He Xiaoyu, Ye Xiaoting, Yang Kaiqian, Li Zhenjiang
Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
People's Hospital of Zhenhai, Ningbo, Zhejiang, China.
Brain Behav. 2025 May;15(5):e70462. doi: 10.1002/brb3.70462.
Observational studies have associated obstructive sleep apnea (OSA) with a higher risk of various cancers; however, causal relationships have not yet been definitively established.
Our study evaluated the causal impact of OSA on the risk of developing 22 different types of cancer using univariable and multivariable Mendelian randomization (MR). OSA-associated genetic instruments were obtained from the FinnGen study, which incorporates 38,998 OSA individuals and 336,659 non-OSA individuals from European descent. Summary-level data for 22 site-specific cancers were estimated from large genetic consortia and UK Biobank. We used inverse-variance weighting (IVW) as the primary analysis, along with several sensitivity analyses.
Univariable MR analyses indicated a causal relationship of genetic susceptibility to OSA on an increased risk of Barrett's esophagus (BE) and esophageal cancer (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.07-1.62, p = 0.01), endometrial cancer (OR = 1.36, 95% CI = 1.16-1.60, p = 2.26E-04), and its endometrioid subtype (OR = 1.28, 95% CI = 1.04-1.59, p = 0.02). Multivariable MR, accounting for possible confounders like drinking and smoking, confirmed the causal relationships of OSA on BE and esophageal cancer, and endometrial cancer.
This study provided evidence regarding causal associations of OSA with higher risk of BE and esophageal cancer, and endometrial cancer.
观察性研究表明阻塞性睡眠呼吸暂停（OSA）与多种癌症的较高风险相关；然而，因果关系尚未明确确立。
我们的研究使用单变量和多变量孟德尔随机化（MR）评估了OSA对22种不同类型癌症发生风险的因果影响。与OSA相关的遗传工具来自芬兰基因研究，该研究纳入了38998名OSA患者和336659名欧洲血统的非OSA患者。22种特定部位癌症的汇总数据来自大型基因联盟和英国生物银行。我们使用逆方差加权（IVW）作为主要分析方法，并进行了多项敏感性分析。
单变量MR分析表明，OSA的遗传易感性与巴雷特食管（BE）和食管癌风险增加之间存在因果关系（优势比[OR]=1.32，95%置信区间[CI]=1.07 - 1.62，p = 0.01），子宫内膜癌（OR = 1.36，95%CI = 1.16 - 1.60，p = 2.26E - 04）及其子宫内膜样亚型（OR = 1.28，95%CI = 1.04 - 1.59，p = 0.02）。多变量MR考虑了饮酒和吸烟等可能的混杂因素，证实了OSA与BE、食管癌以及子宫内膜癌之间的因果关系。
本研究提供了证据，证明OSA与BE、食管癌和子宫内膜癌的较高风险之间存在因果关联。
