胃食管返流与房颤之间因果关联的孟德尔随机化研究  

A mendelian randomization study of the causal association between gastroesophageal reflux and atrial fibrillation

作　　者：黄雪 王远涵 张晓熙 杨顷落 高雪 武淑琴 HUANG Xue;WANG Yuanhan;ZHANG Xiaoxi;YANG Qingluo;GAO Xue;WU Shuqin(Department of Health Statistics,Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学公共卫生学院卫生统计教研室,山西太原030001

出　　处：《公共卫生与预防医学》2023年第6期16-20,共5页Journal of Public Health and Preventive Medicine

基　　金：国家自然科学基金(82103949)。

摘　　要：目的为研究胃食管返流病(gastroesophageal reflux disease,GERD)与房颤(atrial fibrillation,AF)之间潜在的关联,采用两样本孟德尔随机化方法(mendelian randomization,MR)进行因果推断,有效解决传统流行病学中反向因果和混杂因素等问题。方法从已发表的全基因组关联研究(genome wide association study,GWAS)中获得GERD和AF的欧洲人群汇总数据,选取逆方差加权法(inverse variance weighted,IVW),加权中位数法(weighted median,WME),MR-Egger法,简单中位数法(simple mode),基于模式的估计法(weighted mode)五种MR分析方法,另外采用MR-PRESSO法,Cochran's Q test检验等作为敏感性分析方法。结果IVW方法表明了GERD和AF之间存在因果关联(P<0.0001,OR=1.16,95%CI:1.10~1.23)。WME法P<0.0001,OR=1.20,95%CI:1.11~1.30;Simple Mode法P=0.01,OR=1.34,95%CI:1.07~1.69;Weighted Mode法P=0.02,OR=1.33,95%CI:1.06~1.66。结论研究基于遗传数据认为GERD和AF之间存在因果关联,GERD会增加AF发生的风险。Objective In this study,we performed two sampie mendelian randomization to infer a causal association between gastroesophageal reflux(GERD)and atrial fibrillation(AF),it can effectively avoid the problems such as reverse causation and confounds in traditional epidemiology.Methods We used the summary data of GERD and AF from published genome wide association study(GWAS)of European individuals.Single nucleotide polymorphisms(SNPs)were extracted as instrumental variables(IVs).The main MR methods include inverse variance weighted(IVW),weighted median(WME),MR-Egger,simple mode,and weighted mode.In addition,we used the sensitivity analysis such as MR-PRESSO,Cochran's Q test etc.Results The IVW shows a causal association between GERD and AF(P<0.0001,OR=1.16,95%CI:1.10-1.23).The WME shows P<0.0001,OR=1.20,95%CI:1.11-1.30;Simple mode shows P=0.01,OR=1.34,95%CI:1.07-1.69;Weighted mode shows P=0.02,OR=1.33,95%CI:1.06-1.66.Conclusion This study based on genetic data supports the causal association between GERD and AF.The occurrence of GERD could increase the risk of AF.

关 键 词：胃食管反流 房颤 孟德尔随机化 因果推断 

分 类 号：R181[医药卫生—流行病学]