Causal relationship between inflammatory pelvic disease and endometriosis:A two-sample bidirectional Mendelian randomization study
Objective To analyze the potential causal relationship between pelvic inflammatory disease(P1D)and endometriosis(EMs)using two-sample bidirectional Mendelian randomization(MR).Methods Single nucleotide polymor-phisms(SNPs)associated with PIDs and EMs were screened from publicly available genome-wide association databases as instrumental variables,and the two-way analyses were all based on inverse variance weighting(IVW)analysis,supplemented by MR-Egger regression,weighted median method(WME),simple model,and weighted model,and Cochrane's Q test,MR-Egger intercept method,MR-PRESSO,and leave-one-out method for sensitivity analysis to ensure the robustness of the results.Results A total of 20 SNPs associated with PID and 5 SNPs associated with EMs were screened.The results of forward Mendelian randomization IVW:OR=1.073,95％CI:1.005-1.146,P=0.033,and there was no heterogeneity and horizontal pleiotropy(all P＞0.05),and the results were robust.The results of reverse MR analysis IVW:OR=1.666,95％CI:1.215-2.283,P=1.493 × 10-3,and the P-values of the heterogeneity test were all＞0.05.The P-values of the analysis results were＞0.05 after the MR-Egger and MR-PRESSO tests and the exclusion of outliers,which can prove the absence of heterogeneity and hori-zontal pleiotropy.Conclusion Genetic analysis in this study showed that PID and EMs are causally related to each other and may have similar pathogenesis.
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