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The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study

Lookup NU author(s): Laura Pascoe, Professor Mark Walker

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Abstract

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age-and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to similar to 2.8M SNPs with BMI and WHRadjBMI in four strata (men <= 50y, men > 50y, women <= 50y, women > 50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR< 5%) age-specific effects, of which 11 had larger effects in younger (< 50y) than in older adults (>= 50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may providefurther insights into the biology that underlies weight change with age or the sexually dimorphism of body shape.


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Author(s): Winkler TW, Justice AE, Graff M, Barata L, Feitosa MF, Chu S, Czajkowski J, Esko T, Fall T, Kilpelainen TO, Lu YC, Magi R, Mihailov E, Pers TH, Rueger S, Teumer A, Ehret GB, Ferreira T, Heard-Costa NL, Karjalainen J, Lagou V, Mahajan A, Neinast MD, Prokopenko I, Simino J, Teslovich TM, Jansen R, Westra HJ, White CC, Absher D, Ahluwalia TS, Ahmad S, Albrecht E, Alves AC, Bragg-Gresham JL, de Craen AJM, Bis JC, Bonnefond A, Boucher G, Cadby G, Cheng YC, Chiang CWK, Delgado G, Demirkan A, Dueker N, Eklund N, Eiriksdottir G, Eriksson J, Feenstra B, Fischer K, Frau F, Galesloot TE, Geller F, Goel A, Gorski M, Grammer TB, Gustafsson S, Haitjema S, Hottenga JJ, Huffman JE, Jackson AU, Jacobs KB, Johansson A, Kaakinen M, Kleber ME, Lahti J, Leach IM, Lehne B, Liu YF, Lo KS, Lorentzon M, Luan J, Madden PAF, Mangino M, McKnight B, Medina-Gomez C, Monda KL, Montasser ME, Muller G, Muller-Nurasyid M, Nolte IM, Panoutsopoulou K, Pascoe L, Paternoster L, Rayner NW, Renstrom F, Rizzi F, Rose LM, Ryan KA, Salo P, Sanna S, Scharnagl H, Shi JX, Smith AV, Southam L, Stancakova A, Steinthorsdottir V, Strawbridge RJ, Sung YJ, Tachmazidou I, Tanaka T, Thorleifsson G, Trompet S, Pervjakova N, Tyrer JP, Vandenput L, van der Laan SW, van der Velde N, van Setten J, van Vliet-Ostaptchouk JV, Verweij N, Vlachopoulou E, Waite LL, Wang SR, Wang ZM, Wild SH, Willenborg C, Wilson JF, Wong A, Yang J, Yengo L, Yerges-Armstrong LM, Yu L, Zhang WH, Zhao JH, Andersson EA, Bakker SJL, Baldassarre D, Banasik K, Barcella M, Barlassina C, Bellis C, Benaglio P, Blangero J, Bluher M, Bonnet F, Bonnycastle LL, Boyd HA, Bruinenberg M, Buchman AS, Campbell H, Chen YDI, Chines PS, Claudi-Boehm S, Cole J, Collins FS, de Geus EJC, de Groot LCPGM, Dimitriou M, Duan J, Enroth S, Eury E, Farmaki AE, Forouhi NG, Friedrich N, Gejman PV, Gigante B, Glorioso N, Go AS, Gottesman O, Grassler J, Grallert H, Grarup N, Gu YM, Broer L, Ham AC, Hansen T, Harris TB, Hartman CA, Hassinen M, Hastie N, Hattersley AT, Heath AC, Henders AK, Hernandez D, Hillege H, Holmen O, Hovingh KG, Hui J, Husemoen LL, Hutri-Kahonen N, Hysi PG, Illig T, De Jager PL, Jalilzadeh S, Jorgensen T, Jukema JW, Juonala M, Kanoni S, Karaleftheri M, Khaw KT, Kinnunen L, Kittner SJ, Koenig W, Kolcic I, Kovacs P, Krarup NT, Kratzer W, Kruger J, Kuh D, Kumari M, Kyriakou T, Langenberg C, Lannfelt L, Lanzani C, Lotay V, Launer LJ, Leander K, Lindstrom J, Linneberg A, Liu YP, Lobbens S, Luben R, Lyssenko V, Mannisto S, Magnusson PK, McArdle WL, Menni C, Merger S, Milani L, Montgomery GW, Morris AP, Narisu N, Nelis M, Ong KK, Palotie A, Perusse L, Pichler I, Pilia MG, Pouta A, Rheinberger M, Ribel-Madsen R, Richards M, Rice KM, Rice TK, Rivolta C, Salomaa V, Sanders AR, Sarzynski MA, Scholtens S, Scott RA, Scott WR, Sebert S, Sengupta S, Sennblad B, Seufferlein T, Silveira A, Slagboom PE, Smit JH, Sparso TH, Stirrups K, Stolk RP, Stringham HM, Swertz MA, Swift AJ, Syvanen AC, Tan ST, Thorand B, Tonjes A, Tremblay A, Tsafantakis E, van der Most PJ, Volker U, Vohl MC, Vonk JM, Waldenberger M, Walker RW, Wennauer R, Widen E, Willemsen G, Wilsgaard T, Wright AF, Zillikens MC, van Dijk SC, van Schoor NM, Asselbergs FW, de Bakker PIW, Beckmann JS, Beilby J, Bennett DA, Bergman RN, Bergmann S, Boger CA, Boehm BO, Boerwinkle E, Boomsma DI, Bornstein SR, Bottinger EP, Bouchard C, Chambers JC, Chanock SJ, Chasman DI, Cucca F, Cusi D, Dedoussis G, Erdmann J, Eriksson JG, Evans DA, de Faire U, Farrall M, Ferrucci L, Ford I, Franke L, Franks PW, Froguel P, Gansevoort RT, Gieger C, Gronberg H, Gudnason V, Gyllensten U, Hall P, Hamsten A, van der Harst P, Hayward C, Heliovaara M, Hengstenberg C, Hicks AA, Hingorani A, Hofman A, Hu F, Huikuri HV, Hveem K, James AL, Jordan JM, Jula A, Kahonen M, Kajantie E, Kathiresan S, Kiemeney LALM, Kivimaki M, Knekt PB, Koistinen HA, Kooner JS, Koskinen S, Kuusisto J, Maerz W, Martin NG, Laakso M, Lakka TA, Lehtimaki T, Lettre G, Levinson DF, Lind L, Lokki ML, Mantyselka P, Melbye M, Metspalu A, Mitchell BD, Moll FL, Murray JC, Musk AW, Nieminen MS, Njolstad I, Ohlsson C, Oldehinkel AJ, Oostra BA, Palmer LJ, Pankow JS, Pasterkamp G, Pedersen NL, Pedersen O, Penninx BW, Perola M, Peters A, Polasek O, Pramstaller PP, Psaty BM, Qi L, Quertermous T, Raitakari OT, Rankinen T, Rauramaa R, Ridker PM, Rioux JD, Rivadeneira F, Rotter JI, Rudan I, den Ruijter HM, Saltevo J, Sattar N, Schunkert H, Schwarz PEH, Shuldiner AR, Sinisalo J, Snieder H, Sorensen TIA, Spector TD, Staessen JA, Stefania B, Thorsteinsdottir U, Stumvoll M, Tardif JC, Tremoli E, Tuomilehto J, Uitterlinden AG, Uusitupa M, Verbeek ALM, Vermeulen SH, Viikari JS, Vitart V, Volzke H, Vollenweider P, Waeber G, Walker M, Wallaschofski H, Wareham NJ, Watkins H, Zeggini E, Chakravarti A, Clegg DJ, Cupples LA, Gordon-Larsen P, Jaquish CE, Rao DC, Abecasis GR, Assimes TL, Barroso I, Berndt SI, Boehnke M, Deloukas P, Fox CS, Groop LC, Hunter DJ, Ingelsson E, Kaplan RC, McCarthy MI, Mohlke KL, O'Connell JR, Schlessinger D, Strachan DP, Stefansson K, van Duijn CM, Hirschhorn JN, Lindgren CM, Heid IM, North KE, Borecki IB, Kutalik Z, Loos RJF, CHARGE Consortium, DIAGRAM Consortium, GLGC Consortium, Global-BPGen Consortium, ICBP Consortium, MAGIC Consortium

Publication type: Article

Publication status: Published

Journal: PLoS Genetics

Year: 2015

Volume: 11

Issue: 10

Online publication date: 01/10/2015

Acceptance date: 22/06/2015

ISSN (electronic): 1553-7404

Publisher: Public Library of Science

URL: http://dx.doi.org/10.1371/journal.pgen.1005378

DOI: 10.1371/journal.pgen.1005378


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Funding

Funder referenceFunder name
Aarne Koskelo Foundation
Aase and Ejner Danielsens Foundation
ALK-Abello A/S (Horsholm, Denmark)
ANR ("Agence Nationale de la 359 Recherche")
Ark (NHMRC Enabling Facility)
Baltimore Geriatrics Research, Education, and Clinical Center of the Department of Veterans Affairs
Danish Agency for Science, Technology and Innovation
Danish Centre for Health Technology Assessment, Novo Nordisk Inc.
Danish Diabetes Association; Danish Heart Foundation
Danish National Research Foundation
Danish Pharmaceutical Association
Danish Research Council
Diabetes Hilfs-und Forschungsfonds Deutschland (DHFD)
Dr. Robert Pfleger-Stiftung
Dutch Diabetes Research Foundation
Dutch Ministry of Education, Culture and Science
Emil Aaltonen Foundation
Erasmus Medical Center and Erasmus University, Rotterdam
European Regional Development Fund (ERDF)
Federal State of Mecklenburg-West Pomerania
Finnish Foundation for Cardiovascular Research
Finnish Foundation for Pediatric Research
Finnish Special Governmental Subsidy for Health Sciences
Finska Lakaresallskapet, Signe and Ane Gyllenberg Foundation
Flemish League against Cancer, ITEA2 (project Care4Me)
Fonds voor Wetenschappelijk Onderzoek (FWO) Vlaanderen
Foundation for Life and Health in Finland; the Foundation for Strategic Research (SSF)
German Ministry of Cultural Affairs
Health Fund of the Danish Health Insurance Societies
John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health
Johns Hopkins University Center for Inherited Disease Research (CIDR)
Joint grant from Siemens Healthcare, Erlangen, Germany
Juho Vainio Foundation
Juselius Foundation (Helsinki, Finland)
Kuopio University Hospital
Leenaards Foundation
Local Government Pensions Institution (KEVA)
Medical Research Council of Canada
MIUR-CNR Italian Flagship Project
Montreal Heart Institute Foundation
MRC Human Genetics Unit
National Institute of Child Health and Human Development (NICHD)
National Institute of Neurological Disorders and Stroke (NINDS)
Neuroscience Campus Amsterdam (NCA)
NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust
Nordic Center of Excellence in Disease Genetics
Novo Nordisk Foundation
Ollqvist Foundation
Paavo Nurmi Foundation
Pahlssons Foundation
Paivikki and Sakari Sohlberg Foundation
Perklen Foundation
Research Centre for Prevention and Health
Research Foundation of Copenhagen County
Reynold's Foundation
Royal Swedish Academy of Science
Samfundet Folkhalsan
Sigrid Juselius Foundation
Societe Francophone du 358 Diabste (SFD)
Stichting Nationale Computerfaciliteiten (National Computing Facilities Foundation, NCF)
Strategic Cardiovascular Programme of Karolinska Institutet
Susan G. Komen Breast Cancer Foundation
Swedish Cancer Society
Swedish Cultural Foundation in Finland
the Helmholtz Zentrum Munchen-German Research Center for Environmental Health
The Paul Michael Donovan Charitable Foundation
Timber Merchant Vilhelm Bangs Foundation
Torsten and Ragnar Sderberg Foundation
Translational Genomics Research Institute
University Hospital of Regensburg (ReForM A, ReForM C)
University Medical Center Groningen
University of Tartu (SP1GVARENG)
Western Australian DNA Bank (NHMRC Enabling Facility)
Agency for Science, Technology and Research of Singapore (A*STAR)
Ahokas Foundation
ALF/LUA research grant in Gothenburg
Althingi (the Icelandic Parliament)
AstraZeneca
Augustinus Foundation
Becket Foundation
Biocentrum Helsinki
Boehringer Ingelheim Foundation
Capital Region of Denmark
Center for Medical Systems Biology (CMSB; NWO Genomics)
Centre of Excellence Baden-Wurttemberg Metabolic Disorders
Chief Scientist Office of the Scottish Government
Clinical Research Facility at Guys & St Thomas NHS Foundation Trust
Contrat de Projets Etat-Region (CPER)
CVON (GENIUS)
Danish Medical Research Council
Danish Ministry of Internal Affairs and Health
Danish Pharmacists Fund
Deutsche Forschungsgemeinschaft
Dresden University of Technology Funding Grant, Med Drive
Dutch Brain Foundation
Dutch Economic Structure Enhancing Fund (FES)
Dutch Kidney Foundation
Dutch Ministry for Health, Welfare and Sports
Dutch Ministry of Economic Affairs
Egmont Foundation
Finlands Slottery Machine Association
Finnish Centre for Pensions (ETK)
Finnish Cultural Foundation
Finnish Diabetes Association
Finnish Diabetes Research Foundation
Finnish National Public Health Institute (current National Institute for Health and Welfare)
Folkhalsan Research Foundation
G. Ph. Verhagen Foundation
Gene-diet Interactions in Obesity' project (GENDINOB)
Genetic Association Information Network (GAIN)
German Diabetes Association
German National Genome Research Network (NGFN-2 and NGFN-plus)
Great Wine Estates of the Margaret River region of Western Australia
Greek General Secretary of Research and Technology research grant (PENED
Gyllenberg Foundation
Health Care Centers in Vasa, Narpes and Korsholm
Hjartavernd (the Icelandic Heart Association)
Ib Henriksen Foundation
Illinois Department of Public Health
International (JDRF)
KfH Stiftung Praventivmedizin e. V.
Knut and Alice Wallenberg Foundation
Leiden University Medical Center
Liv och Halsa
LMUinnovativ
Lokaal Gezondheids Overleg (LOGO) Leuven and Hageland
LudwigMaximilians- Universitat
Lundberg Foundation
March of Dimes Birth Defects Foundation
MEKOS Laboratories Denmark
MRC centre for Causal Analyses in Translational Epidemiology (MRC CAiTE)
MRC Centre for Obesity and Related Metabolic Diseases
Munich Center of Health Sciences (MC Health)
Municipal Health Care Center and Hospital in Jakobstad
Narpes Health Care Foundation
National Alliance for Research on Schizophrenia and Depression (NARSAD)
National Institute for Health and Welfare (THL)
National Institute of Allergy and Infectious Diseases (NIAID)
Northern Netherlands Collaboration of Provinces (SNN)
Office of Research and Development, Medical Research Service
Rotterdam Oncologic Thoracic Study Group, Erasmus Trust Fund, Foundation against Cancer
Social Ministry of the Federal State of Mecklenburg-West Pomerania
South Tyrolean Sparkasse Foundation
Swedish Diabetes Association
Swedish Ministry for Higher Education
Swedish Society for Medical Research;
Tampere Tuberculosis Foundation
Umea Medical Research Foundation
United Kingdom NIHR Cambridge Biomedical Research Centre
Universities and Research of the Autonomous Province of Bolzano, South Tyrol
University of Groningen
Vasterbottens Intervention Programme
Velux Foundation
VU University Institute for Health and Care Research (EMGO+)
Wissenschaftsoffensive TMO
Zorg Onderzoek Nederland-Medische Wetenschappen, KWF Kankerbestrijding, Stichting Centraal Fonds Reserves van voormalig Vrijwillige Ziekenfondsverzekeringen
01 AK 803 A-H, 01 IG 07015 GGerman Bundesministerium fuer Forschung und Technology
014-93-015Research Institute for Diseases in the Elderly
01ZZ0103German Federal Ministry of Education and Research (BMBF)
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03IS2061AGerman Federal Ministry of Education and Research (BMBF)
01KU0908Abi-national BMBF/ANR funded project CARDomics
01ZZ0403German Federal Ministry of Education and Research (BMBF)
050-060-810Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
068545/Z/02Wellcome Trust
03ZIK012German Federal Ministry of Education and Research (BMBF)
079895Wellcome Trust
086596/Z/08/ZWellcome Trust
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09.001Interuniversity Cardiology Institute of the Netherlands (ICIN)
064890Wellcome Trust
070014Nordic Centre of Excellence on Systems biology in controlled dietary interventions and cohort studies, SYSDIET
098017Wellcome Trust
10-000-1002Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
100-001-004Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
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117844Academy of Finland
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175.010.2003.005Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
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18030Arthritis Research UK
184.021.007Biobanking and Biomolecular Resources Research Infrastructure (BBMRINL)
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084723/Z/08/ZWellcome Trust
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1RC2MH089995National Institutes of Health (NIH)
1RL1MH083268-01National Heart, Lung and Blood Institute (NHLBI)
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2001 D 032NIHR Cambridge Biomedical research Centre; the Netherlands Heart Foundation
2004310European Commission
2007-35205-17883National Institute of Food and Agriculture
090532Wellcome Trust
2009-2298Swedish Research Council
098051Wellcome Trust
098381Wellcome Trust
2011-294713-EPLOREEuropean Research Council (ERC)
2011-StG-280559-SEPIEuropean Research Council (ERC)
2012_A147Else Kraner-Fresenius Stiftung
20120197Swedish HeartLung Foundation
1011506Australian National Health and Medical Research Council (NHMRC)
211497Academy of Finland
223004European Commission
230374European Research Council (ERC)
263836Academy of Finland
263-MA-410953National Institute on Aging (NIA)
263-MD-9164National Institute on Aging (NIA)
102318Academy of Finland
104781Academy of Finland
1114194Academy of Finland
117787Academy of Finland
118590Academy of Finland
120315Academy of Finland
124282Academy of Finland
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129378Academy of Finland
31003A-143914Swiss National Science Foundation
134309Academy of Finland
134791Academy of Finland
13POST16500011American Heart Association (AHA)
33CSCO-122661Swiss National Science Foundation
400-05-717Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
41071Academy of Finland
175.010.2005.011Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
185764University of Tromso, Norwegian Research Council
1R01DK8925601National Institute of Diabetes and Digestive and Kidney Disease (NIDDKDRC)
1R01DK8925601National Institutes of Health (NIH)
1RC2MH089951National Institutes of Health (NIH)
442915Australian National Health and Medical Research Council (NHMRC)
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452-04-314Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
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496739Australian National Health and Medical Research Council (NHMRC)
5254Finnish Ministry of Health and Social Affairs
552485Australian National Health and Medical Research Council (NHMRC)
560283Stockholm County Council
5-P60-AR30701National Institute of Arthritis and Musculoskeletal and Skin Diseases
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20121397Swedish Medical Research Council
2013-024Swedish Diabetes Foundation
613601Australian National Health and Medical Research Council (NHMRC)
627Finnish Medical Society; the Finnish Ministry of Education and Culture
70103/06TEKES
77299Academy of Finland
241944Australian National Health and Medical Research Council (NHMRC)
24300796Academy of Finland
261-98-710Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
263924Academy of Finland
263-MD-821336National Institute on Aging (NIA)
8875Croatian Science Council
904-61-090Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
911-03012Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
2T32 HL 00705536National Institutes of Health (NIH)
3.2.0304.11-0312European Regional Development Fund to the Centre of Excellence in Genomics (EXCEGEN)
985-10-002Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
9N035Social Insurance Institution of Finland, Kuopio, Tampere and Turku University Hospital Medical Funds
A28INTERREG IV Oberrhein Program
3200B0105993Swiss National Science Foundation
3200B0-118308Swiss National Science Foundation
33CS30-139468Swiss National Science Foundation
33CS30148401Swiss National Science Foundation
AA014041National Institutes of Health (NIH)
AA07535National Institutes of Health (NIH)
AA10248National Institutes of Health (NIH)
AG000219University of Maryland General Clinical Research Center
AG08861National Institutes of Health (NIH)
AG10175National Institutes of Health (NIH)
AG13196National Institute on Aging (NIA)
389875Australian National Health and Medical Research Council (NHMRC)
389891Australian National Health and Medical Research Council (NHMRC)
389892Australian National Health and Medical Research Council (NHMRC)
389938Australian National Health and Medical Research Council (NHMRC)
40-0056-98-9032Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
40058/07Finnish Funding Agency for Technology and Innovation
40058/07TEKES
40758Academy of Finland
452-06-004Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
480-01-006Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
480-07-001Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
481-08-013Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
496688Australian National Health and Medical Research Council (NHMRC)
51RTP0_151019SystemsX.ch
56358Yrjo Jahnsson Foundation
5R01DK075681National Institutes of Health (NIH)
5R01HL087679-02National Heart, Lung and Blood Institute (NHLBI)
5R01MH63706: 02National Institutes of Health (NIH)
60-60600-97-118Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
613672Australian National Health and Medical Research Council (NHMRC)
75617University Hospital Oulu, Biocenter, University of Oulu, Finland
8691Swedish Research Council
904-61-193Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
91111025Netherlands Organization for the Health Research and Development (ZonMw)
9M048Social Insurance Institution of Finland, Kuopio, Tampere and Turku University Hospital Medical Funds
AA13320National Institutes of Health (NIH)
AA13321National Institutes of Health (NIH)
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Addiction-31160008Netherlands Organisation for Scientific Research (NWO; Geestkracht program grant)
AG023629National Institute on Aging (NIA)
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DA12854National Institutes of Health (NIH)
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CA047988National Cancer Institute
EU/QLRT-2001-01254European Science Foundation (ESF)
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FP6-LSHG-CT-2006-01947European Commission
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FP7-ENGAGE-HEALTH-F4-2007-201413European Commission
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DK091718National Institutes of Health (NIH)
G. 0881.13Ministry of the Flemish Community, Brussels, Belgium
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FP-006EuroSTRESS project
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FP7-HEALTH-F42007-201550European Commission
FRCN-CCT-83028Canadian Institutes for Health Reseaerch
G. 0880.13Ministry of the Flemish Community, Brussels, Belgium
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HEALTH-F2-2008-201865-GEFOSEuropean Commission
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