Chen Xunsheng, Chen Jingyi, Yin Qingling, Hou Meijun, Xie Xueqing, Lu Wei, Tian Jingjing, Zhang Ke, Ding Jie
School of Clinical Medicine, Guizhou Medical University, Guiyang, Guizhou Province, China.
Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital, Guiyang, Guizhou Province, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44251. doi: 10.1097/MD.0000000000044251.
Gastroesophageal reflux disease (GERD) is linked to various esophageal and extra-esophageal complications. While GERD is theoretically a potential risk factor for abdominal hernias, current evidence is limited. Observational studies have suggested associations between GERD and both congenital diaphragmatic hernia and hiatal hernia. This study employed a bidirectional Mendelian randomization analysis to assess the causal relationship between GERD and 7 types of abdominal hernias. The inverse variance weighting method served as the primary statistical approach, supplemented by sensitivity analyses. Inverse variance weighting results demonstrated significant causal relationships between GERD and increased risks of 5 types of hernias: abdominal wall hernia (odds ratio [OR]: 1.277, 95% confidence interval [CI]: 1.144-1.425, P < .001), umbilical hernia (OR: 1.270, 95% CI: 1.086-1.485, P < .01), incisional hernia (OR: 1.484, 95% CI: 1.261-1.748, P < .001), diaphragmatic hernia (OR: 1.333, 95% CI: 1.171-1.518, P < .001), and hiatal hernia (OR: 1.015, 95% CI: 1.012-1.018, P < .001). No causal links were found with inguinal or femoral hernia. Reverse Mendelian randomization analysis revealed that both diaphragmatic hernia (OR: 1.119, 95% CI: 1.077-1.162, P < .001) and hiatal hernia (OR: 609.061, 95% CI: 83.659-4434.156, P < .001) were causally associated with an increased risk of GERD. Other hernia types showed no significant reverse association. These findings support a bidirectional causal relationship between GERD and specific hernias and may inform improved strategies for diagnosis, treatment, and prevention.
胃食管反流病（GERD）与多种食管及食管外并发症相关。虽然从理论上讲，GERD是腹疝的一个潜在危险因素，但目前的证据有限。观察性研究表明GERD与先天性膈疝和食管裂孔疝均有关联。本研究采用双向孟德尔随机化分析来评估GERD与7种腹疝之间的因果关系。逆方差加权法作为主要的统计方法，并辅以敏感性分析。逆方差加权结果表明，GERD与5种疝风险增加之间存在显著因果关系：腹壁疝（优势比[OR]：1.277，95%置信区间[CI]：1.144 - 1.425，P <.001）、脐疝（OR：1.270，95% CI：1.086 - 1.485，P <.01）、切口疝（OR：1.484，95% CI：1.261 - 1.748，P <.001）、膈疝（OR：1.333，95% CI：1.171 - 1.518，P <.001）和食管裂孔疝（OR：1.015，95% CI：1.012 - 1.018，P <.001）。未发现与腹股沟疝或股疝存在因果联系。反向孟德尔随机化分析显示，膈疝（OR：1.119，95% CI：1.077 - 1.162，P <.001）和食管裂孔疝（OR：609.061，95% CI：83.659 - 4434.156，P <.001）均与GERD风险增加存在因果关联。其他疝类型未显示出显著的反向关联。这些发现支持了GERD与特定疝之间的双向因果关系，并可能为改进诊断、治疗和预防策略提供依据。
