Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
BMC Urol. 2023 Oct 12;23(1):162. doi: 10.1186/s12894-023-01332-4.
Existing epidemiological observational studies have suggested interesting but inconsistent clinical correlations between inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), and kidney stone disease (KSD). Herein, we implemented a two-sample bidirectional Mendelian randomization (MR) to investigate the causal relationship between IBD and KSD.
Data on IBD and KSD were obtained from Genome-Wide Association Studies (GWAS) summary statistics and the FinnGen consortium, respectively. Strict selection steps were used to screen for eligible instrumental SNPs. We applied inverse variance weighting (IVW) with the fix-effects model as the major method. Several sensitivity analyses were used to evaluate pleiotropy and heterogeneity. Causal relationships between IBD and KSD were explored in two opposite directions. Furthermore, we carried out multivariable MR (MVMR) to obtain the direct causal effects of IBD on KSD.
Our results demonstrated that CD could increase the risk of KSD (IVW: OR = 1.06, 95% CI = 1.03-1.10, p < 0.001). Similar results were found in the validation group (IVW: OR = 1.05, 95% CI = 1.01-1.08, p = 0.013) and in the MVMR analysis. Meanwhile, no evidence of a causal association between UC and KSD was identified. The reverse MR analysis detected no causal association.
This MR study verified that CD plays a critical role in developing kidney stones and that the effect of UC on KSD needs to be further explored.
现有的流行病学观察性研究表明,炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),与肾结石病(KSD)之间存在有趣但不一致的临床关联。在此,我们进行了两样本双向孟德尔随机化(MR)分析,以研究 IBD 与 KSD 之间的因果关系。
IBD 和 KSD 的数据分别来自全基因组关联研究(GWAS)汇总统计数据和芬兰基因联合会(FinnGen)。采用严格的选择步骤筛选出合格的工具性 SNP。我们主要采用逆方差加权(IVW)固定效应模型进行分析。采用多种敏感性分析来评估异质性和混杂性。我们从两个相反的方向探讨了 IBD 和 KSD 之间的因果关系。此外,我们进行了多变量 MR(MVMR)分析,以获得 IBD 对 KSD 的直接因果效应。
我们的结果表明,CD 可能会增加 KSD 的发病风险(IVW:OR=1.06,95%CI=1.03-1.10,p<0.001)。在验证组中也得到了类似的结果(IVW:OR=1.05,95%CI=1.01-1.08,p=0.013),并且在 MVMR 分析中也得到了类似的结果。同时,没有证据表明 UC 与 KSD 之间存在因果关联。反向 MR 分析未检测到因果关联。
这项 MR 研究验证了 CD 在肾结石形成中起着关键作用,而 UC 对 KSD 的影响需要进一步探索。