Jiang Hui-Fang, Hu Wei, Jin Ting-Ting, Shan Hai-Li, Zhu Tao, Xu Jun-Jun, Hu Yang-Min, Dai Hai-Bin
Department of Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
Int J Clin Pharm. 2025 Jul 1. doi: 10.1007/s11096-025-01931-1.
Psychological distress and sleep disorders have been associated with increased sepsis risk and mortality, but their causal genetic relationships remain unclear.
This study aimed to evaluate the causal relationship between genetically predicted psychological distress, sleep disorders, and sepsis risk, using a two-sample Mendelian randomization approach.
Genetic instrumental variables were identified for anxiety disorders, depression, post-traumatic stress disorders (PTSD), insomnia, and sleep-wake schedule disorders. Genome-wide association study (GWAS) data were used as exposure datasets, and five sepsis severity levels were analyzed. The inverse-variance weighted (IVW) method was the primary analysis, supported by the MR-Egger and weighted median methods. Heterogeneity was assessed using Cochran's Q test and pleiotropy was evaluated using the MR-Egger intercept test. A Leave-one-out sensitivity analysis was conducted to ensure robustness.
MR analysis found that genetically predicted depression was significantly associated with increased sepsis risk in individuals under 75 years of age (OR 1.15, 95% CI 1.03-1.28; P = 0.016), while PTSD was associated with a higher likelihood of requiring critical care for sepsis (OR 1.11, 95% CI 1.04-1.18; P = 0.002). No significant associations were found between other psychological distress factors, sleep disorders, and the risk of sepsis. Sensitivity analyses confirmed the stability of these results.
This study provides genetic evidence linking depression and PTSD to sepsis risk and severity, emphasizing the need for clinical awareness and targeted interventions in at-risk individuals.
心理困扰和睡眠障碍与脓毒症风险及死亡率增加有关,但其因果遗传关系仍不清楚。
本研究旨在使用两样本孟德尔随机化方法评估基因预测的心理困扰、睡眠障碍与脓毒症风险之间的因果关系。
确定了焦虑症、抑郁症、创伤后应激障碍(PTSD)、失眠症和睡眠-觉醒节律障碍的基因工具变量。全基因组关联研究(GWAS)数据用作暴露数据集,并分析了五个脓毒症严重程度级别。逆方差加权(IVW)方法是主要分析方法,由MR-Egger和加权中位数方法支持。使用Cochran's Q检验评估异质性,使用MR-Egger截距检验评估多效性。进行了留一法敏感性分析以确保稳健性。
孟德尔随机化分析发现,基因预测的抑郁症与75岁以下个体的脓毒症风险增加显著相关(比值比1.15,95%置信区间1.03-1.28;P = 0.016),而PTSD与因脓毒症需要重症监护的可能性较高相关(比值比1.11,95%置信区间1.04-1.18;P = 0.002)。未发现其他心理困扰因素、睡眠障碍与脓毒症风险之间存在显著关联。敏感性分析证实了这些结果的稳定性。
本研究提供了将抑郁症和PTSD与脓毒症风险及严重程度联系起来的遗传证据,强调了对高危个体进行临床认识和针对性干预的必要性。