Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair.
Day FR., Ruth KS., Thompson DJ., Lunetta KL., Pervjakova N., Chasman DI., Stolk L., Finucane HK., Sulem P., Bulik-Sullivan B., Esko T., Johnson AD., Elks CE., Franceschini N., He C., Altmaier E., Brody JA., Franke LL., Huffman JE., Keller MF., McArdle PF., Nutile T., Porcu E., Robino A., Rose LM., Schick UM., Smith JA., Teumer A., Traglia M., Vuckovic D., Yao J., Zhao W., Albrecht E., Amin N., Corre T., Hottenga J-J., Mangino M., Smith AV., Tanaka T., Abecasis G., Andrulis IL., Anton-Culver H., Antoniou AC., Arndt V., Arnold AM., Barbieri C., Beckmann MW., Beeghly-Fadiel A., Benitez J., Bernstein L., Bielinski SJ., Blomqvist C., Boerwinkle E., Bogdanova NV., Bojesen SE., Bolla MK., Borresen-Dale A-L., Boutin TS., Brauch H., Brenner H., Brüning T., Burwinkel B., Campbell A., Campbell H., Chanock SJ., Chapman JR., Chen Y-DI., Chenevix-Trench G., Couch FJ., Coviello AD., Cox A., Czene K., Darabi H., De Vivo I., Demerath EW., Dennis J., Devilee P., Dörk T., Dos-Santos-Silva I., Dunning AM., Eicher JD., Fasching PA., Faul JD., Figueroa J., Flesch-Janys D., Gandin I., Garcia ME., García-Closas M., Giles GG., Girotto GG., Goldberg MS., González-Neira A., Goodarzi MO., Grove ML., Gudbjartsson DF., Guénel P., Guo X., Haiman CA., Hall P., Hamann U., Henderson BE., Hocking LJ., Hofman A., Homuth G., Hooning MJ., Hopper JL., Hu FB., Huang J., Humphreys K., Hunter DJ., Jakubowska A., Jones SE., Kabisch M., Karasik D., Knight JA., Kolcic I., Kooperberg C., Kosma V-M., Kriebel J., Kristensen V., Lambrechts D., Langenberg C., Li J., Li X., Lindström S., Liu Y., Luan J., Lubinski J., Mägi R., Mannermaa A., Manz J., Margolin S., Marten J., Martin NG., Masciullo C., Meindl A., Michailidou K., Mihailov E., Milani L., Milne RL., Müller-Nurasyid M., Nalls M., Neale BM., Nevanlinna H., Neven P., Newman AB., Nordestgaard BG., Olson JE., Padmanabhan S., Peterlongo P., Peters U., Petersmann A., Peto J., Pharoah PDP., Pirastu NN., Pirie A., Pistis G., Polasek O., Porteous D., Psaty BM., Pylkäs K., Radice P., Raffel LJ., Rivadeneira F., Rudan I., Rudolph A., Ruggiero D., Sala CF., Sanna S., Sawyer EJ., Schlessinger D., Schmidt MK., Schmidt F., Schmutzler RK., Schoemaker MJ., Scott RA., Seynaeve CM., Simard J., Sorice R., Southey MC., Stöckl D., Strauch K., Swerdlow A., Taylor KD., Thorsteinsdottir U., Toland AE., Tomlinson I., Truong T., Tryggvadottir L., Turner ST., Vozzi D., Wang Q., Wellons M., Willemsen G., Wilson JF., Winqvist R., Wolffenbuttel BBHR., Wright AF., Yannoukakos D., Zemunik T., Zheng W., Zygmunt M., Bergmann S., Boomsma DI., Buring JE., Ferrucci L., Montgomery GW., Gudnason V., Spector TD., van Duijn CM., Alizadeh BZ., Ciullo M., Crisponi L., Easton DF., Gasparini PP., Gieger C., Harris TB., Hayward C., Kardia SLR., Kraft P., McKnight B., Metspalu A., Morrison AC., Reiner AP., Ridker PM., Rotter JI., Toniolo D., Uitterlinden AG., Ulivi S., Völzke H., Wareham NJ., Weir DR., Yerges-Armstrong LM., PRACTICAL consortium None., kConFab Investigators None., AOCS Investigators None., Generation Scotland None., EPIC-InterAct Consortium None., LifeLines Cohort Study None., Price AL., Stefansson K., Visser JA., Ong KK., Chang-Claude J., Murabito JM., Perry JRB., Murray A.
Menopause timing has a substantial impact on infertility and risk of disease, including breast cancer, but the underlying mechanisms are poorly understood. We report a dual strategy in ∼70,000 women to identify common and low-frequency protein-coding variation associated with age at natural menopause (ANM). We identified 44 regions with common variants, including two regions harboring additional rare missense alleles of large effect. We found enrichment of signals in or near genes involved in delayed puberty, highlighting the first molecular links between the onset and end of reproductive lifespan. Pathway analyses identified major association with DNA damage response (DDR) genes, including the first common coding variant in BRCA1 associated with any complex trait. Mendelian randomization analyses supported a causal effect of later ANM on breast cancer risk (∼6% increase in risk per year; P = 3 × 10(-14)), likely mediated by prolonged sex hormone exposure rather than DDR mechanisms.