Qiao Feng, Li Xiaoyan, Liu Yuchang, Zhang Shunming, Liu Dayong, Li Changyi
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.
Department of Endodontics, School and Hospital of Stomatology, Tianjin Medical University, Tianjin, China.
Oral Dis. 2024 Jul;30(5):3452-3461. doi: 10.1111/odi.14785. Epub 2023 Oct 25.
Epidemiological studies have shown an association between periodontitis and nonalcoholic fatty liver disease (NAFLD)-related diseases. However, a causal relationship between these two diseases remains unclear. To examine the causal relationship between these two diseases, we conducted a bidirectional two-sample Mendelian randomization (MR) analysis using genetic markers as proxies.
Statistical summary was obtained from a large genome-wide association study (GWAS) on NAFLD (N = 342,499), nonalcoholic steatohepatitis (NASH, N = 342,499), fibrosis (N = 339,081), cirrhosis (N = 342,499), fibrosis/cirrhosis (N = 334,553), and periodontitis (N = 34,615) in the European ancestry. The inverse variance weighted (IVW) method was used as the main method to estimate the bidirectional association. Sensitivity analysis was performed to evaluate the rigidity of the results.
Limited evidence indicated positive causal associations between genetically predicted NAFLD and periodontitis (IVW odds ratio [OR], 1.094; 95% confidence interval [CI], 1.006-1.189; p = 0.036) and between cirrhosis and periodontitis (IVW OR, 1.138; 95% CI, 1.001-1.294; p = 0.048). However, the opposite trend did not indicate a causative effect of periodontitis on NAFLD-related diseases. The sensitivity analysis revealed no obvious pleiotropy or heterogeneity.
Our MR analysis provides new evidence in favor of the moderate causal impact of NAFLD on periodontitis. The causal effects of periodontitis on NAFLD-related diseases warrant further investigation.
流行病学研究表明，牙周炎与非酒精性脂肪性肝病（NAFLD）相关疾病之间存在关联。然而，这两种疾病之间的因果关系仍不明确。为了研究这两种疾病之间的因果关系，我们使用遗传标记作为替代指标进行了双向双样本孟德尔随机化（MR）分析。
从一项针对欧洲血统人群的大型全基因组关联研究（GWAS）中获取统计摘要，该研究涉及非酒精性脂肪性肝病（N = 342,499）、非酒精性脂肪性肝炎（NASH，N = 342,499）、纤维化（N = 339,081）、肝硬化（N = 342,499）、纤维化/肝硬化（N = 334,553）和牙周炎（N = 34,615）。采用逆方差加权（IVW）方法作为主要方法来估计双向关联。进行敏感性分析以评估结果的稳健性。
有限的证据表明，遗传预测的非酒精性脂肪性肝病与牙周炎之间（IVW优势比[OR]，1.094；95%置信区间[CI]，1.006 - 1.189；p = 0.036）以及肝硬化与牙周炎之间（IVW OR，1.138；95% CI，1.001 - 1.294；p = 0.048）存在正向因果关联。然而，相反的趋势并未表明牙周炎对非酒精性脂肪性肝病相关疾病有因果作用。敏感性分析未发现明显的多效性或异质性。
我们的MR分析提供了新的证据，支持非酒精性脂肪性肝病对牙周炎有中度因果影响。牙周炎对非酒精性脂肪性肝病相关疾病的因果作用值得进一步研究。
