State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China.
State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China.
Dig Liver Dis. 2023 Sep;55(9):1208-1213. doi: 10.1016/j.dld.2023.03.006. Epub 2023 Apr 5.
Observational studies suggest that higher educational attainment (EA) contributes to the prevention and treatment of gastroesophageal reflux disease (GERD). However, the causality of this relationship is not supported by strong evidence. We used publicly available genetic summary data, including that on EA, GERD, and the common risk of GERD, to prove this causality.
Multiple methods in Mendelian randomization (MR) were employed to evaluate the causality. The leave-one-out sensitivity test, MR-Egger regression, and multivariable MR (MVMR) analysis were applied to evaluate the MR results.
Higher EA was significantly associated with lower GERD risk (inverse variance weighted method, odds ratio [OR]: 0.979, 95% confidence interval [CI]: 0.975-0.984, P <0.001). Similar results were obtained when the weighted median and weighted mode were used for causal estimation. After adjusting for potential mediators, the MVMR analysis showed that body mass index (BMI) and EA were still significantly correlated and negatively correlated with GERD (OR: 0.997, 95% CI: 0.996-0.998, P =0.008 and OR: 0.981, 95% CI: 0.977-0.984, P <0.001), respectively.
Higher levels of EA may have a protective effect against GERD by having a negative causal relationship. Additionally, BMI may be a crucial factor in the EA-GERD pathway.
观察性研究表明，较高的教育程度（EA）有助于预防和治疗胃食管反流病（GERD）。然而，这种关系的因果关系并没有得到强有力的证据支持。我们使用公开可用的遗传汇总数据，包括 EA、GERD 和 GERD 的常见风险，来证明这种因果关系。
采用多种孟德尔随机化（MR）方法来评估因果关系。采用单倍型缺失敏感性检验、MR-Egger 回归和多变量 MR（MVMR）分析来评估 MR 结果。
较高的 EA 与较低的 GERD 风险显著相关（逆方差加权法，比值比 [OR]：0.979，95%置信区间 [CI]：0.975-0.984，P<0.001）。当使用加权中位数和加权模式进行因果估计时，也得到了类似的结果。在调整了潜在的中介因素后，MVMR 分析表明，体重指数（BMI）和 EA 仍然与 GERD 显著相关且呈负相关（OR：0.997，95% CI：0.996-0.998，P=0.008 和 OR：0.981，95% CI：0.977-0.984，P<0.001）。
较高的 EA 水平可能通过负向因果关系对 GERD 具有保护作用。此外，BMI 可能是 EA-GERD 途径中的一个关键因素。
