Luo X, Chang R, Zhang J, Jiang P, Xu S. Bi-directional and multivariate mendelian randomization analysis of the relationship between circulating 25-hydroxyvitamin D concentration and obstructive sleep apnea.
BMC Pulm Med 2022;
22:380. [PMID:
36241991 PMCID:
PMC9569054 DOI:
10.1186/s12890-022-02172-y]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/28/2022] [Accepted: 09/23/2022] [Indexed: 11/14/2022] Open
Abstract
Background
25-hydroxyvitamin D [25(OH)D] deficiency in patients with Obstructive Sleep Apnea (OSA) has long been noted, but identifying the exact causal relationship remains hard. Investigation of the causality between 25(OH)D deficiency and OSA would help facilitate disease prevention.
Methods
We conducted a two-sample bi-directional Mendelian randomization (MR) study. For forward analysis, 237 newly identified genetic variants are used as proxies for 25(OH)D to estimate the unconfounded effect on OSA among 16,761 OSA cases and 201,194 controls of European ancestry. Reverse analysis was performed to detect the causal impact of OSA on 25(OH)D levels. The inverse variance weighted (IVW) method was used as the primary analysis. Sensitivity analysis was performed to evaluate the robustness of our results. Multivariate MR analysis was conducted to evaluate the direct link between 25(OH)D and OSA after accounting for body mass index (BMI).
Results
IVW indicated that OSA causally associated with a lower level of 25(OH)D ((β = -0.03, 95% CI = -0.06 ~ -0.007, P = 0.01). No evidence of the causal link from 25(OH)D to OSA was detected (OR = 0.99, 95% CI = 0.88 ~ 1.12, P = 0.85). Sensitivity analysis suggested the MR estimates were not biased. Multivariate MR analysis indicated the effect of OSA on 25(OH)D vanished upon accounting for BMI (β = -0.011, 95% CI = -0.028 ~ 0.007, P = 0.23).
Conclusion
This MR study provided evidence that OSA was causally associated with a lower level of 25(OH)D, which might be driven by BMI. Obesity management should be enhanced in patients with OSA to prevent 25(OH)D deficiency.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12890-022-02172-y.
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