Title: Genetic estimation of causalities between educational attainment with common digestive
tract diseases and the mediating pathways
Version: 2 Date: 05 Jul 2024
Reviewer's report:
Review report:
The study by Wang et al. aimed to determine the independent causal effects of education on
six digestive tract diseases, while adjusting for intelligence and cognition. Authors employed
Mendelian Randomization (MR) to explore these effects and identified five significant
mediators: BMI, WHR, body fat percentage, fasting insulin, and major depression. The study
utilized large sample sizes from the FinnGen Study and UK Biobank to ensure robustness of
their MR analyses. Their findings demonstrated that education significantly influences digestive
tract health, independent of cognitive factors. Education was shown to have a direct protective
effect on these diseases, with the identified mediators explaining part of this relationship. The
study emphasizes the crucial role of educational attainment in reducing the risk of digestive
tract diseases and suggests that targeting these mediators could further improve gastrointestinal
health outcomes. Overall, this study provides robust evidence supporting the independent role
of education in gastrointestinal health and highlights the importance of addressing educational
disparities as a strategy to mitigate the prevalence and burden of digestive tract diseases. Overall,
the study findings are interesting and adds a significant value to public health research, however
I have few questions and suggestions to improve further on this:
Major comments:
1. Gender-Specific Analysis: Has the analysis been performed in a gender-dependent fashion?
This could reveal gender-specific causality estimates of education on specific disease outcomes.
2. Gastrointestinal Cancers: It would be interesting to examine the causal associations of
education with gastrointestinal cancers, such as stomach, liver, and pancreas cancer.
3. Selection of Modifiable Risk Factors: How did the authors choose the 21 modifiable risk
factors included in the analysis is not well documented in the manuscript.
4. Additional Mediators: Do the authors have information on oral health and food choices as
mediators? Investigating the effect of education on oral health or food preferences could provide
insights into preventive actions for digestive tract diseases, as these lifestyle factors can be
modified to prevent the occurrence of these diseases.
5. The details of various statistical analyses should be explained in simpler terms to simplify
their purpose.
Minor comments:
1. There are spelling mistakes in a few places in the manuscript. Please check and correct them
carefully.
Title: Genetic estimation of causalities between educational attainment with common digestive
tract diseases and the mediating pathways
Version: 2 Date: 05 Jul 2024
Reviewer's report:
Review report:
The study by Wang et al. aimed to determine the independent causal effects of education on
six digestive tract diseases, while adjusting for intelligence and cognition. Authors employed
Mendelian Randomization (MR) to explore these effects and identified five significant
mediators: BMI, WHR, body fat percentage, fasting insulin, and major depression. The study
utilized large sample sizes from the FinnGen Study and UK Biobank to ensure robustness of
their MR analyses. Their findings demonstrated that education significantly influences digestive
tract health, independent of cognitive factors. Education was shown to have a direct protective
effect on these diseases, with the identified mediators explaining part of this relationship. The
study emphasizes the crucial role of educational attainment in reducing the risk of digestive
tract diseases and suggests that targeting these mediators could further improve gastrointestinal
health outcomes. Overall, this study provides robust evidence supporting the independent role
of education in gastrointestinal health and highlights the importance of addressing educational
disparities as a strategy to mitigate the prevalence and burden of digestive tract diseases. Overall,
the study findings are interesting and adds a significant value to public health research, however
I have few questions and suggestions to improve further on this:
Major comments:
1. Gender-Specific Analysis: Has the analysis been performed in a gender-dependent fashion?
This could reveal gender-specific causality estimates of education on specific disease outcomes.
2. Gastrointestinal Cancers: It would be interesting to examine the causal associations of
education with gastrointestinal cancers, such as stomach, liver, and pancreas cancer.
3. Selection of Modifiable Risk Factors: How did the authors choose the 21 modifiable risk
factors included in the analysis is not well documented in the manuscript.
4. Additional Mediators: Do the authors have information on oral health and food choices as
mediators? Investigating the effect of education on oral health or food preferences could provide
insights into preventive actions for digestive tract diseases, as these lifestyle factors can be
modified to prevent the occurrence of these diseases.
5. The details of various statistical analyses should be explained in simpler terms to simplify
their purpose.
Minor comments:
1. There are spelling mistakes in a few places in the manuscript. Please check and correct them
carefully.
Please review this paper.
user
Title: Genetic estimation of causalities between educational attainment with common digestive
tract diseases and the mediating pathways
Version: 2 Date: 05 Jul 2024
Reviewer's report:
Review report:
The study by Wang et al. aimed to determine the independent causal effects of education on
six digestive tract diseases, while adjusting for intelligence and cognition. Authors employed
Mendelian Randomization (MR) to explore these effects and identified five significant
mediators: BMI, WHR, body fat percentage, fasting insulin, and major depression. The study
utilized large sample sizes from the FinnGen Study and UK Biobank to ensure robustness of
their MR analyses. Their findings demonstrated that education significantly influences digestive
tract health, independent of cognitive factors. Education was shown to have a direct protective
effect on these diseases, with the identified mediators explaining part of this relationship. The
study emphasizes the crucial role of educational attainment in reducing the risk of digestive
tract diseases and suggests that targeting these mediators could further improve gastrointestinal
health outcomes. Overall, this study provides robust evidence supporting the independent role
of education in gastrointestinal health and highlights the importance of addressing educational
disparities as a strategy to mitigate the prevalence and burden of digestive tract diseases. Overall,
the study findings are interesting and adds a significant value to public health research, however
I have few questions and suggestions to improve further on this:
Major comments:
1. Gender-Specific Analysis: Has the analysis been performed in a gender-dependent fashion?
This could reveal gender-specific causality estimates of education on specific disease outcomes.
2. Gastrointestinal Cancers: It would be interesting to examine the causal associations of
education with gastrointestinal cancers, such as stomach, liver, and pancreas cancer.
3. Selection of Modifiable Risk Factors: How did the authors choose the 21 modifiable risk
factors included in the analysis is not well documented in the manuscript.
4. Additional Mediators: Do the authors have information on oral health and food choices as
mediators? Investigating the effect of education on oral health or food preferences could provide
insights into preventive actions for digestive tract diseases, as these lifestyle factors can be
modified to prevent the occurrence of these diseases.
5. The details of various statistical analyses should be explained in simpler terms to simplify
their purpose.
Minor comments:
1. There are spelling mistakes in a few places in the manuscript. Please check and correct them
carefully.
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