睡眠特征对产后抑郁症的遗传影响：双向两样本孟德尔随机化研究。
Genetical effects of sleep traits on postpartum depression: a bidirectional two-sample Mendelian randomization study.
机构信息
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
出版信息
BMC Pregnancy Childbirth. 2024 Oct 30;24(1):711. doi: 10.1186/s12884-024-06929-7.
BACKGROUND
Postpartum depression (PPD) is widely recognized as the most prevalent mental health crisis following childbirth and has been linked to sleep disturbances. However, the potential causal relationships between various sleep traits and PPD remain unclear. This study employs a bidirectional two-sample Mendelian randomization (MR) approach to investigate these associations.
METHODS
The inverse-variance-weighted method was used to evaluate the causally linked sleep traits on postpartum depression. The weighted median, weighted mode, and MR-Egger were used to estimate the robustness of the inverse-variance-weighted method. The leave-one-out method estimated the sensitivity of the result. Cochran's Q method was used for the heterogeneous test. The MR-Egger intercept and MR-PRESSO methods detected the horizontal pleiotropy.
RESULTS
We examined the genetic causal relationships between nine sleep traits and postpartum depression. Sleep apnea syndrome (OR: 1.122; 95%CI: 1.063-1.185; p = 0.000), sleeplessness/insomnia (OR: 1.465; 95%CI: 1.104-1.943; p = 0.008), and frequency of tiredness/lethargy in last 2 weeks (OR: 1.725; 95%CI: 1.345-2.213; p = 0.000) genetically predicted the increased risk of postpartum depression. The reverse Mendelian randomization analysis showed PPD caused sleeplessness/insomnia (β: 0.006; 95%CI: 0.001-0.010; p = 0.016) and frequency of tiredness/lethargy in last 2 weeks (β: 0.007; 95%CI: 0.002-0.011; p = 0.004). The remaining six sleep traits showed no significant association with PPD. There was no heterogeneity or horizontal pleiotropy.
CONCLUSIONS
Genetic evidence reveals causal relationships between specific sleep traits and PPD, including sleep apnea syndrome, sleeplessness/insomnia, and tiredness. Whether certain sleep health indicators suggest a risk of postpartum depression or sleep issues that are caused by PPD, both may offer insights into the prevention and treatment of PPD.
背景
产后抑郁症（PPD）被广泛认为是产后最常见的心理健康危机，与睡眠障碍有关。然而，各种睡眠特征与 PPD 之间的潜在因果关系尚不清楚。本研究采用双向两样本孟德尔随机化（MR）方法来研究这些关联。
方法
采用逆方差加权法评估与产后抑郁相关的因果睡眠特征。采用加权中位数、加权众数和 MR-Egger 法估计逆方差加权法的稳健性。采用逐一剔除法评估结果的敏感性。采用 Cochran's Q 法进行异质性检验。采用 MR-Egger 截距和 MR-PRESSO 法检测水平多效性。
结果
我们研究了 9 种睡眠特征与产后抑郁症之间的遗传因果关系。睡眠呼吸暂停综合征（OR：1.122；95%CI：1.063-1.185；p=0.000）、失眠/入睡困难（OR：1.465；95%CI：1.104-1.943；p=0.008）和过去 2 周内疲劳/乏力的频率（OR：1.725；95%CI：1.345-2.213；p=0.000）遗传上预测了产后抑郁症的风险增加。反向孟德尔随机化分析显示 PPD 导致失眠/入睡困难（β：0.006；95%CI：0.001-0.010；p=0.016）和过去 2 周内疲劳/乏力的频率（β：0.007；95%CI：0.002-0.011；p=0.004）。其余 6 种睡眠特征与 PPD 无显著关联。无异质性或水平多效性。
结论
遗传证据表明特定睡眠特征与 PPD 之间存在因果关系，包括睡眠呼吸暂停综合征、失眠/入睡困难和疲劳。无论是某些睡眠健康指标提示产后抑郁风险，还是由 PPD 引起的睡眠问题，都可能为 PPD 的预防和治疗提供线索。
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