衰弱与腹壁疝：一项孟德尔随机化与回顾性研究。
Frailty and abdominal wall hernias: a Mendelian randomization and retrospective study.
文献信息
| PMID | 42864457 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Pengfei Bo |
| 作者单位 | Department of Hernia and Abdominal Wall Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450052, Henan, China. |
| 期刊 | Surgical endoscopy |
| SCI 分区 | Q1 |
| IF | 3.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
引言： 以衰弱指数（FI）衡量的衰弱涉及多个生理系统功能的下降。已知腹壁功能障碍与腹壁疝的发生有关。在本研究中，我们进行了两样本孟德尔随机化分析，以探讨衰弱与腹壁疝之间的因果关系，并进行了一项回顾性研究，以评估术前衰弱与食管裂孔疝修补术后并发症之间的关联。
方法： 从全基因组关联研究中提取FI、食管裂孔疝、股疝、腹股沟疝及其他未特指腹疝的汇总数据。采用逆方差加权（IVW）法作为评估因果效应的核心方法，并进行了其他敏感性分析。我们对接受食管裂孔疝修补术的患者进行了回顾性分析。收集了人口学、手术及随访数据。
结果： 基因预测的较高FI与食管裂孔疝风险增加相关（OR 1.020，95% CI 1.010-1.030，P < 0.001），且在敏感性分析中保持稳定。然而，没有证据表明FI与股疝（P = 0.958）、腹股沟疝（P = 0.874）或其他未特指腹疝（P = 0.403）风险增加相关。在回顾性研究中，严重衰弱是吞咽困难的独立危险因素（P < 0.001）。然而，未发现衰弱与住院时间（P = 0.419）、上腹痛（P = 0.283）、气胀综合征（P = 0.926）、腹泻（P = 0.083）、复发（P = 0.618）或生活质量（P = 0.071）之间存在显著关联。
结论： 衰弱与食管裂孔疝风险增加相关，但与股疝、腹股沟疝或其他未特指腹疝无因果关联。衰弱患者在食管裂孔疝修补术后更易发生吞咽困难。
英文摘要
INTRODUCTION: Frailty, measured by frailty index (FI), involves a decline in the function of multiple physiological systems. It is known that the dysfunction of abdominal wall is related to the occurrence of abdominal wall hernias. In this research, we conducted a two-sample Mendelian randomization analysis to explore the causal relationship between frailty and abdominal wall hernias and did a retrospective study to evaluate the association between preoperative frailty and postoperative complications following hiatal hernia repair.
METHODS: Summary data of FI, hiatal hernia, femoral hernia, inguinal hernia, and other unspecified abdominal hernias were extracted from genome-wide association study. The inverse variance weighted (IVW) method was used as the core approach to assess causal effects, and other sensitivity analyses were also carried out. We conducted a retrospective analysis on patients who underwent hiatal hernia repair. Demographic, operative, and follow-up data were collected.
RESULTS: Genetically predicted higher FI was associated with an increased risk of hiatal hernia (OR 1.020, 95% CI 1.010-1.030, P < 0.001) and remained stable in sensitivity analyses. However, there was no evidence to suggest an association between FI and an increased risk of femoral hernia (P = 0.958), inguinal hernia (P = 0.874), or other unspecified abdominal hernias (P = 0.403). In the retrospective study, severe frailty was an independent risk factor for dysphagia (P < 0.001). However, no significant associations were found between frailty and hospital stay (P = 0.419), epigastric pain (P = 0.283), gas-bloat syndrome (P = 0.926), diarrhea (P = 0.083), recurrence (P = 0.618), or quality of life (P = 0.071).
CONCLUSIONS: Frailty is associated with an increased risk of hiatal hernia but has no causal association with femoral hernia, inguinal hernia, or other unspecified abdominal hernias. Frail patients are more likely to have dysphagia following hiatal hernia repair.