首页|胃食管反流病与支气管哮喘因果关系的孟德尔随机化研究

胃食管反流病与支气管哮喘因果关系的孟德尔随机化研究

Mendelian randomization study on causal relationship between gastroesophageal reflux disease and bronchial asthma

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目的 基于孟德尔随机化(MR)探讨胃食管反流病(GERD)与不同支气管哮喘(简称哮喘)表型之间的因果关系.方法 通过全基因组关联研究(GWAS)汇总数据集,其中GERD包含602 604例患者,未指定哮喘包含156 078例患者,肥胖相关性哮喘139 591例患者,儿童哮喘138 474例患者,过敏性哮喘140 308例患者,嗜酸性粒细胞性哮喘136 633例患者.采用逆方差加权法作为MR分析的主要方法,加权中位数法、简单模型、加权模型和MR-Egger进行补充,并进行敏感性分析评估结果的稳定性.结果 MR分析显示,未指定哮喘(OR=1.61,95%CI:1.45~1.77,P<0.01)、肥胖相关性哮喘(OR=2.40,95%CI:1.98~2.90,P<0.01)、儿童哮喘(OR=1.56,95%CI:1.25~1.94,P<0.01)、过敏性哮喘(OR=1.47,95%CI:1.25~1.74,P<0.01)与GERD呈正向因果效应,嗜酸性粒细胞性哮喘与GERD无因果关系(OR=1.31,95%CI:0.95~1.81,P=0.10).敏感性分析显示,结果不存在水平多效性和异质性.结论 GERD会导致未指定哮喘、肥胖相关性哮喘、儿童哮喘、过敏性哮喘的患病风险升高,而对嗜酸性粒细胞性哮喘的效应不明显.
Objective To investigate the causal relationship between gastroesophageal reflux disease(GERD)and different phenotypes of asthma based on Mendelian randomization(MR).Methods The dataset was pooled by genome-wide association studies(GWAS),in which the GERD data contained 602 604 cases,the unspecified asthma data contained 156 078 cases,139 591 cases of obesity-associated asthma,138 474 cases of pediatric asthma,140 308 cases of allergic asthma and 136 633 cases of eosinophilic asthma.The inverse va-riance weighting method was used as the main method of MR analysis,and the weighted median method,sim-ple model,weighted models and MR-Egger conducted the supplement,and the sensitivity analysis was carried out to assess the stability of the results.Results The MR analysis showed that unspecified asthma(OR=1.61,95%CI:1.45-1.77,P<0.01),obesity-related asthma(OR=2.40,95%CI:1.98-2.90,P<0.01),Childhood asthma(OR=1.56,95%CI:1.25-1.94,P<0.01)and allergic asthma(OR=1.47,95%CI:1.25-1.74,P<0.01)present the forward cause effect,but eosinophilic asthma had no causal relation with GERD(OR=1.31,95%CI:0.95-1.81,P=0.10).The sensitivity analysis showed that the horizontal pleiot-ropy and heterogeneity in the results did not exist.Conclusion GERD could lead to an increased risk of un-specified asthma asthma,obesity-associated asthma,pediatric asthma and allergic asthma,while the effect on eosinophilic asthma is not significant.

gastroesophageal refluxasthmaobesity-related asthmachildhood asthmaallergic asth-maeosinophilic asthmaeosinophilic asthmaMendelian randomisation analysis

刘莲莲、王成祥

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北京中医药大学第三附属医院呼吸科,北京 100029

胃食管反流病 哮喘 肥胖相关性哮喘 儿童哮喘 过敏性哮喘 嗜酸性粒细胞性哮喘 孟德尔随机化分析

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(22)