Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Sleep Breath. 2024 Oct;28(5):2045-2053. doi: 10.1007/s11325-024-03082-5. Epub 2024 Jul 20.
Clinical studies suggested associations between obstructive sleep apnea (OSA) and gastrointestinal tract disorders. This study aims to investigate the genetic causal relationship between OSA and gastrointestinal tract disorders, specifically gastroesophageal reflux disease (GERD) and inflammatory bowel disease (IBD).
In this study, we employed two-sample Mendelian Randomization (MR) analysis to investigate the potential relationships between OSA and GERD, and between OSA and IBD. More specifically, the primary analysis utilized inverse variance weighting (IVW). Weighted median, MR Egger, and MR PRESSO were applied to complicate potential violations of MR assumptions. Also, sensitivity analysis was evaluated and similar analysis was performed again after outliers were removed. Additionally, multivariable MR (MVMR) was conducted for associated pairs to adjust for obesity.
Genetically predicted risk of GERD increased OSA risk by approximately 60% (OR = 1.62, 95%CI = [1.43,1.84]) which was also stable by other complicated approaches, and even with BMI adjusted by MVMR (OR[95%CI] = 1.26 [1.15,1.37]). Besides, OSA showed a mild causal effect on increased GERD risk after adjusting for obesity (OR[95%CI] = 1.05 [1.02,1.08]). Additionally, OSA increased the risks for IBD (OR95%CI] = 1.36 [1.12,1.65]), including a higher risk of CD (OR[95%CI] = 1.41 [1.08,1.83]), and a trend for increasing UC risk (OR[95%CI] = 1.29 [0.99,1.67]).
GERD exerts a substantial causality on increasing the risk of OSA. Conversely, the potential for a causal relationship that OSA contributes to the development of GERD or IBD remains probable. These findings support the crosstalk between gastrointestinal tract disorders and OSA.
临床研究表明阻塞性睡眠呼吸暂停（OSA）与胃肠道疾病之间存在关联。本研究旨在探讨 OSA 与胃肠道疾病（特别是胃食管反流病（GERD）和炎症性肠病（IBD））之间的遗传因果关系。
本研究采用两样本 Mendelian Randomization（MR）分析来研究 OSA 与 GERD 之间以及 OSA 与 IBD 之间的潜在关系。更具体地说，主要分析采用逆方差加权（IVW）。加权中位数、MR Egger 和 MR PRESSO 用于复杂潜在的 MR 假设违反情况。此外，还进行了敏感性分析，并在剔除离群值后再次进行了类似的分析。此外，还进行了多变量 MR（MVMR）分析，以调整肥胖相关的关联对。
遗传预测的 GERD 风险增加了 OSA 风险约 60%（OR=1.62，95%CI=[1.43,1.84]），这一结果在其他复杂方法中也是稳定的，甚至在 MVMR 调整 BMI 后（OR[95%CI]=1.26[1.15,1.37]）也是如此。此外，在调整肥胖因素后，OSA 对 GERD 风险增加的因果关系较弱（OR[95%CI]=1.05[1.02,1.08]）。此外，OSA 增加了 IBD 的风险（OR[95%CI]=1.36[1.12,1.65]），包括 CD 的风险增加（OR[95%CI]=1.41[1.08,1.83]）和 UC 风险增加的趋势（OR[95%CI]=1.29[0.99,1.67]）。
GERD 对增加 OSA 风险具有显著的因果关系。相反，OSA 可能导致 GERD 或 IBD 发展的因果关系仍然可能存在。这些发现支持了胃肠道疾病与 OSA 之间的相互作用。
