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阿司匹林的使用与阿尔茨海默病风险:两样本孟德尔随机化研究。

Aspirin Use and Risk of Alzheimer's Disease: A 2-Sample Mendelian Randomization Study.

机构信息

Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.

出版信息

J Alzheimers Dis. 2023;92(3):989-1000. doi: 10.3233/JAD-220787.

Abstract

BACKGROUND

Observational studies have shown inconsistent findings of the relationships between aspirin use and the risk of Alzheimer's disease (AD).

OBJECTIVE

Since residual confounding and reverse causality were challenging issues inherent in observational studies, we conducted a 2-sample Mendelian randomization analysis (MR) to investigate whether aspirin use was causally associated with the risk of AD.

METHODS

We conducted 2-sample MR analyses utilizing summary genetic association statistics to estimate the potential causal relationship between aspirin use and AD. Single-nucleotide variants associated with aspirin use in a genome-wide association study (GWAS) of UK Biobank were considered as genetic proxies for aspirin use. The GWAS summary-level data of AD were derived from a meta-analysis of GWAS data from the International Genomics of Alzheimer's Project (IGAP) stage I.

RESULTS

Univariable MR analysis based on these two large GWAS data sources showed that genetically proxied aspirin use was associated with a decreased risk of AD (Odds Ratio (OR): 0.87; 95%CI: 0.77-0.99). In multivariate MR analyses, the causal estimates remained significant after adjusting for chronic pain, inflammation, heart failure (OR = 0.88, 95%CI = 0.78-0.98), or stroke (OR = 0.87, 95%CI = 0.77-0.99), but was attenuated when adjusting for coronary heart disease, blood pressure, and blood lipids.

CONCLUSION

Findings from this MR analysis suggest a genetic protective effect of aspirin use on AD, possibly influenced by coronary heart disease, blood pressure, and lipid levels.

摘要

背景

观察性研究表明,阿司匹林的使用与阿尔茨海默病(AD)风险之间的关系存在不一致的发现。

目的

由于残余混杂和反向因果关系是观察性研究中固有的挑战问题,我们进行了两样本 Mendelian 随机化分析(MR),以调查阿司匹林的使用是否与 AD 的风险存在因果关系。

方法

我们利用汇总遗传关联统计数据进行了两样本 MR 分析,以估计阿司匹林的使用与 AD 之间的潜在因果关系。在 UK Biobank 的全基因组关联研究(GWAS)中与阿司匹林使用相关的单核苷酸变异被视为阿司匹林使用的遗传替代物。AD 的 GWAS 汇总水平数据源自国际阿尔茨海默病基因组学项目(IGAP)第一阶段 GWAS 数据的荟萃分析。

结果

基于这两个大型 GWAS 数据源的单变量 MR 分析表明,遗传上代表的阿司匹林使用与 AD 风险降低相关(优势比(OR):0.87;95%置信区间(CI):0.77-0.99)。在多变量 MR 分析中,在调整慢性疼痛、炎症、心力衰竭(OR=0.88,95%CI=0.78-0.98)或中风(OR=0.87,95%CI=0.77-0.99)后,因果估计仍然显著,但在调整冠心病、血压和血脂后,因果估计减弱。

结论

这项 MR 分析的结果表明,阿司匹林的使用对 AD 具有遗传保护作用,这可能受冠心病、血压和血脂水平的影响。

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