目的 本研究旨在揭示血清叶酸与首发缺血性脑卒中(IS)之间的关系,并探讨长链非编码RNA ANRIL(lncRNA ANRIL)的中介效应。方法 选用病例对照研究,对112例首发缺血性脑卒中患者及142例同期健康体检者进行描述性分析、相关性分析、中介分析;采用百分位Bootstrap法检验中介效应的显著性。结果 调整年龄、性别、BMI、教育水平、吸烟史、饮酒史、高血压病史、糖尿病史和高胆固醇血症病史等因素后,lncRNA ANRIL水平与患缺血性脑卒中风险增加相关(lncRNA ANRIL≥1.64: OR, 5.52; 95% CI: 3.07~10.12);叶酸水平较低与患缺血性脑卒中风险增加有关(叶酸<7.00 nmol/L: OR, 2.12; 95% CI: 1.15~3.90);血清叶酸水平与lncRNA ANRIL水平呈负相关(β=-0.26; 95% CI: –0.44~–0.08);中介效应分析显示,lncRNA ANRIL在血清叶酸对IS的影响中存在部分中介效应,中介效应占其总效应的比例为51.27%。结论 高水平血清叶酸补充能够显著降低首发IS的风险,lncRNA ANRIL不仅增加了IS的发生风险,并且在血清叶酸与IS的关系中起部分中介作用。
Abstract
Objective To explore the association between serum folate and first-onset ischemic stroke (IS), and to investigate the mediating effects of long non-coding RNA ANRIL (lncRNA ANRIL). Methods A case-control study was conducted by descriptive analysis, correlation analysis, and mediation analysis on 112 first-ever ischemic stroke patients and 142 healthy controls. The percentile Bootstrap method was used to test the significance of the mediating effects. Results After adjusting for factors such as age, gender, BMI, education level, smoking, alcohol consumption, hypertension, diabetes, and hypercholesterolemia, lncRNA ANRIL levels were found to be associated with an increased risk of ischemic stroke (lncRNA ANRIL≥1.64: OR, 5.52; 95% CI: 3.07-10.12). Lower serum folate levels were associated with an increased risk of ischemic stroke (folate <7.00 nmol/L: OR, 2.12; 95% CI: 1.15-3.90). Serum folate levels were negatively correlated with lncRNA ANRIL levels (β=–0.26; 95% CI: –0.44-–0.08). Mediation analysis showed that lncRNA ANRIL had a partial mediating effect on the association between serum folate and IS, accounting for 51.27% of the total effect. Conclusion High serum folate level significantly reduces the risk of first-ever IS, while lncRNA ANRIL not only increases the risk of IS but also plays a partial mediating role in the association between serum folate and IS.
关键词
缺血性脑卒中 /
lncRNA ANRIL /
叶酸 /
中介效应
Key words
ischemic stroke /
lncRNA ANRIL /
folate /
mediating effect
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