학술논문

The role of adiposity in cardiometabolic traits: a Mendelian randomization analysis.
Document Type
article
Author
Tove FallSara HäggReedik MägiAlexander PlonerKrista FischerMomoko HorikoshiAntti-Pekka SarinGudmar ThorleifssonClaes LadenvallMart KalsMaris KuningasHarmen H M DraismaJanina S RiedNatalie R van ZuydamVille HuikariMassimo ManginoEmily SonestedtBeben BenyaminChristopher P NelsonNatalia V RiveraKati KristianssonHuei-Yi ShenAki S HavulinnaAbbas DehghanLouise A DonnellyMarika KaakinenMarja-Liisa NuotioNeil RobertsonRenée F A G de BruijnM Arfan IkramNajaf AminAnthony J BalmforthPeter S BraundAlexander S F DoneyAngela DöringPaul ElliottTõnu EskoOscar H FrancoSolveig GretarsdottirAnna-Liisa HartikainenKauko HeikkiläKarl-Heinz HerzigHilma HolmJouke Jan HottengaElina HyppönenThomas IlligAaron IsaacsBo IsomaaLennart C KarssenJohannes KettunenWolfgang KoenigKari KuulasmaaTiina LaatikainenJaana LaitinenCecilia LindgrenValeriya LyssenkoEsa LääräNigel W RaynerSatu MännistöAnneli PoutaWolfgang RathmannFernando RivadeneiraAimo RuokonenMarkku J SavolainenEric J G SijbrandsKerrin S SmallJan H SmitValgerdur SteinthorsdottirAnn-Christine SyvänenAnja TaanilaMartin D TobinAndre G UitterlindenSara M WillemsGonneke WillemsenJacqueline WittemanMarkus PerolaAlun EvansJean FerrièresJarmo VirtamoFrank KeeDavid-Alexandre TregouetDominique ArveilerPhilippe AmouyelMarco M FerrarioPaolo BrambillaAlistair S HallAndrew C HeathPamela A F MaddenNicholas G MartinGrant W MontgomeryJohn B WhitfieldAntti JulaPaul KnektBen OostraCornelia M van DuijnBrenda W J H PenninxGeorge Davey SmithJaakko KaprioNilesh J SamaniChristian GiegerAnnette PetersH Erich WichmannDorret I BoomsmaEco J C de GeusTiinaMaija TuomiChris PowerChristopher J HammondTim D SpectorLars LindMarju Orho-MelanderColin Neil Alexander PalmerAndrew D MorrisLeif GroopMarjo-Riitta JärvelinVeikko SalomaaErkki VartiainenAlbert HofmanSamuli RipattiAndres MetspaluUnnur ThorsteinsdottirKari StefanssonNancy L PedersenMark I McCarthyErik IngelssonInga ProkopenkoEuropean Network for Genetic and Genomic Epidemiology (ENGAGE) consortium
Source
PLoS Medicine, Vol 10, Iss 6, p e1001474 (2013)
Subject
Medicine
Language
English
ISSN
1549-1277
1549-1676
Abstract
BackgroundThe association between adiposity and cardiometabolic traits is well known from epidemiological studies. Whilst the causal relationship is clear for some of these traits, for others it is not. We aimed to determine whether adiposity is causally related to various cardiometabolic traits using the Mendelian randomization approach.Methods and findingsWe used the adiposity-associated variant rs9939609 at the FTO locus as an instrumental variable (IV) for body mass index (BMI) in a Mendelian randomization design. Thirty-six population-based studies of individuals of European descent contributed to the analyses. Age- and sex-adjusted regression models were fitted to test for association between (i) rs9939609 and BMI (n = 198,502), (ii) rs9939609 and 24 traits, and (iii) BMI and 24 traits. The causal effect of BMI on the outcome measures was quantified by IV estimators. The estimators were compared to the BMI-trait associations derived from the same individuals. In the IV analysis, we demonstrated novel evidence for a causal relationship between adiposity and incident heart failure (hazard ratio, 1.19 per BMI-unit increase; 95% CI, 1.03-1.39) and replicated earlier reports of a causal association with type 2 diabetes, metabolic syndrome, dyslipidemia, and hypertension (odds ratio for IV estimator, 1.1-1.4; all p < 0.05). For quantitative traits, our results provide novel evidence for a causal effect of adiposity on the liver enzymes alanine aminotransferase and gamma-glutamyl transferase and confirm previous reports of a causal effect of adiposity on systolic and diastolic blood pressure, fasting insulin, 2-h post-load glucose from the oral glucose tolerance test, C-reactive protein, triglycerides, and high-density lipoprotein cholesterol levels (all p < 0.05). The estimated causal effects were in agreement with traditional observational measures in all instances except for type 2 diabetes, where the causal estimate was larger than the observational estimate (p = 0.001).ConclusionsWe provide novel evidence for a causal relationship between adiposity and heart failure as well as between adiposity and increased liver enzymes.