Centre for Clinical Epidemiology, Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.
Mult Scler. 2017 Oct;23(11):1461-1468. doi: 10.1177/1352458516681196. Epub 2016 Dec 7.
Mendelian randomization (MR) studies have demonstrated strong support for an association between genetically increased body mass index and risk of multiple sclerosis (MS). The adipokine adiponectin may be a potential mechanism linking body mass to risk of MS.
To evaluate whether genetically increased adiponectin levels influence risk of MS.
Using genome-wide significant single nucleotide polymorphisms (SNPs) for adiponectin, we undertook an MR study to estimate the effect of adiponectin on MS. This method prevents bias due to reverse causation and minimizes bias due to confounding. Sensitivity analyses were performed to evaluate the assumptions of MR.
MR analyses did not support a role for genetically elevated adiponectin in risk of MS (odds ratio (OR) = 0.93 per unit increase in natural-log-transformed adiponectin, equivalent to a two-standard deviation increase in adiponectin on the absolute scale; 95% confidence interval (CI) = 0.66-1.33; p = 0.61). Further MR analysis suggested that genetic variation at the adiponectin gene, which influences adiponectin level, does not impact MS risk. Sensitivity analyses, including MR-Egger regression, suggested no bias due to pleiotropy.
Lifelong genetically increased adiponectin levels in humans have no clear effect on risk of MS. Other biological factors driving the association between body mass and MS should be investigated.
孟德尔随机化(MR)研究有力地支持了身体质量指数(BMI)升高与多发性硬化症(MS)风险之间的关联。脂联素可能是将体重与 MS 风险联系起来的潜在机制。
评估脂联素水平升高是否会影响 MS 的发病风险。
我们利用脂联素的全基因组显著单核苷酸多态性(SNP)进行 MR 研究,以评估脂联素对 MS 的影响。这种方法可以防止由于反向因果关系导致的偏倚,并最大程度地减少由于混杂导致的偏倚。进行了敏感性分析以评估 MR 的假设。
MR 分析不支持脂联素升高与 MS 发病风险之间存在因果关系(与自然对数转换的脂联素每单位增加相比,风险比(OR)为 0.93;相当于绝对标度上脂联素增加两个标准差;95%置信区间(CI)为 0.66-1.33;p=0.61)。进一步的 MR 分析表明,影响脂联素水平的脂联素基因的遗传变异不会影响 MS 风险。敏感性分析,包括 MR-Egger 回归,表明不存在由多效性引起的偏倚。
人类终生脂联素水平升高对 MS 风险没有明显影响。应该进一步研究驱动体重与 MS 之间关联的其他生物学因素。