Abstract:

Objective Observational studies have shown an association between otitis media (OM) and gastroesophageal reflux disease (GERD). However, traditional studies have biases that limit our understanding of the impact of GERD on OM. Methods A two-sample Mendelian randomization (MR) approach with the random-effects inverse variance weighted model was adopted to analyze genome-wide association study (GWAS) data in the European population from the available online database. The causal relationship between GERD and OM in the European population was analyzed. MR-Egger regression and weighted median were also used as supplements. Sensitivity analysis was performed by Cochran's Q test, MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO) and Mendelian randomization-Egger (MR-Egger) intercept tests, including horizontal pleiotropy and heterogeneity tests, to ensure the reliability of the study results. Results According to the IVW model, a causal relationship was found between GERD and acute suppurative otitis media (ASOM) ( O R=1.208; 95% C I: 1.030-1.416, P=2.00e-2). A causal relationship between GERD and chronic suppurative otitis media (CSOM) was strongly demonstrated ( O R=2.085, 95% C I: 1.329-3.270, P=1.38e-3). However, there was no causal relationship between GERD and non-suppurative otitis media (NSOM) ( O R=1.151, 95% C I: 0.970-1.366, P=2.50e-1), and a consistent correlation pattern was observed in some MR models. In addition, little evidence of bias was found in the sensitivity analyses. Conclusion The genetic susceptibility of GERD to ASOM and CSOM tends to increase, suggesting that GERD should be checked, and appropriate treatment should be selected when treating OM.

Key words: gastroesophageal reflux, otitis media, suppurative otitis media, otitis media with effusion, Mendelian randomized trial