Causal effects of body mass index on airflow obstruction and forced mid-expiratory flow: a mendelian randomization study taking interactions and age-specific instruments into consideration toward a life course perspective
Author(s)
Type
Journal Article
Abstract
Obesity has complex links to respiratory health. Mendelian randomization (MR) enables assessment of causality of body mass index (BMI) effects on airflow obstruction and mid-expiratory flow. In the adult SAPALDIA cohort, recruiting 9,651 population-representative samples aged 18–60 years at baseline (female 51%), BMI and the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) as well as forced mid-expiratory flow (FEF25–75%) were measured three times over 20 follow-up years. The causal effects of BMI in childhood and adulthood on FEV1/FVC and FEF25–75% were assessed in predictive (BMI averaged over 1st and 2nd, lung function (LF) averaged over 2nd and 3rd follow-up; N = 2,850) and long-term cross-sectional models (BMI and LF averaged over all follow-ups; N = 2,728) by Mendelian Randomization analyses with the use of weighted BMI allele score as an instrument variable and two-stage least squares (2SLS) method. Three different BMI allele scores were applied to specifically capture the part of BMI in adulthood that likely reflects tracking of genetically determined BMI in childhood. The main causal effects were derived from models containing BMI (instrumented by BMI genetic score), age, sex, height, and packyears smoked as covariates. BMI interactions were instrumented by the product of the instrument (BMI genetic score) and the relevant concomitant variable. Causal effects of BMI on FEV1/FVC and FEF25–75% were observed in both the predictive and long-term cross-sectional models. The causal BMI- LF effects were negative and attenuated with increasing age, and stronger if instrumented by gene scores associated with childhood BMI. This non-standard MR approach interrogating causal effects of multiplicative interaction suggests that the genetically rooted part of BMI patterns in childhood may be of particular relevance for the level of small airway function and airflow obstruction later in life. The methodological relevance of the results is first to point to the importance of a life course perspective in studies on the etiological role of BMI in respiratory health, and second to point out novel methodological aspects to be considered in future MR studies on the causal effects of obesity related phenotypes.
Date Issued
2021-05-11
Date Acceptance
2021-04-01
Citation
Frontiers in Public Health, 2021, 9, pp.1-15
ISSN
2296-2565
Publisher
Frontiers Media
Start Page
1
End Page
15
Journal / Book Title
Frontiers in Public Health
Volume
9
Copyright Statement
© 2021 Probst-Hensch, Jeong, Stolz, Pons, Soccal, Bettschart, Jarvis, Holloway, Kronenberg, Imboden, Schindler and Lovison. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Sponsor
Commission of the European Communities
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000653446000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
633212
Subjects
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Mendelian randomization
body mass index
genetic score
lung function
COPD
longitudinal cohort
GENOME-WIDE ASSOCIATION
LUNG-FUNCTION DECLINE
PULMONARY-DISEASE
FOLLOW-UP
OBESITY
ASTHMA
QUALITY
ADULTS
RISK
Publication Status
Published
Article Number
ARTN 584955
Date Publish Online
2021-05-11