Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study

Background: The association between Gastroesophageal reflux disease (GERD) and oral symptoms has been reported in observational studies, but the causality of GERD to oral symptoms remained unknown. We aimed to assess the causal effect of GERD on five oral symptoms (mouth ulcers, toothache, loose tee...

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Main Authors: Shijing Jiang, Liang Zheng, Zhiwei Miao
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Genetics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fgene.2022.1061550/full
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author Shijing Jiang
Liang Zheng
Liang Zheng
Zhiwei Miao
author_facet Shijing Jiang
Liang Zheng
Liang Zheng
Zhiwei Miao
author_sort Shijing Jiang
collection DOAJ
description Background: The association between Gastroesophageal reflux disease (GERD) and oral symptoms has been reported in observational studies, but the causality of GERD to oral symptoms remained unknown. We aimed to assess the causal effect of GERD on five oral symptoms (mouth ulcers, toothache, loose teeth, bleeding gums, and periodontitis) using the two-sample Mendelian randomization (MR) method.Methods: Summary-level statistics for GERD and five oral symptoms were obtained from large-scale genome-wide association studies. Rigorous quality control of genetic instruments was conducted before MR analysis. Several analytical methods, including the inverse-variance weighted (IVW) method, MR-Egger regression, weighted median, maximum likelihood, and robust adjusted profile score (RAPS) were utilized, and the results of IVW were taken as the main results. The MR-Egger intercept test, Cochran’s Q test, and leave-one-out test were used as sensitivity analysis for quality control.Results: After Bonferroni, IVW detected a significant effect of GERD on mouth ulcers (OR = 1.008, 95% CI = 1.003–1.013, p = 0.003), loose teeth (OR = 1.009, 95% CI = 1.005–1.012, p = 9.20 × 10−7), and periodontitis (OR = 1.229, 95% CI = 1.081–1.398, p = 0.002). Consistent patterns of associations were observed across several MR models and sensitivity analysis found little evidence of bias. Nominal significant associations were observed in toothache and bleeding gums (p < 0.05), and heterogeneity was detected.Conclusion: Our MR analyses supported the positive causal effect of GERD on oral symptoms, especially for mouth ulcers, loose teeth, and periodontitis. Our findings might shed light on the mechanism of oral disease and might imply that oral care should be enhanced in patients with GERD.
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spelling doaj.art-d67bd1b398874cd18af59597044c86252023-01-04T07:06:14ZengFrontiers Media S.A.Frontiers in Genetics1664-80212023-01-011310.3389/fgene.2022.10615501061550Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization studyShijing Jiang0Liang Zheng1Liang Zheng2Zhiwei Miao3Department of Gastroenterology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Gastroenterology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaJiangsu Provincial TCM Technology Engineering Research Center of Health and Health Preservation, Nanjing, ChinaDepartment of Gastroenterology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, ChinaBackground: The association between Gastroesophageal reflux disease (GERD) and oral symptoms has been reported in observational studies, but the causality of GERD to oral symptoms remained unknown. We aimed to assess the causal effect of GERD on five oral symptoms (mouth ulcers, toothache, loose teeth, bleeding gums, and periodontitis) using the two-sample Mendelian randomization (MR) method.Methods: Summary-level statistics for GERD and five oral symptoms were obtained from large-scale genome-wide association studies. Rigorous quality control of genetic instruments was conducted before MR analysis. Several analytical methods, including the inverse-variance weighted (IVW) method, MR-Egger regression, weighted median, maximum likelihood, and robust adjusted profile score (RAPS) were utilized, and the results of IVW were taken as the main results. The MR-Egger intercept test, Cochran’s Q test, and leave-one-out test were used as sensitivity analysis for quality control.Results: After Bonferroni, IVW detected a significant effect of GERD on mouth ulcers (OR = 1.008, 95% CI = 1.003–1.013, p = 0.003), loose teeth (OR = 1.009, 95% CI = 1.005–1.012, p = 9.20 × 10−7), and periodontitis (OR = 1.229, 95% CI = 1.081–1.398, p = 0.002). Consistent patterns of associations were observed across several MR models and sensitivity analysis found little evidence of bias. Nominal significant associations were observed in toothache and bleeding gums (p < 0.05), and heterogeneity was detected.Conclusion: Our MR analyses supported the positive causal effect of GERD on oral symptoms, especially for mouth ulcers, loose teeth, and periodontitis. Our findings might shed light on the mechanism of oral disease and might imply that oral care should be enhanced in patients with GERD.https://www.frontiersin.org/articles/10.3389/fgene.2022.1061550/fullgastroesophageal reflux diseasemouth ulcerstoothacheloose teethbleeding gumsperiodontitis
spellingShingle Shijing Jiang
Liang Zheng
Liang Zheng
Zhiwei Miao
Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
Frontiers in Genetics
gastroesophageal reflux disease
mouth ulcers
toothache
loose teeth
bleeding gums
periodontitis
title Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
title_full Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
title_fullStr Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
title_full_unstemmed Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
title_short Gastroesophageal reflux disease and oral symptoms: A two-sample Mendelian randomization study
title_sort gastroesophageal reflux disease and oral symptoms a two sample mendelian randomization study
topic gastroesophageal reflux disease
mouth ulcers
toothache
loose teeth
bleeding gums
periodontitis
url https://www.frontiersin.org/articles/10.3389/fgene.2022.1061550/full
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