身体质量指数与静脉血栓栓塞的关联——双向孟德尔随机化研究  

Association between body mass index and venous thromboembolism:a bidirectional Mendelian randomization study

作　　者：郭展立 李嘉媛 张磊 王媛 李若柠 冬颖[2] 孙建军[2] GUO Zhan-li;LI Jia-yuan;ZHANG Lei;WANG Yuan;LI Ruo-ning;DONG Ying;SUN Jian-jun(Pharmacy Department,Affiliated Hospital of Inner Mongolia Medical University;不详)

机构地区：[1]内蒙古医科大学药学院,内蒙古呼和浩特010107 [2]内蒙古医科大学附属医院药学部,内蒙古呼和浩特010059

出　　处：《现代预防医学》2024年第19期3636-3642,共7页Modern Preventive Medicine

基　　金：国家自然科学基金地区项目(81960770);内蒙古自治区卫生健康科技计划项目(202202184);内蒙古自治区“草原英才”工程青年创新人才(一层次)支持项目(Q2022084);内蒙古自治区高等学校科学研究项目(NJZY22623);内蒙古医科大学重点项目(YKD2023ZD002);内蒙古医科大学“致远”人才项目(ZY20242133)。

摘　　要：目的 本研究旨在验证身体质量指数(BMI)与静脉血栓栓塞(VTE)之间的因果关联并探讨两者之间是否存在相互作用。方法 利用孟德尔随机化(MR)分析方法,以BMI相关的遗传变异基因作为工具变量,以VTE发生风险作为结局变量,采用逆方差加权法(IVW)为主要分析方法,MR-Egger回归法、加权中位数、简单众数及加权众数法作为补充,对BMI与VTE之间的因果关联进行分析,再进行反向MR分析;为更进一步验证其因果关系,同时开展了BMI对深静脉血栓(DVT)形成与肺栓塞的MR分析。结果 BMI对VTE发生风险在遗传预测上具有因果关联,其中IVW(OR=1.376,95%CI:1.109~1.706,P=3.68×10^(-3))、MR-Egger(OR=1.755,95%CI:0.917~3.359,P=0.094)、加权中位数法(OR=1.483,95%CI:1.145~1.921,P=2.86×10^(-3))、简单众数法(OR=1.390,95%CI:0.760~2.542,P=0.288)、加权众数法(OR=1.449,95%CI:0.927~2.266,P=0.109)的结果不能表明BMI对DVT形成与肺栓塞发生风险在遗传预测上有因果关联;其中IVW(OR=0.997,95%CI:0.979~1.015,P=0.724)、MR-Egger(OR=0.994,95%CI:0.957~1.032,P=0.753)、加权中位数法(OR=0.994,95%CI:0.969~1.019,P=0.610)、简单众数法(OR=0.991,95%CI:0.954~1.029,P=0.642)、加权众数法(OR=0.996,95%CI:0.967~1.025,P=0.790)的结果不能表明VTE对BMI高低在遗传预测上有因果关联。结论 BMI对VTE风险在遗传预测上有因果关联,BMI升高可能会增加VTE的发生风险;不能表明VTE对BMI在遗传预测上有因果关联。需进一步研究来了解这种因果关系背后的潜在生物学机制。Objective To verify the causal association between body mass index(BMI)and venous thromboembolism(VTE)and to explore whether there is an interaction between the two.Methods Using Mendelian randomization analysis,genetic variants associated with BMI were employed as instrumental variables,while the risk of VTE occurrence served as the out-come variable.The inverse variance weighted method(IvW)was used as the primary analytical approach,supplemented by MR-Egger regression,weighted median,simple mode,and weighted mode methods to analyze the causal association between BMI and VTE.Additionally,reverse Mendelian randomization analysis was conducted.To further validate the causal rela-tionship,MR analyses of BMI concerning deep vein thrombosis(DVT)and pulmonary embolism(PE)were also performed.Results There was a causal association between BMI and the risk of VTE based on genetic prediction,with IVW(OR=1.376,95%CI:1.109-1.706,P=3.68x10-);MR-Egger(OR=1.755,95%CI:0.917-3.359,P=0.094);weighted median method(OR=1.483,95%CI:1.145-1.921,P=2.86x10-);simple mode method(OR=1.390,95%CI:0.760-2.542,P=0.288);and weighted mode method(OR=1.449,95%CI:0.927-2.266,P-0.109).No causal association was found between BMI and the risk of DVT or PE based on genetic prediction.Furthermore,it could not be established that VTE causally influences BMI levels,with IVW(OR=0.997,95%CI:0.979-1.015,P=0.724);MR-Egger(OR=0.994,95%CI:0.957-1.032,P=0.753);weighted median method(OR=0.994,95%CI:0.969-1.019,P=0.610);simple mode method(0R=0.991,95%CI:0.954-1.029,P=0.642);and weighted mode method(OR=0.996,95%Cl:0.967-1.025,P=0.790).Conclusion There is a causal association between BMI and the risk of VTE based on genetic prediction,suggesting that an increase in BMI may elevate the risk of VTE.However,no causal association is found indicating that VTE affects BMI genetically.Further research is needed to understand the underlying biological mechanisms of this causal relationship.

关 键 词：静脉血栓栓塞 血栓栓塞疾病 身体质量指数 孟德尔随机化 

分 类 号：R543.6[医药卫生—心血管疾病]