The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation

Introduction and Aims: This study aims to examine the possible causal link between periodontal diseases and atrial fibrillation (AF), with a focus on the modifiable risk factors that facilitate this connection. Method: Firstly, bidirectional and multivariable Mendelian Randomisation (MR) analyses we...

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Main Authors: Xiaohan Zhang, Chengzhong Lian, Shuqing Shi, Jiaran Li, Lianxin Wang, Zezhen Guo, Naixu Liu, Huan Wang, Yuanhui Hu, Bai Du
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Dental Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S0020653925000036
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author Xiaohan Zhang
Chengzhong Lian
Shuqing Shi
Jiaran Li
Lianxin Wang
Zezhen Guo
Naixu Liu
Huan Wang
Yuanhui Hu
Bai Du
author_facet Xiaohan Zhang
Chengzhong Lian
Shuqing Shi
Jiaran Li
Lianxin Wang
Zezhen Guo
Naixu Liu
Huan Wang
Yuanhui Hu
Bai Du
author_sort Xiaohan Zhang
collection DOAJ
description Introduction and Aims: This study aims to examine the possible causal link between periodontal diseases and atrial fibrillation (AF), with a focus on the modifiable risk factors that facilitate this connection. Method: Firstly, bidirectional and multivariable Mendelian Randomisation (MR) analyses were conducted using genome-wide association studies (GWAS) data on periodontal disease (87,497 cases/259,234 controls) from FinnGen and AF (55,114 cases/482,295 controls) from AFGen. Then, a 2-step MR approach was employed to evaluate the mediating role and proportions of 25 candidate factors among the direct causality between periodontal disease and AF. Results: Periodontal disease was found to be associated with an increased risk of AF (odds ratio 1.16, 95% CI 1.027-1.314, p = .017), independent of other covariates such as dental caries, pulp, and periapical diseases. Conversely, no causal relationship was detected indicating that AF leads to periodontal disease condition. Furthermore, in the 2-step MR analysis, 5 out of 25 candidate mediators were screened as statistically significant. Ranked by partial mediation proportion, these modifiable mediators included weight (30.3%), IL-17 (17.2%), TNF (14.08%), coronary atherosclerosis (13.4%), and hypertension (11.6%). Conclusion: Our findings demonstrated the genetic causality between periodontal disease and AF. Maintaining oral hygiene, adopting standardised periodontal therapy, and restricting body weight are critical goals for patients with periodontal disease to mitigate disease progression to AF.
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spelling doaj-art-45f2228ba3c74d6f98e1eb2c571e3cc82025-08-20T02:28:40ZengElsevierInternational Dental Journal0020-65392025-06-017532093210310.1016/j.identj.2024.12.029The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial FibrillationXiaohan Zhang0Chengzhong Lian1Shuqing Shi2Jiaran Li3Lianxin Wang4Zezhen Guo5Naixu Liu6Huan Wang7Yuanhui Hu8Bai Du9Department of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Oral Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, ChinaDepartment of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaInstitute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, ChinaFaculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaDepartment of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCorresponding author. Department of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange, Xicheng District, Beijing 100053, China; Department of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaCorresponding author. Department of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange, Xicheng District, Beijing 100053, China; Department of Cardiovascular Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaIntroduction and Aims: This study aims to examine the possible causal link between periodontal diseases and atrial fibrillation (AF), with a focus on the modifiable risk factors that facilitate this connection. Method: Firstly, bidirectional and multivariable Mendelian Randomisation (MR) analyses were conducted using genome-wide association studies (GWAS) data on periodontal disease (87,497 cases/259,234 controls) from FinnGen and AF (55,114 cases/482,295 controls) from AFGen. Then, a 2-step MR approach was employed to evaluate the mediating role and proportions of 25 candidate factors among the direct causality between periodontal disease and AF. Results: Periodontal disease was found to be associated with an increased risk of AF (odds ratio 1.16, 95% CI 1.027-1.314, p = .017), independent of other covariates such as dental caries, pulp, and periapical diseases. Conversely, no causal relationship was detected indicating that AF leads to periodontal disease condition. Furthermore, in the 2-step MR analysis, 5 out of 25 candidate mediators were screened as statistically significant. Ranked by partial mediation proportion, these modifiable mediators included weight (30.3%), IL-17 (17.2%), TNF (14.08%), coronary atherosclerosis (13.4%), and hypertension (11.6%). Conclusion: Our findings demonstrated the genetic causality between periodontal disease and AF. Maintaining oral hygiene, adopting standardised periodontal therapy, and restricting body weight are critical goals for patients with periodontal disease to mitigate disease progression to AF.http://www.sciencedirect.com/science/article/pii/S0020653925000036Periodontal disease1Atrial fibrillation2Cytokines3Mendelian randomisation4Mediating pathway5
spellingShingle Xiaohan Zhang
Chengzhong Lian
Shuqing Shi
Jiaran Li
Lianxin Wang
Zezhen Guo
Naixu Liu
Huan Wang
Yuanhui Hu
Bai Du
The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
International Dental Journal
Periodontal disease1
Atrial fibrillation2
Cytokines3
Mendelian randomisation4
Mediating pathway5
title The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
title_full The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
title_fullStr The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
title_full_unstemmed The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
title_short The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation
title_sort 2 step mendelian randomisation study assesses genetic causality and potential mediators of periodontal disease and atrial fibrillation
topic Periodontal disease1
Atrial fibrillation2
Cytokines3
Mendelian randomisation4
Mediating pathway5
url http://www.sciencedirect.com/science/article/pii/S0020653925000036
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