Li Xue-Feng, Cai Jun-Wei, Hu Yuan-Yuan, Niu Yu-Ming
Department of Endocrinology, Hubei Provincial Clinical Research Center for Umbilical Cord Blood Hematopoietic Stem Cells, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Department of Stomatology, Gongli Hospital of Shanghai Pudong New Area, Shanghai, China.
Int Dent J. 2025 Apr;75(2):596-604. doi: 10.1016/j.identj.2024.08.006. Epub 2024 Sep 3.
Accumulating evidence has indicated a close interrelation between autoimmune arthritis (AA) and temporomandibular disorders (TMD), but the causality is still unclear. The study aimed to explore the causal inference between AA and TMD using a bidirectional Mendelian randomization analysis.
Online genome-wide association study data on rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, and TMD were obtained from the FinnGen and IEU databases. Causality was using the inverse variance-weighted method as the primary analysis and supplemented by other methods. Sensitivity analyses, including heterogeneity tests, horizontal pleiotropy tests, and leave-one-out methods, were conducted to investigate the stability and reliability of the results.
The inverse variance-weighted test indicated that several AA types could causally increase the TMD risk, including overall RA (odds ratio [OR] = 1.348, 95% confidence interval [CI] = 1.1232-1.618, P = .001), subtype nRA (OR = 1.118, 95% CI = 1.044-1.197, P = .001), and AS (OR = 1.060, 95% CI = 1.024-1.097, P = .001). Moreover, the causal association of the above combinations has been proven to be stable and reliable using sensitivity and other tests.
These findings suggest that RA and AS might be causally associated with an increased risk of TMD. However, more studies are needed to check the causal effects of AA on TMD and analyse the potential mechanisms further.
越来越多的证据表明自身免疫性关节炎（AA）与颞下颌关节紊乱病（TMD）之间存在密切的相互关系，但因果关系仍不明确。本研究旨在通过双向孟德尔随机化分析探讨AA与TMD之间的因果推断。
从芬兰基因库（FinnGen）和国际暴露组学联盟（IEU）数据库中获取类风湿关节炎（RA）、强直性脊柱炎（AS）、银屑病关节炎和TMD的全基因组关联研究在线数据。因果关系分析以逆方差加权法作为主要分析方法，并辅以其他方法。进行敏感性分析，包括异质性检验、水平多效性检验和留一法，以研究结果的稳定性和可靠性。
逆方差加权检验表明，几种类型的AA可导致TMD风险增加，包括总体RA（比值比[OR]=1.348，95%置信区间[CI]=1.1232-1.618，P=.001）、nRA亚型（OR=1.118，95%CI=1.044-1.197，P=.001）和AS（OR=1.060，95%CI=1.024-1.097，P=.001）。此外，通过敏感性分析和其他检验已证明上述组合的因果关联是稳定可靠的。
这些发现表明，RA和AS可能与TMD风险增加存在因果关系。然而，需要更多研究来检验AA对TMD的因果效应，并进一步分析潜在机制。
