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高尿酸血症、痛风与维生素D缺乏之间关系的探索。

The exploration of the relationship between hyperuricemia, gout and vitamin D deficiency.

作者信息

Han Yingdong, Han Xinxin, Zhao He, Yao Menghui, Xie Tiange, Wu Juan, Zhang Yun, Zeng Xuejun

机构信息

Department of Family Medicine & Division of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China; Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China.

Department of Family Medicine & Division of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China; Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Beijing, China.

出版信息

J Nutr Biochem. 2025 Apr;138:109848. doi: 10.1016/j.jnutbio.2025.109848. Epub 2025 Jan 23.

Abstract

Our study aims to provide evidence concerning the relationship between hyperuricemia, gout and Vitamin D deficiency by analyzing data from Peking Union Medical College Hospital (PUMCH), the National Health and Nutrition Examination Survey (NHANES) database, and through Mendelian randomization (MR) analyses. Sample 1 involved patients from PUMCH (n = 13,532), and sample 2 involved participants from NHANES (Unweighted n = 22,860; weight n = 182,829,142). Logistic regression and restricted cubic spline analyses were applied to assess above relationship. A two-sample MR analysis was performed using the genome-wide association study summary statistics to identify the causal association between gout and 25-hydroxyvitamin D (25(OH)D). The results from both samples confirmed a positive correlation among hyperuricemia, gout and risk of Vitamin D deficiency. The restricted cubic spline showed positive dose-response relationship between uric acid and risk of Vitamin D deficiency and the minimal threshold of uric acid at 307.5 umol/L and 316.1 umol/L, respectively. Mediation analysis in the sample 2 found that about 29.4% of the total effect of gout on Vitamin D deficiency were mediated by serum uric acid, and 37.1% of which were mediated by body mass index.The results of our MR analysis supported a causal association between gout (IVW β(SE), -0.843 (0.337); P = .0123) and 25(OH)D. Sensitivity analysis and genetic risk scores approach confirmed the robustness and reliability of the above findings. Hyperuricemia and gout are both strong indicators of increased risk of Vitamin D deficiency. Findings highlight the causal effects of gout-associated genetic variants on 25(OH)D.

摘要

我们的研究旨在通过分析北京协和医院(PUMCH)的数据、美国国家健康与营养检查调查(NHANES)数据库的数据,并进行孟德尔随机化(MR)分析,为高尿酸血症、痛风与维生素D缺乏之间的关系提供证据。样本1包括来自北京协和医院的患者(n = 13532),样本2包括来自NHANES的参与者(未加权n = 22860;加权n = 182829142)。应用逻辑回归和限制立方样条分析来评估上述关系。使用全基因组关联研究汇总统计数据进行两样本MR分析,以确定痛风与25-羟基维生素D(25(OH)D)之间的因果关联。两个样本的结果均证实高尿酸血症、痛风与维生素D缺乏风险之间存在正相关。限制立方样条显示尿酸与维生素D缺乏风险之间存在正剂量反应关系,尿酸的最小阈值分别为307.5 μmol/L和316.1 μmol/L。样本2中的中介分析发现,痛风对维生素D缺乏的总效应中约29.4%由血清尿酸介导,其中37.1%由体重指数介导。我们的MR分析结果支持痛风(逆方差加权β(标准误),-0.843(0.337);P = 0.0123)与25(OH)D之间存在因果关联。敏感性分析和遗传风险评分方法证实了上述发现的稳健性和可靠性。高尿酸血症和痛风都是维生素D缺乏风险增加的有力指标。研究结果突出了痛风相关基因变异对25(OH)D的因果效应。

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