rs1229984

mixedMag 7.0

This is a protein-altering variant in the ADH1B gene.

Key Literature Trait Associations

Alcohol Dependence

rs1229984 is a missense variant in ADH1B (alcohol dehydrogenase 1B) encoding the Arg48His substitution. The A allele (His48) produces an ADH1B isoform that oxidizes ethanol to acetaldehyde approximately 70-80 times faster than the wild-type Arg48 form. The rapid acetaldehyde accumulation causes flushing, nausea, and tachycardia, strongly discouraging alcohol consumption. The A (His48) allele is powerfully protective against alcohol dependence (OR 0.34), while carriers of the T (Arg48) reference allele face higher risk. The A allele is common in East Asian populations (~75%) but rare in Europeans (~3%).

Esophageal Cancer

Paradoxically, the His48 (A) allele that protects against alcohol dependence increases esophageal cancer risk in individuals who do drink alcohol. Fast ADH1B activity generates elevated acetaldehyde, a Group 1 IARC carcinogen, in the upper aerodigestive tract mucosa. The association is strongest when combined with ALDH2 rs671 heterozygosity: carriers of both fast-ADH1B and inactive-ALDH2 alleles who drink regularly have esophageal cancer risk approximately 4.8-fold higher than reference genotype drinkers.

Head and neck cancer

The G allele (Arg48) substantially elevates risk for upper aerodigestive tract malignancies including oral cavity, pharyngeal, laryngeal, and hypopharyngeal cancers. A 2012 meta-analysis of 24,252 subjects found the Arg/Arg genotype had OR=3.47 (95% CI: 2.76–4.36) for UADT cancer, with an 18-fold increase among drinkers. A 2019 meta-analysis spanning 31,999 cases and 50,964 controls confirmed reduced cancer risk for the His allele (OR=0.62 for homozygous). A 2024 meta-analysis specifically for head and neck cancer found the A allele (His) conferred a pooled OR=0.73 (allelic model) and 0.42 (homozygous), confirming the G allele's risk. Risk is multiplicatively amplified by concurrent ALDH2 deficiency.

Alcohol consumption

The G allele (Arg48) is robustly associated with higher habitual alcohol intake in genome-wide studies. A large GWAS meta-analysis (n=173,216) identified rs1229984 as one of six genome-wide significant loci for extreme alcohol consumption, with functional validation across model organisms. A GWAS in European and African Americans (n≈9,500) found p=5.96×10⁻¹⁵ for maximum drinks consumed. A UK Biobank study (n=131,510) showed even stronger association after excluding former drinkers (p=1.9×10⁻⁷⁰ for AUDIT-C scores). The His allele (A) reduces alcohol consumption by slowing ethanol oxidation kinetics, particularly in East Asian populations.

Allele G
OR
p 5.0e-8
N 173,216
Small GWAS
multi-ancestry

Gout

The G allele (Arg48) interacts with alcohol consumption to markedly elevate serum urate and gout risk. A large cross-sectional analysis of 458,405 European UK Biobank participants found a non-additive interaction between rs1229984 and alcohol intake for serum urate (p=3.0×10⁻⁴⁴), hyperuricemia (p=7.9×10⁻¹³), and gout (p=8.2×10⁻⁹). Beer intake showed the strongest interaction among men, wine among women. These associations are mediated through the variant's effect on alcohol metabolism rate rather than a direct effect on uric acid pathways. A large Mendelian randomization study in Chinese men (n>500,000) also implicated genotype-predicted alcohol intake (HR=2.33) in gout risk.

Alcohol flushing response

In East Asian populations, the A allele (His48) at rs1229984 is associated with reduced alcohol flushing response compared to the G allele (Arg48). A GWAS meta-analysis in 15,105 East Asian males identified rs1229984 alongside ALDH2 rs671 as the two primary genetic determinants of alcohol-induced flushing. The His48 isoform slows ethanol-to-acetaldehyde conversion, reducing acetaldehyde accumulation that drives the vasodilatory flushing response. This flushing phenotype itself serves as a reliable instrumental variable in Mendelian randomization analyses of alcohol's effects on diseases such as hypertension.

Allele A
OR
p 5.0e-8
N 15,105
Small GWAS
East Asian

Sex hormone levels

The G allele (Arg48) influences circulating sex hormone concentrations through its effect on alcohol metabolism. A meta-analysis with Mendelian randomization in 218,907 women found that genetically predicted alcohol intake (instrumented by rs1229984) was positively associated with total testosterone (+4.1% per 10 g/day, 95% CI: 0.6–7.6%) and free testosterone (+7.8%, 95% CI: 4.1–11.5%), and inversely associated with SHBG (−8.1%, 95% CI: −11.3 to −4.9%). Colocalization analysis identified a shared causal locus at ADH1B for free testosterone and SHBG (posterior probabilities 0.81 and 0.97). These hormonal shifts may partially mediate the associations between alcohol consumption and hormone-sensitive cancers.

GWAS Catalog Trait Associations (107)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

ClinVar annotation

protective
1 submitter5 publications

Alcohol dependence; Aerodigestive tract cancer, squamous cell, alcohol-related, protection against

View on ClinVar →

Research that mentions this SNP (9)

The genetics of alcohol dependence: Twin and SNP‐based heritability, and genome‐wide association study based on AUDIT scores
AssociationN=7,842Hamdi Mbarek et al.(2015)· American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

This genome-wide association study investigated the genetic basis of alcohol dependence (AD) in 7,842 Dutch participants using the AUDIT screening measure. Twin-based heritability was estimated at 60% (95% CI: 55-69%) and common SNPs explained 33% of this heritability. The GWAS identified four suggestive loci (4q34.1, 2p16.1, 6q25.3, 7p14.1) with the strongest association at rs55768019 (P=7.58×10⁻⁷, OR=0.80). Replication confirmed known AD variants: rs1229984 in ADH1B (P=1.58×10⁻⁴, OR=1.77) and rs7119734 in DSCAML1 (P=7.5×10⁻³, OR=1.16).

Traits studied:AUDIT scoreAlcohol dependenceAlcohol use disorder
ALDH2 is associated to alcohol dependence and is the major genetic determinant of "daily maximum drinks" in a GWAS study of an isolated rural Chinese sample.
AssociationN=313Quillen EE et al.(2014)· American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics

Genome-wide association study of alcohol dependence and related phenotypes in 313 males from extended Han Chinese pedigrees in Northern Hunan Province. ALDH2 rs671 (Glu504Lys) was identified as the major genetic determinant, with genome-wide significant associations for alcohol dependence (p=4.73×10⁻⁸), maximum drinks in 24 hours (p=1.54×10⁻¹⁶), and facial flushing response (p=4.75×10⁻²⁶). The rs671 variant explained 7.9% of AD phenotypic variation, 22.9% of maximum drinks variation, and 29.2% of flushing response variation. A previously reported candidate SNP rs10774610 in CCDC63 was confirmed but shown to result from linkage disequilibrium with ALDH2.

Traits studied:Alcohol consumption (maximum drinks in 24 hours)Alcohol dependenceFacial flushing response to alcohol
Genetic variants at 4q21, 4q23 and 12q24 are associated with esophageal squamous cell carcinoma risk in a Chinese population
AssociationN=4,412Yong Gao et al.(2013)· Human Genetics

A case-control study of 2,139 esophageal squamous cell carcinoma (ESCC) cases and 2,273 controls in a Chinese population examined six SNPs previously associated with upper aerodigestive tract cancers in Europeans. Four SNPs showed significant association with ESCC risk: rs1494961 at 4q21 (OR=1.15, 95% CI=1.05-1.26), rs1229984 in ADH1B at 4q23 (OR=1.24, 95% CI=1.13-1.36), rs1789924 near ADH1C at 4q23 (OR=1.20, 95% CI=1.03-1.39), and rs671 in ALDH2 at 12q24 (OR=0.83, 95% CI=0.75-0.91). Combined analysis showed significant allele-dosage effects with individuals carrying 5+ risk alleles having 1.76-fold increased ESCC risk.

Traits studied:Esophageal squamous cell carcinomaUpper aerodigestive tract cancers
A meta-analysis of two genome-wide association studies to identify novel loci for maximum number of alcoholic drinks
Meta-analysisN=4,915Manav Kapoor et al.(2013)· Human Genetics

A meta-analysis of two genome-wide association studies (COGA and SAGE) identifying genetic variants associated with maximum number of alcoholic drinks consumed in 24 hours (maxdrinks). The study combined 4,915 participants of European descent and found suggestive associations with multiple loci including rs1229984 (ADH1B, p=2.04×10⁻⁸), rs4758317 (LMO1, p=7.2×10⁻⁷), and variants in PLCL1 (p=4.07×10⁻⁶). Approximately 40% of the variance in maxdrinks was explained by genome-wide SNPs.

Traits studied:Alcohol dependenceExcessive alcohol consumptionMaximum number of alcoholic drinks in 24-hour period
Extended genetic effects of ADH cluster genes on the risk of alcohol dependence: from GWAS to replication
AssociationN=1,371Byung Lae Park et al.(2013)· Human Genetics

This GWAS and replication study in a Korean cohort identified genetic associations with alcohol dependence (AD), with the ADH gene cluster on chromosome 4q22-q23 and ALDH2 on 12q24 showing the strongest signals. The most significant finding was ADH1B rs1229984 (H47R) with p=2.63×10⁻²¹ and OR=2.35 in the replication cohort of 975 subjects. Conditional analyses revealed that ADH1B rs1229984 is likely the sole functional marker driving effects across the ADH cluster.

Traits studied:Alcohol dependence
Single nucleotide polymorphisms of ADH1B, ADH1C and ALDH2 genes and esophageal cancer: A population‐based case–control study in China
AssociationN=1,925Ming Wu et al.(2013)· International Journal of Cancer

Population-based case-control study in China examining alcohol dehydrogenase and aldehyde dehydrogenase gene polymorphisms in esophageal cancer. ADH1B rs1229984 G-allele showed significant association with esophageal cancer risk (OR=1.34, dominant model), and ALDH2 rs671 showed significant gene-environment interaction with alcohol consumption, with moderate/heavy drinkers carrying ALDH2 A allele and ADH G allele at highest risk. No association found for ADH1C rs698 polymorphism.

Traits studied:Esophageal cancerEsophageal squamous cell carcinoma
Shortened telomeres in individuals with abuse in alcohol consumption
AssociationN=457Sofia Pavanello et al.(2011)· International Journal of Cancer

This case-control study of 457 Caucasian males (200 alcohol abusers, 257 controls) found that alcohol abusers had significantly shorter peripheral blood leukocyte telomere length (TL was 0.42 vs. 0.87 relative T/S ratio, P<0.0001), suggesting accelerated cellular aging. The ADH1B rs1229984 (Arg47His) genotype modulated this association: carriers of the ADH1B*2 allele were protected from alcohol abuse (OR=0.28, 95% CI 0.14-0.55) and showed longer telomeres, while ADH1B*1 carriers exhibited shorter telomeres and higher alcohol consumption. The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with telomere length.

Traits studied:Alcohol abuseCancer riskTelomere length
ADH1A variation predisposes to personality traits and substance dependence
AssociationN=1,523Lingjun Zuo et al.(2010)· American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

ADH1A genetic variation predisposes to personality traits and substance dependence across multiple population groups. Agreeableness and Conscientiousness were associated with ADH1A diplotypes, haplotypes, and genotypes in European-American and African-American subjects (p range: 1.7×10⁻⁴ to 0.055), with effects modified by sex and age. Substance dependence was significantly associated with ADH1A variants (p range: 0.008 to 0.060), suggesting ADH1A's role in both personality phenotyping and addiction vulnerability.

Traits studied:Alcohol DependenceAnxiety traitsCocaine DependenceOpioid DependencePersonality - AgreeablenessPersonality - ConscientiousnessPersonality - ExtraversionPersonality - NeuroticismPersonality - Openness to ExperienceSubstance Dependence
A single nucleotide polymorphism in the alcohol dehydrogenase 7 gene (alanine to glycine substitution at amino acid 92) is associated with the risk of squamous cell carcinoma of the head and neck
AssociationN=2,239Sheng Wei et al.(2010)· Cancer

Hospital-based case-control study of 1,110 SCCHN cases and 1,129 controls examining alcohol dehydrogenase gene polymorphisms. ADH7 A92G (rs1573496: C>G) GG and combined CG+GG genotypes were associated with decreased SCCHN risk (adjusted OR 0.32, 95% CI 0.13-0.82 for GG; adjusted OR 0.74, 95% CI 0.59-0.94 for CG+GG). ADH1B R48H (rs1229984: G>A) showed no overall association with SCCHN risk in this non-Hispanic White population.

Traits studied:Laryngeal cancerOral cavity cancerPharyngeal cancerSquamous cell carcinoma of the head and neck (SCCHN)Upper aerodigestive tract (UADT) cancers

Gene information from NCBI Gene. Variant classifications from ClinVar.

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