Second Department of Orthopedics, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School, Hunan University of Traditional Chinese Medicine, Changsha, China.
Front Endocrinol (Lausanne). 2023 Mar 8;14:1115834. doi: 10.3389/fendo.2023.1115834. eCollection 2023.
Previous observational studies have reported that thyroid dysfunction is associated with hallux valgus (HV). However, the causal effect of thyroid dysfunction on hallux valgus is still unknown. To assess whether there is a causal relationship between thyroid dysfunction and hallux valgus, we performed a two-sample Mendelian randomization (MR) study.
The data of the two-sample Mendelian randomization study were obtained from public databases. In this study, hypothyroidism, hyperthyroidism, free thyroxine (FT4), and thyrotropin (TSH) were chosen as exposures. The single nucleotide polymorphisms (SNP) of hypothyroidism and hyperthyroidism were from the genome-wide association studies (GWAS) of the IEU database, including 337,159 subjects. Data for FT4 and TSH (72,167 subjects) were extracted from the ThyroidOmics Consortium. HV was used as the outcome. The SNPs associated with HV were selected from a GWAS of 202,617 individuals in the fignngen database. The inverse variance weighted (IVW) method was used as the primary analysis. Four complementary methods were applied, including MR-presso, MR-Egger, and weighted median. In addition, Cochran's test, MR-presso, MR-Egger regression, and the leave-one-out test were used as sensitivity analysis, and the MR-pleiotropy test was performed to examine pleiotropy.
According to the results of IVW, we found that there was a causal relationship between hypothyroidism and HV, and hypothyroidism increased the incidence of HV (OR = 2.838 (95% CI: 1.116-7.213); = 0.028). There were no significant causal effects of hyperthyroidism, FT4, and TSH on HV ( > 0.05). Sensitivity analyses showed that the results were robust and reliable, and no horizontal pleiotropy was detected.
Our findings provided genetic support that hypothyroidism might increase the risk of HV. It will predict the occurrence of HV in patients with hypothyroidism and provide suggestions for early prevention and intervention.
先前的观察性研究报告称,甲状腺功能障碍与拇外翻(HV)有关。然而,甲状腺功能障碍对拇外翻的因果效应尚不清楚。为了评估甲状腺功能障碍与拇外翻之间是否存在因果关系,我们进行了一项两样本 Mendelian 随机化(MR)研究。
两样本 Mendelian 随机化研究的数据来自公共数据库。在这项研究中,选择甲状腺功能减退症、甲状腺功能亢进症、游离甲状腺素(FT4)和促甲状腺激素(TSH)作为暴露因素。甲状腺功能减退症和甲状腺功能亢进症的单核苷酸多态性(SNP)来自 IEU 数据库的全基因组关联研究,共包括 337159 例受试者。FT4 和 TSH 数据(72167 例受试者)取自 ThyroidOmics 联盟。HV 被用作结局。HV 相关的 SNP 从 fignngen 数据库中一项针对 202617 名个体的 GWAS 中选择。主要分析采用逆方差加权(IVW)法。还应用了四种补充方法,包括 MR-presso、MR-Egger 和加权中位数。此外,还进行了 Cochran's 检验、MR-presso、MR-Egger 回归和逐一删除观察值检验作为敏感性分析,并进行了 MR-pleiotropy 检验以检查偏倚。
根据 IVW 的结果,我们发现甲状腺功能减退症与 HV 之间存在因果关系,甲状腺功能减退症增加了 HV 的发病率(OR=2.838(95%CI:1.116-7.213); =0.028)。甲状腺功能亢进症、FT4 和 TSH 对 HV 无显著因果作用(>0.05)。敏感性分析表明,结果稳健可靠,未检测到水平性偏倚。
我们的研究结果提供了遗传证据,表明甲状腺功能减退症可能会增加 HV 的风险。这将有助于预测甲状腺功能减退症患者 HV 的发生,并为早期预防和干预提供建议。