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孟德尔随机化揭示了老年人群中痛风与听力损伤之间的因果关联。

Mendelian randomization reveals the causal association between gout and hearing impairment in older adults.

机构信息

College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.

Beijing Chaoyang District Center for Disease Prevention and Control, Beijing, China.

出版信息

Medicine (Baltimore). 2024 May 31;103(22):e38259. doi: 10.1097/MD.0000000000038259.

Abstract

With the global aging trend escalating, the holistic well-being of the elderly has become a paramount concern within public health. Traditional observational studies often struggle with confounding factors and establishing causality, leaving the relationship between age-related hearing loss (ARHL) and gout largely unexplored. Employing bidirectional two-sample Mendelian randomization (MR) analysis, this investigation elucidated the genetic underpinnings associated with age-related hearing impairment, gout, and urate levels within the IEU Open-GWAS database, thereby uncovering potential causal connections that underlie the intricate interplay between gout, serum urate concentrations, and auditory decline in the geriatric demographic. In the forward MR phase, a cohort of 30 single nucleotide polymorphisms was leveraged to dissect the causal dynamics between ARHL and both gout and urate concentrations. Conversely, in the reverse MR phase, gout and urate levels were posited as the exposome to delineate their impact on hearing acuity, employing an array of models for rigorous validation and sensitivity scrutiny. In the forward MR analysis, a statistically significant correlation was discerned between ARHL and gout (P = .003, odds ratio = 1.01, 95% confidence interval: 1.00-1.02), alongside a notable association with serum urate levels (P = .031, odds ratio = 1.39, 95% confidence interval: 1.03-1.88), intimating that ARHL could potentially influence the incidence of gout and urate concentrations. Conversely, the reverse MR investigation revealed that neither gout nor serum urate levels exerted significant impact on auditory degradation (P > .05), insinuating that these factors might not predominantly contribute to hearing loss. Sensitivity analyses concurred with this inference. This study enriches the comprehension of geriatric health intricacies and unveils that ARHL potentially influences gout and serum urate concentrations. This suggests that monitoring ARHL may play a crucial role in the early identification and management of gout and hyperuricemia, potentially contributing to a comprehensive approach to improving geriatric health outcomes.

摘要

随着全球老龄化趋势的加剧,老年人的整体健康已成为公共卫生领域的首要关注点。传统的观察性研究往往受到混杂因素的困扰,难以确定因果关系,因此,年龄相关性听力损失 (ARHL) 与痛风之间的关系在很大程度上仍未得到探索。本研究采用双向两样本孟德尔随机化 (MR) 分析方法,利用 IEU Open-GWAS 数据库,深入探讨了与年龄相关性听力障碍、痛风和尿酸水平相关的遗传基础,揭示了痛风、血清尿酸浓度与老年人群听力下降之间复杂相互作用的潜在因果关系。在正向 MR 分析中,利用 30 个单核苷酸多态性 (SNP) 来剖析 ARHL 与痛风和尿酸浓度之间的因果关系。相反,在反向 MR 分析中,将痛风和尿酸水平作为暴露组,利用一系列模型进行严格的验证和敏感性检查,以评估其对听力敏锐度的影响。在正向 MR 分析中,发现 ARHL 与痛风之间存在统计学显著相关性 (P=0.003,比值比=1.01,95%置信区间:1.00-1.02),与血清尿酸水平也存在显著相关性 (P=0.031,比值比=1.39,95%置信区间:1.03-1.88),表明 ARHL 可能会影响痛风和尿酸浓度的发生。相反,反向 MR 分析显示,痛风和血清尿酸水平均未对听力下降产生显著影响 (P>.05),暗示这些因素可能不是导致听力损失的主要因素。敏感性分析也证实了这一推断。本研究加深了我们对老年健康复杂性的理解,揭示了 ARHL 可能会影响痛风和血清尿酸浓度。这表明,监测 ARHL 可能在早期识别和管理痛风和高尿酸血症方面发挥关键作用,有助于实现改善老年健康结局的综合方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b99/11142788/e8be77d63bb6/medi-103-e38259-g001.jpg

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