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Epidemiology and Population Health

Effect of visceral adipose tissue mass on coronary artery disease and heart failure: A Mendelian randomization study



Obesity is associated with coronary artery disease (CAD) and its risk factors in observational studies. This two-sample Mendelian randomization (MR) study investigated the effect of visceral adipose tissue (VAT) mass on coronary artery disease (CAD), myocardial infarction (MI) and heart failure (HF).


Genetic variants (220 SNPs, P < 5 × 10−8) associated with VAT mass were obtained from a genome-wide association study (GWAS) in the UK Biobank. Genetic associations with CAD outcomes including CAD and myocardial infarction (MI) were obtained from the CARDIoGRAMplusC4D 1000 Genomes-based GWAS (including up to 60,801 cases and 123,504 controls) and data on patients with HF were obtained from the HERMES Consortium (47,309 cases and 930,014 controls). The effects of VAT mass on CAD outcomes and HF were estimated using the inverse variance weighted (IVW) method. Sensitivity analysis and multi-variable MR were used to examine the stability of the IVW results.


Our results showed that genetically predicted higher VAT mass was associated with increased risk of CAD (odds ratio [OR] 1.57, 95% confidence interval [CI], 1.44–1.71; P = 7.62 × 10−24), MI (OR 1.63, 95% CI: 1.48–1.79; P = 3.76 × 10−24) and HF (OR 1.71, 95% CI: 1.60–1.83; P = 1.72 × 10−53). These findings remained significant in the sensitivity analysis and multi-variable MR.


This MR study suggests that genetic determinants of VAT mass are causally associated with CAD, MI and HF.

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Fig. 1: A directed acyclic graph of the Mendelian randomization study.
Fig. 2: Associations between VAT mass and coronary artery disease (CAD).
Fig. 3: Associations between VAT mass and myocardial infarction (MI) and heart failure (HF).

Data availability

The GWAS data used in our MR analysis were publicly available (Supplementary Table 1).


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We would like to thank the High-Performance Computing Center of the First Affiliated Hospital of Xi’an Jiaotong University for assistance of data computing.


This study was supported by the Natural Science Basic Research Program of Shaanxi (No. 2021JQ-395).

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Authors and Affiliations



QC and BY raised the idea for the study. QC, YW, YG, ZZ, TS, and BY contributed to the study design, writing and review of the report. BY and QC did the data analysis. BY handled supervision in our study. All authors approved the final version of the report.

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Correspondence to Bin Yan.

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Chen, Q., Wu, Y., Gao, Y. et al. Effect of visceral adipose tissue mass on coronary artery disease and heart failure: A Mendelian randomization study. Int J Obes 46, 2102–2106 (2022).

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