Age- and Sex-Specific Causal Effects of Adiposity on Cardiovascular Risk Factors

Abstract

Observational studies have reported different effects of adiposity on cardiovascular risk factors across age and sex. Since cardiovascular risk factors are enriched in obese individuals, it has not been easy to dissect the effects of adiposity from those of other risk factors. We used a Mendelian randomization approach, applying a set of 32 genetic markers to estimate the causal effect of adiposity on blood pressure, glycemic indices, circulating lipid levels, and markers of inflammation and liver disease in up to 67,553 individuals. All analyses were stratified by age (cutoff 55 years of age) and sex. The genetic score was associated with BMI in both nonstratified analysis (P = 2.8 × 10−107) and stratified analyses (all P < 3.3 × 10−30). We found evidence of a causal effect of adiposity on blood pressure, fasting levels of insulin, C-reactive protein, interleukin-6, HDL cholesterol, and triglycerides in a nonstratified analysis and in the <55-year stratum. Further, we found evidence of a smaller causal effect on total cholesterol (P for difference = 0.015) in the ≥55-year stratum than in the <55-year stratum, a finding that could be explained by biology, survival bias, or differential medication. In conclusion, this study extends previous knowledge of the effects of adiposity by providing sex- and age-specific causal estimates on cardiovascular risk factors.

Knowledge of Modifiable Risk Factors of Heart Disease Among Patients With Cardiovascular Risk

“…A similar report was found in Fall et al [3] which stated that they observed larger regression coefficients in men than in women for associations of BMI with systolic and diastolic blood pressure and levels of total cholesterol, triglycerides, alkaline transaminase, gama glutamate transaminase, and fasting insulin. Hence, men may have more risk than women.…”

“…It is commonly used algorithm to predict the risk of coronary artery diseases. It is particularly designed for adults of 20 and older patients who are not having heart disease [3]. In this tool, the following details are included which plays a major role age, gender, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), smoker, systolic blood pressure, and diabetes mellitus [6,11,16,17,19].…”

Interdisciplinary Therapy and Decrease of Cardiovascular Overload in Obese Patients

“…This decrease depends mainly on the peripheral vascular resistance and will represent the efficiency of the vasodilator mechanisms. 8,21,22 Corroborating the studies of Franz et al 12 we observed that changes in lifestyle are closely related to improvements in the cardiovascular system.…”

“…8,21,22 It is important to note that decreases in BP, HR and DP even in small magnitudes, promote large reductions in the rate of cardiovascular complications and general mortality. 23 The scientific literature shows that the physical exercise, present in the interdisciplinary therapy, promotes a decrease of the BP values in a chronic way.…”

Increased cardiovascular disease risk in women with a history of recurrent miscarriage

“…Some covariates have an effect on our outcome of interest. It would not make sense to adjust for BMI or smoking as confounding factors, since both are included as variables in the risk estimation 31. On the other hand, it is interesting to verify whether the increased cardiovascular risk score in women with RM persists after adjustments for smoking and hypertension, or whether the results are totally dependent on these variates.…”