Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177, Stockholm, Sweden.
Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Eur J Epidemiol. 2022 Jul;37(7):747-754. doi: 10.1007/s10654-022-00842-z. Epub 2022 Feb 4.
Adiposity, diabetes, and lifestyle factors are linked to gastroesophageal reflux disease (GERD) in observational studies. We conducted a two-sample Mendelian randomization analysis to determine whether those associations are causal. Independent genetic variants associated with body mass index (BMI), waist circumference (with and without adjustment for BMI), type 2 diabetes, smoking, and alcohol, coffee and caffeine consumption at the genome-wide significance level were selected as instrumental variables. Summary-level data for GERD were available from a genome-wide association meta-analysis of 71,522 GERD cases and 261,079 controls of European descent from the UK Biobank and QSkin Sun and Health studies. The odds ratio (OR) of GERD was 1.49 (95% confidence interval (CI), 1.40-1.60) for one standard deviation (SD) increase in BMI, 1.07 (95% CI, 1.04-1.10) for one-unit increase in log-transformed OR of type 2 diabetes, and 1.41 (95% CI, 1.31-1.52) for one SD increase in prevalence of smoking initiation. There were suggestive associations with GERD for higher genetically predicted waist circumference (OR per one SD increase, 1.14, 95% CI, 1.02-1.26) and caffeine consumption (OR per 80 mg increase, 1.08, 95% CI, 1.02-1.15). Genetically predicted waist circumference adjusted for BMI, alcohol or coffee consumption was not associated GERD. This study suggests causal roles of adiposity, diabetes, and smoking, and a possible role of high caffeine consumption in the development of GERD.
肥胖、糖尿病和生活方式因素与观察性研究中的胃食管反流病(GERD)有关。我们进行了两样本孟德尔随机化分析,以确定这些关联是否具有因果关系。选择与体重指数(BMI)、腰围(调整和不调整 BMI)、2 型糖尿病、吸烟和饮酒、咖啡和咖啡因摄入量相关的独立遗传变异作为工具变量,这些变异在全基因组显著水平上具有相关性。GERD 的汇总水平数据来自英国生物库和 QSkin 太阳与健康研究中对欧洲血统的 71522 例 GERD 病例和 261079 例对照进行的全基因组关联荟萃分析。BMI 每增加一个标准差(SD),GERD 的比值比(OR)为 1.49(95%置信区间(CI),1.40-1.60),2 型糖尿病的 OR 对数转换后每增加一个单位,OR 为 1.07(95% CI,1.04-1.10),开始吸烟的流行率每增加一个 SD,OR 为 1.41(95% CI,1.31-1.52)。腰围(每增加一个 SD,OR 为 1.14,95% CI,1.02-1.26)和咖啡因摄入量(每增加 80mg,OR 为 1.08,95% CI,1.02-1.15)与 GERD 呈显著相关。经 BMI、酒精或咖啡消耗调整后的遗传预测腰围与 GERD 无关。本研究表明肥胖、糖尿病和吸烟具有因果作用,咖啡因高消耗可能在 GERD 的发生中起作用。
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