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关节炎会增加患前列腺癌的风险:来自2005 - 2018年美国国家健康与营养检查调查以及两样本孟德尔随机化分析的结果。

Arthritis increases the risk of prostate cancer: Results from the National Health and Nutrition Examination Survey 2005-2018 and two-sample Mendelian randomization analysis.

作者信息

Yuan Xiaobin, Shi Ruikang, Jing Qiang, Cao Xiaoming, Zhang Xuhui

机构信息

Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, China.

Department of Urology, First College of Clinical Medicine, Shanxi Medical University, Taiyuan, China.

出版信息

Investig Clin Urol. 2025 May;66(3):215-226. doi: 10.4111/icu.20240313.

Abstract

PURPOSE

It was aimed to clarify the casual connection between prostate cancer (PCa) and arthritis by utilizing two-sample Mendelian randomization (MR) analysis and data from National Health and Nutrition Examination Survey (NHANES) database.

MATERIALS AND METHODS

This study utilized NHANES data. Through association analysis and risk stratification analysis, the association between arthritis and PCa were examined. MR analysis was performed to elucidate the causal relationship between arthritis and PCa. Sensitivity analysis and Steiger directionality test confirmed the reliability of the MR analysis results.

RESULTS

A total of 23,608 (PCa:controls=413:23,195) participants after a sample exclusion and variable definition process were screened in NHANES database. Adjustments across three diverse models consistently revealed a notable influence of arthritis on PCa progression. Arthritis was identified as a risk factor for PCa (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.36-2.62, p<0.001). Subsequent analysis indicated that in the arthritis-adjusted model with multiple covariates, the area under the curve of the receiver operating characteristic curve was 0.94. The inverse variance weighting method of MR analysis showed a causal relationship between rheumatoid arthritis (RA) and PCa (OR 1.090, 95% CI 1.053-1.128, p<0.001) as well as osteoar-thritis and PCa (OR 1.002, 95% CI 1.001-1.004, p=0.002). This suggested that RA and osteoarthritis were risk factors for PCa. The heterogeneity (p>0.05), horizontal pleiotropy (p>0.05), leave-one-out and Steiger test confirmed reliability of MR results.

CONCLUSIONS

NHANES database and MR analyses identified arthritis as a risk factor for PCa, offering fresh avenues for preventive and therapeutic approaches.

摘要

目的

通过使用两样本孟德尔随机化(MR)分析以及来自美国国家健康与营养检查调查(NHANES)数据库的数据,旨在阐明前列腺癌(PCa)与关节炎之间的因果关系。

材料与方法

本研究使用了NHANES数据。通过关联分析和风险分层分析,研究了关节炎与PCa之间的关联。进行MR分析以阐明关节炎与PCa之间的因果关系。敏感性分析和斯泰格方向性检验证实了MR分析结果的可靠性。

结果

在NHANES数据库中,经过样本排除和变量定义过程后,共筛选出23,608名参与者(PCa:对照 = 413:23,195)。在三种不同模型中的调整一致显示关节炎对PCa进展有显著影响。关节炎被确定为PCa的一个风险因素(优势比[OR] 1.88,95%置信区间[CI] 1.36 - 2.62,p < 0.001)。后续分析表明,在具有多个协变量的关节炎调整模型中,受试者工作特征曲线下面积为0.94。MR分析的逆方差加权法显示类风湿性关节炎(RA)与PCa之间存在因果关系(OR 1.090,95% CI 1.053 - 1.128,p < 0.001)以及骨关节炎与PCa之间存在因果关系(OR 1.002,95% CI 1.001 - 1.004,p = 0.002)。这表明RA和骨关节炎是PCa的风险因素。异质性(p > 0.05)、水平多效性(p > 0.05)、留一法和斯泰格检验证实了MR结果的可靠性。

结论

NHANES数据库和MR分析确定关节炎是PCa的一个风险因素,为预防和治疗方法提供了新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a49f/12058540/22a831d0b44c/icu-66-215-g001.jpg

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