Department of Cardiovascular Medicine, Inabe General Hospital, Inabe, Japan.
Int J Mol Med. 2010 Feb;25(2):281-6.
Although metabolic syndrome has been recognized as a risk factor for ischemic stroke, genetic factors associated with ischemic stroke in individuals with metabolic syndrome remain unknown. We examined an association of genetic variants with ischemic stroke among individuals with or without metabolic syndrome. The study population comprised 4,387 unrelated Japanese individuals, including 1,884 individuals with metabolic syndrome (240 subjects with ischemic stroke and 1,644 controls) and 2,503 individuals without metabolic syndrome (280 subjects with ischemic stroke and 2,223 controls). The 150 polymorphisms examined in the present study were selected by genome-wide association studies of ischemic stroke and myocardial infarction with the use of the GeneChip Human Mapping 500K Array Set (Affymetrix). The initial chi-square test revealed that the Cright curved arrow T polymorphism (rs9925481) of CLEC16A and the Aright curved arrow G polymorphism (rs4923918) of SPTBN5 were significantly (P<0.005) associated with ischemic stroke among individuals with metabolic syndrome. No polymorphism was significantly associated with ischemic stroke among individuals without metabolic syndrome. Multivariable logistic regression analysis with adjustment for covariates and a stepwise forward selection procedure revealed that the Aright curved arrow G polymorphism (rs4923918) of SPTBN5 was significantly (P<0.005), and the Cright curved arrow T polymorphism (rs9925481) of CLEC16A was almost significantly, associated with ischemic stroke in individuals with metabolic syndrome. Genetic variants that confer susceptibility to ischemic stroke may differ among individuals with or without metabolic syndrome. Stratification of subjects according to the presence or absence of metabolic syndrome may thus be important for personalized prevention of ischemic stroke based on genetic information.
虽然代谢综合征已被认为是缺血性卒中的一个危险因素,但与代谢综合征患者缺血性卒中相关的遗传因素仍不清楚。我们研究了遗传变异与代谢综合征患者或无代谢综合征患者缺血性卒中的相关性。研究人群包括 4387 名无关的日本个体,其中 1884 名个体患有代谢综合征(240 名缺血性卒中患者和 1644 名对照者),2503 名个体无代谢综合征(280 名缺血性卒中患者和 2223 名对照者)。本研究中检测的 150 个多态性是通过使用基因芯片人类图谱 500K 阵列集(Affymetrix)对缺血性卒中和心肌梗死的全基因组关联研究选择的。初始卡方检验显示,CLEC16A 的 Cright curved arrow T 多态性(rs9925481)和 SPTBN5 的 Aright curved arrow G 多态性(rs4923918)在代谢综合征患者中与缺血性卒中显著相关(P<0.005)。在无代谢综合征的个体中,没有多态性与缺血性卒中显著相关。经协变量调整和逐步向前选择程序的多变量逻辑回归分析显示,SPTBN5 的 Aright curved arrow G 多态性(rs4923918)(P<0.005)和 CLEC16A 的 Cright curved arrow T 多态性(rs9925481)与代谢综合征患者的缺血性卒中显著相关(P<0.005)。易患缺血性卒中的遗传变异可能在有或无代谢综合征的个体中不同。因此,根据代谢综合征的存在与否对患者进行分层可能对基于遗传信息的个体化缺血性卒中预防很重要。