Title:Myasthenia Gravis and Ischemic Stroke: A Bidirectional Mendelian
Randomization Study
Volume: 20
Issue: 2
Author(s): Chen Liu, Chengyuan Mao, Shen Li, Yun Su, Hongbing Liu, Xin Wang, Weishi Liu, Jiawei Zhao, Xuyang Liu and Yuming Xu*
Affiliation:
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan
Province, China
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan Province, China
- Henan Key Laboratory of Cerebrovascular Diseases of Zhengzhou University, Zhengzhou, Henan Province,
China
Keywords:
Myasthenia gravis, ischemic stroke, mendelian randomization, single nucleotide polymorphism, genetics, causal link.
Abstract:
Background: Autoimmune diseases are associated with cardiovascular and cerebrovascular
diseases. However, whether myasthenia gravis (MG) and ischemic stroke (IS) are causally
related remains unclear.
Objectives: This study aimed to evaluate potential causal links between MG and IS using bidirectional
Mendelian randomization (MR).
Methods: We conducted a two-sample MR analysis to assess the potential associations between
MG and IS. Genetic variants associated with MG and IS as well as their subtypes were extracted
from genome-wide association studies by meta-analysis. The inverse-variance weighted method
was used for the main MR analysis. Sensitivity analyses, including the MREgger, simple mode,
simple median, weighted mode, and weighted median approaches were applied to test the robustness
of the results.
Results: The MR analyses indicated no causal effects of general MG on IS of all causes (odds ratio
[OR] = 0.990, 95% confidence interval [CI]: 0.953-1.029, p = 0.615), large vessel atherosclerosis
stroke (OR = 0.943, 95% CI: 0.856-1.039, p = 0.233), cardioembolic stroke (OR = 0.975, 95% CI:
0.867-1.096, p = 0.670), and small vessel occlusion stroke (OR = 1.059, 95% CI 0.974-1.150, p =
0.178). Subgroup analyses indicated no causal effects of early- or late-onset MG on IS and its subtypes
(all p > 0.05). The reverse MR analysis showed no significant causal associations of IS on
MG (all p > 0.05).
Conclusion: Bidirectional MR analysis did not provide evidence to support a causal relationship
between genetically predicted MG and IS, although observational studies have found such a potential
link.
