Jiang Siqi, Liu Yi, Lei Jing
Department of Stomatology, Taikang Tongji (Wuhan) Hospital, Wuhan, Hubei Province, P.R. China.
Department of Pediatric Stomatology, Wuhan Topchoice Stomatology Hospital, Wuhan, Hubei Province, P.R. China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44252. doi: 10.1097/MD.0000000000044252.
Previous studies have suggested potential associations between some dietary factors and oral mucosal lesions (OMLs), however, existing research could be biased due to limited sample size and unaccounted confounding factors. This study aimed to explore the causal relationships between 13 common dietary factors and 3 OMLs using 2-sample Mendelian randomization (MR) analysis. Data for the MR analysis were extracted from publicly available genome-wide association study statistics. Thirteen dietary intakes were selected as exposure factors, recurrent aphthous stomatitis (RAS), oral lichen planus (OLP), and oral leukoplakia (OLK) were examined as outcomes. Summary data associated with the exposures and outcomes were obtained from individuals of European ancestry. The primary analysis of exposures and outcomes was conducted using the inverse variance weighted (IVW) method. Furthermore, the MR-Egger, weighted median, simple mode, and weighted mode were used to validate the final results. To assess the assumptions, sensitivity tests including the MR-Egger intercept test, leave-one-out analysis, funnel plot, scatter plot, and MR-PRESSO were carried out. The false discovery rate (FDR) correction was employed to adjust P-values (P-FDR) for multiple hypothesis testing. After FDR correction, the analysis revealed a significant causal relationship between dried fruit intake and RAS risk (OR = 0.281, 95% CI = 0.133-0.590, P-FDR = .004), and between nonoily fish intake (OR = 0.072, 95% CI = 0.011-0.453, P-FDR = .026) and OLP risk. No horizontal pleiotropy or heterogeneity was detected. This study suggests that dried fruit intake and nonoily intake may lower the risk of RAS and OLP, respectively. These findings provide more favorable evidence for dietary recommendations for OMLs.
先前的研究表明，某些饮食因素与口腔黏膜病变（OML）之间可能存在关联，然而，由于样本量有限和未考虑的混杂因素，现有研究可能存在偏差。本研究旨在使用两样本孟德尔随机化（MR）分析，探讨13种常见饮食因素与3种口腔黏膜病变之间的因果关系。MR分析的数据来自公开可用的全基因组关联研究统计数据。选择13种饮食摄入量作为暴露因素，以复发性阿弗他口炎（RAS）、口腔扁平苔藓（OLP）和口腔白斑（OLK）作为结局进行研究。与暴露因素和结局相关的汇总数据来自欧洲血统的个体。暴露因素和结局的主要分析采用逆方差加权（IVW）方法。此外，使用MR-Egger、加权中位数、简单模式和加权模式来验证最终结果。为评估假设，进行了包括MR-Egger截距检验、留一法分析、漏斗图、散点图和MR-PRESSO在内的敏感性检验。采用错误发现率（FDR）校正来调整多重假设检验的P值（P-FDR）。经过FDR校正后，分析显示，摄入果干与RAS风险之间存在显著因果关系（OR = 0.281，95%CI = 0.133 - 0.590，P-FDR = 0.004），摄入非油性鱼类与OLP风险之间存在显著因果关系（OR = 0.072，95%CI = 0.011 - 0.453，P-FDR = 0.026）。未检测到水平多效性或异质性。本研究表明，摄入果干和非油性鱼类可能分别降低RAS和OLP的风险。这些发现为口腔黏膜病变的饮食建议提供了更有利的证据。
