可改变的危险因素介导受教育程度与结直肠癌之间的关联:一项孟德尔随机化研究  

Modifiable risk factors mediate the association between educational attainment and colorectal cancer:A Mendelian randomization study

作　　者：姜聪 王娅 林芝 穆艳 JIANG Cong(College of Nursing,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China)

机构地区：[1]福建中医药大学护理学院,福建福州350122 [2]福建中医药大学教学医院护理部(福建省立医院护理部),福建福州350122

出　　处：《牡丹江医科大学学报》2025年第2期26-31,共6页Journal of Mudanjiang Medical University

摘　　要：目的应用孟德尔随机化方法探讨受教育程度与结直肠癌之间的因果关系,并评估可改变的危险因素在教育对结直肠癌风险的中介作用。方法选取来自全基因组关联研究的统计数据,采用逆方差加权法、加权中位数法等评估受教育程度与结直肠癌之间的遗传关联。此外,采用中介分析方法探究可改变的危险因素的潜在中介效应,并进行异质性检验及水平多效性分析来检验结果的有效性和可靠性。结果受教育程度的提升能降低结直肠癌的发病风险(OR=0.690,95%CI=0.567~0.839,P<0.001);BMI(OR=1.144,95%CI=1.013~1.292,P=0.031)、每周饮酒(OR=1.542,95%CI=1.048~2.269,P=0.028)、腰围(OR=1.247,95%CI=1.068~1.456,P=0.005)和久坐时间(OR=1.569,95%CI=1.064~2.314,P=0.023)与结直肠癌发病风险呈正相关;敏感性分析验证了以上结果的稳健性;中介分析结果显示BMI、腰围和久坐时间在受教育程度与结直肠癌的因果关系中起到了中介作用(分别为10.18%、15.07%和48.56%)。结论受教育程度的提升对结直肠癌具有保护作用,并通过BMI、腰围和久坐时间介导。Objective To explore the causal association between educational attainment and colorectal cancer using Mendelian randomization methods and to assess the mediating role of modifiable risk factors in the effect of education on colorectal cancer risk.Methods Statistical data from genome-wide association studies(GWAS)were selected to assess the genetic association between educational attainment and colorectal cancer using inverse variance weighting and weighted median methods.In addition,mediation analysis was used to explore the potential mediating effects of modifiable risk factors.Heterogeneity tests and horizontal multivariate analysis were performed to test the validity and reliability of the results.Results Higher educational attainment was associated with a reduced risk of colorectal cancer(OR=0.690,95%CI=0.567~0.839,P<0.001),Body mass index(BMI)(OR=1.144,95%CI=1.013~1.292,P=0.031),weekly alcohol consumption(OR=1.542,95%CI=1.048~2.269,P=0.028),waist circumference(OR=1.247,95%CI=1.068~1.456,P=0.005)and sedentary time(OR=1.569,95%CI=1.064~2.314,P=0.023)were positively correlated with the risk of colorectal cancer,the sensitivity analyses verified the robustness of the above results and the results of mediation analysis showed that BMI,waist circumference and sedentary time played a mediating role in the causal relationship between educational attainment and colorectal cancer risk(10.18%,15.07%and 48.56%,respectively).Conclusion Increased education has a protective effect against colorectal cancer and is mediated through BMI,waist circumference and sedentary time.

关 键 词：受教育程度 结直肠癌 孟德尔随机化 中介分析 全基因组关联研究 

分 类 号：R473.73[医药卫生—护理学]