Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, No. 150 Jimo Road, Shanghai, 200120, China.
Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Atherosclerosis. 2024 Oct;397:118572. doi: 10.1016/j.atherosclerosis.2024.118572. Epub 2024 Aug 24.
Aortic aneurysm (AAs) is a chronic and severe aortic disease, which is extremely life-threatening due to its delayed diagnosis and a high risk of rupture. In current studies, the association between lifestyle and metabolic factors remains controversial given the complexity of pathogenesis and progression in AAs. Consequently, more reliable and robust evidence should be provided.
Genome-wide association studies summary statistics were obtained for 25 factors (6 lifestyle factors and 19 cardiometabolic factors) and AAs. Univariable Mendelian randomization (UVMR) and multivariable MR (MVMR) were used to estimate the causal effect of these factors on AAs. Meanwhile, mediation analysis was applied to assess the mediated effect of lifestyle on the association of cardiometabolic factors with AAs.
Several factors were associated with AA risk, among which triglyceride (TG) (OR = 1.32, 95 % CI = [1.18-1.47], p < 0.001) and high-density lipoprotein cholesterol (HDL-C) (OR = 0.70, 95 % CI = [0.61-0.82], p < 0.001) remain consistently associated with AA risk, with an idependent effect on AAs after adjusting for body mass index (BMI). In addition, TG mediated 15.6 % of BMI effects and 3.7 % of smoking effects on AAs, and HDL-C mediated 5.3 % of the effects of cigarette smoking on AAs.
TG and HDL-C may be the most reliable factors in the risk of AAs. More scientific management of lifestyle and regular monitoring for cardiometabolic traits may serve as a new and effective direction for the prevention and control of the occurrence of AAs.
主动脉瘤（AAA）是一种慢性且严重的主动脉疾病，由于其诊断延迟和破裂风险高，因此极具生命威胁性。在目前的研究中，由于 AAA 的发病机制和进展复杂，生活方式和代谢因素之间的关联仍存在争议。因此，应该提供更可靠和稳健的证据。
我们获得了 25 个因素（6 个生活方式因素和 19 个心血管代谢因素）和 AAA 的全基因组关联研究汇总统计数据。我们使用单变量孟德尔随机化（UVMR）和多变量 MR（MVMR）来估计这些因素对 AAA 的因果影响。同时，我们应用中介分析来评估生活方式对心血管代谢因素与 AAA 之间关联的中介作用。
一些因素与 AAA 风险相关，其中甘油三酯（TG）（OR=1.32，95%CI=[1.18-1.47]，p<0.001）和高密度脂蛋白胆固醇（HDL-C）（OR=0.70，95%CI=[0.61-0.82]，p<0.001）与 AAA 风险持续相关，在调整体重指数（BMI）后对 AAA 具有独立影响。此外，TG 介导了 BMI 对 AAA 影响的 15.6%，吸烟对 AAA 影响的 3.7%，HDL-C 介导了吸烟对 AAA 影响的 5.3%。
TG 和 HDL-C 可能是 AAA 风险中最可靠的因素。更科学的生活方式管理和定期监测心血管代谢特征可能成为预防和控制 AAA 发生的新的有效方向。
