基于两样本孟德尔随机化分析体质量指数与妊娠期高血压的关系  

Relationship between body mass index and gestational hypertension:a two-sample Mendelian randomization analysis

作　　者：胡梦巾 武德崴 李博宇[1] 夏经钢[1] 尹春琳[1] Hu Mengjin;Wu Dewei;Li Boyu;Xia Jinggang;Yin Chunlin(Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院心脏内科,北京100053

出　　处：《中国医师进修杂志》2024年第3期201-204,共4页Chinese Journal of Postgraduates of Medicine

基　　金：北京市心血管临床重点专科建设项目(京卫医〔2018〕)。

摘　　要：目的利用两样本孟德尔随机化探究体质量指数(BMI)与妊娠期高血压的关系。方法利用BMI与妊娠期高血压的全基因组关联研究汇总数据(数据纳入截止时间为2023年10月31日),通过逆方差加权法、MR-Egger回归法、加权中位数法、简单模型和加权模型进行两样本孟德尔随机化分析。采用Cochrane Q检验评估结果的异质性,MR-Egger回归截距和漏斗图检验结果的水平多效性。结果固定效应和随机效应模型下的逆方差加权结果显示,随着BMI的升高妊娠期高血压的风险也增加(OR=1.62和1.62,95%CI 1.39~1.88和1.39~1.88,P<0.01)。敏感性分析结果显示,MR-Egger回归法、加权中位数法和加权模型提示随着BMI的增加妊娠期高血压风险增加(OR=1.51、1.56和1.71,95%CI 1.01~2.26、1.23~1.99和1.09~2.69,P<0.05或<0.01)。尽管Cochrane Q检验结果显示存在异质性(P=0.04),但随机模型下的逆方差加权结果依然提示BMI会增加妊娠期高血压的风险,且未观察到水平多效性(P=0.73)。结论肥胖会增加妊娠期高血压的风险,孕妇要注意控制体质量以降低妊娠期高血压的风险。Objective To investigate the relationship between body mass index(BMI)and gestational hypertension using two-sample Mendelian randomization analysis.Methods The summary level data for BMI and gestational hypertension were obtained from the genome-wide association study(the deadline for data inclusion was October 31,2023).All data were analyzed by inverse variance weighting,MR-Egger regression,weighted median,simple model and weighted model methods.Cochrane Q test was used to evaluate heterogeneity,MR-Egger regression intercept test and funnel plot were used to assess horizontal pleiotropy.Results Inverse variance weighting result under fixed effects and random effects models showed that the risk of gestational hypertension increased with the increase of BMI(OR=1.62 and 1.62,95%CI 1.39 to 1.88 and 1.39 to 1.88,P<0.01).Sensitivity analysis results including MR-Egger regression,weighted median and weighted model methods showed that BMI increased the risk of gestational hypertension(OR=1.51,1.56 and 1.71;95%CI 1.01 to 2.26,1.23 to 1.99 and 1.09 to 2.69;P<0.05 or<0.01).Although Cochrane Q test result showed evidence of heterogeneity(P=0.04),inverse variance weighting under a random model suggested that BMI increased the risk of gestational hypertension.Horizontal pleiotropy was not observed in the above analysis(P=0.73).Conclusions Obesity may increase the risk of gestational hypertension.Pregnant women should pay attention to weight control to decrease the risk of gestational hypertension.

关 键 词：高血压 妊娠性 人体质量指数 孟德尔随机化分析 

分 类 号：R714.246[医药卫生—妇产科学]