Reduction of sample heterogeneity through use of population substructure: an example from a population of African American families with sarcoidosis.

Sarcoidosis is a granulomatous inflammatory disorder of complex etiology with significant linkage to chromosome 5, and marginal linkage was observed to five other chromosomes in African Americans (AAs) in our previously published genome scan. Because genetic factors underlying complex disease are often population specific, genetic analysis of samples with diverse ancestry (i.e., ethnic confounding) can lead to loss of power. Ethnic confounding is often addressed by stratifying on self-reported race, a controversial and less-than-perfect construct. Here, we propose linkage analysis stratified by genetically determined ancestry as an alternative approach for reducing ethnic confounding. Using data from the 380 microsatellite markers genotyped in the aforementioned genome scan, we clustered AA families into subpopulations on the basis of ancestry similarity. Evidence of two genetically distinct groups was found: subpopulation one (S1) comprised 219 of the 229 families, subpopulation two (S2) consisted of six families (the remaining four families were a mixture). Stratified linkage results suggest that only the S1 families contributed to previously identified linkage signals at 1p22, 3p21-14, 11p15, and 17q21 and that only the S2 families contributed to those found at 5p15-13 and 20q13. Signals on 2p25, 5q11, 5q35, and 9q34 remained significant in both subpopulations, and evidence of a new susceptibility locus at 2q37 was found in S2. These results demonstrate the usefulness of stratifying on genetically determined ancestry, to create genetically homogeneous subsets--more reliable and less controversial than race-stratified subsets--in which to identify genetic factors. Our findings support the presence of sarcoidosis-susceptibility genes in regions identified elsewhere but indicate that these genes are likely to be ancestry specific.