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教育程度与慢性疼痛之间的关联:一项中介性孟德尔随机化研究
Authors Wang H, Liu M, Li H , Xu S
Received 6 January 2025
Accepted for publication 19 March 2025
Published 3 April 2025 Volume 2025:18 Pages 1793—1804
DOI http://doi.org/10.2147/JPR.S515921
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Jonathan Greenberg
Hanqi Wang, Mingjuan Liu, Hongbo Li, Shijie Xu
Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing University, Jiaxing, People’s Republic of China
Correspondence: Hanqi Wang, Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing University, Jiaxing, People’s Republic of China, Tel +86 19517900056, Email 764847739@qq.com
Background: The underlying association between educational attainment (EA) and chronic pain (CP) risk is not clear. This study aimed to investigate the causal relationship of EA with CP using Mendelian randomization (MR).
Methods: Single nucleotide polymorphisms (SNPs) for EA were selected from the Social Science Genetic Association Consortium (SSGAC). Inverse-variance weighted (IVW), weighted median, penalized weighted median, maximum likelihood (ML), and MR-Egger methods were used to estimate causal effects. Two sample MR analyses were undertaken to assess whether EA has a causal effect on CP. We also performed mediation analyses to estimate the mediation effects.
Results: A genetically predicted higher EA was associated with a decreased risk of multisite chronic pain (MCP) (odds ratio [OR] = 0.772, 95% confidence interval [CI] 0.732– 0.816 per one standard deviation of longer education, P < 0.05), and the Genome-wide association studies (GWAS) data for chronic widespread pain (CWP) supported the result mentioned above. Potential mediators included body mass index (BMI) (OR = 1.176, 95% CI 1.091– 1.267, P < 0.05), smoking (OR = 1.054, 95% CI 1.028– 1.081, P < 0.05), and depression (OR = 1.201, 95% CI 1.147– 1.258, P < 0.05) have all been proven to be causally associated with MCP. The proportions of the effects of genetically predicted EA mediated through genetically predicted BMI, smoking, and depression were 17.1%, 23.6%, and 9.2%, respectively.
Conclusion: Genetically predicted higher educational attainment reduces multisite chronic pain risk, partially mediated by body mass index (17.1%), smoking (23.6%), and depression (9.2%), highlighting education’s protective role and its potential in chronic pain prevention strategies.
Keywords: educational attainment, chronic pain, Mendelian randomization, risk factors