【作者】 陈鹏程；

【导师】 张海燕；

【作者基本信息】 吉林大学 ， 临床医学硕士（专业学位）， 2024， 硕士

【摘要】 背景和目的:疝是一种特别常见的腹部外科疾病,其发病率居高不下,随着人们生活水平的提高,越来越多的研究注意到生活方式对于疝的影响。先前的病例对照研究已经报道了生活方式与疝之间的关系,然而,有关生活方式在疝中的因果关系的证据仍然不足。我们旨在利用孟德尔随机化方法评估生活方式与疝发生之间的因果关系。方法:将22种常见的生活方式特征作为暴露因素,选择腹股沟疝、股疝和各类疝作为疝的表型。为了满足孟德尔随机化的三大假设,设置了六个严格的SNP筛选步骤。通过三个MR模型评估生活方式与疝的主要因果关系:逆方差加权法(IVW)、MR-Egger和加权中位数。为了更好地验证因果关系,增加了稳健IVW模型和稳健的MR-Egger模型。此外,还使用了Cochran’s Q检验、MR-Egger截距模型以检测水平多效性,最后绘制了敏感性分析的散点图和留一法分析图。结果:教育年限、中等强度体育活动(MVPA)、睡眠呼吸暂停、大学学位、脂肪摄入、咖啡摄入、每周饮酒量、休闲屏幕时间和失眠这几种生活方式可能与疝有因果关系。然而,在p值的调整后,除了受教育年限和各类疝(调整后p值分别为5.99E-05,IVW,调整后p值为0.015,加权中值)以外,大多数生活方式因素与疝之间没有显著的直接因果关系。结论:我们的研究结果表明,除了受教育年限以外,大多数检测的生活方式因素与疝的发生没有直接因果关系。更多还原

【Abstract】 Background and Purpose:The hernia is a particularly common disease,and its incidence remains high.With the improvement of people’s living standards,more and more studies have paid attention to the influence of lifestyle on hernia.Previous case-control studies have reported the relationship between lifestyle and hernia,however,evidence regarding the causal role of lifestyle in hernia is still lacking.We aim to use Mendelian randomization methods to identify the causal relationship between lifestyle and hernia occurrence.Methods:The 22 common lifestyle traits were included as exposures and inguinal hernia,femoral hernia,and all-kinds hernia were selected as hernia traits.Six strict SNP filtration steps were set to satisfy the assumptions of Mendelian randomization.The main causal associations of lifestyles with hernia were estimated by three MR models: inverse variance weighted(IVW),MR-Egger,and weighted median.To better validate the causal estimates,robust IVW and MR-Egger models were also performed as sensitivity analyses.Moreover,Cochran’s Q test,the MR-Egger intercept test,the scatter plots and leave-one-out analysis were also established as sensitivity analyses.Results:The education years,MVPA,sleep apnoea,college or university degree,fat,coffee intake,drinks per week,leisure screen time,and insomnia may relate to hernia causally.However,after the adjustment of p values,the majority of lifestyle factors do not have a significantly causal relationship with hernia,except education years and all kinds hernia(adjusted p: 5.99E-05,IVW,adjusted p: 0.015,weighted median).Conclusion:Our study reveals that the majority of lifestyle factors examined do not have a causal relationship with the occurrence of hernia,with the exception of education years.更多还原