血清尿酸水平作为高血压的致病因素:来自孟德尔随机分析的见解。

IF 1.5 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Jiayue Xu, Jiajing Zhao, Jiaming Gu, Wenjian Wang, Jingxian Chen
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引用次数: 0

摘要

背景:高尿酸血症和高血压是常见的慢性疾病,经常同时发生。虽然许多观察性研究表明血清尿酸(SUA)水平与高血压之间存在关联,但由于混淆和反向因果关系,这种关系的因果性质仍未得到解决。本研究采用孟德尔随机化(MR)方法系统地调查了SUA水平与高血压风险之间的因果关系。方法:我们利用欧洲人群大规模全基因组关联研究(GWAS)中发现的单核苷酸多态性(snp)作为SUA水平的遗传工具。MR是一种遗传流行病学技术,它使用遗传变异作为代理来模拟随机对照试验,并最大限度地减少混杂和反向因果关系的偏差。收缩压和舒张压(SBP和DBP)是主要关注的结果。采用双样本MR分析来评估因果关系,并辅以敏感性分析(加权中位数、加权模式、MR- egger)以确保结果的稳健性。结果以SUA水平每增加一个标准差(SD) 95%置信区间(Cis)的比值比(ORs)表示。结果:我们的MR分析确定了SUA水平对高血压风险的显著因果影响。具体而言,基因预测的SUA水平与收缩压呈正相关(β = 0.136 [0.035-0.238], p p p =。0.504]或DBP (β = 0.016 [- 0.028-0.059], p >。[05]在SUA水平上,证实了这种关联的单向性。结论:这项研究提供了令人信服的MR证据,支持SUA水平与高血压风险增加之间的单向因果关系。与先前的观察性研究不同,我们的遗传方法有效地减轻了混淆和反向因果关系,为高血压的病因学提供了新的见解。这些发现强调了控制SUA水平以降低高血压风险的临床重要性。需要进一步的研究,包括随机对照试验,来证实这些发现,并探索针对SUA的潜在治疗干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum uric acid levels as a causal factor in hypertension: Insights from Mendelian randomization analysis.

Background: Hyperuricemia and hypertension are prevalent chronic diseases that often co-occur. While numerous observational studies suggest an association between serum uric acid (SUA) levels and hypertension, the causal nature of this relationship remains unresolved due to confounding and reverse causation. This study systematically investigates the causal association between SUA levels and hypertension risk using Mendelian randomization (MR) methodologies.

Methods: We utilized single nucleotide polymorphisms (SNPs) identified in large-scale genome-wide association studies (GWAS) of European populations as genetic instruments for SUA levels. MR, a genetic epidemiology technique, uses genetic variations as proxies to mimic a randomized controlled trial and minimizing biases from confounding and reverse causation. Systolic and diastolic blood pressure (SBP and DBP) were the primary outcomes of interest. A two-sample MR analysis was conducted to assess the causal relationships, complemented by sensitivity analyses (weighted median, weighted mode, MR-Egger) to ensure result robustness. Findings are expressed as odds ratios (ORs) with 95% confidence intervals (Cis) per one standard deviation (SD) increase in SUA levels.

Results: Our MR analysis identified a significant causal effect of SUA levels on hypertension risk. Specifically, genetically predicted SUA levels were positively associated with SBP (β = 0.136 [0.035-0.238], p < .05) and DBP (β = 0.108 [0.007-0.209], p < .05).Conversely, reverse MR analysis revealed no significant causal effect of SBP (b = 0.058 [ - 9.52E-05-0.116],p = .0504] or DBP (β = 0.016 [ - 0.028-0.059], p > .05] on SUA levels, confirming the unidirectional nature of this association.

Conclusion: This study provides compelling evidence from MR supporting a unidirectional causal link between SUA levels and increased hypertension risk. Unlike prior observational studies, our genetic approach effectively mitigates confounding and reverse causation, offering novel insights into the etiology of hypertension. These findings highlight the clinical importance of managing SUA levels to mitigate hypertension risk. Further research, including randomized controlled trials, is needed to confirm these findings and explore potential therapeutic interventions targeting SUA.

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来源期刊
CiteScore
3.90
自引率
0.80%
发文量
66
审稿时长
6-12 weeks
期刊介绍: Clinical and Experimental Hypertension is a reputable journal that has converted to a full Open Access format starting from Volume 45 in 2023. While previous volumes are still accessible through a Pay to Read model, the journal now provides free and open access to its content. It serves as an international platform for the exchange of up-to-date scientific and clinical information concerning both human and animal hypertension. The journal publishes a wide range of articles, including full research papers, solicited and unsolicited reviews, and commentaries. Through these publications, the journal aims to enhance current understanding and support the timely detection, management, control, and prevention of hypertension-related conditions. One notable aspect of Clinical and Experimental Hypertension is its coverage of special issues that focus on the proceedings of symposia dedicated to hypertension research. This feature allows researchers and clinicians to delve deeper into the latest advancements in this field. The journal is abstracted and indexed in several renowned databases, including Pharmacoeconomics and Outcomes News (Online), Reactions Weekly (Online), CABI, EBSCOhost, Elsevier BV, International Atomic Energy Agency, and the National Library of Medicine, among others. These affiliations ensure that the journal's content receives broad visibility and facilitates its discoverability by professionals and researchers in related disciplines.
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