Shi Jiajun, Wu Lang, Zheng Wei, Wen Wanqing, Wang Shuyang, Shu Xiang, Long Jirong, Shen Chen-Yang, Wu Pei-Ei, Saloustros Emmanouil, Chang-Claude Jenny, Brenner Hermann, Shu Xiao-Ou, Cai Qiuyin
Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA.
Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan.
J Psychiatr Brain Sci. 2018;3(4). doi: 10.20900/jpbs.20180007. Epub 2018 Aug 8.
To estimate the potential effect of schizophrenia on breast cancer risk in women, we performed a two-sample Mendelian randomization (MR) study.
The instrumental variables comprised 170 uncorrelated and non-pleiotropic single nucleotide polymorphisms (SNPs) that are significantly associated with schizophrenia risk in genome-wide association studies in 105,000 European descent individuals of the Psychiatric Genomics Consortium (http://www.med.unc.edu/pgc/) and the United Kingdom Clozapine Clinic. The association between these SNPs determined schizophrenia and breast cancer risk was estimated in approximately 229,000 European descent females from the Breast Cancer Association Consortium using the inverse-variance weighted and the weighted median MR methods.
We found that the genetically-predicted risk of schizophrenia was associated with increased breast cancer risk (under a random-effects model: odds ratio per 1 unit increase in log odds of schizophrenia = 1.04, 95% confidence interval: 1.02-1.06, = 5.6 × 10). Similar significant associations were observed in analyses using a weighted median model and sensitivity analysis excluding six SNPs with genotype imputation score of less than 0.8, as well as analyses stratified by estrogen receptor status of breast cancer.
Our findings implicate a modest increased risk for breast cancer in genetically determined schizophrenic females.
为评估精神分裂症对女性患乳腺癌风险的潜在影响,我们开展了一项两样本孟德尔随机化(MR)研究。
工具变量包括170个不相关且无多效性的单核苷酸多态性(SNP),这些SNP在精神疾病基因组学联盟(http://www.med.unc.edu/pgc/)和英国氯氮平诊所对105,000名欧洲裔个体进行的全基因组关联研究中与精神分裂症风险显著相关。使用逆方差加权法和加权中位数MR方法,在乳腺癌协会联盟的约229,000名欧洲裔女性中估计这些SNP所决定的精神分裂症与乳腺癌风险之间的关联。
我们发现,基因预测的精神分裂症风险与乳腺癌风险增加相关(在随机效应模型下:精神分裂症对数优势每增加1个单位的优势比 = 1.04,95%置信区间:1.02 - 1.06,P = 5.6×10)。在使用加权中位数模型的分析、排除基因型推算分数小于0.8的6个SNP的敏感性分析以及按乳腺癌雌激素受体状态分层的分析中,也观察到了类似的显著关联。
我们的研究结果表明,基因决定的精神分裂症女性患乳腺癌的风险略有增加。