Unveiling the Hidden Links: A Mendelian Randomization Study on the Causal Relationship between Smoking, Alcohol Consumption, and the Development of Myopia and Astigmatism

Abstract

Abstract Background： The influence of environmental factors like smoking and alcohol on myopia and astigmatism is controversial. However, due to ethical concerns, alternative study designs are urgently needed to assess causal inference, as mandatory exposure to cigarettes and alcohol is unethical. Methods： Following comprehensive screenings, 326 single nucleotide polymorphisms (SNPs) related to myopia and astigmatism were included in the dataset. To validate the causal association between exposures such as cigarette smoking, alcohol consumption, and coffee intake, and outcomes namely astigmatism and myopia, five regression models were employed. These models encompassed MR-Egger regression, random-effects inverse-variance weighted (IVW), weighted median estimator (WME), weighted model, and simple model. The instrumental variables utilized in these analyses were the aforementioned SNPs. Apply Cochran's Q test to determine heterogeneity of SNPs; if heterogeneity exists, focus on IVW model results. Results： The IVW model showed a 1.379-fold increase in the risk of astigmatism (OR= 1.379, 95%CI: 0.822~2.313, P=0.224) and a 0.963-fold increase in the risk of myopia (OR= 0.963, 95%CI:0.666~1.393, P=0.841) for each unit increase in smoking. For each unit increase in coffee intake, the risk of astigmatism increased 1.610-fold (OR= 1.610, 95%CI:0.444~5.835, P=0.469) and the risk of myopia increased 0.788-fold (OR= 0.788, 95%CI:0.340~1.824, P=0.578). For each additional unit of alcohol consumption, the risk of astigmatism increased by 0.763-fold (OR= 0.763, 95%CI:0.380~1.530, P=0.446), and none of the differences were statistically significant. However, for each unit of alcohol consumption, the risk of myopia increased by 1.597 times, and the difference was statistically significant (OR= 1.597, 95%CI:1.023~2.493, P=0.039). Conclusions: The findings indicate that alcohol consumption is a risk factor for myopia, but smoking and coffee intake do not affect its development. Additionally,there is no association between smoking, alcohol consumption, coffee intake, and the risk of astigmatism.