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循环免疫细胞与糖尿病肾病之间的因果关系:一项孟德尔随机化研究。

Causal relationship between circulating immune cells and diabetic nephropathy: A Mendelian randomization study.

作者信息

Wang Tao, Huang Chun, Mo Yuxia, Li Jinshuai, Wu Xiangjian, Fu Xiaoyan, Hu Yimin, Wu Geping, Yang Chunfeng, Li Minfang, Chen Sheng

机构信息

Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China.

The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.

出版信息

Medicine (Baltimore). 2025 Aug 22;104(34):e43182. doi: 10.1097/MD.0000000000043182.

Abstract

This study explores the causal relationship between circulating immune cells and diabetic nephropathy (DN) progression using Mendelian randomization. We selected instrumental variables from genome-wide association study summary statistics, which included datasets of circulating leukocytes, flow cytometric subgroups of lymphocytes, and DN. Applying the standard Mendelian randomization approach and refining it with sensitivity analysis and horizontal pleiotropy examination, we found a significant causal association between increased eosinophil counts and a higher risk of DN (odds ratio: 1.21, 95% confidence interval: 1.07-1.37, P = .00027), which remained robust after further analysis. However, no causal link was observed between lymphocyte flow cytometric subgroups and DN. These findings suggest that elevated eosinophil counts may contribute to the progression of DN, potentially advancing to end-stage renal disease. The lack of a causal relationship between lymphocyte subtypes and DN underscores the need for larger scale genome-wide association study data for further validation. This research provides important causal evidence for considering eosinophil counts as a potential biomarker in DN diagnosis and management.

摘要

本研究采用孟德尔随机化方法探讨循环免疫细胞与糖尿病肾病(DN)进展之间的因果关系。我们从全基因组关联研究汇总统计数据中选择了工具变量,其中包括循环白细胞数据集、淋巴细胞流式细胞术亚组数据集以及DN数据集。应用标准孟德尔随机化方法,并通过敏感性分析和水平多效性检验对其进行优化,我们发现嗜酸性粒细胞计数增加与DN风险升高之间存在显著的因果关联(优势比:1.21,95%置信区间:1.07 - 1.37,P = 0.00027),进一步分析后该关联依然稳健。然而,未观察到淋巴细胞流式细胞术亚组与DN之间存在因果联系。这些发现表明,嗜酸性粒细胞计数升高可能促进DN的进展,有可能发展至终末期肾病。淋巴细胞亚型与DN之间缺乏因果关系凸显了需要更大规模的全基因组关联研究数据进行进一步验证。本研究为将嗜酸性粒细胞计数视为DN诊断和管理中的潜在生物标志物提供了重要的因果证据。

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