Published online Nov 28, 2023. doi: 10.3748/wjg.v29.i44.5872
Peer-review started: October 8, 2023
First decision: November 1, 2023
Revised: November 6, 2023
Accepted: November 14, 2023
Article in press: November 14, 2023
Published online: November 28, 2023
Processing time: 50 Days and 14.2 Hours
Anxiety is common in patients with inflammatory bowel disease (IBD), including those with ulcerative colitis (UC) and Crohn’s disease (CD); however, the causal relationship between IBD and anxiety remains unknown.
To investigate the causal relationship between IBD and anxiety by using bidirectional Mendelian randomization analysis.
Single nucleotide polymorphisms retrieved from genome-wide association studies (GWAS) of the European population were identified as genetic instrument variants. GWAS statistics for individuals with UC (6968 patients and 20464 controls; adults) and CD (5956 patients and 14927 controls; adults) were obtained from the International IBD Genetics Consortium. GWAS statistics for individuals with anxiety were obtained from the Psychiatric Genomics Consortium (2565 patients and 14745 controls; adults) and FinnGen project (20992 patients and 197800 controls; adults), respectively. Inverse-variance weighted was applied to assess the causal relationship, and the results were strengthened by heterogeneity, pleiotropy and leave-one-out analyses.
Genetic susceptibility to UC was associated with an increased risk of anxiety [odds ratio: 1.071 (95% confidence interval: 1.009-1.135), P = 0.023], while genetic susceptibility to CD was not associated with anxiety. Genetic susceptibility to anxiety was not associated with UC or CD. No heterogeneity or pleiotropy was observed, and the leave-one-out analysis excluded the potential influence of a particular variant.
This study revealed that genetic susceptibility to UC was significantly associated with anxiety and highlighted the importance of early screening for anxiety in patients with UC.
Core Tip: Our study provides evidence that genetic susceptibility to ulcerative colitis (UC) is associated with an increased risk of anxiety [odds ratio: 1.071 (95% confidence interval: 1.009, 1.135), P = 0.023], while genetic susceptibility to Crohn’s disease (CD) is not associated with an increased risk of anxiety. No causal effects of anxiety on UC and CD were observed in this study. In conclusion, our study demonstrates the causal effect of UC on anxiety. These findings may be helpful to increase physicians’ awareness of the need to recognize anxiety in UC patients and influence the management of anxiety in clinical practice.