阻塞性睡眠呼吸暂停与儿童初发哮喘之间的因果关系昭然若揭:孟德尔随机研究

IF 3 2区 医学 Q2 CLINICAL NEUROLOGY
Qiming Gan, Quanzhen Liu, Yanjuan Wu, Xiaofeng Zhu, Jingcun Wang, Xiaofen Su, Dongxing Zhao, Nuofu Zhang, Kang Wu
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引用次数: 0

摘要

目的:在观察性研究中,阻塞性睡眠呼吸暂停(OSA)与哮喘有关,但OSA对儿童期或成年期哮喘发病的影响仍不清楚,因果推论也未得到证实。本研究旨在探讨OSA与哮喘(包括不同发病年龄亚型)之间的潜在因果关系,为OSA与哮喘的临床治疗提供可靠依据:采用双样本双向孟德尔随机分析法(MR)评估 OSA 与哮喘之间的因果关系。OSA数据来自FinnGen R9联盟,而哮喘及其亚型(成人发病型哮喘、儿童发病型哮喘和中重度哮喘)数据来自IEU OpenGWAS项目。我们选择了反方差加权法(IVW)作为主要分析方法,并辅以各种敏感性分析。采用MR-PRESSO离群检验系统地识别和移除离群变异,减轻异质性和水平多向性的潜在影响:MR分析表明,遗传预测的OSA对儿童初发哮喘(OR,1.49;95% CI,1.05-2.11;P=0.025)和中重度哮喘(OR,1.03;95% CI,1.00-1.06;P=0.046)有促进作用。然而,未观察到 OSA 与哮喘和成人哮喘之间存在因果关系:我们的研究表明,OSA 与儿童哮喘之间存在因果关系,但与成人无关。中重度哮喘可能对 OSA 有潜在的促进作用。这些发现强调了在管理哮喘时考虑特定年龄因素的重要性,并表明在临床实践中需要采取个性化的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Causal Association Between Obstructive Sleep Apnea and Child-Onset Asthma Come to Light: A Mendelian Randomization Study
Purpose: Obstructive sleep apnea (OSA) had been associated with asthma in observational studies, but the effect of OSA on the onset of asthma in childhood or adulthood remains unclear, and the causal inferences have not been confirmed. This study aims to investigate the potential causal association between OSA with asthma, including different age-of-onset subtypes, providing reliable basis for the clinical treatment of OSA and asthma.
Patients and Methods: Causality between OSA and asthma was assessed using a two-sample bi-directional Mendelian randomization (MR) analysis. OSA data were obtained from the FinnGen consortium R9, while asthma and its subtypes (adult-onset asthma, child-onset asthma, and moderate-to-severe asthma) were sourced from the IEU OpenGWAS project. The inverse-variance weighted (IVW) method was chosen as the primary analysis and was complemented by various sensitivity analyses. The MR-PRESSO outlier test was employed to systematically identify and remove outlier variants, mitigating heterogeneity and potential effects of horizontal pleiotropy.
Results: The MR analyses provided evidence of genetically predicted OSA having a promoting effect on child-onset asthma (OR,1.49; 95% CI, 1.05– 2.11; P=0.025) and moderate-to-severe asthma (OR,1.03; 95% CI, 1.00– 1.06; P=0.046). However, no causal association between OSA with asthma and adult-onset asthma was observed.
Conclusion: Our study revealed a causal association between OSA and child asthma, but not in adults. Moderate-to-severe asthma may have a potential promoting effect on OSA. These findings underscore the importance of age-specific considerations in managing asthma and suggests the need for personalized approaches in clinical practice.

Keywords: asthma, obstructive sleep apnea, Mendelian randomization, genetic
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来源期刊
Nature and Science of Sleep
Nature and Science of Sleep Neuroscience-Behavioral Neuroscience
CiteScore
5.70
自引率
5.90%
发文量
245
审稿时长
16 weeks
期刊介绍: Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.
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