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PLOS ONE logoLink to PLOS ONE
. 2013 May 22;8(5):e63469. doi: 10.1371/journal.pone.0063469

A Multiethnic Replication Study of Plasma Lipoprotein Levels-Associated SNPs Identified in Recent GWAS

Emily K Bryant 1, Amy S Dressen 1, Clareann H Bunker 2, John E Hokanson 3, Richard F Hamman 3, M Ilyas Kamboh 1,*, F Yesim Demirci 1,*
Editor: Ludmila Prokunina-Olsson4
PMCID: PMC3661596  PMID: 23717430

Abstract

Genome-wide association studies (GWAS) have identified a number of loci/SNPs associated with plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels. The purpose of this study was to replicate 40 recent GWAS-identified HDL-C-related new loci in 3 epidemiological samples comprising U.S. non-Hispanic Whites (NHWs), U.S. Hispanics, and African Blacks. In each sample, the association analyses were performed with all 4 major lipid traits regardless of previously reported specific associations with selected SNPs. A total of 22 SNPs showed nominally significant association (p<0.05) with at least one lipid trait in at least one ethnic group, although not always with the same lipid traits reported as genome-wide significant in the original GWAS. The total number of significant loci was 10 for TC, 12 for LDL-C, 10 for HDL-C, and 6 for TG levels. Ten SNPs were significantly associated with more than one lipid trait in at least one ethnic group. Six SNPs were significantly associated with at least one lipid trait in more than one ethnic group, although not always with the same trait across various ethnic groups. For 25 SNPs, the associations were replicated with the same genome-wide significant lipid traits in the same direction in at least one ethnic group; at nominal significance for 13 SNPs and with a trend for association for 12 SNPs. However, the associations were not consistently present in all ethnic groups. This observation was consistent with mixed results obtained in other studies that also examined various ethnic groups.

Introduction

Prior to genome-wide association studies (GWAS), genome-wide linkage scans and candidate gene (positional and/or biological) association studies were the main approaches used to unravel the genetic determinants of complex traits such as plasma lipid/lipoprotein levels. These studies have implicated a number of genes and variants as determinants of plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, of which some were more consistently replicated while several others yielded inconsistent results. With the availability of GWAS platforms, it became possible to identify susceptibility variants and genes for complex traits without making a priori assumptions.

Several GWAS investigating plasma lipid/lipoprotein traits primarily in subjects of European ancestry have been published to date [1][11]. These GWAS confirmed a number of genes previously implicated in influencing the inter-individual variation in four major lipid traits (TC, LDL-C, HDL-C, and TG) in earlier functional and/or candidate gene association studies as well as identified several new loci and genes. A recent meta-analysis of 46 lipid/lipoprotein GWAS comprising of >100,000 individuals, has identified 95 genome-wide significant loci associated with at least one of the four major lipid traits [11].

Only a handful of post-GWAS replication studies published to date have simultaneously examined various (3 or more) ethnic groups, including non-Hispanic Whites (NHWs), Hispanics, and African Americans. Additional independent studies investigating GWAS-identified variants in diverse racial/ethnic groups are needed. In this study, we sought to replicate 40 recent GWAS-identified HDL-C-related loci, which were not among previously established lipid loci/genes, in 3 epidemiological samples comprising of U.S. NHWs, U.S. Hispanics, and African Blacks. In each sample, we performed association analyses with all four major lipid traits (TC, LDL-C, HDL-C, and TG) regardless of previously reported specific associations with selected SNPs.

Subjects and Methods

Subjects

The study consisted of 621 NHW and 413 Hispanic non-diabetic subjects drawn from the San Luis Valley Diabetes Study, a population-based case-control study in the San Luis Valley in Southern Colorado, and 787 African Blacks drawn from a study on coronary heart disease (CHD)-related risk factors in Benin City, Nigeria. Detailed information on these studies and subjects can be found elsewhere [12][17]. The ages of participants ranged from 24 to 75 in NHWs, 21 to 75 in Hispanics, and 19 to 70 in African Blacks. The demographic and phenotypic characteristics of the study subjects are summarized in Table 1 . The study was approved by the University of Pittsburgh and University of Colorado Denver Institutional Review Boards and all study participants provided written informed consent.

Table 1. Biometric and quantitative data (unadjusted mean ± S.E.) of study samples.

Variable NHWs (n = 621) Hispanics (n = 413) African Blacks (n = 787)
Gender (Female/Male) 328/293 209/204 292/495
Age (years) 52.82±0.46 51.17±0.62 40.96±0.30
BMI (kg/m2) 25.48±0.16 25.76±0.22 22.84±0.14
Total cholesterol (mg/dl) 216.20±1.68 212.79±2.15 171.98±1.39
LDL-C (mg/dl) 138.12±1.53 134.31±1.98 109.23±1.24
HDL-C (mg/dl) 50.79±0.58 48.62±0.65 47.97±0.46
Triglycerides (mg/dl) 139.26±2.80 149.34±3.46 71.80±1.24

SNP Selection

The purpose of this study was to primarily replicate the HDL-C-related new signals (different from those found in established lipid loci/genes) identified in recent lipid/lipoprotein GWAS. We analyzed a total of 40 SNPs selected from four publications [7][9], [11] ( Table 2 ). We primarily targeted those SNPs that reached genome-wide level of significance for association with HDL-C levels (n = 36). We also included 4 additional SNPs (shown in italics in Table 2) that although did not reach genome-wide level of significance for HDL-C [7], [8], they were either highly significant for HDL-C or modestly significant for HDL-C but genome-wide significant for at least one of the three other lipid traits (TC, LDL-C or TG). Whenever there were more than one significant SNP reported for a given locus by the same group and/or various groups, only one SNP was selected for replication in our samples. Although all these GWAS primarily investigated individuals of European ancestry (EU), one of them [11] also sought replication in various non-European populations, including African Americans. Whenever the information was available, the effects observed in African Americans are shown as ‘concordant’ (AA) or ‘discordant’ (AA*) in Table 2. Of 40 SNPs selected from these GWAS, all were analyzed in our NHW and Hispanic samples whereas only a subset (n = 34) with sufficient minor allele frequency (MAF) was analyzed in our African sample.

Table 2. SNPs selected from 4 published GWAS in individuals of European ancestry (EU) for replication in our multiethnic sample§.

SNP Chr Gene(s) Alleles GWAS Trait(s) Population Reference(s)
rs646776 1p13 PSRC1, CELSR2 A/G TC, LDL-C EU Aulchenko et al. 2009 [8]
rs10889353 1p31 DOCK7 A/C TC, TG EU Aulchenko et al. 2009 [8]
rs10903129 1p36 TMEM57 G/A TC EU Aulchenko et al. 2009 [8]
rs4660293 1p34 PABPC4 A/G HDL-C EU, AA Teslovich et al. 2010 [11]
rs1689800 1q25 LOC100130996, ZNF648 A/G HDL-C EU, AA* Teslovich et al. 2010 [11]
rs2144300 1q42 GALNT2 C/T HDL-C EU Willer et al. 2008 [7]
rs1042034 2p24 APOB T/C HDL-C, TG EU, AA Teslovich et al. 2010 [11]
rs12328675 2q24 COBLL1 T/C HDL-C EU, AA Teslovich et al. 2010 [11]
rs2972146 2q36 IRS1 T/G HDL-C, TG EU, AA Teslovich et al. 2010 [11]
rs13107325 4q24 SLC39A8 C/T HDL-C EU, AA* Teslovich et al. 2010 [11]
rs6450176 5q11 ARL15 G/A HDL-C EU, AA Teslovich et al. 2010 [11]
rs2814944 6p21 C6orf106 G/A HDL-C EU, AA* Teslovich et al. 2010 [11]
rs605066 6q24 CITED2 T/C HDL-C EU, AA Teslovich et al. 2010 [11]
rs17145738 7q11 TBL2, MLXIPL C/T HDL-C, TG EU, AA* Teslovich et al. 2010 [11]
rs4731702 7q32 KLF14 C/T HDL-C EU, AA Teslovich et al. 2010 [11]
rs9987289 8p23 PPP1R3B G/A HDL-C, LDL-C, TC EU, AA Teslovich et al. 2010 [11]
rs2293889 8q23 TRPS1 G/T HDL-C EU, AA Teslovich et al. 2010 [11]
rs471364 9p22 C9orf52, TTC39B T/C HDL-C EU Kathiresan et al. 2009 [9]
rs1323432 9q31 PPP3R2, GRIN3A A/G HDL-C EU Willer et al. 2008 [7]
rs7395662 11p11 OR4A47, MADD-FOLH1 G/A HDL-C EU Aulchenko et al. 2009 [8]
rs3136441 11p11 F2, LRP4 T/C HDL-C EU Teslovich et al. 2010 [11]
rs2923084 11p15 AMPD3 A/G HDL-C EU, AA Teslovich et al. 2010 [11]
rs174547 11q12 FADS1-FADS2-FADS3 T/C HDL-C, TG EU Kathiresan et al. 2009 [9]
rs7941030 11q24 STS-1, UBASH3B T/C HDL-C, TC EU, AA Teslovich et al. 2010 [11]
rs7134375 12p12 PDE3A C/A HDL-C EU, AA Teslovich et al. 2010 [11]
rs2338104 12q24 KCTD10, MMAB, MVK G/C HDL-C EU Kathiresan et al. 2009; Willer et al. 2008 [7], [9]
rs11613352 12q13 LRP1 C/T HDL-C, TG EU, AA Teslovich et al. 2010 [11]
rs2652834 15q22 LACTB G/A HDL-C EU Teslovich et al. 2010 [11]
rs2271293 16q22 NUTF2, CTCF G/A HDL-C EU Aulchenko et al. 2009 [8]
rs2925979 16q23 CMIP C/T HDL-C EU, AA Teslovich et al. 2010 [11]
rs11869286 17q12 STARD3 C/G HDL-C EU, AA Teslovich et al. 2010 [11]
rs4148008 17q24 ABCA8 C/G HDL-C EU, AA Teslovich et al. 2010 [11]
rs4129767 17q25 PGS1 A/G HDL-C EU, AA Teslovich et al. 2010 [11]
rs12967135 18q21 MC4R G/A HDL-C EU, AA Teslovich et al. 2010 [11]
rs2967605 19p13 RAB11B, ANGPTL4 C/T HDL-C EU Kathiresan et al. 2009 [9]
rs737337 19p13 LOC55908, DOCK6 T/C HDL-C EU, AA Teslovich et al. 2010 [11]
rs386000 19q13 LILRA3 , LILRB2 G/C HDL-C EU, AA* Teslovich et al. 2010 [11]
rs1800961 20q13 HNF4A C/T HDL-C, TC EU, AA* Kathiresan et al. 2009; Teslovich et al. 2010 [9], [11]
rs6065906 20q13 FLJ40606, PLTP , PCIF1 T/C HDL-C, TG EU, AA Teslovich et al. 2010 [11]
rs181362 22q11 UBE2L3 C/T HDL-C EU, AA Teslovich et al. 2010 [11]
§

For HDL-C, p-values ranged from 7.7×10−4 to 0.02 for 4 SNPs (in italics) but were ≤5×10−8 for other SNPs as well as for other lipid traits included in the table. When available, replication results in African Africans (AA) are also shown (* = discordant finding with opposite direction of association). Primarily implicated genes, associated alleles, and increased lipid levels are shown in bold (decreased levels in unbold). Alleles (on forward or reverse strands) reflect those stated in the original papers.

Genotyping

DNAs were extracted from either buffy coats (NHWs and Hispanics) or blood clots (African Blacks) using standard methods. Samples were whole-genome amplified using the GenomiPhi DNA Amplification Kit (GE Healthcare Bio-Sciences, Piscataway, NJ) prior to genotyping. Twenty SNPs were genotyped using the TaqMan allelic discrimination method (Applied Biosystems, Foster City, CA) in 621 NHWs, 413 Hispanics, and 787 African Blacks. The other twenty were genotyped using the iPLEX Gold technology (Sequenom, San Diego, CA) in 621 NHWs, 382 Hispanics, and 787 African Blacks. Depending on the genotyping method used, about 7–10% of samples were repeated to test the consistency of genotype calls for each assay.

Statistical Methods

Concordance of the genotype distribution to Hardy-Weinberg equilibrium (HWE) was tested for each variant using χ2 goodness-of-fit test. Whenever it was necessary to reduce the effects of non-normality, dependent quantitative variables were transformed using either log or square root transformation: ‘log10’ transformation was used for HDL-C and TG levels in NHWs and Hispanics, ‘natural log’ transformation for TC and TG levels in African Blacks, and ‘square root’ transformation for LDL-C and HDL-C levels in African Blacks. Significant covariates for each dependent variable were identified using stepwise regression in order to determine the most parsimonious set of covariates to be included into analysis in each population. Detailed information on the evaluation and effects of covariates in our study samples can be found elsewhere [16]. To test for the effects of genotypes on the means of the quantitative traits, a linear regression analysis was performed (under the additive model) and the results were adjusted for the relevant covariates. For NHWs and Hispanics, the covariates were sex, age, BMI, and smoking. For African Blacks, the covariates were sex, age, waist measurement, exercise (minutes walking or bicycling to work each day), and staff level (junior or senior). The R statistical software package (version 2.12.2, http://www.r-project.org) was used to perform all analyses. Because this was a replication study, we considered a nominal p<0.05 as evidence of association. In addition, because we compared our results to those obtained in large GWAS and meta-analyses that included several thousand subjects, we have also discussed the results of the SNPs that showed a trend (p-values between 0.05–0.20) for ‘the same direction’ of association with ‘the same genome-wide significant lipid trait’ reported in the original GWAS.

Results

The genotype call rates were very high (≥95%) for almost all assays and only a small number of SNPs showed lower call rates: 1 in NHWs (87%), 3 in Hispanics (between 92–95%), and 2 in African Blacks (between 92–95%). No SNP showed low call rates across all populations genotyped. Discrepancy among replicates was detected for only one assay (rs174547) for which the discrepancy rate was 0.5%.

The association results for 4 major lipid traits examined in 3 ethnic groups are summarized in Table 3 . Most SNPs differed in allele frequencies among various ethnic groups. For 10 SNPs (shown in italics in Table 3), it was not always the same allele that was the minor allele across various ethnic groups and this was taken into account when making cross-sample comparison because the genotypic effects were modeled as the additive effect of the population-specific minor allele in each ethnic group.

Table 3. Summary of SNP associations with 4 lipid traits in our multi-ethnic study samples§.

Chr Gene(s) SNP Traits NHWs Hispanics African Blacks
MAF Association MAF Association MAF Association
1p13 rs646776 C - 0.212 beta p-value C - 0.258 beta p-value C - 0.348 beta p-value
PSRC1 TC −6.801 0.012 1.515 0.675 0.006 0.616
CELSR2 LDL-C −5.754 0.023 0.712 0.830 −0.044 0.601
HDL-C 0.003 0.711 0.012 0.163 0.062 0.199
TG −0.005 0.722 −0.019 0.218 0.004 0.857
1p31 rs10889353 C - 0.337 beta p-value C - 0.365 beta p-value C - 0.447 beta p-value
DOCK7 TC −5.183 0.031 −4.087 0.190 −0.003 0.790
LDL-C −2.223 0.320 −2.515 0.382 −0.004 0.964
HDL-C −9.2×10−5 0.988 0.008 0.305 −0.029 0.546
TG −0.046 4.9×10 5 −0.038 0.004 −0.028 0.172
1p36 rs10903129 A - 0.439 beta p-value A - 0.492 beta p-value A - 0.222 beta p-value
TMEM57 TC 1.767 0.448 0.283 0.926 0.002 0.897
LDL-C 1.680 0.437 −0.553 0.842 0.048 0.621
HDL-C −0.008 0.186 0.011 0.110 0.014 0.800
TG 0.018 0.099 −0.006 0.669 0.005 0.829
1p34 rs4660293 G - 0.212 beta p-value G - 0.206 beta p-value N.A*
PABPC4 TC 0.796 0.765 1.972 0.630
LDL-C 0.673 0.785 3.258 0.386
HDL-C 3.3×10−4 0.961 −0.010 0.278
TG 0.002 0.902 −0.002 0.917
1q25 rs1689800 G - 0.347 beta p-value G - 0.346 beta p-value G - 0.264 beta p-value
ZNF648 TC −2.747 0.268 −0.820 0.798 −0.017 0.170
LDL-C −2.481 0.279 −0.014 0.996 −0.141 0.117
HDL-C −0.010 0.121 −0.007 0.378 0.019 0.713
TG 0.013 0.261 −0.001 0.945 0.009 0.689
1q42 rs2144300 C - 0.384 beta p-value C - 0.425 beta p-value T - 0.040 beta p-value
GALNT2 TC 4.585 0.051 1.537 0.631 0.039 0.172
LDL-C 4.498 0.040 0.636 0.830 0.233 0.260
HDL-C −0.011 0.060 −0.005 0.534 0.100 0.401
TG 0.030 0.006 0.009 0.533 0.001 0.990
2p24 rs1042034 G - 0.215 beta p-value G - 0.298 beta p-value G - 0.119 beta p-value
APOB TC −2.519 0.361 −12.814 2.0×10 4 −0.012 0.504
LDL-C −2.721 0.285 −12.508 8.0×10 5 −0.102 0.432
HDL-C 0.006 0.398 −0.005 0.528 0.078 0.300
TG −0.019 0.142 −0.006 0.669 −0.050 0.118
2q24 rs12328675 C - 0.143 beta p-value C - 0.101 beta p-value C - 0.201 beta p-value
COBLL1 TC −3.158 0.315 4.136 0.425 −0.016 0.260
LDL-C −4.021 0.169 1.913 0.686 −0.160 0.119
HDL-C 0.002 0.814 0.007 0.559 −0.002 0.968
TG 0.009 0.522 0.023 0.289 0.022 0.383
2q36 rs2972146 C - 0.377 beta p-value C - 0.230 beta p-value C - 0.123 beta p-value
IRS1 TC 0.726 0.756 −1.986 0.561 0.006 0.733
LDL-C 1.337 0.536 −0.623 0.842 0.019 0.879
HDL-C 0.005 0.373 −0.005 0.562 −0.035 0.622
TG −0.004 0.710 −0.023 0.111 0.027 0.361
4q24 rs13107325 T - 0.068 beta p-value T - 0.045 beta p-value N.A*
SLC39A8 TC −1.391 0.762 −3.310 0.667
LDL-C −3.258 0.444 0.236 0.973
HDL-C 0.022 0.064 −0.032 0.066
TG −0.013 0.554 0.008 0.812
5q11 rs6450176 A - 0.240 beta p-value A - 0.296 beta p-value A - 0.317 beta p-value
ARL15 TC 1.573 0.552 −3.270 0.337 −0.003 0.832
LDL-C 1.193 0.627 −2.020 0.517 0.004 0.967
HDL-C 0.003 0.668 −0.005 0.514 −0.040 0.425
TG −0.002 0.859 −0.006 0.662 0.003 0.906
6p21 rs2814944 A - 0.163 beta p-value A - 0.132 beta p-value A - 0.342 beta p-value
C6orf106 TC −1.491 0.623 −6.484 0.156 0.005 0.681
LDL-C −0.349 0.901 −7.810 0.062 0.055 0.527
HDL-C −0.007 0.377 −0.008 0.428 −0.057 0.250
TG −0.002 0.879 0.026 0.181 0.027 0.202
6q24 rs605066 C - 0.403 beta p-value C - 0.406 beta p-value T - 0.402 beta p-value
CITED2 TC −4.002 0.092 1.230 0.699 0.013 0.248
LDL-C −4.946 0.025 1.408 0.628 0.105 0.208
HDL-C 0.003 0.675 −0.010 0.170 0.014 0.776
TG 0.001 0.918 0.015 0.266 0.001 0.969
7q11 rs17145738 T - 0.108 beta p-value T - 0.071 beta p-value T - 0.086 beta p-value
TBL2 TC 2.133 0.558 1.020 0.869 −0.001 0.962
MLXIPL LDL-C 4.142 0.219 2.486 0.663 0.075 0.611
HDL-C 0.011 0.219 −0.001 0.940 −0.044 0.605
TG −0.041 0.016 −0.020 0.448 0.014 0.697
7q32 rs4731702 T - 0.494 beta p-value T - 0.436 beta p-value T - 0.184 beta p-value
KLF14 TC 0.120 0.960 0.638 0.845 −0.011 0.425
LDL-C −0.881 0.689 1.459 0.625 −0.126 0.212
HDL-C 0.018 0.003 −0.009 0.222 0.012 0.840
TG −0.012 0.302 0.007 0.617 0.012 0.620
8p23 rs9987289 A - 0.091 beta p-value A - 0.178 beta p-value A - 0.191 beta p-value
PPP1R3B TC 0.971 0.808 −7.966 0.051 −0.038 0.009
LDL-C 1.565 0.671 −6.099 0.106 −0.273 0.010
HDL-C 0.002 0.867 −0.025 0.011 −0.065 0.276
TG 0.006 0.757 0.017 0.340 0.035 0.177
8q23 rs2293889 T - 0.442 beta p-value T - 0.445 beta p-value T - 0.040 beta p-value
TRPS1 TC −0.410 0.861 1.852 0.551 −0.012 0.680
LDL-C 0.715 0.743 2.085 0.467 0.014 0.947
HDL-C −0.005 0.399 0.005 0.506 −0.168 0.148
TG −0.013 0.258 0.001 0.914 −0.002 0.969
9p22 rs471364 C - 0.125 beta p-value C - 0.105 beta p-value C - 0.206 beta p-value
TTC39B TC −2.177 0.532 −6.466 0.233 −0.009 0.524
LDL-C 2.511 0.437 −3.277 0.515 −0.060 0.551
HDL-C −0.016 0.063 −0.015 0.253 0.014 0.813
TG −0.016 0.344 −0.007 0.776 −0.002 0.948
9q31 rs1323432 G - 0.115 beta p-value G - 0.087 beta p-value N.A*
PPP3R2 TC 11.295 0.002 7.703 0.148
GRIN3A LDL-C 8.951 0.009 4.455 0.364
HDL-C −0.003 0.754 0.027 0.038
TG 0.026 0.141 −0.006 0.799
11p11 rs7395662 A - 0.373 beta p-value A - 0.323 beta p-value G - 0.407 beta p-value
OR4A47 TC 2.869 0.225 −8.075 0.014 0.002 0.848
MADD- LDL-C 3.129 0.154 −7.407 0.014 0.011 0.898
FOLH1 HDL-C −2.9×10−6 1.000 0.008 0.289 0.025 0.608
TG 0.008 0.484 −0.018 0.204 0.016 0.448
11p11 rs3136441 C - 0.137 beta p-value C - 0.268 beta p-value N.A*
F2 TC −0.523 0.874 −4.952 0.168
LRP4 LDL-C −0.607 0.843 −4.207 0.202
HDL-C 0.006 0.469 −0.006 0.444
TG 0.013 0.420 −9.8E-04 0.950
11p15 rs2923084 G - 0.179 beta p-value G - 0.307 beta p-value A - 0.474 beta p-value
AMPD3 TC 2.969 0.307 −3.556 0.289 0.006 0.578
LDL-C 3.145 0.243 −2.051 0.508 0.032 0.693
HDL-C −0.015 0.048 −0.004 0.591 0.019 0.688
TG 0.020 0.135 −0.002 0.870 0.006 0.744
11q12 rs174547 C - 0.345 beta p-value T - 0.441 beta p-value N.A*
FADS1 TC −3.992 0.112 5.627 0.072
FADS2 LDL-C −2.996 0.196 5.716 0.048
FADS3 HDL-C −0.010 0.098 0.001 0.901
TG −0.011 0.371 0.005 0.711
11q24 rs7941030 C - 0.367 beta p-value C - 0.294 beta p-value C - 0.444 beta p-value
UBASH3B TC 5.359 0.030 −0.860 0.797 −0.011 0.315
LDL-C 3.490 0.131 −0.729 0.814 −0.084 0.302
HDL-C 0.005 0.410 −0.005 0.511 0.038 0.412
TG 0.021 0.067 0.015 0.292 −0.040 0.043
12p12 rs7134375 A - 0.458 beta p-value C - 0.497 beta p-value A - 0.308 beta p-value
PDE3A TC 1.439 0.525 3.594 0.269 0.006 0.611
LDL-C 0.531 0.799 3.243 0.278 0.013 0.885
HDL-C 0.011 0.049 0.003 0.695 0.059 0.240
TG −0.009 0.412 0.006 0.687 −0.002 0.910
12q24 rs2338104 C - 0.429 beta p-value C - 0.486 beta p-value C - 0.196 beta p-value
KCTD10 TC 0.357 0.877 −5.109 0.098 −0.010 0.477
MMAB LDL-C 0.705 0.740 −5.855 0.041 0.089 0.390
MVK HDL-C −0.005 0.383 0.002 0.777 −0.187 0.002
TG 0.006 0.601 −0.004 0.751 −0.043 0.094
12q13 rs11613352 T - 0.245 beta p-value T - 0.382 beta p-value T - 0.063 beta p-value
LRP1 TC 1.291 0.635 1.589 0.621 −0.008 0.713
LDL-C 0.244 0.923 1.545 0.599 −0.250 0.132
HDL-C −0.002 0.722 −0.004 0.569 0.198 0.035
TG −0.003 0.815 0.006 0.669 0.054 0.183
15q22 rs2652834 T - 0.188 beta p-value T - 0.154 beta p-value T - 0.338 beta p-value
LACTB TC −0.576 0.847 −2.073 0.638 0.009 0.429
LDL-C −0.532 0.848 −3.853 0.340 0.055 0.522
HDL-C −0.001 0.918 −0.009 0.368 0.013 0.792
TG 0.006 0.682 0.018 0.341 0.001 0.945
16q22 rs2271293 A - 0.121 beta p-value A - 0.155 beta p-value A - 0.081 beta p-value
NUTF2 TC 7.170 0.044 2.092 0.626 0.010 0.635
LDL-C 4.285 0.192 3.055 0.440 0.126 0.387
HDL-C 0.023 0.009 0.006 0.549 0.090 0.284
TG −0.003 0.843 −0.014 0.427 −0.056 0.120
16q23 rs2925979 A - 0.287 beta p-value A - 0.203 beta p-value A - 0.293 beta p-value
CMIP TC 1.514 0.544 −4.750 0.224 −0.032 0.008
LDL-C 3.074 0.184 −3.317 0.355 −0.203 0.022
HDL-C −0.007 0.273 −0.008 0.383 −0.053 0.290
TG −0.014 0.236 −0.007 0.687 −0.016 0.459
17q12 rs11869286 G - 0.357 beta p-value G - 0.387 beta p-value C - 0.172 beta p-value
STARD3 TC 3.194 0.182 0.465 0.885 0.022 0.128
LDL-C 2.940 0.185 0.435 0.883 0.191 0.069
HDL-C −0.006 0.286 −0.003 0.732 0.106 0.077
TG 0.009 0.431 0.003 0.845 0.034 0.182
17q24 rs4148008 G - 0.332 beta p-value G - 0.272 beta p-value C - 0.409 beta p-value
ABCA8 TC 1.800 0.458 3.567 0.323 0.007 0.541
LDL-C 2.287 0.310 3.112 0.351 0.007 0.938
HDL-C 3.4×10−4 0.957 −0.003 0.694 0.008 0.874
TG 0.008 0.488 0.010 0.539 0.005 0.817
17q25 rs4129767 A - 0.498 beta p-value G - 0.461 beta p-value A - 0.313 beta p-value
PGS1 TC 3.112 0.183 6.496 0.038 0.027 0.026
LDL-C 3.988 0.065 6.770 0.019 0.135 0.120
HDL-C −0.014 0.015 0.007 0.385 0.064 0.205
TG 0.027 0.013 0.015 0.269 0.009 0.685
18q21 rs12967135 A - 0.235 beta p-value A - 0.175 beta p-value A - 0.324 beta p-value
MC4R TC −4.651 0.078 6.168 0.121 0.018 0.163
LDL-C −3.709 0.130 6.215 0.090 0.127 0.166
HDL-C −0.001 0.848 −0.010 0.295 0.126 0.017
TG −0.018 0.152 0.004 0.824 −0.029 0.206
19p13 rs2967605 T - 0.169 beta p-value T - 0.214 beta p-value T - 0.237 beta p-value
RAB11B TC 1.575 0.598 −1.284 0.734 0.013 0.324
ANGPTL4 LDL-C 1.256 0.649 0.781 0.823 0.123 0.199
HDL-C −0.003 0.678 −0.012 0.189 −0.003 0.959
TG 0.007 0.625 −0.014 0.377 −0.007 0.780
19p13 rs737337 C - 0.079 beta p-value C - 0.267 beta p-value T - 0.483 beta p-value
DOCK6 TC −2.436 0.555 −4.401 0.195 0.012 0.284
LDL-C −4.911 0.198 −6.843 0.029 0.050 0.536
HDL-C 0.014 0.180 −0.003 0.723 0.048 0.300
TG 0.012 0.527 0.018 0.220 0.003 0.881
19q13 rs386000 G - 0.203 beta p-value G - 0.437 beta p-value G - 0.183 beta p-value
LILRA3 TC 1.725 0.524 4.067 0.224 0.003 0.857
LILRB2 LDL-C 3.353 0.180 2.619 0.396 −0.025 0.810
HDL-C −0.003 0.629 1.2E-04 0.988 0.082 0.169
TG −0.005 0.703 0.020 0.175 −0.027 0.292
20q13 rs1800961 T - 0.032 beta p-value T - 0.033 beta p-value N.A*
HNF4A TC −0.463 0.943 −11.381 0.169
LDL-C 1.910 0.748 −9.706 0.211
HDL-C −0.009 0.568 0.005 0.794
TG −0.028 0.345 −0.042 0.238
20q13 rs6065906 C - 0.173 beta p-value C - 0.097 beta p-value C - 0.158 beta p-value
PLTP TC 3.707 0.213 2.927 0.583 −0.012 0.432
PCIF1 LDL-C 2.263 0.416 1.173 0.811 −0.088 0.424
HDL-C −0.001 0.921 −0.018 0.138 −0.060 0.336
TG 0.010 0.461 0.046 0.044 0.019 0.487
22q11 rs181362 T - 0.201 beta p-value T - 0.366 beta p-value T - 0.445 beta p-value
UBE2L3 TC 0.284 0.921 1.535 0.625 0.005 0.673
LDL-C 0.948 0.721 1.257 0.664 0.074 0.365
HDL-C −0.002 0.790 0.003 0.684 −0.017 0.710
TG −0.002 0.896 0.002 0.878 0.012 0.547
§

Significant p-values (<0.05) are shown in bold. ‘Log10’ transformation was used for HDL-C and TG levels in Non-Hispanic Whites (NHWs) and Hispanics, ‘natural log’ transformation for TC and TG levels in African Blacks, and ‘square root’ transformation for LDL-C and HDL-C levels in African Blacks. The genotypic effects were modeled as the additive effect of the population-specific minor allele in each ethnic group (minor alleles that differed from those in NHWs are shown in italics). The results were adjusted for relevant covariates in each ethnic group. *N.A: These SNPs were not analyzed in African Blacks among which they did not have sufficient minor allele frequency (MAF). Six SNPs showed lower genotyping call rate (<95%) in one of the 3 ethnic groups studied (MAF underlined) while the remaining SNPs had high call rates in all ethnic groups. This SNP showed low rate (0.5%) of discrepancy among replicates included in genotyping.

A total of 22 SNPs showed nominally significant association (p<0.05, shown in bold in Table 3) with at least one lipid trait in at least one ethnic group with a total of 40 significant p-values, although not always with the same lipid traits reported as genome-wide significant in the original GWAS (13 of 22 significant SNPs showed replicated association with the same lipid traits reported in the original GWAS). The total number of significant loci was 10 for TC, 12 for LDL-C, 10 for HDL-C, and 6 for TG levels. Ten SNPs were significantly associated with more than one lipid trait in at least one ethnic group and these associations were as follows: 6 SNPs (CELSR2/rs646776, APOB/rs1042034, PPP1R3B/rs9987289, GRIN3A/rs1323432, OR4A47/rs7395662, CMIP/rs2925979) with TC and LDL-C, DOCK7/rs10889353 with TC and TG, GALNT2/rs2144300 with LDL-C and TG, NUTF2/rs2271293 with TC and HDL-C, and PGS1/rs4129767 with TC, LDL-C, HDL-C, and TG. Six SNPs (DOCK7/rs10889353, PPP1R3B/rs9987289, GRIN3A/rs1323432, UBASH3B/rs7941030, MMAB-MVK/rs2338104, PGS1/rs4129767) were significantly associated with at least one lipid trait in more than one ethnic group, although not always with the same trait across various ethnic groups.

In NHWs, 12 SNPs showed significant association with at least one lipid trait. The most significant SNP for each trait was: GRIN3A/rs1323432 with TC (p = 0.002) and LDL-C (p = 0.009), KLF14/rs4731702 with HDL-C (p = 0.003), and DOCK7/rs10889353 with TG (p = 4.9×10−5). Six SNPs (CELSR2/rs646776, DOCK7/rs10889353, GALNT2/rs2144300, GRIN3A/rs1323432, NUTF2/rs2271293, and PGS1/rs4129767) were significantly associated with more than one lipid trait.

In Hispanics, 10 SNPs showed significant association with at least one lipid trait. The most significant SNP for each trait was: APOB/rs1042034 with TC (p = 2.0×10−4) and LDL-C (p = 8.0×10−5), PPP1R3B/rs9987289 with HDL-C (p = 0.011), and DOCK7/rs10889353 with TG (p = 0.004). Three SNPs (APOB/rs1042034, OR4A47/rs7395662, and PGS1/rs4129767) were significantly associated with more than one lipid trait.

In African Blacks, 7 SNPs showed significant association with at least one lipid trait. The most significant SNP for each trait was: CMIP/rs2925979 with TC (p = 0.008), PPP1R3B/rs9987289 with LDL-C (p = 0.010), MMAB-MVK/rs2338104 with HDL-C (p = 0.002), and UBASH3B/rs7941030 with TG (p = 0.043). Two SNPs (PPP1R3B/rs9987289, CMIP/rs2925979) were significantly associated with more than one lipid trait.

For 25 of 40 SNPs analyzed (34 in African Blacks), we were able to replicate the GWAS associations (with the same lipid trait in the same direction) in at least one ethnic group that we studied; at nominal significance (p<0.05) for 13 SNPs and with a trend for association (p-values between 0.05–0.20) for 12 SNPs (please see Table 4 for details). There were additional SNPs with higher p-values that showed similar trends for effects on the same lipid traits as seen in the original GWAS. Of 6 SNPs showing genome-wide significance for TC levels, we were able to replicate the associations in the same direction for 5 SNPs (at nominal significance for 4 SNPs and with a trend for association for one SNP) in at least one ethnic group studied. Of 2 SNPs showing genome-wide significance for LDL-C levels, we were able to replicate the associations in the same direction for both SNPs at nominal significance in at least one ethnic group studied. Of 36 SNPs with genome-wide significance and one with p = 7.7×10−4 for HDL-C levels, we were able to replicate the associations in the same direction for 18 SNPs (at nominal significance for 8 SNPs and with a trend for association for 10 SNPs) in at least one ethnic group studied. Two SNPs (PGS1/rs4129767 and MC4R/12967135) showed significant but discordant results (opposite direction) for association with HDL-C levels as compared to the original GWAS. Of 7 SNPs showing genome-wide significance for TG levels, we were able to replicate the associations in the same direction for 5 SNPs (at nominal significance for 3 SNPs and with a trend for association for 2 SNPs) in at least one ethnic group studied.

Table 4. SNPs significantly (p<0.05) associated with at least one lipid trait in at least one ethnic group in our study, as well as those that showed a trend for the same direction of association (p between 0.05–0.20, italic traits) as seen for at least one genome-wide significant lipid trait in the original GWAS§ (only relevant observations have been included in the table).

Locus SNP NHWs MAF HSPsMAF ABs MAF NHWs Traits HSPs Traits ABsTraits GWAS Alleles GWAS Trait(s) Population
1p13 rs646776 C-0.212 C-0.258 C-0.348 TC, LDL-C A/G TC, LDL-C EU
1p31 rs10889353 C-0.337 C-0.365 C-0.447 TC, TG TG, TC TG A/C TC, TG EU
1q25 rs1689800 G-0.347 G-0.346 G-0.264 HDL-C A/G HDL-C EU, AA*
1q42 rs2144300 C-0.384 C-0.425 T-0.040 LDL-C, HDL-C , TG C/T HDL-C EU
2p24 rs1042034 G-0.215 G-0.298 G-0.119 TG TC, LDL-C TG T/C HDL-C, TG EU, AA
2q36 rs2972146 C-0.377 C-0.230 C-0.123 TG T/G HDL-C, TG EU, AA
4q24 rs13107325 T-0.068 T-0.045 na HDL-C na C/T HDL-C EU, AA*
6q24 rs605066 C-0.403 C-0.406 T-0.402 LDL-C HDL-C T/C HDL-C EU, AA
7q11 rs17145738 T-0.108 T-0.071 T-0.086 TG C/T HDL-C, TG EU, AA*
7q32 rs4731702 T-0.494 T-0.436 T-0.184 HDL-C C/T HDL-C EU, AA
8p23 rs9987289 A-0.091 A-0.178 A-0.191 TC, HDL-C, LDL-C TC, LDL-C G/A HDL-C, LDL-C, TC EU, AA
8q23 rs2293889 T-0.442 T-0.445 T-0.040 HDL-C G/T HDL-C EU, AA
9p22 rs471364 C-0.125 C-0.105 C-0.206 HDL-C T/C HDL-C EU
9q31 rs1323432 G-0.115 G-0.087 na TC, LDL-C HDL-C na A/G HDL-C EU
11p11 rs7395662 A-0.373 A-0.323 G-0.407 TC, LDL-C G/A HDL-C EU
11p15 rs2923084 G-0.179 G-0.307 A-0.474 HDL-C A/G HDL-C EU, AA
11q12 rs174547 C-0.345 T-0.441 na HDL-C LDL-C na T/C HDL-C, TG EU
11q24 rs7941030 C-0.367 C-0.294 C-0.444 TC TG T/C HDL-C, TC EU, AA
12p12 rs7134375 A-0.458 C-0.497 A-0.308 HDL-C C/A HDL-C EU, AA
12q24 rs2338104 C-0.429 C-0.486 C-0.196 LDL-C HDL-C G/C HDL-C EU
12q13 rs11613352 T-0.245 T-0.382 T-0.063 HDL-C C/T HDL-C, TG EU, AA
16q22 rs2271293 A-0.121 A-0.155 A-0.081 TC, HDL-C G/A HDL-C EU
16q23 rs2925979 A-0.287 A-0.203 A-0.293 TC, LDL-C C/T HDL-C EU, AA
17q25 rs4129767 A-0.498 G-0.461 A-0.313 HDL-C, TG TC, LDL-C TC A/G HDL-C EU, AA
18q21 rs12967135 A-0.235 A-0.175 A-0.324 HDL-C G/A HDL-C EU, AA
19p13 rs2967605 T-0.169 T-0.214 T-0.237 HDL-C C/T HDL-C EU
19p13 rs737337 C-0.079 C-0.267 T-0.483 LDL-C T/C HDL-C EU, AA
19q13 rs386000 G-0.203 G-0.437 G-0.183 HDL-C G/C HDL-C EU, AA*
20q13 rs1800961 T-0.032 T-0.033 na TC na C/T HDL-C, TC EU, AA*
20q13 rs6065906 C-0.173 C-0.097 C-0.158 TG, HDL-C T/C HDL-C, TG EU, AA
§

Alternate alleles evaluated as compared to GWAS alleles (in bold), for which opposite effects are expected, are shown in italics. Up-regulated lipid traits are shown in bold vs. down-regulated in unbold. MAF: Minor allele frequency, NHWs: Non-Hispanic Whites, HSPs: Hispanics, ABs: African Blacks, EU: Individuals of European descent included in original GWAS, AA: African American replication sample in original GWAS (* = discordant finding with opposite direction of association), na: not analyzed.

For 12 SNPs, we observed significant associations with lipid traits other than those reported as genome-wide significant in the original GWAS (Table 4). Three of these 12 SNPs did not show any significant association or a trend for the same direction association with the traits identified as genome-wide significant in the original GWAS.

Discussion

We conducted a replication study on 40 recent GWAS-identified new loci that were associated with HDL-C levels [7][9], [11] using a multiethnic sample comprising of 3 different ethnic groups (NHWs, Hispanics, and African Blacks). Since MAFs of 6 of 40 SNPs were low in African Blacks, only 34 SNPs were included in the analysis in this group. Although we primarily focused on GWAS signals influencing plasma HDL-C levels (with or without effects on other lipids) when selecting the SNPs to be replicated in our study, we performed association analyses with all four major lipid traits (TC, LDL-C, HDL-C, and TG) regardless of previously reported specific associations with selected SNPs.

Given that our study examined various ethnic groups and our sample sizes were modest as compared to those used in large GWAS and meta-analyses (which examined several thousand subjects), we have used nominal significance (p<0.05) for replication and also taken into account the p-values between 0.05 and 0.20 (whenever there was a trend for the same direction of association with the same genome-wide significant lipid trait) when comparing our results with the original GWAS signals. The use of nominal significance for replication and for generalization to non-European populations has been widely employed and applied by some large consortiums [18] and also an acceptable criterion for publications [19]. The comparison of our results to those in original GWAS from which the SNPs were selected has been summarized in Table 4, by including all SNPs that were significantly (p<0.05) associated with at least one lipid trait in at least one ethnic group in our study as well as the SNPs that showed a trend for the same direction of association as seen for at least one genome-wide significant (p≤5×10−8) lipid trait in the original GWAS.

Our analysis revealed a total of 22 SNPs/loci with nominally significant association (p<0.05) with at least one lipid trait in at least one ethnic group, although not always with the same lipid traits reported as genome-wide significant in the original GWAS (13 of 22 significant SNPs showed replicated association with originally reported lipid traits in GWAS). Although our SNP selection was biased toward including primarily HDL-C-related variants, we identified a similar number of significant associations with TC (n = 10), LDL-C (n = 12), and HDL-C (n = 10), but relatively less with TG (n = 6). This observation suggests that replication studies should not restrict their analyses of GWAS signals to only specific lipid traits that were initially reported but should rather evaluate all lipid traits for a given variant. Ten loci (CELSR2, APOB, PPP1R3B, GRIN3A, OR4A47, CMIP, DOCK7, GALNT2, NUTF2, and PGS1) were significantly associated with more than one lipid trait in at least one ethnic group studied. Six loci (DOCK7, PPP1R3B, GRIN3A, UBASH3B, MMAB-MVK, PGS1) were significantly associated with at least one lipid trait in more than one ethnic group, although not always with the same trait across various ethnic groups.

In NHWs, 12 SNPs showed nominally significant association (p<0.05) with at least one lipid trait and 6 were significantly associated with more than one lipid trait. These numbers were 10 and 3 in Hispanics and 7 and 2 in African Blacks. The most significant SNPs for TC levels were GRIN3A/rs1323432 in NHWs, APOB/rs1042034 in Hispanics, and CMIP/rs2925979 in African Blacks. The most significant SNPs for LDL-C levels were GRIN3A/rs1323432 in NHWs, APOB/rs1042034 in Hispanics, and PPP1R3B/rs9987289 in African Blacks. The most significant SNPs for HDL-C levels were KLF14/rs4731702 in NHWs, PPP1R3B/rs9987289 in Hispanics, and MMAB-MVK/rs2338104 in African Blacks. The most significant SNPs for TG levels were DOCK7/rs10889353 in both NHWs and Hispanics, and UBASH3B/rs7941030 in African Blacks.

We were able to replicate the GWAS associations with the same lipid trait in the same direction in at least one ethnic group for 25 of 40 SNPs analyzed (40 in NHWs and Hispanics, 34 in African Blacks); at nominal significance (p<0.05) for 13 SNPs and with a trend for association for 12 SNPs. Five of 6 genome-wide significant TC loci, both of 2 genome-wide significant LDL-C loci, and 5 of 7 genome-wide significant TG loci were replicated in the same direction (at nominal significance or with a trend for association) in at least one ethnic group. Of 36 SNPs with genome-wide level significance and one with p = 7.7×10−4 for HDL-C levels, we were able to replicate the associations in the same direction for 18 SNPs in at least one ethnic group. Two SNPs showed significant but discordant results for association with HDL-C levels as compared to the original GWAS. For 12 SNPs, we observed significant associations with lipid traits other than those reported as genome-wide significant in the original GWAS, however we did not compare our results with GWAS findings that did not reach genome-wide level of significance. Because the nominal statistical significance (p<0.05) is considered acceptable in smaller follow-up studies on the established GWAS signals [19], we did not correct for multiple testing in our study. However, as stated above, we have also observed some new associations (i.e. significant associations with lipid traits other than those reported as genome-wide significant in the original GWAS), which should be considered ‘provisional’ until they are replicated in independent samples.

Overall the concordance rate was high for observed associations as compared to original GWAS findings (same allele with same effect or alternate allele with opposite effect); however, the associations were not consistently present in all ethnic groups that we studied. Other studies that investigated various ethnic groups also reported mixed results [11], [18], [20][22]. An independent replication study by Lanktree et al. [20] reported nominal association of the lead SNP or its proxy with the same lipid in the same direction for 13 of 32 GWAS loci tested in their modest-sized multiethnic sample (272 European, 330 South Asian, and 304 Chinese subjects from Canada). Another replication study by Keebler et al. [21] used a larger multiethnic sample (1,627 non-Hispanic Blacks, 1,659 Mexican Americans, and 2,230 NHWs from the US) and found mixed evidence by ethnic group for 17 lipid loci (19 successfully genotyped SNPs) examined, except for five loci (most of which established) that were shared by all groups. The largest GWAS by Teslovich et al. (a meta- analysis of 46 lipid GWAS comprising >100,000 individuals of European descent) [11] also sought replication in European (n = 7,000) and non-European samples (including >8,000 African Americans) and was able to replicate most, but not all, of the genome-wide significant signals identified in their primary analysis. The number of replicated SNPs was 35 of 36 for LDL-C, 44 of 47 for HDL-C, and 29 of 32 for TG in European replication sample while the replication rate was lower in African American replication sample (LDL-C: 33 of 36, HDL-C: 37 of 44 and TG: 24 of 30). In addition, for some loci, the observed effects were discordant in their replication samples. A recent multiethnic replication study by Chang et al. [22] examined 57 SNPs (55 GWAS-identified) in 3 major racial/ethnic groups from the US (2,296 NHWs, 1,699 non-Hispanic Blacks and 1,713 Mexican Americans) and replicated less than 67%, 44%, and 44% of GWAS-validated SNPs in each ethnic group, respectively. Another recent multiethnic replication study by Dumitrescu et al. [18] investigated 49 GWAS-identified SNPs in six racial/ethnic groups that included larger samples of European Americans (∼20,000), African Americans (∼9,000) and Mexican Americans/Hispanics (∼2,500). Based on nominal significance and consistent direction of effect, they were able to replicate the majority of associations with HDL-C, LDL-C, and TG in European Americans (85%, 95%, and 100%, respectively) and generalize a number of them to African Americans (44%, 58%, and 57%) and Mexican Americans/Hispanics (52%, 53%, and 86%). Overall, the effect sizes they observed in European Americans were smaller than previously reported estimates and, despite their adequately powered study, they failed to replicate some loci even in European Americans, which was predominantly the case for HDL-C loci (15% of SNPs failed to replicate) than LDL-C (5%) and TG (0%) loci.

Although our study has focused only on newly identified GWAS signals and did not include established genes with well-known functions in lipoprotein metabolism (which were most consistently replicated across various studies and/or various ethnic groups), our observations were similar to those in other multiethnic studies in terms of not being able to replicate all associations, observing lower replication rates in non-European populations (Table 4), and obtaining lower replication rates for HDL-C levels (page 12). Although our samples sizes were smaller as compared to two recent multiethnic replication studies by Chang et al. [22] and Dumitrescu et al. [18], our study examined several additional GWAS-identified variants that were not included in those studies.

Gender-specific effects on the genetics of lipid traits have also been suggested. We used gender as a covariate in our analyses but did not perform gender-stratified analyses due to power-related concerns. When Teslovich et al. [11] reanalyzed their GWAS data separately in men and women, they observed gender-specific effect sizes or gender-specific associations at some (but not many) loci.

In conclusion, our study shows evidence of replication for several, but not all, genome-wide significant SNP associations in our multiethnic sample. Lack of replication of genetic associations or the observation of different associations (with different lipid traits) may be related to a number of factors, such as insufficient power, differences in study population characteristics, allelic/genetic heterogeneity, allele frequency and/or linkage disequilibrium (LD) differences across various ethnic groups, population stratification, differences in effect sizes, and gene-environment interactions. Replication of some loci with small effect sizes (captured after meta-analysis of several GWAS by including several thousand subjects) may require the accumulation and meta-analysis of several independent replication studies (such as this study). The difficulty of generalizing the associations to various racial/ethnic populations may also be related to the fact that most GWAS-identified variants are likely to be in LD with the functional variant(s) rather than being functional themselves and LD patterns often vary across populations, which would affect the strength of indirect associations. In fact, a recent large study by Musunuru et al. [23] that performed dense genotyping in various lipid loci in a large sample set comprising of European Americans and African Americans, reported that many loci showed major differences in genetic architecture between these two ethnic groups and the most significant SNP at a given locus for a given trait often varied among them.

Further characterization of relevant lipid loci is necessary through their comprehensive sequencing in individuals with extreme phenotypes followed by functional evaluation of identified variants. Among several loci identified to date, the top priority could be given to those found to be relevant to more than one lipid trait and/or confirmed in more than one ethnic group.

Funding Statement

This study was supported by the National Heart, Lung and Blood Institute (NHLBI) grant, HL084613. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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