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Bidirectional Mendelian randomization highlights causal relationships between circulating INHBC and multiple cardiometabolic diseases and traits

Abstract:
Human genetic and transgenic mouse studies have highlighted a potential liver-adipose tissue endocrine axis, involving activin C (Act-C) and/or Act-E and ALK7, influencing fat distribution and systemic metabolism. We investigated the bidirectional effects between circulating INHBC, which homodimerizes into Act-C, and adiposity traits, insulin resistance, inflammation, and cardiometabolic disease risk. Additionally, we examined whether Act-C is an ALK7 ligand in human adipocytes. We used Mendelian randomization and in vitro studies in immortalized human abdominal and gluteal adipocytes. Circulating INHBC was causally linked to reduced lower-body fat, dyslipidemia, and increased risks of coronary artery disease (CAD) and nonalcoholic fatty liver disease (NAFLD). Conversely, upper-body fat distribution, obesity, hypertriglyceridemia, subclinical inflammation, and type 2 diabetes positively impacted plasma INHBC levels. Mechanistically, an atherogenic lipid profile may partly explain the INHBC-CAD link, while inflammation and hypertriglyceridemia may partly explain how adiposity traits affect circulating INHBC. Phenome-wide Mendelian randomization showed weak causal relationships between higher plasma INHBC and impaired kidney function and higher gout risk. In human adipocytes, recombinant Act-C activated SMAD2/3 signaling via ALK7 and suppressed lipolysis. In summary, INHBC influences systemic metabolism by activating ALK7 in adipose tissue and may serve as a drug target for atherogenic dyslipidemia, CAD, and NAFLD.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.2337/db24-0168

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Radcliffe Department of Medicine
Sub department:
RDM-Oxford Centre for Diabetes, Endocrinology and Metabolism
Role:
Author
ORCID:
0000-0002-5979-9019
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Radcliffe Department of Medicine
Sub department:
RDM-Oxford Centre for Diabetes, Endocrinology and Metabolism
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Radcliffe Department of Medicine
Sub department:
RDM-Oxford Centre for Diabetes, Endocrinology and Metabolism
Role:
Author


More from this funder
Funder identifier:
https://ror.org/02wdwnk04
Grant:
FS/SCRF/24/32029
FS/16/45/32359


Publisher:
American Diabetes Association
Journal:
Diabetes More from this journal
Volume:
73
Issue:
12
Pages:
2084-2094
Place of publication:
United States
Publication date:
2024-09-16
Acceptance date:
2024-09-05
DOI:
EISSN:
1939-327X
ISSN:
0012-1797
Pmid:
39283655


Language:
English
Pubs id:
2031085
Local pid:
pubs:2031085
Source identifiers:
W4402580303
Deposit date:
2026-02-25
ARK identifier:

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