Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Turk J Gastroenterol. 2023 May;34(5):457-462. doi: 10.5152/tjg.2023.22231.
Although observational studies have reported that depression is a risk factor for gastroesophageal reflux disease, it is difficult to determine the potential causal correlation. Thus, this study investigated the causal relevance of depression for gastroesophageal reflux disease using Mendelian randomization and provided new evidence for their association.
Based on data from the UK Biobank, we assessed the causality of the 2 diseases by analyzing 135 458 severe depressive disorder cases and 41 024 gastroesophageal reflux disease cases. The causal inference was assessed using inverse-variance weighting, weighted median, Mendelian randomization-Egger, and weighted median methods. Simultaneously, pleiotropy and sensitivity analyses were used for quality control. Finally, we also explored whether depression affects gastroesophageal reflux disease through other risk factors.
A positive causal relationship between depression and gastroesophageal reflux disease was found in the inverse-variance weighted and weighted median methods, both of which were statistically significant [odds ratio = 1.011, 95% CI: 1.004-1.017, P =.001; odds ratio = 1.011, 95% CI: 1.004-1.020, P =.002)]. Sensitivity analyses were consistent with a causal interpretation, and the main deviation of genetic pleiotropy was not found (Intercept β = 0.0005; SE = 0.005, P =.908). The genetic susceptibility to depression was also associated with smoking, insomnia, and sleep apnea (odds ratio = 1.166, 95% CI: 1.033-1.316, P =.013; odds ratio = 1.089, 95% CI: 1.045-1.134; and odds ratio = 1.004, 95% CI: 1.001-1.006, P =.001, respectively).
Our results verified a causal correlation that depression could slightly increase the risk of gastroesophageal reflux disease.
尽管观察性研究报告称抑郁是胃食管反流病的一个风险因素，但很难确定潜在的因果关系。因此，本研究使用孟德尔随机化方法研究了抑郁对胃食管反流病的因果关系，并为它们的相关性提供了新的证据。
基于英国生物库的数据，我们通过分析 135458 例严重抑郁障碍病例和 41024 例胃食管反流病病例来评估这两种疾病的因果关系。使用逆方差加权、加权中位数、孟德尔随机化-易格检验和加权中位数方法评估因果关系。同时，进行了多效性和敏感性分析以进行质量控制。最后，我们还探讨了抑郁是否通过其他风险因素影响胃食管反流病。
在逆方差加权和加权中位数方法中，发现抑郁与胃食管反流病之间存在正相关关系，且均具有统计学意义[比值比=1.011，95%置信区间：1.004-1.017，P=0.001；比值比=1.011，95%置信区间：1.004-1.020，P=0.002]。敏感性分析支持因果关系的解释，并且没有发现主要的遗传多效性偏差（截距β=0.0005；SE=0.005，P=0.908）。抑郁的遗传易感性也与吸烟、失眠和睡眠呼吸暂停相关（比值比=1.166，95%置信区间：1.033-1.316，P=0.013；比值比=1.089，95%置信区间：1.045-1.134；比值比=1.004，95%置信区间：1.001-1.006，P=0.001）。
我们的结果验证了抑郁可能略微增加胃食管反流病风险的因果关系。
