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Causal mechanisms and balancing selection inferred from genetic associations with polycystic ovary syndrome.


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Authors

Hinds, David A 
Tung, Joyce Y 
Stolk, Lisette 
Styrkarsdottir, Unnur  ORCID logo  https://orcid.org/0000-0001-8146-8278

Abstract

Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women, yet there is little consensus regarding its aetiology. Here we perform a genome-wide association study of PCOS in up to 5,184 self-reported cases of White European ancestry and 82,759 controls, with follow-up in a further ∼2,000 clinically validated cases and ∼100,000 controls. We identify six signals for PCOS at genome-wide statistical significance (P<5 × 10(-8)), in/near genes ERBB4/HER4, YAP1, THADA, FSHB, RAD50 and KRR1. Variants in/near three of the four epidermal growth factor receptor genes (ERBB2/HER2, ERBB3/HER3 and ERBB4/HER4) are associated with PCOS at or near genome-wide significance. Mendelian randomization analyses indicate causal roles in PCOS aetiology for higher BMI (P=2.5 × 10(-9)), higher insulin resistance (P=6 × 10(-4)) and lower serum sex hormone binding globulin concentrations (P=5 × 10(-4)). Furthermore, genetic susceptibility to later menopause is associated with higher PCOS risk (P=1.6 × 10(-8)) and PCOS-susceptibility alleles are associated with higher serum anti-Müllerian hormone concentrations in girls (P=8.9 × 10(-5)). This large-scale study implicates an aetiological role of the epidermal growth factor receptors, infers causal mechanisms relevant to clinical management and prevention, and suggests balancing selection mechanisms involved in PCOS risk.

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Keywords

Acid Anhydride Hydrolases, Adaptor Proteins, Signal Transducing, Aging, Case-Control Studies, DNA Repair Enzymes, DNA-Binding Proteins, ErbB Receptors, Female, Follicle Stimulating Hormone, beta Subunit, Genome-Wide Association Study, Humans, Neoplasm Proteins, Ovary, Phosphoproteins, Polycystic Ovary Syndrome, Selection, Genetic, Transcription Factors, White People, YAP-Signaling Proteins

Journal Title

Nat Commun

Conference Name

Journal ISSN

2041-1723
2041-1723

Volume Title

6

Publisher

Springer Science and Business Media LLC
Sponsorship
Medical Research Council (MC_UU_12015/2)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (G0600717)
Medical Research Council (MC_U106179471)
Medical Research Council (MC_U106179472)
Medical Research Council (G0600717/1)
This work was supported by the Medical Research Council [U106179472; MC_U106179472; U106179471; MC_U106179471] and the National Human Genome Research Institute of the National Institutes of Health (grant number R44HG006981 to 23andMe). The UK Medical Research Council and Wellcome Trust (092731), together with the University of Bristol, provide core support for the ALSPAC study. AMH assays in ALSPAC were funded with a grant from the US National Institute of Health (R01 DK077659). DAL works in a unit that receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_12013/5).