Use of Mendelian Randomization to examine causal inference in osteoporosis

Jie Zheng, Monika Frysz, John P Kemp, David Evans, George Davey Smith, Jonathan H Tobias

Research output: Contribution to journalArticle (Academic Journal)peer-review

23 Citations (Scopus)
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Epidemiological studies have identified many risk factors for osteoporosis, however it is unclear whether these observational associations reflect true causal effects, or the effects of latent confounding or reverse causality. Mendelian randomization (MR) enables causal relationships to be evaluated, by examining the relationship between genetic susceptibility to the risk factor in question, and the disease outcome of interest. This has been facilitated by the development of two-sample MR analysis, where the exposure and outcome are measured in
different studies, and by exploiting summary result statistics from large well-powered genomewide association studies that are available for thousands of traits. Though MR has several inherent limitations, the field is rapidly evolving and at least 14 methodological extensions have been developed to overcome these. The present paper aims to discuss some of the limitations in the MR analytical framework, and how this method has been applied to the osteoporosis field, helping to reinforce conclusions about causality, and discovering potential new regulatory pathways, exemplified by our recent MR study of sclerostin.
Original languageEnglish
Article number807
Number of pages15
JournalFrontiers in Endocrinology
Publication statusPublished - 21 Nov 2019


  • bone mineral density (BMD)
  • fractures - bone
  • pleiotropy
  • sclerostin
  • GWAS - genome-wide association study


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