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Association between sugar-sweetened beverages and pure fruit juice with risk of six cardiovascular diseases: a Mendelian randomization study

European Journal of Clinical Nutrition (2024)Cite this article

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Abstract

Background

In observational and prospective cohort studies, intake of sugar-sweetened beverages (SSBs) and pure fruit juice (PFJ) has been associated with cardiovascular disease (CVD). Still, the causality of the connection has not yet been determined. Our objective was to uncover the relationship between SSBs/PFJ and CVD.

Methods

Genetically predicted causal associations between SSBs/PFJ (obtained in a published genome-wide association study) and six common CVDs (atrial fibrillation (AF), angina, heart failure (HF), acute myocardial infarction, hypertension, and coronary atherosclerosis) were assessed using MR analytic modeling. The primary analysis method utilized was the inverse variance weighted (IVW) method, complemented by additional methods such as the weighted median method, MR Egger regression, Cochran’s Q test, MR pleiotropy residual, funnel plot, Bonferroni correction, and others for MR analysis. To ensure the robustness of the findings, F-values were calculated as a complementary test to set looser thresholds for exposing genetic instrumental variables (P < 1e−5).

Results

The results of MR analysis suggested genetically causal associations between SSBs and AF (odds ratio (OR): 1.023; 95% confidence interval (CI) 1.007–1.038; P = 0.0039) as well as between PFJ and angina (OR: 0.968; 95% CI, 0.943–0.993; P = 0.0138) there was genetic causality. However, MR analysis showed no causal association between SSBs/PFJ and other CVD risks.

Conclusion

This study suggests that there may be a potential causal relationship between SSBs intake and AF and a causal negative association between PFJ intake and angina.

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Fig. 1: The results of MR analysis of significant association.
Fig. 2: Scatter plot of genetically predicted relationship between SSBs and AF.
Fig. 3: Scatter plot of genetically predicted relationship between PFJ and Angina.
Fig. 4: MR results about the causal association of SSBs/PFJ with other CVDs.

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Data availability

All data generated or analyzed during this study are included in this published article and its additional files. All exposure data used in this study are included in the published article and its additional files, and all outcome data are available without restriction from the public database (https://gwas.mrcieu.ac.uk/).

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Acknowledgements

We sincerely thank all investigators for sharing the GWAS summary statistic data.

Funding

This research was funded by the Beijing University of Chinese Medicine New Teacher Initiation Fund Program (2023-JYB-XJSJJ003).

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Authors and Affiliations

  1. Beijing University of Chinese Medicine, 100029, Beijing, China

    Hanzhang Xie, Yiyang Liu, Xiaohan Gu, Shuhan Liu, Yimeng Fang, Wenjie Zhong, Yinan Zhang & Shunyu Yao

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Contributions

HX and YL designed the study; HX and YL mined the data; YL researched the literature; HX analyzed the data; HX, YL, XG, SL, YF, WZ, and YZ wrote the paper. SY supervised and suggested revisions throughout. All authors read and approved the final paper.

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Correspondence to Shunyu Yao.

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The authors declare no competing interests.

Ethical approval

This study obtained all data from publicly available and accessible large-scale genome-wide association studies. All relevant studies used were approved by the appropriate ethical review boards. This study did not exceed the scope of the initial ethics committee approval.

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Xie, H., Liu, Y., Gu, X. et al. Association between sugar-sweetened beverages and pure fruit juice with risk of six cardiovascular diseases: a Mendelian randomization study. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01441-9

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