Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China.
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
J Dermatol. 2023 Mar;50(3):327-336. doi: 10.1111/1346-8138.16642. Epub 2022 Nov 22.
Observation studies have postulated that atopic eczema is associated with a risk of inflammatory bowel disease in the East Asian population; however, this association does not obviate the biases resulting from confounding effects and reverse causation. This study aimed to determine whether this association is causal in the East Asian population using a bidirectional two-sample Mendelian randomization design. Independent genetic variants obtained from public genome-wide association studies for atopic eczema (4296 cases, 163 807 controls) were extracted to estimate the causal effects on inflammatory bowel disease (2824 cases, 3719 controls) and its two main conditions: Crohn's disease (1690 cases, 3719 controls) and ulcerative colitis (1134 cases, 3719 controls). Atopic eczema was found to be strongly associated with inflammatory bowel disease (odds ratio [95% confidence interval]: 1.520 [1.179, 1.959]; p = 0.001), but not vice versa. Subtype analyses revealed that atopic eczema is significantly associated with Crohn's disease (1.650 [1.293, 2.106]; p = 0.000) but not with ulcerative colitis. Both Crohn's disease and ulcerative colitis were found to be causally related to atopic eczema; Crohn's disease could reduce the risk of atopic eczema (0.866 [0.807, 0.930]; p = 0.000) while ulcerative colitis could increase the risk of atopic eczema (1.112 [1.021, 1.212]; p = 0.015). In conclusion, this study revealed that statistically causal relationships are present between atopic eczema and inflammatory bowel disease in the East Asian population. These findings are significant for guiding the treatment of atopic eczema and inflammatory bowel disease in clinical practice.
观察性研究表明，特应性皮炎与东亚人群的炎症性肠病风险相关；然而，这种关联并不能消除混杂效应和反向因果关系导致的偏倚。本研究旨在使用双向两样本 Mendelian 随机化设计，确定在东亚人群中这种关联是否具有因果关系。从特应性皮炎的全基因组关联研究中提取独立的遗传变异（4296 例，163807 例对照），以估计对炎症性肠病（2824 例，3719 例对照）及其两种主要疾病：克罗恩病（1690 例，3719 例对照）和溃疡性结肠炎（1134 例，3719 例对照）的因果效应。特应性皮炎与炎症性肠病强烈相关（比值比[95%置信区间]：1.520[1.179，1.959]；p=0.001），但反之则不然。亚组分析显示，特应性皮炎与克罗恩病显著相关（1.650[1.293，2.106]；p=0.000），但与溃疡性结肠炎无关。克罗恩病和溃疡性结肠炎均与特应性皮炎存在因果关系；克罗恩病可降低特应性皮炎的风险（0.866[0.807，0.930]；p=0.000），而溃疡性结肠炎可增加特应性皮炎的风险（1.112[1.021，1.212]；p=0.015）。总之，本研究表明，在东亚人群中，特应性皮炎与炎症性肠病之间存在统计学上的因果关系。这些发现对指导临床实践中特应性皮炎和炎症性肠病的治疗具有重要意义。
