Zhang Xin, Yu Shi-Liang, Qi Lu-Ming, Xia Li-Na, Yang Qing-Tang
Rehabilitation Traditional Chinese Medicine Department, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, 353000, China.
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China.
SSM Popul Health. 2024 Jan 6;25:101585. doi: 10.1016/j.ssmph.2023.101585. eCollection 2024 Mar.
BACKGROUNDDue to the long time interval between exposure and outcome, it is difficult to infer the causal relationship between educational attainment (EA) and common chronic diseases. Therefore, we utilized Mendelian randomization (MR) to predict the causal relationships of EA with hypertension and type-2 diabetes (T2DM). METHODSA two-sample MR analysis was conducted using genome-wide association studies (GWASs) combined with inferential measurements. A GWAS meta-analysis including 1,131,881 European individuals was used to identify instruments for EA. Hypertension and T2DM data were obtained from a Finnish database. MR analyses were performed using inverse-variance weighted meta-analysis (IVW), weighted median regression, MR‒Egger regression, simple mode regression, weighted mode regression and the MR-Pleiotropy RESidual Sum and Outlier test. Sensitivity analyses were further performed using the leave-one-out method to test the robustness of our findings. RESULTSUsing the MR approach, our results showed that EA was significantly associated with a reduced risk of hypertension (OR = 0.63; P = 2.94 × 10; [95% CI: 0.59, 0.67]) and type-2 diabetes (OR = 0.59; P = 1.25 × 10; [95% CI: 0.52, 0.67]). CONCLUSIONSThis study showed that EA is causally linked to the risk of chronic diseases, including high blood pressure and T2DM.
背景
由于暴露与结果之间的时间间隔较长，难以推断教育程度（EA）与常见慢性病之间的因果关系。因此，我们利用孟德尔随机化（MR）来预测EA与高血压和2型糖尿病（T2DM）之间的因果关系。
方法
采用全基因组关联研究（GWAS）结合推断测量进行两样本MR分析。一项纳入1131881名欧洲个体的GWAS荟萃分析用于确定EA的工具变量。高血压和T2DM数据来自芬兰数据库。使用逆方差加权荟萃分析（IVW）、加权中位数回归、MR-Egger回归、简单模式回归、加权模式回归和MR-多效性残差和离群值检验进行MR分析。进一步使用留一法进行敏感性分析，以检验我们研究结果的稳健性。
结果
采用MR方法，我们的结果显示，EA与高血压风险降低显著相关（OR = 0.63；P = 2.94×10；[95%CI：0.59，0.67]）以及与2型糖尿病风险降低显著相关（OR = 0.59；P = 1.25×10；[95%CI：0.52，0.67]）。
结论
本研究表明，EA与包括高血压和T2DM在内的慢性病风险存在因果联系。
