School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, 646000, People's Republic of China.
Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, 646000, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2024 Jan 10;19:87-95. doi: 10.2147/COPD.S437257. eCollection 2024.
BACKGROUND: Gastroesophageal reflux disease (GERD) and Chronic Obstructive Pulmonary Disease (COPD) often coexist and have been associated in observational studies. However, the real potential causal relationship between GERD and COPD is unknown and not well established. METHODS: In this study, we conducted a bidirectional two-sample Mendelian randomization(MR) to estimate whether GERD and COPD are causal. The GERD genetic data is from summary level data of a genome-wide association (GWAS) meta-analysis (Ncases = 71,522, Ncontrol=26,079). The COPD GWAS are available from the FinnGen (Ncases=16,410, Ncontrol=283,589). MR-Egger regression, Weighted Median, and Inverse-variance weighted (IVW) were used for MR analysis from the R package "TwoSampleMR", and IVW was the dominant estimation method. Additionally, the MR pleiotropy residual sum and outlier (MR-PRESSO), Cochran Q statistic, and leave-one-out analysis were used to detect and correct for the effect of heterogeneity and horizontal pleiotropy. RESULTS: MR analysis indicated that GERD was causally associated with an increased risk of COPD (IVW odds ratio (OR): 1.3760, 95% confidence interval (CI): 1.1565-1.6371, P=0.0003), and vice versa (IVW OR: 1.1728, 95% CI:1.0613-1.2961, P=0.0018). The analyses did not reveal any pleiotropy or heterogeneity. CONCLUSION: Our study revealed possible evidence for a bidirectional causal relationship between GERD and COPD. Implementing screening and preventive strategies for GERD in individuals with COPD, and vice versa, will be crucial in future healthcare management. Further studies are needed to elucidate the mechanisms underlying the causal relationship between GERD and COPD.
背景:胃食管反流病(GERD)和慢性阻塞性肺疾病(COPD)经常同时存在,并在观察性研究中相关联。然而,GERD 和 COPD 之间的真正潜在因果关系尚不清楚,也未得到充分证实。
方法:在这项研究中,我们进行了双向两样本 Mendelian 随机化(MR)分析,以估计 GERD 和 COPD 是否具有因果关系。GERD 遗传数据来自全基因组关联(GWAS)荟萃分析的汇总水平数据(病例数=71522,对照组=26079)。COPD 的 GWAS 数据可从 FinnGen 获得(病例数=16410,对照组=283589)。MR 分析使用 R 包“TwoSampleMR”中的 MR-Egger 回归、加权中位数和逆方差加权(IVW)进行,IVW 是主要的估计方法。此外,使用 MR 多效残余和异常值(MR-PRESSO)、Cochran Q 统计量和逐一剔除分析来检测和纠正异质性和水平多效性的影响。
结果:MR 分析表明,GERD 与 COPD 的发病风险增加相关(IVW 比值比(OR):1.3760,95%置信区间(CI):1.1565-1.6371,P=0.0003),反之亦然(IVW OR:1.1728,95% CI:1.0613-1.2961,P=0.0018)。分析未发现任何多效性或异质性。
结论:我们的研究结果提示 GERD 和 COPD 之间可能存在双向因果关系的证据。在 COPD 患者中实施 GERD 的筛查和预防策略,反之亦然,这将是未来医疗保健管理的关键。需要进一步研究以阐明 GERD 和 COPD 之间因果关系的机制。
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