Shi Wei, Wu Kaixuan, Li Hui, Zhang Huafeng
Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
Department of Orthopedics, Tianjin University Central Hospital, Tianjin, People's Republic of China.
Tob Induc Dis. 2025 Jan 30;23. doi: 10.18332/tid/199930. eCollection 2025.
It is currently uncertain whether smoking is a risk factor for carpal tunnel syndrome (CTS). This study aims to elucidate association between smoking and CTS using Mendelian randomization (MR) analysis.
This study was a secondary analysis of publicly available GWAS data, using four smoking phenotypes (smoking initiation, smoking status, lifetime smoking, and never smoking) as exposures, and two CTS datasets (discovery and validation sets) as outcomes for MR analysis. The discovery set (n=480201) was used to explore the causal relationship between smoking and CTS, while the validation set (n=385304) was used to confirm the results. The effects of smoking on CTS were assessed using inverse variance weighted (IVW), MR-Egger, and weighted median methods. Cochran's Q test was used to detect heterogeneity, and MREgger to test for pleiotropy. Finally, a meta-analysis was performed on the IVW results from both the discovery and validation sets.
IVW results showed that in both the discovery and validation sets, smoking initiation, smoking status, and lifetime smoking are risk factors for CTS. The summary results from the meta-analysis are as follows: smoking initiation (OR=1.17; 95% CI: 1.08-1.27, p<0.001), smoking status (OR=1.87; 95% CI: 1.56-2.24, p<0.001), and lifetime smoking (OR=2.46; 95% CI: 2.03-3.00, p<0.001). Conversely, never smoking is a protective factor against CTS, with the summary result of the meta-analysis being: OR=0.55; 95% CI: 0.42-0.71, p<0.001.
Based on genetic evidence, smoking may be a risk factor for CTS. Further clinical trials are needed to confirm this causal relationship.
目前尚不确定吸烟是否为腕管综合征（CTS）的危险因素。本研究旨在通过孟德尔随机化（MR）分析阐明吸烟与CTS之间的关联。
本研究是对公开可用的全基因组关联研究（GWAS）数据进行的二次分析，使用四种吸烟表型（开始吸烟、吸烟状态、终生吸烟和从不吸烟）作为暴露因素，以及两个CTS数据集（发现集和验证集）作为MR分析的结果。发现集（n = 480201）用于探索吸烟与CTS之间的因果关系，而验证集（n = 385304）用于确认结果。使用逆方差加权（IVW）、MR-Egger和加权中位数方法评估吸烟对CTS的影响。采用 Cochr an's Q检验检测异质性，并用MREgger检验多效性。最后，对发现集和验证集的IVW结果进行荟萃分析。
IVW结果显示，在发现集和验证集中，开始吸烟、吸烟状态和终生吸烟均为CTS的危险因素。荟萃分析的汇总结果如下：开始吸烟（比值比[OR]=1.17；95%可信区间[CI]：1.08 - 1.27，p<0.001）、吸烟状态（OR = 1.87；95% CI：1.56 - 2.24，p<0.001）和终生吸烟（OR = 2.46；95% CI：2.03 - 3.00，p<0.001）。相反，从不吸烟是CTS的保护因素，荟萃分析的汇总结果为：OR = 0.55；95% CI：0.42 - 0.71，p<0.001。
基于遗传证据，吸烟可能是CTS的危险因素。需要进一步的临床试验来证实这种因果关系。
