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      Physical activity and risk of gallstone disease: A Mendelian randomization study

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          Abstract

          Objective: Given the association between physical activity and the reduced risk of gallstone disease as suggested in observational studies, a Mendelian randomization study was conducted to evaluate the causal nature of this association in genetic epidemiology.

          Study: Including self-reported and accelerometer-based physical activity traits, the independent genetic variants associated with physical activity were selected from the corresponding genome-wide association studies as instrumental variables. The summary-level data for gallstone disease were sourced from the UK Biobank (7,682 cases and 455,251 non-cases) and FinnGen consortium (23,089 cases and 231,644 non-cases). Then, two-sample Mendelian randomization analysis was conducted. Inverse-variance weight (IVW), weighted median, and Mendelian randomization–Egger regression were determined through Mendelian randomization analyses. To ensure the robustness of the results, sensitivity analyses were also carried out in the study.

          Results: The negative causality between the genetically predicted accelerometer-based “average acceleration” physical activity and the risk of gallstone disease was suggested in the UK Biobank study ( p = 0.023, OR = 0.93, 95% CI: 0.87–0.99), and accelerometer-based “overall activity” physical activity and the risk of gallstone disease in the UK Biobank study ( p = 0.017, OR = 0.38, 95% CI: 0.17–0.84). With accelerometer-based “average acceleration” physical activity negatively correlated with gallstone disease in the FinnGen consortium data ( p = 0.001, OR = 0.94, 95% CI: 0.90–0.97). As for self-reported moderate-to-vigorous physical activity, however, there was no causality observed in both pieces of data.

          Conclusion: Our studies provide the evidence suggesting a casual association between physical activities and gallstone disease through analysis of genetic data. As indicated by the research results, there is a possibility that a higher level of physical activities could mitigate the risk of gallstone disease.

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          Most cited references53

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          Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression

          Background: The number of Mendelian randomization analyses including large numbers of genetic variants is rapidly increasing. This is due to the proliferation of genome-wide association studies, and the desire to obtain more precise estimates of causal effects. However, some genetic variants may not be valid instrumental variables, in particular due to them having more than one proximal phenotypic correlate (pleiotropy). Methods: We view Mendelian randomization with multiple instruments as a meta-analysis, and show that bias caused by pleiotropy can be regarded as analogous to small study bias. Causal estimates using each instrument can be displayed visually by a funnel plot to assess potential asymmetry. Egger regression, a tool to detect small study bias in meta-analysis, can be adapted to test for bias from pleiotropy, and the slope coefficient from Egger regression provides an estimate of the causal effect. Under the assumption that the association of each genetic variant with the exposure is independent of the pleiotropic effect of the variant (not via the exposure), Egger’s test gives a valid test of the null causal hypothesis and a consistent causal effect estimate even when all the genetic variants are invalid instrumental variables. Results: We illustrate the use of this approach by re-analysing two published Mendelian randomization studies of the causal effect of height on lung function, and the causal effect of blood pressure on coronary artery disease risk. The conservative nature of this approach is illustrated with these examples. Conclusions: An adaption of Egger regression (which we call MR-Egger) can detect some violations of the standard instrumental variable assumptions, and provide an effect estimate which is not subject to these violations. The approach provides a sensitivity analysis for the robustness of the findings from a Mendelian randomization investigation.
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            Consistent Estimation in Mendelian Randomization with Some Invalid Instruments Using a Weighted Median Estimator

            ABSTRACT Developments in genome‐wide association studies and the increasing availability of summary genetic association data have made application of Mendelian randomization relatively straightforward. However, obtaining reliable results from a Mendelian randomization investigation remains problematic, as the conventional inverse‐variance weighted method only gives consistent estimates if all of the genetic variants in the analysis are valid instrumental variables. We present a novel weighted median estimator for combining data on multiple genetic variants into a single causal estimate. This estimator is consistent even when up to 50% of the information comes from invalid instrumental variables. In a simulation analysis, it is shown to have better finite‐sample Type 1 error rates than the inverse‐variance weighted method, and is complementary to the recently proposed MR‐Egger (Mendelian randomization‐Egger) regression method. In analyses of the causal effects of low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol on coronary artery disease risk, the inverse‐variance weighted method suggests a causal effect of both lipid fractions, whereas the weighted median and MR‐Egger regression methods suggest a null effect of high‐density lipoprotein cholesterol that corresponds with the experimental evidence. Both median‐based and MR‐Egger regression methods should be considered as sensitivity analyses for Mendelian randomization investigations with multiple genetic variants.
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              Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases

              Horizontal pleiotropy occurs when the variant has an effect on disease outside of its effect on the exposure in Mendelian randomization (MR). Violation of the ‘no horizontal pleiotropy’ assumption can cause severe bias in MR. We developed the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test to identify horizontal pleiotropic outliers in multi-instrument summary-level MR testing. We showed using simulations that MR-PRESSO is best suited when horizontal pleiotropy occurs in <50% of instruments. Next, we applied MR-PRESSO, along with several other MR tests to complex traits and diseases, and found that horizontal pleiotropy: (i) was detectable in over 48% of significant causal relationships in MR; (ii) introduced distortions in the causal estimates in MR that ranged on average from −131% to 201%; (iii) induced false positive causal relationships in up to 10% of relationships; and (iv) can be corrected in some but not all instances.
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                Author and article information

                Contributors
                Journal
                Front Genet
                Front Genet
                Front. Genet.
                Frontiers in Genetics
                Frontiers Media S.A.
                1664-8021
                06 December 2022
                2022
                : 13
                : 943353
                Affiliations
                [1] 1 School of Public Health , Hangzhou Medical College , Hangzhou, China
                [2] 2 Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province , Shulan International Medical College , Zhejiang Shuren University , Hangzhou, China
                Author notes

                Edited by: Hai-Feng Pan, Anhui Medical University, China

                Reviewed by: Zhaoyan Jiang, Tongji University, China

                Gabriella Garruti, University of Bari Aldo Moro, Italy

                *Correspondence: Minmin Jiang, 601457@ 123456zjsru.edu.cn

                This article was submitted to Applied Genetic Epidemiology, a section of the journal Frontiers in Genetics

                [ † ]

                These authors have contributed equally to this work and share first authorship

                Article
                943353
                10.3389/fgene.2022.943353
                9763559
                36561321
                dc39373c-9d1c-4bb4-a791-607b6885a8c9
                Copyright © 2022 Qian, Jiang, Cai, Chen and Jiang.

                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.

                History
                : 13 May 2022
                : 16 November 2022
                Categories
                Genetics
                Original Research

                Genetics
                physical activity,gallstone disease,mendelian randomization analysis,casual association,genetic epidemiology

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