Chen Chunli, Hu Zhiping
Department of Neurology, Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China.
Cerebrovasc Dis. 2016;41(3-4):119-38. doi: 10.1159/000442678. Epub 2016 Jan 12.
Numerous studies have evaluated the association between apolipoprotein E (ApoE) gene polymorphisms and the risk of different subtypes of stroke. However, the results remain uncertain, and few sources of data specific to the Chinese ethnic population contribute to these outstanding questions. Therefore, we performed a meta-analysis to derive a more comprehensive estimate of the association between ApoE polymorphisms and stroke risk in the Chinese population.
Case-control studies in Chinese and English publications were identified by searching the PubMed, EMBASE, Web of Science, China Nation Knowledge Infrastructure Platform, Wanfang, and VIP databases and by hand-searching relevant journals and the reference lists of the retrieved articles. ORs and 95% CIs were applied to assess the strength of the associations. Subgroup and sensitivity analyses were performed to explore between-study heterogeneity.
Evidence of a significant association was found between the ApoE ε4 allele and different subtypes of stroke (for ischemic stroke (IS): OR 2.19, 95% CI 1.90-2.52, p < 0.001; for intracerebral hemorrhage (ICH): OR 2.08, 95% CI 1.57-2.75, p < 0.001; and for subarachnoid hemorrhage (SAH): OR 2.03, 95% CI 1.28-3.23, p = 0.003) among the Chinese population. In addition, a significant difference in the risk for different subtypes of stroke between ε4 carriers and ε3ε3 genotype carriers was found (for IS: OR 2.41, 95% CI 2.00-2.89, p < 0.001; for ICH: OR 2.41, 95% CI 1.68-3.47, p < 0.001; and for SAH: OR 2.04, 95% CI 1.21-3.45, p = 0.008).
The ApoE ε4 allele may predict an increased risk for different subtypes of stroke, including IS, ICH and SAH, in the Chinese population, and the results of this genotypic analysis may help to identify populations at an increased risk for stroke. Further studies with larger sample sizes are needed to confirm our findings.
众多研究评估了载脂蛋白E（ApoE）基因多态性与不同类型中风风险之间的关联。然而，结果仍不确定，且针对中国人群的特定数据来源很少能解答这些突出问题。因此，我们进行了一项荟萃分析，以更全面地估计ApoE基因多态性与中国人群中风风险之间的关联。
通过检索PubMed、EMBASE、Web of Science、中国知网、万方和维普数据库，并手工检索相关期刊及检索文章的参考文献列表，确定中英文出版物中的病例对照研究。应用比值比（OR）和95%置信区间（CI）评估关联强度。进行亚组分析和敏感性分析以探讨研究间的异质性。
在中国人群中，发现ApoE ε4等位基因与不同类型的中风之间存在显著关联（缺血性中风（IS）：OR 2.19，95% CI 1.90 - 2.52，p < 0.001；脑出血（ICH）：OR 2.08，95% CI 1.57 - 2.75，p < 0.001；蛛网膜下腔出血（SAH）：OR 2.03，95% CI 1.28 - 3.23，p = 0.003）。此外，发现ε4携带者与ε3ε3基因型携带者在不同类型中风风险上存在显著差异（IS：OR 2.41，95% CI 2.00 - 2.89，p < 0.001；ICH：OR 2.41，95% CI 1.68 - 3.47，p < 0.001；SAH：OR 2.04，95% CI 1.21 - 3.45，p = 0.008）。
ApoE ε4等位基因可能预示着中国人群中包括IS、ICH和SAH在内的不同类型中风风险增加，该基因型分析结果可能有助于识别中风风险增加的人群。需要进一步进行更大样本量的研究来证实我们的发现。
