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1.
Nat Genet ; 55(8): 1413-1420, 2023 08.
Article in English | MEDLINE | ID: mdl-37443256

ABSTRACT

The trait of participating in a genetic study probably has a genetic component. Identifying this component is difficult as we cannot compare genetic information of participants with nonparticipants directly, the latter being unavailable. Here, we show that alleles that are more common in participants than nonparticipants would be further enriched in genetic segments shared by two related participants. Genome-wide analysis was performed by comparing allele frequencies in shared and not-shared genetic segments of first-degree relative pairs of the UK Biobank. In nonoverlapping samples, a polygenic score constructed from that analysis is significantly associated with educational attainment, body mass index and being invited to a dietary study. The estimated correlation between the genetic components underlying participation in UK Biobank and educational attainment is estimated to be 36.6%-substantial but far from total. Taking participation behaviour into account would improve the analyses of the study data, including those of health traits.


Subject(s)
Family , Genome-Wide Association Study , Humans , Genotype , Phenotype , Educational Status , Polymorphism, Single Nucleotide/genetics
2.
Nat Genet ; 54(6): 897-905, 2022 06.
Article in English | MEDLINE | ID: mdl-35681053

ABSTRACT

Effects estimated by genome-wide association studies (GWASs) include effects of alleles in an individual on that individual (direct genetic effects), indirect genetic effects (for example, effects of alleles in parents on offspring through the environment) and bias from confounding. Within-family genetic variation is random, enabling unbiased estimation of direct genetic effects when parents are genotyped. However, parental genotypes are often missing. We introduce a method that imputes missing parental genotypes and estimates direct genetic effects. Our method, implemented in the software package snipar (single-nucleotide imputation of parents), gives more precise estimates of direct genetic effects than existing approaches. Using 39,614 individuals from the UK Biobank with at least one genotyped sibling/parent, we estimate the correlation between direct genetic effects and effects from standard GWASs for nine phenotypes, including educational attainment (r = 0.739, standard error (s.e.) = 0.086) and cognitive ability (r = 0.490, s.e. = 0.086). Our results demonstrate substantial confounding bias in standard GWASs for some phenotypes.


Subject(s)
Genome-Wide Association Study , Polymorphism, Single Nucleotide , Genome-Wide Association Study/methods , Genotype , Humans , Parents , Polymorphism, Single Nucleotide/genetics , Software
3.
Nat Genet ; 54(4): 437-449, 2022 04.
Article in English | MEDLINE | ID: mdl-35361970

ABSTRACT

We conduct a genome-wide association study (GWAS) of educational attainment (EA) in a sample of ~3 million individuals and identify 3,952 approximately uncorrelated genome-wide-significant single-nucleotide polymorphisms (SNPs). A genome-wide polygenic predictor, or polygenic index (PGI), explains 12-16% of EA variance and contributes to risk prediction for ten diseases. Direct effects (i.e., controlling for parental PGIs) explain roughly half the PGI's magnitude of association with EA and other phenotypes. The correlation between mate-pair PGIs is far too large to be consistent with phenotypic assortment alone, implying additional assortment on PGI-associated factors. In an additional GWAS of dominance deviations from the additive model, we identify no genome-wide-significant SNPs, and a separate X-chromosome additive GWAS identifies 57.


Subject(s)
Genome-Wide Association Study , Multifactorial Inheritance , Humans , Multifactorial Inheritance/genetics , Polymorphism, Single Nucleotide/genetics
4.
Science ; 365(6460): 1396-1400, 2019 09 27.
Article in English | MEDLINE | ID: mdl-31604265

ABSTRACT

Efforts to link variation in the human genome to phenotypes have progressed at a tremendous pace in recent decades. Most human traits have been shown to be affected by a large number of genetic variants across the genome. To interpret these associations and to use them reliably-in particular for phenotypic prediction-a better understanding of the many sources of genotype-phenotype associations is necessary. We summarize the progress that has been made in this direction in humans, notably in decomposing direct and indirect genetic effects as well as population structure confounding. We discuss the natural next steps in data collection and methodology development, with a focus on what can be gained by analyzing genotype and phenotype data from close relatives.


Subject(s)
Genetic Association Studies , Genetics, Population , Genome, Human , Genome-Wide Association Study , Humans , Inheritance Patterns , Models, Genetic , Polymorphism, Single Nucleotide , Principal Component Analysis
5.
Nat Genet ; 50(12): 1674-1680, 2018 12.
Article in English | MEDLINE | ID: mdl-30397338

ABSTRACT

De novo mutations (DNMs) cause a large proportion of severe rare diseases of childhood. DNMs that occur early may result in mosaicism of both somatic and germ cells. Such early mutations can cause recurrence of disease. We scanned 1,007 sibling pairs from 251 families and identified 878 DNMs shared by siblings (ssDNMs) at 448 genomic sites. We estimated DNM recurrence probability based on parental mosaicism, sharing of DNMs among siblings, parent-of-origin, mutation type and genomic position. We detected 57.2% of ssDNMs in the parental blood. The recurrence probability of a DNM decreases by 2.27% per year for paternal DNMs and 1.78% per year for maternal DNMs. Maternal ssDNMs are more likely to be T>C mutations than paternal ssDNMs, and less likely to be C>T mutations. Depending on the properties of the DNM, the recurrence probability ranges from 0.011% to 28.5%. We have launched an online calculator to allow estimation of DNM recurrence probability for research purposes.


Subject(s)
Family , Inheritance Patterns , Mutation , Parent-Child Relations , Adult , Child , Embryonic Germ Cells/metabolism , Family Characteristics , Female , Germ-Line Mutation , Humans , Inheritance Patterns/genetics , Male , Mosaicism , Pedigree
6.
Nat Genet ; 50(11): 1616, 2018 11.
Article in English | MEDLINE | ID: mdl-30237445

ABSTRACT

In the version of this article published, statements about the impact of insertions and deletions on gene conversions were incorrect. We reported a bias toward deletions, whereas in fact the bias was toward insertions. We are deeply indebted to Laurent Duret and Brice Letcher for noticing this mistake in our manuscript. The following statements are incorrect in the published manuscript.

7.
Nat Genet ; 50(9): 1304-1310, 2018 09.
Article in English | MEDLINE | ID: mdl-30104764

ABSTRACT

Heritability measures the proportion of trait variation that is due to genetic inheritance. Measurement of heritability is important in the nature-versus-nurture debate. However, existing estimates of heritability may be biased by environmental effects. Here, we introduce relatedness disequilibrium regression (RDR), a novel method for estimating heritability. RDR avoids most sources of environmental bias by exploiting variation in relatedness due to random Mendelian segregation. We used a sample of 54,888 Icelanders who had both parents genotyped to estimate the heritability of 14 traits, including height (55.4%, s.e. 4.4%) and educational attainment (17.0%, s.e. 9.4%). Our results suggest that some other estimates of heritability may be inflated by environmental effects.


Subject(s)
Genetic Variation/genetics , Linkage Disequilibrium/genetics , Environment , Gene-Environment Interaction , Genotype , Humans , Iceland , Models, Genetic , Phenotype , Quantitative Trait, Heritable
8.
Science ; 359(6374): 424-428, 2018 Jan 26.
Article in English | MEDLINE | ID: mdl-29371463

ABSTRACT

Sequence variants in the parental genomes that are not transmitted to a child (the proband) are often ignored in genetic studies. Here we show that nontransmitted alleles can affect a child through their impacts on the parents and other relatives, a phenomenon we call "genetic nurture." Using results from a meta-analysis of educational attainment, we find that the polygenic score computed for the nontransmitted alleles of 21,637 probands with at least one parent genotyped has an estimated effect on the educational attainment of the proband that is 29.9% (P = 1.6 × 10-14) of that of the transmitted polygenic score. Genetic nurturing effects of this polygenic score extend to other traits. Paternal and maternal polygenic scores have similar effects on educational attainment, but mothers contribute more than fathers to nutrition- and heath-related traits.


Subject(s)
Child Development , Fathers/psychology , Maternal Behavior , Mothers/psychology , Multifactorial Inheritance , Paternal Behavior , Alleles , Child , Educational Status , Female , Genomics , Genotype , Humans , Male , Parent-Child Relations
9.
Nat Genet ; 50(2): 199-205, 2018 02.
Article in English | MEDLINE | ID: mdl-29335549

ABSTRACT

A genome is a mosaic of chromosome fragments from ancestors who existed some arbitrary number of generations earlier. Here, we reconstruct the genome of Hans Jonatan (HJ), born in the Caribbean in 1784 to an enslaved African mother and European father. HJ migrated to Iceland in 1802, married and had two children. We genotyped 182 of his 788 descendants using single-nucleotide polymorphism (SNP) chips and whole-genome sequenced (WGS) 20 of them. Using these data, we reconstructed 38% of HJ's maternal genome and inferred that his mother was from the region spanned by Benin, Nigeria and Cameroon.


Subject(s)
Black People/genetics , Enslaved Persons , Genome, Human , Haploidy , Pedigree , Family Characteristics/history , Genome-Wide Association Study/methods , History, 18th Century , Humans , Iceland , Male , Polymorphism, Single Nucleotide , Sequence Analysis, DNA/methods , Transients and Migrants , West Indies
10.
Sci Data ; 4: 170115, 2017 09 21.
Article in English | MEDLINE | ID: mdl-28933420

ABSTRACT

Understanding of sequence diversity is the cornerstone of analysis of genetic disorders, population genetics, and evolutionary biology. Here, we present an update of our sequencing set to 15,220 Icelanders who we sequenced to an average genome-wide coverage of 34X. We identified 39,020,168 autosomal variants passing GATK filters: 31,079,378 SNPs and 7,940,790 indels. Calling de novo mutations (DNMs) is a formidable challenge given the high false positive rate in sequencing datasets relative to the mutation rate. Here we addressed this issue by using segregation of alleles in three-generation families. Using this transmission assay, we controlled the false positive rate and identified 108,778 high quality DNMs. Furthermore, we used our extended family structure and read pair tracing of DNMs to a panel of phased SNPs, to determine the parent of origin of 42,961 DNMs.


Subject(s)
Genome, Human , Humans , INDEL Mutation , Iceland , Polymorphism, Single Nucleotide
11.
Nature ; 549(7673): 519-522, 2017 09 28.
Article in English | MEDLINE | ID: mdl-28959963

ABSTRACT

The characterization of mutational processes that generate sequence diversity in the human genome is of paramount importance both to medical genetics and to evolutionary studies. To understand how the age and sex of transmitting parents affect de novo mutations, here we sequence 1,548 Icelanders, their parents, and, for a subset of 225, at least one child, to 35× genome-wide coverage. We find 108,778 de novo mutations, both single nucleotide polymorphisms and indels, and determine the parent of origin of 42,961. The number of de novo mutations from mothers increases by 0.37 per year of age (95% CI 0.32-0.43), a quarter of the 1.51 per year from fathers (95% CI 1.45-1.57). The number of clustered mutations increases faster with the mother's age than with the father's, and the genomic span of maternal de novo mutation clusters is greater than that of paternal ones. The types of de novo mutation from mothers change substantially with age, with a 0.26% (95% CI 0.19-0.33%) decrease in cytosine-phosphate-guanine to thymine-phosphate-guanine (CpG>TpG) de novo mutations and a 0.33% (95% CI 0.28-0.38%) increase in C>G de novo mutations per year, respectively. Remarkably, these age-related changes are not distributed uniformly across the genome. A striking example is a 20 megabase region on chromosome 8p, with a maternal C>G mutation rate that is up to 50-fold greater than the rest of the genome. The age-related accumulation of maternal non-crossover gene conversions also mostly occurs within these regions. Increased sequence diversity and linkage disequilibrium of C>G variants within regions affected by excess maternal mutations indicate that the underlying mutational process has persisted in humans for thousands of years. Moreover, the regional excess of C>G variation in humans is largely shared by chimpanzees, less by gorillas, and is almost absent from orangutans. This demonstrates that sequence diversity in humans results from evolving interactions between age, sex, mutation type, and genomic location.


Subject(s)
Aging/genetics , Germ-Line Mutation/genetics , Maternal Age , Mutagenesis , Parents , Paternal Age , Adolescent , Adult , Aged , Animals , Child , Chromosomes, Human, Pair 8/genetics , Evolution, Molecular , Female , GC Rich Sequence , Genome, Human/genetics , Gorilla gorilla/genetics , Humans , INDEL Mutation , Iceland , Linkage Disequilibrium/genetics , Male , Middle Aged , Mutation Rate , Pan troglodytes/genetics , Polymorphism, Single Nucleotide , Pongo/genetics , Young Adult
13.
Nat Genet ; 49(8): 1251-1254, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28628109

ABSTRACT

Thus far, a handful of highly penetrant mutations conferring risk of psychosis have been discovered. Here we used whole-genome sequencing and long-range phasing to investigate an Icelandic kindred containing ten individuals with psychosis (schizophrenia, schizoaffective disorder or psychotic bipolar disorder). We found that all affected individuals carry RBM12 (RNA-binding-motif protein 12) c.2377G>T (P = 2.2 × 10-4), a nonsense mutation that results in the production of a truncated protein lacking a predicted RNA-recognition motif. We replicated the association in a Finnish family in which a second RBM12 truncating mutation (c.2532delT) segregates with psychosis (P = 0.020). c.2377G>T is not fully penetrant for psychosis; however, we found that carriers unaffected by psychosis resemble patients with schizophrenia in their non-psychotic psychiatric disorder and neuropsychological test profile (P = 0.0043) as well as in their life outcomes (including an increased chance of receiving disability benefits, P = 0.011). As RBM12 has not previously been linked to psychosis, this work provides new insight into psychiatric disease.


Subject(s)
Codon, Nonsense , Psychotic Disorders/genetics , RNA-Binding Proteins/genetics , Family Health , Female , Genome, Human , Humans , Iceland , Male , Sequence Analysis, DNA
14.
Nat Commun ; 8: 15833, 2017 06 13.
Article in English | MEDLINE | ID: mdl-28607503

ABSTRACT

The persistence of common, heritable psychiatric disorders that reduce reproductive fitness is an evolutionary paradox. Here, we investigate the selection pressures on sequence variants that predispose to schizophrenia, autism, bipolar disorder, major depression and attention deficit hyperactivity disorder (ADHD) using genomic data from 150,656 Icelanders, excluding those diagnosed with these psychiatric diseases. Polygenic risk of autism and ADHD is associated with number of children. Higher polygenic risk of autism is associated with fewer children and older age at first child whereas higher polygenic risk of ADHD is associated with having more children. We find no evidence for a selective advantage of a high polygenic risk of schizophrenia or bipolar disorder. Rare copy-number variants conferring moderate to high risk of psychiatric illness are associated with having fewer children and are under stronger negative selection pressure than common sequence variants.


Subject(s)
Attention Deficit Disorder with Hyperactivity/genetics , Autistic Disorder/genetics , Bipolar Disorder/genetics , Genetic Fitness , Schizophrenia/genetics , Adult , Aged , Aged, 80 and over , Female , Genetic Predisposition to Disease , Genetics, Population , Genotype , Humans , Iceland , Male , Middle Aged , Multifactorial Inheritance , Polymorphism, Single Nucleotide
15.
Diabetes ; 66(11): 2888-2902, 2017 11.
Article in English | MEDLINE | ID: mdl-28566273

ABSTRACT

To characterize type 2 diabetes (T2D)-associated variation across the allele frequency spectrum, we conducted a meta-analysis of genome-wide association data from 26,676 T2D case and 132,532 control subjects of European ancestry after imputation using the 1000 Genomes multiethnic reference panel. Promising association signals were followed up in additional data sets (of 14,545 or 7,397 T2D case and 38,994 or 71,604 control subjects). We identified 13 novel T2D-associated loci (P < 5 × 10-8), including variants near the GLP2R, GIP, and HLA-DQA1 genes. Our analysis brought the total number of independent T2D associations to 128 distinct signals at 113 loci. Despite substantially increased sample size and more complete coverage of low-frequency variation, all novel associations were driven by common single nucleotide variants. Credible sets of potentially causal variants were generally larger than those based on imputation with earlier reference panels, consistent with resolution of causal signals to common risk haplotypes. Stratification of T2D-associated loci based on T2D-related quantitative trait associations revealed tissue-specific enrichment of regulatory annotations in pancreatic islet enhancers for loci influencing insulin secretion and in adipocytes, monocytes, and hepatocytes for insulin action-associated loci. These findings highlight the predominant role played by common variants of modest effect and the diversity of biological mechanisms influencing T2D pathophysiology.


Subject(s)
Diabetes Mellitus, Type 2/genetics , Gene Expression Regulation/physiology , Genome-Wide Association Study , White People , Genetic Variation , Humans
16.
Blood ; 130(6): 742-752, 2017 08 10.
Article in English | MEDLINE | ID: mdl-28483762

ABSTRACT

Clonal hematopoiesis (CH) arises when a substantial proportion of mature blood cells is derived from a single dominant hematopoietic stem cell lineage. Somatic mutations in candidate driver (CD) genes are thought to be responsible for at least some cases of CH. Using whole-genome sequencing of 11 262 Icelanders, we found 1403 cases of CH by using barcodes of mosaic somatic mutations in peripheral blood, whether or not they have a mutation in a CD gene. We find that CH is very common in the elderly, trending toward inevitability. We show that somatic mutations in TET2, DNMT3A, ASXL1, and PPM1D are associated with CH at high significance. However, known CD mutations were evident in only a fraction of CH cases. Nevertheless, the highly prevalent CH we detect associates with increased mortality rates, risk for hematological malignancy, smoking behavior, telomere length, Y-chromosome loss, and other phenotypic characteristics. Modeling suggests some CH cases could arise in the absence of CD mutations as a result of neutral drift acting on a small population of active hematopoietic stem cells. Finally, we find a germline deletion in intron 3 of the telomerase reverse transcriptase (TERT) gene that predisposes to CH (rs34002450; P = 7.4 × 10-12; odds ratio, 1.37).


Subject(s)
DNA (Cytosine-5-)-Methyltransferases/genetics , DNA-Binding Proteins/genetics , Hematopoiesis , Hematopoietic Stem Cells/cytology , Mutation , Protein Phosphatase 2C/genetics , Proto-Oncogene Proteins/genetics , Repressor Proteins/genetics , Adult , Age Factors , Aged , Aged, 80 and over , Clone Cells , DNA Methyltransferase 3A , Dioxygenases , Female , Hematologic Neoplasms/epidemiology , Hematologic Neoplasms/genetics , Hematopoietic Stem Cells/metabolism , Humans , Male , Middle Aged , Risk Factors
17.
Nat Genet ; 49(5): 801-805, 2017 May.
Article in English | MEDLINE | ID: mdl-28319091

ABSTRACT

We performed a genome-wide association study of total hip replacements, based on variants identified through whole-genome sequencing, which included 4,657 Icelandic patients and 207,514 population controls. We discovered two rare signals that strongly associate with osteoarthritis total hip replacement: a missense variant, c.1141G>C (p.Asp369His), in the COMP gene (allelic frequency = 0.026%, P = 4.0 × 10-12, odds ratio (OR) = 16.7) and a frameshift mutation, rs532464664 (p.Val330Glyfs*106), in the CHADL gene that associates through a recessive mode of inheritance (homozygote frequency = 0.15%, P = 4.5 × 10-18, OR = 7.71). On average, c.1141G>C heterozygotes and individuals homozygous for rs532464664 had their hip replacement operation 13.5 years and 4.9 years earlier than others (P = 0.0020 and P = 0.0026), respectively. We show that the full-length CHADL transcript is expressed in cartilage. Furthermore, the premature stop codon introduced by the CHADL frameshift mutation results in nonsense-mediated decay of the mutant transcripts.


Subject(s)
Cartilage Oligomeric Matrix Protein/genetics , Extracellular Matrix Proteins/genetics , Genetic Predisposition to Disease/genetics , Genome, Human/genetics , Osteoarthritis, Hip/genetics , Sequence Analysis, DNA/methods , Arthroplasty, Replacement, Hip , Cells, Cultured , Codon, Nonsense , Frameshift Mutation , Gene Expression , Gene Frequency , Genome-Wide Association Study , Genotype , Humans , Iceland , Kaplan-Meier Estimate , Mutation, Missense , Osteoarthritis, Hip/surgery , Polymorphism, Single Nucleotide , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors
18.
Nat Commun ; 8: 14265, 2017 02 22.
Article in English | MEDLINE | ID: mdl-28223688

ABSTRACT

Lumbar disc herniation (LDH) is common and often debilitating. Microdiscectomy of herniated lumbar discs (LDHsurg) is performed on the most severe cases to resolve the resulting sciatica. Here we perform a genome-wide association study on 4,748 LDHsurg cases and 282,590 population controls and discover 37 highly correlated markers associating with LDHsurg at 8q24.21 (between CCDC26 and GSDMC), represented by rs6651255[C] (OR=0.81; P=5.6 × 10-12) with a stronger effect among younger patients than older. As rs6651255[C] also associates with height, we performed a Mendelian randomization analysis using height polygenic risk scores as instruments to estimate the effect of height on LDHsurg risk, and found that the marker's association with LDHsurg is much greater than predicted by its effect on height. In light of presented findings, we speculate that the effect of rs6651255 on LDHsurg is driven by susceptibility to developing severe and persistent sciatica upon LDH.


Subject(s)
Chromosomes, Human, Pair 8/genetics , Genetic Predisposition to Disease , Genetic Variation , Intervertebral Disc Degeneration/genetics , Intervertebral Disc Displacement/genetics , Lumbar Vertebrae/pathology , Sciatica/genetics , Adult , Base Sequence , Body Height/genetics , Demography , Female , Genetic Loci , Humans , Intervertebral Disc Degeneration/surgery , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Male , Middle Aged , Phenotype , Polymorphism, Single Nucleotide/genetics , Risk Factors
19.
Proc Natl Acad Sci U S A ; 114(5): E727-E732, 2017 01 31.
Article in English | MEDLINE | ID: mdl-28096410

ABSTRACT

Epidemiological and genetic association studies show that genetics play an important role in the attainment of education. Here, we investigate the effect of this genetic component on the reproductive history of 109,120 Icelanders and the consequent impact on the gene pool over time. We show that an educational attainment polygenic score, POLYEDU, constructed from results of a recent study is associated with delayed reproduction (P < 10-100) and fewer children overall. The effect is stronger for women and remains highly significant after adjusting for educational attainment. Based on 129,808 Icelanders born between 1910 and 1990, we find that the average POLYEDU has been declining at a rate of ∼0.010 standard units per decade, which is substantial on an evolutionary timescale. Most importantly, because POLYEDU only captures a fraction of the overall underlying genetic component the latter could be declining at a rate that is two to three times faster.


Subject(s)
Educational Status , Genetic Variation , Adolescent , Adult , Female , Fertility , Genome, Human , Genotype , Humans , Iceland , Intelligence , Male , Young Adult
20.
Eur Heart J ; 38(1): 27-34, 2017 01 01.
Article in English | MEDLINE | ID: mdl-27742809

ABSTRACT

AIMS: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in man, causing substantial morbidity and mortality with a major worldwide public health impact. It is increasingly recognized as a highly heritable condition. This study aimed to determine genetic risk factors for early-onset AF. METHODS AND RESULTS: We sequenced the whole genomes of 8453 Icelanders and imputed genotypes of the 25.5 million sequence variants we discovered into 1799 Icelanders with early-onset AF (diagnosed before 60 years of age) and 337 453 controls. Each sequence variant was tested for association based on multiplicative and recessive inheritance models. We discovered a rare frameshift deletion in the myosin MYL4 gene (c.234delC) that associates with early-onset AF under a recessive mode of inheritance (allelic frequency = 0.58%). We found eight homozygous carriers of the mutation, all of whom had early-onset AF. Six of the homozygotes were diagnosed by the age of 30 and the remaining two in their 50s. Three of the homozygotes had received pacemaker implantations due to sick sinus syndrome, three had suffered an ischemic stroke, and one suffered sudden cardiac death. CONCLUSIONS: Through a population approach we found a loss of function mutation in the myosin gene MYL4 that, in the homozygous state, is completely penetrant for early-onset AF. The finding may provide novel mechanistic insight into the pathophysiology of this complex arrhythmia.


Subject(s)
Atrial Fibrillation/genetics , Frameshift Mutation/genetics , Myosin Light Chains/genetics , Aged , Atrial Fibrillation/ethnology , Case-Control Studies , Death, Sudden, Cardiac/ethnology , Death, Sudden, Cardiac/etiology , Female , Gene Deletion , Genes, Recessive/genetics , Genome-Wide Association Study/methods , Heterozygote , Homozygote , Humans , Iceland/ethnology , Male , Middle Aged , Pedigree , Risk Factors , Sarcomeres , Sequence Alignment/methods , Sick Sinus Syndrome/ethnology , Sick Sinus Syndrome/genetics , Stroke/ethnology , Stroke/genetics
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