Hormonal
Higher BMI causally increases the risk of coronary heart disease (CHD), and this effect is significantly mediated by elevated triacylglycerol levels, higher HbA1c, and type 2 diabetes risk.
High body weight increases heart disease risk, but much of that risk comes from how it affects your blood fats (triglycerides) and blood sugar (HbA1c/Diabetes). Managing these specific metabolic markers is crucial for heart health, potentially more so than focusing on LDL cholesterol alone, which this study suggests isn't a primary mediator of BMI's effect.
Increased triacylglycerol levels and poor glycaemic control appear to mediate much of the effect of BMI on CHD.
Why this rating
Large sample size (60k+ CHD cases), robust Mendelian Randomization methodology with sensitivity analyses for pleiotropy, but observational genetic associations rather than direct intervention.
Source
The role of glycaemic and lipid risk factors in mediating the effect of BMI on coronary heart disease: a two-step, two-sample Mendelian randomisation study
Lin Xu et al. · Diabetologia · 2017
DOI 10.1007/s00125-017-4396-y
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