Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Clin Gastroenterol Hepatol. 2022 May;20(5):1077-1084. doi: 10.1016/j.cgh.2021.06.013. Epub 2021 Jun 15.
BACKGROUND & AIMS: Adiposity, type 2 diabetes, alcohol and coffee consumption, and smoking have been examined in relation to diverticular disease in observational studies. We conducted a Mendelian randomization study to assess the causality of these associations. METHODS: Independent genetic instruments associated with the studied exposures at genome-wide significance were obtained from published genome-wide association studies. Summary-level data for the exposure-associated single nucleotide polymorphisms with diverticular disease were available in the FinnGen consortium (10,978 cases and 149,001 noncases) and the UK Biobank study (12,662 cases and 348,532 noncases). RESULTS: Higher genetically predicted body mass index and genetic liability to type 2 diabetes and smoking initiation were associated with an increased risk of diverticular disease in meta-analyses of results from the two studies. The combined odds ratio of diverticular disease was 1.23 (95% confidence interval [CI], 1.14-1.33; P < .001) for a 1-standard deviation (~4.8 kg/m) increase in body mass index, 1.04 (95% CI, 1.01-1.07; P = .007) for a 1-unit increase in log-transformed odds ratio of type 2 diabetes, and 1.21 (95% CI, 1.12-1.30; P < .001) for a 1-standard deviation increase in prevalence of smoking initiation. Coffee consumption was not associated with diverticular disease, whereas the association for alcohol consumption largely differed between the 2 studies. CONCLUSIONS: This study strengthens the causal associations of higher body mass index, type 2 diabetes, and smoking with an increased risk of diverticular disease. Coffee consumption is not associated with diverticular disease. Whether alcohol consumption affects the risk of diverticular disease needs further investigation.
背景与目的:在观察性研究中,已经研究了肥胖、2 型糖尿病、饮酒和吸烟与憩室病的关系。我们进行了一项孟德尔随机化研究,以评估这些关联的因果关系。
方法:从已发表的全基因组关联研究中获得与所研究的暴露因素相关的独立遗传工具,这些遗传工具在全基因组范围内具有显著性。在 FinnGen 联盟(10978 例病例和 149001 例非病例)和英国生物银行研究(12662 例病例和 348532 例非病例)中,可获得与暴露相关的单核苷酸多态性与憩室病的汇总水平数据。
结果:在这两项研究结果的荟萃分析中,较高的遗传预测体重指数和 2 型糖尿病发病的遗传易感性与憩室病风险增加相关。憩室病的合并比值比为 1.23(95%置信区间[CI],1.14-1.33;P <.001),体重指数每增加 1 个标准差(~4.8kg/m),2 型糖尿病的对数比值比增加 1 个单位(95%CI,1.01-1.07;P =.007),吸烟起始的流行率增加 1 个标准差(95%CI,1.12-1.30;P <.001)。咖啡消费与憩室病无关,而饮酒与憩室病的关联在这两项研究中存在很大差异。
结论:本研究加强了体重指数升高、2 型糖尿病和吸烟与憩室病风险增加的因果关联。咖啡消费与憩室病无关。饮酒是否影响憩室病的风险需要进一步研究。
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