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| Association between smoking and ankylosing spondylitis: a Mendelian randomization study |
| YANG Hong1, LIU Wei1, LUO Peiyang2, SONG Jie1, JIANG Yuqing1, HE Zhixing2, YE Ding1, MAO Yingying1
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1. School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China;
2. Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China |
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Abstract Objective To evaluate the association of smoking with the risk of ankylosing spondylitis (AS) using a Mendelian randomization (MR) approach. Methods A total of 16 383 186 AS-associated single nucleotide polymorphisms (SNPs), 378 smoking initiation associated SNPs and 126 lifetime smoking score-associated SNPs were collected from three large-scale genome-wide association studies (GWAS). The association of smoking phenotypes with the risk of AS was examined using inverse-variance weighted (IVW) with AS as a outcome variable, smoking initiation and lifetime smoking score as exposure factors and SNPs with strong associations with smoking as instrumental variables, and sensitivity analyses were performed with maximum likelihood-based method, MR pleiotropy residual sum and outlier (MR-PRESSO) test and MR-Egger regression analysis. Results A 33.5% increased risk of AS was found among genetically predicted smokers relative to non-smokers (OR=1.335, 95%CI: 1.059-1.682), and an increase in predicted lifetime smoking by per standard deviation resulted in a 101.4% increased risk of AS (OR=2.014, 95%CI: 1.341-3.024). The maximum likelihood-based method and MR-PRESSO test showed consistent correlated effect estimations and MR-Egger regression analysis identified no evidence of pleiotropy. Conclusion It is genetically predicted that smoking is associated with an increased risk of AS.
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Received: 06 October 2022
Revised: 29 November 2022
Published: 11 January 2023
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