The causal association between type 2 diabetes and spinal stenosis: A Mendelian randomization analysis

Area of Science:

• Orthopedics and Endocrinology
• Genetics and Epidemiology

Background:

• Spinal stenosis is a common degenerative condition causing pain and dysfunction, particularly in older adults.
• A potential association exists between type 2 diabetes mellitus (T2DM) and spinal stenosis, but causality remains unproven.

Purpose of the Study:

• To investigate the causal relationship between T2DM and spinal stenosis using Mendelian Randomization (MR).
• To determine if body mass index (BMI) mediates the effect of T2DM on spinal stenosis.

Main Methods:

• Bidirectional two-sample MR analysis utilizing genome-wide association study (GWAS) data for T2DM and spinal stenosis.
• Sensitivity analyses including Cochran's Q, MR-Egger-intercept, and leave-one-out methods to assess heterogeneity and pleiotropy.
• Multivariate MR was employed to evaluate the direct effect of T2DM on spinal stenosis, adjusting for BMI.

Main Results:

• A statistically significant positive causal effect of T2DM on spinal stenosis was identified (OR: 1.050, P=0.031).
• No evidence of reverse causality from spinal stenosis to T2DM was found.
• Multivariate MR confirmed the causal link between T2DM and spinal stenosis, independent of BMI (OR: 1.047, P=0.032).

Conclusions:

• Type 2 diabetes mellitus is a risk factor for developing spinal stenosis.
• The identified causal relationship between T2DM and spinal stenosis is not influenced by body mass index.