Causal Associations Between Three Types of Anemia and Pulmonary Tuberculosis: A Bidirectional Mendelian Randomization Study.
Source: PubMed, NCBI / U.S. National Library of Medicine
Anemia and pulmonary tuberculosis (PTB) are major global public health problems. Available observational studies have suggested a potential link between them. However, the causal relationship between anemia and PTB remains uncertain. Therefore, our study aims to investigate the causal relationship between different anemia types and PTB by bidirectional Mendelian Randomization (MR) analysis. Pernicious Anemia (PA), Iron Deficiency Anemia (IDA), Aplastic Anemia (AA), and PTB genetic summary data were obtained from several independent large Genome-Wide Association Studies (GWAS). The Inverse Variance Weighting (IVW) method was used as the primary method for MR analysis, complemented by methods such as weighted median and MR-Egger to enhance the robustness of the MR analysis. In addition, sensitivity analyses and heterogeneity tests were conducted to assess the robustness of the results and identify potential sources of heterogeneity. Our study showed a causal relationship between PA and PTB (IVW: OR = 1.135, 95% CI = 1.035-1.244, p = 0.007). However, there was no evidence of a causal relationship between IDA and PTB or between AA and PTB. In addition, reversedirection MR analysis found no evidence of causal effects between PTB and these three anemias. This study identified a significant positive causal effect of PA on PTB. Therefore, it is recommended to strengthen screening for PTB-related indicators in PA patients in clinical practice. Additionally, in regions with high PTB in
Abstract
Anemia and pulmonary tuberculosis (PTB) are major global public health problems. Available observational studies have suggested a potential link between them. However, the causal relationship between anemia and PTB remains uncertain. Therefore, our study aims to investigate the causal relationship between different anemia types and PTB by bidirectional Mendelian Randomization (MR) analysis. Pernicious Anemia (PA), Iron Deficiency Anemia (IDA), Aplastic Anemia (AA), and PTB genetic summary data were obtained from several independent large Genome-Wide Association Studies (GWAS). The Inverse Variance Weighting (IVW) method was used as the primary method for MR analysis, complemented by methods such as weighted median and MR-Egger to enhance the robustness of the MR analysis. In addition, sensitivity analyses and heterogeneity tests were conducted to assess the robustness of the results and identify potential sources of heterogeneity. Our study showed a causal relationship between PA and PTB (IVW: OR = 1.135, 95% CI = 1.035-1.244, p = 0.007). However, there was no evidence of a causal relationship between IDA and PTB or between AA and PTB. In addition, reversedirection MR analysis found no evidence of causal effects between PTB and these three anemias. This study identified a significant positive causal effect of PA on PTB. Therefore, it is recommended to strengthen screening for PTB-related indicators in PA patients in clinical practice. Additionally, in regions with high PTB incidence, PA can be designated as a risk warning indicator for PTB. Vitamin B12 malabsorption, a characteristic feature of PA, may play a crucial role in the causal relationship between PA and PTB. Our study is the first to explore the genetic causality between anemia and PTB, identifying PA as a significant genetic risk factor for PTB. Future studies are needed to elucidate the underlying mechanisms and provide new insights into the prevention and treatment of PTB.