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中华关节外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (02) : 193 -199. doi: 10.3877/ cma.j.issn.1674-134X.2025.02.009

基础论著

孟德尔随机化探讨免疫性疾病与人工关节再手术的关联
史彦纪1, 张磊2, 雷宁波2, 常瑞龙2, 左宁2, 顾玉彪2,()   
  1. 1. 730000 兰州市,甘肃中医药大学
    2. 730000 兰州市,甘肃省中医院关节骨三科
  • 收稿日期:2024-04-13 出版日期:2025-04-01
  • 通信作者: 顾玉彪
  • 基金资助:
    国家自然科学基金地区项目(8216150892)甘肃省自然科学基金项目(25JRRA271)联合科研基金一般项目(24JRRA899)甘肃省青年人才(2023LQTD08)

Mendelian randomization explored causal associations between immune diseases and artificial joint reoperation

Yanji Shi1, Lei Zhang2, Ningbo Lei2, Ruilong Chang2, Ning Zuo2, Yubiao Gu2,()   

  1. 1. Gansu University of Chinese Medicine, Lanzhou 730000, China
    2. Department of Joint and Orthopedics III, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730000, China
  • Received:2024-04-13 Published:2025-04-01
  • Corresponding author: Yubiao Gu
引用本文:

史彦纪, 张磊, 雷宁波, 常瑞龙, 左宁, 顾玉彪. 孟德尔随机化探讨免疫性疾病与人工关节再手术的关联[J/OL]. 中华关节外科杂志(电子版), 2025, 19(02): 193-199.

Yanji Shi, Lei Zhang, Ningbo Lei, Ruilong Chang, Ning Zuo, Yubiao Gu. Mendelian randomization explored causal associations between immune diseases and artificial joint reoperation[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2025, 19(02): 193-199.

目的

采用孟德尔随机化的分析方法,探讨免疫性疾病与人工关节再次手术的因果关联。

方法

通过对非重叠全基因组关联研究(GWAS)公开数据进行筛选,暴露因素为炎症性肠病、银屑病、类风湿性关节炎、多发性硬化、系统性红斑狼疮,结局因素为人工关节再次手术。采用逆方差加权法(IVW)作为该研究评估因果效应的主要分析方法,孟德尔随机化-埃格回归法(MR-Egger)、加权中位数法(weighted median)、加权模型(weighted mode)、简单模型(simple mode)等作为补充方法,并进行敏感性分析。

结果

IVW估计表明银屑病是人工关节再次手术的危险因素[OR=1.12,95%C(I1.01,1.25),P=0.026];本研究没有发现炎症性肠病、类风湿性关节炎、多发性硬化、系统性红斑狼疮与人工关节再次手术发生存在统计学意义(均为P>0.05)。

结论

银屑病和人工关节再次手术之间存在因果关联,可能会增加人工关节再次手术的风险。

Objective

To explore the causal association between immune diseases and artificial joint reoperation using Mendelian randomization analysis.

Methods

Through screening public data from nonoverlapping genome-wide association studies, the exposure factors were inflammatory bowel disease, psoriasis,rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, and the outcome factors were resurgery for artificial joints. inverse variance weighted (IVW) method was adopted as the main analysis method to evaluate the causal effect in this study. The Mendel randomization-Egger method (MR-Egger), weighted median method, weighted mode model and simple mode were used as supplementary methods, and the sensitivity analysis was carried out.

Results

IVW estimates suggested that psoriasis is a risk factor for reoperation of artificial joints[OR=1.12,95%CI (1.01,1.25), P=0.026]. There was no statistically significant occurrence of inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, or artificial joint reoperation in this study (all P>0.05).

Conclusion

There is a causal association between psoriasis and artificial joint reoperation that may increase the risk of artificial joint reoperation.

图1 MR(孟德尔随机化)研究中的全基因组关联分析数据汇总
Figure 1 Summary of genome-wide association analysis data in MR (Mendel randomization)studies
表1 孟德尔随机化MR分析结果
Table 1 Results of MR analysis
暴露因素Exposure factors 结局Outcomes SNP个数SNP number 方法Methods OR(95%CI 效应P值Effect P value 异质性P值Heterogeneit P value 截距项P值Intercept P value
IVW 1. 05(0. 96,1. 14) 0. 293 0. 522 -
MR-Egger 1. 11(0. 96,1. 27) 0. 169 0. 519 0. 345
炎症性肠病Inflammatory bowel disease 人工关节再手术 95 加权中位数法 1. 11(0. 97,1. 28) 0. 134 - -
简单模型 0. 81(0. 59,1. 12) 0. 204 - -
加权模型 1. 09(0. 95,1. 26) 0. 202 - -
IVW 1. 12(1. 01,1. 25) 0. 026 0. 490 -
MR-Egger 1. 12(0. 97,1. 30) 0. 152 0. 401 0. 972
银屑病Psoriasis 人工关节再手术 12 加权中位数法 1. 14(1. 00,1. 29) 0. 051 - -
简单模型 1. 11(0. 89,1. 38) 0. 392 - -
加权模型 1. 13(1. 00,1. 28) 0. 068 - -
IVW 1. 05(0. 97,1. 15) 0. 222 0. 075 -
MR-Egger 1. 09(0. 96,1. 25) 0. 179 0. 071 0. 465
类风湿性关节炎Rheumatoid arthritis 人工关节再手术 82 加权中位数法 1. 12(1. 00,1. 26) 0. 043 - -
简单模型 0. 88(0. 69,1. 12) 0. 309 - -
加权模型 1. 11(1. 01,1. 22) 0. 031 - -
IVW 0. 99(0. 89,1. 09) 0. 804 0. 732 -
MR-Egger 0. 94(0. 78,1. 13) 0. 489 0. 713 0. 506
多发性硬化Multiple sclerosis 人工关节再手术 44 加权中位数法 1. 01(0. 85,1. 19) 0. 918 - -
简单模型 1. 07(0. 79,1. 45) 0. 652 - -
加权模型 1. 02(0. 86,1. 21) 0. 850 - -
IVW 1. 10(0. 96,1. 26) 0. 162 0. 915
MR-Egger 1. 19(0. 71,2. 00) 0. 553 0. 834 0. 775
系统性红斑狼疮Systemic lupus erythematosus 人工关节再手术 5 加权中位数法 1. 09(0. 93,1. 28) 0. 284 - -
简单模型 1. 11(0. 90,1. 37) 0. 385 - -
加权模型 1. 09(0. 91,1. 30) 0. 410 - -
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