School of Medicine, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
Hernia. 2024 Apr;28(2):599-606. doi: 10.1007/s10029-023-02954-1. Epub 2024 Jan 31.
Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH.
A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH.
None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively.
This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH.
肥胖和高身体质量指数（BMI）被认为是腹壁疝（AWH）的危险因素。然而，身体脂肪分布（BFD）的人体测量指标在疝领域似乎是更好的指标。本孟德尔随机分析旨在为腰围（WC）、身体、躯干、手臂和腿部脂肪百分比（BFP、TFP、AFP、LFP）对 AWH 的影响提供更有力的证据。
采用单变量 MR 设计，并从全基因组关联研究（GWAS）中获得允许评估的汇总统计数据。应用逆方差加权（IVW）方法作为主要分析，使用比值比（OR）值评估 BFD 与 AWH 之间的因果关系。
没有一个 MR-Egger 回归截距偏离零，表明没有水平多效性的证据（p > 0.05）。Cochran Q 检验显示，WC（p = 0.005；p = 0.005）、TFP（p < 0.001；p < 0.001）、AFP-L（p = 0.016；p = 0.015）、LFP-R（p = 0.012；p = 0.009）和 LFP-L（p = 0.012；p = 0.009）的遗传 IV 之间存在异质性。以 IVW 随机效应模型为金标准，遗传决定的 WC、BFP、TFP、AFP-R、AFP-L、LFP-R 和 LFP-L 每增加一个标准差，AWH 的风险分别增加 70.9%、70.7%、56.5%、69.7%、78.3%、87.7%和 72.5%。
本研究证明了 AWH 与 BFD 之间的因果关系，引起了从 BMI 到 BFD 的更多关注。它提供了基于证据的医学证据，表明健康的体型管理可以预防 AWH。
