Genetically proxied GLP-1R expression was associated with reduced risks of chronic kidney disease (OR 0.96), heart failure (OR 0.96), and MASLD (OR 0.96) in the general population.
Observational (n=362,322)
Mendelian randomization
Does GLP-1R expression reduce the risk of CKD, HF, and MASLD in non-diabetic and non-obese populations?
Genetic and observational evidence suggests GLP-1R expression mitigates CKD, HF, and MASLD risks in the general population, but these benefits may not extend to non-obese and non-diabetic individuals.
Effect estimate: OR 0.96 (95% CI 0.95 to 0.97)
p-value: p=1.7x10^-10
Glucagon-like peptide-1 receptor (GLP-1R) agonists are emerging as promising therapies for cardiovascular-kidney-metabolic (CKM) related diseases in individuals with type 2 diabetes mellitus (T2DM) or obesity. But their effects in non-obese and non-diabetic individuals are unclear. This study triangulates evidence using Mendelian randomization (MR), polygenic scores (PGS) and observational analyses to estimate the associations of GLP-1R expression with chronic kidney disease (CKD), heart failure (HF) and metabolic dysfunction-associated steatotic liver disease (MASLD). For the MR analysis, instruments mimicking GLP-1R expression were identified using pancreas-specific cis-expression quantitative trait loci from GTEx (N ≤ 305). MR-Robust method was used as the primary MR approach. PGS and observational analyses were performed both in non-diabetic and non-obese individuals separately. A genome-wide association study (GWAS) for MASLD (14,231 cases and 348,091 controls) was performed in the general population using data from UK Biobank. GLP-1R expression showed robust effects on CKD (odds ratio OR 0.96, 95%CI 0.95 to 0.97, q = 1.7 × 10− 10 ), HF (OR = 0.96, 95%CI 0.94 to 0.97, q = 2.5 × 10− 8) and MASLD (OR = 0.96, 95%CI 0.93 to 0.98, q = 1.3 × 10− 3) in the general population. Consistent results were observed in validation analyses. Furthermore, PGS and observational analyses among non-T2DM and non-obese individuals found little evidence to support its association with CKD, HF or MASLD. GWAS analysis identified eight conditionally independent variants associated with MASLD, in which rs563199662 was a new signal located at TFPI region. This study provides multilayered evidence for GLP-1R expression in mitigating CKD, HF and MASLD risks in the general population, while de-prioritized its effect on CKM-related diseases in non-obese and non-diabetic individuals. Further clinical trials are needed to validate the effects of GLP-1R agonists in relative health population.
Chen et al. (Tue,) conducted a observational in Cardiovascular-kidney-metabolic-related diseases (n=362,322). GLP-1R expression was evaluated on Chronic kidney disease (CKD) (OR 0.96, 95% CI 0.95 to 0.97, p=1.7x10^-10). Genetically proxied GLP-1R expression was associated with reduced risks of chronic kidney disease (OR 0.96), heart failure (OR 0.96), and MASLD (OR 0.96) in the general population.
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