Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Int J Stroke. 2022 Dec;17(10):1107-1113. doi: 10.1177/17474930211065640. Epub 2022 Jan 4.
Intracranial aneurysm (IA) is a crucial health concern with limited strategies for prevention and treatment.
To identify potentially modifiable risk factors, such as socioeconomic, behaviors, dietary, and cardiometabolic factors, for IA and its subtypes.
Summary statistics for IA were derived from a genome-wide association study with an overall 79,429 participants. Single nucleotide polymorphisms associated with modifiable risk factors at genome-wide significance ( = 5 × 10) were used as instrumental variables. The inverse-variance-weighted method, weighted-median method, Mendelian randomization (MR)-Egger regression, MR-Pleiotropy RESidual Sum and Outlier, and multivariable MR analyses were performed to evaluate the effect estimates.
Genetically predicted educational attainment, insomnia, smoking, and systolic and diastolic blood pressure (SBP and DBP) were significantly associated with the risk of IA. The odds ratios (ORs) were 0.44 (95% confidence interval (CI): 0.37-0.52) for educational attainment, 1.15 (95% CI: 1.08-1.23) for insomnia, 1.56 (95% CI: 1.38-1.75) for smoking initiation, 2.69 (95% CI: 1.77-4.07) for cigarette per day, 2.65 (95% CI: 1.72-4.08) for lifetime smoking, 1.07 (95% CI: 1.06-1.09), and 1.06 (95% CI: 1.04-1.10) for SBP and DBP, respectively. Similar effect estimates were observed for unruptured IAs and aneurysmal subarachnoid hemorrhage.
This study provided genetic evidence that several modifiable risk factors, including blood pressure, smoking, educational attainment, and insomnia were associated with the risk of IA.
颅内动脉瘤 (IA) 是一个重要的健康问题，目前预防和治疗的策略有限。
确定可改变的风险因素，如社会经济、行为、饮食和心血管代谢因素，与 IA 及其亚型的关系。
从一项全基因组关联研究中得出了 IA 的汇总统计数据，该研究共有 79429 名参与者。使用与可改变风险因素相关的全基因组显著关联的单核苷酸多态性（ = 5 × 10）作为工具变量。采用逆方差加权法、加权中位数法、孟德尔随机化 (MR)-Egger 回归、MR-Pleiotropy RESidual Sum and Outlier 和多变量 MR 分析来评估效应估计值。
遗传预测的教育程度、失眠、吸烟以及收缩压和舒张压（SBP 和 DBP）与 IA 的发病风险显著相关。比值比 (OR) 分别为教育程度降低（OR：0.44；95%置信区间 [CI]：0.37-0.52）、失眠（OR：1.15；95% CI：1.08-1.23）、吸烟开始（OR：1.56；95% CI：1.38-1.75）、每天吸烟量（OR：2.69；95% CI：1.77-4.07）、终生吸烟（OR：2.65；95% CI：1.72-4.08）、SBP（OR：1.07；95% CI：1.06-1.09）和 DBP（OR：1.06；95% CI：1.04-1.10）。未破裂的 IA 和蛛网膜下腔出血的动脉瘤也观察到了类似的效应估计值。
本研究提供了遗传证据，表明包括血压、吸烟、教育程度和失眠在内的几种可改变的风险因素与 IA 的发病风险有关。
