类风湿性关节炎与阻塞性肺病的因果关系:来自孟德尔随机化研究的证据
Ziqin Cao1, Qiangxiang Li2, Jianhuang Wu1
1Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Heart & lung : the journal of critical care
|June 11, 2023
概括
对类风湿性关节炎 (RA) 的遗传倾向因果性地增加了阻塞性肺部疾病 (ORD) 的风险,包括COPD和喘. 这种遗传联系也增加了相关感染和肺炎的风险.
科学领域:
- 风湿病学和呼吸系统医学
- 遗传流行病学遗传流行病学
- 因果推理因果推理
背景情况:
- 观察性研究表明,类风湿性关节炎 (RA) 和阻塞性肺部疾病 (ORD) 之间存在联系.
- 风湿性关节炎和ORDs的发展之间的因果关系仍然不确定.
- 这项研究调查了RA在ORDs病变发生过程中的潜在因果作用.
研究的目的:
- 调查类风湿性关节炎 (RA) 与阻塞性肺部疾病 (ORD) 风险之间的潜在因果关系.
主要方法:
- 使用了门德尔随机化 (MR) 分析,包括单变量,多变量和调解MR.
- 全基因组关联研究 (GWAS) 的RA和ORD (COPD和喘) 的总结统计数据来自大规模的元分析和FinnGen Biobank.
- 使用总结效果估计 (CAUSE) 的因果分析方法用于增强统计能力.
主要成果:
- 对RA的遗传倾向与喘/COPD (OR=1.03),相关感染 (OR=1.02) 和肺炎/败血症 (OR=1.02) 的风险增加有关.
- 对早期发病的COPD和喘观察到显著的因果关系,有迹象表明非过敏性喘.
- 经过对混因素进行调整后,独立的因果作用仍然存在,调解分析没有发现任何显著的调解因素.
结论:
- 类风湿性关节炎对阻塞性肺部疾病的风险增加有因果作用,特别是早期出现的慢性肺炎和非过敏性喘.
- 肌痛性关节炎的遗传倾向与喘/COPD相关感染和肺炎的风险更高有关.
- 在RA和ORD之间的因果途径中没有发现任何显著的调解者.
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