School of Medicine, Shihezi University, Shihezi, China.
Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Endocrinol (Lausanne). 2024 Sep 30;15:1436713. doi: 10.3389/fendo.2024.1436713. eCollection 2024.
Hypothyroidism and coronary heart disease are both common diseases in life and both are increasing in prevalence. Many studies have found a strong association between the two. However, they have not been able to prove a causal relationship. Furthermore, numerous studies have demonstrated that glycemic traits play a role in both. Consequently, the objective of this study was to ascertain the causal estimation of the association between hypothyroidism and coronary heart disease and to quantify the potential mediating role of glycemic traits in this relationship.
We used two-sample Mendelian randomisation (UVMR) to explore causality between hypothyroidism and coronary heart disease. Additionally, multivariate Mendelian randomisation (MVMR) was applied to quantify the potential mediation of glycemic traits in this relationship. A variety of Mendelian randomization methods were employed in this study, including the inverse variance weighting (IVW) method, weighted median method, and MR-Egger test. Heterogeneity and horizontal pleiotropy were evaluated through MR-Egger intercept test, Cochran's Q test, and leave-one-out analysis to ensure the robustness of the study results.
The results of the MR analyses indicated that hypothyroidism was associated with an increased risk of coronary heart disease (IVW: OR=2.75, 95% CI: 1.53-4.94). In mediation analyses, the proportion of HbA1c-mediated effects of hypothyroidism on coronary heart disease was 7.3% (2.2%-12.5%).
The results of our study indicate a causal relationship between hypothyroidism and coronary heart disease. Furthermore, HbA1c partially mediated the causal effect of hypothyroidism on coronary heart disease. Consequently, intervention in this factor may reduce the risk of coronary heart disease associated with hypothyroidism.
甲状腺功能减退症和冠心病都是生活中的常见病，且两者的发病率都在上升。许多研究发现两者之间存在很强的关联。然而，他们还未能证明两者之间存在因果关系。此外，大量研究表明血糖特征在两者中都发挥了作用。因此，本研究旨在确定甲状腺功能减退症与冠心病之间关联的因果估计，并量化血糖特征在这种关系中的潜在中介作用。
我们使用两样本 Mendelian randomization（UVMR）来探索甲状腺功能减退症与冠心病之间的因果关系。此外，还应用多变量 Mendelian randomization（MVMR）来量化血糖特征在这种关系中的潜在中介作用。本研究采用了多种 Mendelian randomization 方法，包括逆方差加权（IVW）法、加权中位数法和 MR-Egger 检验。通过 MR-Egger 截距检验、Cochran's Q 检验和逐一剔除分析评估异质性和水平多效性，以确保研究结果的稳健性。
MR 分析的结果表明，甲状腺功能减退症与冠心病的风险增加相关（IVW：OR=2.75，95%CI：1.53-4.94）。在中介分析中，HbA1c 介导甲状腺功能减退症对冠心病的因果效应比例为 7.3%（2.2%-12.5%）。
本研究结果表明甲状腺功能减退症与冠心病之间存在因果关系。此外，HbA1c 部分介导了甲状腺功能减退症对冠心病的因果效应。因此，干预这一因素可能会降低与甲状腺功能减退症相关的冠心病风险。
