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  • Causal mechanisms and balan...
    Day, Felix R; Hinds, David A; Tung, Joyce Y; Stolk, Lisette; Styrkarsdottir, Unnur; Saxena, Richa; Bjonnes, Andrew; Broer, Linda; Dunger, David B; Halldorsson, Bjarni V; Lawlor, Debbie A; Laval, Guillaume; Mathieson, Iain; McCardle, Wendy L; Louwers, Yvonne; Meun, Cindy; Ring, Susan; Scott, Robert A; Sulem, Patrick; Uitterlinden, André G; Wareham, Nicholas J; Thorsteinsdottir, Unnur; Welt, Corrine; Stefansson, Kari; Laven, Joop S E; Ong, Ken K; Perry, John R B

    Nature communications, 09/2015, Letnik: 6, Številka: 1
    Journal Article

    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.