Causal relationship between type 1 diabetes mellitus and mycoses: a Mendelian randomization study

Area of Science:

• Genetics
• Immunology
• Endocrinology

Background:

• Type 1 diabetes mellitus (T1DM) is linked to various infections, but the relationship with fungal infections (mycoses) is not well understood.
• Investigating the causal link between T1DM and mycoses is crucial for understanding disease comorbidities.

Purpose of the Study:

• To investigate the potential causal relationship between Type 1 diabetes mellitus and fungal infections using a Mendelian randomization approach.
• To determine if genetic predisposition to T1DM influences susceptibility to specific mycoses such as candidiasis, aspergillosis, and pneumocystosis.

Main Methods:

• Mendelian randomization (MR) analysis utilizing genetic variants for T1DM and fungal infections from large European population databases.
• Inverse variance weighted (IVW) and MR-Egger regression methods were employed for primary and sensitivity analyses.
• Multivariable MR (MVMR) was used to adjust for potential confounders including BMI, HbA1c, and immune cell counts.

Main Results:

• A significant genetic predisposition to candidiasis was observed in individuals with T1DM (OR=1.05, p=0.0001).
• Sensitivity and multivariable analyses, including adjustments for BMI, HbA1c, and immune cell counts, confirmed the association with candidiasis.
• No significant causal associations were identified between T1DM and aspergillosis or pneumocystosis.

Conclusions:

• Mendelian randomization suggests a genetic link between Type 1 diabetes mellitus and an increased susceptibility to candidiasis.
• The study did not find evidence of a causal relationship between T1DM and other fungal infections like aspergillosis or pneumocystosis.