Assessing Causality between Obstructive Sleep Apnea and Erectile Dysfunction: A Bidirectional Mendelian Randomization Study.

INTRODUCTION

Emerging studies have indicated that obstructive sleep apnea (OSA) is an independent risk factor for erectile dysfunction (ED). However, the results are inconsistent. By leveraging aggregated statistical data from genome-wide association studies (GWAS), we performed a bidirectional mendelian randomization (MR) analysis to further investigate the potential causal link between OSA and ED.

MATERIALS AND

METHODS

We chose single nucleotide polymorphisms (SNPs) as instrumental variables based on rigorous criteria. Our research adopted five advanced two-sample MR analysis approaches, specifically encompassing inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. Additionally, we conducted several sensitivity analyses to evaluate heterogeneity, horizontal pleiotropy, and stability, including Cochrane's Q test, MR-Egger intercept test, MR-pleiotropy residual sum and outlier (MR-PRESSO) global test, and leave-one-out analysis.

RESULTS

The study included one dataset related to ED (Bovijn et al.) and two datasets related to OSA (Finngen and Sakaue et al.). The MR study results using the IVW method showed no significant causal association between OSA and ED in two datasets related to OSA. (IVW, odds ratio (OR): 1.01, 95% confidence interval (CI): 0.82-1.24, p = 0.954; 1.07, 0.87-1.30, p = 0.532, respectively). The results of other four MR analysis methods were consistent with IVW. In the reverse MR analyses, there was no causal effect of ED on OSA according to IVW method (IVW, OR: 1.01, 95% CI: 0.96 to 1.06, p = 0.708; 0.95, 0.87-1.05, p = 0.319, respectively). Moreover, sensitivity analysis showed that the study results remain highly consistent, with no indication of multi-collinearity or heterogeneity.

CONCLUSIONS

Our MR analysis revealed no clear bidirectional causal link between OSA and ED.