Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization

<b>Background:</b> Rheumatoid arthritis (RA) is a globally prevalent chronic inflammatory disease. Environmental exposures, such as air pollution and smoking, are considered potential risk factors. However, the causal relationships and underlying mechanisms between these factors and RA a...

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Main Authors: Chao Wang, Wenqing Xie, Chenggong Wang, Yong Zhu, Da Zhong
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/2/513
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author Chao Wang
Wenqing Xie
Chenggong Wang
Yong Zhu
Da Zhong
author_facet Chao Wang
Wenqing Xie
Chenggong Wang
Yong Zhu
Da Zhong
author_sort Chao Wang
collection DOAJ
description <b>Background:</b> Rheumatoid arthritis (RA) is a globally prevalent chronic inflammatory disease. Environmental exposures, such as air pollution and smoking, are considered potential risk factors. However, the causal relationships and underlying mechanisms between these factors and RA are not fully understood. <b>Methods:</b> This study utilized large-scale genome-wide association studies (GWASs) from European ethnic backgrounds and employed bidirectional two-sample Mendelian randomization (MR) to investigate the relationships between air pollution, smoking, and RA. Genetic correlations were assessed using linkage disequilibrium score regression (LDSC). Furthermore, mediation analysis was conducted to evaluate the potential mediating roles of iron metabolism and urinary biomarkers in these relationships. <b>Results:</b> The MR analysis revealed that genetically predicted lifetime smoking intensity was associated with an 85% increased risk of RA. Subgroup analysis differentiating between seropositive RA (SPRA) and seronegative RA (SNRA) showed a causal association with SPRA, but not with SNRA. C-reactive protein was identified as a mediator in the relationship between lifetime smoking and both RA and SPRA, mediating 18.23% and 32.45% of the effects, respectively. Genetic correlation analysis further confirmed a positive genetic association between smoking and both RA and SPRA. <b>Conclusions:</b> This study provides significant insights into the genetic and causal connections between air pollution, smoking, and the development of RA, highlighting the mediating role of C-reactive protein. These findings not only offer new perspectives on how smoking might enhance RA risk through inflammatory pathways but also underscore the importance of reducing smoking exposure in public health strategies.
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spelling doaj-art-873baeb9dee64b0d9296fb112eb48e1c2025-08-20T02:44:40ZengMDPI AGBiomedicines2227-90592025-02-0113251310.3390/biomedicines13020513Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian RandomizationChao Wang0Wenqing Xie1Chenggong Wang2Yong Zhu3Da Zhong4Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, ChinaDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China<b>Background:</b> Rheumatoid arthritis (RA) is a globally prevalent chronic inflammatory disease. Environmental exposures, such as air pollution and smoking, are considered potential risk factors. However, the causal relationships and underlying mechanisms between these factors and RA are not fully understood. <b>Methods:</b> This study utilized large-scale genome-wide association studies (GWASs) from European ethnic backgrounds and employed bidirectional two-sample Mendelian randomization (MR) to investigate the relationships between air pollution, smoking, and RA. Genetic correlations were assessed using linkage disequilibrium score regression (LDSC). Furthermore, mediation analysis was conducted to evaluate the potential mediating roles of iron metabolism and urinary biomarkers in these relationships. <b>Results:</b> The MR analysis revealed that genetically predicted lifetime smoking intensity was associated with an 85% increased risk of RA. Subgroup analysis differentiating between seropositive RA (SPRA) and seronegative RA (SNRA) showed a causal association with SPRA, but not with SNRA. C-reactive protein was identified as a mediator in the relationship between lifetime smoking and both RA and SPRA, mediating 18.23% and 32.45% of the effects, respectively. Genetic correlation analysis further confirmed a positive genetic association between smoking and both RA and SPRA. <b>Conclusions:</b> This study provides significant insights into the genetic and causal connections between air pollution, smoking, and the development of RA, highlighting the mediating role of C-reactive protein. These findings not only offer new perspectives on how smoking might enhance RA risk through inflammatory pathways but also underscore the importance of reducing smoking exposure in public health strategies.https://www.mdpi.com/2227-9059/13/2/513rheumatoid arthritisiron homeostasishematuria markersMendelian randomizationgenome-wide association studies
spellingShingle Chao Wang
Wenqing Xie
Chenggong Wang
Yong Zhu
Da Zhong
Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
Biomedicines
rheumatoid arthritis
iron homeostasis
hematuria markers
Mendelian randomization
genome-wide association studies
title Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
title_full Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
title_fullStr Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
title_full_unstemmed Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
title_short Causal Relationships Between Environmental Exposures, Iron Metabolism, Hematuria Markers, and Rheumatoid Arthritis: An Investigation Using Mendelian Randomization
title_sort causal relationships between environmental exposures iron metabolism hematuria markers and rheumatoid arthritis an investigation using mendelian randomization
topic rheumatoid arthritis
iron homeostasis
hematuria markers
Mendelian randomization
genome-wide association studies
url https://www.mdpi.com/2227-9059/13/2/513
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