临床荟萃 ›› 2024, Vol. 39 ›› Issue (4): 325-331.doi: 10.3969/j.issn.1004-583X.2024.04.005

• 论著 • 上一篇    下一篇

欧洲人群体质指数与2型糖尿病因果关系的双向孟德尔随机化研究

孙辉1, 刘海英2, 任俊豪1, 李锦霞1()   

  1. 1.西安国际医学中心医院 医学检验科, 陕西 西安 710000
    2.西安市长安区卫生计生综合监督所,陕西 西安 710000
  • 收稿日期:2023-10-09 出版日期:2024-04-20 发布日期:2024-06-27
  • 通讯作者: 李锦霞,Email:94396012@qq.com

Bidirectional Mendelian randomization study of causality between body mass index and type 2 diabetes in a European population

Sun Hui1, Liu Haiying2, Ren Junhao1, Li Jinxia1()   

  1. 1. Clinical Laboratory Center, Xi'an International Medical Center Hospital, Xi'an 710000, China
    2. Xi'an Changan District Health and Family Planning Comprehensive Supervision, Xi'an 710000, China
  • Received:2023-10-09 Online:2024-04-20 Published:2024-06-27
  • Contact: Li Jinxia, Email: 94396012@qq.com

摘要:

目的 通过双向孟德尔随机化(mendelian randomization,MR)研究分析评估体质指数(body mass index, BMI)与2型糖尿病(type 2 diabetes, T2DM)之间的因果关联。方法 利用公开的全基因组关联研究 (genome wide association study, GWAS) 汇总统计数据。共得到BMI数据样本461460例,T2DM数据样本655666例。选取与T2DM密切相关的373个SNPs遗传变异作为正向工具变量,118个SNPs作为反向工具变量,使用逆方差加权法(inverse-variance weighted,IVW)、加权中位数法 (Weighted median,WME)、MR-Egger法、Simple mode、 weighted mode法进行双向MR分析,使用OR值评估BMI与T2DM的因果关系。进一步使用异质性检验、多效性检验及leave-one-out法进行敏感性分析以评估结果的稳健性及可靠性。结果 IVW显示BMI与T2DM发生之间呈显著正相关,比值比(odds ratio, OR)为2.88,95%可信区间 (confidence interval,CI) 为2.66-3.12,P =5.37e-87;其他方法显示了相似的因果关系。此外,水平多效性检测(P=0.25)没有观察到水平多效性。反向MR分析没有观察到BMI与T2DM的反向因果关系。结论 体质指数与T2DM之间可能存在正向因果关系。

关键词: 2型糖尿病, 孟德尔随机化, 体质指数, 因果关系

Abstract:

Objective The causal association between body mass index (BMI) and type 2 diabetes mellitus (T2DM) was evaluated by bidirectional Mendelian randomization (MR). Methods Statistical data were pooled using the publicly available Genome-wide association study (GWAS). A total of 461460 cases of BMI and 655666 cases of T2DM were obtained. Totally 373 Single Nucleotide Polymorphisms (SNPs) genetic variations closely related to T2DM were selected as forward instrumental variables, and 118 SNPs were selected as reverse instrumental variables. Inverse variance weighted (IVW), Weighted median (WME), MR-Egger, Simple mode, and weighted mode were used for two-way MR analysis, and odds ratio (OR) values were used to evaluate the causal relationship between BMI and T2DM. The heterogeneity test, pleiotropy test, and leave-one-out method were further used for sensitivity analysis to evaluate the robustness and reliability of the results. Results IVW showed a significant positive correlation between BMI and the incidence of T2DM, OR was 2.88, 95% confidence interval (CI) was 2.66-3.12, P value was 5.37e-87. Other methods showed similar cause-and-effect relationships. In addition, horizontal pleiotropy was not observed by the horizontal pleiotropy test (P=0.25). Reverse MR analysis did not observe reverse causality between BMI and T2DM. Conclusion There may be a positive causal relationship between BMI and T2DM.

Key words: type 2 diabetes mellitus, Mendelian randomization, body mass index, causal relationship

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