Associations between body composition, fat distribution and metabolic consequences of excess adiposity with severe COVID-19 outcomes: observational study and Mendelian randomisation analysis.
Associations between body composition, fat distribution and metabolic consequences of excess adiposity with severe COVID-19 outcomes: observational study and Mendelian randomisation analysis.
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DOI：
10.1038/s41366-021-01054-3
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Aveyard P
中科院分区：
文献类型：
--
作者：
Gao M;Wang Q;Piernas C;Astbury NM;Jebb SA;Holmes MV;Aveyard P
较高的体重指数和超重的代谢后果与严重新冠肺炎风险的增加有关，尽管它们的调节途径尚不清楚。一项前瞻性队列研究包括435,504名英国生物库参与者。一项包含两个样本的孟德尔随机化(MR)研究在160万名参与者中使用了新冠肺炎宿主遗传学倡议。我们检查了总肥胖、身体成分、脂肪分布和超重的代谢后果，特别是2型糖尿病，与新冠肺炎的发生率和严重程度之间的关系，通过检测阳性、住院、重症监护病房入院和死亡来评估。在观察性和磁共振分析中，体重指数和体脂与新冠肺炎有关，但肌肉质量与此无关。观察性研究表明，与中心脂肪分布的关联比与BMI的关联更强，但从磁共振分析中几乎没有证据表明这是因果关系。有证据表明，在观察性分析中，新陈代谢结果与新冠肺炎的结果有很强的相关性，但MR分析没有。在观察性分析中，2型糖尿病与新冠肺炎密切相关，但在MR分析中则不然。在调整后的模型中，观察性分析显示，体重指数与新冠肺炎的关联减弱，而中心脂肪分布和超重造成的代谢后果仍然密切相关。相比之下，李嘉诚的研究结果正好相反，只有体重指数对新冠肺炎有直接影响。过度的完全肥胖很可能偶然地与严重的新冠肺炎有关。孟德尔随机数据不支持观察到的中心脂肪分布或过度肥胖的代谢后果与新冠肺炎之间的因果关系。
Higher body mass index (BMI) and metabolic consequences of excess weight are associated with increased risk of severe COVID-19, though their mediating pathway is unclear. A prospective cohort study included 435,504 UK Biobank participants. A two-sample Mendelian randomisation (MR) study used the COVID-19 Host Genetics Initiative in 1.6 million participants. We examined associations of total adiposity, body composition, fat distribution and metabolic consequences of excess weight, particularly type 2 diabetes, with incidence and severity of COVID-19, assessed by test positivity, hospital admission, intensive care unit (ICU) admission and death. BMI and body fat were associated with COVID-19 in the observational and MR analyses but muscle mass was not. The observational study suggested the association with central fat distribution was stronger than for BMI, but there was little evidence from the MR analyses than this was causal. There was evidence that strong associations of metabolic consequences with COVID-19 outcomes in observational but not MR analyses. Type 2 diabetes was strongly associated with COVID-19 in observational but not MR analyses. In adjusted models, the observational analysis showed that the association of BMI with COVID-19 diminished, while central fat distribution and metabolic consequences of excess weight remained strongly associated. In contrast, MR showed the reverse, with only BMI retaining a direct effect on COVID-19. Excess total adiposity is probably casually associated with severe COVID-19. Mendelian randomisation data do not support causality for the observed associations of central fat distribution or metabolic consequences of excess adiposity with COVID-19.
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影响因子：
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作者：
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BMJ (Clinical research ed.)
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