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
Processing time: 77 Days and 4.7 Hours
Abstract
BACKGROUND

The evidence from observational studies has been inconclusive on the causal relationship between cheese intake and gestational hypertension or diabetes.

AIM

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

METHODS

This was a two-sample Mendelian randomized (MR) study. Summary-level genetic data for cheese intake was exposure and corresponding outcome data for gestational hypertension and gestational diabetes were extracted from the IEU OpenGWAS database. MR analysis was conducted using inverse variance weighting. For sensitivity analyses, MR-Egger regression, weighted median, weighted mode, and leave-one-out methods were conducted. A fixed-effect model was used to meta-analyze two sample MR estimates. The traits of gestational hypertension were pregnancy hypertension (123579 individuals) and oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (123579 individuals), and traits of gestational diabetes were gestational diabetes (123579 individuals) and diabetes mellitus in pregnancy (116363 individuals), respectively.

RESULTS

Cheese intake per standard deviation increase has causally reduced the risks of gestational hypertension [odds ratio (OR) = 0.60, 95% confidence interval (CI): 0.47-0.76, P < 0.001] and gestational diabetes (OR = 0.41, 95%CI: 0.30-0.55, P < 0.001) in inverse variance weighted analysis. Sensitivity analysis showed no heterogeneity (all P > 0.05) nor horizontal pleiotropy (all P > 0.05) in the relationship between cheese intake and gestational hypertension, but heterogeneity presented (all P < 0.05) in relation to gestational diabetes in the two-sample MR analysis.

CONCLUSION

Cheese intake was inversely associated with gestational hypertension and gestational diabetes in MR analysis, suggesting that cheese consumption may be beneficial in preventing hypertension and diabetes during pregnancy.

Keywords: Cheese intake; Gestational hypertension; Gestational diabetes; Mendelian randomization

Core Tip: Gestational hypertension and gestational diabetes were associated with an increased risk of complications for both the mother and fetus during pregnancy. We found that cheese intake was inversely associated with gestational hypertension and gestational diabetes in Mendelian randomization analysis, suggesting that cheese consumption may be beneficial in preventing hypertension and diabetes during pregnancy. These findings suggested that dietary interventions, especially increasing cheese intake, may be effective in the prevention gestational hypertension and gestational diabetes, and should be promoted in more regions.