Bipolar disorder with comorbid binge eating history: A genome-wide association study implicates APOB

Stacey J. Winham, Alfredo B. Cuellar-Barboza, Susan L. McElroy, Alfredo Oliveros, Scott Crow, Colin L. Colby, Doo Sup Choi, Mohit Chauhan, Mark A. Frye, Joanna M. Biernacka

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30 Scopus citations


Background Bipolar disorder (BD) is a highly heritable disease. While genome-wide association (GWA) studies have identified several genetic risk factors for BD, few of these studies have investigated the genetic etiology of specific disease subtypes. In particular, BD is positively associated with eating dysregulation traits such as binge eating behavior (BE), yet the genetic risk factors underlying BD with comorbid BE have not been investigated. Methods Utilizing data from the Genetic Association Information Network study of BD, which included 729,454 single nucleotide polymorphisms (SNPs) genotyped in 1001 European American bipolar cases and 1034 controls, we performed GWA analyses of bipolar subtypes defined by the presence or absence of BE history, and performed a case-only analysis comparing BD subjects with and without BE history. Association signals were refined using imputation, and network analysis was performed with Ingenuity Pathway Analysis software. Based on these results, candidate SNPs were selected for replication in an independent sample of 855 cases and 857 controls. Results Top ranking SNPs in the discovery set included rs6006893 in PRR5, rs17045162 in ANK2, rs13233490 near PER4, rs4665788 and rs10198175 downstream of APOB, rs2367911 in CACNA2D1, and rs7249968 near ZNF536. Rs10198175 in APOB also demonstrated evidence of association in the replication sample and a meta-analysis of the two samples. Limitations Without information of BE history in controls, it is not possible to determine whether the observed association with APOB reflects a risk factor for BE behavior in general or a risk factor for a subtype of BD with BE. Further longitudinal and functional studies are needed to determine the causal pathways underlying the observed associations. Conclusions This study identified new potential BD-susceptibility genes, highlighting the advantages of phenotypic sub-classification in genetic research and clinical practice.

Original languageEnglish (US)
Pages (from-to)151-158
Number of pages8
JournalJournal of Affective Disorders
StatePublished - Aug 20 2014

Bibliographical note

Funding Information:
Dr. Crow has received research grants from Shire , Alkermes , and National Institute of Diabetes and Digestive and Kidney Diseases, United States ( P30DK50456 ).

Funding Information:
Dr Frye has received grant support from Assurex Health, Myriad, Pfizer, National Institute of Mental Health (RO1 MH079261), National Institute of Alcohol Abuse and Alcoholism (P20AA017830), Mayo Foundation; has been a consultant to Janssen Global Services, LLC, Mitsubishi Tanabe Pharma Corporation, Myriad, Sunovion, and Teva Pharmaceuticals; has received CME/Travel Support/presentation from CME Outfitters Inc. and Sunovian.

Funding Information:
This study was supported by funding from the Marriott Family Foundation , Mayo Clinic ׳s Center for Individualized Medicine, and NIH K12 HD65987 (SJW). Funding support for the Whole Genome Association Study of Bipolar Disorder was provided by the National Institute of Mental Health (NIMH) and the genotyping of samples was provided through the Genetic Association Information Network (GAIN).

Funding Information:
Dr. McElroy is a consultant to or member of the scientific advisory boards of Alkermes, Bracket, Corcept, MedAvante, Shire, and Teva. She is a principal or co-investigator on studies sponsored by the Agency for Healthcare Research & Quality (AHRQ), Alkermes, AstraZeneca, Cephalon, Eli Lilly and Company, Forest, Marriott Foundation, National Institute of Mental Health, Orexigen Therapeutics, Inc., Pfizer, Shire, Takeda Pharmaceutical Company Ltd., and Transcept Pharmaceutical, Inc. Dr. McElroy has consulted for: F. Hoffman LaRoche and Naurex. She is also an inventor on United States Patent No. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and along with the patient׳s assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson, which has exclusive rights under the patent.


  • APOB
  • Binge eating
  • Bipolar disorder
  • Genome-wide association study (GWAS)
  • Network analysis
  • Phenotypic subtypes


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