Chaojie Ye MD, Dong Liu MD, Lijie Kong MD, Yiying Wang MD, Chun Dou MD, Min Xu MD, PhD, Jie Zheng MD, PhD, Ruizhi Zheng MD, PhD, Mian Li MD, PhD, Zhiyun Zhao MD, PhD, Jieli Lu MD, PhD, Yuhong Chen MD, PhD, Weiqing Wang MD, PhD, Yufang Bi MD, PhD, Yu Xu MD, PhD, Tiange Wang MD, PhD, Guang Ning MD, PhD
{"title":"相对蛋白质摄入量对高血压的影响以及体能和循环脂肪酸的中介作用：孟德尔随机研究。","authors":"Chaojie Ye MD, Dong Liu MD, Lijie Kong MD, Yiying Wang MD, Chun Dou MD, Min Xu MD, PhD, Jie Zheng MD, PhD, Ruizhi Zheng MD, PhD, Mian Li MD, PhD, Zhiyun Zhao MD, PhD, Jieli Lu MD, PhD, Yuhong Chen MD, PhD, Weiqing Wang MD, PhD, Yufang Bi MD, PhD, Yu Xu MD, PhD, Tiange Wang MD, PhD, Guang Ning MD, PhD","doi":"10.1016/j.mayocp.2024.02.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the causal effect of protein intake on hypertension and the related mediating pathways.</div></div><div><h3>Patients and Methods</h3><div><span>Using genome-wide association study summary statistics of European ancestry, we applied univariable and multivariable Mendelian randomization<span> to estimate the bidirectional associations of relative protein intake and related </span></span>metabolomic<span><span> signatures with hypertension (FinnGen: Ncase=42,857/Ncontrol=162,837; UK Biobank: Ncase=77,723/Ncontrol=330,366) and blood pressure (International Consortium of Blood Pressure: N=757,601) and two-step </span>Mendelian randomization to assess the mediating roles of 40 cardiometabolic factors therein. Mendelian randomization estimates of hypertension from FinnGen and UK Biobank were meta-analyzed without heterogeneity. We performed the study from May 15, 2023, to September 15, 2023.</span></div></div><div><h3>Results</h3><div><span><span>Each 1-SD higher relative protein intake was causally associated with 69% (odds ratio, 0.31; 95% CI, 0.11 to 0.89) lower hypertension risk independent of the effects of other macronutrients, and was the only macronutrient associated with 2.21 (95% CI, 0.52 to 3.91) mm Hg lower pulse pressure, in a unidirectional manner. Higher plant protein–related metabolomic<span> signature (glycine) was associated with lower hypertension risk and pulse pressure, whereas higher animal protein–related metabolomic signatures (leucine, </span></span>isoleucine, </span>valine<span><span>, and isovalerylcarnitine [only systolic blood pressure]) were associated with higher hypertension risk, pulse pressure, and systolic blood pressure<span>. The effect of relative protein intake on hypertension was causally mediated by frailty index (mediation proportion, 40.28%), </span></span>monounsaturated fatty acids<span> (13.81%), saturated fatty acids (11.39%), grip strength (5.34%), standing height (3.99%), and sitting height (3.61%).</span></span></div></div><div><h3>Conclusion</h3><div>Higher relative protein intake causally reduces the risk of hypertension, partly mediated by physical fitness and circulating fatty acids.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 10","pages":"Pages 1589-1605"},"PeriodicalIF":6.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Relative Protein Intake on Hypertension and Mediating Role of Physical Fitness and Circulating Fatty Acids\",\"authors\":\"Chaojie Ye MD, Dong Liu MD, Lijie Kong MD, Yiying Wang MD, Chun Dou MD, Min Xu MD, PhD, Jie Zheng MD, PhD, Ruizhi Zheng MD, PhD, Mian Li MD, PhD, Zhiyun Zhao MD, PhD, Jieli Lu MD, PhD, Yuhong Chen MD, PhD, Weiqing Wang MD, PhD, Yufang Bi MD, PhD, Yu Xu MD, PhD, Tiange Wang MD, PhD, Guang Ning MD, PhD\",\"doi\":\"10.1016/j.mayocp.2024.02.019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To investigate the causal effect of protein intake on hypertension and the related mediating pathways.</div></div><div><h3>Patients and Methods</h3><div><span>Using genome-wide association study summary statistics of European ancestry, we applied univariable and multivariable Mendelian randomization<span> to estimate the bidirectional associations of relative protein intake and related </span></span>metabolomic<span><span> signatures with hypertension (FinnGen: Ncase=42,857/Ncontrol=162,837; UK Biobank: Ncase=77,723/Ncontrol=330,366) and blood pressure (International Consortium of Blood Pressure: N=757,601) and two-step </span>Mendelian randomization to assess the mediating roles of 40 cardiometabolic factors therein. Mendelian randomization estimates of hypertension from FinnGen and UK Biobank were meta-analyzed without heterogeneity. We performed the study from May 15, 2023, to September 15, 2023.</span></div></div><div><h3>Results</h3><div><span><span>Each 1-SD higher relative protein intake was causally associated with 69% (odds ratio, 0.31; 95% CI, 0.11 to 0.89) lower hypertension risk independent of the effects of other macronutrients, and was the only macronutrient associated with 2.21 (95% CI, 0.52 to 3.91) mm Hg lower pulse pressure, in a unidirectional manner. Higher plant protein–related metabolomic<span> signature (glycine) was associated with lower hypertension risk and pulse pressure, whereas higher animal protein–related metabolomic signatures (leucine, </span></span>isoleucine, </span>valine<span><span>, and isovalerylcarnitine [only systolic blood pressure]) were associated with higher hypertension risk, pulse pressure, and systolic blood pressure<span>. The effect of relative protein intake on hypertension was causally mediated by frailty index (mediation proportion, 40.28%), </span></span>monounsaturated fatty acids<span> (13.81%), saturated fatty acids (11.39%), grip strength (5.34%), standing height (3.99%), and sitting height (3.61%).</span></span></div></div><div><h3>Conclusion</h3><div>Higher relative protein intake causally reduces the risk of hypertension, partly mediated by physical fitness and circulating fatty acids.</div></div>\",\"PeriodicalId\":18334,\"journal\":{\"name\":\"Mayo Clinic proceedings\",\"volume\":\"99 10\",\"pages\":\"Pages 1589-1605\"},\"PeriodicalIF\":6.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Mayo Clinic proceedings\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0025619624001058\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mayo Clinic proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0025619624001058","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Effect of Relative Protein Intake on Hypertension and Mediating Role of Physical Fitness and Circulating Fatty Acids
Objective
To investigate the causal effect of protein intake on hypertension and the related mediating pathways.
Patients and Methods
Using genome-wide association study summary statistics of European ancestry, we applied univariable and multivariable Mendelian randomization to estimate the bidirectional associations of relative protein intake and related metabolomic signatures with hypertension (FinnGen: Ncase=42,857/Ncontrol=162,837; UK Biobank: Ncase=77,723/Ncontrol=330,366) and blood pressure (International Consortium of Blood Pressure: N=757,601) and two-step Mendelian randomization to assess the mediating roles of 40 cardiometabolic factors therein. Mendelian randomization estimates of hypertension from FinnGen and UK Biobank were meta-analyzed without heterogeneity. We performed the study from May 15, 2023, to September 15, 2023.
Results
Each 1-SD higher relative protein intake was causally associated with 69% (odds ratio, 0.31; 95% CI, 0.11 to 0.89) lower hypertension risk independent of the effects of other macronutrients, and was the only macronutrient associated with 2.21 (95% CI, 0.52 to 3.91) mm Hg lower pulse pressure, in a unidirectional manner. Higher plant protein–related metabolomic signature (glycine) was associated with lower hypertension risk and pulse pressure, whereas higher animal protein–related metabolomic signatures (leucine, isoleucine, valine, and isovalerylcarnitine [only systolic blood pressure]) were associated with higher hypertension risk, pulse pressure, and systolic blood pressure. The effect of relative protein intake on hypertension was causally mediated by frailty index (mediation proportion, 40.28%), monounsaturated fatty acids (13.81%), saturated fatty acids (11.39%), grip strength (5.34%), standing height (3.99%), and sitting height (3.61%).
Conclusion
Higher relative protein intake causally reduces the risk of hypertension, partly mediated by physical fitness and circulating fatty acids.
期刊介绍：
Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.
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