Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.
J Affect Disord. 2024 Nov 1;364:125-131. doi: 10.1016/j.jad.2024.08.061. Epub 2024 Aug 13.
Previous studies have linked kidney stone disease (KSD) with depression, but there are no reports on the relationship between anxiety and KSD, and the mechanism underlying the potential relationship remains unclear.
Associations of anxiety and incident KSD were assessed in the National Health and Nutrition Examination Survey (NHENES) using multivariate logistic regression. Two-sample bidirectional Mendelian randomization studies and a two-step two-sample MR was used to estimate the mediating factors that influence KSD risk.
Examinations of NHANES data revealed that a rise in the frequency and intensity of anxiety were independently associated with incident KSD. In MR analysis, anxiety (uk-a-51 and uk-b-6519) were from the UK Biobank, with sample sizes of 328,717 and 450,765 respectively. KSD data were from the FinnGen, including 8597 cases and 333,128 controls. In the IVW analysis, genetically predicted anxieties (ukb-a-51 and ukb-b-6519) were found to be causally associated with a higher risk of KSD, with odds ratios of 6.18 (95 % CI 2.54-15.04) and 3.44 (95 % CI 1.67-7.08), respectively. There were no reverse causal effects. Further mediation analysis indicated that anxiety increases the risk of KSD by raising eGFR, through which 11.8 % of the effect of anxiety on KSD risk was mediated.
The research was confined to individuals of European heritage, and there could be specific genetic variances among diverse ethnicities.
The current study suggests anxiety as an independent causal risk factor for KSD and unveils a new pathogenic mechanism, showing that anxiety raises eGFR, thereby increasing the risk of KSD.
先前的研究将肾结石病（KSD）与抑郁症联系起来，但目前尚无关于焦虑与 KSD 之间关系的报道，潜在关系的机制仍不清楚。
使用多变量逻辑回归评估国家健康和营养检查调查（NHENES）中焦虑与 KSD 事件之间的关联。采用双样本双向孟德尔随机化研究和两阶段两样本 MR 来估计影响 KSD 风险的中介因素。
对 NHANES 数据的检查表明，焦虑频率和强度的增加与 KSD 事件的发生独立相关。在 MR 分析中，焦虑（uk-a-51 和 uk-b-6519）来自英国生物银行，样本量分别为 328717 和 450765。KSD 数据来自 FinnGen，包括 8597 例病例和 333128 例对照。在 IVW 分析中，遗传预测的焦虑（ukb-a-51 和 ukb-b-6519）与 KSD 风险增加呈因果关系，比值比分别为 6.18（95%CI 2.54-15.04）和 3.44（95%CI 1.67-7.08）。没有反向因果效应。进一步的中介分析表明，焦虑通过提高 eGFR 增加 KSD 的风险，焦虑对 KSD 风险的影响中有 11.8%是通过这种方式介导的。
该研究仅限于欧洲血统的个体，不同种族之间可能存在特定的遗传差异。
本研究表明焦虑是 KSD 的一个独立因果风险因素，并揭示了一个新的发病机制，即焦虑会升高 eGFR，从而增加 KSD 的风险。
