Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Mol Genet Metab. 2021 Sep-Oct;134(1-2):212-215. doi: 10.1016/j.ymgme.2021.08.010. Epub 2021 Aug 22.
BACKGROUND: Obesity and type 2 diabetes have been associated with an increased risk of kidney stones in observational studies, but the causality of these associations remains unestablished. We conducted a Mendelian randomization study to determine these associations. METHODS: Independent single nucleotide polymorphisms at the genome-wide significance threshold (p < 5 × 10) were selected as instrumental variables and were identified from meta-analyses of genome-wide association studies on body mass index (up to 806,834 individuals) and type 2 diabetes (228,499 cases and 1,178,783 non-cases). Summary-level data for the associations of exposure-associated SNPs with kidney stones were obtained from the UK Biobank study (3540 cases and 357,654 non-cases) and the FinnGen consortium (3856 cases and 172,757 non-cases). Causal estimates from two sources were combined using the meta-analysis method. RESULTS: Higher genetically predicted body mass index and genetic liability to type 2 diabetes were associated with an increased risk of kidney stones in both the UK Biobank study and FinnGen consortium. In the meta-analysis of results from the two data sources, the odds ratios of kidney stones were 1.33 (95% confidence interval, 1.17, 1.51; p < 0.001) per one standard deviation increase in genetically predicted body mass index (~4.8 kg/m) and 1.15 (95% confidence interval, 1.10, 1.20; p < 0.001) for one unit increase in genetically predicted log-transformed odds of type 2 diabetes. INTERPRETATION: This study based on genetic data suggests that a high body mass index and type 2 diabetes may be causal risk factors for kidney stone formation.
背景:在观察性研究中,肥胖症和 2 型糖尿病与肾结石风险增加相关,但这些关联的因果关系尚未确定。我们进行了一项孟德尔随机化研究以确定这些关联。
方法:选择全基因组关联研究中具有全基因组显著阈值(p<5×10-8)的独立单核苷酸多态性作为工具变量,这些研究分别针对体重指数(最多 806834 人)和 2 型糖尿病(228499 例病例和 1178783 例非病例)。从英国生物库研究(3540 例病例和 357654 例非病例)和芬兰遗传研究联盟(3856 例病例和 172757 例非病例)获得暴露相关 SNP 与肾结石关联的汇总水平数据。使用荟萃分析方法将来自两个来源的因果估计值进行合并。
结果:更高的遗传预测体重指数和 2 型糖尿病遗传易感性与英国生物库研究和芬兰遗传研究联盟中肾结石风险增加相关。在来自两个数据源的结果的荟萃分析中,肾结石的优势比为每增加一个标准偏差的遗传预测体重指数(~4.8kg/m)增加 1.33(95%置信区间,1.17,1.51;p<0.001),每增加一个单位遗传预测的 2 型糖尿病对数转换几率增加 1.15(95%置信区间,1.10,1.20;p<0.001)。
解释:这项基于遗传数据的研究表明,高体重指数和 2 型糖尿病可能是肾结石形成的因果危险因素。
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