A multi-stage genome-wide association study of uterine fibroids in African Americans

Hum Genet. 2017 Oct;136(10):1363-1373. doi: 10.1007/s00439-017-1836-1. Epub 2017 Aug 23.


Uterine fibroids are benign tumors of the uterus affecting up to 77% of women by menopause. They are the leading indication for hysterectomy, and account for $34 billion annually in the United States. Race/ethnicity and age are the strongest known risk factors. African American (AA) women have higher prevalence, earlier onset, and larger and more numerous fibroids than European American women. We conducted a multi-stage genome-wide association study (GWAS) of fibroid risk among AA women followed by in silico genetically predicted gene expression profiling of top hits. In Stage 1, cases and controls were confirmed by pelvic imaging, genotyped and imputed to 1000 Genomes. Stage 2 used self-reported fibroid and GWAS data from 23andMe, Inc. and the Black Women's Health Study. Associations with fibroid risk were modeled using logistic regression adjusted for principal components, followed by meta-analysis of results. We observed a significant association among 3399 AA cases and 4764 AA controls at rs739187 (risk-allele frequency = 0.27) in CYTH4 (OR (95% confidence interval) = 1.23 (1.16-1.30), p value = 7.82 × 10-9). Evaluation of the genetic association results with MetaXcan identified lower predicted gene expression of CYTH4 in thyroid tissue as significantly associated with fibroid risk (p value = 5.86 × 10-8). In this first multi-stage GWAS for fibroids among AA women, we identified a novel risk locus for fibroids within CYTH4 that impacts gene expression in thyroid and has potential biological relevance for fibroids.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alleles
  • Black or African American / genetics*
  • Cell Adhesion Molecules* / biosynthesis
  • Cell Adhesion Molecules* / genetics
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Gene Frequency*
  • Genetic Loci
  • Genome-Wide Association Study
  • Guanine Nucleotide Exchange Factors* / biosynthesis
  • Guanine Nucleotide Exchange Factors* / genetics
  • Humans
  • Leiomyoma* / genetics
  • Leiomyoma* / metabolism
  • Middle Aged
  • Neoplasm Proteins* / biosynthesis
  • Neoplasm Proteins* / genetics
  • Risk Factors
  • Uterine Neoplasms* / genetics
  • Uterine Neoplasms* / metabolism


  • CYTH4 protein, human
  • Cell Adhesion Molecules
  • Guanine Nucleotide Exchange Factors
  • Neoplasm Proteins