 –7 to 3.0 × 10 –4), known to be involved in cardiovascular disorders, lipid metabolism, autoimmune diseases, anthropomorphic traits, ocular disorders, and neurological diseases. The latter variants represent 20 novel AMD-associated, pleiotropic loci. Genes in the novel loci reinforce previous findings strongly implicating the complement system in AMD pathogenesis.

          Conclusions

          We demonstrate a substantial overlap of the genetics of several complex diseases/traits with AMD and provide statistically significant evidence for an additional 20 loci associated with AMD. This highlights the possibility that so far unrelated pathologies may have disease pathways in common.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13073-017-0418-0) contains supplementary material, which is available to authorized users.

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          Most cited references61

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          Robust associations of four new chromosome regions from genome-wide analyses of type 1 diabetes.

          The Wellcome Trust Case Control Consortium (WTCCC) primary genome-wide association (GWA) scan on seven diseases, including the multifactorial autoimmune disease type 1 diabetes (T1D), shows associations at P < 5 x 10(-7) between T1D and six chromosome regions: 12q24, 12q13, 16p13, 18p11, 12p13 and 4q27. Here, we attempted to validate these and six other top findings in 4,000 individuals with T1D, 5,000 controls and 2,997 family trios independent of the WTCCC study. We confirmed unequivocally the associations of 12q24, 12q13, 16p13 and 18p11 (P(follow-up)
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            A simplified severity scale for age-related macular degeneration: AREDS Report No. 18.

            To develop a simplified clinical scale defining risk categories for development of advanced age-related macular degeneration (AMD). Following development of a detailed scale for individual eyes based on gradings of fundus photographs in the Age-Related Eye Disease Study, rates of progression to advanced AMD were assessed in cross-tabulations of presence or absence in each eye of 2 easily identified retinal abnormalities, drusen and pigment abnormalities. Large drusen and any pigment changes were particularly predictive of developing advanced AMD. The scoring system developed for patients assigns to each eye 1 risk factor for the presence of 1 or more large (> or = 125 microm, width of a large vein at disc margin) drusen and 1 risk factor for the presence of any pigment abnormality. Risk factors are summed across both eyes, yielding a 5-step scale (0-4) on which the approximate 5-year risk of developing advanced AMD in at least one eye increases in this easily remembered sequence: 0 factors, 0.5%; 1 factor, 3%; 2 factors, 12%; 3 factors, 25%; and 4 factors, 50%. For persons with no large drusen, presence of intermediate drusen in both eyes is counted as 1 risk factor. This simplified scale provides convenient risk categories for development of advanced AMD that can be determined by clinical examination or by less demanding photographic procedures than used in the Age-Related Eye Disease Study.
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              Genome-wide association study identifies loci influencing concentrations of liver enzymes in plasma.

              Concentrations of liver enzymes in plasma are widely used as indicators of liver disease. We carried out a genome-wide association study in 61,089 individuals, identifying 42 loci associated with concentrations of liver enzymes in plasma, of which 32 are new associations (P = 10(-8) to P = 10(-190)). We used functional genomic approaches including metabonomic profiling and gene expression analyses to identify probable candidate genes at these regions. We identified 69 candidate genes, including genes involved in biliary transport (ATP8B1 and ABCB11), glucose, carbohydrate and lipid metabolism (FADS1, FADS2, GCKR, JMJD1C, HNF1A, MLXIPL, PNPLA3, PPP1R3B, SLC2A2 and TRIB1), glycoprotein biosynthesis and cell surface glycobiology (ABO, ASGR1, FUT2, GPLD1 and ST3GAL4), inflammation and immunity (CD276, CDH6, GCKR, HNF1A, HPR, ITGA1, RORA and STAT4) and glutathione metabolism (GSTT1, GSTT2 and GGT), as well as several genes of uncertain or unknown function (including ABHD12, EFHD1, EFNA1, EPHA2, MICAL3 and ZNF827). Our results provide new insight into genetic mechanisms and pathways influencing markers of liver function.
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                Author and article information

                Contributors
                felix.grassmann@ukr.de
                christina.kiel@ukr.de
                martina.zimmermann@ukr.de
                mathias.gorski@ukr.de
                veronika.grassmann@ukr.de
                klaus.stark@ukr.de
                iris.heid@ukr.de
                +49-941-944-5400 , bweb@klinik.uni-regensburg.de
                Journal
                Genome Med
                Genome Med
                Genome Medicine
                BioMed Central (London )
                1756-994X
                27 March 2017
                27 March 2017
                2017
                : 9
                : 29
                Affiliations
                [1 ]ISNI 0000 0001 2190 5763, GRID grid.7727.5, Institute of Human Genetics, , University of Regensburg, ; Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
                [2 ]ISNI 0000 0001 2190 5763, GRID grid.7727.5, Department of Genetic Epidemiology, , University of Regensburg, ; Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
                [3 ]ISNI 0000 0001 2190 5763, GRID grid.7727.5, Institute of Medical Microbiology and Hygiene, , University of Regensburg, ; Franz-Josef-Strauss-Allee 11, Regensburg, 93053 Germany
                Article
                418
                10.1186/s13073-017-0418-0
                5368911
                28347358
                175e8a15-d52e-4884-aa43-b427ca1c9570
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 1 November 2016
                : 2 March 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000053, National Eye Institute;
                Award ID: EY022310
                Funded by: FundRef http://dx.doi.org/10.13039/501100001659, Deutsche Forschungsgemeinschaft;
                Award ID: WE 1259/19-1
                Award ID: WE 1259/19-2
                Funded by: FundRef http://dx.doi.org/10.13039/100007817, Alcon Research Institute;
                Award ID: Award 2007
                Funded by: CIDR
                Award ID: HHSN268201200008I
                Funded by: FundRef http://dx.doi.org/10.13039/100000053, National Eye Institute ;
                Award ID: 1X01HG006934
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Molecular medicine
                age-related macular degeneration,amd,genetic risk scores,grs,genetic association studies,complex traits,shared genetics

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