GWAS identifies an NAT2 acetylator status tag single nucleotide polymorphism to be a major locus for skin fluorescence

Karen M. Eny, Helen L. Lutgers, John Maynard, Barbara E.K. Klein, Kristine E. Lee, Gil Atzmon, Vincent M. Monnier, Jana V. Van Vliet-Ostaptchouk, Reindert Graaff, Pim Van Der Harst, Harold Snieder, Melanie M. Van Der Klauw, David R. Sell, S. Mohsen Hosseini, Patricia A. Cleary, Barbara H. Braffett, Trevor J. Orchard, Timothy J. Lyons, Kerri Howard, Ronald KleinJill P. Crandall, Nir Barzilai, Sofiya Milman, Danny Ben-Avraham, Bruce H.R. Wolffenbuttel, Andrew D. Paterson

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Aims/hypothesis: Skin fluorescence (SF) is a non-invasive marker of AGEs and is associated with the long-term complications of diabetes. SF increases with age and is also greater among individuals with diabetes. A familial correlation of SF suggests that genetics may play a role. We therefore performed parallel genome-wide association studies of SF in two cohorts. Methods: Cohort 1 included 1,082 participants, 35-67 years of age with type 1 diabetes. Cohort 2 included 8,721 participants without diabetes, aged 18-90 years. Results: rs1495741 was significantly associated with SF in Cohort 1 (p<6×10 -10), which is known to tag the NAT2 acetylator phenotype. The fast acetylator genotype was associated with lower SF, explaining up to 15% of the variance. In Cohort 2, the top signal associated with SF (p=8.3×10 -42) was rs4921914, also in NAT2, 440 bases upstream of rs1495741 (linkage disequilibrium r2=1.0 for rs4921914 with rs1495741). We replicated these results in two additional cohorts, one with and one without type 1 diabetes. Finally, to understand which compounds are contributing to the NAT2-SF signal, we examined 11 compounds assayed from skin biopsies (n=198): the fast acetylator genotype was associated with lower levels of the AGEs hydroimidazolones of glyoxal (p=0.017). Conclusions/interpretation: We identified a robust association between NAT2 and SF in people with and without diabetes. Our findings provide proof of principle that genetic variation contributes to interindividual SF and that NAT2 acetylation status plays a major role.

Original languageEnglish (US)
Pages (from-to)1623-1634
Number of pages12
Issue number8
StatePublished - Aug 2014


  • Acetylation
  • Genome-wide association study
  • NAT2
  • Skin autofluorescence
  • Skin fluorescence
  • Skin intrinsic fluorescence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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