Garrod's concept of 'chemical individuality' has contributed to comprehension of the molecular origins of human diseases. Untargeted high-throughput metabolomic technologies provide an in-depth snapshot of human metabolism at scale. We studied the genetic architecture of the human plasma metabolome using 913 metabolites assayed in 19,994 individuals and identified 2,599 variant-metabolite associations (P < 1.25 × 10-11) within 330 genomic regions, with rare variants (minor allele frequency ≤ 1%) explaining 9.4% of associations. Jointly modeling metabolites in each region, we identified 423 regional, co-regulated, variant-metabolite clusters called genetically influenced metabotypes. We assigned causal genes for 62.4% of these genetically influenced metabotypes, providing new insights into fundamental metabolite physiology and clinical relevance, including metabolite-guided discovery of potential adverse drug effects (DPYD and SRD5A2). We show strong enrichment of inborn errors of metabolism-causing genes, with examples of metabolite associations and clinical phenotypes of non-pathogenic variant carriers matching characteristics of the inborn errors of metabolism. Systematic, phenotypic follow-up of metabolite-specific genetic scores revealed multiple potential etiological relationships.
GrantsGerman Federal Ministry of Education and Research Cambridge Trust Rutherford Fund Fellowship from the Medical Research Council Wellcome British Heart Foundation Public Health Agency (Northern Ireland) Health and Social Care Research and Development Division (Welsh Government) Chief Scientist Office of the Scottish Government Health and Social Care Directorates Department of Health and Social Care (England) Economic and Social Research Council Engineering and Physical Sciences Research Council Health Data Research UK - UK Medical Research Council UK Medical Research Council NIHR Blood and Transplant Research Unit in Donor Health and Genomics NIHR Cambridge BRC Wellcome Trust NIHR Cambridge Biomedical Research Centre NIHR BioResource National Institute for Health Research (NIHR) Innovative Medicines Initiative Joint Undertaking under EMIF MRC Cambridge Initiative in Metabolic Science Cancer Research UK Medical Research Council QNRF Qatar Foundation Biomedical Research Program at Weill Cornell Medicine in Qatar National Institute on Aging (NIA) NIHR Senior Investigator Award British Heart Foundation Professorship BHF Accelerator Award NIHR-UKRI CONVALESCENCE study BHF Data Science Centre Chronic Disease Research Foundation BHF-Turing Cardiovascular Data Science Award Innovative Medicines Initiative-2 Joint Undertaking BHF Programme grant National Institutes of Health NIHR Birmingham Biomedical Research Centre Wellcome Trust Investigator grant BrightFocus Foundation King's College London Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust National Institute for Health Research (NIHR) Clinical Research Facility European Commission H2020 grants SYSCID NIHR Biomedical Research Centre at University College London (UCL) Hospital NHS Trust