Department of Rheumatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China.
Front Endocrinol (Lausanne). 2024 Sep 4;15:1361581. doi: 10.3389/fendo.2024.1361581. eCollection 2024.
Observational studies have revealed a higher probability of hypothyroidism in patients with dermatomyositis (DM) or polymyositis (PM), but there is no consensus on whether hypothyroidism causally influences DM or PM. In the present study, we assessed the causal association between hypothyroidism and the risk of dermatomyositis or polymyositis using two-sample Mendelian randomization (TSMR).
The genome-wide association data of hypothyroidism and dermatomyositis/polymyositis were obtained from the IEU Open GWAS project. Then, TSMR was used to determine whether hypothyroidism is causally associated with DM or PM. Single-nucleotide polymorphisms (SNPs) significantly associated with hypothyroidism were identified and used as instrumental variables (IVs), and the causal relationship between hypothyroidism and DM/PM was examined using TSMR. MR pleiotropy and Cochran's Q test were used to confirm the heterogeneity and pleiotropy of identified IVs, then four different models, including the inverse variance weighted model (IVW), MR-Egger, weighted median and weighted model were applied in this MR analysis.
Sixty-eight SNPs for DM and 68 SNPs for PM were selected as the IVs (P<5×10; linkage disequilibrium R <0.001) to assess the causal association between hypothyroidism and DM/PM selected from GWASs on hypothyroidism. The results revealed a positive causal effect of hypothyroidism on both DM and PM (DM: OR 2.563, 95% CI [1.348, 4.874], P = 0.00156; PM: OR1.709, 95% CI [1.157, 2.525], P =0.007). Moreover, there was no heterogeneity or pleiotropy in the results.
In conclusion, the MR analysis results provided strong evidence to indicate that hypothyroidism might be causally associated with DM and PM. These findings may have important implications for the pathogenesis and possible future therapies of DM/PM.
观察性研究表明,甲状腺功能减退症(甲减)患者发生皮肌炎(DM)或多发性肌炎(PM)的概率更高,但甲减是否会导致 DM 或 PM 尚未达成共识。本研究采用两样本 Mendelian 随机化(TSMR)评估甲减与 DM 或 PM 风险之间的因果关系。
从 IEU Open GWAS 项目获取甲减和 DM/PM 的全基因组关联数据。然后,采用 TSMR 确定甲减是否与 DM 或 PM 存在因果关系。选择与甲减显著相关的单核苷酸多态性(SNP)作为工具变量(IVs),并采用 TSMR 检验甲减与 DM/PM 之间的因果关系。采用 MR 异质性和 Cochran's Q 检验来确认所识别 IVs 的异质性和多效性,然后在该 MR 分析中应用了四种不同的模型,包括逆方差加权模型(IVW)、MR-Egger、加权中位数和加权模型。
从 GWAS 中选择 68 个 DM 相关 SNP 和 68 个 PM 相关 SNP 作为 IVs(P<5×10; 连锁不平衡 R <0.001),以评估从甲减 GWAS 中选择的甲减与 DM/PM 之间的因果关系。结果显示,甲减对 DM 和 PM 均存在正向因果效应(DM:OR 2.563,95%CI [1.348, 4.874],P = 0.00156;PM:OR 1.709,95%CI [1.157, 2.525],P =0.007)。此外,结果无异质性或多效性。
综上所述,MR 分析结果提供了有力证据表明,甲减可能与 DM 和 PM 存在因果关系。这些发现可能对 DM/PM 的发病机制和未来可能的治疗方法具有重要意义。