Genome-Wide Association Study of Retinopathy in Individuals without Diabetes

Background Mild retinopathy (microaneurysms or dot-blot hemorrhages) is observed in persons without diabetes or hypertension and may reflect microvascular disease in other organs. We conducted a genome-wide association study (GWAS) of mild retinopathy in persons without diabetes. Methods A working group agreed on phenotype harmonization, covariate selection and analytic plans for within-cohort GWAS. An inverse-variance weighted fixed effects meta-analysis was performed with GWAS results from six cohorts of 19,411 Caucasians. The primary analysis included individuals without diabetes and secondary analyses were stratified by hypertension status. We also singled out the results from single nucleotide polymorphisms (SNPs) previously shown to be associated with diabetes and hypertension, the two most common causes of retinopathy. Results No SNPs reached genome-wide significance in the primary analysis or the secondary analysis of participants with hypertension. SNP, rs12155400, in the histone deacetylase 9 gene (HDAC9) on chromosome 7, was associated with retinopathy in analysis of participants without hypertension, −1.3±0.23 (beta ± standard error), p = 6.6×10−9. Evidence suggests this was a false positive finding. The minor allele frequency was low (∼2%), the quality of the imputation was moderate (r2 ∼0.7), and no other common variants in the HDAC9 gene were associated with the outcome. SNPs found to be associated with diabetes and hypertension in other GWAS were not associated with retinopathy in persons without diabetes or in subgroups with or without hypertension. Conclusions This GWAS of retinopathy in individuals without diabetes showed little evidence of genetic associations. Further studies are needed to identify genes associated with these signs in order to help unravel novel pathways and determinants of microvascular diseases.

[1]  P. Donnelly,et al.  A new multipoint method for genome-wide association studies by imputation of genotypes , 2007, Nature Genetics.

[2]  R. Klein,et al.  Do retinopathy signs in non-diabetic individuals predict the subsequent risk of diabetes? , 2006, British Journal of Ophthalmology.

[3]  K. Lunetta,et al.  Methods in Genetics and Clinical Interpretation Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium Design of Prospective Meta-Analyses of Genome-Wide Association Studies From 5 Cohorts , 2010 .

[4]  L. Bouter,et al.  Retinopathy is associated with cardiovascular and all-cause mortality in both diabetic and nondiabetic subjects: the hoorn study. , 2003, Diabetes care.

[5]  M. Daly,et al.  Candidate gene association study for diabetic retinopathy in persons with type 2 diabetes: the Candidate gene Association Resource (CARe). , 2011, Investigative ophthalmology & visual science.

[6]  J. J. Wang,et al.  Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. , 1995, Ophthalmology.

[7]  C. D. A. Stehouwer,et al.  Inflammation and endothelial dysfunction are associated with retinopathy: the Hoorn Study , 2005, Diabetologia.

[8]  Ronald Klein,et al.  The relationship of retinopathy in persons without diabetes to the 15-year incidence of diabetes and hypertension: Beaver Dam Eye Study. , 2006, Transactions of the American Ophthalmological Society.

[9]  Tien Yin Wong,et al.  Associations between the metabolic syndrome and retinal microvascular signs: the Atherosclerosis Risk In Communities study. , 2004, Investigative ophthalmology & visual science.

[10]  Aric Invest The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators , 1989 .

[11]  J. Marchini,et al.  Genotype imputation for genome-wide association studies , 2010, Nature Reviews Genetics.

[12]  Yurii S. Aulchenko,et al.  ProbABEL package for genome-wide association analysis of imputed data , 2010, BMC Bioinformatics.

[13]  T. Raghunathan,et al.  The risk of myocardial infarction associated with antihypertensive drug therapies. , 1995, JAMA.

[14]  Monique M. B. Breteler,et al.  The Rotterdam Study: 2016 objectives and design update , 2015, European Journal of Epidemiology.

[15]  Tien Yin Wong,et al.  Associations between findings on cranial magnetic resonance imaging and retinal photography in the elderly: the Cardiovascular Health Study. , 2006, American journal of epidemiology.

[16]  R. Kronmal,et al.  Multi-Ethnic Study of Atherosclerosis: objectives and design. , 2002, American journal of epidemiology.

[17]  Nora Franceschini,et al.  Recent findings in the genetics of blood pressure and hypertension traits. , 2011, American journal of hypertension.

[18]  K. Mossman The Wellcome Trust Case Control Consortium, U.K. , 2008 .

[19]  L. Bouter,et al.  Blood pressure, lipids, and obesity are associated with retinopathy: the hoorn study. , 2002, Diabetes care.

[20]  L. Molday,et al.  RD3, the protein associated with Leber congenital amaurosis type 12, is required for guanylate cyclase trafficking in photoreceptor cells , 2010, Proceedings of the National Academy of Sciences.

[21]  Andrew D. Johnson,et al.  SNAP: a web-based tool for identification and annotation of proxy SNPs using HapMap , 2008, Bioinform..

[22]  Toshihiro Tanaka The International HapMap Project , 2003, Nature.

[23]  V. Gudnason,et al.  Age, Gene/Environment Susceptibility-Reykjavik Study: multidisciplinary applied phenomics. , 2007, American journal of epidemiology.

[24]  R. Klein,et al.  Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality. , 2001, Survey of ophthalmology.

[25]  R. Kronmal,et al.  The Cardiovascular Health Study: design and rationale. , 1991, Annals of epidemiology.

[26]  M. Pirinen,et al.  Genome-wide association study identifies a variant in HDAC9 associated with large vessel ischemic stroke , 2012, Nature Genetics.

[27]  Andrew D. Johnson,et al.  Genome-wide association study of blood pressure and hypertension , 2009, Nature Genetics.

[28]  A. Folsom,et al.  The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. , 1989, American journal of epidemiology.

[29]  J. J. Wang,et al.  Retinal microvascular signs and risk of stroke and stroke mortality , 2005, Neurology.

[30]  P. Mitchell,et al.  Methodology of the Singapore Indian Chinese Cohort (SICC) Eye Study: Quantifying ethnic variations in the epidemiology of eye diseases in Asians , 2009, Ophthalmic epidemiology.

[31]  B M Psaty,et al.  Antihypertensive drug therapies and the risk of ischemic stroke. , 2001, Archives of internal medicine.

[32]  Paul Mitchell,et al.  The eye in hypertension , 2007, The Lancet.

[33]  C. Vaillend,et al.  Dystrophins, Utrophins, and Associated Scaffolding Complexes: Role in Mammalian Brain and Implications for Therapeutic Strategies , 2010, Journal of biomedicine & biotechnology.

[34]  R. Klein,et al.  Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study. , 2003, Ophthalmology.

[35]  D L DeMets,et al.  The Wisconsin Epidemiologic Study of Diabetic Retinopathy. VI. Retinal photocoagulation. , 1987, Ophthalmology.

[36]  Uwe Völker,et al.  New loci associated with kidney function and chronic kidney disease , 2010, Nature Genetics.

[37]  Julian P T Higgins,et al.  Controlling the risk of spurious findings from meta‐regression , 2004, Statistics in medicine.

[38]  R. Klein,et al.  Retinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study , 2001, The Lancet.

[39]  B. Klein,et al.  Retinopathy in old persons with and without diabetes mellitus: the Age, Gene/Environment Susceptibility—Reykjavik Study (AGES-R) , 2012, Diabetologia.

[40]  Ronald Klein,et al.  Retinopathy and risk of congestive heart failure. , 2005, JAMA.

[41]  J. Shaw,et al.  Retinopathy in persons with impaired glucose metabolism: the Australian Diabetes Obesity and Lifestyle (AusDiab) study. , 2005, American journal of ophthalmology.

[42]  Simon C. Potter,et al.  Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls , 2007, Nature.

[43]  H. Izzedine,et al.  Eye and kidney: from clinical findings to genetic explanations. , 2003, Journal of the American Society of Nephrology : JASN.

[44]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[45]  D L DeMets,et al.  The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. , 1984, Archives of ophthalmology.

[46]  E. Feldman,et al.  Microvascular complications of impaired glucose tolerance. , 2003, Diabetes.

[47]  R Nick Bryan,et al.  Retinal Microvascular Abnormalities and MRI-Defined Subclinical Cerebral Infarction: The Atherosclerosis Risk in Communities Study , 2006, Stroke.

[48]  Tien Yin Wong,et al.  Similarities and differences in early retinal phenotypes in hypertension and diabetes , 2011, Journal of hypertension.

[49]  A. Hofman,et al.  The Rotterdam Study: objectives and design update , 2007, European Journal of Epidemiology.

[50]  Ronald Klein,et al.  Associations between retinal microvascular abnormalities and declining renal function in the elderly population: the Cardiovascular Health Study. , 2005, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[51]  James B. Meigs,et al.  Is genetic testing useful to predict type 2 diabetes? , 2012, Best practice & research. Clinical endocrinology & metabolism.

[52]  Chelsea E. Myers,et al.  15-year cumulative incidence and associated risk factors for retinopathy in nondiabetic persons. , 2010, Archives of ophthalmology.

[53]  K. Roeder,et al.  Genomic Control for Association Studies , 1999, Biometrics.

[54]  R. Klein,et al.  Cerebral white matter lesions, retinopathy, and incident clinical stroke. , 2002, JAMA.

[55]  H. Stefánsson,et al.  A novel TEAD1 mutation is the causative allele in Sveinsson's chorioretinal atrophy (helicoid peripapillary chorioretinal degeneration). , 2004, Human molecular genetics.

[56]  Tien Yin Wong,et al.  Retinal microvascular abnormalities and renal dysfunction: the atherosclerosis risk in communities study. , 2004, Journal of the American Society of Nephrology : JASN.