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Impact of Rare and Common Genetic Variants on Diabetes Diagnosis by Hemoglobin A1c in Multi-Ancestry Cohorts: The Trans-Omics for Precision Medicine Program.


ABSTRACT: Hemoglobin A1c (HbA1c) is widely used to diagnose diabetes and assess glycemic control in individuals with diabetes. However, nonglycemic determinants, including genetic variation, may influence how accurately HbA1c reflects underlying glycemia. Analyzing the NHLBI Trans-Omics for Precision Medicine (TOPMed) sequence data in 10,338 individuals from five studies and four ancestries (6,158 Europeans, 3,123 African-Americans, 650 Hispanics, and 407 East Asians), we confirmed five regions associated with HbA1c (GCK in Europeans and African-Americans, HK1 in Europeans and Hispanics, FN3K and/or FN3KRP in Europeans, and G6PD in African-Americans and Hispanics) and we identified an African-ancestry-specific low-frequency variant (rs1039215 in HBG2 and HBE1, minor allele frequency (MAF) = 0.03). The most associated G6PD variant (rs1050828-T, p.Val98Met, MAF = 12% in African-Americans, MAF = 2% in Hispanics) lowered HbA1c (-0.88% in hemizygous males, -0.34% in heterozygous females) and explained 23% of HbA1c variance in African-Americans and 4% in Hispanics. Additionally, we identified a rare distinct G6PD coding variant (rs76723693, p.Leu353Pro, MAF = 0.5%; -0.98% in hemizygous males, -0.46% in heterozygous females) and detected significant association with HbA1c when aggregating rare missense variants in G6PD. We observed similar magnitude and direction of effects for rs1039215 (HBG2) and rs76723693 (G6PD) in the two largest TOPMed African American cohorts, and we replicated the rs76723693 association in the UK Biobank African-ancestry participants. These variants in G6PD and HBG2 were monomorphic in the European and Asian samples. African or Hispanic ancestry individuals carrying G6PD variants may be underdiagnosed for diabetes when screened with HbA1c. Thus, assessment of these variants should be considered for incorporation into precision medicine approaches for diabetes diagnosis.

SUBMITTER: Sarnowski C 

PROVIDER: S-EPMC6817529 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Impact of Rare and Common Genetic Variants on Diabetes Diagnosis by Hemoglobin A1c in Multi-Ancestry Cohorts: The Trans-Omics for Precision Medicine Program.

Sarnowski Chloé C   Leong Aaron A   Raffield Laura M LM   Wu Peitao P   de Vries Paul S PS   DiCorpo Daniel D   Guo Xiuqing X   Xu Huichun H   Liu Yongmei Y   Zheng Xiuwen X   Hu Yao Y   Brody Jennifer A JA   Goodarzi Mark O MO   Hidalgo Bertha A BA   Highland Heather M HM   Jain Deepti D   Liu Ching-Ti CT   Naik Rakhi P RP   O'Connell Jeffrey R JR   Perry James A JA   Porneala Bianca C BC   Selvin Elizabeth E   Wessel Jennifer J   Psaty Bruce M BM   Curran Joanne E JE   Peralta Juan M JM   Blangero John J   Kooperberg Charles C   Mathias Rasika R   Johnson Andrew D AD   Reiner Alexander P AP   Mitchell Braxton D BD   Cupples L Adrienne LA   Vasan Ramachandran S RS   Correa Adolfo A   Morrison Alanna C AC   Boerwinkle Eric E   Rotter Jerome I JI   Rich Stephen S SS   Manning Alisa K AK   Dupuis Josée J   Meigs James B JB  

American journal of human genetics 20190926 4


Hemoglobin A1c (HbA1c) is widely used to diagnose diabetes and assess glycemic control in individuals with diabetes. However, nonglycemic determinants, including genetic variation, may influence how accurately HbA1c reflects underlying glycemia. Analyzing the NHLBI Trans-Omics for Precision Medicine (TOPMed) sequence data in 10,338 individuals from five studies and four ancestries (6,158 Europeans, 3,123 African-Americans, 650 Hispanics, and 407 East Asians), we confirmed five regions associated  ...[more]

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