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儿童肥胖与骨关节炎风险之间的因果关系:来自两样本孟德尔随机分析的结果。

A causal relationship between childhood obesity and risk of osteoarthritis: results from a two-sample Mendelian randomization analysis.

机构信息

Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.

Nanchang University Queen Mary School, Nanchang, China.

出版信息

Ann Med. 2022 Dec;54(1):1636-1645. doi: 10.1080/07853890.2022.2085883.

Abstract

PURPOSE

It has been found that childhood obesity (CO) may play an important role in the onset and progression of osteoarthritis (OA). Thus we conducted this mendelian randomisation analysis (MR) to evaluate the causal association between childhood obesity and osteoarthritis.

METHODS

Instrumental variables (IVs) were obtained from publicly available genome-wide association study datasets. The leave-one-out sensitivity test, MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO), and Cochran's test were used to confirm the heterogeneity and pleiotropy of identified IVs, then five different models, including the inverse variance weighted model (IVW), weighted median estimator model (WME), weighted model-based method (WM), MR-Egger regression model (MER), and MR-Robust Adjusted Profile Score (MRAPS) were applied in this MR analysis.

RESULTS

After excluding all outliers identified by the MR-PRESSO test, no evident directional pleiotropy was found. Significant heterogeneity was found in the secondary MR and as a result, the multiplicative random-effect model was used. Significant causal association between CO and OA (OR 1.0075, 95% CI [1.0054, 1.0010],  = 8.12 × 10). The secondary MR also revealed that CO was causally associated with knee OA (OR 1.1067, 95% CI [1.0769, 1.1373],  = 3.30 × 10) and hip OA (OR 1.1272, 95% CI [1.0610, 1.1976],  = 1.07 × 10). The accuracy and robustness of these findings were confirmed by sensitivity tests.

CONCLUSION

There appears to be a causal relationship between childhood obesity and OA. Our results indicate that individuals with a history of childhood obesity require specific clinical attention to prevent the development of knee and hip OA.

摘要

目的

已经发现儿童肥胖(CO)可能在骨关节炎(OA)的发病和进展中起重要作用。因此,我们进行了这项孟德尔随机分析(MR),以评估儿童肥胖与骨关节炎之间的因果关系。

方法

工具变量(IVs)从公开的全基因组关联研究数据集获得。采用单样本缺失敏感性检验、MR 可加性残差和异常值检验(MR-PRESSO)以及 Cochrane's 检验来确认鉴定出的 IVs 的异质性和可加性,然后应用五种不同的模型,包括逆方差加权模型(IVW)、加权中位数估计模型(WME)、加权基于模型的方法(WM)、MR-Egger 回归模型(MER)和 MR-稳健调整轮廓评分(MRAPS)进行了这项 MR 分析。

结果

在排除了 MR-PRESSO 检验中识别出的所有异常值后,未发现明显的方向性可加性。在二次 MR 中发现了显著的异质性,因此使用了乘法随机效应模型。CO 与 OA 之间存在显著的因果关系(OR 1.0075,95%CI [1.0054, 1.0010],  = 8.12 × 10)。二次 MR 还表明,CO 与膝 OA(OR 1.1067,95%CI [1.0769, 1.1373],  = 3.30 × 10)和髋 OA(OR 1.1272,95%CI [1.0610, 1.1976],  = 1.07 × 10)之间存在因果关系。通过敏感性检验证实了这些发现的准确性和稳健性。

结论

儿童肥胖与 OA 之间似乎存在因果关系。我们的研究结果表明,有儿童肥胖史的个体需要特别的临床关注,以预防膝和髋 OA 的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4cb/9225762/33d69fd64966/IANN_A_2085883_F0001_C.jpg

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