肥胖与急性呼吸窘迫综合征的孟德尔随机化研究  

Causal relationship between obesity and acute respiratory distress syndrome:evidence from Mendelian randomization

作　　者：梁明昊 任秀红 靳敏燕 许一飞 许志伟 孙莉莉 陈宪海[5] 邱占军[6] Liang Minghao;Ren Xiuhong;Jin Minyan;Xu Yifei;Xu Zhiwei;Sun Lili;Chen Xianhai;Qiu Zhanjun(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东大学齐鲁医院重症医学科,山东济南250014 [3]山东中医药大学针炙推拿学院,山东济南250014 [4]山东中医药大学中医学院,山东济南250014 [5]山东中医药大学附属医院呼吸与危重症医学科,山东济南250014 [6]山东中医药大学附属医院老年医学一科,山东济南250014

出　　处：《中国急救医学》2024年第7期586-592,共7页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金面上项目(82274320);国家自然科学基金面上项目(82374379);山东省自然科学基金项目(ZR2020MH392);山东省自然科学联合基金项目(ZR2021LZY027)。

摘　　要：目的 探讨肥胖与急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的遗传因果效应。方法 使用公开的全基因组关联汇总数据,进行双样本双向孟德尔随机化(Mendelian randomization, MR)分析。分别从开放全基因组关联研究(IEU Open GWAS)数据库和芬兰数据库(FinnGen)获取肥胖的6种表型和ARDS的遗传数据。使用逆方差加权法(IVW)、MR-Egger法、加权中位数法和简单中位数法评估暴露与结局的因果关系。并对结果的异质性和水平多效性进行敏感性分析。结果 体重指数(OR=1.93,95%CI 1.20~3.10,P=0.007)、体质量(OR=1.93,95%CI 1.18~3.15,P=0.009)、全身脂肪量(OR=1.87,95%CI 1.12~3.11,P=0.017)、躯干脂肪量(OR=1.75,95%CI 1.07~2.87,P=0.027)及腰围(OR=2.22,95%CI 1.24~3.97,P=0.007)与ARDS有正向因果关系。在反向MR分析中,只有ARDS与腰围有显著关系(OR=1.00,95%CI 1.00~1.01,P=0.034)。敏感性分析未发现明显的异质性和水平多效性。结论 肥胖与ARDS之间具有因果关系,肥胖会增加ARDS的发生风险,肥胖患者作为ARDS的高风险人群,在临床中应当引起重视。Objective To discuss the genetic causal effect between obesity and acute respiratory distress syndrome(ARDS).Methods Two-sample bidirectional Mendelian randomization(MR)analysis was performed by using publicly available genome-wide association studies(GWAS)summary data.Genetic data for six phenotypes of obesity and ARDS were obtained from the IEU Open GWAS and FinGen,respectively.The causal relationship between exposure and outcome was evaluated by using inverse variance weighted,MR-Egger,weighted median,and simple median methods.Sensitivity analysis was also performed to analyze the heterogeneity and horizontal pleiotropy of the results.Results There was a positive causal relationship of body mass index(OR=1.93,95%CI 1.20-3.10,P=0.007),body weight(OR=1.93,95%CI 1.18-3.15,P=0.009),total body fat mass(OR=1.87,95%CI 1.12-3.11,P=0.017),trunk fat mass(OR=1.75,95%CI 1.07-2.87,P=0.027),waist circumference(OR=2.22,95%CI 1.24-3.97,P=0.007)with ARDS.In the reverse MR analysis,there was significance only between ARDS and waist circumference(OR=1.00,95%CI 1.00-1.01,P=0.034).Sensitivity analysis showed no significant heterogeneity or horizontal pleiotropy was found.Conclusions There is a causal relationship between obesity and ARDS,and obesity increases the risk of developing ARDS.Obese patients,as a high-risk group for ARDS,should be emphasized in clinical practice.

关 键 词：肥胖 腰围 急性呼吸窘迫综合征(ARDS) 孟德尔随机化(MR) 因果推断 双样本 双向 

分 类 号：R563.8[医药卫生—呼吸系统]