Does educational attainment modify the causal relationship between adiposity and cardiovascular disease? A Mendelian...

Area of Science:

• Epidemiology
• Genetics
• Public Health

Background:

• Cardiovascular disease (CVD) risk is linked to lower educational attainment and higher adiposity.
• The modifying effect of education on the adiposity-CVD risk relationship is not well understood.

Purpose of the Study:

• To investigate how educational attainment influences the risk of incident CVD associated with adiposity.
• To differentiate between associational and causal effects using Mendelian randomization.

Main Methods:

• Utilized associational and Mendelian randomization (MR) survival analyses.
• Included large cohorts (N > 250,000) with data on body mass index (BMI), waist-to-hip ratio (WHRadjBMI), education level, and incident CVD.
• Analyzed data collected between 2006 and 2021.

Main Results:

• Associational models suggested lower education levels amplify CVD risk from higher BMI.
• Mendelian randomization models did not find significant evidence that education modifies the causal effect of BMI on CVD.
• Waist-to-hip ratio (WHRadjBMI) did not show modified effects by education level in either model.

Conclusions:

• While observational data suggest education modifies adiposity-CVD risk, Mendelian randomization does not support a causal link.
• The discrepancy may indicate that lower education does not causally increase CVD risk from adiposity, or MR methods have limitations in detecting such differences.
• Further investigation is required to clarify the role of education in the adiposity-CVD relationship.