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当前位置：国际妇产科研究 > 2024年 4卷 (2)期

Open Access Article

International Journal of Obstetrics and Gynecology. 2024; 4: (2) ; 35-42 ; DOI: 10.12208/j.ijog.20240017.

Causal relationship between gestational diabetes mellitus and postpartum depression: Mendelian randomized study
妊娠期糖尿病与产后抑郁症之间的因果关系：孟德尔随机化研究

作者： 张婷 *

浙江中医药大学生命科学学院浙江杭州

*通讯作者：张婷,单位：浙江中医药大学生命科学学院浙江杭州；

发布时间: 2024-12-31 总浏览量: 44

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摘要

目的采用两样本孟德尔随机化（MR）分析探讨妊娠期糖尿病（GDM）与产后抑郁症发生风险的因果关系。方法使用公开的全基因组关联研究汇总数据集，运用逆方差加权（IVW）方法相结合，包括敏感性分析，如加权中位数、MR Egger和MR多效性残差和异常值（PRESSO）进行两样本MR分析，评估GDM与产后抑郁症风险增加存在因果关系。结果原始数据集共纳入38个SNP位点作为工具变量，MR分析结果表明，GDM与产后抑郁症风险增加存在因果关系（IVW:OR=1.0503，95%Cl:1.0060～1.0965，P=0.0257）。在GDM对产后抑郁症的MR分析中，工具变量不存在水平多效性与异质性。使用留一法（leave-one-out法）进行的敏感性分析发现，MR分析结果稳健。结论两样本MR分析结果显示，GDM与产后抑郁症风险增加存在因果关系。与传统观察性研究相比，MR方法通过遗传工具变量规避混杂，增强因果推断可靠性。提示临床实践中应对GDM孕妇需加强产后抑郁筛查，以便早期识别高风险个体并及时干预。

关键词： 妊娠期糖尿病；产后抑郁症；因果关系；孟德尔随机化研究；敏感性分析

Abstract

Objective To explore the causal relationship between gestational diabetes mellitus (GDM) and the risk of postpartum depression (PPD) by two-sample Mendelian randomization (MR).
Methods A two-sample MR analysis was performed to assess the causal relationship between gestational diabetes mellitus and postpartum depression risk using a publicly available genome-wide association study aggregation data set using inverse variance weighting (IVW) combined with inclusion such as weighted median MR Egger and MR pleiotropic residuals and outliers (PRESSO).
Results A total of 38 SNP loci were included in the original data set as instrumental variables. MR results showed that there was a causal relationship between gestational diabetes mellitus (GDM) and postpartum depression risk (IVW: OR=1.0503, 95%Cl:1.0060~1.0965, P= 0.0257). There is no level pleiotropy and heterogeneity of instrumental variables in MR of gestational diabetes mellitus and postpartum depression. The MR results of sex discovery using leave-one-out method are robust.
Conclusion The MR results of the two samples showed a causal relationship between GDM and the risk of postpartum depression. Compared with observational studies, MR avoids confounding through genetic instrumental variables and enhances causal inference reliability. It is suggested that postpartum depression screening should be strengthened for GDM pregnant women in clinical practice, so as to identify high-risk individuals early and intervene in time.

Key words： Gestational diabetes mellitus; Postpartum depression; Causality; Mendelian randomization study; Sensitivity analysis

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引用本文

张婷, 妊娠期糖尿病与产后抑郁症之间的因果关系：孟德尔随机化研究[J]. 国际妇产科研究, 2024; 4: (2) : 35-42.

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