颞下颌关节紊乱病与失眠之间因果关系的两样本孟德尔随机化研究

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[中图分类号] R782.6[文献标志码] A [doi] 10.7518/hxkq.2025.2024255

[Abstract]ObjectiveThis study aimed to investigate the asociation between temporomandibular disorder （TMD） and insomnia using a two-sample Mendelian randomization （MR）approach.MethodsBidirectional MR analyses of twosamples，TD n=377277 andinsomnia （n=375359 ），wereperformed using genome-wide association study statisticspublishedintheFinnGendatabase.Instrumentalvariables werefirstscreened，andtheninversevariance weighting （IVW）and MR-Egger were used as the main-effect assessment methods.Weighted median，weighted mode，and

simple mode served as supplementary methods.We used IVW and MR-Egger to test for heterogeneity，as wellas MR-Egger intercepts to assess the single nucleotidepolymorphism（SNP）potential levelofmultiplicity effects.Sensitivity analyses were conducted based on

leave-one-out to identify potentiall influential SNPs.Allanalyses wereconducted by using the two-sampleMRR package and were considered statistically significant when P<0.05 .ResultsMR analysis showed the presence of TMDon insomnia（O R=1.089 ， 95%CI ： 1.017-1.166， P=0.014 ）.Meanwhile，no effectof insomnia on TMD（ OR= 0.996， 95%CI ：0.964-1.029， P=0.816 ）was found.The sensitivity-analysis showed that no heterogeneity existed（ P> 0.05），and the presence of horizontal pleiotropy was not detected （P>0.05） .Leave-one-out sensitivity analysis showed no single SNP，which may affect thecausal relation.All findings indicated that thecausal relationshipbetweenTMDand insomnia was notsignificantlyafected byanyindividualSNPandthatIVdidnotbias theresults. ConclusionResults of MR analyses showed that TMD is a risk factorfor insomnia， whereas insomnia is not arisk factor for TMD.

[Keywords] temporomandibulardisorder; insomnia; Mendelian randomization; genome-wide association study;risk factors

颞下颌关节紊乱病（temporomandibulardisor-der，TMD）是最常见的慢性疾病之一，它是涉及咀嚼肌、颞下颌关节（temporomandibular joint，TMJ）和其他颌面解剖结构的肌肉骨骼疼痛[]。（剩余15824字）