Lu Shan, Zhu Yahong, Cui Mingyu, Guo Zheng, Li Xingang, Song Ying
Gastroenteric Medicine and Digestive Endoscopy Center, The Second Hospital of Jilin University Changchun Jilin China.
School of Medical and Health Sciences Edith Cowan University Joondalup Western Australia Australia.
Health Sci Rep. 2025 Mar 2;8(3):e70479. doi: 10.1002/hsr2.70479. eCollection 2025 Mar.
Gastroesophageal reflux disease (GERD) is common worldwide. Although associations between sedentary behaviour (LSBs), physical activity (PAs), and GERD have been reported, their causal relationships remain unclear. This study uses Mendelian randomization (MR) to examine these associations with GERD.
Genetic instruments from the UK Biobank and other consortia were utilized to assess the causal relationship between LSBs, PAs, and GERD. Causal analyses employed inverse variance weighted (IVW), weighted-median (WM), and MR-Egger regression. Sensitivity analyses included Cochran's test, MR-Egger intercept test, leave-one-out analysis, and funnel plot assessment. Outliers were detected using MR-PRESSO and Radial MR. A risk factor analysis explored potential causal links.
Genetically predicted leisure television (TV) watching (OR = 2.29, 95% CI 2.12-2.48; < 0.001) and self-reported moderate physical activity (MPAs) (OR = 2.45, 95% CI 1.46-4.13; < 0.001) were associated with an higher risk of GERD. In contrast, leisure computer use (OR = 0.62, 95% CI 0.53-0.73; < 0.001) and accelerometer-measured fractional accelerations > 425 milligravities (OR = 0.68, 95% CI 0.52-0.88; = 0.003) were associated with a lower risk of GERD. No causal relationship was observed between driving, self-reported vigorous physical activities (VPAs), and accelerometer-measured "average acceleration" with GERD. Risk factor analyses suggested that metabolic risk factors, such as smoking, high body mass index, elevated serum triglyceride levels, insulin resistance, and type 2 diabetes might mediate the observed causal links.
Leisure TV watching and self-reported MPA are associated with an higher risk of GERD, whereas leisure computer use and accelerometer-measured fractional acceleration > 425 milligravities may serve as protective factors against GERD. These findings highlight the necessity of differentiating various LSBs and PAs in GERD research.
胃食管反流病（GERD）在全球范围内都很常见。尽管已有报告指出久坐行为（LSB）、身体活动（PA）与GERD之间存在关联，但其因果关系仍不明确。本研究采用孟德尔随机化（MR）方法来检验这些因素与GERD的关联。
利用英国生物银行及其他联盟的基因工具，评估LSB、PA与GERD之间的因果关系。因果分析采用逆方差加权（IVW）、加权中位数（WM）和MR-Egger回归。敏感性分析包括 Cochr an检验、MR-Egger截距检验、留一法分析和漏斗图评估。使用MR-PRESSO和径向MR检测异常值。进行危险因素分析以探索潜在的因果联系。
基因预测的休闲看电视（比值比[OR]=2.29，95%置信区间[CI] 2.12 - 2.48；P<0.001）和自我报告的中等强度身体活动（MPA）（OR = 2.45，95% CI 1.46 - 4.13；P<0.001）与GERD风险较高相关。相比之下，休闲使用电脑（OR = 0.62，95% CI 0.53 - 0.73；P<0.001）以及加速度计测量的分数加速度>425毫重力（OR = 0.68，95% CI 0.52 - 0.88；P = 0.003）与GERD风险较低相关。未观察到驾驶、自我报告的剧烈身体活动（VPA）以及加速度计测量的“平均加速度”与GERD之间存在因果关系。危险因素分析表明，吸烟、高体重指数、血清甘油三酯水平升高、胰岛素抵抗和2型糖尿病等代谢危险因素可能介导了所观察到的因果联系。
休闲看电视和自我报告的MPA与GERD风险较高相关，而休闲使用电脑和加速度计测量的分数加速度>425毫重力可能是预防GERD的保护因素。这些发现凸显了在GERD研究中区分不同LSB和PA的必要性。
