Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of General Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
J Clin Periodontol. 2023 Jun;50(6):736-743. doi: 10.1111/jcpe.13782. Epub 2023 Feb 1.
AIM: This Mendelian randomization (MR) study was performed to explore the potential bidirectional causal association between inflammatory bowel disease (IBD) and periodontitis. MATERIALS AND METHODS: We used genetic instruments from the genome-wide association study summary statistics of European descent for IBD (12,882 cases and 21,770 controls) to investigate the association with periodontitis (3046 cases and 195,395 controls) and vice versa. The radial inverse-variance weighted method was carried out to obtain the primary causal estimates, and the robustness of the results was assessed by a series of sensitivity analyses. Due to multiple testing, associations with p values <.008 were considered as statistically significant, and p values ≥.008 and <.05 were considered as suggestively significant. RESULTS: In the primary causal estimates, IBD as a whole was associated with an increased risk of periodontitis (odds ratio [OR], 1.060; 95% confidence interval [CI], 1.017; 1.105; p = .006). Subtype analyses showed that ulcerative colitis (UC) was associated with periodontitis (OR, 1.074; 95% CI 1.029; 1.122; p = .001), while Crohn's disease (CD) was not. Regarding the reverse direction, periodontitis showed a suggestive association with IBD as a whole (OR, 1.065; 95% CI 1.013; 1.119; p = .014). Subtype analyses revealed that periodontitis was associated with CD (OR, 1.100; 95% CI 1.038; 1.167; p = .001) but not UC. The final models after outlier removal showed no obvious pleiotropy, indicating that our primary analysis results were reliable. CONCLUSIONS: The present MR study provides moderate evidence on the bidirectional causal relationship between IBD and periodontitis. The bidirectional increased risk found in our study was marginal and, possibly, of limited clinical relevance. More studies are needed to support the findings of our current study.
目的:本孟德尔随机化(MR)研究旨在探讨炎症性肠病(IBD)和牙周炎之间潜在的双向因果关联。
材料和方法:我们使用欧洲血统的 IBD 全基因组关联研究汇总统计数据中的遗传工具(12882 例病例和 21770 例对照),来研究与牙周炎(3046 例病例和 195395 例对照)之间的关联,并反之亦然。采用径向逆方差加权法获得主要因果估计值,并通过一系列敏感性分析评估结果的稳健性。由于多重检验,p 值<0.008 被认为具有统计学意义,p 值≥0.008 且<0.05 被认为具有提示意义。
结果:在主要因果估计中,IBD 整体与牙周炎风险增加相关(比值比[OR],1.060;95%置信区间[CI],1.017;1.105;p=0.006)。亚组分析显示,溃疡性结肠炎(UC)与牙周炎相关(OR,1.074;95%CI 1.029;1.122;p=0.001),而克罗恩病(CD)则没有。关于相反的方向,牙周炎与 IBD 整体呈提示性关联(OR,1.065;95%CI 1.013;1.119;p=0.014)。亚组分析显示,牙周炎与 CD 相关(OR,1.100;95%CI 1.038;1.167;p=0.001),但与 UC 无关。去除异常值后的最终模型表明没有明显的混杂,表明我们的主要分析结果是可靠的。
结论:本 MR 研究提供了 IBD 和牙周炎之间双向因果关系的中等证据。我们的研究发现双向增加的风险是边缘的,可能具有有限的临床意义。需要更多的研究来支持我们当前研究的发现。
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