ESPE Abstracts

Background: Pubertal timing varies considerably and has been associated with a range of health outcomes in later life.

Methods: To elucidate the underlying biological mechanisms, we performed multi-ancestry genetic analyses in ~800,000 women.

Results: We identified 1,080 independent common genetic signals associated (at P<5×10-8) with age at menarche. Collectively these loci explained 11% of the trait variance in an independent sample. Women at the top and bottom 1% of a polygenic risk score exhibited a ~11 and ~14-fold higher risk of delayed (menarche >15 years) and precocious (menarche <10 years) pubertal development, respectively, compared to those with median polygenic risk. These common variant analyses were supported by whole exome sequence analysis of ~220,000 women, identifying several genes, including rare loss of function variants in ZNF483 which abolished the impact of polygenic risk. We implicated 660 genes in the regulation of pubertal development using a combination of in silico variant-to-gene mapping approaches and integration with dynamic gene expression data from mouse embryonic GnRH neurons. This included an uncharacterized G-protein coupled receptor GPR83, which we demonstrate amplifies signaling of MC3R, a key sensor of nutritional status. Finally, we identified several genes, including ovary-expressed genes involved in DNA damage response that co-localize with signals associated with menopause timing, leading us to hypothesize that the ovarian reserve might signal centrally to trigger puberty.

Conclusions: These findings extend our understanding of the biological complexity of puberty timing and highlight body size dependent and independent mechanisms that potentially link reproductive timing to later life disease.