Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization

The causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating r...

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Main Authors: Peijiang Pan, Hao Liang, Mingli Li
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Current Issues in Molecular Biology
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Online Access:https://www.mdpi.com/1467-3045/47/7/494
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author Peijiang Pan
Hao Liang
Mingli Li
author_facet Peijiang Pan
Hao Liang
Mingli Li
author_sort Peijiang Pan
collection DOAJ
description The causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating roles of cardiometabolic traits in the causal effects of SHBG levels on stroke subtypes. Further two-sample MR analyses were performed to explore the inverse associations between significant cardiometabolic mediators and SHBG levels. The MR results indicated a protective effect of genetically increased SHBG levels on any stroke (odd ratio [OR] = 0.941; 95% confidence interval [CI]: 0.898, 0.984), any ischemic stroke (OR = 0.951; 95% CI: 0.922, 0.981), and small-vessel stroke (OR = 0.871; 95% CI: 0.765, 0.977). Moreover, genetically elevated SHBG levels were associated with lower waist circumference (WC, β = −0.091; 95% CI: −0.136, −0.046), waist-to-hip ratio (WHR, β = −0.057; 95% CI: −0.084, −0.030), triglycerides (TG, β = −0.188; 95% CI: −0.249, −0.127), systolic blood pressure (β = −0.799; 95% CI: −1.068, −0.530), and diastolic blood pressure (β = −0.436; 95% CI: −0.605, −0.267), and a reduced risk of type 2 diabetes mellitus (OR = 0.684; 95% CI: 0.400, 0.968) in both the discovery and replication datasets. The proportions of such cardiometabolic traits that mediated the causal effects of SHBG levels on any stroke, any ischemic stroke, or small-vessel stroke ranged from 17.8% to 52.7%; while the mediating effects of SHBG levels on the causal associations between WC, WHR, and TG and stroke ranged from 18.4% to 68.3%. Our findings suggest a protective effect of genetically elevated SHBG levels on stroke risk via key cardiometabolic mediators, primarily WC, WHR, and TG. The mediating roles of SHBG levels in the causal links from WC, WHR and TG to stroke risk were also established. These pathways support SHBG as a potential biomarker and therapeutic target in stroke prevention.
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spelling doaj-art-fa07aca5a6fc42d7a5ff41c11eb72cf52025-08-20T02:45:34ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452025-06-0147749410.3390/cimb47070494Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian RandomizationPeijiang Pan0Hao Liang1Mingli Li2Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, ChinaGuangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, ChinaCenter for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, ChinaThe causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating roles of cardiometabolic traits in the causal effects of SHBG levels on stroke subtypes. Further two-sample MR analyses were performed to explore the inverse associations between significant cardiometabolic mediators and SHBG levels. The MR results indicated a protective effect of genetically increased SHBG levels on any stroke (odd ratio [OR] = 0.941; 95% confidence interval [CI]: 0.898, 0.984), any ischemic stroke (OR = 0.951; 95% CI: 0.922, 0.981), and small-vessel stroke (OR = 0.871; 95% CI: 0.765, 0.977). Moreover, genetically elevated SHBG levels were associated with lower waist circumference (WC, β = −0.091; 95% CI: −0.136, −0.046), waist-to-hip ratio (WHR, β = −0.057; 95% CI: −0.084, −0.030), triglycerides (TG, β = −0.188; 95% CI: −0.249, −0.127), systolic blood pressure (β = −0.799; 95% CI: −1.068, −0.530), and diastolic blood pressure (β = −0.436; 95% CI: −0.605, −0.267), and a reduced risk of type 2 diabetes mellitus (OR = 0.684; 95% CI: 0.400, 0.968) in both the discovery and replication datasets. The proportions of such cardiometabolic traits that mediated the causal effects of SHBG levels on any stroke, any ischemic stroke, or small-vessel stroke ranged from 17.8% to 52.7%; while the mediating effects of SHBG levels on the causal associations between WC, WHR, and TG and stroke ranged from 18.4% to 68.3%. Our findings suggest a protective effect of genetically elevated SHBG levels on stroke risk via key cardiometabolic mediators, primarily WC, WHR, and TG. The mediating roles of SHBG levels in the causal links from WC, WHR and TG to stroke risk were also established. These pathways support SHBG as a potential biomarker and therapeutic target in stroke prevention.https://www.mdpi.com/1467-3045/47/7/494sex hormone-binding globulinstrokecardiometabolic traitsMendelian randomizationmediation effect
spellingShingle Peijiang Pan
Hao Liang
Mingli Li
Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
Current Issues in Molecular Biology
sex hormone-binding globulin
stroke
cardiometabolic traits
Mendelian randomization
mediation effect
title Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
title_full Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
title_fullStr Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
title_full_unstemmed Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
title_short Investigating the Mediating Role of Cardiometabolic Traits in the Causal Link Between SHBG Levels and Stroke Risk via Network Mendelian Randomization
title_sort investigating the mediating role of cardiometabolic traits in the causal link between shbg levels and stroke risk via network mendelian randomization
topic sex hormone-binding globulin
stroke
cardiometabolic traits
Mendelian randomization
mediation effect
url https://www.mdpi.com/1467-3045/47/7/494
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AT minglili investigatingthemediatingroleofcardiometabolictraitsinthecausallinkbetweenshbglevelsandstrokeriskvianetworkmendelianrandomization