Department of Obstetrics and Gynecology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Department of Obstetrics and Gynecology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
Acta Diabetol. 2024 Feb;61(2):161-168. doi: 10.1007/s00592-023-02190-0. Epub 2023 Oct 7.
Observational studies have reported that autoimmune diseases are associated with gestational diabetes mellitus (GDM), but the causality is unknown. The study aimed to evaluate the potential causal effect of autoimmune diseases on GDM.
A two-sample Mendelian randomization (MR) study was designed using the summary statistics of GDM (123,579 individuals) and three common autoimmune diseases, including inflammatory bowel disease (IBD, 59,957 individuals), rheumatoid arthritis (RA, 80,799 individuals) and systemic lupus erythematosus (SLE, 14,267 individuals), from the genome-wide association study (GWAS). The fixed-effects inverse variance weighted (IVW) was used to deduce the causal association between autoimmune diseases and GDM, and sensitivity analyses were further performed.
The inverse variance weighting (IVW) method showed that RA and SLE increased the risk of GDM (RA: OR = 1.076, 95%CI = 1.033-1.122, P = 4.649E-04; SLE: OR = 1.025, 95%CI = 1.001-1.049, P = 0.044). But there were no any associations of IBD with GDM (P > 0.05). No significant horizontal pleiotropy was found by MR Egger regression (IBD: P for intercept = 0.905; RA: P for intercept = 0.103; SLE = P for intercept = 0.608).
This two-sample MR study found that both SLE and RA are positively associated with the risk of GDM. Our findings provide help for the future prevention and treatment of GDM to reduce associated maternal and fetal complications. However, more research is needed to obviate the role of the GC and the HCQ to ensure this relationship is causal.
观察性研究报告称，自身免疫性疾病与妊娠糖尿病（GDM）有关，但因果关系尚不清楚。本研究旨在评估自身免疫性疾病对 GDM 的潜在因果影响。
采用两样本 Mendelian 随机化（MR）研究设计，使用 GDM（123579 人）和三种常见自身免疫性疾病（包括炎症性肠病[IBD，59957 人]、类风湿关节炎[RA，80799 人]和系统性红斑狼疮[SLE，14267 人]）的全基因组关联研究（GWAS）汇总统计数据。采用固定效应逆方差加权（IVW）推断自身免疫性疾病与 GDM 之间的因果关系，并进一步进行敏感性分析。
IVW 方法表明 RA 和 SLE 增加了 GDM 的风险（RA：OR=1.076，95%CI=1.033-1.122，P=4.649E-04；SLE：OR=1.025，95%CI=1.001-1.049，P=0.044）。但 IBD 与 GDM 无任何关联（P>0.05）。MR Egger 回归未发现明显的水平异质性（IBD：P 截距=0.905；RA：P 截距=0.103；SLE=P 截距=0.608）。
本两样本 MR 研究发现，SLE 和 RA 均与 GDM 风险呈正相关。我们的研究结果为未来预防和治疗 GDM 以减少相关母婴并发症提供了帮助。但是，需要进一步的研究来排除 GC 和 HCQ 的作用，以确保这种关系是因果关系。
