BACKGROUND:In recent years,epidemiological studies have shown that obesity is a risk factor for knee osteoarthritis,and fatty acid intake,metabolism and biosynthesis are closely related to the development of obesity.However,the causal relationship between fatty acids and osteoarthritis is still unknown.OBJECTIVE:Using the Mendelian randomization analysis to investigate the causal relationship between five fatty acid phenotypes and knee osteoarthritis.METHODS:The genome-wide association study data on fatty acid ratios from the UK Biobank(met-D)and genome-wide association study data on knee osteoarthritis from the EBI-A database were pooled together.Single nucleotide polymorphisms were used as instrumental variables and sensitive single nucleotide polymorphisms were selected for analysis.Two-sample Mendelian randomization analysis was conducted to evaluate the causal relationship between fatty acids and knee osteoarthritis outcome risk.We used inverse variance weighting method,MR-Egger regression method,weighted median method,weighted model method,and simple model method to study the causal relationship between fatty acids and knee osteoarthritis.Further inverse Mendelian randomization analysis was performed in the same way to ensure the validity of the results.RESULTS AND CONCLUSION:The forward analysis and inverse variance weighting method showed a causal relationship between three types of fatty acid phenotypes and knee osteoarthritis.Among them,the proportion of saturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(odds ratio[OR]=1.825,95%confidence interval(CI):1.230,2.706,P=0.003),the proportion of omega 3 polyunsaturated fatty acids to total fatty acids was negatively correlated with the risk of knee osteoarthritis(OR=0.822,95%CI:0.688 8,0.981,P=0.03),and the proportion of omega 6 polyunsaturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(OR=1.268,95%CI:1.079,1.491,P=0.004).There were two types of fatty acid phenotypes that do not have a causal relationship with knee osteoarthritis,including total fatty acids(OR=0.925,95%CI:0.804-1.066,P=0.283)and the proportion of monounsaturated fatty acids to total fatty acids(OR=0.877,95%CI:0.756-1.018,P=0.084).The reverse analysis results indicated that when knee osteoarthritis was used as exposure data,there was no significant causal relationship with the phenotype of fatty acids.The sensitivity analysis results showed that the P-values of the bidirectional Mendelian randomization Cochran's Q-test and MR Egger regression were both greater than 0.05,indicating that there was no significant heterogeneity or pleiotropy in the causal effect analysis between fatty acid phenotype and knee osteoarthritis.To conclude,reducing the content of saturated fatty acids and omega 6 polyunsaturated fatty acids and increasing the content of omega 3 polyunsaturated fatty acids can reduce the risk of knee osteoarthritis.This provides valuable clues for studying the biological mechanisms of knee osteoarthritis and exploring the early prevention and treatment of knee osteoarthritis,as well as providing new directions for the development of interventional drugs.

BACKGROUND:In recent years,epidemiological studies have shown that obesity is a risk factor for knee osteoarthritis,and fatty acid intake,metabolism and biosynthesis are closely related to the development of obesity.However,the causal relationship between fatty acids and osteoarthritis is still unknown.OBJECTIVE:Using the Mendelian randomization analysis to investigate the causal relationship between five fatty acid phenotypes and knee osteoarthritis.METHODS:The genome-wide association study data on fatty acid ratios from the UK Biobank(met-D)and genome-wide association study data on knee osteoarthritis from the EBI-A database were pooled together.Single nucleotide polymorphisms were used as instrumental variables and sensitive single nucleotide polymorphisms were selected for analysis.Two-sample Mendelian randomization analysis was conducted to evaluate the causal relationship between fatty acids and knee osteoarthritis outcome risk.We used inverse variance weighting method,MR-Egger regression method,weighted median method,weighted model method,and simple model method to study the causal relationship between fatty acids and knee osteoarthritis.Further inverse Mendelian randomization analysis was performed in the same way to ensure the validity of the results.RESULTS AND CONCLUSION:The forward analysis and inverse variance weighting method showed a causal relationship between three types of fatty acid phenotypes and knee osteoarthritis.Among them,the proportion of saturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(odds ratio[OR]=1.825,95%confidence interval(CI):1.230,2.706,P=0.003),the proportion of omega 3 polyunsaturated fatty acids to total fatty acids was negatively correlated with the risk of knee osteoarthritis(OR=0.822,95%CI:0.688 8,0.981,P=0.03),and the proportion of omega 6 polyunsaturated fatty acids to total fatty acids was positively correlated with the risk of knee osteoarthritis(OR=1.268,95%CI:1.079,1.491,P=0.004).There were two types of fatty acid phenotypes that do not have a causal relationship with knee osteoarthritis,including total fatty acids(OR=0.925,95%CI:0.804-1.066,P=0.283)and the proportion of monounsaturated fatty acids to total fatty acids(OR=0.877,95%CI:0.756-1.018,P=0.084).The reverse analysis results indicated that when knee osteoarthritis was used as exposure data,there was no significant causal relationship with the phenotype of fatty acids.The sensitivity analysis results showed that the P-values of the bidirectional Mendelian randomization Cochran's Q-test and MR Egger regression were both greater than 0.05,indicating that there was no significant heterogeneity or pleiotropy in the causal effect analysis between fatty acid phenotype and knee osteoarthritis.To conclude,reducing the content of saturated fatty acids and omega 6 polyunsaturated fatty acids and increasing the content of omega 3 polyunsaturated fatty acids can reduce the risk of knee osteoarthritis.This provides valuable clues for studying the biological mechanisms of knee osteoarthritis and exploring the early prevention and treatment of knee osteoarthritis,as well as providing new directions for the development of interventional drugs.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.