Genome-wide association analysis and fine mapping of NT-proBNP level provide novel insight into the role of the MTHFR-CLCN6-NPPA-NPPB gene cluster.

Authors:
Fabiola Del Greco M, Cristian Pattaro, Andreas Luchner, Irene Pichler, Thomas Winkler, Andrew A Hicks, Christian Fuchsberger, Andre Franke, Scott A Melville, Annette Peters, H Erich Wichmann, Stefan Schreiber, Iris M Heid, Michael Krawczak, Cosetta Minelli, Christian J Wiedermann, Peter P Pramstaller
Year of publication:
2011
Volume:
20
Issue:
8
Issn:
0964-6906
Journal title abbreviated:
HUM MOL GENET
Journal title long:
Human molecular genetics
Impact factor:
4.902
Abstract:
High blood concentration of the N-terminal cleavage product of the B-type natriuretic peptide (NT-proBNP) is strongly associated with cardiac dysfunction and is increasingly used for heart failure diagnosis. To identify genetic variants associated with NT-proBNP level, we performed a genome-wide association analysis in 1325 individuals from South Tyrol, Italy, and followed up the most significant results in 1746 individuals from two German population-based studies. A genome-wide significant signal in the MTHFR-CLCN6-NPPA-NPPB gene cluster was replicated, after correction for multiple testing (replication one-sided P-value = 8.4 × 10(-10)). A conditional regression analysis of 128 single-nucleotide polymorphisms in the region of interest identified novel variants in the CLCN6 gene as independently associated with NT-proBNP. In this locus, four haplotypes were associated with increased NT-proBNP levels (haplotype-specific combined P-values from 8.3 × 10(-03) to 9.3 × 10(-11)). The observed increase in the NT-proBNP level was proportional to the number of haplotype copies present (i.e. dosage effect), with an increase associated with two copies that varied between 20 and 100 pg/ml across populations. The identification of novel variants in the MTHFR-CLCN6-NPPA-NPPB cluster provides new insights into the biological mechanisms of cardiac dysfunction.