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We perform a genome-wide association meta-analysis (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009~\u200943,800) of SK-BMD, identifying 59 loci, collectively explaining 12.5% of the trait variance. Association signals cluster within gene-sets involved in skeletal development and osteoporosis. Among the four novel loci (\n                    <jats:italic>ZIC1<\/jats:italic>\n                    ,\n                    <jats:italic>PRKAR1A<\/jats:italic>\n                    ,\n                    <jats:italic>AZIN1\/ATP6V1C1<\/jats:italic>\n                    ,\n                    <jats:italic>GLRX3<\/jats:italic>\n                    ), there are factors implicated in intramembranous ossification and as we show, inherent to craniosynostosis processes. Functional follow-up in zebrafish confirms the importance of\n                    <jats:italic>ZIC1<\/jats:italic>\n                    on cranial suture patterning. Likewise, we observe abnormal cranial bone initiation that culminates in ectopic sutures and reduced BMD in mosaic\n                    <jats:italic>atp6v1c1<\/jats:italic>\n                    knockouts. Mosaic\n                    <jats:italic>prkar1a<\/jats:italic>\n                    knockouts present asymmetric bone growth and, conversely, elevated BMD. In light of this evidence linking SK-BMD loci to craniofacial abnormalities, our study provides new insight into the pathophysiology, diagnosis and treatment of skeletal diseases.\n                  <\/jats:p>","DOI":"10.1038\/s42003-023-04869-0","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T12:05:44Z","timestamp":1688472344000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Bone mineral density loci specific to the skull portray potential pleiotropic effects on craniosynostosis"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-5538","authenticated-orcid":false,"given":"Carolina","family":"Medina-Gomez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0743-770X","authenticated-orcid":false,"given":"Benjamin H.","family":"Mullin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Chesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9463-3962","authenticated-orcid":false,"given":"Vid","family":"Prijatelj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9105-2249","authenticated-orcid":false,"given":"John P.","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Shochat-Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Trajanoska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimo","family":"Joro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2390-286X","authenticated-orcid":false,"given":"Tavia E.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina E.","family":"Schraut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifang","family":"Li-Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-3354","authenticated-orcid":false,"given":"Tarunveer S.","family":"Ahluwalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9186-3423","authenticated-orcid":false,"given":"M. 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