牙周炎与肝细胞癌：一项两样本孟德尔随机化研究
Periodontitis and Hepatocellular Carcinoma: A Two-Sample Mendelian Randomisation Study.
作者信息
Sergeeva Irina, Meng Zhanzhi, Ma Yong
机构信息
Department of Minimally Invasive Hepatic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Minimally Invasive Hepatic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
出版信息
Int Dent J. 2025 Apr;75(2):605-612. doi: 10.1016/j.identj.2024.09.015. Epub 2024 Oct 2.
INTRODUCTION AND AIMS
Observational studies have reported conflicting associations between periodontitis (PD) and hepatocellular carcinoma (HCC). To overcome these limitations, we performed a two-sample Mendelian randomization (MR) analysis to investigate the potential association between PD and HCC.
METHODS
We used summary data from genome-wide association studies (GWASs) of European ancestry, integrating data from chronic/acute periodontitis (CP/AP) samples (n1 = 34,615; n2 = 277,036; n3 = 410,811) and HCC samples (n1 = 456,348; n2 = 475,638). The inverse variance-weighted (IVW) approach represents our primary analysis method, supplemented by MR-Egger regression, weighted median, weighted-mode, and simple-mode methods. Pleiotropy and heterogeneity tests were also performed.
RESULTS
IVW analysis suggested that PD had no effect on HCC (Group 1: odds ratio [OR] = 0.912, 95% confidence interval [CI] = 0.690-1.204, P = .514; Group 2: OR = 1.038, 95% CI = 0.895-1.203, P = .623; Group 3: OR = 0.966, 95% CI = 0.851-1.096, P = .591; Group 4: OR = 1.103, 95% CI = 0.576-2.113, P = .768; Group 5: OR = 1.257, 95% CI = 0.511-1.037, P = .540; Group 6: OR = 0.728, 95% CI = 0.511-1.037, P = .079). Four complementary analyses further support this conclusion. Both the IVW and MR-Egger results indicate that the instrumental variables in each group did not exhibit significant pleiotropy. MR-Egger regression analysis showed no evidence of pleiotropic effects.
CONCLUSION
Our MR analysis suggests that PD does not significantly impact the risk of developing HCC. These results provide a new perspective on the relationship between these 2 conditions.
CLINICAL RELEVANCE
This MR study suggests no significant genetic causal relationship between PD and HCC, providing a new perspective. It indicates that clinicians may not need to over-intervene in periodontal disease to prevent liver cancer, thereby avoiding unnecessary psychological burden on patients.
引言与目的
观察性研究报告了牙周炎（PD）与肝细胞癌（HCC）之间存在相互矛盾的关联。为克服这些局限性，我们进行了双样本孟德尔随机化（MR）分析，以研究PD与HCC之间的潜在关联。
方法
我们使用了欧洲血统的全基因组关联研究（GWAS）的汇总数据，整合了慢性/急性牙周炎（CP/AP）样本（n1 = 34,615；n2 = 277,036；n3 = 410,811）和HCC样本（n1 = 456,348；n2 = 475,638）的数据。逆方差加权（IVW）方法是我们的主要分析方法，并辅以MR-Egger回归、加权中位数、加权模式和简单模式方法。还进行了多效性和异质性检验。
结果
IVW分析表明，PD对HCC没有影响（第1组：优势比[OR]=0.912，95%置信区间[CI]=0.690 - 1.204，P = 0.514；第2组：OR = 1.038，95% CI = 0.895 - 1.203，P = 0.623；第3组：OR = 0.966，95% CI = 0.851 - 1.096，P = 0.591；第4组：OR = 1.103，95% CI = 0.576 - 2.113，P = 0.768；第5组：OR = 1.257，95% CI = 0.511 - 1.037，P = 0.540；第6组：OR = 0.728，95% CI = 0.511 - 1.037，P = 0.079）。四项补充分析进一步支持了这一结论。IVW和MR-Egger结果均表明，每组中的工具变量均未表现出显著的多效性。MR-Egger回归分析未显示多效性效应的证据。
结论
我们的MR分析表明，PD不会显著影响发生HCC的风险。这些结果为这两种疾病之间的关系提供了新的视角。
临床意义
这项MR研究表明，PD与HCC之间不存在显著的遗传因果关系，提供了一个新的视角。这表明临床医生可能无需为预防肝癌而对牙周疾病进行过度干预，从而避免给患者带来不必要的心理负担。
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