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Chiou JS, Lin YJ, Chang CYY, Liang WM, Liu TY, Yang JS, Chou CH, Lu HF, Chiu ML, Lin TH, Liao CC, Huang SM, Chou IC, Li TM, Huang PY, Chien TS, Chen HR, Tsai FJ. Menarche-a journey into womanhood: age at menarche and health-related outcomes in East Asians. Hum Reprod 2024; 39:1336-1350. [PMID: 38527428 DOI: 10.1093/humrep/deae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
STUDY QUESTION Are there associations of age at menarche (AAM) with health-related outcomes in East Asians? SUMMARY ANSWER AAM is associated with osteoporosis, Type 2 diabetes (T2D), glaucoma, and uterine fibroids, as demonstrated through observational studies, polygenic risk scores, genetic correlations, and Mendelian randomization (MR), with additional findings indicating a causal effect of BMI and T2D on earlier AAM. WHAT IS KNOWN ALREADY Puberty timing is linked to adult disease risk, but research predominantly focuses on European populations, with limited studies in other groups. STUDY DESIGN, SIZE, DURATION We performed an AAM genome-wide association study (GWAS) with 57 890 Han Taiwanese females and examined the association between AAM and 154 disease outcomes using the Taiwanese database. Additionally, we examined genetic correlations between AAM and 113 diseases and 67 phenotypes using Japanese GWAS summary statistics. PARTICIPANTS/MATERIALS, SETTING, METHODS We performed AAM GWAS and gene-based GWAS studies to obtain summary statistics and identify potential AAM-related genes. We applied phenotype, polygenic risk scores, and genetic correlation analyses of AAM to explore health-related outcomes, using multivariate regression and linkage disequilibrium score regression analyses. We also explored potential bidirectional causal relationships between AAM and related outcomes through univariable and multivariable MR analyses. MAIN RESULTS AND THE ROLE OF CHANCE Fifteen lead single-nucleotide polymorphisms and 24 distinct genes were associated with AAM in Taiwan. AAM was genetically associated with later menarche and menopause, greater height, increased osteoporosis risk, but lower BMI, and reduced risks of T2D, glaucoma, and uterine fibroids in East Asians. Bidirectional MR analyses indicated that higher BMI/T2D causally leads to earlier AAM. LIMITATIONS, REASONS FOR CAUTION Our findings were specific to Han Taiwanese individuals, with genetic correlation analyses conducted in East Asians. Further research in other ethnic groups is necessary. WIDER IMPLICATIONS OF THE FINDINGS Our study provides insights into the genetic architecture of AAM and its health-related outcomes in East Asians, highlighting causal links between BMI/T2D and earlier AAM, which may suggest potential prevention strategies for early puberty. STUDY FUNDING/COMPETING INTEREST(S) The work was supported by China Medical University, Taiwan (CMU110-S-17, CMU110-S-24, CMU110-MF-49, CMU111-SR-158, CMU111-MF-105, CMU111-MF-21, CMU111-S-35, CMU112-SR-30, and CMU112-MF-101), the China Medical University Hospital, Taiwan (DMR-111-062, DMR-111-153, DMR-112-042, DMR-113-038, and DMR-113-103), and the Ministry of Science and Technology, Taiwan (MOST 111-2314-B-039-063-MY3, MOST 111-2314-B-039-064-MY3, MOST 111-2410-H-039-002-MY3, and NSTC 112-2813-C-039-036-B). The funders had no influence on the data collection, analyses, or conclusions of the study. No conflict of interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Jian-Shiun Chiou
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ying-Ju Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Cherry Yin-Yi Chang
- Division of Minimal Invasive Endoscopy Surgery, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ting-Yuan Liu
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Jai-Sing Yang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chen-Hsing Chou
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Hsing-Fang Lu
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Mu-Lin Chiu
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - I-Ching Chou
- Department of Pediatrics, China Medical University Children's Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Te-Mao Li
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Peng-Yan Huang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Tzu-Shun Chien
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Hou-Ren Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Pediatrics, China Medical University Children's Hospital, Taichung, Taiwan
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
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Fan HY, Chien KL, Huang YT, Hsu JB, Chen YY, Lai EY, Su JY, Lu TP, Li HY, Hsu SY, Chen YC. Hypertension as a Novel Link for Shared Heritability in Age at Menarche and Cardiometabolic Traits. J Clin Endocrinol Metab 2023; 108:2389-2399. [PMID: 36810613 DOI: 10.1210/clinem/dgad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT Extremely early age at menarche, also called precocious puberty, has been associated with various cardiometabolic traits, but their shared heritability remains unclear. OBJECTIVES This work aimed to identify new shared genetic variants and their pathways for age at menarche and cardiometabolic traits and to investigate the influence of central precocious puberty on childhood cardiometabolic traits. METHODS Using the conjunction false discovery rate method, this study analyzed genome-wide association study data from the menarche-cardiometabolic traits among 59 655 females of Taiwanese ancestry and systemically investigated pleiotropy between age at menarche and cardiometabolic traits. To support the novel hypertension link, we used the Taiwan Puberty Longitudinal Study (TPLS) to investigate the influence of precocious puberty on childhood cardiometabolic traits. RESULTS We discovered 27 novel loci, with an overlap between age at menarche and cardiometabolic traits, including body fat and blood pressure. Among the novel genes discovered, SEC16B, CSK, CYP1A1, FTO, and USB1 are within a protein interaction network with known cardiometabolic genes, including traits for obesity and hypertension. These loci were confirmed through demonstration of significant changes in the methylation or expression levels of neighboring genes. Moreover, the TPLS provided evidence regarding a 2-fold higher risk of early-onset hypertension that occurred in girls with central precocious puberty. CONCLUSION Our study highlights the usefulness of cross-trait analyses for identifying shared etiology between age at menarche and cardiometabolic traits, especially early-onset hypertension. The menarche-related loci may contribute to early-onset hypertension through endocrinological pathways.
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Affiliation(s)
- Hsien-Yu Fan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Yen-Tsung Huang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
- Institute of Statistical Science, Academia Sinica, Taipei 115, Taiwan
- Department of Mathematics, National Taiwan University, Taipei 106, Taiwan
| | - Justin BoKai Hsu
- Department of Computer Science and Engineering, Yuan Ze University, Taoyuan 320, Taiwan
| | - Yun-Yu Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Cardiovascular Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - En-Yu Lai
- Institute of Statistical Science, Academia Sinica, Taipei 115, Taiwan
| | - Jia-Ying Su
- Institute of Statistical Science, Academia Sinica, Taipei 115, Taiwan
| | - Tzu-Pin Lu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Shih-Yuan Hsu
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 110, Taiwan
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Yuan S, Merino J, Larsson SC. Causal factors underlying diabetes risk informed by Mendelian randomisation analysis: evidence, opportunities and challenges. Diabetologia 2023; 66:800-812. [PMID: 36786839 PMCID: PMC10036461 DOI: 10.1007/s00125-023-05879-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023]
Abstract
Diabetes and its complications cause a heavy disease burden globally. Identifying exposures, risk factors and molecular processes causally associated with the development of diabetes can provide important evidence bases for disease prevention and spur novel therapeutic strategies. Mendelian randomisation (MR), an epidemiological approach that uses genetic instruments to infer causal associations between an exposure and an outcome, can be leveraged to complement evidence from observational and clinical studies. This narrative review aims to summarise the evidence on potential causal risk factors for diabetes by integrating published MR studies on type 1 and 2 diabetes, and to reflect on future perspectives of MR studies on diabetes. Despite the genetic influence on type 1 diabetes, few MR studies have been conducted to identify causal exposures or molecular processes leading to increased disease risk. In type 2 diabetes, MR analyses support causal associations of somatic, mental and lifestyle factors with development of the disease. These studies have also identified biomarkers, some of them derived from the gut microbiota, and molecular processes leading to increased disease risk. These studies provide valuable data to better understand disease pathophysiology and explore potential therapeutic targets. Because genetic association studies have mostly been restricted to participants of European descent, multi-ancestry cohorts are needed to examine the role of different types of physical activity, dietary components, metabolites, protein biomarkers and gut microbiome in diabetes development.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jordi Merino
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Programs in Metabolism and Medical and Population Genetics, Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Ardissino M, Slob EAW, Carter P, Rogne T, Girling J, Burgess S, Ng FS. Sex-Specific Reproductive Factors Augment Cardiovascular Disease Risk in Women: A Mendelian Randomization Study. J Am Heart Assoc 2023; 12:e027933. [PMID: 36846989 PMCID: PMC10111460 DOI: 10.1161/jaha.122.027933] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Background Observational studies suggest that reproductive factors are associated with cardiovascular disease, but these are liable to influence by residual confounding. This study explores the causal relevance of reproductive factors on cardiovascular disease in women using Mendelian randomization. Methods and Results Uncorrelated (r2<0.001), genome-wide significant (P<5×10-8) single-nucleotide polymorphisms were extracted from sex-specific genome-wide association studies of age at first birth, number of live births, age at menarche, and age at menopause. Inverse-variance weighted Mendelian randomization was used for primary analyses on outcomes of atrial fibrillation, coronary artery disease, heart failure, ischemic stroke, and stroke. Earlier genetically predicted age at first birth increased risk of coronary artery disease (odds ratio [OR] per year, 1.49 [95% CI, 1.28-1.74], P=3.72×10-7) heart failure (OR, 1.27 [95% CI, 1.06-1.53], P=0.009), and stroke (OR, 1.25 [95% CI, 1.00-1.56], P=0.048), with partial mediation through body mass index, type 2 diabetes, blood pressure, and cholesterol traits. Higher genetically predicted number of live births increased risk of atrial fibrillation (OR for <2, versus 2, versus >2 live births, 2.91 [95% CI, 1.16-7.29], P=0.023), heart failure (OR, 1.90 [95% CI, 1.28-2.82], P=0.001), ischemic stroke (OR, 1.86 [95% CI, 1.03-3.37], P=0.039), and stroke (OR, 2.07 [95% CI, 1.22-3.52], P=0.007). Earlier genetically predicted age at menarche increased risk of coronary artery disease (OR per year, 1.10 [95% CI, 1.06-1.14], P=1.68×10-6) and heart failure (OR, 1.12 [95% CI, 1.07-1.17], P=5.06×10-7); both associations were at least partly mediated by body mass index. Conclusions These results support a causal role of a number of reproductive factors on cardiovascular disease in women and identify multiple modifiable mediators amenable to clinical intervention.
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Affiliation(s)
- Maddalena Ardissino
- National Heart and Lung Institute Imperial College London London United Kingdom.,Nuffield Department of Population Health University of Oxford Oxford United Kingdom
| | - Eric A W Slob
- Medical Research Council Biostatistics Unit University of Cambridge Cambridge United Kingdom.,Department of Applied Economics, Erasmus School of Economics Erasmus University Rotterdam Rotterdam The Netherlands.,Erasmus University Rotterdam Institute for Behavior and Biology, Erasmus University Rotterdam Rotterdam The Netherlands
| | - Paul Carter
- Department of Medicine University of Cambridge Cambridge United Kingdom
| | - Tormod Rogne
- Department of Chronic Disease Epidemiology Yale School of Public Health New Haven CT.,Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway.,Centre for Fertility and Health Norwegian Institute of Public Health Oslo Norway
| | - Joanna Girling
- Department of Obstetrics and Gynaecology Chelsea and Westminster Hospital NHS Foundation Trust London United Kingdom
| | - Stephen Burgess
- Medical Research Council Biostatistics Unit University of Cambridge Cambridge United Kingdom.,Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care University of Cambridge Cambridge United Kingdom
| | - Fu Siong Ng
- National Heart and Lung Institute Imperial College London London United Kingdom
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Su Y, Hu Y, Xu Y, Yang M, Wu F, Peng Y. Genetic causal relationship between age at menarche and benign oesophageal neoplasia identified by a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1113765. [PMID: 37025412 PMCID: PMC10071044 DOI: 10.3389/fendo.2023.1113765] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVE The occurrence and development of oesophageal neoplasia (ON) is closely related to hormone changes. The aim of this study was to investigate the causal relationships between age at menarche (AAMA) or age at menopause (AAMO) and benign oesophageal neoplasia (BON) or malignant oesophageal neoplasia (MON) from a genetic perspective. METHODS Genome-wide association study (GWAS) summary data of exposures (AAMA and AAMO) and outcomes (BON and MON) were obtained from the IEU OpenGWAS database. We performed a two-sample Mendelian randomization (MR) study between them. The inverse variance weighted (IVW) was used as the main analysis method, while the MR Egger, weighted median, simple mode, and weighted mode were supplementary methods. The maximum likelihood, penalized weighted median, and IVW (fixed effects) were validation methods. We used Cochran's Q statistic and Rucker's Q statistic to detect heterogeneity. The intercept test of the MR Egger and global test of MR pleiotropy residual sum and outlier (MR-PRESSO) were used to detect horizontal pleiotropy, and the distortion test of the MR-PRESSO analysis was used to detect outliers. The leave-one-out analysis was used to detect whether the MR analysis was affected by single nucleotide polymorphisms (SNPs). In addition, the MR robust adjusted profile score (MR-RAPS) method was used to assess the robustness of MR analysis. RESULTS The random-effects IVW results showed that AAMA had a negative genetic causal relationship with BON (odds ratio [OR] = 0.285 [95% confidence interval [CI]: 0.130-0.623], P = 0.002). The weighted median, maximum likelihood, penalized weighted median, and IVW (fixed effects) were consistent with random-effects IVW (P < 0.05). The MR Egger, simple mode and weighted mode results showed that AAMA had no genetic causal relationship with BON (P > 0.05). However, there were no causal genetic relationships between AAMA and MON (OR = 1.132 [95%CI: 0.621-2.063], P = 0.685), AAMO and BON (OR = 0.989 [95%CI: 0.755-1.296], P = 0.935), or AAMO and MON (OR = 1.129 [95%CI: 0.938-1.359], P = 0.200). The MR Egger, weighted median, simple mode, weighted mode, maximum likelihood, penalized weighted median, and IVW (fixed effects) were consistent with a random-effects IVW (P > 0.05). MR analysis results showed no heterogeneity, the horizontal pleiotropy and outliers (P > 0.05). They were not driven by a single SNP, and were normally distributed (P > 0.05). CONCLUSION Only AAMA has a negative genetic causal relationship with BON, and no genetic causal relationships exist between AAMA and MON, AAMO and BON, or AAMO and MON. However, it cannot be ruled out that they are related at other levels besides genetics.
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Affiliation(s)
- Yani Su
- Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, China
- Esophageal Cancer Prevention and Control Research Center, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - Yunfeng Hu
- Department of Radiotherapy, Yan'an University Affiliated Hospital, Yan’an, China
| | - Yiwei Xu
- Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, China
- Esophageal Cancer Prevention and Control Research Center, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - Mingyi Yang
- Department of Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Yuhui Peng, ; Fangcai Wu, ; Mingyi Yang,
| | - Fangcai Wu
- Esophageal Cancer Prevention and Control Research Center, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, Guangzhou, China
- Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Yuhui Peng, ; Fangcai Wu, ; Mingyi Yang,
| | - Yuhui Peng
- Department of Clinical Laboratory Medicine, Cancer Hospital of Shantou University Medical College, Shantou, China
- Esophageal Cancer Prevention and Control Research Center, Cancer Hospital of Shantou University Medical College, Shantou, China
- Guangdong Esophageal Cancer Institute, Guangzhou, China
- *Correspondence: Yuhui Peng, ; Fangcai Wu, ; Mingyi Yang,
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Chen J, Chen H, Zhu Q, Liu Q, Zhou Y, Li L, Wang Y. Age at menarche and ischemic heart disease: An update mendelian randomization study. Front Genet 2022; 13:942861. [PMID: 36406117 PMCID: PMC9671358 DOI: 10.3389/fgene.2022.942861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/20/2022] [Indexed: 12/01/2023] Open
Abstract
Background: Although earlier menarche age has been associated with ischemic heart disease in previous observational studies, the relationship's causation has not been shown. Through two-sample Mendelian randomization (MR), we were able to define the causal connection. Methods: We performed Mendelian Randomization (MR) analysis to explore the associations between genetically predicted AAM and IHD. Summary-level databases for exposure and outcome were selected from the MR-Base database (https://gwas.mrcieu.ac.uk/). Single-nucleotide polymorphisms (SNPs) connected to AAM at genome-wide significance level (p < 5 × 10-8) were considered as instrumental variables (IVs). We used four methods to pool MR estimates, including fixed-effects inverse variance weighting (fe-IVW), multiplicative random-effects inverse variance weighting (mre-IVW), weighted median (WM), and MR-Egger regression methods. Sensitivity analyses were performed to evaluate the robustness of the results. PhenoScanner searches and Multivariable Mendelian randomization (MVMR) analysis was used for assessing confounders. Results: 117 SNPs significantly correlated with AAM were screened as instruments, the results of three main methods showed that genetically earlier AAM may have a causal effect on the higher risk of IHD (fe-IVW: OR = 0.80, 95% CI: 0.72-0.88, p < 0.001; mre-IVW: OR = 0.80, 95% CI: 0.70-0.90, p < 0.001; WE: OR = 0.79, 95% CI: 0.66-0.93, p = 0.006). These results were consistent across sensitivity analyses. MR analysis revealed that there was still a relationship between AAM and IHD even when pleiotropic SNPs of confounders were removed employing PhenoScanner searches. In MVMR, the significant association remained after adjusting for biological sex, but it was attenuated with adjustment of body mass index including childhood and adult. Conclusion: Our MR analysis revealed a substantial genetically determined confounder-mediated relationship between an increase in genetically predicted AAM and a lower risk of IHD. By addressing the intervention of body mass index, the risk of IHD may be lowered.
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Affiliation(s)
- Jing Chen
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Heng Chen
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Qiaozhen Zhu
- Clinical Medical School, Henan University, Kaifeng, China
| | - Qiannan Liu
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Zhou
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lan Li
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Pediatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Vorobeľová L, Falbová D, Candráková Čerňanová V. Contribution of environmental factors and female reproductive history to hypertension and obesity incidence in later life. Ann Hum Biol 2022; 49:236-247. [PMID: 35867530 DOI: 10.1080/03014460.2022.2105398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hypertension (HT) and obesity, which are important risk factors for cardiovascular diseases, are complex traits determined by multiple biological and behavioural factors. However, the role of female reproductive history in evaluating HT and obesity is still unclear. AIM To investigate the long-term effects of reproductive factors on the probability of obesity and HT in later life after adjusting for socio-demographic and lifestyle behaviour factors. SUBJECTS AND METHODS A total of 503 women (39 - 65 years) were recruited from different localities in Slovakia. Multivariable logistic regression analyses were performed to test the associations. RESULTS Early menarche age of 11 years and under was associated with twice higher probability of obesity at midlife, independent of environmental confounders (OR = 2.27, CI = 1.35 - 3.81, p = 0.002). Breastfeeding (Bf) women had a lower likelihood of obesity in later life than non-Bf parous women, independent of environmental confounders (OR = 0.35, CI = 0.17 - 0.72, p = 0.004). Finally, age at menarche was associated with obesity-associated HT. CONCLUSION Reproductive factors are significantly associated with obesity and obesity-associated HT in later life. The age at menarche and Bf can be risk factors for early identification of women with increased likelihood of adult cardiovascular risk.
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Affiliation(s)
- Lenka Vorobeľová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Darina Falbová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
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Zhang L, Yang L, Wang C, Yuan T, Zhang D, Wei H, Li J, Lei Y, Sun L, Li X, Hua Y, Che H, Li Y. Mediator or moderator? The role of obesity in the association between age at menarche and blood pressure in middle-aged and elderly Chinese: a population-based cross-sectional study. BMJ Open 2022; 12:e051486. [PMID: 35618334 PMCID: PMC9137347 DOI: 10.1136/bmjopen-2021-051486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE We investigated the moderation/mediation between the age of menarche and obesity parameters in predicting blood pressure (BP) in middle-aged and elderly Chinese. DESIGN Our study is a population-based cross-sectional study. SETTING Participants in this study came from the China Health and Retirement Longitudinal Study (CHARLS). PARTICIPANTS The analytical sample included 4513 participants aged 45-96 years. MAIN OUTCOME MEASUREMENTS Data were selected from the CHARLS, a cross-sectional study. Between-group differences were evaluated using χ2, t-test and one-way analysis of variance. The trend of related variables by characteristics was also tested using contrast analysis, as appropriate. Then, correlations between characteristics, moderator, mediator, and independent and dependent variables were used by Spearman's correlation test and Pearson's correlation test. Finally, the mediation analysis was performed by model 4 in PROCESS V3.3 macro for SSPSS, and moderation analysis was used by model 1 for assessment. All covariates were adjusted in the moderation or mediation models. RESULTS In the correlation analysis, body mass index (BMI) and waist circle (WC) level were positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in women (BMI and DBP: r=0.221, p<0.001; WC and DBP: r=0.183, p<0.001; BMI and SBP: r=0.129, p<0.001; WC and SBP: r=0.177, p<0.001). Age of menarche was negatively correlated with DBP (r=-0.060, p<0.001). However, the age of menarche was not significantly correlated with SBP (r=-0.014, p=0.335). In the moderator analysis, after controlling for the potential confounders, the interaction term of obesity parameters×age of menarche was not significant for predicting either DBP (BMI: B=0.0260, SE=0.0229, p=0.2556, 95% CI -0.0189 to 0.071; WC: B=0.0099, SE=0.0074, p=0.1833, 95% CI -0.0047 to 0.0244) or SBP (BMI: B=0.0091, SE=0.0504, p=0.8561, 95% CI -0.0897 to 0.108; WC: B=-0.0032, SE=0.0159, p=0.8427, 95% CI -0.0343 to 0.028). All correlations were significant correlation between age of menarche, obesity parameters and BP except the path of the menarche age→SBP (with the addition of the BMI indicator: β=-0.0004, B=-0.0046, p=0.9797, 95% CI -0.3619 to 0.3526; with the addition of the WC indicator: β=0.0004, B=0.0044, p=0.9804, 95% CI -0.3439 to 0.3526) in crude model. In general, after controlling for potential confounders, BMI (DBP: β=-0.0471, B= -0.2682, p=0.0021, 95% CI -0.4388 to -0.0976; SBP: β=-0.0515, B=-0.6314, p<0.001, 95% CI -0.9889 to -0.2739) and WC (DBP: β=-0.0474, B= -0.2689, p<0.001, 95% CI -0.4395 to -0.0984; SBP: β=-0.0524, B=-0.6320, p<0.001, 95% CI -0.9832 to -0.2807) partly mediated the relationship between age of menarche and BP. CONCLUSIONS The interaction term of obesity parameters×age of menarche was not significant for predicting either DBP or SBP in women. Moreover, obesity parameters partly mediated the relationship between the age of menarche and BP.
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Affiliation(s)
- Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Huanhuan Wei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
- School of Nursing, Henan University of Science and Technology, Luoyang, Henan, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Hengying Che
- Department of Nursing, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Yuanzhen Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
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Zheng J, Chen K, Huang T, Shao C, Li P, Wang J, Wang W, Zhang K, Meng X, Gao J, Wang X, Liu Y, Song J, Dong E, Tang YD. Genetically Determined Lifestyle and Cardiometabolic Risk Factors Mediate the Association of Genetically Predicted Age at Menarche With Genetic Predisposition to Myocardial Infarction: A Two-Step, Two-Sample Mendelian Randomization Study. Front Cardiovasc Med 2022; 9:821068. [PMID: 35548428 PMCID: PMC9081496 DOI: 10.3389/fcvm.2022.821068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Observational studies have shown an association between early age at menarche (AAM) and myocardial infarction (MI) with recorded cases. In this Mendelian randomization (MR) study, we used large amounts of summary data from genome-wide association studies (GWASs) to further estimate the association of genetically predicted AAM with genetically predicated risk of MI and investigate to what extent this association is mediated by genetically determined lifestyles, cardiometabolic factors, and estrogen exposure. Methods A two-step, two-sample MR study was performed by mediation analysis. Genetic variants identified by GWAS meta-analysis of reproductive genetics consortium (n = 182,416) were selected for genetically predicted AAM. Genetic variants identified by the Coronary ARtery DIsease Genome-wide Replication and Meta-analysis plus The Coronary Artery Disease Genetics Consortium (n = 184,305) were selected for genetically predicted risk of MI. Genetic variants from other international GWAS summary data were selected for genetically determined mediators. Results This MR study showed that increase in genetically predicted AAM was associated with lower risk of genetically predicted MI (odds ratio 0.91, 95% confidence interval 0.84–0.98). Inverse variance weighted (IVW) MR analysis also showed that decrease in genetically predicted AAM was associated with higher genetically predicted alcohol intake frequency, current smoking behavior, higher waist-to-hip ratio, and higher levels of systolic blood pressure (SBP), fasting blood glucose, hemoglobin A1c (HbA1c), and triglycerides (TGs). Furthermore, increase in genetically predicted AAM was associated with genetically predicted longer sleep duration, higher levels of high-density lipoproteins, and older age at which hormone replacement therapy was started. The most essential mediators identified were genetically predicted current smoking behavior and levels of HbA1c, SBP, and TGs, which were estimated to genetically mediate 13.9, 12.2, 10.5, and 9.2%, respectively, with a combined mediation proportion of 37.5% in the association of genetically predicted AAM with genetically predicted increased risk of MI in an MR framework. Conclusion Our MR analysis showed that increase in genetically predicted AAM was associated with lower genetically predicted risk of MI, which was substantially mediated by genetically determined current smoking behavior and levels of HbA1c, SBP, and TGs. Intervening on the above mediators may reduce the risk of MI.
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Affiliation(s)
- Jilin Zheng
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ken Chen
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Huang
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Epidemiology and Biostatistics, Center for Intelligent Public Health, Academy for Artificial Intelligence, School of Public Health, Ministry of Education, Peking University, Beijing, China
| | - Chunli Shao
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Ping Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingjia Wang
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Wenyao Wang
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Kuo Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiangbin Meng
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Jun Gao
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Xuliang Wang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yupeng Liu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingjing Song
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Eran Dong
- NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing Key Laboratory of Cardiovascular Receptors Research, Department of Cardiology, Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Institute of Cardiovascular Sciences, Ministry of Education, Peking University, Beijing, China
| | - Yi-Da Tang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Department of Cardiology, Institute of Vascular Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
- *Correspondence: Yi-Da Tang,
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10
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Prince C, Sharp GC, Howe LD, Fraser A, Richmond RC. The relationships between women's reproductive factors: a Mendelian randomisation analysis. BMC Med 2022; 20:103. [PMID: 35321746 PMCID: PMC8944090 DOI: 10.1186/s12916-022-02293-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Women's reproductive factors include their age at menarche and menopause, the age at which they start and stop having children and the number of children they have. Studies that have linked these factors with disease risk have largely investigated individual reproductive factors and have not considered the genetic correlation and total interplay that may occur between them. This study aimed to investigate the nature of the relationships between eight female reproductive factors. METHODS We used data from the UK Biobank and genetic consortia with data available for the following reproductive factors: age at menarche, age at menopause, age at first birth, age at last birth, number of births, being parous, age first had sexual intercourse and lifetime number of sexual partners. Linkage disequilibrium score regression (LDSC) was performed to investigate the genetic correlation between reproductive factors. We then applied Mendelian randomisation (MR) methods to estimate the causal relationships between these factors. Sensitivity analyses were used to investigate directionality of the effects, test for evidence of pleiotropy and account for sample overlap. RESULTS LDSC indicated that most reproductive factors are genetically correlated (rg range: |0.06-0.94|), though there was little evidence for genetic correlations between lifetime number of sexual partners and age at last birth, number of births and ever being parous (rg < 0.01). MR revealed potential causal relationships between many reproductive factors, including later age at menarche (1 SD increase) leading to a later age at first sexual intercourse (beta (B) = 0.09 SD, 95% confidence intervals (CI) = 0.06,0.11), age at first birth (B = 0.07 SD, CI = 0.04,0.10), age at last birth (B = 0.06 SD, CI = 0.04,0.09) and age at menopause (B = 0.06 SD, CI = 0.03,0.10). Later age at first birth was found to lead to a later age at menopause (B = 0.21 SD, CI = 0.13,0.29), age at last birth (B = 0.72 SD, CI = 0.67, 0.77) and a lower number of births (B = -0.38 SD, CI = -0.44, -0.32). CONCLUSION This study presents evidence that women's reproductive factors are genetically correlated and causally related. Future studies examining the health sequelae of reproductive factors should consider a woman's entire reproductive history, including the causal interplay between reproductive factors.
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Affiliation(s)
- Claire Prince
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Gemma C Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca C Richmond
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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11
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Fan HY, Huang YT, Chen YY, Hsu JB, Li HY, Su TC, Lin HJ, Chien KL, Chen YC. Systolic blood pressure as the mediator of the effect of early menarche on the risk of coronary artery disease: A Mendelian randomization study. Front Cardiovasc Med 2022; 9:1023355. [PMID: 36698922 PMCID: PMC9868731 DOI: 10.3389/fcvm.2022.1023355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Background Menarche timing may not be directly associated with the risk of coronary artery disease (CAD). Therefore, we investigated the roles of metabolic factors in explaining the effect of age at menarche on CAD risk. Methods We identified women with age at menarche and CAD by using three analytical methods: Mendelian randomization (MR), logistic regression analysis, and Cox proportional hazard regression. The first two analyses were performed in the Taiwan Biobank (N = 71,923) study, and the last analysis was performed in the Chin-Shan Community Cardiovascular Cohort study (N = 1,598). We further investigated the role of metabolic factors in mediating the effect of age at menarche on CAD risk by using three complementary methods with mediation analyses. Results One standard deviation of earlier age at menarche was associated with a 2% higher CAD risk [odds ratio = 1.02, 95% confidence interval (CI) = 1.001-1.03] in the MR analysis, an 11% higher risk (odds ratio = 1.11, 95% CI = 1.02-1.21) in the logistic regression analysis, and a 57% higher risk (hazard ratio = 1.57, 95% CI = 1.12-2.19) in the Cox proportional hazard regression. All the analyses consistently supported the role of systolic blood pressure in mediating this effect. The MR results indicated that 29% (95% CI = 26%-32%) of the effect of genetically predicted earlier age at menarche on CAD risk was mediated by genetically predicted systolic blood pressure. Conclusion The results obtained using different analytical methods suggest that interventions aimed at lowering systolic blood pressure can reduce the cases of CAD attributable to earlier age at menarche.
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Affiliation(s)
- Hsien-Yu Fan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yen-Tsung Huang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.,Department of Mathematics, National Taiwan University, Taipei, Taiwan
| | - Yun-Yu Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.,Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Justin BoKai Hsu
- Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
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12
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Chan II, Kwok MK, Schooling CM. Timing of Pubertal Development and Midlife Blood Pressure in Men and Women: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e386-e393. [PMID: 34343299 DOI: 10.1210/clinem/dgab561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Observational studies suggest earlier puberty is associated with higher adulthood blood pressure (BP), but these findings have not been replicated using Mendelian randomization (MR). We examined this question sex-specifically using larger genome-wide association studies (GWAS) with more extensive measures of pubertal timing. METHODS We obtained genetic instruments proxying pubertal maturation (age at menarche [AAM] or voice breaking [AVB]) from the largest published GWAS. We applied them to summary sex-specific genetic associations with systolic and diastolic BP z-scores, and self-reported hypertension in women (n = 194 174) and men (n = 167 020) from the UK Biobank, using inverse-variance weighted meta-analysis. We conducted sensitivity analyses using other MR methods, including multivariable MR adjusted for childhood obesity proxied by body mass index (BMI). We used late pubertal growth as a validation outcome. RESULTS AAM (beta per 1-year later = -0.030 [95% confidence interval, -0.055 to -0.005] and AVB (beta -0.058 [95% CI, -0.100 to -0.015]) were inversely associated with systolic BP independent of childhood BMI, as were diastolic BP (-0.035 [95% CI, -0.060 to -0.009] for AAM and -0.046 [95% CI, -0.089 to -0.004] for AVB) and self-reported hypertension (odds ratio 0.89 [95% CI, 0.84-0.95] for AAM and 0.87 [95% CI, 0.79-0.96] for AVB). AAM and AVB were positively associated with late pubertal growth, as expected. The results were robust to sensitivity analysis using other MR methods. CONCLUSION Timing of pubertal maturation was associated with adulthood BP independent of childhood BMI, highlighting the role of pubertal maturation timing in midlife BP.
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Affiliation(s)
- Io Ieong Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Graduate School of Public Health and Health Policy, City University of New York, NY 10027, USA
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13
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Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood. Sci Rep 2021; 11:148. [PMID: 33420216 PMCID: PMC7794383 DOI: 10.1038/s41598-020-80496-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
Evidence suggests that early menarche increases cardiometabolic risk, and adiposity would be a possible mediator of this association. We assessed the association between age at menarche and metabolic cardiovascular risk factors and estimated the indirect effect of body composition in adulthood. In 1982, all hospital births in the city of Pelotas/Brazil, were identified and live births were examined and have been prospectively followed. At 30 years, information on age at menarche and metabolic cardiovascular risk factors was available for 1680 women. Mediation analysis was performed using G-computation to estimate the direct effect of age at menarche and the indirect effect of body composition. The prevalence of age at menarche < 12 years was 24.5% and was associated with higher mean diastolic blood pressure [β: 1.98; 95% CI: 0.56, 3.40], total cholesterol (β: 8.28; 95% CI: 2.67, 13.88), LDL-cholesterol (β: 6.53; 95% CI: 2.00, 11.07), triglycerides (β: 0.11; 95% CI: 0.03, 0.19). For diastolic blood pressure, total cholesterol, LDL-cholesterol, triglycerides, body composition assessed by fat mass index captured from 43.8 to 98.9% of the effect of early menarche, except to systolic blood pressure, HDL-cholesterol, C-reactive-protein. Suggesting that the effect of menarche age < 12 years on some metabolic cardiovascular risk factors is mediated partially by body composition in adulthood.
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Yuan S, Larsson SC. An atlas on risk factors for type 2 diabetes: a wide-angled Mendelian randomisation study. Diabetologia 2020; 63:2359-2371. [PMID: 32895727 PMCID: PMC7527357 DOI: 10.1007/s00125-020-05253-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/10/2020] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to use Mendelian randomisation (MR) to identify the causal risk factors for type 2 diabetes. METHODS We first conducted a review of meta-analyses and review articles to pinpoint possible risk factors for type 2 diabetes. Around 170 possible risk factors were identified of which 97 risk factors with available genetic instrumental variables were included in MR analyses. To reveal more risk factors that were not included in our MR analyses, we conducted a review of published MR studies of type 2 diabetes. For our MR analyses, we used summary-level data from the DIAbetes Genetics Replication And Meta-analysis consortium (74,124 type 2 diabetes cases and 824,006 controls of European ancestry). Potential causal associations were replicated using the FinnGen consortium (11,006 type 2 diabetes cases and 82,655 controls of European ancestry). The inverse-variance weighted method was used as the main analysis. Multivariable MR analysis was used to assess whether the observed associations with type 2 diabetes were mediated by BMI. We used the Benjamini-Hochberg method that controls false discovery rate for multiple testing. RESULTS We found evidence of causal associations between 34 exposures (19 risk factors and 15 protective factors) and type 2 diabetes. Insomnia was identified as a novel risk factor (OR 1.17 [95% CI 1.11, 1.23]). The other 18 risk factors were depression, systolic BP, smoking initiation, lifetime smoking, coffee (caffeine) consumption, plasma isoleucine, valine and leucine, liver alanine aminotransferase, childhood and adulthood BMI, body fat percentage, visceral fat mass, resting heart rate, and four plasma fatty acids. The 15 exposures associated with a decreased risk of type 2 diabetes were plasma alanine, HDL- and total cholesterol, age at menarche, testosterone levels, sex hormone binding globulin levels (adjusted for BMI), birthweight, adulthood height, lean body mass (for women), four plasma fatty acids, circulating 25-hydroxyvitamin D and education years. Eight associations remained after adjustment for adulthood BMI. We additionally identified 21 suggestive risk factors (p < 0.05), such as alcohol consumption, breakfast skipping, daytime napping, short sleep, urinary sodium, and certain amino acids and inflammatory factors. CONCLUSIONS/INTERPRETATION The present study verified several previously reported risk factors and identified novel potential risk factors for type 2 diabetes. Prevention strategies for type 2 diabetes should be considered from multiple perspectives on obesity, mental health, sleep quality, education level, birthweight and smoking.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden.
- Department of Surgical Sciences, Uppsala University, Dag Hammarskjölds Väg 14B, 75185, Uppsala, Sweden.
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15
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Huang C, Deng J, Xu Y, Wu H, Peng C, Wu L, Ye J, Ma J. Early age at menarche and risk of postpartum hemorrhage: a retrospective study in Chinese women. J Matern Fetal Neonatal Med 2020; 35:2266-2272. [PMID: 32597269 DOI: 10.1080/14767058.2020.1784871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The objective of this study is to investigate whether early age at menarche is associated with increased risk of postpartum hemorrhage among Chinese women.Materials and methods: Clinical data from 6,383 Chinese women who gave birth to live singleton infants at The First Affiliated Hospital of Chengdu Medical College between October 2016 and October 2019 were extracted from the electronic medical records system. Patients were categorized into four groups according to their age at menarche (≤12, 13, 14 and ≥15 years). Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for postpartum hemorrhage for the different menarche age groups.Results: After controlling for potential confounders, women with menarche at an early age (≤12 years) had a significantly higher risk of developing postpartum hemorrhage than women with an age at menarche of 13 years, and the ORs (95% CIs) for postpartum hemorrhage across the menarche age categories (≤12, 13, 14 and ≥15 years) were 1.27 (1.02-1.81), 1.00 (reference), 0.95 (0.61-1.57), and 0.91 (0.51-1.58), respectively. Moreover, age at menarche was inversely associated with the risk of postpartum hemorrhage after adjustment for all relevant confounding factors, and the OR (95% CI) for postpartum hemorrhage per year of increasing in the age at menarche was 0.93 (0.74-0.99).Conclusion: Early age at menarche was associated with a significantly increased risk of postpartum hemorrhage after adjustment for known confounding factors. This finding could help obstetricians and midwives to identify pregnant women at higher risk of developing postpartum hemorrhage, and allow early preventative strategies to be implemented.
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Affiliation(s)
- Chaolin Huang
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jie Deng
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yao Xu
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Haiyan Wu
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Cong Peng
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Lingjiao Wu
- Department of Gynaecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jun Ye
- Department of Clinical Laboratory, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Junru Ma
- Department of Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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