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Published on: July 21, 2023
Exploring Stroke Risk through Mendelian Randomization: A Comprehensive Study Integrating Genetics and Metabolic
Hyo-Jeong Ban1, Siwoo Lee1, Hee-Jeong Jin1
1Korean Medicine (KM) Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.
Insights
Genetic factors influence stroke risk differently across Korean constitutional types. Individuals with higher metabolic risk (TE subtypes) showed increased cardioembolic stroke risk, while SE subtypes showed decreased risk, emphasizing personalized medicine.
Area of Science:
- Genetics
- Cardiovascular Medicine
- Neurology
Background:
- Cardiometabolic conditions are significant stroke risk factors.
- Korean medicine utilizes constitutional types for disease treatment.
- Constitutional types exhibit variations in cardiometabolic disease prevalence.
Purpose of the Study:
- To investigate the causal effects of genetic characteristics on stroke risk.
- To analyze these effects based on Korean constitutional types.
- To compare Mendelian randomization estimates across different constitutional groups.
Main Methods:
- Applied Mendelian randomization (MR) to assess genetic associations with stroke.
- Utilized data from large-scale genetic consortia (MEGASTROKE, ISGC, UKbiobank, BBJ).
- Employed single nucleotide polymorphisms (SNPs) as instrumental variables for MR analysis.
Main Results:
- TE constitutional subtypes, prone to metabolic disease, showed a significant increase in cardioembolic stroke (CES) risk (beta = 4.190, p = 0.035).
- SE constitutional subtypes demonstrated a significant decrease in CES risk (beta = -9.336, p = 3.87 × 10^-5).
- Clinical analysis indicated significant differences in diabetes and dyslipidemia among subtypes.
Conclusions:
- Constitutional type is a critical factor in genetic predisposition to stroke subtypes.
- Personalized medicine approaches are essential for accurate stroke risk assessment.
- Findings support tailoring stroke risk evaluation based on individual constitutional profiles.
Abstract:
Numerous risk factors play a role in the causation of stroke, and the cardiometabolic condition is a one of the most important. In Korea, various treatment methods are employed based on the constitutional type, which is known to differ significantly in cardiometabolic disease. In this study, we compared the estimates obtained for different groups by applying the Mendelian randomization method to investigate the causal effects of genetic characteristics on stroke, according to constitutional type. In clinical analysis, the subtypes differ significantly in diabetes or dyslipidemia. The genetic association estimates for the stroke subtype risk were obtained from MEGASTROKE, the International Stroke Genetics Consortium (ISGC), UKbiobank, and BioBank Japan (BBJ), using group-related SNPs as instrumental variables. The TE subtypes with higher risk of metabolic disease were associated with increased risk (beta = 4.190; s.e. = 1.807; p = 0.035) of cardioembolic stroke (CES), and the SE subtypes were associated with decreased risk (beta = -9.336, s.e. = 1.753; p = 3.87 × 10-5) of CES. The findings highlight the importance of personalized medicine in assessing disease risk based on an individual's constitutional type.
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