Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study

Abstract Background Delineating the causal chain effects of reproductive traits and fat- and muscle-related traits on cardiovascular disease (CVD) is essential for optimizing precision prevention and control of cardiovascular health in women. Methods In this study, we applied the two-sample Mendelia...

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Main Authors: Dong Liu, Chun Dou, Chaojie Ye, Lijie Kong, Zheng Zhu, Mingling Chen, Jie Zheng, Min Xu, Yu Xu, Mian Li, Zhiyun Zhao, Jieli Lu, Yuhong Chen, Guang Ning, Weiqing Wang, Yufang Bi, Tiange Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Cardiovascular Diabetology
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Online Access:https://doi.org/10.1186/s12933-025-02681-0
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author Dong Liu
Chun Dou
Chaojie Ye
Lijie Kong
Zheng Zhu
Mingling Chen
Jie Zheng
Min Xu
Yu Xu
Mian Li
Zhiyun Zhao
Jieli Lu
Yuhong Chen
Guang Ning
Weiqing Wang
Yufang Bi
Tiange Wang
author_facet Dong Liu
Chun Dou
Chaojie Ye
Lijie Kong
Zheng Zhu
Mingling Chen
Jie Zheng
Min Xu
Yu Xu
Mian Li
Zhiyun Zhao
Jieli Lu
Yuhong Chen
Guang Ning
Weiqing Wang
Yufang Bi
Tiange Wang
author_sort Dong Liu
collection DOAJ
description Abstract Background Delineating the causal chain effects of reproductive traits and fat- and muscle-related traits on cardiovascular disease (CVD) is essential for optimizing precision prevention and control of cardiovascular health in women. Methods In this study, we applied the two-sample Mendelian randomization (MR) analyses and two-step MR framework to investigate the causal chain effects and the mediating effect pathways among reproductive factors and fat- and muscle-related traits on CVD outcomes in women, applying the genome-wide association study summary statistics of 16 women's reproductive traits across puberty and pre-pregnancy, pregnancy and postpartum, and menopausal transition stages, 16 women's fat- and muscle-related traits, and five CVD outcomes of coronary artery disease (CAD), myocardial infarction (MI), heart failure, atrial fibrillation, and ischemic stroke (IS) from over one million individuals of European descent. Results The MR analyses revealed the associations of genetically predicted nine reproductive traits (i.e., age at menarche [odds ratio (OR) for CAD: 0.92], age at first sexual intercourse [AFS; 0.71], age at first birth [AFB; 0.89], hypertensive disorders of pregnancy [HDP; 1.21], pre-eclampsia [PE; 1.34], preterm birth [PTB; 1.09], sex hormone-binding globulin [SHBG; 0.73], bioavailable testosterone [BT; 1.17], and number of stillbirths [OR for IS: 2.14]) and 13 fat- and muscle-related traits with at least one of five CVD outcomes. Two-step MR identified 30 causal pathways where AFS, AFB, HDP, PE, PTB, SHBG, and BT mediated the effects of body composition on five CVD outcomes, and nine pathways where waist-to-hip ratio, trunk-trunk fat ratio, abdominal subcutaneous adipose tissue, and gluteofemoral adipose tissue mediated the effects of reproductive traits on CAD and MI. Conclusions Lifecourse reproductive characteristics and fat- and muscle-related traits manifested reciprocal mediating effects on CVD, informing targeted strategies for bridging cardiovascular health inequalities in women.
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spelling doaj-art-22e64fc7b92b4e4881a680d812feb9732025-08-20T02:17:46ZengBMCCardiovascular Diabetology1475-28402025-04-0124111210.1186/s12933-025-02681-0Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization studyDong Liu0Chun Dou1Chaojie Ye2Lijie Kong3Zheng Zhu4Mingling Chen5Jie Zheng6Min Xu7Yu Xu8Mian Li9Zhiyun Zhao10Jieli Lu11Yuhong Chen12Guang Ning13Weiqing Wang14Yufang Bi15Tiange Wang16Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Delineating the causal chain effects of reproductive traits and fat- and muscle-related traits on cardiovascular disease (CVD) is essential for optimizing precision prevention and control of cardiovascular health in women. Methods In this study, we applied the two-sample Mendelian randomization (MR) analyses and two-step MR framework to investigate the causal chain effects and the mediating effect pathways among reproductive factors and fat- and muscle-related traits on CVD outcomes in women, applying the genome-wide association study summary statistics of 16 women's reproductive traits across puberty and pre-pregnancy, pregnancy and postpartum, and menopausal transition stages, 16 women's fat- and muscle-related traits, and five CVD outcomes of coronary artery disease (CAD), myocardial infarction (MI), heart failure, atrial fibrillation, and ischemic stroke (IS) from over one million individuals of European descent. Results The MR analyses revealed the associations of genetically predicted nine reproductive traits (i.e., age at menarche [odds ratio (OR) for CAD: 0.92], age at first sexual intercourse [AFS; 0.71], age at first birth [AFB; 0.89], hypertensive disorders of pregnancy [HDP; 1.21], pre-eclampsia [PE; 1.34], preterm birth [PTB; 1.09], sex hormone-binding globulin [SHBG; 0.73], bioavailable testosterone [BT; 1.17], and number of stillbirths [OR for IS: 2.14]) and 13 fat- and muscle-related traits with at least one of five CVD outcomes. Two-step MR identified 30 causal pathways where AFS, AFB, HDP, PE, PTB, SHBG, and BT mediated the effects of body composition on five CVD outcomes, and nine pathways where waist-to-hip ratio, trunk-trunk fat ratio, abdominal subcutaneous adipose tissue, and gluteofemoral adipose tissue mediated the effects of reproductive traits on CAD and MI. Conclusions Lifecourse reproductive characteristics and fat- and muscle-related traits manifested reciprocal mediating effects on CVD, informing targeted strategies for bridging cardiovascular health inequalities in women.https://doi.org/10.1186/s12933-025-02681-0Cardiovascular diseaseLifecourse reproductive characteristicsBody fatMuscleMendelian randomization
spellingShingle Dong Liu
Chun Dou
Chaojie Ye
Lijie Kong
Zheng Zhu
Mingling Chen
Jie Zheng
Min Xu
Yu Xu
Mian Li
Zhiyun Zhao
Jieli Lu
Yuhong Chen
Guang Ning
Weiqing Wang
Yufang Bi
Tiange Wang
Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
Cardiovascular Diabetology
Cardiovascular disease
Lifecourse reproductive characteristics
Body fat
Muscle
Mendelian randomization
title Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
title_full Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
title_fullStr Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
title_full_unstemmed Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
title_short Chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women: a Mendelian randomization study
title_sort chain effect of lifecourse reproductive characteristics and body fat and muscle on cardiovascular disease in women a mendelian randomization study
topic Cardiovascular disease
Lifecourse reproductive characteristics
Body fat
Muscle
Mendelian randomization
url https://doi.org/10.1186/s12933-025-02681-0
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