Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China; Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Int Dent J. 2024 Dec;74(6):1438-1446. doi: 10.1016/j.identj.2024.05.004. Epub 2024 Jun 8.
Studies have increasingly focussed on the relationship between periodontitis (PD) and preeclampsia (PE). However, conclusions have not been consistent, and it is unclear whether any causal relationship exists between them and whether causality is bidirectional. This study employed Mendelian randomisation (MR) analysis to investigate the potential bidirectional causal relationship between PD and PE.
Genetic variants strongly linked to PD (17,353 cases and 28,210 controls), chronic periodontitis (CP; 1817 cases and 2215 controls), aggressive periodontitis (AgP; 851 cases and 6580 controls), and PE (7212 cases and 194,266 controls) in the genome-wide association study (GWAS) of European ancestry were used as instrumental variables (IVs). Inverse variance weighting (IVW) served as the primary method for causal inference. MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) was utilised to analyse horizontal pleiotropy. Cochrane Q tests and leave-one-out analyses were used to assess heterogeneity and stability amongst IVs.
The MR analysis revealed no causal impacts of PD or its 2 subtypes-CP and AgP-on PE. Similarly, no significant causal effect of PE on PD was found in the reverse-MR analysis (IVW odds ratio, 0.97; 95% confidence interval, 0.91-1.05; P = .58). The findings from MR-Egger, weighted median, weighted mode, and the simple modelling approaches, as well as the pleiotropy and sensitivity analyses, aligned with those of the IVW method.
The MR analysis suggests no bidirectional causal relationship between PD and PE; hence, PD and PE might not increase or prevent the risk of one other.
Genetically, periodontitis or its subtypes chronic periodontitis and aggressive periodontitis may not require specific clinical attention to prevent the development of preeclampsia.
越来越多的研究集中在牙周炎（PD）和子痫前期（PE）之间的关系。然而，结论并不一致，尚不清楚两者之间是否存在因果关系，以及这种关系是否具有双向性。本研究采用孟德尔随机化（MR）分析来研究 PD 和 PE 之间潜在的双向因果关系。
使用全基因组关联研究（GWAS）中与欧洲血统个体的 PD（17353 例病例和 28210 例对照）、慢性牙周炎（CP；1817 例病例和 2215 例对照）、侵袭性牙周炎（AgP；851 例病例和 6580 例对照）和 PE（7212 例病例和 194266 例对照）相关的遗传变异作为工具变量（IVs）。逆方差加权（IVW）作为因果推断的主要方法。MR 多效性残余和异常值（MR-PRESSO）用于分析水平多效性。Cochrane Q 检验和逐一剔除分析用于评估 IVs 之间的异质性和稳定性。
MR 分析显示 PD 或其 2 个亚型 CP 和 AgP 与 PE 之间没有因果关系。同样，反向 MR 分析也未发现 PE 对 PD 的显著因果影响（IVW 比值比，0.97；95%置信区间，0.91-1.05；P=0.58）。MR-Egger、加权中位数、加权众数和简单建模方法以及多效性和敏感性分析的结果与 IVW 方法一致。
MR 分析表明 PD 和 PE 之间没有双向因果关系；因此，PD 和 PE 可能不会增加或预防另一种疾病的风险。
从遗传角度来看，牙周炎或其慢性牙周炎和侵袭性牙周炎等亚型可能不需要特别关注以预防子痫前期的发生。
