Item-Level Genome-Wide Association Study of the Alcohol Use Disorders Identification Test in Three Population-Based Cohorts.
- Authors
- Mallard, Travis T; Savage, Jeanne E; Johnson, Emma C; Huang, Yuye; Edwards, Alexis C; Hottenga, Jouke J; Grotzinger, Andrew D; Gustavson, Daniel E; Jennings, Mariela V; Anokhin, Andrey; Dick, Danielle M; Edenberg, Howard J; Kramer, John R; Lai, Dongbing; Meyers, Jacquelyn L; Pandey, Ashwini K; Harden, Kathryn Paige; Nivard, Michel G; de Geus, Eco J C; Boomsma, Dorret I; Agrawal, Arpana; Davis, Lea K; Clarke, Toni-Kim; Palmer, Abraham A; Sanchez-Roige, Sandra
- Year
- 2022
- Journal
- The American journal of psychiatry
- PMID
- 33985350
- DOI
- 10.1176/appi.ajp.2020.20091390
- PMCID
- PMC9272895
OBJECTIVE: Genome-wide association studies (GWASs) of the Alcohol Use Disorders Identification Test (AUDIT), a 10-item screen for alcohol use disorder (AUD), have elucidated novel loci for alcohol consumption and misuse. However, these studies also revealed that GWASs can be influenced by numerous biases (e.g., measurement error, selection bias), which may have led to inconsistent genetic correlations between alcohol involvement and AUD, as well as paradoxically negative genetic correlations between alcohol involvement and psychiatric disorders and/or medical conditions. The authors used genomic structural equation modeling to elucidate the genetics of alcohol consumption and problematic consequences of alcohol use as measured by AUDIT. METHODS: To explore these unexpected differences in genetic correlations, the authors conducted the first item-level and the largest GWAS of AUDIT items (N=160,824) and applied a multivariate framework to mitigate previous biases. RESULTS: The authors identified novel patterns of similarity (and dissimilarity) among the AUDIT items and found evidence of a correlated two-factor structure at the genetic level ("consumption" and "problems," r=0.80). Moreover, by applying empirically derived weights to each of the AUDIT items, the authors constructed an aggregate measure of alcohol consumption that was strongly associated with alcohol dependence (r=0.67), moderately associated with several other psychiatric disorders, and no longer positively associated with health and positive socioeconomic outcomes. Lastly, by conducting polygenic analyses in three independent cohorts that differed in their ascertainment and prevalence of AUD, the authors identified novel genetic associations between alcohol consumption, alcohol misuse, and health. CONCLUSIONS: This work further emphasizes the value of AUDIT for both clinical and genetic studies of AUD and the importance of using multivariate methods to study genetic associations that are more closely related to AUD.
Genetic relationships between AUDIT items. Path diagram of the best fitting genetic confirmatory factor model for AUDIT, as estimated with Genomic Structural Equation Modeling. All parameter estimates are standardized, and standard errors are presented in parentheses. The genetic components of items and factors (denoted by g) are inferred variables that are represented as circles. Regression relationships between variables are represented as straight one-headed arrows pointing from the independent variable(s) to the dependent variable(s). Covariance relationships are depicted as curved two-headed arrows linking two variables. The variances for factors are represented as a two-headed arrow connecting the variable to itself, as are the residual variances for individual items (denoted by u). As item 6 was included via factor extension, its parameter estimates are illustrated using dashed lines.
Genetic correlations between latent AUDIT phenotypes and other complex traits. Bar charts of the genetic correlation (rg) results for three AUDIT phenotypes: Consumption (green), Problems (blue), and Frequency Residual (gray). Point estimates and corresponding standard errors (SEs) are displayed for select phenotypes related to substance use, psychopathology, impulsivity, cognition, and socioeconomic factors. Full results are reported in Table S8.
Multivariate genome-wide association analyses for the latent genetic factors. Miami plot for the two latent genetic factors: Consumption (top) and Problems (bottom). Approximately independent lead SNPs are labeled with a white diamond. For each lead SNP, the neared gene is labeled. Additional symbols convey findings from additional biological annotation; filled symbols indicate that the gene was identified in the corresponding pipeline, while empty symbols indicate that the gene was not. The y-axis refers to the significance on a -log10 scale, the x-axis refers to chromosomal position, the horizontal dotted line marks suggestive significance (p = 1E-5), and the horizontal dashed line denotes genome-wide significance (p = 5E-8).
Associations between Consumption and Problems PRS and selected alcohol-related phenotypes. Bar charts of the variance explained by Consumption and Problems PRS for various clinical and quantitative measures of alcohol use. Values correspond to the proportion of variance explained the outcome (R2 or pseudo R2 depending on the use of linear or logistic regression; see Supplementary Section 7 for more details). Results for the independent UK Biobank subsample are presented on the left, while results for the independent COGA cohort are presented on the right. Please note that the COGA models are not directly comparable to those from the UKB models, as mixed-effect models were used in COGA. Please also note that the R2 for each PRS is calculated from a single PRS model and, as such, the values not independent (due to shared variance between PRSs). Complete results are available in Tables S32βS35.
Phenome-wide association study of polygenic risk scores for Consumption (left panel) and Problems (right panel) against 1,338 diseases available in the biobank from Vanderbilt University Medical Center, BioVU. PheWAS of both Consumption and Problems revealed positive genetic associations with alcohol use disorders. Problems was positively genetically associated with multiple psychiatric conditions, whereas Consumption was counterintuitively negatively associated with metabolic conditions. Importantly, most of the associations disappear when adjusting for alcohol use disorders diagnosis (non-significant associations are highlighted in gray).
| Name | Type |
|---|---|
| 1000 Genomes Project | cohort |
| ADH1B | gene |
| ADH1C | gene |
| Age at first assessment | phenotype |
| alcohol | phenotype |
| alcohol dependence | phenotype |
| Alcohol Problems | phenotype |
| alcohol-related phenotypes | phenotype |
| alcohol-related problems | phenotype |
| Alcohol Use | phenotype |
| Alcohol Use Disorder | phenotype |
| Alcohol Use Disorders Identification Test | phenotype |
| ALSPAC | cohort |
| ancestry principal components | drug |
| anxiety | phenotype |
| AUD | phenotype |
| AUDIT | phenotype |
| AUDIT-C | phenotype |
| AUDIT item 10 local | phenotype |
| AUDIT item 1 (frequency of consumption) local | phenotype |
| AUDIT item 2 local | phenotype |
| AUDIT item 3 local | phenotype |
| AUDIT item 4 local | phenotype |
| AUDIT item 5 local | phenotype |
| AUDIT item 6 local | phenotype |
| AUDIT item 7 local | phenotype |
| AUDIT item 8 local | phenotype |
| AUDIT item 9 local | phenotype |
| AUDIT latent genetic factors local | phenotype |
| AUDIT-P | phenotype |
| AUDIT-P PRS local | phenotype |
| AUDIT-P PRS local | variant |
| AUDIT-Total local | phenotype |
| AUD phenotypes local | phenotype |
| Avon Longitudinal Study of Parents and Children | cohort |
| binge drinking | phenotype |
| BioVU | cohort |
| bipolar disorder | phenotype |
| brain | anatomy |
| brain tissue | anatomy |
| cannabis use disorder | phenotype |
| CELF1 local | gene |
| Clinical-ascertained AUD GWAS dataset local | cohort |
| Clinically-defined AUD local | phenotype |
| Collaborative Study on the Genetics of Alcoholism (COGA) | cohort |
| complex traits and disorders broadly related to human health local | phenotype |
| Congenital conditions local | phenotype |
| consumption | phenotype |
| Consumption PRS local | phenotype |
| Consumption PRS local | variant |
| CPS1 | gene |
| CRHR1 | gene |
| depression | phenotype |
| diabetes | phenotype |
| DRD2 | gene |
| drinking | phenotype |
| drinks per week | phenotype |
| educational attainment | phenotype |
| ethanol consumption | phenotype |
| European ancestry | cohort |
| Eye opener local | phenotype |
| FAM180B local | gene |
| fetal brain | anatomy |
| frequency of alcohol use | phenotype |
| Frequency Residual local | phenotype |
| genetic factor local | phenotype |
| GTEx v8 | cohort |
| HapMap | cohort |
| Human health local | phenotype |
| impulsivity | phenotype |
| income | phenotype |
| intelligence | phenotype |
| iPSC-derived astrocytes local | anatomy |
| iPSC-derived neurons local | anatomy |
| Klb | gene |
| lifetime alcohol use | phenotype |
| lifetime AUD diagnosis local | phenotype |
| major depressive disorder | phenotype |
| major histocompatibility region local | anatomy |
| malnutrition | phenotype |
| Mapt | gene |
| maxdrinks | phenotype |
| metabolic conditions | phenotype |
| mood disorders | phenotype |
| MTCH2 | gene |
| NDUFS3 | gene |
| Netherlands Twin Register | cohort |
| non-drinkers | phenotype |
| obesity-related phenotype | phenotype |
| pain | phenotype |
| phenotypic factor local | phenotype |
| physical health | phenotype |
| population-based cohorts | cohort |
| Post-Traumatic Stress Disorder | phenotype |
| previous drinkers local | phenotype |
| problematic alcohol use | phenotype |
| Problematic alcohol use phenotypes (AUDIT items 4β10) local | phenotype |
| Problematic consequences of alcohol consumption local | phenotype |
| problems | phenotype |
| Problems PRS local | phenotype |
| Problems PRS local | variant |
| protein-coding gene | gene |
| psychiatric disorders | phenotype |
| psychopathology | phenotype |
| RCF1 | gene |
| retinoic acid | drug |
| schizophrenia | phenotype |
| Screener-based AUD symptoms local | phenotype |
| sex | phenotype |
| SNP | cohort |
| Social satisfaction local | phenotype |
| socioeconomic status | phenotype |
| Socioeconomic variables local | phenotype |
| study cohort | cohort |
| substance use | phenotype |
| suicide | phenotype |
| Tobacco and Substance Use Disorders local | phenotype |
| Townsend Deprivation Index local | phenotype |
| Type 2 Diabetes with Renal Manifestations local | phenotype |
| UK Biobank | cohort |
| United Kingdom | cohort |
| US | cohort |
| Validation samples local | cohort |
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