阻塞性睡眠呼吸暂停的遗传分析及其与严重COVID-19的关系
Satu Strausz1,2,3,4,5, Elizabete Agafonova2,6, Varvara Tiullinen1
1Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, and.
Annals of the American Thoracic Society
|February 8, 2024
概括
阻塞性睡眠呼吸暂停 (OSA) 是严重COVID-19的因果风险因素,主要是由较高的体重指数 (BMI) 驱动的. 与对照组相比,接种疫苗为OSA患者提供了更好的防范COVID-19住院治疗.
科学领域:
- 遗传学和基因组学 遗传学和基因组学
- 流行病学 流行病学
- 睡眠的药物 睡眠的药物
- 传染病研究传染病研究.
背景情况:
- 患有阻塞性睡眠呼吸暂停 (OSA) 的患者面临严重冠状病毒病 (COVID-19) 住院治疗的风险增加.
- 之前还没有确定OSA和COVID-19严重程度之间的因果关系.
- 了解这种关系对于公共卫生战略和患者管理至关重要.
研究的目的:
- 为了调查阻塞性睡眠呼吸暂停 (OSA) 和COVID-19住院治疗之间的因果关系.
- 为了确定OSA的遗传风险因素及其对COVID-19严重性的贡献.
- 评估疫苗接种对OSA患者COVID-19住院风险的影响.
主要方法:
- 在FinnGen数据集 (N=377,277) 上进行全基因组关联研究 (GWAS),以确定OSA遗传风险因素.
- 门德尔随机化 (MR) 分析,包括单变量和多变量方法,使用已识别的遗传变异作为仪器变量.
- 分析电子健康记录和疫苗接种数据,以计算COVID-19住院的绝对风险降低.
主要成果:
- 在百万退伍军人计划中,OSA的9个新型遗传基因位点被确定并复制.
- 门德尔随机化证实OSA是严重COVID-19的因果风险因素 (P=9.41×10−4).
- 多变量MR表明,较高的体重指数 (BMI) 主要驱动OSA和严重的COVID-19之间的因果关系 (P=5.97×10−6,β=0.47).
- 与非OSA对照组 (6.3%) 相比,接种疫苗对OSA患者 (13.3%) 的COVID-19住院绝对风险降低更大.
结论:
- 阻塞性睡眠呼吸暂停 (OSA) 与严重的COVID-19风险增加有关.
- 观察到的因果关系在很大程度上是由体重指数 (BMI) 介导的,这表明BMI依赖的影响.
- 发现了OSA的新型遗传风险因素,有助于我们了解其病理生理学.
- 接种疫苗对COVID-19住院提供了显著的保护,在OSA患者中观察到更大的益处.
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