2型糖尿病与年龄相关性黄斑变性之间的因果关系:一项孟德尔随机化研究

Causality between type 2 diabetes mellitus and age-related macular degeneration: a Mendelian randomization study

摘要:

目的：利用双样本孟德尔随机化(MR)分析2型糖尿病(T2DM)与年龄相关性黄斑变性(ARMD)之间潜在的因果关系。方法：本研究提取FinnGen数据库中T2DM与ARMD数据，将逆方差加权(IVW)作为主要分析方法，MR-Egger回归和加权中位数(WM)作为补充方法分析二者之间的潜在关系，利用Cochran Q检验、MR-Egger回归截距进行敏感性分析，并将P值作为研究结果指标。结果：IVW分析显示，T2DM与渗出性ARMD之间存在因果关系(OR=1.14，95%CI 1.01～1.28，P=0.021)，但与萎缩性ARMD的发病无明显关联(OR=0.96，95%CI 0.86～1.07，P=0.554)。敏感性分析结果证实结果不存在异质性及多效性，分析结果可靠。结论：T2DM与渗出性ARMD之间存在因果关系，由于ARMD具有高致盲率，认识和控制ARMD的危险因素对降低其患病率及早诊早治具有重要意义。

Abstract:

AIM: To analyze the causality between type 2 diabetes mellitus(T2DM)and age-related macular degeneration(ARMD)based on two-sample Mendelian randomization(MR).METHODS: T2DM and ARMD samples were extracted from the FinnGen database. Inverse variance weighted(IVW)was used as the main analysis method, MR-Egger and weighted median(WM)as supplementary methods to analyze the potential relationship between them. In addition, Cochran Q test and MR-Egger intercept were also used to analyze the sensitivity, and the P-value was used as the index of research results.RESULTS: IVW showed that T2DM was associated with the incidence of exudative ARMD(OR=1.14, 95%CI 1.01～1.28, P=0.021), but it was not significantly associated with the incidence of atrophic ARMD(OR=0.96, 95%CI 0.86～1.07, P=0.554). The results of sensitivity analysis confirmed that there was no heterogeneity and pleiotropy in this study, and the results were reliable.CONCLUSION: There is a causal relationship between T2DM and exudative ARMD. Considering the high rate of blindness caused by ARMD, it is of great significance to recognize and control the risk factors of ARMD to reduce its prevalence rate and early diagnosis and treatment.