Abstract
Polycystic ovary syndrome (PCOS) is a common metabolic disorder in women. To identify causative genes, we conducted a genome-wide association study (GWAS) of PCOS in Han Chinese. The discovery set included 744 PCOS cases and 895 controls; subsequent replications involved two independent cohorts (2,840 PCOS cases and 5,012 controls from northern Han Chinese; 498 cases and 780 controls from southern and central Han Chinese). We identified strong evidence of associations between PCOS and three loci: 2p16.3 (rs13405728; combined P-value by meta-analysis Pmeta = 7.55 × 10−21, odds ratio (OR) 0.71); 2p21 (rs13429458, Pmeta = 1.73 × 10−23, OR 0.67); and 9q33.3 (rs2479106, Pmeta = 8.12 × 10−19, OR 1.34). These findings provide new insight into the pathogenesis of PCOS. Follow-up studies of the candidate genes in these regions are recommended.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Change history
28 January 2011
In the version of this article originally posted online corresponding author Yongyong Shi was not designated as a corresponding author. This error has been corrected in the HTML version of the paper.
References
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome. Fertil. Steril. 81, 19–25 (2004).
Goodarzi, M.O. & Azziz, R. Diagnosis, epidemiology, and genetics of the polycystic ovary syndrome. Best Pract. Res. Clin. Endocrinol. Metab. 20, 193–205 (2006).
Ehrmann, D.A., Barnes, R.B., Rosenfield, R.L., Cavaghan, M.K. & Imperial, J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 22, 141–146 (1999).
Carmina, E. Cardiovascular risk and events in polycystic ovary syndrome. Climacteric 12 (suppl. 1), 22–25 (2009).
Kandaraki, E., Christakou, C. & Diamanti-Kandarakis, E. Metabolic syndrome and polycystic ovary syndrome...; and vice versa. Arq. Bras. Endocrinol. Metabol. 53, 227–237 (2009).
Wild, S., Pierpoint, T., Jacobs, H. & McKeigue, P. Long-term consequences of polycystic ovary syndrome: results of a 31 year follow-up study. Hum. Fertil. (Camb.) 3, 101–105 (2000).
Espinós-Gómez, J.J., Corcoy, R. & Calaf, J. Prevalence and predictors of abnormal glucose metabolism in Mediterranean women with polycystic ovary syndrome. Gynecol. Endocrinol. 25, 199–204 (2009).
Kulshreshtha, B. et al. Insulin response to oral glucose in healthy, lean young women and patients with polycystic ovary syndrome. Gynecol. Endocrinol. 24, 637–643 (2008).
Shi, Y. et al. Analysis of clinical characteristics in large-scale Chinese women with polycystic ovary syndrome. Neuroendocrinol. Lett. 28, 807–810 (2007).
Sudo, S. et al. Genetic and functional analyses of polymorphisms in the human FSH receptor gene. Mol. Hum. Reprod. 8, 893–899 (2002).
Wang, Y., Wu, X., Cao, Y., Yi, L. & Chen, J. A microsatellite polymorphism (tttta)n in the promoter of the CYP11a gene in Chinese women with polycystic ovary syndrome. Fertil. Steril. 86, 223–226 (2006).
Chen, Z.J. et al. Correlation between single nucleotide polymorphism of insulin receptor gene with polycystic ovary syndrome. Zhonghua Fu Chan Ke Za Zhi 39, 582–585 (2004).
Villuendas, G., San Millán, J.L., Sancho, J. & Escobar-Morreale, H.F. The -597 G→A and -174 G→C polymorphisms in the promoter of the IL-6 gene are associated with hyperandrogenism. J. Clin. Endocrinol. Metab. 87, 1134–1141 (2002).
Carlson, C.S., Eberle, M.A., Kruglyak, L. & Nickerson, D.A. Mapping complex disease loci in whole-genome association studies. Nature 429, 446–452 (2004).
Xu, S. et al. Genomic dissection of population substructure of Han Chinese and its implication in association studies. Am. J. Hum. Genet. 85, 762–774 (2009).
Price, A.L. et al. Principal components analysis corrects for stratification in genome-wide association studies. Nat. Genet. 38, 904–909 (2006).
Huang, M. et al. Involvement of ALF in human spermatogenesis and male infertility. Int. J. Mol. Med. 17, 599–604 (2006).
Latronico, A.C. et al. A homozygous microdeletion in helix 7 of the luteinizing hormone receptor associated with familial testicular and ovarian resistance is due to both decreased cell surface expression and impaired effector activation by the cell surface receptor. Mol. Endocrinol. 12, 442–450 (1998).
Toledo, S.P.A. et al. An inactivating mutation of the luteinizing hormone receptor causes amenorrhea in a 46, XX female. J. Clin. Endocrinol. Metab. 81, 3850–3854 (1996).
Latronico, A.C., Lins, T.S., Brito, V.N., Arnhold, I.J. & Mendonca, B.B. The effect of distinct activating mutations of the luteinizing hormone receptor gene on the pituitary-gonadal axis in both sexes. Clin. Endocrinol. 53, 609–613 (2000).
Valkenburg, O. et al. Genetic polymorphisms of GnRH and gonadotrophic hormone receptors affect the phenotype of polycystic ovary syndrome. Hum. Reprod. 24, 2014–2022 (2009).
Tong, Y., Liao, W.X., Roy, A.C. & Ng, S.C. Absence of mutations in the coding regions of follicle-stimulating hormone receptor gene in Singapore Chinese women with premature ovarian failure and polycystic ovary syndrome. Horm. Metab. Res. 33, 221–226 (2001).
Du, J. et al. Two FSHR variants, haplotypes and meta-analysis in Chinese women with premature ovarian failure and polycystic ovary syndrome. Mol. Genet. Metab. 100, 292–295 (2010).
Drieschner, N. et al. Evidence for a 3p25 breakpoint hot spot region in thyroid tumors of follicular origin. Thyroid 16, 1091–1096 (2006).
Zeggini, E. et al. Meta-analysis of genome-wide association data and large-scale replication identifies additional susceptibility loci for type 2 diabetes. Nat. Genet. 40, 638–645 (2008).
Hu, C. et al. PPARG, KCNJ11, CDKAL1, CDKN2A-CDKN2B, IDE-KIF11-HHEX, IGF2BP2 and SLC30A8 are associated with type 2 diabetes in a Chinese population. PLoS ONE 4, e7643 (2009).
Del Villar, K. & Miller, C.A. Down-regulation of DENN/MADD, a TNF receptor binding protein, correlates with neuronal cell death in Alzheimer?s disease brain and hippocampal neurons. Proc. Natl. Acad. Sci. USA 101, 4210–4215 (2004).
Olszanecka-Glinianowicz, M. et al. Is the polycystic ovary syndrome associated with chronic inflammation per se? Eur. J. Obstet. Gynecol. Reprod. Biol. 133, 197–202 (2007).
Ferriman, D. & Gallwey, J.D. Clinical assessment of body hair growth in women. J. Clin. Endocrinol. Metab. 21, 1440–1447 (1961).
Shi, Y., Gao, X., Sun, X., Zhang, P. & Chen, Z. Clinical and metabolic characteristics of polycystic ovary syndrome without polycystic ovary: a pilot study on Chinese women. Fertil. Steril. 90, 1139–1143 (2008).
Radziuk, J. Insulin sensitivity and its measurement: structural commonalities among the methods. J. Clin. Endocrinol. Metab. 85, 4426–4433 (2000).
Korn, J.M. et al. Integrated genotype calling and association analysis of SNPs, common copy number polymorphisms and rare CNVs. Nat. Genet. 40, 1253–1260 (2008).
Thomas, G. et al. Capillary and microelectrophoretic separations of ligase detection reaction products produced from low-abundant point mutations in genomic DNA. Electrophoresis 25, 1668–1677 (2004).
Yi, P. et al. PCR/LDR/capillary electrophoresis for detection of single-nucleotide differences between fetal and maternal DNA in maternal plasma. Prenat. Diagn. 29, 217–222 (2009).
Shi, Y.Y. & He, L. SHEsis, a powerful software platform for analyses of linkage disequilibrium, haplotype construction, and genetic association at polymorphism loci. Cell Res. 15, 97–98 (2005).
Petukhova, L. et al. Genome-wide association study in alopecia areata implicates both innate and adaptive immunity. Nature 466, 113–117 (2010).
Barrett, J.C., Fry, B., Maller, J. & Daly, M.J. Haploview: analysis and visualization of LD and haplotype maps. Bioinformatics 21, 263 (2005).
Saxena, R. et al. Genome-wide association analysis identifies loci for type 2 diabetes and triglyceride levels. Science 316, 1331–1336 (2007).
Mantel, N. & Haenszel, W. Statistical aspects of the analysis of data from retrospective studies. J. Natl. Cancer Inst. 22, 719–748 (1959).
Acknowledgements
We thank all participants involved in this study. We thank J. Simpson for revising this manuscript and X. Xu, X. Xing, T. Li, M. Guo, L. Cui, Q. Zheng, C. Li, J. Zhang, D. Wu, C. Zhang, X. Yan, W. He, Y. Cui, M. Xia, J. Li, P. Wang, H. Lv, S. Xu and L. Wang for subject recruitment. This study was supported by grants from the National Basic Research Program of China (973 Program-2006CB944004, 2010CB945000, 2007CB947403, 2007CB914703, 2007CB947300, 2010CB529600), the National 863 Project of China grants (2006AA02A407, 2009AA022701), the National Natural Science Foundation of China (30973170) and the Shanghai Municipal Commission of Science and Technology Program (09DJ1400601).
Author information
Authors and Affiliations
Contributions
Z.-J.C., L.H. and Yongyong Shi designed the study and revised the manuscript. Z.-J.C. supervised patients' diagnosis, subject recruitment and performance of experiments. Yongyong Shi supervised the experiments and data analysis. H.Z. and Z.L. conducted data analyses and drafted the manuscript. H.Z., Yuhua Shi, Y.Q., L.Y., L.G. and J.Y. recruited subjects. Junli Zhao, J.L., X.L., X.Z., Junzhao Zhao, Y. Sun, B.Z., H.J., D. Zhao, Yiran Li, D. Zhu, X.S., J.-e.X., C.H., C.-e.R., Y. Zhang, S.C., W.Z. and A.Y. coordinated and provided samples from different hospitals. L.Y., Y.B., Yuan Li, J.M. and Y. Zhao performed DNA extraction. X.G. performed endocrine biochemical examination. All authors critically reviewed the article and approved the final manuscript.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Supplementary information
Supplementary Text and Figures
Supplementary Figures 1–5 and Supplementary Tables 1–7 (PDF 2263 kb)
Rights and permissions
About this article
Cite this article
Chen, ZJ., Zhao, H., He, L. et al. Genome-wide association study identifies susceptibility loci for polycystic ovary syndrome on chromosome 2p16.3, 2p21 and 9q33.3. Nat Genet 43, 55–59 (2011). https://doi.org/10.1038/ng.732
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ng.732
This article is cited by
-
Screening of premature ovarian insufficiency associated genes in Hungarian patients with next generation sequencing
BMC Medical Genomics (2024)
-
Molecular Mechanisms in the Etiology of Polycystic Ovary Syndrome (PCOS): A Multifaceted Hypothesis Towards the Disease with Potential Therapeutics
Indian Journal of Clinical Biochemistry (2024)
-
Susceptibility loci identified in Han Chinese influence genetic predisposition of PCOS in Indian women
Molecular Biology Reports (2024)
-
Induced Pluripotent Stem Cells as a Possible Approach for Exploring the Pathophysiology of Polycystic Ovary Syndrome (PCOS)
Stem Cell Reviews and Reports (2024)
-
Body mass index stratified meta-analysis of genome-wide association studies of polycystic ovary syndrome in women of European ancestry
BMC Genomics (2024)