PT - JOURNAL ARTICLE AU -张志忠AU -王萌萌AU - Gill Dipender AU -朱武生AU -刘新峰TI .缺血性脑卒中后睡眠特征与功能预后的基因预测[j] . doi: 10.1212/WNL.0000000000206745DP - 2023 3月14日TA -神经学首页PG - e1159—e1165 VI - 100 IP - 114099 - //www.ez-admanager.com/content/100/11/e1159.short 4100 - //www.ez-admanager.com/content/100/11/e1159.full SO -神经学2023 3月14日;背景和目的在观察性研究中，睡眠特征可能对缺血性脑卒中的恢复有影响。本研究的目的是利用孟德尔随机化(MR)方法探讨基因预测睡眠特征与脑卒中后功能结局之间的关系。方法采用欧洲血统个体全基因组关联研究数据中失眠和睡眠时间的工具变量。缺血性卒中后功能结局的汇总数据来自缺血性卒中功能结局网络的遗传学。采用反方差加权法进行主要分析。敏感性分析采用了其他MR方法。采用I2和Q值统计来评价遗传变异间的异质性。结果在单变量分析中，缺血性卒中后失眠症的遗传倾向与较差的功能结局(改良Rankin量表≥3)显著相关(优势比[OR] = 1.30;95% CI: 1.10-1.54, p = 0.002)。 Genetic liability to short sleep, long sleep, and continuous sleep duration were not associated with poststroke functional outcome (all p > 0.05). Sensitivity analyses without adjustment for stroke severity also supported that insomnia was causally associated with poor functional outcome (OR = 1.25; 95% CI: 1.08–1.44, p = 0.003). In the multivariable MR analysis adjusting for potentially confounding traits including body mass index, depression, type 2 diabetes, smoking, and alcohol consumption, the overall patterns between genetic liability to insomnia and poststroke outcome remained (all p < 0.05).Discussion This MR study supports potential adverse effects of liability to insomnia on functional outcome after ischemic stroke. Interventions that address insomnia may offer a therapeutic target to improve recovery after ischemic stroke and warrant exploration in a clinical context.BMI=body mass index; GISCOME=Genetics of Ischemic Stroke Functional Outcome; IVW=inverse-variance weighted; MR=Mendelian randomization; mRS=modified Rankin Scale; NIHSS=NIH Stroke Scale; OR=odds ratio; SNPs=single nucleotide polymorphisms; T2D=type 2 diabetes; UKB=UK Biobank