Department of Spine Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443002, China.
Department of Orthopaedics, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, 443003, China.
Eur Spine J. 2024 Sep;33(9):3352-3358. doi: 10.1007/s00586-024-08367-7. Epub 2024 Jun 24.
The role of basal metabolic rate (BMR) in intervertebral disc degeneration (IVDD) is still uncertain. To address this gap, we conducted a Mendelian randomization (MR) study to comprehensively explore the causal relationship between BMR and IVDD.
BMR data were obtained from a large genome-wide association study (GWAS) database, while IVDD data were derived from the FinnGen project. The causal relationship between IVDD and BMR was investigated using MR, with inverse-variance weighting (IVW) as the primary estimate. MR-Egger weighed median and weighed mode were employed for robustness. Sensitivity analyses, including the Cochran Q test, leave-one-out analysis, and MR-Egger intercept analysis, were conducted. Furthermore, the study also identified causal relationships between IVDD and factors associated with BMR (hyperthyroidism, type 2 diabetes, standing height, weight, and body mass index). Multivariable MR was applied to further assess the direct effect of BMR on IVDD.
Genetic predisposition to BMR (after removing outliers OR: 1.49; 95% CI: 1.37-1.63; P = 5.073e-21) were associated with an increased risk of IVDD. Additionally, IVDD risk increased with greater height, weight, and BMI. No causal relationship was observed between hy/thy and T2D and intervertebral disc degeneration (IVDD) (P > 0.05). In multivariable MR, a significant causal association between BMR and IVDD persisted, even after adjusting for BMI, height, and weight.
In this study, we successfully identified that a higher BMR is independently and causally linked to IVDD, indicating an increased risk of developing IVDD. These findings suggest that managing BMR could potentially mitigate the risk of IVDD.
基础代谢率（BMR）在椎间盘退变（IVDD）中的作用仍不确定。为了解决这一差距，我们进行了孟德尔随机化（MR）研究，全面探讨了 BMR 与 IVDD 之间的因果关系。
BMR 数据来自大型全基因组关联研究（GWAS）数据库，而 IVDD 数据来自 FinnGen 项目。使用 MR 方法，以逆方差加权（IVW）作为主要估计值，研究 IVDD 与 BMR 之间的因果关系。中位数加权和加权模式加权用于稳健性检验。进行敏感性分析，包括 Cochran Q 检验、单倍型缺失分析和 MR-Egger 截距分析。此外，该研究还确定了 IVDD 与与 BMR 相关的因素（甲状腺功能亢进、2 型糖尿病、站立身高、体重和体重指数）之间的因果关系。应用多变量 MR 进一步评估 BMR 对 IVDD 的直接影响。
BMR 的遗传易感性（去除离群值后 OR：1.49；95%CI：1.37-1.63；P=5.073e-21）与 IVDD 风险增加相关。此外，身高、体重和 BMI 越高，IVDD 风险越大。甲状腺功能亢进和 2 型糖尿病与椎间盘退变（IVDD）之间没有因果关系（P>0.05）。在多变量 MR 中，即使在调整 BMI、身高和体重后，BMR 与 IVDD 之间仍存在显著的因果关系。
在这项研究中，我们成功地确定了较高的 BMR 与 IVDD 独立且因果相关，表明 IVDD 的发病风险增加。这些发现表明，控制 BMR 可能有助于降低 IVDD 的风险。
