Impact of adjustments for intermediate phenotypes on the power to detect linkage

Since the manifestation of a complex disease is likely to be influenced through multiple genetic and/or environmental pathways, it may be advantageous to adjust for these multiple factors in a genetic analysis of a complex quantitative trait. Sib-pair linkage analysis was performed on the simulated complex quantitative trait Q1 after adjustment for age, sex, and the environmental factor (i.e., minimally adjusted) and all combinations of the four intermediate phenotypes Q2, Q3, Q4, and Q5 (n = 15) for all 200 replications of the nuclear families data set. From the minimally adjusted Q1, the power to detect suggestive linkage to any of the three loci affecting Q1 was 0.585 with a false positive rate of 0.0025. Adjusting Q1 for Q3 increased the power to detect suggestive linkage to 0.860 with a similar false positive rate. Additional adjustments for Q2, Q4, and Q5 yielded no substantial improvements in power nor changes in the false positive rate. The power to detect significant linkage was also substantially improved after adjustment of Q1 for Q3 with no change in the false positive rate. The adjustment of a complex trait for other factors in the causal pathway reduces the phenotype variability and enhances the ability to detect linkage.