SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study

Abstract Aims We aim to investigate the causal effect of blood lipids mediating sodium‐glucose cotransporter 2 (SGLT2) inhibition in cardiovascular disease (CVD) using Mendelian randomization (MR). Methods and results A two‐sample two‐step MR study was conducted to evaluate the association of SGLT2...

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Main Authors: Jiangtao Li, Chenhe Li, Xin Feng, Xiang Wei
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.14987
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author Jiangtao Li
Chenhe Li
Xin Feng
Xiang Wei
author_facet Jiangtao Li
Chenhe Li
Xin Feng
Xiang Wei
author_sort Jiangtao Li
collection DOAJ
description Abstract Aims We aim to investigate the causal effect of blood lipids mediating sodium‐glucose cotransporter 2 (SGLT2) inhibition in cardiovascular disease (CVD) using Mendelian randomization (MR). Methods and results A two‐sample two‐step MR study was conducted to evaluate the association of SGLT2 inhibition with CVDs and the mediation effects of blood lipids linking SGLT2 inhibition with CVDs. Genetic instruments for SGLT2 inhibition were identified as genetic variants, which were associated with the expression of the SLC5A2 gene and glycated haemoglobin level (HbA1c). SGLT2 inhibition was associated with reduced risk of heart failure (HF) (OR 0.44 [95% CI 0.32–0.61]; P = 6.0 × 10−7), atrial fibrillation (AF) (0.47 [0.37–0.61]; P = 1.81 × 10−8), coronary artery disease (CAD) (0.47 [0.30–0.73]; P = 7.46 × 10−4), myocardial infarction (MI) (0.30 [0.15–0.61]; P = 7.44 × 10−4), any stroke (AS) (0.28 [0.18–0.42]; P = 1.14 × 10−9), and ischaemic stroke (IS) (0.27 [0.17–0.44]; P = 1.97 × 10−7). Our results indicated that the proportion mediated of the mediating effect of total cholesterol was 1.7% (OR 0.99 [95% CI 0.98, 0.99], P = 0.004), 4.7% (0.96 [0.95, 0.98], P = 0.002), and 2.7% (0.97 [0.95, 0.98], P = 0.002) in the association between SGLT2 inhibition and the risk of HF, CAD, and MI, respectively. For low‐density lipoprotein cholesterol, the proportion mediated of the mediating effect was 2.2% for HF (OR 0.98 [95% CI 0.98, 0.99], P = 0.003), 8.6% for CAD (0.93 [0.91, 0.95], P = 5.74 × 10−4), and 5.0% for MI (0.95 [0.94, 0.96], P = 6.97 × 10−4). For non‐high‐density lipoprotein cholesterol, the proportion mediated of the mediating effect was 3.4% for HF (OR 0.98 [95% CI 0.97, 0.98], P = 4.42 × 10−6), 11.8% for CAD (0.92 [0.90, 0.93], P = 7.23 × 10−8), 5.7% for MI (0.94 [0.92, 0.95], P = 8.17 × 10−7), 1.5% for AS (0.98 [0.98, 0.99], P = 0.001), and 1.4% for IS (0.98 [0.98, 0.99], P = 0.004). Conclusions Our study showed the association of SGLT2 inhibition with the reduced risk of CVDs and blood lipids might mediate this association.
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spelling doaj-art-703fb76fb7ce44d2990a4744b0d98f492024-12-11T01:57:00ZengWileyESC Heart Failure2055-58222024-12-011163960397110.1002/ehf2.14987SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization studyJiangtao Li0Chenhe Li1Xin Feng2Xiang Wei3Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDivision of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDivision of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaDivision of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaAbstract Aims We aim to investigate the causal effect of blood lipids mediating sodium‐glucose cotransporter 2 (SGLT2) inhibition in cardiovascular disease (CVD) using Mendelian randomization (MR). Methods and results A two‐sample two‐step MR study was conducted to evaluate the association of SGLT2 inhibition with CVDs and the mediation effects of blood lipids linking SGLT2 inhibition with CVDs. Genetic instruments for SGLT2 inhibition were identified as genetic variants, which were associated with the expression of the SLC5A2 gene and glycated haemoglobin level (HbA1c). SGLT2 inhibition was associated with reduced risk of heart failure (HF) (OR 0.44 [95% CI 0.32–0.61]; P = 6.0 × 10−7), atrial fibrillation (AF) (0.47 [0.37–0.61]; P = 1.81 × 10−8), coronary artery disease (CAD) (0.47 [0.30–0.73]; P = 7.46 × 10−4), myocardial infarction (MI) (0.30 [0.15–0.61]; P = 7.44 × 10−4), any stroke (AS) (0.28 [0.18–0.42]; P = 1.14 × 10−9), and ischaemic stroke (IS) (0.27 [0.17–0.44]; P = 1.97 × 10−7). Our results indicated that the proportion mediated of the mediating effect of total cholesterol was 1.7% (OR 0.99 [95% CI 0.98, 0.99], P = 0.004), 4.7% (0.96 [0.95, 0.98], P = 0.002), and 2.7% (0.97 [0.95, 0.98], P = 0.002) in the association between SGLT2 inhibition and the risk of HF, CAD, and MI, respectively. For low‐density lipoprotein cholesterol, the proportion mediated of the mediating effect was 2.2% for HF (OR 0.98 [95% CI 0.98, 0.99], P = 0.003), 8.6% for CAD (0.93 [0.91, 0.95], P = 5.74 × 10−4), and 5.0% for MI (0.95 [0.94, 0.96], P = 6.97 × 10−4). For non‐high‐density lipoprotein cholesterol, the proportion mediated of the mediating effect was 3.4% for HF (OR 0.98 [95% CI 0.97, 0.98], P = 4.42 × 10−6), 11.8% for CAD (0.92 [0.90, 0.93], P = 7.23 × 10−8), 5.7% for MI (0.94 [0.92, 0.95], P = 8.17 × 10−7), 1.5% for AS (0.98 [0.98, 0.99], P = 0.001), and 1.4% for IS (0.98 [0.98, 0.99], P = 0.004). Conclusions Our study showed the association of SGLT2 inhibition with the reduced risk of CVDs and blood lipids might mediate this association.https://doi.org/10.1002/ehf2.14987Blood lipidCardiovascular diseaseMendelian randomizationSodium‐glucose cotransporter 2 inhibition
spellingShingle Jiangtao Li
Chenhe Li
Xin Feng
Xiang Wei
SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
ESC Heart Failure
Blood lipid
Cardiovascular disease
Mendelian randomization
Sodium‐glucose cotransporter 2 inhibition
title SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
title_full SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
title_fullStr SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
title_full_unstemmed SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
title_short SGLT2 inhibition, blood lipids, and cardiovascular disease: A Mendelian randomization study
title_sort sglt2 inhibition blood lipids and cardiovascular disease a mendelian randomization study
topic Blood lipid
Cardiovascular disease
Mendelian randomization
Sodium‐glucose cotransporter 2 inhibition
url https://doi.org/10.1002/ehf2.14987
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