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Ulcerative colitis increases the risk of atrioventricular block: evidence from a Mendelian randomized analysis
Wanqiong Shu1, Guanghong Huang2
1Affiliated Guangdong Hospital of Integrated Traditional Chinese and Western Medicine of Guangzhou University of Chinese Medicine, No.16, Guicheng South Fifth Road, Nanhai District, Foshan, 528200, China.
Insights
Inflammatory bowel disease (IBD), specifically ulcerative colitis (UC), may increase the risk of developing atrioventricular block (AVB). This study used Mendelian randomization to explore the causal link between IBD and arrhythmia.
Area of Science:
- Cardiovascular Medicine
- Gastroenterology
- Genetics
Background:
- Growing evidence links inflammatory bowel disease (IBD) to cardiovascular disease.
- The specific relationship between IBD and cardiac arrhythmias remains largely undetermined.
Purpose of the Study:
- To investigate the potential causal relationship between inflammatory bowel disease (IBD) and specific arrhythmia phenotypes using Mendelian randomization.
- To assess the association between IBD subtypes (ulcerative colitis and Crohn's disease) and atrioventricular block (AVB) and paroxysmal tachycardia (PTA).
Main Methods:
- Two-sample Mendelian randomization analysis utilizing single nucleotide polymorphisms (SNPs) associated with IBD (including UC and CD) as instrumental variables.
- Outcome data for atrioventricular block (AVB) and paroxysmal tachycardia (PTA) were analyzed using inverse variance weighting and other MR methods.
- Sensitivity analyses, including heterogeneity, pleiotropy, and leave-one-out analyses, were performed to ensure result validity, with MR-Egger regression and weighted median methods employed.
Main Results:
- A significant association was found between ulcerative colitis (UC) and an increased risk of atrioventricular block (AVB) (OR 1.178, P=0.000828).
- MR-Egger regression and weighted median methods confirmed this association.
- Verification analysis using an independent dataset corroborated the findings (OR 1.048, P=0.022947).
Conclusions:
- Ulcerative colitis (UC) may be associated with a heightened risk of developing atrioventricular block (AVB).
- These findings suggest a potential role for inflammatory bowel disease (IBD) in increasing the risk of cardiac arrhythmias.
- Further research is warranted to elucidate the mechanisms underlying this association.
Abstract:
Although inflammatory bowel disease (IBD) has been linked to cardiovascular disease in a growing body of literature, the relationship between IBD and arrhythmia remains unclear. To investigate the causal relationship between inflammatory bowel disease and arrhythmia, we conducted this Mendelian randomization (MR) analysis. We identified single nucleotide polymorphisms (SNP) associated with IBD as instruments, including IBD, ulcerative colitis (UC), and Crohn's disease (CD). SNPs of two arrhythmia phenotypes as outcome data, namely atrioventricular block (AVB), and paroxysmal tachycardia (PTA). The inverse variance weighting method was used to analyze the two-sample Mendelian randomization with four other methods, including MR Egger, Weighted median, Simple mode, and Weighted mode. Sensitivity analysis involves different methods to detect and adjust for bias in results, including heterogeneity analysis, pleiotropy analysis, and leave-one-out sensitivity analysis. To ensure the rigor of the analysis results, we selected another set of exposure data sets and conducted the MR verification analysis using the same method. Results suggested UC is significantly associated with an increased risk of AVB (odds ratio, OR 1.178, 95% CI 1.070-1.297, P = 0.000828), the verification analysis results are consistent with this (OR 1.048, 95% CI 1.007-1.091, P = 0.022947). Our study suggests a potential risk increase of atrioventricular block in patients with UC. These results also provide further evidence that inflammatory bowel disease may increase the risk of developing arrhythmia.
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