Journal Home > Volume 21 , Issue 2
BACKGROUND

Myocardial infarction (MI) is a critical cardiovascular event with multifaceted etiology, involving several genetic and environmental factors. It is essential to understand the function of plasma metabolites in the development of MI and unravel its complex pathogenesis.

METHODS

This study employed a bidirectional Mendelian randomization (MR) approach to investigate the causal relationships between plasma metabolites and MI risk. We used genetic instruments as proxies for plasma metabolites and MI and conducted MR analyses in both directions to assess the impact of metabolites on MI risk and vice versa. In addition, the large-scale genome-wide association studies datasets was used to identify genetic variants associated with plasma metabolite (1400 metabolites) and MI (20,917 individuals with MI and 440,906 individuals without MI) susceptibility. Inverse variance weighted was the primary method for estimating causal effects. MR estimates are expressed as beta coefficients or odds ratio (OR) with 95% CI.

RESULTS

We identified 14 plasma metabolites associated with the occurrence of MI (P < 0.05), among which 8 plasma metabolites [propionylglycine levels (OR = 0.922, 95% CI: 0.881–0.965, P < 0.001), gamma-glutamylglycine levels (OR = 0.903, 95% CI: 0.861–0.948, P < 0.001), hexadecanedioate (C16-DC) levels (OR = 0.941, 95% CI: 0.911–0.973, P < 0.001), pentose acid levels (OR = 0.923, 95% CI: 0.877–0.972, P = 0.002), X-24546 levels (OR = 0.936, 95% CI: 0.902–0.971, P < 0.001), glycine levels (OR = 0.936, 95% CI: 0.909–0.964, P < 0.001), glycine to serine ratio (OR = 0.930, 95% CI: 0.888–0.974, P = 0.002), and mannose to trans-4-hydroxyproline ratio (OR = 0.912, 95% CI: 0.869–0.958, P < 0.001)] were correlated with a decreased risk of MI, whereas the remaining 6 plasma metabolites [1-palmitoyl-2-arachidonoyl-GPE (16:0/20:4) levels (OR = 1.051, 95% CI: 1.018–1.084, P = 0.002), behenoyl dihydrosphingomyelin (d18:0/22:0) levels (OR = 1.076, 95% CI: 1.027–1.128, P = 0.002), 1-stearoyl-2-docosahexaenoyl-GPE (18:0/22:6) levels (OR = 1.067, 95% CI: 1.027–1.109, P = 0.001), alpha-ketobutyrate levels (OR = 1.108, 95% CI: 1.041–1.180, P = 0.001), 5-acetylamino-6-formylamino-3-methyluracil levels (OR = 1.047, 95% CI: 1.019–1.076, P < 0.001), and N-acetylputrescine to (N (1) + N (8))-acetylspermidine ratio (OR = 1.045, 95% CI: 1.018–1.073, P < 0.001)] were associated with an increased risk of MI. Furthermore, we also observed that the mentioned relationships were unaffected by horizontal pleiotropy (P > 0.05). On the contrary, MI did not lead to significant alterations in the levels of the aforementioned 14 plasma metabolites (P > 0.05 for each comparison).

CONCLUSIONS

Our bidirectional MR study identified 14 plasma metabolites associated with the occurrence of MI, among which 13 plasma metabolites have not been reported previously. These findings provide valuable insights for the early diagnosis of MI and potential therapeutic targets.


menu
Abstract
Full text
Outline
About this article

Plasma metabolites and risk of myocardial infarction: a bidirectional Mendelian randomization study

Show Author's information Dong-Hua LI1,*Qiang WU2,*Jing-Sheng LAN1Shuo CHEN3You-Yi HUANG1Lan-Jin WU1Zhi-Qing QIN1Ying HUANG1Wan-Zhong HUANG4Ting ZENG4Xin HAO5Hua-Bin SU4( )Qiang SU4( )
Department of Cardiovascular Medicine, Minzu Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
Senior Department of Cardiology, the Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
Library of Graduate School, Chinese PLA General Hospital, Beijing, China
Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
Health Management Institute, the Second Medical Center, Chinese PLA General Hospital, Beijing, China

*The authors contributed equally to this manuscript

Abstract

BACKGROUND

Myocardial infarction (MI) is a critical cardiovascular event with multifaceted etiology, involving several genetic and environmental factors. It is essential to understand the function of plasma metabolites in the development of MI and unravel its complex pathogenesis.

METHODS

This study employed a bidirectional Mendelian randomization (MR) approach to investigate the causal relationships between plasma metabolites and MI risk. We used genetic instruments as proxies for plasma metabolites and MI and conducted MR analyses in both directions to assess the impact of metabolites on MI risk and vice versa. In addition, the large-scale genome-wide association studies datasets was used to identify genetic variants associated with plasma metabolite (1400 metabolites) and MI (20,917 individuals with MI and 440,906 individuals without MI) susceptibility. Inverse variance weighted was the primary method for estimating causal effects. MR estimates are expressed as beta coefficients or odds ratio (OR) with 95% CI.

RESULTS

We identified 14 plasma metabolites associated with the occurrence of MI (P < 0.05), among which 8 plasma metabolites [propionylglycine levels (OR = 0.922, 95% CI: 0.881–0.965, P < 0.001), gamma-glutamylglycine levels (OR = 0.903, 95% CI: 0.861–0.948, P < 0.001), hexadecanedioate (C16-DC) levels (OR = 0.941, 95% CI: 0.911–0.973, P < 0.001), pentose acid levels (OR = 0.923, 95% CI: 0.877–0.972, P = 0.002), X-24546 levels (OR = 0.936, 95% CI: 0.902–0.971, P < 0.001), glycine levels (OR = 0.936, 95% CI: 0.909–0.964, P < 0.001), glycine to serine ratio (OR = 0.930, 95% CI: 0.888–0.974, P = 0.002), and mannose to trans-4-hydroxyproline ratio (OR = 0.912, 95% CI: 0.869–0.958, P < 0.001)] were correlated with a decreased risk of MI, whereas the remaining 6 plasma metabolites [1-palmitoyl-2-arachidonoyl-GPE (16:0/20:4) levels (OR = 1.051, 95% CI: 1.018–1.084, P = 0.002), behenoyl dihydrosphingomyelin (d18:0/22:0) levels (OR = 1.076, 95% CI: 1.027–1.128, P = 0.002), 1-stearoyl-2-docosahexaenoyl-GPE (18:0/22:6) levels (OR = 1.067, 95% CI: 1.027–1.109, P = 0.001), alpha-ketobutyrate levels (OR = 1.108, 95% CI: 1.041–1.180, P = 0.001), 5-acetylamino-6-formylamino-3-methyluracil levels (OR = 1.047, 95% CI: 1.019–1.076, P < 0.001), and N-acetylputrescine to (N (1) + N (8))-acetylspermidine ratio (OR = 1.045, 95% CI: 1.018–1.073, P < 0.001)] were associated with an increased risk of MI. Furthermore, we also observed that the mentioned relationships were unaffected by horizontal pleiotropy (P > 0.05). On the contrary, MI did not lead to significant alterations in the levels of the aforementioned 14 plasma metabolites (P > 0.05 for each comparison).

CONCLUSIONS

Our bidirectional MR study identified 14 plasma metabolites associated with the occurrence of MI, among which 13 plasma metabolites have not been reported previously. These findings provide valuable insights for the early diagnosis of MI and potential therapeutic targets.

References(32)

[1]

Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet 2017; 389: 197−210.

[2]

Anderson JL, Morrow DA. Acute myocardial infarction. N Engl J Med 2017; 376: 2053−2064.

[3]

Chang C, Cai R, Wu Q, et al. Uncovering the genetic link between acute myocardial infarction and ulcerative colitis co-morbidity through a systems biology approach. Cardiovasc Innov Appl 2023; 8: e978.

[4]

Li YX, Wang BN, Fan FF, et al. Thirty-day outcomes of in-hospital multi-vessel versus culprit-only revascularization strategy for ST-segment elevation myocardial infarction with multivessel coronary disease. J Geriatr Cardiol 2023; 20: 485−494.

[5]

Wu Q, Li LF, Chen YD. Advances in Journal of Geriatric Cardiology over the course of a decade. J Geriatr Cardiol 2020; 17: 733−739.

[6]

Johansson S, Rosengren A, Young K, et al. Mortality and morbidity trends after the first year in survivors of acute myocardial infarction: a systematic review. BMC Cardio vasc Disord 2017; 17: 53.

[7]

Agarwal M, Agrawal S, Garg L, et al. Effect of chronic obstructive pulmonary disease on in-hospital mortality and clinical outcomes after ST-segment elevation myocardial infarction. Am J Cardiol 2017; 119: 1555−1559.

[8]

Hayıroğlu Mİ, Keskin M, Uzun AO, et al. Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction complicated with cardiogenic shock. Heart Lung Circ 2019; 28: 237−244.

[9]

Salari N, Morddarvanjoghi F, Abdolmaleki A, et al. The global prevalence of myocardial infarction: systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23: 206.

[10]

Floegel A, Kühn T, Sookthai D, et al. Serum metabolites and risk of myocardial infarction and ischemic stroke: a targeted metabolomic approach in two German prospective cohorts. Eur J Epidemiol 2018; 33: 55−66.

[11]

Ward-Caviness CK, Xu T, Aspelund T, et al. Improvement of myocardial infarction risk prediction via inflammation-associated metabolite biomarkers. Heart 2017; 103: 1278−1285.

[12]

Yu Z, Coresh J, Qi G, et al. A bidirectional Mendelian randomization study supports causal effects of kidney function on blood pressure. Kidney Int 2020; 98: 708−716.

[13]

Choi KW, Chen CY, Stein MB, et al. Assessment of bidirectional relationships between physical activity and depression among adults: a 2-sample Mendelian randomization study. JAMA Psychiatry 2019; 76: 399−408.

[14]

Park S, Lee S, Kim Y, et al. Atrial fibrillation and kidney function: a bidirectional Mendelian randomization study. Eur Heart J 2021; 42: 2816−2823.

[15]

Guan B, Chen XQ, Liu Y, et al. Causal effects of circulating vitamin levels on the risk of heart failure: a Mendelian randomization study. J Geriatr Cardiol 2023; 20: 195−204.

[16]

Burgess S, Davey Smith G, Davies NM, et al. Guidelines for performing Mendelian randomization investigations: update for summer 2023. Wellcome Open Res 2023; 4: 186.

[17]

Skrivankova VW, Richmond RC, Woolf BAR, et al. Strengthening the reporting of observational studies in epidemiology using Mendelian randomization: the STROBE-MR statement. JAMA 2021; 326: 1614−1621.

[18]

Chen Y, Lu T, Pettersson-Kymmer U, et al. Genomic atlas of the plasma metabolome prioritizes metabolites implicated in human diseases. Nat Genet 2023; 55: 44−53.

[19]

Sakaue S, Kanai M, Tanigawa Y, et al. A cross-population atlas of genetic associations for 220 human phenotypes. Nat Genet 2021; 53: 1415−1424.

[20]

Staley JR, Blackshaw J, Kamat MA, et al. PhenoScanner: a database of human genotype-phenotype associations. Bi oinformatics 2016; 32: 3207−3209.

[21]

Palmer TM, Lawlor DA, Harbord RM, et al. Using multiple genetic variants as instrumental variables for modifiable risk factors. Stat Methods Med Res 2012; 21: 223−242.

[22]

Levin MG, Judy R, Gill D, et al. Genetics of height and risk of atrial fibrillation: a Mendelian randomization study. PLoS Med 2020; 17: e1003288.

[23]

Gill D, Efstathiadou A, Cawood K, et al. Education protects against coronary heart disease and stroke independently of cognitive function: evidence from Mendelian randomization. Int J Epidemiol 2019; 48: 1468−1477.

[24]

Shi X, Yuan W, Cao Q, et al. Education plays a crucial role in the pathway from poverty to smoking: a Mendelian randomization study. Addiction 2023; 118: 128−139.

[25]

Larsson SC, Burgess S, Michaëlsson K. Association of genetic variants related to serum calcium levels with coronary artery disease and myocardial infarction. JAMA 2017; 318: 371−380.

[26]

Bowden J, Del Greco M F, Minelli C, et al. A framework for the investigation of pleiotropy in two-sample summary data Mendelian randomization. Stat Med 2017; 36: 1783−1802.

[27]

Davey Smith G, Hemani G. Mendelian randomization: genetic anchors for causal inference in epidemiological studies. Hum Mol Genet 2014; 23: R89−R98.

[28]

Bowden J, Davey Smith G, Haycock PC, et al. Consistent estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol 2016; 40: 304−314.

[29]

Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol 2017; 32: 377−389.

[30]

Ding Y, Svingen GF, Pedersen ER, et al. Plasma glycine and risk of acute myocardial infarction in patients with suspected stable angina pectoris. J Am Heart Assoc 2015; 5: e002621.

[31]

Aa N, Lu Y, Yu M, et al. Plasma metabolites alert patients with chest pain to occurrence of myocardial infarction. Front Cardiovasc Med 2021; 8: 652746.

[32]

Hasegawa S, Ichiyama T, Sonaka I, et al. Cysteine, histidine and glycine exhibit anti-inflammatory effects in human coronary arterial endothelial cells. Clin Exp Immunol 2012; 167: 269−274.

Publication history
Copyright
Acknowledgements

Publication history

Published: 28 February 2024
Issue date: February 2024

Copyright

© 2024 JGC All rights reserved

Acknowledgements

ACKNOWLEDGMENTS

The study was supported by the Guangxi Natural Science Foundation (No.2020GXNSFDA238007), the Key Research and Development Program of Guangxi (No.2023AB22024), and the Chongzuo Science and Technology Bureau Planning Project (No.FA2018026). All authors had no conflicts of interest to disclose.

Return