Sleep-disordered breathing-related symptoms and risk of stroke: cohort study and Mendelian randomization analysis
| Autor: | Olga E. Titova, John A. Baron, Karl Michaëlsson, Susanna C. Larsson, Shuai Yuan, Eva Lindberg |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Single-nucleotide polymorphisms Cohort Studies Sleep Apnea Syndromes Risk Factors Internal medicine Mendelian randomization medicine Humans cardiovascular diseases Sleep-disordered breathing Stroke Cerebral Hemorrhage Ischemic Stroke Intracerebral hemorrhage business.industry Snoring Hazard ratio Cohort Sleep apnea Public Health Global Health Social Medicine and Epidemiology Mendelian Randomization Analysis Subarachnoid Hemorrhage medicine.disease Confidence interval Folkhälsovetenskap global hälsa socialmedicin och epidemiologi Neurology Female Neurology (clinical) business Genome-Wide Association Study Cohort study |
| Zdroj: | Journal of Neurology. 269:2460-2468 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-021-10824-y |
| Popis: | Background Sleep-disordered breathing (SDB) may contribute to development of stroke. However, findings are inconclusive. We investigated whether SDB-related symptoms are associated with incidence of stroke and its types in a general community sample of adult men and women as well as to perform Mendelian randomization (MR) analysis. Methods We used data from a cohort of 41,742 Swedish adults (56–94 years of age) who completed questionnaires regarding snoring, cessation of breathing, lifestyle and health characteristics. Participants were followed up for incident stroke and death over 8 years through linkage to the Swedish Registers. Hazard ratios, adjusted for potential confounders, were estimated by Cox proportional hazards regression. MR analyses were performed using single-nucleotide polymorphisms associated with sleep apnea at the genome-wide significance level and summary-level data for stroke and its subtypes from consortia and a meta-analysis of Genome-Wide Association Studies. Results In the cohort study, symptoms of disturbing snoring and/or cessation of breathing were associated with increased risk of total stroke (hazard ratio 1.12, 95% confidence interval 1.02–1.24) and intracerebral hemorrhage (hazard ratio 1.59, 95% confidence interval 1.23–2.05) but not with ischemic stroke or subarachnoid hemorrhage. MR analyses showed no association of genetic liability to sleep apnea with the risk of overall stroke or any specific types of stroke or ischemic stroke subtypes. Conclusions SDB-related symptoms were associated with increased risk of total stroke, specifically intracerebral hemorrhage, in the observational analyses but not in the MR analyses. There was limited evidence of an association of SDB with ischemic stroke and subarachnoid hemorrhage. |
| Databáze: | OpenAIRE |
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