Gene Expression and RNA Splicing Imputation Identifies Novel Candidate Genes Associated with Osteoporosis.

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Though genome wide association studies (GWASs) have identified hundreds of genetic variants associated with osteoporosis related traits, such as bone mineral density (BMD) and fracture, it remains a challenge to interpret their biological functions and underlying biological mechanisms.Integrate diverse expression quantitative trait loci (eQTLs) and splicing QTLs (sQTLs) data with several powerful GWASs datasets to identify novel candidate genes associated with osteoporosis.Here, we conducted a transcriptome-wide association study (TWAS) for total body BMD (TB-BMD) (n = 66,628 for discovery and 7,697 for validation) and fracture (53,184 fracture cases and 373,611 controls for discovery and 37,857 cases and 227,116 controls for validation), respectively. We also conducted multi-SNP-based summarized mendelian randomization (SMR) analysis to further validate our findings.In total, we detected 88 genes significantly associated with TB-BMD or fracture through expression or RNA splicing. SMR analysis revealed that 78 of the significant genes may have potential causal effects on TB-BMD or fracture in at least one specific tissue. Among them, 64 genes have been reported in previous GWASs or TWASs for osteoporosis, such as ING3, CPED1 and WNT16, as well as 14 novel genes, such as DBF4B, GRN, TMUB2 and UNC93B1.Overall, our findings provide novel insights into the pathogenesis mechanisms of osteoporosis and highlight the power of TWAS to identify and prioritize potential causal genes.


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