遺伝的肥満と心房細動のリスク:メンデルのランダム化による因果的推定
Neal A Chatterjee1, Franco Giulianini1, Bastiaan Geelhoed2
1Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Circulation
|December 16, 2016
まとめ
この研究では,遺伝データを用いて,より高い体量指数 (BMI) と心房細動 (AF) のリスクの増加との間の因果関係を確認しました. これらの発見は肥満を予防することで AFの発生率を下げる可能性があることを示唆しています.
科学分野:
- 心血管遺伝学
- 流行病学
- 肥満に関する研究
背景:
- 観察研究は,ボディマス指数 (BMI) と心房細動 (AF) の間の関連性を示唆しているが,潜在的なバイアスのために因果関係は不確実である.
- メンデルのランダム化は,観察データの限界を克服し,因果関係を推論するために用いられる.
研究 の 目的:
- 体質指数 (BMI) と心房細動 (AF) の発生率との因果関係を,遺伝的変数を用いて調査する.
主な方法:
- ヨーロッパの祖先の5万1,646人のデータを利用した.
- FTO遺伝子型と39-SNP BMI遺伝子スコアを用いたメンデルのランダム化を用いた.
- ランダム効果による,インバース・バリエンス・ウェイトメットメタアナリシスによる,コホート特有の推定値の組み合わせで,平均フォローアップ期間は7. 4~19. 2年.
主要な成果:
- 両方の遺伝子指標 (FTOとBMI遺伝子スコア) は,より高いBMIとインシデントAFのリスクの増加と有意に関連していました.
- インストゥルメンタル変数の分析により,因果関係が明らかになった.BMIが1kg/ m2増加すると,AFの危険比率は1. 11 - 1. 15であった.
- 結果は観察データと一致し,多変数調整に強固であった.
結論:
- この研究は,より高いBMIと発生したAFとの間の因果関係に強い証拠を提供します.
- 肥満予防に焦点を当てた公衆衛生戦略は AFの負担を減らすのに有効です
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