Higher exposure Lower exposure Mendelian randomization design Obesity Type 2 diabetes Smoking Diverticular disease data from • FinnGen (10 978 cases and 149 001 controls) • UK Biobank (12 662 cases and 348 532 controls) Results and conclusions Coffee intake Alcohol intake risk risk risk Analysis • Inverse-variance weighted method • Weighted median method • MR-Egger method • MR-PRESSO method • Contamination mixture method Random allocation of effect alleles
BACKGROUND & AIMS:Adiposity, type 2 diabetes, alcohol and coffee consumption, and smoking have been examined in relation to diverticular disease in observational studies. We conducted a Mendelian randomization study to assess the causality of these associations.
METHODS:Independent genetic instruments associated with the studied exposures at genome-wide significance were obtained from published genome-wide association studies. Summary-level data for the exposure-associated single nucleotide polymorphisms with diverticular disease were available in the FinnGen consortium (10,978 cases and 149,001 noncases) and the UK Biobank study (12,662 cases and 348,532 noncases).
RESULTS:Higher genetically predicted body mass index and genetic liability to type 2 diabetes and smoking initiation were associated with an increased risk of diverticular disease in metaanalyses of results from the two studies. The combined odds ratio of diverticular disease was 1.23 (95% confidence interval [CI], 1.14-1.33; P < .001) for a 1-standard deviation (~4.8 kg/m 2 ) increase in body mass index, 1.04 (95% CI, 1.01-1.07; P ¼ .007) for a 1-unit increase in logtransformed odds ratio of type 2 diabetes, and 1.21 (95% CI, 1.12-1.30; P < .001) for a 1standard deviation increase in prevalence of smoking initiation. Coffee consumption was not associated with diverticular disease, whereas the association for alcohol consumption largely differed between the 2 studies.