[Bidirectional causal relationship between glucose-lipid metabolism, obesity indicators, and myocardial infarction: a bidirectional Mendelian randomization analysis study].

To explore the causal association of glucose-lipid metabolism and obesity indicators with myocardial infarction by a two-sample Mendelian randomization analysis. Single nucleotide polymorphisms (SNPs) related to phenotypes were obtained from genome-wide association study databases. The body mass index (BMI) and glycated hemoglobin dataset includes 99 998 samples and 8 126 035 SNPs; the waist-to-hip ratio dataset includes 224 459 samples and 2 562 516 SNPs; the waist circumference and hip circumference dataset includes 462 166 samples and 9 851 867 SNPs; the fasting glucose dataset includes approximately 12 million SNPs; the low-density lipoprotein cholesterol (LDL-C) dataset includes 201 678 samples and 12 321 875 SNPs; the high-density lipoprotein cholesterol (HDL-C), and triglycerides dataset includes 156 109 samples and 15 784 414 SNPs; and the body fat percentage, whole-body fat mass, trunk fat percentage, and trunk fat mass dataset includes 454 588 samples and 9 851 867 SNPs. This study primarily used inverse-variance weighted method to analyze the associations between various exposure factors and outcomes. Heterogeneity among SNPs was assessed using Cochran's test, and horizontal pleiotropy of SNPs was examined using the MR-Egger method. Additionally, a multivariable MR approach was used to adjust for BMI, further validating associations between exposure factors and the risk of myocardial infarction. Higher BMI (1.070, 95%: 1.041-1.100), waist-to-hip ratio (=1.366, 95%: 1.113-1.677), LDL-C (=1.638, 95%: 1.488-1.803), triglycerides (=1.445, 95%: 1.300-1.606), waist circumference (=1.841, 95%: 1.650-2.055), hip circumference (=1.247, 95%: 1.132-1.372), body fat percentage (=1.795, 95%: 1.568-2.055), whole-body fat mass (=1.519, 95% 1.381-1.670), trunk fat percentage (=1.538, 95%: 1.374-1.723), and trunk fat mass (=1.421, 95%: 1.294-1.561), as well as lower HDL-C (=0.799, 95%: 0.729-0.875), have causal effects on myocardial infarction (all <0.05). After adjusting for BMI, hip circumference, trunk fat percentage, and trunk fat mass were no longer associated with myocardial infarction. However, waist-to-hip ratio (=1.457, 95%: 1.132-1.877), fasting glucose (=1.191, 95%: 1.024-1.383), glycated hemoglobin (=1.129, 95%: 1.034-1.233), LDL-C (=1.592, 95%: 1.314-1.929), triglycerides (=1.410, 95%: 1.279-1.553), waist circumference (=1.922, 95%: 1.448-2.551), body fat percentage (=1.421, 95%: 1.072-1.884), and whole-body fat mass (=1.295, 95%: 1.031-1.626) remained positively associated with myocardial infarction, while HDL-C (=0.809, 95%: 0.729-0.897) remained negatively associated. Abdominal obesity and dysregulation of glucose-lipid metabolism are risk factors for myocardial infarction. Screening for glucose-lipid metabolism (fasting glucose, HDL-C, LDL-C, triglycerides) and obesity-related indicators (waist circumference, waist-to-hip ratio, body fat percentage, and whole-body fat mass) is of great importance for the primary prevention of myocardial infarction.