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探索桥本甲状腺炎与代谢相关脂肪性肝病之间的因果关系:一项孟德尔随机化研究。

Exploring the causal relationship between Hashimoto thyroiditis and metabolic-associated fatty liver disease: A Mendelian randomization study.

作者信息

Xiao Xi, Xiao Zhengping, Shi Doufei, Wang Xiaoning, Zhang Jie

机构信息

Department of Geriatrics, Binzhou Medical University Hospital, Binzhou, Shandong, China.

Department of Colorectal Hernia Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.

出版信息

Medicine (Baltimore). 2025 May 23;104(21):e42533. doi: 10.1097/MD.0000000000042533.

Abstract

This study aims to investigate the possible causal link between Hashimoto thyroiditis (HT), an autoimmune disorder, and metabolic-associated fatty liver disease (MAFLD), previously referred to as nonalcoholic fatty liver disease (NAFLD), a common metabolic condition. Using genome-wide association study data from large European populations, we performed a bidirectional Mendelian randomization (MR) analysis. We identified single nucleotide polymorphisms strongly associated with HT and MAFLD/NAFLD, which we used as instrumental variables to probe the causal relationship between these 2 conditions. The forward MR analysis, using the inverse variance weighted method, showed that HT may increase the risk of MAFLD/NAFLD (odds ratio = 1.065, 95% confidence intervals: 1.014-1.119, P = .011). However, the reverse MR analysis did not establish a significant causal effect of MAFLD/NAFLD on HT (P > .05). Sensitivity analyses were carried out to assess potential heterogeneity or pleiotropy, and the results supported the robustness of our findings, indicating no significant concerns. These results suggest that HT may be a risk factor for the development of MAFLD/NAFLD. The bidirectional MR study revealed an elevated risk of MAFLD/NAFLD in individuals with HT, but no causal relationship was found from MAFLD/NAFLD to HT in the opposite direction. This understanding could assist healthcare professionals in improving their comprehension and management of both HT and MAFLD/NAFLD, leading to more comprehensive clinical guidance for patients and promoting the development of interdisciplinary treatment strategies.

摘要

本研究旨在调查自身免疫性疾病桥本甲状腺炎(HT)与代谢相关脂肪性肝病(MAFLD,以前称为非酒精性脂肪性肝病(NAFLD),一种常见的代谢性疾病)之间可能存在的因果关系。利用来自欧洲大型人群的全基因组关联研究数据,我们进行了双向孟德尔随机化(MR)分析。我们确定了与HT和MAFLD/NAFLD密切相关的单核苷酸多态性,将其用作工具变量来探究这两种疾病之间的因果关系。采用逆方差加权法的正向MR分析表明,HT可能会增加患MAFLD/NAFLD的风险(优势比=1.065,95%置信区间:1.014 - 1.119,P = 0.011)。然而,反向MR分析未发现MAFLD/NAFLD对HT有显著的因果效应(P > 0.05)。进行了敏感性分析以评估潜在的异质性或多效性,结果支持了我们研究结果的稳健性,表明没有重大问题。这些结果表明,HT可能是MAFLD/NAFLD发生发展的一个风险因素。双向MR研究显示,患有HT的个体患MAFLD/NAFLD的风险升高,但未发现从MAFLD/NAFLD到HT的相反方向的因果关系。这一认识有助于医疗保健专业人员更好地理解和管理HT和MAFLD/NAFLD,为患者提供更全面的临床指导,并促进跨学科治疗策略的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d97/12113919/9259a55782bb/medi-104-e42533-g001.jpg

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