Genetic predictive links between oropharyngeal microecology and obstructive sleep apnea syndrome: expanding the perspective of etiology.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS), a global public health concern, is linked to oropharyngeal microbiota, but observational studies cannot confirm their causal association. OBJECTIVE: To explore the potential causal relationship between oropharyngeal microecology and OSAS. METHODS: The data related to the oropharyngeal microbiome and this disease were obtained from China Nucleotide Sequence Archive and genome-wide association studies. Moreover, we screened qualified single nucleotide polymorphisms as instrumental variables. Two-sample Mendelian randomization bidirectional analysis was conducted using methods such as Wald ratio and inverse-variance weighted. The horizontal pleiotropy was judged by the MR-Egger intercept, and the sensitivity analysis was conducted by the "Leave-one-out" method and Cochran's Q assessment. RESULTS: Interferences in the abundance of specific strains of oropharynx (overall, the Firmicutes/Bacteroidetes phylum ratio ↑) raised the risk of OSAS, such as increased Streptococcus mgs 2253 (OR = 4.280) and decreased Prevotella mgs 3161 (OR = 0.218). Conversely, OSAS also affected the abundance of some oropharyngeal microorganisms, such as a decrease in Neisseria lactamica mgs 343 and an increase in Pauljensenia mgs 2308. CONCLUSION: This study emphasizes the causal relationship between oropharyngeal microecology and OSAS, expands the new etiological mechanism, and provides potential novel strategies for the prevention and treatment of OSAS.