Song Jingru, Chen Wenjing, Ye Wei
Department of Gastroenterology, Hangzhou Traditional Chinese Medicine (TCM) Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Front Neurol. 2023 Feb 21;14:1131250. doi: 10.3389/fneur.2023.1131250. eCollection 2023.
The issue of whether a stroke is causally related to gastrointestinal disorders was still not satisfactorily understood. Therefore, we investigated if there is a connection between stroke and the most prevalent gastrointestinal disorders, including peptic ulcer disease (PUD), gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD).
We applied two-sample Mendelian randomization to investigate relationships with gastrointestinal disorders. We obtained genome-wide association study (GWAS) summary data of any stroke, ischemic stroke, and its subtypes from the MEGASTROKE consortium. From the International Stroke Genetics Consortium (ISGC) meta-analysis, we acquired GWAS summary information on intracerebral hemorrhage (ICH), including all ICH, deep ICH, and lobar ICH. Several sensitivity studies were performed to identify heterogeneity and pleiotropy, while inverse-variance weighted (IVW) was utilized as the most dominant estimate.
No evidence for an effect of genetic predisposition to ischemic stroke and its subtypes on gastrointestinal disorders were found in IVW. The complications of deep ICH are a higher risk for PUD and GERD. Meanwhile, lobar ICH has a higher risk of complications for PUD.
This study provides proof of the presence of a brain-gut axis. Among the complications of ICH, PUD and GERD were more common and associated with the site of hemorrhage.
中风与胃肠道疾病是否存在因果关系这一问题仍未得到令人满意的理解。因此，我们调查了中风与最常见的胃肠道疾病之间是否存在联系，这些疾病包括消化性溃疡病（PUD）、胃食管反流病（GERD）、肠易激综合征（IBS）和炎症性肠病（IBD）。
我们应用两样本孟德尔随机化方法来研究与胃肠道疾病的关系。我们从MEGASTROKE联盟获得了任何中风、缺血性中风及其亚型的全基因组关联研究（GWAS）汇总数据。从国际中风遗传学联盟（ISGC）的荟萃分析中，我们获取了关于脑出血（ICH）的GWAS汇总信息，包括所有脑出血、深部脑出血和脑叶脑出血。进行了多项敏感性研究以识别异质性和多效性，同时采用逆方差加权（IVW）作为最主要的估计方法。
在IVW分析中，未发现缺血性中风及其亚型的遗传易感性对胃肠道疾病有影响的证据。深部脑出血的并发症发生PUD和GERD的风险更高。同时，脑叶脑出血发生PUD并发症的风险更高。
本研究提供了脑-肠轴存在的证据。在脑出血的并发症中，PUD和GERD更为常见，且与出血部位有关。
