双向孟德尔随机化研究分析哮喘与肌少症的因果效应

Causal effect between asthma and sarcopenia:a bidirectional Mendelian randomization study

目的采用孟德尔随机化研究(MR)探索哮喘与肌少症的因果效应。方法两样本MR评估哮喘数据集对肌少症关联的3个数据集(低手握力、四肢肌肉重量和行走速度)的因果关系。逆方差加权法结果作为主要指标,MR-Egger回归、加权中位值、基于众数的简单估计和基于众数的加权估计作为参考。逐步剔除法检验敏感性,Q检验检验异质性,MR-pleiotropy函数检验多效性。反向MR研究肌少症对哮喘的影响。结果哮喘与低手握力概率增加有关(OR=1.703,95%CI:1.206~2.405,P=0.003);与四肢肌肉重量减少有关(OR=0.733,95%CI:0.598~0.899,P=0.003);与行走速度降低有关(OR=0.930,95%CI:0.873~0.990,P=0.022)。逐步剔除法证实哮喘对肌少症3个数据集因果效应结果稳定。反向研究未发现肌少症对哮喘存在促进作用。结论哮喘促进肌少症的发生和发展,是肌少症的潜在不利因素。

Objective To explore the causal effect between asthma and sarcopenia by means of a Mendelian randomization(MR)study.Methods Two-sample MR method was used to evaluate the causal relationship between asthma dataset and three datasets associated with sarcopenia(low hand grip strength,limb muscle weight,and walking speed).The results of inverse variance weighting method were used as the main indicators,and the MR-Egger regression,weighted median value,simple modebased estimation and mode-based weighted estimation were used as the references.The stepwise elimination method was used to test sensitivity,the Q test was used to test heterogeneity,and the MR pleiotropy function was used to test pleiotropy.The reverse MR study was conducted to investigate the effect of sarcopenia on asthma.Results Asthma was associated with an increased probability of low hand grip strength(OR=1.703,95%CI:1.206-2.405,P=0.003),decreased limb muscle weight(OR=0.733,95%CI:0.598-0.899,P=0.003),and decreased walking speed(OR=0.930,95%CI:0.873-0.990,P=0.022).The stepwise elimination method confirmed that the causal effect of asthma on the 3 datasets of sarcopenia was stable.The reverse study did not find any promoting effect of sarcopenia on asthma.Conclusion Asthma promotes the occurrence and development of sarcopenia,and is a potential adverse factor for sarcopenia.