Jinzhou Medical University Postgraduate Training Base (Jinzhou Central Hospital), Jinzhou, Liaoning, China.
Department of Clinical Medicine, Anhui University of Science and Technology, Huainan, Anhui, China.
Front Public Health. 2024 Apr 29;12:1368483. doi: 10.3389/fpubh.2024.1368483. eCollection 2024.
The association between air pollution, lung function, gastroesophageal reflux disease, and Non-alcoholic fatty liver disease (NAFLD) remains inconclusive. Previous studies were not convincing due to confounding factors and reverse causality. We aim to investigate the causal relationship between air pollution, lung function, gastroesophageal reflux disease, and NAFLD using Mendelian randomization analysis.
In this study, univariate Mendelian randomization analysis was conducted first. Subsequently, Steiger testing was performed to exclude the possibility of reverse association. Finally, significant risk factors identified from the univariate Mendelian analysis, as well as important factors affecting NAFLD from previous observational studies (type 2 diabetes and body mass index), were included in the multivariable Mendelian randomization analysis.
The results of the univariable Mendelian randomization analysis showed a positive correlation between particulate matter 2.5, gastroesophageal reflux disease, and NAFLD. There was a negative correlation between forced expiratory volume in 1 s, forced vital capacity, and NAFLD. The multivariable Mendelian randomization analysis indicated a direct causal relationship between gastroesophageal reflux disease (OR = 1.537, = 0.011), type 2 diabetes (OR = 1.261, < 0.001), and NAFLD.
This Mendelian randomization study confirmed the causal relationships between air pollution, lung function, gastroesophageal reflux, and NAFLD. Furthermore, gastroesophageal reflux and type 2 diabetes were identified as independent risk factors for NAFLD, having a direct causal connection with the occurrence of NAFLD.
空气污染、肺功能、胃食管反流病和非酒精性脂肪性肝病（NAFLD）之间的关联仍不确定。由于混杂因素和反向因果关系，先前的研究没有说服力。我们旨在使用孟德尔随机化分析来研究空气污染、肺功能、胃食管反流病和 NAFLD 之间的因果关系。
本研究首先进行了单变量孟德尔随机化分析。然后，进行了 Steiger 检验以排除反向关联的可能性。最后，将单变量孟德尔分析中确定的显著危险因素，以及来自先前观察性研究的影响 NAFLD 的重要因素（2 型糖尿病和体重指数）纳入多变量孟德尔随机化分析。
单变量孟德尔随机化分析的结果表明，细颗粒物 2.5、胃食管反流病和 NAFLD 之间呈正相关。1 秒用力呼气量、用力肺活量与 NAFLD 呈负相关。多变量孟德尔随机化分析表明，胃食管反流病（OR=1.537，=0.011）、2 型糖尿病（OR=1.261，<0.001）与 NAFLD 之间存在直接因果关系。
这项孟德尔随机化研究证实了空气污染、肺功能、胃食管反流和 NAFLD 之间的因果关系。此外，胃食管反流病和 2 型糖尿病被确定为 NAFLD 的独立危险因素，与 NAFLD 的发生存在直接因果关系。
