代谢异常、肝酶增加胆结石风险:一项横断面研究和多变量孟德尔随机分析。

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Internal and Emergency Medicine Pub Date : 2024-12-11 DOI:10.1007/s11739-024-03838-7
Ameng Shi, Sinan Xiao, Ying Wang, Xin He, Lei Dong, Qian Wang, Xiaolan Lu, Jue Jiang, Haitao Shi
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引用次数: 0

摘要

背景与目的:一些研究探讨了代谢异常、肝酶升高与胆结石风险之间的关系,但结果并不一致。本研究的目的是通过横断面研究和孟德尔随机化分析,全面评估代谢异常、肝酶和胆结石风险之间的关系。方法:首先,采用横断面研究方法,纳入2021年1月至2021年12月在西安交通大学第二附属医院体检的55531名受试者。胆结石的诊断是基于超声检查结果。采用多变量logistic回归分析来研究代谢异常、肝酶和胆结石风险之间的关系。此外,还进行了双样本和多变量孟德尔随机化分析,以进一步探索遗传因果关系。结果:在横断面分析中,胆结石的检出率为4.8%,男女均随年龄和体重指数(BMI)的增加而逐渐增加。胆结石被发现与各种代谢紊乱共病,并与肝酶升高有关。多因素分析显示,女性性别、年龄、体重指数、舒张压、脂肪肝、丙氨酸转氨酶和γ -谷氨酰转移酶可能是胆结石的独立危险因素,而高密度脂蛋白胆固醇可能是保护因素。双样本和多变量孟德尔随机化分析进一步揭示了遗传预测BMI、2型糖尿病、丙氨酸转氨酶、γ -谷氨酰转移酶和胆结石风险增加之间的因果关系。结论:代谢异常和肝酶升高可能增加胆结石发生的风险。
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Metabolic abnormalities, liver enzymes increased risk of gallstones: a cross-sectional study and multivariate mendelian randomization analysis.

Background and aims: Some studies have explored the relationship between metabolic abnormalities, elevated liver enzymes and gallstone risk, but the results have been inconsistent. The aim of this study was to comprehensively assess the relationship between metabolic abnormalities, liver enzymes, and gallstone risk through a cross-sectional study and Mendelian randomization analysis.

Methods: Firstly, a cross-sectional study was conducted involving 555,31 subjects who underwent physical examinations at the Second Affiliated Hospital of Xi'an Jiaotong University between January 2021 and December 2021. The diagnosis of gallstones was based on ultrasound findings. Multivariable logistic regression analysis was employed to investigate the associations between metabolic abnormalities, liver enzymes, and the risk of gallstones. Additionally, two-sample and multivariate Mendelian randomization analyses were performed to further explore the genetic causal associations.

Results: In the cross-sectional analysis, the detection rate of gallstones was 4.8%, showing a gradual increase with age and BMI (body mass index) in both men and women. Gallstones were found to be comorbid with various metabolic disorders and were associated with elevated liver enzymes. Multivariate analysis showed that female sex, age, body mass index, diastolic blood pressure, fatty liver, alanine aminotransferase, and gamma-glutamyltransferase may be independent risk factors for gallstones, whereas high-density lipoprotein cholesterol may be a protective factor. Two-sample and multivariate Mendelian randomization analyses further revealed a causal association between genetically predicted BMI, type 2 diabetes mellitus, alanine aminotransferase, gamma-glutamyl transferase, and an increased risk of gallstones.

Conclusion: The findings suggest that metabolic abnormalities and elevated liver enzymes may increase the risk of developing gallstones.

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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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