质子抑制剂与痴呆风险之间的因果关系:来自孟德尔随机化研究的证据
Mengmeng Ou1, Zhiqiang Du1, Rongrong Lu1
1Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China.
概括
像兰索普拉这样的质子抑制剂 (PPI) 可能会增加痴呆的风险,而奥梅普拉可能会增加前性痴呆的风险,降低血管性痴呆的风险. 这项研究为知情的PPI处方提供了洞察力.
科学领域:
- 药物基因组学 药物基因组学
- 神经科学是一个神经科学.
- 流行病学 流行病学
背景情况:
- 质子抑制剂 (PPI) 广泛用于与酸有关的胃肠道疾病.
- 新出现的证据表明,PPI使用与认知衰退之间存在潜在的关联,需要进行因果调查.
- 了解不同PPI对各种痴呆症亚型的特定风险对于临床实践至关重要.
研究的目的:
- 调查两种常见的PPI,兰索普拉 (LAN) 和奥梅普拉 (OME) 之间的潜在因果关系,以及痴呆症 (DEM) 和其亚型的风险.
- 为合理的临床决策提供基于证据的参考资料,以提供关于PPI使用的合理临床决策.
主要方法:
- 在基因组广泛关联研究 (GWAS) 的总结数据上利用孟德尔随机化 (MR) 分析.
- 作为暴露因素,研究了兰索普拉 (LAN) 和奥梅普拉 (OME).
- 评估结果包括痴呆症 (DEM) 和五种亚型:阿尔茨海默氏症痴呆症 (DAD),血管痴呆症 (VD),帕金森病导致的痴呆症 (DPD),勒维体痴呆症 (DLB) 和前性痴呆症 (FTD).
- 采用了反变量加权 (IVW) 方法,并补充了其他MR方法和灵敏度分析.
主要成果:
- 兰索普拉 (LAN) 与整体痴呆症 (DEM) 和阿尔茨海默氏症痴呆症 (DAD) 有显著的积极因果关系.
- 奥梅普拉 (OME) 与前性痴呆症 (FTD) 有显著的积极因果关系,与血管性痴呆症 (VD) 有显著的负面因果关系.
- 没有发现LAN与VD,DPD,DLB或FTD的显著因果关系,也没有发现OME与DEM,DAD,DPD或DLB的因果关系.
结论:
- 兰索普拉 (LAN) 的使用可能与患痴呆症和阿尔茨海默氏症痴呆症的风险增加有关.
- 欧米 (OME) 的使用可能与前性痴呆症的风险增加和血管性痴呆症的风险降低有关.
- 这些发现突出了与特定的PPI和痴呆症亚型相关的差异性风险,为PPI处方提供了临床指导.
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