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Leveraging Mendelian Randomization for Causal Inference in Periodontal Research

Yi Wang*, Hanxin Que, Qingliang Zhang, Tengda Chu

Mendelian Randomization (MR) is an analytical approach assessing the causal inference in putative exposure-outcome pathways by employing genetic variants as proxies for exposures of interest. Due to the randomized allocation of genetic variants, MR is less susceptible to confounding, reverse causation, and measurement error, as compared with conventional epidemiological observational studies. Periodontal disease is a multifactorial inflammatory disorder. The risk factors for periodontal diseases are often identified by epidemiological observational studies, lacking causality. In addition, consistency and sustainability are not established in studies evaluating the effect of periodontal disease on systemic conditions. MR can be therefore leveraged to provide alternative lines of evidence to infer causality in periodontal research. In this review, we will briefly review the recent application of MR in periodontal research. In addition, although we recognize the potential of MR to make a significant impact in periodontal research, we want to stress the importance of triangulation with multiple lines of evidence to draw a conclusion on the cause - effect relationship.