A Mendelian randomization study of the effect of type-2 diabetes on coronary heart disease

Omar S. Ahmad, John A. Morris, Muhammad Mujammami, Vincenzo Forgetta, Aaron Leong, Rui Li, Maxime Turgeon, Celia M.T. Greenwood, George Thanassoulis, James B. Meigs, Robert Sladek and J. Brent Richards ()
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Omar S. Ahmad: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University
John A. Morris: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University
Muhammad Mujammami: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University
Vincenzo Forgetta: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University
Aaron Leong: Harvard Medical School
Rui Li: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University
Maxime Turgeon: Epidemiology, Biostatistics and Occupational Health, and Human Genetics, McGill University
Celia M.T. Greenwood: Epidemiology, Biostatistics and Occupational Health, and Human Genetics, McGill University
George Thanassoulis: McGill University
James B. Meigs: Harvard Medical School
Robert Sladek: McGill University
J. Brent Richards: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University

Nature Communications, 2015, vol. 6, issue 1, 1-11

Abstract: Abstract In observational studies, type-2 diabetes (T2D) is associated with an increased risk of coronary heart disease (CHD), yet interventional trials have shown no clear effect of glucose-lowering on CHD. Confounding may have therefore influenced these observational estimates. Here we use Mendelian randomization to obtain unconfounded estimates of the influence of T2D and fasting glucose (FG) on CHD risk. Using multiple genetic variants associated with T2D and FG, we find that risk of T2D increases CHD risk (odds ratio (OR)=1.11 (1.05–1.17), per unit increase in odds of T2D, P=8.8 × 10−5; using data from 34,840/114,981 T2D cases/controls and 63,746/130,681 CHD cases/controls). FG in non-diabetic individuals tends to increase CHD risk (OR=1.15 (1.00–1.32), per mmol·per l, P=0.05; 133,010 non-diabetic individuals and 63,746/130,681 CHD cases/controls). These findings provide evidence supporting a causal relationship between T2D and CHD and suggest that long-term trials may be required to discern the effects of T2D therapies on CHD risk.

Date: 2015
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DOI: 10.1038/ncomms8060

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