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      Dietary intake and incidence risk of idiopathic pulmonary fibrosis: a Mendelian randomization study

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          Abstract

          Background

          Dietary intake has been shown to have a causal relationship with various lung diseases, such as lung cancer and asthma. However, the causal relationship between dietary intake and idiopathic pulmonary fibrosis (IPF) remains unclear. We conducted a two-sample Mendelian Randomization (MR) study to investigate the causal relationship between dietary intake and IPF.

          Methods

          The exposure datasets included meat, fruit, vegetable, and beverage intake from the UK Biobank. IPF data came from the EBI database of 451,025 individuals. All data in this study were obtained from the IEU Open GWAS Project. The inverse variance weighted (IVW), MR-Egger, and weighted median methods were used as the primary methods. Sensitivity analyses were performed to ensure the validity of the results.

          Results

          Oily fish intake [odds ratio (OR):0.995; 95% confidence interval (CI): 0.993–0.998; p = 6.458E-05] and Dried fruit intake (OR:0.995;95%CI:0.991–0.998; p = 0.001) were discovered as protective factors. There was also a suggestive correlation between Beef intake (OR:1.006;95%Cl:1.001–1.012; p = 0.023) and IPF. Sensitivity analysis did not reveal any contradictory results. No causal relationship was found between IPF and the rest of the dietary exposures.

          Conclusions

          Our study found that Oily fish and Dried fruit intake were associated with the risk of IPF, while Beef intake was suggestively associated with the risk of IPF. Other studies are still needed to confirm the results in the future.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12890-023-02673-4.

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          Most cited references46

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          Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression

          Background: The number of Mendelian randomization analyses including large numbers of genetic variants is rapidly increasing. This is due to the proliferation of genome-wide association studies, and the desire to obtain more precise estimates of causal effects. However, some genetic variants may not be valid instrumental variables, in particular due to them having more than one proximal phenotypic correlate (pleiotropy). Methods: We view Mendelian randomization with multiple instruments as a meta-analysis, and show that bias caused by pleiotropy can be regarded as analogous to small study bias. Causal estimates using each instrument can be displayed visually by a funnel plot to assess potential asymmetry. Egger regression, a tool to detect small study bias in meta-analysis, can be adapted to test for bias from pleiotropy, and the slope coefficient from Egger regression provides an estimate of the causal effect. Under the assumption that the association of each genetic variant with the exposure is independent of the pleiotropic effect of the variant (not via the exposure), Egger’s test gives a valid test of the null causal hypothesis and a consistent causal effect estimate even when all the genetic variants are invalid instrumental variables. Results: We illustrate the use of this approach by re-analysing two published Mendelian randomization studies of the causal effect of height on lung function, and the causal effect of blood pressure on coronary artery disease risk. The conservative nature of this approach is illustrated with these examples. Conclusions: An adaption of Egger regression (which we call MR-Egger) can detect some violations of the standard instrumental variable assumptions, and provide an effect estimate which is not subject to these violations. The approach provides a sensitivity analysis for the robustness of the findings from a Mendelian randomization investigation.
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            Consistent Estimation in Mendelian Randomization with Some Invalid Instruments Using a Weighted Median Estimator

            ABSTRACT Developments in genome‐wide association studies and the increasing availability of summary genetic association data have made application of Mendelian randomization relatively straightforward. However, obtaining reliable results from a Mendelian randomization investigation remains problematic, as the conventional inverse‐variance weighted method only gives consistent estimates if all of the genetic variants in the analysis are valid instrumental variables. We present a novel weighted median estimator for combining data on multiple genetic variants into a single causal estimate. This estimator is consistent even when up to 50% of the information comes from invalid instrumental variables. In a simulation analysis, it is shown to have better finite‐sample Type 1 error rates than the inverse‐variance weighted method, and is complementary to the recently proposed MR‐Egger (Mendelian randomization‐Egger) regression method. In analyses of the causal effects of low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol on coronary artery disease risk, the inverse‐variance weighted method suggests a causal effect of both lipid fractions, whereas the weighted median and MR‐Egger regression methods suggest a null effect of high‐density lipoprotein cholesterol that corresponds with the experimental evidence. Both median‐based and MR‐Egger regression methods should be considered as sensitivity analyses for Mendelian randomization investigations with multiple genetic variants.
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              Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases

              Horizontal pleiotropy occurs when the variant has an effect on disease outside of its effect on the exposure in Mendelian randomization (MR). Violation of the ‘no horizontal pleiotropy’ assumption can cause severe bias in MR. We developed the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test to identify horizontal pleiotropic outliers in multi-instrument summary-level MR testing. We showed using simulations that MR-PRESSO is best suited when horizontal pleiotropy occurs in <50% of instruments. Next, we applied MR-PRESSO, along with several other MR tests to complex traits and diseases, and found that horizontal pleiotropy: (i) was detectable in over 48% of significant causal relationships in MR; (ii) introduced distortions in the causal estimates in MR that ranged on average from −131% to 201%; (iii) induced false positive causal relationships in up to 10% of relationships; and (iv) can be corrected in some but not all instances.
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                Author and article information

                Contributors
                hz.zhanghong@aliyun.com
                Journal
                BMC Pulm Med
                BMC Pulm Med
                BMC Pulmonary Medicine
                BioMed Central (London )
                1471-2466
                6 October 2023
                6 October 2023
                2023
                : 23
                : 376
                Affiliations
                [1 ]The First School of Clinical Medicine, Zhejiang Chinese Medical University, ( https://ror.org/04epb4p87) Hangzhou, China
                [2 ]The First Affiliated Hospital of Zhejiang Chinese Medical University, ( https://ror.org/04epb4p87) Hangzhou, China
                Article
                2673
                10.1186/s12890-023-02673-4
                10559423
                37803281
                81c3e3a7-abde-4718-a07e-0f84d22caceb
                © BioMed Central Ltd., part of Springer Nature 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 2 September 2023
                : 22 September 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100012175, Zhejiang Traditional Chinese Medicine Administration;
                Award ID: No. 2021ZZ018
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Respiratory medicine
                idiopathic pulmonary fibrosis,dietary intake,mendelian randomization,incidence risk; genome-wide association study (gwas)

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