Cheng Xi, Li Lei, Lin Xijuan, Chen Na, Liu Xudong, Li Yaqian, Li Zhaoai, Gong Jian, Liu Qing, Wang Yuling, Wang Juntao, Xia Zhijun, Lu Yongxian, Jin Hangmei, Zhang Xiaowei, Wang Luwen, Chen Juan, Fan Guorong, Deng Shan, Zhao Sen, Zhu Lan
Department of Obstetrics and Gynecology National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Common Mechanism Research for Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
The State Key Laboratory for Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Beijing, 100730, China.
Front Med. 2025 May 3. doi: 10.1007/s11684-024-1114-2.
Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
盆腔器官脱垂(POP)的病因受遗传和临床风险因素影响,对女性生活质量有重大影响。然而,非欧洲人群的遗传基础以及整合遗传和临床因素的综合风险模型仍未得到充分研究。本研究利用现有最大规模全基因组关联研究中的20个疾病相关变异,构建了中国人群中首个盆腔器官脱垂的多基因风险评分(PRS)。我们分析了一个由576例病例和623例对照组成的发现队列以及一个由264例病例和200例对照组成的验证队列。结果显示,病例组的PRS显著高于对照组。此外,风险最高的前10%组的优势比是最低的后10%组的2.6倍。高PRS与50岁以上未生育或只生育过一个孩子的女性发生盆腔器官脱垂显著相关。据我们所知,结合PRS和临床风险因素的综合预测模型比其他现有的PRS模型具有更好的预测准确性。这种综合风险评估模型是盆腔器官脱垂风险预测和分层的有力工具,从而为未来临床实践中的个体化预防措施和治疗策略提供见解。