心血管危险因素和生活方式行为与神经退行性疾病的关联:一项孟德尔随机化研究。

Associations of cardiovascular risk factors and lifestyle behaviors with neurodegenerative disease: a Mendelian randomization study.

机构信息

Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.

Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontier Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Transl Psychiatry. 2023 Jul 24;13(1):267. doi: 10.1038/s41398-023-02553-9.

Abstract

Previous observational studies reported that midlife clustering of cardiovascular risk factors and lifestyle behaviors were associated with neurodegenerative disease; however, these findings might be biased by confounding and reverse causality. This study aimed to investigate the causal associations of cardiovascular risk factors and lifestyle behaviors with neurodegenerative disease, using the two-sample Mendelian randomization design. Genetic variants for the modifiable risk factors and neurodegenerative disease were extracted from large-scale genome-wide association studies. The inverse-variance weighted method was used as the main analysis method, and MR-Egger regression and leave-one-out analyses were performed to identify potential violations. Genetically predicted diastolic blood pressure (DBP: OR per 1 mmHg, 0.990 [0.979-1.000]), body mass index (BMI: OR per 1 SD, 0.880 [0.825-0.939]), and educational level (OR per 1 SD, 0.698 [0.602-0.810]) were associated with lower risk of late-onset Alzheimer's disease (LOAD), while genetically predicted low-density lipoprotein (LDL: OR per 1 SD, 1.302 [1.066-1.590]) might increase LOAD risk. Genetically predicted exposures (including LDL and BMI) applied to familial AD showed the same effect. The association of LDL was also found with Amyotrophic lateral sclerosis (ALS) (LDL: OR per 1 SD, 1.180 [1.080-1.289]). This MR analysis showed that LDL, BMI, BP, and educational level were causally related to AD; a significant association between LDL and ALS risk, as well as the potential effect of sleep duration on PD risk, were also revealed. Targeting these modifiable factors was a promising strategy of neurodegenerative disease prevention.

摘要

先前的观察性研究报告称,中年时期心血管风险因素和生活方式行为的聚集与神经退行性疾病有关;然而,这些发现可能受到混杂因素和反向因果关系的影响。本研究旨在使用两样本孟德尔随机化设计,调查心血管风险因素和生活方式行为与神经退行性疾病之间的因果关联。从大规模全基因组关联研究中提取可改变的风险因素和神经退行性疾病的遗传变异。采用逆方差加权法作为主要分析方法,并进行 MR-Egger 回归和单样本分析,以识别潜在的违反情况。遗传预测的舒张压(DBP:每增加 1mmHg,0.990[0.979-1.000])、体重指数(BMI:每增加 1SD,0.880[0.825-0.939])和教育水平(每增加 1SD,0.698[0.602-0.810])与较低的迟发性阿尔茨海默病(LOAD)风险相关,而遗传预测的低密度脂蛋白(LDL:每增加 1SD,1.302[1.066-1.590])可能增加 LOAD 风险。应用于家族性 AD 的遗传预测暴露(包括 LDL 和 BMI)也显示出相同的效果。LDL 与肌萎缩侧索硬化症(ALS)(LDL:每增加 1SD,1.180[1.080-1.289])也存在关联。本孟德尔随机分析表明,LDL、BMI、BP 和教育水平与 AD 有因果关系;还揭示了 LDL 与 ALS 风险之间的显著关联,以及睡眠时间对 PD 风险的潜在影响。针对这些可改变的因素是预防神经退行性疾病的一种有前途的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80e8/10366095/98174bc5cff5/41398_2023_2553_Fig1_HTML.jpg

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