Liu Yu-Xin, Yang Wen-Tao, Li Yang
Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China.
Department of Cardiovascular, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2024 May 16;12(14):2370-2381. doi: 10.12998/wjcc.v12.i14.2370.
In observational studies, dietary intakes are associated with gastroesophageal reflux disease (GERD).
To conduct a two-sample mendelian randomization (MR) analysis to determine whether those associations are causal.
To explore the relationship between dietary intake and the risk of GERD, we extracted appropriate single nucleotide polymorphisms from genome-wide association study data on 24 dietary intakes. Three methods were adopted for data analysis: Inverse variance weighting, weighted median methods, and MR-Egger's method. The odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the causal association between dietary intake and GERD.
Our univariate Mendelian randomization (UVMR) results showed significant evidence that pork intake (OR, 2.83; 95%CI: 1.76-4.55; = 1.84 × 10), beer intake (OR, 2.70, 95%CI: 2.00-3.64; = 6.54 × 10), non-oily fish intake (OR, 2.41; 95%CI: 1.49-3.91; = 3.59 × 10) have a protective effect on GERD. In addition, dried fruit intake (OR, 0.37; 95%CI: 0.27-0.50; 6.27 × 10), red wine intake (OR, 0.34; 95%CI: 0.25-0.47; = 1.90 × 10), cheese intake (OR, 0.46; 95%CI: 0.39-0.55; =3.73 × 10), bread intake (OR, 0.72; 95%CI: 0.56-0.92; = 0.0009) and cereal intake (OR, 0.45; 95%CI: 0.36-0.57; = 2.07 × 10) were negatively associated with the risk of GERD. There was a suggestive association for genetically predicted coffee intake (OR per one SD increase, 1.22, 95%CI: 1.03-1.44; = 0.019). Multivariate Mendelian randomization further confirmed that dried fruit intake, red wine intake, cheese intake, and cereal intake directly affected GERD. In contrast, the impact of pork intake, beer intake, non-oily fish intake, and bread intake on GERD was partly driven by the common risk factors for GERD. However, after adjusting for all four elements, there was no longer a suggestive association between coffee intake and GERD.
This study provides MR evidence to support the causal relationship between a broad range of dietary intake and GERD, providing new insights for the treatment and prevention of GERD.
在观察性研究中,饮食摄入与胃食管反流病(GERD)相关。
进行两样本孟德尔随机化(MR)分析,以确定这些关联是否具有因果关系。
为探究饮食摄入与GERD风险之间的关系,我们从关于24种饮食摄入的全基因组关联研究数据中提取了合适的单核苷酸多态性。数据分析采用了三种方法:逆方差加权法、加权中位数法和MR-Egger法。比值比(OR)和95%置信区间(CI)用于评估饮食摄入与GERD之间的因果关联。
我们的单变量孟德尔随机化(UVMR)结果显示,有显著证据表明猪肉摄入量(OR,2.83;95%CI:1.76 - 4.55; = 1.84×10)、啤酒摄入量(OR,2.70,95%CI:2.00 - 3.64; = 6.54×10)、非油性鱼类摄入量(OR,2.41;95%CI:1.49 - 3.91; = 3.59×10)对GERD有保护作用。此外,干果摄入量(OR,0.37;95%CI:0.27 - 0.50;6.27×10)、红酒摄入量(OR,0.34;95%CI:0.25 - 0.47; = 1.90×10)、奶酪摄入量(OR,0.46;95%CI:0.39 - 0.55; =3.73×10)、面包摄入量(OR,0.72;95%CI:0.56 - 0.92; = 0.0009)和谷类摄入量(OR,0.45;95%CI:0.36 - 0.57; = 2.07×10)与GERD风险呈负相关。基因预测的咖啡摄入量存在提示性关联(每增加一个标准差的OR为1.22,95%CI:1.03 - 1.44; = 0.019)。多变量孟德尔随机化进一步证实,干果摄入量、红酒摄入量、奶酪摄入量和谷类摄入量直接影响GERD。相比之下,猪肉摄入量、啤酒摄入量、非油性鱼类摄入量和面包摄入量对GERD的影响部分由GERD的共同风险因素驱动。然而,在对所有四个因素进行调整后,咖啡摄入量与GERD之间不再存在提示性关联。
本研究提供了MR证据,支持多种饮食摄入与GERD之间的因果关系,为GERD的治疗和预防提供了新的见解。