Causal relationship between hypothyroidism and treatment with levothyroxine sodium and Helicobacter pylori infection:a Mendelian randomization study
Objective To explore the causal relationship between hypothyroidism and levothyroxine sodium treatment with helicobacter pylori(Hp)infection.Methods A two-sample Mendelian randomization(MR)approach was employed.Data on hypothyroidism and levothyroxine sodium treatment associated with Hp infection were extracted from MRC Integrative Epidemiology Unit(IEU)GWAS database.Single nucleotide polymorphisms related to confounding factors and outcomes were removed using PhenoScanner database.Five statistical methods,namely inverse variance weighting(IVV),MR-Egger,Weighted median,Simple mode and Weighted mode,are used for causal inference,and MR Egger Q and IVW Q were used for heterogeneity test.The MR Egger intercept test was conducted to analyze the level of horizontal pleiotropy,and the leave-one-out method was utilized to evaluate the robustness of the results.Results The IVW results showed a positive causal rela-tionship between hypothyroidism(OR=1.026,95%CI:1.009 to 1.043,P=0.003)and levothyroxine sodium treatment(OR=1.742,95%CI:1.123 to 2.702,P=0.013)with the risk of Hp infection.The IVW Q and MR-Egger Q test showed no hetero-geneity(P>0.05),and the MR-Egger intercept analysis did not detect potential horizontal pleiotropy(P>0.05),the leave-one-out method confirmed the robustness of the analytical findings.Conclusion Genetically predicted hypothyroidism and le-vothyroxine sodium treatment are causally associated with Hp infection,underscoring the need to enhance screening and pre-vention efforts for Hp infection among patients with hypothyroidism and those undergoing levothyroxine sodium treatment.
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