Brain-derived neurotrophic factor (
BDNF) plays an important role in brain development and function. Substantial amounts of
BDNF are present in peripheral blood, and may serve as
biomarkers for
Alzheimer's disease incidence as well as targets for intervention to reduce
Alzheimer's disease risk. With the exception of the genetic polymorphism in the
BDNF gene, Val66Met, which has been extensively studied with regard to
neurodegenerative diseases, the genetic variation that influences circulating
BDNF levels is unknown. We aimed to explore the genetic determinants of circulating
BDNF levels in order to clarify its mechanistic involvement in brain structure and function and
Alzheimer's disease pathophysiology in middle-aged and old adults. Thus, we conducted a meta-analysis of genome-wide association study of circulating
BDNF in 11 785 middle- and old-aged individuals of European ancestry from the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES), the Framingham Heart Study (FHS), the Rotterdam Study and the Study of Health in Pomerania (SHIP-Trend). Furthermore, we performed functional annotation analysis and related the genetic polymorphism influencing circulating
BDNF to common
Alzheimer's disease pathologies from brain autopsies. Mendelian randomization was conducted to examine the possible causal role of circulating
BDNF levels with various phenotypes including cognitive function,
stroke, diabetes,
cardiovascular disease, physical activity and diet patterns. Gene interaction networks analysis was also performed. The estimated heritability of
BDNF levels was 30% (standard error = 0.0246, P-value = 4 × 10-48). We identified seven novel independent loci mapped near the
BDNF gene and in BRD3, CSRNP1, KDELC2, RUNX1 (two single-nucleotide polymorphisms) and
BDNF-AS. The expression of
BDNF was associated with neurofibrillary tangles in brain tissues from the Religious Orders Study and Rush Memory and Aging Project (ROSMAP). Seven additional genes (ACAT1, ATM, NPAT, WDR48, TTC21A, SCN114 and COX7B) were identified through expression and
protein quantitative trait loci analyses. Mendelian randomization analyses indicated a potential causal role of
BDNF in cardioembolism. Lastly, Ingenuity Pathway Analysis placed circulating
BDNF levels in four major networks. Our study provides novel insights into genes and molecular pathways associated with circulating
BDNF levels and highlights the possible involvement of plaque instability as an underlying mechanism linking
BDNF with brain neurodegeneration. These findings provide a foundation for a better understanding of
BDNF regulation and function in the context of brain aging and neurodegenerative pathophysiology.