Causal relationships of physical activity and leisure sedentary behaviors with COPD: A Mendelian randomization study.

• Our findings show that the positive casual relationship only explored between the duration of TV watching time and COPD and its related respiratory insufficiency. • There is no causal relationship between physical activity, leisure sedentary behaviors (driving and computer-using), COPD risk, and COPD insufficiency. • COPD patients, especially middle-aged and elderly people, should promote regular physical exercise and reduce leisure sedentary behaviors like TV watching. Chronic diseases such as chronic obstructive pulmonary disease (COPD) have been linked to low levels of physical activity (PA) and higher frequency of leisure sedentary behavior (LSB). The main causes of COPD include respiratory and peripheral muscle dysfunction, low levels of PA, and LSB which are associated with a higher risk of developing COPD. The attribution relationship between PA or LSB and COPD risk or COPD respiratory insufficiency is unclear. To explore this further, we conducted a Mendelian randomization (MR) study using a genotype-simulated randomized trial group to systematically evaluate the causal relationships of PA/LSB on COPD risk and respiratory insufficiency. The exposure data were obtained from large-scale genome-wide association studies (GWAS), including the PA dataset (N = 729,373) and LSB dataset (N = 1,109,337). The outcome data were derived from the Finn-Gen COPD dataset (N = 381,392). The causal effects were estimated with IVW 1 1 IVW: inverse variance weighted , MR-Egger, and WM 2 2 WM: weighted median methods. Sensitivity analysis was conducted using Cochran's Q test, MR-Egger intercept test, MR-PRESSO 3 3 MR-PRESSO: Mendelian Randomization Pleiotropy Residual Sum and Outlier , leave-one-out analysis, and funnel plot to estimate the robustness of our findings. Genetically predicted leisure television (TV) watching significantly increased the risk of COPD (OR = 2.4895, 95 % CI: 1.85259 to 3.34536; P = 1.44 × 10−9) and COPD respiratory insufficiency (OR = 2.55, 95 % CI: 1.53 to 4.27; P = 3.54 × 10−4). No casual effect of other PA or LSB phenotypes on COPD risk or respiratory insufficiency was observed. Our study provides evidence that TV watching may increase the risk of COPD and its related respiratory insufficiency. These findings emphasized the importance of promoting regular physical exercise and reducing leisure sedentary behavior to prevent COPD. [ABSTRACT FROM AUTHOR]