| Title: | The causal effects of remnant cholesterol on increased risk of cardiovascular diseases in East Asians |
| Journal: | BMC Medicine |
| Published: | 26 Aug 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40859268/ |
| DOI: | https://doi.org/10.1186/s12916-025-04329-y |
Publication 19661
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Abstract
BackgroundRemnant cholesterol (RC) has been implicated in cardiovascular diseases (CVDs) in populations of European ancestry, yet its causal role remains underexplored in populations of East Asian ancestry, which are underrepresented in genetic studies. We sought to investigate the causal association between circulating RC levels and CVD risk in East Asian populations.MethodsWe first conducted observational analyses of RC and multiple CVD outcomes in Chinese populations. We then conducted genome-wide association studies (GWAS) of RC in 14,939 Chinese individuals and assessed its causal associations with CVD risk using two-sample Mendelian randomization (MR) with Biobank Japan data. Replication analyses in European ancestry populations utilized summary statistics from the UK Biobank and FinnGen.ResultsCirculating RC levels were significantly associated with multiple CVD outcomes in Chinese individuals. Our GWAS identified seven significant loci associated with circulating RC levels in the Chinese population. In the MR analyses, we found that genetically predicted higher RC levels were significantly associated with increased risks of aortic aneurysm (odds ratio per standard deviation increase, 1.82; 95% CI, 1.53-2.17; P = 1.17 × 10−11) and ischemic heart diseases, such as myocardial infarction (1.22, 1.13-1.32; P = 1.81 × 10−7) and stable angina pectoris (1.17, 1.11-1.23; P = 1.18 × 10−8). Notably, these associations persisted after adjustment for total cholesterol, low-density and high-density lipoprotein cholesterols, Apolipoprotein A1 and Apolipoprotein B, respectively. Replication in European ancestry populations confirmed consistent causal effects for aortic aneurysm and ischemic heart diseases. A suggestive East Asian-specific association was identified between genetically predicted higher RC levels and an increased risk of peripheral artery disease, whereas a suggestive association with a higher risk of atrial flutter/fibrillation and ventricular arrhythmia was only observed in populations of European ancestry.ConclusionsOur findings establish RC as an independent causal CVD risk factor in East Asian ancestry individuals and highlight population-specific differences in CVD risk profiles, emphasizing the need for ethnicity-tailored prevention strategies.</p>
13 Keywords
- Aged
- Cardiovascular Diseases
- China
- Cholesterol
- East Asian People
- Female
- Genome-Wide Association Study
- Humans
- Male
- Mendelian Randomization Analysis
- Middle Aged
- Polymorphism, Single Nucleotide
- Risk Factors
16 Authors
- Chenhao Lin
- Haolong Wen
- Mengyao Yu
- Qingxia Huang
- Qi Wang
- Jinran Lin
- Wenjun Yang
- Jennifer Ming Jen Wong
- Mingfeng Xia
- Huiru Tang
- Li Jin
- Sijia Wang
- Xiaofeng Wang
- Yuxiang Dai
- Guo-Chong Chen
- Yan Zheng
1 Application
| Application ID | Title |
|---|---|
| 54294 | Screening and evaluation of causal relationships of cardiometabolic, psychological, and neurological traits with osteoporosis. |
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