在HUNT和英国生物库研究中,体重指数和全因死亡率:修订的非线性门德尔随机化分析
Stephen Burgess1,2,3, Yi-Qian Sun4,5,6, Ang Zhou7,8
1MRC Biostatistics Unit, University of Cambridge, Cambridge, UK sb452@medschl.cam.ac.uk.
BMJ open
|May 15, 2024
概括
这项研究使用了门德尔的随机化来检查体重指数 (BMI) 和死亡风险. 结果显示,BMI超过25公斤/平方米的死亡风险增加,这挑战了之前的研究结果.
科学领域:
- 遗传学和流行病学
- 公共卫生研究 公共卫生研究
- 统计遗传学 统计遗传学
背景情况:
- 之前的研究表明,25kg/m2的体重指数 (BMI) 的死亡风险最低.
- 在先前的门德尔随机化分析中",持续的遗传效应"假设可能被违反.
- 准确估计BMI与死亡率的关系对于公共卫生指南至关重要.
研究的目的:
- 估计身体质量指数 (BMI) 和死亡风险之间的因果关系的形状.
- 使用强大的孟德尔随机化框架调查BMI与死亡率的关联.
- 挑战现有的关于最佳BMI和死亡率的流行病学发现.
主要方法:
- 孟德尔的随机化分析是在两个大型前性基于人口的队列 (HUNT和英国生物库) 上进行的.
- 在重新分析中使用了双级分层方法,解决了以前的残余分层方法的局限性.
- 在欧洲血统的人群中,评估了全因和因特定死亡结果.
主要成果:
- 在基因预测的BMI和死亡率之间有J形关系,在较低的BMI水平下,确定性较低.
- 在一些分析中,降低BMI的有害影响仅在20kg/m2以下观察到.
- 超过25公斤/平方米的BMI增加明显与所有原因死亡风险增加有关,心血管和癌症死亡率的门不同.
结论:
- 这些发现挑战了25公斤/米2的BMI最低死亡风险的既定概念.
- 有证据表明,对于一小部分人群来说,降低BMI可能会增加死亡风险.
- 显著增加的死亡风险是显而易见的个人与BMI超过25公斤/m2.
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