rs4420638

mixedMag 7.0

This is a intergenic variant variant in the APOC1 gene.

Key Literature Trait Associations

Alzheimer's disease

rs4420638-G shows one of the strongest GWAS signals for Alzheimer's disease ever reported (OR≈2.77, p=2.99×10⁻²⁵⁴ in unadjusted analyses), but this association is almost entirely a proxy for APOE ε4 status: after adjusting for APOE ε2/ε3/ε4 alleles in 18,795 individuals, the association becomes non-significant (OR=1.06, p=0.24). rs4420638-G is therefore best interpreted as a tagging variant for APOE ε4 rather than an independent AD risk factor. Large consortium meta-analyses (Lambert et al., n=74,046) confirm APOE as the dominant common genetic risk locus for late-onset AD.

Allele G
OR 2.77
p 3.0e-254
N 18,795
Large GWAS
European
Allele G
OR
p 1.0e-295
N 74,046
Meta-analysisLarge GWAS
European

LDL Cholesterol Levels

Located near the APOE-APOC1-APOC4 gene cluster, this variant is a strong proxy for APOE ε4 status and is associated with significantly elevated LDL cholesterol. It is one of the strongest common associations with lipid levels genome-wide.

Allele G
OR
β 7.140
p 9.0e-147
N 22,562
Large GWAS
European
Allele G
OR
β 6.000
p 1.0e-150
Large GWAS
Asselbergs FW et al. Large-scale gene-centric meta-analysis across 32 studies identifies multiple lipid loci. American Journal of Human Genetics (2012)
Allele G
OR
β 0.290
p 4.0e-27
N 66,240
Meta-analysisLarge GWAS
European
Allele G
OR
p 3.6e-4
N 4,192
Preliminary work
East Asian

Longevity

The rs4420638-A allele (non-ε4 tag) is associated with increased odds of surviving to age 90 or beyond. A genome-wide meta-analysis (Deelen et al. 2014) comprising 7,729 long-lived cases (≥85 years) and 16,121 controls, with replication in 74,216 additional individuals, found OR=0.72 (95%CI approximately 0.67–0.77) for the G allele versus A allele for longevity (p=3.40×10⁻³⁶), meaning the A allele confers protection. This effect is consistent with APOE ε4's known association with earlier mortality via Alzheimer's disease and cardiovascular disease.

Allele A
OR 0.72
p 3.4e-36
N 98,066
Meta-analysisLarge GWAS
European

Coronary heart disease

The rs4420638-G allele is associated with increased coronary heart disease risk. A large GWAS and Mendelian randomization study in JAMA (n=14,365 cases, 32,069 controls for CHD) found OR=1.16 (95%CI 1.12–1.21) per minor allele. A meta-analysis across European and Asian populations reported OR=1.18 (95%CI 1.14–1.22). The CHD risk is likely mediated through both the LDL-raising effect and the APOE ε4 haplotype's broader atherogenic properties.

Allele G
OR 1.16
p 8.1e-26
N 46,434
Large GWAS
European
Allele G
OR 1.18
p 1.0e-4
N 1,508
Preliminary work
multi-ancestry

Diabetic nephropathy

The rs4420638-G allele has been associated with diabetic nephropathy in type 1 diabetic patients. McKnight et al. (2009) found OR=1.54 (95%CI 1.29–1.84, combined p<0.00001) in 597 cases (type 1 diabetes with nephropathy) vs 502 without nephropathy, with replication in 2,668 additional British Isles subjects. The authors proposed that the SNP, or a functional variant in LD with it, confers susceptibility to renal complications in diabetes, possibly via APOE's role in glomerular lipid metabolism.

McKnight AJ et al. Genetic analysis of coronary artery disease single-nucleotide polymorphisms in diabetic nephropathy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association (2009)
Allele G
OR 1.54
p 1.0e-5
N 3,767
Preliminary work
European

Lipoprotein-associated phospholipase A2 levels

rs4420638-G shows one of the strongest associations with lipoprotein-associated phospholipase A2 (Lp-PLA2) activity, an inflammatory marker linked to cardiovascular risk. Grallert et al. (2012, n=13,664) identified the APOE-APOC1 cluster including rs4420638 as the top locus for Lp-PLA2 activity (p=4.9×10⁻³⁰). Elevated Lp-PLA2 is associated with increased risk of coronary events and stroke, and its genetic regulation by APOE haplotype has implications for understanding the atherogenic properties of the ε4 allele.

GWAS Catalog Trait Associations (56)

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

ClinVar annotation

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1 submitter
View on ClinVar →

Research that mentions this SNP (10)

Investigation of genetic risk factors for chronic adult diseases for association with preterm birth
AssociationN=1,792Nadia Falah et al.(2013)· Human Genetics

Case-control study of 673 preterm birth (PTB) cases vs 1,119 controls across four maternal cohorts testing 35 SNPs in cardiovascular, inflammatory, and metabolic disease genes. Found 13 statistically significant associations with PTB (P<0.05), more than expected by chance (binomial P=0.02). Most significant was HLA-DQA1 rs9272346 G allele protective effect in US White mothers (P=0.02, OR=0.65, 95% CI 0.46-0.94), which nominally replicated in Danish cohort (P=0.02, OR=0.85, 95% CI 0.75-0.97) but lost significance after correction for multiple testing.

Traits studied:Cardiovascular diseaseHeight and weightHemostasis and thrombosisHypertensionInflammatory and immunological diseaseLipids and glucose metabolismMyocardial infarctionObesityPreterm birth
Genetic Susceptibility for Alzheimer Disease Neuritic Plaque Pathology
AssociationN=725Joshua M. Shulman et al.(2013)· JAMA Neurology

A genome-wide association study of 725 deceased subjects identified genetic susceptibility loci for Alzheimer's disease neuritic plaque pathology. Beyond APOE and CR1, the study found ABCA7 (rs3764650, p=0.03) and CD2AP (rs9349407, p=0.03) associated with increased neuritic plaque burden. Notably, a novel APP locus variant (rs2829887, p=3.3×10⁻⁶) was associated with neuritic plaques and β-amyloid load in postmortem samples and independently replicated in cognitively normal PET imaging cohorts, implicating common genetic variation in amyloid pathology at pre-symptomatic AD stages.

Traits studied:Alzheimer's diseasecognitive declinefibrillar β-amyloid depositionmild cognitive impairmentneuritic plaque pathologyβ-amyloid load
Pleiotropy and allelic heterogeneity in the TOMM40-APOE genomic region related to clinical and metabolic features of hepatitis C infection
AssociationN=732Ornit Chiba-Falek et al.(2012)· Human Genetics

This association study of 732 chronic hepatitis C patients examined polymorphisms in the TOMM40-APOE genomic region. rs7412 was significantly associated with serum apolipoprotein E levels (p=2.3×10⁻¹¹), explaining 7% of variance. Among IL28B-CC patients (n=196), rs429358 and TOMM40 '523' polymorphisms together explained 12% of variance in apolipoprotein B levels. Patients homozygous for APOE e3 isoform showed >2-fold increased odds of F2-F4 hepatic fibrosis (p=1.8×10⁻⁵), independent of lipid levels.

Traits studied:Chronic hepatitis CHCV-associated dyslipidemiaHepatic fibrosisLDL cholesterolSerum apolipoprotein B levelsSerum apolipoprotein E levels
A Comprehensive Genetic Association Study of Alzheimer Disease in African Americans
AssociationN=1,009Logue MW et al.(2011)· Archives of Neurology

This comprehensive genome-wide association study examined genetic variants contributing to late-onset Alzheimer's disease (AD) in 513 African American cases and 496 controls, plus replication in 5 white cohorts. The APOE ε4 allele showed strong association (P=9.69×10⁻²³), and after adjusting for APOE, rs6859 in PVRL2 remained significantly associated (P=0.0087). The study found associations with variants in CLU, PICALM, BIN1, EPHA1, MS4A, ABCA7, and CD33, though effect directions sometimes differed from white populations. Novel associations with suggestive evidence were identified in PROX1, CNTNAP2, STK24, and other genes, though not replicated in whites.

Traits studied:Alzheimer diseaseLate-onset Alzheimer disease (LOAD)
Association and Expression Analyses With Single-Nucleotide Polymorphisms in &lt;emph type="ital"&gt;TOMM40&lt;/emph&gt; in Alzheimer Disease
AssociationN=2,784Cruchaga C. et al.(2011)· Archives of Neurology

This case-control study attempted to replicate the association of TOMM40 polyT polymorphism (rs10524523) with Alzheimer's disease risk and age at onset. In a large series of 1594 LOAD cases and 1190 controls, the study failed to replicate the previously reported association with age at onset but found a significant association between rs10524523 and risk for LOAD among APOE 33 homozygotes in the opposite direction (OR=0.78, 95% CI=0.65-0.95; p=0.004, allele frequencies 0.41 vs 0.48 in cases vs controls). No association was found between rs10524523 and CSF biomarker levels (tau, phosphorylated tau, Aβ42) or TOMM40/APOE gene expression.

Traits studied:Age at onset of Alzheimer's diseaseCSF Aβ40 levelsCSF Aβ42 levelsCSF phosphorylated tau (ptau181) levelsCSF tau levelsLate-onset Alzheimer's disease (LOAD)
Genome-wide Analysis of Genetic Loci Associated With Alzheimer Disease
AssociationN=35,000Seshadri S. et al.(2010)· JAMA

This 3-stage genome-wide association meta-analysis study identified 5 novel and confirmed loci associated with late-onset Alzheimer's disease across over 35,000 individuals. The study discovered two new genome-wide significant loci: rs744373 in BIN1 (OR 1.13, p=1.59×10⁻¹¹) and rs597668 near EXOC3L2 (OR 1.18, p=6.45×10⁻⁹), and confirmed three previously reported loci in APOE (OR 2.53, p=1.04×10⁻²⁹⁵), CLU (OR 0.85, p=1.62×10⁻¹⁶), and PICALM (OR 0.89, p=3.16×10⁻¹²). These findings were validated in an independent Spanish replication sample of 2,349 individuals.

Traits studied:Alzheimer's diseaseLate-onset Alzheimer's disease
GAB2 as an Alzheimer Disease Susceptibility Gene
AssociationN=4,007Brit-Maren M. Schjeide et al.(2009)· Archives of Neurology

This follow-up study of genomewide association findings tested 4 putative Alzheimer's disease susceptibility loci from prior GWA studies in 4,007 DNA samples from 1,299 families with AD. Only rs7101429 in GAB2 showed significant evidence of association (P = .002), with a protective effect (OR = 0.76, 95% CI 0.62-0.94). The other 3 loci (GOLM1, chromosome 15q, and chromosome 9p) did not show consistent evidence of association across the datasets.

Traits studied:Alzheimer's disease
Genome‐wide association studies and the genetic dissection of complex traits
ReviewPaola Sebastiani et al.(2009)· American Journal of Hematology

This review examines genome-wide association studies (GWAS) methodology and challenges in genetic dissection of complex traits. The authors review study design, genotyping platforms, quality control, and statistical analysis approaches for GWAS, citing key examples including associations of rs1051730 (CHRNA3) with lung cancer and nicotine dependence, rs10484554 (HLA-C) with AIDS nonprogression and psoriasis, rs2476601 (PTPN22) with Crohn's disease and type 1 diabetes, and BCL11A variants with fetal hemoglobin levels.

Traits studied:AIDS nonprogressionAge-related macular degenerationAlzheimer's diseaseBeta-thalassemiaBreast cancerChronic lymphocytic leukemiaCoronary artery diseaseCrohn's diseaseDiabetesDrug toxicityFetal hemoglobin levelsLDL cholesterolLung cancerNicotine dependenceOsteonecrosis of the jawPlatelet functionProstate cancerPsoriasisRheumatoid arthritisSickle cell anemiaTriglyceridesType 1 diabetesWarfarin maintenance dose
Genetic Loci Associated With C-Reactive Protein Levels and Risk of Coronary Heart Disease
AssociationN=130,857Elliott P. et al.(2009)· JAMA

Genome-wide association study identified five genetic loci influencing C-reactive protein (CRP) levels: rs6700896 in LEPR (-14.7% per allele, OR 1.06 for CHD), rs4537545 in IL6R (-10.8%, OR 0.94 for CHD), rs7553007 in CRP locus (-20.7%, OR 0.98 for CHD), rs1183910 in HNF1A (-13.6%), and rs4420638 in APOE-CI-CII (-21.8%, OR 1.16 for CHD). Mendelian randomization analysis of 28,112 CHD cases and 100,823 controls found no causal association between CRP genetic variants and coronary heart disease (OR 1.00, 95% CI 0.97-1.02), arguing against CRP having a causal role in atherosclerosis.

Traits studied:C-reactive protein levelsCoronary heart diseaseHDL cholesterolLDL cholesterolMyocardial infarctionTotal cholesterolTriglycerides
Does APOE explain the linkage of Alzheimer's disease to chromosome 19q13?
AssociationN=827Blom ES et al.(2008)· American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

This linkage study of 417 affected sibling pairs with Alzheimer's disease from Sweden/Norway, UK, and USA examined chromosome 19q13. The strongest linkage peak (Zlr=3.28, P=0.036) was located 1 Mb from APOE. APOE ε4 alleles explained the linkage in the whole sample and UK/USA subsamples, though the Swedish sample showed marginal evidence of additional linkage. Age at onset had a significant effect on the linkage peak (lod increase=3.31, P=0.002), partially explained by APOE genotypes.

Traits studied:Alzheimer's disease

Gene information from NCBI Gene. Variant classifications from ClinVar.

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