Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma: from genetic and prospective evidence
Higher risk of osteoporosis in adult-onset asthma than childhood-onset asthma: from genetic and prospective evidence
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DOI：
10.1007/s00198-023-07004-1
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发表时间：
2023-12-23
影响因子：
4
通讯作者：
Li，Feng
中科院分区：
文献类型：
--
作者：
Ding，Weizhong;Huang，Yong;Li，Feng
COA和AOA都对骨质疏松症有遗传因果关系。COA和AOA与偶发性骨质疏松症独立相关，AOA的风险更高。除了皮质类固醇，哮喘患者骨质疏松症的风险增加应归因于遗传易感性和其他哮喘药物治疗。目的/IntroductionChildhood-onset asthma（COA）与成人发作哮喘（AOA）的遗传易感性，严重程度和共病。COA或AOA是否与骨质疏松症独立相关尚不清楚。我们的目的是确定COA和AOA对骨质疏松症的影响，在遗传和个人level.MethodsWe采用两个样本孟德尔随机化分析，探讨COA和AOA对骨质疏松症的因果关系。在英国生物库队列中，我们纳入了478，289名基线（2006-2010）无糖尿病的参与者。参与者在招募时被分类为非哮喘、COA和AOA。多变量考克斯回归分析被用来评估COA，AOA，和多种哮喘药物对偶发性骨质疏松症risk.ResultsCOA和AOA与骨质疏松症的因果关系，比值比分别为1.007（95%可信区间（CI），1.0003-1.0132）和1.012（95% CI，1.002-1.023）。多因素考克斯回归分析显示，COA（风险比（HR），1.46; 95%CI，1.32-1.61）和AOA（HR，1.70; 95%CI，1.61-1.80）与骨质疏松症的发生独立相关，AOA的风险更高（HR，1.51; 95%CI，1.34-1.70）。除皮质类固醇外，（HR，1.70; 95% CI，1.20-2.42），长效β受体激动剂（HR，1.49; 95% CI，1.18-1.87）和短效β受体激动剂（HR，1.72; 95%CI1.01 -2.93）与骨质疏松症的高风险独立相关。AOA患者患骨质疏松症的风险更高。除了皮质类固醇，哮喘患者骨质疏松症的风险增加应归因于遗传易感性和其他哮喘药物。
Both COA and AOA have a genetically causal effect on osteoporosis. COA and AOA were independently associated with incident osteoporosis, and the risk was greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications.Purpose/IntroductionChildhood-onset asthma (COA) differs with adult-onset asthma (AOA) on genetic susceptibility, severity, and co-morbidities. Whether COA or AOA is independently associated with osteoporosis is unexplored. We aimed to determine the effects of COA and AOA on osteoporosis at genetic and individual level.MethodsWe used two-sample Mendelian randomization analysis to explore the causal effects of COA and AOA on osteoporosis. In the UK Biobank cohort, we included 478,289 osteoporosis-free participants at baseline (2006–2010). Participants were classified as non-asthma, COA, and AOA at recruitment. Multivariate Cox regression analysis was used to evaluate the effects of COA, AOA, and multiple asthma medications on incident osteoporosis risk.ResultsCOA and AOA were causally related to osteoporosis, with odds ratio of 1.007 (95% confidence interval (CI), 1.0003–1.0132) and 1.012 (95% CI, 1.002–1.023), respectively. Multivariate Cox regression analysis suggested that COA (hazard ratio (HR), 1.46; 95% CI, 1.32–1.61) and AOA (HR, 1.70; 95% CI, 1.61–1.80) were independently associated with incident osteoporosis, and the risk was greatly higher in AOA (HR, 1.51; 95% CI, 1.34–1.70). In addition to corticosteroids, monotherapy with leukotriene modifiers (HR, 1.70; 95% CI, 1.20–2.42), long-acting beta agonists (HR, 1.49; 95% CI, 1.18–1.87), and short-acting beta agonists (HR, 1.72; 95% CI1.01–2.93) were independently associated with a higher risk of osteoporosis.ConclusionsBoth COA and AOA have a genetically causal effect on osteoporosis, and the risk of osteoporosis is greatly higher in AOA. Besides corticosteroids, the increased risk of osteoporosis among asthma patients should be attributed to genetic susceptibility and other asthma medications.