揭示睡眠特征在糖尿病视网膜病变发展中的因果作用：一项英国生物银行观察性研究及孟德尔随机化研究
Unraveling the causal role of sleep traits in development of diabetic retinopathy: A UK Biobank observational study and Mendelian randomization.
作者信息
Huang Yikeng, Xu Xiaoyin, Zhang Xinyu, Zhu Xinyu, Li Bo, Ma Mingming, Zhou Chuandi, Gu Chufeng, Jiang Yujin, Wu Yanlin, Zheng Zhi, Zhao Shuzhi
机构信息
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai engineering center for precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
Department of Ophthalmology, The Fourth Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China.
出版信息
Diab Vasc Dis Res. 2025 Jan-Feb;22(1):14791641251318319. doi: 10.1177/14791641251318319.
AIMS
To evaluate the potential causal role of sleep traits (STs) on diabetic retinopathy (DR).
METHODS
The cross-sectional study included 23,851 patients with type 2 diabetes from the UK Biobank and used multivariate logistic models to investigate the observational association between STs and DR. Genetic correlation analysis and two-sample Mendelian randomization (MR) were conducted using ST data from the UK Biobank and DR data from the FinnGen consortium to investigate the genetic and causal associations between STs and DR.
RESULTS
Patients who experienced daytime sleepiness often/all of the time had a higher risk for DR (OR: 1.40; 95% CI, 1.09-1.79; = .008) compared with those who sometimes/never/rarely experienced daytime sleepiness. Genetic correlations between several STs and DR were detected by cross-trait linkage disequilibrium score regression. MR suggested a causal effect of self-reported daytime sleepiness (OR: 4.08; 95% CI, 1.44-11.61; = .008), and accelerator-derived sleep duration (OR: 0.73; 95% CI, 0.54-0.98; = .036) and sleep efficiency (OR: 0.54; 95% CI, 0.36-0.80; = .002) on DR.
CONCLUSIONS
STs may have a potential causal role for DR. Attention should be paid to the STs of patients for better prevention and treatment of DR.
目的
评估睡眠特征（STs）对糖尿病视网膜病变（DR）的潜在因果作用。
方法
这项横断面研究纳入了来自英国生物银行的23851例2型糖尿病患者，并使用多变量逻辑模型研究STs与DR之间的观察性关联。利用来自英国生物银行的ST数据和来自芬兰基因联盟的DR数据进行遗传相关性分析和两样本孟德尔随机化（MR），以研究STs与DR之间的遗传和因果关联。
结果
与有时/从不/很少经历白天嗜睡的患者相比，经常/总是经历白天嗜睡的患者发生DR的风险更高（比值比：1.40；95%置信区间，1.09 - 1.79；P = 0.008）。通过跨性状连锁不平衡评分回归检测到几种STs与DR之间的遗传相关性。MR提示自我报告的白天嗜睡（比值比：4.08；95%置信区间，1.44 - 11.61；P = 0.008）、加速度计得出的睡眠时间（比值比：0.73；95%置信区间，0.54 - 0.98；P = 0.036）和睡眠效率（比值比：0.54；95%置信区间，0.36 - 0.80；P = 0.002）对DR有因果效应。
结论
STs可能对DR具有潜在因果作用。为更好地预防和治疗DR，应关注患者的STs。
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