慢性阻塞性肺病和心血管疾病之间的双向因果关联:孟德尔的随机化研究
Guangzan Yu1, Lulu Liu1, Qian Ma1
1Cardiac Division of Emergency Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People's Republic of China.
这项研究使用了门德尔的随机化来调查慢性阻塞性肺病 (COPD) 和心血管疾病 (CVD) 之间的因果关系. 慢性肺炎导致心力衰竭,基本高血压和中风的风险增加,而BMI和吸烟是关键调解因素.
科学领域:
- 心血管研究研究心血管研究
- 肺部医学 肺部医学
- 遗传流行病学遗传流行病学
背景情况:
- 在慢性阻塞性肺病 (COPD) 和心血管疾病 (CVD) 之间存在已确定的联系.
- 确切的因果方向和COPD和心血管疾病之间的潜在反向因果关系仍然不完全理解.
研究的目的:
- 使用孟德尔随机化阐明基因预测的COPD和各种心血管疾病之间的因果关系.
- 确定COPD到心血管疾病的因果途径中的潜在调解因素.
主要方法:
- 利用大规模的全基因组关联研究数据进行门德尔随机化 (MR) 分析.
- 采用逆方差权衡 (IVW) 进行初级单变量MR分析,并补充了灵敏度和多变量MR分析.
- 研究了BMI,吸烟状况和FEV1.1等因素的调解效应.
主要成果:
- 基因预测的COPD显示与心力衰竭 (HF),基本高血压 (EH) 和中风有显著的因果关系.
- 经过对混因素进行调整后,COPD和冠心病 (CHD) 之间的关联并不显著.
- 身体质量指数 (BMI),肥胖,吸烟开始,吸烟状态和FEV1被确定为显著的调解因素.
结论:
- 证实了COPD与HF,EH和中风之间的积极因果关系,基本上独立于混因素.
- 似乎COPD和CHD之间的因果关系受到混变量的影响.
- 体重指数,肥胖,吸烟行为和肺功能 (FEV1) 调解了COPD对心血管结果的因果关系.
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