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The causal relationship between obstructive sleep apnea and rheumatic disease: A bidirectional Mendelian
1Department of Rheumatology & Immunology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Rheumatology and Immunology Research
|April 7, 2025
Summary
This study found a causal link between ankylosing spondylitis (AS) and obstructive sleep apnea (OSA). No causal relationship was identified between OSA and other rheumatic diseases, warranting further research into specific mechanisms.
Area of Science:
- Rheumatology
- Sleep Medicine
- Genetic Epidemiology
Background:
- Obstructive sleep apnea (OSA) is associated with rheumatic diseases, but causality remains unclear due to confounding factors.
- Existing research is limited by potential reverse causality and confounding variables.
- Defining the precise causal relationship between OSA and rheumatic conditions is crucial for clinical management.
Purpose of the Study:
- To investigate the bidirectional causal association between obstructive sleep apnea and rheumatoid immune diseases.
- To employ a two-sample Mendelian randomization (MR) analysis to assess genetic links.
- To differentiate causal effects from mere associations in rheumatic diseases.
Main Methods:
- Utilized a two-sample bidirectional Mendelian randomization (MR) design.
- Employed large-scale genome-wide association studies (GWAS) summary statistics for robust analysis.
- Applied Inverse Variance Weighted (IVW) as the primary method, supported by MR-Egger and Weighted Median for sensitivity analysis.
Main Results:
- A significant causal association was detected between ankylosing spondylitis (AS) and the risk of obstructive sleep apnea (OSA).
- Mendelian randomization analysis indicated that AS is a risk factor for developing OSA.
- No significant bidirectional causal relationship was observed between OSA and other rheumatic diseases, confirmed by sensitivity analyses.
Conclusions:
- The findings suggest a potential causal link between ankylosing spondylitis and obstructive sleep apnea.
- No direct causal relationship was established between OSA and other rheumatoid immune diseases.
- Further experimental research is recommended to elucidate the underlying pathological and physiological mechanisms involved.
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