The potential association between metabolic disorders and pulmonary TB [TB0109]

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Mendelian randomization (MR) is a scientific approach used to assess causal relationships between modifiable risk factors and clinically relevant outcomes by utilizing genetic variants as instrumental variables in natural experiments. This method, which relies on genome-wide association studies (GWAS) data, provides valuable insights into potential causal connections, enabling researchers to make informed decisions regarding preventive measures and therapeutic interventions.

Randomized controlled trials (RCTs) remain the gold standard for establishing causality. However, when clinical research is too costly, impractical, or unethical, MR has become a compelling alternative. Compared to traditional observational studies, MR is less susceptible to confounding factors and reverse causality since it focuses on genetic components rather than environmental ones.

In this study, the causal relationships between metabolic factors and pulmonary tuberculosis (PTB) were examined through two-sample MR analysis. The findings revealed that HDL-C, HbA1c, TP, and diabetes mellitus (DM) are causally linked to the incidence of active tuberculosis. Specifically, HDL-C, LDL, and triglycerides (TG) were positively correlated with PTB incidence, while total cholesterol (TC) was negatively correlated. Abnormal lipid metabolism, including HDL-C, LDL, TG, and TC, was thus confirmed to have a direct causal association with PTB occurrence.

This study highlights that metabolic disorders, particularly hyperglycemia and dyslipidemia, are associated with active PTB. Although epidemiologically confirming whether abnormalities in lipid metabolism are a cause or consequence of TB development is challenging, MR analysis provides a robust means to confirm the causal relationship between exposure factors and outcomes, as evidenced by the demonstrated link between lipid metabolism irregularities and TB risk.

Source: Du, Z.X., Ren, Y.Y., Wang, J.L., Li, S.X., Hu, Y.F., Wang, L., Chen, M.Y., Li, Y., Hu, C.M. and Yang, Y.F., 2024. The potential association between metabolic disorders and pulmonary tuberculosis: a Mendelian randomization study. European Journal of Medical Research, 29(1), p.277.

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