Zheng Feibo, Li Jinan, Ma Lina, Zhang Yu, Tu Zhengwei, Cui Yunfeng
Department of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, Tianjin, 300100, China.
Department of Surgery, Tianjin Occupational Diseases Precaution and Therapeutic Hospital, Tianjin, 300011, China.
Open Med (Wars). 2025 May 22;20(1):20251189. doi: 10.1515/med-2025-1189. eCollection 2025.
We explored the causal relationship between pancreatitis and various autoimmune diseases using bidirectional Mendelian randomization (MR).
We collected genome-wide association study summary data for four pancreatitis types and five autoimmune diseases to conduct our bidirectional MR analysis. The primary analysis was performed using the inverse variance weighted (IVW) method, complemented by MR Egger, weighted median, and weighted mode methods. Sensitivity analyses included Cochran's test for heterogeneity, MR-Egger regression for pleiotropy, and MR-PRESSO and leave-one-out analyses for outliers.
The result of IVW revealed a significant association between genetically predicted inflammatory bowel disease (IBD) and an increased risk of acute pancreatitis (AP) (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 1.03-1.12, = 0.0015). Subsequent analyses further confirmed this association in IBD subtypes, with genetically predicted ulcerative colitis (UC) and Crohn's disease (CD) also showing increased risks of AP (UC: OR = 1.07, 95% CI = 1.02-1.13, = 0.01; CD: OR = 1.05, 95% CI = 1-1.09, = 0.03), affirming IBD as a risk factor for pancreatitis. Reverse analysis ruled out reverse causality and did not find a causal relationship between other immune diseases and pancreatitis.
These findings suggest that pancreatitis in IBD patients may arise from the disease itself, necessitating increased vigilance for AP during diagnosis and treatment.
我们使用双向孟德尔随机化（MR）方法探究胰腺炎与各种自身免疫性疾病之间的因果关系。
我们收集了四种胰腺炎类型和五种自身免疫性疾病的全基因组关联研究汇总数据，以进行双向MR分析。主要分析采用逆方差加权（IVW）方法，并辅以MR Egger、加权中位数和加权模式方法。敏感性分析包括用于异质性的 Cochr an检验、用于多效性的MR-Egger回归以及用于异常值的MR-PRESSO和留一法分析。
IVW结果显示，遗传预测的炎症性肠病（IBD）与急性胰腺炎（AP）风险增加之间存在显著关联（优势比[OR]=1.07，95%置信区间[CI]=1.03-1.12，P=0.0015）。后续分析进一步证实了IBD亚型中的这种关联，遗传预测的溃疡性结肠炎（UC）和克罗恩病（CD）也显示出AP风险增加（UC：OR=1.07，95%CI=1.02-1.13，P=0.01；CD：OR=1.05，95%CI=1-1.09，P=0.03），确认IBD是胰腺炎的一个风险因素。反向分析排除了反向因果关系，未发现其他免疫疾病与胰腺炎之间存在因果关系。
这些发现表明，IBD患者的胰腺炎可能源于疾病本身，在诊断和治疗期间需要提高对AP的警惕性。
