Causal relationship of cheese and tea intake with gastroesophageal reflux disease: a two<b>-</b>sample Mendelian randomization study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xinming ,  ZHAO Pingwu , HE Yunsheng , HUANG Kun , HUANG Chaolin , LIU Yang , LIAO Fengwan

Department of General Surgery, Affiliated Mianyang Hospital of Chengdu University of Traditional Chinese Medicine, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

ZHAO Pingwu, Email: zhaopingwu01@hotmail.com

Keywords：

cheese; tea; Mendelian randomization; gastroesophageal reflux disease; causal inference

DOI：

10.7507/1007-9424.202404018

Video：

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Objective To analyze the causal relationship between the intake of cheese or tea and the risk of gastroesophageal reflux disease (GERD). Methods Using a two-sample Mendelian randomization approach, single nucleotide polymorphisms (SNPs) associated with milk or tea intake were used as instrumental variables. The causal effect of milk or tea intake on the risk of GERD was investigated using the MR Egger method, the weighted median method, the inverse-variance weighted (IVW) random-effects model, and the IVW fixed-effects model. Multivariable analysis was conducted using the MR Egger method, and leave-one-out sensitivity analysis was performed to validate the reliability of the data. Results Cheese intake could reduce the occurrence of GERD [IVW random-effects model β=–1.010, 95%CI (0.265, 0.502), P<0.05], while tea intake could lead to the occurrence of GERD [IVW random-effects model β=0.288, 95%CI (1.062, 1.673), P<0.05]. Conclusion Cheese intake may have a positive causal relationship with reducing the risk of GERD occurrence, while tea intake may have a positive causal relationship with increasing the risk of GERD occurrence.

Citation： CHEN Xinming, ZHAO Pingwu, HE Yunsheng, HUANG Kun, HUANG Chaolin, LIU Yang, LIAO Fengwan. Causal relationship of cheese and tea intake with gastroesophageal reflux disease: a two-sample Mendelian randomization study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(9): 1099-1104. doi: 10.7507/1007-9424.202404018 Copy

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2.	Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut, 2018, 67(3): 430-440.
3.	Maret-Ouda J, Markar SR, Lagergren J. Gastroesophageal reflux disease: a review. JAMA, 2020, 324(24): 2536-2547.
4.	Zhang M, Hou ZK, Huang ZB, et al. Dietary and lifestyle factors related to gastroesophageal reflux disease: a systematic review. Ther Clin Risk Manag, 2021, 17: 305-323.
5.	Timon CM, O’Connor A, Bhargava N, et al. Dairy consumption and metabolic health. Nutrients, 2020, 12(10): 3040. doi: 10.3390/nu12103040.
6.	Ndebia EJ, Sammon AM, Umapathy E, et al. Diet affects reflux in a rural African community. Acta Gastroenterol Belg, 2017, 80(3): 357-360.
7.	Chen Y, Sun X, Fan W, et al. Differences in dietary and lifestyle triggers between non-erosive reflux disease and reflux esophagitis—A multicenter cross-sectional survey in China. Nutrients, 2023, 15(15): 3400. doi: 10.3390/nu15153400.
8.	Nam SY, Park BJ, Cho YA, et al. Different effects of dietary factors on reflux esophagitis and non-erosive reflux disease in 11 690 Korean subjects. J Gastroenterol, 2017, 52(7): 818-829.
9.	Chowdhury SD, George G, Ramakrishna K, et al. Prevalence and factors associated with gastroesophageal reflux disease in southern India: A community-based study. Indian J Gastroenterol, 2019, 38(1): 77-82.
10.	Rai S, Kulkarni A, Ghoshal UC. Prevalence and risk factors for gastroesophageal reflux disease in the Indian population: A meta-analysis and meta-regression study. Indian J Gastroenterol, 2021, 40(2): 209-219.
11.	Chen Y, Chen C, Ouyang Z, et al. Prevalence and beverage-related risk factors of gastroesophageal reflux disease: An original study in Chinese college freshmen, a systemic review and meta-analysis. Neurogastroenterol Motil, 2022, 34(5): e14266. doi: 10.1111/nmo.14266.
12.	Gu C, Olszewski T, Vaezi m F, et al. Objective ambulatory pH monitoring and subjective symptom assessment of gastroesophageal reflux disease show type of carbohydrate and type of fat matter. Therap Adv Gastroenterol, 2022, 15: 17562848221101289. doi:10.1177/ 17562848221101289.
13.	Fox M, Gyawali CP. Dietary factors involved in GERD management. Best Pract Res Clin Gastroenterol, 2023, 62-63: 101826. doi: 10.1016/j.bpg.2023.101826.
14.	Surdea-Blaga T, Negrutiu DE, Palage M, et al. Food and gastroesophageal reflux disease. Curr Med Chem, 2019, 26(19): 3497-3511.
15.	尚文茹, 柯立鑫, 王子怡, 等. 牛奶、咖啡摄入与非酒精性脂肪性肝病的因果关联: 两样本孟德尔随机化研究. 中国循证医学杂志, 2023, 23(12): 1373-1377.
16.	张学成, 刘岩, 张晶晶, 等. 急性心力衰竭患者30天再住院率: 基于真实世界研究与随机对照试验比较的Meta分析. 中国循证医学杂志, 2021, 21(10): 1203-1210.
17.	Swanson SA, Tiemeier H, Ikram MA, et al. Nature as a trialist?: Deconstructing the analogy between mendelian randomization and randomized trials. Epidemiology, 2017, 28(5): 653-659.
18.	高雪, 薛付忠, 黄丽红, 等. 孟德尔随机化模型及其规范化应用的统计学共识. 中国卫生统计, 2021, 38(3): 471-475,480.
19.	曹瑞奇, 冯正源, 吴佼星, 等. 受教育程度与胰腺炎的因果关系: 一项孟德尔随机化研究. 西安交通大学学报(医学版), 2024, 45(2): 200-205.
20.	于天琦, 徐文涛, 苏雅娜, 等. 孟德尔随机化研究基本原理、方法和局限性. 中国循证医学杂志, 2021, 21(10): 1227-1234.
21.	Bowden J, Hemani G, Davey Smith G. Invited commentary: detecting individual and global horizontal pleiotropy in Mendelian randomization—A job for the humble heterogeneity statistic? Am J Epidemiol, 2018, 187(12): 2681-2685.
22.	夏露, 谢治年, 廖芯艺, 等. 阻塞性睡眠呼吸暂停与高血压: 一项双向孟德尔随机化研究. 解放军医学杂志, 2024, 49(6): 636-642.
23.	徐徐, 刘曼, 王丹. 老年胃食管反流病治疗现状和进展. 中国老年学杂志, 2023, 43(21): 5371-5375.
24.	Fernando I, Schmidt KA, Cromer G, et al. The impact of low-fat and full-fat dairy foods on symptoms of gastroesophageal reflux disease: an exploratory analysis based on a randomized controlled trial. Eur J Nutr, 2022, 61(5): 2815-2823.
25.	Manaer T, Yu L, Nabi XH, et al. The beneficial effects of the composite probiotics from camel milk on glucose and lipid metabolism, liver and renal function and gut microbiota in db/db mice. BMC Complement Med Ther, 2021, 21(1): 127. doi: 10.1186/s12906-021- 03303-4.
26.	Ye X, Yu F, Zhou J, et al. Analysis of the gut microbiota in children with gastroesophageal reflux disease using metagenomics and metabolomics. Front Cell Infect Microbiol, 2023, 13: 1267192. doi: 10.3389/fcimb.2023.1267192.
27.	Gudjonsson H, McAuliffe TL, Kaye MD. The effect of coffee and tea upon lower esophageal sphincteric function. Laeknabladid, 1995, 81(6): 484-488.

1. Fass R. Gastroesophageal reflux disease. N Engl J Med, 2022, 387(13): 1207-1216.
2. Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut, 2018, 67(3): 430-440.
3. Maret-Ouda J, Markar SR, Lagergren J. Gastroesophageal reflux disease: a review. JAMA, 2020, 324(24): 2536-2547.
4. Zhang M, Hou ZK, Huang ZB, et al. Dietary and lifestyle factors related to gastroesophageal reflux disease: a systematic review. Ther Clin Risk Manag, 2021, 17: 305-323.
5. Timon CM, O’Connor A, Bhargava N, et al. Dairy consumption and metabolic health. Nutrients, 2020, 12(10): 3040. doi: 10.3390/nu12103040.
6. Ndebia EJ, Sammon AM, Umapathy E, et al. Diet affects reflux in a rural African community. Acta Gastroenterol Belg, 2017, 80(3): 357-360.
7. Chen Y, Sun X, Fan W, et al. Differences in dietary and lifestyle triggers between non-erosive reflux disease and reflux esophagitis—A multicenter cross-sectional survey in China. Nutrients, 2023, 15(15): 3400. doi: 10.3390/nu15153400.
8. Nam SY, Park BJ, Cho YA, et al. Different effects of dietary factors on reflux esophagitis and non-erosive reflux disease in 11 690 Korean subjects. J Gastroenterol, 2017, 52(7): 818-829.
9. Chowdhury SD, George G, Ramakrishna K, et al. Prevalence and factors associated with gastroesophageal reflux disease in southern India: A community-based study. Indian J Gastroenterol, 2019, 38(1): 77-82.
10. Rai S, Kulkarni A, Ghoshal UC. Prevalence and risk factors for gastroesophageal reflux disease in the Indian population: A meta-analysis and meta-regression study. Indian J Gastroenterol, 2021, 40(2): 209-219.
11. Chen Y, Chen C, Ouyang Z, et al. Prevalence and beverage-related risk factors of gastroesophageal reflux disease: An original study in Chinese college freshmen, a systemic review and meta-analysis. Neurogastroenterol Motil, 2022, 34(5): e14266. doi: 10.1111/nmo.14266.
12. Gu C, Olszewski T, Vaezi m F, et al. Objective ambulatory pH monitoring and subjective symptom assessment of gastroesophageal reflux disease show type of carbohydrate and type of fat matter. Therap Adv Gastroenterol, 2022, 15: 17562848221101289. doi:10.1177/ 17562848221101289.
13. Fox M, Gyawali CP. Dietary factors involved in GERD management. Best Pract Res Clin Gastroenterol, 2023, 62-63: 101826. doi: 10.1016/j.bpg.2023.101826.
14. Surdea-Blaga T, Negrutiu DE, Palage M, et al. Food and gastroesophageal reflux disease. Curr Med Chem, 2019, 26(19): 3497-3511.
15. 尚文茹, 柯立鑫, 王子怡, 等. 牛奶、咖啡摄入与非酒精性脂肪性肝病的因果关联: 两样本孟德尔随机化研究. 中国循证医学杂志, 2023, 23(12): 1373-1377.
16. 张学成, 刘岩, 张晶晶, 等. 急性心力衰竭患者30天再住院率: 基于真实世界研究与随机对照试验比较的Meta分析. 中国循证医学杂志, 2021, 21(10): 1203-1210.
17. Swanson SA, Tiemeier H, Ikram MA, et al. Nature as a trialist?: Deconstructing the analogy between mendelian randomization and randomized trials. Epidemiology, 2017, 28(5): 653-659.
18. 高雪, 薛付忠, 黄丽红, 等. 孟德尔随机化模型及其规范化应用的统计学共识. 中国卫生统计, 2021, 38(3): 471-475,480.
19. 曹瑞奇, 冯正源, 吴佼星, 等. 受教育程度与胰腺炎的因果关系: 一项孟德尔随机化研究. 西安交通大学学报(医学版), 2024, 45(2): 200-205.
20. 于天琦, 徐文涛, 苏雅娜, 等. 孟德尔随机化研究基本原理、方法和局限性. 中国循证医学杂志, 2021, 21(10): 1227-1234.
21. Bowden J, Hemani G, Davey Smith G. Invited commentary: detecting individual and global horizontal pleiotropy in Mendelian randomization—A job for the humble heterogeneity statistic? Am J Epidemiol, 2018, 187(12): 2681-2685.
22. 夏露, 谢治年, 廖芯艺, 等. 阻塞性睡眠呼吸暂停与高血压: 一项双向孟德尔随机化研究. 解放军医学杂志, 2024, 49(6): 636-642.
23. 徐徐, 刘曼, 王丹. 老年胃食管反流病治疗现状和进展. 中国老年学杂志, 2023, 43(21): 5371-5375.
24. Fernando I, Schmidt KA, Cromer G, et al. The impact of low-fat and full-fat dairy foods on symptoms of gastroesophageal reflux disease: an exploratory analysis based on a randomized controlled trial. Eur J Nutr, 2022, 61(5): 2815-2823.
25. Manaer T, Yu L, Nabi XH, et al. The beneficial effects of the composite probiotics from camel milk on glucose and lipid metabolism, liver and renal function and gut microbiota in db/db mice. BMC Complement Med Ther, 2021, 21(1): 127. doi: 10.1186/s12906-021- 03303-4.
26. Ye X, Yu F, Zhou J, et al. Analysis of the gut microbiota in children with gastroesophageal reflux disease using metagenomics and metabolomics. Front Cell Infect Microbiol, 2023, 13: 1267192. doi: 10.3389/fcimb.2023.1267192.
27. Gudjonsson H, McAuliffe TL, Kaye MD. The effect of coffee and tea upon lower esophageal sphincteric function. Laeknabladid, 1995, 81(6): 484-488.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Causal relationship of cheese and tea intake with gastroesophageal reflux disease: a two-sample Mendelian randomization study

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