Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Operating Room, Taixing People's Hospital, Taixing, China.
Front Endocrinol (Lausanne). 2023 Aug 29;14:1196269. doi: 10.3389/fendo.2023.1196269. eCollection 2023.
The relationship between different autoimmune diseases and bone mineral density (BMD) and fractures has been reported in epidemiological studies. This study aimed to explore the causal relationship between autoimmune diseases and BMD, falls, and fractures using Mendelian randomization (MR).
The instrumental variables were selected from the aggregated statistical data of these diseases from the largest genome-wide association study in Europe. Specifically, 12 common autoimmune diseases were selected as exposure. Outcome variables included BMD, falls, and fractures. Multiple analysis methods were utilized to comprehensively evaluate the causal relationship between autoimmune diseases and BMD, falls, and fractures. Additionally, sensitivity analyses, including Cochran's Q test, MR-Egger intercept test, and one analysis, were conducted to verify the result's reliability.
Strong evidence was provided in the results of the negatively association of ulcerative colitis (UC) with forearm BMD. UC also had a negatively association with the total body BMD, while inflammatory bowel disease (IBD) depicted a negatively association with the total body BMD at the age of 45-60 years. Horizontal pleiotropy or heterogeneity was not detected through sensitivity analysis, indicating that the causal estimation was reliable.
This study shows a negative causal relationship between UC and forearm and total body BMD, and between IBD and total body BMD at the age of 45-60 years. These results should be considered in future research and when public health measures and osteoporosis prevention strategies are formulated.
流行病学研究已经报道了不同自身免疫性疾病与骨密度（BMD）和骨折之间的关系。本研究旨在使用孟德尔随机化（MR）方法探索自身免疫性疾病与 BMD、跌倒和骨折之间的因果关系。
从欧洲最大的全基因组关联研究中汇总的这些疾病的统计数据中选择了工具变量。具体来说，选择了 12 种常见的自身免疫性疾病作为暴露因素。结局变量包括 BMD、跌倒和骨折。采用多种分析方法综合评估自身免疫性疾病与 BMD、跌倒和骨折之间的因果关系。此外，还进行了 Cochran's Q 检验、MR-Egger 截距检验和单一分析等敏感性分析，以验证结果的可靠性。
结果提供了强有力的证据表明溃疡性结肠炎（UC）与前臂 BMD 呈负相关。UC 还与全身 BMD 呈负相关，而炎症性肠病（IBD）在 45-60 岁时与全身 BMD 呈负相关。通过敏感性分析未检测到水平异质性或混杂性，表明因果估计可靠。
本研究表明 UC 与前臂和全身 BMD 之间以及 IBD 与 45-60 岁时全身 BMD 之间呈负相关因果关系。在未来的研究和制定公共卫生措施和骨质疏松症预防策略时，应考虑这些结果。
