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贝叶斯加权的门德尔随机化揭示睡眠呼吸暂停综合征介导着BMI-慢性疼痛联系
Wenbao Shi1, Jing Luo1, Liu Yang2
1Department of Anesthesiology, Affiliated Hospital of Kunming University of Science and Technology, the First People's Hospital of Yunnan Province, Kunming, China.
Journal of thoracic disease
|July 21, 2025
概括
高体重指数 (BMI) 与慢性疼痛有因果关系,睡眠呼吸暂停综合征 (SAS) 调解了一些影响. 管理BMI和治疗SAS可能会降低慢性疼痛风险.
科学领域:
- 遗传学 是一个遗传学.
- 流行病学 流行病学
- 疼痛医学 医学 疼痛医学
背景情况:
- 身体质量指数 (BMI) 与慢性疼痛疾病有着复杂的关联.
- 睡眠呼吸暂停综合征 (SAS) 可能会影响BMI和慢性疼痛之间的关系.
- 需要确认SAS在BMI-慢性疼痛途径中的调解作用.
研究的目的:
- 调查睡眠呼吸暂停综合征 (SAS) 是否调解人体质量指数 (BMI) 和慢性疼痛之间的因果关系.
- 量化SAS在多种慢性疼痛疾病上调解BMI影响的程度.
- 用贝叶斯加权孟德尔随机化 (BWMR) 来进行因果推理.
主要方法:
- 采用两样,两步的门德尔随机化 (MR) 设计,使用全基因组关联研究 (GWAS) 的BMI,SAS和欧洲人口的慢性疼痛总结数据.
- 使用贝叶斯加权门德尔随机化 (BWMR) 和反变量加权 (IVW) 方法.
- 进行了敏感性分析,包括MR-PRESSO,MR-Egger回归和Cochran的Q测试,以确保稳定性.
主要成果:
- 确认了BMI和慢性疼痛疾病之间的显著遗传关联,包括四肢疼痛,腰部疼痛,带有或没有坐骨折的腰部疼痛和胸部脊柱疼痛.
- 发现BMI的遗传倾向与睡眠呼吸暂停综合征 (SAS) 的风险之间存在强烈联系.
- 调解分析表明,SAS调解了BMI对四肢疼痛 (15.3%),腰部疼痛 (26.8%) 和带有或没有坐骨神经炎的腰部疼痛 (26.8%) 的因果作用的很大一部分.
结论:
- 建立了BMI和慢性疼痛之间的因果关系,SAS作为部分调解者.
- 临床策略应优先考虑维持正常的BMI范围,以减少慢性疼痛的发生率.
- 在患有高BMI和并发性SAS的人群中,向SAS治疗可能会缓解与BMI相关的慢性疼痛.
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