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. 2020 Jan 7;41(2):221-226.
doi: 10.1093/eurheartj/ehz388.

Body mass index and body composition in relation to 14 cardiovascular conditions in UK Biobank: a Mendelian randomization study

Susanna C Larsson  1   2 , Magnus Bäck  3   4 , Jessica M B Rees  5   6 , Amy M Mason  5 , Stephen Burgess  5   7
Affiliations

Body mass index and body composition in relation to 14 cardiovascular conditions in UK Biobank: a Mendelian randomization study

Susanna C Larsson et al. Eur Heart J. .

Abstract

Aims: The causal role of adiposity for several cardiovascular diseases (CVDs) is unclear. Our primary aim was to apply the Mendelian randomization design to investigate the associations of body mass index (BMI) with 13 CVDs and arterial hypertension. We also assessed the roles of fat mass and fat-free mass on the same outcomes.

Methods and results: Single-nucleotide polymorphisms associated with BMI and fat mass and fat-free mass indices were used as instrumental variables to estimate the associations with the cardiovascular conditions among 367 703 UK Biobank participants. After correcting for multiple testing, genetically predicted BMI was significantly positively associated with eight outcomes, including and with decreasing magnitude of association: aortic valve stenosis, heart failure, deep vein thrombosis, arterial hypertension, peripheral artery disease, coronary artery disease, atrial fibrillation, and pulmonary embolism. The odds ratio (OR) per 1 kg/m2 increase in BMI ranged from 1.06 [95% confidence interval (CI) 1.02-1.11; P = 2.6 × 10-3] for pulmonary embolism to 1.13 (95% CI 1.05-1.21; P = 1.2 × 10-3) for aortic valve stenosis. There was suggestive evidence of positive associations of genetically predicted fat mass index with nine outcomes (P < 0.05). The strongest magnitude of association was with aortic valve stenosis (OR per 1 kg/m2 increase in fat mass index 1.46, 95% CI 1.13-1.88; P = 3.9 × 10-3). There was suggestive evidence of inverse associations of fat-free mass index with atrial fibrillation, ischaemic stroke, and abdominal aortic aneurysm.

Conclusion: This study provides evidence that higher BMI and particularly fat mass index are associated with increased risk of aortic valve stenosis and most other cardiovascular conditions.

Keywords: Adiposity; Body composition; Body mass index; Cardiovascular disease; Mendelian randomization; Obesity.

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Figures

Figure 1
Figure 1
Associations of genetically predicted 1 kg/m2 increase in body mass index with 14 cardiovascular conditions in UK Biobank. aTotal number of individuals is 367 703.
Figure 2
Figure 2
Associations of genetically predicted 1 kg/m2 increase in fat mass and fat-free mass indices with 14 cardiovascular conditions in UK Biobank.
Take home figure
Take home figure
Observed associations of BMI and fat mass index with cardiovascular conditions in UK Biobank. aSignificant association at the P < 0.05 level; all other associations are significant at a Bonferroni threshold of P < 3.6 × 10−3 (corrected for 14 outcomes).
None
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References

    1. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS, Vos T, Abate KH, Abbafati C, Ahmed MB, Al-Aly Z, Alkerwi A, Al-Raddadi R, Amare AT, Amberbir A, Amegah AK, Amini E, Amrock SM, Anjana RM, Arnlov J, Asayesh H, Banerjee A, Barac A, Baye E, Bennett DA, Beyene AS, Biadgilign S, Biryukov S, Bjertness E, Boneya DJ, Campos-Nonato I, Carrero JJ, Cecilio P, Cercy K, Ciobanu LG, Cornaby L, Damtew SA, Dandona L, Dandona R, Dharmaratne SD, Duncan BB, Eshrati B, Esteghamati A, Feigin VL, Fernandes JC, Furst T, Gebrehiwot TT, Gold A, Gona PN, Goto A, Habtewold TD, Hadush KT, Hafezi-Nejad N, Hay SI, Horino M, Islami F, Kamal R, Kasaeian A, Katikireddi SV, Kengne AP, Kesavachandran CN, Khader YS, Khang YH, Khubchandani J, Kim D, Kim YJ, Kinfu Y, Kosen S, Ku T, Defo BK, Kumar GA, Larson HJ, Leinsalu M, Liang X, Lim SS, Liu P, Lopez AD, Lozano R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, McAlinden C, McGarvey ST, Mengistu DT, Mensah GA, Mensink GBM, Mezgebe HB, Mirrakhimov EM, Mueller UO, Noubiap JJ, Obermeyer CM, Ogbo FA, Owolabi MO, Patton GC, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ranabhat CL, Reinig N, Safiri S, Salomon JA, Sanabria JR, Santos IS, Sartorius B, Sawhney M, Schmidhuber J, Schutte AE, Schmidt MI, Sepanlou SG, Shamsizadeh M, Sheikhbahaei S, Shin MJ, Shiri R, Shiue I, Roba HS, Silva DAS, Silverberg JI, Singh JA, Stranges S, Swaminathan S, Tabares-Seisdedos R, Tadese F, Tedla BA, Tegegne BS, Terkawi AS, Thakur JS, Tonelli M, Topor-Madry R, Tyrovolas S, Ukwaja KN, Uthman OA, Vaezghasemi M, Vasankari T, Vlassov VV, Vollset SE, Weiderpass E, Werdecker A, Wesana J, Westerman R, Yano Y, Yonemoto N, Yonga G, Zaidi Z, Zenebe ZM, Zipkin B, Murray CJL.. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017;377:13–27. - PMC - PubMed
    1. Steel N, Ford JA, Newton JN, Davis ACJ, Vos T, Naghavi M, Glenn S, Hughes A, Dalton AM, Stockton D, Humphreys C, Dallat M, Schmidt J, Flowers J, Fox S, Abubakar I, Aldridge RW, Baker A, Brayne C, Brugha T, Capewell S, Car J, Cooper C, Ezzati M, Fitzpatrick J, Greaves F, Hay R, Hay S, Kee F, Larson HJ, Lyons RA, Majeed A, McKee M, Rawaf S, Rutter H, Saxena S, Sheikh A, Smeeth L, Viner RM, Vollset SE, Williams HC, Wolfe C, Woolf A, Murray CJL.. Changes in health in the countries of the UK and 150 English Local Authority areas 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2018;392:1647–1661. - PMC - PubMed
    1. Hagg S, Fall T, Ploner A, Magi R, Fischer K, Draisma HH, Kals M, de Vries PS, Dehghan A, Willems SM, Sarin AP, Kristiansson K, Nuotio ML, Havulinna AS, de Bruijn RF, Ikram MA, Kuningas M, Stricker BH, Franco OH, Benyamin B, Gieger C, Hall AS, Huikari V, Jula A, Jarvelin MR, Kaakinen M, Kaprio J, Kobl M, Mangino M, Nelson CP, Palotie A, Samani NJ, Spector TD, Strachan DP, Tobin MD, Whitfield JB, Uitterlinden AG, Salomaa V, Syvanen AC, Kuulasmaa K, Magnusson PK, Esko T, Hofman A, de Geus EJ, Lind L, Giedraitis V, Perola M, Evans A, Ferrieres J, Virtamo J, Kee F, Tregouet DA, Arveiler D, Amouyel P, Gianfagna F, Brambilla P, Ripatti S, van Duijn CM, Metspalu A, Prokopenko I, McCarthy MI, Pedersen NL, Ingelsson E; European Network for Genetic and Genomic Epidemiology Consorium. Adiposity as a cause of cardiovascular disease: a Mendelian randomization study. Int J Epidemiol 2015;44:578–586. - PMC - PubMed
    1. Dale CE, Fatemifar G, Palmer TM, White J, Prieto-Merino D, Zabaneh D, Engmann JEL, Shah T, Wong A, Warren HR, McLachlan S, Trompet S, Moldovan M, Morris RW, Sofat R, Kumari M, Hypponen E, Jefferis BJ, Gaunt TR, Ben-Shlomo Y, Zhou A, Gentry-Maharaj A, Ryan A, Mutsert R, Noordam R, Caulfield MJ, Jukema JW, Worrall BB, Munroe PB, Menon U, Power C, Kuh D, Lawlor DA, Humphries SE, Mook-Kanamori DO, Sattar N, Kivimaki M, Price JF, Davey Smith G, Dudbridge F, Hingorani AD, Holmes MV, Casas JP.. Causal associations of adiposity and body fat distribution with coronary heart disease, stroke subtypes, and type 2 diabetes mellitus: a Mendelian randomization analysis. Circulation 2017;135:2373–2388. - PMC - PubMed
    1. Nordestgaard BG, Palmer TM, Benn M, Zacho J, Tybjaerg-Hansen A, Davey Smith G, Timpson NJ.. The effect of elevated body mass index on ischemic heart disease risk: causal estimates from a Mendelian randomisation approach. PLoS Med 2012;9:e1001212. - PMC - PubMed

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