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Comment
. 2024 Apr 29:12:1368483.
doi: 10.3389/fpubh.2024.1368483. eCollection 2024.

Causal relationship between air pollution, lung function, gastroesophageal reflux disease, and non-alcoholic fatty liver disease: univariate and multivariate Mendelian randomization study

Runmin Cao  1 , Honghe Jiang  2 , Yurun Zhang  3 , Ying Guo  4 , Weibin Zhang  1
Affiliations
Comment

Causal relationship between air pollution, lung function, gastroesophageal reflux disease, and non-alcoholic fatty liver disease: univariate and multivariate Mendelian randomization study

Runmin Cao et al. Front Public Health. .

Abstract

Background: The association between air pollution, lung function, gastroesophageal reflux disease, and Non-alcoholic fatty liver disease (NAFLD) remains inconclusive. Previous studies were not convincing due to confounding factors and reverse causality. We aim to investigate the causal relationship between air pollution, lung function, gastroesophageal reflux disease, and NAFLD using Mendelian randomization analysis.

Methods: In this study, univariate Mendelian randomization analysis was conducted first. Subsequently, Steiger testing was performed to exclude the possibility of reverse association. Finally, significant risk factors identified from the univariate Mendelian analysis, as well as important factors affecting NAFLD from previous observational studies (type 2 diabetes and body mass index), were included in the multivariable Mendelian randomization analysis.

Results: The results of the univariable Mendelian randomization analysis showed a positive correlation between particulate matter 2.5, gastroesophageal reflux disease, and NAFLD. There was a negative correlation between forced expiratory volume in 1 s, forced vital capacity, and NAFLD. The multivariable Mendelian randomization analysis indicated a direct causal relationship between gastroesophageal reflux disease (OR = 1.537, p = 0.011), type 2 diabetes (OR = 1.261, p < 0.001), and NAFLD.

Conclusion: This Mendelian randomization study confirmed the causal relationships between air pollution, lung function, gastroesophageal reflux, and NAFLD. Furthermore, gastroesophageal reflux and type 2 diabetes were identified as independent risk factors for NAFLD, having a direct causal connection with the occurrence of NAFLD.

Keywords: Mendelian randomization; air pollution; gastroesophageal reflux disease; lung function; non-alcoholic fatty liver disease.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The specific flow chart of the study.
Figure 2
Figure 2
Scatterplot of significantly associated (IVW derived p < 0.05) and directionally consistent estimates.
Figure 3
Figure 3
Multivariate Mendelian randomization results of air pollution, lung function, gastroesophageal reflus disease, diabetes, BMI and Non-alcoholic liver disease.
See this image and copyright information in PMC

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