孟德尔随机化探究2型糖尿病与急性心肌梗死的性别特异性因果关系

Objective Observational studies have demonstrated that type 2 diabetes (T2D) is a strong risk factor for acute myocardial infarction (AMI), and the risk is higher in females than males. However, observational studies are often affected by confounding factors, and a clear causal effect between the two is helpful for the prevention and control of AMI. The purpose of this study is utilizing Mendelian randomized (MR) to assess the sex-specific causal association between T2D and AMI. Methods T2D and AMI summary data were obtained from the European population. There were 890 002 samples of T2D (425 613 male samples and 464 389 females), and 355 246 samples of AMI. Single nucleotide polymorphisms significantly associated with T2D were selected as instrumental variants. Two -sample MR method was used to evaluate the causal associations between T2D and AMI in total samples, females and males. Inverse variance weighted (IVW) method was used as the main MR analysis method. We used Cochran's Q test to detect sex differences. Results There was a positive causal effect between T2D and AMI in total samples (0R=l .06; 95%CI: 1.04-1.09). We also detected positive association between T2D and AMI in males (OR=1.03, 95%CI: 1.02-1.04), however, there was no effect between T2D and AMI in females (OR= 1.01, 95%CI: 1.00-1.02). Sex heterogeneity analysis revealed a significant difference between male and female groups (P= 0.004). Conclusion T2D can increase the risk of AMI, especially in males.