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Association between vascular risk factors and idiopathic normal pressure hydrocephalus: a Mendelian randomization
Ziang Deng1, Haoxiang Wang1, Keru Huang1
1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Insights
Essential hypertension is a causal risk factor for idiopathic normal pressure hydrocephalus (iNPH). This study suggests hypertension may play a role in iNPH development, highlighting the need for blood pressure management.
Area of Science:
- Neurology
- Genetics
- Epidemiology
Background:
- Idiopathic normal pressure hydrocephalus (iNPH) is associated with higher rates of hypertension and diabetes.
- The causal link between vascular risk factors (VRFs) and iNPH remains unclear.
Purpose of the Study:
- To investigate the causal relationship between various VRFs and iNPH using Mendelian randomization.
Main Methods:
- Mendelian randomization (MR) analysis was performed on iNPH.
- Nineteen VRFs including hypertension, diabetes, lipids, obesity, smoking, alcohol, exercise, and sleep were analyzed as exposures.
- Inverse-variance weighted method was used for primary analysis, with weighted median, maximum likelihood, and MR Egger regression for sensitivity.
Main Results:
- Essential hypertension was identified as a significant causal risk factor for iNPH (OR=1.608, p=0.013).
- Increased sleep duration showed a strong association with higher odds of iNPH (OR=16.395, p=0.009).
- Type 1 diabetes was associated with lower odds of iNPH (OR=0.869, p=0.004). No significant associations were found for the other 16 VRFs.
Conclusions:
- Essential hypertension is a causal risk factor for iNPH.
- Hypertension may contribute to the pathophysiology of iNPH.
- Further research into the mechanisms linking hypertension and iNPH is warranted.
Background And Objective:
Patients with idiopathic normal pressure hydrocephalus (iNPH) have a higher prevalence of hypertension and diabetes. However, the causal effects of these vascular risk factors on iNPH remain unclear. This study aimed to explore the causal relationship between vascular risk factors (VRFs) and iNPH.
Methods:
We conducted the Mendelian randomization (MR) analysis of iNPH. We included nineteen vascular risk factors related to hypertension, diabetes, lipids, obesity, smoking, alcohol consumption, exercise, sleep, and cardiovascular events as exposure factors. We used the inverse-variance weighted method for causal effect estimation and weighted median, maximum likelihood, and MR Egger regression methods for sensitivity analyses.
Results:
We found that genetically predicting essential hypertension (OR = 1.608 (1.330-1.944), p = 0.013) and increased sleep duration (OR = 16.395 (5.624-47.799), p = 0.009) were associated with higher odds of iNPH. Type 1 diabetes (OR = 0.869 (0.828-0.913), p = 0.004) was associated with lower odds of iNPH. For the other 16 VRFs, there was no evidence that they were significantly associated with iNPH. Sensitivity analyses showed that essential hypertension and type 1 diabetes were significantly associated with iNPH.
Conclusion:
In our MR study on VRFs and iNPH, we found essential hypertension to be a causal risk factor for iNPH. This suggests that hypertension may be involved in the pathophysiological mechanism of iNPH.
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