Causality between Sarcopenia and Coronary Artery Disease: An updated Mendelian Randomization Study

Background: There is evidence of a potential association between sarcopenia and coronary artery disease (CAD), but the causal relationship remains to be further determined. Methods We conducted a two-sample Mendelian randomization (MR) to evaluate the causal effect of sarcopenia, described as appendicular lean mass (ALM), walking pace (WP), and hand grip strength (HGS: right and left), on the risk of coronary heart disease (CHD) and myocardial infarction (MI). The inverse variance weighted (IVW) method was used as the main model, with auxiliary methods including weighted median (WM) and MR-Egger. A sensitivity analysis was conducted to evaluate the robustness. Risk factor analysis was performed to explore the potential pathway. Results IVW revealed that sarcopenia-related traits were causally associated with both CHD and MI. WM and MR-Egger further substantiated the causal associations. Sensitivity analysis showed no heterogeneity or pleiotropy was detected. Risk factor analysis showed that sarcopenia-related traits exerted effects on several traditional risk factors of CAD. Conclusion Sarcopenia might increase the risk of CHD and MI, which might imply that indexes for sarcopenia, like ALM, HGS, and WP, could be developed to screen specific populations with higher risk of CAD.