Lei Jiaming, Wu Ling
Department of Gastroenterology, People's Hospital of Leshan, Leshan City, Sichuan Province, China.
Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China.
Clin Nutr ESPEN. 2025 Feb;65:86-92. doi: 10.1016/j.clnesp.2024.11.028. Epub 2024 Nov 26.
BACKGROUND & AIMS: Previous studies have indicated that, in addition to the types of food consumed, eating habits are also associated with the risk of esophageal diseases. Some studies have suggested a possible link between breakfast skipping and esophageal tumors as well as gastroesophageal reflux disease. However, it remains unclear whether breakfast skipping has a causal relationship with esophageal diseases. To address this issue, this study aimed to investigate the potential causal relationship between breakfast skipping and esophageal diseases using a two-sample mendelian randomization (MR) approach.
We obtained data from genome-wide association studies (GWAS) involving 193,860 individuals from the UK Biobank on breakfast skipping. The summary statistics for the esophageal diseases were derived from the IEU open GWAS project. In this two-sample MR analysis, inverse variance weighted was used, supplemented with weighted median, simple mode and weighted mode methods.
The results revealed significant causal relationships between breakfast skipping and esophageal cancer (odds ratio (OR): 5.992, 95 % confidence interval (CI): 1.606-22.350, p = 0.008), Barrett's esophagus (OR: 4.041, 95 % CI: 1.837-8.889, p < 0.001), gastroesophageal reflux disease (OR: 2.463, 95 % CI: 1.995-3.041, p < 0.001), and esophageal varices (OR: 4.454, 95 % CI: 1.785-11.112, p = 0.001). All of the supplementary methods supported the findings.
Our research provides evidence for the association between breakfast skipping and esophageal diseases. Breakfast skipping could be a potential risk factor for esophageal cancer, Barrett's esophagus, gastroesophageal reflux disease and esophageal varices. For high-risk groups prone to these esophageal diseases, emphasizing the importance of regular breakfast and maintaining consistent dietary habits is crucial for esophageal health.
既往研究表明，除所摄入食物的类型外，饮食习惯也与食管疾病风险相关。一些研究提示不吃早餐与食管肿瘤以及胃食管反流病之间可能存在联系。然而，不吃早餐与食管疾病之间是否存在因果关系仍不清楚。为解决这一问题，本研究旨在采用两样本孟德尔随机化（MR）方法探究不吃早餐与食管疾病之间的潜在因果关系。
我们从英国生物银行涉及193,860人的全基因组关联研究（GWAS）中获取了关于不吃早餐的数据。食管疾病的汇总统计数据来自IEU开放GWAS项目。在这项两样本MR分析中，使用了逆方差加权法，并辅以加权中位数、简单模式和加权模式方法。
结果显示，不吃早餐与食管癌（优势比（OR）：5.992，95%置信区间（CI）：1.606 - 22.350，p = 0.008）、巴雷特食管（OR：4.041，95% CI：1.837 - 8.889，p < 0.001）、胃食管反流病（OR：2.463，95% CI：1.995 - 3.041，p < 0.001）和食管静脉曲张（OR：4.454，95% CI：1.785 - 11.112，p = 0.001）之间存在显著的因果关系。所有补充方法均支持这些发现。
我们的研究为不吃早餐与食管疾病之间的关联提供了证据。不吃早餐可能是食管癌、巴雷特食管、胃食管反流病和食管静脉曲张的潜在危险因素。对于易患这些食管疾病的高危人群，强调规律吃早餐的重要性并保持一致的饮食习惯对食管健康至关重要。
