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孟德尔随机化强调睡眠障碍介导了抑郁对慢性疼痛的影响。

Mendelian randomization highlights sleep disturbances mediated the effect of depression on chronic pain.

机构信息

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Brain Behav. 2024 Jul;14(7):e3596. doi: 10.1002/brb3.3596.


DOI:10.1002/brb3.3596
PMID:38967065
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11224770/
Abstract

INTRODUCTION: Depression and chronic pain are significant contributors to the global burden of disease. Previous research has revealed complex relationships between these two conditions, which may be influenced by sleep quality. However, observational studies have limitations, including confounding factors and reverse causation. This study aims to explore the mediating effects of sleep on the relationship between depression and chronic pain using Mendelian randomization (MR). METHODS: We conducted a two-step, two-sample MR study using mediation analysis. We obtained major depressive disorder (MDD) Genome-Wide Association Studdies (GWAS) data from Wray et al.'s GWAS meta-analysis. Phenotypic data related to sleep were collected from the UK Biobank. Chronic pain data were obtained from the Finnish database. RESULTS: MR analysis revealed significant genetic associations between MDD and chronic localized pain [IVW: odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.16-1.38, p = 2.52 × 10] as well as fibromyalgia (IVW: OR = 2.17, 95% CI = 1.34-3.52, p = .002). Genetic susceptibility for MDD was also associated with insomnia (IVW: OR = 1.10, 95% CI = 1.06-1.13, p = 3.57 × 10) and self-reported short sleep duration (IVW: OR = 1.03, 95% CI = 1.00-1.06, p = .047). The mediating effects of insomnia and fibromyalgia on the pathway from depression to chronic regional pain were 1.04 and 1.03, respectively, with mediation proportions of 12.8% and 15.2%. Insomnia mediated the pathway between depression and fibromyalgia with an effect of 1.12, accounting for 15.2% of the total effect. CONCLUSION: This two-step MR analysis strengthens the evidence of genetic predictive associations between depression and chronic pain, highlighting the mediating roles of insomnia and short sleep duration. It further elucidates the specific roles of distinct sleep disorders, differentiating insomnia and short sleep duration from other sleep-related phenotypes.

摘要

简介:抑郁和慢性疼痛是全球疾病负担的重要因素。先前的研究揭示了这两种情况之间的复杂关系,而睡眠质量可能会影响这种关系。然而,观察性研究存在局限性,包括混杂因素和反向因果关系。本研究旨在使用孟德尔随机化(MR)方法探索睡眠对抑郁和慢性疼痛之间关系的中介作用。

方法:我们采用中介分析进行了两步、两样本 MR 研究。我们从 Wray 等人的 GWAS 荟萃分析中获得了重度抑郁症(MDD)全基因组关联研究(GWAS)数据。与睡眠相关的表型数据来自英国生物库。慢性疼痛数据来自芬兰数据库。

结果:MR 分析显示,MDD 与慢性局部疼痛[IVW:比值比(OR)=1.26,95%置信区间(CI)=1.16-1.38,p=2.52×10]以及纤维肌痛[IVW:OR=2.17,95%CI=1.34-3.52,p=0.002]之间存在显著的遗传关联。MDD 的遗传易感性也与失眠(IVW:OR=1.10,95%CI=1.06-1.13,p=3.57×10)和自我报告的短睡眠时间(IVW:OR=1.03,95%CI=1.00-1.06,p=0.047)有关。失眠和纤维肌痛对抑郁到慢性区域性疼痛通路的中介作用分别为 1.04 和 1.03,中介比例分别为 12.8%和 15.2%。失眠对抑郁和纤维肌痛之间的通路产生了 1.12 的影响,占总效应的 15.2%。

结论:这项两步 MR 分析加强了抑郁和慢性疼痛之间存在遗传预测关联的证据,突出了失眠和短睡眠时间的中介作用。它进一步阐明了不同睡眠障碍的特定作用,将失眠和短睡眠时间与其他与睡眠相关的表型区分开来。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd7/11224770/853f639d3cb6/BRB3-14-e3596-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd7/11224770/853f639d3cb6/BRB3-14-e3596-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd7/11224770/853f639d3cb6/BRB3-14-e3596-g002.jpg

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[1]
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[2]
A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders.

Behav Sci (Basel). 2024-4-15

[3]
Sleep quality as a mediator of the relation between depression and chronic pain: a systematic review and meta-analysis.

Br J Anaesth. 2023-6

[4]
Disentangling the relationship between depression and chronic widespread pain: A Mendelian randomisation study.

Semin Arthritis Rheum. 2023-6

[5]
Association of insomnia and daytime sleepiness with low back pain: A bidirectional mendelian randomization analysis.

Front Genet. 2022-10-4

[6]
Sleep disturbance and psychiatric disorders: a bidirectional Mendelian randomisation study.

Epidemiol Psychiatr Sci. 2022-4-25

[7]
Reciprocal interaction between depression and pain: results from a comprehensive bidirectional Mendelian randomization study and functional annotation analysis.

Pain. 2022-1-1

[8]
Strengthening the reporting of observational studies in epidemiology using mendelian randomisation (STROBE-MR): explanation and elaboration.

BMJ. 2021-10-26

[9]
Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization: The STROBE-MR Statement.

JAMA. 2021-10-26

[10]
Associations between pain, self-efficacy, sleep duration, and symptoms of depression in adolescents: a cross-sectional survey.

BMC Public Health. 2021-9-5

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