数理医药学杂志2024,Vol.37Issue(7) :481-489.DOI:10.12173/j.issn.1004-4337.202403071

自身免疫性肝病与糖尿病之间的因果关系:一项双向双样本孟德尔随机化研究

A two-sample bidirectional Mendelian randomization study of the causality between autoimmune liver disease and diabetes mellitus

林梦璐 程洁 胡凡 奉佳辉 陈肖佳 唐努尔·买买提艾山 程燕 林军
数理医药学杂志2024,Vol.37Issue(7) :481-489.DOI:10.12173/j.issn.1004-4337.202403071

自身免疫性肝病与糖尿病之间的因果关系:一项双向双样本孟德尔随机化研究

A two-sample bidirectional Mendelian randomization study of the causality between autoimmune liver disease and diabetes mellitus

林梦璐 1程洁 1胡凡 1奉佳辉 1陈肖佳 1唐努尔·买买提艾山 1程燕 1林军1
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作者信息

  • 1. 武汉大学中南医院消化内科(武汉 430071);湖北省肠病医学临床研究中心/肠病湖北省重点实验室(武汉 430071)
  • 折叠

摘要

目的 利用GWAS数据进行双向双样本孟德尔随机化(Mendelian randomization,MR)分析,探究自身免疫性肝病(autoimmune liver disease,AILD)与糖尿病(diabetes mellitus,DM)的因果关联性.方法 从IEU数据库下载AILD和 1 型糖尿病(type 1 diabetes mellitus,T1DM)的GWAS数据,从DIAGRAM联合会下载 2 型糖尿病(type 2 diabetes mellitus,T2DM)的GWAS数据,提取合格的单核苷酸多态性(single nucleotide polymorphism,SNP).采用MR-Egger回归、加权中位数(weighted median estimator,WME)和逆方差加权(inverse variance weighted,IVW)方法进行MR分析.通过异质性检验、多效性分析、留一法分析和MR-PRESSO分析验证结果的稳健性.结果 IVW分析结果显示,原发性胆汁性胆管炎(primary biliary cholangitis,PBC)与T1DM呈正相关关系(OR=1.244,95%CI:1.137~1.361,P<0.001).反向MR分析结果显示,T1DM显著增加自身免疫性肝炎(autoimmune hepatitis,AIH)(OR=1.111,95%CI:1.053~1.173,P<0.001)、PBC(OR=1.218,95%CI:1.133~1.310,P<0.001)、原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)(OR=1.375,95%CI:1.187~1.592,P<0.001)的发病风险.未观察到AILD与T2DM间存在显著的因果关系.异质性检验提示SNP之间存在异质性,故采用随机效应IVW模型进行MR分析.多效性分析未提示存在水平多效性.留一法分析表明,去除每个SNP后,因果关系保持一致.通过MR-PRESSO分析发现离群值,去掉离群值重新进行MR分析,其结果变化不大,进一步证实了结果的可靠性.结论 PBC与T1DM间存在双向因果关系,T1DM患者发生AIH、PSC的风险增加,未观察到AILD与T2DM间存在显著的因果关系.

Abstract

Objective This study aimed to explore the causal association between autoimmune liver disease(AILD)and diabetes mellitus(DM)by two-sample bidirectional Mendelian randomization(MR)analysis.Methods GWAS data for AILD and type 1 diabetes mellitus(T1DM)were downloaded from the IEU database,and GWAS data for type 2 diabetes mellitus(T2DM)were downloaded from the DIAGRAM consortium,and eligible single nucleotide polymorphisms(SNP)were extracted.MR analyses were performed using MR-Egger regression,weighted median(WME),and inverse variance weighting(IVW)methods.In addition,the robustness of the results was verified by heterogeneity test,multiple validity analysis,leave-one-out analysis and MR-PRESSO analysis.Results IVW results showed that primary biliary cholangitis(PBC)had a positive causal effect on T1DM(OR=1.244,95%CI:1.137-1.361,P<0.001).Reverse MR analysis showed that T1DM significantly increased the morbidity risk of autoimmune hepatitis(AIH)(OR=1.111,95%CI:1.053-1.173,P<0.001),PBC(OR=1.218,95%CI:1.133-1.310,P<0.001),and primary sclerosing cholangitis(PSC)(OR=1.375,95%CI:1.187-1.592,P<0.001).No significant causal association between AILD and T2DM was observed.Heterogeneity tests suggested heterogeneity among SNPs,consequently,the random effects IVW model was used for MR analysis.Multivariate analysis did not suggest horizontal pleiotropy.Leave-one-out analysis showed that causality remained consistent after removing each SNP.Outliers were detected by MR-PRESSO analysis,and the results did not change much when the outliers were removed and the MR analysis was repeated,further confirming the reliability of the results.Conclusion Bidirectional causality was observed between PBC and T1DM.Patients with T1DM were at increased risk of AIH and PSC,and no significant causality was observed between AILD and T2DM.

关键词

自身免疫性肝病/糖尿病/孟德尔随机化/因果关系

Key words

Autoimmune liver disease/Diabetes mellitus/Mendelian randomization/Causality

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出版年

2024
数理医药学杂志
武汉大学,中国工业与应用数学学会,医药数学专业委员会

数理医药学杂志

影响因子:0.479
ISSN:1004-4337
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