Influence of control selection in genome-wide association studies: the example of diabetes in the Framingham Heart Study.

Epidemiologic study designs represent a major challenge for genome-wide association studies. Most such studies to date have selected controls from the pool of participants without the disease of interest at the end of the study time. These choices can lead to biased estimates of exposure effects. Using data from the Framingham Heart Study (Genetic Analysis Workshop 16 Problem 2), we evaluate the impact on genetic association estimates for designs with control selection based on status at the end of a study (case exclusion (CE) sampling) to control selection based on incidence density (ID) sampling, when controls are selected from the pool of participants who are disease-free at the time a case is diagnosed. Cases are defined as those diagnosed with type 2 diabetes (T2D). We estimated odds ratios for 18 previously confirmed T2D variants using 189 cases selected by ID sampling and using 231 cases selected by CE sampling. We found none of these single-nucleotide polymorphisms to be significantly associated with T2D using either design. Because these empirical analyses were based on a small number of cases and on single-nucleotide polymorphisms with likely small effect sizes, we supplemented this work with simulated data sets of 500 cases from each strategies across a variety of allele frequencies and effect sizes. In our simulated datasets, we show ID sampling to be less biased than CE, although CE shows apparent increased power due to the upward bias of point estimates. We conclude that ID sampling is an appropriate option for genome-wide association studies.