The First Clinical College of Shandong University of Traditional Chinese Medicine, Jinan, China.
Guang'anmen Hospital Jinan Hospital (Jinan Municipal Hospital of Traditional Chinese Medicine), Jinan, China.
Medicine (Baltimore). 2024 Sep 27;103(39):e39671. doi: 10.1097/MD.0000000000039671.
Otitis media and allergic rhinitis are prevalent conditions. Some data posit a significant association between the 2 ailments, proposing mechanisms such as allergic rhinitis-induced Eustachian tube dysfunction or concurrent allergic pathophysiology affecting both the nasal and aural cavities. Observational studies hint at an association between allergic rhinitis (AR) and nonsuppurative otitis media, yet definitive causality remains elusive. Thus, to elucidate the causal impact of AR on otitis media, a 2-sample Mendelian randomization study was undertaken. Data on AR, acute suppurative otitis media, chronic suppurative otitis media, and nonsuppurative otitis media were sourced from the Genome for Extensive Association Study, encompassing individuals of European ancestry. Single nucleotide polymorphisms linked with AR were utilized as instrumental variables. The inverse-variance weighting (IVW) method, alongside sensitivity analyses employing the weighted median and Mendelian randomization-Egger methods, was employed to assess causal effects. Our analysis revealed a significant causal effect of AR on nonsuppurative otitis media (IVW, odds ratio [OR] = 12.22, 95% confidence interval, 1.38-107.93, P = .024) and indicated an association with acute suppurative otitis media (IVW, OR = 6.95, 95% confidence interval, 0.80-60.35, P = .078). However, no causal effect of AR on chronic suppurative otitis media was discerned. Our findings delineate a measurable causal link between AR and nonsuppurative otitis media (OR = 12.22) and suggest an association with acute suppurative otitis media (OR = 6.95), though lacking evidence for a causal effect on chronic suppurative otitis media. These results underscore the propensity of AR to correlate with diverse forms of otitis media and furnish high-quality causal evidence pertinent to clinical management.
中耳炎和变应性鼻炎是常见疾病。一些数据表明这两种疾病之间存在显著关联，提出了一些机制，如变应性鼻炎引起的咽鼓管功能障碍或同时影响鼻腔和中耳的过敏病理生理学。观察性研究提示变应性鼻炎（AR）与非化脓性中耳炎之间存在关联，但明确的因果关系仍难以确定。因此，为了阐明 AR 对中耳炎的因果影响，进行了一项两样本孟德尔随机化研究。AR、急性化脓性中耳炎、慢性化脓性中耳炎和非化脓性中耳炎的数据来源于包含欧洲血统个体的全基因组广泛关联研究。与 AR 相关的单核苷酸多态性被用作工具变量。采用逆方差加权（IVW）法，以及使用加权中位数和孟德尔随机化-Egger 法的敏感性分析，评估因果效应。我们的分析表明 AR 对非化脓性中耳炎有显著的因果影响（IVW，优势比[OR] = 12.22，95%置信区间，1.38-107.93，P =.024），并与急性化脓性中耳炎相关（IVW，OR = 6.95，95%置信区间，0.80-60.35，P =.078）。然而，AR 对慢性化脓性中耳炎没有因果影响。我们的研究结果描绘了 AR 与非化脓性中耳炎之间可衡量的因果关系（OR = 12.22），并提示与急性化脓性中耳炎相关（OR = 6.95），尽管缺乏对慢性化脓性中耳炎的因果关系的证据。这些结果强调了 AR 与多种形式的中耳炎相关的倾向，并为临床管理提供了高质量的因果证据。
