Zhuo Chengui, Chen Lei, Wang Qiqi, Cai Haipeng, Lin Zujin, Pan Huili, Wu Meicui, Jin Yuxiang, Jin Hong, Zheng Liangrong
Department of Cardiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
Zhejiang Provincial Center for Drug and Medical Device Procurement, Hangzhou, China.
Front Cardiovasc Med. 2023 Dec 7;10:1267906. doi: 10.3389/fcvm.2023.1267906. eCollection 2023.
Limited studies have explored the association between sexual factors [age at first sexual intercourse (AFS) and lifetime number of sexual partners (LNSP)] and cardiovascular diseases (CVDs), leaving the causality inconclusive.
We performed a bi-directional Mendelian randomization (MR) study to investigate the causality between sexual factors and CVDs, including coronary artery disease, myocardial infarction, atrial fibrillation (AF), heart failure (HF), and ischemic stroke (IS). Single-nucleotide polymorphisms (SNPs) for sexual factors were extracted from the UK Biobank. Statistics for each CVD were derived from two different databases. MR estimates were calculated per outcome database and were combined through meta-analysis. Several complementary sensitivity analyses were also performed.
The primary analysis suggested that AFS was causally associated with the risk of CVDs; the odds ratios (ORs) ranged from 0.686 [95% confidence interval (CI), 0.611-0.770] for HF to 0.798 (95% CI, 0.719-0.886) for AF. However, the association between AFS and IS (OR, 0.844; 95% CI, 0.632-1.126) was not consistent in the meta-analysis after excluding SNPs related to confounders. Moreover, non-significant associations were found between LNSP and CVDs. Reverse direction MR analysis showed that CVDs were not associated with sexual factors.
Genetic evidence suggested that AFS was causally associated with the risk of CVDs except for IS, whereas non-significant association of LNSP with CVDs was detected. Further investigation into AFS could be warranted in preventing the progression of CVDs.
仅有有限的研究探讨了性因素[首次性交年龄（AFS）和性伴侣终生数量（LNSP）]与心血管疾病（CVD）之间的关联，因果关系尚无定论。
我们进行了一项双向孟德尔随机化（MR）研究，以调查性因素与CVD之间的因果关系，包括冠状动脉疾病、心肌梗死、心房颤动（AF）、心力衰竭（HF）和缺血性中风（IS）。性因素的单核苷酸多态性（SNP）从英国生物银行提取。每种CVD的统计数据来自两个不同的数据库。每个结局数据库计算MR估计值，并通过荟萃分析进行合并。还进行了几项补充敏感性分析。
初步分析表明，AFS与CVD风险存在因果关联；优势比（OR）范围从HF的0.686[95%置信区间（CI），0.611 - 0.770]到AF的0.798（95%CI，0.719 - 0.886）。然而，在排除与混杂因素相关的SNP后，荟萃分析中AFS与IS之间的关联（OR，0.844；95%CI，0.632 - 1.126）并不一致。此外，未发现LNSP与CVD之间存在显著关联。反向MR分析表明，CVD与性因素无关。
遗传证据表明，除IS外，AFS与CVD风险存在因果关联，而未检测到LNSP与CVD之间存在显著关联。在预防CVD进展方面，可能有必要对AFS进行进一步研究。
