Zou Chenchao, Zou Huaxi, Jiang Ying, Lai Songqing, Liu Jichun
Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China; Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
Nutr Metab Cardiovasc Dis. 2025 Jan;35(1):103752. doi: 10.1016/j.numecd.2024.09.022. Epub 2024 Sep 25.
Dilated cardiomyopathy is a major cause of heart failure, and hypertrophic cardiomyopathy is a common cause of sudden cardiac death in young adults. Epidemiological studies reporting the association between these cardiomyopathies and common cardiovascular risk factors, including smoking, alcohol, and obesity, are limited, and the published studies are mostly observational, making them vulnerable to bias.
We performed a two-sample Mendelian randomization analysis to assess whether cardiovascular risk factors were causally associated with dilated and hypertrophic cardiomyopathies. Independent genetic variants associated with body mass index, smoking, and alcohol were selected as instrumental variables, with two sets of instrumental variables utilized for alcohol. Dilated cardiomyopathy data on 355,318 samples and hypertrophic cardiomyopathy data on 489,727 samples were obtained from a European population-based genome-wide association study (GWAS) meta-analysis. The large GWAS data sample size improved the statistical power. Our results showed significant associations between a genetic predisposition for smoking and the risk of dilated cardiomyopathy (odds ratio (OR) = 1.33; 95 % confidence level (CI): 1.07-1.67; p = 0.012) and between a genetic predisposition for obesity and the risk of dilated cardiomyopathy (OR = 1.62; 95 % CI, 1.30-2.02; p = 1.51 × 10). The results of the other associations were not significant.
This study suggests that smoking and obesity are causally associated with an increased risk of dilated cardiomyopathy.
扩张型心肌病是心力衰竭的主要病因，肥厚型心肌病是年轻成年人心脏性猝死的常见病因。关于这些心肌病与包括吸烟、饮酒和肥胖在内的常见心血管危险因素之间关联的流行病学研究有限，且已发表的研究大多为观察性研究，容易产生偏差。
我们进行了一项两样本孟德尔随机化分析，以评估心血管危险因素是否与扩张型和肥厚型心肌病存在因果关联。将与体重指数、吸烟和饮酒相关的独立基因变异作为工具变量，对饮酒使用了两组工具变量。从一项基于欧洲人群的全基因组关联研究（GWAS）荟萃分析中获取了355,318个样本的扩张型心肌病数据和489,727个样本的肥厚型心肌病数据。大规模的GWAS数据样本量提高了统计效能。我们的结果显示，吸烟的遗传易感性与扩张型心肌病风险之间存在显著关联（优势比（OR）=1.33；95%置信区间（CI）：1.07 - 1.67；p = 0.012），肥胖的遗传易感性与扩张型心肌病风险之间也存在显著关联（OR = 1.62；95% CI，1.30 - 2.02；p = 1.51×10）。其他关联结果不显著。
本研究表明，吸烟和肥胖与扩张型心肌病风险增加存在因果关联。
