系统性红斑狼疮与甲状腺功能减退症的关联:基于两样本孟德尔随机化方法
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Association between systemic lupus erythematosus and hypothyroidism: a two-sample Mendelian randomization study
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    摘要:

    目的 采用双向两样本孟德尔随机化(MR)方法探讨系统性红斑狼疮(SLE)和甲状腺功能减退症之间的关系。方法 在线获取SLE及甲状腺功能减退症的全基因组关联研究数据。筛选与SLE密切相关的独立单核苷酸多态性作为工具变量(IV),用R 4.3.1软件MR-PRESSO包进行离群值检验并剔除离群值,分别运用逆方差加权法(IVW)、MR-Egger、加权众数法(WM)、加权中位数法(WME)和基于众数的简单估计(SM)进行MR分析,以OR及95%CI评价SLE与甲状腺功能减退症之间是否存在关联。分别对IVW和MR-Egger结果进行Cochran’s Q异质性检验,用Egger-截距法进行多效性检验,用逐个剔除检验进行敏感性分析,并计算F值以评估是否存在弱IV偏倚。结果 MR分析结果显示,整体人群中SLE与甲状腺功能减退症具有正向的因果关系,IVW、MR-Egger、WM、WME所得结果均有统计学意义,OR(95%CI)分别为1.004(1.002~1.005)、1.004(1.001~1.008)、1.004(1.002~1.007)、1.004(1.002~1.006)。IVW和MR-Egger的异质性检验结果分别为P=0.086和P=0.098,即不存在异质性;Egger-截距法检验结果为P=0.295,即不存在多效性;敏感性分析显示MR结果稳定;全部F值>10,提示不存在弱IV偏倚。结论 与健康人群相比,SLE患者罹患甲状腺功能减退症的风险明显升高。

    Abstract:

    Objective To investigate the relationship between systemic lupus erythematosus (SLE) and hypothyroidism using bidirectional two-sample Mendelian randomization (MR) method. Methods The Genome-Wide Association Study data of SLE and hypothyroidism were obtained online. Independent single nucleotide polymorphisms closely related to SLE were screened as instrumental variable (IV), and outlier values were tested and eliminated by MR-PRESSO tool of R 4.3.1 software. The inverse variance weighted (IVW), MR-Egger, weighted mode (WM), weighted median (WME) and simple mode (SM) were used for MR analysis, and the values of odds ratio (OR) and 95% confidence interval (95%CI) were used to evaluate whether there was an association between SLE and hypothyroidism. The Cochran’s Q heterogeneity test was performed for the results of IVW and MR-Egger, the pleiotropy test was performed by Egger-intercept method, and the sensitivity analysis was performed by elimination test one by one. F value was calculated to evaluate whether there was a weak IV bias. Results MR analysis results showed that there was a positive causal relationship between SLE and hypothyroidism in the overall population, and the results calculated by IVW, MR-Egger, WM and WME were statistically significant, with OR (95%CI) being 1.004 (1.002-1.005), 1.004 (1.001-1.008), 1.004 (1.002-1.007), and 1.004 (1.002-1.006), respectively. The heterogeneity test results for IVW and MR-Egger were P=0.086 and P=0.098, respectively, indicating no heterogeneity; the Egger-intercept result was P=0.295, indicating no pleiotropy; sensitivity analysis showed MR results were stable; and all F values were greater than 10, indicating no weak IV bias. Conclusion Compared with healthy people, the risk of hypothyroidism in patients with SLE is significantly higher.

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  • 收稿日期:2024-01-26
  • 最后修改日期:2024-10-30
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  • 在线发布日期: 2025-08-19
  • 出版日期: 2025-08-20
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