Iron homoeostasis is tightly regulated, with hepcidin and soluble transferrin receptor (sTfR) playing significant roles. However, the genetic determinants of these traits and the biomedical consequences of iron homoeostasis variation are unclear. In a meta-analysis of 12 cohorts involving 91,675 participants, we found 43 genomic loci associated with either hepcidin or sTfR concentration, of which 15 previously unreported. Mapping to putative genes indicated involvement in iron-trait expression, erythropoiesis, immune response and cellular trafficking. Mendelian randomisation of 292 disease outcomes in 1,492,717 participants revealed associations of iron-related loci and iron status with selected health outcomes across multiple domains. These associations were largely driven by HFE, which was associated with the largest iron variation. Our findings enhance understanding of iron homoeostasis and its biomedical consequences, suggesting that lifelong exposure to higher iron levels is likely associated with lower risk of anaemia-related disorders and higher risk of genitourinary, musculoskeletal, infectious and neoplastic diseases.
GrantsBritish Heart Foundation Department of Innovation, Research University of the Autonomous Province of Bolzano-South Tyrol EuropeanRegionalDevelopment Fund LURM Research Facility at the University Hospital of Verona Medical Research Council (UK) European Commission Republic ofCroatia Ministry of Science, Education, and Sports anMRC Human Genetics Unit programme grant, 'Quantitative traits in health and disease' Danish Council for IndependentResearch Bio-andGenome BankDenmark The Danish Council for IndependentResearch Novo Nordisk Foundation Finnish Funding Agency for Technology and Innovation (Tekes) VTR funding from the Finnish Government Business Finland Innovative Medicines Initiative-2 Joint Undertaking NIHR National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre UK Medical Research Council 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) Wellcome Cancer Research UK NIHR Blood and Transplant Research Unit (BTRU) in Donor Health and Behaviour Rhodes Trust Wellcome Trust United KingdomResearch and InnovationMedical Research Council National Institute for Health Research Cambridge Biomedical Research Centre AbbVie Inc. The Italian Ministry of Health NIHR Blood and Transplant Research Unit in Donor Health and Genomics BritishHeart Foundation NIHRCambridgeBRC Helmholtz Zentrum Munchen-German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF) State of Bavaria Munich Center of Health Sciences (MC-Health), Ludwig-Maximilians-Universitat, as part of LMUinnovativ Dutch Kidney Foundation EU National Institutes of Health Netherlands organisation for health research and development (NWO-Groot grant ) Dutch Inter University Cardiology Institute Netherlands (ICIN) Telethon, Italy Ministry ofHealth AstraZeneca UK Ltd Biogen MA Inc. Bristol Myers Squibb Genentech Inc. Merck Sharp Dohme LCC Pfizer Inc. GlaxoSmithKline Intellectual Property Development Ltd. Sanofi US Services Inc. Maze Therapeutics Inc Janssen Biotech Inc Novartis AG Boehringer Ingelheim International GmbH Italian Ministry of Health U.S. National Institute on Aging Compagnia di San Paolo, Torino, Italy Fondazione Cariplo, Italy NWO VENI grant