{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:20:33Z","timestamp":1763400033223,"version":"3.41.2"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The impact of educational attainment (EA) on multiple urological and reproductive health outcomes has been explored in observational studies. Here we used Mendelian randomization (MR) to investigate whether EA has causal effects on 14 urological and reproductive health outcomes.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We obtained summary statistics for EA and 14 urological and reproductive health outcomes from genome-wide association studies (GWAS). MR analyses were applied to explore the potential causal association between EA and them. Inverse variance weighted was the primary analytical method.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Genetically predicted one standard deviation (SD) increase in EA was causally associated with a higher risk of prostate cancer [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.05\u20131.25, <jats:italic>P<\/jats:italic> = 0.003] and a reduced risk of kidney stone (OR 0.73, 95% CI 0.62\u20130.87, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and cystitis (OR 0.76, 95% CI 0.67\u20130.86, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) after Bonferroni correction. EA was also suggestively correlated with a lower risk of prostatitis (OR 0.76, 95% CI 0.59\u20130.98, <jats:italic>P<\/jats:italic> = 0.037) and incontinence (OR 0.64, 95% CI 0.47\u20130.87, <jats:italic>P<\/jats:italic> = 0.004). For the bioavailable testosterone levels and infertility, sex-specific associations were observed, with genetically determined increased EA being related to higher levels of testosterone in men (\u03b2 0.07, 95% CI 0.04\u20130.10, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), lower levels of testosterone in women (\u03b2 \u22120.13, 95% CI\u22120.16 to\u22120.11, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), and a lower risk of infertility in women (OR 0.74, 95% CI 0.64\u20130.86, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) but was not related to male infertility (OR 0.79, 95% CI 0.52\u20131.20, <jats:italic>P<\/jats:italic> = 0.269) after Bonferroni correction. For bladder cancer, kidney cancer, testicular cancer, benign prostatic hyperplasia, and erectile dysfunction, no causal effects were observed.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> EA plays a vital role in urological diseases, especially in non-oncological outcomes and reproductive health. These findings should be verified in further studies when GWAS data are sufficient.<\/jats:p>","DOI":"10.3389\/fpubh.2021.742952","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T06:39:20Z","timestamp":1635403160000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Causal Associations Between Educational Attainment and 14 Urological and Reproductive Health Outcomes: A Mendelian Randomization Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Menghua","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongyu","family":"Jian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoshuai","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunjie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1111\/1468-0009.12372","article-title":"The economic value of education for longer lives and reduced disability","volume":"97","author":"Krueger","year":"2019","journal-title":"Milbank Q."},{"key":"B2","doi-asserted-by":"publisher","first-page":"112","DOI":"10.3389\/fpubh.2020.00112","article-title":"Association of educational attainment with adiposity, type 2 diabetes, and coronary artery diseases: a mendelian randomization study","volume":"8","author":"Cao","year":"2020","journal-title":"Front Public Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1080\/02841860801888773","article-title":"Cancer risk by education in Iceland; a census-based cohort study","volume":"47","author":"Vidarsdottir","year":"2008","journal-title":"Acta Oncol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1177\/0733464812473798","article-title":"Clarifying the positive association between education and prostate cancer: a Monte Carlo simulation approach","volume":"34","author":"Pudrovska","year":"2015","journal-title":"J Appl Gerontol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1097\/CEJ.0000000000000018","article-title":"Cigarette smoking, educational level and total and site-specific cancer: a cohort study in men in Lithuania","volume":"23","author":"Everatt","year":"2014","journal-title":"Eur J Cancer Prev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e3639","DOI":"10.1371\/journal.pone.0003639","article-title":"Education and risk of cancer in a large cohort of men and women in the United States","volume":"3","author":"Mouw","year":"2008","journal-title":"PLoS One."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1016\/j.ejca.2008.06.012","article-title":"Social inequality and incidence of and survival from male genital cancer in a population-based study in Denmark, 1994\u20132003","volume":"44","author":"Marsa","year":"2008","journal-title":"Eur J Cancer."},{"key":"B8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.urology.2019.05.009","article-title":"Influence of socioeconomic factors on stone burden at presentation to tertiary referral center: data from the registry for stones of the kidney and ureter","volume":"131","author":"Bayne","year":"2019","journal-title":"Urology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.urology.2011.12.017","article-title":"Effect of socioeconomic status on 24-hour urine composition in patients with nephrolithiasis","volume":"80","author":"Eisner","year":"2012","journal-title":"Urology."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e13125","DOI":"10.1111\/and.13125","article-title":"Association between the symptoms of benign prostatic hyperplasia and social disparities: Does social capital promote prostate health?","volume":"50","author":"Park","year":"2018","journal-title":"Andrologia."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1016\/j.juro.2008.07.059","article-title":"Race and socioeconomic status are independently associated with benign prostatic hyperplasia","volume":"180","author":"Fowke","year":"2008","journal-title":"J Urol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"NP1118","DOI":"10.1177\/1010539511429370","article-title":"Prevalence and risk factors of urinary incontinence in Chinese women: a population-based study","volume":"27","author":"Ge","year":"2015","journal-title":"Asia Pac J Public Health."},{"key":"B13","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/ggi.14115","article-title":"Urinary incontinence and its association with socioeconomic status among middle-aged and older persons in Taiwan: a population-based study","volume":"21","author":"Lin","year":"2021","journal-title":"Geriatr Gerontol Int."},{"key":"B14","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.amjmed.2006.06.010","article-title":"Prevalence and risk factors for erectile dysfunction in the US","volume":"120","author":"Selvin","year":"2007","journal-title":"Am J Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.1093\/humrep\/dew123","article-title":"Prevalence of infertility and help seeking among 15 000 women and men","volume":"31","author":"Datta","year":"2016","journal-title":"Hum Reprod."},{"key":"B16","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1111\/1471-0528.14966","article-title":"Epidemiology of infertility in China: a population-based study","volume":"125","author":"Zhou","year":"2018","journal-title":"BJOG."},{"key":"B17","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/j.1365-2605.2007.00764.x","article-title":"Infertility among couples in a population-based study in Iran: prevalence and associated risk factors","volume":"31","author":"Safarinejad","year":"2008","journal-title":"Int J Androl."},{"key":"B18","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.socscimed.2015.11.001","article-title":"Socioeconomic conditions across life related to multiple measures of the endocrine system in older adults: Longitudinal findings from a British birth cohort study","volume":"147","author":"Bann","year":"2015","journal-title":"Soc Sci Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/ije\/dyaa013","article-title":"Empirical comparisons of multiple Mendelian randomization approaches in the presence of assortative mating","volume":"49","author":"Minica","year":"2020","journal-title":"Int J Epidemiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1038\/s41588-018-0147-3","article-title":"Gene discovery and polygenic prediction from a genome-wide association study of educational attainment in 11 million individuals","volume":"50","author":"Lee","year":"2018","journal-title":"Nat Genet."},{"key":"B21","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/j.joca.2020.12.015","article-title":"Cardiometabolic traits mediating the effect of education on osteoarthritis risk: a Mendelian randomization study","volume":"29","author":"Gill","year":"2021","journal-title":"Osteoarthritis Cartilage."},{"key":"B22","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1007\/s00592-020-01647-w","article-title":"Educational attainment protects against type 2 diabetes independently of cognitive performance: a Mendelian randomization study","volume":"58","author":"Liang","year":"2021","journal-title":"Acta Diabetol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1038\/s41588-018-0142-8","article-title":"Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci","volume":"50","author":"Schumacher","year":"2018","journal-title":"Nat Genet."},{"key":"B24","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1038\/s41591-020-0751-5","article-title":"Using human genetics to understand the disease impacts of testosterone in men and women","volume":"26","author":"Ruth","year":"2020","journal-title":"Nat Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.ajhg.2018.11.004","article-title":"GWAS identifies risk locus for erectile dysfunction and implicates hypothalamic neurobiology and diabetes in etiology","volume":"104","author":"Bovijn","year":"2019","journal-title":"Am J Hum Genet."},{"key":"B26","unstructured":"Documentation of R5 Release2021"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2021.08.010","article-title":"Assessing causal associations of obesity and diabetes with kidney stones using Mendelian randomization analysis","author":"Yuan","year":"2021","journal-title":"Mol Genet Metab."},{"key":"B28","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1093\/ije\/dyv080","article-title":"Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression","volume":"44","author":"Bowden","year":"2015","journal-title":"Int J Epidemiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1093\/ije\/dyx102","article-title":"Robust inference in summary data Mendelian randomization via the zero modal pleiotropy assumption","volume":"46","author":"Hartwig","year":"2017","journal-title":"Int J Epidemiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1186\/s12916-021-02041-1","article-title":"Circulating vitamin C concentration and risk of cancers: a Mendelian randomization study","volume":"19","author":"Fu","year":"2021","journal-title":"BMC Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e277","DOI":"10.1016\/S2214-109X(17)30058-X","article-title":"Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review","volume":"5","author":"Allen","year":"2017","journal-title":"Lancet Glob Health."},{"key":"B32","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s40168-017-0316-0","article-title":"Oxalobacter formigenes-associated host features and microbial community structures examined using the American Gut Project","volume":"5","author":"Liu","year":"2017","journal-title":"Microbiome."},{"key":"B33","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1177\/0022146517715671","article-title":"Why do college graduates behave more healthfully than those who are less educated?","volume":"58","author":"Lawrence","year":"2017","journal-title":"J Health Soc Behav."},{"key":"B34","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s00192-010-1215-0","article-title":"Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors","volume":"22","author":"Walker","year":"2011","journal-title":"Int Urogynecol J."},{"key":"B35","doi-asserted-by":"publisher","first-page":"43990","DOI":"10.7554\/eLife.43990","article-title":"Multivariable two-sample Mendelian randomization estimates of the effects of intelligence and education on health","volume":"8","author":"Davies","year":"2019","journal-title":"Elife."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.742952\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T06:39:22Z","timestamp":1635403162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.742952\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,28]]},"references-count":35,"alternative-id":["10.3389\/fpubh.2021.742952"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.742952","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2021,10,28]]},"article-number":"742952"}}