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Differentiating Associations of Glycemic Traits With Atherosclerotic and Thrombotic Outcomes: Mendelian Randomization Investigation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Medical epidemiology. Karolinska Inst, Karolinska Inst, Unit Cardiovasc & Nutr Epidemiol, Stockholm, Sweden.ORCID iD: 0000-0003-0118-0341
2022 (English)In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 71, no 10, p. 2222-2232Article in journal (Refereed) Published
Abstract [en]

We conducted a Mendelian randomization analysis to differentiate associations of four glycemic indicators with a broad range of atherosclerotic and thrombotic diseases. Independent genetic variants associated with fasting glucose (FG), 2 h glucose after an oral glucose challenge (2hGlu), fasting insulin (FI), and glycated hemoglobin (HbA1c) at the genome-wide significance threshold were used as instrumental variables. Summary-level data for 12 atherosclerotic and 4 thrombotic outcomes were obtained from large genetic consortia and the FinnGen and UK Biobank studies. Higher levels of genetically predicted glycemic traits were consistently associated with increased risk of coronary atherosclerosis-related diseases and symptoms. Genetically predicted glycemic traits except HbA1c showed positive associations with peripheral artery disease risk. Genetically predicted FI levels were positively associated with risk of ischemic stroke and chronic kidney disease. Genetically predicted FG and 2hGlu were positively associated with risk of large artery stroke. Genetically predicted 2hGlu levels showed positive associations with risk of small vessel stroke. Higher levels of genetically predicted glycemic traits were not associated with increased risk of thrombotic outcomes. Most associations for genetically predicted levels of 2hGlu and FI remained after adjustment for other glycemic traits. Increase in glycemic status appears to increase risks of coronary and peripheral artery atherosclerosis but not thrombosis.

Place, publisher, year, edition, pages
American Diabetes Association , 2022. Vol. 71, no 10, p. 2222-2232
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-489520DOI: 10.2337/db21-0905ISI: 000905186900017PubMedID: 35499407OAI: oai:DiVA.org:uu-489520DiVA, id: diva2:1715139
Funder
Swedish Heart Lung Foundation, 20210351Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00123Swedish Research Council, 2016-01042Swedish Research Council, 2019-00977Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2023-01-23Bibliographically approved

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Larsson, Susanna C.

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