Impact of college completion and mediating factors on the risk of acute pancreatitis: a Mendelian randomization study

This study aimed to investigate the causal relationship between college completion and incidence of acute pancreatitis (AP). We assessed the impact of various factors, such as smoking, alcohol consumption, triglyceride levels, type 2 diabetes, and cholelithiasis, on this causal association. We conducted a genome-wide association study (GWAS) summary statistics from European populations using a two-sample Mendelian randomization (MR) approach to analyze the causal link between college completion and AP. Two-step MR was further applied to evaluate potential mediating pathways. College completion was associated with a reduced risk of AP (odds ratio [OR] = 0.29, 95% confidence interval [CI] 0.10–0.80), as well as protective effects against smoking status (OR = 0.78, 95% CI 0.69–0.89), total triglyceride levels (OR = 0.67, 95% CI 0.53–0.85), and cholelithiasis (OR = 0.46, 95% CI 0.32–0.66). Smoking status (OR = 2.54, 95% CI 1.58–4.10), alcohol consumption (OR = 7.30, 95% CI 2.62–20.22), cholelithiasis (OR = 1.58, 95% CI 1.48–1.70), and type 2 diabetes (OR = 1.10, 95% CI 1.03–1.16) were identified as risk factors for AP. The mediating percentages of smoking status and cholelithiasis in the effect of education on AP were 18.5% (95% CI 8.53–28.6%) and 28.8% (95% CI 2.26–55.3%), respectively. College completion has a protective effect against AP, partly through its influence on smoking and cholelithiasis. These findings highlight education as a potential upstream determinant of AP risk and emphasize the role of lifestyle and metabolic factors in shaping preventive strategies.