Risk of myocardial infarction and Osteoporosis: Insights from the 2015-2018 NHANES and Mendelian randomization Studies

Abstract

Background: There are some common pathophysiological risk factors between myocardial infarction and osteoporosis, and the exact relationship between the two is not yet clear. Our study aims to provide evidence on the relationship between myocardial infarction and osteoporosis through the analysis of data from the National Health and Nutrition Examination Survey (NHANES) and Mendelian Randomization (MR) analysis from 2015 to 2018.

Methods: A two-sample MR study using summary statistics from genome-wide association studies (GWAS) was conducted to determine the causal relationship between myocardial infarction and osteoporosis. The Inverse Variance Weighted (IVW) method and other supplementary MR methods were used to validate the causal relationship between myocardial infarction and osteoporosis. Sensitivity analysis was performed to verify the robustness of the results. Weighted multivariable adjusted logistic regression was used on the NHANES 2015-2018 data to evaluate the relationship between HDL, LDL, and BMD factors closely related to myocardial infarction.

Results: An observational study conducted in NHANES included a total of 2516 participants. Weighted multivariable adjusted logistic regression analysis showed that HDL was positively correlated with BMD, with OR and 95 % CI of 0.051 and 0.013-0.088, respectively. LDL was negatively correlated with BMD. The MR analysis also indicated a causal relationship between myocardial infarction and osteoporosis (IVW (OR = 1.16, 95 % CI = 1.02-1.32, P = 0.03)). Sensitivity analysis further confirmed the robustness and reliability of these study results (all P > 0.05).

Conclusion: There is a causal relationship between myocardial infarction and osteoporosis.

Keywords: Inflammation; Mendelian randomization; Myocardial infarction; National Health and Nutrition Examination Survey; Osteoporosis.

Fig. 1

Schematic diagram design of two-sample Mendelian randomization study on myocardial infarction and osteoporosis.

Fig. 2

Flowchart of participants in NHANES 2015–2018.BMD，Bone Mineral Density；HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Fig. 3

The forest plot shows the relationship between myocardial infarction and osteoporosis in MR.

Fig. 4

Forest plot of the causal effects of single nucleotide polymorphisms (SNPs). (A) Causal effects of single nucleotide polymorphisms (SNPs) with exposure to osteoporosis and outcome of myocardial infarction. (B) Causal effects of single nucleotide polymorphisms (SNPs) with exposure to myocardial infarction and outcome of osteoporosis.

Fig. 5

Scatter plot of the genetic association between myocardial infarction and osteoporosis. (A) Scatter plot with exposure to osteoporosis and outcome of myocardial infarction. (B) Scatter plot with exposure to myocardial infarction and outcome of osteoporosis.

Fig. 6

The association between the probabilities of HDL, LDL, and BMD. Adjusting for potential confounding variables (age; sex; race/ethnicity; PIR; systolic blood pressure; diastolic blood pressure; triglyceride; diabetes; hypertension; hypercholesterolemia). The red dotted line represents the fitted spline curve. The blue dotted line represents the 95% confidence interval. (A) The association between HDL and the probability of BMD; (B) The association between LDL and the probability of BMD.

Fig. 7

Subgroup analysis of the correlation between HDL and BMD scores (A) and the correlation between LDL and BMD scores (B).