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引用次数: 0
摘要
背景：淋巴瘤是一种复杂亚型的重大公共卫生挑战。虽然肥胖和脂肪因子与淋巴瘤有关，但因果关系尚不清楚。本研究使用孟德尔随机化（MR）系统地评估这些关联。研究设计和方法：双样本MR分析了全基因组关联研究的遗传数据，以评估肥胖、脂肪因子（脂联素、瘦素、抵抗素）和淋巴瘤亚型（弥漫性大b细胞淋巴瘤、滤泡性淋巴瘤、套细胞淋巴瘤、霍奇金淋巴瘤和其他未明确类型的非霍奇金淋巴瘤）之间的因果关系。初步分析采用反方差加权（IVW），支持MR-Egger、加权中位数和加权模式方法。敏感性分析（MR-Egger回归、Cochran’s Q检验、MR-PRESSO、leave-one-out）和连锁不平衡评分回归（LDSC）确保了稳健性。结果：IVW显示肥胖与滤泡性淋巴瘤（OR = 1.352, 95%CI: 1.095 ~ 1.670, p = 0.005）和其他未明确类型的非霍奇金淋巴瘤（OR = 1.297, 95%CI: 1.050 ~ 1.603, p = 0.016）呈正相关。在脂肪因子和淋巴瘤之间没有发现明显的联系。敏感性分析证实无异质性或多效性。结论：肥胖可能单独增加淋巴瘤风险，与脂肪因子无关。这些发现强调了新的危险因素，敦促进一步研究病理机制和生物标志物。
May obesity increase the risk of lymphoma? Insights from genetic evidence.
Background: Lymphoma poses a significant public health challenge with complex subtypes. While obesity and adipokines have been linked to lymphoma, causal relationships remain unclear. This study uses Mendelian randomization (MR) to systematically assess these associations.
Research design and methods: Two-sample MR analyzed genetic data from genome-wide association studies to evaluate causal links between obesity, adipokines (adiponectin, leptin, resistin), and lymphoma subtypes (diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, Hodgkin lymphoma and other unspecified types of non-Hodgkin lymphoma). Primary analysis used inverse variance weighted (IVW), supported by MR-Egger, weighted median, and weighted mode methods. Sensitivity analyses (MR-Egger regression, Cochran's Q test, MR-PRESSO, leave-one-out) and linkage disequilibrium score regression (LDSC) ensured robustness.
Results: IVW revealed obesity positively associated with follicular lymphoma (OR = 1.352, 95%CI: 1.095-1.670, p = 0.005) and other unspecified types of non-Hodgkin lymphoma (OR = 1.297, 95%CI: 1.050-1.603, p = 0.016). No significant links were found between adipokines and lymphoma. Sensitivity analyses confirmed no heterogeneity or pleiotropy.
Conclusions: Obesity may independently increase lymphoma risk, unrelated to adipokines. These findings highlight new risk factors, urging further research into pathological mechanisms and biomarkers.
期刊介绍：
Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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