Causal relationship between Helicobacter pylori and periodontal disease: Two-sample Mendelian randomization study

Objective:This study aims to investigate the causal inference underlying this association through the application of Mendelian randomization (MR) analysis. Basic research design: A Two-Sample Mendelian Randomization Study. Clinical setting: NA. Participants: This study uses summary data from genome-wide association studies (GWAS) of seven antibodies targeting Helicobacter pylori (H. pylori) and periodontal diseases, employing a two-sample MR design. It analyzed 97,830 cases and 272,252 controls for gingivitis, 4784 cases for chronic periodontitis, and 367 cases for acute periodontitis. Interventions: NA. Main outcome measures: This study aimed to overcome the limitations of observational studies and provide insights into whether H. pylori plays a causal role in the development of periodontal disease (PD). Results:The genetic prediction results indicate a statistically significant association between H. pylori UREA antibody levels and the risk of acute periodontitis (OR = 0.7, 95% CI: 0.50-0.98, p = 0.035). In the Weighted Median method, comparable results were obtained (OR = 0.61, 95% CI: 0.39 - 0.95, p = 0.028). However, we did not identify a causal association between genetically predicted levels of other H. pylori antibodies and periodontal disease. For sensitivity analysis, heterogeneity was detected in studies of CagA antibody and acute periodontitis through Cochran's Q tests, and one outlier was identified using MR-PRESSO. Upon exclusion of outliers, the results remained robust and were not influenced by other factors. Conclusions:The study results revealed a causal relationship between H. pylori UREA antibody levels and acute periodontitis, indicating that H. pylori UREA antibody levels are a protective factor against acute periodontitis.