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关于幽门螺杆菌与糖尿病的孟德尔随机化研究

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目的 利用孟德尔随机化(Mendelian randomization,MR)方法研究幽门螺杆菌(helicobacter pylori,Hp)感染与糖尿病发病之间的因果关系,为Hp感染后胃肠外疾病的发病研究提供参考.方法 利用已经报道的Hp遗传易感性强相关两个单核苷酸多态性(single nucleotide polymorphisms,SNPs)及公开可用的全基因组关联研究(genome-wide association studies,GWAS)的数据,采用逆方差加权法(inverse variance weighted analysis,IVW)、MR-Egger 法、加权中位数法进行分析,评估Hp感染与糖尿病之间的关联性.结果 IVW结果显示Hp感染遗传易感性与糖尿病风险增加之间不存在因果关系(OR=1.018,95%CI:0.984~1.054,P=0.304).此外,Hp 相关空泡毒素(VacA)抗体(OR=1.007,95%CI:0.986~1.028,P=0.537)、细胞毒素相关蛋白(CagA)抗体(OR=0.988,95%CI:0.967~1.010,P=0.298)和免疫球蛋白 IgG(OR=0.973,95%CI:0.939~1.008,P=0.129)均与糖尿病风险无因果关系.异质性和多效性检验表明各暴露间不存在异质性且无水平多效性,MR的结果较为可靠.结论 Hp感染与糖尿病风险增加之间不存在因果关系.
A Mendelian randomized study on helicobacter pylori and diabetes mellitus
Objective To utilize the Mendelian randomized(MR)method to investigate the causal relationship between helicobacter pylori(Hp)infection and the development of diabetes mellitus,providing reference value for understanding the pathogenesis of extragastrointestinal diseases following Hp infection.Methods We employed two single nucleotide polymorphisms(SNPs)that have been previously reported as genetic variants associated with Hp seroprevalence,along with publicly available genome-wide association studies(GWAS)data.We used the inverse variance-weighted(IVW)technique,MR-Egger regression,and weighted median technique for the analysis.Results The IVW results indicated no causal relationship between genetic susceptibility to Hp infection and an increased risk of diabetes(OR=1.018,95%CI:0.984-1.054,P=0.304).Moreover,none of the Hp-related antibodies,including VacA(OR=1.007,95%CI:0.986-1.028,P=0.537),CagA(OR=0.988,95%CI:0.967-1.010,P=0.298),and IgG(OR=0.973,95%CI:0.939-1.008,P=0.129),showed a causal association with the risk of diabetes.Heterogeneity and horizontal pleiotropy tests were conducted,and the results indicated no heterogeneity or horizontal pleiotropy,confirming the reliability of the MR analysis.Conclusion The findings of this study suggest that there is no causal relationship between Hp infection and an increased risk of diabetes.

Mendelian randomizationHelicobacter pyloriDiabetes mellitusCausal inference

韩经略、安方梅

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南京医科大学附属无锡人民医院消化内科,江苏无锡 214023

孟德尔随机化 幽门螺杆菌 糖尿病 因果推断

江苏省自然科学基金面上项目江苏省无锡市第二届"双百拔尖人才"项目南京医科大学无锡医学中心队列研究项目

BK20211039BJ2023008WMCC202302

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(20)