Yu Guo, Dong Tao, Gu Haoyuan, Liang Depeng, Song Liming, Shi Jijing, Duan Xibin, Ma Chao
Xinxiang Medical College, China.
Zhengzhou University, China.
Clin Exp Hepatol. 2025 Mar;11(1):52-60. doi: 10.5114/ceh.2025.149078. Epub 2025 Mar 31.
It appears that type 1 diabetes mellitus (T1DM) and autoimmune liver diseases (AILDs) are associated, but there is no evidence linking them causally or in a specific direction. This study aims to evaluate the causal relationship between T1DM and AILDs.
We performed a two-sample Mendelian randomization (MR) analysis. Following thorough evaluation, the dataset from the genome-wide association study was utilized to identify potential candidate single nucleotide polymorphisms. Inverse variance weighting (IVW) served as the primary analytical method, complemented by four sensitivity analysis approaches to evaluate result robustness.
Mendelian randomization analysis demonstrated a significant positive causal association between genetically elevated risk of T1DM and autoimmune hepatitis (AIH) (OR = 1.168, 95% CI: 1.060-1.287, = 0.001), primary biliary cholangitis (PBC) (OR = 1.186, 95% CI: 1.050-1.341, = 0.006), as well as primary sclerosing cholangitis (PSC) (OR = 1.291, 95% CI: 1.016-1.642, = 0.037). MR-Egger regression analysis suggested a potential influence of horizontal pleiotropy on the causal association for these conditions (AIH: intercept = -0.026, = 0.451; PBC: intercept = 0.014, = 0.745; PSC: intercept = -0.013, = 0.862). Sensitivity analysis utilizing the leave-one-out method supported the robustness of the Mendelian randomization findings. Conversely, reverse Mendelian randomization analysis revealed that genetically predisposed PBC also raises the likelihood of developing T1DM (OR = 1.236, 95% CI: 1.085-1.407, = 0.001). Conversely, no causal association was found between AIH and T1DM (OR = 1.032, 95% CI: 0.983-1.084, = 0.207) or between PSC and T1DM (OR = 0.989, 95% CI: 0.849-1.152, = 0.888).
Employing two-sample MR analysis, we explored the association between T1DM and AILDs, finding that T1DM elevates the risk of AIH, PBC, and PSC. Further elucidation of the genomic landscape of T1DM and AILDs necessitates large-scale cross-disease genome-wide association studies (GWAS).
1型糖尿病(T1DM)与自身免疫性肝病(AILDs)似乎存在关联,但尚无证据表明它们之间存在因果关系或特定方向的联系。本研究旨在评估T1DM与AILDs之间的因果关系。
我们进行了双样本孟德尔随机化(MR)分析。经过全面评估后,利用全基因组关联研究的数据集来识别潜在的候选单核苷酸多态性。逆方差加权(IVW)作为主要分析方法,并辅以四种敏感性分析方法来评估结果的稳健性。
孟德尔随机化分析表明,T1DM遗传风险升高与自身免疫性肝炎(AIH)(比值比[OR]=1.168,95%置信区间[CI]:1.060 - 1.287,P = 0.001)、原发性胆汁性胆管炎(PBC)(OR = 1.186,95% CI:1.050 - 1.341,P = 0.006)以及原发性硬化性胆管炎(PSC)(OR = 1.291,95% CI:1.016 - 1.642,P = 0.037)之间存在显著的正因果关联。MR-Egger回归分析表明,水平多效性可能对这些疾病的因果关联产生影响(AIH:截距=-0.026,P = 0.451;PBC:截距=0.014,P = 0.745;PSC:截距=-0.013,P = 0.862)。采用留一法的敏感性分析支持了孟德尔随机化研究结果的稳健性。相反,反向孟德尔随机化分析显示,遗传易患PBC也会增加患T1DM的可能性(OR = 1.236,95% CI:1.085 - 1.407,P = 0.001)。相反,未发现AIH与T1DM之间(OR = 1.032,95% CI:0.983 - 1.084,P = 0.207)或PSC与T1DM之间(OR = 0.989,95% CI:0.849 - 1.152,P = 0.888)存在因果关联。
通过双样本MR分析,我们探讨了T1DM与AILDs之间的关联,发现T1DM会增加AIH、PBC和PSC的风险。进一步阐明T1DM和AILDs的基因组格局需要大规模的跨疾病全基因组关联研究(GWAS)。