
浏览全部资源
扫码关注微信
1.河南中医药大学第一附属医院生殖医学科, 郑州
2.河南中医药大学第一临床医学院, 郑州
卫爱武, E-mail:waw201912@163. com
收稿日期:2024-05-29,
修回日期:2024-07-19,
纸质出版日期:2025-02-28
移动端阅览
袁昊,李霄,孙志玉,等.焦虑、抑郁、神经质与复发性流产的因果关系:一项孟德尔随机化研究[J].陆军军医大学学报,2025,47(04):378-384.
YUAN Hao,LI Xiao,SUN Zhiyu,et al.Causal relationships of anxiety, depression and neuroticism with recurrent spontaneous abortion: a Mendelian randomization analysis[J].J Army Med Univ,2025,47(04):378-384.
袁昊,李霄,孙志玉,等.焦虑、抑郁、神经质与复发性流产的因果关系:一项孟德尔随机化研究[J].陆军军医大学学报,2025,47(04):378-384. DOI:10.16016/j.2097-0927.202405107.
YUAN Hao,LI Xiao,SUN Zhiyu,et al.Causal relationships of anxiety, depression and neuroticism with recurrent spontaneous abortion: a Mendelian randomization analysis[J].J Army Med Univ,2025,47(04):378-384. DOI:10.16016/j.2097-0927.202405107.
目的
2
分别探究焦虑、抑郁、神经质等3种负面情绪与复发性流产之间的因果关系。
方法
2
利用全基因组关联研究数据提取与焦虑、抑郁、神经质密切相关的遗传位点作为工具变量,分别利用逆方差加权法、加权中位数法、加权众数法及MR-Egger回归法进行孟德尔随机化分析,评价焦虑、抑郁、神经质与复发性流产之间的因果效应,并进行异质性、基因多效性与敏感性分析。
结果
2
从全基因组关联研究(genome-wide association study, GWAS)数据中提取共46个SNPs作为工具变量(焦虑数据5个,抑郁数据9个,神经质数据32个),经逆方差加权法、加权中位数法、加权众数法及MR-Egger回归法计算
OR
值与95%
CI
,焦虑数据结果分别为1.07(0.86~1.32)、1.10(0.85~1.43)、1.14(0.81~1.59)、1.18(0.53~2.61),抑郁数据结果分别为1.11(0.93~1.32)、1.05(0.83~1.32)、0.96(0.67~1.38)、0.57(0.25~1.31),神经质数据结果分别为1.01(0.75~1.36)、1.07(0.73~1.56)、1.02(0.49~2.12)、2.40(0.46~12.44),上述因果分析均无统计学意义(
P
均
>
0.05);经可靠性分析,异质性评价Cochran’s
Q
检验差异不具有显著性(
P
均
>
0.05),基因多效性评价MR-Egger回归截距均接近于0(
P
均
>
0.05),敏感性评价留一法检验后合并因果效应值相近。
结论
2
焦虑、抑郁、神经质与复发性流产之间不存在因果关联,可靠性检验提示结果相对稳健。
Objective
2
To explore the causal relationships of anxiety
depression and neuroticism with recurrent spontaneous abortion (RSA).
Methods
2
Genome-wide association study (GWAS) data were used to extract single nucleotide polymorphisms (SNPs) closely related to anxiety
depression and neuroticism as instrumental variables (IVs). Inverse variance weighting (IVW)
weighted median estimator (WME)
weighted mode (WM) and Mendelian randomization (MR)-Egger regression were employed for MR analysis to evaluate the causal effects of anxiety
depression and neuroticism with RSA
and to analyze heterogeneity
gene pleiotropy and sensitivity.
Results
2
A total of 46 SNPs were extracted from GWAS data as IVs (5 anxiety SNPs
9 depression SNPs
and 32 neuroticism SNPs). IVW
WME
WM and MR-Egger regression analysis revealed that the odds ratio (OR) and 95% confidence interval (
CI
) of anxiety data were 1.07 (0.86-1.32)
1.10 ( 0.85-1.43)
1.14 (0.81-1.59) and 1.18 (0.53-2.61); those of depression data were 1.11 (0.93-1.32)
1.05 (0.83-1.32)
0.96 (0.67-1.38) and 0.57 (0.25-1.31); those of neuroticism data were 1.01 (0.75-1.36)
1.07 (0.73-1.56)
1.02 (0.49-2.12) and 2.40 (0.46-12.44)
but none of the above causal analyses were statistically significant (all
P
>
0.05). After reliability analysis
the Cochran's
Q
test for heterogeneity evaluation was not significant (
P
>
0.05)
the MR-Egger regression intercepts for gene pleiotropy evaluation were all close to 0 (
P
>
0.05)
and the sensitivity evaluation "Leave-one-out" test also shows that the combined causal effect values are similar.
Conclusion
2
There dose not exist causal relationships of anxiety
depression and neuroticism with RSA. The reliability test shows that the results are relatively robust.
中华医学会妇产科学分会产科学组 , 复发性流产诊治专家共识编写组 . 复发性流产诊治专家共识(2022) [J]. 中华妇产科杂志 , 2022 , 57 ( 9 ): 653 - 667 . DOI: 10.3760/cma.j.cn112141-20220421-00259 http://dx.doi.org/10.3760/cma.j.cn112141-20220421-00259 .
Obstetrics Science Group of Obstetrics and Gynecology Branch of Chinese Medical Association , Expert consensus on the diagnosis and treatment of recurrent abortion . Chinese expert consensus on diagnosis and management of recurrent spontaneous abortion (2022) [J]. Chin J Obstet Gynecol , 2022 , 57 ( 9 ): 653 - 667 . DOI: 10.3760/cma.j.cn112141-20220421-00259 http://dx.doi.org/10.3760/cma.j.cn112141-20220421-00259 .
QUENBY S , GALLOS I D , DHILLON-SMITH R K , et al . Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss [J]. Lancet , 2021 , 397 ( 10285 ): 1658 - 1667 . DOI: 10.1016/S0140-6736(21)00682-6 http://dx.doi.org/10.1016/S0140-6736(21)00682-6 .
Practice Committee of the American Society for Reproductive Medicine . Evaluation and treatment of recurrent pregnancy loss: a committee opinion [J]. Fertil Steril , 2012 , 98 ( 5 ): 1103 - 1111 . DOI: 10.1016/j.fertnstert.2012.06.048 http://dx.doi.org/10.1016/j.fertnstert.2012.06.048 .
乔杰 . 复发性流产孕前管理 [J]. 中国实用妇科与产科杂志 , 2018 , 34 ( 12 ): 1309 - 1314 . DOI: 10.19538/j.fk2018120102 http://dx.doi.org/10.19538/j.fk2018120102 .
QIAO J . Preconception care for recurrent spontaneous abortion [J]. Chin J Pract Gynecol Obstet , 2018 , 34 ( 12 ): 1309 - 1314 . DOI: 10.19538/j.fk2018120102 http://dx.doi.org/10.19538/j.fk2018120102 .
LI W , NEWELL-PRICE J , JONES G L , et al . Relationship between psychological stress and recurrent miscarriage [J]. Reprod Biomed Online , 2012 , 25 ( 2 ): 180 - 189 . DOI: 10.1016/j.rbmo.2012.03.012 http://dx.doi.org/10.1016/j.rbmo.2012.03.012 .
TURNER K , REYNOLDS-MAY M F , ZITEK E M , et al . Stress and anxiety scores in first and repeat IVF cycles: a pilot study [J]. PLoS One , 2013 , 8 ( 5 ): e63743 . DOI: 10.1371/journal.pone.0063743 http://dx.doi.org/10.1371/journal.pone.0063743 .
陈晶晶 , 曾韩 , 徐细凤 , 等 . 支持性心理治疗对辅助生殖术后复发性流产病人心理状态及妊娠结局的影响 [J]. 全科护理 , 2017 , 15 ( 29 ): 3674 - 3676 . DOI: 10.3969/j.issn.1674-4748.2017.29.036 http://dx.doi.org/10.3969/j.issn.1674-4748.2017.29.036 .
CHEN J J , ZENG H , XU X F , et al . Effects of supportive psychotherapy on the psychological state and pregnancy outcomes of patients with recurrent abortion after assisted reproduction [J]. Chin Gen Pract Nurs , 2017 , 15 ( 29 ): 3674 - 3676 . DOI: 10.3969/j.issn.1674-4748.2017.29.036 http://dx.doi.org/10.3969/j.issn.1674-4748.2017.29.036 .
CARMICHAEL S L , SHAW G M , YANG W , et al . Maternal stressful life events and risks of birth defects [J]. Epidemiology , 2007 , 18 ( 3 ): 356 - 361 . DOI: 10.1097/01.ede.0000259986.85239.87 http://dx.doi.org/10.1097/01.ede.0000259986.85239.87 .
NAGEL M , WATANABE K , STRINGER S , et al . Item-level analyses reveal genetic heterogeneity in neuroticism [J]. Nat Commun , 2018 , 9 ( 1 ): 905 . DOI: 10.1038/s41467-018-03242-8 http://dx.doi.org/10.1038/s41467-018-03242-8 .
VISSCHER P M , ZHANG Q , SKLAR P , et al . 10 years of GWAS discovery: biology, function, and translation [J]. Am J Hum Genet , 2017 , 101 ( 1 ): 5 - 22 . DOI: 10.1016/j.ajhg.2017.06.005 http://dx.doi.org/10.1016/j.ajhg.2017.06.005 .
SMITH G D , EBRAHIM S . 'Mendelian randomization': can genetic epidemiology contribute to understanding environmental determinants of disease? [J]. Int J Epidemiol , 2003 , 32 ( 1 ): 1 - 22 . DOI: 10.1093/ije/dyg070 http://dx.doi.org/10.1093/ije/dyg070 .
PIERCE B L , AHSAN H , VANDERWEELE T J . Power and instrument strength requirements for Mendelian randomization studies using multiple genetic variants [J]. Int J Epidemiol , 2011 , 40 ( 3 ): 740 - 752 . DOI: 10.1093/ije/dyq151 http://dx.doi.org/10.1093/ije/dyq151 .
于天琦 , 徐文涛 , 苏雅娜 , 等 . 孟德尔随机化研究基本原理、方法和局限性 [J]. 中国循证医学杂志 , 2021 , 21 ( 10 ): 1227 - 1234 .
YU T Q , XU W T , SU Y N , et al . Mendelian randomization: the basic principles, methods and limitations [J]. Chin J Evid Based Med , 2021 , 21 ( 10 ): 1227 - 1234 .
BOWDEN J , DAVEY SMITH G , BURGESS S . Mendelian randomization with invalid instruments: effect estimation and bias detection through egger regression [J]. Int J Epidemiol , 2015 , 44 ( 2 ): 512 - 525 . DOI: 10.1093/ije/dyv080 http://dx.doi.org/10.1093/ije/dyv080 .
YAVORSKA O O , BURGESS S . MendelianRandomization: an R package for performing Mendelian randomization analyses using summarized data [J]. Int J Epidemiol , 2017 , 46 ( 6 ): 1734 - 1739 . DOI: 10.1093/ije/dyx034 http://dx.doi.org/10.1093/ije/dyx034 .
WOOTTON R E , LAWN R B , MILLARD L A C , et al . Evaluation of the causal effects between subjective wellbeing and cardiometabolic health: Mendelian randomisation study [J]. BMJ , 2018 , 362 : k3788 . DOI: 10.1136/bmj.k3788 http://dx.doi.org/10.1136/bmj.k3788 .
BURGESS S , THOMPSON S G . Bias in causal estimates from Mendelian randomization studies with weak instruments [J]. Stat Med , 2011 , 30 ( 11 ): 1312 - 1323 . DOI: 10.1002/sim.4197 http://dx.doi.org/10.1002/sim.4197 .
史杨 , 姚利 , 吴玉 , 等 . 复发性流产女性的负性情绪及社会支持状况调查 [J]. 中国计划生育学杂志 , 2022 , 30 ( 3 ): 514 - 519 .
SHI Y , YAO L , WU Y , et al . Investigation of the negative emotion and social support status of women with spontaneous recurrent abortion [J]. Chin J Fam Plan , 2022 , 30 ( 3 ): 514 - 519 .
ROONEY K L , DOMAR A D . The relationship between stress and infertility [J]. Dialogues Clin Neurosci , 2018 , 20 ( 1 ): 41 - 47 . DOI: 10.31887/DCNS.2018.20.1/klrooney http://dx.doi.org/10.31887/DCNS.2018.20.1/klrooney .
郭家庄 . 社会心理相关因素对复发性流产影响的Meta分析 [J]. 循证护理 , 2022 , 8 ( 3 ): 297 - 304 .
GUO J Z . Influence of psychosocial factors on recurrent spontaneous abortion: a meta-analysis [J]. Chin Evid Based Nurs , 2022 , 8 ( 3 ): 297 - 304 .
张红 , 张觇宇 . 心理应激对复发性流产患者母儿的影响及作用机制探讨 [J]. 重庆医学 , 2017 , 46 ( 11 ): 1562 - 1564 . DOI: 10.3969/j.issn.1671-8348.2017.11.043 http://dx.doi.org/10.3969/j.issn.1671-8348.2017.11.043 .
ZHANG H , ZHANG C Y . Influence of psychological stress on mother and fetus of patients with recurrent abortion and its mechanism [J]. Chongqing Med , 2017 , 46 ( 11 ): 1562 - 1564 . DOI: 10.3969/j.issn.1671-8348.2017.11.043 http://dx.doi.org/10.3969/j.issn.1671-8348.2017.11.043 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621