观察性研究报告了多种常见皮肤病与精神疾病之间的关系。评估3种皮肤病(牛皮癣,湿疹,和荨麻疹)和4种精神疾病(双相情感障碍,精神分裂症,重度抑郁症,和焦虑)在欧洲人口中,我们使用孟德尔随机化(MR)分析,这为因果推断提供了明确的证据。使用全基因组关联研究数据库筛选皮肤病和精神疾病的合格单核苷酸多态性。我们进行了双向,使用与银屑病相关的工具变量进行2样本MR分析,湿疹,和荨麻疹作为暴露因素,和双相情感障碍,精神分裂症,严重的抑郁症,和焦虑作为结果。双相情感障碍的反向MR分析,精神分裂症,严重的抑郁症,焦虑和牛皮癣,湿疹,和荨麻疹作为结果也进行了,并使用方差反加权(IVW)分析因果关系,MR-Egger,和加权中位数方法。为了彻底评估因果关系,使用IVW进行敏感性分析,MR-PRESSO,和MR-Egger方法。结果显示,双相情感障碍增加了银屑病的发病率(比值比=1.271,95%置信区间=1.003-1.612,P=.047),在IVW中使用CochranQ检验进行的异质性检验显示P值>.05,(P=.302),多重检验中的MR-Pleiotropy和MR-PRESSO(异常值方法)显示P值>.05,(P=.694;P=.441),和MR-Pleiotropy证据显示没有明显的截距(截距=-0.060;SE=0.139;P=.694)。重度抑郁症增加了患湿疹的风险(比值比=1.002,95%置信区间=1.000-1.004,P=.024),异质性检验显示P值>.05,(P=.328),多重性检测显示P值>.05,(P=.572;P=.340),和MR-Pleiotropy证据显示没有明显的截距(截距=-0.099;SE=0.162;P=.572)。上述结果的敏感性分析是可靠的,没有发现异质性或多重性。这项研究表明,双相情感障碍和牛皮癣之间存在统计学上显著的因果关系,严重的抑郁症,和欧洲人口的湿疹,这可以为医生在常见皮肤疾病的临床管理提供重要信息。
Observational studies have reported a relationship between multiple common dermatoses and mental illness. To assess the potential bidirectional causality between 3 skin disorders (psoriasis, eczema, and
urticaria) and 4 psychiatric disorders (bipolar disorder, schizophrenia, major depressive disorder, and anxiety) in the European population, we used Mendelian randomization (MR) analysis, which provides definitive evidence for causal inference. Eligible single nucleotide polymorphisms were screened for dermatological and psychiatric disorders using a genome-wide association study database. We conducted bidirectional, 2-sample MR analysis using instrumental variables related to psoriasis, eczema, and
urticaria as exposure factors, and bipolar disorder, schizophrenia, major depression, and anxiety as outcomes. Reverse MR analysis with bipolar disorder, schizophrenia, major depression, and anxiety as exposure and psoriasis, eczema, and
urticaria as outcomes were also performed, and the causality was analyzed using inverse-variance weighting (IVW), MR-Egger, and weighted median methods. To thoroughly assess causality, sensitivity analyses were conducted using the IVW, MR-PRESSO, and MR-Egger methods. The results showed that bipolar disorder increased the incidence of psoriasis (odds ratio = 1.271, 95% confidence interval = 1.003-1.612, P = .047), heterogeneity test with Cochran Q test in the IVW showed P value > .05, (P = .302), the MR-Pleiotropy and MR-PRESSO (outlier methods) in the multiplicity test showed P value > .05, (P = .694; P = .441), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.060; SE = 0.139; P = .694). Major depression increased the risk of eczema (odds ratio = 1.002, 95% confidence interval = 1.000-1.004, P = .024), heterogeneity test showed P value > .05, (P = .328), multiplicity detection showed P value > .05, (P = .572; P = .340), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.099; SE = 0.162; P = .572). Sensitivity analyses of the above results were reliable, and no heterogeneity or multiplicity was found. This study demonstrated a statistically significant causality between bipolar disorder and psoriasis, major depression, and eczema in a European population, which could provide important information for physicians in the clinical management of common skin conditions.