Liu Chennan, Wang Laicheng, Lin Mei, You Jing, Zheng Xuan, Wang Ailing, Lin Yunchai, Peng Feng, Hu Dan
Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Cardiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Front Cardiovasc Med. 2025 Jul 22;12:1415263. doi: 10.3389/fcvm.2025.1415263. eCollection 2025.
Observational studies have indicated a potential association between ankylosing spondylitis and elevated cardiovascular disease (CVD) risk. However, it remains uncertain whether this association reflects a causal association. Therefore, we conducted this Mendelian randomization to investigate the causal relationship between ankylosing spondylitis and CVD.
We performed a two-sample Mendelian randomization analysis to establish a causal relationship between ankylosing spondylitis and the risk of six prevalent CVDs: hypertension, heart failure, atrial fibrillation, coronary heart disease, myocardial infarction, and peripheral artery disease. Furthermore, multivariate Mendelian randomization was employed to determine the influence of confounding factors.
Genetically predicted ankylosing spondylitis increased the risk of heart failure according to the Mendelian randomization analysis (OR = 1.02; 95% CI = 1.00-1.04; = 0.030). Multivariate analysis results indicated that the causal relationship between ankylosing spondylitis and heart failure risk remained significant after adjusting for hypertension, diabetes, smoking, body mass index, and pulse wave reflection index. The associations diminished and lost significance after adjusting for pulse wave peak-to-peak time and pulse wave arterial stiffness index.
Genetically predicted ankylosing spondylitis increased the risk of heart failure, and the causality may partly be mediated by increased arterial stiffness.
观察性研究表明强直性脊柱炎与心血管疾病（CVD）风险升高之间可能存在关联。然而，这种关联是否反映因果关系仍不确定。因此，我们进行了这项孟德尔随机化研究，以探讨强直性脊柱炎与心血管疾病之间的因果关系。
我们进行了一项两样本孟德尔随机化分析，以确定强直性脊柱炎与六种常见心血管疾病风险之间的因果关系，这六种疾病分别为：高血压、心力衰竭、心房颤动、冠心病、心肌梗死和外周动脉疾病。此外，采用多变量孟德尔随机化来确定混杂因素的影响。
根据孟德尔随机化分析，遗传预测的强直性脊柱炎增加了心力衰竭的风险（比值比=1.02；95%置信区间=1.00-1.04；P=0.030）。多变量分析结果表明，在调整高血压、糖尿病、吸烟、体重指数和脉搏波反射指数后，强直性脊柱炎与心力衰竭风险之间的因果关系仍然显著。在调整脉搏波峰峰值时间和脉搏波动脉僵硬度指数后，这种关联减弱并失去显著性。
遗传预测的强直性脊柱炎增加了心力衰竭的风险，其因果关系可能部分由动脉僵硬度增加介导。
