Association between pulp and periapical disease with type 2 diabetes: A bidirectional Mendelian randomization

Area of Science:

• Oral Health Epidemiology
• Metabolic Disease Research
• Genetic Epidemiology

Background:

• Pulp and periapical disease (PAP) and type 2 diabetes mellitus (T2DM) are prevalent conditions with potential shared risk factors.
• Understanding the bidirectional relationship between PAP and T2DM is crucial for public health and clinical management.

Approach:

• This Mendelian randomization (MR) study utilized summary-level data from European genome-wide association studies (GWASs).
• Single nucleotide polymorphisms (SNPs) were used as instrumental variables, with the radial inverse-variance weighted (radial IVW) method applied.
• Sensitivity analyses were performed to assess pleiotropy, and results were pooled using a fixed-effect meta-analysis model.

Key Points:

• The MR analysis revealed no statistically significant evidence for a causal effect of PAP on T2DM (OR=1.04, 95% CI: 1.00-1.07, p=0.033).
• Conversely, no significant causal association was found for T2DM influencing PAP (OR=1.04, 95% CI: 0.96-1.14, p=0.329).
• Robust sensitivity analyses indicated no significant pleiotropy, supporting the reliability of the primary findings.

Conclusions:

• This study provides no significant evidence for a causal relationship between pulp and periapical disease and type 2 diabetes mellitus.
• The findings suggest that any observed associations between these conditions may be due to confounding factors or reverse causation not captured by this MR analysis.
• Further investigation with diverse populations and methodologies may be warranted to fully elucidate the complex interplay between oral infections and metabolic health.