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Vimaleswaran, KS; Berry, DJ; Lu, C; Tikkanen, E; Pilz, S; Hiraki, LT; Cooper, JD; Dastani, Z; Li, R; Houston, DK; Wood, AR; Michaëlsson, K; Vandenput, L; Zgaga, L; Yerges-Armstrong, LM; McCarthy, MI; Dupuis, J; Kaakinen, M; Kleber, ME; Jameson, K; Arden, N; Raitakari, O; Viikari, J; Lohman, KK; Ferrucci, L; Melhus, H; Ingelsson, E; Byberg, L; Lind, L; Lorentzon, M; Salomaa, V; Campbell, H; Dunlop, M; Mitchell, BD; Herzig, KH; Pouta, A; Hartikainen, AL; Genetic Investigation of Anthropometric Traits (GIANT) consortium; Streeten, EA; Theodoratou, E; Jula, A; Wareham, NJ; Ohlsson, C; Frayling, TM; Kritchevsky, SB; Spector, TD; Richards, JB; Lehtimäki, T; Ouwehand, WH; Kraft, P; Cooper, C; März, W; Power, C; Loos, RJ; Wang, TJ; Järvelin, MR; Whittaker, JC; Hingorani, AD; Hyppönen, E.
Causal Relationship between Obesity and Vitamin D Status: Bi-Directional Mendelian Randomization Analysis of Multiple Cohorts.
PLoS Med. 2013; 10(2):e1001383-e1001383
Doi: 10.1371/journal.pmed.1001383
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- Co-Autor*innen der Med Uni Graz
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März Winfried
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Pilz Stefan
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- Abstract:
- Background: Obesity is associated with vitamin D deficiency, and both are areas of active public health concern. We explored the causality and direction of the relationship between body mass index (BMI) and 25-hydroxyvitamin D [25(OH) D] using genetic markers as instrumental variables (IVs) in bi-directional Mendelian randomization (MR) analysis.
Methods and Findings: We used information from 21 adult cohorts (up to 42,024 participants) with 12 BMI-related SNPs (combined in an allelic score) to produce an instrument for BMI and four SNPs associated with 25(OH) D (combined in two allelic scores, separately for genes encoding its synthesis or metabolism) as an instrument for vitamin D. Regression estimates for the IVs (allele scores) were generated within-study and pooled by meta-analysis to generate summary effects. Associations between vitamin D scores and BMI were confirmed in the Genetic Investigation of Anthropometric Traits (GIANT) consortium (n = 123,864). Each 1 kg/m(2) higher BMI was associated with 1.15% lower 25(OH) D (p = 6.52x10(-27)). The BMI allele score was associated both with BMI (p = 6.30x10(-62)) and 25(OH) D (20.06% [95% CI -0.10 to -0.02], p = 0.004) in the cohorts that underwent meta-analysis. The two vitamin D allele scores were strongly associated with 25(OH) D (p ANDlt;= 8.07x10(-57) for both scores) but not with BMI (synthesis score, p = 0.88; metabolism score, p = 0.08) in the meta-analysis. A 10% higher genetically instrumented BMI was associated with 4.2% lower 25(OH) D concentrations (IV ratio: -4.2 [95% CI -7.1 to -1.3], p = 0.005). No association was seen for genetically instrumented 25(OH) D with BMI, a finding that was confirmed using data from the GIANT consortium (p ANDgt;= 0.57 for both vitamin D scores).
Conclusions: On the basis of a bi-directional genetic approach that limits confounding, our study suggests that a higher BMI leads to lower 25(OH) D, while any effects of lower 25(OH) D increasing BMI are likely to be small. Population level interventions to reduce BMI are expected to decrease the prevalence of vitamin D deficiency.
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Adult -
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Biological Markers - blood
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Body Mass Index -
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Body Mass Index -
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European Continental Ancestry Group - genetics
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Evidence-Based Medicine -
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Female -
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Genetic Predisposition to Disease -
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Humans -
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Linear Models -
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Male -
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Mendelian Randomization Analysis -
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Multivariate Analysis -
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Multivariate Analysis -
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Obesity - diagnosis Obesity - ethnology Obesity - genetics Obesity - therapy
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Polymorphism, Single Nucleotide -
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Risk Assessment -
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Risk Factors -
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Vitamin D - analogs & derivatives Vitamin D - blood
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Vitamin D Deficiency - diagnosis Vitamin D Deficiency - ethnology Vitamin D Deficiency - genetics Vitamin D Deficiency - prevention & control