血代谢物,缩血压,生活方式和中风风险:一个前性队列研究
Canjia Zhang1,2, Mingxiao Li1,3, Miaomiao Yang1
1Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, People's Republic of China.
概括
高代谢风险评分 (MRS) 显著增加中风风险,特别是当与高血压或不健康的生活方式相结合时. 将MRS纳入中风预测模型中略有改善,而与生活方式相关的代谢特征可能会降低中风风险.
科学领域:
- 代谢学 代谢学 代谢学
- 心血管流行病学心血管流行病学
- 生物统计学 生物统计学
背景情况:
- 血代谢物和代谢风险评分 (MRS) 越来越多地被认为对心血管健康的作用.
- 了解代谢特征,生活方式因素和高血压之间的相互作用对于中风风险评估至关重要.
研究的目的:
- 调查血代谢物,MRS和中风风险之间的关联,包括不同的中风亚型.
- 评估MRS与高血压和生活方式对中风风险的综合影响.
- 评估MRS在中风风险模型中的预测价值,并确定与生活方式相关的代谢特征.
主要方法:
- 在77,315名英国生物库参与者中利用XGBoost和LASSO-Cox回归进行代谢物选择和MRS构造.
- 采用弹性净回归来开发与生活方式相关的代谢特征.
- 应用多变量考克斯回归来分析代谢物,MRS,组合因素,代谢特征和中风风险之间的关联.
主要成果:
- 鉴定了与中风,缺血性中风 (IS),下大脑下出血 (SAH) 和脑内出血 (ICH) 相关的众多代谢物.
- 高MRS显著增加了中风,IS,ICH和SAH的风险.
- 高MRS与血压升高 (SBP) 或不健康的生活方式相结合显著增加中风风险.
- 整合MRS改善了中风和IS预测模型的AUC,分别从0.746到0.766和0.771到0.811.
- 代谢特征与坚持健康的生活方式相关,与中风风险相反相关 (HR=0.80).
结论:
- 血代谢物和MRS是中风,IS,ICH和SAH的重要预测因素.
- 患有高MRS的人面临高风险的中风,特别是那些高SBP或不健康的生活方式.
- 在中风风险预测方面,MRS提供了适度但有价值的改进.
- 与生活方式相关的代谢特征显示,有可能将中风风险降低约20%.
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