喘和发病冠心病:一个观察性和门德尔随机化研究
Carlos A Valencia-Hernández1, Fabiola Del Greco M2, Varun Sundaram3
1National Heart and Lung Institute, Imperial College London, London, UK.
The European respiratory journal
|November 9, 2023
概括
喘不是冠状动脉心脏病 (CHD) 的危险因素. 观察性和门德尔随机化研究的三角测量证实没有显著的关联,挑战了以前的发现.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 流行病学 流行病学
- 遗传学 是一个遗传学.
背景情况:
- 观察性研究表明喘和冠状动脉心脏病 (CHD) 之间存在联系,可能存在性别特异性风险变化.
- 之前研究的方法限制,如检测偏差和混,可能影响了这些发现.
- 采用了使用多种方法的三角化方法,以增加对结果的信心.
研究的目的:
- 调查喘和发病冠心病 (CHD) 之间的关联.
- 为了确定性别是否改变了喘和心脏病之间的关系.
- 通过采用强大的多方法方法方法,克服先前研究的局限性.
主要方法:
- 一项使用英国医疗记录的观察性研究将喘患者 (1:1) 与对照人匹配,调整为混因素和医疗保健行为.
- 一项孟德尔随机化 (MR) 研究,利用来自英国生物银行,TAGC和CARDIoGRAM联盟的遗传数据.
- 分析涉及反向方差加权的元分析和解决类型的方法.
主要成果:
- 观察性研究最初显示,心脏病风险增加了6% (HR 1.06),在考虑医疗保健行为 (HR 0.99) 后消失了.
- 性别改变了观察数据中的关联 (女性:HR 1.11;男性:HR 0.91),但这在MR研究中没有观察到.
- 门德尔的随机化研究发现喘和心血管疾病之间没有显著的关联 (OR 1.01),没有性别修改.
结论:
- 喘不是冠状动脉心脏病 (CHD) 的重要危险因素.
- 以前的关联可能归因于观察性研究中的检测偏差或残留混.
- 这些发现凸显了流行病学研究中强大的方法论的重要性.
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