Genetic associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries
Taller adult height is associated with lower risks of ischemic heart disease in mendelian randomization (MR) studies, but little is known about the causal relevance of height for different subtypes of ischemic stroke. The present study examined the causal relevance of height for different subtypes o...
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creator | Linden, Andrew B Clarke, Robert Hammami, Imen Hopewell, Jemma C Guo, Yu Whiteley, William N Lin, Kuang Turnbull, Iain Chen, Yiping Yu, Canqing Lv, Jun Offer, Alison Bennett, Derrick Walters, Robin G Li, Liming Chen, Zhengming Parish, Sarah |
description | Taller adult height is associated with lower risks of ischemic heart disease in mendelian randomization (MR) studies, but little is known about the causal relevance of height for different subtypes of ischemic stroke. The present study examined the causal relevance of height for different subtypes of ischemic stroke.
Height-associated genetic variants (up to 2,337) from previous genome-wide association studies (GWASs) were used to construct genetic instruments in different ancestral populations. Two-sample MR approaches were used to examine the associations of genetically determined height with ischemic stroke and its subtypes (cardioembolic stroke, large-artery stroke, and small-vessel stroke) in multiple ancestries (the MEGASTROKE consortium, which included genome-wide studies of stroke and stroke subtypes: 60,341 ischemic stroke cases) supported by additional cases in individuals of white British ancestry (UK Biobank [UKB]: 4,055 cases) and Chinese ancestry (China Kadoorie Biobank [CKB]: 10,297 cases). The associations of genetically determined height with established cardiovascular and other risk factors were examined in 336,750 participants from UKB and 58,277 participants from CKB. In MEGASTROKE, genetically determined height was associated with a 4% lower risk (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.94, 0.99; p = 0.007) of ischemic stroke per 1 standard deviation (SD) taller height, but this masked a much stronger positive association of height with cardioembolic stroke (13% higher risk, OR 1.13 [95% CI 1.07, 1.19], p < 0.001) and stronger inverse associations with large-artery stroke (11% lower risk, OR 0.89 [0.84, 0.95], p < 0.001) and small-vessel stroke (13% lower risk, OR 0.87 [0.83, 0.92], p < 0.001). The findings in both UKB and CKB were directionally concordant with those observed in MEGASTROKE, but did not reach statistical significance: For presumed cardioembolic stroke, the ORs were 1.08 (95% CI 0.86, 1.35; p = 0.53) in UKB and 1.20 (0.77, 1.85; p = 0.43) in CKB; for other subtypes of ischemic stroke in UKB, the OR was 0.97 (95% CI 0.90, 1.05; p = 0.49); and for other nonlacunar stroke and lacunar stroke in CKB, the ORs were 0.89 (0.80, 1.00; p = 0.06) and 0.99 (0.88, 1.12; p = 0.85), respectively. In addition, genetically determined height was also positively associated with atrial fibrillation (available only in UKB), and with lean body mass and lung function, and inversely associated with low-density lipoprotein (LDL) cho |
doi_str_mv | 10.1371/journal.pmed.1003967 |
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Height-associated genetic variants (up to 2,337) from previous genome-wide association studies (GWASs) were used to construct genetic instruments in different ancestral populations. Two-sample MR approaches were used to examine the associations of genetically determined height with ischemic stroke and its subtypes (cardioembolic stroke, large-artery stroke, and small-vessel stroke) in multiple ancestries (the MEGASTROKE consortium, which included genome-wide studies of stroke and stroke subtypes: 60,341 ischemic stroke cases) supported by additional cases in individuals of white British ancestry (UK Biobank [UKB]: 4,055 cases) and Chinese ancestry (China Kadoorie Biobank [CKB]: 10,297 cases). The associations of genetically determined height with established cardiovascular and other risk factors were examined in 336,750 participants from UKB and 58,277 participants from CKB. In MEGASTROKE, genetically determined height was associated with a 4% lower risk (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.94, 0.99; p = 0.007) of ischemic stroke per 1 standard deviation (SD) taller height, but this masked a much stronger positive association of height with cardioembolic stroke (13% higher risk, OR 1.13 [95% CI 1.07, 1.19], p < 0.001) and stronger inverse associations with large-artery stroke (11% lower risk, OR 0.89 [0.84, 0.95], p < 0.001) and small-vessel stroke (13% lower risk, OR 0.87 [0.83, 0.92], p < 0.001). The findings in both UKB and CKB were directionally concordant with those observed in MEGASTROKE, but did not reach statistical significance: For presumed cardioembolic stroke, the ORs were 1.08 (95% CI 0.86, 1.35; p = 0.53) in UKB and 1.20 (0.77, 1.85; p = 0.43) in CKB; for other subtypes of ischemic stroke in UKB, the OR was 0.97 (95% CI 0.90, 1.05; p = 0.49); and for other nonlacunar stroke and lacunar stroke in CKB, the ORs were 0.89 (0.80, 1.00; p = 0.06) and 0.99 (0.88, 1.12; p = 0.85), respectively. In addition, genetically determined height was also positively associated with atrial fibrillation (available only in UKB), and with lean body mass and lung function, and inversely associated with low-density lipoprotein (LDL) cholesterol in both British and Chinese ancestries. Limitations of this study include potential bias from assortative mating or pleiotropic effects of genetic variants and incomplete generalizability of genetic instruments to different populations.
The findings provide support for a causal association of taller adult height with higher risk of cardioembolic stroke and lower risk of other ischemic stroke subtypes in diverse ancestries. Further research is needed to understand the shared biological and physical pathways underlying the associations between height and stroke risks, which could identify potential targets for treatments to prevent stroke.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003967</identifier><identifier>PMID: 35452448</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Apolipoproteins ; Assortative mating ; Atrial fibrillation ; Biobanks ; Biology and Life Sciences ; Blood pressure ; Body height ; Body mass ; Body measurements ; Cardiac arrhythmia ; Cardiovascular disease ; Cardiovascular diseases ; Cholesterol ; Consortia ; Coronary artery disease ; Embolic Stroke ; Ethics ; Fibrillation ; Genetic aspects ; Genetic diversity ; Genetic research ; Genetic variation ; Genome-wide association studies ; Genome-Wide Association Study ; Genomes ; Genotype & phenotype ; Health aspects ; Heart diseases ; High density lipoprotein ; Humans ; Ischemia ; Ischemic Stroke ; Lean body mass ; Low density lipoprotein ; Medicine and Health Sciences ; Mendelian Randomization Analysis ; Polymorphism, Single Nucleotide ; Population genetics ; Prevention ; Quality control ; Respiratory function ; Risk Factors ; Stature, Tall ; Stroke ; Stroke (Disease) ; Stroke - epidemiology ; Stroke - genetics ; Thromboembolism ; Triglycerides ; Womens health</subject><ispartof>PLoS medicine, 2022-04, Vol.19 (4), p.e1003967-e1003967</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Linden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Linden et al 2022 Linden et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c694t-60d65d368a99867582700ae1c5c1e5244561d4321d51d1e4222d4da904c48ecd3</citedby><cites>FETCH-LOGICAL-c694t-60d65d368a99867582700ae1c5c1e5244561d4321d51d1e4222d4da904c48ecd3</cites><orcidid>0000-0002-4973-0296 ; 0000-0002-9802-8241 ; 0000-0001-7916-3870 ; 0000-0002-9913-1961 ; 0000-0003-3532-0832 ; 0000-0002-9179-0321 ; 0000-0001-5873-7089 ; 0000-0002-0019-0014 ; 0000-0003-4254-1596 ; 0000-0002-4816-8991 ; 0000-0002-3870-8018</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032370/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032370/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35452448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Willey, Joshua Z</contributor><creatorcontrib>Linden, Andrew B</creatorcontrib><creatorcontrib>Clarke, Robert</creatorcontrib><creatorcontrib>Hammami, Imen</creatorcontrib><creatorcontrib>Hopewell, Jemma C</creatorcontrib><creatorcontrib>Guo, Yu</creatorcontrib><creatorcontrib>Whiteley, William N</creatorcontrib><creatorcontrib>Lin, Kuang</creatorcontrib><creatorcontrib>Turnbull, Iain</creatorcontrib><creatorcontrib>Chen, Yiping</creatorcontrib><creatorcontrib>Yu, Canqing</creatorcontrib><creatorcontrib>Lv, Jun</creatorcontrib><creatorcontrib>Offer, Alison</creatorcontrib><creatorcontrib>Bennett, Derrick</creatorcontrib><creatorcontrib>Walters, Robin G</creatorcontrib><creatorcontrib>Li, Liming</creatorcontrib><creatorcontrib>Chen, Zhengming</creatorcontrib><creatorcontrib>Parish, Sarah</creatorcontrib><creatorcontrib>China Kadoorie Biobank Collaborative Group</creatorcontrib><creatorcontrib>for the China Kadoorie Biobank Collaborative Group</creatorcontrib><title>Genetic associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Taller adult height is associated with lower risks of ischemic heart disease in mendelian randomization (MR) studies, but little is known about the causal relevance of height for different subtypes of ischemic stroke. The present study examined the causal relevance of height for different subtypes of ischemic stroke.
Height-associated genetic variants (up to 2,337) from previous genome-wide association studies (GWASs) were used to construct genetic instruments in different ancestral populations. Two-sample MR approaches were used to examine the associations of genetically determined height with ischemic stroke and its subtypes (cardioembolic stroke, large-artery stroke, and small-vessel stroke) in multiple ancestries (the MEGASTROKE consortium, which included genome-wide studies of stroke and stroke subtypes: 60,341 ischemic stroke cases) supported by additional cases in individuals of white British ancestry (UK Biobank [UKB]: 4,055 cases) and Chinese ancestry (China Kadoorie Biobank [CKB]: 10,297 cases). The associations of genetically determined height with established cardiovascular and other risk factors were examined in 336,750 participants from UKB and 58,277 participants from CKB. In MEGASTROKE, genetically determined height was associated with a 4% lower risk (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.94, 0.99; p = 0.007) of ischemic stroke per 1 standard deviation (SD) taller height, but this masked a much stronger positive association of height with cardioembolic stroke (13% higher risk, OR 1.13 [95% CI 1.07, 1.19], p < 0.001) and stronger inverse associations with large-artery stroke (11% lower risk, OR 0.89 [0.84, 0.95], p < 0.001) and small-vessel stroke (13% lower risk, OR 0.87 [0.83, 0.92], p < 0.001). The findings in both UKB and CKB were directionally concordant with those observed in MEGASTROKE, but did not reach statistical significance: For presumed cardioembolic stroke, the ORs were 1.08 (95% CI 0.86, 1.35; p = 0.53) in UKB and 1.20 (0.77, 1.85; p = 0.43) in CKB; for other subtypes of ischemic stroke in UKB, the OR was 0.97 (95% CI 0.90, 1.05; p = 0.49); and for other nonlacunar stroke and lacunar stroke in CKB, the ORs were 0.89 (0.80, 1.00; p = 0.06) and 0.99 (0.88, 1.12; p = 0.85), respectively. In addition, genetically determined height was also positively associated with atrial fibrillation (available only in UKB), and with lean body mass and lung function, and inversely associated with low-density lipoprotein (LDL) cholesterol in both British and Chinese ancestries. Limitations of this study include potential bias from assortative mating or pleiotropic effects of genetic variants and incomplete generalizability of genetic instruments to different populations.
The findings provide support for a causal association of taller adult height with higher risk of cardioembolic stroke and lower risk of other ischemic stroke subtypes in diverse ancestries. Further research is needed to understand the shared biological and physical pathways underlying the associations between height and stroke risks, which could identify potential targets for treatments to prevent stroke.</description><subject>Adult</subject><subject>Apolipoproteins</subject><subject>Assortative mating</subject><subject>Atrial fibrillation</subject><subject>Biobanks</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Body height</subject><subject>Body mass</subject><subject>Body measurements</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>Consortia</subject><subject>Coronary artery disease</subject><subject>Embolic Stroke</subject><subject>Ethics</subject><subject>Fibrillation</subject><subject>Genetic aspects</subject><subject>Genetic diversity</subject><subject>Genetic research</subject><subject>Genetic variation</subject><subject>Genome-wide association studies</subject><subject>Genome-Wide Association Study</subject><subject>Genomes</subject><subject>Genotype & phenotype</subject><subject>Health aspects</subject><subject>Heart diseases</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Ischemic Stroke</subject><subject>Lean body mass</subject><subject>Low density lipoprotein</subject><subject>Medicine and Health Sciences</subject><subject>Mendelian Randomization Analysis</subject><subject>Polymorphism, Single Nucleotide</subject><subject>Population genetics</subject><subject>Prevention</subject><subject>Quality control</subject><subject>Respiratory function</subject><subject>Risk Factors</subject><subject>Stature, Tall</subject><subject>Stroke</subject><subject>Stroke (Disease)</subject><subject>Stroke - epidemiology</subject><subject>Stroke - genetics</subject><subject>Thromboembolism</subject><subject>Triglycerides</subject><subject>Womens health</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqVk99uFCEUxidGY2v1DYySmBi92BUYYBYvTJpGa5PGJv67JSyc3aFlhhUYtb6L7yqz3TZdsxeauWDC-X3f4Rw4VfWY4CmpG_LqPAyx13666sBOCca1FM2dap9wJidENOLurf-96kFK5xhTiSW-X-3VnHHK2Gy_-n0MPWRnkE4pGKezC31CYYG0HXxGLbhlm9EPl1sUXboYI0ZH6wJ08-BHXW9RyC1ElIZ5vlzBWu2SaaEr4ZRjuIDX6BB10FvwTvcoFk3o3K91skIM9hK5HnUloVt5KJYGis5BeljdW2if4NFmPai-vHv7-ej95PTs-OTo8HRihGR5IrAV3NZipqWciYbPaIOxBmK4ITAWygWxrKbEcmIJMEqpZVZLzAybgbH1QfX0ynflQ1KbziZFheCkZrwmhTi5ImzQ52oVXafjpQraqfVGiEulY-mjB4UxJthK3AgqWGOYnEs5t2KBa8qZkU3xerPJNszL5Rnoc9R-y3Q70rtWLcN3JYtF3eBi8GJjEMO3ofRKdaXh4L3uIQzjuTmjM0owL-izv9Dd1W2opS4FuH4RSl4zmqrDBlMuScNHr8kOalkeUDlk6GHhyvYWP93Bl8-OT2On4OWWoDAZfualHlJSJ58-_gf74d_Zs6_b7PNbbAva5zYFP6wHYxtkV6CJIaUIi5sLJFiNE3rdaTVOqNpMaJE9uX35N6Lrkaz_AFKBNd8</recordid><startdate>20220422</startdate><enddate>20220422</enddate><creator>Linden, 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associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries</title><author>Linden, Andrew B ; Clarke, Robert ; Hammami, Imen ; Hopewell, Jemma C ; Guo, Yu ; Whiteley, William N ; Lin, Kuang ; Turnbull, Iain ; Chen, Yiping ; Yu, Canqing ; Lv, Jun ; Offer, Alison ; Bennett, Derrick ; Walters, Robin G ; Li, Liming ; Chen, Zhengming ; Parish, Sarah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c694t-60d65d368a99867582700ae1c5c1e5244561d4321d51d1e4222d4da904c48ecd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Apolipoproteins</topic><topic>Assortative mating</topic><topic>Atrial fibrillation</topic><topic>Biobanks</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Body height</topic><topic>Body mass</topic><topic>Body measurements</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>Consortia</topic><topic>Coronary artery disease</topic><topic>Embolic Stroke</topic><topic>Ethics</topic><topic>Fibrillation</topic><topic>Genetic aspects</topic><topic>Genetic diversity</topic><topic>Genetic research</topic><topic>Genetic variation</topic><topic>Genome-wide association studies</topic><topic>Genome-Wide Association Study</topic><topic>Genomes</topic><topic>Genotype & phenotype</topic><topic>Health aspects</topic><topic>Heart diseases</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Ischemic Stroke</topic><topic>Lean body mass</topic><topic>Low density lipoprotein</topic><topic>Medicine and Health Sciences</topic><topic>Mendelian Randomization Analysis</topic><topic>Polymorphism, Single Nucleotide</topic><topic>Population genetics</topic><topic>Prevention</topic><topic>Quality control</topic><topic>Respiratory function</topic><topic>Risk Factors</topic><topic>Stature, Tall</topic><topic>Stroke</topic><topic>Stroke (Disease)</topic><topic>Stroke - epidemiology</topic><topic>Stroke - genetics</topic><topic>Thromboembolism</topic><topic>Triglycerides</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Linden, Andrew B</creatorcontrib><creatorcontrib>Clarke, Robert</creatorcontrib><creatorcontrib>Hammami, Imen</creatorcontrib><creatorcontrib>Hopewell, Jemma C</creatorcontrib><creatorcontrib>Guo, Yu</creatorcontrib><creatorcontrib>Whiteley, William N</creatorcontrib><creatorcontrib>Lin, Kuang</creatorcontrib><creatorcontrib>Turnbull, Iain</creatorcontrib><creatorcontrib>Chen, Yiping</creatorcontrib><creatorcontrib>Yu, Canqing</creatorcontrib><creatorcontrib>Lv, Jun</creatorcontrib><creatorcontrib>Offer, Alison</creatorcontrib><creatorcontrib>Bennett, Derrick</creatorcontrib><creatorcontrib>Walters, Robin G</creatorcontrib><creatorcontrib>Li, Liming</creatorcontrib><creatorcontrib>Chen, Zhengming</creatorcontrib><creatorcontrib>Parish, Sarah</creatorcontrib><creatorcontrib>China Kadoorie Biobank Collaborative Group</creatorcontrib><creatorcontrib>for the China Kadoorie Biobank Collaborative Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Linden, Andrew B</au><au>Clarke, Robert</au><au>Hammami, Imen</au><au>Hopewell, Jemma C</au><au>Guo, Yu</au><au>Whiteley, William N</au><au>Lin, Kuang</au><au>Turnbull, Iain</au><au>Chen, Yiping</au><au>Yu, Canqing</au><au>Lv, Jun</au><au>Offer, Alison</au><au>Bennett, Derrick</au><au>Walters, Robin G</au><au>Li, Liming</au><au>Chen, Zhengming</au><au>Parish, Sarah</au><au>Willey, Joshua Z</au><aucorp>China Kadoorie Biobank Collaborative Group</aucorp><aucorp>for the China Kadoorie Biobank Collaborative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Genetic associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2022-04-22</date><risdate>2022</risdate><volume>19</volume><issue>4</issue><spage>e1003967</spage><epage>e1003967</epage><pages>e1003967-e1003967</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Taller adult height is associated with lower risks of ischemic heart disease in mendelian randomization (MR) studies, but little is known about the causal relevance of height for different subtypes of ischemic stroke. The present study examined the causal relevance of height for different subtypes of ischemic stroke.
Height-associated genetic variants (up to 2,337) from previous genome-wide association studies (GWASs) were used to construct genetic instruments in different ancestral populations. Two-sample MR approaches were used to examine the associations of genetically determined height with ischemic stroke and its subtypes (cardioembolic stroke, large-artery stroke, and small-vessel stroke) in multiple ancestries (the MEGASTROKE consortium, which included genome-wide studies of stroke and stroke subtypes: 60,341 ischemic stroke cases) supported by additional cases in individuals of white British ancestry (UK Biobank [UKB]: 4,055 cases) and Chinese ancestry (China Kadoorie Biobank [CKB]: 10,297 cases). The associations of genetically determined height with established cardiovascular and other risk factors were examined in 336,750 participants from UKB and 58,277 participants from CKB. In MEGASTROKE, genetically determined height was associated with a 4% lower risk (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.94, 0.99; p = 0.007) of ischemic stroke per 1 standard deviation (SD) taller height, but this masked a much stronger positive association of height with cardioembolic stroke (13% higher risk, OR 1.13 [95% CI 1.07, 1.19], p < 0.001) and stronger inverse associations with large-artery stroke (11% lower risk, OR 0.89 [0.84, 0.95], p < 0.001) and small-vessel stroke (13% lower risk, OR 0.87 [0.83, 0.92], p < 0.001). The findings in both UKB and CKB were directionally concordant with those observed in MEGASTROKE, but did not reach statistical significance: For presumed cardioembolic stroke, the ORs were 1.08 (95% CI 0.86, 1.35; p = 0.53) in UKB and 1.20 (0.77, 1.85; p = 0.43) in CKB; for other subtypes of ischemic stroke in UKB, the OR was 0.97 (95% CI 0.90, 1.05; p = 0.49); and for other nonlacunar stroke and lacunar stroke in CKB, the ORs were 0.89 (0.80, 1.00; p = 0.06) and 0.99 (0.88, 1.12; p = 0.85), respectively. In addition, genetically determined height was also positively associated with atrial fibrillation (available only in UKB), and with lean body mass and lung function, and inversely associated with low-density lipoprotein (LDL) cholesterol in both British and Chinese ancestries. Limitations of this study include potential bias from assortative mating or pleiotropic effects of genetic variants and incomplete generalizability of genetic instruments to different populations.
The findings provide support for a causal association of taller adult height with higher risk of cardioembolic stroke and lower risk of other ischemic stroke subtypes in diverse ancestries. Further research is needed to understand the shared biological and physical pathways underlying the associations between height and stroke risks, which could identify potential targets for treatments to prevent stroke.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35452448</pmid><doi>10.1371/journal.pmed.1003967</doi><orcidid>https://orcid.org/0000-0002-4973-0296</orcidid><orcidid>https://orcid.org/0000-0002-9802-8241</orcidid><orcidid>https://orcid.org/0000-0001-7916-3870</orcidid><orcidid>https://orcid.org/0000-0002-9913-1961</orcidid><orcidid>https://orcid.org/0000-0003-3532-0832</orcidid><orcidid>https://orcid.org/0000-0002-9179-0321</orcidid><orcidid>https://orcid.org/0000-0001-5873-7089</orcidid><orcidid>https://orcid.org/0000-0002-0019-0014</orcidid><orcidid>https://orcid.org/0000-0003-4254-1596</orcidid><orcidid>https://orcid.org/0000-0002-4816-8991</orcidid><orcidid>https://orcid.org/0000-0002-3870-8018</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1549-1676 |
ispartof | PLoS medicine, 2022-04, Vol.19 (4), p.e1003967-e1003967 |
issn | 1549-1676 1549-1277 1549-1676 |
language | eng |
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source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Public Library of Science (PLoS) |
subjects | Adult Apolipoproteins Assortative mating Atrial fibrillation Biobanks Biology and Life Sciences Blood pressure Body height Body mass Body measurements Cardiac arrhythmia Cardiovascular disease Cardiovascular diseases Cholesterol Consortia Coronary artery disease Embolic Stroke Ethics Fibrillation Genetic aspects Genetic diversity Genetic research Genetic variation Genome-wide association studies Genome-Wide Association Study Genomes Genotype & phenotype Health aspects Heart diseases High density lipoprotein Humans Ischemia Ischemic Stroke Lean body mass Low density lipoprotein Medicine and Health Sciences Mendelian Randomization Analysis Polymorphism, Single Nucleotide Population genetics Prevention Quality control Respiratory function Risk Factors Stature, Tall Stroke Stroke (Disease) Stroke - epidemiology Stroke - genetics Thromboembolism Triglycerides Womens health |
title | Genetic associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries |
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