1 型糖尿病与阿尔茨海默病和帕金森病之间的因果关系:双向两样本 Mendelian 随机研究。

Causal relationships between type 1 diabetes mellitus and Alzheimer's disease and Parkinson's disease: a bidirectional two-sample Mendelian randomization study.

机构信息

Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, 45 Changchun Street, Beijing, 100053, China.

Department of Neurology, Rongcheng People's Hospital, The Affiliated Hospital of Jining Medical University, Weihai, China.

出版信息

Eur J Med Res. 2024 Jan 16;29(1):53. doi: 10.1186/s40001-023-01628-z.

Abstract

BACKGROUND

Previous compelling evidence suggests an association between Type 2 diabetes (T2D) and neurodegenerative diseases. However, it remains uncertain whether Type 1 diabetes mellitus (T1DM) exerts a causal influence on the risk of Alzheimer's disease (AD) and Parkinson's disease (PD). Consequently, this study employed a bidirectional two-sample Mendelian Randomization (MR) approach to investigate the causal relationship between T1DM and the genetic susceptibility to AD and PD.

METHODS

We utilized large-scale cohorts derived from publicly available genome-wide association study datasets involving European populations to perform MR analyses. The primary analytical method employed was the inverse-variance weighted (IVW) approach. Furthermore, sensitivity analyses, including assessments of heterogeneity and horizontal pleiotropy, were carried out using Cochran's Q, MR-Egger intercept, and MR-PRESSO tests to enhance the robustness of our conclusions.

RESULTS

Using the IVW-based method, the MR analysis indicated no significant association between genetically determined T1DM and AD (OR = 0.984, 95% CI: 0.958-1.011, p = 0.247). Conversely, T1DM appeared to be associated with a reduced risk of genetic susceptibility to PD (IVW: OR = 0.958, 95% CI: 0.928-0.989, p = 0.001). In the reverse direction, no evidence of reverse causality was observed between AD (OR = 1.010, 95% CI: 0.911-1.116, p = 0.881) or PD (OR = 1.164, 95% CI: 0.686-2.025, p = 0.5202) and T1DM. Additionally, our analysis found no indications of the results being influenced by horizontal pleiotropy.

CONCLUSION

This MR study reveals that T1DM is associated with a reduced genetic susceptibility to PD, whereas no significant genetic susceptibility is observed between T1DM and AD. These findings suggest that T1DM may have a distinct role in the development of neurodegenerative diseases compared to T2D. Further investigations are warranted to elucidate the underlying mechanisms and provide a more comprehensive understanding of this relationship.

摘要

背景

先前的有力证据表明 2 型糖尿病(T2D)与神经退行性疾病之间存在关联。然而,1 型糖尿病(T1DM)是否对阿尔茨海默病(AD)和帕金森病(PD)的遗传易感性产生因果影响仍不确定。因此,本研究采用双向两样本 Mendelian Randomization(MR)方法来研究 T1DM 与 AD 和 PD 的遗传易感性之间的因果关系。

方法

我们利用来自欧洲人群的公开全基因组关联研究数据集的大型队列进行 MR 分析。主要分析方法是逆方差加权(IVW)方法。此外,我们还进行了异质性和水平多效性的敏感性分析,包括 Cochran's Q、MR-Egger 截距和 MR-PRESSO 检验,以增强我们结论的稳健性。

结果

使用基于 IVW 的方法,MR 分析表明,遗传确定的 T1DM 与 AD 之间没有显著关联(OR=0.984,95%CI:0.958-1.011,p=0.247)。相反,T1DM 似乎与 PD 的遗传易感性降低相关(IVW:OR=0.958,95%CI:0.928-0.989,p=0.001)。在相反的方向上,AD(OR=1.010,95%CI:0.911-1.116,p=0.881)或 PD(OR=1.164,95%CI:0.686-2.025,p=0.5202)与 T1DM 之间没有观察到反向因果关系的证据。此外,我们的分析没有发现结果受到水平多效性影响的迹象。

结论

这项 MR 研究表明,T1DM 与 PD 的遗传易感性降低有关,而 T1DM 与 AD 之间没有显著的遗传易感性。这些发现表明,与 T2D 相比,T1DM 在神经退行性疾病的发展中可能具有不同的作用。需要进一步的研究来阐明潜在的机制,并提供对这种关系的更全面理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a658/10790511/7e95711106c5/40001_2023_1628_Fig1_HTML.jpg

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