Using mendelian randomization to evaluate the effects of alcohol consumption on the risk of coronary heart disease

This paper aims to evaluate the use of Mendelian randomization (MR) analyses for judging the effects of alcohol consumption on the risk of coronary heart disease (CHD). The authors present a review of methodology for MR and describe its early application to judging health effects of alcohol, current uses, and a recommended approach of combining MR results with those from observational and experimental studies.
Early applications of MR for judging health effects of alcohol consumption, based on one or few genetically determined factors related to metabolism of alcohol, were inadequate for providing unbiased results. However, newer attempts using polygenic scores show promise, as a large number of potentially important factors are now being considered as the instrumental variable. While some studies show that MR is effective in judging the effects of alcohol on risk of CHD, most studies show little or no improvement over results obtained using usual cardiovascular risk factors for estimating risk. Still, it is anticipated that future polygenic scores will improve the ability to identify subjects at risk of disease.
It is realized, however, that given that light-to-moderate alcohol intake is associated with a lower risk of CHD, type II diabetes mellitus, and total mortality, it is important to be able to evaluate both the benefits and harms from alcohol before giving advice regarding drinking. Scientific evidence now indicates that the combination of results from MR, observational data, animal studies, and human clinical trials, when considered together, offer the best opportunity to determine the overall effects of alcohol on health.
Source: Ellison, R.C., Grønbæk, M. and Skovenborg, E. (2021), “Using Mendelian randomization to evaluate the effects of alcohol consumption on the risk of coronary heart disease”, Drugs and Alcohol Today, Vol. 21 No. 1, pp. 84-95. .