浙江医学2026，Vol.48Issue(6)：573-580,8.DOI:10.12056/j.issn.1006-2785.2026.48.6.2025-2131
炎症性肠病与20种感染性疾病关系的孟德尔随机化研究和中介效应分析
Causal associations between inflammatory bowel disease and 20 infectious diseases:a Mendelian randomization study and me-diation effect analysis
摘要
Abstract
Objective To investigate the causal associations between inflammatory bowel disease(IBD)and 20 infectious diseases,and to analyze the mediating effects of glucocorticoids and immunosuppressants.Methods Based on genome-wide association study(GWAS)summary data,a bidirectional two-sample Mendelian randomization(MR)approach was employed to evaluate the causal effects between IBD,ulcerative colitis(UC),Crohn's disease(CD),and 20 infectious diseases.A two-step MR was utilized to assess the mediating effects of medications.The inverse-variance weighted(IVW)method was used as the primary analysis,complemented by MR-Egger,weighted median,and weighted mode methods for validation.Sensitivity analyses were performed using Cochran's Q test,MR-PRESSO,MR Steiger test,and leave-one-out analysis.The results were adjusted for multiple testing using the Benjamini-Hochberg procedure.Results After multiple testing correction,both IBD(OR=1.159,95％CI:1.092-1.230)and UC(OR=1.157,95％CI:1.093-1.225)were significantly associated with an increased risk of Clostridioides difficile infection(both FDR＜0.05).CD was associated with a higher risk of hepatitis C virus infection(OR=1.143,95％CI:1.052-1.241,FDR＜0.05).Furthermore,the two-step MR analysis revealed no significant mediating effects of glucocorticoids and immunosuppressants in these causal associations.Conclusion Significant causal associations exist between IBD and specific infectious diseases.This highlights the necessity for clinical vigilance regarding opportunistic infection risk management in patients with IBD,and warrants further investigation into the potential mechanisms of viral exposure in IBD pathogenesis.关键词
孟德尔随机化/炎症性肠病/艰难梭菌感染/丙型肝炎病毒感染/中介效应Key words
Mendelian randomization analysis/Inflammatory bowel disease/Clostridioides difficile infection/Hepatitis C virus infection/Mediation effect引用本文复制引用
于佳丽,刘源,韩冰玉,杨雨潇,陈冠妤,程小韵,刘芳,杜时雨..炎症性肠病与20种感染性疾病关系的孟德尔随机化研究和中介效应分析[J].浙江医学,2026,48(6):573-580,8.基金项目
国家重点研发计划项目(2025YFC3408601) （2025YFC3408601）
北京市自然科学基金资助项目(7204303) （7204303）
