Sodium intake and the risk of various types of cardiovascular diseases: a Mendelian randomization study

Qingming Fu; Rumeng Chen; Yining Ding; Shuling Xu; Chunxia Huang; Binsheng He; Ting Jiang; Bin Zeng; Meihua Bao; Sen Li

doi:10.3389/fnut.2023.1250509

Sodium intake and the risk of various types of cardiovascular diseases: a Mendelian randomization study

Front Nutr. 2023 Dec 22:10:1250509. doi: 10.3389/fnut.2023.1250509. eCollection 2023.

Authors

Qingming Fu^#¹, Rumeng Chen^#², Yining Ding^#³, Shuling Xu⁴, Chunxia Huang¹, Binsheng He⁵, Ting Jiang¹, Bin Zeng¹, Meihua Bao^{5

6}, Sen Li³

Affiliations

¹ School of Stomatology, Changsha Medical University, Changsha, China.
² Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
³ School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.
⁴ The Second Affiliated Hospital of Anhui Medical University, Heifei, China.
⁵ The Hunan Provincial Key Laboratory of the TCM Agricultural Biogenomics, Changsha Medical University, Changsha, China.
⁶ Hunan Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, School of Pharmaceutical Science, Changsha Medical University, Changsha, China.

^# Contributed equally.

Abstract

Background: The existing literature on the link between sodium intake and cardiovascular disease (CVD) largely consists of observational studies that have yielded inconsistent conclusions. In this study, our objective is to assess the causal relationship between sodium intake and 50 CVDs using two-sample Mendelian randomization (MR) analysis.

Methods: MR analyses were performed to investigate the associations between urinary sodium/creatinine ratio (U_Na/U_Cr), an indicator of sodium intake, and 50 CVDs. The genome-wide association study (GWAS) for U_Na/U_Cr was from the UK Biobank (UKBB), and the GWASs for CVDs were from FinnGen. A false discovery rate (FDR) threshold of 5% was applied for multiple comparison correction.

Results: The inverse-variance weighted method indicated that the genetically predicted U_Na/U_Cr was significantly associated with 7 of 50 CVDs, including "Coronary atherosclerosis" (OR = 2.01; 95% CI: 1.37, 2.95), "Diseases of arteries, arterioles and capillaries" (OR = 1.88; 95% CI: 1.20, 2.94), "Hard cardiovascular diseases" (OR = 1.71; 95% CI: 1.24, 2.35), "Ischemic heart diseases" (OR = 2.06; 95% CI: 1.46, 2.93), "Major coronary heart disease event" (OR = 1.99; 95% CI: 1.36, 2.91), "Myocardial infarction" (OR = 2.03; 95% CI: 1.29, 3.19), and "Peripheral artery disease" (OR = 2.50; 95% CI: 1.35, 4.63). Similar results were obtained with the MR-Egger and weighted median methods. No significant heterogeneity or horizontal pleiotropy was found in this analysis.

Conclusion: Our study has uncovered a significant positive causal relationship between U_Na/U_Cr and various CVDs. These results offer a new theoretical foundation for advocating the restriction of sodium intake as a preventive measure against CVD.

Keywords: FinnGen; Mendelian randomization; UK Biobank; cardiovascular disease; sodium intake.

Grants and funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81973698 and 81703942), the Young Elite Scientists Sponsorship Program by CACM (Grant No. 2019-QNRC2-B08), the BUCM Precision Cultivation Program (Grant No. JZPY-202205), the Science Fund for Distinguished Young Scholars in BUCM (Grant No. BUCM-2019-JCRC004), and the BUCM Research Development Fund (Grant No. 2021-ZXFZJJ-052).