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. 2021 Apr 13;134(9):1064–1069. doi: 10.1097/CM9.0000000000001505

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Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

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Principles of Mendelian randomization (MR) analysis for thyroid function and serum lipids traits and assumptions that need to be met to obtain unbiased estimates of causal effects. Broken lines represent potential pleiotropic or direct causal effects between variables that would violate MR assumptions. Three assumptions of MR: (1) Genetic variants must be associated with thyroid traits. (2) Genetic variants must not be associated with confounders. (3) Genetic variants must influence the serum lipids outcomes only through thyroid traits and not through any alternative pathways. FT3: Free triiodothyronine; FT4: Free thyroxine; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; SNP: Single nucleotide polymorphism; TC: Total cholesterol; TG: Total triglyceride; TPOAb: Thyroid peroxidase antibodies; TSH: Thyrotropin.