基因预测的缺血性卒中后睡眠特征和功能结局[j] - Neurology - JO - Neurology SP - e1159 LP - e1165 DO - 10.1212/WNL.00000000首页00206745VL - 100 IS - 11 AU -张志忠AU -王萌萌AU -吉尔Dipender AU -朱武生AU -刘新峰Y1 - 2023/03/14 UR - //www.ez-admanager.com/content/100/11/e1159.abstract N2 -背首页景与目的观察性研究表明，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)。短睡眠、长睡眠和连续睡眠时间的遗传倾向与卒中后功能结局无关(所有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 ER -