School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
Jockey Club School of Public Health and Primary Care School, The Chinese University of Hong Kong, Hong Kong.
Sleep Med. 2024 Jan;113:6-12. doi: 10.1016/j.sleep.2023.10.029. Epub 2023 Nov 10.
Observational findings suggest that patients with narcolepsy are at higher risk for cardiovascular diseases (CVDs), but the potential causal relationship between narcolepsy and CVDs is unclear. Therefore, Mendelian randomization (MR) was used to explore the association between narcolepsy and CVDs.
Summary statistics related to narcolepsy, coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), any stroke (AS), and any ischemic stroke (AIS) were extracted from the public database of relevant published genome-wide association studies (GWAS). Independent single nucleotide polymorphisms were selected as instrumental variables under strict quality control criteria. Inverse variance-weighted (IVW) was the main analytical method to assess causal effects. In addition, we conducted MR pleiotropy residual sum and outlier (MR-PRESSO), weighted median, MR-Egger, and leave-one-out sensitivity analysis to verify the robustness and reliability of the results.
The results of the MR study revealed that narcolepsy was significantly associated with an increased risk of HF (OR = 1.714; 95%CI [1.031-2.849]; P = 0.037), CAD (OR = 1.702; 95%CI [1.011-2.864]; P = 0.045). There was no statistically significant causal association between narcolepsy and MI, AS, and AIS. In addition, further sensitivity analysis showed robust results.
The results of the two-sample MR study reveal a potential causal relationship between the increased risk of HF and CAD in narcolepsy. These findings emphasize the importance of early monitoring and assessment of cardiovascular risk in patients with narcolepsy.
观察性研究结果表明，发作性睡病患者患心血管疾病（CVDs）的风险更高，但发作性睡病与 CVDs 之间的潜在因果关系尚不清楚。因此，采用孟德尔随机化（MR）方法来探讨发作性睡病与 CVDs 之间的关联。
从相关已发表的全基因组关联研究（GWAS）的公共数据库中提取与发作性睡病、冠状动脉疾病（CAD）、心肌梗死（MI）、心力衰竭（HF）、任何卒中（AS）和任何缺血性卒中（AIS）相关的汇总统计数据。在严格的质量控制标准下，选择独立的单核苷酸多态性作为工具变量。逆方差加权（IVW）是评估因果效应的主要分析方法。此外，我们还进行了 MR 多效性残差和异常值（MR-PRESSO）、加权中位数、MR-Egger 和逐一剔除敏感性分析，以验证结果的稳健性和可靠性。
MR 研究的结果表明，发作性睡病与 HF（OR=1.714；95%CI [1.031-2.849]；P=0.037）和 CAD（OR=1.702；95%CI [1.011-2.864]；P=0.045）的风险增加显著相关。发作性睡病与 MI、AS 和 AIS 之间无统计学显著的因果关联。此外，进一步的敏感性分析显示结果稳健。
两样本 MR 研究的结果表明，发作性睡病与 HF 和 CAD 风险增加之间存在潜在的因果关系。这些发现强调了在发作性睡病患者中早期监测和评估心血管风险的重要性。
