Department of Neurology Beijing Tiantan HospitalCapital Medical University Beijing China.
China National Clinical Research Center for Neurological Diseases Beijing China.
J Am Heart Assoc. 2021 Dec 7;10(23):e022560. doi: 10.1161/JAHA.121.022560. Epub 2021 Nov 19.
Background Obstructive sleep apnea (OSA) has shown to be associated with an increased risk of atrial fibrillation in observational studies. Whether this association reflect causal effect is still unclear. The aim of this study was to evaluate the causal effect of OSA on atrial fibrillation. Methods and Results We used a 2-sample Mendelian randomization (MR) method to evaluate the causal effect of OSA on atrial fibrillation. Summary data on genetic variant-OSA association were obtained from a recently published genome-wide association studies with up to 217 955 individuals and data on variant-atrial fibrillation association from another genome-wide association study with up to 1 030 836 individuals. Effect estimates were evaluated using inverse-variance weighted method. Other MR analyses, including penalized inverse-variance weighted, penalized robust inverse-variance weighted, MR-Egger, simple median, weighted median, weighted mode-based estimate and Mendelian Randomization Pleiotropy Residual Sum and Outlier methods were performed in sensitivity analyses. The MR analyses in both the fixed-effect and random-effect inverse-variance weighted models showed that genetically predicted OSA was associated with an increased risk of atrial fibrillation (odds ratio [OR], 1.21; 95% CI, 1.12-1.31, <0.001; OR, 1.21; 95% CI, 1.11-1.32, <0.001) using 5 single nucleotide polymorphisms as the instruments. MR-Egger indicated no evidence of genetic pleiotropy (intercept, -0.014; 95% CI, -0.033 to 0.005, =0.14). Results were robust using other MR methods in sensitivity analyses. Conclusions This MR analysis found that genetically predicted OSA had causal effect on an increased risk of atrial fibrillation.
背景:观察性研究表明阻塞性睡眠呼吸暂停(OSA)与心房颤动的风险增加有关。但这种关联是否反映了因果关系尚不清楚。本研究旨在评估 OSA 对心房颤动的因果效应。
方法和结果:我们使用两样本 Mendelian 随机化(MR)方法来评估 OSA 对心房颤动的因果效应。关于遗传变异与 OSA 关联的汇总数据来自最近发表的一项全基因组关联研究,该研究纳入了多达 217955 名个体;关于变异与心房颤动关联的汇总数据来自另一项全基因组关联研究,该研究纳入了多达 1030836 名个体。使用逆方差加权法评估效应估计值。其他 MR 分析,包括惩罚逆方差加权法、惩罚稳健逆方差加权法、MR-Egger 法、简单中位数法、加权中位数法、加权模式估计法和 Mendelian Randomization 多效性残差和异常值法,在敏感性分析中进行。固定效应和随机效应逆方差加权模型中的 MR 分析均表明,遗传预测的 OSA 与心房颤动风险增加相关(优势比[OR],1.21;95%置信区间[CI],1.12-1.31,<0.001;OR,1.21;95%CI,1.11-1.32,<0.001),使用 5 个单核苷酸多态性作为工具。MR-Egger 分析表明没有遗传多效性的证据(截距,-0.014;95%CI,-0.033 至 0.005,=0.14)。在敏感性分析中,其他 MR 方法的结果具有稳健性。
结论:本 MR 分析发现,遗传预测的 OSA 对心房颤动风险增加有因果作用。
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