Evidence-Based Medicine
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2023; 11(30): 7318-7328
Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7318
Causal relationship association of cheese intake with gestational hypertension and diabetes result from a Mendelian randomization study
Tao Zhong, Yu-Qing Huang, Gui-Ming Wang
Tao Zhong, Gui-Ming Wang, Department of Cardiology, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
Yu-Qing Huang, Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
Author contributions: All authors contributed to the design; Huang YQ contributed to analysis of the study; all authors prepared the written manuscript; and all authors critically reviewed and edited the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Ming Wang, MD, Department of Cardiology, The First Hospital of Nanchang, No. 128 Xiangshan North Road, Donghu District, Nanchang 330008, Jiangxi Province, China. wanggm2008@163.com
Received: August 9, 2023
Peer-review started: August 9, 2023
First decision: September 13, 2023
Revised: September 17, 2023
Accepted: September 28, 2023
Article in press: September 28, 2023
Published online: October 26, 2023
ARTICLE HIGHLIGHTS
Research background

Evidence from observational studies has not been able to establish a causal association of cheese intake with hypertension or diabetes during pregnancy.

Research motivation

Eating cheese during pregnancy may help prevent hypertension and diabetes.

Research objectives

The objective was to determine whether cheese consumption was causally related to hypertension and diabetes during pregnancy.

Research methods

A Mendelian randomised (MR) study with two samples was conducted. The IEU OpenGWAS database’s corresponding outcome data for gestational diabetes and gestational hypertension were taken out, and summary-level genetic information for cheese consumption was exposed. MR analysis was performed by using inverse variance weighting as the main method. Methods used for sensitivity studies included MR-Egger regression, weighted median, weighted mode, and leave-one-out techniques. The meta-analysis of two sample MR estimations was performed using a fixed-effect model. The characteristics of gestational diabetes were gestational diabetes (123579 individuals) and diabetes mellitus in pregnancy (116363 individuals), whereas the characteristics of gestational hypertension were pregnancy hypertension (123579 individuals) and oedema, proteinuria, and hypertensive disorders in pregnancy, childbirth, and the puerperium (123579 individuals).

Research results

Inverse variance weighted analysis has shown a causal relationship between cheese consumption per standard deviation increase and the risks of gestational hypertension and gestational diabetes (odds ratio = 0.41, 95% confidence interval: 0.30-0.55, P < 0.001). The two-sample MR analysis of the relationship between cheese intake and gestational hypertension revealed no heterogeneity (all P > 0.05) or horizontal pleiotropy, but there was heterogeneity (all P > 0.05) in relation to gestational diabetes.

Research conclusions

In this MR analysis, cheese consumption was found to be inversely related to gestational hypertension and gestational diabetes, implying that cheese intake may be beneficial in preventing gestational hypertension and gestational diabetes.

Research perspectives

These findings indicated that dietary interventions, particularly increasing cheese consumption, could be effective in preventing hypertension and diabetes during pregnancy, and should be promoted in more areas.