To further evaluate the robustness of the causal effect estimates, we conducted a series of sensitivity analyses. The MR-Egger intercept test did not detect significant directional pleiotropy (intercept = -0.0134, SE = 0.0142, P = 0.350), supporting the reliability of the MR analysis results. The MR-PRESSO global test further supported this conclusion, with no significant horizontal pleiotropy detected (P = 0.244).