Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis

Background: Insomnia and osteoporosis are both prevalent conditions with rising incidence. Observational studies have suggested that insomnia may lead to thyroid dysfunction, which in turn contributes to osteoporosis. However, the interplay among these three conditions remains unexamined. This study...

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Main Authors: Lei Wu, Hengheng Zhang, Yongwen Li, Jinxin Tang, Dengwen wang, Linrong Zhu
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Experimental Gerontology
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Online Access:http://www.sciencedirect.com/science/article/pii/S0531556525001718
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author Lei Wu
Hengheng Zhang
Yongwen Li
Jinxin Tang
Dengwen wang
Linrong Zhu
author_facet Lei Wu
Hengheng Zhang
Yongwen Li
Jinxin Tang
Dengwen wang
Linrong Zhu
author_sort Lei Wu
collection DOAJ
description Background: Insomnia and osteoporosis are both prevalent conditions with rising incidence. Observational studies have suggested that insomnia may lead to thyroid dysfunction, which in turn contributes to osteoporosis. However, the interplay among these three conditions remains unexamined. This study aimed to investigate the causal association between insomnia and osteoporosis, while also analyzing whether thyroid dysfunction mediates this relationship. Method: A two-sample Mendelian randomization approach was applied to examine the genetic association between insomnia and osteoporosis. Mediator MR was subsequently used to assess the intermediary role of thyroid dysfunction. The inverse variance weighting method served as the primary analytical strategy. Heterogeneity was evaluated using MR-Egger's intercept, Cochran's Q test, and leave-one-out analysis. The MR-PRESSO test was conducted to assess horizontal pleiotropy. To ensure robustness, FDR correction was applied. Results: A genetic association between insomnia and osteoporosis was observed (IVW: OR = 1.004, p = 0.007). Insomnia showed a genetic link with hypothyroidism (IVW: OR = 1.010, p = 0.00075), but not with hyperthyroidism, Hashimoto's thyroiditis, or Graves' disease (p > 0.05). Mediator MR revealed that hypothyroidism accounted for 6.29 % (6.27 %–6.31 %) of the effect of insomnia on osteoporosis. Conclusion: This study supports a causal link between insomnia and osteoporosis. Hypothyroidism plays a mediating role in this pathway. Targeting hypothyroidism may lower the risk of osteoporosis associated with insomnia.
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spelling doaj-art-f3e7aef2e01e488a82dcf538e340d85c2025-08-20T03:58:35ZengElsevierExperimental Gerontology1873-68152025-10-0120911284210.1016/j.exger.2025.112842Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysisLei Wu0Hengheng Zhang1Yongwen Li2Jinxin Tang3Dengwen wang4Linrong Zhu5Department of Bone and Joint Surgery, Affiliated Hospital of Qinghai University, Xining 810000, ChinaQinghai University, ChinaQinghai University, ChinaQinghai University, ChinaDepartment of Bone and Joint Surgery, Affiliated Hospital of Qinghai University, Xining 810000, China; Corresponding authors.Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qinghai University, Xining 810000, China; Corresponding authors.Background: Insomnia and osteoporosis are both prevalent conditions with rising incidence. Observational studies have suggested that insomnia may lead to thyroid dysfunction, which in turn contributes to osteoporosis. However, the interplay among these three conditions remains unexamined. This study aimed to investigate the causal association between insomnia and osteoporosis, while also analyzing whether thyroid dysfunction mediates this relationship. Method: A two-sample Mendelian randomization approach was applied to examine the genetic association between insomnia and osteoporosis. Mediator MR was subsequently used to assess the intermediary role of thyroid dysfunction. The inverse variance weighting method served as the primary analytical strategy. Heterogeneity was evaluated using MR-Egger's intercept, Cochran's Q test, and leave-one-out analysis. The MR-PRESSO test was conducted to assess horizontal pleiotropy. To ensure robustness, FDR correction was applied. Results: A genetic association between insomnia and osteoporosis was observed (IVW: OR = 1.004, p = 0.007). Insomnia showed a genetic link with hypothyroidism (IVW: OR = 1.010, p = 0.00075), but not with hyperthyroidism, Hashimoto's thyroiditis, or Graves' disease (p > 0.05). Mediator MR revealed that hypothyroidism accounted for 6.29 % (6.27 %–6.31 %) of the effect of insomnia on osteoporosis. Conclusion: This study supports a causal link between insomnia and osteoporosis. Hypothyroidism plays a mediating role in this pathway. Targeting hypothyroidism may lower the risk of osteoporosis associated with insomnia.http://www.sciencedirect.com/science/article/pii/S0531556525001718InsomniaThyroid diseasesOsteoporosisMendelian randomization analysisMediation analysis
spellingShingle Lei Wu
Hengheng Zhang
Yongwen Li
Jinxin Tang
Dengwen wang
Linrong Zhu
Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
Experimental Gerontology
Insomnia
Thyroid diseases
Osteoporosis
Mendelian randomization analysis
Mediation analysis
title Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
title_full Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
title_fullStr Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
title_full_unstemmed Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
title_short Mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis: A Mendelian randomization analysis
title_sort mediating role of thyroid dysfunction in the relationship between insomnia and osteoporosis a mendelian randomization analysis
topic Insomnia
Thyroid diseases
Osteoporosis
Mendelian randomization analysis
Mediation analysis
url http://www.sciencedirect.com/science/article/pii/S0531556525001718
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