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Causal analysis between gastroesophageal reflux disease and chronic rhinosinusitis

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 15 February 2024

Abstract

Background

Gastroesophageal reflux disease (GERD) and chronic rhinosinusitis (CRS) have been shown to be potentially closely related, but the relationship between these conditions, particularly the possibility of a causal link, is not fully understood. This study used Mendelian randomization (MR) to assess the causal relationship between these two disorders.

Methods

We extracted genome-wide association study data sets for GERD and CRS from publicly available gene summaries, and used MR to conduct a causal inference analysis. The main robustness test used in this study included MR-Egger regression, a leave-one-out sensitivity test, and multivariate MR (MVMR).

Results

GERD increased the risk of developing CRS by 36%, based on the inverse-variance weighted method, a statistically significant association (odds ratio [OR] 1.360, 95% confidence interval [CI] 1.179–1.568, P < 0.001). Other MR assessment methods, such as weighted median, simple mode, and weighted mode, similarly observed a significant increase in the risk of CRS occurrence (OR 1.434, 95% CI 1.186–1.734, P < 0.001; OR 1.927, 95% CI 1.166–3.184, P = 0.013; and OR 1.910, 95% CI 1.222–2.983, P = 0.006, respectively). No significant bias was found in the heterogeneity or pleiotropy tests (P = 0.071 and P = 0.700, respectively). Even after excluding possible mediators using MVMR, GERD appeared to significantly increase the risk of developing CRS (OR 1.013, 95% CI 1.008–1.023, P = 0.002).

Conclusions

This study provides new, significant evidence that GERD is genetically associated with a higher incidence rate of CRS. However, further research is needed to elucidate the potential underlying biological mechanisms of this relationship.

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Data availability

The data sets (GWAS for GERD and CRS) for this study can be found in the UK Biobank (https://www.ukbiobank.ac.uk/) and the FinnGen research project (https://www.finngen.fi/en).

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Acknowledgements

We express our gratitude to the participants and research teams who made the GWAS results publicly accessible. Thank you for the language assistance provided by Editage.

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Author notes

  1. Gui Chen and Wucheng Guo have contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China

    Gui Chen, Wucheng Guo, Yingqi Wang & Xiaowen Zhang

  2. Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China

    Shenrong Liu

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  1. Gui Chen
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Correspondence to Xiaowen Zhang.

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No ethical clearance was required for this study, as no patients were involved in the formulation of the research question or outcome measures. Only secondary analysis was performed using published GWAS summary statistics available in the public domain. All authors have viewed and agreed to the submission.

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Fig. S1

Funnel plot of SNPs associated with gastroesophageal reflux disease and the risk of chronic rhinosinusitis. MR; Mendelian randomization. (TIF 2711 KB)

Fig: S2

Leave-one-out of SNPs associated with gastroesophageal reflux disease and the risk of chronic rhinosinusitis. MR; Mendelian randomization. (TIF 4259 KB)

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Chen, G., Guo, W., Liu, S. et al. Causal analysis between gastroesophageal reflux disease and chronic rhinosinusitis. Eur Arch Otorhinolaryngol 281, 1819–1825 (2024). https://doi.org/10.1007/s00405-023-08350-w

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