1 Autozygosity, meaning inheritance of an ancestral allele in the homozygous state is known to 2 lead bi-allelic mutations that manifest their effects through the autosomal recessive 3 inheritance pattern. Autosomal recessive mutations are known to be the underlying cause of 4 several Mendelian metabolic diseases, especially among the offspring of related individuals.
5In line with this, inbreeding coefficient of an individual as a measure of cryptic autozygosity 6 among the general population is known to lead adverse metabolic outcomes including type 2 7 diabetes (T2DM), a multifactorial metabolic disease for which the recessive genetic causes 8 remain unknown. In order to unravel such effects for multiple metabolic facades of the 9 disease, we investigated the relationship between the excess of homozygosity and the 10 metabolic signature of T2DM. We included a set of heritable 143 circulating markers 11 associated with fasting glucose in a Dutch genetic isolate Erasmus Rucphen Family (ERF) of 12 up to 2,580 individuals. We calculated individual whole genome-based, exome-based and 13 pedigree-based inbreeding coefficients and tested their influence on the T2DM-related 14 metabolites as well as T2DM risk factors. We also performed model supervised genome-wide 15 association analysis (GWAS) for the metabolites which significantly correlate with inbreeding 16 values. Inbreeding value of the population significantly and positively correlated with 17 associated with risk factors of T2DM: body-mass index (BMI), glucose, insulin resistance, 18 fasting insulin and waist-hip ratio. We found that inbreeding influenced 32.9% of the T2DM-19 related metabolites, clustering among chemical groups of lipoproteins, amino-acids and 20 phosphatidylcholines, whereas 80 % of these significant associations were independent of the 21 BMI. The most remarkable effect of inbreeding is observed for S-HDL-ApoA1, for which we 22 show evidence of the novel DISP1 genetic region discovered by model supervised GWAS, in 23 the ERF population. In conclusion, we show that inbreeding effects human metabolism and 24 genetic models other than the globally used additive model is worth considering for study of 25 metabolic phenotypes. 26 27 45 Recent technological advances in metabolomics allow us to capture the current state 46 of biochemical events in an organism. The metabolome level is the result of our genome and 47 environmental exposures. Application of metabolomics to metabolic disorders, especially type 48 2 diabetes (T2DM), is particularly promising since deregulations of biochemical processes are 49 involved in the pathophysiology of disease 7,8 . In line with this, several circulating molecules50have been found associated with T2DM: such as phospholipids, branch-chain amino-acids and 51 lipoprotein subclasses 9-11 . In order to find target endophenotypes for researching the 52 recessive genetic effects, we studied the influence of inbreeding over a selected list of 53 metabolites that are known to be related to changes in glucose. Figure 1 ...