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BMC Medical Genetics logoLink to BMC Medical Genetics
. 2007 Sep 19;8(Suppl 1):S16. doi: 10.1186/1471-2350-8-S1-S16

Genome-wide association with diabetes-related traits in the Framingham Heart Study

James B Meigs 1,, Alisa K Manning 2, Caroline S Fox 3, Jose C Florez 4, Chunyu Liu 2, L Adrienne Cupples 2, Josée Dupuis 2
PMCID: PMC1995610  PMID: 17903298

Abstract

Background

Susceptibility to type 2 diabetes may be conferred by genetic variants having modest effects on risk. Genome-wide fixed marker arrays offer a novel approach to detect these variants.

Methods

We used the Affymetrix 100K SNP array in 1,087 Framingham Offspring Study family members to examine genetic associations with three diabetes-related quantitative glucose traits (fasting plasma glucose (FPG), hemoglobin A1c, 28-yr time-averaged FPG (tFPG)), three insulin traits (fasting insulin, HOMA-insulin resistance, and 0–120 min insulin sensitivity index); and with risk for diabetes. We used additive generalized estimating equations (GEE) and family-based association test (FBAT) models to test associations of SNP genotypes with sex-age-age2-adjusted residual trait values, and Cox survival models to test incident diabetes.

Results

We found 415 SNPs associated (at p < 0.001) with at least one of the six quantitative traits in GEE, 242 in FBAT (18 overlapped with GEE for 639 non-overlapping SNPs), and 128 associated with incident diabetes (31 overlapped with the 639) giving 736 non-overlapping SNPs. Of these 736 SNPs, 439 were within 60 kb of a known gene. Additionally, 53 SNPs (of which 42 had r2 < 0.80 with each other) had p < 0.01 for incident diabetes AND (all 3 glucose traits OR all 3 insulin traits, OR 2 glucose traits and 2 insulin traits); of these, 36 overlapped with the 736 other SNPs. Of 100K SNPs, one (rs7100927) was in moderate LD (r2 = 0.50) with TCF7L2 (rs7903146), and was associated with risk of diabetes (Cox p-value 0.007, additive hazard ratio for diabetes = 1.56) and with tFPG (GEE p-value 0.03). There were no common (MAF > 1%) 100K SNPs in LD (r2 > 0.05) with ABCC8 A1369S (rs757110), KCNJ11 E23K (rs5219), or SNPs in CAPN10 or HNFa. PPARG P12A (rs1801282) was not significantly associated with diabetes or related traits.

Conclusion

Framingham 100K SNP data is a resource for association tests of known and novel genes with diabetes and related traits posted at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?id=phs000007. Framingham 100K data replicate the TCF7L2 association with diabetes.

Background

Type 2 diabetes is a cause of poor health and early death that is spreading worldwide and exerting a fearsome human and economic toll [1,2]. Prevention and control of diabetes requires a better understanding of its basic molecular causes. Type 2 diabetes is a heterogeneous disease arising from physiological dysfunction in the pancreas, skeletal muscle, liver, adipose and vascular tissue. Much of the heterogeneity of type 2 diabetes has a genetic basis. A full picture of the complex genetic architecture of diabetes has been elusive [3-7].

Among type 2 diabetes susceptibility genes few, if any, individual loci are expected to carry alleles of major effect explaining a substantial proportion of cases, although a few genes could have a substantial population effect but not give a strong genetic signal if the causal alleles were common and the increase in risk were modest [6,7]. Such genes have proven hard to detect using linkage-based approaches, although recent rapid advances in genetic association methodologies have led to some successes. The P12A polymorphism in the gene encoding the peroxisome proliferator-activated receptor-g (PPARG) [7], the E23K polymorphism in the gene encoding the islet ATP-dependent potassium channel Kir6.2 (ABCC8-KCNJ11) [8-10] and common variants in the gene encoding the transcription factor 7-like 2 gene (TCF7L2) [11,12] were all found using well-powered association mapping, and all have been reproducibly associated with diabetes in diverse samples at highly significant p-values.

Current gene discovery strategies have focused on coding regions, but regulatory variants also influence disease [11,13,14]. A comprehensive picture of diabetes genetics will require a wide and adequately dense search across coding and conserved non-coding genomic regions using an association analysis approach, where power is superior to linkage analysis when seeking common variants of modest effect [6]. Resources are now becoming available to perform such genome-wide association (GWA) studies of type 2 diabetes [15-18].

In this report we describe the Framingham Heart Study (FHS) Affymetrix 100K SNP genome-wide association (GWA) study resource for type 2 diabetes. This resource complements the several other large extant type 2 diabetes GWA studies in three major respects: it is population-based (not diabetes proband-based), studies two generations, and has decades of longitudinal, standardized, detailed follow-up. We describe results of a simple low p-value-based SNP selection strategy and an alternate novel SNP selection strategy that takes advantage of the unique FHS diabetes-related quantitative traits data. We use FHS 100K SNPs in an in silico replication analysis that tests the hypothesis that SNPs in LD with published causal variants in PPARG, ABCC8, TCF7L2, CAPN10, and HNFa are associated with diabetes and related quantitative traits.

Methods

Study subjects

The study sample is described in the Overview Methods section [19]. With respect to diabetes-related traits, Offspring subjects provided genotypes and diabetes-related traits to the analyses, and Offspring parents from the Original FHS Cohort contributed genotypes for linkage analysis and FBAT statistics. Of 1,345 FHS subjects with 100K SNP data, 1,087 were Offspring and of these 560 were women, the mean age at exam 5 was 52 years, and the mean age at last follow-up was 59 years. Every study subject provided written informed consent at every examination, including consent for genetic analyses, and the study was approved by Boston University's Institutional Review Board.

Genotyping and annotation

Affymetrix 100K SNP and Marshfield STR genotyping are described in the Overview Methods section [19]. Genotype annotation sources are described in the Overview Methods section [19].

Diabetes phenotyping

Diabetes and related quantitative traits have been ascertained at every FHS exam for every generation. Diabetes-related quantitative traits available in the FHS 100K resource are displayed in Table 1. FPG data for the analyses came from all 7 Offspring exams, but the remainder of the data came from exam 5 (1991–94), when subjects without diagnosed diabetes underwent a 75 gram oral glucose tolerance test, or exam 7 (1998–2001), the most recent exam. We defined diabetes as chart-review-confirmed diabetes, new or ongoing hypoglycemic treatment for diabetes at any exam, or a FPG > 125 mg/dl at two or more of the seven exams. Diabetes age-of-onset was defined as the subject's age at the exam at which diabetes was first identified. Among Offspring with diabetes, >99% have type 2 diabetes [4]. Of the 1,083 Offspring with 100K genotypes and known diabetes status, 91 had diabetes. The mean age of onset of was 58 yr; through exam 7, 9.3% of diabetic subjects had developed diabetes by age 40 yr, 33.0% by age 50, 68.1% by age 60, and 99.7% by age 80.

Table 1.

Type 2 diabetes-related quantitative traits in 1087 Framingham Offspring Study subjects with 100K genotype data

Trait Number of traits Offspring Exam Cycle Cohort Exam Cycle Adjustment * Number with Genotype and Trait Levels †
Fasting plasma glucose (FPG) 1 5, 7 - age, age2 age, age2, BMI 1,027
Hemoglobin A1c (HbA1c) 1 5, 7 - age, age2 age, age2, BMI 623
28 yr time averaged FPG (tFPG) 1 1–7 - age, age2 age, age2, BMI 1,087
Fasting insulin 1 5, 7 - age, age2 age, age2, BMI 982
Homeostasis model insulin resistance (HOMA-IR) 1 5 - age, age2 age, age2, BMI 980
0–120 min insulin sensitivity (ISI_0-120) 1 5 - age, age2 age, age2, BMI 935
Incident type 2 diabetes 1 1–7 - age, age2 age, age2, BMI 91 with diabetes
1,083 without diabetes
Adiponectin 1 7 - age, age2 age, age2, BMI 828
Resistin 1 7 - age, age2 age, age2, BMI 831

* Traits were modeled as log(trait value) in sex-specific models. Residuals from these models were tested as quantitative traits associated with SNP genotype, and ranked residuals were used in linkage analyses.

† For traits with data at both exams 5 and 7, numbers are given for subjects with data at exam 5

In this presentation we focus on six (three glucose and three insulin) primary Offspring diabetes-related quantitative traits. Glucose traits are fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) measured at exam 5, and up to 28 yr time-averaged FPG (tFPG) level obtained from the mean of up to seven serial exams. Glucose traits included all subjects, including those with diabetes regardless of treatment, as these were the most informative subjects with respect to hyperglycemia. Subjects with diabetes had the highest glucose values when subjects were ranked with respect to any glucose trait; those on treatment had the highest values. The three insulin traits are fasting insulin, homeostasis model-assessed insulin resistance (HOMA-IR), and Gutt's 0–120 min insulin sensitivity index (ISI_0-120) measured at exam 5. Subjects with insulin-treated diabetes were removed from all insulin trait analyses, as we had no information on insulin dose and so measured insulin values were confounded by insulin treatment [20-22]. We also analyzed incident diabetes from first exam through last follow-up. We previously have described FHS laboratory methods for these diabetes-related quantitative traits [4,23-25]. In addition to glucose and insulin traits, levels of adiponectin and resistin are available in the FHS dbGaP resource. Plasma adiponectin and resistin concentrations were measured using a commercial ELISA (R&D Systems, Minneapolis, MN); inter- and intra-assays CVs were 5.3%–9.6% for adiponectin and 7.6%–10.5% for resistin.

SNP prioritization

We used two approaches to prioritize SNPs potentially associated with diabetes or diabetes related traits. In the first, we simply ordered SNPs from lowest to highest p-value for association with one or more of the six primary glucose and insulin traits. We also ordered SNPs or Marshfield STRS by highest to lowest LOD score for linkage to one or more of the six primary traits, and present LOD scores > 2.0. In an alternative SNP prioritization strategy, we selected SNPs associated with multiple-related traits. In this approach, we selected SNPs with consistent nominal associations (p < 0.01 in GEE or FBAT) with all three glucose traits OR all three insulin-related traits OR (two glucose and two insulin traits). Among these we used extent of LD to select a non-redundant set of SNPs; when several were perfect proxies for each other (r2 ≥ 0.8) only one SNP was selected, based on the highest genotyping call rate.

Statistical analysis

The general statistical methods for linkage and GWA analyses are described in the Overview Methods [19]. For diabetes-related quantitative traits we used additive GEE and FBAT models, testing associations between SNP genotypes and age-age2-sex-adjusted residual trait values. We kept 70,987 SNPs in the analyses that were on autosomes, had genotypic call rates ≥ 80%, HWE p ≥ 0.001 and MAF ≥ 10%.

We tested association of 100K SNPs with incident type 2 diabetes in two additional models using the same adjustment strategy. First, Martingale residuals were created to measure the age-of-onset of type 2 diabetes; residuals were analyzed with FBAT [26]. Individuals with lower values of this 'martingale residual' trait developed diabetes at younger ages, and those with the highest values had been observed for the longest time without development of diabetes [27]. Second, we used a Cox proportional hazard survival analysis with robust covariance estimates in order to find SNPs associated with development of diabetes over all seven exams [28].

Results

Diabetes-related quantitative traits available in the FHS 100K SNP resource are listed in Table 1 and posted on the NCBI web site [29]. Each trait is available as an age-age2-adjusted or age-age2-BMI-adjusted residuals from sex-specific models. In this analysis we only consider the age-age2-adjusted traits. Among these, the following were the primary traits used in this analysis: exam 5 fasting plasma glucose (FPG; n with data = 1,027; mean, SD 99, 24.7 mg/dl); exam 5 HbA1c (n = 623; 5.28, 0.9%); 28-year time averaged FPG (tFPG; n = 1,087; 98, 16.2 mg/dl); exam 5 fasting insulin (n = 982; 30.1, 16.4 uU/ml); exam 5 HOMA-IR (n = 980; 7.8, 7.3 units); and the 0–120 min insulin sensitivity index (ISI_0-120; n = 935; 26.1, 7.6 mg·l2/mmol·mU·min). Among 1,087 Offspring with 100K SNP data there were 91 cases of type 2 diabetes. Additional diabetes-related quantitative traits not used in this analysis but that are available in the FHS 100K SNP dbGaP resource include, at exam 7: FPG (n = 987; 103, 26 mg/dl); fasting insulin (n = 999; 15.8, 12.8 uU/ml); HOMA-IR (n = 969; 4.2, 4.1 units); HbA1c (n = 893; 5.59, 0.97%); resistin (n = 831; 14.5, 7.4 ng/dl); adiponectin (n = 828; 9.9, 6.2 ng/dl).

The six primary quantitative traits had significant associations with 415 SNPs in GEE models and 242 SNPs in FBAT models, using p-value < 0.001, and only considering SNPs with call rate ≥ 0.80, HWE p-value ≥ 0.001, and MAF ≥ 10%. Additionally, there were 91 significant associations with incident diabetes in the survival analyses and 42 significant associations with age-of-onset in FBAT, representing 128 non-overlapping SNPs. The 25 SNPs with lowest p-values in GEE or FBAT models, and LOD scores > 2.0 in linkage analyses, are displayed in Table 2. After accounting for the overlap between sets of significant associations, 736 non-overlapping SNPs were identified by the p-value approach for SNP prioritization.

Table 2.

Twenty five lowest p-values from GEE and FBAT models and LOD scores > 2 for 100K SNPs and FHS diabetes-related quantitative traits

No. Trait SNP Chr Physical position GEE or Cox p-value FBAT p-value Known Genes
2a. Ordered by GEE p-value

1 tFPG rs2722425 8 40603396 0.00000002 0.0047 ZMAT4
2 Incident DM rs10497721 2 192739868 0.0000007 0.0346 TMEFF2
3 Fasting Insulin rs2877832 14 26870017 0.000002 0.0770
4 HOMA-IR rs2877832 14 26870017 0.000003 0.0918
5 tFPG rs10510634 3 30321972 0.000005 0.0516
6 FPG rs180730 4 122159395 0.000005 0.0374 PRDM5
7 tFPG rs180730 4 122159395 0.000006 0.0252 PRDM5
8 tFPG rs7731657 5 129971218 0.000007 0.0015
9 HbA1c rs10486607 7 28957729 0.000008 0.0440 CPVL
10 ISI_0-120 rs2066219 13 68428665 0.000009 0.0245
11 FPG rs2722425 8 40603396 0.000009 0.0998 ZMAT4
12 Incident DM rs2195499 2 41778050 0.000011 0.3860
13 Incident DM rs830604 3 71673037 0.000014 0.5914 FOXP1
14 FPG rs2377689 2 106924358 0.000017 0.0015 ST6GAL2
15 Incident DM rs931567 3 31410581 0.000018 0.0095
16 FPG rs10494331 1 156395176 0.000019 0.0369 APCS
17 tFPG rs7147624 14 64935378 0.000019 0.0201 FUT8
18 tFPG rs931567 3 31410581 0.000019 0.0189
19 Incident DM rs10511182 3 102255525 0.000020 0.0510
20 FPG rs337112 5 122556671 0.000022 0.0148
21 ISI_0-120 rs9319109 13 84510270 0.000025 0.0048
22 HOMA-IR rs1927384 13 101943751 0.000026 0.0059
23 ISI_0-120 rs7139897 13 107879625 0.000026 0.0033
24 HbA1c rs721346 11 103242667 0.000027 0.5054 PDGFD
25 HOMA-IR rs300703 2 229416 0.000027 0.1086 SH3YL1

2b. Ordered by FBAT p-value

1 HbA1c rs7719971 5 119990475 0.0324 0.00002
2 HOMA-IR rs10425253 19 36038375 0.0005 0.00002
3 HOMA-IR rs10511886 9 31826555 0.0933 0.00002
4 Incident DM rs256962 5 114970610 0.0030 0.00002 TICAM2
5 Fasting Insulin rs10494321 1 154721517 0.0029 0.00002 KIRREL
6 Incident DM rs1549415 8 120252290 0.0332 0.00002
7 FPG rs6910169 6 112990680 0.0062 0.00003
8 HbA1c rs2400207 5 145360290 0.0305 0.00003 SH3RF2
9 HbA1c rs991672 5 120002649 0.0272 0.00003
10 ISI_0-120 rs633082 9 107992360 0.0068 0.00004
11 tFPG rs10496802 2 139478604 0.0172 0.00004
12 FPG rs7684538 4 96725483 0.0202 0.00005 UNC5C
13 Fasting Insulin rs963328 1 209426056 0.2949 0.00005 FLVCR
14 Incident DM rs2432961 8 120266196 0.0069 0.00005
15 Incident DM rs2468168 8 120238819 0.0426 0.00006 COLEC10
16 ISI_0-120 rs6594987 5 116256211 0.1298 0.00006
17 HOMA-IR rs10511885 9 31821043 0.1250 0.00007
18 tFPG rs10487976 7 122429976 0.0076 0.00007 SLC13A1
19 tFPG rs2204295 7 122432041 0.0060 0.00007 SLC13A1
20 HbA1c rs9325002 5 145406441 0.0295 0.00007 SH3RF2
21 HbA1c rs1365371 8 129018405 0.0298 0.00007
22 HOMA-IR rs2020362 19 36033107 0.0016 0.00009
23 Incident DM rs1489092 3 76204196 0.0535 0.00010
24 ISI_0-120 rs2942321 5 19365227 0.4753 0.00010
25 ISI_0-120 rs10501828 11 94883857 0.0067 0.00010

2c. LOD > 2, Ordered by Lod Score

No. Trait SNP or STR Chr Physical position Marshfield cM Max LOD Physical position

Lower bound where LOD = 1.5 Upper bound where LOD = 1.5

1 FPG rs1890843 1 207225242 230.9 3.64 205357346 209935673
2 HbA1c rs1463697 3 195278503 217.5 3.16 191762568 197963623
3 HOMA-IR rs10513843 3 190998205 209.4 3.08 188644318 193634077
4 Fasting insulin rs4803953 19 51650847 70.1 2.98 43726908 56203682
5 HbA1c rs10510060 10 121853460 139.9 2.41 119524854 125827901
6 HOMA-IR rs10500300 19 53439815 73.3 2.36 42063572 57117898
7 tFPG rs2837076 21 39850406 38.7 2.36 34879124 41000937
8 HbA1c rs10497392 2 174176465 177.5 2.30 153549351 177629785
9 tFPG rs876362 2 80327060 102.6 2.29 70585709 112151653
10 Fasting insulin rs10513860 3 191902243 212.8 2.21 187447466 196384998
11 FPG rs1882347 2 164233821 167.3 2.20 146837297 171264176
12 FPG rs10512296 9 102073227 108.4 2.15 91062454 107815119
13 tFPG ATA20G07 5 180431 0.0 2.10 180431 2855065
14 tFPG rs2444962 15 31214059 24.7 2.05 23732660 35462954
15 HbA1c rs10494382 1 159838765 175.2 2.03 157467831 200055293

The FHS has multiple measures of diabetes-related quantitative traits. We used a multiple-related trait approach in a strategy different from prioritizing SNPs based solely on small p-values. This approach yielded 203 SNPs associated with multiple traits. Of these, 53 were also associated with incident diabetes (p < 0.01 by GEE or FBAT). We defined redundant SNPs as those in LD with r2 >= 0.80 to select 168 non-redundant SNPs associated with multiple traits; 42 of these non-redundant SNPs also were associated with incident diabetes (Table 3). Examination of the multiple trait-based approach revealed 1) consistent associations of traits with SNPs that were in LD (providing reassurance that the signal was due to an association of traits with a particular genomic region rather than to technical error); 2) several putative associations of traits with SNPs in the same gene but not in perfect LD (suggesting that the association signal may be due to a functional role of that gene rather than a statistical fluctuation); and 3) associations of traits with SNPs in a variety of novel but plausible biological candidate genes.

Table 3.

Forty two (42) SNPs associated with (FPG, HbA1c, and tFPG) OR (fasting insulin, HOMA-IR, and ISI_0-120) OR (any two of either) AND incident DM

No. Chr SNP N other SNPs with r2 > 0.8 Minor Allele A/G/T/C MAF Gene * Gene Position GEE Mean p-value FBAT Mean p-value Cox p-value Minor Allele Cox HR for DM FBAT DM Incidence p-value

3 Glucose Traits 3 Insulin Traits 3 Glucose Traits 3 Insulin Traits
1 12 rs1368254 135 G 48.3% LOC387882 Near 0.02 0.001 0.01 0.007 0.007 0.67 0.0008
2 12 rs10506806 76 T 29.7% Out 0.003 0.03 0.01 0.01 0.02 0.65 0.004
3 2 rs10496417 74 A 34.5% SLC5A7 Near 0.01 0.003 0.04 0.02 0.007 1.58 0.11
4 8 rs10503835 8 C 21.9% HMBOX1 In 0.004 0.03 0.03 0.008 0.005 0.59 0.03
5 5 rs459743 83 C 16.9% Out 0.009 0.009 0.03 0.02 0.002 0.42 0.012
6 10 rs1879316 55 A 13.5% RASGEF1A Near 0.004 0.001 0.18 0.07 0.009 0.45 0.48
7 13 rs2066219 79 G 23.0% Out 0.005 0.0009 0.22 0.08 0.009 0.59 0.22
8 7 rs10487974 11 A 36.9% SLC13A1 Near 0.02 0.08 0.002 0.02 0.001 0.58 0.001
9 3 rs1878175 54 G 11.2% Out 0.003 0.003 0.39 0.02 0.003 0.36 0.12
10 3 rs697957 32 T 25.2% CD47 Near 0.005 0.03 0.03 0.03 0.001 1.65 0.02
11 1 rs952635 9 G 31.3% PDE4B In 0.0007 0.009 0.06 0.41 0.001 0.56 0.16
12 3 rs10512839 77 C 25.9% CPNE4 In 0.02 0.02 0.05 0.009 0.000 1.78 0.03
13 12 rs4767161 84 A 13.3% RBM19 In 0.19 0.05 0.01 0.002 0.15 0.63 0.0014
14 2 rs1073893 27 A 17.7% FLJ32745 In 0.008 0.16 0.003 0.06 0.18 0.75 0.0008
15 16 rs10500547 133 G 16.3% AB051533 In 0.07 0.06 0.03 0.003 0.21 1.29 0.002
16 3 rs1489100 29 G 41.0% Out 0.01 0.06 0.004 0.16 0.09 0.75 0.0015
17 2 rs2367204 73 G 47.4% IMMT In 0.007 0.006 0.27 0.05 0.001 1.58 0.03
18 4 rs10489088 71 C 12.7% Out 0.24 0.22 0.01 0.001 0.35 1.22 0.005
19 20 rs6093416 86 A 14.0% TOP1 Near 0.01 0.003 0.22 0.12 0.00 0.35 0.02
20 5 rs871853 14 G 41.5% CPLX2 In 0.10 0.68 0.001 0.02 0.36 1.15 0.0003
21 7 rs1355037 156 C 23.4% ZPBP In 0.29 0.07 0.05 0.001 0.32 1.18 0.006
22 8 rs4418368 82 T 36.1% DLGAP2 In 0.08 0.08 0.03 0.008 0.27 1.18 0.004
23 4 rs10516471 26 G 43.6% PPP3CA In 0.006 0.12 0.02 0.10 0.04 0.70 0.007
24 17 rs2322969 158 C 46.6% Out 0.18 0.006 0.08 0.02 0.04 1.34 0.003
25 4 rs1395114 28 A 19.3% BX537758 In 0.004 0.17 0.01 0.22 0.001 1.79 0.02
26 7 rs711517 88 G 18.4% Out 0.02 0.008 0.26 0.05 0.000 1.86 0.17
27 10 rs332148 80 T 18.5% WAC In 0.02 0.01 0.18 0.09 0.004 0.46 0.03
28 16 rs2042389 136 T 32.9% Out 0.10 0.17 0.07 0.002 0.003 1.54 0.05
29 16 rs7186570 90 G 17.2% A2BP1 In 0.34 0.12 0.01 0.008 0.91 1.03 0.005
30 8 rs9297181 36 A 19.4% Out 0.18 0.08 0.004 0.08 0.25 0.79 0.003
31 18 rs540128 85 A 36.2% PHLPP In 0.38 0.13 0.02 0.005 0.83 0.97 0.004
32 14 rs1954673 78 A 26.4% Out 0.005 0.008 0.35 0.43 0.005 0.56 0.63
33 10 rs10509923 154 C 33.0% CSPG6 Near 0.18 0.002 0.42 0.03 0.008 0.64 0.20
34 5 rs861085 35 T 30.6% NUDT12 Near 0.008 0.48 0.01 0.28 0.001 0.52 0.02
35 1 rs7531174 33 C 20.6% SLC44A3 In 0.001 0.21 0.09 0.68 0.001 1.72 0.09
36 7 rs6949530 57 T 18.8% TAS2R16 Near 0.67 0.83 0.007 0.005 0.96 0.99 0.009
37 5 rs2967017 137 T 45.1% Out 0.65 0.15 0.06 0.003 0.82 1.04 0.007
38 3 rs729511 159 A 43.8% SLC9A9 In 0.45 0.003 0.14 0.13 0.03 0.70 0.008
39 9 rs1060586 155 T 49.3% RBM18 Near 0.16 0.0008 0.67 0.28 0.00 1.60 0.99
40 17 rs2190706 157 T 34.2% Out 0.48 0.04 0.20 0.007 0.00 1.55 0.03
41 3 rs509208 31 C 16.8% Out 0.002 0.06 0.64 0.53 0.01 0.51 0.63
42 10 rs7089102 87 G 47.2% Out 0.04 0.006 0.71 0.49 0.01 1.48 0.86

* Gene symbol and position from UCSC Genome Browser (http://genome.ucsc.edu/; accessed September 2006); SNPs within 60 kb of a known gene are considered 'Near'.

We used the UCSC Genome Browser (http://genome.ucsc.edu/; accessed September 2006) to annotate SNP details [30,31]. Of the 823 (736 + 203; 116 overlapped) SNPs identified by both prioritization methods without removing SNPs in LD (r2 >= 0.80), 304 (36.9%) were in genes, 173 (21%) were within 60 kb of a known gene and 5 (0.61%) were coding. For comparison, of the 70,987 SNPs included in this analysis, 25,916 (36.5%) were in genes, 14,333 (20.2%) were within 60 kb of a known gene and 421 (0.59%) were coding.

Some SNPs had p-values < 0.001 overlapping more than one analytical method. For instance, 18 SNPs were associated at p < 0.001 with at least one quantitative trait in both the GEE and the FBAT analyses. For incident diabetes, 5 SNPs were associated with diabetes survival in the Cox models and with age-of-onset in the FBAT analyses.

We used the FHS 100K array data to verify, in silico, replicated associations of reported diabetes candidate genes (Table 4). We found 7 SNPs in or near TCF7L2. One 100K SNP (rs7100927) was in moderate LD (r2 = 0.5) with TCF7L2-associated SNP rs7903146 and was nominally associated with a 56% increased relative risk of diabetes (p = 0.007) and with tFPG (GEE p = 0.03). We found 6 SNPs in or near ABCC8, but no SNPs in strong LD with ABCC8 A1369S (rs757110) or KCNJ11 E23K (rs5219), and thus could not replicate these associations. One 100K SNP (rs878208) ~25 kb upstream of ABCC8 showed nominal association with risk of diabetes, but it was not in LD with rs757110 in ABCC8 (r2 = 0.04). We found 15 SNPs in or near PPARG, but none were associated with diabetes. Four SNPs were associated (p < 0.05) with quantitative traits but were not in LD (r2 < 0.03) with PPARG P12A (rs1801282), the variant previously associated with type 2 diabetes [7]. We found no polymorphic (MAF > 1%) 100K SNPs in, near, or in LD with CAPN10 or HNFA.

Table 4.

FHS 100K SNP Test of Association with SNPs in Established Candidate Genes for Type 2 Diabetes

Candidate Gene Candidate SNP Physical Position FHS 100K SNP Physical Position r2 GEE lowest p-value GEE Trait FBAT Lowest p-value FBAT Trait Cox p-value Cox HR for DM
ABCC8 rs757110 17375053 rs878208 17478662 0.04 0.05 Fasting insulin 0.12 Fasting insulin 0.02 1.96
rs722341 17429722 0.05 0.11 tFPG 0.009 HbA1c 0.70 1.09
rs916829 17397049 0.02 0.18 Fasting insulin 0.02 Fasting insulin 0.47 0.84
rs2283257 17446021 0.03 0.23 ISI_0-120 0.05 ISI_0-120 0.98 0.99
rs2299641 17397566 0.01 0.38 Fasting insulin 0.21 ISI_0-120 0.19 1.24
rs2190454 17490211 0.01 0.35 Fasting insulin 0.25 ISI_0-120 0.48 0.90
PPARG rs1801282 12368125 rs10510422 12505413 0.00 0.003 tFPG 0.13 ISI_0-120 0.13 3.86
rs3856808 12505184 0.00 0.005 tFPG 0.17 ISI_0-120 0.11 0.25
rs10510421 12502242 0.00 0.006 tFPG 0.14 ISI_0-120 0.12 0.26
rs2938392 12409608 0.03 0.007 Fasting insulin 0.14 Fasting insulin 0.36 1.13
rs709157 12526881 0.00 0.05 ISI_0-120 0.10 ISI_0-120 0.68 0.93
rs10510418 12363563 0.04 0.07 Fasting insulin 0.10 ISI_0-120 0.46 0.89
rs1801282 12368125 1.00 0.07 ISI_0-120 0.20 HbA1c 0.89 0.96
rs1899951 12369840 1.00 0.11 ISI_0-120 0.25 HbA1c 0.86 0.96
rs4135268 12525199 0.01 0.11 ISI_0-120 0.20 tFPG 0.80 0.92
rs10510417 12352294 0.31 0.17 ISI_0-120 0.45 ISI_0-120 0.62 0.91
rs2292101 12409901 0.00 0.19 tFPG 0.22 Fasting insulin 0.08 1.62
rs10510419 12401936 0.01 0.26 tFPG 0.35 ISI_0-120 0.24 1.31
rs10510410 12321738 0.31 0.38 FPG 0.36 Fasting insulin 0.88 0.97
rs10510411 12321849 0.31 0.40 FPG 0.39 Fasting insulin 0.94 0.99
rs10510412 12321962 0.31 0.44 FPG 0.38 Fasting insulin 0.84 1.03
rs12255372* 114798892 rs10509967 114685922 0.00 0.04 HbA1c 0.12 ISI_0-120 0.82 0.96
TCF7L2 rs7903146* 114748339 rs7100927 114786038 0.50 0.03 tFPG 0.13 tFPG 0.007 1.56
rs10509966 114666170 0.00 0.04 HbA1c 0.07 ISI_0-120 0.64 1.09
rs10509969 114903549 0.08 0.14 Fasting insulin 0.08 FPG 0.60 0.89
rs290483 114905204 0.10 0.17 Fasting insulin 0.34 tFPG 0.93 0.99
rs7917983 114722872 0.09 0.27 tFPG 0.29 HbA1c 0.17 0.82
rs10509970 114904903 0.05 0.32 tFPG 0.43 tFPG 0.51 1.14

* LD betweaen rs12255372 and rs7903146 in HapMap CEU: r2 = 0.78; Bold = r2 >= 0.5 or p-value < 0.05

We also assessed our approach for confirmation of 4 SNPs associated with FPG reported on the Boston University Department of Genetics and Genomics public site http://gmed.bu.edu/about/index.html that displays selected associations with FHS 100K data. We found no association (all p-values > 0.6) of incident diabetes or levels of FPG with SNPs rs10495355, rs9302082, rs10483948, or rs1148509.

Discussion and conclusion

In this paper we describe the characteristics and initial GWA results for type 2 diabetes and related quantitative traits in the FHS 100K SNP resource. Over 1000 men and women from a community-based sample have detailed linkage and association of diabetes-related phenotypes and 100K dense array SNP results available on the web. About 0.3%–0.6% of SNPs in the 100K array with MAF > 10% are associated at p < 0.001 with six diabetes-related quantitative traits or with incident type 2 diabetes. A similar proportion of SNPs in the array (0.21%) are associated with multiple related diabetes traits. These several hundred SNPs likely contain more false positive than true positive associations with diabetes and related traits, however, they offer logical next targets for the follow-up replication studies in independent samples necessary to resolve true diabetes risk genes. The FHS 100K data replicate the otherwise widely-replicated TCF7L2 association with diabetes [11,12,32-40] in an in silico analysis.

The FHS 100K SNP data resource has potential value to detect and replicate novel type 2 diabetes susceptibility genes. The 100K SNP array is limited by relatively sparse coverage in some regions, accounting on average for just 30%–40% of the human genome in whites [17,41]. Association with the risk SNP in TCF7L2 is detectable at p < 0.05, but there are no SNPs in adequate LD with ABCC8 or PPARG to assess replication of causal SNPs in these accepted diabetes susceptibility genes. Thin coverage will be remedied to a large degree by the incipient availability in FHS of Affymetrix 500 k SNP array data as part of the planned FHS SHARe Study. (http://www.nhlbi.nih.gov/meetings/nhlbac/sept06sum.htm; accessed September 2006) Our analysis also demonstrates that true positive diabetes susceptibility gene signals are likely to be associated with modest p-values and will remain challenging to detect at the stringent p-values required for GWA studies. The enormous datasets generated by GWA scans have the potential to greatly advance understanding, or conversely to overwhelm the field with false leads. SNP prioritization strategies that leverage the complexity of the diabetes phenotype may offer some advantages over strictly p-value driven approaches. Replication, fine mapping, and functional studies are required to determine which approaches are most efficient and which SNPs are true positive diabetes risk factors. Integration with other GWA scans in similar cohorts will allow in silico replication of significant findings, increase power and reveal generalizability.

This report details the FHS contribution to publicly available diabetes-related genetic data. An important key to efficiently and economically achieving adequate power to detect association will be to integrate information from several GWA scans. While several cohorts have been assembled to perform GWA scans in type 2 diabetes, few possess the wealth of longitudinal, multigenerational phenotypic data available in Framingham. The FHS complements extant type 2 diabetes GWA studies. This report guides the way to harness the power of the FHS 100K SNP GWA resource to identify type 2 diabetes susceptibility genes.

Abbreviations

FPG = fasting plasma glucose; FBAT = family-based association test; FHS = Framingham Heart Study; GEE = generalized estimating equations; GWA = Genome-wide association; HbA1c = hemoglobin A1c; HOMA-IR = homeostasis model insulin resistance; HWE = Hardy Weinberg equilibrium; IBD = Identity-by-descent; ISI_0-120 = 0–120 min insulin sensitivity index; LD = Linkage disequilibrium; LOD = Log odds score; MAF = Minor allele frequency; SNP = Single nucleotide polymorphism;TFPG = 28-yr time-averaged FPG.

Authors' contributions

All authors participated in the design and conduct of the study and edited and approved the final manuscript. JM drafted the manuscript and coordinated the study. JM and CF contributed to FHS diabetes-related phenotyping. JD, AM, and and LAC coordinated the data management and conducted the statistical analyses. CL prepared traits for analyses. JF contributed the multiple-related traits method for SNP selection and the literature review for Table 4.

Contributor Information

James B Meigs, Email: jmeigs@partners.org.

Alisa K Manning, Email: amanning@bu.edu.

Caroline S Fox, Email: foxca@nhlbi.nih.gov.

Jose C Florez, Email: jcflorez@partners.org.

Chunyu Liu, Email: liuc@bu.edu.

L Adrienne Cupples, Email: adrienne@bu.edu.

Josée Dupuis, Email: dupuis@bu.edu.

Acknowledgements and Disclosures

Supported by the by the National Heart, Lung, and Blood Institute's Framingham Heart Study (Contract No. N01-HC-25195), the Boston University Linux Cluster for Genetic Analysis (LinGA) funded by the NIH NCRR Shared Instrumentation grant (1S10RR163736-01A1), National Center for Research Resources (NCRR) General Clinical Research Center (GCRC) M01-RR-01066, and by an American Diabetes Association Career Development Award to Dr. Meigs. Dr. Meigs currently has research grants from GlaxoSmithKline, Wyeth and Sanofi-aventis, and serves on safety or advisory boards for GlaxoSmithKline, Merck, and Lilly. Dr. Florez is supported by the NIH Research Career Award K23 DK65978-03. The funding bodies had no role in the research design and conduct or the decision to publish this study.

This article has been published as part of BMC Medical Genetics Volume 8 Supplement 1, 2007: The Framingham Heart Study 100,000 single nucleotide polymorphisms resource. The full contents of the supplement are available online at http://www.biomedcentral.com/1471-2350/8?issue=S1.

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