妊娠糖尿病与妊娠期泌尿生殖感染之间的回顾性分析和孟德尔随机化研究
A retrospective analysis and Mendelian randomization study on gesta-tional diabetes mellitus and genitourinary tract infections during preg-nancy
魏馨 1粟艳林 1王妍 2程利 1殷玲 1刘鹏敏 1谢清华3
作者信息
- 1. 南华大学附属长沙中心医院妇产科,湖南长沙 410004
- 2. 南华大学附属长沙中心医院病理科
- 3. 南华大学附属长沙中心医院检验科,湖南长沙 410004
- 折叠
摘要
目的 本研究通过回顾性分析和孟德尔随机化分析(Mendelian randomization,MR),评估了妊娠期糖尿病(gestational diabetes mellitus,GDM)与妊娠期泌尿生殖道感染(genitourinary tract infections during pregnancy,GUTIs)之间的关联.方法 对2020-2022年产检并分娩的7 751名孕妇进行了回顾性分析,比较GDM和非GDM妇女的GUTIs率.同时,选取了全基因组关联研究(genome-wide association study,GWAS)数据,采用逆方差加权法(inverse-variance weighted method,IVW)作为主要分析方法,加权中介方差(MR-Egger)回归、简单模态法(SM)、加权中位数法和加权众数法作为补充分析,通过MR-Egger回归、Cochran Q检验和留一法作为敏感性检验,进行双样本MR分析,来探讨GDM和GUTIs的因果关系.结果 单因素x2检验(P=2.2 × 10-16)与多因素逐步逻辑回归分析(P=2 × 10-16)均显示GDM与GUTIs间存在显著相关性;双样本MR研究进一步证实了两者之间的显著关联(IVW:β=0.211,P=0.013),MR-Egger回归法未发现明显的水平多效性(P=0.813),留一法、Cochran Q检验表明所有SNPs不存在明显异质性(P=0.876,P=0.938).结论 GDM的存在可能增加GUTIs风险.有效的筛查和管理GDM患者,将有助于降低和预防GUTIs.
Abstract
Objective To evaluate the association between gestational diabetes mellitus(GDM)and genitourinary tract infec-tions during pregnancy(GUTIs)through retrospective analysis and Mendelian randomization(MR)analysis.Methods A retro-spective analysis was conducted on 7 751 pregnant women who underwent prenatal check-ups and delivered between 2020 and 2022,comparing the rates of GUTIs between women with GDM and those without.Additionally,data from genome-wide association studies(GWAS)were selected,and the inverse-variance weighted(IVW)method was employed as the primary analytical approach,supplemented by weighted median(WM),weighted mode(WM),and MR-Egger regression methods.Sensitivity analyses were performed using MR-Egger regression,Cochran's Q test,and leave-one-out analysis to investigate the causal relationship between GDM and GUTIs.Results Both univariate chi-square tests(P=2.2×10-16)and multivariate stepwise logistic regression analyses(P=2×10-16)revealed a significant correlation between GDM and GUTIs.The two-sample MR study further confirmed a significant association between the two(IVW:β=0.211,P=0.013).The MR-Egger regression method did not indicate significant horizontal pleiotropy(P=0.813),and leave-one-out analysis and Cochran's Q test showed no significant heterogeneity among all SNPs(P=0.876,P=0.938).Conclusion The presence of GDM may increase the risk of GUTIs.Effective screening and management of GDM patients could help reduce and prevent GUTIs.
关键词
妊娠糖尿病/妊娠期泌尿生殖道感染/多因素逐步逻辑回归分析/孟德尔随机化分析Key words
Gestational diabetes mellitus/Genitourinary tract infections during pregnancy/Multivariate stepwise logistic re-gression analysis/Mendelian randomization analysis引用本文复制引用
出版年
2025
NETL
NSTL
万方数据