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葡萄胎与营养物质之间的因果关系:一项双样本孟德尔随机化研究。

The causal relationship between hydatidiform mole and nutrients: A two-sample Mendelian randomization study.

作者信息

Zhu Guohua, Zhu Tingting, Jiang Ruhe, Lu Xin, Du Yan

机构信息

Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Clinical Research Unit, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

出版信息

Clin Nutr ESPEN. 2024 Dec;64:100-106. doi: 10.1016/j.clnesp.2024.09.018. Epub 2024 Sep 27.

Abstract

BACKGROUND

Hydatidiform mole (HM), a subset of gestational trophoblastic disease, is considered precancerous and exhibits geographical variation. The incidence of HM is linked to nutritional factors. This study aimed to investigate the causal relationship between nutrients and HM using a bidirectional two-sample Mendelian randomization (MR) approach.

METHODS

We utilized publicly available genome-wide association study data to assess the causal associations between levels of specific vitamins (retinol, vitamins B12, B6, C, D, E, folate, and carotene) and minerals (iron, calcium, and magnesium) with HM. The MR analysis was conducted and reported following the STROBE-MR guidelines, employing MR Egger and inverse variance weighted (IVW) methods to estimate associations, with MR-PRESSO for pleiotropy testing.

RESULTS

The study revealed vitamin B6 as a significant protective factor against HM (MR-Egger OR: 0.094, 95 % CI: 0.011-0.0778, P < 0.05; IVW OR: 0.365, 95 % CI: 0.142-0.936, P < 0.05). Folate and magnesium showed suggestive associations with HM, whereas most other nutrients did not exhibit a causal relationship. MR-PRESSO analysis supported the absence of horizontal pleiotropy of vitamin B6. Besides, reverse MR analysis did not reveal a significant causal association between HM and serum nutrient levels, suggesting that differences of nutrients in HM patients may not be directly attributed to the mole.

CONCLUSION

This MR study provides evidence that vitamin B6 may protect against HM, and suggests potential roles for folate and magnesium in HM development, while highlighting the need for further research to confirm these findings.

摘要

背景

葡萄胎(HM)是妊娠滋养细胞疾病的一种,被认为是癌前病变,且存在地域差异。HM的发病率与营养因素有关。本研究旨在采用双向两样本孟德尔随机化(MR)方法探讨营养素与HM之间的因果关系。

方法

我们利用公开的全基因组关联研究数据,评估特定维生素(视黄醇、维生素B12、B6、C、D、E、叶酸和胡萝卜素)和矿物质(铁、钙和镁)水平与HM之间的因果关联。按照STROBE-MR指南进行MR分析并报告,采用MR Egger和逆方差加权(IVW)方法估计关联,使用MR-PRESSO进行多效性检验。

结果

研究表明维生素B6是预防HM的重要保护因素(MR-Egger比值比:0.094,95%置信区间:0.011-0.0778,P<0.05;IVW比值比:0.365,95%置信区间:0.142-0.936,P<0.05)。叶酸和镁与HM存在提示性关联,而大多数其他营养素未显示出因果关系。MR-PRESSO分析支持维生素B6不存在水平多效性。此外,反向MR分析未发现HM与血清营养素水平之间存在显著因果关联,这表明HM患者的营养素差异可能并非直接归因于葡萄胎。

结论

这项MR研究提供了证据表明维生素B6可能预防HM,并提示叶酸和镁在HM发生发展中的潜在作用,同时强调需要进一步研究以证实这些发现。

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