心理困扰与子宫肌瘤：双向两样本孟德尔随机化研究。

Psychological distress and uterine fibroids: a bidirectional two-sample mendelian randomization study.

机构信息

Department of First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China.

Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26, Heping Road, Xiang-fang District, Harbin, Heilongjiang Province, China.

出版信息

BMC Womens Health. 2024 Jun 18;24(1):351. doi: 10.1186/s12905-024-03196-8.

DOI:10.1186/s12905-024-03196-8

PMID:38890689

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11184690/

Abstract

BACKGROUND

Observational data indicates a connection between emotional discomfort, such as anxiety and depression, and uterine fibroids (UFs). However, additional investigation is required to establish the causal relationship between them. Hence, we assessed the reciprocal causality between four psychological disorders and UFs utilizing two-sample Mendelian randomization (MR).

METHODS

To evaluate the causal relationship between four types of psychological distress (depressive symptoms, severe depression, anxiety or panic attacks, mood swings) and UFs, bidirectional two-sample MR was employed, utilizing single nucleotide polymorphisms (SNPs) associated with these conditions. Both univariate MR (UVMR) and multivariate MR (MVMR) primarily applied inverse variance weighted (IVW) as the method for estimating potential causal effects. Complementary approaches such as MR Egger, weighted median, simple mode, and weighted mode were utilized to validate the findings. To assess the robustness of our MR results, we conducted sensitivity analyses using Cochran's Q-test and the MR Egger intercept test.

RESULTS

The results of our UVMR analysis suggest that genetic predispositions to depressive symptoms (Odds Ratio [OR] = 1.563, 95% Confidence Interval [CI] = 1.209-2.021, P = 0.001) and major depressive disorder (MDD) (OR = 1.176, 95% CI = 1.044-1.324, P = 0.007) are associated with an increased risk of UFs. Moreover, the IVW model showed a nominally significant positive correlation between mood swings (OR: 1.578; 95% CI: 1.062-2.345; P = 0.024) and UFs risk. However, our analysis did not establish a causal relationship between UFs and the four types of psychological distress. Even after adjusting for confounders like body mass index (BMI), smoking, alcohol consumption, and number of live births in the MVMR, the causal link between MDD and UFs remained significant (OR = 1.217, 95% CI = 1.039-1.425, P = 0.015).

CONCLUSIONS

Our study presents evidence supporting the causal relationship between genetic susceptibility to MDD and the incidence of UFs. These findings highlight the significance of addressing psychological health issues, particularly depression, in both the prevention and treatment of UFs.

摘要

背景

观察性数据表明，情绪不适（如焦虑和抑郁）与子宫肌瘤（UFs）之间存在关联。然而，需要进一步研究以确定它们之间的因果关系。因此，我们利用两样本 Mendelian 随机化（MR）评估了四种心理障碍与 UFs 之间的相互因果关系。

方法

为评估四种心理困扰（抑郁症状、重度抑郁、焦虑或惊恐发作、情绪波动）与 UFs 之间的因果关系，我们采用了双向两样本 MR，利用与这些情况相关的单核苷酸多态性（SNPs）。主要使用单变量 MR（UVMR）和多变量 MR（MVMR）中的逆方差加权（IVW）方法来估计潜在的因果效应。互补方法，如 MR Egger、加权中位数、简单模式和加权模式，用于验证结果。为了评估我们的 MR 结果的稳健性，我们使用 Cochran's Q 检验和 MR Egger 截距检验进行了敏感性分析。

结果

我们的 UVMR 分析结果表明，抑郁症状（比值比 [OR] = 1.563，95%置信区间 [CI] = 1.209-2.021，P = 0.001）和重度抑郁障碍（MDD）（OR = 1.176，95% CI = 1.044-1.324，P = 0.007）的遗传易感性与 UFs 风险增加相关。此外，IVW 模型显示情绪波动（OR：1.578；95% CI：1.062-2.345；P = 0.024）与 UFs 风险之间存在显著的正相关。然而，我们的分析并未确定 UFs 与四种类型的心理困扰之间存在因果关系。即使在 MVMR 中调整了体重指数（BMI）、吸烟、饮酒和活产数量等混杂因素，MDD 与 UFs 之间的因果关系仍然显著（OR = 1.217，95% CI = 1.039-1.425，P = 0.015）。