Lin Chun-Mei, Meng Qian, Li Ying-Jun, Zhang Shuang-Xi, Luo Qiong-Xi, Dai Zhen-Yu
Postgraduate Student, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China.
Department of Gastroenterology, Guangzhou University of Chinese Medicine Shunde Hospital, Foshan 528300, Guangdong Province, China.
World J Clin Cases. 2024 Sep 6;12(25):5729-5738. doi: 10.12998/wjcc.v12.i25.5729.
Previous epidemiologic investigations have consistently demonstrated a strong association between the ratio of cholesterol to total lipids in medium very-low-density lipoprotein (VLDL) and the occurrence of peptic ulcers (PU). However, the precise causal relationship between these factors remains ambiguous. Consequently, this study aims to elucidate the potential correlation between the ratio of cholesterol to total lipids in medium VLDL and the incidence of peptic ulcer.
To investigate the ratio of cholesterol to total lipids in medium very-low-density lipoprotein (VLDL) association with PU genetic methods, guiding future clinical research.
Genome-wide association study (GWAS) datasets for the ratio of cholesterol to total lipids in intermediate VLDL and peptic ulcer were retrieved from the IEU OpenGWAS project (https://gwas.mrcieu.ac.uk). For the forward Mendelian randomization (MR) analysis, 72 single nucleotide polymorphisms (SNPs) were identified as instrumental variables. These SNPs were selected based on their association with the ratio of cholesterol to total lipids in intermediate VLDL, with peptic ulcer as the outcome variable. Conversely, for the inverse MR analysis, no SNPs were identified with peptic ulcer as the exposure variable and the ratio of cholesterol to total lipids in intermediate VLDL as the outcome. All MR analyses utilized inverse variance weighted (IVW) as the primary analytical method. Additionally, weighted median and MR-Egger methods were employed as supplementary analytical approaches to assess causal effects. Egger regression was used as a supplementary method to evaluate potential directional pleiotropy. Heterogeneity and multiplicity tests were conducted using the leave-one-out method to evaluate result stability and mitigate biases associated with multiple testing.
The genetically predicted ratio of cholesterol to total lipids in medium VLDL was significantly associated with an elevated risk of peptic ulcer (IVW: OR = 2.557, 95%CI = 1.274-5.132, = 0.008). However, no causal association of peptic ulcer with the ratio of cholesterol to total lipids in medium VLDL was observed in the inverse Mendelian randomization analysis.
In conclusion, our study reveals a significant association between the ratio of cholesterol to total lipids in medium VLDL and an elevated risk of peptic ulcers. However, further validation through laboratory investigations and larger-scale studies is warranted to strengthen the evidence and confirm the causal relationship between these factors.
以往的流行病学调查一致表明，中极低密度脂蛋白（VLDL）中胆固醇与总脂质的比例与消化性溃疡（PU）的发生之间存在密切关联。然而，这些因素之间的确切因果关系仍不明确。因此，本研究旨在阐明中VLDL中胆固醇与总脂质的比例与消化性溃疡发病率之间的潜在相关性。
采用遗传方法研究中极低密度脂蛋白（VLDL）中胆固醇与总脂质的比例与PU的关联，为未来的临床研究提供指导。
遗传预测的中VLDL中胆固醇与总脂质的比例与消化性溃疡风险升高显著相关（IVW：OR = 2.557，95%CI = 1.274 - 5.132，P = 0.008）。然而，在反向孟德尔随机化分析中未观察到消化性溃疡与中VLDL中胆固醇与总脂质比例之间的因果关联。
总之，我们的研究揭示了中VLDL中胆固醇与总脂质的比例与消化性溃疡风险升高之间存在显著关联。然而，有必要通过实验室研究和更大规模的研究进行进一步验证，以加强证据并确认这些因素之间的因果关系。
