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. 2023 Apr 6:10:1073626.
doi: 10.3389/fnut.2023.1073626. eCollection 2023.

Evaluating the association between dietary salt intake and the risk of atrial fibrillation using Mendelian randomization

Sicen Wang  1 , Ye Cheng  1   2 , Qi Zheng  3 , Xin Su  2 , Yingjian Deng  2
Affiliations

Evaluating the association between dietary salt intake and the risk of atrial fibrillation using Mendelian randomization

Sicen Wang et al. Front Nutr. .

Abstract

Background: Previous studies have suggested that dietary salt intake affects atrial fibrillation (AF); however, the causal association between them still remains unclear. Thus, we conducted this Mendelian randomization (MR) study to explore the correlation between them.

Methods: Genetic instruments for dietary salt intake were from a genome-wide association study (GWAS), which included 462,630 European individuals. Summary-level data for AF were obtained from another published GWAS (22,068 cases and 116,926 controls). The inverse-variance weighting (IVW) method was performed as the primary MR analysis. Multiple MR methods, including Robust Adjusted Profile Score (MR-RAPS), maximum likelihood estimation, and Mendelian randomization pleiotropy residual sum and outlier test (MR-PRESSO) were conducted as complementary analyses. The MR-Egger regression intercept and MR-PRESSO global test were conducted to test potential horizontal pleiotropy. The IVW (Q) method and MR-Egger were performed to detect heterogeneity.

Results: Our results suggested that high dietary salt intake was significantly correlated with increased risk of AF [IVW: odds ratio (OR), 1.36; 95% confidence interval (CI), 1.04-1.77; p = 2.25E-02]. The maximum likelihood estimation (OR, 1.37; 95% CI, 1.05-1.78; p = 2.09E-02), MR-RAPS (OR, 1.37; 95% CI, 1.03-1.81; p = 2.79E-02), and MR-PRESSO method (OR, 1.36; 95% CI, 1.05-1.76; p = 2.37E-02) also showed that dietary salt intake was significantly correlated with the risk of AF.

Conclusion: The findings of this study provide robust evidence supporting the correlation between dietary salt intake and the risk of AF. Future studies are required to further clarify this relationship and translate the findings into clinical and public health practice.

Keywords: Mendelian randomization; atrial fibrillation; causal association; dietary salt intake; genetic instrument.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Assumptions of the Mendelian randomization analysis for dietary salt intake and the risk of atrial fibrillation. IVs, instrumental variables; SNPs: single nucleotide polymorphisms; IVW, inverse variance weighted; MR-RAPS, Mendelian randomization robust adjusted profile score; MR-PRESSO: Mendelian randomization pleiotropy residual sum and outlier; PWM, penalized weighted median; MR-Egger, Mendelian randomization-Egger.
Figure 2
Figure 2
Association of dietary salt intake and the risk of atrial fibrillation. SNPs, single nucleotide polymorphisms; IVW, inverse variance weighted; MR-Egger, Mendelian randomization-Egger; PWM, penalized weighted median; MR-RAPS, Mendelian randomization robust adjusted profile score; MR-PRESSO: Mendelian randomization pleiotropy residual sum and outlier.
Figure 3
Figure 3
Forest plot, Scatter plot and funnel plot of the effect of dietary salt intake on atrial fibrillation. (A) Forest plot shows the odds ratio (OR) and 95% confidence interval (CI) of each SNP assessed in the present study; (B) Scatter plot for MR analyzes of the association between dietary salt intake an atrial fibrillation. The slope of each line corresponds to the estimated association of different MR methods; (C) Funnel plot shows the estimates of precision (1/SE) and Wald ratios for each SNP; SNP, single nucleotide polymorphism; MR, Mendelian randomization.
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