Xiao Yixi, Zhang Haowei, Zhang Fang, Luo Jing, Zhao Xiaoyue, Liu Hai, Zhang Jianhui
Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Otolaryngology Head and Neck Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41750. doi: 10.1097/MD.0000000000041750.
In this study, we conducted a 2-sample Mendelian randomization (MR) analysis to explore the relationship between gastroesophageal reflux disease (GERD) and 16 common otolaryngological diseases. Single-nucleotide polymorphisms that are strongly associated with GERD were used as instrumental variables. The primary estimation of the causal effect utilized the inverse variance weighting method, supplemented by MR Egger, weighted median, simple mode, and weighted mode as alternative methods for estimating the causal effect. Then, sensitivity analyses, including heterogeneity, pleiotropy, and leave-one-out analyses, were performed to verify the robustness of the results. The analysis of MR showed that genetically predicted GERD was associated with an increased risk of acute upper respiratory infection (odds ratios [OR] = 1.1418, 95% confidence intervals [CI] = 1.0664-1.2225, P = 1.00 × 10-4), chronic pharyngitis (OR = 1.483, 95% CI = 1.1495-1.9132, P = 2.40 × 10-3), vocal cord dysfunction (OR = 2.2963, 95% CI = 1.4174-3.7201, P = 7.00 × 10-4), sleep apnea (OR = 1.0022, 95% CI = 1.0009-1.0035, P = 8.00 × 10-4), acute sinusitis (OR = 1.3247, 95% CI = 1.1774-1.4905, P = 2.94 × 10-6), chronic sinusitis (OR = 1.3649, 95% CI = 1.1854-1.5715, P = 1.52 × 10-6), chronic suppurative otitis media (OR = 2.085, 95% CI = 1.3292-3.2704, P = 1.40 × 10-3). Further sensitivity analyses showed no evidence of pleiotropy. The results of this study indicate that GERD may contribute to the development of some otolaryngological diseases. Further research and mechanistic investigations are warranted to elucidate the underlying connections and potential therapeutic implications.
在本研究中，我们进行了一项双样本孟德尔随机化（MR）分析，以探讨胃食管反流病（GERD）与16种常见耳鼻喉科疾病之间的关系。将与GERD密切相关的单核苷酸多态性用作工具变量。因果效应的主要估计采用逆方差加权法，并辅以MR Egger、加权中位数、简单模式和加权模式作为估计因果效应的替代方法。然后，进行敏感性分析，包括异质性、多效性和留一法分析，以验证结果的稳健性。MR分析表明，基因预测的GERD与急性上呼吸道感染风险增加相关（比值比[OR]=1.1418，95%置信区间[CI]=1.0664-1.2225，P=1.00×10-4）、慢性咽炎（OR=1.483，95%CI=1.1495-1.9132，P=2.40×10-3）、声带功能障碍（OR=2.2963，95%CI=1.4174-3.7201，P=7.00×10-4）、睡眠呼吸暂停（OR=1.0022，95%CI=1.0009-1.0035，P=8.00×10-4）、急性鼻窦炎（OR=1.3247，95%CI=1.1774-1.4905，P=2.94×10-6）、慢性鼻窦炎（OR=1.3649，95%CI=1.1854-1.5715，P=1.52×10-6）、慢性化脓性中耳炎（OR=2.085，95%CI=1.3292-3.2704，P=1.40×10-3）。进一步的敏感性分析未发现多效性证据。本研究结果表明，GERD可能促成某些耳鼻喉科疾病的发生。有必要进行进一步的研究和机制调查，以阐明潜在的联系和潜在的治疗意义。
