Abstract

Differences between sexes contribute to variation in the levels of fasting glucose and insulin. Epidemiological studies established a higher prevalence of impaired fasting glucose in men and impaired glucose tolerance in women, however, the genetic component underlying this phenomenon is not established. We assess sex-dimorphic (73,089/50,404 women and 67,506/47,806 men) and sex-combined (151,188/105,056 individuals) fasting glucose/fasting insulin genetic effects via genome-wide association study meta-analyses in individuals of European descent without diabetes. Here we report sex dimorphism in allelic effects on fasting insulin at IRS1 and ZNF12 loci, the latter showing higher RNA expression in whole blood in women compared to men. We also observe sex-homogeneous effects on fasting glucose at seven novel loci. Fasting insulin in women shows stronger genetic correlations than in men with waist-to-hip ratio and anorexia nervosa. Furthermore, waist-to-hip ratio is causally related to insulin resistance in women, but not in men. These results position dissection of metabolic and glycemic health sex dimorphism as a steppingstone for understanding differences in genetic effects between women and men in related phenotypes.

Highlights

  • Differences between sexes contribute to variation in the levels of fasting glucose and insulin

  • We investigated the sex-dimorphic and homogeneous effects of 8.7 million autosomal single-nucleotide polymorphisms (SNPs) on fasting glucose (FG)/fasting insulin (FI) under an additive genetic model

  • We evaluated the effects of these loci on type 2 diabetes (T2D) in a large-scale European ancestry Genome-wide association studies (GWAS) meta-analysis, and only the variant at ZBTB38 was nominally associated with T2D (P = 0.0080), further supporting only partial overlap between genetic variation influencing glucose levels and T2D risk[6]

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Summary

Introduction

Differences between sexes contribute to variation in the levels of fasting glucose and insulin. We assess sex-dimorphic (73,089/50,404 women and 67,506/47,806 men) and sex-combined (151,188/105,056 individuals) fasting glucose/ fasting insulin genetic effects via genome-wide association study meta-analyses in individuals of European descent without diabetes. Cultural, lifestyle, and environmental factors contribute to the relationship between sex dimorphism of early changes in glucose homeostasis and type 2 diabetes (T2D) pathogenesis[4,5] These observations raise hypotheses about a role for the genetic mechanisms underlying sex differences in the maintenance of glucose homeostasis as measured by FG and fasting insulin (FI). We evaluate sex-specific, sex-dimorphic, and sexhomogeneous effects in FG/FI GWAS from individuals of European descent without diabetes within the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC). Our simulation study highlights that, given the current sample size, the 2-df sex-dimorphic test is more powerful, compared to the sex-combined approach, when causal variants have allelic effects specific to one sex and in the presence of heterogeneous allelic effects in men and women

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