肥胖、外周血血脂指标与非小细胞肺癌的孟德尔随机化研究  

Associations of obesity and peripheral blood lipid indicators with non-small cell lung cancer:a Mendelian randomization study

作　　者：白勇[1] 李萍[1] 姜楠[1] BAI Yong;LI Ping;JIANG Nan(Department of Respiratory Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院呼吸内科,河南郑州450052

出　　处：《预防医学》2024年第6期518-522,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：河南省医学科技攻关计划项目(2018020097)。

摘　　要：目的采用孟德尔随机化(MR)方法探究肥胖、外周血血脂指标与非小细胞肺癌(NSCLC)的因果关系,为制定NSCLC防控策略提供依据。方法通过全基因组关联研究(GWAS)及相关公开数据库收集体质指数(BMI)、体脂率(BFR)、腰臀比(WHR)3种肥胖评价指标,以及三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)和脂蛋白a[LP(a)]7种外周血血脂指标资料,采用随机效应模型的逆方差加权法和多因素MR分析肥胖、外周血血脂指标与NSCLC的因果关系。采用Cochran Q检验和MR-Egger回归法评估工具变量的异质性和水平多效性。结果BMI与NSCLC存在统计学关联(OR=1.256,95%CI:1.087~1.451);BFR、WHR及7种外周血血脂指标与NSCLC无统计学关联(均P>0.005)。BMI、BFR、WHR、TG、HDL-C与NSCLC的关联存在异质性(均P<0.05);未发现工具变量的水平多效性(均P>0.05)。调整BFR后,BMI与NSCLC无统计学关联(OR=1.367,95%CI:0.878~2.128);分别调整WHR、外周血血脂指标后,BMI与NSCLC仍有统计学关联(均P<0.05)。结论BMI升高与NSCLC发病风险升高有关,BFR是BMI与NSCLC关联的潜在影响因素。Objective To examine the causal relationships between obesity,peripheral blood lipid indicators and non small cell lung cancer(NSCLC)using Mendelian randomization(MR)method,so as to provide the basis for developing NSCLC prevention and control strategies.Methods Genetic variation data of three obesity evaluation indicators,including body mass index(BMI),body fat ratio(BFR)and waist-to-hip ratio(WHR),and seven peripheral blood lipid indicators,including triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB)and lipoprotein a[LP(a)]were collected through genome-wide association studies(GWAS)and related public databases.Potential causal relationships between obesity,peripheral blood lipid indicators and NSCLC were analyzed using inverse-variance weighted(IVW)method and multivariable MR analysis upon a random effect model.Heterogeneity and horizontal pleiotropy of instrumental variables were evaluated using Cochran's Q test and MR-Egger regression.Results There was statistically association between BMI with NSCLC(OR=1.256,95%CI:1.087-1.451);there were no statistically associations between BFR,WHR,seven peripheral blood lipid indicators and NSCLC(all P>0.005).There was heterogeneity in the association between BMI,BFR,WHR,TG,HDL-C and NSCLC(all P<0.05);no horizontal pleiotropy of instrumental variables was found(all P>0.05).There was no statistically association between BMI and NSCLC after adjusting BFR(OR=1.367,95%CI:0.878-2.128);there was still statistically association between BMI and NSCLC after adjusting WHR and peripheral blood lipid indicators(both P<0.05).Conclusions The increase of BMI is associated with the increased risk of NSCLC incidence.BFR may be a potential influencing factor for the association between BMI and NSCLC.

关 键 词：肥胖 血脂 非小细胞肺癌 关联 体质指数 体脂率 

分 类 号：R734.2[医药卫生—肿瘤]