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Chen G, Xie J, Liang T, Wang Y, Liao W, Song L, Zhang X. Exploring the causality between educational attainment and gastroesophageal reflux disease: A Mendelian randomization study. Dig Liver Dis 2023; 55:1208-1213. [PMID: 37029064 DOI: 10.1016/j.dld.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Observational studies suggest that higher educational attainment (EA) contributes to the prevention and treatment of gastroesophageal reflux disease (GERD). However, the causality of this relationship is not supported by strong evidence. We used publicly available genetic summary data, including that on EA, GERD, and the common risk of GERD, to prove this causality. METHODS Multiple methods in Mendelian randomization (MR) were employed to evaluate the causality. The leave-one-out sensitivity test, MR-Egger regression, and multivariable MR (MVMR) analysis were applied to evaluate the MR results. RESULTS Higher EA was significantly associated with lower GERD risk (inverse variance weighted method, odds ratio [OR]: 0.979, 95% confidence interval [CI]: 0.975-0.984, P <0.001). Similar results were obtained when the weighted median and weighted mode were used for causal estimation. After adjusting for potential mediators, the MVMR analysis showed that body mass index (BMI) and EA were still significantly correlated and negatively correlated with GERD (OR: 0.997, 95% CI: 0.996-0.998, P =0.008 and OR: 0.981, 95% CI: 0.977-0.984, P <0.001), respectively. CONCLUSIONS Higher levels of EA may have a protective effect against GERD by having a negative causal relationship. Additionally, BMI may be a crucial factor in the EA-GERD pathway.
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Affiliation(s)
- Gui Chen
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Junyang Xie
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Tianhao Liang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Yiyan Wang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Wenjing Liao
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Lijuan Song
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China
| | - Xiaowen Zhang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong 510120, PR China.
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Zhang Y, Liu W, Zhang W, Cheng R, Tan A, Shen S, Xiong Y, Zhao L, Lei X. Association between blood lead levels and hyperlipidemiais: Results from the NHANES (1999-2018). Front Public Health 2022; 10:981749. [PMID: 36159291 PMCID: PMC9500574 DOI: 10.3389/fpubh.2022.981749] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
Background Research on the association between blood lead (Pb) and lipid biomarkers have yielded inconsistent results, and epidemiological studies on blood Pb levels and hyperlipidemia are scarce. The present study aimed to examine the association between blood Pb levels and hyperlipidemia in adults from the National Health and Nutrition Examination Survey (NHANES). Methods A total of 43,196 participants in the NHANES from 1999 to 2018 were included in the final analysis. Hyperlipidemia was determined based on the National Cholesterol Education Program guidelines. Blood Pb levels were assessed using inductively-coupled plasma mass spectrometry. Weighted multivariable logistic regression analysis and subgroup analysis were conducted to determine the correlation between blood Pb levels and hyperlipidemia. Results In the multivariable logistic regression model, high blood Pb levels were significantly associated with hyperlipidemia after adjusting for confounders (OR 1.41; 95%CI: 1.18-1.67). Furthermore, elevated blood Pb levels were associated with an increased risk of hyperlipidemia across the four quartile (Q) groups (Q1: OR 1.00; Q2: OR 1.16 [95%CI: 1.04-1.29]; Q3: OR 1.39 [95%CI: 1.21-1.59]; and Q4: OR 1.33 [95%CI: 1.15-1.54]; P for trend <0.05). Significant moderating effects were found in the subgroup analysis stratified by age, education, hypertension, and diabetes (P < 0.05). In sensitivity analysis, the ORs for hyperlipidemia across the quartiles of blood Pb levels were 1.00, 1.17 (95%CI: 1.05-1.30), 1.42 (95%CI: 1.24-1.62), and 1.38 (95%CI: 1.19-1.60) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after removing adults with arteriosclerotic cardiovascular disease, and the ORs were 1.00, 1.13 (95%CI: 1.01-1.25), 1.38 (95%CI: 1.21-1.56), and 1.32 (95%CI: 1.16-1.52) for Q1, Q2, Q3, and Q4, respectively (P for trend <0.001) after including pregnant women. Conclusion The current study showed a positive association between blood lead levels and hyperlipidemia.
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Affiliation(s)
- Yangchang Zhang
- School of Public Health, Chongqing Medical University, Chongqing, China,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China,Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Weiwei Liu
- School of Public Health, Chongqing Medical University, Chongqing, China,Chongqing College of Traditional Chinese Medicine, Chongqing, China,Research Center for Medicine and Social Development, Chongqing, China
| | - Wei Zhang
- Chongqing College of Traditional Chinese Medicine, Chongqing, China
| | - Rui Cheng
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Andi Tan
- International Business School, Yunnan University of Finance and Economics, Kunming, China
| | - Shisi Shen
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Yang Xiong
- West China Hospital, Sichuan University, Chengdu, China
| | - Limei Zhao
- Chongqing Jiangjin Central Hospital, Chongqing, China
| | - Xun Lei
- School of Public Health, Chongqing Medical University, Chongqing, China,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China,Research Center for Public Health Security, Chongqing Medical University, Chongqing, China,*Correspondence: Xun Lei
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Huang G, Cai J, Li W, Zhong Y, Liao W, Wu P. Causal relationship between educational attainment and the risk of rheumatoid arthritis: a Mendelian randomization study. BMC Rheumatol 2021; 5:47. [PMID: 34670623 PMCID: PMC8529827 DOI: 10.1186/s41927-021-00216-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Educational attainment is moderately heritable and inversely associated with the risk of rheumatoid arthritis. However, the causality from educational attainment on rheumatoid arthritis remained unknown. Here, we aimed to determine whether educational attainment is causally associated with rheumatoid arthritis (RA) by using Mendelian randomization (MR) approach. Methods Summary statistics data for RA were obtained from an available, published meta-analysis of genome-wide association studies (GWAS) that included 14,361 RA cases and 43,923 controls of European ancestry. The instrumental variables for educational attainment were obtained from a GWAS meta-analysis that included over 1 million individuals (N = 1,131,881) of European ancestry. MR analyses were mainly performed using the inverse-variance weighted (IVW) method. Sensitivity analyses were further performed to test the robustness of the association using the weighted median method, MR-Egger, Cochran Q test, “leave-one-out” analysis and MR-PRESSO test. Results A total of 387 SNPs were employed as instrumental variables in our MR analysis. Genetically predicted higher educational attainment was associated with a significantly lower risk of RA using the IVW method (odds ratio [OR] = 0.42, 95% confidence interval [CI]: 0.34–0.52; p = 1.78 × 10− 14). The weighted median method and MR Egger regression analysis yielded consistent results. The effect estimate remained robust after the outlier variants and SNPs (associated with the confounding factors) were excluded. “Leave-one-out” analysis confirmed the stability of our results. Additionally, the results suggested the absence of the horizontal pleiotropy. Conclusions The MR analysis supported a potential inverse causative relationship between educational attainment and the risk of RA. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-021-00216-0.
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Affiliation(s)
- Guiwu Huang
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Jiahao Cai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenchang Li
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yanlin Zhong
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Weiming Liao
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Peihui Wu
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.
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