Adiposity and Functional Outcome After Ischemic Stroke: A Mendelian Randomization Study

IF 8.5 1区医学 Q1 CLINICAL NEUROLOGY

Neurology Pub Date : 2024-02-13 Epub Date: 2024-01-05 DOI:10.1212/WNL.0000000000208080

Mengmeng Wang, Zhizhong Zhang, Iyas Daghlas, Dipender Gill, Dandan Liu, Xuegan Lian

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引用次数: 0

Abstract

Background and objectives: To investigate the causal relationships of abdominal adiposity (waist-to-hip ratio [WHR]) and overall adiposity (body mass index [BMI]) with functional outcome after ischemic stroke using Mendelian randomization.

Methods: Genetic instruments for WHR and BMI were obtained from the largest available genome-wide association studies meta-analysis of the Genetic Investigation of ANthropometric Traits consortium and the UK Biobank (N max = 806,834). Functional outcome after ischemic stroke was assessed using the modified Rankin Scale (mRS) score at 3-month after stroke onset, with mRS >2 (mRS 3-6) defined as an unfavorable functional outcome. Corresponding genetic estimates for an unfavorable functional outcome were extracted from the Genetics of Ischemic Stroke Functional Outcome network (N = 6,021). We applied a random-effects inverse variance weighted method as our main analysis.

Results: Genetically predicted higher WHR (per 0.09 ratio units) was associated with unfavorable functional outcome after ischemic stroke (mRS 3-6, OR = 1.48; 95% CI = 1.03-2.13; p = 0.033). The results remained directionally consistent in sensitivity analyses. Conversely, genetically predicted BMI (per 4.8 kg/m²) was not associated with unfavorable functional outcome after ischemic stroke (OR = 1.01; 95% CI = 0.75-1.36; p = 0.937).

Discussion: This study provides genetic evidence supporting the hypothesis that abdominal adiposity has a detrimental effect on functional recovery after ischemic stroke.

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肥胖与缺血性脑卒中后的功能预后

背景和目的：采用孟德尔随机法研究腹部脂肪率（腰臀比 [WHR]）和总体脂肪率（体质指数 [BMI]）与缺血性脑卒中后功能预后的因果关系：WHR和BMI的遗传工具来自现有最大的全基因组关联研究荟萃分析（Genetic Investigation of ANthropometric Traits consortium）和英国生物库（UK Biobank）（N max = 806,834）。缺血性脑卒中后的功能预后采用脑卒中发病 3 个月后的改良兰金量表（mRS）评分进行评估，mRS>2（mRS 3-6）定义为功能预后不良。从缺血性中风功能性结果遗传学网络（N = 6,021）中提取了不利功能性结果的相应遗传估计值。我们采用随机效应逆方差加权法作为主要分析方法：结果：遗传预测的较高 WHR（每 0.09 比值单位）与缺血性卒中后的不良功能预后有关（mRS 3-6，OR = 1.48；95% CI = 1.03-2.13；p = 0.033）。在敏感性分析中，结果仍保持方向一致。相反，遗传预测的体重指数（每 4.8 kg/m2）与缺血性中风后的不良功能预后无关（OR = 1.01; 95% CI = 0.75-1.36; p = 0.937）：本研究提供了遗传学证据，支持腹部脂肪对缺血性卒中后功能恢复有不利影响的假设。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology 医学-临床神经学

CiteScore

12.20

自引率

4.00%

发文量

1973

审稿时长

2-3 weeks

期刊介绍： Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology. As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content. Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.