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1. Sattumalta löydetyistä lisämunuaiskasvaimista valtaosa ei vaadi seurantaa

Author

Koivikko, M. (Minna), Itkonen, T. (Tuukka), Jaakola, J. (Juho), Pääkkö, E. (Eija), Salmela, P. (Pasi), Ebeling, T. (Tapani), Koivikko, M. (Minna), Itkonen, T. (Tuukka), Jaakola, J. (Juho), Pääkkö, E. (Eija), Salmela, P. (Pasi), and Ebeling, T. (Tapani)

Abstract

Tiivistelmä Lähtökohdat: Kuvantamisen lisääntyessä sattumalta löydettyjen lisämunuaiskasvainten määrä on kasvanut. Jatkotutkimusten ja seurannan käytännöt ovat olleet vaihtelevia ja hyöty kyseenalainen. Selvitimme lisämunuaisinsidentaloomien luonnetta ja tietokonetomografian osuvuutta kasvainten luokittelussa ja seurannan ohjauksessa Pohjois-Pohjanmaan sairaanhoitopiirin potilasaineistossa. Menetelmät: Aineisto muodostui 451 täysi-ikäisestä potilaasta vuosilta 2003–2013. Lisämunuaisinsidentaloomien radiologiset ja hormonaaliset löydökset kartoitettiin. Tulokset: Adenoomia oli 352 (78,0 %), feokromosytoomia 10 (2,2 %), kortikaalisia karsinoomia 5 (1,1 %) ja etäpesäkkeitä 6 (1,3 %). Adenoomat olivat läpimitaltaan keskimäärin 2,1 cm (0,5–5,5 cm). Alle 20 Hounsfieldin yksikön tiheyksisistä kasvaimista ei löytynyt yhtään pahanlaatuista primaarikasvainta. TT-kuvauksessa adenoomiksi lausutut kasvaimet eivät kasvaneet tai osoittautuneet seurannassa pahanlaatuisiksi potilailla, joilla ei ollut syöpähistoriaa. Päätelmät: Tuloksemme on sopusoinnussa European Society of Endocrinologyn suosituksen kanssa, jonka mukaan pienitiheyksisten (≤ 10 HU) ja pienikokoisten (≤ 4 cm), hormonaalisesti toimimattomien kasvainten kuvantamisseurannasta voidaan luopua., Most adrenal incidentalomas do not require routine follow-up Background: Increased used of computerized tomography (CT) imaging has led to an increased number of incidentally found adrenal masses. Guidelines for management of adrenal incidentalomas have been extensive and inconsistent. Methods: We examined the biochemical characteristics and unenhanced density of adrenal incidentalomas in the Northern Ostrobothnia Hospital District in 2003–2013. Results: In this retrospective study, 451 adult patients with incidentally found adrenal tumours were identified. Of these tumours, 352 (78.0%) were adenomas, 10 (2.2%) phaeochromocytomas, 5 (1.1%) cortical carcinomas and 6 (1.3%) metastases. In the group of low attenuation (< 20 Hounsfield units, HU), none of the patients had a primary adrenal malignancy. The attenuation value was > 25 HU in all phaeochromocytomas. If the adrenal tumour was classified as an adenoma in the initial imaging, no growth or malignant transformation was observed if the patient did not have an earlier history of malignancy. Conclusions: Our results are consistent with the European Society of Endocrinology Clinical Practice Guideline. When a small (≤ 4 cm), hormonally inactive adrenal incidentaloma with an unenhanced attenuation ≤ 10 HU is found, further routine follow-up is not needed.

Published
2023

2. Ruoansulatuskanavan yläosan neuroendokriiniset kasvaimet ovat harvinaisia

Author

Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Koivikko, M. (Minna), Yliaska, I. (Iina), Ebeling, T. (Tapani), Salmela, P. (Pasi), Meriläinen, S. (Sanna), Pohjanen, V.-M. (Vesa-Matti), Koivikko, M. (Minna), Yliaska, I. (Iina), Ebeling, T. (Tapani), and Salmela, P. (Pasi)

Abstract

Tiivistelmä Ruoansulatuskanavan yläosassa äärimmäisen harvinaiset neuroendokriiniset kasvaimet ovat yleensä hormonaalisesti toimimattomia. Ruokatorvessa yleisin tyyppi on huonoennusteinen neuroendokriininen karsinooma. Mahalaukussa yleisin on atrofiseen gastriittiin liittyvä tyypin 1 neuroendokriininen kasvain. Siinä ennuste on parempi kuin tyypin 2 ja 3 kasvaimissa ja neuroendokriinisessä karsinoomassa. Pohjukaissuolen neuroendokriiniset kasvaimet ovat yleensä toimimattomia. Yleisin hormonaalisesti aktiivinen kasvain on yleensä MEN1-oireyhtymään liittyvä gastrinooma.

Published
2022

3. Thymic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1

Author

Yliaska, I. (Iina), Tokola, H. (Heikki), Ebeling, T. (Tapani), Kuismin, O. (Outi), Ukkola, O. (Olavi), Koivikko, M. L. (Minna L.), Lesonen, T. (Timo), Rimpiläinen, J. (Jussi), Felin, T. (Tuuli), Ryhänen, E. (Eeva), Metso, S. (Saara), Schalin-Jäntti, C. (Camilla), Salmela, P. (Pasi), Yliaska, I. (Iina), Tokola, H. (Heikki), Ebeling, T. (Tapani), Kuismin, O. (Outi), Ukkola, O. (Olavi), Koivikko, M. L. (Minna L.), Lesonen, T. (Timo), Rimpiläinen, J. (Jussi), Felin, T. (Tuuli), Ryhänen, E. (Eeva), Metso, S. (Saara), Schalin-Jäntti, C. (Camilla), and Salmela, P. (Pasi)

Abstract

Objective: MEN1 is associated with an increased risk of developing tumors in different endocrine organs. Neuroendocrine tumors of the thymus (TNETs) are very rare but often have an aggressive nature. We evaluated patients with MEN1 and TNET in three university hospitals in Finland. Design/Methods: We evaluated patient records of 183 MEN1-patients from three university hospitals between the years 1985–2019 with TNETs. Thymus tumor specimens were classified according to the new WHO 2021 classification of TNET. We collected data on treatments and outcomes of these patients. Results: There were six patients (3.3%) with MEN1 and TNET. Five of them had the same common gene mutation occurring in Finland. They originated from common ancestors encompassing two pairs of brothers from sequential generations. The mean age at presentation of TNET was 44.7 ± 11.9 years. TNET was classified as atypical carcinoid (AC) in five out of six patients. One patient had a largely necrotic main tumor with very few mitoses and another nodule with 25 mitoses per 2 mm², qualifying for the 2021 WHO diagnosis of large cell neuroendocrine carcinoma (LCNEC). In our patients, the 5-year survival of the TNET patients was 62.5% and 10-year survival 31.3%. Conclusion: In this study, TNETs were observed in one large MEN1 founder pedigree, where an anticipation-like earlier disease onset was observed in the most recent generation. TNET in MEN1 patients is an aggressive disease. The prognosis can be better by systematic screening. We also show that LCNEC can be associated with TNET in MEN1 patients.

Published
2022

4. Acromegaly caused by a GHRH-producing pancreatic neuroendocrine tumor:a rare manifestation of MEN1 syndrome

Author

Koivikko, M. (Minna), Ebeling, T. (Tapani), Mäkinen, M. (Markus), Leppäluoto, J. (Juhani), Raappana, A. (Antti), Ahtiainen, P. (Petteri), Salmela, P. (Pasi), Koivikko, M. (Minna), Ebeling, T. (Tapani), Mäkinen, M. (Markus), Leppäluoto, J. (Juhani), Raappana, A. (Antti), Ahtiainen, P. (Petteri), and Salmela, P. (Pasi)

Abstract

Summary Multiple endocrine neoplasia type 1 NM_001370259.2(MEN1):c.466G>C(p.Gly156Arg) is characterized by tumors of various endocrine organs. We report on a rare, growth hormone-releasing hormone (GHRH)-releasing pancreatic tumor in a MEN1 patient with a long-term follow-up after surgery. A 22-year-old male with MEN1 syndrome, primary hyperparathyroidism and an acromegalic habitus was observed to have a pancreatic tumor on abdominal CT scanning, growth hormone (GH) and insulin-like growth factor 1 (IGF1) were elevated and plasma GHRH was exceptionally high. GHRH and GH were measured before the treatment and were followed during the study. During octreotide treatment, IGF1 normalized and the GH curve was near normal. After surgical treatment of primary hyperparathyroidism, a pancreatic tail tumor was enucleated. The tumor cells were positive for GHRH antibody staining. After the operation, acromegaly was cured as judged by laboratory tests. No reactivation of acromegaly has been seen during a 20-year follow-up. In conclusion, an ectopic GHRH-producing, pancreatic endocrine neoplasia may represent a rare manifestation of MEN1 syndrome.

Published
2022

5. Onset of the climacteric phase by the mid-forties associated with impaired insulin sensitivity:a birth cohort study

Author

Savukoski, S. M. (Susanna M.), Suvanto, E. T. (Eila TJ.), Auvinen, J. P. (Juha P.), Pesonen, P. R. (Paula RO.), Keinänen-Kiukaanniemi, S. M. (Sirkka M.), Puukka, K. S. (Katri S.), Ebeling, T. (Tapani), and Niinimäki, M. J. (Maarit J.)

Subjects
age at menopause, menopausal transition, glycated haemoglobin, insulin sensitivity, oral glucose tolerance test
Abstract

Objective: To investigate whether the early-onset menopausal transition is associated with deteriorated glucose tolerance in women in their mid-forties. Methods: A cross-sectional analysis of a cohort study including 2,632 women of the Northern Finland Birth Cohort 1966. The participants were divided into two groups by their menstrual history and follicle-stimulating hormone values at age 46: climacteric and preclimacteric women. Glucose and insulin parameters, as well as mathematical indices derived from them to evaluate insulin sensitivity, were compared between the groups. The results were adjusted for measured body mass index and smoking. The possible effect of hormone therapy was investigated in subanalyses excluding hormone therapy users. Results: Climacteric women (n = 379) were more often current smokers at age 46 (P = 0.008), and their body mass indices increased more from 31 to 46 years (P = 0.013), compared to preclimacteric women (n = 2,253). In a multivariable generalized linear model, being climacteric at age 46 was associated with several findings suggesting decreased insulin sensitivity: increased glycated hemoglobin (P < 0.001), 2-hour oral glucose tolerance test 30- and 60-minute insulin (P = 0.040 and 0.006, respectively), and area under the insulin curve (P = 0.005). Being climacteric also was associated with a decreased the McAuley (P = 0.024) and Belfiore indices (P = 0.027) and glucose tolerance test 60-minute glucose (P = 0.015). In subanalyses excluding hormone therapy users (n = 94), the results did not change significantly. Conclusions: Earlier onset of climacteric transition is associated with impaired insulin sensitivity in middle-aged women.

Published
2021

6. Is climacterium by the mid-40s associated with thyroid dysfunction or autoimmunity?:a population-based study

Author

Savukoski, S. M. (Susanna M.), Niinimäki, M. J. (Maarit J.), Pesonen, P. R. (Paula RO.), Auvinen, J. P. (Juha P.), Männistö, T. (Tuija), Puukka, K. S. (Katri S.), Ebeling, T. (Tapani), and Suvanto, E. T. (Eila TJ.)

Subjects
Thyroid autoimmune disorders, Antithyroid peroxidase antibodies, Thyroid dysfunction, Menopause, Early menopause
Abstract

Objective: We investigated whether more advanced climacteric stage in the mid-40s is associated with thyroid autoimmunity and dysfunction. Methods: This cross-sectional cohort study included 2,569 46-year-old women. Thyroid hormone, thyroid peroxidase antibodies, and follicle-stimulating hormone levels were determined. Using menstrual history and follicle-stimulating hormone levels, the participants were divided into climacteric (n = 340) and preclimacteric (n = 2,229) groups. Women diagnosed with premature ovarian insufficiency (menopause by 40 y of age) were excluded. The use of thyroid medication was evaluated from the medication reimbursement register. The prevalence of thyroid medication use, laboratory-based thyroid dysfunction, and thyroid peroxidase antibody positivity was compared between the two groups. The association between climacteric status and thyroid disorders was investigated using a logistic regression model including smoking and thyroid antibody status. Results: At 46 years old, climacteric women used thyroid medication more often than preclimacteric women (9.1% vs 6.1%; P = 0.04). There was no difference in the prevalence of subclinical or clinical hypothyroidism and hyperthyroidism in nonmedicated participants (5.5% vs 5.0%; P = 0.7) or thyroid peroxidase antibody positivity (14.0% vs 15.0%, P = 0.7). In the regression model, being climacteric (OR = 1.6; 95% CI 1.1–2.3; P = 0.02) and antibody positivity (OR 4.9; 95% CI 3.6–6.6; P < 0.001) were associated with a higher prevalence of thyroid dysfunction. Conclusions: More advanced climacteric stage in the mid-40s was slightly associated with thyroid dysfunction but not thyroid autoimmunity.

Published
2021

7. Long-term morbidity and mortality in patients diagnosed with an insulinoma

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Laaksonen, D. E. (David E), Ebeling, T. (Tapani), Arola, J. (Johanna), Schalin-Jäntti, C. (Camilla), Jaatinen, P. (Pia), Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Laaksonen, D. E. (David E), Ebeling, T. (Tapani), Arola, J. (Johanna), Schalin-Jäntti, C. (Camilla), and Jaatinen, P. (Pia)

Abstract

Objective: Insulinomas are rare functional pancreatic neuroendocrine tumours. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the morbidity and mortality in the Finnish insulinoma cohort. Design: Retrospective cohort study. Methods: Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980–2010 (n = 79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched controls, using the Mantel–Haenszel method. Overall survival was analysed with Kaplan–Meier and Cox regression analyses Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation (rate ratio (RR): 2.07 (95% CI: 1.02–4.22)), intestinal obstruction (18.65 (2.09–166.86)), and possibly breast (4.46 (1.29–15.39) and kidney cancers (RR not applicable) was increased among insulinoma patients vs controls, P < 0.05 for all comparisons. Endocrine disorders and pancreatic diseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a non-metastatic insulinoma (n = 70) was similar to that of controls, but for patients with distant metastases (n = 9), the survival was significantly impaired (median 3.4 years). Conclusions: The long-term prognosis of patients with a non-metastatic insulinoma is similar to the general population, except for an increased incidence of atrial fibrillation, intestinal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.

Published
2021

8. Long‐term health‐related quality of life in persons diagnosed with an insulinoma in Finland 1980‐2010

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Sintonen, H. (Harri), Metso, S. (Saara), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin‐Jäntti, C. (Camilla), Sirén, J. (Jukka), Soinio, M. (Minna), Nuutila, P. (Pirjo), Moilanen, L. (Leena), Ebeling, T. (Tapani), and Jaatinen, P. (Pia)

Subjects
endocrine system, insulin, quality of life, hyperinsulinism, pancreas, insulinoma, neuroendocrine tumors, hypoglycaemia
Abstract

Objective: Insulinomas are rare pancreatic neoplasms, which can usually be cured by surgery. As the diagnostic delay is often long and the prolonged hyperinsulinemia may have long‐term effects on health and the quality of life, we studied the long‐term health‐related quality of life (HRQoL) in insulinoma patients. Design, patients and measurements: The HRQoL of adults diagnosed with an insulinoma in Finland in 1980‐2010 was studied with the 15D instrument, and the results were compared to those of an age‐ and gender‐matched sample of the general population. The minimum clinically important difference in the total 15D score has been defined as ±0.015. The clinical characteristics, details of insulinoma diagnosis and treatment, and the current health status of the subjects were examined to specify the possible determinants of long‐term HRQoL. Results: Thirty‐eight insulinoma patients participated in the HRQoL survey (response rate 75%). All had undergone surgery with a curative aim, a median of 13 (min 7, max 34) years before the survey. The insulinoma patients had a clinically importantly and statistically significantly better mean 15D score compared with the controls (0.930 ± 0.072 vs 0.903 ± 0.039, P = .046) and were significantly better off regarding mobility, usual activities and eating. Among the insulinoma patients, younger age at the time of survey, higher level of education and smaller number of chronic diseases were associated with better overall HRQoL. Conclusions: In the long term, the overall HRQoL of insulinoma patients is slightly better than that of the general population.

Published
2020

9. Climacteric status at the age of 46:impact on metabolic outcomes in population-based study

Author

Savukoski, S. (Susanna), Mäkelä, H. (Hannele), Auvinen, J. (Juha), Jokelainen, J. (Jari), Puukka, K. (Katri), Ebeling, T. (Tapani), Suvanto, E. (Eila), and Niinimäki, M. (Maarit)

Abstract

Context: Menopausal transition is associated with increased cardiovascular risks. Available data on the effect of earlier climacterium on these risks are limited. Objective: To compare cardiovascular risk-associated parameters at the ages of 14, 31, and 46 in relation to climacteric status at the age of 46. Design, Setting, and Participants: A prospective cohort study including 2685 women from the Northern Finland Birth Cohort 1966. Main Outcome Measures: Follicle-stimulating hormone, body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), blood pressure (BP), body composition, cholesterol levels, testosterone (T) levels, free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and liver enzymes. Results: Women who were climacteric at the age of 46 had lower BMIs (P = 0.029), T levels (P = 0.018), and FAIs (P = 0.009) at the age of 31. At the age of 46, they had less skeletal muscle (P < 0.001), a higher fat percentage (P = 0.016), higher cholesterol levels [total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), high-density lipoprotein cholesterol (HDL-C; P = 0.022), and triglycerides (P = 0.008)], and higher alanine aminotransferase (P = 0.023) and γ-glutamyltransferase (P < 0.001) levels compared with preclimacteric women. Waist circumference, WHR, BP, and hs-CRP levels did not differ between the groups. Of the climacteric women, 111/381 were using hormone-replacement therapy (HRT). In subanalysis that excluded the HRT users, triglycerides, HDL-C, and body fat percentage did not differ among the groups. Conclusions: Earlier climacterium is associated with mainly unfavorable metabolic changes.

Published
2019

10. Genetic variants in SGLT1, glucose tolerance, and cardiometabolic risk

Author

Seidelmann, S. B. (Sara B.), Feofanova, E. (Elena), Yu, B. (Bing), Franceschini, N. (Nora), Claggett, B. (Brian), Kuokkanen, M. (Mikko), Puolijoki, H. (Hannu), Ebeling, T. (Tapani), Perola, M. (Markus), Salomaa, V. (Veikko), Shah, A. (Amil), Coresh, J. (Josef), Selvin, E. (Elizabeth), MacRae, C. A. (Calum A.), Cheng, S. (Susan), Boerwinkle, E. (Eric), Solomon, S. D. (Scott D.), Seidelmann, S. B. (Sara B.), Feofanova, E. (Elena), Yu, B. (Bing), Franceschini, N. (Nora), Claggett, B. (Brian), Kuokkanen, M. (Mikko), Puolijoki, H. (Hannu), Ebeling, T. (Tapani), Perola, M. (Markus), Salomaa, V. (Veikko), Shah, A. (Amil), Coresh, J. (Josef), Selvin, E. (Elizabeth), MacRae, C. A. (Calum A.), Cheng, S. (Susan), Boerwinkle, E. (Eric), and Solomon, S. D. (Scott D.)

Abstract

Background: Loss-of-function mutations in the SGLT1 (sodium/glucose co-transporter-1) gene result in a rare glucose/galactose malabsorption disorder and neonatal death if untreated. In the general population, variants related to intestinal glucose absorption remain uncharacterized. Objectives: The goal of this study was to identify functional SGLT1 gene variants and characterize their clinical consequences. Methods: Whole exome sequencing was performed in the ARIC (Atherosclerosis Risk in Communities) study participants enrolled from 4 U.S. communities. The association of functional, nonsynonymous substitutions in SGLT1 with 2-h oral glucose tolerance test results was determined. Variants related to impaired glucose tolerance were studied, and Mendelian randomization analysis of cardiometabolic outcomes was performed. Results: Among 5,687 European-American subjects (mean age 54 ± 6 years; 47% male), those who carried a haplotype of 3 missense mutations (frequency of 6.7%)—Asn51Ser, Ala411Thr, and His615Gln—had lower 2-h glucose and odds of impaired glucose tolerance than noncarriers (β-coefficient: −8.0; 95% confidence interval [CI]: −12.7 to −3.3; OR: 0.71; 95% CI: 0.59 to 0.86, respectively). The association of the haplotype with oral glucose tolerance test results was consistent in a replication sample of 2,791 African-American subjects (β = −16.3; 95% CI: −36.6 to 4.1; OR: 0.39; 95% CI: 0.17 to 0.91) and an external European-Finnish population sample of 6,784 subjects (β = −3.2; 95% CI: −6.4 to −0.02; OR: 0.81; 95% CI: 0.68 to 0.98). Using a Mendelian randomization approach in the index cohort, the estimated 25-year effect of a reduction of 20 mg/dl in 2-h glucose via SGLT1 inhibition would be reduced prevalent obesity (OR: 0.43; 95% CI: 0.23 to 0.63), incident diabetes (hazard ratio [HR]: 0.58; 95% CI: 0.35 to 0.81), heart failure (HR: 0.53; 95% CI: 0.24 to 0.83), and death (HR: 0.66; 95% CI: 0.42 to 0.90). Conclusions: Functionally damaging missense v

Published
2018

11. Characteristics and outcomes of 79 patients with an insulinoma:a nationwide retrospective study in Finland

Author

Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Kiviniemi, U. (Ulla), Vornanen, M. (Martine), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin-Jäntti, C. (Camilla), Arola, J. (Johanna), Sirén, J. (Jukka), Piiroinen, A. (Antti), Soinio, M. (Minna), Nuutila, P. (Pirjo), Söderström, M. (Mirva), Hämäläinen, H. (Hanna), Moilanen, L. (Leena), Laaksonen, D. (David), Pirinen, E. (Elina), Sundelin, F. (Fia), Ebeling, T. (Tapani), Salmela, P. (Pasi), Mäkinen, M. J. (Markus J.), Jaatinen, P. (Pia), Peltola, E. (Elina), Hannula, P. (Päivi), Huhtala, H. (Heini), Metso, S. (Saara), Kiviniemi, U. (Ulla), Vornanen, M. (Martine), Sand, J. (Juhani), Laukkarinen, J. (Johanna), Tiikkainen, M. (Mirja), Schalin-Jäntti, C. (Camilla), Arola, J. (Johanna), Sirén, J. (Jukka), Piiroinen, A. (Antti), Soinio, M. (Minna), Nuutila, P. (Pirjo), Söderström, M. (Mirva), Hämäläinen, H. (Hanna), Moilanen, L. (Leena), Laaksonen, D. (David), Pirinen, E. (Elina), Sundelin, F. (Fia), Ebeling, T. (Tapani), Salmela, P. (Pasi), Mäkinen, M. J. (Markus J.), and Jaatinen, P. (Pia)

Abstract

Objective: Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades. Design and Methods: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010. Results: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010. Results. Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0 002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p < 0 001). Seventy-one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare.. Conclusions: The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system.

Published
2018

12. Two missense mutations in KCNQ1 cause pituitary hormone deficiency and maternally inherited gingival fibromatosis

Author

Tommiska, J. (Johanna), Känsäkoski, J. (Johanna), Skibsbye, L. (Lasse), Vaaralahti, K. (Kirsi), Liu, X. (Xiaonan), Lodge, E. J. (Emily J.), Tang, C. (Chuyi), Yuan, L. (Lei), Fagerholm, R. (Rainer), Kanters, J. K. (Jørgen K.), Lahermo, P. (Päivi), Kaunisto, M. (Mari), Keski-Filppula, R. (Riikka), Vuoristo, S. (Sanna), Pulli, K. (Kristiina), Ebeling, T. (Tapani), Valanne, L. (Leena), Sankila, E.-M. (Eeva-Marja), Kivirikko, S. (Sirpa), Lääperi, M. (Mitja), Casoni, F. (Filippo), Giacobini, P. (Paolo), Phan-Hug, F. (Franziska), Buki, T. (Tal), Tena-Sempere, M. (Manuel), Pitteloud, N. (Nelly), Veijola, R. (Riitta), Lipsanen-Nyman, M. (Marita), Kaunisto, K. (Kari), Mollard, P. (Patrice), Andoniadou, C. L. (Cynthia L.), Hirsch, J. A. (Joel A.), Varjosalo, M. (Markku), Jespersen, T. (Thomas), Raivio, T. (Taneli), Tommiska, J. (Johanna), Känsäkoski, J. (Johanna), Skibsbye, L. (Lasse), Vaaralahti, K. (Kirsi), Liu, X. (Xiaonan), Lodge, E. J. (Emily J.), Tang, C. (Chuyi), Yuan, L. (Lei), Fagerholm, R. (Rainer), Kanters, J. K. (Jørgen K.), Lahermo, P. (Päivi), Kaunisto, M. (Mari), Keski-Filppula, R. (Riikka), Vuoristo, S. (Sanna), Pulli, K. (Kristiina), Ebeling, T. (Tapani), Valanne, L. (Leena), Sankila, E.-M. (Eeva-Marja), Kivirikko, S. (Sirpa), Lääperi, M. (Mitja), Casoni, F. (Filippo), Giacobini, P. (Paolo), Phan-Hug, F. (Franziska), Buki, T. (Tal), Tena-Sempere, M. (Manuel), Pitteloud, N. (Nelly), Veijola, R. (Riitta), Lipsanen-Nyman, M. (Marita), Kaunisto, K. (Kari), Mollard, P. (Patrice), Andoniadou, C. L. (Cynthia L.), Hirsch, J. A. (Joel A.), Varjosalo, M. (Markku), Jespersen, T. (Thomas), and Raivio, T. (Taneli)

Abstract

Familial growth hormone deficiency provides an opportunity to identify new genetic causes of short stature. Here we combine linkage analysis with whole-genome resequencing in patients with growth hormone deficiency and maternally inherited gingival fibromatosis. We report that patients from three unrelated families harbor either of two missense mutations, c.347G>T p.(Arg116Leu) or c.1106C>T p.(Pro369Leu), in KCNQ1, a gene previously implicated in the long QT interval syndrome. Kcnq1 is expressed in hypothalamic GHRH neurons and pituitary somatotropes. Co-expressing KCNQ1 with the KCNE2 β-subunit shows that both KCNQ1 mutants increase current levels in patch clamp analyses and are associated with reduced pituitary hormone secretion from AtT-20 cells. In conclusion, our results reveal a role for the KCNQ1 potassium channel in the regulation of human growth, and show that growth hormone deficiency associated with maternally inherited gingival fibromatosis is an allelic disorder with cardiac arrhythmia syndromes caused by KCNQ1 mutations.

Published
2017

13. Rare and low-frequency coding variants alter human adult height

Author

Marouli, E. (Eirini), Graff, M.J. (Maud J.L.), Medina-Gomez, C. (Carolina), Lo, K.S., Wood, A.R. (Andrew), Kjaer, T.R. (Troels R.), Fine, R.S. (Rebecca S.), Lu, Y. (Yingchang), Schurmann, C. (Claudia), Highland, H. (Heather), Rüeger, S. (Sina), Thorleifsson, G. (Gudmar), Justice, A.E. (Anne), Lamparter, D. (David), Stirrups, K. (Kathy), Turcot, V. (Valérie), Young, K.L. (Kristin L.), Winkler, T.W. (Thomas W.), Esko, T. (Tõnu), Karaderi, T. (Tugce), Locke, A. (Adam), Masca, N.G.D. (Nicholas G.D.), Ng, M.C.Y. (Maggie C.Y.), Mudgal, P. (Poorva), Rivas, M.A. (Manuel), Vedantam, S. (Sailaja), Mahajan, A. (Anubha), Guo, X. (Xiuqing), Abecasis, G.R. (Gonçalo), Aben, K.K.H. (Katja), Adair, L.S. (Linda), Alam, D.S. (Dewan S.), Albrecht, E. (Eva), Allin, K.H. (Kristine H), Allison, M.A. (Matthew), Amouyel, P. (Philippe), Appel, E.V. (Emil V.), Arveiler, D. (Dominique), Asselbergs, F.W. (Folkert), Auer, P. (Paul), Balkau, B. (Beverley), Banas, B. (Bernhard), Bang, L.E. (Lia E.), Benn, M. (Marianne), Bergmann, S. (Sven), Bielak, L.F. (Lawrence F.), Blüher, M. (Matthias), Boeing, H. (Heiner), Boerwinkle, E.A. (Eric), Böger, C.A. (Carsten), Bonnycastle, L.L. (Lori), Bork-Jensen, J. (Jette), Bots, M.L. (Michiel), Bottinger, E.P. (Erwin), Bowden, D.W. (Donald), Brandslund, I. (Ivan), Breen, G. (Gerome), Brilliant, M.H. (Murray H.), Broer, L. (Linda), Burt, A.D. (Alastair), Butterworth, A.S. (Adam), Carey, D.J. (David J.), Caulfield, M. (Mark), Chambers, J.C. (John), Chasman, D.I. (Daniel), Chen, Y.-D.I. (Yii-Der Ida), Chowdhury, R. (Rajiv), Christensen, C. (Cramer), Chu, A.Y. (Audrey), Cocca, M. (Massimiliano), Collins, F.S. (Francis), Cook, J.P. (James P.), Corley, J. (Janie), Galbany, J.C. (Jordi Corominas), Cox, A.J. (Amanda J.), Cuellar-Partida, G. (Gabriel), Danesh, J. (John), Davies, G. (Gail), Bakker, P.I.W. (Paul) de, Borst, G.J. (Gert) de, De Denus, S. (Simon), De Groot, M.C.H. (Mark C.H.), Mutsert, R. (Reneé) de, Deary, I.J. (Ian), Dedoussis, G.V. (George), Demerath, E.W. (Ellen), Hollander, A.I. (Anneke), Dennis, J. (Joe), Angelantonio, E. (Emanuele) di, Drenos, F. (Fotios), Du, M. (Mengmeng), Dunning, A.M. (Alison M.), Easton, D.F. (Douglas), Ebeling, T. (Tapani), Edwards, T.L. (Todd L.), Ellinor, P.T. (Patrick), Elliott, P. (Paul), Evangelou, E. (Evangelos), Farmaki, A.-E. (Aliki-Eleni), Faul, J.D. (Jessica D.), Feitosa, M.F. (Mary Furlan), Feng, S. (Shuang), Ferrannini, E. (Ele), Ferrario, M.M. (Marco M.), Ferrieres, J. (Jean), Florez, J.C. (Jose), Ford, I., Fornage, M. (Myriam), Franks, P.W. (Paul), Frikke-Schmidt, R. (Ruth), Galesloot, T.E. (Tessel), Gan, W. (Wei), Gandin, I. (Ilaria), Gasparini, P. (Paolo), Giedraitis, V. (Vilmantas), Giri, A. (Ayush), Girotto, S., Gordon, S.D. (Scott D.), Gordon-Larsen, P. (Penny), Gorski, M. (Mathias), Grarup, N. (Niels), Grove, M.L. (Megan), Gudnason, V. (Vilmundur), Gustafsson, S. (Stefan), Hansen, T. (T.), Harris, K.M. (Kathleen Mullan), Harris, T.B. (Tamara), Hattersley, A.T. (Andrew), Hayward, C. (Caroline), He, L. (Liang), Heid, I.M. (Iris), Heikkilä, K. (Kauko), Helgeland, Ø. (Øyvind), Hernesniemi, J. (Jussi), Hewit, A.W. (Alex), Hocking, L.J. (Lynne), Hollensted, M. (Mette), Holmen, O.L. (Oddgeir), Hovingh, G.K. (Kees), Howson, J.M.M. (Joanna M.M.), Hoyng, C.B. (Carel), Huang, P.L. (Paul L.), Hveem, K. (Kristian), Ikram, M.K. (Kamran), Ingelsson, E. (Erik), Jackson, A.U. (Anne), Jansson, J.-H. (Jan-Håkan), Jarvik, G.P. (Gail), Jensen, G.B. (Gorm B.), Jhun, M.A. (Min A.), Jia, Y. (Yucheng), Jiang, X. (Xuejuan), Johansson, S. (Stefan), Jørgensen, M.E. (Marit E.), Jorgensen, T. (Torben), Jousilahti, P. (Pekka), Jukema, J.W. (Jan Wouter), Kahali, B. (Bratati), Kahn, R. (René), Kähönen, M. (Mika), Kamstrup, P.R. (Pia R.), Kanoni, S. (Stavroula), Kaprio, J. (Jaakko), Karaleftheri, M. (Maria), Kardia, S.L.R. (Sharon L.R.), Karpe, F. (Fredrik), Kee, F. (Frank), Keeman, J.N., Kiemeney, L.A.L.M. (Bart), Kitajima, H. (Hidetoshi), Kluivers, K.B. (Kirsten B.), Kocher, T., Komulainen, P. (Pirjo), Kontto, J. (Jukka), Kooner, J.S. (Jaspal S.), Kooperberg, C. (Charles), Kovacs, P. (Peter), Kriebel, J. (Jennifer), Kuivaniemi, H. (Helena), Küry, S. (Sébastien), Kuusisto, J. (Johanna), La Bianca, M. (Martina), Laakso, M. (Markku), Lakka, T.A. (Timo), Lange, E.M. (Ethan), Lange, L.A. (Leslie), Langefeld, C.D. (Carl), Langenberg, C. (Claudia), Larson, E.B. (Eric B.), Lee, I.-T. (I-Te), Lehtimäki, T. (Terho), Lewis, C.E. (Cora E.), Li, H. (Huaixing), Li, J. (Jin), Li-Gao, R. (Ruifang), Lin, H. (Honghuang), Lin, L.-A. (Li-An), Lin, X. (Xu), Kao, W.H.L. (Wen), Lindström, J. (Jaana), Linneberg, A. (Allan), Liu, Y. (Yeheng), Liu, Y. (YongMei), Lophatananon, A. (Artitaya), Luan, J. (Jian'An), Lubitz, S.A. (Steven), Lyytikäinen, L.-P. (Leo-Pekka), Mackey, D.A. (David A.), Madden, P.A. (Pamela), Manning, A.K. (Alisa), Männistö, S. (Satu), Marenne, G. (Gaëlle), Marten, J. (Jonathan), Martin, N.G. (Nicholas), Mazul, A.L. (Angela L.), Meidtner, K. (Karina), Metspalu, A. (Andres), Mitchell, P. (Paul), Mohlke, K.L. (Karen), Mook-Kanamori, D.O. (Dennis), Morgan, A. (Anna), Morris, A.D. (Andrew D.), Morris, A.P. (Andrew), Müller-Nurasyid, M. (Martina), Munroe, P. (Patricia), Nalls, M.A. (Michael), Nauck, M. (Matthias), Nelson, C.P. (Christopher P.), Neville, M.J. (Matthew), Nielsen, S.F. (Sune), Nikus, K. (Kjell), Njolstad, P. (Pal), Nordestgaard, B.G. (Børge), Ntalla, I. (Ioanna), O'Connel, J.R. (Jeffrey R.), Oksa, H. (Heikki), Loohuis, L.M.O. (Loes M. Olde), Ophoff, R.A. (Roel), Owen, K.R. (Katharine R.), Packard, C.J. (Chris J.), Padmanabhan, S. (Sandosh), Palmer, C.N.A. (Colin), Pasterkamp, G. (Gerard), Patel, A.P. (Aniruddh), Pattie, A. (Alison), Pedersen, O. (Oluf), Peissig, P.L. (Peggy L.), Peloso, G.M. (Gina), Pennell, C.E. (Craig), Perola, M. (Markus), Perry, J.A. (James A.), Perry, J.R.B. (John R.B.), Person, A.D. (Anthony), Pirie, A. (Ailith), Polasek, O. (Ozren), Posthuma, D. (Danielle), Raitakari, O.T. (Olli T.), Rasheed, A. (Asif), Rauramaa, R. (Rainer), Reilly, D.F. (Dermot F.), Reiner, A. (Alexander), Renström, F. (Frida), Ridker, P.M. (Paul), Rioux, J.D. (John), Robertson, N.R. (Neil), Robino, A. (Antonietta), Rolandsson, O. (Olov), Rudan, I. (Igor), Ruth, K.S. (Katherine S.), Saleheen, D. (Danish), Salomaa, V. (Veikko), Samani, N.J. (Nilesh), Sandow, K. (Kevin), Sapkota, Y. (Yadav), Sattar, N. (Naveed), Schmidt, M.K. (Marjanka), Schreiner, P.J. (Pamela), Schulze, M.B. (Matthias B), Scott, R.A. (Robert), Segura-Lepe, M.P. (Marcelo P.), Shah, S.H. (Svati), Sim, X. (Xueling), Sivapalaratnam, S. (Suthesh), Small, K.S. (Kerrin), Smith, A.V. (Albert Vernon), Smith, J.A. (Jennifer A), Southam, L. (Lorraine), Spector, T.D. (Timothy), Speliotes, E.K. (Elizabeth K.), Starr, J.M. (John), Steinthorsdottir, V. (Valgerdur), Stringham, H.M. (Heather), Stumvoll, M. (Michael), Surendran, P. (Praveen), Hart't, L.M. (Leen M.), Tansey, K.E. (Katherine E.), Tardif, J.-C. (Jean-Claude), Taylor, K.D. (Kent), Teumer, A. (Alexander), Thompson, D. (Deborah), Thorsteinsdottir, U. (Unnur), Thuesen, B.H. (Betina H.), Tönjes, A. (Anke), Tromp, G. (Gerard), Trompet, S. (Stella), Tsafantakis, E. (Emmanouil), Tuomilehto, J. (Jaakko), Tybjaerg-Hansen, A. (Anne), Tyrer, J.P. (Jonathan), Uher, R., Uitterlinden, A.G. (André), Ulivi, S. (Sheila), Van Der Laan, S.W. (Sander W.), Van Der Leij, A.R. (Andries R.), Duijn, C.M. (Cornelia) van, Schoor, N.M. (Natasja) van, Setten, J. (Jessica) van, Varbo, A. (Anette), Varga, T.V. (Tibor V.), Varma, R. (Rohit), Velez Edwards, D.R. (Digna R.), Vermeulen, S.H.H.M. (Sita), Vestergaard, H. (Henrik), Vitart, V. (Veronique), Vogt, T.F. (Thomas F.), Vozzi, D. (Diego), Walker, M. (Mark), Wang, F. (Feijie), Wang, C.A. (Carol A.), Wang, S. (Shuai), Wang, Y. (Yiqin), Wareham, N.J. (Nicholas J.), Warren, H. (Helen), Wessel, J. (Jennifer), Willems, S.M. (Sara), Wilson, J.F. (James), Witte, D.R. (Deniel), Woods, M.O. (Michael), Wu, Y. (Ying), Yaghootkar, H. (Hanieh), Yao, J. (Jiefen), Yao, P. (Pang), Yerges-Armstrong, L.M. (Laura), Young, R. (Robin), Zeggini, E. (Eleftheria), Zhan, X. (Xiaowei), Zhang, W. (Weihua), Zhao, J.H. (Jing Hua), Zhao, W. (Wei), Zheng, H. (He), Zhou, W. (Wei), Rotter, J.I. (Jerome I.), Boehnke, M. (Michael), Kathiresan, S. (Sekar), McCarthy, M.I. (Mark I.), Willer, C.J. (Cristen), Zwart, J-A. (John-Anker), Borecki, I.B. (Ingrid), Liu, D. (Dajiang), North, K.E. (Kari), Heard-Costa, N.L. (Nancy), Pers, T.H. (Tune), Lindgren, C.M. (Cecilia M.), Oxvig, C. (Claus), Kutalik, Z. (Zoltán), Rivadeneira Ramirez, F. (Fernando), Loos, R.J.F. (Ruth), Frayling, T.M. (Timothy), Hirschhorn, J.N. (Joel), Deloukas, P. (Panos), Lettre, G. (Guillaume), Marouli, E. (Eirini), Graff, M.J. (Maud J.L.), Medina-Gomez, C. (Carolina), Lo, K.S., Wood, A.R. (Andrew), Kjaer, T.R. (Troels R.), Fine, R.S. (Rebecca S.), Lu, Y. (Yingchang), Schurmann, C. (Claudia), Highland, H. (Heather), Rüeger, S. (Sina), Thorleifsson, G. (Gudmar), Justice, A.E. (Anne), Lamparter, D. (David), Stirrups, K. (Kathy), Turcot, V. (Valérie), Young, K.L. (Kristin L.), Winkler, T.W. (Thomas W.), Esko, T. (Tõnu), Karaderi, T. (Tugce), Locke, A. (Adam), Masca, N.G.D. (Nicholas G.D.), Ng, M.C.Y. (Maggie C.Y.), Mudgal, P. (Poorva), Rivas, M.A. (Manuel), Vedantam, S. (Sailaja), Mahajan, A. (Anubha), Guo, X. (Xiuqing), Abecasis, G.R. (Gonçalo), Aben, K.K.H. (Katja), Adair, L.S. (Linda), Alam, D.S. (Dewan S.), Albrecht, E. (Eva), Allin, K.H. (Kristine H), Allison, M.A. (Matthew), Amouyel, P. (Philippe), Appel, E.V. (Emil V.), Arveiler, D. (Dominique), Asselbergs, F.W. (Folkert), Auer, P. (Paul), Balkau, B. (Beverley), Banas, B. (Bernhard), Bang, L.E. (Lia E.), Benn, M. (Marianne), Bergmann, S. (Sven), Bielak, L.F. (Lawrence F.), Blüher, M. (Matthias), Boeing, H. (Heiner), Boerwinkle, E.A. (Eric), Böger, C.A. (Carsten), Bonnycastle, L.L. (Lori), Bork-Jensen, J. (Jette), Bots, M.L. (Michiel), Bottinger, E.P. (Erwin), Bowden, D.W. (Donald), Brandslund, I. (Ivan), Breen, G. (Gerome), Brilliant, M.H. (Murray H.), Broer, L. (Linda), Burt, A.D. (Alastair), Butterworth, A.S. (Adam), Carey, D.J. (David J.), Caulfield, M. (Mark), Chambers, J.C. (John), Chasman, D.I. (Daniel), Chen, Y.-D.I. (Yii-Der Ida), Chowdhury, R. (Rajiv), Christensen, C. (Cramer), Chu, A.Y. (Audrey), Cocca, M. (Massimiliano), Collins, F.S. (Francis), Cook, J.P. (James P.), Corley, J. (Janie), Galbany, J.C. (Jordi Corominas), Cox, A.J. (Amanda J.), Cuellar-Partida, G. (Gabriel), Danesh, J. (John), Davies, G. (Gail), Bakker, P.I.W. (Paul) de, Borst, G.J. (Gert) de, De Denus, S. (Simon), De Groot, M.C.H. (Mark C.H.), Mutsert, R. (Reneé) de, Deary, I.J. (Ian), Dedoussis, G.V. (George), Demerath, E.W. (Ellen), Hollander, A.I. (Anneke), Dennis, J. (Joe), Angelantonio, E. (Emanuele) di, Drenos, F. (Fotios), Du, M. (Mengmeng), Dunning, A.M. (Alison M.), Easton, D.F. (Douglas), Ebeling, T. (Tapani), Edwards, T.L. (Todd L.), Ellinor, P.T. (Patrick), Elliott, P. (Paul), Evangelou, E. (Evangelos), Farmaki, A.-E. (Aliki-Eleni), Faul, J.D. (Jessica D.), Feitosa, M.F. (Mary Furlan), Feng, S. (Shuang), Ferrannini, E. (Ele), Ferrario, M.M. (Marco M.), Ferrieres, J. (Jean), Florez, J.C. (Jose), Ford, I., Fornage, M. (Myriam), Franks, P.W. (Paul), Frikke-Schmidt, R. (Ruth), Galesloot, T.E. (Tessel), Gan, W. (Wei), Gandin, I. (Ilaria), Gasparini, P. (Paolo), Giedraitis, V. (Vilmantas), Giri, A. (Ayush), Girotto, S., Gordon, S.D. (Scott D.), Gordon-Larsen, P. (Penny), Gorski, M. (Mathias), Grarup, N. (Niels), Grove, M.L. (Megan), Gudnason, V. (Vilmundur), Gustafsson, S. (Stefan), Hansen, T. (T.), Harris, K.M. (Kathleen Mullan), Harris, T.B. (Tamara), Hattersley, A.T. (Andrew), Hayward, C. (Caroline), He, L. (Liang), Heid, I.M. (Iris), Heikkilä, K. (Kauko), Helgeland, Ø. (Øyvind), Hernesniemi, J. (Jussi), Hewit, A.W. (Alex), Hocking, L.J. (Lynne), Hollensted, M. (Mette), Holmen, O.L. (Oddgeir), Hovingh, G.K. (Kees), Howson, J.M.M. (Joanna M.M.), Hoyng, C.B. (Carel), Huang, P.L. (Paul L.), Hveem, K. (Kristian), Ikram, M.K. (Kamran), Ingelsson, E. (Erik), Jackson, A.U. (Anne), Jansson, J.-H. (Jan-Håkan), Jarvik, G.P. (Gail), Jensen, G.B. (Gorm B.), Jhun, M.A. (Min A.), Jia, Y. (Yucheng), Jiang, X. (Xuejuan), Johansson, S. (Stefan), Jørgensen, M.E. (Marit E.), Jorgensen, T. (Torben), Jousilahti, P. (Pekka), Jukema, J.W. (Jan Wouter), Kahali, B. (Bratati), Kahn, R. (René), Kähönen, M. (Mika), Kamstrup, P.R. (Pia R.), Kanoni, S. (Stavroula), Kaprio, J. (Jaakko), Karaleftheri, M. (Maria), Kardia, S.L.R. (Sharon L.R.), Karpe, F. (Fredrik), Kee, F. (Frank), Keeman, J.N., Kiemeney, L.A.L.M. (Bart), Kitajima, H. (Hidetoshi), Kluivers, K.B. (Kirsten B.), Kocher, T., Komulainen, P. (Pirjo), Kontto, J. (Jukka), Kooner, J.S. (Jaspal S.), Kooperberg, C. (Charles), Kovacs, P. (Peter), Kriebel, J. (Jennifer), Kuivaniemi, H. (Helena), Küry, S. (Sébastien), Kuusisto, J. (Johanna), La Bianca, M. (Martina), Laakso, M. (Markku), Lakka, T.A. (Timo), Lange, E.M. (Ethan), Lange, L.A. (Leslie), Langefeld, C.D. (Carl), Langenberg, C. (Claudia), Larson, E.B. (Eric B.), Lee, I.-T. (I-Te), Lehtimäki, T. (Terho), Lewis, C.E. (Cora E.), Li, H. (Huaixing), Li, J. (Jin), Li-Gao, R. (Ruifang), Lin, H. (Honghuang), Lin, L.-A. (Li-An), Lin, X. (Xu), Kao, W.H.L. (Wen), Lindström, J. (Jaana), Linneberg, A. (Allan), Liu, Y. (Yeheng), Liu, Y. (YongMei), Lophatananon, A. (Artitaya), Luan, J. (Jian'An), Lubitz, S.A. (Steven), Lyytikäinen, L.-P. (Leo-Pekka), Mackey, D.A. (David A.), Madden, P.A. (Pamela), Manning, A.K. (Alisa), Männistö, S. (Satu), Marenne, G. (Gaëlle), Marten, J. (Jonathan), Martin, N.G. (Nicholas), Mazul, A.L. (Angela L.), Meidtner, K. (Karina), Metspalu, A. (Andres), Mitchell, P. (Paul), Mohlke, K.L. (Karen), Mook-Kanamori, D.O. (Dennis), Morgan, A. (Anna), Morris, A.D. (Andrew D.), Morris, A.P. (Andrew), Müller-Nurasyid, M. (Martina), Munroe, P. (Patricia), Nalls, M.A. (Michael), Nauck, M. (Matthias), Nelson, C.P. (Christopher P.), Neville, M.J. (Matthew), Nielsen, S.F. (Sune), Nikus, K. (Kjell), Njolstad, P. (Pal), Nordestgaard, B.G. (Børge), Ntalla, I. (Ioanna), O'Connel, J.R. (Jeffrey R.), Oksa, H. (Heikki), Loohuis, L.M.O. (Loes M. Olde), Ophoff, R.A. (Roel), Owen, K.R. (Katharine R.), Packard, C.J. (Chris J.), Padmanabhan, S. (Sandosh), Palmer, C.N.A. (Colin), Pasterkamp, G. (Gerard), Patel, A.P. (Aniruddh), Pattie, A. (Alison), Pedersen, O. (Oluf), Peissig, P.L. (Peggy L.), Peloso, G.M. (Gina), Pennell, C.E. (Craig), Perola, M. (Markus), Perry, J.A. (James A.), Perry, J.R.B. (John R.B.), Person, A.D. (Anthony), Pirie, A. (Ailith), Polasek, O. (Ozren), Posthuma, D. (Danielle), Raitakari, O.T. (Olli T.), Rasheed, A. (Asif), Rauramaa, R. (Rainer), Reilly, D.F. (Dermot F.), Reiner, A. (Alexander), Renström, F. (Frida), Ridker, P.M. (Paul), Rioux, J.D. (John), Robertson, N.R. (Neil), Robino, A. (Antonietta), Rolandsson, O. (Olov), Rudan, I. (Igor), Ruth, K.S. (Katherine S.), Saleheen, D. (Danish), Salomaa, V. (Veikko), Samani, N.J. (Nilesh), Sandow, K. (Kevin), Sapkota, Y. (Yadav), Sattar, N. (Naveed), Schmidt, M.K. (Marjanka), Schreiner, P.J. (Pamela), Schulze, M.B. (Matthias B), Scott, R.A. (Robert), Segura-Lepe, M.P. (Marcelo P.), Shah, S.H. (Svati), Sim, X. (Xueling), Sivapalaratnam, S. (Suthesh), Small, K.S. (Kerrin), Smith, A.V. (Albert Vernon), Smith, J.A. (Jennifer A), Southam, L. (Lorraine), Spector, T.D. (Timothy), Speliotes, E.K. (Elizabeth K.), Starr, J.M. (John), Steinthorsdottir, V. (Valgerdur), Stringham, H.M. (Heather), Stumvoll, M. (Michael), Surendran, P. (Praveen), Hart't, L.M. (Leen M.), Tansey, K.E. (Katherine E.), Tardif, J.-C. (Jean-Claude), Taylor, K.D. (Kent), Teumer, A. (Alexander), Thompson, D. (Deborah), Thorsteinsdottir, U. (Unnur), Thuesen, B.H. (Betina H.), Tönjes, A. (Anke), Tromp, G. (Gerard), Trompet, S. (Stella), Tsafantakis, E. (Emmanouil), Tuomilehto, J. (Jaakko), Tybjaerg-Hansen, A. (Anne), Tyrer, J.P. (Jonathan), Uher, R., Uitterlinden, A.G. (André), Ulivi, S. (Sheila), Van Der Laan, S.W. (Sander W.), Van Der Leij, A.R. (Andries R.), Duijn, C.M. (Cornelia) van, Schoor, N.M. (Natasja) van, Setten, J. (Jessica) van, Varbo, A. (Anette), Varga, T.V. (Tibor V.), Varma, R. (Rohit), Velez Edwards, D.R. (Digna R.), Vermeulen, S.H.H.M. (Sita), Vestergaard, H. (Henrik), Vitart, V. (Veronique), Vogt, T.F. (Thomas F.), Vozzi, D. (Diego), Walker, M. (Mark), Wang, F. (Feijie), Wang, C.A. (Carol A.), Wang, S. (Shuai), Wang, Y. (Yiqin), Wareham, N.J. (Nicholas J.), Warren, H. (Helen), Wessel, J. (Jennifer), Willems, S.M. (Sara), Wilson, J.F. (James), Witte, D.R. (Deniel), Woods, M.O. (Michael), Wu, Y. (Ying), Yaghootkar, H. (Hanieh), Yao, J. (Jiefen), Yao, P. (Pang), Yerges-Armstrong, L.M. (Laura), Young, R. (Robin), Zeggini, E. (Eleftheria), Zhan, X. (Xiaowei), Zhang, W. (Weihua), Zhao, J.H. (Jing Hua), Zhao, W. (Wei), Zheng, H. (He), Zhou, W. (Wei), Rotter, J.I. (Jerome I.), Boehnke, M. (Michael), Kathiresan, S. (Sekar), McCarthy, M.I. (Mark I.), Willer, C.J. (Cristen), Zwart, J-A. (John-Anker), Borecki, I.B. (Ingrid), Liu, D. (Dajiang), North, K.E. (Kari), Heard-Costa, N.L. (Nancy), Pers, T.H. (Tune), Lindgren, C.M. (Cecilia M.), Oxvig, C. (Claus), Kutalik, Z. (Zoltán), Rivadeneira Ramirez, F. (Fernando), Loos, R.J.F. (Ruth), Frayling, T.M. (Timothy), Hirschhorn, J.N. (Joel), Deloukas, P. (Panos), and Lettre, G. (Guillaume)

Abstract

Height is a highly heritable, classic polygenic trait with approximately 700 common associated variants identified through genome-wide association studies so far. Here, we report 83 height-associated coding variants with lower minor-allele frequencies (in the range of 0.1-4.8%) and effects of up to 2 centimetres per allele (such as those in IHH, STC2, AR and CRISPLD2), greater than ten times the average effect of common variants. In functional follow-up studies, rare height-increasing alleles of STC2 (giving an increase of 1-2 centimetres per allele) compromised proteolytic inhibition of PAPP-A and increased cleavage of I

Published
2017
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14. Genome-wide physical activity interactions in adiposity ― A meta-analysis of 200,452 adults

Author

Graff, M.J. (Maud J.L.), Scott, R.A. (Robert), Justice, A.E. (Anne), Young, K.L. (Kristin L.), Feitosa, M.F. (Mary Furlan), Barata, L. (Llilda), Winkler, T.W. (Thomas W.), Chu, A.Y. (Audrey), Mahajan, A. (Anubha), Hadley, D. (David), Xue, L. (Luting), Workalemahu, T. (Tsegaselassie), Heard-Costa, N.L. (Nancy), Hoed, M. (Marcel) den, Ahluwalia, T.S. (Tarunveer Singh), Qi, Q., Ngwa, J.S., Renström, F. (Frida), Quaye, L. (Lydia), Eicher, J.D. (John D.), Hayes, J.E. (James E.), Cornelis, M. (Marilyn), Kutalik, Z. (Zoltán), Lim, E. (Elise), Luan, J. (Jian'An), Huffman, J.E. (Jennifer), Zhang, W. (Weihua), Zhao, W. (Wei), Griffin, P.J. (Paula J.), Haller, T. (Toomas), Ahmad, S. (Shafqat), Marques-Vidal, P. (Pedro), Bien, S. (Stephanie), Yengo, L. (Loic), Teumer, A. (Alexander), Smith, A.V. (Albert Vernon), Kumari, M. (Meena), Harder, M.N. (Marie Neergaard), Justesen, J.M. (Johanne M.), Kleber, M.E. (Marcus), Hollensted, M. (Mette), Lohman, K. (Kurt), Rivera, N.V. (Natalia), Whitfield, J.B. (John B.), Zhao, J.H. (Jing Hua), Stringham, H.M. (Heather), Lyytikäinen, L.-P. (Leo-Pekka), Huppertz, C. (Charlotte), Willemsen, G.A.H.M. (Gonneke), Peyrot, W.J. (Wouter ), Wu, Y. (Ying), Kristiansson, K. (Kati), Demirkan, A. (Ayşe), Fornage, M. (Myriam), Hassinen, M. (Maija), Bielak, L.F. (Lawrence F.), Cadby, G. (Gemma), Tanaka, T. (Toshiko), Mägi, R. (Reedik), Most, P.J. (Peter) van der, Jackson, A.U. (Anne), Bragg-Gresham, J.L. (Jennifer L.), Vitart, V. (Veronique), Marten, J. (Jonathan), Navarro, P. (Pau), Bellis, C. (Claire), Pasko, D. (Dorota), Johansson, Å. (Åsa), Snitker, S. (Soren), Cheng, Y.-C. (Yu-Ching), Eriksson, J. (Joel), Lim, U. (Unhee), Aadahl, M. (Mette), Adair, L.S. (Linda), Amin, N. (Najaf), Balkau, B. (Beverley), Auvinen, J. (Juha), Beilby, J.P. (John), Bergman, R.N. (Richard N.), Bergmann, S.M. (Sven), Bertoni, A.G. (Alain G.), Blangero, J. (John), Bonnefond, A. (Amélie), Bonnycastle, L.L. (Lori), Borja, J.B. (Judith), Brage, S. (Soren), Busonero, F., Buyske, S. (Steven), Campbell, H. (Harry), Chines, P.S. (Peter), Collins, F.S. (Francis), Corre, T. (Tanguy), Smith, G.D. (George Davey), Delgado, G., Dueker, N. (Nicole), Dörr, M. (Marcus), Ebeling, T. (Tapani), Eiriksdottir, G. (Gudny), Esko, T. (Tõnu), Faul, J.D. (Jessica D.), Fu, M. (Mao), Færch, K. (Kristine), Gieger, C. (Christian), Gläser, S., Gong, J. (Jian), Gordon-Larsen, P. (Penny), Grallert, H. (Harald), Grammer, T.B. (Tanja B), Grarup, N. (Niels), Grootheest, G. (Gerard) van, Harald, K. (Kennet), Hastie, N. (Nick), Havulinna, A.S. (Aki), Hernandez, D.G. (Dena), Hindorff, L.A. (Lucia A), Hocking, L.J. (Lynne), Holmens, O.L. (Oddgeir L.), Holzapfel, C. (Christina), Hottenga, J.J. (Jouke Jan), Huang, J. (Jian), Huang, T. (Tao), Hui, J. (Jennie), Huth, C. (Cornelia), Hutri-Kähönen, N. (Nina), James, A. (Alan), Jansson, J.-O. (John-Olov), Jhun, M.A. (Min A.), Juonala, M. (Markus), Kinnunen, L. (Leena), Koistinen, H. (Heikki), Kolcic, I. (Ivana), Komulainen, P. (Pirjo), Kuusisto, J. (Johanna), Kvaløy, K. (Kirsti), Kähönen, M. (Mika), Lakka, T.A. (Timo), Launer, L.J. (Lenore), Lehne, B. (Benjamin), Lindgren, C.M. (Cecilia M.), Lorentzon, M. (Mattias), Luben, R.N. (Robert), Marre, M. (Michel), Milaneschi, Y. (Yuri), Monda, K.L. (Keri), Montgomery, G.W. (Grant W.), Moor, M.H.M. de, Mulas, A. (Antonella), Müller-Nurasyid, M. (Martina), Musk, A.W., Männikkö, R. (Reija), Männistö, S. (Satu), Narisu, N. (Narisu), Nauck, M. (Matthias), Nettleton, J.A. (Jennifer ), Nolte, I.M. (Ilja M.), Oldehinkel, A.J. (Albertine), Olden, M. (Matthias), Ong, K.K. (Ken K.), Padmanabhan, S. (Sandosh), Paternoster, L. (Lavinia), Perez, J. (Jeremiah), Perola, M. (Markus), Peters, A. (Annette), Peters, U. (Ulrike), Peyser, P.A. (Patricia A.), Prokopenko, I. (Inga), Puolijoki, H. (Hannu), Raitakari, O.T. (Olli T.), Rankinen, T. (Tuomo), Rasmussen-Torvik, L.J. (Laura J.), Rawal, R. (Rajesh), Ridker, P.M. (Paul), Rose, L.M. (Lynda), Rudan, I. (Igor), Sarti, C. (Cinzia), Sarzynski, M.A. (Mark A.), Savonen, K. (Kai), Scott, W.R. (William R.), Sanna, S. (Serena), Shuldiner, A.R. (Alan), Sidney, S. (Steve), Silbernagel, G. (Günther), Smith, B.H., Smith, J.A. (Jennifer A), Snieder, H. (Harold), Stancáková, A. (Alena), Sternfeld, B. (Barbara), Swift, A.J. (Amy), Tammelin, T. (Tuija), Tan, S.-T. (Sian-Tsung), Thorand, B. (Barbara), Thuillier, D. (Dorothee), Vandenput, L. (Liesbeth), Vestergaard, H. (Henrik), Vliet-Ostaptchouk, J.V. (Jana) van, Vohl, M.-C. (Marie-Claude), Völker, U. (Uwe), Waeber, G. (Gérard), Walker, M. (Mark), Wild, S. (Sarah), Wong, A. (Andrew), Wright, A.F. (Alan), Zillikens, M.C. (Carola), Zubair, N. (Niha), Haiman, C.A. (Christopher), LeMarchand, L. (Loic), Gyllensten, U. (Ulf), Ohlsson, C. (Claes), Hofman, A. (Albert), Rivadeneira Ramirez, F. (Fernando), Uitterlinden, A.G. (André), Perusse, L. (Louis), Wilson, J.F. (James), Hayward, C. (Caroline), Polasek, O. (Ozren), Cucca, F. (Francesco), Hveem, K. (Kristian), Hartman, C.A. (Catharina A.), Tönjes, A. (Anke), Bandinelli, S. (Stefania), Palmer, L.J. (Lyle J.), Kardia, S.L.R. (Sharon L. R.), Rauramaa, R. (Rainer), Sørensen, T.I.A. (Thorkild), Tuomilehto, J. (Jaakko), Salomaa, V. (Veikko), Penninx, B.W.J.H. (Brenda), Geus, E.J.C. (Eco) de, Boomsma, D.I. (Dorret), Lehtimäki, T. (Terho), Mangino, M. (Massimo), Laakso, M. (Markku), Bouchard, C. (Claude), Martin, N.G. (Nicholas), Kuh, D. (Diana), Liu, Y. (YongMei), Linneberg, A. (Allan), März, W. (Winfried), Strauch, K. (Konstantin), Kivimaki, M. (Mika), Harris, T.B. (Tamara), Gudnason, V. (Vilmundur), Völzke, H. (Henry), Qi, L. (Lu), Jarvelin, M.-R. (Marjo-Riitta), Chambers, J.C. (John), Kooner, J.S. (Jaspal S.), Froguel, P. (Philippe), Kooperberg, C. (Charles), Vollenweider, P. (Peter), Hallmans, G. (Göran), Hansen, T. (T.), Pedersen, O. (Oluf), Metspalu, A. (Andres), Wareham, N.J. (Nick), Langenberg, C. (Claudia), Weir, D.R. (David), Porteous, D.J. (David J.), Boerwinkle, E.A. (Eric), Chasman, D.I. (Daniel), Abecasis, G.R. (Gonçalo R.), Barroso, I.E. (Inês), McCarthy, M.I. (Mark I.), Frayling, T.M. (Timothy), O’Connell, J.R. (Jeffrey R.), Duijn, C.M. (Cornelia) van, Boehnke, M. (Michael), Heid, I.M. (Iris), Mohlke, K.L. (Karen), Strachan, D.P. (David), Fox, C.S. (Caroline), Liu, C.-T. (Ching-Ti), Hirschhorn, J.N. (Joel), Klein, R.J. (Robert J.), Johnson, A.D. (Andrew), Borecki, I.B. (Ingrid), Franks, P.W. (Paul), North, K.E. (Kari), Cupples, L.A. (Adrienne), Loos, R.J.F. (Ruth), Kilpeläinen, T.O. (Tuomas), Graff, M.J. (Maud J.L.), Scott, R.A. (Robert), Justice, A.E. (Anne), Young, K.L. (Kristin L.), Feitosa, M.F. (Mary Furlan), Barata, L. (Llilda), Winkler, T.W. (Thomas W.), Chu, A.Y. (Audrey), Mahajan, A. (Anubha), Hadley, D. (David), Xue, L. (Luting), Workalemahu, T. (Tsegaselassie), Heard-Costa, N.L. (Nancy), Hoed, M. (Marcel) den, Ahluwalia, T.S. (Tarunveer Singh), Qi, Q., Ngwa, J.S., Renström, F. (Frida), Quaye, L. (Lydia), Eicher, J.D. (John D.), Hayes, J.E. (James E.), Cornelis, M. (Marilyn), Kutalik, Z. (Zoltán), Lim, E. (Elise), Luan, J. (Jian'An), Huffman, J.E. (Jennifer), Zhang, W. (Weihua), Zhao, W. (Wei), Griffin, P.J. (Paula J.), Haller, T. (Toomas), Ahmad, S. (Shafqat), Marques-Vidal, P. (Pedro), Bien, S. (Stephanie), Yengo, L. (Loic), Teumer, A. (Alexander), Smith, A.V. (Albert Vernon), Kumari, M. (Meena), Harder, M.N. (Marie Neergaard), Justesen, J.M. (Johanne M.), Kleber, M.E. (Marcus), Hollensted, M. (Mette), Lohman, K. (Kurt), Rivera, N.V. (Natalia), Whitfield, J.B. (John B.), Zhao, J.H. (Jing Hua), Stringham, H.M. (Heather), Lyytikäinen, L.-P. (Leo-Pekka), Huppertz, C. (Charlotte), Willemsen, G.A.H.M. (Gonneke), Peyrot, W.J. (Wouter ), Wu, Y. (Ying), Kristiansson, K. (Kati), Demirkan, A. (Ayşe), Fornage, M. (Myriam), Hassinen, M. (Maija), Bielak, L.F. (Lawrence F.), Cadby, G. (Gemma), Tanaka, T. (Toshiko), Mägi, R. (Reedik), Most, P.J. (Peter) van der, Jackson, A.U. (Anne), Bragg-Gresham, J.L. (Jennifer L.), Vitart, V. (Veronique), Marten, J. (Jonathan), Navarro, P. (Pau), Bellis, C. (Claire), Pasko, D. (Dorota), Johansson, Å. (Åsa), Snitker, S. (Soren), Cheng, Y.-C. (Yu-Ching), Eriksson, J. (Joel), Lim, U. (Unhee), Aadahl, M. (Mette), Adair, L.S. (Linda), Amin, N. (Najaf), Balkau, B. (Beverley), Auvinen, J. (Juha), Beilby, J.P. (John), Bergman, R.N. (Richard N.), Bergmann, S.M. (Sven), Bertoni, A.G. (Alain G.), Blangero, J. (John), Bonnefond, A. (Amélie), Bonnycastle, L.L. (Lori), Borja, J.B. (Judith), Brage, S. (Soren), Busonero, F., Buyske, S. (Steven), Campbell, H. (Harry), Chines, P.S. (Peter), Collins, F.S. (Francis), Corre, T. (Tanguy), Smith, G.D. (George Davey), Delgado, G., Dueker, N. (Nicole), Dörr, M. (Marcus), Ebeling, T. (Tapani), Eiriksdottir, G. (Gudny), Esko, T. (Tõnu), Faul, J.D. (Jessica D.), Fu, M. (Mao), Færch, K. (Kristine), Gieger, C. (Christian), Gläser, S., Gong, J. (Jian), Gordon-Larsen, P. (Penny), Grallert, H. (Harald), Grammer, T.B. (Tanja B), Grarup, N. (Niels), Grootheest, G. (Gerard) van, Harald, K. (Kennet), Hastie, N. (Nick), Havulinna, A.S. (Aki), Hernandez, D.G. (Dena), Hindorff, L.A. (Lucia A), Hocking, L.J. (Lynne), Holmens, O.L. (Oddgeir L.), Holzapfel, C. (Christina), Hottenga, J.J. (Jouke Jan), Huang, J. (Jian), Huang, T. (Tao), Hui, J. (Jennie), Huth, C. (Cornelia), Hutri-Kähönen, N. (Nina), James, A. (Alan), Jansson, J.-O. (John-Olov), Jhun, M.A. (Min A.), Juonala, M. (Markus), Kinnunen, L. (Leena), Koistinen, H. (Heikki), Kolcic, I. (Ivana), Komulainen, P. (Pirjo), Kuusisto, J. (Johanna), Kvaløy, K. (Kirsti), Kähönen, M. (Mika), Lakka, T.A. (Timo), Launer, L.J. (Lenore), Lehne, B. (Benjamin), Lindgren, C.M. (Cecilia M.), Lorentzon, M. (Mattias), Luben, R.N. (Robert), Marre, M. (Michel), Milaneschi, Y. (Yuri), Monda, K.L. (Keri), Montgomery, G.W. (Grant W.), Moor, M.H.M. de, Mulas, A. (Antonella), Müller-Nurasyid, M. (Martina), Musk, A.W., Männikkö, R. (Reija), Männistö, S. (Satu), Narisu, N. (Narisu), Nauck, M. (Matthias), Nettleton, J.A. (Jennifer ), Nolte, I.M. (Ilja M.), Oldehinkel, A.J. (Albertine), Olden, M. (Matthias), Ong, K.K. (Ken K.), Padmanabhan, S. (Sandosh), Paternoster, L. (Lavinia), Perez, J. (Jeremiah), Perola, M. (Markus), Peters, A. (Annette), Peters, U. (Ulrike), Peyser, P.A. (Patricia A.), Prokopenko, I. (Inga), Puolijoki, H. (Hannu), Raitakari, O.T. (Olli T.), Rankinen, T. (Tuomo), Rasmussen-Torvik, L.J. (Laura J.), Rawal, R. (Rajesh), Ridker, P.M. (Paul), Rose, L.M. (Lynda), Rudan, I. (Igor), Sarti, C. (Cinzia), Sarzynski, M.A. (Mark A.), Savonen, K. (Kai), Scott, W.R. (William R.), Sanna, S. (Serena), Shuldiner, A.R. (Alan), Sidney, S. (Steve), Silbernagel, G. (Günther), Smith, B.H., Smith, J.A. (Jennifer A), Snieder, H. (Harold), Stancáková, A. (Alena), Sternfeld, B. (Barbara), Swift, A.J. (Amy), Tammelin, T. (Tuija), Tan, S.-T. (Sian-Tsung), Thorand, B. (Barbara), Thuillier, D. (Dorothee), Vandenput, L. (Liesbeth), Vestergaard, H. (Henrik), Vliet-Ostaptchouk, J.V. (Jana) van, Vohl, M.-C. (Marie-Claude), Völker, U. (Uwe), Waeber, G. (Gérard), Walker, M. (Mark), Wild, S. (Sarah), Wong, A. (Andrew), Wright, A.F. (Alan), Zillikens, M.C. (Carola), Zubair, N. (Niha), Haiman, C.A. (Christopher), LeMarchand, L. (Loic), Gyllensten, U. (Ulf), Ohlsson, C. (Claes), Hofman, A. (Albert), Rivadeneira Ramirez, F. (Fernando), Uitterlinden, A.G. (André), Perusse, L. (Louis), Wilson, J.F. (James), Hayward, C. (Caroline), Polasek, O. (Ozren), Cucca, F. (Francesco), Hveem, K. (Kristian), Hartman, C.A. (Catharina A.), Tönjes, A. (Anke), Bandinelli, S. (Stefania), Palmer, L.J. (Lyle J.), Kardia, S.L.R. (Sharon L. R.), Rauramaa, R. (Rainer), Sørensen, T.I.A. (Thorkild), Tuomilehto, J. (Jaakko), Salomaa, V. (Veikko), Penninx, B.W.J.H. (Brenda), Geus, E.J.C. (Eco) de, Boomsma, D.I. (Dorret), Lehtimäki, T. (Terho), Mangino, M. (Massimo), Laakso, M. (Markku), Bouchard, C. (Claude), Martin, N.G. (Nicholas), Kuh, D. (Diana), Liu, Y. (YongMei), Linneberg, A. (Allan), März, W. (Winfried), Strauch, K. (Konstantin), Kivimaki, M. (Mika), Harris, T.B. (Tamara), Gudnason, V. (Vilmundur), Völzke, H. (Henry), Qi, L. (Lu), Jarvelin, M.-R. (Marjo-Riitta), Chambers, J.C. (John), Kooner, J.S. (Jaspal S.), Froguel, P. (Philippe), Kooperberg, C. (Charles), Vollenweider, P. (Peter), Hallmans, G. (Göran), Hansen, T. (T.), Pedersen, O. (Oluf), Metspalu, A. (Andres), Wareham, N.J. (Nick), Langenberg, C. (Claudia), Weir, D.R. (David), Porteous, D.J. (David J.), Boerwinkle, E.A. (Eric), Chasman, D.I. (Daniel), Abecasis, G.R. (Gonçalo R.), Barroso, I.E. (Inês), McCarthy, M.I. (Mark I.), Frayling, T.M. (Timothy), O’Connell, J.R. (Jeffrey R.), Duijn, C.M. (Cornelia) van, Boehnke, M. (Michael), Heid, I.M. (Iris), Mohlke, K.L. (Karen), Strachan, D.P. (David), Fox, C.S. (Caroline), Liu, C.-T. (Ching-Ti), Hirschhorn, J.N. (Joel), Klein, R.J. (Robert J.), Johnson, A.D. (Andrew), Borecki, I.B. (Ingrid), Franks, P.W. (Paul), North, K.E. (Kari), Cupples, L.A. (Adrienne), Loos, R.J.F. (Ruth), and Kilpeläinen, T.O. (Tuomas)

Abstract

Physical activity (PA) may modify the genetic effects that give rise to increased risk of obesity. To identify adiposity loci whose effects are modified by PA, we performed genome-wide interaction meta-analyses of BMI and BMI-adjusted waist circumference and waist-hip ratio from up to 200,452 adults of European (n = 180,423) or other ancestry (n = 20,029). We standardized PA by categorizing it into a dichotomous variable where, on average, 23% of participants were categorized as inactive and 77% as physically active. While we replicate the interaction with PA for the strongest known obesity-risk locus in the FTO gene, of which the effect is attenuated by ~30% in physically active individuals compared to inactive individuals, we do not identify additional loci that are sensitive to PA. In additional genome-wide meta-analyses adjusting for PA and interaction with PA, we identify 11 novel adiposity loci, suggesting that accounting for PA or other environmental factors that contribute to variation in adiposity may facilitate gene discovery.

Published
2017
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15. Genome-wide physical activity interactions in adiposity:a meta-analysis of 200,452 adults

Author

Graff, M. (Mariaelisa), Scott, R. A. (Robert A.), Justice, A. E. (Anne E.), Young, K. L. (Kristin L.), Feitosa, M. F. (Mary F.), Barata, L. (Llilda), Winkler, T. W. (Thomas W.), Chu, A. Y. (Audrey Y.), Mahajan, A. (Anubha), Hadley, D. (David), Xue, L. (Luting), Workalemahu, T. (Tsegaselassie), Heard-Costa, N. L. (Nancy L.), den Hoed, M. (Marcel), Ahluwalia, T. S. (Tarunveer S.), Qi, Q. (Qibin), Ngwa, J. S. (Julius S.), Renstrom, F. (Frida), Quaye, L. (Lydia), Eicher, J. D. (John D.), Hayes, J. E. (James E.), Cornelis, M. (Marilyn), Kutalik, Z. (Zoltan), Lim, E. (Elise), Luan, J. (Jian'an), Huffman, J. E. (Jennifer E.), Zhang, W. (Weihua), Zhao, W. (Wei), Griffin, P. J. (Paula J.), Haller, T. (Toomas), Ahmad, S. (Shafqat), Marques-Vidal, P. M. (Pedro M.), Bien, S. (Stephanie), Yengo, L. (Loic), Teumer, A. (Alexander), Smith, A. V. (Albert Vernon), Kumari, M. (Meena), Harder, M. N. (Marie Neergaard), Justesen, J. M. (Johanne Marie), Kleber, M. E. (Marcus E.), Hollensted, M. (Mette), Lohman, K. (Kurt), Rivera, N. V. (Natalia V.), Whitfield, J. B. (John B.), Zhao, J. H. (Jing Hua), Stringham, H. M. (Heather M.), Lyytikainen, L.-P. (Leo-Pekka), Huppertz, C. (Charlotte), Willemsen, G. (Gonneke), Peyrot, W. J. (Wouter J.), Wu, Y. (Ying), Kristiansson, K. (Kati), Demirkan, A. (Ayse), Fornage, M. (Myriam), Hassinen, M. (Maija), Bielak, L. F. (Lawrence F.), Cadby, G. (Gemma), Tanaka, T. (Toshiko), Magl, R. (Reedlk), Van der Most, P. J. (Peter J.), Jackson, A. U. (Anne U.), Bragg-Gresham, J. L. (Jennifer L.), Vitart, V. (Veronique), Marten, J. (Jonathan), Navarro, P. (Pau), Bellis, C. (Claire), Pasko, D. (Dorota), Johansson, A. (Asa), Snitker, S. (Soren), Cheng, Y.-C. (Yu-Ching), Eriksson, J. (Joel), Lim, U. (Unhee), Aadahl, M. (Mette), Adair, L. S. (Linda S.), Amin, N. (Najaf), Balkau, B. (Beverley), Auvinen, J. (Juha), Beilby, J. (John), Bergman, R. N. (Richard N.), Bergmann, S. (Sven), Bertoni, A. G. (Alain G.), Blangero, J. (John), Bonnefond, A. (Amelle), Bonnycastle, L. L. (Lori L.), Borja, J. B. (Judith B.), Brage, S. (Soren), Busonero, F. (Fabio), Buyske, S. (Steve), Campbell, H. (Harry), Chines, P. S. (Peter S.), Collins, F. S. (Francis S.), Corre, T. (Tanguy), Smith, G. D. (George Davey), Delgado, G. E. (Graciela E.), Dueker, N. (Nicole), Doerr, M. (Marcus), Ebeling, T. (Tapani), Eiriksdottir, G. (Gudny), Esko, T. (Tonu), Faul, J. D. (Jessica D.), Fu, M. (Mao), Faerch, K. (Kristine), Gieger, C. (Christian), Glaeser, S. (Sven), Gong, J. (Jian), Gordon-Larsen, P. (Penny), Grallert, H. (Harald), Grammer, T. B. (Tanja B.), Grarup, N. (Niels), van Grootheest, G. (Gerard), Harald, K. (Kennet), Hastie, N. D. (Nicholas D.), Havulinna, A. S. (Aki S.), Hernandez, D. (Dena), Hindorff, L. (Lucia), Hocking, L. J. (Lynne J.), Holmens, O. L. (Oddgeir L.), Holzapfel, C. (Christina), Hottenga, J. J. (Jouke Jan), Huang, J. (Jie), Huang, T. (Tao), Hui, J. (Jennie), Huth, C. (Cornelia), Hutri-Kahonen, N. (Nina), James, A. L. (Alan L.), Jansson, J.-O. (John-Olov), Jhun, M. A. (Min A.), Juonala, M. (Markus), Kinnunen, L. (Leena), Koistinen, H. A. (Heikki A.), Kolcic, I. (Ivana), Komulainen, P. (Pirjo), Kuusisto, J. (Johanna), Kvaloy, K. (Kirsti), Kahonen, M. (Mika), Lakka, T. A. (Timo A.), Launer, L. J. (Lenore J.), Lehne, B. (Benjamin), Lindgren, C. M. (Cecilia M.), Lorentzon, M. (Mattias), Luben, R. (Robert), Marre, M. (Michel), Milaneschi, Y. (Yuri), Monda, K. L. (Keri L.), Montgomery, G. W. (Grant W.), De Moor, M. H. (Marleen H. M.), Mulas, A. (Antonella), Mueller-Nurasyid, M. (Martina), Musk, A. W. (A. W.), Mannikko, R. (Reija), Mannisto, S. (Satu), Narisu, N. (Narisu), Nauck, M. (Matthias), Nettleton, J. A. (Jennifer A.), Nolte, I. M. (Ilja M.), Oldehinkel, A. J. (Albertine J.), Olden, M. (Matthias), Ong, K. K. (Ken K.), Padmanabhan, S. (Sandosh), Paternoster, L. (Lavinia), Perez, J. (Jeremiah), Perola, M. (Markus), Peters, A. (Annette), Peters, U. (Ulrike), Peyser, P. A. (Patricia A.), Prokopenko, I. (Inga), Puolijoki, H. (Hannu), Raitakari, O. T. (Olli T.), Rankinen, T. (Tuomo), Rasmussen-Torvik, L. J. (Laura J.), Rawal, R. (Rajesh), Ridker, P. M. (Paul M.), Rose, L. M. (Lynda M.), Rudan, I. (Igor), Sarti, C. (Cinzia), Sarzynski, M. A. (Mark A.), Savonen, K. (Kai), Scott, W. R. (William R.), Sanna, S. (Serena), Shuldiner, A. R. (Alan R.), Sidney, S. (Steve), Silbernagel, G. (Guenther), Smith, B. H. (Blair H.), Smith, J. A. (Jennifer A.), Snieder, H. (Harold), Stancakova, A. (Alena), Sternfeld, B. (Barbara), Swift, A. J. (Amy J.), Tammelin, T. (Tuija), Tan, S.-T. (Sian-Tsung), Thorand, B. (Barbara), Thuillier, D. (Dorothee), Vandenput, L. (Liesbeth), Vestergaard, H. (Henrik), van Vliet-Ostaptchouk, J. V. (Jana V.), Vohl, M.-C. (Marie-Claude), Voelker, U. (Uwe), Waeber, G. (Gerard), Walker, M. (Mark), Wild, S. (Sarah), Wong, A. (Andrew), Wright, A. F. (Alan F.), Zillikens, M. C. (M. Carola), Zubair, N. (Niha), Haiman, C. A. (Christopher A.), Lemarchand, L. (Loic), Gyllensten, U. (Ulf), Ohlsson, C. (Claes), Hofman, A. (Albert), Rivadeneira, F. (Fernando), Uitterlinden, A. G. (Andre G.), Perusse, L. (Louis), Wilson, J. F. (James F.), Hayward, C. (Caroline), Polasek, O. (Ozren), Cucca, F. (Francesco), Hveem, K. (Kristian), Hartman, C. A. (Catharina A.), Toenjes, A. (Anke), Bandinelli, S. (Stefania), Palmer, L. J. (Lyle J.), Kardia, S. L. (Sharon L. R.), Rauramaa, R. (Rainer), Sorensen, T. I. (Thorkild I. A.), Tuomilehto, J. (Jaakko), Salomaa, V. (Veikko), Penninx, B. W. (Brenda W. J. H.), de Geus, E. J. (Eco J. C.), Boomsma, D. I. (Dorret I.), Lehtimaki, T. (Terho), Mangino, M. (Massimo), Laakso, M. (Markku), Bouchard, C. (Claude), Martin, N. G. (Nicholas G.), Kuh, D. (Diana), Liu, Y. (Yongmei), Linneberg, A. (Allan), Maerz, W. (Winfried), Strauch, K. (Konstantin), Kivimaki, M. (Mika), Harris, T. B. (Tamara B.), Gudnason, V. (Vilmundur), Voelzke, H. (Henry), Qi, L. (Lu), Jarvelin, M.-R. (Marjo-Riitta), Chambers, J. C. (John C.), Kooner, J. S. (Jaspal S.), Froguel, P. (Philippe), Kooperberg, C. (Charles), Vollenweider, P. (Peter), Hallmans, G. (Goran), Hansen, T. (Torben), Pedersen, O. (Oluf), Metspalu, A. (Andres), Wareham, N. J. (Nicholas J.), Langenberg, C. (Claudia), Weir, D. R. (David R.), Porteous, D. J. (David J.), Boerwinkle, E. (Eric), Chasman, D. I. (Daniel I.), Abecasis, G. R. (Goncalo R.), Barroso, I. (Ines), McCarthy, M. I. (Mark I.), Frayling, T. M. (Timothy M.), O'Connell, J. R. (Jeffrey R.), van Duijn, C. M. (Cornelia M.), Boehnke, M. (Michael), Heid, I. M. (Iris M.), Mohlke, K. L. (Karen L.), Strachan, D. P. (David P.), Fox, C. S. (Caroline S.), Liu, C.-T. (Ching-Ti), Hirschhorn, J. N. (Joel N.), Klein, R. J. (Robert J.), Johnson, A. D. (Andrew D.), Borecki, I. B. (Ingrid B.), Franks, P. W. (Paul W.), North, K. E. (Kari E.), Cupples, L. A. (L. Adrienne), Loos, R. J. (Ruth J. F.), Kilpelainen, T. O. (Tuomas O.), Graff, M. (Mariaelisa), Scott, R. A. (Robert A.), Justice, A. E. (Anne E.), Young, K. L. (Kristin L.), Feitosa, M. F. (Mary F.), Barata, L. (Llilda), Winkler, T. W. (Thomas W.), Chu, A. Y. (Audrey Y.), Mahajan, A. (Anubha), Hadley, D. (David), Xue, L. (Luting), Workalemahu, T. (Tsegaselassie), Heard-Costa, N. L. (Nancy L.), den Hoed, M. (Marcel), Ahluwalia, T. S. (Tarunveer S.), Qi, Q. (Qibin), Ngwa, J. S. (Julius S.), Renstrom, F. (Frida), Quaye, L. (Lydia), Eicher, J. D. (John D.), Hayes, J. E. (James E.), Cornelis, M. (Marilyn), Kutalik, Z. (Zoltan), Lim, E. (Elise), Luan, J. (Jian'an), Huffman, J. E. (Jennifer E.), Zhang, W. (Weihua), Zhao, W. (Wei), Griffin, P. J. (Paula J.), Haller, T. (Toomas), Ahmad, S. (Shafqat), Marques-Vidal, P. M. (Pedro M.), Bien, S. (Stephanie), Yengo, L. (Loic), Teumer, A. (Alexander), Smith, A. V. (Albert Vernon), Kumari, M. (Meena), Harder, M. N. (Marie Neergaard), Justesen, J. M. (Johanne Marie), Kleber, M. E. (Marcus E.), Hollensted, M. (Mette), Lohman, K. (Kurt), Rivera, N. V. (Natalia V.), Whitfield, J. B. (John B.), Zhao, J. H. (Jing Hua), Stringham, H. M. (Heather M.), Lyytikainen, L.-P. (Leo-Pekka), Huppertz, C. (Charlotte), Willemsen, G. (Gonneke), Peyrot, W. J. (Wouter J.), Wu, Y. (Ying), Kristiansson, K. (Kati), Demirkan, A. (Ayse), Fornage, M. (Myriam), Hassinen, M. (Maija), Bielak, L. F. (Lawrence F.), Cadby, G. (Gemma), Tanaka, T. (Toshiko), Magl, R. (Reedlk), Van der Most, P. J. (Peter J.), Jackson, A. U. (Anne U.), Bragg-Gresham, J. L. (Jennifer L.), Vitart, V. (Veronique), Marten, J. (Jonathan), Navarro, P. (Pau), Bellis, C. (Claire), Pasko, D. (Dorota), Johansson, A. (Asa), Snitker, S. (Soren), Cheng, Y.-C. (Yu-Ching), Eriksson, J. (Joel), Lim, U. (Unhee), Aadahl, M. (Mette), Adair, L. S. (Linda S.), Amin, N. (Najaf), Balkau, B. (Beverley), Auvinen, J. (Juha), Beilby, J. (John), Bergman, R. N. (Richard N.), Bergmann, S. (Sven), Bertoni, A. G. (Alain G.), Blangero, J. (John), Bonnefond, A. (Amelle), Bonnycastle, L. L. (Lori L.), Borja, J. B. (Judith B.), Brage, S. (Soren), Busonero, F. (Fabio), Buyske, S. (Steve), Campbell, H. (Harry), Chines, P. S. (Peter S.), Collins, F. S. (Francis S.), Corre, T. (Tanguy), Smith, G. D. (George Davey), Delgado, G. E. (Graciela E.), Dueker, N. (Nicole), Doerr, M. (Marcus), Ebeling, T. (Tapani), Eiriksdottir, G. (Gudny), Esko, T. (Tonu), Faul, J. D. (Jessica D.), Fu, M. (Mao), Faerch, K. (Kristine), Gieger, C. (Christian), Glaeser, S. (Sven), Gong, J. (Jian), Gordon-Larsen, P. (Penny), Grallert, H. (Harald), Grammer, T. B. (Tanja B.), Grarup, N. (Niels), van Grootheest, G. (Gerard), Harald, K. (Kennet), Hastie, N. D. (Nicholas D.), Havulinna, A. S. (Aki S.), Hernandez, D. (Dena), Hindorff, L. (Lucia), Hocking, L. J. (Lynne J.), Holmens, O. L. (Oddgeir L.), Holzapfel, C. (Christina), Hottenga, J. J. (Jouke Jan), Huang, J. (Jie), Huang, T. (Tao), Hui, J. (Jennie), Huth, C. (Cornelia), Hutri-Kahonen, N. (Nina), James, A. L. (Alan L.), Jansson, J.-O. (John-Olov), Jhun, M. A. (Min A.), Juonala, M. (Markus), Kinnunen, L. (Leena), Koistinen, H. A. (Heikki A.), Kolcic, I. (Ivana), Komulainen, P. (Pirjo), Kuusisto, J. (Johanna), Kvaloy, K. (Kirsti), Kahonen, M. (Mika), Lakka, T. A. (Timo A.), Launer, L. J. (Lenore J.), Lehne, B. (Benjamin), Lindgren, C. M. (Cecilia M.), Lorentzon, M. (Mattias), Luben, R. (Robert), Marre, M. (Michel), Milaneschi, Y. (Yuri), Monda, K. L. (Keri L.), Montgomery, G. W. (Grant W.), De Moor, M. H. (Marleen H. M.), Mulas, A. (Antonella), Mueller-Nurasyid, M. (Martina), Musk, A. W. (A. W.), Mannikko, R. (Reija), Mannisto, S. (Satu), Narisu, N. (Narisu), Nauck, M. (Matthias), Nettleton, J. A. (Jennifer A.), Nolte, I. M. (Ilja M.), Oldehinkel, A. J. (Albertine J.), Olden, M. (Matthias), Ong, K. K. (Ken K.), Padmanabhan, S. (Sandosh), Paternoster, L. (Lavinia), Perez, J. (Jeremiah), Perola, M. (Markus), Peters, A. (Annette), Peters, U. (Ulrike), Peyser, P. A. (Patricia A.), Prokopenko, I. (Inga), Puolijoki, H. (Hannu), Raitakari, O. T. (Olli T.), Rankinen, T. (Tuomo), Rasmussen-Torvik, L. J. (Laura J.), Rawal, R. (Rajesh), Ridker, P. M. (Paul M.), Rose, L. M. (Lynda M.), Rudan, I. (Igor), Sarti, C. (Cinzia), Sarzynski, M. A. (Mark A.), Savonen, K. (Kai), Scott, W. R. (William R.), Sanna, S. (Serena), Shuldiner, A. R. (Alan R.), Sidney, S. (Steve), Silbernagel, G. (Guenther), Smith, B. H. (Blair H.), Smith, J. A. (Jennifer A.), Snieder, H. (Harold), Stancakova, A. (Alena), Sternfeld, B. (Barbara), Swift, A. J. (Amy J.), Tammelin, T. (Tuija), Tan, S.-T. (Sian-Tsung), Thorand, B. (Barbara), Thuillier, D. (Dorothee), Vandenput, L. (Liesbeth), Vestergaard, H. (Henrik), van Vliet-Ostaptchouk, J. V. (Jana V.), Vohl, M.-C. (Marie-Claude), Voelker, U. (Uwe), Waeber, G. (Gerard), Walker, M. (Mark), Wild, S. (Sarah), Wong, A. (Andrew), Wright, A. F. (Alan F.), Zillikens, M. C. (M. Carola), Zubair, N. (Niha), Haiman, C. A. (Christopher A.), Lemarchand, L. (Loic), Gyllensten, U. (Ulf), Ohlsson, C. (Claes), Hofman, A. (Albert), Rivadeneira, F. (Fernando), Uitterlinden, A. G. (Andre G.), Perusse, L. (Louis), Wilson, J. F. (James F.), Hayward, C. (Caroline), Polasek, O. (Ozren), Cucca, F. (Francesco), Hveem, K. (Kristian), Hartman, C. A. (Catharina A.), Toenjes, A. (Anke), Bandinelli, S. (Stefania), Palmer, L. J. (Lyle J.), Kardia, S. L. (Sharon L. R.), Rauramaa, R. (Rainer), Sorensen, T. I. (Thorkild I. A.), Tuomilehto, J. (Jaakko), Salomaa, V. (Veikko), Penninx, B. W. (Brenda W. J. H.), de Geus, E. J. (Eco J. C.), Boomsma, D. I. (Dorret I.), Lehtimaki, T. (Terho), Mangino, M. (Massimo), Laakso, M. (Markku), Bouchard, C. (Claude), Martin, N. G. (Nicholas G.), Kuh, D. (Diana), Liu, Y. (Yongmei), Linneberg, A. (Allan), Maerz, W. (Winfried), Strauch, K. (Konstantin), Kivimaki, M. (Mika), Harris, T. B. (Tamara B.), Gudnason, V. (Vilmundur), Voelzke, H. (Henry), Qi, L. (Lu), Jarvelin, M.-R. (Marjo-Riitta), Chambers, J. C. (John C.), Kooner, J. S. (Jaspal S.), Froguel, P. (Philippe), Kooperberg, C. (Charles), Vollenweider, P. (Peter), Hallmans, G. (Goran), Hansen, T. (Torben), Pedersen, O. (Oluf), Metspalu, A. (Andres), Wareham, N. J. (Nicholas J.), Langenberg, C. (Claudia), Weir, D. R. (David R.), Porteous, D. J. (David J.), Boerwinkle, E. (Eric), Chasman, D. I. (Daniel I.), Abecasis, G. R. (Goncalo R.), Barroso, I. (Ines), McCarthy, M. I. (Mark I.), Frayling, T. M. (Timothy M.), O'Connell, J. R. (Jeffrey R.), van Duijn, C. M. (Cornelia M.), Boehnke, M. (Michael), Heid, I. M. (Iris M.), Mohlke, K. L. (Karen L.), Strachan, D. P. (David P.), Fox, C. S. (Caroline S.), Liu, C.-T. (Ching-Ti), Hirschhorn, J. N. (Joel N.), Klein, R. J. (Robert J.), Johnson, A. D. (Andrew D.), Borecki, I. B. (Ingrid B.), Franks, P. W. (Paul W.), North, K. E. (Kari E.), Cupples, L. A. (L. Adrienne), Loos, R. J. (Ruth J. F.), and Kilpelainen, T. O. (Tuomas O.)

Abstract

Physical activity (PA) may modify the genetic effects that give rise to increased risk of obesity. To identify adiposity loci whose effects are modified by PA, we performed genome-wide interaction meta-analyses of BMI and BMI-adjusted waist circumference and waist-hip ratio from up to 200,452 adults of European (n = 180,423) or other ancestry (n = 20,029). We standardized PA by categorizing it into a dichotomous variable where, on average, 23% of participants were categorized as inactive and 77% as physically active. While we replicate the interaction with PA for the strongest known obesity-risk locus in the FTO gene, of which the effect is attenuated by ~30% in physically active individuals compared to inactive individuals, we do not identify additional loci that are sensitive to PA. In additional genome-wide meta-analyses adjusting for PA and interaction with PA, we identify 11 novel adiposity loci, suggesting that accounting for PA or other environmental factors that contribute to variation in adiposity may facilitate gene discovery.

Published
2017

16. Risk of rupture of small anterior communicating artery aneurysms is similar to posterior circulation aneurysms

Author

Bijlenga, P. (Philippe), Ebeling, T. (Tapani), Jaegersberg, M. (Max), Summers, P. (Paul), Rogers, A. (Alister), Waterworth, D. (Dawn), Iavindrasana, J. (Jimison), MacHo, J. (Juan), Pereira, V.M. (Vitor Mendes), Bukovics, P. (Peter), Vivas, E. (Elio), Sturkenboom, M.C.J.M. (Miriam), Wright, J. (Juliet), Friedrich, C.M. (Christoph), Frangi, A.F. (Alejandro), Byrne, P.J. (James), Schaller, K. (Karl), Rüfenacht, D. (Daniel), Bijlenga, P. (Philippe), Ebeling, T. (Tapani), Jaegersberg, M. (Max), Summers, P. (Paul), Rogers, A. (Alister), Waterworth, D. (Dawn), Iavindrasana, J. (Jimison), MacHo, J. (Juan), Pereira, V.M. (Vitor Mendes), Bukovics, P. (Peter), Vivas, E. (Elio), Sturkenboom, M.C.J.M. (Miriam), Wright, J. (Juliet), Friedrich, C.M. (Christoph), Frangi, A.F. (Alejandro), Byrne, P.J. (James), Schaller, K. (Karl), and Rüfenacht, D. (Daniel)

Abstract

Background and Purpose: According to the International Study of Unruptured Intracranial Aneurysms (ISUIA), anterior circulation (AC) aneurysms of <7 mm in diameter have a minimal risk of rupture. It is general experience, however, that anterior communicating artery (AcoA) aneurysms are frequent and mostly rupture at <7 mm. The aim of the study was to assess whether AcoA aneurysms behave differently from other AC aneurysms. Methods: Information about 932 patients newly diagnosed with intracranial aneurysms between November 1, 2006, and March 31, 2012, including aneurysm status at diagnosis, its location, size, and risk factors, was collected during the multicenter @neurIST project. For each location or location and size subgroup, the odds ratio (OR) of aneurysms being ruptured at diagnosis was calculated. Results: The OR for aneurysms to be discovered ruptured was significantly higher for AcoA (OR, 3.5 [95% confidence interval, 2.6-4.5]) and posterior circulation (OR, 2.6 [95% confidence interval, 2.1-3.3]) than for AC excluding AcoA (OR, 0.5 [95% confidence interval, 0.4-0.6]). Although a threshold of 7 mm has been suggested by ISUIA as a threshold for aggressive treatment, AcoA aneurysms <7 mm were more frequently found ruptured (OR, 2.0 [95% confidence interval, 1.3-3.0]) than AC aneurysms of 7 to 12 mm diameter as defined in ISUIA. Conclusions: We found that AC aneurysms are not a homogenous group. Aneurysms between 4 and 7 mm located in AcoA or distal anterior cerebral artery present similar rupture odds to posterior circulation aneurysms. Intervention should be recommended for this high-risk lesion group.

Published
2013
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