| 基于“肾藏精”理论探讨糖尿病肾病与肌少症的因果关系 |
| 投稿时间：2025-04-30 修订日期：2025-07-01 点此下载全文 |
| 引用本文：吴琳琳,王豪浩,贾润可,石海荣,马继伟.基于“肾藏精”理论探讨糖尿病肾病与肌少症的因果关系[J].医学研究杂志,2025,54(11):63-71 |
| DOI：
10.11969/j.issn.1673-548X.2025.11.013 |
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| 基金项目:河南省国家中医药传承创新中心科研专项(2023ZXZX1020)；河南省中医药科学研究专项课题(2024ZY2006) |
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| 中文摘要:目的 在“肾藏精”理论下,探讨糖尿病肾病(diabetic kidney disease, DKD)与肌少症相关特征(低握力、四肢瘦体重、步行速度)之间的因果关系。方法 利用DKD和肌少症相关特征的全基因组关联分析(Genome-Wide Association Study, GWAS)数据,分别筛选出10、9、9、9、9、12个工具变量,进行两样本孟德尔随机化(Mendelian randomization,MR)分析。采用逆方差加权(inverse-variance weighted, IVW)法、MR-Egger回归法和加权中位数法来评估因果效应,并通过多种敏感度分析,验证结果是否稳健。结果 IVW法作为主要的分析方法,其结果显示DKD与低握力(OR=1.042,95% CI:1.010~1.075,P=0.009)、左腿瘦体重(OR=1.011,95% CI:1.001~1.020,P=0.024)和右腿瘦体重(OR=1.012,95% CI:1.003~1.022,P=0.013)之间存在因果关系,但与左臂瘦体重、右臂瘦体重和步行速度之间没有显著的关系；异质性、多效性和敏感度分析显示,工具变量不存在偏倚,因果效应较为可靠。结论 DKD可能导致患肌少症的风险增加,深化了对“肾藏精”理论的认识,为DKD患者肌少症的防治提供了新的中医依据及辩证思路。 |
| 中文关键词:肾藏精 糖尿病肾病 肌少症 孟德尔随机化 因果关联分析 |
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| Causal Relationship between Diabetic Nephropathy and Sarcopenia Based on the "Kidney Stores Essence" Theory. |
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| Abstract:Objective To explore the causal relationship between diabetic kidney disease (DKD) and sarcopenia-related characteristics (low grip strength, appendicular lean mass, and walking speed) based on the "kidney stores essence" theory. Methods The Genome-Wide Association Study (GWAS) data of DKD and sarcopenia-related characteristics were utilized, 10,9, 9,9, 9 and 12 instrumental variables were respectively screened out, and conduct two-sample Mendelian randomization (MR) analyses. The causal effects were assessed using inverse-variance weighting (IVW) method, MR-Egger regression method, and weighted median method, and the robustness of the results was verified through various sensitivity analyses. Results The primary analysis using the IVW method showed that DKD had causal relationship with low grip strength (OR=1.042,95% CI:1.010-1.075, P=0.009), left leg lean mass (OR=1.011,95% CI:1.001-1.020, P=0.024), and right leg lean mass (OR=1.012,95% CI:1.003-1.022, P=0.013). However, no significant associations were found between DKD and left arm lean mass, right arm lean mass, or gait speed. Heterogeneity, pleiotropy, and sensitivity analyses showed that there was no bias in the instrumental variables and the causal effect was relatively reliable. Conclusion DKD may increase the risk of sarcopenia. It not only deepens the understanding of the "kidney stores essence" theory, but also provides new evidence-based insights and diagnostic and therapeutic approaches for the prevention and treatment of sarcopenia in patients with DKD from the perspective of traditional Chinese medicine. |
| keywords:Kidney stores essence Diabetic kidney disease Sarcopenia Mendelian randomization Causal association analysis |
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