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上海中医药大学附属岳阳中西医结合医院呼吸内科,上海
王振伟,E-mail:luckytcm@126.com
收稿:2025-10-15,
修回:2025-11-28,
纸质出版:2025-12-30
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陆曦,苏秋玲,刘良善,等.哮喘与内分泌疾病的关联:孟德尔随机化研究与中介分析[J].陆军军医大学学报,2025,47(24):3139-3149.DOI:10.16016/j.2097-0927.202510031.
LU X,SU Q L,LIU L S,et al.Association between asthma and endocrine diseases: A Mendelian randomization study and mediation analysis[J].J Army Med Univ,2025,47(24):3139-3149.DOI:10.16016/j.2097-0927.202510031.
陆曦,苏秋玲,刘良善,等.哮喘与内分泌疾病的关联:孟德尔随机化研究与中介分析[J].陆军军医大学学报,2025,47(24):3139-3149.DOI:10.16016/j.2097-0927.202510031. DOI:
LU X,SU Q L,LIU L S,et al.Association between asthma and endocrine diseases: A Mendelian randomization study and mediation analysis[J].J Army Med Univ,2025,47(24):3139-3149.DOI:10.16016/j.2097-0927.202510031. DOI:
目的
2
本研究旨在通过孟德尔随机化(Mendelian randomization, MR)探讨哮喘与内分泌疾病双向因果关系以及中介分析。
方法
2
在本研究中,通过公开发表的基因组关联研究(genome-wide association study
GWAS)统计数据进行了MR分析,并主要采用逆方差加权(inverse variance weighting
IVW)方法来研究哮喘与内分泌疾病之间的关系。为确保结果的稳定性,还进行了一系列敏感性分析。我们通过两步程序进行了中介 MR 分析,并采用多变量MR分析来消除内分泌疾病间的相互影响。
结果
2
正向单变量MR结果提示,1 型糖尿病可能是哮喘的危险因素(
OR
=1.02,95%
CI
:1.01~1.04,
P
=0.001),以及自身免疫性甲状腺功能亢进症可能是哮喘的危险因素(
OR
=1.05,95%
CI
:1.02~1.08,
P
=0.001)。反向单变量MR结果提示,哮喘是自身免疫性甲状腺功能亢进症的可能危险因素(
OR
=1.36,95%
CI
:1.07~1.73,
P
=0.011)。多变量 MR分析确定1型糖尿病是哮喘风险的唯一阳性预测因子(
OR
=1.03,95%
CI
:1.01~1.04;
P
=0.002)。基于中介MR分析,C反应蛋白(C-reactive protein
CRP)在1型糖尿病与哮喘的因果关系连接中起中介作用。
结论
2
这项研究提示1型糖尿病可能是哮喘的危险因素。此外,哮喘可能是自身免疫性甲状腺功能亢进的危险因素。CRP 可能在1型糖尿病与哮喘之间的因果关系起中介作用。
Objective
2
To explore the bidirectional causal relationship between asthma and endocrine diseases and make a mediation analysis through Mendelian randomization (MR).
Methods
2
An MR analysis was performed on the statistical data from the published genome-wide association study (GWAS)
and inverse variance weighting (IVW) was mainly used to study the relationship between asthma and endocrine diseases. To ensure the stability of the results
a series of sensitivity analyses were also performed. Mediated MR analysis was carried out with a two-step procedure
and multivariate MR analysis was employed to eliminate the interaction between endocrine diseases.
Results
2
Positive univariate MR results suggested that type 1 diabetes and autoimmune hyperthyroidism may be risk factors for asthma (
OR
=1.02
95%
CI
: 1.01~1.04
P
=0.001;
OR
=1.05
95%
CI
: 1.02~1.08
P
=0.001). Inverse univariate MR results suggested asthma as a possible risk factor for autoimmune hyperthyroidism (
OR
=1.36
95%
CI
: 1.07~1.73
P
=0.011). Multivariable MR analysis identified type 1 diabetes as the only positive predictor of asthma risk (
OR
=1.03
95%
CI
: 1.01~1.04;
P
=0.002). Based on mediation MR analysis
C-reactive protein (CRP) played a mediating role in the causal association between type 1 diabetes and asthma.
Conclusion
2
This study suggests that type 1 diabetes may be a risk factor for asthma. Additionally
asthma may be a risk factor for autoimmune hyperthyroidism. CRP may mediate the causal relationship between type 1 diabetes and asthma.
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