慢性肩颈痛与慢性腰痛的因果关系:一项双向孟德尔随机化研究  

Causal relationship between chronic shoulder and neck pain and chronic low back pain:a bidirectional Mendelian randomization study

作　　者：金晖 吴洁 吴睿哲 马怀玉 曾景奇[1] 王凡[1] JIN Hui;WU Jie;WU Ruizhe;MA Huaiyu;ZENG Jingqi;WANG Fan(Department of Orthopedics II,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005;Graduate School of Hunan University of Chinese Medicine,Changsha 410005)

机构地区：[1]湖南中医药大学第二附属医院骨伤二科,长沙410005 [2]湖南中医药大学研究生院,长沙410005

出　　处：《颈腰痛杂志》2025年第2期320-325,共6页The Journal of Cervicodynia and Lumbodynia

基　　金：湖南省自然科学基金(2023JJ60484);湖南省科技厅创新引导项目(2021SK51306);湖南省卫健委一般指导项目(D202304075958);湖南省教育厅优秀青年项目(23B0344);湖南中医药大学研究生创新课题(2023CX108)。

摘　　要：目的探讨慢性肩颈疼痛与慢性腰痛之间的因果联系,为早期干预和个体化治疗提供帮助。方法利用全基因组关联研究(GWAS)获取慢性肩颈疼痛和慢性腰痛的遗传工具变量,并采用逆方差加权(IVW)法、MR-Egger回归法和加权中位数(WME)法进行孟德尔随机化分析(MR)。同时对分析结果进行异质性检验和多效性分析。结果对于慢性肩颈疼痛,筛选后获得了13个单核苷酸多样性(SNP)作为工具变量,IVW法、MR-Egger法和WME法的结果显示,OR值和95%置信区间(CI)分别为1.334(95%CI:1.196~1.487)、1.237(95%CI:0.934~1.639)和1.359(95%CI:1.167~1.581)。对于慢性腰痛,筛选后获得了12个SNP作为工具变量,IVW法、MR-Egger法和WME法的结果显示,OR值和95%CI分别为1.273(95%CI:1.126~1.438)、1.007(95%CI:0.779~1.300)和1.225(95%CI:1.454~1.032)。在双向MR分析中,异质性检验结果均显示不存在异常变量,敏感性分析结果表明稳健性良好,并且结果不具有多效性。结论慢性肩颈疼痛与慢性腰痛之间存在双向因果关联。Objective To explore the causal relationship between chronic shoulder and neck pain and chronic low back pain,provide help for early intervention and individualized treatment.Methods The genetic instrumental variables of chronic shoulder and neck pain and chronic low back pain were obtained from genome-wide association studies(GWAS).Inverse-variance weighted(IVW)method,MR-Egger method and weighted median(WME)method were used for Mendelian randomization(MR)analysis.The results were tested for heterogeneity and pleiotropy.Results For chronic shoulder and neck pain,13 SNP were obtained after screening as instrumental variables.The results of IVW method,MR-Egger method and WME method showed that the OR value and 95%confidence interval(CI)were 1.334(95%CI:1.196-1.487),1.237(95%CI:0.934~1.639),and 1.359(95%CI:1.167-1.581)respectively.For chronic low back pain,12 SNP were selected as instrumental variables.The results of IVW method,MR-Egger method and WME method showed that the OR value and 95%CI were 1.273(95%CI:1.126-1.438),1.007(95%CI:0.779-1.300),and 1.225(95%CI:1.454-1.032)respectively.In the two-way MR analysis,the results of heterogeneity test showed no abnormal variables,the results of sensitivity analysis showed good robustness,and the results did not have pleiotropic effects.Conclusion There is a bidirectional relationship between chronic shoulder and neck pain and chronic low back pain.

关 键 词：慢性肩颈疼痛 慢性腰痛 双向孟德尔随机化 全基因组关联研究 水平多效性 因果关联 

分 类 号：R274.9[医药卫生—中西医结合]