Pan Peijiang, Liang Hao, Li Mingli
Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, China.
Biosafety III Laboratory, Life Science Institute, Guangxi Medical University, Nanning 530021, China.
Curr Issues Mol Biol. 2025 Jun 27;47(7):494. doi: 10.3390/cimb47070494.
The causal nature of sex hormone-binding globulin (SHBG) in the pathogenesis of stroke remains uncertain. We explored whether SHBG levels are causally associated with stroke via cardiometabolic traits. A network two-sample Mendelian randomization (MR) study was conducted to determine the mediating roles of cardiometabolic traits in the causal effects of SHBG levels on stroke subtypes. Further two-sample MR analyses were performed to explore the inverse associations between significant cardiometabolic mediators and SHBG levels. The MR results indicated a protective effect of genetically increased SHBG levels on any stroke (odd ratio [OR] = 0.941; 95% confidence interval [CI]: 0.898, 0.984), any ischemic stroke (OR = 0.951; 95% CI: 0.922, 0.981), and small-vessel stroke (OR = 0.871; 95% CI: 0.765, 0.977). Moreover, genetically elevated SHBG levels were associated with lower waist circumference (WC, β = -0.091; 95% CI: -0.136, -0.046), waist-to-hip ratio (WHR, β = -0.057; 95% CI: -0.084, -0.030), triglycerides (TG, β = -0.188; 95% CI: -0.249, -0.127), systolic blood pressure (β = -0.799; 95% CI: -1.068, -0.530), and diastolic blood pressure (β = -0.436; 95% CI: -0.605, -0.267), and a reduced risk of type 2 diabetes mellitus (OR = 0.684; 95% CI: 0.400, 0.968) in both the discovery and replication datasets. The proportions of such cardiometabolic traits that mediated the causal effects of SHBG levels on any stroke, any ischemic stroke, or small-vessel stroke ranged from 17.8% to 52.7%; while the mediating effects of SHBG levels on the causal associations between WC, WHR, and TG and stroke ranged from 18.4% to 68.3%. Our findings suggest a protective effect of genetically elevated SHBG levels on stroke risk via key cardiometabolic mediators, primarily WC, WHR, and TG. The mediating roles of SHBG levels in the causal links from WC, WHR and TG to stroke risk were also established. These pathways support SHBG as a potential biomarker and therapeutic target in stroke prevention.
性激素结合球蛋白(SHBG)在中风发病机制中的因果性质仍不确定。我们探讨了SHBG水平是否通过心脏代谢特征与中风存在因果关联。进行了一项网络两样本孟德尔随机化(MR)研究,以确定心脏代谢特征在SHBG水平对中风亚型的因果效应中的中介作用。进一步进行两样本MR分析,以探索显著的心脏代谢中介因素与SHBG水平之间的反向关联。MR结果表明,基因决定的SHBG水平升高对任何中风具有保护作用(优势比[OR]=0.941;95%置信区间[CI]:0.898,0.984)、对任何缺血性中风(OR=0.951;95%CI:0.922,0.981)以及对小血管中风(OR=0.871;95%CI:0.765,0.977)。此外,在发现和重复数据集中基因决定的SHBG水平升高与较低的腰围(WC,β=-0.091;95%CI:-0.136,-0.046)、腰臀比(WHR,β=-0.057;95%CI:-0.084,-0.030)、甘油三酯(TG,β=-0.188;95%CI:-0.249,-0.127)、收缩压(β=-0.799;95%CI:-1.068,-0.530)和舒张压(β=-0.436;95%CI:-0.605,-0.267)相关,并且2型糖尿病风险降低(OR=0.684;95%CI:0.400,0.968)。这些心脏代谢特征介导SHBG水平对任何中风、任何缺血性中风或小血管中风的因果效应的比例范围为17.8%至52.7%;而SHBG水平对WC、WHR和TG与中风之间因果关联的中介效应范围为18.4%至68.3%。我们的研究结果表明,基因决定的SHBG水平升高通过关键的心脏代谢中介因素,主要是WC、WHR和TG,对中风风险具有保护作用。还确立了SHBG水平在从WC、WHR和TG到中风风险的因果联系中的中介作用。这些途径支持SHBG作为中风预防中的潜在生物标志物和治疗靶点。
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