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代谢综合征与炎症性肠病因果效应分析:一项孟德尔随机化研究

Analysis of causal effects on metabolic syndrome and inflammatory bowel disease: a Mendelian randomization study.

作者信息

Zhang Danyang, Shi Haitao, Wei Chongcao, Chen Fenrong, Zhang Pan, Gao Xin, Wang Yan

机构信息

Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 of Xiwu Road, Xi'an, Shaanxi, 710004, China.

出版信息

Diabetol Metab Syndr. 2025 Apr 28;17(1):143. doi: 10.1186/s13098-025-01704-w.

Abstract

BACKGROUND

Metabolic syndrome (MetS) is a conglomerate of metabolic abnormalities including hypertension, obesity, hyperglycemia, hypertriglyceridemia, and low levels of high-density lipoprotein cholesterol (HDL-C). The relationship between MetS and Inflammatory Bowel Disease (IBD) has received a lot of attention lately. Epidemiological investigation has yet to determine if the two illnesses are causally related. To investigate the causal link between IBD and MetS levels, we screened publically available genome-wide association study (GWAS) data using Mendelian randomization (MR) analysis. The study aimed to comprehensively analyze the causal association of each component of MetS, including fasting blood glucose(FBG), HDL-C, triglyceride(TG), waist circumference(WC), and hypertension, on the risk of IBD and its subtypes via univariate, two-way, and multivariate MR (MVMR) methods.

METHODS

We selected independent genetic variants of MetS and IBD as instrumental variables (IVs) from published data from the IEU OpenGWAS project and IIBDGC (International Inflammatory Bowel Disease Genetic Consortium), used MR to infer potential causal effects between them, and used a variety of methods (random effect inverse variance weighting (IVW), weighted median, MR-Egger regression, etc.) to ensure the robustness of causal effects.

RESULTS

Univariate two-sample MR (TSMR) revealed that WC was significantly linked to the risk of Crohn's disease (CD) (OR = 1.659; 95% CI: 1.144-2.405; p = 0.008) and IBD (OR = 1.383; 95% CI: 1.050-1.822; p = 0.021). However, MVMR did not support this finding. In MVMR analysis, hypertension was predicted to be positively associated with the risk of IBD (OR = 2.322516, 95% CI: 1.097713-4.91392, p = 0.0275365), whereas FBG was confirmed to reduce the risk of CD in MVMR studies (OR = 0.4346427, 95% CI: 0.2685399-0.7034868, p = 0.0006948939). Other elements of the MetS did not significantly correlate with IBD.

CONCLUSION

Although confounding factors cannot be completely ruled out, certain metabolic components, such as WC, may impact the risk of IBD. In addition to highlighting the need for more research to understand the underlying mechanisms and potential indirect effects between MetS components and IBD, this research offers insight into therapeutic treatment decisions for patients with IBD and MetS.

摘要

背景

代谢综合征(MetS)是一种代谢异常的集合,包括高血压、肥胖、高血糖、高甘油三酯血症和低水平的高密度脂蛋白胆固醇(HDL-C)。近年来,代谢综合征与炎症性肠病(IBD)之间的关系受到了广泛关注。流行病学调查尚未确定这两种疾病是否存在因果关系。为了研究IBD与MetS水平之间的因果联系,我们使用孟德尔随机化(MR)分析筛选了公开可用的全基因组关联研究(GWAS)数据。本研究旨在通过单变量、双变量和多变量MR(MVMR)方法,全面分析MetS各组成部分,包括空腹血糖(FBG)、HDL-C、甘油三酯(TG)、腰围(WC)和高血压,对IBD及其亚型风险的因果关联。

方法

我们从IEU OpenGWAS项目和IIBDGC(国际炎症性肠病遗传联盟)的已发表数据中选择MetS和IBD的独立基因变异作为工具变量(IVs),使用MR推断它们之间的潜在因果效应,并使用多种方法(随机效应逆方差加权(IVW)、加权中位数、MR-Egger回归等)来确保因果效应的稳健性。

结果

单变量双样本MR(TSMR)显示,WC与克罗恩病(CD)风险显著相关(OR = 1.659;95% CI:1.144 - 2.405;p = 0.008)以及与IBD风险相关(OR = 1.383;95% CI:1.050 - 1.822;p = 0.021)。然而,MVMR不支持这一发现。在MVMR分析中,预测高血压与IBD风险呈正相关(OR = 2.322516,95% CI:1.097713 - 4.91392,p = 0.0275365),而在MVMR研究中FBG被证实可降低CD风险(OR = 0.4346427,95% CI:0.2685399 - 0.7034868,p = 0.0006948939)。MetS的其他要素与IBD无显著相关性。

结论

虽然不能完全排除混杂因素,但某些代谢成分,如WC,可能会影响IBD风险。除了强调需要更多研究来了解MetS成分与IBD之间的潜在机制和间接影响外,本研究还为IBD和MetS患者的治疗决策提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00f8/12036182/fd837b85c5c5/13098_2025_1704_Fig1_HTML.jpg

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