The associations between risk factors and pituitary neuroendocrine tumors: A bidirectional Mendelian randomization...

The etiological basis of pituitary neuroendocrine tumors is uncertain. We used Mendelian randomization technique to investigate the potential influence of several risk factors on the likelihood of developing pituitary neuroendocrine tumors. We admitted 8 risk factors, divided into 3 lifestyle factors and 5 chronic diseases as exposure factors. We used weighted median, simple model, weighted model, inverse-variance weighted, and the MR-Egger regression method for causal effect estimations and sensitivity analyses. We observed that genetically forecasting increased moderate to vigorous physical activity levels (OR = 5.21 [1.38-19.72], P = .015) was linked with a higher incidence of pituitary neuroendocrine tumors. Allergic disease (asthma, hay fever, or eczema) (OR = 0.81 [0.66-0.99], P = .039), chronic kidney disease (OR = 0.67 [0.50-0.90], P = .008), increased sleep duration (OR = 0.07 [0.01-0.37], P = .001), and types of physical activity (e.g., swimming, cycling, keeping fit, and bowling) (OR = 0.02 [0.01-0.66], P = .029) were connected with lower incidence of pituitary neuroendocrine tumors. There was no evidence that the other 3 risk factors notably correlated with pituitary neuroendocrine tumors. This study provides evidence that allergic diseases, chronic kidney disease, sleep duration, and physical activity are associated with the development of pituitary neuroendocrine tumors. The findings highlight the importance of reconsidering causality in epidemiological studies to better understand risk factors and prevention strategies for pituitary neuroendocrine tumors.