出版简讯｜健康的生活方式与减轻基于单核苷酸多态性的缺血性卒中、脑出血和心肌梗死的遗传风险有关
文摘
科学
2024-07-02 18:31
北京
Healthy lifestyles are associated with alleviating the single-nucleotide polymorphism-based genetic risks of ischaemic stroke, intracerebral haemorrhage and myocardial infarctionJingru Wang, Zhenqiu Liu, Chengxin Hu, Renjia Zhao, Dongliang Zhu, Yijing Xie, Pengyan Zhang, Mei Cui, Kelin Xu, Genming Zhao, Li Jin, Xingdong Chen, Chen Suo, Yanfeng Jiangdoi: 10.1136/svn-2024-003257
Stroke & Vascular Neurology（SVN）新近上线文章“Healthy lifestyles are associated with alleviating the single-nucleotide polymorphism-based genetic risks of ischaemic stroke, intracerebral haemorrhage and myocardial infarction”，来自张江复旦国际创新中心、复旦大学人类表型组研究院蒋艳峰，复旦大学泰州健康科学研究院索晨等。遗传和生活方式因素都有可能引发心肌梗死（myocardial infarction, MI）和卒中，包括缺血性卒中（IS）和脑出血（ICH）。作者团队通过综合考量各种因素，探讨了健康的生活方式如何以及在多大程度上可以抵消这些疾病的遗传风险。研究基于英国生物样本库（UK Biobank）明确了315044例基线时未曾伴有卒中和心肌梗死的参与者。分别构建了这些疾病的遗传风险评分（Genetic risk scores, GRS），并依照三分位数分为低、中、高GRS组。分别使用吸烟、饮酒、体力活动、饮食模式和睡眠模式构建了生活方式风险评分（Lifestyle risk scores, LRS）。同样，参与者被分为低、中、高LRS组。使用Cox比例风险模型分析数据。Figure 1. Flowchart for the selection of the analysed study sample from the UK Biobank study.研究结果显示，经过中位12.8年的随访，分别有4642、1046和9485例参与者发生了IS、ICH和MI。与GRS和LRS水平较低的参与者相比，GRS和LRS水平较高的参与者的IS、ICH和MI的HR分别为3.45（95%CI 2.71 to 4.41）、2.32（95%CI 1.40 to 3.85）和4.89（95%CI 4.16 to 5.75）。此外，在GRS较高的参与者中，LRS较高的参与者的标准化14年IS事件发生率为4.40%（95%CI 3.45% to 5.36%）。相比之下，LRS较低的参与者仅为1.78%（95%CI 1.63% to 1.94%）。同样，对于MI，高LRS组的标准化发生率为8.60%（95%CI 7.38% to 9.81%），而低LRS组的标准化发生率为3.34%（95%CI 3.12% to 3.56%）。在ICH的高遗传风险组中，与低LRS组相比，高LRS组的发生率降低了约一半，尽管两者的发生率都很低，分别为0.36%（95%CI 0.31% to 0.42%）和0.71%（95%CI 0.36% to 1.05%）。![]()
Figure 2. Associations between each lifestyle and the risk of IS, ICH and MI. Cox regression models were additionally adjusted for age, sex, body mass index, Townsend deprivation index, qualification, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, history of cardiovascular disease, history of hypertension, history of diabetes and history of cancer. The green vertical dashed line represents the reference line, the green squares represent the HRs, and the green solid line represents the 95% CIs. The figure shows that high-risk levels in most lifestyle categories were associated with a higher risk of IS, ICH and MI.
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Figure 3. Standardised health event rates according to genetic and lifestyle risks. The left-hand panel, including A1, B1 and C1, shows the standardised event rates of IS, ICH and MI according to the genetic risk. The right-hand panel, including A2, B2 and C2, shows the standardised event rates of IS, ICH and MI according to lifestyle risk. Cox regression models, including lifestyle risk score, were adjusted for age, sex, body mass index, qualification, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, history of cardiovascular disease, history of hypertension, history of diabetes and history of cancer. Models, including genetic risk scores were adjusted for age, sex, the first 10 principal components of ancestry and genotyping batch. The 95% CIs for the HRs are provided in parentheses. The covariates were corrected by covariate mean substitution.
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Figure 4. Risk of incident events associated with joint lifestyle and genetic risk. Cox regression models were adjusted for age, sex, body mass index, qualification, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, history of cardiovascular disease, history of hypertension, history of diabetes, history of cancer, the first 10 principal components of ancestry and genotyping batch. The green vertical solid line represents the reference line, the green squares represent HRs, and the green solid line represents 95% CIs.Figure 5. Association of each lifestyle with incident IS, ICH and MI in genetic risk strata. Cox regression models were additionally adjusted for age, sex, body mass index, qualification, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, history of cardiovascular disease, history of hypertension, history of diabetes and history of cancer. *p<0.500; **p<0.010 and ***p<0.001.
Figure 6. Standardised 14-year outcome event rates, according to lifestyle and genetic risk. Shown are standardised 14-year cumulative incidence rates for IS, ICH and MI, according to lifestyle and genetic risks. A healthy lifestyle substantially reduced the risk of IS, ICH and MI and attenuated the genetic risk of those diseases by nearly 60%, 50% and 60%, respectively. Standardisation was performed on averages for each covariate. The I bars represent 95% CIs. The covariates were corrected by covariate mean substitution.
研究结论：健康的生活方式与降低IS、ICH和MI风险显著相关，且分别将IS、ICH和MI的遗传风险降低至少一半。更多内容详见文章原文：https://svn.bmj.com/content/early/2024/06/24/svn-2024-003257，或点击文末“阅读原文”。投稿 / 转载 / 商务合作：csa.svn@chinastroke.netEmail：csa.svn@chinastroke.net地址：北京市丰台区南四环西路119号B区1号楼508室本公众号对其刊载的所有内容，包括文字、图片、音视频资料以及版式设计等享有版权，未经本公众号授权同意，其他任何机构不得以任何形式侵犯本公众号作品著作权，包括但不限于：擅自复制、链接、非法使用或转载，或以任何方式建立作品镜像。转载请联系后台或邮箱。如获转载授权，发布请注明出处，不得擅自修改文章内容
