■目前尚无全面的孟德尔随机化研究集中在肥胖如何影响呼吸系统疾病。
■BMI和腰围,主要来自英国生物银行,来自FinnGen生物库的35种呼吸系统疾病进行了孟德尔随机分析。在这项研究中,方差逆加权法作为主要分析方法,并辅以MR-Egger和加权中位数法.通过使用MR-PRESSO方法检测水平多效性和潜在异常值。
■这项研究表明,肥胖增加了急性上呼吸道感染的可能性(BMI:OR=1.131,p<0.0001;WC:OR=1.097,p=0.00406),急性鼻窦炎(BMI:OR=1.161,p=0.000262;WC:OR=1.209,p=0.000263),急性咽炎(WC:OR=1.238,p=0.0258),急性喉炎和支气管炎(BMI:OR=1.202,p=0.0288;WC:OR=1.381,p=0.00192),所有流感(BMI:OR=1.243,p=0.000235;WC:OR=1.206,p=0.0119),病毒性肺炎(WC:OR=1.446,p=0.000870),所有肺炎(BMI:OR=1.174,p<0.0001;WC:OR=1.272,p<0.0001),肺炎细菌(BMI:OR=1.183,p=0.000290;WC:OR=1.274,p<0.0001),急性支气管炎(BMI:OR=1.252,p<0.0001;WC:OR=1.237,p=0.000268),急性不明原因下呼吸道感染(BMI:OR=1.303,p=0.000403),慢性扁桃体和腺样体疾病(BMI:OR=1.236,p<0.0001;WC:OR=1.178,p=0.000157),慢性喉支气管炎和喉炎(WC:OR=1.300,p=0.00785),COPD(BMI:OR=1.429,p<0.0001;WC:OR=1.591,p<0.0001),哮喘(BMI:OR=1.358,p<0.0001;WC:OR=1.515,p<0.0001),下呼吸道坏死和化脓情况(WC:OR=1.405,p=0.0427),胸腔积液(BMI:OR=1.277,p=0.00225;WC:OR=1.561,p<0.0001),胸膜斑块(BMI:OR=1.245,p=0.0312),其他呼吸系统疾病(BMI:OR=1.448,p<0.0001;WC:OR=1.590,p<0.0001),和非小细胞肺癌(BMI:OR=1.262,p=0.00576;WC:OR=1.398,p=0.00181)。这项研究还表明,肥胖可降低支气管扩张的可能性(BMI:OR=0.705;p=0.00200)。
■这项研究表明,肥胖会增加大多数呼吸系统疾病(包括所有35种呼吸系统疾病中的20种)的风险,肥胖会降低支气管扩张的风险。
No existing comprehensive Mendelian randomization studies have focused on how obesity affects respiratory diseases.
BMI and waist circumference, mainly from the UK Biobank, and 35 respiratory diseases from the FinnGen Biobank were subjected to Mendelian randomization analyses. In this study, the inverse variance weighting method was used as the predominant analysis method and was complemented by MR-Egger and weighted median methods. Horizontal pleiotropy and potential outliers were detected by employing the MR-PRESSO method.
This study indicated that obesity rises the possibility of acute upper respiratory infections (BMI: OR=1.131, p<0.0001; WC: OR=1.097, p=0.00406), acute sinusitis (BMI: OR=1.161, p=0.000262; WC: OR=1.209, p=0.000263), acute pharyngitis (WC: OR=1.238, p=0.0258), acute
laryngitis and tracheitis (BMI: OR=1.202, p=0.0288; WC: OR=1.381, p=0.00192), all influenza (BMI: OR=1.243, p=0.000235; WC: OR=1.206, p=0.0119), viral pneumonia (WC: OR=1.446, p=0.000870), all pneumoniae (BMI: OR=1.174, p <0.0001; WC: OR=1.272, p <0.0001), bacterial pneumoniae (BMI: OR=1.183, p=0.000290; WC: OR=1.274, p<0.0001), acute bronchitis (BMI: OR=1.252, p <0.0001; WC: OR=1.237, p=0.000268), acute unspecified lower respiratory infection (BMI: OR=1.303, p=0.000403), chronic tonsils and adenoids diseases (BMI: OR=1.236, p <0.0001; WC: OR=1.178, p=0.000157), chronic laryngotracheitis and
laryngitis (WC: OR=1.300, p=0.00785), COPD (BMI: OR=1.429, p <0.0001; WC: OR=1.591, p <0.0001), asthma (BMI: OR=1.358, p <0.0001; WC: OR=1.515, p <0.0001), necrotic and suppurative conditions of lower respiratory tract (WC: OR=1.405, p=0.0427), pleural effusion (BMI: OR=1.277, p=0.00225; WC: OR=1.561, p<0.0001), pleural plaque (BMI: OR=1.245, p=0.0312), other diseases of the respiratory system (BMI: OR=1.448, p <0.0001; WC: OR=1.590, p <0.0001), and non-small cell lung cancer (BMI: OR=1.262, p=0.00576; WC: OR=1.398, p=0.00181). This study also indicated that obesity decreases the possibility of bronchiectasis (BMI: OR=0.705; p=0.00200).
This study revealed that obesity increases the risk of the majority of respiratory diseases (including 20 of all 35 respiratory diseases) and that obesity decreases the risk of bronchiectasis.