ArticleNature and science of sleep2026
Obstructive Sleep Apnea and Hypercoagulability: Combining Observational and Mendelian Randomization Analyses to Explore Causal Relationships.
Article in Nature and science of sleep, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The relationship between Obstructive sleep apnea (OSA) and hypercoagulability remains unclear. To address this uncertainty, the present study combined observational and Mendelian randomization (MR) analyses to assess the associations of OSA and coagulation markers. Patients and Methods: We conducted an observational study of 790 patients with OSA, evaluating associations between OSA severity and coagulation markers, including activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (Fib). Multivariate linear regression adjusted for age, gender, body mass index (BMI), and comorbidities. Additionally, we performed a large-scale Mendelian randomization analysis using two East Asian OSA genome-wide association study (GWAS) datasets (Million Veteran Program [MVP], n=6550; Taiwan Precision Medicine Initiative [TPMI], n=316351) as exposures, and East Asian coagulation GWAS data from BioBank Japan (BBJ) as outcomes (APTT: n=37767; Fib: n=18348; PT: n=58110). Multivariable MR (MVMR) with body mass index (BMI)(TPMI GWAS, n=191458) was performed to assess residual direct effects of OSA. Results: Severe OSA showed higher Fib ( Conclusion: Severe OSA is associated with subclinical hypercoagulability, but this relationship is confounded by BMI. Genetic evidence does not support a moderate or clinically meaningful causal role for OSA in coagulation dysfunction, urging a paradigm shift toward obesity management as the primary strategy to reduce thrombotic risk in OSA patients.
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