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血清尿酸水平与脑出血:一项两样本孟德尔随机化研究。

Serum uric acid levels and intracerebral hemorrhage: A two-sample Mendelian randomization study.

作者信息

Lu Buyou, Sun Xiaorui, Zhong Qi, Sun Zijiu

机构信息

Department of Clinical Laboratory, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.

Shanghai YK Pao School, Shanghai, China.

出版信息

J Stroke Cerebrovasc Dis. 2025 Mar;34(3):108192. doi: 10.1016/j.jstrokecerebrovasdis.2024.108192. Epub 2025 Jan 11.

Abstract

OBJECTIVE

Previous observational studies have generated controversy regarding the correlation between serum uric acid (UA) levels and intracerebral hemorrhage (ICH), with the causal relationship remaining uncertain. To assess the potential causal relationship between serum UA levels and ICH, two-sample Mendelian randomization analysis was applied.

METHODS

Single-nucleotide polymorphisms (SNPs) closely associated with serum UA were retrieved from the genome-wide association study (GWAS) database, including 580,505 individuals of European descent. A total of 27 and 251 SNPs were chosen as instrumental variables. Summary data for ICH included 1935 cases and 471,578 controls. Two-sample MR analyses, including inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods, were employed to assess the potential causal relationship between serum UA levels and ICH, with odds ratios (ORs) as effect estimates. Heterogeneity was evaluated using Cochran's Q test, and sensitivity analyses were conducted using the leave-one-out method.

RESULTS

The IVW analysis revealed that a 1 mg/dL increase in serum UA was associated with a 16.5 % higher risk of ICH (OR 1.165, 95 % CI 1.01-1.34, P = 0.034), while a 1 quantile increase in serum UA was associated with a 25.9 % higher risk (OR 1.259, 95 % CI 1.091-1.46, P = 0.002). Cochran's Q test showed no evidence of heterogeneity. No horizontal pleiotropy was detected. The sensitivity analysis using the leave-one-out method supported the robustness and reliability of our results.

CONCLUSION

The study reveals that elevated serum UA levels are causally linked to ICH, suggesting the potential applicability of serum UA as a biomarker for the occurrence of ICH.

摘要

目的

既往观察性研究在血清尿酸(UA)水平与脑出血(ICH)之间的相关性方面引发了争议,因果关系尚不明确。为评估血清UA水平与ICH之间的潜在因果关系,应用了两样本孟德尔随机化分析。

方法

从全基因组关联研究(GWAS)数据库中检索与血清UA密切相关的单核苷酸多态性(SNP),包括580,505名欧洲血统个体。共选择27个和251个SNP作为工具变量。ICH的汇总数据包括1935例病例和471,578例对照。采用两样本MR分析,包括逆方差加权(IVW)、MR-Egger、加权中位数和加权模式方法,以评估血清UA水平与ICH之间的潜在因果关系,以比值比(OR)作为效应估计值。使用Cochran's Q检验评估异质性,并使用留一法进行敏感性分析。

结果

IVW分析显示,血清UA每升高1 mg/dL与ICH风险升高16.5%相关(OR 1.165,95%CI 1.01-1.34,P = 0.034),而血清UA每升高1个分位数与风险升高25.9%相关(OR 1.259,95%CI 1.091-1.46,P = 0.002)。Cochran's Q检验未显示异质性证据。未检测到水平多效性。使用留一法的敏感性分析支持了我们结果的稳健性和可靠性。

结论

该研究表明,血清UA水平升高与ICH存在因果关系,提示血清UA作为ICH发生的生物标志物具有潜在适用性。

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