Extending causality tests with genetic instruments: an integration of Mendelian Randomization and the Classical Twin Design

ABSTRACT Mendelian Randomization (MR) is an important approach to modelling causality in non-experimental settings. MR uses genetic instruments to test causal relationships between exposures and outcomes of interest. Individual genetic variants have small effects, and so, when used as instruments, render MR liable to weak instrument bias. Polygenic scores have the advantage of larger effects, but may be characterized by direct pleiotropy, which violates a central assumption of MR. We developed the MR-DoC twin model by integrating MR with the Direction of Causation twin model. This model allows us to test pleiotropy directly. We considered the issue of parameter identification, and given identification, we conducted extensive power calculations. MR-DoC allows one to test causal hypotheses and to obtain unbiased estimates of the causal effect given pleiotropic instruments (polygenic scores), while controlling for genetic and environmental influences common to the outcome and exposure. Furthermore, MR-DoC in twins has appreciably greater statistical power than a standard MR analysis applied to singletons, if the unshared environmental effects on the exposure and the outcome are uncorrelated. Generally, power increases with: 1) decreasing residual exposure-outcome correlation, and 2) decreasing heritability of the exposure variable. MR-DoC allows one to employ strong instrumental variables (polygenic scores, possibly pleiotropic), guarding against weak instrument bias and increasing the power to detect causal effects. Our approach will enhance and extend MR’s range of applications, and increase the value of the large cohorts collected at twin registries as they correctly detect causation and estimate effect sizes even in the presence of pleiotropy.