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载脂蛋白B与动脉粥样硬化性心血管疾病风险之间的因果关系:一项孟德尔随机化分析

Causal relationship between apolipoprotein B and risk of atherosclerotic cardiovascular disease: a mendelian randomization analysis.

作者信息

Kong Xiangyong, Cai Yanchen, Li Yuwei, Wang Ping

机构信息

School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200093 China.

Department of Nephrology and Rheumatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200000 China.

出版信息

Health Inf Sci Syst. 2025 Jan 3;13(1):13. doi: 10.1007/s13755-024-00323-5. eCollection 2025 Dec.

Abstract

BACKGROUND

Atherosclerotic cardiovascular disease (ASCVD) is a major threat to human life and health, and dyslipidemia with elevated low-density lipoprotein cholesterol (LDL-C) is an important risk factor, and in the optimal LDL-C scenario, apolipoprotein B (ApoB) has a more predictive value of ASCVD risk.

METHODS

The study is a genome-wide association study (GWAS) based on a European population. A large GWAS dataset for atherosclerotic cardiovascular diseases was targeted, including coronary heart disease (CHD), ischemic stroke (IS), large-artery atherosclerotic stroke (ISL), small-vessel stroke (ISS), and myocardial infarction (MI). Univariate two-sample mendelian randomization (MR) analyses of ApoB and the above cardiovascular diseases were performed separately, and the association was assessed mainly using the inverse variance weighted (IVW) method, with confidence intervals for the superiority ratios set at 95%. In addition, the experiment was supplemented using MR-Egger, weighted model and weighted median (WM).

RESULTS

Based on the results of univariate two-sample mendelian randomisation analysis, it was shown that there was a causal relationship between ApoB and CHD (OR = 1.710, 95% CI 1.529-1.912, P = 0.010), ISL (OR = 1.430, 95% CI 1.231-1.661, P = 2.714E-06), ISS (OR = 1.221, 95% CI 1.062-1.405, P = 0.005) were causally related to each other and the disease prevalence ratio was positively correlated with ApoB concentration.

CONCLUSION

This MR analysis demonstrated a causal relationship between ApoB and CHD, ISL, ISS, but not with the risk of developing IS and MI, which further validated the relationship between ApoB and the risk of ASCVD, and contributed to a better understanding of the genetic impact of ApoB on ASCVD, and to a certain extent, could improve the management of ApoB and reduce the prevalence of ASCVD.

摘要

背景

动脉粥样硬化性心血管疾病(ASCVD)是对人类生命和健康的主要威胁,低密度脂蛋白胆固醇(LDL-C)升高的血脂异常是一个重要危险因素,在最佳LDL-C情况下,载脂蛋白B(ApoB)对ASCVD风险具有更高的预测价值。

方法

该研究是一项基于欧洲人群的全基因组关联研究(GWAS)。针对一个大型的动脉粥样硬化性心血管疾病GWAS数据集,包括冠心病(CHD)、缺血性中风(IS)、大动脉粥样硬化性中风(ISL)、小血管中风(ISS)和心肌梗死(MI)。分别对ApoB与上述心血管疾病进行单变量两样本孟德尔随机化(MR)分析,主要采用逆方差加权(IVW)方法评估关联,优势比的置信区间设定为95%。此外,使用MR-Egger、加权模型和加权中位数(WM)对实验进行补充。

结果

基于单变量两样本孟德尔随机化分析结果,表明ApoB与CHD(OR = 1.710,95% CI 1.529 - 1.912,P = 0.010)、ISL(OR = 1.430,95% CI 1.231 - 1.661,P = 2.714E - 06)、ISS(OR = 1.221,95% CI 1.062 - 1.405,P = 0.005)之间存在因果关系,且疾病患病率与ApoB浓度呈正相关。

结论

该MR分析表明ApoB与CHD、ISL、ISS之间存在因果关系,但与IS和MI的发生风险无关,这进一步验证了ApoB与ASCVD风险之间的关系,有助于更好地理解ApoB对ASCVD的遗传影响,并在一定程度上可改善ApoB的管理,降低ASCVD的患病率。

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