Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
BMC Pulm Med. 2023 Nov 20;23(1):450. doi: 10.1186/s12890-023-02759-z.
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) currently ranks as the third leading cause of mortality worldwide, imposing substantial burdens on societal and individual health. Amongst health research tools, walking pace (WP) and hand grip strength (HGS) are cornerstones, extensively associated with diverse health conditions. However, the intricate interplay between these factors and COPD risk remains ambiguous. This study aims to elucidate the causal association of WP, HGS, with COPD risk through a bidirectional Mendelian randomization (MR) approach. METHODS: Bidirectional MR analysis was performed using Genome-wide association study (GWAS) data of European individuals for WP, HGS, and COPD. Inverse Variance Weighted (IVW) served as the primary MR analysis approach. To supplement the IVW findings, four additional MR methods [MR-Egger, weighted median, maximum likelihood, simple median] were used. To assess heterogeneity and pleiotropy, sensitivity analyses were performed. In addition, multivariate MR (MVMR) analysis was used to assess causality after adjustment for potential confounders. RESULTS: IVW method results show a significant negative association between WP and COPD risk in both initial (genome-wide threshold, odds ratio (OR) = 0.21, 95% confidence interval (CI) 0.09-0.51, P = 5.06 × 10) and secondary (locus-wide threshold, OR = 0.27, 95%CI: 0.18-0.41, P = 4.88 × 10) MR analysis. The reverse MR analysis suggested that COPD also diminishes WP. Additionally, a causal risk reduction for COPD with right HGS (OR = 0.74, 95% CI: 0.58-0.94, P = 1.44 × 10) was only found in secondary MR analysis. The outcomes of the four additional MR methods also suggested similar causal relationships, and sensitivity analyses endorsed their robustness. Lastly, the MVMR analysis demonstrated that the WP's effect on reducing COPD risk persisted independently of potential confounding variables. CONCLUSION: A bidirectional causal relationship exists between typical WP and COPD risk. Conversely, a decrease in right HGS is unidirectionally associated with an increased risk of COPD. The study suggests that WP may serve as a predictive factor for COPD or as a simple evaluative indicator for prognosis.
背景：慢性阻塞性肺疾病（COPD）目前是全球第三大死亡原因，给社会和个人健康带来了巨大负担。在健康研究工具中，步行速度（WP）和手握力（HGS）是基石，与多种健康状况密切相关。然而，这些因素与 COPD 风险之间的复杂相互关系仍不清楚。本研究旨在通过双向 Mendelian 随机化（MR）方法阐明 WP 和 HGS 与 COPD 风险的因果关系。
方法：使用欧洲人群的全基因组关联研究（GWAS）数据对 WP、HGS 和 COPD 进行双向 MR 分析。反向方差加权（IVW）作为主要的 MR 分析方法。为了补充 IVW 的发现，使用了另外四种 MR 方法[MR-Egger、加权中位数、最大似然、简单中位数]。为了评估异质性和多效性，进行了敏感性分析。此外，还使用多变量 MR（MVMR）分析在调整潜在混杂因素后评估因果关系。
结果：IVW 方法的结果表明，WP 与 COPD 风险之间存在显著负相关，无论是在初始（全基因组阈值，优势比（OR）=0.21，95%置信区间（CI）0.09-0.51，P=5.06×10）还是次要（基因座范围阈值，OR=0.27，95%CI：0.18-0.41，P=4.88×10）MR 分析中。反向 MR 分析表明，COPD 也会降低 WP。此外，只有在次要 MR 分析中才发现右手 HGS 对 COPD 的风险降低有因果关系（OR=0.74，95%CI：0.58-0.94，P=1.44×10）。另外四种 MR 方法的结果也表明存在类似的因果关系，敏感性分析证实了其稳健性。最后，MVMR 分析表明，WP 降低 COPD 风险的影响在独立于潜在混杂变量的情况下仍然存在。
结论：WP 与 COPD 风险之间存在双向因果关系。相反，右手 HGS 的降低与 COPD 风险的增加呈单向相关。该研究表明，WP 可能是 COPD 的预测因素或预后的简单评估指标。
Int J Chron Obstruct Pulmon Dis. 2024
Medicine (Baltimore). 2025-3-14
Int J Chron Obstruct Pulmon Dis. 2025-1-25
Front Cardiovasc Med. 2022-8-30
Int J Chron Obstruct Pulmon Dis. 2022
Scand J Med Sci Sports. 2022-9
Lancet. 2022-6-11
Tuberk Toraks. 2022-3
Zotero 插件
