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Y 染色体镶嵌缺失与缺血性脑卒中后的功能结局相关。

Mosaic Loss of Chromosome Y Is Associated With Functional Outcome After Ischemic Stroke.

机构信息

Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden (M.D., A.P., T.M.S., C.J.).

Department of Clinical Genetics and Genomics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden (A.P., C.J.).

出版信息

Stroke. 2023 Sep;54(9):2434-2437. doi: 10.1161/STROKEAHA.123.043551. Epub 2023 Jul 19.

Abstract

BACKGROUND

Mosaic loss of chromosome Y (LOY) is associated with cardiovascular and neurodegenerative diseases in men, and genetic predisposition to LOY is associated with poor poststroke outcome. We, therefore, tested the hypothesis that LOY itself is associated with functional outcome after ischemic stroke.

METHODS

The study comprised male patients with ischemic stroke from the cohort studies SAHLSIS2 (Sahlgrenska Academy Study on Ischemic Stroke Phase 2; n=588) and LSR (Lund Stroke Register; n=735). We used binary logistic regression to analyze associations between LOY, determined by DNA microarray intensity data, and poor 3-month functional outcome (modified Rankin Scale score, >2) in each cohort separately and combined. Patients who received recanalization therapy were excluded from sensitivity analyses.

RESULTS

LOY was associated with about 2.5-fold increased risk of poor outcome in univariable analyses (<0.001). This association withstood separate adjustment for stroke severity and diabetes in both cohorts but not age. In sensitivity analyses restricted to the nonrecanalization group (n=987 in the combined cohort), the association was significant also after separate adjustment for age (odds ratio, 1.6 [95% CI, 1.1-2.4]) and when additionally adjusting for stroke severity and diabetes (odds ratio, 1.6 [95% CI, 1.1-2.5]).

CONCLUSIONS

We observed an association between LOY and poor outcome after ischemic stroke in patients not receiving recanalization therapy. Future studies on LOY and other somatic genetic alterations in larger stroke cohorts are warranted.

摘要

背景

Y 染色体的镶嵌性缺失(LOY)与男性的心血管和神经退行性疾病有关,LOY 的遗传易感性与中风后的不良预后有关。因此,我们检验了这样一个假设,即LOY 本身与缺血性中风后的功能结局有关。

方法

该研究包括来自 SAHLSIS2(Sahlgrenska Academy 缺血性中风研究 2 期;n=588)和 LSR(Lund 中风登记处;n=735)队列研究的男性缺血性中风患者。我们使用二元逻辑回归分析了 LOY 与 3 个月时功能结局不良(改良 Rankin 量表评分>2)之间的关联,分别在每个队列中进行分析,并进行了合并分析。接受再通治疗的患者被排除在敏感性分析之外。

结果

在单变量分析中,LOY 与不良结局的风险增加约 2.5 倍有关(<0.001)。这种关联在两个队列中都独立于中风严重程度和糖尿病进行了调整,但不能独立于年龄进行调整。在排除再通组(合并队列中 987 例)的敏感性分析中,在单独调整年龄(比值比,1.6[95%CI,1.1-2.4])以及进一步调整中风严重程度和糖尿病后,该关联仍然显著(比值比,1.6[95%CI,1.1-2.5])。

结论

我们观察到在未接受再通治疗的缺血性中风患者中,LOY 与不良结局之间存在关联。需要在更大的中风队列中对 LOY 和其他体细胞遗传改变进行进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d3a/10453343/2d48b65b894e/str-54-2434-g002.jpg

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