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双向的双样本门德尔随机化研究,研究甲状腺功能低下症和心血管疾病之间的因果关系
Jianing Chi1, Sheng Qiu, Wenqiang Ma
1Naval Submarine Academy, Qingdao, China.
甲状腺功能低下症显著增加心肌梗塞,冠状动脉疾病,心力衰竭和高血压的风险. 心力衰竭也因果上增加了甲状腺功能低下的风险,突出了双向的心血管疾病途径.
科学领域:
- 遗传学和心血管医学
- 内分泌学和公共卫生
背景情况:
- 甲状腺功能低下症和心血管疾病 (CVD) 之间的关系是复杂的,观察性研究表明了相关性.
- 因果推断对于了解甲状腺功能低下是否是心血管疾病的危险因素或相反至关重要.
研究的目的:
- 用双向门德尔随机化方法研究甲状腺功能低下症和主要心血管疾病之间的因果关系.
- 评估甲状腺功能低下对心肌梗塞,冠状动脉疾病,心力衰竭和高血压的影响.
- 为了确定这些心血管疾病是否相互影响甲状腺功能低下症的风险.
主要方法:
- 进行了一种双向的双样本孟德尔随机化 (MR) 分析.
- 用全基因组关联研究总结数据来识别单核酸多态性作为仪器变量.
- 用多种MR方法 (反变量加权,加权中位数,MR-Egger) 和灵敏度分析 (异质性,多重性,留出一个) 来进行可靠的推断.
主要成果:
- 基因预测的甲状腺功能低下症导致心肌梗塞 (OR=3.003),冠心病 (OR=2.780),心力衰竭 (OR=1.892) 和高血压 (OR=1.102) 的风险增加.
- 反向MR分析表明,心力衰竭因果上增加了甲状腺功能低下的风险 (OR=1.006).
- 灵敏度分析证实了无变性和发现的稳定性.
结论:
- 甲状腺功能低下是多种心血管疾病的重要因果风险因素,包括心肌梗塞,冠状动脉疾病,心力衰竭和高血压.
- 存在一种相互的因果关系,心力衰竭也会增加患甲状腺功能低下症的风险.
- 这些发现强调了甲状腺功能作为心血管风险改变者的重要性,并突出了甲状腺功能障碍和心血管疾病之间的双向途径.
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