Department of Acupuncture and Moxibustion, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, China.
Pain Management Department, Zhongxian County Traditional Chinese Medicine Hospital, Chongqing, China.
Fr J Urol. 2024 Dec;34(13):102750. doi: 10.1016/j.fjurol.2024.102750. Epub 2024 Sep 19.
Ankylosing spondylitis (AS) is an inflammatory condition affecting the spine. Observational studies have suggested a heightened risk of urolithiasis in AS patients. However, due to the inherent limitations of observational research, the causal relationship between the two remains to be determined.
Utilizing the Mendelian randomization analysis approach, this study sought to explore the causal link between AS and urolithiasis.
Data from genome-wide association studies were employed for analysis. Mendelian randomization analyses were conducted using the IVW, MR-Egger, Weighted Median, and Weighted Mode methods. Heterogeneity tests, sensitivity analyses, and pleiotropy analyses were also performed.
The causality between AS and urolithiasis was supported by the IVW (P=.02), Weighted Median (P=.006), and Weighted Mode (P=.01) methods. The MR-Egger method (P=.07) did not support this causal relationship, yet its directionality was consistent with the other three methods. None of the four analysis methods supported a reverse causal relationship between AS and urolithiasis.
Our study demonstrates a causal relationship between AS and urolithiasis, with no evidence of reverse causality. Given the increased risk of urolithiasis in AS patients, it is crucial to implement preventive strategies and early detection. Stone composition analysis should also be incorporated into clinical practice for these patients, as it can provide essential insights into the metabolic and genetic factors contributing to stone formation, thus improving diagnostic accuracy and treatment outcomes. Future studies are needed to further validate these findings and explore the detailed mechanisms involved.
强直性脊柱炎（AS）是一种影响脊柱的炎症性疾病。观察性研究表明，AS 患者发生尿路结石的风险增加。然而，由于观察性研究的固有局限性，两者之间的因果关系仍需确定。
本研究采用孟德尔随机化分析方法，探讨 AS 与尿路结石之间的因果关系。
采用全基因组关联研究数据进行分析。采用 IVW、MR-Egger、加权中位数和加权模式方法进行孟德尔随机化分析。还进行了异质性检验、敏感性分析和多效性分析。
IVW（P=.02）、加权中位数（P=.006）和加权模式（P=.01）方法支持 AS 与尿路结石之间的因果关系。MR-Egger 方法（P=.07）不支持这种因果关系，但方向与其他三种方法一致。四种分析方法均不支持 AS 与尿路结石之间的反向因果关系。
本研究表明 AS 与尿路结石之间存在因果关系，没有反向因果关系的证据。鉴于 AS 患者尿路结石的风险增加，实施预防策略和早期检测至关重要。还应将结石成分分析纳入这些患者的临床实践，因为它可以为结石形成的代谢和遗传因素提供重要的见解，从而提高诊断准确性和治疗效果。需要进一步的研究来验证这些发现并探讨涉及的详细机制。
