乳糜泻与炎症性肠病之间的因果关系:两样本双向孟德尔随机化研究。

Causal association between celiac disease and inflammatory bowel disease: A two-sample bidirectional Mendelian randomization study.

机构信息

Division of Pancreatobiliary Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.

Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea.

出版信息

Front Immunol. 2023 Jan 4;13:1057253. doi: 10.3389/fimmu.2022.1057253. eCollection 2022.

Abstract

BACKGROUND

An epidemiological link between celiac disease (CeD) and inflammatory bowel disease (IBD) has been well established recently. In this study, Mendelian randomization (MR) analysis was performed employing pooled data of publicly available genome-wide association studies (GWAS) to determine the causal relationship between CeD and IBD, encompassing ulcerative colitis (UC) and Crohn's disease (CD).

METHODS

Dataset of CeD was acquired from GWAS for 12,041 cases and 12,228 controls. A GWAS of more than 86,000 patients and controls was used to identify genetic variations underlying IBD. MR analyses were performed with an inverse-variance-weighted approach, an MR-Egger regression, a weighted-mode approach, a weighted-median method, and sensitivity analyses of MR pleiotropy residual sum and outlie (MR-PRESSO).

RESULTS

MR demonstrated that genetic predisposition to CeD was linked to a augmented risk of IBD (OR: 1.1408; 95% CI: 1.0614-1.2261; = 0.0003). In the analysis of the two IBD subtypes, genetic predisposition to CeD was also linked to increased risks of UC (OR: 1.1646; 95% CI: 1.0614-1.2779; = 0.0012) and CD (OR: 1.1865; 95% CI: 1.0948-1.2859; P = 3.07E-05). Reverse MR analysis results revealed that genetic susceptibility to IBD and CD was correlated with an augmented risk of CeD. However, there was no genetic correlation between UC and CeD. All of the above results were validated with other GWAS databases.

CONCLUSION

There is a bidirectional causal relationship of CeD with IBD and CD. However, UC only augments the risk of developing CeD.

摘要

背景

近年来,乳糜泻(CeD)和炎症性肠病(IBD)之间存在流行病学联系已得到充分证实。在这项研究中,采用来自公开全基因组关联研究(GWAS)的汇总数据进行孟德尔随机化(MR)分析,以确定 CeD 和 IBD(包括溃疡性结肠炎(UC)和克罗恩病(CD))之间的因果关系。

方法

从 GWAS 获得了 12041 例 CeD 病例和 12228 例对照的数据集。使用超过 86000 例患者和对照的 GWAS 来鉴定潜在的 IBD 遗传变异。使用逆方差加权法、MR-Egger 回归、加权模式法、加权中位数法以及 MR 多效残余总和和异常值(MR-PRESSO)敏感性分析进行 MR 分析。

结果

MR 表明,CeD 的遗传易感性与 IBD 风险增加相关(OR:1.1408;95%CI:1.0614-1.2261; = 0.0003)。在两种 IBD 亚型的分析中,CeD 的遗传易感性也与 UC(OR:1.1646;95%CI:1.0614-1.2779; = 0.0012)和 CD(OR:1.1865;95%CI:1.0948-1.2859;P = 3.07E-05)风险增加相关。反向 MR 分析结果表明,IBD 和 CD 的遗传易感性与 CeD 风险增加相关。然而,UC 与 CeD 之间没有遗传相关性。上述所有结果均通过其他 GWAS 数据库进行了验证。

结论

CeD 与 IBD 和 CD 之间存在双向因果关系。然而,UC 仅增加了 CeD 的发病风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e245/9845610/f72acccb4618/fimmu-13-1057253-g001.jpg

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