In recent years, epidemiologists have increasingly sought to employ genetic data to identify ‘causal’ relationships between exposures of interest and various endpoints – an instrumental variable approach sometimes termed Mendelian randomization. However, this approach is subject to all of the limitations of instrumental variable analysis and to several limitations specific to its genetic underpinnings, including confounding, weak instrument bias, pleiotropy, adaptation, and failure of replication. Although the approach enjoys some utility in testing the etiological role of discrete biochemical pathways, like folate metabolism, examples like that of alcohol consumption and cardiovascular disease demonstrate that it must be treated with all of the circumspection that should accompany all forms of observational epidemiology. Going forward, we urge the elimination of randomization or causality in reports of its use and suggest that Mendelian randomization instead be termed exactly what it is – genetic instrumental variable analysis.

中文翻译：

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遗传工具变量分析：是时候称呼孟德尔随机化了。酒精和心血管疾病的例子

近年来，流行病学家越来越多地寻求利用遗传数据来确定感兴趣的暴露量和各个终点之间的“因果”关系-一种工具变量方法，有时称为孟德尔随机化。但是，此方法受仪器变量分析的所有限制以及其遗传基础所特有的若干限制，包括混杂，仪器偏倚弱，多效性，适应性和复制失败。尽管该方法在测试离散生化途径（如叶酸代谢）的病因学作用方面具有一定的实用性，但像饮酒和心血管疾病这样的例子表明，必须在所有形式的观察流行病学中都应加倍考虑。往前走，