There is increasing interest in the joint analysis of multiple phenotypes in genome-wide association studies (GWASs), especially for the analysis of multiple secondary phenotypes in case-control studies and in detecting pleiotropic effects. Multiple phenotypes often measure the same underlying trait. By taking advantage of similarity across phenotypes, one could potentially gain statistical power in association analysis. Because continuous phenotypes are likely to be measured on different scales, we propose a scaled marginal model for testing and estimating the common effect of single-nucleotide polymorphism (SNP) on multiple secondary phenotypes in case-control studies. This approach improves power in comparison to individual phenotype analysis and traditional multivariate analysis when phenotypes are positively correlated and measure an underlying trait in the same direction (after transformation) by borrowing strength across outcomes with a one degree of freedom (1-DF) test and jointly estimating outcome-specific scales along with the SNP and covariate effects. To account for case-control ascertainment bias for the analysis of multiple secondary phenotypes, we propose weighted estimating equations for fitting scaled marginal models. This weighted estimating equation approach is robust to departures from normality of continuous multiple phenotypes and the misspecification of within-individual correlation among multiple phenotypes. Statistical power improves when the within-individual correlation is correctly specified. We perform simulation studies to show the proposed 1-DF common effect test outperforms several alternative methods. We apply the proposed method to investigate SNP associations with smoking behavior measured with multiple secondary smoking phenotypes in a lung cancer case-control GWAS and identify several SNPs of biological interest.
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