RT杂志文章SR电子T1基因预测缺血性中风后的睡眠特征和功能结局JF神经学JO神经学FD Lippincott Williams & Wilkins SP e1159 OP e1165 DO 10.1212/WNL.00000000002半岛投注体育官网06745VO 100 IS 11 A1张志忠A1王志忠，孟萌A1 Gill, Dipender A1 Zhu，刘武生A1, Xinfeng YR 2023 UL //www.ebmtp.com/content/100/11/e1159半岛投注体育官网.abstract AB背景和目的在观察性研究中，睡眠特征可能与缺血性卒中恢复有关。本研究的目的是利用孟德尔随机化(MR)方法探讨遗传预测的睡眠特征与脑卒中后功能结局之间的关系。方法从欧洲血统个体的全基因组关联研究数据中采用失眠和睡眠时间的工具变量。缺血性卒中后功能结局的总结数据来自缺血性卒中功能结局遗传学网络。采用方差加权法作为主要分析方法。敏感性分析中使用了替代MR方法。用I2和Q值统计量评价遗传变异间的异质性。结果在单变量分析中，遗传性失眠易患性与缺血性卒中后较差的功能预后(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脑卒中后功能预后无相关性(均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