基于孟德尔随机化研究的高血压相关影响因素因果关联的证据图谱

朱先尚; 毛华博; 曾泓钰; 吕凤丽; 王建成

doi:10.16766/j.cnki.issn.1674-4152.003938

基于孟德尔随机化研究的高血压相关影响因素因果关联的证据图谱

doi: 10.16766/j.cnki.issn.1674-4152.003938

朱先尚^{1, 2},
毛华博¹,
曾泓钰³,
吕凤丽³,
王建成^{2, 4, ,}

1.
甘肃中医药大学第一临床医学院，甘肃兰州 730000
2.
甘肃省人民医院全科医学科，甘肃兰州 730000
3.
兰州大学公共卫生学院，甘肃兰州 730000
4.
甘肃卫生职业学院临床护理学院, 甘肃兰州 730000

基金项目:

中国医药教育协会重大项目 2022KTZ010

甘肃省人民医院院内科研基金项目 22GSSYD-54

详细信息

通讯作者:
王建成，E-mail: 30922329@qq.com

中图分类号: R544.11
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出版历程
- 收稿日期: 2024-05-22
- 网络出版日期: 2025-05-14

Evidence map of causal associations between hypertension and its influencing factors based on Mendelian randomization studies

1.
The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu 730000, China

摘要

摘要: 目的通过证据图谱系统识别、描述和评价高血压与其影响因素之间的因果关联的研究证据。方法检查中国知网、万方数据、PubMed和Web of Science数据库，检索时间截止到2023年10月18日，获取有关高血压与影响因素因果关联的孟德尔随机化研究。使用Excel对纳入研究进行数据提取和整理，并按照MR研究的三大假设对纳入研究进行描述性质量评价。采用证据图谱来综合呈现纳入研究的数量、暴露或结局、研究结果等内容。结果纳入108篇文献，共提取出182项孟德尔随机化研究。研究涉及高血压分别作为暴露或结局时，与相关影响因素之间的因果关系，并评估了9类暴露和7类结局与高血压的因果关联。97.80%的研究采用逆方差加权法，95.05%的研究是双样本MR设计。研究对象主要是欧洲人群，80.77%的研究结果基本满足了MR研究的三大假设，且研究结论差异有统计学意义。结论本研究系统总结了高血压与相关影响因素之间的因果关系，目前的MR研究主要集中在高血压与人体测量特征、常见疾病以及心脑血管疾病之间的因果关系。此外，仍需要进一步探究暴露因素对血压水平的具体影响，并制定孟德尔随机化研究的质量控制标准，以提高证据可靠性和外推性，为高血压的防治提供更准确的参考依据。
- 高血压 /
- 孟德尔随机化 /
- 循证医学 /
- 证据图谱
Abstract: Objective To systematically identify, describe, and evaluate research evidence on the causal association between hypertension and its influencing factors through an evidence mapping system. Methods A comprehensive search was conducted across CNKI, Wanfang Data, PubMed, and Web of Science databases up to October 18, 2023 to obtain Mendelian randomization studies exploring causal associations between hypertension and influencing factors. Excel was used to extract and organize data incorporated into research, and to conduct the properties of the studies based on the three major assumptions of MR research. An evidence map was constructed to summarize the number of studies, exposures or outcomes, and research results. Results A total of 108 documents were included in this study, encompassing 182 Mendelian randomization studies. The research focused on exploring the causal relationship between hypertension, either as an exposure or an outcome, and various influencing factors. Nine categories of exposures and seven categories of outcomes related hypertension were identified. The majority (97.80%) of the studies utilized the inverse variance weighting method, and 95.05% utilized a two-sample MR design, primarily involving European populations. Approximately 80.77% of the studies met the three major assumptions of MR research, with statistically significant findings reported in most cases. Conclusion This study systematically summarizes the causal relationships between hypertension and its influencing factors. Current Mendelian randomization research primarily examines the causal links between hypertension and anthropometric characteristics, common diseases, and cardiovascular or cerebrovascular diseases. Furthermore, exploration is needed to clarify the specific effects of exposure factors on blood pressure levels and to establish quality control standards for MR studies. Improving the reliability and generalizability of evidence will provide more precise reference for the prevention and treatment of hypertension.
- Hypertension /
- Mendelian randomization /
- Evidence-based medicine /
- Evidence map

HTML全文

图 1 高血压为暴露时与结局的因果关联证据图

注：横轴表示因果关系的方向，纵轴表示MR研究的质量分级，气泡大小表示研究的数量。

Figure 1. Evidence diagram of the causal association between hypertension and outcomes when exposed

下载: 全尺寸图片幻灯片

图 2 高血压为结局时与暴露因素的因果关联证据图

注：横轴表示因果关系的方向，纵轴表示MR研究的质量分级，气泡大小表示研究的数量。

Figure 2. Evidence diagram showing the causal association with exposure factors when hypertension is the outcome

下载: 全尺寸图片幻灯片

表 1 纳入研究结局分类及数量

Table 1. Outcome classification and number of included studies

结局分类	MR研究数量	结局分类	MR研究数量
心脑血管疾病	14	呼吸系统疾病	2
中风	6	睡眠呼吸暂停	1
腹主动脉瘤	2	打鼾	1
主动脉夹层	1	其他结局	8
脑小血管病	1	勃起功能障碍	2
颅内动脉瘤	1	阿尔兹海默病	1
冠状动脉疾病	1	膝关节骨关节炎	1
心力衰竭	1	牛皮癣	1
心房颤动	1	前列腺癌	1
内分泌相关疾病	5	长寿	1
糖尿病	4	血小板计数	1
痛风	1	心脏结构功能	10
神经精神疾病	5	心房排空分数	3
神经过敏症	2	心房容积指数	2
抑郁	1	心室容积	2
焦虑	1	心室射血分数	1
贝尔麻痹	1	左心室质量	1
肾脏相关疾病	4	心室质量与舒张末期容积比	1
慢性肾脏病	2
肾结石	2

下载: 导出CSV

表 2 纳入研究暴露分类及数量

Table 2. Exposure classification and number of included studies

暴露分类	MR研究数量	暴露分类	MR研究数量
人体测量学特征	27	血液脂肪酸	10
体重指数	8	脂蛋白a	3
肥胖	3	天冬氨酸苯丙氨酸	1
握力	3	支链氨基酸	1
内脏脂肪组织	2	血浆皮质醇	1
去脂体重	2	异亮氨酸	1
体脂肪量	2	亮氨酸	1
体型	2	缬氨酸	1
步行速度	1	甘氨酸	1
出生体重	1	脂质标志物	8
腰臀比	1	甘油三酯	3
腰围	1	低密度脂蛋白	3
身高	1	高密度脂蛋白	2
病理状况	32	血液成分	5
糖尿病	6	糖化血红蛋白	3
甲状腺功能	3	血小板计数	1
家族糖尿病	3	嗜酸性粒细胞计数	1
抑郁	3	生殖相关指标	4
睡眠呼吸暂停	2	性成熟年龄	2
神经过敏症	2	性激素结合球蛋白	1
心房颤动	2	游离睾酮	1
非酒精性脂肪性肝病	1	炎性标志物	3
类风湿性关节炎	1	C反应蛋白	2
过敏性疾病	1	抗巨细胞病毒免疫球蛋白	1
前列腺癌	1	其他标志物	20
空腹胰岛素	1	受教育程度	4
空腹血糖	1	尿酸盐	3
肾结石	1	端粒长度	2
蛋白尿	1	尿调素	2
打鼾	1	肠道微生物菌群	1
失眠	1	认知功能	1
痛风	1	DNA甲基化	1
生活习惯	20	骨保护素	1
乳制品摄入	4	家庭收入	1
酒精摄入	3	父亲寿命	1
午睡	3	肉毒碱	1
低维生素C摄入	2	叶酸	1
茶摄入	2	智力	1
家禽摄入	1
干果摄入	1
面条摄入	1
植物性饮食	1
钠摄入量	1
易怒	1

下载: 导出CSV

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