受教育程度与冻结肩之间的因果关系：一项双向两样本孟德尔随机化研究-现代医学

受教育程度与冻结肩之间的因果关系：一项双向两样本孟德尔随机化研究

单位：1. 广州中医药大学第一临床医学院, 广东广州 510405;
2. 广州市正骨医院骨科, 广东广州 510055;
3. 广州中医药大学第一附属医院骨科, 广东广州 510405

分类号：R684

出版年·卷·期（页码）：2024·52·第七期（1009-1018）

摘要：

目的：应用双向两样本孟德尔随机化(MR)研究方法探究受教育程度与冻结肩及其高危因素之间的因果关系。方法：从公共数据库中获取受教育程度、冻结肩、1型糖尿病、2型糖尿病、甲状腺功能减退症的全基因组关联性研究(GWAS)数据，筛选与暴露因素具有强相关性的单核苷酸多态性(SNPs)位点作为MR分析的工具变量，通过逆方差加权法、MR-Egger法、加权中位数法等5种方法评估暴露与结局之间的因果效应，并采用多种敏感性分析方法检验结果的有效性和可靠性。结果：双向MR分析结果显示，受教育程度的提升能够降低冻结肩的发病风险，并且两者之间不存在反向因果关系(OR=0.88, 95%CI 0.83~0.94, P<0.001)。同时，两样本MR分析发现，受教育程度的提升能够降低1型糖尿病(OR=0.91,95%CI 0.88~0.94, P<0.001)和2型糖尿病(OR=0.89, 95%CI 0.85~0.93, P<0.001)的发病风险。敏感性分析结果显示，上述MR研究中不存在异质性与水平多效性。结论：受教育程度的提升能够降低冻结肩、1型糖尿病、2型糖尿病的发病风险。

Objective: To explore the causal relationship between educational attainment and frozen shoulder and its risk factors by bidirectional two-sample Mendelian randomization(MR). Methods: Genome-wide association studies(GWAS) data on educational attainment, frozen shoulder, type 1 diabetes, type 2 diabetes, and hypothyroidism were obtained from public databases. And single nucleotide polymorphism(SNPs) loci strongly associated with the exposure factors were screened as instrumental variables for MR analyses. Five methods including the inverse variance weighting method, the MR-Egger method, and the weighted median method were utilized to assess the causal effect between exposure and outcome. Then multiple sensitivity analyses were applied to test the validity and reliability of the results. Results: The results of the bidirectional MR analysis showed that increased educational attainment could reduce the risk of developing frozen shoulder, and there was no reverse causality(OR=0.88, 95%CI 0.83-0.94, P<0.001). Meanwhile, two-sample MR analysis found that increased educational attainment reduced the risk of developing type 1 diabetes(OR=0.91, 95%CI 0.88-0.94, P<0.001) and type 2 diabetes(OR=0.89, 95%CI 0.85-0.93, P<0.001). Sensitivity analyses showed that there were no heterogeneity and horizontal pleiotropy in MR studies above. Conclusion: This study suggests that increased educational attainment could reduce the risk of frozen shoulder, type 1 diabetes, and type 2 diabetes.

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