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目的:从基因层面探讨抑郁症(MDD)、焦虑症(AD)与多种高发癌症的因果关系。方法:利用双向双样本孟德尔随机化研究(MR),基于大规模全基因组关联研究(GWAS)汇总统计数据，以逆方差加权(IVW)法作为主要分析方法。采用MR-Egger回归的截距项和MR-PRESSO法进行多效性检验。结果:IVW法结果表明，MDD与乳腺癌[OR (95%CI):1.11 (1.01～1.22),P<0.05]、AD与肺癌[OR (95%CI):1.30 (1.02～1.65),P<0.05]、结肠癌与MDD[OR (95%CI):1.05 (1.00～1.11),P<0.05]之间存在潜在因果关系。多效性检验结果表示，MR-Egger回归的截距项均无统计学意义(均P>0.05);MR-PRESSO法仅在MDD与乳腺癌中检测到离群值，校正后MDD与乳腺癌的关联依旧存在[OR (95%CI):1.10(1.03～1.17),P<0.05]。结论:本研究表明，抑郁症可能是乳腺癌的危险因素，焦虑症可能是肺癌的危险因素，结肠癌可能是抑郁症的危险因素，且均排除了存在反向因果关系的可能。
Abstract：Objective:To explore the potential causal relationships between major depressive disorder(MDD),anxiety disorder(AD) and various highly prevalent cancers from the genetic perspective.Methods:Summary statistics from large-scale genome-wide association studies(GWAS) were analyzed using a bidirectional two-sample Mendelian randomization(MR) approach.The inverse variance weighting method(IVW) was usedas the main analytical approach.The intercept term of MR-Egger regression and the MR-PRESSO method were adopted for the pleiotropy test.Results:The IVW analysis revealed potential causal relationships between MDD and breast cancer [OR(95%CI):1.11(1.01-1.22),P<0.05],AD and lung cancer [OR(95%CI):1.30(1.02-1.65),P<0.05],and between colon cancer and MDD [OR(95%CI):1.05(1.00-1.11),P<0.05].The results of the pleiotropy test showed that the intercept terms of the MR-Egger regression were not statistically significant, indicating the absence of pleiotropy.The MR-PRESSO method detected outliers only in the relationship between MDD and breast cancer.The association between MDD and breast cancer remained significant after correction for outliers [OR(95%CI):1.10(1.03-1.17),P<0.05].Conclusion:The study suggests that MDD may be a risk factor for breast cancer, AD may increase the risk factor for lung cancer, and colon cancer may elevate the risk factor of MDD.Moreover, the possibility of reverse causal relationships has been excluded in all these cases.
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基本信息:
中图分类号:R749;R73-31
引用信息:
[1]张玉良,张明,杨龙,等.抑郁症和焦虑症与癌症因果关系的双向双样本孟德尔随机化研究[J].中国心理卫生杂志,2025,39(11):929-936.