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降脂药物与肌肉减少症风险的关联:药物靶点孟德尔随机化研究和荟萃分析。

Association of lipid-lowering drugs with risk of sarcopenia: a drug target mendelian randomization study and meta-analysis.

机构信息

Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Hum Genomics. 2024 Jul 3;18(1):76. doi: 10.1186/s40246-024-00643-3.


DOI:10.1186/s40246-024-00643-3
PMID:38961447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11223278/
Abstract

BACKGROUND: Lipid-lowering drugs are widely used among the elderly, with some studies suggesting links to muscle-related symptoms. However, the causality remains uncertain. METHODS: Using the Mendelian randomization (MR) approach, we assessed the causal effects of genetically proxied reduced low-density lipoprotein cholesterol (LDL-C) through inhibitions of hydroxy-methyl-glutaryl-CoA reductase (HMGCR), proprotein convertase subtilisin/kexin type 9 (PCSK9), and Niemann-Pick C1-like 1 (NPC1L1) on sarcopenia-related traits, including low hand grip strength, appendicular lean mass, and usual walking pace. A meta-analysis was conducted to combine the causal estimates from different consortiums. RESULTS: Using LDL-C pooled data predominantly from UK Biobank, genetically proxied inhibition of HMGCR was associated with higher appendicular lean mass (beta = 0.087, P = 7.56 × 10) and slower walking pace (OR = 0.918, P = 6.06 × 10). In contrast, inhibition of PCSK9 may reduce appendicular lean mass (beta = -0.050, P = 1.40 × 10), while inhibition of NPC1L1 showed no causal impact on sarcopenia-related traits. These results were validated using LDL-C data from Global Lipids Genetics Consortium, indicating that HMGCR inhibition may increase appendicular lean mass (beta = 0.066, P = 2.17 × 10) and decelerate walking pace (OR = 0.932, P = 1.43 × 10), whereas PCSK9 inhibition could decrease appendicular lean mass (beta = -0.048, P = 1.69 × 10). Meta-analysis further supported the robustness of these causal associations. CONCLUSIONS: Genetically proxied HMGCR inhibition may increase muscle mass but compromise muscle function, PCSK9 inhibition could result in reduced muscle mass, while NPC1L1 inhibition is not associated with sarcopenia-related traits and this class of drugs may serve as viable alternatives to sarcopenia individuals or those at an elevated risk.

摘要

背景:降脂药在老年人中广泛使用,一些研究表明与肌肉相关症状有关。然而,因果关系仍不确定。

方法:我们使用孟德尔随机化(MR)方法,通过评估羟甲基戊二酰基辅酶 A 还原酶(HMGCR)、前蛋白转化酶枯草杆菌蛋白酶/激肽释放酶 9(PCSK9)和 Niemann-Pick C1 样 1(NPC1L1)的遗传相关性,来评估降低低密度脂蛋白胆固醇(LDL-C)对与肌肉减少症相关的特征的因果效应,包括低手握力、四肢瘦体重和通常的行走速度。对来自不同联盟的因果估计值进行了荟萃分析。

结果:使用主要来自英国生物库的 LDL-C 汇总数据,遗传相关性 HMGCR 抑制与较高的四肢瘦体重(β=0.087,P=7.56×10)和较慢的行走速度(OR=0.918,P=6.06×10)相关。相反,PCSK9 的抑制可能会降低四肢瘦体重(β=-0.050,P=1.40×10),而 NPC1L1 的抑制对与肌肉减少症相关的特征没有因果影响。这些结果使用来自全球脂质遗传学联盟的 LDL-C 数据进行了验证,表明 HMGCR 抑制可能会增加四肢瘦体重(β=0.066,P=2.17×10)并减缓行走速度(OR=0.932,P=1.43×10),而 PCSK9 的抑制会降低四肢瘦体重(β=-0.048,P=1.69×10)。荟萃分析进一步支持了这些因果关联的稳健性。

结论:遗传相关性 HMGCR 抑制可能会增加肌肉质量,但会损害肌肉功能,PCSK9 抑制可能会导致肌肉质量减少,而 NPC1L1 抑制与肌肉减少症相关特征无关,这类药物可能是肌肉减少症患者或处于高风险人群的可行替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/3cf9d5b42d15/40246_2024_643_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/b43d930ad9c1/40246_2024_643_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/aef50a1b55a7/40246_2024_643_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/451625fd6a86/40246_2024_643_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/3cf9d5b42d15/40246_2024_643_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/b43d930ad9c1/40246_2024_643_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/aef50a1b55a7/40246_2024_643_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/451625fd6a86/40246_2024_643_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e221/11223278/3cf9d5b42d15/40246_2024_643_Fig4_HTML.jpg

相似文献

[1]
Association of lipid-lowering drugs with risk of sarcopenia: a drug target mendelian randomization study and meta-analysis.

Hum Genomics. 2024-7-3

[2]
Associations of genetically proxied inhibition of HMG-CoA reductase, NPC1L1, and PCSK9 with breast cancer and prostate cancer.

Breast Cancer Res. 2022-2-12

[3]
Genetic association of lipid-lowering drugs with aortic aneurysms: a Mendelian randomization study.

Eur J Prev Cardiol. 2024-7-23

[4]
Using genetic variants to evaluate the causal effect of cholesterol lowering on head and neck cancer risk: A Mendelian randomization study.

PLoS Genet. 2021-4

[5]
Association Between Genetically Proxied Inhibition of HMG-CoA Reductase and Epithelial Ovarian Cancer.

JAMA. 2020-2-18

[6]
Effects of genetically proxied lipid-lowering drugs on acute myocardial infarction: a drug-target mendelian randomization study.

Lipids Health Dis. 2024-6-3

[7]
Novel insights into the association between genetically proxied inhibition of proprotein convertase subtilisin/kexin type 9 and risk of sarcopenia.

J Cachexia Sarcopenia Muscle. 2024-12

[8]
LDL-c Lowering, Ischemic Stroke, and Small Vessel Disease Brain Imaging Biomarkers: A Mendelian Randomization Study.

Stroke. 2024-6

[9]
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Lipids Health Dis. 2024-10-2

[10]
Associations between Genetically Proxied Inhibition of Lipid-Lowering Drug Targets and Serum Micronutrients among Individuals of European Descent: A Mendelian Randomization Study.

J Nutr. 2022-5-5

本文引用的文献

[1]
Evidence for genetic causal relationships between gut microbiome, metabolites, and myasthenia gravis: a bidirectional Mendelian randomization study.

Front Immunol. 2023

[2]
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Curr Probl Cardiol. 2024-1

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Front Pharmacol. 2022-11-24

[10]
Statins are associated with reduced likelihood of sarcopenia in a sample of heart failure outpatients: a cross-sectional study.

BMC Cardiovasc Disord. 2022-8-5

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