中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (9): 1953-1962.doi: 10.12307/2025.161

• 植入物相关大数据分析 Implant related big data analysis • 上一篇    下一篇

可干预因素与关节运动损伤的因果关系

董婷婷，陈天鑫，李  妍，张  晟，张  磊   

  1. 中国中医科学院望京医院骨关节四科，北京市   100102
  • 收稿日期:2024-02-27 接受日期:2024-04-13 出版日期:2025-03-28 发布日期:2024-10-11
  • 通讯作者: 张磊，博士，教授，主任医师，中国中医科学院望京医院骨关节四科，北京市 100102
  • 作者简介:董婷婷，女，1994年生，辽宁省沈阳市人，汉族，中国中医科学院在读博士，主要从事骨科运动医学研究。
  • 基金资助:
    中央级公益性科研院所基本科研业务费专项资金资助(ZZ15-XY-CT-10)，项目负责人：张磊；中国中医科学院科技创新工程-重大攻关项目(CI2021A02009)，项目负责人：张磊

Causal relationship between modifiable factors and joint sports injuries

Dong Tingting, Chen Tianxin, Li Yan, Zhang Sheng, Zhang Lei   

  1. Forth Department of Bone and Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
  • Received:2024-02-27 Accepted:2024-04-13 Online:2025-03-28 Published:2024-10-11
  • Contact: Zhang Lei, MD, Professor, Chief physician, Forth Department of Bone and Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
  • About author:Dong Tingting, MD candidate, Forth Department of Bone and Joint, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
  • Supported by:
    Fundamental Research Funds for Central Public Welfare Research Institutes, No. ZZ15-XY-CT-10 (to ZL); Innovation Fund-Major Research Project of China Academy of Chinese Medical Sciences, No. CI2021A02009 (to ZL)

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摘要：

文题释义：
可干预因素：是指可以通过特定干预或治疗手段来改变或影响的因素，可以是疾病发病原因，也可以是疾病发展过程中的影响因素，包括生活方式、代谢特征及营养摄入等。
关节运动损伤：是由于外部冲击、过度使用及姿势不当等原因，导致韧带、肌肉及软骨等软组织结构在运动损伤过程受到损伤，常引起关节疼痛、肿胀及活动受限等症状。

摘要
背景：生活方式、代谢特征及营养摄入等干预因素与关节运动损伤的因果关系逐渐得到临床研究的重视，然而可干预因素与关节运动损伤的因果关系尚不明确。
目的：运用孟德尔随机化的方法，探讨可干预因素与关节运动损伤的因果关系，为运动损伤预防提供依据。
方法：从公开数据库获取可干预因素和关节运动损伤的GWAS数据集，运用逆方差加权法、MR-Egger法、加权中位数法探讨生活方式、代谢特征、营养摄入与关节运动损伤的因果关系。敏感性分析方面，采用Cochran’s Q检验、MR-Egger回归、留一法和MR-PRESSO，以验证结果的稳定性和可靠性。

结果与结论：① 生活方式方面，咖啡(OR=0.29，95%CI：0.10-0.79，P=0.016)、茶消耗量(OR=0.41，95%CI=0.19-0.85，P=0.017)与足踝关节运动损伤风险下降，咖啡消耗量(OR=3.31，95%CI=1.02-10.73，P=0.046)与肩关节运动损伤风险上升具有潜在因果关系；从未吸烟(OR=0.78，95%CI=0.70-0.87，P=1.49×10-5)与足踝关节运动损伤风险下降具有显著因果关系。②代谢特征方面，钙水平(OR=0.88，95%CI=0.79-0.98，P=0.017)与手腕关节运动损伤风险下降具有潜在因果关系。③营养摄入方面，维生素A摄入(OR=1.08，95%CI：1.02-1.13，P=0.007)与膝关节运动损伤风险增加具有潜在因果关系。④敏感性分析方面，Cochran’s Q检验显示存在异质性(P < 0.05)，故采用随机效应模型分析。MR-Egger回归、MR-PRESSO检验未发现水平多效性(P > 0.05)，留一法显示逐个剔除单核苷酸多态性后，结果具有稳定性。⑤此研究初步揭示生活方式、代谢特征及营养摄入等可干预因素对关节运动损伤风险的影响，为关节运动损伤的预防提供研究证据与研究方向。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 孟德尔随机化, 关节运动损伤, 可干预因素, 生活方式, 代谢特征, 营养摄入, 因果关系, 敏感性分析

Abstract: BACKGROUND: The causal relationship between modifiable factors such as lifestyle, metabolic characteristics, and nutritional intake and joint sports injuries has been increasingly recognized in clinical studies. However, the exact causal relationship between these modifiable factors and joint sports injuries remains unclear.
OBJECTIVE: To investigate the causal relationship between modifiable factors and joint sports injuries using Mendelian randomization to provide a basis for sports injury prevention. 
METHODS: The GWAS dataset of intervening factors and joint sports injuries was obtained from publicly available data. The causal relationships between lifestyle, metabolic characteristics, nutritional intake, and joint sports injuries were explored using the inverse variance weighting method, the MR-Egger method, and the weighted median method. For sensitivity analyses, Cochran’s Q test, MR-Egger regression, leave-one-out method, and MR-PRESSO were used to verify the stability and reliability of the results. 

RESULTS AND CONCLUSION: (1) In terms of lifestyle, coffee (OR=0.29, 95%CI:0.10-0.79, P=0.016), and tea consumption (OR=0.41, 95%CI=0.19-0.85, P=0.017) were associated with a decreased risk of ankle and foot joint sports injuries, and coffee consumption (OR=3.31, 95%CI=1.02-10.73, P=0.046) was potentially causally associated with an increased risk of shoulder joint sports injuries; and never smoking (OR=0.78, 95%CI=0.70-0.87, P=1.49×10-5) was significantly causally associated with a decreased risk of ankle and foot joint sports injuries. (2) In terms of metabolic characteristics, calcium levels (OR=0.88, 95%CI=0.79-0.98, P=0.017) were potentially causally associated with a decreased risk of wrist and hand joint sports injuries. (3) In terms of nutritional intake, vitamin A intake (OR=1.08, 95%CI:1.02-1.13, P=0.007) was potentially causally associated with increased risk of knee joint sports injury. (4) For the sensitivity analysis, Cochran’s Q test showed the existence of heterogeneity (P < 0.05), so the random effect model was used for the analysis. MR-Egger regression and MR-PRESSO test did not find evidence of pleiotropy (P > 0.05), and the leave-one-out method showed that the results were stable after eliminating single nucleotide polymorphisms one by one. (5) This study preliminarily reveals the effects of modifiable factors, such as lifestyle, metabolic characteristics, and nutritional intake, on the risk of joint sports injuries. It provides valuable research evidence and guidance for the prevention of joint sports injuries.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Mendelian randomization, joint sports injury, modifiable factor, lifestyle, metabolic characteristics, nutritional intake, causal relationship, sensitivity analysis

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