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. 2024 Aug 26;24(1):409.
doi: 10.1186/s12890-024-03228-x.

Causal associations of obstructive sleep apnea with Chronic Respiratory Diseases: a Mendelian Randomization study

Ping-Yang Hong #  1   2   3 , Dong Liu #  4 , Ang Liu  5 , Xin Su  3 , Xiao-Bin Zhang  6   7 , Yi-Ming Zeng  8
Affiliations

Causal associations of obstructive sleep apnea with Chronic Respiratory Diseases: a Mendelian Randomization study

Ping-Yang Hong et al. BMC Pulm Med. .

Abstract

Purpose: This study aimed to elucidate the causal relationship between Obstructive Sleep Apnea (OSA) and Chronic Respiratory Diseases (CRDs), employing Mendelian Randomization (MR) to overcome limitations inherent in observational studies.

Methods: Utilizing a two-sample MR approach, this study analyzed genetic variants as instrumental variables to investigate the causal link between OSA and various CRDs, including chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, and idiopathic pulmonary fibrosis (IPF). Data were sourced from the FinnGen Consortium (OSA, n = 375,657) and UK Biobank, focusing on genome-wide associations between single-nucleotide polymorphisms (SNPs) and the diseases. Instrumental variables were selected based on strict criteria, and analyses included a random-effects inverse-variance weighted method supplemented by several sensitivity analyses.

Results: The study suggests a protective effect of OSA against COPD (OR = 0.819, 95% CI 0.722-0.929, P-value = 0.002), which becomes non-significant after adjusting for BMI, indicating a potential mediating role of BMI in the OSA-COPD nexus. No significant causal links were found between OSA and other CRDs (asthma, IPF, bronchiectasis) or between COPD, asthma, and OSA.

Conclusions: Our findings reveal a BMI-mediated protective effect of OSA on COPD, with no causal connections identified between OSA and other CRDs. These results emphasize the complex relationship between OSA, BMI, and COPD, guiding future clinical strategies and research directions, particularly in light of the study's genetic analysis limitations.

Keywords: Chronic obstructive pulmonary disease; Chronic respiratory diseases; Mendelian randomization analysis; Obstructive sleep apnea.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mendelian randomization model of OSA and CRDs. Abbreviation OSA, obstructive sleep apnea; CRDs: chronic respiratory diseases
Fig. 2
Fig. 2
The causal effect of OSA on chronic respiratory diseases. Abbreviation OSA, obstructive sleep apnea; SNP: single-nucleotide polymorphisms; COPD: chronic obstructive pulmonary disease; MVMR: multivariate Mendelian randomization analysis; BMI: body mass index; IPF: idiopathic pulmonary fibrosis
See this image and copyright information in PMC

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