Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study

ABSTRACT Background Emerging evidence from observational studies suggested that epigenetic age acceleration may result in an increased incidence of stroke and poorer functional outcomes after a stroke. However, the causality of these associations remains controversial and may be confounded by bias....

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Main Authors: Baizhi Qiu, Shuyang Wen, Zifan Li, Yuxin Cai, Qi Zhang, Yuting Zeng, Shuqi Zheng, Zhishan Lin, Yupeng Xiao, Jihua Zou, Guozhi Huang, Qing Zeng
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Brain and Behavior
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Online Access:https://doi.org/10.1002/brb3.70412
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author Baizhi Qiu
Shuyang Wen
Zifan Li
Yuxin Cai
Qi Zhang
Yuting Zeng
Shuqi Zheng
Zhishan Lin
Yupeng Xiao
Jihua Zou
Guozhi Huang
Qing Zeng
author_facet Baizhi Qiu
Shuyang Wen
Zifan Li
Yuxin Cai
Qi Zhang
Yuting Zeng
Shuqi Zheng
Zhishan Lin
Yupeng Xiao
Jihua Zou
Guozhi Huang
Qing Zeng
author_sort Baizhi Qiu
collection DOAJ
description ABSTRACT Background Emerging evidence from observational studies suggested that epigenetic age acceleration may result in an increased incidence of stroke and poorer functional outcomes after a stroke. However, the causality of these associations remains controversial and may be confounded by bias. We aimed to investigate the causal effects of epigenetic age on stroke and its functional outcomes. Methods We conducted a two‐sample Mendelian randomization (MR) analysis to explore the causal relationships between epigenetic age and stroke and its outcomes. Additionally, a two‐step MR analysis was performed to investigate whether lifestyle factors affect stroke via epigenetic age. Datasets of epigenetic age were obtained from a recent meta‐analysis (n = 34,710), while those of stroke and its outcomes were sourced from the MEGASTROKE (n = 520,000) consortium and Genetics of Ischaemic Stroke Functional Outcome (GISCOME) network (n = 6165). Results Two‐sample MR analysis revealed a causal relationship between PhenoAge and small vessel stroke (SVS) (OR = 1.07; 95% CI, 1.03–1.12; p = 2.01 × 10−3). Mediation analysis through two‐step MR indicated that the increased risk of SVS due to smoking initiation was partially mediated by PhenoAge, with a mediation proportion of 9.5% (95% CI, 1.6%–20.6%). No causal relationships were identified between epigenetic age and stroke outcomes. Conclusions Our study supports using epigenetic age as a biomarker to predict stroke occurrence. Interventions specifically aimed at decelerating epigenetic aging, such as specific lifestyle changes, offer effective strategies for reducing stroke risk.
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spelling doaj-art-0e6e5bac17d847e49b6a7076fd29a37f2025-08-20T03:05:14ZengWileyBrain and Behavior2162-32792025-03-01153n/an/a10.1002/brb3.70412Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization StudyBaizhi Qiu0Shuyang Wen1Zifan Li2Yuxin Cai3Qi Zhang4Yuting Zeng5Shuqi Zheng6Zhishan Lin7Yupeng Xiao8Jihua Zou9Guozhi Huang10Qing Zeng11Department of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Zhujiang Hospital, Southern Medical University Guangzhou ChinaABSTRACT Background Emerging evidence from observational studies suggested that epigenetic age acceleration may result in an increased incidence of stroke and poorer functional outcomes after a stroke. However, the causality of these associations remains controversial and may be confounded by bias. We aimed to investigate the causal effects of epigenetic age on stroke and its functional outcomes. Methods We conducted a two‐sample Mendelian randomization (MR) analysis to explore the causal relationships between epigenetic age and stroke and its outcomes. Additionally, a two‐step MR analysis was performed to investigate whether lifestyle factors affect stroke via epigenetic age. Datasets of epigenetic age were obtained from a recent meta‐analysis (n = 34,710), while those of stroke and its outcomes were sourced from the MEGASTROKE (n = 520,000) consortium and Genetics of Ischaemic Stroke Functional Outcome (GISCOME) network (n = 6165). Results Two‐sample MR analysis revealed a causal relationship between PhenoAge and small vessel stroke (SVS) (OR = 1.07; 95% CI, 1.03–1.12; p = 2.01 × 10−3). Mediation analysis through two‐step MR indicated that the increased risk of SVS due to smoking initiation was partially mediated by PhenoAge, with a mediation proportion of 9.5% (95% CI, 1.6%–20.6%). No causal relationships were identified between epigenetic age and stroke outcomes. Conclusions Our study supports using epigenetic age as a biomarker to predict stroke occurrence. Interventions specifically aimed at decelerating epigenetic aging, such as specific lifestyle changes, offer effective strategies for reducing stroke risk.https://doi.org/10.1002/brb3.70412epigenetic agemediationMendelian randomizationstroke
spellingShingle Baizhi Qiu
Shuyang Wen
Zifan Li
Yuxin Cai
Qi Zhang
Yuting Zeng
Shuqi Zheng
Zhishan Lin
Yupeng Xiao
Jihua Zou
Guozhi Huang
Qing Zeng
Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
Brain and Behavior
epigenetic age
mediation
Mendelian randomization
stroke
title Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
title_full Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
title_fullStr Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
title_full_unstemmed Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
title_short Causal Associations of Epigenetic Age Acceleration With Stroke and Its Functional Outcome: A Two‐Sample, Two‐Step Mendelian Randomization Study
title_sort causal associations of epigenetic age acceleration with stroke and its functional outcome a two sample two step mendelian randomization study
topic epigenetic age
mediation
Mendelian randomization
stroke
url https://doi.org/10.1002/brb3.70412
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