Association between glaucoma and stroke:A bidirectional mendelian randomization study  

作　　者：Kai Wang Xueqi Lin Siting Sheng Dan Chen Xin Liu Ke Yao 

机构地区：[1]Eye Center of the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,China [2]Department of Ophthalmology,Zhongshan Hospital,Fudan University,Shanghai,China [3]Shanghai Institute of Infectious Disease and Biosecurity,Zhongshan Hospital,Fudan University,Shanghai,China

出　　处：《Advances in Ophthalmology Practice and Research》2024年第3期147-155,共9页眼科实践与研究新进展（英文）

基　　金：supported by grants from the Program of National Natural Science Foundation(81870641,82070939,82201242);Strategic Priority Research Program of the Chinese Academy of Sciences(XDA16010304);Key Research and Development Project of Zhejiang Province(2020C03035).

摘　　要：Purpose:Observational studies have reported positive associations between glaucoma and stroke;however,controversial results exist.Importantly,the nature of the relationship remains unknown since previous studies were not designed to test causality.Therefore,we aimed to investigate the possible causal relationships between glaucoma and stroke.Methods:Our two-sample Mendelian randomization(MR)encompassed multi-ethnic large-scale genome-wide association studies with more than 20000 cases and 260000 controls for glaucoma,and more than 80000 cases and 630000 controls for stroke.Individual effect estimates for each SNP were combined using the inverse-variance weighted(IVW)method.To avoid potential pleiotropic effects,we adjusted the main results by excluding genetic variants associated with metabolic factors.The weighted median and MR-Egger methods were also used for the sensitivity analysis.Results:Our MR analysis revealed that glaucoma and its subtypes,including primary open-angle glaucoma and primary angle-closure glaucoma,exhibited no causal role in relation to any stroke(AS),any ischemic stroke(AIS),large-artery atherosclerotic stroke(LAS),small-vessel stroke(SVS),or cardioembolic stroke(CES)across MR analyses(all P>0.05).The null associations remained robust even after adjusting for metabolic-related traits and were consistent in both the European and Asian populations.Furthermore,reverse MR analyses also did not indicate any significant causal effects of AS,AIS,LAS,or CES on glaucoma risk.Conclusions:Evidence from our series of causal inference approaches using large-scale population-based MR an-alyses did not support causal effects between glaucoma and stroke.These findings suggest that the relationship of glaucoma management and stroke risk prevention should be carefully evaluated in future studies.In turn,stroke diagnosis should not be simply applied to glaucoma risk prediction.

关 键 词：GLAUCOMA STROKE Mendelian randomization CAUSATION Metabolic-related trait 

分 类 号：R775[医药卫生—眼科]