目的 压疮是指由于组织受压时间过长引起的严重并发症，2025年的数据显示，压疮在活动受限患者中发生率高。机体代谢紊乱可能会引起压疮，但是否与血清代谢物有因果影响，暂不明确。方法 本文运用孟德尔随机化（MR）方法评价血清代谢物与压疮间风险因素，基于MR方法评价血清代谢物和压疮的因果联系，分别纳入由欧洲人群全基因组关联研究（GWAS）。压疮：FinnGen R10，3 167例；血清代谢物：EMBL-EBI数据库16种代谢物数据作为研究样本；筛选条件：工具变量筛选条件［P＜5×10-8，连锁不平衡聚类r 2 ＜0.001，kb=10 000，F统计量＞10（公式：F=R2 ×N-2/1-R2 ）］；主要分析方法：使用（IVW）法，辅助采用加权中位数法（WM）、MR-Egger回归法校验；用Benjamini-Hochberg法进行多重检验校正（FDR＜0.05为有统计学意义）。结果 共鉴定出10种代谢物与压疮存在关联（P＜0.01），经FDR校正后4种：代谢物18：2/20：4n6的水平升高（P＜0.000 2）2-Oxopeptide的作用相反，降低压疮的风险（OR=0.73，95%CI：0.59~0.92，P=0.011）；琥珀酸可增加压疮的风险（OR=1.13，95%CI：1.03~1.24，P=0.018）；甘氨酸/丙氨酸比值降低压疮风险（OR=0.849，95%CI：0.76~0.93，P=0.022）。稳定性分析证明上述发现是可信的、稳健的（heterogeneity：P＞0.05，pleoitropy：P＞0.05）。结论 血清代谢物通过调控炎症反应、影响微循环障碍以及干预能量代谢途径，参与压疮的发生发展，可作为构建压疮风险的模型以及制定相关干预策略为压疮评估、治疗、预防提供因果层面的理论依据。
Objective Pressure ulcer（PU）is a serious complication caused by prolonged tissue compression．Data of 2025 shows that PUs have a high incidence among patients requiring long-term bed rest．Metabolic disorders may contribute to PU development，but whether serum metabolites causally affect PU risk remains unclear．Methods this study employed the Mendelian randomization（MR）method to evaluate whether serum metabolites are risk factors for PU．To assess the causal relationship between serum metabolites and PU，data from Genome-Wide Association Studies（GWAS）of European populations were included：PU data from FinnGen R10（3 167 cases）and data on 16 serum metabolites from the EMBL-EBI database．Instrumental variable screening criteria were as follows：P＜5×10-8，linkage disequilibrium clustering（r 2 ＜0.001，kb=10，000），and F-statistic ＞10（Formula：F=［R2 ×N-2］/［1-R2 ］）．The inverse variance weighting（IVW）method was used as the primary analytical approach，supplemented by the weighted median（WM）method and MR-Egger regression for verification．The Benjamini-Hochberg method was applied for multiple test correction（FDR＜0.05 was considered statistically significant）．Results A total of 10 metabolites were identified to be associated with PU（P＜0.01），and 4 remained significant after FDR correction：elevated levels of metabolite 18：2/20：4n6（P＜0.0002）；2-Oxopeptide exerted an opposite effect，reducing PU risk（OR=0.73，95%CI：0.59-0.92，P=0.011）；succinic acid increased PU risk（OR=1.13，95%CI：1.03-1.24，P=0.018）；and the glycine/alanine ratio reduced PU risk（OR=0.849，95%CI：0.76-0.93，P=0.022）．Stability analysis（PH-TauNE［novel pleiotropy test］） confirmed that the above findings were credible and robust（heterogeneity：P＞0.05，pleiotropy：P＞0.05）．Conclusions Serum metabolites are involved in the occurrence and development of PU by regulating inflammatory responses，affecting microcirculatory disorders，and interfering with energy metabolism pathways．They can provide causal theoretical basis for constructing PU risk prediction models，formulating relevant intervention strategies，and guiding PU treatment，prevention，and assessment．
