Genetic Evidence Strongly Supports Managing Weight and Blood Pressure in Addition to Glycemic Control in Preventing Vascular Complications in People With Type 2 Diabetes
Authors' conclusion
Our findings add strong evidence to support the importance of BMI and systolic blood pressure in the development of vascular complications in people with type 2 diabetes. Such findings strongly support the need for better weight and blood pressure management in type 2 diabetes, independent of glucose lowering, to limit important complications.
Study context
- Population
- Summary-level genetic data for 18 vascular diseases (15 for T2D) from FinnGen and publicly available genome-wide association studies
- Comparison
- Genetically predicted T2D, fasting glucose, HbA1c, fasting insulin, BMI and systolic blood pressure vs risk of vascular complications
- Outcome
- Risk of vascular complications (18 vascular diseases; 15 for T2D)
Methodological detailsunivariable and multivariable Mendelian randomization (MR), sensitivity tests for pleiotropy, summary-level data from FinnGen and publicly available GWAS
- Univariable and multivariable MR
- Sensitivity tests for pleiotropy
- Summary-level data from FinnGen and publicly available GWAS
Main finding
As reported in the abstract
Associations with vascular outcomes, univariable MR
- T2D associated with vascular outcomes
- 9 of 15
- BMI associated with vascular outcomes
- 13 of 18
- Systolic blood pressure associated with vascular outcomes
- 15 of 18
- Fasting insulin associated with vascular outcomes
- 4
- Fasting glucose associated with vascular outcomes
- 2
Further findings
Multivariable MR, adjusted for correlated traits
- T2D associations attenuated to null (CKD, ischemic heart disease, HF, subarachnoid hemorrhage, intracerebral hemorrhage)
- 5
- BMI and systolic blood pressure: consistent causal effects maintained
Original publication
Genetic Evidence Strongly Supports Managing Weight and Blood Pressure in Addition to Glycemic Control in Preventing Vascular Complications in People With Type 2 Diabetes. Diabetes Care. Published 9 August 2023. doi:10.
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