Research

rs143383 — GDF5 C/T

Regulatory variant in GDF5 affecting cartilage development and osteoarthritis risk in knees, hips, and spine

Established Risk Factor

Details

Gene
GDF5
Chromosome
20
Risk allele
T
Consequence
Regulatory
Inheritance
Codominant
Clinical
Risk Factor
Evidence
Established
Chip coverage
v2 v3 v4

Population Frequency

CC
42%
CT
45%
TT
13%

Ancestry Frequencies

east_asian
61%
south_asian
40%
european
36%
latino
35%
african
20%

Category

Fitness & Body

GDF5 and Joint Health — A Genetic Influence on Cartilage Longevity

The GDF5 gene encodes growth differentiation factor 511 growth differentiation factor 5
a member of the bone morphogenetic protein (BMP) family essential for skeletal development
, particularly in forming and maintaining cartilage in synovial joints. rs143383 is a C to T transition SNP located in the 5'untranslated region (5'UTR) of the GDF5 gene . This regulatory region controls how much GDF5 protein your cells produce, and the T allele of the SNP is associated with increased risk of osteoarthritis (OA) in Europeans and in Asians .

GDF5 is on the minus strand of chromosome 20, and this is an intron variant located in a critical regulatory region. While technically classified as an intron variant in some databases, it functions as a regulatory element in the gene's 5' UTR, affecting transcription.

The Mechanism

The T allele produces less GDF5 transcript relative to the C allele, a phenomenon known as differential allelic expression (DAE) . Studies show an average of 27% lower expression of the disease-associated T allele than the C allele in synovial joint tissues from OA patients . The mechanism involves transcription factor binding:

Sp1, Sp3, and DEAF-1 are repressors of GDF5 expression, with DEAF-1 modulating the differential allelic effect — the rs143383 T allele being repressed to a significantly greater extent than the C allele .

This reduced expression matters because GDF5 is essential for cartilage homeostasis. It promotes chondrocyte differentiation, stimulates production of cartilage matrix proteins like aggrecan and type II collagen22 cartilage matrix proteins like aggrecan and type II collagen
key structural components of healthy cartilage
, and supports joint repair processes. Less GDF5 means less cartilage maintenance capacity over time.

The Evidence

GDF5 is the most compelling candidate association signal so far reported for OA, with the rs143383 single nucleotide polymorphism (SNP) showing association in both Europeans and Asians and at a significance level of P < 5.0 × 10⁻⁸ . The evidence spans multiple joint sites:

Knee osteoarthritis33 Knee osteoarthritis
Valdes et al. (2011). The GDF5 rs143383 polymorphism is associated with osteoarthritis of the knee with genome-wide statistical significance. Ann Rheum Dis.
:

A significant random-effects summary OR for knee OA was demonstrated for rs143383 (1.15 [95% confidence interval 1.09-1.22]) (P=9.4×10⁻⁷), with no significant between-study heterogeneity . This is the strongest and most consistent association.

Lumbar disc degeneration44 Lumbar disc degeneration
Williams et al. (2011). GDF5 single-nucleotide polymorphism rs143383 is associated with lumbar disc degeneration in Northern European women. Arthritis Rheum.
:

An association between LDD and the SNP rs143383 was identified in women, with the same risk allele as in knee and hip OA (odds ratio 1.72 [95% confidence interval 1.15–2.57], P = 0.008) . The association was specific to women and particularly evident with severe disc degeneration.

Meta-analysis across musculoskeletal conditions55 Meta-analysis across musculoskeletal conditions
Liu et al. (2018). Association between GDF5 rs143383 genetic polymorphism and musculoskeletal degenerative diseases susceptibility: a meta-analysis. BMC Med Genet.
:

Meta-analysis of GDF5 rs143383 polymorphism was statistically associated with increased risk of musculoskeletal degenerative diseases under each genetic model (allele model: OR = 1.32, 95% CI 1.19–1.48, P = 0.000; homozygote model: OR = 1.80, 95%CI 1.49–2.16, P = 0.000) , covering 5,915 cases and 12,252 controls across both osteoarthritis and intervertebral disc degeneration.

The effect sizes are modest but highly reproducible — classic for common variants affecting complex traits. The T allele doesn't guarantee joint problems, but it tips the scales toward faster cartilage degradation over decades.

Practical Implications

This variant influences your joints' capacity to maintain and repair cartilage throughout life. The T allele creates a slight ongoing deficit in GDF5 expression, which compounds with age, mechanical stress, and other risk factors.

Weight matters more for you. With reduced cartilage maintenance capacity, excess mechanical load accelerates degeneration. Each extra 5 kg of body weight increases knee OA risk, and this effect is amplified when your baseline cartilage repair is compromised.

Joint-protective nutrients and supplements may help compensate. Glucosamine and chondroitin66 Glucosamine and chondroitin
natural components of cartilage
support cartilage structure. Studies show they can slow cartilage loss and reduce pain in OA, particularly the glucosamine sulfate form combined with chondroitin. Omega-3 fatty acids (EPA/DHA) reduce inflammatory responses in joints. Vitamin D and K support bone health underlying cartilage. SAM-e has shown cartilage-protective effects and pain relief comparable to NSAIDs.

Activity patterns should favor joint preservation. Low-impact exercise (swimming, cycling, elliptical) maintains joint health without excessive wear. Strength training builds muscle support around joints, offloading cartilage. Avoid chronic high-impact activities and repetitive joint stress if possible.

Interactions

This effect is influenced by a second SNP (rs143384, C/T) in the same area . The two variants work together to regulate GDF5 expression through methylation:

The C alleles of both SNPs form CpG dinucleotides. Demethylation of both SNP's increases GDF5 expression . When you carry the T allele at rs143383 along with the T allele at rs143384, the reduction in GDF5 expression is most pronounced. This represents a compound heterozygosity scenario where the combined genotype creates a stronger effect than either variant alone.

Other genes in cartilage homeostasis pathways may also interact with GDF5 function, including COL2A1 (type II collagen), ACAN (aggrecan), and other BMP family members, though specific compound implications require individual research into those variants.

Genotype Interpretations

What each possible genotype means for this variant:

CC “Typical GDF5 Expression” Normal

Normal cartilage maintenance capacity

You have two copies of the C allele, which produce normal levels of GDF5 protein. This gives you standard cartilage maintenance and repair capacity. About 40-45% of people of European descent share this genotype (frequencies vary by ancestry — it's more common in African populations at ~65%, less common in East Asians at ~15%).

Your baseline joint health depends on the same factors as everyone else: maintaining healthy weight, staying active without overuse injuries, and supporting joint nutrition. You don't have a genetic disadvantage in cartilage longevity.

CT “Reduced GDF5 Expression” Intermediate Caution

Moderately reduced cartilage maintenance capacity

Studies show that carrying one T allele increases osteoarthritis risk by about 10-15% compared to CC individuals. This translates to an odds ratio of approximately 1.12-1.15 across large meta-analyses. The risk is highest for knee OA, moderate for hip OA, and present but smaller for hand OA.

Women with this genotype show particularly strong associations with lumbar disc degeneration. The mechanism likely involves both reduced GDF5 in intervertebral discs and hormonal influences on cartilage metabolism.

Your cartilage can still maintain itself well with proper care, but you have less margin for error. Protecting your joints through weight management and appropriate activity becomes more important.

TT “Low GDF5 Expression” Reduced Warning

Significantly reduced cartilage maintenance capacity

Meta-analyses show that carrying two T alleles increases osteoarthritis risk with an odds ratio of 1.80 (95% CI 1.49-2.16) across musculoskeletal degenerative diseases. For knee OA specifically, the association is even stronger in some populations.

The mechanism is clear: your chondrocytes (cartilage cells) produce substantially less GDF5, reducing their ability to synthesize cartilage matrix proteins, respond to mechanical stress, and repair micro-damage that accumulates with age and use. Over decades, this deficit becomes clinically meaningful.

Women with the TT genotype show particularly elevated risk for lumbar disc degeneration, suggesting sex-specific effects possibly mediated through hormonal influences on GDF5 expression or cartilage metabolism.

However, genetics is not destiny. Environmental factors — especially weight, activity patterns, injury prevention, and nutritional support — have large effects on whether this genetic predisposition manifests as clinical osteoarthritis. Proactive joint care matters enormously for you.

Key References

PMID: 20870806

Meta-analysis achieving genome-wide significance for knee OA association (OR 1.15)

PMID: 17384641

Original discovery study linking rs143383 T allele to OA in Asian populations

PMID: 19479880

Large-scale analysis of 5,789 hip, 5,085 knee, and 4,040 hand OA cases

PMID: 23825960

Functional study identifying transcription factors regulating GDF5 via rs143383

PMID: 21128259

Association with lumbar disc degeneration in Northern European women (OR 1.72)

PMID: 30186416

Meta-analysis confirming musculoskeletal degenerative disease association