Causal relationships between the gut microbiota, immune cells, and diabetic kidney disease: a Mendelian randomization and mediation analysis.

A few traits exhibited nominally significant associations ( p < 0.05), but the effect directions were inconsistent across traits and sensitivity analyses (weighted median, MR Egger) did not uniformly support these findings.

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All instruments demonstrated strong explanatory power (exposure R 2 > outcome R 2 ) and highly significant Steiger P -values, confirming adequate instrument strength and the correct causal direction without evidence of reverse causation.

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