Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis

Nat Commun. 2019 Oct 24;10(1):4857. doi: 10.1038/s41467-019-12536-4.


Uterine leiomyomata (UL) are the most common neoplasms of the female reproductive tract and primary cause for hysterectomy, leading to considerable morbidity and high economic burden. Here we conduct a GWAS meta-analysis in 35,474 cases and 267,505 female controls of European ancestry, identifying eight novel genome-wide significant (P < 5 × 10-8) loci, in addition to confirming 21 previously reported loci, including multiple independent signals at 10 loci. Phenotypic stratification of UL by heavy menstrual bleeding in 3409 cases and 199,171 female controls reveals genome-wide significant associations at three of the 29 UL loci: 5p15.33 (TERT), 5q35.2 (FGFR4) and 11q22.3 (ATM). Four loci identified in the meta-analysis are also associated with endometriosis risk; an epidemiological meta-analysis across 402,868 women suggests at least a doubling of risk for UL diagnosis among those with a history of endometriosis. These findings increase our understanding of genetic contribution and biology underlying UL development, and suggest overlapping genetic origins with endometriosis.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ataxia Telangiectasia Mutated Proteins / genetics
  • Endometriosis / epidemiology
  • Endometriosis / genetics*
  • Female
  • Forkhead Box Protein O1 / genetics
  • Forkhead Box Protein O1 / metabolism
  • Genome-Wide Association Study
  • Humans
  • Leiomyoma / complications
  • Leiomyoma / epidemiology
  • Leiomyoma / genetics*
  • Mendelian Randomization Analysis
  • Menorrhagia / etiology
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Proportional Hazards Models
  • Receptor, Fibroblast Growth Factor, Type 4 / genetics
  • Signal Transduction
  • Telomerase / genetics
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / epidemiology
  • Uterine Neoplasms / genetics*
  • White People / genetics


  • FOXO1 protein, human
  • Forkhead Box Protein O1
  • FGFR4 protein, human
  • Receptor, Fibroblast Growth Factor, Type 4
  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • TERT protein, human
  • Telomerase