Abstract

Glycated haemoglobin (HbA1c) is widely used as a biomarker for the diagnosis of diabetes, for population-level screening, and for monitoring the glycaemic status during medical treatment. Although the heritability of HbA1c has been estimated at ~55–75%, a much smaller proportion of phenotypic variance is explained by the HbA1c-associated variants identified so far. To search for novel loci influencing the HbA1c levels, we conducted a genome-wide meta-analysis of 2 non-diabetic Japanese populations (n = 7,704 subjects in total). We identified 2 novel loci that achieved genome-wide significance: TMC6–TMC8 (P = 5.3 × 10−20) and SIX3–SIX2 (P = 8.6 × 10−9). Data from the largest-scale European GWAS conducted for HbA1c supported an association between the novel TMC6–TMC8 locus and HbA1c (P = 2.7 × 10−3). The association analysis with glycated albumin and glycation gap conducted using our Japanese population indicated that the TMC6–TMC8 and SIX3–SIX2 loci may influence the HbA1c level through non-glycaemic and glycaemic pathways, respectively. In addition, the pathway-based analysis suggested that the linoleic acid metabolic and 14-3-3-mediated signalling pathways were associated with HbA1c. These findings provide novel insights into the molecular mechanisms that modulate the HbA1c level in non-diabetic subjects.

Highlights

  • The glycated haemoglobin (HbA1c) level represents the percentage of haemoglobin proteins bound by glucose

  • Of the 4 loci, the TMC6–TMC8 locus on chromosome 17 and the SIX3–SIX2 locus on chromosome 2 have not been reported by previous Genome-wide association studies (GWASs) for HbA1c; these 2 loci were novel findings

  • The association between the TMC6–TMC8 locus and HbA1c was replicated in European populations, and the association between the SIX3–SIX2 locus and fasting plasma glucose (FPG) was previously reported in East Asian

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Summary

Introduction

The glycated haemoglobin (HbA1c) level represents the percentage of haemoglobin proteins bound by glucose. Genome-wide association studies (GWASs) have revealed ~20 HbA1c-associated genetic loci[8,9,10,11,12,13,14,15]. HbA1c-associated variants located at the ANK1, CDKAL1, G6PC2/ABCB11, GCK, MTNR1B, SLC30A8, and TCF7L2 loci confer an increased risk for type 2 diabetes (T2D) and/or are associated with 1 or more glycaemic traits, including FPG, 2-hour glucose, and fasting proinsulin[16]. Non-glycaemic variants have been identified that are associated with HbA1c but not with glycaemic traits and the T2D risk. To search for novel HbA1c-associated loci and to elucidate the molecular pathways involved in HbA1c biology, we conducted a genome-wide meta-analysis of HbA1c in 2 Japanese populations of non-diabetic subjects (n = 7,704 subjects)

Methods
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Conclusion

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