Pulse Brain · Growing Health Evidence Index
Tier 1 — Meta-analysis / systematic reviewPeer-reviewed

Causal Associations of Adiposity and Body Fat Distribution With Coronary Heart Disease, Stroke Subtypes, and Type 2 Diabetes Mellitus

Caroline Dale, Ghazaleh Fatemifar, Tom Palmer, Jon White, David Prieto‐Merino, Delilah Zabaneh, Jorgen Engmann, Tina Shah, Andrew Wong, Helen R. Warren, Stela McLachlan, Stella Trompet, Max Moldovan, Richard Morris, Reecha Sofat, Meena Kumari, Elina Hyppönen, Barbara J. Jefferis, Tom R. Gaunt, Yoav Ben‐Shlomo, Ang Zhou, Aleksandra Gentry‐Maharaj, Andy Ryan, Renée de Mutsert, Raymond Noordam, Mark J. Caulfield, J. Wouter Jukema, Bradford B. Worrall, Patricia B. Munroe, Usha Menon, Chris Power, Diana Kuh, Debbie A. Lawlor, Steve E. Humphries, Dennis O. Mook‐Kanamori, Naveed Sattar, Mika Kivimäki, Jacqueline F. Price, George Davey Smith, Frank Dudbridge, Aroon D. Hingorani, Michael V. Holmes, Juan P. Casas

Circulation · 2017

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Summary

This Mendelian randomization study of 14 prospective cohorts and multiple disease consortia (66,842 CHD cases, 12,389 ischaemic stroke cases, 34,840 type 2 diabetes cases) establishes causal associations between both general and central adiposity and cardiometabolic disease. Central adiposity (WHRadjBMI) showed stronger causal effects on ischaemic stroke risk (48% excess per 1 SD) compared to general adiposity, whilst both measures exerted large causal effects on type 2 diabetes risk. The findings suggest that adiposity distribution matters differentially across disease endpoints, with implications for risk stratification and preventive strategies.

Regional applicability

The findings are directly applicable to UK population health strategy, given the reliance on BMI for obesity screening and cardiovascular risk assessment in NHS guidance. The demonstration that central adiposity (waist-to-hip ratio) has stronger causal effects on stroke risk may inform refinement of UK cardiovascular risk prediction tools and obesity management priorities.

Key measures

Odds ratios per 1 SD increase in WHRadjBMI (≈0.08 U) and BMI (≈4.6 kg/m²); 95% confidence intervals for CHD, ischemic stroke, haemorrhagic stroke, and type 2 diabetes mellitus; associations with intermediate cardiometabolic traits

Outcomes reported

The study quantified causal associations between central adiposity (waist-to-hip ratio adjusted for BMI) and general adiposity (BMI) with coronary heart disease, stroke subtypes, and type 2 diabetes mellitus using Mendelian randomization. Secondary outcomes included 18 cardiometabolic traits and intermediate mechanisms including lipids, glycaemic traits, and inflammatory markers.

Theme
Nutrition & health
Subject
Dietary patterns & chronic disease
Study type
Meta-analysis
Study design
Mendelian randomization analysis using genome-wide association study data from multiple prospective cohorts and disease consortia
Source type
Peer-reviewed study
Status
Published
Geography
International
System type
Human clinical
DOI
10.1161/circulationaha.116.026560
Catalogue ID
BFmoef2ocf-lfsng1

Topic tags

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