Comparative Analysis of Metabolic Syndrome Components in over 15,000 African Americans Identifies Pleiotropic Variants: Results from the PAGE Study
Background—Metabolic syndrome (MetS) refers to the clustering of cardio-metabolic risk factors including dyslipidemia, central adiposity, hypertension and hyperglycemia in individuals. Identification of pleiotropic genetic factors associated with MetS traits may shed light on key pathways or mediators underlying MetS.
Methods and Results—Using the Metabochip array in 15,148 African Americans (AA) from the PAGE Study, we identify susceptibility loci and investigate pleiotropy among genetic variants using a subset-based meta-analysis method, ASsociation-analysis-based-on-subSETs (ASSET). Unlike conventional models which lack power when associations for MetS components are null or have opposite effects, ASSET uses one-sided tests to detect positive and negative associations for components separately and combines tests accounting for correlations among components. With ASSET, we identify 27 SNPs in 1 glucose and 4 lipids loci (TCF7L2, LPL, APOA5, CETP, LPL, APOC1/APOE/TOMM40) significantly associated with MetS components overall, all P< 2.5e-7, the Bonferroni adjusted P-value. Three loci replicate in a Hispanic population, n=5172. A novel AA-specific variant, rs12721054/APOC1, and rs10096633/LPL are associated with ≥3 MetS components. We find additional evidence of pleiotropy for APOE, TOMM40, TCF7L2 and CETP variants, many with opposing effects; e.g. the same rs7901695/TCF7L2 allele is associated with increased odds of high glucose and decreased odds of central adiposity.
Conclusions—We highlight a method to increase power in large-scale genomic association analyses, and report a novel variant associated with all MetS components in AA. We also identify pleiotropic associations that may be clinically useful in patient risk profiling and for informing translational research of potential gene targets and medications.
- PAGE Study
- African Americans
- cardio-metabolic traits
- metabolic syndrome
- population studies
- high-density lipoprotein cholesterol
- genetic variation
- Received October 16, 2013.
- Revision received May 12, 2014.
- Accepted May 23, 2014.