Causal association between medication use and sepsis: A two-sample Mendelian randomization study.

IF 2.7 3区 医学 Q2 CRITICAL CARE MEDICINE
SHOCK Pub Date : 2025-03-11 DOI:10.1097/SHK.0000000000002582
Mingfen Sun, Yi Chen, Zhaoquan Jin, Bo Yang, Minghui Zhu
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引用次数: 0

Abstract

Abstract: Objective: This study aimed to explore the causal association between genetically predicted medication use and sepsis.Methods: Utilizing summary data from genome-wide association studies (GWAS) on selected medications use and sepsis, a two-sample Mendelian randomization (MR) design was employed. Analysis was conducted using the Inverse Variance Weighted (IVW), weighted median, weighted mode, and MR-Egger regression methods. Sensitivity analysis included MR-Egger, MR-PRESSO, Cochran's Q, and leave-one-out methods.Results: The IVW method suggested that genetically predicted medication use, including Drugs used in diabetes (OR=1.08, 95%CI: 1.02 - 1.15, p=0.015), Diuretics (OR=1.08, 95%CI: 1.01 - 1.15, p=0.034), Thyroid preparations (OR=1.08, 95%CI: 1.03 - 1.13, p=0.001), and Adrenergics (OR=1.09, 95%CI: 1.01 - 1.18, p=0.037), might be causally associated with a higher risk of sepsis. Datasets for drugs in diabetes, antithrombotic agents, renin-angiotensin system agents, anilides, and glucocorticoids may exhibit heterogeneity. MR-Egger regression results indicated minimal influence of horizontal pleiotropy on all associations except possibly for antithrombotic agents and sepsis. MR-PRESSO test found no outliers. Leave-one-out analysis confirmed associations were not driven by any single factor. After removing confounders, the IVW method suggested that genetically predicted diuretics use (OR=1.17, 95%CI: 1.03 - 1.34, p=0.018) might be causally associated with a higher risk of sepsis, while drugs used in diabetes, thyroid preparations, and inhaled adrenergics were not. No heterogeneity was observed. MR-Egger regression results indicated the minimal influence of horizontal pleiotropy on all associations. MR-PRESSO test found no outliers. Leave-one-out analysis confirmed any single factor did not drive associations.Conclusions: This study found that prior use of diuretics may increase sepsis risk, with inconclusive evidence for other medications.

摘要:目的:本研究旨在探讨基因预测药物使用与败血症之间的因果关系:本研究旨在探讨基因预测药物使用与败血症之间的因果关系:利用全基因组关联研究(GWAS)中有关选定药物使用和败血症的汇总数据,采用双样本孟德尔随机化(MR)设计。分析采用了反方差加权(IVW)、加权中位数、加权模式和 MR-Egger 回归法。敏感性分析包括 MR-Egger、MR-PRESSO、Cochran's Q 和 leave-one-out 方法:IVW方法表明,基因可预测药物使用情况,包括糖尿病用药(OR=1.08,95%CI:1.02 - 1.15,p=0.015)、利尿剂(OR=1.08,95%CI:1.01 - 1.15,p=0.034)、甲状腺制剂(OR=1.08,95%CI:1.03 - 1.13,p=0.001)和肾上腺素类药物(OR=1.09,95%CI:1.01 - 1.18,p=0.037)可能与脓毒症风险较高有因果关系。糖尿病药物、抗血栓药物、肾素-血管紧张素系统药物、苯胺类药物和糖皮质激素的数据集可能存在异质性。MR-Egger回归结果表明,除了抗血栓药物和败血症可能有关联外,水平多效性对所有关联的影响微乎其微。MR-PRESSO 检验未发现异常值。剔除分析证实相关性不受任何单一因素的影响。剔除混杂因素后,IVW 方法表明,基因预测的利尿剂使用(OR=1.17,95%CI:1.03 - 1.34,p=0.018)可能与脓毒症风险较高有因果关系,而糖尿病用药、甲状腺制剂和吸入肾上腺素则没有因果关系。未观察到异质性。MR-Egger回归结果表明,水平多效性对所有关联的影响极小。MR-PRESSO测试未发现异常值。剔除分析证实,任何单一因素都不会产生关联:本研究发现,既往使用利尿剂可能会增加败血症风险,其他药物的相关性尚无定论。
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来源期刊
SHOCK
SHOCK 医学-外科
CiteScore
6.20
自引率
3.20%
发文量
199
审稿时长
1 months
期刊介绍: SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.
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