Prabhakar Puttachandra, De Tanima, Nagaraja Dindagur, Christopher Rita
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India.
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India.
Int J Vasc Med. 2014;2014:305309. doi: 10.1155/2014/305309. Epub 2014 Jan 12.
Background. Hypertension is an established risk factor for small-vessel cerebral stroke and the renin-angiotensin system plays an important role in the maintenance of blood pressure. We aimed at evaluating the contribution of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism to the risk of small-vessel stroke in south Indian population. Materials and Methods. We investigated 128 patients diagnosed with small-vessel stroke and 236 age, and gender-matched healthy controls. ACE I/D polymorphism was detected by polymerase chain reaction. Results. Hypertension was significantly more prevalent in the patient group and was associated with 6-fold increase in risk for stroke. ACE genotypes were in Hardy-Weinberg equilibrium in both patients and controls. Prevalence of DD, ID, and II genotypes in cases (34.4%, 43.7%, and 28%) did not differ significantly from controls (31.8%, 43.2%, and 25%). The polymorphism was not associated with small-vessel stroke (OR: 1.34; 95% CI: 0.52-1.55). However, diastolic blood pressure was associated with the ACE I/D genotypes in the patients. (DD; 90.2 ± 14.2> ID; 86.2 ± 11.9> II; 82.3 ± 7.8 mm Hg, P = 0.047). Conclusion. Our study showed that hypertension, but not ACE I/D polymorphism, increased the risk of small-vessel stroke.
背景。高血压是小血管性脑卒的确立危险因素，肾素-血管紧张素系统在血压维持中起重要作用。我们旨在评估血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性对印度南部人群小血管性卒中风险的影响。材料与方法。我们调查了128例诊断为小血管性卒中的患者以及236例年龄和性别匹配的健康对照者。通过聚合酶链反应检测ACE I/D多态性。结果。高血压在患者组中显著更常见，并且与卒中风险增加6倍相关。ACE基因型在患者和对照中均处于哈迪-温伯格平衡。病例组中DD、ID和II基因型的患病率（分别为34.4%、43.7%和28%）与对照组（分别为31.8%、43.2%和25%）无显著差异。该多态性与小血管性卒中无关（比值比：1.34；95%置信区间：0.52 - 1.55）。然而，患者的舒张压与ACE I/D基因型相关。（DD；90.2±14.2＞ID；86.2±11.9＞II；82.3±7.8 mmHg，P = 0.047）。结论。我们的研究表明，高血压而非ACE I/D多态性增加了小血管性卒中的风险。
