Yin Yulai, Zhang Xiaoyu
Cangzhou Central Hospital Affiliated to Hebei Medical University, Cangzhou, 061000, China.
Department of Thyroid and Breast Surgery III, Cangzhou Central Hospital, No.16 West Xinhua Road, Cangzhou, 061000, Hebei, China.
Arch Dermatol Res. 2024 Dec 14;317(1):116. doi: 10.1007/s00403-024-03591-z.
This Mendelian Randomization (MR) study aims to explore the potential bidirectional causal relationship between thyroidectomy, thyroid function status, and eczema. We utilized summary statistics from genome-wide association studies of European ancestry for thyroidectomy (4360 cases and 458,573 controls), hyperthyroidism (2547 cases and 334,612 controls), and hypothyroidism (337,199 samples), employing genetic instruments to investigate their association with eczema (461,199 samples), and vice versa. Primary causal estimates were obtained using the inverse variance weighting method (IVW), with a series of sensitivity analyses conducted to assess the robustness of the results. The study found that genetically predicted thyroidectomy has a negative effect on eczema (OR = 0.645; 95% CI 0.498-0.837; P < 0.001), while neither hyperthyroidism nor hypothyroidism showed significant causal associations with eczema. Reverse Mendelian Randomization analysis indicated that genetically predicted eczema does not significantly affect the incidence of thyroidectomy, hyperthyroidism, or hypothyroidism. To correct for the impact of post-thyroidectomy hypothyroidism on eczema, a multivariable Mendelian Randomization analysis was performed, treating thyroidectomy and hypothyroidism as exposures and eczema as the outcome. After adjusting for hypothyroidism, thyroidectomy still reduced the risk of developing eczema (OR = 0.632; 95% CI 0.476-0.838; P = 0.001). This study elucidates the bidirectional causal relationship between thyroidectomy, thyroid function status, and eczema, providing ancillary scientific evidence on the influence of thyroidectomy on the mechanism of eczema development.
这项孟德尔随机化（MR）研究旨在探讨甲状腺切除术、甲状腺功能状态和湿疹之间潜在的双向因果关系。我们利用了欧洲血统人群全基因组关联研究的汇总统计数据，涉及甲状腺切除术（4360例病例和458,573例对照）、甲状腺功能亢进（2547例病例和334,612例对照）和甲状腺功能减退（337,199个样本），采用基因工具研究它们与湿疹（461,199个样本）的关联，反之亦然。使用逆方差加权法（IVW）获得主要因果估计值，并进行了一系列敏感性分析以评估结果的稳健性。研究发现，基因预测的甲状腺切除术对湿疹有负面影响（OR = 0.645；95% CI 0.498 - 0.837；P < 0.001），而甲状腺功能亢进和甲状腺功能减退均未显示与湿疹有显著的因果关联。反向孟德尔随机化分析表明，基因预测的湿疹对甲状腺切除术、甲状腺功能亢进或甲状腺功能减退的发生率没有显著影响。为校正甲状腺切除术后甲状腺功能减退对湿疹的影响，进行了多变量孟德尔随机化分析，将甲状腺切除术和甲状腺功能减退作为暴露因素，湿疹作为结局。在调整甲状腺功能减退后，甲状腺切除术仍降低了发生湿疹的风险（OR = 0.632；95% CI 0.476 - 0.838；P = 0.001）。本研究阐明了甲状腺切除术、甲状腺功能状态和湿疹之间的双向因果关系，为甲状腺切除术对湿疹发病机制的影响提供了辅助科学证据。
