甲状腺功能减退与多种心血管疾病的因果关系:一项双向孟德尔随机研究

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Zhifeng Xu, Jian Peng, Wanjun Lu, Junwei Xu, Minglong Zhu, Mengxuan Yuan
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引用次数: 0

摘要

目的:甲状腺功能减退与多种心血管疾病相关,但两者之间是否存在因果关系尚不清楚。本研究拟采用孟德尔随机化(Mendelian randomization, MR)方法探讨甲状腺功能减退与四种常见心血管疾病的双向因果关系。方法:研究所需的工具变量单核苷酸多态性(snp)从公共全基因组关联研究(GWAS)数据库中获得,样本来自欧洲人群。采用逆方差加权(IVW)、MR-Egger回归和加权中位数(WM)三种方法评估因果效应,其中IVW是主要方法。采用MR-PRESSO、Cochran’s Q检验、MR-Egger回归截距项和留一法进行敏感性分析,评估研究结果的可靠性和稳定性。结果:IVW方法结果显示甲状腺功能减退与冠心病(CHD) (OR: 2.313, 95% CI: 1.271 ~ 4.208, p = 0.006)和高血压(OR: 2.293, 95% CI: 1.331 ~ 3.955, p = 0.003)有因果关系。相比之下,甲状腺功能减退对心律失常(OR: 1.448, 95% CI: 0.885 ~ 2.371, p = 0.141)和心力衰竭(OR: 1.512, 95% CI: 0.775 ~ 2.951, p = 0.226)没有因果关系。MR-PRESSO和Cochran’s Q检验结果显示,研究甲状腺功能减退对冠心病影响的工具变量不存在异质性,而研究高血压影响的工具变量存在异质性;此外,MR-Egger回归截距项的结果显示,所纳入的工具变量均不具有水平多效性。反向磁共振分析的结果显示,四种心血管疾病中的任何一种与甲状腺功能减退都没有因果关系。结论:甲状腺功能减退患者更易发生冠心病和高血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Causal Relationship Between Hypothyroidism and Multiple Cardiovascular Diseases: A Bidirectional Mendelian Randomization Study

Causal Relationship Between Hypothyroidism and Multiple Cardiovascular Diseases: A Bidirectional Mendelian Randomization Study

Objective: Hypothyroidism is associated with a variety of cardiovascular diseases, but whether they are causally related to each other is unclear. This study intends to explore the bidirectional causal relationship between hypothyroidism and four common cardiovascular diseases using Mendelian randomization (MR).

Methods: Single-nucleotide polymorphisms (SNPs), the instrumental variable required for the study, were obtained from the public genome-wide association study (GWAS) database, and samples were obtained from European populations. Causal effects were assessed using three methods: inverse variance weighted (IVW), MR-Egger regression, and weighted median (WM), with IVW being the main method. Sensitivity analyses were conducted using MR-PRESSO, Cochran’s Q test, MR-Egger regression intercept term, and leave-one-out method to assess the reliability and stability of the study results.

Results: The results of IVW method showed a causal effect of hypothyroidism on coronary heart disease (CHD) (OR: 2.313, 95% CI: 1.271 to 4.208, p = 0.006) and hypertension (OR: 2.293, 95% CI: 1.331 to 3.955, p = 0.003). In contrast, there was no causal effect of hypothyroidism on arrhythmias (OR: 1.448, 95% CI: 0.885 to 2.371, p = 0.141) and heart failure (OR: 1.512, 95% CI: 0.775 to 2.951, p = 0.226). The results of MR-PRESSO and Cochran’s Q test showed that there was no heterogeneity in the instrumental variables included to study the effect of hypothyroidism on CHD, while there was heterogeneity in the instrumental variables included to study the effect on hypertension; also, the results of the MR-Egger regression intercept term showed that none of the included instrumental variables were horizontally pleiotropic. The results of the reverse MR analysis showed no causal effect of any of the four cardiovascular diseases on hypothyroidism.

Conclusion: Patients with hypothyroidism are more likely to develop CHD as well as hypertension.

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来源期刊
CiteScore
5.30
自引率
0.00%
发文量
274
审稿时长
3-8 weeks
期刊介绍: IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.
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