Liu Zan, Huang Junyu
Department of Health Management Center, Hui Ya Hospital of The First Affiliated Hospital, Sun Yat-sen University, Huizhou, China.
Department of Gastroenterology, Hui Ya Hospital of The First Affiliated Hospital, Sun Yat-sen University, Huizhou, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44402. doi: 10.1097/MD.0000000000044402.
Prior observational studies suggested an association between chronic rhinosinusitis (CRS) and inflammatory bowel disease (IBD), but causality remains unclear. This study employed a bidirectional 2-sample Mendelian randomization (MR) analysis to investigate potential causal relationships. Genetic variants associated with CRS and IBD (including Crohn's disease and ulcerative colitis) were sourced from the IEU Open genome-wide association study project. Primary analysis used inverse-variance weighted, supplemented by weighted median and MR-Egger methods. Sensitivity analyses included Cochran's Q test, MR-Egger intercept, Mendelian Randomization Pleiotropy RESidual Sum and Outlier, and leave-one-out analysis. Inverse-variance weighted revealed CRS increased IBD risk (OR = 1.108, 95% confidence interval = 1.009-1.217, P = .032), while reverse MR indicated IBD increased CRS risk (OR = 1.035, 95% confidence interval = 1.001-1.071, P = .043). No significant causality was found between CRS and IBD subtypes, Crohn's disease and ulcerative colitis. Sensitivity analyses supported robustness, with no evidence of pleiotropy (P > .05). This MR study suggests a bidirectional causal relationship between CRS and IBD, though not with subtypes. Further research is needed to elucidate underlying mechanisms.
先前的观察性研究表明慢性鼻-鼻窦炎(CRS)与炎症性肠病(IBD)之间存在关联,但因果关系仍不明确。本研究采用双向双样本孟德尔随机化(MR)分析来探究潜在的因果关系。与CRS和IBD(包括克罗恩病和溃疡性结肠炎)相关的基因变异来源于IEU开放全基因组关联研究项目。主要分析采用逆方差加权法,并辅以加权中位数法和MR-Egger法。敏感性分析包括Cochran's Q检验、MR-Egger截距、孟德尔随机化多效性残差和离群值分析以及留一法分析。逆方差加权法显示CRS增加IBD风险(比值比[OR]=1.108,95%置信区间=1.009-1.217,P=0.032),而反向MR表明IBD增加CRS风险(OR=1.035,95%置信区间=1.001-1.071,P=0.043)。未发现CRS与IBD亚型、克罗恩病和溃疡性结肠炎之间存在显著因果关系。敏感性分析支持结果的稳健性,无多效性证据(P>0.05)。这项MR研究表明CRS与IBD之间存在双向因果关系,但与亚型无关。需要进一步研究以阐明潜在机制。