基于“痰湿困脾”理论运用孟德尔随机化法探讨儿童发作性睡病与变应性鼻炎的因果关系  

A mendelian randomization study to explore the relationship between childhood narcolepsy and allergic rhinitis based on the theory of"phlegm-dampness impairing the spleen"

作　　者：戴雨晨 玛伊热·牙生 叶伟涛 张新光[1] Dai Yuchen;Mayire·Yasheng;Ye Weitao;Zhang Xinguang(Department of Paediatrics,Shanghai Municipal Hospital of TCM,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院儿科,上海200071

出　　处：《国际中医中药杂志》2024年第11期1419-1425,共7页International Journal of Traditional Chinese Medicine

基　　金：上海市进一步加快中医药传承创新发展三年行动计划(ZY〔2021-2023〕-0206-04)。

摘　　要：目的采用两样本孟德尔随机化(TSMR)法探究儿童发作性睡病与变应性鼻炎(AR)间是否存在因果关联,为临床防治提供参考。方法从欧洲人种的关联分析(GWAS)数据库中选择与发作性睡病密切相关的遗传位点作为工具变量,将AR作为结局变量进行分析。发作性睡病数据包含335410例样本量和10894596个单核苷酸多态性(SNP),AR包含5527例患者和212387例对照者,总计16380461个SNPs。采用逆方差加权法(IVW)、加权中位数法和MR-Egger回归法进行孟德尔随机化(MR)分析,并通过OR(95%CI)评估发作性睡病与AR的因果关系。采用异质性检验、多效性检验和敏感性分析,评估结果的稳定性和可靠性。结果共纳入42个SNPs位点作为工具变量,发现发作性睡病与AR的效应估计值>1且有统计学意义[OR(95%CI)=1.79(1.02,3.13),P=0.04]。结论发作性睡病与AR之间可能存在正向因果关联,“痰湿困脾”是两者之间共同病因病机。Objective To investigate the causal relationship between childhood narcolepsy and allergic rhinitis using two-sample Mendelian randomization;To provide references for clinical prevention and treatment.Methods Genetic variants closely related to narcolepsy were extracted from GWAS summary data as instrumental variables,with allergic rhinitis(AR)as the outcome variable.The narcolepsy data included 335410 samples and 10894596 single nucleotide polymorphisms(SNPs).The AR data included 5527 cases and 212387 controls,with a total of 16380461 SNPs.Two-sample Mendelian randomization analyses were conducted using inverse variance weighted,weighted median,and MR-Egger regression methods mainly to evaluate the causal relationship between narcolepsy and AR with OR.Heterogeneity testing,pleiotropy assessment,and sensitivity analysis were used to evaluate the stability and reliability of the results.Results A total of 42 SNPs were included as instrumental variables.It was found that the estimated effect of narcolepsy on AR was greater than 1 and with statistical significance[OR(95%CI)=1.79(1.02,3.13),P=0.04].Conclusions There may be a positive causal relationship between narcolepsy and AR."Phlegm-dampness impairing the spleen"is a common pathogenic mechanism between the two diseases.

关 键 词：发作性睡病 嗜睡症 鼻炎 变应性 孟德尔随机化 

分 类 号：R277.7[医药卫生—中医学] R276.1