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通过孟德尔随机化评估血浆咖啡因水平与神经精神障碍之间的因果关系。

Appraising the causal relationship between plasma caffeine levels and neuropsychiatric disorders through Mendelian randomization.

机构信息

School of Psychological Science, University of Bristol, Bristol, UK.

MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.

出版信息

BMC Med. 2023 Aug 8;21(1):296. doi: 10.1186/s12916-023-03008-0.

Abstract

BACKGROUND

Caffeine exposure modifies the turnover of monoamine neurotransmitters, which play a role in several neuropsychiatric disorders. We conducted a Mendelian randomization study to investigate whether higher plasma caffeine levels are causally associated with the risk of anorexia nervosa, bipolar disorder, major depressive disorder (MDD), and schizophrenia.

METHODS

Summary-level data on the neuropsychiatric disorders were obtained from large-scale genome-wide association studies (GWASs) of European ancestry participants (n = 72,517 to 807,553) and meta-analyzed with the corresponding data from the FinnGen study (n = 356,077). Summary-level data on plasma caffeine were extracted from a GWAS meta-analysis of 9876 European ancestry individuals. The Mendelian randomization analyses estimated the Wald ratio for each genetic variant and meta-analyzed the variant-specific estimates using multiplicative random effects meta-analysis.

RESULTS

After correcting for multiple testing, genetically predicted higher plasma caffeine levels were associated with higher odds of anorexia nervosa (odds ratio [OR] = 1.124; 95% confidence interval [CI] = 1.024-1.238, p = 0.039) and a lower odds of bipolar disorder (OR = 0.905, 95% CI = 0.827-0.929, p = 0.041) and MDD (OR = 0.965, 95% CI = 0.937-0.995, p = 0.039). Instrumented plasma caffeine levels were not associated with schizophrenia (OR = 0.986, 95% CI = 0.929-1.047, p = 0.646).

CONCLUSIONS

These Mendelian randomization findings indicate that long-term higher plasma caffeine levels may lower the risk of bipolar disorder and MDD but increase the risk of anorexia nervosa. These results warrant further research to explore whether caffeine consumption, supplementation, or abstinence could render clinically relevant therapeutic or preventative psychiatric effects.

摘要

背景

咖啡因暴露会改变单胺神经递质的周转率,而单胺神经递质在几种神经精神疾病中发挥作用。我们进行了一项孟德尔随机化研究,以调查血浆中较高的咖啡因水平是否与神经性厌食症、双相情感障碍、重性抑郁障碍(MDD)和精神分裂症的风险有因果关系。

方法

从欧洲血统参与者的大规模全基因组关联研究(GWAS)中获得神经精神疾病的汇总水平数据(n=72517 至 807553),并与 FinnGen 研究(n=356077)的相应数据进行荟萃分析。从一项对 9876 名欧洲血统个体的 GWAS 荟萃分析中提取血浆咖啡因的汇总水平数据。孟德尔随机化分析估计了每个遗传变异的 Wald 比值,并使用乘法随机效应荟萃分析对变异特异性估计值进行荟萃分析。

结果

在进行多重检验校正后,遗传预测的血浆咖啡因水平升高与神经性厌食症的发病风险增加相关(比值比[OR]为 1.124;95%置信区间[CI]为 1.024-1.238,p=0.039),与双相情感障碍(OR 为 0.905,95%CI 为 0.827-0.929,p=0.041)和 MDD(OR 为 0.965,95%CI 为 0.937-0.995,p=0.039)的发病风险降低相关。但与精神分裂症无关(OR 为 0.986,95%CI 为 0.929-1.047,p=0.646)。

结论

这些孟德尔随机化研究结果表明,长期较高的血浆咖啡因水平可能降低双相情感障碍和 MDD 的发病风险,但增加神经性厌食症的发病风险。这些结果需要进一步研究,以探索咖啡因的摄入、补充或戒断是否能产生有临床意义的治疗或预防精神疾病的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8b/10408049/747fd3f9ced3/12916_2023_3008_Fig1_HTML.jpg

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