Jiangxi Province Division of National Clinical Research Center for Ocular Diseases, Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China.
Front Endocrinol (Lausanne). 2023 Jan 10;13:1088557. doi: 10.3389/fendo.2022.1088557. eCollection 2022.
It is difficult to get evidence from randomized trials of a causal relationship between steroid hormones produced by the adrenal gland and gonad and retinal neurodegenerative disorders (RND). In this study, genetic variations of aldosterone (Aldo), androstenedione (A4), progesterone (P4), hydroxyprogesterone (17-OHP), and testosterone/17β-estradiol (T/E2) were obtained from genome-wide association studies as instrumental variables. Mendelian randomization (MR) analysis was used to assess the impact on the risk of RND, including glaucoma (8,591 cases and 210,201 controls), diabetic retinopathy (DR, 14,584 cases and 202,082 controls) and age-related macular degeneration (AMD, 14,034 cases and 91,214 controls). As the main method, inverse variance weighted results suggest that the increased glaucoma risk was affected by T/E2 (OR = 1.11, 95% CI, 1.01-1.22, = 0.03), which was further validated by other methods ( = 0.03, = 0.03, 0.03). In the replicated stage, the causal relationship between T/E2 and glaucoma was verified based on the MRC-IEU consortium ( = 0.04). No impact of Aldo, A4, P4, 17-OHP, and T/E2 was observed for the risk of DR ( > 0.05) and AMD ( > 0.05). The heterogeneity test ( > 0.05) and pleiotropy test ( > 0.05) verified the robustness of the results. Our results suggest that T/E2 has a suggestive effect on the glaucoma risk. However, the genetic evidence based on a large sample does not support the effect of steroid hormones on DR and AMD risk. Further studies are vital to assess the possibility of steroid hormones as targets for prevention and treatment.
从肾上腺和性腺产生的类固醇激素与视网膜神经退行性疾病(RND)之间因果关系的随机试验中获得证据是困难的。在这项研究中,醛固酮(Aldo)、雄烯二酮(A4)、孕酮(P4)、17-羟孕酮(17-OHP)和睾酮/17β-雌二醇(T/E2)的遗传变异从全基因组关联研究中获得,作为工具变量。孟德尔随机化(MR)分析用于评估其对 RND 风险的影响,包括青光眼(8591 例和 210201 例对照)、糖尿病性视网膜病变(DR,14584 例和 202082 例对照)和年龄相关性黄斑变性(AMD,14034 例和 91214 例对照)。作为主要方法,反向方差加权结果表明,T/E2 增加了青光眼风险(OR=1.11,95%CI,1.01-1.22, =0.03),这一结果通过其他方法得到了进一步验证( =0.03, =0.03, =0.03)。在复制阶段,基于 MRC-IEU 联盟,验证了 T/E2 与青光眼之间的因果关系( =0.04)。Aldo、A4、P4、17-OHP 和 T/E2 对 DR(>0.05)和 AMD(>0.05)风险无影响。异质性检验(>0.05)和多效性检验(>0.05)验证了结果的稳健性。我们的结果表明,T/E2 对青光眼风险有提示作用。然而,基于大样本的遗传证据不支持类固醇激素对 DR 和 AMD 风险的影响。进一步的研究对于评估类固醇激素作为预防和治疗靶点的可能性至关重要。
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