心肾代谢综合征中心血管疾病和肾脏疾病的因果关系分析  

Causal relationship between cardiovascular disease and renal disease in cardiovascular kidney metabolic syndrome

作　　者：宋菲 胡梦巾 夏经钢[1] 尹春琳[1] SONG Fei;HU Meng-jin;XIA Jing-gang;YIN Chun-lin(Department of Cardiology,Xuanwu Hospital,Capital Medical University,National Clinical Research Center for Geriatric Diseases,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院心脏内科,国家老年疾病临床医学研究中心,北京市100053

出　　处：《中国心血管病研究》2025年第3期236-240,共5页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划(2023YFC3605003)。

摘　　要：目的采用双样本孟德尔随机化(MR)分析方法,探讨心血管疾病(CVD)与慢性肾脏病(CKD)之间的潜在因果关系。方法本研究基于公开的全基因组关联研究(GWAS)数据库,采用双样本MR分析方法推断因果关系。主要分析采用逆方差加权法(IVW),同时辅以MR-Egger回归、加权中位数法和加权众数法进行敏感性分析,以验证结果的稳健性。结果MR分析结果显示,基因预测的心力衰竭与CKD风险呈显著正相关(OR=1.197,95%CI 1.090~1.314,P<0.001);心房颤动(房颤)亦与CKD发生风险显著相关(OR=1.088,95%CI 1.037~1.140,P=0.001)。然而,冠心病、卒中及外周血管疾病与CKD之间未发现因果关系。结论本研究通过MR分析为CVD对CKD的因果关系提供了遗传学证据,特别是心力衰竭和房颤与CKD风险的显著关联。这一发现为心肾代谢综合征的临床管理提供了新的理论依据,提示在CKD防治中应重点关注特定类型CVD的干预。Objective Employs a two-sample Mendelian Randomization(MR)approach to investigate the potential causal relationship between cardiovascular diseases(CVD)and chronic kidney disease(CKD).Methods A two-sample MR analysis based on publicly available genome-wide association studies was employed to infer the causal relationship.The preliminary estimate was calculated using the random-effects inverse-variance-weighted method.MR-Egger,weighted median and weighted mode were performed as sensitivity analyses.Results MR analysis showed that the genetically predicted heart failure was positively associated with an increased risk of CKD(OR=1.197,95%CI 1.090-1.314,P<0.001)and atrial fibrillation was positively associated with an increased risk of CKD(OR=1.088,95%CI 1.037-1.140,P=0.001).No causal relationship was found between coronary heart disease,stroke,peripheral vascular disease and CKD.Conclusions There should be a potential causal relationship between CVD and CKD,and particularly heart failure and atrial fibrillation might be more associated with CKD risk.These findings offer new theoretical insights for the clinical management of cardiovascular kidney metabolic syndrome(CKM),suggesting that targeted interventions for specific types of CVD should be prioritized in the prevention and treatment of CKD.

关 键 词：心肾代谢综合征 心血管疾病 慢性肾脏病 因果关系 孟德尔随机化 

分 类 号：R54[医药卫生—心血管疾病]