閉塞性睡眠時無呼吸と心房細動リスクの因果関係の評価

Atrial fibrillation (AF) and obstructive sleep apnea (OSA) are associated, however the majority of the research to date has been observational in nature and is unable to definitively prove a causative relationship. Using Mendelian randomization (MR) analysis and meta-analysis, this study attempts to assess the causal link between AF and OSA in more detail. Six genome-wide association studies (GWAS) datasets were subjected to de novo 2-sample MR analysis, and a series of analyses were carried out to guarantee the validity of the MR findings. In order to better elucidate the relationship between OSA and AF, a meta-analysis was performed on the inverse-variance weighted results of all MR analyses. GWAS data from several large-scale cohorts suggested an increased risk of atrial fibrillation (AF) associated with obstructive sleep apnea (OSA), whereas results from other GWAS datasets showed no clear evidence supporting a causal relationship. After excluding GWAS data that may contain false positive results, the meta-analysis results revealed a causal relationship between OSA and AF (odds ratio = 1.0030, 95% confidence interval = 1.0007-1.0054, P < .01). This study provides support for a causal relationship between OSA and AF. Efforts should be made to screen for AF in patients with OSA, elucidate its clinical significance, and explore its role as a potentially modifiable risk factor.