Department of Pancreatitis Treatment Center, People's Hospital of Deyang City, Deyang, China.
Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2024 May 31;103(22):e38331. doi: 10.1097/MD.0000000000038331.
Several observational studies have reported a correlation between the gut microbiota (GM) and the risk of acute pancreatitis (AP). However, the causal relationship between them remains uncertain. We conducted a 2-sample Mendelian randomization (MR) study using pooled data from genome-wide association studies of 211 taxa (131 genera, 35 families, 20 orders, 16 classes, and 9 phyla) and AP patients. We evaluated the causal relationship between the GM and AP using methods such as inverse-variance weighting, MR-Egger, weighted medians, simple mode, and weighted mode. Cochran Q test, MR-Egger regression intercept analysis, and MR-PRESSO were used to examine the heterogeneity, multipotency, and outlier values of the variables, respectively. The reverse causal relationship between AP and the GM was assessed with reverse MR. In total, 5 gut microbial taxa were significantly associated with AP. The inverse-variance weighting results indicated that Acidaminococcaceae (odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.66-1.00, P = .045) and Ruminococcaceae UCG004 (OR: 0.85, 95% CI: 0.72-0.99, P = .040) were protective factors against the occurrence of AP. Coprococcus 3 (OR: 1.32, 95% CI: 1.03-1.70, P = .030), Eisenbergiella (OR: 1.13, 95% CI: 1.00-1.28, P = .043), and the Eubacterium fissicatena group (OR: 1.18, 95% CI: 1.05-1.33, P = .006) were risk factors for the development of AP. A comprehensive sensitivity analysis proved our results to be reliable. Reverse MR analysis did not indicate any causal relationship between AP and the GM. This study revealed a complex causal relationship between 5 GM taxa and AP, providing new insights into the diagnostic and therapeutic potential of the GM in AP patients.
几项观察性研究报告称，肠道微生物群（GM）与急性胰腺炎（AP）的风险之间存在相关性。然而，它们之间的因果关系仍不确定。我们使用来自 211 个分类群（131 个属，35 个科，20 个目，16 个纲，9 个门）的全基因组关联研究的汇总数据进行了两样本 Mendelian 随机化（MR）研究。我们使用逆方差加权、MR-Egger、加权中位数、简单模式和加权模式等方法评估 GM 与 AP 之间的因果关系。Cochran Q 检验、MR-Egger 回归截距分析和 MR-PRESSO 分别用于检验变量的异质性、多效性和异常值。使用反向 MR 评估 AP 和 GM 之间的反向因果关系。共有 5 种肠道微生物与 AP 显著相关。逆方差加权结果表明，双歧杆菌科（比值比[OR]：0.81，95%置信区间[CI]：0.66-1.00，P=0.045）和 Ruminococcaceae UCG004（OR：0.85，95% CI：0.72-0.99，P=0.040）是 AP 发生的保护因素。粪肠球菌 3（OR：1.32，95% CI：1.03-1.70，P=0.030）、Eisenbergiella（OR：1.13，95% CI：1.00-1.28，P=0.043）和 Eubacterium fissicatena 组（OR：1.18，95% CI：1.05-1.33，P=0.006）是 AP 发展的危险因素。综合敏感性分析证明我们的结果是可靠的。反向 MR 分析并未表明 AP 和 GM 之间存在任何因果关系。这项研究揭示了 5 种 GM 分类群与 AP 之间复杂的因果关系，为 GM 在 AP 患者中的诊断和治疗潜力提供了新的见解。
