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炎症性肠病对皮肤癌的因果影响:两样本孟德尔随机化研究。

The causal effects of inflammatory bowel disease on skin carcinoma: A two-sample Mendelian randomization study.

机构信息

Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2024 Oct 11;103(41):e39997. doi: 10.1097/MD.0000000000039997.

Abstract

Observational studies have indicated that inflammatory bowel disease (IBD) patients have higher incidence of skin carcinoma (SC), including melanoma skin carcinoma (MSC) and nonmelanoma skin carcinoma (NMSC) than healthy people. However, whether there is a causal relationship between the 2 is unclear. The purpose of this study was to evaluate the causality of IBD on SC using the Mendelian randomization (MR) analysis. We performed a two-sample MR analysis using publicly available genome-wide association study data. Eligible instrumental variables were selected based on the 3 core assumptions of MR analysis. The inverse-variance weighted (IVW) approach served as the primary analytical method. Supplementary analyses were conducted using MR-Egger regression, the weighted median, the weighted mode, and MR pleiotropy residual sum and outlier methods. Genetically predicted IBD (IVW odds ratio [OR] = 1.07, 95% confidence interval [CI]: 1.02-1.13, P = .011) and ulcerative colitis (UC; IVW OR = 1.09, 95% CI: 1.03-1.16, P = .003) were associated with an increased risk of MSC. Results of complementary methods were consistent with those of the IVW method with the exception of the weighted mode. In addition, Crohn disease (CD; IVW OR = 1.04, 95% CI: 0.99-1.08, P = .128) did not have a causal effect on MSC. Moreover, IBD (IVW OR = 1.03, 95% CI: 1.00-1.07, P = .034) and CD (IVW OR = 1.03, 95% CI: 1.00-1.06, P = .045) were associated with an increased risk of NMSC. However, UC (IVW OR = 1.00, 95% CI: 0.97-1.04, P = .803) was not significantly associated with an increased risk of NMSC. Our study revealed genetically predicted associations between IBD and the risks of MSC and NMSC in European populations. Furthermore, UC was associated with an increased risk of MSC, while CD was associated with a higher risk of NMSC. However, the potential influence of immunosuppressive agents or biologics cannot be excluded.

摘要

观察性研究表明,与健康人群相比,炎症性肠病(IBD)患者皮肤癌(SC)的发病率更高,包括黑色素瘤皮肤癌(MSC)和非黑色素瘤皮肤癌(NMSC)。然而,两者之间是否存在因果关系尚不清楚。本研究旨在通过孟德尔随机化(MR)分析评估 IBD 对 SC 的因果关系。我们使用公开的全基因组关联研究数据进行了两样本 MR 分析。根据 MR 分析的 3 个核心假设选择了合格的工具变量。逆方差加权(IVW)方法作为主要分析方法。使用 MR-Egger 回归、加权中位数、加权模式和 MR 多效性残差总和和异常值方法进行补充分析。遗传预测的 IBD(IVW 比值比[OR] = 1.07,95%置信区间[CI]:1.02-1.13,P =.011)和溃疡性结肠炎(UC;IVW OR = 1.09,95%CI:1.03-1.16,P =.003)与 MSC 风险增加相关。补充方法的结果与 IVW 方法一致,除了加权模式。此外,克罗恩病(CD;IVW OR = 1.04,95%CI:0.99-1.08,P =.128)对 MSC 没有因果影响。此外,IBD(IVW OR = 1.03,95%CI:1.00-1.07,P =.034)和 CD(IVW OR = 1.03,95%CI:1.00-1.06,P =.045)与 NMSC 风险增加相关。然而,UC(IVW OR = 1.00,95%CI:0.97-1.04,P =.803)与 NMSC 风险增加无显著相关性。本研究揭示了欧洲人群中 IBD 与 MSC 和 NMSC 风险之间的遗传预测关联。此外,UC 与 MSC 风险增加相关,而 CD 与 NMSC 风险增加相关。然而,不能排除免疫抑制剂或生物制剂的潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/11479435/f0738ce900c0/medi-103-e39997-g001.jpg

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