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Kiel, D. P.

Publications and source records attributed to Kiel, D. P..

4 recordsLinked to original sources

The genetic architecture of trabecular bone score and association with fracture: a genome-wide association and meta-analysis

BackgroundTrabecular bone score (TBS) is a texture-based measurement derived from DXA scans, which describes the distribution of mineral across the vertebral bodies. Identifying its genetic determinants is crucial for enhancing understanding of its biological basis and clarifying its relationship with fracture risk. MethodsWe conducted a large-scale genome-wide association study (GWAS) of TBS from 44,767 participants (95.08% European ancestry). Sex heterogeneity was assessed through sex-stratified GWAS. Post-GWAS analyses included functional annotation, gene-set enrichment analysis, and cis-expression quantitative trait locus (cis-eQTL) colocalization. Two-sample and multivariable Mendelian randomization (MR) were employed to investigate the causal effect of TBS on fractures. FindingsWe identified 33 independent variants associated with TBS, which explained 4.06% of TBS phenotypic variance. All the discovered signals map to previously identified BMD-associated loci. Additionally, we identified genetic variants in the RAB11FIP3 locus that exhibited a sex-heterogeneous effect, being associated with TBS exclusively in males. Functional annotation and colocalization identified functional genes related to TBS. The two-sample and multivariable MR analyses indicated that TBS potentially has an independent causal effect on fracture risk. InterpretationOur study unveiled 33 independent loci associated with TBS, all in BMD-associated loci. One locus was further identified as associated with TBS only in males. MR results suggested that genetically derived TBS may be causally associated with fracture risk at different sites, potentially beyond BMD. This study provides insights into the TBS genetic architecture and uncovers its potential clinical applications in fracture risk prediction. FundingAll funding information can be found in the Acknowledgements section. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSOsteoporosis is a common disease prevalent in older adults, mainly diagnosed by low bone mineral density and disruption of bone architecture. While the genetic determinants of bone mass have been well studied, the genetic architecture of bone features beyond BMD remains largely unknown. Added value of this studyThis study presents a large genome-wide association meta-analysis of the trabecular bone score (TBS), a measurement of trabecular distribution of bone mineralization across vertebral bodies. Our study identified 33 independent variants associated with TBS and one association signal only in males. Functional annotation highlighted crucial genes related to TBS. The two-sample and multivariable Mendelian randomization (MR) analyses suggested that TBS may be causally linked with fracture risk, potentially independent of BMD. Implications of all the available evidenceOur study represents an expansion of the traditional bone density phenotype used in most previous skeletal genetic studies. Based on the findings that all of the significant loci for TBS have been previously identified in GWAS of BMD, we conclude that TBS-associated variants have pleiotropic effects affecting not only mineral density but also the distribution patterns of minerals in the cancellous bone. Continuing to perform genetic studies of new skeletal phenotypes beyond BMD could ultimately impact the management and prediction of osteoporosis patients.

genomics↗

Transcriptomic network analysis of brain and bone reveals shared molecular mechanisms underlyingAlzheimer's Disease and related dementias and Osteoporosis

Alzheimers disease and related dementias (ADRD) and Osteoporosis (OP) are two prevalent diseases of aging with numerous epidemiological associations, but the underlying molecular mechanisms contributing to this association are unknown. We used WGCNA (weighted gene co-expression network analysis) to develop transcriptomic networks in bone and brain tissue using two different studies to discover common molecular mechanisms. We used RNA-sequencing data from the dorsolateral prefrontal cortex tissue of autopsied brains in 629 participants from ROSMAP (Religious Orders Study and the Memory and Aging Project), including a subset of 298 meeting criteria for inclusion in five ADRD categories and the full set in a secondary analysis, and RNA array data from transiliac bone in 84 participants from the Oslo study of postmenopausal women. After developing each network, we analyzed associations between modules (groups of co-expressed genes) with multiple bone and neurological traits, examined overlap in modules between networks, and performed pathway enrichment analysis to discover conserved mechanisms. We discovered three modules in ROSMAP that showed significant associations with ADRD and bone related traits and four modules in Oslo that showed significant associations with multiple bone outcomes. We found significant module overlap between the two networks, most notably among those modules linked to canonical Wnt signaling and skeletal tissue homeostasis and development. These results were preserved with a network from the full ROSMAP cohort (n=629), which included a broader spectrum of participants. Our results require validation in experimental studies but show support for Wnt signaling as an important driver of pathology in OP and ADRD. We additionally show a strong link between Dementia with Lewy bodies and bone outcomes. These results have translational significance in the development of novel treatments and biomarkers for both ADRD and OP.

neuroscience↗

Machine Learning to Predict Osteoporotic Fracture Risk from Genotypes

BackgroundGenomics-based prediction could be useful since genome-wide genotyping costs less than many clinical tests. We tested whether machine learning methods could provide a clinically-relevant genomic prediction of quantitative ultrasound speed of sound (SOS)--a risk factor for osteoporotic fracture.\n\nMethodsWe used 341,449 individuals from UK Biobank with SOS measures to develop genomically-predicted SOS (gSOS) using machine learning algorithms. We selected the optimal algorithm in 5,335 independent individuals and then validated it and its ability to predict incident fracture in an independent test dataset (N = 80,027). Finally, we explored whether genomic pre-screening could complement a UK-based osteoporosis screening strategy, based on the validated tool FRAX.\n\nResultsgSOS explained 4.8-fold more variance in SOS than FRAX clinical risk factors (CRF) alone (r2 = 23% vs. 4.8%). A standard deviation decrease in gSOS, adjusting for the CRF-FRAX score was associated with a higher increased odds of incident major osteoporotic fracture (1,491 cases / 78,536 controls, OR = 1.91 [1.70-2.14], P = 10-28) than that for measured SOS (OR = 1.60 [1.50-1.69], P = 10-52) and femoral neck bone mineral density (147 cases / 4,594 controls, OR = 1.53 [1.27-1.83], P = 10-6). Individuals in the bottom decile of the gSOS distribution had a 3.25-fold increased risk of major osteoporotic fracture (P = 10-18) compared to the top decile. A gSOS-based FRAX score, identified individuals at high risk for incident major osteoporotic fractures better than the CRF-FRAX score (P = 10-14). Introducing a genomic pre-screening step into osteoporosis screening in 4,741 individuals reduced the number of required clinical visits from 2,455 to 1,273 and the number of BMD tests from 1,013 to 473, while only reducing the sensitivity to identify individuals eligible for therapy from 99% to 95%.\n\nInterpretationThe use of genotypes in a machine learning algorithm resulted in a clinically-relevant prediction of SOS and fracture, with potential to impact healthcare resource utilization.\n\nResearch in ContextO_ST_ABSEvidence Before this StudyC_ST_ABSGenome-wide association studies have identified many loci associated with risk of clinically-relevant fracture risk factors, such as SOS. Yet, it is unclear if such information can be leveraged to identify those at risk for disease outcomes, such as osteoporotic fractures. Most previous attempts to predict disease risk from genotypes have used polygenic risk scores, which may not be optimal for genomic-prediction. Despite these obstacles, genomic-prediction could enable screening programs to be more efficient since most people screened in a population are not determined to have a level of risk that would prompt a change in clinical care. Genomic pre-screening could help identify individuals whose risk of disease is low enough that they are unlikely to benefit from screening.\n\nAdded Value of this StudyUsing a large dataset of 426,811 individuals we trained and tested a machine learning algorithm to genomically-predict SOS. This metric, gSOS, had performance characteristics for predicting fracture risk that were similar to measured SOS and femoral neck BMD. Implementing a gSOS-based pre-screening step into the UK-based osteoporosis treatment guidelines reduced the number of individuals who would require screening clinical visits and skeletal testing by approximately 50%, while having little impact on the sensitivity to identify individuals at high risk for osteoporotic fracture.\n\nImplications of all of the Available EvidenceClinically-relevant genomic prediction of heritable traits is feasible using the machine learning algorithm presented here in large sample sizes. Genome-wide genotyping is now less expensive than many clinical tests, needs to be performed once over a lifetime and could risk stratify for multiple heritable traits and diseases years prior to disease onset, providing an opportunity for prevention. The implementation of such algorithms could improve screening efficiency, yet their cost-effectiveness will need to be ascertained in subsequent analyses.

genomics↗

GWAS of epigenetic ageing rates in blood reveals a critical role for TERT

DNA methylation age is an accurate biomarker of chronological age and predicts lifespan, but its underlying molecular mechanisms are unknown. In this genome-wide association study of 9,907 individuals, we found gene variants mapping to five loci associated with intrinsic epigenetic age acceleration (IEAA) and gene variants in 3 loci associated extrinsic epigenetic age acceleration (EEAA). Mendelian randomization analysis suggested causal influences of menarche and menopause on IEAA and lipid levels on IEAA and EEAA. Variants associated with longer leukocyte telomere length (LTL) in the telomerase reverse transcriptase gene (TERT) locus at 5p15.33 confer higher IEAA (P<2.7x10-11). Causal modelling indicates TERT-specific and independent effects on LTL and IEAA. Experimental hTERT expression in primary human fibroblasts engenders a linear increase in DNA methylation age with cell population doubling number. Together, these findings indicate a critical role for hTERT in regulating the DNA methylation clock, in addition to its established role of compensating for cell replication-dependent telomere shortening.

genetics↗