Crosstalk between gastrointestinal tract disorders and obstructive sleep apnea

Clinical studies suggested associations between obstructive sleep apnea (OSA) and gastrointestinal tract disorders. This study aims to investigate the genetic causal relationship between OSA and gastrointestinal tract disorders, specifically gastroesophageal reflux disease (GERD) and inflammatory bowel disease (IBD).

In this study, we employed two-sample Mendelian Randomization (MR) analysis to investigate the potential relationships between OSA and GERD, and between OSA and IBD. More specifically, the primary analysis utilized inverse variance weighting (IVW). Weighted median, MR Egger, and MR PRESSO were applied to complicate potential violations of MR assumptions. Also, sensitivity analysis was evaluated and similar analysis was performed again after outliers were removed. Additionally, multivariable MR (MVMR) was conducted for associated pairs to adjust for obesity.

Genetically predicted risk of GERD increased OSA risk by approximately 60% (OR_IVW = 1.62, 95%CI = [1.43,1.84]) which was also stable by other complicated approaches, and even with BMI adjusted by MVMR (OR_adjBMI[95%CI] = 1.26 [1.15,1.37]). Besides, OSA showed a mild causal effect on increased GERD risk after adjusting for obesity (OR_adjBMI[95%CI] = 1.05 [1.02,1.08]). Additionally, OSA increased the risks for IBD (OR_IVW[95%CI] = 1.36 [1.12,1.65]), including a higher risk of CD (OR_IVW[95%CI] = 1.41 [1.08,1.83]), and a trend for increasing UC risk (OR_IVW[95%CI] = 1.29 [0.99,1.67]).

GERD exerts a substantial causality on increasing the risk of OSA. Conversely, the potential for a causal relationship that OSA contributes to the development of GERD or IBD remains probable. These findings support the crosstalk between gastrointestinal tract disorders and OSA.