CGH:遗传易感性和肥胖对于症状性胆结石病的发病具有促进作用

2022-05-09 xuyihan MedSci原创

胆石症又称胆结石,是指胆道系统包括胆囊或胆管内发生结石的疾病;胆道感染是属于常见的疾病。

胆石症是美国胃肠道相关住院的最常见原因之一,以前的研究已经确定了胆石症与许多生活方式有关。肥胖一直与胆结石病风险相关,并被认为会影响脂质代谢并使胆汁过饱和度。同时胆结石的遗传和环境因素之间复杂的相互作用也是扮演了重要角色。Yuan等人通过孟德尔随机化研究发现高BMI、高腰围的遗传易感性与与胆石症的高风险独立相关。本项研究旨在根据胆结石疾病多基因风险评分的层次来描述人体测量指标(体重指数 [BMI]、近期体重变化、长期体重变化、腰围和腰臀比)与症状性胆结石疾病之间的关联(PRS)。

为了完成本项研究,研究人员在美国 3个大型前瞻性队列——护士健康研究 (NHS)、卫生专业人员随访研究和 NHS II 中对 34626 名参与者进行了相关分析,所有这些参与者均具有可用的全基因组遗传数据。然后研究人员根据统计结果描述了 PRS 和人体测量指标的联合关联,并测试了相对和绝对风险量表上的相互作用。

 

研究结果发现,与最低BMI和PRS类别的女性相比,最高BMI和PRS类别(BMI≥30 kg/m 2和 PRS ≥ 1 SD 高于平均值)的女性患胆结石疾病的优势比为5.55(95% 置信区间,5.29 至 5.81),男性的相应优势比为 1.65(95% 置信区间,1.02 至 2.29)。BMI 的相关性在 PRS 的相对风险等级上没有变化。在绝对风险量表上,在最高 PRS 类别中,肥胖和正常体重个体的发病率差异为1086/10000人年,而在最低 PRS 类别中为每 666 /100000人年。

本项研究结果证实虽然维持健康的体重可以降低所有人患胆结石病的风险,但对胆结石病遗传易感性较高的亚群的风险降低程度更高。

原始出处:

Junghyun Lim. Et al. Obesity, Adiposity, and Risk of Symptomatic Gallstone Disease According to Genetic Susceptibility. Clinical Gastroenterology and Hepatology.2022.

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