Restless legs syndrome (RLS) affects up to 10% of older adults. Their healthcare is impeded by delayed diagnosis and insufficient treatment. To advance disease prediction and find new entry points for therapy, we performed meta-analyses of genome-wide association studies in 116,647 individuals with RLS (cases) and 1,546,466 controls of European ancestry. The pooled analysis increased the number of risk loci eightfold to 164, including three on chromosome X. Sex-specific meta-analyses revealed largely overlapping genetic predispositions of the sexes (rg = 0.96). Locus annotation prioritized druggable genes such as glutamate receptors 1 and 4, and Mendelian randomization indicated RLS as a causal risk factor for diabetes. Machine learning approaches combining genetic and nongenetic information performed best in risk prediction (area under the curve (AUC) = 0.82-0.91). In summary, we identified targets for drug development and repurposing, prioritized potential causal relationships between RLS and relevant comorbidities and risk factors for follow-up and provided evidence that nonlinear interactions are likely relevant to RLS risk prediction.
FörderungenHeart and Stroke Foundation of Canada Charles University Cooperation Program in Neuroscience RLS and AL Williams Jr. Family Foundations Institute of Epidemiology and Social Medicine Dean of the medical faculty, both at the University of Muenster German Center for Cardiovascular Disease University of Muenster from the German Restless Legs Society (RLS e.V. Deutsche Restless Legs Vereinigung) Boehringer Ingelheim Pharma, Mundipharma Research, Roche Pharma, NeuroBioTec and UCB (Schwarz Pharma) Helmholtz Zentrum Muenchen-German Research Center for Environmental Health German Federal Ministry of Education and Research (BMBF), state of Bavaria Munich Center of Health Sciences, Ludwig-Maximilians-Universitaet, LMUinnovativ NIH Research Cambridge Biomedical Research Centre National Institute for Health and Care Research (NIHR) NIHR Bio Resource Canadian Diabetes Association Natural Sciences and Engineering Research Council of Canada Deutsche Forschungsgemeinschaft European Regional Development Fund University of Thessaly NIH-NIA NIH-NINDS Mayo Clinic Center for Regenerative Medicine Albertson Parkinson's Research Foundation National Institutes of Health National Institute of Neurological Disorders and Stroke Mayo Clinic Neuroscience Focused Research Team (Cecilia and Dan Carmichael Family Foundation) James C. and Sarah K. Kennedy Fund for Neurodegenerative Disease Research Canadian Institutes of Health Research NIHR Cambridge Biomedical Research Centre NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR ) NIHR BTRU in Donor Health and Behaviour Cancer Research UK National Institute for Health Research (NIHR) European Commission NHSBT Wellcome Trust European Commission Framework Programme 7 NIHR NIHR Senior Investigator Award LX22 NPO Danish Council for Independent Research-Medical Sciences Danish Administrative Regions and Bio- and Genome Bank Denmark Danish Blood Donor Research Foundation Science and Technology Facilities Council Wellcome. Regarding the INTERVAL data UK Medical Research Council British Heart Foundation NIHR Cambridge BRC Health Data Research UK Engineering and Physical Sciences Research Council Economic and Social Research Council Department of Health and Social Care (England) Chief Scientist Office of the Scottish Government Health and Social Care Directorates Health and Social Care Research and Development Division (Welsh Government) Public Health Agency (Northern Ireland) Novo Nordisk Foundation Challenge Program