Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Orthop Res. 2024 Jan;42(1):183-192. doi: 10.1002/jor.25656. Epub 2023 Aug 8.
This study aimed to investigate the causal risk factors for intervertebral disc disorders (IVDD) to help establish prevention strategies for IVDD-related diseases. We performed two-sample Mendelian randomization analyses to investigate the causal effects of body mass index (BMI), education, and lifestyle behaviors (sedentary behavior, smoking, and sleeping) on thoracic/thoracolumbar/lumbosacral IVDD (TTL-IVDD) and cervical IVDD. The inverse-variance weighted (IVW) method was conducted as the primary model to pool effect sizes using odds ratio and 95% confidence interval. The strength of causal evidence was evaluated from the effect size and different Mendelian randomization methods (MR-Egger/weighted median/weighted mode method, Cochran's Q test, leave-one-out analysis, MR Steiger, MR-PRESSO and radial IVW analyses). We found strong evidence for the causal associations between IVDD and BMI (TTL-IVDD, 1.27 [1.18, 1.37], p = 2.40 × 10 ; cervical IVDD, 1.24 [1.12, 1.37, p = 6.58 × 10 ), educational attainment (TTL-IVDD, 0.57 [0.51, 0.64], p = 9.64 × 10 ; cervical IVDD, 0.58 [0.49, 0.68], p = 1.78 × 10 ), leisure television watching (TTL-IVDD, 1.54 [1.29, 1.84], p = 7.80 × 10 ; cervical IVDD, 1.65 [1.29, 2.11], p = 0.0001), smoking initiation (TTL-IVDD, 1.37 [1.25, 1.50], p = 1.78 × 10 ; cervical IVDD, 1.32 [1.16, 1.51], p = 6.49 × 10 ), short sleep (TTL-IVDD, 1.28 [1.09, 1.49], p = 0.0027; cervical IVDD, 1.53 [1.21, 1.94], p = 0.0008), or frequent insomnia (TTL-IVDD, 1.20 [1.11, 1.30], p = 1.54 × 10 ; cervical IVDD, 1.37 [1.20, 1.57], p = 7.80 × 10 ). This study provided genetic evidence that increased BMI, low educational attainment, sedentary behavior by leisure television watching, smoking initiation, short sleep, and frequent insomnia were causal risk factors for IVDD. More efforts should be directed toward increasing public awareness of these modifiable risk factors and mobilizing individuals to adopt healthy lifestyles.
本研究旨在探讨椎间盘疾病（IVDD）的因果风险因素，以帮助制定与 IVDD 相关疾病的预防策略。我们进行了两样本孟德尔随机化分析，以研究体重指数（BMI）、教育程度和生活方式行为（久坐行为、吸烟和睡眠）对胸/胸腰椎/腰骶椎 IVDD（TTL-IVDD）和颈椎 IVDD 的因果影响。采用优势比和 95%置信区间的逆方差加权（IVW）方法作为主要模型来汇总效应大小。从效应大小和不同的孟德尔随机化方法（MR-Egger/加权中位数/加权模式法、Cochran's Q 检验、单样本剔除分析、MR Steiger、MR-PRESSO 和放射状 IVW 分析）评估因果证据的强度。我们发现 IVDD 与 BMI（TTL-IVDD，1.27[1.18，1.37]，p=2.40×10；颈椎 IVDD，1.24[1.12，1.37，p=6.58×10）之间存在强烈的因果关联，教育程度（TTL-IVDD，0.57[0.51，0.64]，p=9.64×10；颈椎 IVDD，0.58[0.49，0.68]，p=1.78×10），休闲看电视（TTL-IVDD，1.54[1.29，1.84]，p=7.80×10；颈椎 IVDD，1.65[1.29，2.11]，p=0.0001），吸烟开始（TTL-IVDD，1.37[1.25，1.50]，p=1.78×10；颈椎 IVDD，1.32[1.16，1.51]，p=6.49×10），睡眠不足（TTL-IVDD，1.28[1.09，1.49]，p=0.0027；颈椎 IVDD，1.53[1.21，1.94]，p=0.0008）或频繁失眠（TTL-IVDD，1.20[1.11，1.30]，p=1.54×10；颈椎 IVDD，1.37[1.20，1.57]，p=7.80×10）。本研究提供了遗传证据，表明 BMI 增加、教育程度低、休闲看电视导致的久坐行为、吸烟开始、睡眠不足和频繁失眠是 IVDD 的因果风险因素。应加大力度提高公众对这些可改变风险因素的认识，并动员个人采取健康的生活方式。
