Genetic liability to meniscus degeneration and its comorbidity patterns: a phenome-wide association study in the UK Biobank

Meniscus degeneration is a common knee pathology causing pain, disability, and osteoarthritis. While mechanical factors are established, the contribution of inherited genetic liability to its systemic disease patterns remains unclear. We applied a polygenic risk score (PRS) for meniscus degeneration, derived from FinnGen genome-wide association study (GWAS) results to 323,999 UK Biobank participants and conducted a phenome-wide association study (PRS-PheWAS) across 962 clinical phenotypes. The PRS-PheWAS revealed significant associations beyond musculoskeletal traits, extending to metabolic, cardiovascular, psychiatric, and gastrointestinal domains, indicating broad shared genetic architecture. To support these findings, linkage disequilibrium score regression confirmed strong genetic correlations with osteoarthritis and related arthropathies, and genotype-tissue expression (GTEx) analysis highlighted tissue-specific expression of lead genes (e.g., GDF5, SOX5, BMP6) in connective and metabolic tissues. The results demonstrate that genetic liability to meniscus degeneration extends beyond the knee, sharing pathways with systemic conditions. This systemic genetic architecture underscores the need for integrative management approaches that combine orthopedic care with metabolic and lifestyle interventions.