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Using multiple genetic variants as instrumental variables for modifiable risk factors
Open accessAbstract
Mendelian randomisation analyses use genetic variants as instrumental variables (IVs) to estimate causal effects of modifiable risk factors on disease outcomes. Genetic variants typically explain a small proportion of the variability in risk factors; hence Mendelian randomisation analyses can require large sample sizes. However, an increasing number of genetic variants have been found to be robustly associated with disease-related outcomes in genome-wide association studies. Use of multiple instruments can improve the precision of IV estimates, and also permit examination of underlying IV assumptions. We discuss the use of multiple genetic variants in Mendelian randomisation analyses with continuous outcome variables where all relationships are assumed to be linear. We describe possible violations of IV assumptions, and how multiple instrument analyses can be used to identify them. We present an example using four adiposity-associated genetic variants as IVs for the causal effect of fat mass on bone density, using data on 5509 children enrolled in the ALSPAC birth cohort study. We also use simulation studies to examine the effect of different sets of IVs on precision and bias. When each instrument independently explains variability in the risk factor, use of multiple instruments increases the precision of IV estimates. However, inclusion of weak instruments could increase finite sample bias. Missing data on multiple genetic variants can diminish the available sample size, compared with single instrument analyses. In simulations with additive genotype-risk factor effects, IV estimates using a weighted allele score had similar properties to estimates using multiple instruments. Under the correct conditions, multiple instrument analyses are a promising approach for Mendelian randomisation studies. Further research is required into multiple imputation methods to address missing data issues in IV estimation.
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“All three of these SNPs have previously been shown to be strong instruments for MR analysis as measured by F-statistics > 10 [8,18]”
From Associations of genetically determined iron status across the phenome: A mendelian randomization study (2019) · cites this paper as [18]
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“Interpretation of results from MR studies relies on four conditions.12,24”
From Mendelian randomization (2022) · cites this paper as [24]
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“This problem can be partially redressed by the use of multiple genetic variants [Palmer et al., 2011].”
BackgroundMendelian Randomization as an Approach to Assess Causality Using Observational Data
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BackgroundMethodSelf-citation
Metadata
- Authors
- Palmer, T. M., Lawlor, D. A., Harbord, R. M., Sheehan, N. A., Tobias, J. H., Timpson, N. J., Smith, G. D., & Sterne, J. A.
- Affiliations
- University of Bristol (GB)
- University of Leicester (GB)
- School of Clinical Sciences, University of Bristol, Bristol, UK
- Corresponding author
- Palmer, Tom M
- ORCID
- Venue
- Statistical Methods in Medical Research
- Publisher
- SAGE Publications
- Published
- 2011-01-07
- Volume
- 21
- Issue
- 3
- Pages
- 223-242
- ISSN
- 0962-2802 (ISSN-L)
- 1477-0334
- PMC
- PMC3917707
- OpenAlex
- W2151096860
- Cited by
- 1,289
- References
- 76
- Citations by year
- 2026: 92 · 2025: 240 · 2024: 394 · 2023: 164 · 2022: 83 · 2021: 67 · 2020: 44 · 2019: 33 · 2018: 22 · 2017: 20 · 2016: 27 · 2015: 44 · 2014: 20 · 2013: 19 · 2012: 14
- FWCI
- 11.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Statistical Methods in Medical Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (G0600705, 092731)
- University of Bristol (G0600705)
- Medical Research Council (G0600705)
- Economic and Social Research Council (ES/E00234X/1)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Physical Performance
- Keywords
- Mendelian randomization, modifiable risk factors, weak instruments, finite-sample bias, fat mass, bone mineral density, children, causal effect estimation, continuous outcomes
- MeSH terms
- Female, Genotype, Humans, Male, Risk Factors, Genetic Variation, Mendelian Randomization Analysis
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