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ORIGINAL RESEARCH article

Front. Med.
Sec. Obstetrics and Gynecology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1440157
This article is part of the Research Topic Endometriosis: Updates on the Etiology, Pathophysiology, Measurements and Therapeutics View all 7 articles

The Causal Role of Gastroesophageal Reflux Disease in Endometriosis: A Bidirectional Mendelian Randomization Study

Provisionally accepted
Zunlin Shi Zunlin Shi 1Zhi Li Zhi Li 1Kana Wang Kana Wang 2,3FAN YANG FAN YANG 2,3*
  • 1 College of Electronics and Information Engineering, Sichuan University, Chengdu, Sichuan Province, China
  • 2 Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China
  • 3 Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Observational studies have reported an association between gastroesophageal reflux disease (GERD) and endometriosis. We conducted a two-sample and bidirectional Mendelian randomization analysis to determine whether those associations are causal. Two-sample and bidirectional MR analyses were performed using summary statistics from the European Individual Genome-Wide Association Study (GWAS). The inverse variance weighting (IVW) method is used as the main analysis method to evaluate causality. Sensitivity analyses were performed to assess heterogeneity, horizontal versatility, and stability. The results showed no significant causal association between GERD in women with endometriosis in the UK Bank database (ratio (OR) ≈ 0, 95% adjusted interval (CI) 1.0007 ~1.0044, P = 0.006) and Finn databases (ratio (OR) = 1.29, 95% adjusted interval (CI) 0.99 ~1.67, P = 0.06).However, when studying the Finn database only for endometriosis, which is confined to the uterus, a significant increase in GERD was limited to the risk of endometriosis in the uterus (ratio (OR) = 1.47, 95% adjusted interval (CI) 1.00 ~2.17, P = 0.05). Sensitivity analysis showed that the results were robust and did not detect multiefficacy or heterogeneity. Meanwhile, reverse MR analysis showed that endometriosis did not increase the risk of GERD. This MR study supports a causal relationship between GERD and an increased risk of endometriosis confined to the uterus. Therefore, patients with gastric esophageal reflux should be treated with gynecological examination to avoid and prevent the development of endometriosis.

    Keywords: bidirectional Mendelian Randomization (MR) analysis1, Gastroesophageal reflux disease2, risk of developing endometriosis3, endometriosis confined to the uterus4, endometriosis5

    Received: 29 May 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Shi, Li, Wang and YANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: FAN YANG, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

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