Background: Despite the well-documented influence of traditional risk factors on varicose veins, the potential causal role of the gut microbiome in this condition remains underexplored. This study aims to elucidate the association between specific gut microbial taxa and varicose veins using a Mendelian Randomization (MR) approach. Methods: Utilizing genome-wide association study datasets from the MiBioGen Consortium and the Finnish database, this study carefully selected instrumental variables based on their genetic association with the gut microbiome and stringent statistical criteria. Multiple MR techniques were applied to analyze the data, accompanied by comprehensive sensitivity analyses to ensure the reliability of the causal relationships between the gut microbiota and varicose veins. Results: The study identified three microbial taxa—genus Terrisporobacter, Coprococcus2, and Ruminococcus gnavus group—as protective factors against varicose veins. Conversely, the family Ruminococcaceae, genus Flavonifractor, and genus RuminococcaceaeUCG009 were associated with an increased risk of developing varicose veins. Bidirectional analyses indicated that the presence of varicose veins does not influence the abundance of these microbiota groups. Conclusion: The results of this study support a relationship between specific gut microbiota and varicose veins, revealing potential new targets for therapeutic intervention. These insights not only deepen our understanding of the pathophysiology of varicose veins but also provide a theoretical basis for future medical applications, highlighting the potential value of microbiome research in the prevention and treatment strategies for varicose veins.
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