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精神分裂症对睡眠和饮食失调的因果效应:一项孟德尔随机化研究。

Causal effects of schizophrenia on sleep and eating disorders: A Mendelian randomization study.

作者信息

Huo Kangming, Shao Fang, Zhang Zhongwen

机构信息

School of Public Health, Binzhou Medical University, Yantai, China.

Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.

出版信息

Medicine (Baltimore). 2025 May 2;104(18):e42334. doi: 10.1097/MD.0000000000042334.

Abstract

Previous studies have suggested a potential connection between schizophrenia (SCZ) and sleep and eating disorders. However, these studies have not sufficiently accounted for potential confounding factors, leaving the true causal relationship unclear. Understanding this causal link is essential for developing effective prevention and treatment strategies. To address this gap, we aim to investigate the causal effect of SCZ on sleep and eating disorders using Mendelian randomization (MR) analysis. This method offers a more robust approach by leveraging genetic variants as instrumental variables to rigorously examine the relationship between SCZ and its comorbidities. We conducted bidirectional MR analyses using genome-wide association study summary statistics of SCZ, sleep disorders, and eating disorders. These analyses were conducted after confirming adherence to the 3 core MR assumptions, removing instrumental variables with confounding effects, and directionally harmonizing all data. Then we used Cochran Q test, MR-Egger intercept analysis, and leave-one-out method to conduct the sensitivity analysis of this study to test its heterogeneity and pleiotropy. The results of the inverse-variance weighted (IVW) approach suggest that SCZ increases the risk of sleep disorders (IVW: odds ratio [OR] = 1.041, 95% confidence interval [CI]: 1.012-1.070, P < .01), whereas studies in the opposite direction have not found an effect of sleep disorders on SCZ. The results of IVW suggest that SCZ increases the risk of eating disorders (IVW: OR = 1.228, 95% CI: 1.090-1.384, P < .001), and the weighted median (WM) method similarly provided evidence that SCZ increases the risk of eating disorders (WM: OR = 1.200, 95% CI: 1.019-1.407, P < .05). This study concluded that SCZ is causally associated with sleep and eating disorders. In clinical practice, psychiatrists should pay attention to the daily sleep and eating status of patients with SCZ, and take appropriate measures and countermeasures as early as possible if there is any abnormality.

摘要

先前的研究表明精神分裂症(SCZ)与睡眠及饮食障碍之间可能存在联系。然而,这些研究并未充分考虑潜在的混杂因素,使得真正的因果关系尚不明晰。理解这种因果联系对于制定有效的预防和治疗策略至关重要。为填补这一空白,我们旨在利用孟德尔随机化(MR)分析来研究SCZ对睡眠和饮食障碍的因果效应。该方法通过将基因变异用作工具变量,提供了一种更为稳健的途径,以严格检验SCZ与其共病之间的关系。我们使用SCZ、睡眠障碍和饮食障碍的全基因组关联研究汇总统计数据进行了双向MR分析。这些分析是在确认符合3个核心MR假设、去除具有混杂效应的工具变量并对所有数据进行定向协调之后进行的。然后我们使用 Cochr an Q检验、MR-Egger截距分析和留一法对本研究进行敏感性分析,以检验其异质性和多效性。逆方差加权(IVW)方法的结果表明,SCZ会增加睡眠障碍的风险(IVW:优势比[OR]=1.041,95%置信区间[CI]:1.012 - 1.070,P<.01),而反向研究未发现睡眠障碍对SCZ有影响。IVW的结果表明,SCZ会增加饮食障碍的风险(IVW:OR = 1.228,95% CI:1.090 - 1.384,P<.001),加权中位数(WM)方法同样提供了证据表明SCZ会增加饮食障碍的风险(WM:OR = 1.200,95% CI:1.019 - 1.407,P<.05)。本研究得出结论,SCZ与睡眠和饮食障碍存在因果关联。在临床实践中,精神科医生应关注SCZ患者的日常睡眠和饮食状况,如有任何异常应尽早采取适当措施和应对方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b48c/12055115/09ae4598ee33/medi-104-e42334-g001.jpg

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