Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Front Endocrinol (Lausanne). 2023 May 23;14:1154271. doi: 10.3389/fendo.2023.1154271. eCollection 2023.
Numerous studies have demonstrated that rheumatoid arthritis (RA) is related to increased incidence of heart failure (HF), but the underlying association remains unclear. In this study, the potential association of RA and HF was clarified using Mendelian randomization analysis.
Genetic tools for RA, HF, autoimmune disease (AD), and NT-proBNP were acquired from genome-wide studies without population overlap. The inverse variance weighting method was employed for MR analysis. Meanwhile, the results were verified in terms of reliability by using a series of analyses and assessments.
According to MR analysis, its genetic susceptibility to RA may lead to increased risk of heart failure (OR=1.02226, 95%CI [1.005495-1.039304], =0.009067), but RA was not associated with NT-proBNP. In addition, RA was a type of AD, and the genetic susceptibility of AD had a close relation to increased risk of heart failure (OR=1.045157, 95%CI [1.010249-1.081272], =0.010825), while AD was not associated with NT-proBNP. In addition, the MR Steiger test revealed that RA was causal for HF and not the opposite (P = 0.000).
The causal role of RA in HF was explored to recognize the underlying mechanisms of RA and facilitate comprehensive HF evaluation and treatment of RA.
大量研究表明类风湿关节炎（RA）与心力衰竭（HF）的发病率增加有关，但潜在的关联尚不清楚。本研究采用孟德尔随机化分析阐明 RA 与 HF 之间的潜在关联。
RA、HF、自身免疫性疾病（AD）和 NT-proBNP 的遗传工具均来自全基因组研究，且无人群重叠。采用逆方差加权法进行 MR 分析。同时，通过一系列分析和评估来验证结果的可靠性。
根据 MR 分析，RA 的遗传易感性可能导致心力衰竭风险增加（OR=1.02226，95%CI [1.005495-1.039304]，=0.009067），但 RA 与 NT-proBNP 无关。此外，RA 是一种 AD，AD 的遗传易感性与心力衰竭风险增加密切相关（OR=1.045157，95%CI [1.010249-1.081272]，=0.010825），而 AD 与 NT-proBNP 无关。此外，MR Steiger 检验表明 RA 是 HF 的原因，而不是相反（P = 0.000）。
本研究探索了 RA 导致 HF 的因果关系，以认识 RA 的潜在机制，并促进全面的 HF 评估和 RA 治疗。
