胃食管反流病与阻塞性睡眠呼吸暂停之间的关系:孟德尔随机化研究  

Association between gastroesophageal reflux disease and obstructive sleep apnea:aMendelian randomization study

作　　者：焦欣 邵阿雪 何清清 吴文玉 刘建博[1,2] 王凯 JIAO Xin;SHAO Axue;HE Qingqing;WU Wenyu;LIU Jianbo;WANG Kai(The First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405,P.R.China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,P.R.China)

机构地区：[1]广州中医药大学第一临床医学院,广州510405 [2]广州中医药大学第一附属医院,广州510405

出　　处：《中国循证医学杂志》2024年第9期1004-1010,共7页Chinese Journal of Evidence-based Medicine

基　　金：国家中医药传承创新中心科研专项项目(编号:2022QN24);广东省医学科学技术研究基金项目(编号:B2023051)。

摘　　要：目的使用孟德尔随机化(Mendelian randomization,MR)方法探讨胃食管反流病(gastroesophageal reflux disease,GERD)与阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)及其典型症状(打鼾、白天嗜睡)之间的因果关联。方法采用逆方差加权法(inverse variance-weighted,IVW)作为主要的分析方法来评估因果关系,以留一法进行敏感性分析,MR-Egger法进行多效性分析,然后进行异质性检验。结果在MR分析中,基因预测的GERD与更高的OSA风险相关[IVW:OR=1.528,95%CI(1.374,1.699),P=5.315E-15],其他的MR分析结果与IVW结果一致,没有发现多效性和异质性。IVW法分析结果也显示GERD与打鼾[OR=0.959,95%CI(0.949,0.969),P=1.507E-15]、白天嗜睡[OR=1.024,95%CI(1.021,1.036),P=4.580E-5]之间存在因果关系,未发现多效性。结论本研究支持GERD与OSA及典型症状(打鼾、白天嗜睡)发生的风险之间存在因果关系。Objective To investigate the causal relationship between gastroesophageal reflux disease(GERD)and obstructive sleep apnea(OSA)with its typical symptoms(snoring and daytime sleepiness)by using Mendelian randomization(MR).Methods The inverse-variance weighted method was used as the main analysis method to assess the causal effect.Sensitivity and pleiotropy analyses were carried out using leave-one-out and MR-Egger analysis,and then heterogeneity tests were conducted.Results In the MR analysis,genetically predicted GERD was associated with a greater risk of OSA(IVW:OR=1.528,95%CI 1.374 to 1.699,P=5.315E‒15).Additional MR results were consistent with the IVW results,and no pleiotropy or heterogeneity was found.We also discovered a significant causal relationship between GRED and snoring(IVW:OR=0.959,95%CI 0.949 to 0.969,P=1.507E‒15),and daytime sleepiness(IVW:OR=1.024,95%CI 1.021 to 1.036,P=4.580E‒5),with no evidence of pleiotropy.Conclusion The MR study supports a causal effect between GERD and OSA with its typical symptoms(daytime sleepiness and snoring).

关 键 词：胃食管反流病 阻塞性睡眠呼吸暂停 打鼾 白天嗜睡 孟德尔随机化 因果关系 

分 类 号：R766[医药卫生—耳鼻咽喉科] R571[医药卫生—临床医学]