可干预因素与关节运动损伤的因果关系  

Causal relationship between modifiable factors and joint sports injuries

作　　者：董婷婷 陈天鑫 李妍 张晟[1] 张磊[1] Dong Tingting;Chen Tianxin;Li Yan;Zhang Sheng;Zhang Lei(Forth Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院骨关节四科,北京市100102

出　　处：《中国组织工程研究》2025年第9期1953-1962,共10页Chinese Journal of Tissue Engineering Research

基　　金：中央级公益性科研院所基本科研业务费专项资金资助(ZZ15-XY-CT-10),项目负责人:张磊;中国中医科学院科技创新工程-重大攻关项目(CI2021A02009),项目负责人:张磊。

摘　　要：背景:生活方式、代谢特征及营养摄入等干预因素与关节运动损伤的因果关系逐渐得到临床研究的重视,然而可干预因素与关节运动损伤的因果关系尚不明确。目的:运用孟德尔随机化的方法,探讨可干预因素与关节运动损伤的因果关系,为运动损伤预防提供依据。方法:从公开数据库获取可干预因素和关节运动损伤的GWAS数据集,运用逆方差加权法、MR-Egger法、加权中位数法探讨生活方式、代谢特征、营养摄入与关节运动损伤的因果关系。敏感性分析方面,采用Cochran’s Q检验、MR-Egger回归、留一法和MR-PRESSO,以验证结果的稳定性和可靠性。结果与结论:①生活方式方面,咖啡(OR=0.29,95%CI:0.10-0.79,P=0.016)、茶消耗量(OR=0.41,95%CI=0.19-0.85,P=0.017)与足踝关节运动损伤风险下降,咖啡消耗量(OR=3.31,95%CI=1.02-10.73,P=0.046)与肩关节运动损伤风险上升具有潜在因果关系;从未吸烟(OR=0.78,95%CI=0.70-0.87,P=1.49×10^(-5))与足踝关节运动损伤风险下降具有显著因果关系。②代谢特征方面,钙水平(OR=0.88,95%CI=0.79-0.98,P=0.017)与手腕关节运动损伤风险下降具有潜在因果关系。③营养摄入方面,维生素A摄入(OR=1.08,95%CI:1.02-1.13,P=0.007)与膝关节运动损伤风险增加具有潜在因果关系。④敏感性分析方面,Cochran’s Q检验显示存在异质性(P<0.05),故采用随机效应模型分析。MR-Egger回归、MR-PRESSO检验未发现水平多效性(P>0.05),留一法显示逐个剔除单核苷酸多态性后,结果具有稳定性。⑤此研究初步揭示生活方式、代谢特征及营养摄入等可干预因素对关节运动损伤风险的影响,为关节运动损伤的预防提供研究证据与研究方向。BACKGROUND:The causal relationship between modifiable factors such as lifestyle,metabolic characteristics,and nutritional intake and joint sports injuries has been increasingly recognized in clinical studies.However,the exact causal relationship between these modifiable factors and joint sports injuries remains unclear.OBJECTIVE:To investigate the causal relationship between modifiable factors and joint sports injuries using Mendelian randomization to provide a basis for sports injury prevention.METHODS:The GWAS dataset of intervening factors and joint sports injuries was obtained from publicly available data.The causal relationships between lifestyle,metabolic characteristics,nutritional intake,and joint sports injuries were explored using the inverse variance weighting method,the MR-Egger method,and the weighted median method.For sensitivity analyses,Cochran’s Q test,MR-Egger regression,leave-one-out method,and MR-PRESSO were used to verify the stability and reliability of the results.RESULTS AND CONCLUSION:(1)In terms of lifestyle,coffee(OR=0.29,95%CI:0.10-0.79,P=0.016),and tea consumption(OR=0.41,95%CI=0.19-0.85,P=0.017)were associated with a decreased risk of ankle and foot joint sports injuries,and coffee consumption(OR=3.31,95%CI=1.02-10.73,P=0.046)was potentially causally associated with an increased risk of shoulder joint sports injuries;and never smoking(OR=0.78,95%CI=0.70-0.87,P=1.49×10^(-5))was significantly causally associated with a decreased risk of ankle and foot joint sports injuries.(2)In terms of metabolic characteristics,calcium levels(OR=0.88,95%CI=0.79-0.98,P=0.017)were potentially causally associated with a decreased risk of wrist and hand joint sports injuries.(3)In terms of nutritional intake,vitamin A intake(OR=1.08,95%CI:1.02-1.13,P=0.007)was potentially causally associated with increased risk of knee joint sports injury.(4)For the sensitivity analysis,Cochran’s Q test showed the existence of heterogeneity(P<0.05),so the random effect model was used for the analysis.MR-Egger regres

关 键 词：孟德尔随机化 关节运动损伤 可干预因素 生活方式 代谢特征 营养摄入 因果关系 敏感性分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R873.1