血压升高增加增生型糖尿病视网膜病变发生风险的孟德尔随机化分析

Elevated blood pressure increases risk of proliferative diabetic retinopathy:a Mendelian randomization study

目的孟德尔随机化(MR)分析血压与增生型糖尿病视网膜病变(PDR)之间的潜在关系。方法采用全基因组关联研究的汇总统计数据,进行双样本MR分析。选择收缩压(SBP)、舒张压(DBP)作为暴露;PDR作为结局。SBP、DBP的工具变量来自英国医学研究委员会综合流行病学单位和Neale实验室的公开可用数据;结局数据(病例组8681例,对照组204208例,欧洲人群)来自FinnGen数据库。采用逆方差加权(IVW)、加权中位数(WM)分析SBP、DBP与PDR之间的潜在关系。结果MR分析发现,IVW[SBP:比值比(OR)=1.36,95%可信区间(CI)1.17~1.57,P=4.22E-05;DBP:OR=1.29,95%CI 1.11~1.51,P=8.6E-04]、WM(SBP:OR=1.33,95%CI 1.07~1.66,P=0.009;DBP:OR=1.28,95%CI=1.03~1.59,P=0.002)结果显示,SBP、DBP升高均增加PDR的发病风险。结论血压变化(SBP、DBP)与PDR发生风险呈正相关。

Objective Mendelian randomization(MR)was used to analyze the potential relationship between blood pressure and proliferative diabetic retinopathy(PDR).Methods Two-sample MR analysis was performed using summary statistics from genome-wide association studies.Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were selected as the exposure,PDR as the outcome.The instrumental variable of SBP and DBP came from the publicly available data of the the UK Medical Research Council Comprehensive Epidemiology Unit and Neale Laboratory;the outcome data(8681 cases in the case group,204208 cases in the control group,European population)are from the FinnGen database.Inverse variance weighting(IVW)and weighted median(WM)were used to analyze the potential relationships between SBP,DBP and PDR.Results MR analysis showed that IVW[SBP:odds ratio(OR)=1.36,95%confidence interval(CI)1.17-1.57,P=4.22E-05;DBP:OR=1.29,95%CI 1.11-1.51,P=8.6E-04],WM(SBP:OR=1.33,95%CI 1.07-1.66,P=0.009;DBP:OR=1.28,95%CI=1.03-1.59,P=0.002).The results showed that elevated SBP and DBP increased the risk of PDR.Conclusion Blood pressure(SBP,DBP)change is positively correlated with the risk of PDR.