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The causality between rheumatoid arthritis and postural deformities: bidirectional Mendelian randomization study and
Piqian Zhao1,2,3, Zhe Chen4, Ya Wen5
1Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China.
Frontiers in Immunology
|October 18, 2024
Summary
Rheumatoid arthritis (RA) is causally linked to hallux valgus and flat foot. Hallux valgus also mediates the effect of RA on flat foot, highlighting the need for early intervention in RA patients.
Area of Science:
- Genetics
- Rheumatology
- Orthopedics
Background:
- Rheumatoid arthritis (RA) is an autoimmune disease with potential associations with postural deformities.
- Investigating the causal link between RA and conditions like hallux valgus, flat foot, and scoliosis is crucial for understanding disease mechanisms and developing interventions.
Purpose of the Study:
- To determine if rheumatoid arthritis (RA) is causally associated with postural deformities, specifically hallux valgus, flat foot, and scoliosis, in European populations.
- To explore the potential mediating role of hallux valgus in the relationship between RA and flat foot.
Main Methods:
- Mendelian randomization (MR) analysis using summary-level data from the IEU OpenGWAS project and Finngen database.
- Inverse variance weighting (IVW) as the primary method, supplemented by MR-Egger, maximum likelihood, weighted median, and cML-MA for robustness.
- Mediation analyses using two-step MR to assess the indirect effect of RA on flat foot via hallux valgus.
Main Results:
- Rheumatoid arthritis (RA) showed a significant causal association with hallux valgus (OR 1.132) and flat foot (OR 1.197).
- Among postural deformities, hallux valgus was causally linked to flat foot (OR 1.823) and scoliosis (OR 1.150).
- Mediation analysis revealed that hallux valgus mediates 41.31% of the effect of RA on flat foot.
Conclusions:
- Genetically predicted rheumatoid arthritis (RA) is causally associated with hallux valgus and flat foot.
- Hallux valgus acts as a mediator in the pathway from RA to flat foot.
- Early screening and preventive treatment for foot deformities in RA patients are recommended, with further research needed for non-European populations.
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