Using genetic loci to understand the relationship between adiposity and psychological distress: a Mendelian Randomization study in the Copenhagen General Population Study of 53,221 adults

Debbie A Lawlor, Roger M Harbord, Anne Tybjærg-Hansen, Tom M Palmer, Jeppe Zacho, Marianne Benn, Nicholas J Timpson, George Davey Smith, Børge G Nordestgaard, Marianne Benn

    42 Citations (Scopus)

    Abstract

    Objective. We used genetic variants that are robustly associated with adiposity to examine the causal association of adiposity with psychological distress. Methods. We examined the association of adiposity with psychological distress in a large (N=53221) general population cohort of 20- to 99-year-old adults from Copenhagen, Denmark. Psychological distress was assessed using four questions that asked about: feeling stressed; not accomplishing very much; wanting to give up; and regular use of antidepressants/sedatives. We used the genetic loci FTO rs9939609 and MC4R rs17782313 as instrumental variables for adiposity quantified by body mass index (BMI) and waist to hip ratio (WHR). Results. In conventional multivariable analyses, BMI and WHR were positively associated with distress. For example, the odds ratio of reporting not accomplishing for each additional standard deviation increase for BMI was 1.11 (95% CI: 1.09, 1.13) and for WHR was 1.10 (95% CI: 1.08, 1.13) in the fully adjusted analyses. In contrast, instrumental variable analyses showed an inverse association of adiposity on distress; corresponding odds ratio in instrumental variable analyses was 0.64 (95% CI: 0.46, 0.89) for BMI and 0.49 (95% CI: 0.25, 0.94) for WHR (P-values for difference between the two approaches both= 0.001). Conclusion. The inverse associations of adiposity and psychological distress when genetic variants are used as instrumental variables could be explained by biological pathways linking adiposity and distress. The positive associations of adiposity with distress in multivariable analyses might be explained by residual confounding or reverse causality.

    Original languageEnglish
    JournalJournal of Internal Medicine
    Volume269
    Issue number5
    Pages (from-to)525-37
    Number of pages13
    ISSN0954-6820
    DOIs
    Publication statusPublished - May 2011

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