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Title:¡¡Genomic landscape of Type 2 Diabetes in East Asians

Abstract
Type 2 diabetes (T2D) is a common metabolic disease that is primarily caused by insufficient
insulin production and/or secretion by the pancreatic ©¬ cells, and insulin resistance in peripheral
tissues. To date, several genome-wide association studies (GWAS) have revealed hundreds of T2D
associated loci analyzing nearly one million individuals. However, most genetic loci associated with
T2D have been identified in European populations (EUR). These European biased results may
result in reduced accuracy in predicting T2D for non-Europeans. The relative contributions of
different pathways to the pathophysiology of T2D may also differ between ancestry groups. For
example, the prevalence of T2D is greater in East Asians (EAS) populations than in EUR among
people of similar body mass index (BMI) or waist circumference. To identify new genetic
associations and provide insight into the pathogenesis of T2D, we conducted the largest meta-
analysis of T2D data analyzing 433,540 East Asian individuals (77,418 T2D cases and 356,122
healthy controls) from 3 biobanks and 20 different cohorts. As a result, 301 distinct association
signals at 183 loci were discovered. Among them, 61 loci were newly implicated in predisposition
to T2D. Common variants associated with T2D in both EAS and EUR exhibited strongly correlated
effect sizes. When T2D genetic risk scores using discovered variants employed to access the
prevalence of T2D in Koreans, genetically high risk group showed several times higher prevalence
compared to those of median group. The results of our study implicate that association studies in
diverse populations would provide additional loci and elucidate disease associated genes, biology,
and pathways.