School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China.
The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34802. doi: 10.1097/MD.0000000000034802.
Pathogenesis, diagnosis, and treatment of irritable bowel syndrome (IBS) have been reported to be challenging hotspots in clinical practice. Previous observational studies have found that stress, anxiety, depression, and other mental and psychological diseases are closely associated with IBS. This study aimed to further explore the causal relationships of these associations through Mendelian randomization (MR).
The data needed for MR were obtained from publicly published genome-wide association databases. We performed a bidirectional, 2-sample MR analysis using instrumental variables (IV) associated with stress, anxiety, and depression, and other mental and psychological factors as exposures and IBS as the outcome. A reverse MR analysis with IBS as exposure and stress, anxiety, depression, and other mental and psychological factors as the outcomes was also performed. The inverse variance weighting (IVW) method was adopted as the main method of MR, and the causal effect between stress, anxiety, depression, and other mental and psychological factors and IBS was evaluated as the main result of the study. In addition, a series of sensitivity analyses was conducted to comprehensively evaluate the causal relationship between them.
Stress, anxiety, depression, and other mental and psychological factors were the underlying etiologies for IBS (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.03-1.08), and they were positively correlated. Univariate analysis further supported the above conclusions (Depression, [OR = 1.31, 95% CI: 1.05-1.63, P = .016], Anxiety, [OR = 1.53, 95% CI: 1.16-2.03, P = .003]). However, in reverse MR analysis, we found that IBS did not affect stress, anxiety, depression, or other mental and psychological factors and that there was no causal relationship between IBS and stress, anxiety, depression, or other mental and psychological factors (P > .05).
This study demonstrates that mental and psychological factors are the underlying etiologies for IBS. These findings may provide important information for physicians regarding the clinical treatment of IBS.
肠易激综合征（IBS）的发病机制、诊断和治疗一直是临床实践中的热点难题。先前的观察性研究发现，压力、焦虑、抑郁和其他精神心理疾病与 IBS 密切相关。本研究旨在通过孟德尔随机化（MR）进一步探讨这些关联的因果关系。
MR 所需的数据来自公开发表的全基因组关联数据库。我们使用与压力、焦虑和抑郁以及其他精神心理因素相关的工具变量（IV）作为暴露因素，将 IBS 作为结果，进行了双向、2 样本 MR 分析。还进行了以 IBS 为暴露因素，压力、焦虑、抑郁和其他精神心理因素为结果的反向 MR 分析。采用逆方差加权（IVW）法作为 MR 的主要方法，评估压力、焦虑、抑郁和其他精神心理因素与 IBS 之间的因果关系作为研究的主要结果。此外，还进行了一系列敏感性分析，以全面评估它们之间的因果关系。
压力、焦虑、抑郁和其他精神心理因素是 IBS 的潜在病因（比值比[OR] = 1.06，95%置信区间[CI]：1.03-1.08），并且它们呈正相关。单变量分析进一步支持了上述结论（抑郁，[OR = 1.31，95% CI：1.05-1.63，P = 0.016]，焦虑，[OR = 1.53，95% CI：1.16-2.03，P = 0.003]）。然而，在反向 MR 分析中，我们发现 IBS 不会影响压力、焦虑、抑郁或其他精神心理因素，并且 IBS 与压力、焦虑、抑郁或其他精神心理因素之间没有因果关系（P > 0.05）。
本研究表明，精神心理因素是 IBS 的潜在病因。这些发现可能为医生治疗 IBS 提供重要信息。
