Association of diuretics with falls and wrist fractures

A Mendelian randomization study

Bibliographic Data

ID22090598
AuthorsFei Liu (0000-0003-0967-9112, Chinese Academy of Medical Sciences & Peking Union Medical College), Jun-ze Dai (Chinese Academy of Medical Sciences & Peking Union Medical College), Xiao-xi Deng (Chinese Academy of Medical Sciences & Peking Union Medical College), Runmin Cao (0000-0002-8173-2961, Chinese Academy of Medical Sciences & Peking Union Medical College), Ren-shuang Cao, Yongzhong Cheng (0000-0003-2733-2622, Chinese Academy of Medical Sciences & Peking Union Medical College, corresponding author), Yong-zhong Cheng, Chao-lu Wang (Chinese Academy of Medical Sciences & Peking Union Medical College, corresponding author)
Year2024
Volume12
Pages1381486-1381486
Publication date2024-10-25
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1381486
PMID39525456
OpenAlexW4403779010
LanguageEN
References cited44

Background The association between diuretics and falls in older adult has been reported in previous studies, but discrepancy remains between the different types of diuretics. The association of diuretics with the risk of wrist fractures due to diuretics is also unclear. Therefore, in this study, we determined the association of diuretics with falls and wrist fractures by Mendelian randomization. Methods We used a two-sample Mendelian randomization (MR) approach to evaluate the effects of the loop diuretics\potassium-sparing diuretics\thiazide diuretics (LDs\PSDs\TDs) on the risk of falls and wrist fracture using the three diuretic-associated genetically-predicted single nucleotide polymorphisms (SNPs) as genetic tools. The inverse variance weighting (IVW) method was used as the main evaluation method, with odds ratio (OR) as the evaluation criterion. Additionally, weighted median (WME), MR-Egger, weighted mode (WM) and simple mode (SM) methods were used together for the MR analysis, and sensitivity analyses were performed to assess the robustness of the main results. Result A total of 35 SNPs were included in this study as instrumental variables to replace LDs, PSDs, and TDs, which were 24, 7, and 4. Genetic substitutions for diuretics associated with increased risk of falls were LDs (OR = 1.012043, 95%CI: 1.001607–1.022588, p = 0.022337), PSDs (OR = 1.023794, 95%CI: 1.005605–1.042312, p = 0.010138). Genetically proxied TDs showed no association with falls, but the use of TDs showed a negative correlation with the incidence of wrist fracture (OR = 0.833, 95%CI: 0.767–0.905, p < 0.001). The Cochran Q -test showed no heterogeneity and MR-PRESSO method excluded data pleiotropy. Conclusion Our findings suggest that the use of loop diuretics (LDs) or potassium-sparing diuretics (PSDs) increases the incidence of falls, but there is no causal relationship between thiazide diuretics (TDs) and falls, and TDs may actually reduce the risk of wrist fractures. Clinical use of diuretics necessitates vigilance and appropriate preventive measures to minimize fall-related events

Biology · Mendelian randomization · Physical medicine and rehabilitation · Physical therapy · Randomization · Randomized controlled trial · Wrist · Electrolyte and hormonal disorders · Medicine · Metabolism and Genetic Disorders · Pharmacological Effects and Toxicity Studies · Psychology · Genetics · Internal Medicine · Surgery

Tools

Open DOIOpen Access