Ren Zhenxiao, Cheng Xing, Xu Jinghui, Niu Tianzuo, Long Houqing
Department of Spine Surgery, Orthopaedic, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University/The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, China.
Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Front Genet. 2024 Apr 25;15:1297213. doi: 10.3389/fgene.2024.1297213. eCollection 2024.
Education, cognition, and intelligence are phenotypically and genetically related. Education has been shown to have a protective effect on the risk of developing cervical spondylosis. However, it is unclear whether cognition and intelligence have independent causal effects on cervical spondylosis, and whether health and lifestyle factors influence this association. We first assessed the independent effects of education, cognition, and intelligence on cervical spondylosis by two-sample Mendelian randomization and multivariable Mendelian randomization analysis, and evaluated 26 potential association mediators using two-step Mendelian randomization, and calculated the median proportion. The results showed that only education had an independent causal effect on cervical spondylosis, and had a protective effect on the risk of cervical spondylosis (β: 0.3395; se: 0.166; < 0.05; OR:0.71; [95%CI: 0.481-0.943]. Of the 26 potential associated mediators, a factor was identified: SHBG (mediated proportion: 2.5%). Univariable Mendelian randomization results showed that the risk factors for cervical spondylosis were time spent watching TV (OR:1.96; [95%CI: 1.39-2.76]), smoking (OR:2.56; [95%CI: 1.061-1.486]), body mass index (OR:1.26; [95%CI: 1.124-1.418]), percentage of body fat (OR:1.32; [95%CI: 1.097-1.593]), major depression (OR:1.27; [95%CI: 1.017-1.587]) and sitting height (OR:1.15; [95%CI: 1.025-1.291]). Protective factors include computer using (OR:0.65; [95%CI: 0.418-0.995]), sex hormone binding globulin (OR:0.87; [95%CI: 0.7955-0.951]) and high-density lipoprotein (OR:0.90; [95%CI: 0.826-0.990]). Our findings demonstrate the causal and independent effects of education on cervical spondylosis and suggest that lifestyle media may be a priority target for the prevention of cervical spondylosis due to low educational attainment.
教育、认知和智力在表型和基因上相互关联。研究表明，教育对颈椎病的发病风险具有保护作用。然而，认知和智力是否对颈椎病有独立的因果影响，以及健康和生活方式因素是否会影响这种关联尚不清楚。我们首先通过两样本孟德尔随机化和多变量孟德尔随机化分析评估了教育、认知和智力对颈椎病的独立影响，并使用两步孟德尔随机化评估了26种潜在的关联中介因素，并计算了中位数比例。结果表明，只有教育对颈椎病有独立的因果影响，并对颈椎病风险具有保护作用（β：0.3395；标准误：0.166；P<0.05；比值比：0.71；[95%置信区间：0.481 - 0.943]）。在26种潜在的相关中介因素中，确定了一个因素：性激素结合球蛋白（中介比例：2.5%）。单变量孟德尔随机化结果表明，颈椎病的危险因素包括看电视时间（比值比：1.96；[95%置信区间：1.39 - 2.76]）、吸烟（比值比：2.56；[95%置信区间：1.061 - 1.486]）、体重指数（比值比：1.26；[95%置信区间：1.124 - 1.418]）、体脂百分比（比值比：1.32；[95%置信区间：1.097 - 1.593]）、重度抑郁症（比值比：1.27；[95%置信区间：1.017 - 1.587]）和坐高（比值比：1.15；[95%置信区间：1.025 - 1.291]）。保护因素包括使用电脑（比值比：0.65；[95%置信区间：0.418 - 0.995]）、性激素结合球蛋白（比值比：0.87；[95%置信区间：0.7955 - 0.951]）和高密度脂蛋白（比值比：0.90；[95%置信区间：0.826 - 0.990]）。我们的研究结果证明了教育对颈椎病的因果和独立影响，并表明由于教育程度低，生活方式因素可能是预防颈椎病的优先目标。
