首页|慢性鼻窦炎与慢性阻塞性肺疾病:一项两样本双向孟德尔随机化研究

慢性鼻窦炎与慢性阻塞性肺疾病:一项两样本双向孟德尔随机化研究

扫码查看
目的 采用两样本双向孟德尔随机化(Mendelian randomization,MR)方法探究慢性鼻窦炎(chronic rhinosinusitis,CRS)与慢性阻塞性肺疾病(慢阻肺)之间是否存在因果关联.方法 正向研究从公开的全基因组关联研究数据集中筛选与CRS密切相关的单核苷酸多态性(single nucleotide polymorphism,SNP)作为工具变量,慢阻肺作为结局变量;反向研究则筛选与慢阻肺密切相关的SNP作为工具变量,CRS作为结局变量.运用逆方差加权法(inverse variance weighted,I VW)、MR-Egger 回归分析法、加权中位数法(weighted median,WME)3种回归模型进行双向MR分析以评估CRS与慢阻肺之间的因果关系.采用Cochran Q统计、MR-Egger截距项、MR-PRESSO、"留一法"进行异质性和水平多效性检验,以评估MR结果的稳定性和可靠性.结果 正向研究共纳入14个与CRS密切相关的SNP.正向研究的固定效应IVW分析结果显示CRS可能会增加慢阻肺的发病风险[比值比(odds ratio,OR)=1.003,95%置信区间(confidence interval,CI)(1.002,1.004),P<0.001],且在 WME 法中加以证实,而MR-Egger回归分析法则未显示出二者之间的因果关联.异质性检验(IVW结果:Cochran Q=7.910,P=0.849;MR-Egger 回归分析法结果:Cochran Q=7.450,P=0.827)、MR-Egger 截距法(P=0.510)、MR-PRESSO检验(P=0.917)、"留一法"分析结果均提示MR分析结果具有可靠性.反向研究共纳入12个与慢阻肺相关的SNP作为工具变量,其MR分析结果不支持慢阻肺会增加CRS的发病风险(P>0.05);异质性检验(IVW结果:Cochran Q=5.947,P=0.877;MR-Egger 回归分析法结果:5.937,P=0.821)、MR-Egger 截距法(P=0.921)、MR-PRESSO检验(P=0.875)、"留一法"分析结果均提示MR分析结果可靠.结论 CRS与慢阻肺之间可能存在因果关联,CRS可能会增加慢阻肺的发病风险,但未发现慢阻肺导致CRS风险增加的证据.
Chronic rhinosinusitis and chronic obstructive pulmonary disease:a two-sample two-way Mendelian randomization study
Objective To investigate the potential causal relationship between chronic rhinosinusitis(CRS)and chronic obstructive pulmonary disease(COPD)using a two-sample two-way Mendelian randomization(MR)approach.Methods In the forward study,single nucleotide polymorphisms(SNPs)closely associated with CRS were selected as instrumental variables from publicly available genome-wide association studies datasets,with COPD as the outcome variable;conversely,in the reverse study,SNPs closely associated with COPD were selected as instrumental variables,with CRS as the outcome variable.MR analysis was conducted using three regression models:inverse variance weighted(IVW),MR-Egger regression analysis,and weighted median(WME)to assess the causal relationship between CRS and COPD.Cochran's Q statistic,MR-Egger intercept,MR-PRESSO,and"leave-one-out"methods were employed to test for heterogeneity and horizontal pleiotropy,thereby evaluating the stability and reliability of the MR results.Results A total of 14 SNPs closely associated with CRS were included in the forward study;the IVW-fixed effects analysis indicated that CRS may increase the risk of developing COPD[odds ratio=1.003,95%confidence interval(1.002,1.004),P<0.001],which was confirmed by the WME method,while the MR-Egger regression method did not show a causal link between CRS and COPD.Heterogeneity test(IVW result:Cochran's Q=7.910,P=0.849;MR-Egger regression result:Cochran's Q=7.450,P=0.827),MR-Egger intercept method(P=0.510),MR-PRESSO test(P=0.917),and"leave-one-out"method showed that the MR analysis results were reliable.In the reverse study,a total of 12 SNPs related to COPD were included as instrumental variables;MR analysis did not support the notion that COPD would increase the risk of CRS(P>0.05).Heterogeneity test(IVW result:Cochran's Q=5.947,P=0.877;MR-Egger regression result:Cochran's Q=5.937,P=0.821),MR-Egger intercept method(P=0.921),MR-PRESSO test(P=0.875),and"leave-one-out"analysis method showed that the MR analysis results were reliable.Conclusions There is a potential causal association between CRS and COPD,and CRS may increase the risk of developing COPD.But there is no evidence to suggest that COPD increases the risk of CRS.

Chronic rhinosinusitischronic obstructive pulmonary diseaseMendelian randomizationcausal association

郭晴晴、牛丁忍、周凌

展开 >

黑龙江中医药大学第一临床医学院(哈尔滨 150040)

黑龙江中医药大学附属第一医院耳鼻喉科(哈尔滨 150040)

慢性鼻窦炎 慢性阻塞性肺疾病 孟德尔随机化 因果关联

2024

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子:0.744
ISSN:1002-0179
年,卷(期):2024.39(9)