Causal relationship between stable angina and bone mineral density: A two-sample bidirectional Mendelian randomization study

This study assesses the causal relationship between bone mineral density (BMD) and stable angina pectoris (SAP) using Mendelian randomization analysis. We obtained genome-wide association study databases for stable angina and BMD, and conducted Mendelian randomization analysis with BMD as the exposure factor and SAP as the outcome. The inverse variance weighted (IVW) method was used as the primary analytical approach, complemented by Cochran Q test, the weighted median method, MR-Egger regression, and the simple weighted model to evaluate the robustness and reliability of the results. The IVW results revealed a significant positive correlation between BMD and the incidence of SAP. When BMD was considered as the exposure factor, the analysis indicated an increased risk of SAP with higher BMD. Similarly, when only left heel BMD was considered as the exposure factor, a positive correlation with SAP was observed. However, no significant associations were observed between BMD at other sites and SAP. When SAP is the exposure factor and BMD is the outcome factor, left heel BMD and right heel BMD are both negatively correlated with SAP, while no significant correlation is observed for the remaining sites. There is a positive correlation between BMD and left calcaneal BMD with SAP, whereas SAP exhibits a negative correlation with both left and right calcaneal BMD. These findings are consistent with previous observational studies.