The State Key Laboratory of Cardiovascular Diseases, Sino-German Laboratory for Molecular Medicine, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, PR China.
Clin Sci (Lond). 2013 Mar 13;125(1):27-36. doi: 10.1042/CS20120691.
Inter-individual differences in biological aging could affect susceptibility to stroke. To date, the relationship between stroke and telomere shortening remain inconclusive; and sparse data are available for haemorrhagic stroke. A Chinese case-control study was conducted, comprising 1756 cases (767 atherothrombosis, 503 lacunar infarction and 486 haemorrhagic strokes) and 1801 controls. Stroke patients were prospectively followed up for a median of 4.5 (range, 0.1-6.0) years. Individuals with shorter telomere length had a higher presence of atherothrombotic stroke {multivariate OR (odds ratio) 1.37 [95% CI (confidence interval), 1.06-1.77]; P=0.015} or haemorrhagic stroke [multivariate OR 1.48 (95% CI, 1.08-2.02); P=0.016] in comparison of the lowest to highest tertile of telomere length. Particularly, in subjects with a family history of stroke, there was a significant 2.55-fold increased presence of atherothrombotic stroke (95% CI, 1.87-3.48; Ptrend<0.0001) and a 2.33-fold increased presence of haemorrhagic stroke (95% CI, 1.62-3.36; Ptrend<0.0001). During the follow-up, 338 recurrent strokes and 312 deaths (181 from stroke or coronary heart disease and 131 from other causes) were documented. Associations with stroke recurrence were not observed in the follow-up patients, whereas atherothrombotic stroke cases with shorter telomeres had 69% increased risk of post-stroke death [relative risk, 1.69 (95% CI, 1.07-2.67); P=0.02]. Finally, we compared telomere lengths in 12 paired samples of circulating leucocytes and carotid atherosclerotic plaques from patients undergoing carotid endarterectomy; there was a positive correlation between vessel wall tissue and leucocyte telomere length. In conclusion, shorter telomere length may serve as a potential marker for the presence of atherothrombotic and haemorrhagic stroke and for the risk of post-stroke death.
个体间生物学衰老的差异可能会影响中风的易感性。迄今为止，中风与端粒缩短之间的关系仍不确定；而且出血性中风的数据很少。进行了一项中国病例对照研究，包括 1756 例病例（767 例动脉粥样硬化血栓形成、503 例腔隙性梗死和 486 例出血性中风）和 1801 例对照。前瞻性随访中风患者中位时间为 4.5 年（范围，0.1-6.0）。与端粒长度最短的三分之一相比，端粒长度较短的个体发生动脉粥样硬化血栓形成性中风[多变量 OR（比值比）1.37（95%可信区间（置信区间），1.06-1.77）；P=0.015]或出血性中风[多变量 OR 1.48（95% CI，1.08-2.02）；P=0.016]的可能性更高。特别是在有中风家族史的患者中，动脉粥样硬化血栓形成性中风的发生率显著增加了 2.55 倍（95% CI，1.87-3.48；Ptrend<0.0001），出血性中风的发生率增加了 2.33 倍（95% CI，1.62-3.36；Ptrend<0.0001）。在随访期间，记录了 338 例复发性中风和 312 例死亡（181 例死于中风或冠心病，131 例死于其他原因）。在随访患者中未观察到与中风复发相关的关联，而端粒较短的动脉粥样硬化血栓形成性中风患者中风后死亡的风险增加了 69%[相对风险，1.69（95% CI，1.07-2.67）；P=0.02]。最后，我们比较了 12 例接受颈动脉内膜切除术的患者循环白细胞和颈动脉粥样硬化斑块的配对样本中的端粒长度；血管壁组织和白细胞端粒长度之间存在正相关。总之，较短的端粒长度可能是动脉粥样硬化性和出血性中风以及中风后死亡风险的潜在标志物。
