Abstract

BackgroundBone accrual impacts lifelong skeletal health, but genetic discovery has been primarily limited to cross-sectional study designs and hampered by uncertainty about target effector genes. Here, we capture this dynamic phenotype by modeling longitudinal bone accrual across 11,000 bone scans in a cohort of healthy children and adolescents, followed by genome-wide association studies (GWAS) and variant-to-gene mapping with functional follow-up.ResultsWe identify 40 loci, 35 not previously reported, with various degrees of supportive evidence, half residing in topological associated domains harboring known bone genes. Of several loci potentially associated with later-life fracture risk, a candidate SNP lookup provides the most compelling evidence for rs11195210 (SMC3). Variant-to-gene mapping combining ATAC-seq to assay open chromatin with high-resolution promoter-focused Capture C identifies contacts between GWAS loci and nearby gene promoters. siRNA knockdown of gene expression supports the putative effector gene at three specific loci in two osteoblast cell models. Finally, using CRISPR-Cas9 genome editing, we confirm that the immediate genomic region harboring the putative causal SNP influences PRPF38A expression, a location which is predicted to coincide with a set of binding sites for relevant transcription factors.ConclusionsUsing a new longitudinal approach, we expand the number of genetic loci putatively associated with pediatric bone gain. Functional follow-up in appropriate cell models finds novel candidate genes impacting bone accrual. Our data also raise the possibility that the cell fate decision between osteogenic and adipogenic lineages is important in normal bone accrual.

Highlights

  • Osteoporosis is a chronic disease characterized by low bone mineral density (BMD) and strength, which subsequently increase risk of fracture

  • Longitudinal modeling of areal BMD (aBMD) and bone mineral content (BMC) We modeled aBMD (g/cm2) and BMC (g/cm) from age 5 to 20 years in the Bone Mineral Density in Childhood Study (BMDCS), a mixed longitudinal, multiethnic cohort of healthy children and adolescents with up to seven annual measurements (n = 1885)

  • We modeled sex- and ancestry-specific bone accrual with “Super Imposition by Translation and Rotation” (SITAR) [17], a shape invariant model that generates a population mean curve based on all measurements

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Summary

Introduction

Osteoporosis is a chronic disease characterized by low bone mineral density (BMD) and strength, which subsequently increase risk of fracture. Given that pediatric genetic studies of bone accrual to date have mainly employed cross-sectional study designs, intrinsic limits are placed on the discovery of genetic variants that influence dynamic changes in bone accrual during development. Bone accrual impacts lifelong skeletal health, but genetic discovery has been primarily limited to cross-sectional study designs and hampered by uncertainty about target effector genes. We capture this dynamic phenotype by modeling longitudinal bone accrual across 11,000 bone scans in a cohort of healthy children and adolescents, followed by genome-wide association studies (GWAS) and variantto-gene mapping with functional follow-up

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