Sarcopenia is characterized by low skeletal muscle, a complex trait with high heritability. With the dramatically increasing prevalence of obesity, obesity and sarcopenia occur simultaneously, a condition known as sarcopenic obesity. fat mass and obesity-associated (fto) gene is a candidate gene of obesity. to identify associations between lean mass and fto gene, we performed a genome-wide association study (GWAS) of lean mass index (LMI) in 2207 unrelated Caucasian subjects and replicated major findings in two replication samples including 6,004 unrelated Caucasian and 38,292 unrelated Caucasian. We found 29 single nucleotide polymorphisms (SNPs) in FTO significantly associated with sarcopenia (combined p-values ranging from 5.92 × 10 −12 to 1.69 × 10 −9 ). potential biological functions of SNPs were analyzed by HaploReg v4.1, RegulomeDB, GTEx, IMPC and STRING. Our results provide suggestive evidence that fto gene is associated with lean mass.Sarcopenia is a complex disease described as the age-associated loss of skeletal muscle mass, strength and function impairment 1,2 . The low skeletal muscle mass will lead to many public health problems such as sarcopenia, osteoporosis and increased mortality 3,4 , especially in the elderly. Skeletal muscle is heritable with heritability estimates of 30-85% for muscle strength and 45-90% for muscle mass 5 . Although there are many genetic researches have shown some SNPs and copy number variants (CNVs) associated with lean mass 6-14 , the majority of specific genes underlying the variations in low lean body mass (LBM) are still unknown. And sarcopenia can be predicted by LMI 15 .FTO gene is proved the association with fat mass, which contributes to human obesity [16][17][18][19][20][21] . According to many vivo studies using FTO overexpression or knockout mouse models, FTO gene can cause abnormal adipose tissues and body mass, implying a pivotal role of FTO in adipogenesis and energy homeostasis [22][23][24][25] . But the exact biological functions of this gene are unknown yet. In recent researches, FTO gene is proved the association with lean mass 22,23,[26][27][28][29][30][31] . Zillikens et al. reported a series of SNPs of FTO associated with LBM and appendicular lean mass (ALM) 30 . In our study, we performed a GWAS to identify the associations between FTO and LMI in 2,207 unrelated Caucasians (516 men and 1,691 women). Then we replicated our findings in two replication samples, including 6,004 unrelated Caucasians and 38,292 unrelated Caucasians subjects 30 .
Methods ethic statement. This study was approved by institutional review boards of Creighton University and theUniversity of Missouri-Kansas City. Before entering the study, all subjects provide written informed consent documents. The methods carried out in accordance with the approved study protocol.Discovery sample. The discovery sample consisted of 2,207 unrelated Caucasian subjects of European ancestry that were recruited in Midwestern U.S. (Kansas City, Missouri and Omaha, Nebraska). All discovery subjects com...