Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Sci Rep. 2024 Jul 19;14(1):16677. doi: 10.1038/s41598-024-66940-y.
Observational studies have reported an association between inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), and hemorrhoids (HEM). However, the presence of a causal relationship within this observed association remains to be confirmed. Consequently, we utilized the Mendelian randomization (MR) method to assess the causal effects of IBD on hemorrhoids. We validated the association between IBD and hemorrhoids in humans based on genome-wide association studies (GWAS) data. To investigate the causal relationship between IBD and hemorrhoids, we performed a two-sample Mendelian randomization study using training and validation sets. The genetic variation data for IBD, CD, UC, and hemorrhoids were derived from published genome-wide association studies (GWAS) of individuals of European. Two-sample Mendelian randomization and Multivariable Mendelian randomization (MVMR) were employed to determine the causal relationship between IBD (CD or UC) and hemorrhoids. Genetically predicted overall IBD was positively associated with hemorrhoids risk, with ORs of 1.02 (95% CIs 1.01-1.03, P = 4.39 × 10) and 1.02 (95% CIs 1.01-1.03, P = 4.99 × 10) in the training and validation sets, respectively. Furthermore, we found that CD was positively associated with hemorrhoids risk, with ORs of 1.02 (95% CIs 1.01-1.03, P = 4.12 × 10) and 1.02 (95% CIs 1.01-1.02, P = 3.78 × 10) for CD in the training and validation sets, respectively. In addition, we found that UC in the training set was positively associated with hemorrhoids risk (ORs 1.02, 95% CIs 1.01-1.03, P = 4.65 × 10), while no significant causal relationship between UC and hemorrhoids was shown in the validation set (P > 0.05). However, after MVMR adjustment, UC in the training set was not associated with an increased risk of hemorrhoids. Our study showed that there is a causal relationship between CD and hemorrhoids, which may suggest that clinicians need to prevent the occurrence of hemorrhoids in CD patients.
观察性研究报告称，炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），与痔疮（HEM）之间存在关联。然而，在这种观察到的关联中，是否存在因果关系仍有待证实。因此，我们利用孟德尔随机化（MR）方法来评估 IBD 对痔疮的因果影响。我们根据全基因组关联研究（GWAS）数据验证了 IBD 和痔疮之间的关联。为了研究 IBD 和痔疮之间的因果关系，我们使用训练集和验证集进行了两样本孟德尔随机化研究。IBD、CD、UC 和痔疮的遗传变异数据源自欧洲个体的已发表全基因组关联研究（GWAS）。采用两样本孟德尔随机化和多变量孟德尔随机化（MVMR）来确定 IBD（CD 或 UC）与痔疮之间的因果关系。总体上，遗传预测的 IBD 与痔疮风险呈正相关，OR 分别为 1.02（95%CI 1.01-1.03，P=4.39×10）和 1.02（95%CI 1.01-1.03，P=4.99×10）在训练集和验证集中。此外，我们发现 CD 与痔疮风险呈正相关，OR 分别为 1.02（95%CI 1.01-1.03，P=4.12×10）和 1.02（95%CI 1.01-1.02，P=3.78×10）在训练集和验证集中。此外，我们发现在训练集中 UC 与痔疮风险呈正相关（ORs 1.02，95%CI 1.01-1.03，P=4.65×10），而在验证集中 UC 与痔疮之间没有显示出显著的因果关系（P>0.05）。然而，在 MVMR 调整后，训练集中的 UC 与痔疮的发生风险无关。我们的研究表明，CD 和痔疮之间存在因果关系，这可能表明临床医生需要在 CD 患者中预防痔疮的发生。
