Causal relationship of central and general adiposity with CHD and T2DM
Causal Associations of Adiposity and Body Fat Distribution with Coronary Heart Disease, Stroke Subtypes and Type 2 Diabetes: A Mendelian Randomization AnalysisLiterature - Dale C, Fatemifar G, Palmer P, et al; on behalf of UCLEB consortium and METASTROKE consortium - Circulation. 2017; published online ahead of print
- Both genetically instrumented adiposity measures (single nucleotide polymorphisms for BMI and for WHR adjusted for BMI) were causally associated with increased insulin and triglyceride levels, decreased levels of HDL-C and higher IL-6, as well as with some of the left ventricular hypertrophy ECG measures.
- WHR was associated with increased LDL-C, systolic blood pressure (SBP) and weakly with lung function, while BMI was inversely associated with albumin.
- The OR for CHD per 1 SD increment in BMI was 1.36 (95% CI: 1.22-1.52).
- There was an association between WHR and CHD using conventional MR (OR per SD 1.48; 95% CI: 1.28-1.71).
- The causal OR for the association between BMI and IS was 1.09 per SD (95% CI: 0.93-1.28), however, estimates for the association between BMI and stroke subtypes were imprecise and all 95% CIs included the null.
- There was some evidence for a causal association of WHR with IS (OR per SD 1.32; 95% CI: 1.03-1.70), with limited evidence for a causal association with stroke subtypes.
- There was a causal OR for T2DM of 1.98 (95% CI: 1.41-2.78) per SD increase in BMI.
- There was a causal relationship between WHR and T2DM (OR per SD increase 1.82; 95% CI: 1.38-2.42).
- The multivariate MR, adjusted for smoking, for the causal association of WHR with IS was 1.27 (95% CI: 0.84-1.93).
In a Mendelian randomization analysis of 14 studies and 4 consortia, there was a causal relationship of both central and general adiposity with the risk of CHD and T2DM. Central adiposity was associated with the risk of IS and may represent a higher risk for stroke and CHD. These results suggest that different types of adiposity may have different effects on CVD risk.