重新评估初潮时的年龄与心血管疾病之间的关联:观察性和门德尔随机化分析
Lena Tschiderer1, Sanne A E Peters2,3,4, Yvonne T van der Schouw2
1Institute of Clinical Epidemiology, Public Health, Health Economics, Medical Statistics and Informatics, Medical University of Innsbruck, Anichstraße 35, Innsbruck 6020, Austria.
European journal of preventive cardiology
|March 18, 2025
概括
初潮时的早期或晚年 (AAM) 与心血管疾病 (CVD) 风险有关. 门德尔的随机化表明,较高的AAM因果降低了心肌梗塞风险,但并没有降低中风风险.
科学领域:
- 流行病学 流行病学
- 遗传学 遗传学 是一个
- 心血管医学 心血管医学
背景情况:
- 观察性研究表明,初潮时的年龄 (AAM) 和心血管疾病 (CVD) 之间存在U形关系.
- 非线性关联和潜在的因果关系需要进一步调查.
研究的目的:
- 评估AAM和CVD之间的非线性关联.
- 使用孟德尔随机化 (MR) 调查AAM和心血管疾病之间的潜在因果关系.
主要方法:
- 利用了欧洲癌症和营养心血管疾病前性调查 (EPIC-CVD) 研究和英国生物库的数据.
- 在观测分析中使用考克斯回归和非线性/线性MR进行因果推断.
- 包括283,210名女性,分析发生的心肌梗塞 (MI),缺血性中风和出血性中风.
主要成果:
- 观察分析显示,AAM和MI/缺血性中风风险之间存在U形的关联.
- 核磁共振分析没有发现遗传代理AAM和CVD的非线性证据.
- 每年基因代理AAM的增加与心脏病发作风险降低有关 (HR 0.92 [0.860.99]).
结论:
- 在AAM和MI/缺血性中风之间存在非线性观察关联.
- 较高的AAM似乎会因果性地降低心脏病发作风险,没有非线性.
- 在AAM和缺血性或出血性中风之间没有支持的因果关系.
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