What you carry at this position in your DNA and what research says about it.
Drug and Toxin Metabolism: 10/10 evidence, 36 publications.
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Sample genotype (not yours): G/G
Rapid Drug Metabolism and Higher Lipids
Rapid processing of certain medications and environmental toxins lowers bladder cancer risk. However, this genotype is linked to slightly higher triglyceride and cholesterol levels.
What this genotype means: Rapid clearance of certain medications; Lower risk of bladder cancer; Slightly higher triglyceride levels.
Sample genotype (not yours): A/A
Slow Drug Metabolism and Lower Lipids
Slow processing of certain medications and environmental toxins increases bladder cancer risk, particularly for smokers. However, this genotype is associated with lower triglyceride and cholesterol levels.
What this genotype means: Slower clearance of certain medications; Higher risk of bladder cancer (especially for smokers); Lower triglyceride and cholesterol levels.
Sample genotype (not yours): G/A
Typical Drug Metabolism and Lipid Levels
Processing of medications and environmental toxins occurs at a typical, moderate speed. Lipid levels and bladder cancer risks are generally near the population average.
What this genotype means: Typical rate of drug clearance; Average risk of bladder cancer; Typical baseline lipid levels.
Gene function and biological role
Gene Function: The NAT2 gene encodes N-acetyltransferase 2, a critical liver enzyme responsible for metabolizing foreign chemicals, environmental toxins, and various medications [1]. This enzyme works through a chemical process called acetylation, which helps the body neutralize and eliminate substances like caffeine, arylamine carcinogens, and certain prescription drugs [2]. Variations in this gene divide the human population into rapid, intermediate, and slow metabolizers [3]. These metabolic differences can significantly influence how a person responds to specific medical therapies and their susceptibility to certain environmental diseases [4].
Variant Impact: The intergenic variant rs1495741 serves as a highly accurate genetic tag for the NAT2 gene, predicting an individual's metabolic speed with up to 99% sensitivity [5]. The genetic change alters how efficiently the body processes arylamines and hydrazines, which are found in tobacco smoke, industrial chemicals, and medications [1]. Carrying the G allele is associated with rapid enzyme activity, whereas the A allele is linked to slow metabolism [3]. In addition to drug clearance, this genetic marker is strongly associated with systemic lipid levels, including triglycerides and cholesterol [6].
Key Insight: This single genetic marker can predict how quickly your liver processes certain medications with over 95% accuracy, while simultaneously influencing your blood cholesterol and triglyceride levels.
Location: NAT2. Chromosome 8 · 8p22 · 18.4 Mb
Estimated prevalence by population
Global 9.2%; European 5.1%; African 14.4%; East Asian 29.2%; South Asian 5.2%; Americas 11.5%; Ashkenazi 2.8%; Finnish 6.5%; Middle Eastern 4.3%; Amish 8.0%.
Estimated GG genotype frequency.
Global 39.9%; European 35.0%; African 47.1%; East Asian 49.7%; South Asian 35.1%; Americas 44.8%; Ashkenazi 28.0%; Finnish 37.9%; Middle Eastern 32.9%; Amish 40.6%.
Estimated GA genotype frequency.
Global 50.9%; European 59.9%; African 38.5%; East Asian 21.1%; South Asian 59.8%; Americas 43.7%; Ashkenazi 69.2%; Finnish 55.6%; Middle Eastern 62.8%; Amish 51.4%.
Estimated AA genotype frequency.
Showing effects for G/G genotype
Cancer & Oncology
Urologic Cancers
Bladder Cancer. Evidence: 6/10. Source: PMID 20972438. Lower Risk.
Cardiovascular & Metabolic
Lipids & Cholesterol
Triglycerides. Evidence: 10/10.
Total Cholesterol. Evidence: 10/10.
Pharmacogenomics
Antimicrobial & Antiviral Response
Tuberculosis Drug Safety. Evidence: 6/10. Source: PMID 23407048. Typical Risk.
Showing effects for A/A genotype
Bladder Cancer. Evidence: 6/10. Source: PMID 20972438. ~1.14x Higher Risk.
Triglycerides. Evidence: 10/10. Source: PMID 20686565. Lower Levels.
Total Cholesterol. Evidence: 10/10. Source: PMID 20686565. Lower Levels.
Tuberculosis Drug Safety. Evidence: 6/10. Source: PMID 23407048. Higher Toxicity Risk.
Showing effects for G/A genotype
Bladder Cancer. Evidence: 6/10. Source: PMID 20972438. Typical Risk.
Triglycerides. Evidence: 10/10. Source: PMID 20686565. Typical.
Total Cholesterol. Evidence: 10/10. Source: PMID 20686565. Typical.
What this genotype means for the people who carry it
Sample genotype: GG (Homozygous)
Fast enzymatic activity allows the liver to quickly neutralize environmental carcinogens, resulting in a lower risk of bladder cancer [1]. This rapid clearance also protects the liver from toxicity when taking standard doses of tuberculosis medications like isoniazid [2]. However, the rapid metabolic state is consistently associated with higher levels of circulating triglycerides and total cholesterol [3]. These elevated lipid levels can slightly increase long-term cardiovascular risks [4]. Individuals with this genotype may also process dietary compounds like caffeine more rapidly than average.
Rapid clearance of certain medications; Lower risk of bladder cancer; Slightly higher triglyceride levels.
Sample genotype: AA (Homozygous)
Reduced enzymatic activity leads to slower clearance of environmental toxins, which can accumulate and increase bladder cancer risk, especially when exposed to tobacco smoke [1]. Slower metabolism also increases the risk of liver toxicity when undergoing treatment with tuberculosis drugs like isoniazid due to prolonged drug exposure [2]. On the positive side, this slow metabolic state is strongly linked to lower levels of triglycerides and total cholesterol [3]. These lower lipid levels may offer a protective effect against cardiovascular disease [4]. Individuals with this genotype may also notice a higher sensitivity to caffeine.
Slower clearance of certain medications; Higher risk of bladder cancer (especially for smokers); Lower triglyceride and cholesterol levels.
Sample genotype: GA (Heterozygous)
An intermediate metabolic rate balances the clearance of foreign chemicals and medications [1]. The liver processes compounds like isoniazid and caffeine at a typical pace, avoiding the extreme clearance rates of other genotypes [2]. Risk levels for bladder cancer remain close to the population baseline, though avoiding tobacco smoke is still highly recommended [3]. Blood lipid profiles, including triglycerides and cholesterol, are generally typical and do not show significant genetic elevation [4]. This genotype represents a balanced, common metabolic profile across most global populations.
Typical rate of drug clearance; Average risk of bladder cancer; Typical baseline lipid levels.
Variants with shared genetic architecture
rs1041983 · NAT2 Gene · Chr 8 · Drug Metabolism Speed
rs1495743 · NAT2 Gene · Chr 8 · Cholesterol Levels
rs4921913 · NAT2 Gene · Chr 8 · Blood Lipid Levels
Polymorphic enzymes, urinary bladder cancer risk, and structural change in the local industry.
An atlas of genetic influences on human blood metabolites.
Biological, clinical and population relevance of 95 loci for blood lipids.
Genome-wide association study identifies multiple loci associated with bladder cancer risk.
Content updated August 2026.
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