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目的采用孟德尔随机化方法探索调整体质指数的臀围与冠心病患病风险的因果关系。方法利用大样本全基因组关联研究数据,从人体测量特征基因研究(GIANT)数据库(211 114名欧洲人)中筛选出与臀围密切相关且相互独立的遗传位点,进而在冠心病全基因重复验证与Meta分析合作组(CARDIoGRAM)数据库(86 995名欧洲人)中选出对应的遗传位点,确定工具变量,通过逆方差加权法的两样本孟德尔随机化方法,以OR值反映臀围与冠心病的因果关系。结果共筛选出70个单核苷酸多态性(SNP)作为工具变量,逆方差加权法结果表明,臀围每增加1倍标准差,冠心病的风险降低16.9%(OR=0.831,95%CI 0.730~0.946);MR-Egger回归截距表明遗传多效性不会对结果造成偏倚(截距为-0.0012,P=0.875);"leave-one-out"分析未发现非特异性SNP。结论臀围增加会降低冠心病的患病风险。
Abstract:OBJECTIVE To test the causal effect of hip circumference adjusted for body mass index(HCadjBMI) and coronary heart disease(CHD) using a Mendelian randomization analysis. METHODS Based on genome-wide association study, the associations between the genetic instruments(IVs) and HCadjBMI were obtained from the GIANT consortium(n=211 114, European), the associations between IVs and CHD were derided from CARDIoGRAM consortium(n=86 995, European). The inverse-variance weighted method was used to estimate a pooled OR for the effect of a 1 cm higher HCadjBMI on CHD. Evidence of directional pleiotropy averaged across all variants was sought using MR-Egger regression. RESULTS A total of 70 genetic variants that reached genome-wide significance and independent of each other were identified as IVs. A combined genetic variants expected to confer a lifetime exposure of per SD higher HCadjBMI was associated with a lower risk of CHD(OR=0.831, 95%CI 0.730-0.946). MR-Egger regression intercept suggested that directional pleiotropy was unlikely to be biasing the result(intercept-0.0012,P=0.875). There was no specific single nucleotide polymorphism(SNP) detected by "leave one out" analysis. CONCLUSION A genetic predisposition to higher HCadjBMI was associated with lower risk of CHD.
[1] NORDESTGAARD B G,PALMER T M,BENN M,et al.The effect of elevated body mass index on ischemic heart disease risk:causal estimates from a Mendelian randomisation approach[J].PLoS Med,2012,9(5):e1001212.
[2] WHITLOCK G,LEWINGTON S,SHERLIKER P,et al.Body-mass index and cause-specific mortality in 900 000 adults:collaborative analyses of 57 prospective studies[J].Lancet,2009,373(9669):1083-1096.
[3] DE KONING L,MERCHANT A T,POGUE J,et al.Waist circumference and waist-to-hip ratio as predictors of cardiovascular events:meta-regression analysis of prospective studies[J].Eur Heart J,2007,28(7):850-856.
[4] DESPRES J P.Body fat distribution and risk of cardiovascular disease:an update[J].Circulation,2012,126(10):1301-1313.
[5] YUSUF S,HAWKEN S,OUNPUU S,et al.Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries:a case-control study[J].Lancet,2005,366(9497):1640-1649.
[6] VAZQUEZ G,DUVAL S,JACOBS D J,et al.Comparison of body mass index,waist circumference,and waist/hip ratio in predicting incident diabetes:a meta-analysis[J].Epidemiol Rev,2007,29:115-128.
[7] NILSSON G,HEDBERG P,LEPPERT J,et al.Basic anthropometric measures in acute myocardial infarction patients and individually sex- and age-matched controls from the general population[J].J Obes,2018,2018:3839482.
[8] BENETOU V,BAMIA C,TRICHOPOULOS D,et al.Associations of anthropometric characteristics with blood cholesterol fractions among adults:the Greek EPIC study[J].Eur J Clin Nutr,2006,60(8):942-948.
[9] HASSINEN M,LAKKA T A,KOMULAINEN P,et al.Association of waist and hip circumference with 12-year progression of carotid intima-media thickness in elderly women[J].Int J Obes,2007,31(9):1406-1411.
[10] ZHANG C,REXRODE K M,VAN DAM R M,et al.Abdominal obesity and the risk of all-cause,cardiovascular,and cancer mortality:sixteen years of follow-up in US women[J].Circulation,2008,117(13):1658-1667.
[11] CAMERON A J,MAGLIANO D J,SHAW J E,et al.The influence of hip circumference on the relationship between abdominal obesity and mortality[J].Int J Epidemiol,2012,41(2):484-494.
[12] CAMERON A J,MAGLIANO D J,SODERBERG S.A systematic review of the impact of including both waist and hip circumference in risk models for cardiovascular diseases,diabetes and mortality[J].Obes Rev,2013,14(1):86-94.
[13] PARKER E D,PEREIRA M A,STEVENS J,et al.Association of hip circumference with incident diabetes and coronary heart disease:the atherosclerosis risk in communities study[J].Am J Epidemiol,2009,169(7):837-847.
[14] YANG R F,ZHANG H,WANG Z,et al.A study on the relationship between waist phenotype,hypertriglyceridemia,coronary artery lesions and serum free fatty acids in adult and elderly patients with coronary diseases[J].Immun Ageing,2018,15:14.
[15] HORVEI L D,BRAEKKAN S K,MATHIESEN E B,et al.Obesity measures and risk of venous thromboembolism and myocardial infarction[J].Eur J Epidemiol,2014,29(11):821-830.
[16] KATAN M B.Commentary:Mendelian randomization,18 years on[J].Int J Epidemiol,2004,33(1):10-11.
[17] BOWDEN J,DAVEY S G,BURGESS S.Mendelian randomization with invalid instruments:effect estimation and bias detection through Egger regression[J].Int J Epidemiol,2015,44(2):512-525.
[18] BURGESS S,BUTTERWORTH A,THOMPSON S G.Mendelian randomization analysis with multiple genetic variants using summarized data[J].Genet Epidemiol,2013,37(7):658-665.
[19] PIERCE B L,BURGESS S.Efficient design for Mendelian randomization studies:subsample and 2-sample instrumental variable estimators[J].Am J Epidemiol,2013,178(7):1177-1184.
[20] SHUNGIN D,WINKLER T W,CROTEAU-CHONKA D C,et al.New genetic loci link adipose and insulin biology to body fat distribution[J].Nature,2015,518(7538):187-196.
[21] LAWLOR D A,HARBORD R M,STERNE J A,et al.Mendelian randomization:using genes as instruments for making causal inferences in epidemiology[J].Stat Med,2008,27(8):1133-1163.
[22] SCHUNKERT H,KONIG I R,KATHIRESAN S,et al.Large-scale association analysis identifies 13 new susceptibility loci for coronary artery disease[J].Nat Genet,2011,43(4):333-338.
[23] HEMANI G,ZHENG J,ELSWORTH B,et al.The MR-Base platform supports systematic causal inference across the human phenome[J].Elife,2018,7:e34408.
[24] LANFER A,MEHLIG K,HEITMANN B L,et al.Does change in hip circumference predict cardiovascular disease and overall mortality in Danish and Swedish women[J].Obesity,2014,22(3):957-963.
[25] MOHEBI R,BOZORGMANESH M,AZIZI F,et al.Effects of obesity on the impact of short-term changes in anthropometric measurements on coronary heart disease in women[J].Mayo Clin Proc,2013,88(5):487-494.
[26] CANOY D,BOEKHOLDT S M,WAREHAM N,et al.Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort:a population-based prospective study[J].Circulation,2007,116(25):2933-2943.
[27] MANOLOPOULOS K N,KARPE F,FRAYN K N.Gluteofemoral body fat as a determinant of metabolic health[J].Int J Obes,2010,34(6):949-959.
[28] RAMEZANKHANI A,BAGHERZADEH-KHIABANI F,KHALILI D,et al.A new look at risk patterns related to coronary heart disease incidence using survival tree analysis:12 years longitudinal study[J].Sci Rep,2017,7(1):3237.
基本信息:
DOI:10.19813/j.cnki.weishengyanjiu.2020.03.003
中图分类号:R541.4
引用信息:
[1]袁同慧,李洪凯,马韫韬,等.臀围与冠心病的因果推断——孟德尔随机化分析[J].卫生研究,2020,49(03):362-367.DOI:10.19813/j.cnki.weishengyanjiu.2020.03.003.
基金信息:
国家自然科学基金(No.81773547)
2020-05-30
2020-05-30