eprintid: 10171019 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/17/10/19 datestamp: 2023-06-01 09:36:09 lastmod: 2023-06-01 09:36:09 status_changed: 2023-06-01 09:36:09 type: article metadata_visibility: show sword_depositor: 699 creators_name: Morris, Tim T creators_name: Heron, Jon creators_name: Sanderson, Eleanor CM creators_name: Davey Smith, George creators_name: Didelez, Vanessa creators_name: Tilling, Kate title: Interpretation of Mendelian randomization using a single measure of an exposure that varies over time ispublished: pub divisions: UCL divisions: B16 divisions: B14 divisions: J81 divisions: K26 keywords: Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, Mendelian randomization, causal inference, longitudinal, simulation, BLOOD-PRESSURE, EARLY-LIFE, GENE, VARIANTS, AGE note: © The Author(s) 2022. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. abstract: Background: Mendelian randomization (MR) is a powerful tool through which the causal effects of modifiable exposures on outcomes can be estimated from observational data. Most exposures vary throughout the life course, but MR is commonly applied to one measurement of an exposure (e.g. weight measured once between ages 40 and 60 years). It has been argued that MR provides biased causal effect estimates when applied to one measure of an exposure that varies over time. Methods: We propose an approach that emphasizes the liability that causes the entire exposure trajectory. We demonstrate this approach using simulations and an applied example. Results: We show that rather than estimating the direct or total causal effect of changing the exposure value at a given time, MR estimates the causal effect of changing the underlying liability for the exposure, scaled to the effect of the liability on the exposure at that time. As such, results from MR conducted at different time points are expected to differ (unless the effect of the liability on exposure is constant over time), as we illustrate by estimating the effect of body mass index measured at different ages on systolic blood pressure. Conclusion: Univariable MR results should not be interpreted as time-point-specific direct or total causal effects, but as the effect of changing the liability for the exposure. Estimates of how the effects of a genetic variant on an exposure vary over time, together with biological knowledge that provides evidence regarding likely effective exposure periods, are required to interpret time-point-specific causal effects. date: 2022-12 date_type: published publisher: OXFORD UNIV PRESS official_url: https://doi.org/10.1093/ije/dyac136 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1998451 doi: 10.1093/ije/dyac136 medium: Print pii: 6645008 lyricists_name: Morris, Tim lyricists_id: TMORR75 actors_name: Morris, Tim actors_id: TMORR75 actors_role: owner funding_acknowledgements: MC_UU_00011/1 [UK Medical Research Council]; MC_UU_00011/3 [UK Medical Research Council] full_text_status: public publication: International Journal of Epidemiology volume: 51 number: 6 pagerange: 1899-1909 pages: 11 event_location: England issn: 0300-5771 citation: Morris, Tim T; Heron, Jon; Sanderson, Eleanor CM; Davey Smith, George; Didelez, Vanessa; Tilling, Kate; (2022) Interpretation of Mendelian randomization using a single measure of an exposure that varies over time. International Journal of Epidemiology , 51 (6) pp. 1899-1909. 10.1093/ije/dyac136 <https://doi.org/10.1093/ije%2Fdyac136>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10171019/1/Interpretation%20of%20Mendelian%20randomization%20using%20a%20single%20measure%20of%20an%20exposure%20that%20varies%20over%20time.pdf