Fu Qingming, Chen Rumeng, Ding Yining, Xu Shuling, Huang Chunxia, He Binsheng, Jiang Ting, Zeng Bin, Bao Meihua, Li Sen
School of Stomatology, Changsha Medical University, Changsha, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Nutr. 2023 Dec 22;10:1250509. doi: 10.3389/fnut.2023.1250509. eCollection 2023.
The existing literature on the link between sodium intake and cardiovascular disease (CVD) largely consists of observational studies that have yielded inconsistent conclusions. In this study, our objective is to assess the causal relationship between sodium intake and 50 CVDs using two-sample Mendelian randomization (MR) analysis.
MR analyses were performed to investigate the associations between urinary sodium/creatinine ratio (U/U), an indicator of sodium intake, and 50 CVDs. The genome-wide association study (GWAS) for U/U was from the UK Biobank (UKBB), and the GWASs for CVDs were from FinnGen. A false discovery rate (FDR) threshold of 5% was applied for multiple comparison correction.
The inverse-variance weighted method indicated that the genetically predicted U/U was significantly associated with 7 of 50 CVDs, including "Coronary atherosclerosis" (OR = 2.01; 95% CI: 1.37, 2.95), "Diseases of arteries, arterioles and capillaries" (OR = 1.88; 95% CI: 1.20, 2.94), "Hard cardiovascular diseases" (OR = 1.71; 95% CI: 1.24, 2.35), "Ischemic heart diseases" (OR = 2.06; 95% CI: 1.46, 2.93), "Major coronary heart disease event" (OR = 1.99; 95% CI: 1.36, 2.91), "Myocardial infarction" (OR = 2.03; 95% CI: 1.29, 3.19), and "Peripheral artery disease" (OR = 2.50; 95% CI: 1.35, 4.63). Similar results were obtained with the MR-Egger and weighted median methods. No significant heterogeneity or horizontal pleiotropy was found in this analysis.
Our study has uncovered a significant positive causal relationship between U/U and various CVDs. These results offer a new theoretical foundation for advocating the restriction of sodium intake as a preventive measure against CVD.
关于钠摄入与心血管疾病(CVD)之间联系的现有文献主要由观察性研究组成,这些研究得出了不一致的结论。在本研究中,我们的目标是使用两样本孟德尔随机化(MR)分析来评估钠摄入与50种心血管疾病之间的因果关系。
进行MR分析以研究钠摄入指标尿钠/肌酐比值(U/U)与50种心血管疾病之间的关联。U/U的全基因组关联研究(GWAS)来自英国生物银行(UKBB),心血管疾病的GWAS来自芬兰基因库(FinnGen)。采用5%的错误发现率(FDR)阈值进行多重比较校正。
逆方差加权法表明,基因预测的U/U与50种心血管疾病中的7种显著相关,包括“冠状动脉粥样硬化”(比值比[OR]=2.01;95%置信区间[CI]:1.37,2.95)、“动脉、小动脉和毛细血管疾病”(OR=1.88;95%CI:1.20,2.94)、“严重心血管疾病”(OR=1.71;95%CI:1.24,2.35)、“缺血性心脏病”(OR=2.06;95%CI:1.46,2.93)、“主要冠心病事件”(OR=1.99;95%CI:1.36,2.91)、“心肌梗死”(OR=2.03;95%CI:1.29,3.19)和“外周动脉疾病”(OR=2.50;95%CI:1.35,4.63)。MR-Egger法和加权中位数法也得到了类似结果。该分析未发现显著的异质性或水平多效性。
我们的研究发现U/U与多种心血管疾病之间存在显著的正因果关系。这些结果为倡导限制钠摄入作为预防心血管疾病的措施提供了新的理论基础。