Phenome-wide Mendelian randomization study evaluating the association of circulating vitamin D with complex diseases.

ABSTRACT

Background: Circulating vitamin D has been associated with multiple clinical diseases in observational studies, but the association was inconsistent due to the presence of confounders. We conducted a bidirectional Mendelian randomization (MR) study to explore the healthy atlas of vitamin D in many clinical traits and evaluate their causal association. Methods: Based on a large-scale genome-wide association study (GWAS), the single nucleotide polymorphism (SNPs) instruments of circulating 25-hydroxyvitamin D (25OHD) from 443,734 Europeans and the corresponding effects of 10 clinical diseases and 42 clinical traits in the European population were recruited to conduct a bidirectional two-sample Mendelian randomization study. Under the network of Mendelian randomization analysis, inverse-variance weighting (IVW), weighted median, weighted mode, and Mendelian randomization (MR)-Egger regression were performed to explore the causal effects and pleiotropy. Mendelian randomization pleiotropy RESidual Sum and Outlier (MR-PRESSO) was conducted to uncover and exclude pleiotropic SNPs. Results: The results revealed that genetically decreased vitamin D was inversely related to the estimated BMD (ß = -0.029 g/cm2, p = 0.027), TC (ß = -0.269 mmol/L, p = 0.006), TG (ß = -0.208 mmol/L, p = 0.002), and pulse pressure (ß = -0.241 mmHg, p = 0.043), while positively associated with lymphocyte count (ß = 0.037%, p = 0.015). The results did not reveal any causal association of vitamin D with clinical diseases. On the contrary, genetically protected CKD was significantly associated with increased vitamin D (ß = 0.056, p = 2.361 × 10-26). Conclusion: The putative causal effects of circulating vitamin D on estimated bone mass, plasma triglyceride, and total cholesterol were uncovered, but not on clinical diseases. Vitamin D may be linked to clinical disease by affecting health-related metabolic markers.