Nguyen Tuan V, Chandrashekar Kiran, Qin Zhen, Parent Andrew D, Zhang Jun
Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
J Stroke Cerebrovasc Dis. 2009 Sep-Oct;18(5):374-80. doi: 10.1016/j.jstrokecerebrovasdis.2008.12.004.
Despite massive efforts, progress so far has been modest in isolating the genetic determinants for intracranial aneurysm (IA). More detailed epidemiology data might be essential for successful genome-wide association study. Here, we aimed to investigate epidemiology and identify the key risk factors associated with the pathogenesis of IA in a large specific population.
We investigated the epidemiology and analyzed the risk factors of IA pathogenesis by using an International Classification of Diseases, Ninth Revision database search of the patients treated at the University of Mississippi Medical Center, Jackson, MS, within the past 10-year period (1998-2007). All recruited patients were interviewed to assess multiple risk factors and comorbidities (hypertension, tobacco abuse, females sex, diabetes mellitus, coronary artery disease, coronary obstructive pulmonary disease, alcohol abuse, stroke, hyperlipidemia, illicit drug use, and family history).
In this retrospective study, we identified several significant risk factors among well-defined human subjects. The 3 major risk factors identified for our IA population are hypertension, tobacco abuse, and female sex. However, African American race was not a significant risk factor in our study. Furthermore, top two risk factors (hypertension, tobacco abuse) were found to be highly associated with familial cases.
In this study, using a specific and well-defined large population, we reported that some key risk factors were further confirmed to be strongly associated with the pathogenesis of IA whereas further investigation into racial factors is apparently needed. Our finding of the confounding effects of top risks with familial cases further complicated the genetic analysis of IA.
尽管付出了巨大努力，但迄今为止在分离颅内动脉瘤（IA）的遗传决定因素方面进展甚微。更详细的流行病学数据对于成功开展全基因组关联研究可能至关重要。在此，我们旨在调查流行病学情况，并确定一大特定人群中与IA发病机制相关的关键风险因素。
我们通过使用国际疾病分类第九版数据库，对过去10年期间（1998 - 2007年）在密西西比大学医学中心（位于密西西比州杰克逊市）接受治疗的患者进行搜索，以调查IA的流行病学情况并分析其发病机制的风险因素。对所有招募的患者进行访谈，以评估多种风险因素和合并症（高血压、吸烟、女性、糖尿病、冠状动脉疾病、慢性阻塞性肺疾病、酗酒、中风、高脂血症、非法药物使用和家族史）。
在这项回顾性研究中，我们在明确界定的人群中确定了几个重要的风险因素。在我们的IA患者群体中确定的3个主要风险因素是高血压、吸烟和女性。然而，非裔美国人种族在我们的研究中并不是一个显著的风险因素。此外，发现前两个风险因素（高血压、吸烟）与家族性病例高度相关。
在本研究中，通过使用一个特定且明确界定的大群体，我们报告了一些关键风险因素被进一步证实与IA的发病机制密切相关，而显然需要对种族因素进行进一步调查。我们发现主要风险因素对家族性病例存在混杂影响，这使得IA的遗传分析更加复杂。
