饮食来源的循环抗氧化剂与缺血性中风后的功能预后：遗传研究的证据。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-25 DOI:10.1016/j.jstrokecerebrovasdis.2024.108039

Xudong Li , Wei Liu , Tianyu Jin , Tong Zhang

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引用次数: 0

摘要

目的：饮食中的循环抗氧化剂与缺血性脑卒中（IS）后的功能预后有关，但其因果关系仍不清楚。我们的研究旨在通过孟德尔随机化（MR）方法，探讨饮食中循环抗氧化剂对缺血性脑卒中（IS）后长期功能预后（3 个月）的潜在因果效应：在这项双样本 MR 分析中，从大型全基因组关联研究 (GWAS) 数据库中确定了与膳食中循环抗氧化剂（包括硒、锌、维生素 A（视黄醇）、维生素 C 和维生素 E（α-生育酚和γ-生育酚））相关的遗传变异，并将其作为工具变量 (IV)。缺血性中风功能性结果遗传学（GISCOME）网络中的 6021 名患者获得了 IS 后长期功能性结果的汇总数据。我们的研究采用了反方差加权法作为主要的MR方法，并对多义性和异质性进行了一系列敏感性分析：我们观察到，硒（几率比（OR）=0.81；95% 置信区间（CI）：0.68-0.97；P=0.02）与 IS 后的不良功能预后（改良 Rankin 量表评分≥3）显著相关。其他来源于饮食的循环抗氧化剂的遗传负债与 IS 后的功能预后关系不大（所有 p>0.05）。敏感性分析证实了这些结果的可靠性：这项磁共振研究表明，硒对IS术后的长期功能预后有积极影响。给予较长时间的硒暴露可作为一种潜在的治疗方法，以改善 IS 后的恢复。

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Diet-derived circulating antioxidants and functional outcome after ischemic stroke: Evidence from genetic studies

Objective

Diet-derived circulating antioxidants have been associated with functional outcome after ischemic stroke (IS), but the causality remains unclear. The aim of our study is to explore the potential causal effect of diet-derived circulating antioxidants on long-term functional outcome (at 3 months) following IS through the utilization of the Mendelian randomization (MR) approach.

Materials and methods

For this two-sample MR analysis, genetic variants associated with the diet-derived circulating antioxidants, including selenium, zinc, vitamin A (retinol), vitamin C, and vitamin E (α-tocopherol and γ-tocopherol), were identified in a large-scale Genome-Wide Association Studies (GWAS) database and utilized as instrumental variables (IVs). Summary data for long-term functional outcome after IS were obtained from the Genetics of Ischemic Stroke Functional Outcome (GISCOME) network of 6021 patients. Our study used the Inverse-variance weighting method as our primary MR method and also performed a series of sensitivity analyses for pleiotropy and heterogeneity.

Results

We observed that selenium (odds ratio (OR)=0.81; 95 % confidence interval (CI): 0.68-0.97; p=0.02) was significantly associated with poor functional outcome (modified Rankin Scale score≥3) after IS. Genetic liabilities to other diet-derived circulating antioxidants were not strongly associated with functional outcome after IS (all p>0.05). Sensitivity analyses confirmed the reliability of these results.

Conclusion

This MR study suggested the positive effect of selenium on the long-term functional outcome after IS. Giving a longer period of selenium exposure can be used as a potential treatment to improve recovery after IS.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.