Wang Jing, Sui Wan-Nian, Zhao Yu-Qiang, Meng Shi-Yin, Han Wen-Xiu, Ni Jing
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Hefei, China.
J Gastroenterol Hepatol. 2024 Nov;39(11):2332-2339. doi: 10.1111/jgh.16678. Epub 2024 Jul 9.
BACKGROUND AND AIM: Insomnia has been implicated in gastrointestinal diseases (GIs), but the causal effect between insomnia and GIs and underlying mechanisms remain unknown. METHODS: By using the released summary-level data, we conducted a two-step Mendelian randomization (MR) analysis to examine the relationship between insomnia and four GIs and estimate the mediating role of candidate mediators. The first step was to investigate the causal association between insomnia and GIs using univariable MR analysis. The second step was to estimate the mediation proportion of selected mediators in these associations using multivariable MR analysis. Subsequently, results from different datasets were combined using the fixed-effect meta-analysis. RESULTS: Univariable MR analysis provided strong evidence for the causal effects of insomnia on four GIs after Bonferroni correction for multiple comparisons, including peptic ulcer disease (PUD) (odds ratio [OR] = 1.15, 95% interval confidence [CI] = 1.10-1.20, P = 1.83 × 10), gastroesophageal reflux (GORD) (OR = 1.19, 95% CI = 1.16-1.22, P = 5.95 × 10), irritable bowel syndrome (IBS) (OR = 1.18, 95% CI = 1.15-1.22, P = 8.69 × 10), and inflammatory bowel disease (IBD) (OR = 1.09, 95% CI = 1.03-1.05, P = 3.46 × 10). In the mediation analysis, body mass index (BMI) and waist-to-hip ratio (WHR) were selected as mediators in the association between insomnia and PUD (BMI: mediation proportion [95% CI]: 13.61% [7.64%-20.70%]; WHR: 8.74% [5.50%-12.44%]) and GORD (BMI: 11.82% [5.94%-18.74%]; WHR: 7.68% [4.73%-11.12%]). CONCLUSIONS: Our findings suggest that genetically instrumented insomnia has causal effects on PUD, GORD, IBS, and IBD, respectively. Adiposity traits partially mediated the associations between insomnia and GIs. Further clinical studies are warranted to evaluate the protective effect of insomnia treatment on GIs.
背景与目的:失眠与胃肠道疾病(GI)有关,但失眠与GI之间的因果关系及其潜在机制尚不清楚。 方法:通过使用已发布的汇总水平数据,我们进行了两步孟德尔随机化(MR)分析,以研究失眠与四种GI之间的关系,并估计候选中介因素的中介作用。第一步是使用单变量MR分析研究失眠与GI之间的因果关联。第二步是使用多变量MR分析估计选定中介因素在这些关联中的中介比例。随后,使用固定效应荟萃分析合并不同数据集的结果。 结果:在对多重比较进行Bonferroni校正后,单变量MR分析为失眠对四种GI的因果效应提供了有力证据,包括消化性溃疡疾病(PUD)(优势比[OR]=1.15,95%置信区间[CI]=1.10-1.20,P=1.83×10)、胃食管反流(GORD)(OR=1.19,95%CI=1.16-1.22,P=5.95×10)、肠易激综合征(IBS)(OR=1.18,95%CI=1.15-1.22,P=8.69×10)和炎症性肠病(IBD)(OR=1.09,95%CI=1.03-1.05,P=3.46×10)。在中介分析中,体重指数(BMI)和腰臀比(WHR)被选为失眠与PUD(BMI:中介比例[95%CI]:13.61%[7.64%-20.70%];WHR:8.74%[5.50%-12.44%])和GORD(BMI:11.82%[5.94%-18.74%];WHR:7.68%[4.73%-11.12%])之间关联的中介因素。 结论:我们的研究结果表明,基因检测的失眠分别对PUD、GORD、IBS和IBD有因果效应。肥胖特征部分介导了失眠与GI之间的关联。有必要进行进一步的临床研究,以评估失眠治疗对GI的保护作用。
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