慢性病,高血压和中风之间的相互作用:来自多变量孟德尔随机化分析的见解
Dearbhla M Kelly1, Marios K Georgakis2, Nora Franceschini2
1From the J. Philip Kistler Stroke Research Center (D.M.K., A.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Program in Medical and Population Genetics (D.M.K., M.K.G., C.D.A.), Broad Institute of Harvard and the Massachusetts Institute of Technology, Boston; Institute for Stroke and Dementia Research (M.K.G.), University Hospital of LMU Munich, Germany; McCance Center for Brain Health (M.K.G., C.D.A.), Massachusetts General Hospital, Boston; Department of Epidemiology (N.F.), University of North Carolina, Chapel Hill; Department of Psychiatry (D.B.), Massachusetts General Hospital, Harvard Medical School; Department of Epidemiology (D.B.), Harvard T.H. Chan School of Public Health; and Department of Neurology (C.D.A.), Brigham and Women's Hospital, Boston, MA. dearbhlakelly2@gmail.com.
慢性病 (CKD) 独立增加中风风险,特别是大动脉中风. 有针对性的病预防可以减少动脉样硬化性中风风险,不论高血压.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
背景情况:
- 慢性病 (CKD) 是已知的中风风险因素之一.
- 高血压在中介CKD-中风关联中的作用需要进一步澄清.
研究的目的:
- 使用遗传数据调查CKD,高血压和中风之间的因果关系.
- 确定高血压在多大程度上调解CKD对中风风险的影响.
主要方法:
- 利用来自欧洲祖先的全基因组关联研究数据.
- 采用孟德尔随机化 (MR) 分析,包括单变量,多变量和调解分析.
- 检查了CKD (eGFR,UACR),静脉血压 (SBP) 和脑血管疾病的遗传代理.
主要成果:
- 较低的估计膜过率 (eGFR) 与所有中风,缺血性中风和大动脉中风 (LAS) 的风险增加有关.
- 在多变量MR分析中对SBP进行控制后,这些关联仍然显著.
- 缩血压仅占EGFR对中风风险总影响的很小一部分 (6.5%-7.2%).
结论:
- 功能障碍 (降低EGFR) 对中风风险,尤其是LAS风险具有独立的因果关系.
- 预防病可能提供一种策略,以减少动脉样硬化性中风风险,独立于高血压管理.
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