Tang Xun, Zhu Yan-ping, Li Na, Chen Da-fang, Zhang Zong-xin, Dou Hui-dong, Hu Yong-hua
Department of Epidemiology & Biostatistics, Peking University School of Public Health, Beijing, and Department of Clinical Laboratory Medicine, The First Hospital of Fangshan District, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Apr 18;39(2):119-25.
To investigate the association among serum lipids, blood pressure, -514C/T polymorphism of hepatic lipase gene and subtypes of ischemic stroke in the discordant sib pairs.
Ischemic stroke cases were enrolled from a hospital-based stroke registry, the proband-initiated contact was used to recruit pedigrees, and participants' information and blood samples were collected through the community-based health care networks in rural areas of China. Statistical analysis was performed by using the Wilcoxon signed rank test to compare quantitative differences between sib pairs and the McNemar test to compare qualitative differences. Generalized estimating equation (GEE) was used to adjust for within-family correlation in analysis of discordant sib pairs. Family based association test (FBAT) was applied to associations between serum lipids, blood pressure and the -514T allele in hepatic lipase gene.
Totally 107 discordant sib pairs from 71 ischemic stroke patients pedigrees were analyzed by univariate and multivariate methods. The blood pressure and serum lipids were associated with ischemic stroke (P<0.05) The lipid level was higher in large-artery atherosclerosis ischemic stroke than in the subtype of small-vessel occlusion, while the blood pressure was higher in the latter. The -514T allele in hepatic lipase gene was associated with low density lipoprotein-cholesterol (LDL-C) and diastolic blood pressure in additive model by FBAT analysis (Z=2.366, P<0.05), and it was also associated with diastolic blood pressure in additive model (Z=-2.277, P<0.05) and recessive model (Z=-2.244,P< 0.05), but not associated with ischemic stroke or its subtypes.
In these discordant sib pairs, the abnormalities of blood pressure and serum lipids may increase risks of ischemic stroke, and different subtypes of ischemic stroke may differ from each other in etiology. The -514T allele in hepatic lipase gene may be associated with LDL-C and diastolic blood pressure.
研究不一致同胞对中血脂、血压、肝脂酶基因-514C/T多态性与缺血性脑卒中各亚型之间的关联。
从一项基于医院的脑卒中登记中纳入缺血性脑卒中病例，采用先证者发起联系的方式招募家系，并通过中国农村地区的社区卫生保健网络收集参与者的信息和血样。采用Wilcoxon符号秩检验比较同胞对之间的定量差异，采用McNemar检验比较定性差异。在分析不一致同胞对时，使用广义估计方程（GEE）调整家庭内部相关性。基于家系的关联检验（FBAT）用于分析血脂、血压与肝脂酶基因-514T等位基因之间的关联。
采用单变量和多变量方法分析了来自71个缺血性脑卒中患者家系的107对不一致同胞对。血压和血脂与缺血性脑卒中相关（P<0.05）。大动脉粥样硬化性缺血性脑卒中的血脂水平高于小血管闭塞亚型，而后者的血压更高。通过FBAT分析，肝脂酶基因中的-514T等位基因在加性模型中与低密度脂蛋白胆固醇（LDL-C）和舒张压相关（Z=2.366，P<0.05），在加性模型中也与舒张压相关（Z=-2.277，P<0.05）以及隐性模型中与舒张压相关（Z=-2.244，P<0.05），但与缺血性脑卒中或其亚型无关。
在这些不一致同胞对中，血压和血脂异常可能增加缺血性脑卒中风险，且不同亚型的缺血性脑卒中病因可能存在差异。肝脂酶基因中的-514T等位基因可能与LDL-C和舒张压相关。
