Bidirectional two-sample Mendelian randomization analysis identifies protein C rather than protein S or

Liang Shu1, Liyan Sun2, Cong Yu3

  • 1Department of Neurology, Shanghai Ninth People's Hospital, Shanghai, China.

Insights

Higher protein C levels are genetically linked to an increased risk of deep venous thrombosis (DVT). This association is partially mediated by body mass index, suggesting new avenues for DVT risk identification.

Area of Science:

  • Genetics
  • Thrombosis Research
  • Epidemiology

Background:

  • Observational studies suggest protein C and S influence thrombotic diseases.
  • The "anticoagulation paradox" in deep venous thrombosis (DVT) remains unexplained.
  • Causal links between anticoagulant proteins and DVT risk require elucidation.

Purpose of the Study:

  • To investigate the causal effects of protein C, protein S, and antithrombin-III on DVT risk.
  • To utilize a bidirectional Mendelian randomization (MR) framework for assessing these associations.
  • To explore potential mediation pathways in the protein C-DVT relationship.

Main Methods:

  • Employed a two-sample bidirectional Mendelian randomization (MR) framework.
  • Utilized genome-wide association study data from 484,598 individuals for DVT.
  • Conducted multivariable MR and two-step MR mediation analysis.

Main Results:

  • Protein C showed a significant causal association with increased DVT risk (OR per SD increase: 1.005, p < 0.001).
  • No significant causal associations were found for protein S (OR: 0.997, p = 0.146) or antithrombin-III (OR: 1.001, p = 0.456).
  • Body mass index partially mediated the protein C-DVT association (11.4% mediated proportion).

Conclusions:

  • Genetic variation in protein C levels, not protein S or antithrombin-III, is causally associated with DVT risk.
  • Findings suggest protein C's role in DVT pathogenesis, potentially influenced by BMI.
  • Offers insights for identifying individuals at higher genetic risk for DVT.
Abstract

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