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骨质疏松症和姿势不稳定之间的因果关系:孟德尔的随机化研究
Kun Zhu1,2, ZiJie An2, YaWei Li3
1Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
低骨矿物质密度 (BMD) 因果上增加了姿势不稳定的风险. 这种遗传联系表明,骨质疏松症患者面临更高的平衡问题的风险.
科学领域:
- 骨生物学和老龄化问题
- 生物统计学和流行病学
- 遗传学和公共卫生
背景情况:
- 观察性研究表明,骨质疏松症和姿势不稳定性之间存在联系.
- 骨质疏松症和姿势不稳定之间确定的遗传因果关系尚不清楚.
研究的目的:
- 为了调查骨质疏松症之间的潜在因果关系,使用骨矿物质密度 (BMD) 作为代理,和姿势不稳定.
- 为了利用两个样本的门德尔随机化分析来进行强大的因果推理.
主要方法:
- 两个样本的孟德尔随机化 (MR) 分析使用反变量加权 (IVW),加权中位数和MR-Egger方法.
- 施泰格过,FDR校正,Cochran Q统计,MR-PRESSO,MR-Egger拦截和留出一个分析被用于严格评估和灵敏度分析.
- 与BMD相关的遗传变异 (大腿部,腰椎和前臂) 被用作仪器变量.
主要成果:
- 在部部BMD (FN-BMD) 和姿势不稳定性 (OR=0.9171,FDR P=0.0009) 之间发现了显著的负因果相关性.
- 腰椎骨髓骨质损伤 (LS-BMD) 也显示出与姿势不稳定 (OR=0.9491,FDR P=0.0129) 有显著的负因果关系.
- 没有观察到前臂BMD (FA-BMD) 和姿势不稳定之间有显著的因果关系;敏感性分析证实FN-BMD和LS-BMD没有显著的异质性或性.
结论:
- 这项研究提供了遗传证据,证明 BMD 减少和姿势不稳定性增加之间存在因果关系.
- 患有骨质疏松症的个体,其特征是较低的BMD,可能有经历姿势不稳定的风险较高.
- 准BMD可能是减轻姿势不稳定风险的潜在策略.
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