Risteys · E4_OBESITYDRUG

Endpoint definition steps	FinnGen
Phenotype data	520210
1. Apply sex-specific rule None	520210
2. Check conditions None	520210
3. Check pre-conditions, main-only, mode, registry filters Registry filters: Hospital discharge: ICD-10 — E66.1# Cause of death: ICD-10 — E66.1# 2 out of 7 registries used, show all original rules.	329
4. Check minimum number of events None	329
5. Include endpoints None	329
6. Filter based on genotype QC (FinnGen only)	329

Summary Statistics

↥

-FinRegistry-

Key figures

	All	Female	Male
Number of individuals
Whole population	1947	1310	630
Only index persons	1879	1276	603
Unadjusted period prevalence (%)
Whole population	0.03	0.04	0.02
Only index persons	0.04	0.05	0.02
Median age at first event (years)
Whole population	43.29	41.92	45.89
Only index persons	42.39	41.22	44.86

-FinnGen-

Key figures

	All	Female	Male
Number of individuals	329	250	79
Unadjusted period prevalence (%)	0.07	0.09	0.03
Median age at first event (years)	46.50	43.57	55.76

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

No data

CodeWAS (R11)

↥

CodeWAS is a tool for exploring the associations between an endpoint and all of the medical codes and drug codes.

This is a new tool, please reach out using the contact form for feedback and improvement ideas.

First, a cohort is built by matching controls to the endpoint cases using year of birth and sex. Then, a Fisher test is done for all the medical codes and drug codes between the cases and controls of this cohort. Codes are reported in the table below if they have −log₁₀(p-value) ≥ 6.

Matched cohort

Matched cases
300: Matched controls
2998

Code

Vocabulary

Description

Odds Ratio

-log₁₀(p)

N matched cases

N matched controls

E66.1

ICD-10 Finland

Drug-induced obesity

+∞

323.0

300

E66.01

ICD-10 Finland

Obesity due to excess calories

439.1

232.3

207

E66.8

ICD-10 Finland

Other obesity

503.3

130.4

121

E66.9

ICD-10 Finland

Obesity, unspecified

562.8

87.9

E66.00

ICD-10 Finland

Metabolic syndrome

55.8

69.9

A10BA02

ATC

metformin; oral

8.5

55.7

149

311

JDF11

NOMESCO Finland

Laparoscopic gastric bypass

+∞

52.7

G47.3

ICD-10 Finland

Sleep apnoea

6.3

37.4

118

279

T82

ICPC

Obesity

21.7

36.5

E66

ICD-10 Finland

Obesity

16.4

35.9

E11.9

ICD-10 Finland

Type 2 diabetes mellitus, without complications

6.4

34.4

105

234

QBJ30

NOMESCO Finland

Correction of abdominal apron

165.9

29.2

103

Kela drug reimbursment

Diabetes, insulin-treated

4.9

28.5

111

319

Z71.3

ICD-10 Finland

Dietary counselling and surveillance

11.7

27.9

C03CA01

ATC

furosemide; systemic

5.2

27.3

250

215

Kela drug reimbursment

Diabetes, non-insulin-treated

4.8

26.7

106

307

E66.0

ICD-10 Finland

Obesity due to excess calories

+∞

26.4

E66.2

ICD-10 Finland

Extreme obesity with alveolar hypoventilation

+∞

25.4

T90

ICPC

Diabetes non-insulin dependent

4.8

24.6

264

310

Kela drug reimbursment

Orlistat, sibutramine and other major and expensive medicines used to treat obesity

61.4

24.5

112

Kela drug reimbursment

Severe psychotic and other severe mental disorders

7.3

24.4

103

RD210

NOMESCO Finland

30.1

22.7

E11

ICD-10 Finland

Type 2 diabetes mellitus

5.3

21.6

168

B01AB05

ATC

enoxaparin; parenteral

3.6

21.4

125

497

285

Kela drug reimbursment

Dulaglutide, exenatide, liraglutide, lixisenatide and semaglutide (adults)

13.4

21.2

SPAT1262

SPAT

Handing over of treatment supplies

4.7

21.1

215

SPAT1306

SPAT

Counselling and guidance related to nutrition and weight management

4.6

19.3

199

N02AX02

ATC

tramadol; systemic, rectal

3.1

19.1

153

751

SPAT1250

SPAT

Comprehensive monitoring of chronic illness

3.7

18.7

343

346

Kela drug reimbursment

Dulaglutide, exenatide, liraglutide, lixisenatide and semaglutide (adults)

15.7

18.5

I10

ICD-10 Finland

Essential (primary) hypertension

3.0

18.5

165

862

A46

ICD-10 Finland

Erysipelas

5.3

18.3

136

UJD10

NOMESCO Finland

Esophagoscopy, gastroscopy and duodenoscopy

3.2

17.3

115

486

GD1AA

NOMESCO Finland

Thorax X-ray examination

2.9

16.4

145

734

N05AH03

ATC

olanzapine; systemic

5.6

16.0

R5140

NOMESCO Finland

Monitoring the use of the aid

5.7

15.9

R5110

NOMESCO Finland

Evaluation of the need for aids, the testing, fitting and choice of the aid, instruction in use and delivery of it

5.0

15.8

123

N05AH04

ATC

quetiapine; oral

3.4

15.7

332

N05AX12

ATC

aripiprazole; systemic

6.6

15.0

F32.9

ICD-10 Finland

Depressive episode, unspecified

3.7

15.0

241

A10BB12

ATC

glimepiride; oral

9.2

14.9

205

Kela drug reimbursment

Chronic hypertension

3.4

14.7

287

N05AA02

ATC

levomepromazine; systemic

8.4

14.6

A12AX

ATC

Calcium, combinations with vitamin D and/or other drugs

2.9

14.5

115

534

N02AE01

ATC

buprenorphine; parenteral, sublingual, transdermal

4.5

13.8

130

O24.4

ICD-10 Finland

Diabetes mellitus arising in pregnancy

4.6

13.7

126

JDF01

NOMESCO Finland

Laparoscopic gastroplasty

+∞

13.6

N06AB04

ATC

citalopram; systemic

2.9

13.6

100

440

160

Kela drug reimbursment

exenatide

27.2

13.5

F61.0

ICD-10 Finland

Mixed personality disorders

16.0

13.3

K80.2

ICD-10 Finland

Calculus of gallbladder without cholecystitis

4.0

13.2

163

WX404

NOMESCO Finland

Intravenous generell anesthesy

2.8

12.9

438

N06AX16

ATC

venlafaxine; oral

3.2

12.9

281

B03BA03

ATC

hydroxocobalamin; parenteral

7.1

12.7

XG466

NOMESCO Finland

Sleep oxymetry

18.3

12.7

N02BE01

ATC

paracetamol; systemic, rectal

3.6

12.7

272

2184

C07AB07

ATC

bisoprolol; oral

2.5

12.5

131

701

N05BA01

ATC

diazepam; systemic, rectal

3.5

12.5

206

E11.8

ICD-10 Finland

Type 2 diabetes mellitus, with unspecified complications

5.7

12.5

R03AC02

ATC

salbutamol; inhalant

2.4

12.3

188

1224

A08AB01

ATC

orlistat; oral

39.3

12.3

H03AA01

ATC

levothyroxine sodium; systemic

2.8

12.3

442

A10BK03

ATC

empagliflozin; oral

6.3

11.7

A10AE04

ATC

insulin glargine; parenteral

4.8

11.5

R4190

NOMESCO Finland

Nutritional therapy

8.2

11.4

F20.9

ICD-10 Finland

Schizophrenia, unspecified

10.2

10.9

A10BH01

ATC

sitagliptin; oral

4.8

10.9

Z50.8

ICD-10 Finland

Care involving use of other rehabilitation procedures

4.5

10.6

A08AA10

ATC

sibutramine; oral

113.8

10.5

SFC01

NOMESCO Finland

Adjuvant procedure of filling therapy

2.5

10.5

100

501

L17

ICPC

Foot/toe symptom/complaint

2.6

10.3

422

N05AX08

ATC

risperidone; systemic

4.4

10.3

TPH04

NOMESCO Finland

Cathetrisation of vein

2.8

10.2

307

N05CD07

ATC

temazepam; oral

3.7

10.2

135

N05BA06

ATC

lorazepam; systemic, sublingual

5.1

10.0

S97

ICPC

Chronic ulcer skin

6.2

9.9

A08AA02

ATC

fenfluramine; oral (centrally acting antiobesity products)

27.0

9.9

SPAT1301

SPAT

No procedures

2.3

9.9

111

600

K02.1

ICD-10 Finland

Caries of dentine

2.2

9.9

199

1406

N06AX05

ATC

trazodone; oral

7.2

9.8

R4140

NOMESCO Finland

Psychotherapy

14.0

9.8

RD112

NOMESCO Finland

56.8

9.7

N06AB03

ATC

fluoxetine; oral

3.0

9.7

237

A10AC01

ATC

insulin (human); parenteral (insulins and analog. for injection, intermediate-acting)

4.6

9.7

M17.0

ICD-10 Finland

Primary gonarthrosis, bilateral

3.4

9.6

165

A10BJ02

ATC

liraglutide; parenteral

15.7

9.6

N03AX16

ATC

pregabalin; oral

2.5

9.6

421

A02BC02

ATC

pantoprazole; systemic

2.2

9.5

202

1449

J01DB01

ATC

cefalexin; oral

2.9

9.5

265

2177

N02AA59

ATC

codeine, combinations excl. psycholeptics; systemic

2.2

9.5

156

998

O24.1

ICD-10 Finland

Diabetes mellitus in pregnancy: Pre-existing diabetes mellitus, non-insulin-dependent

103.1

9.5

SPAT1310

SPAT

Counselling related to known health issue

2.3

9.4

118

667

2780A

ICD-9 Finland

Obesity and other hyperalimentation, Obesity

+∞

9.4

SPAT1229

SPAT

Assessment of need for aid

4.3

9.4

B01AA03

ATC

warfarin; systemic

3.2

9.4

178

WX110

NOMESCO Finland

Local anesthesy

2.3

9.3

229

1748

JKA21

NOMESCO Finland

Laparoscopic cholecystectomy

3.4

9.3

157

C03DA01

ATC

spironolactone; oral

4.3

9.3

J45.9

ICD-10 Finland

Asthma, unspecified

2.7

9.2

312

N05BA04

ATC

oxazepam; oral

2.4

9.2

480

EBA05

NOMESCO Finland

Complicated extraction of tooth

2.6

9.2

340

JN1AE

NOMESCO Finland

Ultrasound examination of upper part of abdomen

3.5

9.1

136

WYA30

NOMESCO Finland

Preparations for expected poor cooperation

3.6

9.1

125

T81.4

ICD-10 Finland

Infection following a procedure, not elsewhere classified

3.3

9.1

160

R4160

NOMESCO Finland

Other therapy enhancing rehabilitation

7.8

9.1

M54.5

ICD-10 Finland

Low back pain

2.2

9.0

119

688

R10.4

ICD-10 Finland

Other and unspecified abdominal pain

2.2

9.0

132

801

N02AJ06

ATC

codeine and paracetamol; systemic

2.2

9.0

129

775

J01FF01

ATC

clindamycin; systemic

2.3

8.9

518

WX290

NOMESCO Finland

Other blockade of nerve

2.1

8.8

159

1048

M79.6

ICD-10 Finland

Pain in limb

2.2

8.6

121

716

N05CF01

ATC

zopiclone; oral

2.2

8.6

102

559

F32.2

ICD-10 Finland

Severe depressive episode without psychotic symptoms

3.4

8.5

132

Z50.4

ICD-10 Finland

Psychotherapy, not elsewhere classified

20.7

8.5

A10BD07

ATC

metformin and sitagliptin; systemic

8.2

8.5

N03AG01

ATC

valproic acid; systemic, rectal

4.0

8.5

TLC00

NOMESCO Finland

Insertion of intrauterine device

3.4

8.5

133

M17.9

ICD-10 Finland

Gonarthrosis, unspecified

3.3

8.2

142

A08

ICPC

Swelling

7.2

8.2

R60.0

ICD-10 Finland

Localized oedema

3.4

8.2

131

L28

ICPC

Limited function/disability (L)

2.9

8.1

191

E28.2

ICD-10 Finland

Polycystic ovarian syndrome

9.3

8.1

C09AA05

ATC

ramipril; oral

2.6

8.1

270

F60.30

ICD-10 Finland

Emotionally unstable personality disorder, impulsive

7.6

8.1

A10BX04

ATC

[U] exenatide; parenteral

22.7

8.1

T36

ICD-10 Finland

Poisoning by systemic antibiotics

4.6

8.1

N03AX09

ATC

lamotrigine; oral

4.0

8.0

F31.9

ICD-10 Finland

Bipolar affective disorder, unspecified

5.7

8.0

M17.1

ICD-10 Finland

Other primary gonarthrosis

2.6

8.0

286

SPAT1249

SPAT

Treatment-related counselling outside office

2.0

8.0

135

857

EBA00

NOMESCO Finland

Extraction of tooth

2.1

7.9

113

668

A10BJ06

ATC

semaglutide; parenteral

9.8

7.9

X69

ICD-10 Finland

Intentional self-poisoning by and exposure to other and unspecified chemicals and noxious substances

5.6

7.9

J45

ICD-10 Finland

Asthma

3.1

7.8

158

M51.1

ICD-10 Finland

Lumbar and other intervertebral disc disorders with radiculopathy

2.7

7.8

229

A06AD11

ATC

lactulose; oral

3.1

7.8

152

SPAT1305

SPAT

Counselling and guidance related to physical exercise

3.2

7.8

142

N10

ICD-10 Finland

Acute tubulo-interstitial nephritis

3.1

7.7

153

R03AK06

ATC

salmeterol and fluticasone; inhalant

2.8

7.7

212

B01AB04

ATC

dalteparin; parenteral

6.0

7.7

N05AE04

ATC

ziprasidone; systemic

25.7

7.6

WYA05

NOMESCO Finland

Emergency visit or other similar visit involving procedures

2.0

7.6

162

1116

H02AB09

ATC

hydrocortisone; systemic

7.4

7.6

SPAT1230

SPAT

Aid fitting and borrowing and monitoring of use

2.7

7.6

238

F33.2

ICD-10 Finland

Recurrent depressive disorder, current episode severe without psychotic symptoms

3.9

7.5

F33.9

ICD-10 Finland

Recurrent depressive disorder, unspecified

4.4

7.5

M04AA01

ATC

allopurinol; systemic

3.6

7.4

100

N05AB03

ATC

perphenazine; systemic, rectal

5.2

7.4

W01

ICD-10 Finland

Fall on same level from slipping, tripping and stumbling

2.2

7.4

468

N02AA05

ATC

oxycodone; systemic

3.1

7.4

145

I50.9

ICD-10 Finland

Heart failure, unspecified

3.8

7.3

C10AA01

ATC

simvastatin; oral

2.1

7.3

552

SFA10

NOMESCO Finland

Fillning on one surface of tooth

2.0

7.3

179

1291

Y83

ICD-10 Finland

Surgical operation and other surgical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure

3.6

7.3

RD140

NOMESCO Finland

+∞

7.3

P06

ICPC

Sleep disturbance

3.0

7.3

154

SPAT1253

SPAT

Initiation, adjustment, discontinuation or repetition of medication

2.0

7.3

109

654

F29

ICD-10 Finland

Unspecified nonorganic psychosis

4.8

7.2

S18

ICPC

Laceration/cut

2.0

7.2

124

781

F31.7

ICD-10 Finland

Bipolar affective disorder, currently in remission

6.3

7.2

F31.30

ICD-10 Finland

Bipolar disorder Depressive episode without somatic syndrome

6.3

7.2

F60.31

ICD-10 Finland

Emotionally unstable personality disorder, borderline condition

8.2

7.2

WX722

NOMESCO Finland

PEEP

5.0

7.2

WZB00

NOMESCO Finland

Telephone receipt or other advice

2.1

7.1

105

622

C03EA01

ATC

hydrochlorothiazide and potassium-sparing agents; oral

2.8

7.1

194

J20.9

ICD-10 Finland

Acute bronchitis, unspecified

2.5

7.1

280

L02.2

ICD-10 Finland

Cutaneous abscess, furuncle and carbuncle of trunk

5.2

7.1

J01DA09

ATC

[U] cefadroxil; inhalant, oral

2.1

7.1

535

Z00.4

ICD-10 Finland

General psychiatric examination, not elsewhere classified

2.8

7.1

186

N05AH02

ATC

clozapine; systemic

7.3

7.1

C03AA03

ATC

hydrochlorothiazide; oral

4.0

7.1

SPAT1148

SPAT

Treatment of chronic ulcer or burn

3.1

7.1

137

A28

ICPC

Limited function/disability NOS

3.1

7.0

138

N06AX03

ATC

mianserin; oral

4.6

7.0

SGC10

NOMESCO Finland

Covering pulpa of tooth

2.9

7.0

163

R06.0

ICD-10 Finland

Dyspnoea

2.3

6.9

373

203

Kela drug reimbursment

Chronic asthma and similar chronic obstructive pulmonary diseases

2.3

6.9

347

JAD30

NOMESCO Finland

Repair of incisional hernia using prosthetic material

11.3

6.9

N04AA02

ATC

biperiden; systemic

7.5

6.8

IGY02

NOMESCO Finland

Psychiatric monitoring contact

7.5

6.8

A10BJ01

ATC

exenatide; parenteral

17.2

6.8

IER04

NOMESCO Finland

Rehabilitative psychiatric group intervention, functional

17.2

6.8

F20

ICD-10 Finland

Schizophrenia

41.0

6.8

B81

ICPC

Anaemia vit B12/folate deficiency

5.7

6.7

SPAT1234

SPAT

Support of social functional capacity

6.1

6.7

IFA99

NOMESCO Finland

Other psychiatric pharmacotherapy service

23.1

6.7

J01MA12

ATC

levofloxacin; systemic

2.4

6.7

278

Z71.8

ICD-10 Finland

Other specified counselling

2.1

6.7

482

SPAT1156

SPAT

Guidance concerning treatment of rash and skin

2.7

6.6

190

IFA01

NOMESCO Finland

Psychiatric pharmacotherapy plan, not specified

9.0

6.6

K43.9

ICD-10 Finland

Other and unspecified ventral hernia without obstruction or gangrene

5.3

6.6

N05AD01

ATC

haloperidol; systemic

7.1

6.6

F32.10

ICD-10 Finland

Moderate depressive episode without somatic syndrome

2.9

6.6

157

WX408

NOMESCO Finland

General anesthesy, balanced

2.1

6.5

501

J18.9

ICD-10 Finland

Pneumonia, unspecified

2.3

6.5

289

A10BH05

ATC

linagliptin; oral

5.7

6.4

O24.0

ICD-10 Finland

Diabetes mellitus in pregnancy: Pre-existing diabetes mellitus, insulin-dependent

8.4

6.4

SGA01

NOMESCO Finland

Tooth opening as first aid

2.3

6.4

283

R06.5

ICD-10 Finland

Mouth breathing

3.3

6.4

102

N03AX11

ATC

topiramate; oral

5.0

6.3

F20.30

ICD-10 Finland

Undifferentiated schizophrenia continuous

9.6

6.3

A10BX01

ATC

guar gum; systemic

7.3

6.3

IEY05

NOMESCO Finland

Dedicated profession-specific psychiatric intervention, individual

5.2

6.3

IEY08

NOMESCO Finland

Psychiatric coaching, domestic and community skills

27.3

6.3

SPAT1256

SPAT

Intramuscular and subcutaneous injection

1.9

6.3

124

813

SPAT1008

SPAT

Photography of fundus of the eye or interpretation of photograph

5.6

6.2

F31.8

ICD-10 Finland

Other bipolar affective disorders

6.0

6.2

JN3BD

NOMESCO Finland

Extensive abdominal CT

2.7

6.2

177

R50.9

ICD-10 Finland

Fever, unspecified

2.6

6.2

208

D50.9

ICD-10 Finland

Iron deficiency anaemia, unspecified

3.4

6.2

F33.10

ICD-10 Finland

Recurrent depression, moderate episode without somatic syndrome

3.1

6.2

116

M54.4

ICD-10 Finland

Lumbago with sciatica

2.2

6.2

323

N06AA12

ATC

doxepin; systemic

4.2

6.1

K04.0

ICD-10 Finland

Pulpitis

2.7

6.1

171

E11.6

ICD-10 Finland

Type 2 diabetes mellitus, with other specified complications

12.9

6.1

TPH07

NOMESCO Finland

Cathetrisation of artery

3.0

6.1

121

LCA13

NOMESCO Finland

Curettage of cervix and body of uterus

3.5

6.1

N06AB06

ATC

sertraline; oral

2.5

6.0

194

Mortality – FinRegistry

↥

Association

Association between endpoint E4_OBESITYDRUG and mortality.

Females

Parameter	HR [95% CI]	p-value
E4_OBESITYDRUG	2.566 [2.01, 3.27]	< 0.001
Birth year	0.997 [0.99, 1.01]	0.542

During the follow-up period (1.1.1998 — 31.12.2019), 125 out of 1189 females with E4_OBESITYDRUG died.

Males

Parameter	HR [95% CI]	p-value
E4_OBESITYDRUG	3.083 [2.32, 4.1]	< 0.001
Birth year	0.989 [0.98, 1.0]	0.065

During the follow-up period (1.1.1998 — 31.12.2019), 123 out of 581 males with E4_OBESITYDRUG died.

Mortality risk

Mortality risk for people of age

years, who have E4_OBESITYDRUG.

N-year risk	Females	Males
1	0.326%	0.507%
5	1.67%	3.295%
10	4.356%	8.667%
15	8.38%	15.952%
20	13.586%	26.563%

Relationships between endpoints

↥

Index endpoint: E4_OBESITYDRUG – Drug-induced obesity

GWS hits: -

Endpoint

Case Overlap

Survival Analysis

Genetic Correlations

Genetic Signals

N (Jaccard index)

HR [CI]

Extremity

rg [CI]

Extremity

Hits

Coloc Hits

FinRegistry

FinnGen

FinRegistry

FinnGen

Loading data

NAME	E4_OBESITYDRUG
CONTROL_EXCLUDE	E4_OBESITY
CONTROL_PRECONDITIONS
CONTROL_CONDITIONS
SEX
INCLUDE
PRE_CONDITIONS
CONDITIONS
OUTPAT_ICD
OUTPAT_OPER
HD_MAINONLY
HD_ICD_10_ATC
HD_ICD_10	E661
HD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
HD_ICD_10_EXCL
HD_ICD_9_EXCL
HD_ICD_8_EXCL
COD_MAINONLY
COD_ICD_10	E661
COD_ICD_9	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_8	$!$	The FinnGen clinical team has checked and no code can be used for this rule.
COD_ICD_10_EXCL
COD_ICD_9_EXCL
COD_ICD_8_EXCL
OPER_NOM
OPER_HL
OPER_HP1
OPER_HP2
KELA_REIMB
KELA_REIMB_ICD
KELA_ATC_NEEDOTHER
KELA_ATC
KELA_VNRO_NEEDOTHER
KELA_VNRO
CANC_TOPO
CANC_TOPO_EXCL
CANC_MORPH
CANC_MORPH_EXCL
CANC_BEHAV

Drug-induced obesity

Endpoint definition

Endpoint definition steps

FinnGen

Phenotype data

1. Apply sex-specific rule

2. Check conditions

3. Check pre-conditions, main-only, mode, registry filters

4. Check minimum number of events

5. Include endpoints

6. Filter based on genotype QC (FinnGen only)

Similar endpoints

Case counts by codes

Summary Statistics

-FinRegistry-

Key figures

-FinnGen-

Key figures

-FinRegistry-

Age distribution of first events

-FinnGen-

Age distribution of first events

-FinRegistry-

Year distribution of first events

-FinnGen-

Year distribution of first events

-FinRegistry-

Cumulative Incidence Function

-FinnGen-

Cumulative Incidence Function

CodeWAS (R11)

Matched cohort

Mortality – FinRegistry

Association

Females

Males

Mortality risk

Relationships between endpoints