Genetic analysis in European ancestry individuals identifies 517 loci associated with liver enzymes


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Serum concentration of hepatic enzymes are linked to liver dysfunction, metabolic and cardiovascular diseases. We perform genetic analysis on serum levels of alanine transaminase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) using data on 437,438 UK Biobank participants. Replication in 315,572 individuals from European descent from the Million Veteran Program, Rotterdam Study and Lifeline study confirms 517 liver enzyme SNPs. Genetic risk score analysis using the identified SNPs is strongly associated with serum activity of liver enzymes in two independent European descent studies (The Airwave Health Monitoring study and the Northern Finland Birth Cohort 1966). Gene-set enrichment analysis using the identified SNPs highlights involvement in liver development and function, lipid metabolism, insulin resistance, and vascular formation. Mendelian randomization analysis shows association of liver enzyme variants with coronary heart disease and ischemic stroke. Genetic risk score for elevated serum activity of liver enzymes is associated with higher fat percentage of body, trunk, and liver and body mass index. Our study highlights the role of molecular pathways regulated by the liver in metabolic disorders and cardiovascular disease.

Original languageEnglish
Article number2579
Pages (from-to)1-12
JournalNature Communications
Issue number1
Publication statusPublished - 10 May 2021
Externally publishedYes


  • Aged
  • Alanine Transaminase/blood
  • Alkaline Phosphatase/blood
  • Cardiovascular Diseases/enzymology
  • Cohort Studies
  • Databases, Genetic
  • Female
  • Gene Expression Regulation, Enzymologic/genetics
  • Genetic Predisposition to Disease
  • Genetic Testing
  • Genome-Wide Association Study
  • Humans
  • Insulin Resistance/genetics
  • Lipid Metabolism/genetics
  • Liver/enzymology
  • Male
  • Mendelian Randomization Analysis
  • Metabolic Diseases/enzymology
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Risk Factors
  • Whites
  • gamma-Glutamyltransferase/blood


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