Liu Rui-Lin, Ou Yu-Ping, Zhang Qian, Yang Yi-Feng
Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha, China.
Department of Ultrasound, Chen Zhou No. 1 People's Hospital, ChenZhou, China.
Int Dent J. 2025 Apr;75(2):832-839. doi: 10.1016/j.identj.2024.07.011. Epub 2024 Aug 2.
Clarifying the uncertain causal relationship between periodontitis and infective endocarditis using Mendelian randomization analysis, given their historically perceived association and clinical significance.
Genetic variation data for acute periodontitis, chronic periodontitis, aggressive periodontitis, and infective endocarditis were obtained from published GWAS in individuals of European ancestry. Instrumental variables significantly associated with periodontitis were selected and univariable Mendelian randomization was conducted to infer the causal association between periodontitis and infective endocarditis. Multivariable Mendelian randomization was also performed to adjust for potential confounders including smoking, drinking, diabetes, and education.
Our analysis found no evidence of a causal association between periodontitis and infective endocarditis, with odds ratios (ORs) of 0.992 (95% CI: 0.879-1.120), 0.947 (95% CI: 0.738-1.214), and 1.056 (95% CI: 0.916-1.217) for acute periodontitis, chronic periodontitis, aggressive periodontitis, respectively. The robustness of our findings was confirmed by heterogeneity tests, pleiotropy tests, leave-one-out analyses, and MR-PRESSO. In the multivariable MR analysis, adjusting for smoking, drinking, diabetes, and education, the overall patterns between genetic liability to periodontitis and infective endocarditis remained consistent (all P > .05).
Our findings indicate that there is no genetic causal association between periodontitis and infective endocarditis.
鉴于牙周炎与感染性心内膜炎在历史上被认为有关联且具有临床意义，使用孟德尔随机化分析来阐明它们之间不确定的因果关系。
从已发表的欧洲血统个体的全基因组关联研究（GWAS）中获取急性牙周炎、慢性牙周炎、侵袭性牙周炎和感染性心内膜炎的基因变异数据。选择与牙周炎显著相关的工具变量，并进行单变量孟德尔随机化以推断牙周炎与感染性心内膜炎之间的因果关联。还进行了多变量孟德尔随机化以调整包括吸烟、饮酒、糖尿病和教育程度等潜在混杂因素。
我们的分析未发现牙周炎与感染性心内膜炎之间存在因果关联的证据，急性牙周炎、慢性牙周炎、侵袭性牙周炎的优势比（OR）分别为0.992（95%可信区间：0.879 - 1.120）、0.947（95%可信区间：0.738 - 1.214）和1.056（95%可信区间：0.916 - 1.217）。通过异质性检验、多效性检验、留一法分析和MR-PRESSO证实了我们发现的稳健性。在多变量孟德尔随机化分析中，调整吸烟、饮酒、糖尿病和教育程度后，牙周炎遗传易感性与感染性心内膜炎之间的总体模式保持一致（所有P > 0.05）。
我们的研究结果表明，牙周炎与感染性心内膜炎之间不存在遗传因果关联。
