Department of Hepatology, Shuguang Hospital Attached to Shanghai Chinese Medicine University, Shanghai, China.
Front Endocrinol (Lausanne). 2024 Aug 5;15:1302611. doi: 10.3389/fendo.2024.1302611. eCollection 2024.
There has been controversy and uncertainty regarding the causal relationship between type 1 diabetes, its consequences, liver fibrosis, and cirrhosis. In order to determine the causal relationship, we conducted a Mendelian randomization study (MR).
For the first time, we subjected multiple diabetes data to analyze its relationship with the progression of liver fibrosis. Once the instrumental variables had been extracted, we assessed them employing Cochran's Q multi-analysis, inverse variance weighted, MR-Egger, MR-PRESSO, weighted mode, and weighted median.
Genetically predicted type 1 diabetes (OR = 1.13, 95% CI: 1.04-1.23, = 3.42 × 10), type 1 diabetes without complications (OR = 1.12, 95% CI: 1.03-1.23, = 1.26 × 10), type 1 diabetes with coma (OR = 1.09, 95% CI: 1-1.18, = 4.74 × 10), type 1 diabetes with ketoacidosis (OR = 1.07, 95% CI: 1.01-1.13, = 1.3 × 10), type 1 diabetes with neurological complications (OR = 1.18, 95% CI: 1.11-1.26, = 4.05 × 10), type 1 diabetes with ophthalmic complications (OR = 1.16, 95% CI: 1.05-1.28, = 3.06 × 10), type 1 diabetes with renal complications (OR = 1.07, 95% CI: 1-1.13, * = 3.45 × 10), type 1 diabetes with other specified/multiple/unspecified complications (OR = 1.12, 95% CI: 1.02-1.23, = 1.41 × 10) were all associated with an increased risk of liver fibrosis progression.
According to our MR investigation, type 1 diabetes and both its acute and chronic implications may increase the likelihood that liver fibrosis could continue to develop. Additionally, type 1 diabetes with neurological and ocular problems is more likely to accelerate the development of liver fibrosis and inflammation, which offers new insights for genetic investigations.
1 型糖尿病、其后果、肝纤维化和肝硬化之间的因果关系一直存在争议和不确定性。为了确定因果关系，我们进行了孟德尔随机化研究（MR）。
我们首次将多种糖尿病数据进行分析，以研究其与肝纤维化进展的关系。一旦提取出工具变量，我们就使用 Cochran's Q 多分析、逆方差加权、MR-Egger、MR-PRESSO、加权模式和加权中位数对其进行评估。
遗传预测的 1 型糖尿病（OR=1.13，95%CI：1.04-1.23， =3.42×10）、无并发症的 1 型糖尿病（OR=1.12，95%CI：1.03-1.23， =1.26×10）、伴有昏迷的 1 型糖尿病（OR=1.09，95%CI：1-1.18， =4.74×10）、伴有酮症酸中毒的 1 型糖尿病（OR=1.07，95%CI：1.01-1.13， =1.3×10）、伴有神经并发症的 1 型糖尿病（OR=1.18，95%CI：1.11-1.26， =4.05×10）、伴有眼部并发症的 1 型糖尿病（OR=1.16，95%CI：1.05-1.28， =3.06×10）、伴有肾脏并发症的 1 型糖尿病（OR=1.07，95%CI：1-1.13， * =3.45×10）、伴有其他指定/多种/未指定并发症的 1 型糖尿病（OR=1.12，95%CI：1.02-1.23， =1.41×10）均与肝纤维化进展风险增加相关。
根据我们的 MR 研究，1 型糖尿病及其急性和慢性并发症都可能增加肝纤维化继续发展的可能性。此外，伴有神经和眼部问题的 1 型糖尿病更有可能加速肝纤维化和炎症的发展，这为遗传研究提供了新的见解。
