title: Common low-density lipoprotein receptor p.G116S variant has a large effect on plasma low-density lipoprotein cholesterol in circumpolar inuit populations.
abstract: BACKGROUND
  Inuit are considered to be vulnerable to cardiovascular disease because their lifestyles are becoming more Westernized. During sequence analysis of Inuit individuals at extremes of lipid traits, we identified 2 nonsynonymous variants in low-density lipoprotein receptor (LDLR), namely p.G116S and p.R730W.
  
  
  RESULTS
  Genotyping these variants in 3324 Inuit from Alaska, Canada, and Greenland showed they were common, with allele frequencies 10% to 15%. Only p.G116S was associated with dyslipidemia: the increase in LDL cholesterol was 0.54 mmol/L (20.9 mg/dL) per allele (P=5.6×10(-49)), which was >3× larger than the largest effect sizes seen with other common variants in other populations. Carriers of p.G116S had a 3.02-fold increased risk of hypercholesterolemia (95% confidence interval, 2.34-3.90; P=1.7×10(-17)), but did not have classical familial hypercholesterolemia. In vitro, p.G116S showed 60% reduced ligand-binding activity compared with wild-type receptor. In contrast, p.R730W was associated with neither LDL cholesterol level nor altered in vitro activity.
  
  
  CONCLUSIONS
  LDLR p.G116S is thus unique: a common dysfunctional variant in Inuit whose large effect on LDL cholesterol may have public health implications.
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Dubé
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Henian
authors.initials: H
authors.lastname: Cao
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Adam D
authors.initials: AD
authors.lastname: McIntyre
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Johansen
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Scarlett E
authors.initials: SE
authors.lastname: Hopkins
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Randa
authors.initials: R
authors.lastname: Stringer
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Siyavash
authors.initials: S
authors.lastname: Hosseinzadeh
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Brooke A
authors.initials: BA
authors.lastname: Kennedy
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Ban
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: T Kue
authors.initials: TK
authors.lastname: Young
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Eric
authors.initials: E
authors.lastname: Dewailly
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Peter
authors.initials: P
authors.lastname: Bjerregaard
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.).
authors.forename: Bert B
authors.initials: BB
authors.lastname: Boyer
authors.affiliation: From the Molecular Medicine Group, Robarts Research Institute (J.B.D., J.W., H.C., A.M., C.T.J., R.S., S.H., B.A.K., M.R.B., R.A.H.) and Department of Medicine (C.T.J., R.A.H.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; The Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks (S.E.H., B.B.B.); The Dalla Lana School of Public Health (T.K.Y.) and The Keenan Research Centre for Biomedical Science of St. Michael's Hospital (P.W.C.), and Department of Medicine, University of Toronto, Toronto, ON, Canada; Département de médecine sociale et preventive, Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Université Laval, QC, Canada (E.D.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (P.B.). hegele@robarts.ca.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hegele
mesh_terms: D000328:Adult; D000413:Alaska / Q000208:ethnology; D000483:Alleles; D002170:Canada / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology / Q000235:genetics; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D005787:Gene Frequency; D006116:Greenland / Q000208:ethnology; D006801:Humans; D004930:Inuit / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011973:Receptors, LDL / Q000235:genetics / Q000378:metabolism
chemical_list: D008078:Cholesterol, LDL; D011973:Receptors, LDL
keywords: cardiovascular diseases; genetic variation; low-density lipoprotein cholesterol