Department of Rehabilitation Medicine, Suining Central Hospital.
Medicine (Baltimore). 2024 Sep 13;103(37):e39741. doi: 10.1097/MD.0000000000039741.
To investigate the causal relationship between sleep duration and heart failure (HF) in a European population. We focused on the continuous sleep duration of 460,099 European individuals as our primary exposure. Genome-wide significant single nucleotide polymorphisms (SNPs, n = 9851,867) linked to continuous sleep duration were adopted as instrumental variables. The outcome of interest was based on HF events in a European cohort (n = 977,323; with 930,014 controls and 47,309 cases). We employed a two-sample Mendelian randomization (MR) approach to infer causality between sleep duration and the incidence of HF. For validation purposes, an additional cohort of 336,965 European individuals diagnosed with insomnia was selected as a secondary exposure group. Using its SNPs, a subsequent two-sample MR analysis was conducted with the HF cohort to further corroborate our initial findings. Employing the MR methodology, we selected 57 SNPs that are associated with sleep duration, and 24 SNPs that are associated with insomnia as instrumental variables. We discerned a substantial association between genetically inferred sleep duration and HF risk (odds ratio: 0.61; 95% confidence interval: 0.47-0.78, P < .0001). Our subsequent analysis highlighted a pronounced increased HF risk associated with insomnia (odds ratio: 1.54; 95% confidence interval: 1.08-2.17, P < .02). These conclusions were further bolstered by consistent results from sensitivity analyses. Our study suggests a causal linkage between sleep duration and the onset risk of HF in the European population. Notably, shorter sleep durations were associated with a heightened risk of HF.
在欧洲人群中探究睡眠时长与心力衰竭(HF)之间的因果关系。我们主要关注 460099 名欧洲个体的连续睡眠时长作为主要暴露因素。采用与连续睡眠时长相关的全基因组显著单核苷酸多态性(SNP,n=9851867)作为工具变量。感兴趣的结局基于欧洲队列中的 HF 事件(n=977323;其中 930014 名对照和 47309 例)。我们采用两样本 Mendelian 随机化(MR)方法推断睡眠时长与 HF 发生率之间的因果关系。为了验证目的,选择了 336965 名被诊断为失眠的欧洲个体作为次要暴露组。利用其 SNPs,我们对 HF 队列进行了后续的两样本 MR 分析,以进一步证实我们的初步发现。采用 MR 方法,我们选择了 57 个与睡眠时长相关的 SNP 和 24 个与失眠相关的 SNP 作为工具变量。我们发现,遗传推断的睡眠时长与 HF 风险之间存在显著关联(比值比:0.61;95%置信区间:0.47-0.78,P<0.0001)。我们随后的分析强调了与失眠相关的 HF 风险显著增加(比值比:1.54;95%置信区间:1.08-2.17,P<0.02)。这些结论通过敏感性分析得到了一致的结果进一步证实。本研究表明,在欧洲人群中,睡眠时长与 HF 的发病风险之间存在因果关系。值得注意的是,较短的睡眠时长与 HF 风险增加相关。