■观察性研究表明缺铁性贫血(IDA)与缺血性中风(IS)的可能性增加之间存在联系,然而,由于此类研究的固有局限性,建立因果关系具有挑战性,包括它们对混杂因素的脆弱性和反向因果关系的可能性。本研究采用双向双样本孟德尔随机化(MR)方法来评估IDA和IS及其亚型之间的因果关系。
■与IDA或IS及其亚型具有显著联系的可识别的单核苷酸多态性(SNP)被用作工具变量(IV)。IDA和任何IS之间的关系,小血管冲程(SVS),心源性卒中(CES),大动脉中风(LAS),使用逆方差加权(IVW)方法进行量化。利用MR-Egger和加权中位数方法的补充分析进一步补充了IVW的发现。此外,漏报分析,MR-Egger截距测试,MR-PRESSO全局测试,和Cochrane的Q检验进行敏感性分析。
■这项研究显示IDA与任何IS之间没有相关性(IVW方法:OR[95%CI]=0.977[0.863-1.106];p=0.716),LAS(OR[95%CI]=1.158[0.771-1.740];p=0.479),CES(OR[95%CI]=1.065[0.882-1.285];p=0.512),或SVS(OR[95%CI]=1.138[0.865-1.498];p=0.357)。进行反向MR分析,确定任何IS之间都没有因果关系,LAS,CES,SVS,和IDA(均p>0.05)。敏感性分析表明,异质性不显著,没有检测到水平多效性的证据。
■这项MR研究表明,IDA对IS没有因果关系,LAS,CES,和SVS。通过反向MR分析,确定IS及其亚型对IDA没有因果影响.
UNASSIGNED: Observational researches have suggested a connection between iron deficiency anemia (IDA) and an increased likelihood of ischemic stroke (IS), yet establishing causality is challenging owing to the inherent limitations of such studies, including their vulnerability to confounding factors and the potential for reverse causation. This study employs a bidirectional two-sample Mendelian randomization (MR) approach to assess the causal linkage between IDA and IS and its subtypes.
UNASSIGNED: Identifiable single nucleotide polymorphisms (SNPs) with significant links to either IDA or IS and its subtypes were employed as instrumental variables (IVs). The relationship between IDA and any IS, small vessel stroke (SVS), cardioembolic stroke (CES), and large artery stroke (LAS), was quantified using the inverse variance weighted (IVW) method. Complementary analyses utilizing MR-Egger and weighted median methods further supplemented the IVW findings. Moreover, the leave-one-out analysis, MR-Egger intercept test, MR-PRESSO global test, and Cochrane\'s Q test were conducted for sensitivity analyses.
UNASSIGNED: This study revealed no correlation between IDA and any IS (IVW method: OR [95% CI] = 0.977 [0.863-1.106]; p = 0.716), LAS (OR [95% CI] = 1.158 [0.771-1.740]; p = 0.479), CES (OR [95% CI] = 1.065 [0.882-1.285]; p = 0.512), or SVS (OR [95% CI] = 1.138 [0.865-1.498]; p = 0.357). Conducting a reverse MR analysis, it was determined that there is no causal connection between any IS, LAS, CES, SVS, and IDA (all p > 0.05). Sensitivity analysis indicated that heterogeneity was not significant and no evidence of horizontal pleiotropy was detected.
UNASSIGNED: This MR study suggested no causal effect of IDA on IS, LAS, CES, and SVS. Through reverse MR analyses, it was determined that IS and its subtypes did not exert a causal impact on IDA.