Patients with hip osteoarthritis may be at increased risk for stroke
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Hip osteoarthritis may be a risk factor for stroke, ischemic stroke and small-vessel ischemic stroke, according to data published in Osteoarthritis and Cartilage.
“The real causal relationship between OA and stroke remains unclear because conclusions derived from observational studies were potentially biased due to residual confounding such as OA medications and reverse causality,” Yingjun Li, MD, of the School of Public Health at Hangzhou Medical College, in Hangzhou, China, and co-authors wrote. “By leveraging summary [genome-wide association studies (GWAS)] data, we verified whether OA is causally associated with stroke and investigated whether the stroke is causally associated with OA using the [Mendelian randomization (MR)] approach for the first time.”
To investigate the connection between hip OA and strokes, Li and colleagues examined publicly available data from large-scale genome-wide association studies and conducted a bidirectional two-sample Mendelian randomization study.
The researchers acquired data for the prevalence of OA at varying sites from the UK Biobank and the Arthritis Research UK Osteoarthritis Genetics resources. The authors collected data for strokes from a meta-analysis of 29 genome-wide association studies, consisting of 40,585 participants who had had strokes and 406,111 control patients. The authors used a bidirectional Mendelian randomization analysis while employing inverse-variance weighting (IVW) when they had only a single nucleotide polymorphism.
There was an overall lack of data regarding intracerebral hemorrhages, meaning the authors could not investigate the relationship between those on any type of OA, they wrote.
According to the researchers, higher risk for hip OA was significantly associated with overall stroke (IVW OR = 1.12; 95% CI, 1.06-1.20), ischemic stroke (OR = 1.13; 95% CI, 1.06-1.21) and small-vessel ischemic stroke (OR = 1.25; 95% CI, 1.10-1.42). The analysis did not show that stroke risks had any impact on risks for developing any type of osteoarthritis, the researchers wrote.
“To our knowledge, this is the first two-sample MR study to understand the bidirectional causal association between OA (77,052 cases and 378,169 controls from UK biobank and arcOGEN) and stroke (40,585 cases and 406,111 controls from MEGASTROKE project),” Li and colleagues wrote. “In conclusion, we found a causal link between hip OA and stroke and stroke subtypes by using the two-sample MR analysis.
“Further studies are warranted to elucidate the underlying mechanisms of potential varied causal associations between site-specific OA and stroke subtypes,” they added.
Reference:
Smith GD, et al. Int J Epidemiol. 2003;doi:10.1093/ije/dyg070.
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