Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany.
J Clin Periodontol. 2022 Jun;49(6):573-579. doi: 10.1111/jcpe.13620. Epub 2022 Apr 1.
Observational research suggests that periodontitis affects psoriasis. However, observational studies are prone to reverse causation and confounding, which hampers drawing causal conclusions and the effect direction. We applied the Mendelian randomization (MR) method to comprehensively assess the potential bi-directional association between periodontitis and psoriasis.
We used genetic instruments from the largest available genome-wide association study of European descent for periodontitis (17,353 cases, 28,210 controls) to investigate the relationship with psoriasis (13,229 cases, 21,543 controls), and vice versa. Causal Analysis Using Summary Effect (CAUSE) estimates and inverse variance-weighted (IVW) MR analyses were used for the primary analysis. Robust MR approaches were used for sensitivity analyses.
Both univariable methods, CAUSE and IVW MR analyses, did not reveal any impact of periodontitis on psoriasis (CAUSE odds ratio [OR] = 1.00, p = 1.00; IVW OR = 1.02, p = .6247), or vice versa (CAUSE OR = 1.01, p = .5135; IVW OR = 1.00, p = .7070). The null association was corroborated by pleiotropy-robust methods with ORs close to 1 and p-values >.59. Overall, MR analyses did not suggest any effect of periodontitis on psoriasis. Similarly, there was no evidence to support an effect of psoriasis on periodontitis.
Within the limitations of this MR study, the outcomes supported neither periodontitis affecting psoriasis nor psoriasis affecting periodontitis.
观察性研究表明牙周炎会影响银屑病。然而,观察性研究容易受到反向因果关系和混杂因素的影响,这阻碍了得出因果结论和确定作用方向。我们应用孟德尔随机化(MR)方法综合评估牙周炎和银屑病之间潜在的双向关联。
我们使用欧洲血统最大的全基因组关联研究中与牙周炎(17353 例病例,28210 例对照)相关的遗传工具,来研究与银屑病(13229 例病例,21543 例对照)之间的关系,反之亦然。使用因果分析使用汇总效应(CAUSE)估计和逆方差加权(IVW)MR 分析进行主要分析。使用稳健的 MR 方法进行敏感性分析。
两种单变量方法,CAUSE 和 IVW MR 分析,均未显示牙周炎对银屑病有任何影响(CAUSE 比值比[OR] = 1.00,p = 1.00;IVW OR = 1.02,p =.6247),反之亦然(CAUSE OR = 1.01,p =.5135;IVW OR = 1.00,p =.7070)。稳健性方法的结果表明,这种零关联的可能性较高,OR 值接近 1,p 值>.59。总体而言,MR 分析并未表明牙周炎会对银屑病产生影响。同样,也没有证据支持银屑病会对牙周炎产生影响。
在本 MR 研究的限制范围内,结果既不支持牙周炎影响银屑病,也不支持银屑病影响牙周炎。