背景:肝脂肪变性及其相关并发症是多种呼吸系统疾病的危险因素;然而,代谢功能障碍相关脂肪变性肝病(MASLD)与肺功能之间的因果关系仍存在争议.我们的目标是使用国家队列和孟德尔随机化(MR)来识别它。
方法:我们从2007年至2012年的国家健康和营养调查中招募了30,442名参与者。人口统计,肺功能指数(1s用力呼气量[FEV1],强制肺活量[FVC]),收集用于计算肝脏脂肪评分(LFS)的变量。使用MASLD和FEV1/FVC的全基因组关联研究的摘要数据进行的双样本MR分析,慢性阻塞性肺疾病(COPD),和来自Finngen生物库和医学研究理事会综合流行病学单位的哮喘进行了研究。
结果:共有3,462名参与者,其中1,335人具有MASLD(LFS>-0.640),最终被纳入研究。FEV1(3,204.7vs.3,262.5ml,P=0.061),FVC(4,089.1vs.4,143.8ml,P=0.146),FEV1/FVC比率(78.5%vs.78.8%,P=0.233),和FEV1/预测FEV1比率(146.5%与141.7%,P=0.366)在有MASLD的人和没有MASLD的人之间没有显着差异。此外,MR分析提示MASLD与FEV1/FVC无因果关系(P=0.817),MASLD和COPD(P=0.407),MASLD与哮喘(P=0.808)。反向MR研究显示无因果关系(均P>0.05)。
结论:我们的研究提供了令人信服的证据,表明MASLD与肺功能之间没有因果关系。
BACKGROUND: Hepatic steatosis and its related complications are risk factors for multiple respiratory diseases; however, the causal relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and pulmonary function remains controversial. We aimed to identify it using a national cohort and Mendelian randomization (MR).
METHODS: We enrolled 30,442 participants from the 2007 to 2012 National Health and Nutrition Examination Survey. Demographics, pulmonary function indices (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC]), and variables used to calculate the liver fat score (LFS) were collected. A two-sample MR analysis employing the summary data of genome-wide association studies on MASLD and FEV1/FVC, chronic obstructive pulmonary disease (COPD), and asthma from the Finngen Biobank and Medical Research Council Integrative Epidemiology Unit was performed.
RESULTS: A total of 3,462 participants, 1,335 of whom had MASLD (LFS > -0.640), were finally included in the
study. The FEV1 (3,204.7 vs. 3,262.5 ml, P = 0.061), FVC (4,089.1 vs. 4,143.8 ml, P = 0.146), FEV1/FVC ratio (78.5% vs. 78.8%, P = 0.233), and FEV1/predicted FEV1 ratio (146.5% vs. 141.7%, P = 0.366) were not significantly different between people with MASLD and those without. Additionally, the MR analysis suggested no causal correlation between MASLD and FEV1/FVC (P = 0.817), MASLD and COPD (P = 0.407), and MASLD and asthma (P = 0.808). Reverse MR studies showed no causal relationships yet (all P > 0.05).
CONCLUSIONS: Our
study provides convincing evidence that there is no causal association between MASLD and pulmonary function.