Jixin Li, Wang Wenru, Qiu Linjie, Ren Yan, Li Meijie, Li Wenjie, Zhang Jin
Xiyuan Hospital, China Academy of Chinese Medical Sciences, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40618. doi: 10.1097/MD.0000000000040618.
Observational studies and meta-analyses have indicated a notable correlation between obesity and vitamin D deficiency, yet the causal relationship between the 2 remains contentious. This study employed a bidirectional Mendelian randomization (MR) analysis to explore the interrelation between obesity-associated body metrics: specifically body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage (BFP), whole-body fat percentage (WHF), and 25-hydroxyvitamin D (25(OH)D) levels. Instrumental variables for BMI, WHR, BFP, whole body fat mass (WFM), and 25(OH)D were carefully selected based on predefined thresholds. The association between these metrics and 25(OH)D levels was assessed using the TwoSampleMR package in R 4.2.3. Analysis methods included inverse variance weighted (IVW), MR Egger regression, weighted median, weighted mode, and simple mode. Sensitivity analyses were conducted employing the TwoSampleMR and MR-PRESSO software packages in R 4.2.3 to evaluate heterogeneity and multiplicity of findings. All 4 body components exhibited statistically significant causal associations with decreased 25(OH)D levels: BMI (IVW: odds ratio [OR] = 0.912, 95% confidence interval [CI]: 0.888-0.937, P < .001), WHR (IVW: OR = 0.927, 95% CI: 0.882-0.975, P = .003), BFP (IVW: OR = 0.883, 95% CI: 0.867-0.899, P < .001), and WFM (IVW: OR = 0.850, 95% CI: 0.829-0.872, P < .001). However, no statistically significant inverse causative association was observed between these body components and 25(OH)D levels. Sensitivity analyses revealed no substantial heterogeneity or pleiotropy, ensuring robustness of the findings. This study substantiates a significant causal link between 4 obesity-related body components and decreased 25(OH)D levels, excluding reverse causality.
观察性研究和荟萃分析表明,肥胖与维生素D缺乏之间存在显著相关性,但两者之间的因果关系仍存在争议。本研究采用双向孟德尔随机化(MR)分析,以探讨肥胖相关身体指标之间的相互关系:具体而言,包括体重指数(BMI)、腰臀比(WHR)、体脂百分比(BFP)、全身脂肪百分比(WHF)和25-羟基维生素D(25(OH)D)水平。基于预定义阈值,精心选择了BMI、WHR、BFP、全身脂肪量(WFM)和25(OH)D的工具变量。使用R 4.2.3中的TwoSampleMR软件包评估这些指标与25(OH)D水平之间的关联。分析方法包括逆方差加权(IVW)、MR Egger回归、加权中位数、加权众数和简单众数。使用R 4.2.3中的TwoSampleMR和MR-PRESSO软件包进行敏感性分析,以评估研究结果的异质性和多重性。所有4种身体成分与25(OH)D水平降低均表现出具有统计学意义的因果关联:BMI(IVW:优势比[OR]=0.912,95%置信区间[CI]:0.888-0.937,P<.001)、WHR(IVW:OR=0.927,95%CI:0.882-0.975,P=.003)、BFP(IVW:OR=0.883,95%CI:0.867-0.899,P<.001)和WFM(IVW:OR=0.850,95%CI:0.829-0.872,P<.001)。然而,未观察到这些身体成分与25(OH)D水平之间存在具有统计学意义的反向因果关联。敏感性分析未发现实质性的异质性或多效性,确保了研究结果的稳健性。本研究证实了4种肥胖相关身体成分与25(OH)D水平降低之间存在显著的因果关系,排除了反向因果关系。