基于孟德尔随机化探讨原发性甲状腺功能减退症与肠易激综合征的因果关系及相关病机  

Analysis on Causality and Pathogenesis of Primary Hypothyroidism and Irritable Bowel Syndrome Based on Mendelian Randomization

作　　者：宋帅 杜冬青[2] 贾聪聪 周悦 马玉侠[2] SONG Shuai;DU Dongqing;JIA Congcong;ZHOU Yue;MA Yuxia(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;College of Acupuncture,Moxibustion and Tuina,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Affiliated Occupational Disease Hospital,Shandong First Medical University,Jinan 250002,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学针灸推拿学院,山东济南250355 [3]山东第一医科大学附属职业病医院,山东济南250002

出　　处：《山东中医药大学学报》2024年第4期434-439,共6页Journal of Shandong University of Traditional Chinese Medicine

基　　金：山东省自然科学基金面上项目(编号:ZR2021MH373)。

摘　　要：目的:采用孟德尔随机化(MR)方法探究原发性甲状腺功能减退症与肠易激综合征(IBS)的因果关系,并分析二者中医病机特点。方法:利用全基因组关联研究(GWAS)数据进行MR分析,以原发性甲状腺功能减退症为暴露因素,以IBS为结局变量。采用方差反加权法(IVW)作为主要研究指标,同时采用MREgger、加权中位数法、加权模式法等方法保证MR结果的可靠性;进行异质性检验、敏感性分析、多效性分析保证研究结果的稳定性。结果:原发性甲状腺功能减退症对IBS有因果关系,IVW(OR=1.08,95%CI为1.01~1.16,P=0.02)。IBS对原发性甲状腺功能减退症有因果关系,IVW(OR=1.11,95%CI为1.03~1.20,P=0.006)。结论:原发性甲状腺功能减退症可以增加IBS的患病风险,IBS亦可增加原发性甲状腺功能减退症的患病风险。肝郁脾虚、肾阳亏虚是两者互为因果关系及共病的主要中医病机。Objective:To investigate the causal relationship between primary hypothyroidism and irritable bowel syndrome(IBS)by using Mendelian randomization(MR)method,and to analyze the pathogenesis characteristics of traditional Chinese medicine in both.Methods:Genome-wide association study(GWAS)data were used for MR analysis,with primary hypo-thyroidism as the exposure factor and IBS as the outcome variable.Inverse weighting of variance(IVW)was adopted as the main research index,and MR-Egger,weighted median method,weighted model method and other methods were adopted to ensure the reliability of MR.Heterogeneity test,sensitivity analysis and pleiotropy analysis were carried out to ensure the stability of the study results.Results:Primary hypothyroidism had a causal relationship with IBS,IVW(OR=1.08,95%CI was 1.01~1.16,P=0.02).IBS was causally associated with primary hypothyroidism,IVW(OR=1.11,95%CI was 1.03~1.20,P=0.006).Conclusions:Primary hypothyroidism can increase the risk of IBS,and IBS can also increase the risk of primary hypothyroidism.Liver stagnation spleen deficiency,kidney yang deficiency were main pathogenesis of Traditional Chinese Medicine of mutual causality and comorbidity between them.

关 键 词：原发性甲状腺功能减退症 肠易激综合征 孟德尔随机化 肝郁脾虚 肾阳亏虚 治未病 

分 类 号：R256.3[医药卫生—中医内科学] R581.2[医药卫生—中医学]