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传统中风风险因素对早期和晚期缺血性中风的影响:孟德尔的随机化研究

Kevin T K Nguyen¹, Huichun Xu¹, Brady J Gaynor¹

¹Department of Medicine (K.T.K.N., H.X., B.J.G., P.F.M, T.D.O., J.A.P., B.D.M.), University of Maryland School of Medicine, Baltimore.

|February 24, 2025

概括

脑卒中风险因素,如体重指数,对早发性脑卒中 (EOS) 有较强的因果作用,而不是晚发性脑卒中 (LOS). 针对这些因素可能有助于减少中风的发生率.

科学领域:

遗传学和流行病学
心血管疾病研究研究
公共卫生公共卫生

背景情况:

在老年人中,中风的发生率正在下降,但在年轻人中正在上升.
不同的趋势可能源于不同年龄组的不同风险因素影响.
调查中风风险因素的特定年龄因果关系至关重要.

研究的目的:

评估中风风险因素与早发性缺血性中风 (EOS) 与晚发性缺血性中风 (LOS) 的年龄特定关联.
使用门德尔的随机化来确定因果关系.
为了比较风险因素对不同年龄组中风的影响.

主要方法:

从GWAS目录中确定了基因变异作为中风风险因素的工具变量.
这些变异对英国生物库参与者 (年轻和年长) 风险因素的估计影响.
应用孟德尔随机化来估计来自SiGN和EOSC的EOS和LOS病例的因果作用,按TOAST亚型分层.

主要成果:

早期发作的中风 (EOS) 与更高的体重指数,血压,2型糖尿病和更低的HDL胆固醇有关.
晚期发作的中风 (LOS) 与较高的缩血压有关.
身体质量指数对中风的因果作用对于EOS (OR,1.26) 比LOS (OR,1.03) 显著更强;这种差异在亚型分析后减少了.

结论:

确认了体质指数,血压,2型糖尿病和高密度胆固醇与EOS之间的因果关系.
证实了血压和LOS之间的因果关系.
针对这些可修改的风险因素的干预措施可以降低整体中风风险.

关键词:

门德尔的随机化分析.缺血性中风中风有关风险因素的风险因素.一次性中风中风中风中风中风年轻的成年人年轻的成年人

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