scholarly journals Causal Evaluation of Laboratory Markers in Type 2 Diabetes on Cancer and Vascular Diseases Using Various Mendelian Randomization Tools

Author(s):  
Heejin Jin ◽  
Sanghun Lee ◽  
Sungho Won

Multiple studies have demonstrated the effects of type 2 diabetes (T2D) on various human diseases; however, most of these were observational epidemiological studies that suffered from many potential biases including reported confounding and reverse causations. In this article, we investigated whether cancer and vascular disease can be affected by T2D-related traits, including fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2h-PG), and glycated hemoglobin A1c (HbA1c) levels, by using Mendelian randomization (MR). The summary statistics for FPG, 2h-PG, and HbA1c were obtained through meta-analyses of large-scale genome-wide association studies that included data from 133,010 non-diabetic individuals from collaborating Meta-Analysis of Glucose and Insulin related traits Consortium studies. Thereafter, based on the statistical assumptions for MR analyses, the most reliable approaches including inverse-variance-weighted (IVW), MR-Egger, MR-Egger with a simulation extrapolation (SIMEX), weighted median and MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO) methods were applied to identify traits affected by FPG, 2h-PG, and HbAlc. We found that coronary artery disease is affected by FPG, as per the IVW [log odds ratio (logOR): 0.21; P=0.012], MR-Egger (SIMEX) (logOR: 0.22; P=0.014), MR-PRESSO (logOR: 0.18; P=0.045), and weighted median (logOR: 0.29; P<0.001) methods, but not as per the MR-Egger (logOR: 0.13; P=0.426) approach. Furthermore, low-density lipoprotein cholesterol levels are affected by HbA1c, as per the IVW (beta (B): 0.23; P=0.015), MR-Egger (B: 0.45; P=0.046), MR-Egger (SIMEX) (B: 0.27; P=0.007), MR-PRESSO (B; 0.14; P=0.010), and the weighted median (B: 0.15; P=0.012) methods. Further studies of the associated biological mechanisms are required to validate and understand the disease-specific differences identified in the TD2-related causal effects of each trait.

2020 ◽  
Vol 11 ◽  
Author(s):  
Heejin Jin ◽  
Sanghun Lee ◽  
Sungho Won

Multiple studies have demonstrated the effects of type 2 diabetes (T2D) on various human diseases; however, most of these were observational epidemiological studies that suffered from many potential biases including reported confounding and reverse causations. In this article, we investigated whether cancer and vascular disease can be affected by T2D-related traits, including fasting plasma glucose (FPG), 2-h postprandial glucose (2h-PG), and glycated hemoglobin A1c (HbA1c) levels, by using Mendelian randomization (MR). The summary statistics for FPG, 2h-PG, and HbA1c level were obtained through meta-analyses of large-scale genome-wide association studies that included data from 133,010 nondiabetic individuals from collaborating Meta-analysis of Glucose and Insulin Related Traits Consortium studies. Thereafter, based on the statistical assumptions for MR analyses, the most reliable approaches including inverse-variance-weighted (IVW), MR-Egger, MR-Egger with a simulation extrapolation (SIMEX), weighted median, and MR-pleiotropy residual sum and outlier (MR-PRESSO) methods were applied to identify traits affected by FPG, 2h-PG, and HbAlc. We found that coronary artery disease is affected by FPG, as per the IVW [log odds ratio (logOR): 0.21; P = 0.012], MR-Egger (SIMEX) (logOR: 0.22; P = 0.014), MR-PRESSO (logOR: 0.18; P = 0.045), and weighted median (logOR: 0.29; P &lt; 0.001) methods but not as per the MR-Egger (logOR: 0.13; P = 0.426) approach. Furthermore, low-density lipoprotein cholesterol levels are affected by HbA1c, as per the IVW [beta (B): 0.23; P = 0.015), MR-Egger (B: 0.45; P = 0.046), MR-Egger (SIMEX) (B: 0.27; P = 0.007), MR-PRESSO (B; 0.14; P = 0.010), and the weighted median (B: 0.15; P = 0.012] methods. Further studies of the associated biological mechanisms are required to validate and understand the disease-specific differences identified in the TD2-related causal effects of each trait.


2015 ◽  
Vol 4 (4) ◽  
pp. 249-260 ◽  
Author(s):  
Ali Abbasi

Many biomarkers are associated with type 2 diabetes (T2D) risk in epidemiological observations. The aim of this study was to identify and summarize current evidence for causal effects of biomarkers on T2D. A systematic literature search in PubMed and EMBASE (until April 2015) was done to identify Mendelian randomization studies that examined potential causal effects of biomarkers on T2D. To replicate the findings of identified studies, data from two large-scale, genome-wide association studies (GWAS) were used: DIAbetes Genetics Replication And Meta-analysis (DIAGRAMv3) for T2D and the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) for glycaemic traits. GWAS summary statistics were extracted for the same genetic variants (or proxy variants), which were used in the original Mendelian randomization studies. Of the 21 biomarkers (from 28 studies), ten have been reported to be causally associated with T2D in Mendelian randomization. Most biomarkers were investigated in a single cohort study or population. Of the ten biomarkers that were identified, nominally significant associations with T2D or glycaemic traits were reached for those genetic variants related to bilirubin, pro-B-type natriuretic peptide, delta-6 desaturase and dimethylglycine based on the summary data from DIAGRAMv3 or MAGIC. Several Mendelian randomization studies investigated the nature of associations of biomarkers with T2D. However, there were only a few biomarkers that may have causal effects on T2D. Further research is needed to broadly evaluate the causal effects of multiple biomarkers on T2D and glycaemic traits using data from large-scale cohorts or GWAS including many different genetic variants.


2022 ◽  
Vol 12 ◽  
Author(s):  
Yong-Bo Wang ◽  
Si-Yu Yan ◽  
Xu-Hui Li ◽  
Qiao Huang ◽  
Li-Sha Luo ◽  
...  

Background: Previous observational studies have reported a bidirectional association between periodontitis and type 2 diabetes, but the causality of these relationships remains unestablished. We clarified the bidirectional causal association through two-sample Mendelian randomization (MR).Methods: We obtained summary-level data for periodontitis and type 2 diabetes from several published large-scale genome-wide association studies (GWAS) of individuals of European ancestry. For the casual effect of periodontitis on type 2 diabetes, we used five independent single-nucleotide polymorphisms (SNPs) specific to periodontitis from three GWAS. The summary statistics for the associations of exposure-related SNPs with type 2 diabetes were drawn from the GWAS in the Diabetes Genetics Replication and Meta-analysis (DIAGRAM) consortium and the FinnGen consortium R5 release, respectively. For the reversed causal inference, 132 and 49 SNPs associated with type 2 diabetes from the DIAGRAM consortium and the FinnGen consortium R5 release were included, and the summary-level statistics were obtained from the Gene-Lifestyle Interactions in Dental Endpoints consortium. Multiple approaches of MR were carried out.Results: Periodontitis was not causally related with the risk of type 2 diabetes (all p &gt; 0.05). No causal effect of type 2 diabetes on periodontitis was found (all p &gt; 0.05). Estimates were consistent across multiple MR analyses.Conclusion: This study based on genetic data does not support a bidirectional causal association between periodontitis and type 2 diabetes.


Author(s):  
Guanghao Qi ◽  
Nilanjan Chatterjee

Abstract Background Previous studies have often evaluated methods for Mendelian randomization (MR) analysis based on simulations that do not adequately reflect the data-generating mechanisms in genome-wide association studies (GWAS) and there are often discrepancies in the performance of MR methods in simulations and real data sets. Methods We use a simulation framework that generates data on full GWAS for two traits under a realistic model for effect-size distribution coherent with the heritability, co-heritability and polygenicity typically observed for complex traits. We further use recent data generated from GWAS of 38 biomarkers in the UK Biobank and performed down sampling to investigate trends in estimates of causal effects of these biomarkers on the risk of type 2 diabetes (T2D). Results Simulation studies show that weighted mode and MRMix are the only two methods that maintain the correct type I error rate in a diverse set of scenarios. Between the two methods, MRMix tends to be more powerful for larger GWAS whereas the opposite is true for smaller sample sizes. Among the other methods, random-effect IVW (inverse-variance weighted method), MR-Robust and MR-RAPS (robust adjust profile score) tend to perform best in maintaining a low mean-squared error when the InSIDE assumption is satisfied, but can produce large bias when InSIDE is violated. In real-data analysis, some biomarkers showed major heterogeneity in estimates of their causal effects on the risk of T2D across the different methods and estimates from many methods trended in one direction with increasing sample size with patterns similar to those observed in simulation studies. Conclusion The relative performance of different MR methods depends heavily on the sample sizes of the underlying GWAS, the proportion of valid instruments and the validity of the InSIDE assumption. Down-sampling analysis can be used in large GWAS for the possible detection of bias in the MR methods.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Shiu Lun Au Yeung ◽  
Jie V Zhao ◽  
C Mary Schooling

Abstract Background Observational studies suggest poorer glycemic traits and type 2 diabetes associated with coronavirus disease 2019 (COVID-19) risk although these findings could be confounded by socioeconomic position. We conducted a two-sample Mendelian randomization to clarify their role in COVID-19 risk and specific COVID-19 phenotypes (hospitalized and severe cases). Method We identified genetic instruments for fasting glucose (n = 133,010), 2 h glucose (n = 42,854), glycated hemoglobin (n = 123,665), and type 2 diabetes (74,124 cases and 824,006 controls) from genome wide association studies and applied them to COVID-19 Host Genetics Initiative summary statistics (17,965 COVID-19 cases and 1,370,547 population controls). We used inverse variance weighting to obtain the causal estimates of glycemic traits and genetic predisposition to type 2 diabetes in COVID-19 risk. Sensitivity analyses included MR-Egger and weighted median method. Results We found genetic predisposition to type 2 diabetes was not associated with any COVID-19 phenotype (OR: 1.00 per unit increase in log odds of having diabetes, 95%CI 0.97 to 1.04 for overall COVID-19; OR: 1.02, 95%CI 0.95 to 1.09 for hospitalized COVID-19; and OR: 1.00, 95%CI 0.93 to 1.08 for severe COVID-19). There were no strong evidence for an association of glycemic traits in COVID-19 phenotypes, apart from a potential inverse association for fasting glucose albeit with wide confidence interval. Conclusion We provide some genetic evidence that poorer glycemic traits and predisposition to type 2 diabetes unlikely increase the risk of COVID-19. Although our study did not indicate glycemic traits increase severity of COVID-19, additional studies are needed to verify our findings.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ming-Kai Tsai ◽  
Hui-Min David Wang ◽  
Jeng-Chuan Shiang ◽  
I-Hung Chen ◽  
Chih-Chiang Wang ◽  
...  

Diabetes is a serious global health problem. Large-scale genome-wide association studies identified loci for type 2 diabetes mellitus (T2DM), including adiponectin (ADIPOQ) gene and transcription factor 7-like 2 (TCF7L2), but few studies clarified the effect of genetic polymorphisms ofADIPOQandTCF7L2on risk of T2DM. We attempted to elucidate association between T2DM and polymorphic variations of both in Taiwan’s Chinese Han population, with our retrospective case-control study genotyping single nucleotide polymorphisms (SNPs) inADIPOQandTCF7L2genes both in 149 T2DM patients and in 139 healthy controls from Taiwan. Statistical analysis gauged association of these polymorphisms with risk of T2DM to showADIPOQrs1501299 polymorphism variations strongly correlated with T2DM risk(P=0.042), with rs2241766 polymorphism being not associated with T2DM(P=0.967). However, both polymorphisms rs7903146 and rs12255372 ofTCF7L2were rarely detected in Taiwanese people. This study avers thatADIPOQrs1501299 polymorphism contributes to risk of T2DM in the Taiwanese population.


Author(s):  
Karani S. Vimaleswaran ◽  
Ruth J.F. Loos

The prevalence of obesity and diabetes, which are heritable traits that arise from the interactions of multiple genes and lifestyle factors, continues to rise worldwide, causing serious health problems and imposing a substantial economic burden on societies. For the past 15 years, candidate gene and genome-wide linkage studies have been the main genetic epidemiological approaches to identify genetic loci for obesity and diabetes, yet progress has been slow and success limited. The genome-wide association approach, which has become available in recent years, has dramatically changed the pace of gene discoveries. Genome-wide association is a hypothesis-generating approach that aims to identify new loci associated with the disease or trait of interest. So far, three waves of large-scale genome-wide association studies have identified 19 loci for common obesity and 18 for common type 2 diabetes. Although the combined contribution of these loci to the variation in obesity and diabetes risk is small and their predictive value is typically low, these recently identified loci are set to substantially improve our insights into the pathophysiology of obesity and diabetes. This will require integration of genetic epidemiological methods with functional genomics and proteomics. However, the use of these novel insights for genetic screening and personalised treatment lies some way off in the future.


2020 ◽  
Author(s):  
Sarah Shaibu ◽  
Ishaya Yohanna Longdet ◽  
Carrol Domkat Luka ◽  
Jesse Fanen Ortswen ◽  
Gloria Eleojo Eneojoabah ◽  
...  

Type 2 diabetes (T2D), the most prevalent type of diabetes has been associated with Transcription-Factor-7-Like-2 gene Single Nucleotide Polymorphisms (SNPs), rs12255372 and rs7903146 as risk factors, thought to be modulated by obesity status. In sub-Saharan Africa, the onset of T2D in the non-obese is rarely suspected. This study looks into the genetics and the biochemical parameters in non-obese population, with and without T2D and living in Jos, Nigeria. A total of 68 subjects, 40 diabetic patients and 28 healthy control group, all with closely matched age, height, nutrition, family history, Body Mass Index and socioeconomic status, recruited from within the same population were studied. SNPs Genotyping were performed using Polymerase Chain Reaction and Sangers Sequencing. Lipid profiles, Fasting Blood Sugar and C-peptide levels were measured and analysed alongside with demographic data from questionnaire. Odd-ratio at 95% confidence interval at a conventional level of alpha, <0.05 and Product Moment Correlation Coefficient Analysis were used to analyse the data in both groups. The entire population showed the GG genotype for the rs12255372. However, different genotype combination, CC, CT and TT were observed with the rs7903146. Though no significant association was observed between the genotypes and the odd of T2D, healthy subjects with the T allele showed a higher level of two hours postprandial plasma glucose level than those with CC genotype. Patients with T allele shows a more abnormal level of diabetes metabolic syndrome indicators such as Fasting Blood Sugar; two hours postprandial plasma glucose level; C-peptide; Low Density Lipoprotein, High Density Lipoprotein and Total Cholesterol. The study suggests that lower sugar metabolism and more dyslipidaemia are observed in subject with T allele. Hence, this could constitute poorer prognosis and a risk factor for non-obese population, particularly with high carbohydrate intake.


2021 ◽  
Author(s):  
Haoyang Zhang ◽  
Xuehao Xiu ◽  
Angli Xue ◽  
Yuedong Yang ◽  
Yuanhao Yang ◽  
...  

AbstractBackgroundThe epidemiological association between type 2 diabetes and cataract has been well-established. However, it remains unclear whether the two diseases share a genetic basis, and if so, whether this reflects a causal relationship.MethodsWe utilized East Asian population-based genome-wide association studies (GWAS) summary statistics of type 2 diabetes (Ncase=36,614, Ncontrol=155,150) and cataract (Ncase=24,622, Ncontrol=187,831) to comprehensively investigate the shared genetics between the two diseases. We performed 1. linkage disequilibrium score regression (LDSC) and heritability estimation from summary statistics (ρ-HESS) to estimate the genetic correlation and local genetic correlation between type 2 diabetes and cataract; 2. multiple Mendelian randomization (MR) analyses to infer the putative causality between type 2 diabetes and cataract; and 3. Summary-data-based Mendelian randomization (SMR) to identify candidate risk genes underling the causality.ResultsWe observed a strong genetic correlation (rg=0.58; p-value=5.60×10−6) between type 2 diabetes and cataract. Both ρ-HESS and multiple MR methods consistently showed a putative causal effect of type 2 diabetes on cataract, with estimated liability-scale MR odds ratios (ORs) at around 1.10 (95% confidence interval [CI] ranging from 1.06 to 1.17). In contrast, no evidence supports a causal effect of cataract on type 2 diabetes. SMR analysis identified two novel genes MIR4453HG (βSMR=−0.34, p-value=6.41×10−8) and KCNK17 (βSMR=−0.07, p-value=2.49×10−10), whose expression levels were likely involved in the putative causality of type 2 diabetes on cataract.ConclusionsOur results provided robust evidence supporting a causal effect of type 2 diabetes on the risk of cataract in East Asians, and posed new paths on guiding prevention and early-stage diagnosis of cataract in type 2 diabetes patients.Key MessagesWe utilized genome-wide association studies of type 2 diabetes and cataract in a large Japanese population-based cohort and find a strong genetic overlap underlying the two diseases.We performed multiple Mendelian randomization models and consistently disclosed a putative causal effect of type 2 diabetes on the development of cataract.We revealed two candidate genes MIR4453HG and KCNK17 whose expression levelss are likely relevant to the causality between type 2 diabetes and cataract.Our study provided theoretical fundament at the genetic level for improving early diagnosis, prevention and treatment of cataract in type 2 diabetes patients in clinical practice


2021 ◽  
Author(s):  
Ify R Mordi ◽  
R Thomas Lumbers ◽  
Colin NA Palmer ◽  
Ewan R Pearson ◽  
Naveed Sattar ◽  
...  

<b>Objective</b> <p>The aim of this study was to use Mendelian randomization (MR) techniques to estimate the causal relationships between genetic liability to type 2 diabetes, glycaemic traits and risk of HF.</p> <p><b>Research Design and Methods</b></p> <p>Summary-level data were obtained from genome-wide association studies (GWAS) of type 2 diabetes, insulin resistance (IR), glycated haemoglobin, fasting insulin and glucose and HF. MR was conducted using the inverse variance weighted (IVW) method. Sensitivity analyses included MR-Egger, weighted median and mode methods, and multivariable MR conditioning on potential mediators.</p> <p><b>Results</b></p> <p>Genetic liability to type 2 diabetes was causally related to higher risk of HF (OR: 1.13 per 1 log-unit higher risk of type 2 diabetes; 95% CI 1.11-1.14, p<0.001), however sensitivity analysis revealed evidence of directional pleiotropy. The relationship between type 2 diabetes and HF was attenuated when adjusted for coronary disease, body mass index, LDL-cholesterol and blood pressure. Genetically-instrumented higher IR was associated with higher risk of HF (OR 1.19 per 1 log-unit higher risk of IR; 95% CI 1.00-1.41, p=0.041). There were no notable associations identified between fasting insulin, glucose or glycated haemoglobin and risk of HF. Genetic liability to HF was causally linked to higher risk of type 2 diabetes (OR 1.49; 95% CI 1.01-2.19, p=0.042) though again with evidence of pleiotropy.</p> <p><b>Conclusions</b></p> These findings suggest a causal role of type 2 diabetes and IR in HF aetiology, though both the presence of bidirectional effects and directional pleiotropy highlight potential sources of bias that need to be considered.


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