Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels.
Tin A., Marten J., Halperin Kuhns VL., Li Y., Wuttke M., Kirsten H., Sieber KB., Qiu C., Gorski M., Yu Z., Giri A., Sveinbjornsson G., Li M., Chu AY., Hoppmann A., O'Connor LJ., Prins B., Nutile T., Noce D., Akiyama M., Cocca M., Ghasemi S., van der Most PJ., Horn K., Xu Y., Fuchsberger C., Sedaghat S., Afaq S., Amin N., Ärnlöv J., Bakker SJL., Bansal N., Baptista D., Bergmann S., Biggs ML., Biino G., Boerwinkle E., Bottinger EP., Boutin TS., Brumat M., Burkhardt R., Campana E., Campbell A., Campbell H., Carroll RJ., Catamo E., Chambers JC., Ciullo M., Concas MP., Coresh J., Corre T., Cusi D., Felicita SC., de Borst MH., De Grandi A., de Mutsert R., de Vries APJ., Delgado G., Demirkan A., Devuyst O., Dittrich K., Eckardt K-U., Ehret G., Endlich K., Evans MK., Gansevoort RT., Gasparini P., Giedraitis V., Gieger C., Girotto G., Gögele M., Gordon SD., Gudbjartsson DF., Gudnason V., German Chronic Kidney Disease Study None., Haller T., Hamet P., Harris TB., Hayward C., Hicks AA., Hofer E., Holm H., Huang W., Hutri-Kähönen N., Hwang S-J., Ikram MA., Lewis RM., Ingelsson E., Jakobsdottir J., Jonsdottir I., Jonsson H., Joshi PK., Josyula NS., Jung B., Kähönen M., Kamatani Y., Kanai M., Kerr SM., Kiess W., Kleber ME., Koenig W., Kooner JS., Körner A., Kovacs P., Krämer BK., Kronenberg F., Kubo M., Kühnel B., La Bianca M., Lange LA., Lehne B., Lehtimäki T., Lifelines Cohort Study None., Liu J., Loeffler M., Loos RJF., Lyytikäinen L-P., Magi R., Mahajan A., Martin NG., März W., Mascalzoni D., Matsuda K., Meisinger C., Meitinger T., Metspalu A., Milaneschi Y., V. A. Million Veteran Program None., O'Donnell CJ., Wilson OD., Gaziano JM., Mishra PP., Mohlke KL., Mononen N., Montgomery GW., Mook-Kanamori DO., Müller-Nurasyid M., Nadkarni GN., Nalls MA., Nauck M., Nikus K., Ning B., Nolte IM., Noordam R., O'Connell JR., Olafsson I., Padmanabhan S., Penninx BWJH., Perls T., Peters A., Pirastu M., Pirastu N., Pistis G., Polasek O., Ponte B., Porteous DJ., Poulain T., Preuss MH., Rabelink TJ., Raffield LM., Raitakari OT., Rettig R., Rheinberger M., Rice KM., Rizzi F., Robino A., Rudan I., Krajcoviechova A., Cifkova R., Rueedi R., Ruggiero D., Ryan KA., Saba Y., Salvi E., Schmidt H., Schmidt R., Shaffer CM., Smith AV., Smith BH., Spracklen CN., Strauch K., Stumvoll M., Sulem P., Tajuddin SM., Teren A., Thiery J., Thio CHL., Thorsteinsdottir U., Toniolo D., Tönjes A., Tremblay J., Uitterlinden AG., Vaccargiu S., van der Harst P., van Duijn CM., Verweij N., Völker U., Vollenweider P., Waeber G., Waldenberger M., Whitfield JB., Wild SH., Wilson JF., Yang Q., Zhang W., Zonderman AB., Bochud M., Wilson JG., Pendergrass SA., Ho K., Parsa A., Pramstaller PP., Psaty BM., Böger CA., Snieder H., Butterworth AS., Okada Y., Edwards TL., Stefansson K., Susztak K., Scholz M., Heid IM., Hung AM., Teumer A., Pattaro C., Woodward OM., Vitart V., Köttgen A.
Elevated serum urate levels cause gout and correlate with cardiometabolic diseases via poorly understood mechanisms. We performed a trans-ancestry genome-wide association study of serum urate in 457,690 individuals, identifying 183 loci (147 previously unknown) that improve the prediction of gout in an independent cohort of 334,880 individuals. Serum urate showed significant genetic correlations with many cardiometabolic traits, with genetic causality analyses supporting a substantial role for pleiotropy. Enrichment analysis, fine-mapping of urate-associated loci and colocalization with gene expression in 47 tissues implicated the kidney and liver as the main target organs and prioritized potentially causal genes and variants, including the transcriptional master regulators in the liver and kidney, HNF1A and HNF4A. Experimental validation showed that HNF4A transactivated the promoter of ABCG2, encoding a major urate transporter, in kidney cells, and that HNF4A p.Thr139Ile is a functional variant. Transcriptional coregulation within and across organs may be a general mechanism underlying the observed pleiotropy between urate and cardiometabolic traits.