Exome-wide association study of plasma lipids in >300,000 individuals.
Liu DJ., Peloso GM., Yu H., Butterworth AS., Wang X., Mahajan A., Saleheen D., Emdin C., Alam D., Alves AC., Amouyel P., Di Angelantonio E., Arveiler D., Assimes TL., Auer PL., Baber U., Ballantyne CM., Bang LE., Benn M., Bis JC., Boehnke M., Boerwinkle E., Bork-Jensen J., Bottinger EP., Brandslund I., Brown M., Busonero F., Caulfield MJ., Chambers JC., Chasman DI., Chen YE., Chen Y-DI., Chowdhury R., Christensen C., Chu AY., Connell JM., Cucca F., Cupples LA., Damrauer SM., Davies G., Deary IJ., Dedoussis G., Denny JC., Dominiczak A., Dubé M-P., Ebeling T., Eiriksdottir G., Esko T., Farmaki A-E., Feitosa MF., Ferrario M., Ferrieres J., Ford I., Fornage M., Franks PW., Frayling TM., Frikke-Schmidt R., Fritsche LG., Frossard P., Fuster V., Ganesh SK., Gao W., Garcia ME., Gieger C., Giulianini F., Goodarzi MO., Grallert H., Grarup N., Groop L., Grove ML., Gudnason V., Hansen T., Harris TB., Hayward C., Hirschhorn JN., Holmen OL., Huffman J., Huo Y., Hveem K., Jabeen S., Jackson AU., Jakobsdottir J., Jarvelin M-R., Jensen GB., Jørgensen ME., Jukema JW., Justesen JM., Kamstrup PR., Kanoni S., Karpe F., Kee F., Khera AV., Klarin D., Koistinen HA., Kooner JS., Kooperberg C., Kuulasmaa K., Kuusisto J., Laakso M., Lakka T., Langenberg C., Langsted A., Launer LJ., Lauritzen T., Liewald DCM., Lin LA., Linneberg A., Loos RJF., Lu Y., Lu X., Mägi R., Malarstig A., Manichaikul A., Manning AK., Mäntyselkä P., Marouli E., Masca NGD., Maschio A., Meigs JB., Melander O., Metspalu A., Morris AP., Morrison AC., Mulas A., Müller-Nurasyid M., Munroe PB., Neville MJ., Nielsen JB., Nielsen SF., Nordestgaard BG., Ordovas JM., Mehran R., O'Donnell CJ., Orho-Melander M., Molony CM., Muntendam P., Padmanabhan S., Palmer CNA., Pasko D., Patel AP., Pedersen O., Perola M., Peters A., Pisinger C., Pistis G., Polasek O., Poulter N., Psaty BM., Rader DJ., Rasheed A., Rauramaa R., Reilly DF., Reiner AP., Renström F., Rich SS., Ridker PM., Rioux JD., Robertson NR., Roden DM., Rotter JI., Rudan I., Salomaa V., Samani NJ., Sanna S., Sattar N., Schmidt EM., Scott RA., Sever P., Sevilla RS., Shaffer CM., Sim X., Sivapalaratnam S., Small KS., Smith AV., Smith BH., Somayajula S., Southam L., Spector TD., Speliotes EK., Starr JM., Stirrups KE., Stitziel N., Strauch K., Stringham HM., Surendran P., Tada H., Tall AR., Tang H., Tardif J-C., Taylor KD., Trompet S., Tsao PS., Tuomilehto J., Tybjaerg-Hansen A., van Zuydam NR., Varbo A., Varga TV., Virtamo J., Waldenberger M., Wang N., Wareham NJ., Warren HR., Weeke PE., Weinstock J., Wessel J., Wilson JG., Wilson PWF., Xu M., Yaghootkar H., Young R., Zeggini E., Zhang H., Zheng NS., Zhang W., Zhang Y., Zhou W., Zhou Y., Zoledziewska M., Charge Diabetes Working Group None., EPIC-InterAct Consortium None., EPIC-CVD Consortium None., GOLD Consortium None., VA Million Veteran Program None., Howson JMM., Danesh J., McCarthy MI., Cowan CA., Abecasis G., Deloukas P., Musunuru K., Willer CJ., Kathiresan S.
We screened variants on an exome-focused genotyping array in >300,000 participants (replication in >280,000 participants) and identified 444 independent variants in 250 loci significantly associated with total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C), and/or triglycerides (TG). At two loci (JAK2 and A1CF), experimental analysis in mice showed lipid changes consistent with the human data. We also found that: (i) beta-thalassemia trait carriers displayed lower TC and were protected from coronary artery disease (CAD); (ii) excluding the CETP locus, there was not a predictable relationship between plasma HDL-C and risk for age-related macular degeneration; (iii) only some mechanisms of lowering LDL-C appeared to increase risk for type 2 diabetes (T2D); and (iv) TG-lowering alleles involved in hepatic production of TG-rich lipoproteins (TM6SF2 and PNPLA3) tracked with higher liver fat, higher risk for T2D, and lower risk for CAD, whereas TG-lowering alleles involved in peripheral lipolysis (LPL and ANGPTL4) had no effect on liver fat but decreased risks for both T2D and CAD.