title: Pooled genetic analysis in ultrasound measured non-alcoholic fatty liver disease in Indian subjects: A pilot study.
abstract: OBJECTIVE
  To investigate genetic susceptibility in Indian subjects with non-alcoholic fatty liver disease (NAFLD) by performing a pooled genetic study.
  
  
  METHODS
  Study subjects (n = 306) were recruited and categorized into NAFLD and control groups based on ultrasound findings of fatty infiltration. Of the 306 individuals, 156 individuals had fatty infiltration and thus comprised the NAFLD group. One hundred and fifty (n = 150) individuals were normal, without fatty infiltration of the liver, comprising the control group. Blood samples, demographic and anthropometric data from the individuals were collected after obtaining informed consent. Anthropometric data, blood glucose, lipids and liver function tests were estimated using standard methods. Genome wide association studies done to date on NAFLD were identified, 19 single nucleotide polymorphisms (SNPs) were selected from these studies that were reported to be significantly associated with NAFLD and genotyping was performed on the Sequenom platform. Student's t test for continuous variables and χ(2) test was applied to variant carriers from both groups. Required corrections were applied as multiple testing was done. RESULTS The mean age of the control group was 39.78 ± 10.83 and the NAFLD group was 36.63 ± 8.20 years. The waist circumference of males and females in the control and NAFLD groups were 80.13 ± 10.35; 81.77 ± 13.65 and 94.09 ± 10.53; 92.53 ± 8.27 cms respectively. The mean triglyceride and alanine transaminase (ALT) levels in the control and NAFLD groups were 135.18 ± 7.77 mg/dL; 25.39 ± 14.73 IU/L and 184.40 ± 84.31 mg/dL; 110.20 ± 67.05 IU/L respectively. When χ(2) test was applied to the number of individuals carrying the variant risk alleles between the control and NAFLD group, a significant association was seen between rs738409 of the patatin-like phospholipase domain containing 3 (PNPLA3) gene (P = 0.001), rs2073080 of the PARVB gene (P = 0.02), rs2143571 of SAMM50 gene (P = 0.05) and rs6487679 of the pregnancy zone protein (PZP) gene (P = 0.01) with the disease. Variant single nucleotide polymorphisms (SNPs) in NCAN and PNPLA3 gene were associated with higher levels of ALT, whereas variant SNPs in APOC3, PNPLA3, EFCAB4B and COL13A1 were associated with high triglyceride levels. Apart from the above associations, rs2073080, rs343062 and rs6591182 were significantly associated with high BMI; rs2854117 and rs738409 with high triglyceride levels; and rs2073080, rs2143571, rs2228603, rs6487679 and rs738409 with high ALT levels.
  
  
  CONCLUSIONS
  Pooled genetic analysis revealed an association of SNPs in PNPLA3, PARVB, SAMM50 and PZP genes with NAFLD. SNPs in NCAN and PNPLA3 gene were associated with higher levels of ALT, whereas variant SNPs in APOC3, PNPLA3, EFCAB4B and COL13A1 were associated with high triglyceride levels.
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Vishnubhotla Venkata Ravi
authors.initials: VV
authors.lastname: Kanth
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Mitnala
authors.initials: M
authors.lastname: Sasikala
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Padaki Nagaraja
authors.initials: PN
authors.lastname: Rao
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Urmila
authors.initials: U
authors.lastname: Steffie Avanthi
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Kalashikam Rajender
authors.initials: KR
authors.lastname: Rao
authors.affiliation: Vishnubhotla Venkata Ravi Kanth, Mitnala Sasikala, Urmila Steffie Avanthi, Asian Healthcare Foundation, Hyderabad 500082, India.
authors.forename: Duvvuru
authors.initials: D
authors.lastname: Nageshwar Reddy
keywords: Genetic association; Genome wide association studies; Genotyping; Hepatic steatosis; Non-alcoholic fatty liver disease; Single nucleotide polymorphisms; Susceptibility