血清氧化三甲胺水平与胶质母细胞瘤因果关系的孟德尔随机化研究  

A Mendelian randomization study on the causal relationship between serum trimethylamine-n-oxide levels and glioblastoma

作　　者：唐佳雯 丛玲华[1] 陈芳[1] 张继方 Tang Jiawen;Cong Linghua;Chen Fang;Zhang Jifang(Department of Pathology,People's Hospital Affiliated to Ningbo University,Ningbo,Zhejiang 315040,China)

机构地区：[1]宁波大学附属人民医院病理科,浙江宁波315040

出　　处：《中国微侵袭神经外科杂志》2025年第2期87-91,共5页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的利用孟德尔随机化研究血清氧化三甲胺(trimethylamine-N-oxide,TMAO)水平与胶质母细胞瘤(glioblastoma,GBM)的因果关系。方法利用全基因组关联分析数据库,选择有确切关系的血清TMAO与GBM数据。设定暴露为血清TMAO水平,结局为GBM时为正向分析,反之为反向分析。以逆方差加权法(inverse variance weighted,IVW)作为主要结局指标,结合加权中位数法(weighted median,WME)等,并分析多效性、异质性、离群值和敏感性检验,判断结果稳定性。结果IVW结果显示遗传决定的血清TMAO水平与GBM风险呈正相关,具有统计学意义(OR=0.87,95%CI:0.75~0.94,P<0.05)。虽然WME进一步验证未观察到显著性意义(P=0.058),但其余3种方法均显示具有统计学意义(P<0.05),结果与IVW估计方向具有一致性(OR<1)。反向分析显示,IVW结果未发现GBM对血清TMAO的因果关系(P>0.05),余方法发现其对应模型的P值均>0.05,均未发现GBM与血清TMAO有确切因果关联。敏感性分析证明结果不存在异质性和水平多效性(P>0.05)。留一法证实结果的稳定性。结论血清TMAO水平与GBM之间存在因果关系。Objective To investigate the causal relationship between serum trimethylamine-N-oxide(TMAO)levels and glioblastoma(GBM)using Mendelian randomization(MR).Methods Data on serum TMAO and GBM with confirmed associations were selected from genome-wide association study(GWAS)databases.Serum TMAO levels were set as the exposure,and GBM as the outcome for forward analysis,while the reverse was performed for reverse analysis.The inverse variance weighted(IVW)method was used as the primary outcome measure,supplemented by the weighted median(WME)method.Pleiotropy,heterogeneity,outliers,and sensitivity analyses were conducted to assess the stability of the results.Results The IVW results indicated a statistically significant positive correlation between genetically determined serum TMAO levels and GBM risk(OR=0.87,95%CI:0.75-0.94,P<0.05).Although no significance significance was observed in WME further validation(P=0.058),the other three methods showed significant results(P<0.05),their estimates were consistent with the IVW direction(OR<1).Reverse analysis revealed no causal effect of GBM on serum TMAO levels using IVW(P>0.05),and other methods also showed no significant causal relationship(P>0.05).Sensitivity analysis confirmed the absence of heterogeneity and horizontal pleiotropy(P>0.05),and the leave-one-out method demonstrated the stability of the results.Conclusion There is a causal relationship between serum TMAO levels and GBM.

关 键 词：神经胶质瘤 胶质母细胞瘤 氧化三甲胺 因果关系 孟德尔随机化 

分 类 号：R739.41[医药卫生—肿瘤] R730.264[医药卫生—临床医学]