文章基本信息

标题：Estimating the Direct Effect between Dietary Macronutrients and Cardiometabolic Disease, Accounting for Mediation by Adiposity and Physical Activity
本地全文：下载
作者：Hugo Pomares-Millan ; Naeimeh Atabaki-Pasdar ; Daniel Coral 等
期刊名称：Nutrients
电子版ISSN：2072-6643
出版年度：2022
卷号：14
期号：6
DOI：10.3390/nu14061218
语种：English
出版社：MDPI Publishing
摘要：Assessing the causal effects of individual dietary macronutrients and cardiometabolic disease is challenging because distinguish direct effects from those mediated or confounded by other factors is difficult. To estimate these effects, intake of protein, carbohydrate, sugar, fat, and its subtypes were obtained using food frequency data derived from a Swedish population-based cohort (n~60,000). Data on clinical outcomes (i.e., type 2 diabetes (T2D) and cardiovascular disease (CVD) incidence) were obtained by linking health registry data. We assessed the magnitude of direct and mediated effects of diet, adiposity and physical activity on T2D and CVD using structural equation modelling (SEM). To strengthen causal inference, we used Mendelian randomization (MR) to model macronutrient intake exposures against clinical outcomes. We identified likely causal effects of genetically predicted carbohydrate intake (including sugar intake) and T2D, independent of adiposity and physical activity. Pairwise, serial- and parallel-mediational configurations yielded similar results. In the integrative genomic analyses, the candidate causal variant localized to the established T2D gene TCF7L2. These findings may be informative when considering which dietary modifications included in nutritional guidelines are most likely to elicit health-promoting effects.
关键词：enmacronutrient intakemediationcausal inferencecardiometabolic riskcardiovascular diseaseadiposityphysical activity