高血压与2型糖尿病肾病之间的潜在因果关系：将孟德尔随机化证据与2021年全球疾病负担分析相结合
Potential Causal Relationship Between Hypertension and Type 2 Diabetic Nephropathy: Integrating Mendelian Randomization Evidence with Global Burden of Disease 2021 Analysis.
摘要(中文译文)
高血压（HTN）与2型糖尿病是全球重大健康挑战，糖尿病肾病（DN）是糖尿病的关键并发症。尽管观察性研究将高血压与糖尿病肾病的进展相关联，但因果证据仍然有限。我们研究了高血压与糖尿病肾病之间的潜在因果关系，并量化了高血压归因的2型糖尿病肾病（HTN-T2DN）的全球疾病负担。我们整合了双样本孟德尔随机化（MR）、贝叶斯加权孟德尔随机化及敏感性分析与2021年全球疾病负担（GBD）研究分析。评估了1990年至2021年高血压归因的2型糖尿病肾病的疾病负担，并预测至2045年。孟德尔随机化提供了支持高血压在糖尿病肾病中潜在因果作用的遗传学证据（逆方差加权比值比=4.219，95%置信区间：1.807-9.853；=0.001）。全球范围内，2021年高血压归因的2型糖尿病肾病死亡人数增至50,689例，伤残调整生命年（DALYs）增至1,151,216。女性的年龄标准化死亡率和伤残调整生命年率高于男性，中低社会人口学指数（SDI）地区的疾病负担最高。预计到2045年，死亡人数和伤残调整生命年将分别达到162,392例和404万。高血压可能在糖尿病肾病的发生和进展中发挥潜在的因果作用。加强血压控制、早期筛查和制定针对性政策至关重要，尤其是对女性、老年人及低社会人口学指数地区人群。
Abstract
Hypertension (HTN) and type 2 diabetes mellitus are major global health challenges, and diabetic nephropathy (DN) is a critical complication of diabetes. Although observational studies link HTN to DN progression, causal evidence remains limited. We investigated the potential causal relationship between HTN and DN and quantified the global burden of HTN-attributable type 2 diabetic nephropathy (HTN-T2DN). We integrated two-sample Mendelian randomization (MR), Bayesian weighted MR, and sensitivity analyses with Global Burden of Disease (GBD) 2021 analyses. The burden of HTN-T2DN was assessed from 1990 to 2021 and projected to 2045. MR provided genetic evidence supporting a potential causal role of HTN in DN (inverse-variance weighted odds ratio = 4.219, 95% CI: 1.807-9.853; = 0.001). Globally, HTN-T2DN deaths increased to 50,689 and DALYs to 1,151,216 in 2021. Females had higher age-standardized mortality and DALY rates than males, and low-middle sociodemographic index (SDI) regions had the highest burden. By 2045, deaths and DALYs were projected to reach 162,392 and 4.04 million, respectively. HTN may play a potential causal role in DN development and progression. Strengthened blood pressure control, early screening, and tailored policies are essential, particularly for women, older adults, and populations in lower-SDI settings.
如何引用
AMA
Dongsen Hu, Runze Wang, Pengfei Xie, Yexin Chen, Lili Zhang, Linhua Zhao. Potential Causal Relationship Between Hypertension and Type 2 Diabetic Nephropathy: Integrating Mendelian Randomization Evidence with Global Burden of Disease 2021 Analysis.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14121725.
APA
Dongsen Hu, Runze Wang, Pengfei Xie, Yexin Chen, Lili Zhang, Linhua Zhao (2026). Potential Causal Relationship Between Hypertension and Type 2 Diabetic Nephropathy: Integrating Mendelian Randomization Evidence with Global Burden of Disease 2021 Analysis.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14121725
GB/T 7714
Dongsen Hu, Runze Wang, Pengfei Xie, Yexin Chen, Lili Zhang, Linhua Zhao. Potential Causal Relationship Between Hypertension and Type 2 Diabetic Nephropathy: Integrating Mendelian Randomization Evidence with Global Burden of Disease 2021 Analysis.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14121725.
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