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Mendelian randomization analysis of the causal impact of body mass index and waist-hip ratio on rates of hospital admission

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  • Hazewinkel, Audinga-Dea
  • Richmond, Rebecca C.
  • Wade, Kaitlin H.
  • Dixon, Padraig

Abstract

We analyze how measures of adiposity – body mass index (BMI) and waist hip ratio (WHR) – causally influence rates of hospital admission. Conventional analyses of this relationship are susceptible to omitted variable bias from variables that jointly influence both hospital admission and adipose status. We implement a novel quasi-Poisson instrumental variable model in a Mendelian randomization framework, identifying causal effects from random perturbations to germline genetic variation. We estimate the individual and joint effects of BMI, WHR, and WHR adjusted for BMI. We also implement multivariable instrumental variable methods in which the causal effect of one exposure is estimated conditionally on the causal effect of another exposure. Data on 310,471 participants and over 550,000 inpatient admissions in the UK Biobank were used to perform one-sample and two-sample Mendelian randomization analyses. The results supported a causal role of adiposity on hospital admissions, with consistency across all estimates and sensitivity analyses. Point estimates were generally larger than estimates from comparable observational specifications. We observed an attenuation of the BMI effect when adjusting for WHR in the multivariable Mendelian randomization analyses, suggesting that an adverse fat distribution, rather than a higher BMI itself, may drive the relationship between adiposity and risk of hospital admission.

Suggested Citation

  • Hazewinkel, Audinga-Dea & Richmond, Rebecca C. & Wade, Kaitlin H. & Dixon, Padraig, 2022. "Mendelian randomization analysis of the causal impact of body mass index and waist-hip ratio on rates of hospital admission," Economics & Human Biology, Elsevier, vol. 44(C).
  • Handle: RePEc:eee:ehbiol:v:44:y:2022:i:c:s1570677x21001131
    DOI: 10.1016/j.ehb.2021.101088
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    Cited by:

    1. Dixon, Padraig & Harrison, Sean & Hollingworth, William & Davies, Neil M. & Davey Smith, George, 2022. "Estimating the causal effect of liability to disease on healthcare costs using Mendelian Randomization," Economics & Human Biology, Elsevier, vol. 46(C).
    2. Jiwoo Lee & Sakari Jukarainen & Antti Karvanen & Padraig Dixon & Neil M. Davies & George Davey Smith & Pradeep Natarajan & Andrea Ganna, 2023. "Quantifying the causal impact of biological risk factors on healthcare costs," Nature Communications, Nature, vol. 14(1), pages 1-11, December.

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