Lei Hai, Tian Peng, Chen Jun, Chen Shuai, Lai Guochao, Zhou Linli
Department of Orthopedics, The People's Hospital of Jianyang City, Jianyang, China.
Medicine (Baltimore). 2025 Jul 18;104(29):e43377. doi: 10.1097/MD.0000000000043377.
Several observational studies have shown that C-reactive protein (CRP) is an effective biomarker for evaluating septic arthritis (SA). However, the inherent causal relationship of this connection has not yet been clarified. Thus, this study examined the potential causal association between CRP and SA risk using 2-sample Mendelian randomization (MR). The analysis used 2-sample MR, with the exposure and outcome data from the Genome-Wide Association Study Catalog and FinnGen, respectively. Throughout this study, inverse variance weighting has been used as the primary method. To assess the robustness of the research findings, Cochran Q test, Egger regression, and MR pleiotropy residual sum and outlier global tests were conducted. Genetically predicted CRP has a positive causal relationship with the risk of SA (ORinverse variance weighting = 1.37, 95% CI 1.16-1.63, P < .001), (ORMR Egger = 1.62, 95% CI 1.20-2.19, P = .002), (ORweighted media = 1.48, 95% CI 1.11-1.97, P = .008), and (ORMR PRESSO = 1.37, 95% CI 1.18-1.59, P < .001). A sensitivity analysis confirmed the robustness of this result. Our study has, for the first time, established a definite causal relationship between CRP and SA risk; that is, an increase in CRP levels leads to an increase in SA risk.
多项观察性研究表明，C反应蛋白（CRP）是评估化脓性关节炎（SA）的一种有效生物标志物。然而，这种关联的内在因果关系尚未明确。因此，本研究使用两样本孟德尔随机化（MR）方法检验了CRP与SA风险之间的潜在因果关联。分析采用两样本MR，暴露数据和结局数据分别来自全基因组关联研究目录（Genome-Wide Association Study Catalog）和芬兰基因库（FinnGen）。在整个研究过程中，逆方差加权法被用作主要方法。为评估研究结果的稳健性，进行了Cochran Q检验、Egger回归以及MR多效性残差和离群值全局检验。基因预测的CRP与SA风险呈正因果关系（逆方差加权法的OR = 1.37，95% CI为1.16 - 1.63，P <.001）（MR Egger法的OR = 1.62，95% CI为1.20 - 2.19，P =.002）（加权中位数法的OR = 1.48，95% CI为1.11 - 1.9
