Pang Liang, Wu Kai, Zhu Yibo, Wang Qianwei, Zheng Zhihui, Lv Cunxian, Bao Zhancheng
Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, China.
Heilongjiang University of Chinese Medicine, Harbin, China.
Sci Rep. 2025 Apr 12;15(1):12540. doi: 10.1038/s41598-025-97756-z.
This study aims to investigate the association and causality between osteoarthritis (OA) and chronic kidney disease (CKD) using data from the National Health and Nutrition Examination Survey (NHANES) and Mendelian Randomization (MR) analysis. Participants with OA, urinary albumin, urinary creatinine, urinary albumin-to-creatinine ratio (UACR), blood creatinine, and estimated glomerular filtration rate (eGFR) were selected from NHANES. CKD was calculated using the CKD-EPI equation, and logistic regression assessed by the OA-CKD association. A two-sample MR analysis was conducted using Genome-wide association studies (GWAS) data for OA, hip OA (HOA), knee OA (KOA), acute renal failure (ARF), chronic renal failure (CRF), cystatin C, serum creatinine (eGFRcrea), and microalbuminuria. The inverse variance weighted (IVW) method was used, with heterogeneity, sensitivity, and pleiotropy assessments. The cross-sectional analysis showed a significant positive association between OA and CKD [unadjusted OR: 2.398 (95% CI: 2.176-2.643), p < 0.001], which persisted after adjustment for demographic factors, socioeconomic status, lifestyle factors, and medical history [adjusted OR: 1.161 (95% CI: 1.029-1.310), p = 0.015]. The MR analysis revealed no significant causal relationship between overall OA and renal function markers but found a significant genetic association between HOA and cystatin C [IVW p = 0.0014, OR = 1.02, 95% CI: 1.01-1.03], and between KOA and cystatin C [IVW p < 0.0001, OR = 1.06, 95% CI: 1.04-1.08]. Our study indicates that HOA and KOA are risk factors for renal function injury, providing new insights for clinical OA management.
本研究旨在利用美国国家健康与营养检查调查(NHANES)的数据和孟德尔随机化(MR)分析,调查骨关节炎(OA)与慢性肾脏病(CKD)之间的关联及因果关系。从NHANES中选取患有OA、尿白蛋白、尿肌酐、尿白蛋白与肌酐比值(UACR)、血肌酐和估计肾小球滤过率(eGFR)的参与者。使用CKD-EPI方程计算CKD,并通过OA-CKD关联评估逻辑回归。利用全基因组关联研究(GWAS)数据对OA、髋骨关节炎(HOA)、膝骨关节炎(KOA)、急性肾衰竭(ARF)、慢性肾衰竭(CRF)、胱抑素C、血清肌酐(eGFRcrea)和微量白蛋白尿进行两样本MR分析。采用逆方差加权(IVW)方法,并进行异质性、敏感性和多效性评估。横断面分析显示OA与CKD之间存在显著正相关[未调整OR:2.398(95%CI:2.176-2.643),p<0.001],在对人口统计学因素、社会经济地位、生活方式因素和病史进行调整后仍然存在[调整后OR:1.161(95%CI:1.029-1.310),p=0.015]。MR分析显示总体OA与肾功能标志物之间无显著因果关系,但发现HOA与胱抑素C之间存在显著遗传关联[IVW p=0.0014,OR=1.02,95%CI:1.01-1.03],以及KOA与胱抑素C之间存在显著遗传关联[IVW p<0.0001,OR=1.06,95%CI:1.04-1.08]。我们的研究表明,HOA和KOA是肾功能损伤的危险因素,为临床OA管理提供了新的见解。