通过孟德尔随机化分析发现,不吃早餐通过血液代谢物对心力衰竭产生影响。
Blood metabolites mediate effects of breakfast skipping on heart failure via Mendelian randomization analysis.
机构信息
Department of Cardiology, The Second Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China.
Department of Cardiology, The Frist Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China.
出版信息
Sci Rep. 2024 Aug 15;14(1):18957. doi: 10.1038/s41598-024-69874-7.
Numerous observational studies have suggested a potential causal relationship between skipping breakfast and cardiovascular diseases, including heart failure (HF). However, these studies are susceptible to inherent confounders and the challenge of reverse causation, and the underlying metabolic factors are not yet clear. Therefore, our aim is to assess the causal impact of breakfast skipping on HF and the role of potential mediating metabolic products from a genetic perspective, by conducting Mendelian Randomization (MR) studies and mediation analysis. We leveraged summary data from the most extensive genome-wide association studies to date on breakfast skipping (with 193,860 participants), blood metabolites (with 118,461 participants), and HF (involving 47,309 cases and 930,014 controls). To explore the causal relationship between breakfast skipping and HF, as well as the role of 249 potential blood metabolite mediators, we conducted bidirectional MR and mediation MR analyses. We primarily employed the Inverse Variance Weighted (IVW) method, complemented by various other techniques to ensure the comprehensiveness and reliability of our analysis. Our research confirms a causal association between breakfast skipping and an increased risk of HF (odds ratio [OR]: 1.378, 95% confidence interval [CI]: 1.047-1.813; p = 0.022). Furthermore, our research findings demonstrate that breakfast skipping is positively correlated with 6 blood metabolites and negatively correlated with 2 others. Notably, our mediation MR analysis further reveals that three blood metabolites act as mediators in the relationship between breakfast skipping and the risk of HF. Specifically, the mediating effects are attributed to the ratio of docosahexaenoic acid (DHA) to total fatty acids (proportion mediated = 9.41%, 95% CI: 2.10-28.61%), glucose (proportion mediated = 6.17%, 95% CI: 0.97-28.53%), and glycoprotein acetyls (GlycA) (proportion mediated = 5.68%, 95% CI: 0.94-21.62%). The combined mediating effects of these three factors total 20.53% (95%CI: 8.59-91.06%). Our research confirms the causal relationship between genetically instrumented breakfast skipping and HF, underscoring the potential mediating roles played by three key blood metabolites: ratio of DHA to total fatty acids, glucose and GlycA. This discovery offers valuable perspectives for clinical strategies targeting HF.
大量观察性研究表明,不吃早餐与心血管疾病,包括心力衰竭(HF)之间存在潜在的因果关系。然而,这些研究容易受到内在混杂因素和反向因果关系的影响,其潜在的代谢因素尚不清楚。因此,我们的目的是通过孟德尔随机化(MR)研究和中介分析,从遗传角度评估不吃早餐对 HF 的因果影响,以及潜在代谢产物的作用。我们利用迄今为止关于不吃早餐(涉及 193860 名参与者)、血液代谢物(涉及 118461 名参与者)和 HF(涉及 47309 例病例和 930014 名对照)的最大基因组关联研究的汇总数据进行研究。为了探讨不吃早餐与 HF 之间的因果关系,以及 249 种潜在血液代谢物中介物的作用,我们进行了双向 MR 和中介 MR 分析。我们主要采用了逆方差加权(Inverse Variance Weighted,IVW)方法,并辅以其他各种技术,以确保我们分析的全面性和可靠性。我们的研究证实,不吃早餐与 HF 风险增加之间存在因果关系(比值比[OR]:1.378,95%置信区间[CI]:1.047-1.813;p=0.022)。此外,我们的研究结果表明,不吃早餐与 6 种血液代谢物呈正相关,与 2 种血液代谢物呈负相关。值得注意的是,我们的中介 MR 分析进一步表明,三种血液代谢物在不吃早餐与 HF 风险之间的关系中起中介作用。具体而言,介导作用归因于二十二碳六烯酸(DHA)与总脂肪酸的比值(介导比例=9.41%,95%CI:2.10-28.61%)、葡萄糖(介导比例=6.17%,95%CI:0.97-28.53%)和糖蛋白乙酰基(GlycA)(介导比例=5.68%,95%CI:0.94-21.62%)。这三个因素的综合介导作用总计为 20.53%(95%CI:8.59-91.06%)。我们的研究证实了遗传上与不吃早餐相关的 HF 之间的因果关系,强调了三种关键血液代谢物(DHA 与总脂肪酸的比值、葡萄糖和 GlycA)在其中的潜在介导作用。这一发现为针对 HF 的临床策略提供了有价值的视角。