Hunan University of Chinese Medicine, Changsha, Hunan, China.
Hunan Academy of Chinese Medicine, Changsha, Hunan, China.
Medicine (Baltimore). 2024 Oct 11;103(41):e39776. doi: 10.1097/MD.0000000000039776.
With the rising incidence of rheumatoid arthritis (RA) and the increasing percentage of serum RF negativity, more and more accurate methods are urgently needed for the early diagnosis and prevention of RA, among which serum albumin (ALB) is closely related to the development of RA, and it is expected to become a new auxiliary diagnostic means, but its relationship with RA is not clear, so the present study aimed to investigate the Causal relationship. In this study, we used a generalized linear model and smoothed curve fitting to comprehensively evaluate the relationship between ALB and RA through the data of ALB and RA in the NHANES database, in addition, we further used inverse variance weighted (IVW) in Mendelian randomization (MR) in conjunction with the other 4 methods to further validate and clarify the causal relationship. The results were also examined for heterogeneity and horizontal pleiotropy to assess whether the results were robust. Finally, we used Bayesian co-localization analysis to clarify that ALB and RA share common genetic loci. In the observational study, after correction for multiple confounders, ALB remained more significantly negatively associated with RA (OR = 0.66, [95% CI = 0.51-0.86], P = .003), and subgroup analyses showed significant negative associations in both men and women (men: OR = 0.67, [95% CI = 0.46-0.99], P = .046; females: OR = 0.66, [95% CI = 0.44-1.00], P = .049). In further MR analysis, IVW: ALB on RA, OR = 0.70 [95% 0.52-0.93], P = .013; RA on ALB, OR = 0.95 [95% CI = 0.93-0.98], P < .001. The results of the MR analyses were in agreement with those of NHANES, which did not share a common genetic locus in co-localization analysis. There is a significant relationship between ALB and RA, and the reduction of ALB may be one of the risk factors for RA, as well as one of the outcomes in the development of RA.
随着类风湿关节炎（RA）发病率的上升和血清 RF 阴性率的增加，越来越需要更准确的方法来进行 RA 的早期诊断和预防，其中血清白蛋白（ALB）与 RA 的发展密切相关，有望成为新的辅助诊断手段，但与 RA 的关系尚不清楚，因此本研究旨在探讨两者之间的因果关系。在本研究中，我们使用广义线性模型和平滑曲线拟合，通过 NHANES 数据库中的 ALB 和 RA 数据，综合评估了 ALB 与 RA 之间的关系，此外，我们还进一步使用 Mendelian 随机化（MR）中的逆方差加权（IVW）结合其他 4 种方法，进一步验证和阐明因果关系。我们还对异质性和水平偏倚进行了检验，以评估结果的稳健性。最后，我们使用贝叶斯共定位分析来阐明 ALB 和 RA 共享共同的遗传位点。在观察性研究中，在纠正了多个混杂因素后，ALB 与 RA 之间仍存在更显著的负相关（OR=0.66，[95%CI=0.51-0.86]，P=0.003），亚组分析显示男性和女性均存在显著的负相关（男性：OR=0.67，[95%CI=0.46-0.99]，P=0.046；女性：OR=0.66，[95%CI=0.44-1.00]，P=0.049）。在进一步的 MR 分析中，IVW：ALB 对 RA，OR=0.70[95%CI=0.52-0.93]，P=0.013；RA 对 ALB，OR=0.95[95%CI=0.93-0.98]，P<0.001。MR 分析的结果与 NHANES 的结果一致，两者在共定位分析中没有共同的遗传位点。ALB 与 RA 之间存在显著的关系，ALB 的降低可能是 RA 的风险因素之一，也是 RA 发展过程中的一个结果。
