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World Journal of Surgery
Published in: World Journal of Surgery 1/2020

01-01-2020 | Obesity | Original Scientific Report

Association of Genetic Risk of Obesity with Postoperative Complications Using Mendelian Randomization

Authors: Jamie R. Robinson, Robert J. Carroll, Lisa Bastarache, Qingxia Chen, Zongyang Mou, Wei-Qi Wei, John J. Connolly, Frank Mentch, Patrick Sleiman, Paul K. Crane, Scott J. Hebbring, Ian B. Stanaway, David R. Crosslin, Adam S. Gordon, Elisabeth A. Rosenthal, David Carrell, M. Geoffrey Hayes, Wei Wei, Lynn Petukhova, Bahram Namjou, Ge Zhang, Maya S. Safarova, Nephi A. Walton, Christopher Still, Erwin P. Bottinger, Ruth J. F. Loos, Shawn N. Murphy, Gretchen P. Jackson, Iftikhar J. Kullo, Hakon Hakonarson, Gail P. Jarvik, Eric B. Larson, Chunhua Weng, Dan M. Roden, Joshua C. Denny

Published in: World Journal of Surgery | Issue 1/2020

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Abstract

Background

The extent to which obesity and genetics determine postoperative complications is incompletely understood.

Methods

We performed a retrospective study using two population cohorts with electronic health record (EHR) data. The first included 736,726 adults with body mass index (BMI) recorded between 1990 and 2017 at Vanderbilt University Medical Center. The second cohort consisted of 65,174 individuals from 12 institutions contributing EHR and genome-wide genotyping data to the Electronic Medical Records and Genomics (eMERGE) Network. Pairwise logistic regression analyses were used to measure the association of BMI categories with postoperative complications derived from International Classification of Disease-9 codes, including postoperative infection, incisional hernia, and intestinal obstruction. A genetic risk score was constructed from 97 obesity-risk single-nucleotide polymorphisms for a Mendelian randomization study to determine the association of genetic risk of obesity on postoperative complications. Logistic regression analyses were adjusted for sex, age, site, and race/principal components.

Results

Individuals with overweight or obese BMI (≥25 kg/m2) had increased risk of incisional hernia (odds ratio [OR] 1.7–5.5, p < 3.1 × 10−20), and people with obesity (BMI ≥ 30 kg/m2) had increased risk of postoperative infection (OR 1.2–2.3, p < 2.5 × 10−5). In the eMERGE cohort, genetically predicted BMI was associated with incisional hernia (OR 2.1 [95% CI 1.8–2.5], p = 1.4 × 10−6) and postoperative infection (OR 1.6 [95% CI 1.4–1.9], p = 3.1 × 10−6). Association findings were similar after limitation of the cohorts to those who underwent abdominal procedures.

Conclusions

Clinical and Mendelian randomization studies suggest that obesity, as measured by BMI, is associated with the development of postoperative incisional hernia and infection.
Appendix
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Metadata
Title
Association of Genetic Risk of Obesity with Postoperative Complications Using Mendelian Randomization
Authors
Jamie R. Robinson
Robert J. Carroll
Lisa Bastarache
Qingxia Chen
Zongyang Mou
Wei-Qi Wei
John J. Connolly
Frank Mentch
Patrick Sleiman
Paul K. Crane
Scott J. Hebbring
Ian B. Stanaway
David R. Crosslin
Adam S. Gordon
Elisabeth A. Rosenthal
David Carrell
M. Geoffrey Hayes
Wei Wei
Lynn Petukhova
Bahram Namjou
Ge Zhang
Maya S. Safarova
Nephi A. Walton
Christopher Still
Erwin P. Bottinger
Ruth J. F. Loos
Shawn N. Murphy
Gretchen P. Jackson
Iftikhar J. Kullo
Hakon Hakonarson
Gail P. Jarvik
Eric B. Larson
Chunhua Weng
Dan M. Roden
Joshua C. Denny
Publication date
01-01-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 1/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05202-9

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