应用孟德尔随机化研究微量营养素与免疫介导的炎症性皮肤病风险之间的因果关系  

Causal associations between micronutrients concentrations and the risk of immune-mediated inflammatory skin diseases by using Mendelian randomization study

作　　者：金速速 宋丽茹 刘秀静 王颖颖 邵姣 JIN Susu;SONG Liru;LIU Xiujing;WANG Yingying;SHAO Jiao(Department of Clinical Laboratory,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第二医院临床检验中心,浙江温州325000

出　　处：《中国现代医生》2025年第6期24-29,共6页China Modern Doctor

基　　金：温州市公益性科技计划项目(Y2023767)。

摘　　要：目的 探究微量营养素与免疫介导的炎症性皮肤病(immune-mediated inflammatory skin disease,IMID)之间潜在因果关系。方法 通过公开的全基因组关联研究(genome-wide association study,GWAS)数据,选取15种不同的微量营养素作为暴露因素,以及4种主要的IMID(银屑病、特应性皮炎、荨麻疹和斑秃)作为研究结局。采用逆方差加权法(inverse-variance weighting,IVW)作为主要分析方法,并辅以MR-Egger、加权中位数法(weighted median estimate,WME)和加权模式(weighted mode,WM)评价因果效应;使用敏感度分析评估结果的稳健性。结果 维生素D水平与银屑病风险呈负相关(OR=0.996,P=0.001,95%CI:0.994~0.998),且与WME、MR-Egger和WM趋势一致。磷与荨麻疹风险呈正相关(OR=5.634,95%CI:1.792~17.711,P=0.003),与WME和WM的结果方向一致。铜与特应性皮炎风险正相关(OR_(IVW)=1.234,P=0.0007,95%CI:1.092~1.394),维生素E水平与荨麻疹风险呈显著相关(OR=26.643,P=0.013,95%CI:1.981~358.333)。敏感度分析未显示出异质性和多效性(P>0.05)。结论 维生素D与银屑病患病风险存在因果关系,增加维生素D摄入量可能是预防银屑病的有效饮食策略,为IMID的预防和管理提供新的视角。Objective To explore the potential causal links between micronutrient levels and the risk of immune-mediated inflammatory skin disease(IMID).Methods Leveraging publicly accessible genome-wide association study(GWAS)datasets,fifteen specific micronutrients were identified as exposure variables,while four prevalent IMID:Psoriasis,atopic dermatitis,urticaria,and alopecia areata were designated as study outcomes.Robust instrumental variables were meticulously selected to facilitate the Mendelian randomization analysis.The main assessment used the inverse-variance weighting(IVW)method,complemented by an assortment of Mendelian randomization methodologies,inclusive of MR-Egger,weighted median estimate(WME)and weighted mode(WM).Rigorous sensitivity analyses were conducted to bolster the robustness of the findings.Results Vitamin D exhibited a significant inverse association with the risk of psoriasis(OR=0.996,P=0.001,95%CI:0.994-0.998),corroborated by consistent trends across WME,MR-Egger,and WM methods.Phosphorus demonstrated a positive correlation with urticaria risk(OR=5.634,95%CI:1.792-17.711,P=0.003),with findings in alignment with WME and WM methods.Copper was found to be positively associated with atopic dermatitis risk(OR_(IVW)=1.234,P=0.0007,95%CI:1.092-1.394),and vitamin E levels were significantly related to the risk of urticaria(OR=26.643,P=0.013,95%CI:1.981-358.333).Sensitivity analysis did not show heterogeneity and pleiotropy(P>0.05).Conclusion The study establishes a causal relationship between vitamin D levels and the risk of psoriasis,suggesting that augmenting vitamin D intake could be a viable dietary intervention for psoriasis prevention.These findings offer novel insights into the preventative and therapeutic strategies for IMID.

关 键 词：微量营养素 孟德尔随机化研究 特应性皮炎 银屑病 荨麻疹 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]