Wang Yuge, Liu Junyu, Cao Fang, Guo Yuxin, Yan Junxia
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410013, China.
Department of Systematic Neuropharmacology, Graduate School of Medicine, Kyoto University, Kyoto 6068501, Japan.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 May 28;50(5):757-765. doi: 10.11817/j.issn.1672-7347.2025.240422.
Intracranial aneurysm (IA) has an insidious onset, and once ruptured, it carries high rates of mortality and disability. Cardiometabolic factors may be associated with the formation and rupture of IA. This study aims to summarize the application of Mendelian randomization (MR) methods in research on cardiometabolic factors and IA, providing insights for further elucidation of IA etiology and pathogenesis.
Literature about MR-based IA studies published up to February 21, 2024, was retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang. Two researchers independently performed literature screening, data extraction, and quality assessment. A narrative synthesis approach was used to conduct a qualitative systematic review of the included studies.
A total of 11 MR-based studies on IA published between 2017 to 2024 were included, of which 4 were rated as high quality. These studies investigated the associations between blood pressure, blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines with IA and its subtypes, though issues of duplication were noted. Four MR studies based on the same European population but using different instrumental variable selection criteria, as well as another MR study in a different European cohort, consistently identified blood pressure as a risk factor for IA and its subtypes. Findings for blood lipids, blood glucose, obesity-related indicators, and inflammatory cytokines were inconsistent across MR studies.
Blood pressure appears to increase the risk of IA and its subtypes. Associations between other cardiometabolic factors and IA/subtypes require further in-depth investigation. Given the inherent limitations of MR studies, causal inferences should be made cautiously in combination with other lines of evidence.
颅内动脉瘤（IA）起病隐匿，一旦破裂，死亡率和致残率很高。心脏代谢因素可能与IA的形成和破裂有关。本研究旨在总结孟德尔随机化（MR）方法在心脏代谢因素与IA研究中的应用，为进一步阐明IA的病因和发病机制提供见解。
从PubMed、Embase、Web of Science、中国知网和万方数据库中检索截至2024年2月21日发表的关于基于MR的IA研究的文献。两名研究人员独立进行文献筛选、数据提取和质量评估。采用叙述性综合方法对纳入的研究进行定性系统评价。
共纳入2017年至2024年间发表的11项基于MR的IA研究，其中4项被评为高质量。这些研究调查了血压、血脂、血糖、肥胖相关指标和炎性细胞因子与IA及其亚型之间的关联，不过存在重复问题。四项基于相同欧洲人群但使用不同工具变量选择标准的MR研究，以及另一项针对不同欧洲队列的MR研究，一致将血压确定为IA及其亚型的危险因素。不同MR研究中关于血脂、血糖、肥胖相关指标和炎性细胞因子的研究结果不一致。
血压似乎会增加IA及其亚型的风险。其他心脏代谢因素与IA/亚型之间的关联需要进一步深入研究。鉴于MR研究的固有局限性，应结合其他证据谨慎进行因果推断。
