Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
Xin Ge1, Weixin Tang2, Jingmin Ni2
1Department of Traditional Chinese Medicine, Shanghai Chongming District Hospital of Traditional Chinese and Western Medicine, No. 2099 Honghai Highway, Chongming District, Shanghai, 202153, China.
Insights
This study found no causal link between hemorrhoids and cardiovascular diseases (CVD). Shared risk factors like obesity may explain observed associations, suggesting focused prevention strategies for CVD.
Area of Science:
- Cardiovascular Health
- Gastroenterology
- Genetic Epidemiology
Background:
- Emerging research suggests a link between hemorrhoids and cardiovascular disease (CVD).
- However, the precise causal relationship between hemorrhoids and CVD remains unclear.
- This study investigated potential causal associations between hemorrhoids and major cardiovascular conditions.
Purpose of the Study:
- To determine if hemorrhoids causally influence the risk of developing CVD.
- To assess if CVD causally influences the risk of developing hemorrhoids.
- To explore potential shared genetic or environmental factors.
Main Methods:
- Utilized a two-sample bidirectional Mendelian randomization (MR) analysis.
- Employed summary statistics from large genome-wide association studies (GWAS).
- Conducted sensitivity analyses using multiple MR methods and outlier exclusion.
Main Results:
- No statistically significant causal effect of hemorrhoids on arrhythmia, heart failure, myocardial infarction, atrial fibrillation, or coronary artery disease was found.
- The reverse analysis, examining the impact of CVD on hemorrhoids, also yielded no significant causal associations.
- Sensitivity analyses confirmed the robustness of these findings, indicating no significant heterogeneity or pleiotropy.
Conclusions:
- This study found no evidence of a causal relationship between hemorrhoids and cardiovascular diseases.
- The observed associations may be attributed to shared underlying risk factors, such as obesity and diet.
- Future CVD prevention efforts should prioritize managing these common risk factors.
Background:
Emerging evidence suggests that hemorrhoids are associated with cardiovascular disease (CVD). However, the causal associations between hemorrhoids and CVD remain elusive. This study aimed to investigate potential causal links between hemorrhoids and various heart conditions, including arrhythmia, heart failure, myocardial infarction, atrial fibrillation, and coronary artery disease.
Methods:
A two-sample bidirectional Mendelian randomization (MR) analysis was conducted using summary statistics of hemorrhoids and CVD from publicly available genome-wide association studies (GWAS). The MR analyses utilized inverse-variance weighted, weighted median, weighted mode, and MR-Egger methods. Sensitivity analyses included Cochran's Q test, MR-Egger regression, MR pleiotropy residual sum and outlier (MR-PRESSO), and leave-one-out analysis. A radial MR analysis was performed after excluding outliers.
Results:
Genetically determined hemorrhoids did not exhibit a causal effect on arrhythmia (OR = 0.9998, P = 0.83), heart failure (OR = 0.94, P = 0.14), myocardial infarction (OR = 0.94, P = 0.27), atrial fibrillation (OR = 0.98, P = 0.55), or coronary artery disease (OR = 0.99, P = 0.84). The reverse analysis yielded similar results. Consistent results were observed with alternative MR methods, and the absence of significant heterogeneity was confirmed. The radial MR analyses support the conclusions in the forward and reverse analyses.
Conclusions:
This bidirectional MR analysis did not find statistical causal association between hemorrhoids and CVD, suggesting the possibility of shared risk factors such as obesity and diet. Further prevention strategies for CVD could focus on the management of common risk factors.
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