可改变的危险因素和遗传易感性对缺血性脑卒中的共同影响

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-04-17 DOI:10.1016/j.jstrokecerebrovasdis.2025.108313

Jiao Shang MS , Yanmei Wu MS , Lixin Zhang PhD , Xueting Jiang MS , Ruiping Zhang MS

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引用次数: 0

摘要

目的研究可改变的风险因素和遗传易感性对缺血性中风（IS）的影响。方法本研究共纳入英国生物库中的 490365 名参与者，随访 17 年。从早期生活、环境、生活方式、社会经济地位和体能测量五个方面收集了 115 项可改变暴露的数据。此外，还收集了基因数据。研究人员进行了全暴露关联分析，以确定潜在的风险因素。计算出每个领域和基因的风险分数。使用多变量 Cox 模型分析了每个领域得分对 IS 的影响以及五个领域之间的联合影响。结果发现，在 115 个可改变的暴露中，有 64 个与 IS 风险显著相关（P < 4.35 × 10-4 经 Bonferroni 校正）。新发现的因素包括母亲吸烟和10岁时超重或体重不足，这可能会使IS风险分别大幅增加4.78%至14.74%、11.01%至23.75%和3.29%至12.80%。此外，与使用软水相比，使用硬水会使IS风险降低6.96%至11.48%。各领域的相关性各不相同，社会经济因素占IS病例的5.2%，生活方式占2.8%，物理措施占2.5%，是前三大诱因。总体而言，通过消除已确定的风险，估计可预防 10.6% 至 11.3% 的 IS 病例。不同领域的风险因素对 IS 的影响各不相同，其中社会经济因素所占比例最大。

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Joint effect of modifiable risk factors and genetic susceptibility on ischaemic stroke

Purpose

To investigate the effects of modifiable risk factors and genetic susceptibility on ischaemic stroke (IS).

Methods

A total of 490365 participants from the UK Biobank, with a 17-year follow-up, were included in this study. Data on 115 modifiable exposures were collected from five domains: early life, environment, lifestyle, socioeconomic status, and physical measures. Additionaly, genetic data were collected. An exposure-wide association analysis was conducted to identify potential risk factors. Risk scores for each domain and genes were calculated. The effect of each domain score on IS and the joint effects among the five domains were analyzed using multi-variate Cox models. The population attributable fraction was estimated to quantize the impact of eliminating unfavorable factors.

Results

Sixty-four of the 115 modifiable exposures were found to be significantly associated with the risk of IS (P < 4.35 × 10^-4 for Bonferroni correction). Newly identified factors included maternal smoking and being either overweight or underweight at age 10, which could significantly increase the risk of IS by 4.78 % to 14.74 %, 11.01 % to 23.75 %, and 3.29 % to 12.80 %, respectively. Additionally, exposure to hard water was associated with a decreased risk of IS by 6.96 % to 11.48 % compared to exposure to soft water. The associations varied across domains, with socioeconomic factors accounting for 5.2 % of IS cases, lifestyle accounting for 2.8 %, and physical measures accounting for 2.5 %, representing the top three contributing factors. Overall, it was estimated that 10.6 % to 11.3 % of IS cases could be prevented by eliminating the identified risks.

Conclusions

Interactions between risk factors and genetic susceptibility elevated the risk of IS. Risk factors from different domains contributed variably to IS, with socioeconomic factors accounting for the largest proportion.

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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.