鼻部疾病与COPD的因果关联：两样本孟德尔随机化分析

Causality between nasal diseases and COPD: a two-sample Mendelian randomization analysis

摘要

目的 探讨鼻部疾病与慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）之间的因果关系，从而深化对中医理论“鼻为肺之官”的认识。 方法 本研究基于全基因组关联研究（genome-wide association studies，GWAS）的汇总统计数据，利用两样本孟德尔随机化（Mendelian randomization，MR）方法，将遗传因素作为工具变量，分析过敏性鼻炎、急性鼻窦炎、慢性鼻窦炎、鼻息肉与COPD之间的因果关系。 结果 研究结果显示，在排除多效性和异质性因素后，遗传因素决定的慢性鼻窦炎与COPD的风险增加有关（IVW：P=0.008 6）；遗传因素决定的鼻息肉与COPD的风险增加显著相关（IVW：P=0.003 2）。未发现过敏性鼻炎、急性鼻窦炎与COPD的关联。 结论 慢性鼻窦炎、鼻息肉与COPD的患病风险增加有关，但仍需要进行高级别的随机对照试验研究进一步进行验证。

Abstract

Objective To investigate the causality between nasal diseases and chronic obstructive pulmonary disease（COPD） and to enhance understanding of the traditional Chinese medicine theory—the nose is the portal to the lungs. Methods This study was based on pooled statistical data from genome-wide association studies（GWAS）. A two-sample Mendelian randomization（MR） method was used to investigate the causality between allergic rhinitis/acute sinusitis/chronic sinusitis/nasal polyps and COPD，using genetic factors as instrumental variables. Results The study revealed that genetic factors-dependent chronic sinusitis was significantly correlated with an increased risk of COPD after excluding the pleiotropy and heterogeneity（IVW：P=0.008 6）. Genetic factors-dependent nasal polyps were significantly correlated with an elevated risk of COPD（IVW：P=0.003 2）. No associations were found between allergic rhinitis/acute sinusitis and COPD. Conclusion Chronic sinusitis and nasal polyps are correlated with an increased risk of COPD. Nonetheless，high-level randomized controlled trials are imperative to validate these findings.

Graphical abstract

关键词

慢性阻塞性肺疾病 / 鼻窦炎 / 鼻息肉 / 鼻为肺之官 / 孟德尔随机化分析 / 中医

Key words

chronic obstructive pulmonary disease / sinusitis / nasal polyp / the nose is the portal to the lungs / Mendelian randomization analysis / traditional Chinese medicine

基金资助

国家自然科学基金区域创新发展联合基金重点支持资助项目(U20A20398)

安徽省科技厅临床医学研究转化专项资助项目(202204295107020045)