Li Po, Dong Zhiyong, Chen Wenhui, Yang Gang
Department of General Surgery, Second People's Hospital of Zhangye City, Zhangye, 734000, People's Republic of China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
Nat Sci Sleep. 2023 Apr 19;15:257-266. doi: 10.2147/NSS.S398544. eCollection 2023.
Previous studies of obstructive sleep apnea (OSA) in relation to stroke have been noted. However, the exact causality remains to be clearly defined. We aimed to adopt a two-sample Mendelian randomization study to investigate the causal effects of OSA on stroke and its subtypes.
A two-sample Mendelian randomization (MR) analysis was conducted to evaluate the causal effect of OSA on stroke and its subtypes, including, based on publicly genome-wide association studies (GWAS) databases. The inverse variance weighted (IVW) method was used as the main analysis. MR-Egger regression, weighted mode, weighted median, and MR pleiotropy residual sum and outlier (MR-PRESSO) were performed methods and were adopted as supplementary analysis to ensure the robustness of the results.
Genetically predicted OSA was not related to the risk of stroke (odds ratio (OR), 0.99, 95% CI, 0.81-1.21, p = 0.909), and its subtypes, ischemic stroke (IS) (OR, 1.01, 95% CI, 0.82-1.23, p = 0.927), large vessel stroke (LVS) (OR, 1.05, 95% CI, 0.73-1.51, p = 0.795), cardioembolic stroke (CES) (OR, 1.03, 95% CI, 0.74-1.43, p = 0.855), small vessel stroke (SVS) (OR, 1.13, 95% CI, 0.88-1.46, p = 0.329), lacunar stroke (LS) (OR, 1.07, 95% CI, 0.74-1.56, p = 0.721) as well as intracerebral hemorrhage (ICH) (OR, 0.37, 95% CI = 0.09, 1.48, p = 0.160) (Wald ratio method). Other supplementary MR methods also confirmed similar results.
There may be no direct causal relationship between OSA and stroke or its subtypes.
此前已有关于阻塞性睡眠呼吸暂停（OSA）与中风关系的研究报道。然而，确切的因果关系仍有待明确界定。我们旨在采用两样本孟德尔随机化研究来探究OSA对中风及其亚型的因果效应。
基于公开的全基因组关联研究（GWAS）数据库，进行两样本孟德尔随机化（MR）分析，以评估OSA对中风及其亚型的因果效应。采用逆方差加权（IVW）法作为主要分析方法。进行MR-Egger回归、加权模式、加权中位数以及MR多效性残差和异常值（MR-PRESSO）分析，并将其作为补充分析，以确保结果的稳健性。
基因预测的OSA与中风风险无关（优势比（OR）为0.99，95%置信区间为0.81 - 1.21，p = 0.909），与中风各亚型也无关，包括缺血性中风（IS）（OR为1.01，95%置信区间为0.82 - 1.23，p = 0.927）、大动脉粥样硬化性卒中（LVS）（OR为1.05，95%置信区间为0.73 - 1.51，p = 0.795）、心源性栓塞性卒中（CES）（OR为1.03，95%置信区间为0.74 - 1.43，p = 0.855）、小血管性卒中（SVS）（OR为1.13，95%置信区间为0.88 - 1.46，p = 0.329）、腔隙性卒中（LS）（OR为1.07，95%置信区间为0.74 - 1.56，p = 0.721）以及脑出血（ICH）（OR为0.37，95%置信区间为0.09，1.48，p = 0.160）（Wald比值法）。其他补充性MR方法也证实了类似结果。
OSA与中风及其亚型之间可能不存在直接因果关系。
