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血脂在预测器官和组织移植后移植物功能障碍中的价值:孟德尔随机化研究

Value of blood lipid in predicting graft dysfunction after organ and tissue transplantation: A study of Mendelian randomization.

作者信息

Zhao Yuanyuan, Du Dunfeng, Wei Lai, Chen Zhishui

机构信息

Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Organ Transplantation, Ministry of Education, NHC Key Laboratory of Organ Transplantation, Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China.

出版信息

Heliyon. 2023 Sep 15;9(9):e20230. doi: 10.1016/j.heliyon.2023.e20230. eCollection 2023 Sep.

Abstract

BACKGROUND

While immunosuppressive regimens have improved outcomes in solid organ transplantation, non-immune factors have also been identified as contributors to graft prognosis. Age, gender, hormones, heredity, and other diseases have been recognized to affect organ transplantation. However, the causal relationship between blood lipids and graft dysfunction remains unverified in human clinical investigations. In this study, we employed two-sample Mendelian randomization (MR) to examine the causality between different types of blood lipids and graft dysfunction following organ and tissue transplantation.

METHODS

We conducted a two-sample MR study using available genome-wide association summary data from the online database MRBASE (http://app.mrbase.org/), which encompasses over 11 billion associations between genetic factors and health-related outcomes, enabling researchers to explore various potential determinants of poor health. The exposure factors included four types of blood lipids: high-density lipoprotein, low-density lipoprotein, cholesterol, and triglycerides. For each exposure factor, three databases were selected for analysis. The outcome factor was the failure and rejection of transplanted organs and tissues. All databases consisted of European population samples, without specific subgroups. The related studies were conducted between 2016 and 2022, and the "TwoSampleMR" R package was employed for variant selection.

RESULTS

A total of 13 sample groups were collected and analyzed. The results revealed a causal association between blood lipids and graft dysfunction following organ and tissue transplantation. Specifically, the two-sample MR analysis confirmed that low-density lipoprotein and cholesterol levels were significant risk factors for increased graft dysfunction risk after transplantation. Moreover, high-density lipoprotein potentially reduced the risk of allograft dysfunction, while triglycerides possibly elevated the risk.

CONCLUSIONS

Our recent study provides the initial confirmation that blood lipids may initiate causal pathological processes leading to graft dysfunction after organ and tissue transplantation.

摘要

背景

虽然免疫抑制方案改善了实体器官移植的预后,但非免疫因素也被认为是影响移植物预后的因素。年龄、性别、激素、遗传和其他疾病已被证实会影响器官移植。然而,血脂与移植物功能障碍之间的因果关系在人类临床研究中仍未得到证实。在本研究中,我们采用两样本孟德尔随机化(MR)方法来研究不同类型血脂与器官和组织移植后移植物功能障碍之间的因果关系。

方法

我们使用在线数据库MRBASE(http://app.mrbase.org/)中可用的全基因组关联汇总数据进行了两样本MR研究,该数据库包含超过110亿个遗传因素与健康相关结局之间的关联,使研究人员能够探索各种潜在的健康不良决定因素。暴露因素包括四种血脂类型:高密度脂蛋白、低密度脂蛋白、胆固醇和甘油三酯。对于每个暴露因素,选择三个数据库进行分析。结局因素是移植器官和组织的衰竭和排斥反应。所有数据库均由欧洲人群样本组成,无特定亚组。相关研究在2016年至2022年期间进行,并使用“TwoSampleMR”R包进行变异选择。

结果

共收集并分析了13个样本组。结果显示血脂与器官和组织移植后移植物功能障碍之间存在因果关联。具体而言,两样本MR分析证实,低密度脂蛋白和胆固醇水平是移植后移植物功能障碍风险增加的显著危险因素。此外,高密度脂蛋白可能降低同种异体移植物功能障碍的风险,而甘油三酯可能增加该风险。

结论

我们最近的研究初步证实,血脂可能引发导致器官和组织移植后移植物功能障碍的因果病理过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1033/10559986/5e4ec78dc83c/gr1.jpg

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