期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 49, 期 4, 页码 1147-1158出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyz161
关键词
Mendelian randomization; instrumental variables; interaction; causal inference; factorial randomized trial
资金
- UK Medical Research Council [MC_UU_00002/7]
- NIHR Cambridge Biomedical Research Centre
- British Heart Foundation [FS/14/59/31282]
- Sir Henry Dale Fellowship - Wellcome Trust [204623/Z/16/Z]
- Sir Henry Dale Fellowship - Royal Society [204623/Z/16/Z]
- MRC [MC_UU_00002/7] Funding Source: UKRI
Background: Factorial Mendelian randomization is the use of genetic variants to answer questions about interactions. Although the approach has been used in applied investigations, little methodological advice is available on how to design or perform a factorial Mendelian randomization analysis. Previous analyses have employed a 2 x 2 approach, using dichotomized genetic scores to divide the population into four subgroups as in a factorial randomized trial. Methods: We describe two distinct contexts for factorial Mendelian randomization: investigating interactions between risk factors, and investigating interactions between pharmacological interventions on risk factors. We propose two-stage least squares methods using all available genetic variants and their interactions as instrumental variables, and using continuous genetic scores as instrumental variables rather than dichotomized scores. We illustrate our methods using data from UK Biobank to investigate the interaction between body mass index and alcohol consumption on systolic blood pressure. Results: Simulated and real data show that efficiency is maximized using the full set of interactions between genetic variants as instruments. In the applied example, between 4- and 10-fold improvement in efficiency is demonstrated over the 2 x 2 approach. Analyses using continuous genetic scores are more efficient than those using dichotomized scores. Efficiency is improved by finding genetic variants that divide the population at a natural break in the distribution of the risk factor, or else divide the population into more equal-sized groups. Conclusions: Previous factorial Mendelian randomization analyses may have been underpowered. Efficiency can be improved by using all genetic variants and their interactions as instrumental variables, rather than the 2 x 2 approach.
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