Ruan Huanrong, Lei Siyuan, Zhao Hulei, Zhang Hailong, Zhou Xuezhong, Li Jiansheng
National Regional Traditional Chinese Medicine (Lung Disease) Diagnosis and Treatment Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan 450003, People's Republic of China.
Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China.
Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251348393. doi: 10.1177/17534666251348393. Epub 2025 Jun 26.
Chronic obstructive pulmonary disease (COPD) often coexists with various systemic diseases, forming a comorbid condition. The causal evidence from Mendelian randomization (MR) studies on the impact of comorbidities on COPD is accumulating, yet information for comprehensive summary is limited.
This study aimed to systematically summarize the evidence from MR studies on the impact of comorbidities on COPD.
Systematic review and meta-analysis of MR studies.
Eight electronic databases were searched to identify relevant MR studies about comorbidities associated with COPD from inception to June 3, 2024. Strengthening the Reporting of Observational Studies in Epidemiology-Mendelian Randomization (STROBE-MR) guidelines were used for reporting quality assessment. We used either a random-effects model or a fixed-effects model to estimate pooled causal evidence from MR studies of comorbidities and COPD.
A total of 26 studies were included, of which 8, 4, and 3 studies summarized the causal effects of GERD, depression, obesity on the risk of COPD, respectively. Overall, the studies included had high reporting quality. Our meta-analysis using inverse variance weighted (IVW) of main MR analyses revealed positive causal effects of GERD (OR: 1.64; 95% CI: 1.47-1.84), depression (OR: 1.31, 95% CI: 1.01-1.71), and obesity (OR: 1.51; 95% CI: 1.25-1.83) on COPD. Our qualitative analysis also identified multisystem diseases such as asthma, bronchiectasis, peptic ulcers, heart failure, hypertension, rheumatoid arthritis, and osteoarthritis, as well as systemic conditions like anemia and frailty, were related to the risk of COPD.
This study revealed the causal effects of comorbidities on COPD, providing new scientific evidence for the prevention and treatment of COPD, and aiding in the guidance of effective clinical strategies.
This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No CRD42024575341).
慢性阻塞性肺疾病（COPD）常与多种全身性疾病共存，形成共病状态。孟德尔随机化（MR）研究中关于共病对COPD影响的因果证据正在积累，但全面总结的信息有限。
本研究旨在系统总结MR研究中关于共病对COPD影响的证据。
对MR研究进行系统评价和荟萃分析。
检索了8个电子数据库，以识别从数据库建立至2024年6月3日期间有关与COPD相关共病的相关MR研究。采用加强流行病学观察性研究报告-孟德尔随机化（STROBE-MR）指南进行报告质量评估。我们使用随机效应模型或固定效应模型来估计共病与COPD的MR研究中的合并因果证据。
共纳入26项研究，其中分别有8项、4项和3项研究总结了胃食管反流病（GERD）、抑郁症、肥胖对COPD风险的因果效应。总体而言，纳入的研究报告质量较高。我们使用主要MR分析的逆方差加权（IVW）进行的荟萃分析显示，GERD（比值比：1.64；95%置信区间：1.47 - 1.84）、抑郁症（比值比：1.31，95%置信区间：1.01 - 1.71）和肥胖（比值比：1.51；95%置信区间：1.25 - 1.83）对COPD有正向因果效应。我们的定性分析还确定，哮喘、支气管扩张、消化性溃疡、心力衰竭、高血压、类风湿关节炎和骨关节炎等多系统疾病，以及贫血和虚弱等全身性状况与COPD风险相关。
本研究揭示了共病对COPD的因果效应，为COPD的预防和治疗提供了新的科学证据，并有助于指导有效的临床策略。
本系统评价和荟萃分析方案已在国际前瞻性系统评价注册库（PROSPERO）前瞻性注册（注册号CRD42024575341）。
