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肥胖与临床显著抑郁症风险之间的关系:孟德尔随机化研究

Relationship between obesity and the risk of clinically significant depression: Mendelian randomisation study.

作者信息

Hung Chi-Fa, Rivera Margarita, Craddock Nick, Owen Michael J, Gill Michael, Korszun Ania, Maier Wolfgang, Mors Ole, Preisig Martin, Rice John P, Rietschel Marcella, Jones Lisa, Middleton Lefkos, Aitchison Kathy J, Davis Oliver S P, Breen Gerome, Lewis Cathryn, Farmer Anne, McGuffin Peter

机构信息

Chi-Fa Hung, MD, MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry at King's College London, UK, and Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Margarita Rivera, PhD, MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry at King's College London, UK, and CIBERSAM, University of Granada, Section of Psychiatry, Institute of Neurosciences, Biomedical Research Centre (CIBM), Granada, Spain; Nick Craddock, PhD, FRCPsych, FMedSci, Michael J. Owen, PhD, FRCPsych, FMedSci, Department of Psychological Medicine, School of Medicine, Cardiff University, UK; Michael Gill, PhD, Department of Psychiatry, Trinity Centre for Health Sciences, St James' Hospital, Dublin, Ireland; Ania Korszun, PhD, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary's University of London, UK; Wolfgang Maier, PhD, Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Germany; Ole Mors, PhD, Research Department P, Aarhus University Hospital, Risskov, Aarhus, Denmark; Martin Preisig, MD, Department of Adult Psychiatry, University Hospital of Lausanne, Prilly-Lausanne, Switzerland; John P. Rice, PhD, Department of Psychiatry, Washington University, St Louis, Missouri, USA; Marcella Rietschel, MD, Central Institute of Mental Health, Mannheim, Germany; Lisa Jones, PhD, Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, UK; Lefkos Middleton, MD,Division of Neuroscience and Mental Health, Imperial College London, UK; Kathy J. Aitchison, PhD, MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry at King's College London, UK and Department of Psychiatry, University of Alberta, Alberta, Canada; Oliver S. P. Davis, PhD, University College London Genetics Institute, Department of Genetics, Evolution and Environment, University Colleg

出版信息

Br J Psychiatry. 2014 Jul;205(1):24-8. doi: 10.1192/bjp.bp.113.130419. Epub 2014 May 8.

Abstract

BACKGROUND

Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue.

AIMS

To investigate whether higher BMI increases the risk of major depression.

METHOD

Two instrumental variable analyses were conducted to test the causal relationship between obesity and major depression in RADIANT, a large case-control study of major depression. We used a single nucleotide polymorphism (SNP) in FTO and a genetic risk score (GRS) based on 32 SNPs with well-established associations with BMI.

RESULTS

Linear regression analysis, as expected, showed that individuals carrying more risk alleles of FTO or having higher score of GRS had a higher BMI. Probit regression suggested that higher BMI is associated with increased risk of major depression. However, our two instrumental variable analyses did not support a causal relationship between higher BMI and major depression (FTO genotype: coefficient -0.03, 95% CI -0.18 to 0.13, P = 0.73; GRS: coefficient -0.02, 95% CI -0.11 to 0.07, P = 0.62).

CONCLUSIONS

Our instrumental variable analyses did not support a causal relationship between higher BMI and major depression. The positive associations of higher BMI with major depression in probit regression analyses might be explained by reverse causality and/or residual confounding.

摘要

背景

肥胖已被证明与抑郁症有关,有人提出较高的体重指数(BMI)会增加患抑郁症和其他常见精神障碍的风险。然而,因果关系仍不明确,孟德尔随机化作为一种工具变量分析形式,最近已被用于试图解决这一问题。

目的

研究较高的BMI是否会增加患重度抑郁症的风险。

方法

在一项关于重度抑郁症的大型病例对照研究RADIANT中,进行了两项工具变量分析,以检验肥胖与重度抑郁症之间的因果关系。我们使用了FTO基因中的一个单核苷酸多态性(SNP)以及基于32个与BMI有明确关联的SNP的遗传风险评分(GRS)。

结果

正如预期的那样,线性回归分析表明,携带更多FTO风险等位基因或GRS得分较高的个体BMI更高。概率回归表明,较高的BMI与重度抑郁症风险增加有关。然而,我们的两项工具变量分析并不支持较高的BMI与重度抑郁症之间存在因果关系(FTO基因型:系数-0.03,95%置信区间-0.18至0.13,P = 0.73;GRS:系数-0.02,95%置信区间-0.11至0.07,P = 0.62)。

结论

我们的工具变量分析不支持较高的BMI与重度抑郁症之间存在因果关系。概率回归分析中较高的BMI与重度抑郁症之间的正相关可能由反向因果关系和/或残余混杂因素来解释。

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