Causal Relationships between Eczema and Chronic Obstructive Pulmonary Disease, Lung Cancer, and Idiopathic Pulmonary Fibrosis—A Mendelian Randomization Analysis

目的：基于孟德尔随机化研究方法探究湿疹与慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)、肺癌和特发性肺纤维化(idiopathic pulmonary fibrosis, IPF)之间的因果关系。方法：基于孟德尔随机化的基本假设，通过逆方差加权法(IVW)、加权中位数法和MR-Egger回归法探寻湿疹与COPD、肺癌和IPF的因果关系。使用Cochran’s Q检验、MR-Egger回归截距法和留一法进行敏感性分析。结果：逆方差加权法作为主要分析方法，其分析结果显示，湿疹与COPD (OR = 1.279, 95%CI: 1. 168~1.401, P = 1.21*10−7)和IPF (OR = 1.262, 95%CI: 1.026~1.553, P = 0.0277)存在因果关系。没有证据可以证明湿疹与肺腺癌(OR = 1.022, 95%CI: 0.956~1.093, P = 0.516)、小细胞肺癌(OR = 0.976, 95%CI: 0.843~1.131, P = 0.747)和鳞状细胞癌(OR = 1.107, 95%CI, 0.933~1.108, P = 0.706)之间存在因果关系。结论：湿疹在COPD与IPF发病中可能发挥作用，而没有证据证明湿疹在肺癌(腺癌、小细胞癌、鳞状细胞癌)的发病中发挥作用。Objective: To investigate the causal relationships between eczema and chronic obstructive pulmonary disease (COPD), lung cancer, and idiopathic pulmonary fibrosis (IPF) using Mendelian randomization (MR) analysis. Methods: Based on the fundamental assumptions of MR, the inverse-variance weighted (IVW) method, weighted median method, and MR-Egger regression were employed to explore the causal relationships between eczema and COPD, lung cancer, and IPF. Sensitivity analyses were conducted using Cochran’s Q test, MR-Egger intercept test, and leave-one-out analysis. Results: The IVW method, as the primary analytical approach, revealed significant causal relationships between eczema and COPD (OR = 1.279, 95%CI: 1.168~1.401, P = 1.21 × 10−7) and IPF (OR = 1.262, 95%CI: 1.026~1.553, P = 0.0277). However, no evidence supported causal relationships between eczema and lung adenocarcinoma (OR = 1.022, 95%CI: 0.956~1.093, P = 0.516), small cell lung cancer (OR = 0.976, 95%CI: 0.843~1.131, P = 0.747), or squamous cell carcinoma (OR = 1.107, 95%CI: 0.933~1.108, P = 0.706). Conclusion: Eczema may play a role in the pathogenesis of COPD and IPF, but no evidence suggests its involvement in the development of lung cancer (adenocarcinoma, small cell carcinoma, or squamous cell carcinoma).