利尿剂与跌倒和手腕骨折的关联:孟德尔的随机化研究
Fei Liu1, Jun-Ze Dai1, Xiao-Xi Deng1
1Department of Orthopedics, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Frontiers in public health
|November 11, 2024
概括
循环利尿剂 (LDs) 和节利尿剂 (PSDs) 会增加老年人的跌倒风险. 酸性尿剂 (TDs) 不会导致跌倒,并可能降低手腕骨折的风险.
科学领域:
- 药物基因组学 药物基因组学
- 老年医学 老年医学
- 流行病学 流行病学
背景情况:
- 之前的研究表明,在老年人中,尿液剂和跌倒之间存在联系,但根据尿液剂的类型,研究结果会有所不同.
- 特定利尿剂与手腕骨折风险之间的关系尚不清楚.
- 门德尔的随机化被用来研究因果关系.
研究的目的:
- 为了确定不同类型的利尿剂 (循环,节, thiazide) 与跌倒风险之间的关联.
- 调查利尿剂与手腕骨折风险之间的关联.
- 利用门德尔的随机化来建立因果关系.
主要方法:
- 使用了两个样本的门德尔随机化 (MR) 方法.
- 与循环利尿剂 (LDs),节利尿剂 (PSDs) 和 thiazide利尿剂 (TDs) 相关的基因预测单核酸多态 (SNPs) 作为仪器变量.
- 逆方差加权 (IVW) 是主要的分析方法,辅以加权中位数,MR-Egger和基于模式的方法进行灵敏度分析.
主要成果:
- 下肢损伤和后肢损伤与跌倒的风险增加有关 (分别为OR=1.012,P=0.022;OR=1.024,P=0.010).
- TDs没有显示出与跌倒风险增加的显著关联.
- TDs显示了与手腕骨折风险的保护性关联 (OR=0.833,P<0.001).
结论:
- LD和PSD因果上增加了老年人跌倒的发生率.
- TDs与跌倒没有因果关系,可以降低手腕骨折的风险.
- 利尿剂的临床使用需要仔细考虑跌倒和骨折的风险,需要预防策略.
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