肠道微生物群与谵妄的大规模因果分析:一项孟德尔随机化研究。

A large-scale causal analysis of gut microbiota and delirium: A Mendelian randomization study.

作者信息

Yu Hui, Wan Xianjie, Yang Mingyi, Xie Jiale, Xu Ke, Wang Jiachen, Wang Guoqiang, Xu Peng

机构信息

Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, Shanxi 710054, China.

Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, Shanxi 710054, China.

出版信息

J Affect Disord. 2023 May 15;329:64-71. doi: 10.1016/j.jad.2023.02.078. Epub 2023 Feb 24.

Abstract

BACKGROUND

Several studies have linked gut microbiota to human brain activity. This study used Mendelian randomization (MR) to investigate the causal relationship between gut microbes and delirium.

METHODS

MR was used to select SNPs from large-scale GWAS summary data on 211 gut microbiota taxa and delirium. Inverse variance weighting (IVW), weighted median, and MR-Egger methods were used for statistical analyses. Outliers were assessed using the leave-one-out method. To avoid horizontal pleiotropy, we performed the MR-PRESSO and MR-Egger intercept tests. Cochran's Q and I values for IVW and MR-Egger were used to assess heterogeneity.

RESULTS

IVW suggested that genetic prediction of the family Desulfovibrionaceae (1.784 (1.267-2.512), P = 0.001), order Desulfovibrionales (1.501 (1.058-2.128), P = 0.023), and genus Candidatus Soleaferrea (1.322 (1.052-1.659), P = 0.016) increased the risk of delirium, but the family Oxalobacteraceae (0.841 (0.722-0.981), P = 0.027), and genera Holdemania (0.766 (0.620-0.946), P = 0.013), Ruminococcus gnavus (0.806 (0.661-0.982), P = 0.033), and Eggerthella (0.815 (0.667-0.997), P = 0.047) reduced the risk of delirium.

LIMITATIONS

(1) Limited sample size, (2) inability to assess gut microbiota interactions, and (3) limited to European populations.

CONCLUSION

Our results suggest that presence of the microbial family Desulfovibrionaceae, order Desulfovibrionales, and genus Candidatus Soleaferrea increased the risk of delirium, whereas the Oxalobacteraceae family, and the genera Holdemania, Ruminococcus gnavus, and Eggerthella decreased the risk of delirium. However, the potential of gut probiotic interventions in the prevention of perioperative delirium should be emphasized.

摘要

背景

多项研究已将肠道微生物群与人类大脑活动联系起来。本研究采用孟德尔随机化(MR)方法来探究肠道微生物与谵妄之间的因果关系。

方法

利用MR从关于211种肠道微生物分类群和谵妄的大规模全基因组关联研究(GWAS)汇总数据中选择单核苷酸多态性(SNP)。采用逆方差加权(IVW)、加权中位数和MR-Egger方法进行统计分析。使用留一法评估异常值。为避免水平多效性,我们进行了MR-PRESSO和MR-Egger截距检验。IVW和MR-Egger的 Cochr an's Q值和I值用于评估异质性。

结果

IVW分析表明,脱硫弧菌科(1.784(1.267 - 2.512),P = 0.001)、脱硫弧菌目(1.501(1.058 - 2.128),P = 0.023)以及暂定索氏菌属(1.322(1.052 - 1.659),P = 0.016)的遗传预测增加了谵妄风险,而草酸杆菌科(0.841(0.722 - 0.981),P = 0.027)以及霍尔德曼氏菌属(0.766(0.620 - 0.946),P = 0.013)、迟缓瘤胃球菌(0.806(0.661 - 0.982),P = 0.033)和埃格特菌属(0.815(0.667 - 0.997),P = 0.047)降低了谵妄风险。

局限性

(1)样本量有限;(2)无法评估肠道微生物群的相互作用;(3)仅限于欧洲人群。

结论

我们的结果表明,脱硫弧菌科、脱硫弧菌目以及暂定索氏菌属的存在增加了谵妄风险,而草酸杆菌科以及霍尔德曼氏菌属、迟缓瘤胃球菌和埃格特菌属降低了谵妄风险。然而,应强调肠道益生菌干预在预防围手术期谵妄方面的潜力。

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