Department of Endocrinology, The First Affiliated Hospital, School of Medicine, Shantou University, Shantou, China.
Department of Gastroenterology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Front Endocrinol (Lausanne). 2024 Feb 9;15:1310083. doi: 10.3389/fendo.2024.1310083. eCollection 2024.
Previous studies have suggested a potential association between AITD and MG, but the evidence is limited and controversial, and the exact causal relationship remains uncertain.
Therefore, we employed a Mendelian randomization (MR) analysis to investigate the causal relationship between AITD and MG.
To explore the interplay between AITD and MG, We conducted MR studies utilizing GWAS-based summary statistics in the European ancestry. Several techniques were used to ensure the stability of the causal effect, such as random-effect inverse variance weighted, weighted median, MR-Egger regression, and MR-PRESSO. Heterogeneity was evaluated by calculating Cochran's Q value. Moreover, the presence of horizontal pleiotropy was investigated through MR-Egger regression and MR-PRESSO.
The IVW method indicates a causal relationship between both GD(OR 1.31,95%CI 1.08 to 1.60,P=0.005) and autoimmune hypothyroidism (OR: 1.26, 95% CI: 1.08 to 1.47, P =0.002) with MG. However, there is no association found between FT4(OR 0.88,95%CI 0.65 to 1.18,P=0.406), TPOAb(OR: 1.34, 95% CI: 0.86 to 2.07, P =0.186), TSH(OR: 0.97, 95% CI: 0.77 to 1.23, P =0.846), and MG. The reverse MR analysis reveals a causal relationship between MG and GD(OR: 1.50, 95% CI: 1.14 to 1.98, P =3.57e-3), with stable results. On the other hand, there is a significant association with autoimmune hypothyroidism(OR: 1.29, 95% CI: 1.04 to 1.59, P =0.019), but it is considered unstable due to the influence of horizontal pleiotropy (MR PRESSO Distortion Test P < 0.001). MG has a higher prevalence of TPOAb(OR: 1.84, 95% CI: 1.39 to 2.42, P =1.47e-5) positivity and may be linked to elevated TSH levels(Beta:0.08,95% CI:0.01 to 0.14,P =0.011), while there is no correlation between MG and FT4(Beta:-9.03e-3,95% CI:-0.07 to 0.05,P =0.796).
AITD patients are more susceptible to developing MG, and MG patients also have a higher incidence of GD.
先前的研究表明自身免疫性甲状腺疾病（AITD）和重症肌无力（MG）之间可能存在关联，但证据有限且存在争议，确切的因果关系仍不确定。
因此，我们采用孟德尔随机化（MR）分析来研究 AITD 和 MG 之间的因果关系。
为了探讨 AITD 和 MG 之间的相互作用，我们利用欧洲血统的基于 GWAS 的汇总统计数据进行了 MR 研究。采用了几种技术来确保因果效应的稳定性，例如随机效应逆方差加权、加权中位数、MR-Egger 回归和 MR-PRESSO。通过计算 Cochran's Q 值评估异质性。此外，通过 MR-Egger 回归和 MR-PRESSO 研究了水平多效性的存在。
IVW 方法表明 GD（OR 1.31，95%CI 1.08 至 1.60，P=0.005）和自身免疫性甲状腺功能减退症（OR：1.26，95%CI：1.08 至 1.47，P=0.002）与 MG 之间存在因果关系。然而，FT4（OR 0.88，95%CI 0.65 至 1.18，P=0.406）、TPOAb（OR：1.34，95%CI：0.86 至 2.07，P=0.186）、TSH（OR：0.97，95%CI：0.77 至 1.23，P=0.846）与 MG 之间没有关联。反向 MR 分析表明 MG 和 GD（OR：1.50，95%CI：1.14 至 1.98，P=3.57e-3）之间存在因果关系，结果稳定。另一方面，与自身免疫性甲状腺功能减退症（OR：1.29，95%CI：1.04 至 1.59，P=0.019）有显著关联，但由于水平多效性的影响（MR-PRESSO 扭曲测试 P<0.001），结果被认为不稳定。MG 患者 TPOAb 阳性率更高（OR：1.84，95%CI：1.39 至 2.42，P=1.47e-5），并且可能与 TSH 水平升高有关（Beta：0.08，95%CI：0.01 至 0.14，P=0.011），而 MG 与 FT4 之间没有相关性（Beta：-9.03e-3，95%CI：-0.07 至 0.05，P=0.796）。
AITD 患者更容易患上 MG，而 MG 患者也更易患 GD。
