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Background: Extensive observational evidence suggests an association between psychiatric disorders (PDs) and obstructive sleep apnea (OSA), but their causal relationship remains unexplored. The objective of this study was to examine the causal relationship between PDs and OSA. Methods: Mendelian randomization (MR) analysis was conducted with summary genetic data from the FinnGen and Psychiatric Genomics Consortium (PGC). Inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods were employed to ascertain causal influence. Sensitivity analysis employing various methodologies assessed the robustness of the findings. Furthermore, multivariable Mendelian randomization (MVMR) was used to clarify if the exposures independently caused OSA. Results: MR analysis showed that genetically determined major depressive disorder (MDD) increased the risk of OSA (IVW odds ratio [OR]: 1.377, 95% confidence interval [CI]: 1.242-1.526, P = 1.05×10-9). Sensitivity analysis showed no evidence of pleiotropy and heterogeneity. In MVMR, the significant association persisted after adjusting for BMI, smoking, and alcohol consumption. No conclusive evidence indicated the causal impact of other psychological characteristics on OSA. In the reverse MR analyses, there was no causal effect of OSA on PDs. Conclusion: This study suggests a causal effect of MDD on OSA risk. Further research is needed to confirm these findings and understand how MDD contributes to OSA development, potentially aiding in reducing OSA incidence.
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Objective: Migraine is a common neurological disorder, which resulting in significant societal and personal burdens. Acupuncture has attracted widespread attention in migraine prophylaxis and treatment in recent years. Although some studies have confirmed the effectiveness of acupuncture therapy in treating migraines, there is still a lack of comprehensive evaluation regarding the comparison between different types of migraines and various acupuncture therapies. Furthermore, certain special acupuncture methods have not received sufficient attention and research. Therefore, the objective of this study is to summarize and expand upon previous research, update existing evidence, and compare the efficacy of different acupuncture therapies for migraine. We aim to provide stronger evidence-based support for clinical practice through this study, thereby promoting wider application of acupuncture therapy in migraine treatment. Methods: A exhaustive and methodical search was conducted across the nine databases: PubMed, EMBASE, Web of Science, Scopus, the Cochrane Library, CBM, CNKI, WANFANG and VIP Data. The Visual Analog Scale (VAS) scores, migraine attack frequency, duration, days of attack and adverse effects were observation indicators. Results: This study included 34 studies involving a total of 3365 migraineurs. The results of the study demonstrated that acupuncture therapy reduced VAS scores of migraine patients better compared to medication (MD=-1.29, 95% CI=[-1.67,-0.92]) and exhibited greater efficacy in reducing the frequency of migraine attacks (MD=-1.95, 95% CI=[-3.06,-0.85]), the duration of attacks (MD=- 3.29, 95% CI=[-4.65,-1.93]), and days of attack (MD=-1.02, 95% CI=[-1.58,-0.47]). Significant heterogeneity suggested that different acupuncture therapies had varying effects, and that the efficacy of the same therapy may also vary in different migraine types. In the context of network meta-analysis, the SUCRA of acupuncture therapies for reducing VAS scores was ranked as special acupuncture method (98.3%), acupuncture plus medicine (71.9%), and acupuncture (54.5%). Blood-letting and cupping was the most effective treatment for lowering the frequency of migraine attacks. The most effective treatment for shortening the duration of migraine was acupuncture plus medication (81.2%). When it comes to decreasing the days of migraine, acupuncture (80.3%) came out on top. 14 studies reported the occurrence of adverse effects, of which 4 studies had no adverse effects in the test group. Conclusion: Initial findings indicate that acupuncture-related therapy exhibits superior effectiveness in the treatment of migraine and clinical decision-making should be patient-specific.
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Background: Previous observational studies have provided cumulative data linking gut microbiota to myasthenia gravis (MG). However, the causal link between the two remains unexplored. Hence, the current study was performed to explore the causal link between them. Methods: Mendelian randomization (MR) analysis was conducted using the summary statistics of 211 gut microbiota taxa and the largest genome-wide association studies (GWAS) for MG currently available. The inverse variance-weighted (IVW), MR-Egger, weighted median, and weighted mode methods were employed to ascertain the causal influence. Sensitivity studies utilizing several methodologies were then used to assess the robustness of the findings. Lastly, to evaluate reverse causality, a reverse MR analysis was performed. Results: Seven suggestive causal associations between the gastrointestinal microbiota and MG were identified based on the outcomes of the MR analysis. Specifically, phylum Actinobacteria (OR: 0.602, 95% CI: 0.405-0.896, p = 0.012), class Gammaproteobacteria (OR: 0.587, 95% CI: 0.357-0.968, p = 0.037), and families Defluviitaleaceae (OR: 0.695, 95% CI: 0.485-0.996, p = 0.047), Family XIII (OR: 0.614, 95% CI: 0.412-0.916, p = 0.017), and Peptococcaceae (OR: 0.698, 95% CI: 0.505-0.964, p = 0.029) had suggestive protective effects on MG, while order Mollicutes RF9 (OR: 1.424, 95% CI: 1.015-1.998, p = 0.041) and genus Faecalibacterium (OR: 1.763, 95% CI: 1.220-2.547, p = 0.003) were suggestive risk factors for MG. The outcomes indicate that neither heterogeneity nor horizontal pleiotropy had any discernible impact. Nevertheless, this reverse analysis did not reveal any apparent effect of MG on the gut microbiota composition. Conclusion: The MR investigation has substantiated the suggestive causal connection between gut microbiota and MG, which may provide helpful insights for innovative therapeutic and preventative approaches for MG. Further randomized controlled trials are needed to elucidate the gut microbiota's precise role and therapeutic potential in the pathogenesis of MG.
