Genome-wide meta-analysis identifies novel risk loci for uterine fibroids within and across multiple ancestry groups

Jeewoo Kim & Jacklyn N. Hellwege et al. · 2025-03-06

Abstract

Uterine leiomyomata or fibroids are highly heritable, common, and benign tumors of the uterus with poorly understood etiology. Previous GWAS have reported 72 associated genes but included limited numbers of non-European individuals. Here, we identify 11 novel genes associated with fibroids across multi-ancestry and ancestry-stratified GWAS analyses. We replicate a known fibroid GWAS gene in African ancestry individuals and estimate the SNP-based heritability of fibroids in African ancestry populations as 15.9%. Using genetically predicted gene expression and colocalization analyses, we identify 46 novel genes associated with fibroids. These genes are significantly enriched in cancer, cell death and survival, reproductive system disease, and cellular growth and proliferation networks. We also find that increased predicted expression of HEATR3 in uterine tissue is associated with fibroids across ancestry strata. Overall, we report genetic variants associated with fibroids coupled with functional and gene pathway enrichment analyses.

Funding
Understanding the genetic risk underlying racial disparities in uterine fibroidseMERGE IV Northwest: A partnership to evaluate the use of genomic information in health careBuilding Interdisciplinary Research Careers in Women's HealthA Center for GEI Association StudiesThe Future of Genomics Medicine in Patient Care: Contributions from CHOPEMR-Linked Biobank for Translational GenomicsBiorepository for Genomic Medicine in diverse CommunitiesVESPA: Vanderbilt Electronic Systems for Pharmacogenomic AssessmentA new paradigm for identifying patients and drugs at risk for QT prolongationEHR-based Genomic Discovery and Implementation [Funded Extension]Using the Exome to Discover Genetic Determinants of Fibroids in African AmericansGenetic Admixture Study of Uterine Fibroids in African American WomenBioVU Plasma Storage EquipmentBuilding Interdisciplinary Research Careers in Women's HealtheMERGE Coordinating CenterEMERGE III CENTRAL SEQUENCING, GENOTYPING AND INTERPRETATION FACILITYThe Vanderbilt Institute for Clinical and Translational Research (VICTR)Genetic Discovery and Application in a Clinical Setting Continuing a PartnershipJH/CIDR Genotyping for Genome-Wide Association StudiesLarge-scale studies in eMERGE to discover the genetic determinants of uterine fibroidsPheMAP: Measured, Automated Profile to Facilitate High Throughput PhenotypingA Follow-up Study for Causes of Cancer in Black WomenGene Polymorphisms in Relation to Cancer in Black WomenGeisinger eGenonic Medicine (GeM) ProgramPharmacogenomics of Arrhythmia TherapyUsing the Exome to Discover Genetic Determinants of Fibroids in African AmericansPredictive utility of polygenic risk scores for chronic kidney disease.Vanderbilt Genome-Electronic Records ProjectAutomated Storage and Retrieval of Biological SystemsGenome-wide Studies from the NUgene BiorespositoryIRIS: Incorporating Research Into SightNRSA Training CoreVGER, the Vanderbilt Genome-Electronic Records ProjectNational Center for Advancing Translational Sciences Grant UL1TR000445EMR Phenotypes and Community Engaged Genomic AssociationsBetter Outcomes for Children: Promoting Excellence in Healthcare Genomics to Inform PolicyUnderstanding the genetic risk underlying racial disparities in uterine fibroidsMeharry Clinical and Translational Research Center (MeTRC)Building Interdisciplinary Research Careers in Women's HealthA Personalized Genomic Medicine Pilot Program Using the NJgene eMERGE ExperienceEHR-based Genome-Informed Risk Assessment and CommunicationModular Automated -80C Sample Storage SystemVanderbilt Genome Electronic Records ProjectDevelopment and Use of Network Infrastructure for High-Throughput GWA StudiesThe Vanderbilt Institute for Clinical and Translational Research (VICTR) UL1Genomic Medicine at Northwestern: Discovery and ImplementationGenetic Epidemiology of Multiple SclerosisEpidemiologic Architecture for Genes Linked to Environment (EAGLE)Vanderbilt Institute for Clinical and Translational Research (VICTR)eMERGE Phase IV Clinical Center at Mass General BrighamEvaluating the impact of altered gene expression on uterine fibroid risk in African ancestry populationsDNA Sequencing Support for the eMERGE NetworkImproving precision health approaches through large-scale EHRs and biobanksGenome-Wide Study of Cataract and Low HDL in the Personalized Medicine Research PImproving precision health approaches through large-scale EHRs and biobanksThe Electronic Medical Records and Genomics (eMERGE) Network Phase III - Coordinating Center (U01)Large-scale studies in eMERGE to discover the genetic determinants of uterine fibroids

U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

R01HD074711

NHGRI NIH HHS

U01 HG008657

U.S. Department of Health & Human Services | NIH | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

K12AR084232

NHGRI NIH HHS

U01 HG004424

NHGRI NIH HHS

U01 HG008684

NHGRI NIH HHS

U01 HG008679

NHGRI NIH HHS

U01 HG006380

NIGMS NIH HHS

RC2 GM092618

NIGMS NIH HHS

P50 GM115305

NHGRI NIH HHS

U01 HG006379

U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

R03HD078567

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NIH HHS

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U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

R01HD093671

NIGMS NIH HHS

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NCI NIH HHS

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NCI NIH HHS

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NICHD NIH HHS

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Intramural NIH HHS

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NHGRI NIH HHS

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U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute (NHGRI)

ZIAHG200417

NHGRI NIH HHS

U01 HG008701

NICHD NIH HHS

R01 HD093671

U.S. Department of Health & Human Services | NIH | National Institute of Arthritis and Musculoskeletal and Skin Diseases

K12AR084232

U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute

ZIAHG200417

U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development

R01HD074711

U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development

R03HD078567

U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development

R01HD093671