School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China.
Diabetes Care. 2023 Apr 1;46(4):828-835. doi: 10.2337/dc22-1385.
OBJECTIVE: We conducted a Mendelian randomization (MR) study to examine the associations of type 2 diabetes and glycemic traits with gastrointestinal diseases (GDs). RESEARCH DESIGN AND METHODS: Uncorrelated genetic variants associated with type 2 diabetes (n = 231), fasting insulin (n = 38), fasting glucose (n = 71), and hemoglobin A1c (n = 75) at the genome-wide significance were selected as instrument variables. Genetic associations with 23 common GDs were obtained from the FinnGen and UK Biobank studies and other large consortia. RESULTS: Genetic liability to type 2 diabetes was associated with the risk of 12 GDs. Per 1-unit increase in the log-transformed odds ratio (OR) of type 2 diabetes, the OR was 1.06 (95% CI, 1.03-1.09) for gastroesophageal reflux disease, 1.12 (95% CI, 1.07-1.17) for gastric ulcer, 1.11 (95% CI, 1.03-1.20) for acute gastritis, 1.07 (95% CI, 1.01-1.13) for chronic gastritis, 1.08 (95% CI, 1.03-1.12) for irritable bowel syndrome, 1.04 (95% CI, 1.01-1.07) for diverticular disease, 1.08 (95% CI, 1.02-1.14) for acute pancreatitis, 1.09 (95% CI, 1.05-1.12) for cholelithiasis, 1.09 (95% CI, 1.05-1.13) for cholelithiasis with cholecystitis, 1.29 (95% CI, 1.17-1.43) for nonalcoholic fatty liver disease, 1.12 (95% CI, 1.03-1.21) for liver cirrhosis, and 0.93 (95% CI, 0.89-0.97) for ulcerative colitis. Genetically predicted higher levels of fasting insulin and glucose were associated with six and one GDs, respectively. CONCLUSIONS: Associations were found between genetic liability to type 2 diabetes and an increased risk of a broad range of GDs, highlighting the importance of GD prevention in patients with type 2 diabetes.
目的:我们进行了一项孟德尔随机化(MR)研究,以检验 2 型糖尿病和血糖特征与胃肠道疾病(GDs)之间的关联。
研究设计和方法:选择与 231 例 2 型糖尿病(n=231)、空腹胰岛素(n=38)、空腹血糖(n=71)和血红蛋白 A1c(n=75)相关的全基因组显著相关的非相关遗传变异作为工具变量。从 FinnGen 和 UK Biobank 研究以及其他大型联盟中获得了与 23 种常见 GDs 的遗传关联。
结果:2 型糖尿病的遗传易感性与 12 种 GDs 的发病风险相关。每增加 1 个单位的 2 型糖尿病对数转换比值比(OR),胃食管反流病的 OR 为 1.06(95%CI,1.03-1.09),胃溃疡为 1.12(95%CI,1.07-1.17),急性胃炎为 1.11(95%CI,1.03-1.20),慢性胃炎为 1.07(95%CI,1.01-1.13),肠易激综合征为 1.08(95%CI,1.03-1.12),憩室病为 1.04(95%CI,1.01-1.07),急性胰腺炎为 1.08(95%CI,1.02-1.14),胆石症为 1.09(95%CI,1.05-1.13),胆石症伴胆囊炎为 1.09(95%CI,1.05-1.13),非酒精性脂肪性肝病为 1.29(95%CI,1.17-1.43),肝硬化为 1.12(95%CI,1.03-1.21),溃疡性结肠炎为 0.93(95%CI,0.89-0.97)。预测空腹胰岛素和血糖水平升高的遗传倾向与六种和一种 GDs 分别相关。
结论:2 型糖尿病的遗传易感性与多种 GDs 的发病风险增加有关,突出了在 2 型糖尿病患者中预防 GDs 的重要性。
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