基于横断面调查和双向孟德尔随机化分析探究类风湿性关节炎与2型糖尿病之间的关联OA

Rheumatoid arthritis(RA)and type 2 diabetes mellitus(T2DM)are both prevalent chronic diseases worldwide,but their bidirectional causal association remains controversial.Herein,the causal relationship between RA and T2DM was systematically investigated by integrating cross-sectional data from the National Health and Nutrition Examination Survey(NHANES)with bidirectional Mendelian randomization(MR)ana-lysis.NHANES analysis demonstrated that RA was associated with an increased risk of T2DM(OR=1.26.95％CI:1.06～1.49,P=0.010).Through further MR analysis,there was a significant causal association between RA and the increased risk of T2DM(IVW:OR=1.002 8,P=1.441E-7),while T2DM may reduce the risk of RA(IVW:OR=0.105 0,P=0.003).The results of MR analysis are robust but the effect value is weak.It is only used to reveal the real causal relationship between RA and T2DM,and should not be directly used for clinical prediction.This study provides further evidence for bidirectional causal mechanisms between these two chronic diseases.The findings hold significant clinical implications for early screening and intervention of T2DM in RA patients,while offering new theoretical foundations for developing combined therapeutic strate-gies targeting comorbidity mechanisms.