Alcohol consumption in relation to cardiovascular diseases and mortality: a systematic review of Mendelian randomization studies
The causal effects of alcohol-in-moderation on cardiometabolic health are continuously debated. Mendelian randomization (MR) is an established method to address causal questions in observational studies. We performed a systematic review of the current evidence from MR studies on the association betw...
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Veröffentlicht in: | European journal of epidemiology 2022-07, Vol.37 (7), p.655-669 |
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creator | van de Luitgaarden, Inge A. T. van Oort, Sabine Bouman, Emma J. Schoonmade, Linda J. Schrieks, Ilse C. Grobbee, Diederick E. van der Schouw, Yvonne T. Larsson, Susanna C. Burgess, Stephen van Ballegooijen, Adriana J. Onland-Moret, N. Charlotte Beulens, Joline W. J. |
description | The causal effects of alcohol-in-moderation on cardiometabolic health are continuously debated. Mendelian randomization (MR) is an established method to address causal questions in observational studies. We performed a systematic review of the current evidence from MR studies on the association between alcohol consumption and cardiometabolic diseases, all-cause mortality and cardiovascular risk factors. We performed a systematic search of the literature, including search terms on type of design and exposure. We assessed methodological quality based on key elements of the MR design: use of a full instrumental variable analysis and validation of the three key MR assumptions. We additionally looked at exploration of non-linearity. We reported the direction of the studied associations. Our search yielded 24 studies that were eligible for inclusion. A full instrumental variable analysis was performed in 17 studies (71%) and 13 out of 24 studies (54%) validated all three key assumptions. Five studies (21%) assessed potential non-linearity. In general, null associations were reported for genetically predicted alcohol consumption with the primary outcomes cardiovascular disease (67%) and diabetes (75%), while the only study on all-cause mortality reported a detrimental association. Considering the heterogeneity in methodological quality of the included MR studies, it is not yet possible to draw conclusions on the causal role of moderate alcohol consumption on cardiometabolic health. As MR is a rapidly evolving field, we expect that future MR studies, especially with recent developments regarding instrument selection and non-linearity methodology, will further substantiate this discussion. |
doi_str_mv | 10.1007/s10654-021-00799-5 |
format | Article |
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T. ; van Oort, Sabine ; Bouman, Emma J. ; Schoonmade, Linda J. ; Schrieks, Ilse C. ; Grobbee, Diederick E. ; van der Schouw, Yvonne T. ; Larsson, Susanna C. ; Burgess, Stephen ; van Ballegooijen, Adriana J. ; Onland-Moret, N. Charlotte ; Beulens, Joline W. J.</creator><creatorcontrib>van de Luitgaarden, Inge A. T. ; van Oort, Sabine ; Bouman, Emma J. ; Schoonmade, Linda J. ; Schrieks, Ilse C. ; Grobbee, Diederick E. ; van der Schouw, Yvonne T. ; Larsson, Susanna C. ; Burgess, Stephen ; van Ballegooijen, Adriana J. ; Onland-Moret, N. Charlotte ; Beulens, Joline W. J.</creatorcontrib><description>The causal effects of alcohol-in-moderation on cardiometabolic health are continuously debated. Mendelian randomization (MR) is an established method to address causal questions in observational studies. We performed a systematic review of the current evidence from MR studies on the association between alcohol consumption and cardiometabolic diseases, all-cause mortality and cardiovascular risk factors. We performed a systematic search of the literature, including search terms on type of design and exposure. We assessed methodological quality based on key elements of the MR design: use of a full instrumental variable analysis and validation of the three key MR assumptions. We additionally looked at exploration of non-linearity. We reported the direction of the studied associations. Our search yielded 24 studies that were eligible for inclusion. A full instrumental variable analysis was performed in 17 studies (71%) and 13 out of 24 studies (54%) validated all three key assumptions. Five studies (21%) assessed potential non-linearity. In general, null associations were reported for genetically predicted alcohol consumption with the primary outcomes cardiovascular disease (67%) and diabetes (75%), while the only study on all-cause mortality reported a detrimental association. Considering the heterogeneity in methodological quality of the included MR studies, it is not yet possible to draw conclusions on the causal role of moderate alcohol consumption on cardiometabolic health. As MR is a rapidly evolving field, we expect that future MR studies, especially with recent developments regarding instrument selection and non-linearity methodology, will further substantiate this discussion.</description><identifier>ISSN: 0393-2990</identifier><identifier>ISSN: 1573-7284</identifier><identifier>EISSN: 1573-7284</identifier><identifier>DOI: 10.1007/s10654-021-00799-5</identifier><identifier>PMID: 34420153</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Alcohol ; Alcohol consumption ; Alcohol Drinking - adverse effects ; Alcohol use ; Alcohols ; Cardiology ; Cardiovascular disease ; Cardiovascular Diseases ; Cardiovascular risk factors ; Causality ; Diabetes ; Diabetes mellitus ; Epidemiology ; Genome-Wide Association Study ; Health risks ; Heterogeneity ; Humans ; Infectious Diseases ; Medicine ; Medicine & Public Health ; Mendelian randomization ; Mendelian Randomization Analysis ; Mortality ; Nonlinearity ; Observational studies ; Oncology ; Public Health ; Quality assessment ; Randomization ; Research Design ; Review ; Risk analysis ; Risk factors ; Searching ; Systematic review</subject><ispartof>European journal of epidemiology, 2022-07, Vol.37 (7), p.655-669</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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T.</creatorcontrib><creatorcontrib>van Oort, Sabine</creatorcontrib><creatorcontrib>Bouman, Emma J.</creatorcontrib><creatorcontrib>Schoonmade, Linda J.</creatorcontrib><creatorcontrib>Schrieks, Ilse C.</creatorcontrib><creatorcontrib>Grobbee, Diederick E.</creatorcontrib><creatorcontrib>van der Schouw, Yvonne T.</creatorcontrib><creatorcontrib>Larsson, Susanna C.</creatorcontrib><creatorcontrib>Burgess, Stephen</creatorcontrib><creatorcontrib>van Ballegooijen, Adriana J.</creatorcontrib><creatorcontrib>Onland-Moret, N. Charlotte</creatorcontrib><creatorcontrib>Beulens, Joline W. J.</creatorcontrib><title>Alcohol consumption in relation to cardiovascular diseases and mortality: a systematic review of Mendelian randomization studies</title><title>European journal of epidemiology</title><addtitle>Eur J Epidemiol</addtitle><addtitle>Eur J Epidemiol</addtitle><description>The causal effects of alcohol-in-moderation on cardiometabolic health are continuously debated. Mendelian randomization (MR) is an established method to address causal questions in observational studies. We performed a systematic review of the current evidence from MR studies on the association between alcohol consumption and cardiometabolic diseases, all-cause mortality and cardiovascular risk factors. We performed a systematic search of the literature, including search terms on type of design and exposure. We assessed methodological quality based on key elements of the MR design: use of a full instrumental variable analysis and validation of the three key MR assumptions. We additionally looked at exploration of non-linearity. We reported the direction of the studied associations. Our search yielded 24 studies that were eligible for inclusion. A full instrumental variable analysis was performed in 17 studies (71%) and 13 out of 24 studies (54%) validated all three key assumptions. Five studies (21%) assessed potential non-linearity. In general, null associations were reported for genetically predicted alcohol consumption with the primary outcomes cardiovascular disease (67%) and diabetes (75%), while the only study on all-cause mortality reported a detrimental association. Considering the heterogeneity in methodological quality of the included MR studies, it is not yet possible to draw conclusions on the causal role of moderate alcohol consumption on cardiometabolic health. 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T. ; van Oort, Sabine ; Bouman, Emma J. ; Schoonmade, Linda J. ; Schrieks, Ilse C. ; Grobbee, Diederick E. ; van der Schouw, Yvonne T. ; Larsson, Susanna C. ; Burgess, Stephen ; van Ballegooijen, Adriana J. ; Onland-Moret, N. Charlotte ; Beulens, Joline W. 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subjects | Alcohol Alcohol consumption Alcohol Drinking - adverse effects Alcohol use Alcohols Cardiology Cardiovascular disease Cardiovascular Diseases Cardiovascular risk factors Causality Diabetes Diabetes mellitus Epidemiology Genome-Wide Association Study Health risks Heterogeneity Humans Infectious Diseases Medicine Medicine & Public Health Mendelian randomization Mendelian Randomization Analysis Mortality Nonlinearity Observational studies Oncology Public Health Quality assessment Randomization Research Design Review Risk analysis Risk factors Searching Systematic review |
title | Alcohol consumption in relation to cardiovascular diseases and mortality: a systematic review of Mendelian randomization studies |
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