The causal relationship between bacterial pneumonia and diabetes: a two-sample mendelian randomization study

Abstract

ABSTRACT The escalating worldwide occurrence of diabetes mellitus, recognized as a chronic metabolic ailment contributing to an amplified global disease burden, has stimulated researchers to explore its etiology. Consequently, the study employed a two-sample Mendelian randomization (MR) methodology to examine the causal connection between bacterial pneumonia and diabetes, drawing upon the existing observational study that identified a potential association between bacterial pneumonia and diabetes. Furthermore, MR investigations suggest a reciprocal causal relationship between bacterial pneumonia and gestational diabetes mellitus(GDM), and a plausible causal link between bacterial pneumonia and T1DM. Background Previous observational studies have established the high prevalence of bacterial pneumonia in diabetic patients, which in turn leads to increased mortality. However, the presence of a causal connection between bacterial pneumonia and diabetes remains unobserved. Methods We chose genome-wide significant (Ρ < 1 × 10−5 and Ρ < 1 × 10−6) and independent (r2 < 0.001) single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) to proceed a bidirectional two-sample MR study. The extracted SNPs explored the relationship between bacterial pneumonia and diabetes by Inverse variance weighted (IVW), MR-Egger, and weighted median methods. In addition, we conducted the Heterogeneity test, the Pleiotropy test, MR-presso and the Leave-one-out (LOO) sensitivity test to validate the reliability of results. Results In an MR study with bacterial pneumonia as an exposure factor, four different types of diabetes as outcome. It was observed that bacterial pneumonia increases the incidence of GDM (OR = 1.150 (1.027–1.274, P = 0.011) and T1DM (OR = 1.277 (1.024–1.531), P = 0.016). In the reverse MR analysis, it was observed that GDM (OR = 1.112 (1.023–1.201, P = 0.009) is associated with an elevated risk of bacterial pneumonia. However, no significant association was observed bacterial pneumonia with T1DM and other types of diabetes (P > 0.05). Conclusion This study utilizing MR methodology yields robust evidence supporting a bidirectional causal association between bacterial pneumonia and GDM. Furthermore, our findings suggest a plausible causal link between bacterial pneumonia and T1DM.