■心房颤动(AF)是最常见的心律失常形式之一。先前的研究表明房颤与精神疾病之间存在联系。然而,精神疾病与房颤之间的因果关系尚不清楚.目的探讨边缘性人格障碍(BPD)与AF的双向因果关系。
■我们使用双向双样本孟德尔随机化(TSMR)方法评估了BPD与AF之间的因果关系。与BPD相关的仪器变量来自涉及214,816名欧洲人(2,637例和212,179名对照)的全基因组关联研究。然后,我们从GWAS荟萃分析中获得了心房颤动数据(60,620例和970,216例对照)。TSMR分析采用五种方法进行,即固定效应方差逆加权(IVW)法、随机效应IVW法、MREgger回归方法,加权中位数法和简单模态法。几种敏感性分析用于测试阳性结果的稳健性。
■固定效应逆方差加权模型[赔率(OR),1.033,95%置信区间(CI),1.011-1.056,P=0.0031],随机效应逆方差加权模型(OR,1.033;95CI,1.005-1.062;P=0.0191)和加权中位数(OR,1.034;95CI,1.002-1.068;P=0.0394)均显示遗传预测的BPD与AF风险增加相关。使用其他MR方法进行敏感性分析,包括MR-Egger截距,MR-Presso方法,和遗漏分析,表明结果是稳健的。在反向MR分析中,房颤与BPD无因果关系。
■我们的研究提供了BPD和AF之间的因果关系。这意味着应监测患有BPD的患者是否发生AF。早期筛查和BPD的适当管理可能显示出抗心律失常的益处。
UNASSIGNED: Atrial fibrillation (AF) is one of the most common form of arrhythmia. Previous studies have shown a link between AF and mental illness. However, the causal relationship between mental illness and AF remains unclear. The purpose of this study was to investigate the bidirectional causal relationship between borderline personality disorder (BPD) and AF.
UNASSIGNED: We used the bidirectional Two-sample Mendelian randomization (TSMR) method to evaluate the causal relationship between BPD and AF. Instrumental variables associated with BPD were derived from a genome-wide association study involving 214,816 Europeans (2,637 cases and 212,179 controls). We then obtained atrial fibrillation data from the GWAS meta-analysis (60,620 cases and 970,216 controls). The TSMR analyses were performed in five methods, namely fixed-effect inverse-variance weighted (IVW) method、random-effect IVW method, MR Egger regression method, Weighted median method and Simple mode method. Several sensitivity analyses are used to test the robustness of positive results.
UNASSIGNED: The fixed-effect inverse-variance weighted model [Odds ratio (OR), 1.033, 95% confidence interval (CI), 1.011-1.056, P = 0.0031], random-effect inverse-variance weighted model (OR, 1.033; 95%CI, 1.005-1.062; P = 0.0191) and Weighted median (OR, 1.034; 95%CI, 1.002-1.068; P = 0.0394) all showed that genetically predicted BPD was associated with an increased risk of AF. Sensitivity analysis using other MR Methods, including the MR-Egger intercept, MR-Presso method, and leave-one-out analyses, showed that the results were robust. In reverse MR analysis, there was no causal relationship of AF on BPD.
UNASSIGNED: Our study provides a causal relationship between BPD and AF. This means that patients with BPD should be monitored for the occurrence of AF. Early screening and proper management of BPD may show anti-arrhythmic benefits.