药物使用与败血症之间的因果关系:一个双样本的孟德尔随机化研究
Mingfen Sun1, Yi Chen2, Zhaoquan Jin1
1Department of Emergency Medicine, The First People's Hospital of Changzhou, Changzhou, China.
Shock (Augusta, Ga.)
|March 18, 2025
概括
基因预测的利尿剂使用可能会增加败血症风险. 其他药物的证据,包括糖尿病药物和甲状腺制剂,在本门德尔随机化研究中是不确定的.
科学领域:
- 药物基因组学 药物基因组学
- 传染病流行病学 传染病流行病学
背景情况:
- 败血症是一种危及生命的疾病,具有显著的发病率和死亡率.
- 了解先前药物使用对败血症风险的影响对于预防和治疗策略至关重要.
研究的目的:
- 调查基因预测药物使用与发生败血症的风险之间的潜在因果关系.
- 使用强大的遗传方法,区分潜在的关联和因果关系.
主要方法:
- 采用两个样本的孟德尔随机化 (MR) 设计,使用全基因组关联研究 (GWAS) 的总结数据.
- 使用反变量加权 (IVW),加权中位数和MR-Egger回归方法进行初级分析.
- 进行了敏感性分析,包括MR-Egger,MR-PRESSO,Cochran's Q和留出一个方法,以评估强度和排除性.
主要成果:
- 最初的分析表明,基因预测使用利尿剂,糖尿病药物,甲状腺制剂和上腺激素药物之间存在潜在的因果关系,并增加了败血症风险.
- 在调整了混因素后,只有基因预测的利尿剂使用仍然与更高的败血症风险有显著的关联 (OR = 1.17,P = 0.018).
- 敏感性分析表明,水平性或异质性影响利尿剂使用和败血症之间的关联的证据很少.
结论:
- 以前使用利尿剂可能会因果性地增加败血症的风险.
- 其他研究药物 (例如,糖尿病药物,甲状腺制剂) 和败血症风险之间的因果关系的证据在本研究中没有得到支持.
- 这些发现突出了利尿剂作为影响败血症风险的潜在因素,需要进一步的临床研究.
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