The lead variant at the SERPINA1 locus, rs28929474 (P=1.0×10−27), encodes the canonical European Pi*Z allele p.Glu342Lys, causing recessively inherited α-1-antitrypsin deficiency, a disease that affects the lung and liver.36 The Lys allele leads to lower serum concentrations of α-1-antitrypsin37 and higher plasma ACE2 levels (β=0.312; SE=0.029). Here, SERPINA1 is linked to hyperinsulinemic hypoglycemia, familial, 4.