降压药与抑郁症的因果关系:药物靶点的孟德尔随机化研究

Zixian Yang, Jinshuai Li, Peichu Huang, Zhichang Li, Jianfeng He, Dongchun Cai, Yuzheng Lai
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摘要

抑郁症是造成全球疾病负担的主要因素之一。使用降压药与抑郁症之间的潜在因果关系引起了人们的极大兴趣。尽管进行了广泛的调查,但这种关系的性质仍是一个争论不休的话题。因此,本研究旨在通过对药物靶点进行孟德尔随机研究,评估降压药物对抑郁症的影响:我们重点研究了五类抗高血压药物的靶点:血管紧张素转换酶抑制剂(ACEIs)、血管紧张素 II 受体拮抗剂(ARBs)、钙通道阻滞剂(CCBs)、β-受体阻滞剂(BBs)和噻嗪类利尿剂(TDs)。我们从全基因组关联研究(GWAS)统计数据中收集了与这些药物靶点相关的单核苷酸多态性(SNPs),并将其作为药物的替代物。随后,我们针对这些药物进行了孟德尔随机化(MR)分析,以探讨它们对抑郁症的潜在影响。我们的研究结果表明,β-受体阻滞剂(BBs)的基因替代物与抑郁症风险升高有关(OR [95%CI] = 1.027 [1.013, 1.040],p < 0.001)。同样,钙通道阻滞剂(CCB)的基因替代物也与抑郁风险升高有关(OR [95%CI] = 1.030 [1.009, 1.051],p = 0.006)。该研究表明,与β受体阻滞剂(BBs)和钙通道阻滞剂(CCBs)相关的基因代用品可能会增加患者患抑郁症的风险。这些发现强调了在处方这些药物时考虑遗传倾向的重要性,为易感人群预防抑郁症提供了一种战略性方法。
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The causal relationship between antihypertensive drugs and depression: a Mendelian randomization study of drug targets
Depression ranks as a leading contributor to the global disease burden. The potential causal relationship between the use of antihypertensive medications and depression has garnered significant interest. Despite extensive investigation, the nature of this relationship remains a subject of ongoing debate. Therefore, this study aims to evaluate the influence of antihypertensive medications on depression by conducting a Mendelian randomization study focused on drug targets.We focused on the targets of five antihypertensive drug categories: ACE Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Calcium Channel Blockers (CCBs), Beta-Blockers (BBs), and Thiazide Diuretics (TDs). We collected single-nucleotide polymorphisms (SNPs) associated with these drug targets from genome-wide association study (GWAS) statistics, using them as proxies for the drugs. Subsequently, we conducted a Mendelian randomization (MR) analysis targeting these drugs to explore their potential impact on depression.Our findings revealed that genetic proxies for Beta-Blockers (BBs) were associated with an elevated risk of depression (OR [95%CI] = 1.027 [1.013, 1.040], p < 0.001). Similarly, genetic proxies for Calcium Channel Blockers (CCBs) were linked to an increased risk of depression (OR [95%CI] = 1.030 [1.009, 1.051], p = 0.006). No significant associations were identified between the genetic markers of other antihypertensive medications and depression risk.The study suggests that genetic proxies associated with Beta-Blockers (BBs) and Calcium Channel Blockers (CCBs) could potentially elevate the risk of depression among patients. These findings underscore the importance of considering genetic predispositions when prescribing these medications, offering a strategic approach to preventing depression in susceptible individuals.
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