Department of Neurology, The First People's Hospital of Huainan, Huainan, 232007, Anhui province, China.
Beijing Institute for Brain Disorders, Center for Brain Disorders Research, Capital Medical University, Beijing, 100069, China.
Sci Rep. 2018 Feb 2;8(1):2290. doi: 10.1038/s41598-018-20434-w.
The relationship between telomere length and stroke was inconsistent mostly due to different pathogenesis of subtypes, environment and genetics. We aimed to assess whether leukocyte telomere contributes to stroke in Southern Chinese by investigating a case-control study comprising 543 cases (224 atherothrombotic stroke, 94 hemorrhagic stroke and 225 lacunar infraction) and 616 controls and replicated the investigation in an independent study comprising 773 cases and 875 controls with the same diagnostic criteria. Telomere was inversely correlated with increasing age in controls (correlation coefficient γ = -0.28, P < 0.001) and in cases with atherothrombotic stroke (γ = -0.17, P = 0.012). Individuals within the lowest tertile of telomere showed a higher risk for atherothrombotic stroke [odds ratio 2.33, 95% confidence (CI) 1.42-3.83; P = 0.003], whereas had a lower presence of lacunar infarction (OR 0.49, 95% CI 0.30-0.81; P = 0.007). Similar results were obtained in the second replication study. A further meta-analysis showed a 12% increased pooled risk of ischemic stroke (95% CI 1.04-1.18) in relation to shorter telomere, but this association was stronger in the retrospective studies and in Asians when stratified by study design and ethnicity. Our data provided the first evidence that in Southern Chinese stroke population, leukocyte telomere is independently associated with atherothrombotic stroke and lacunar infarction.
端粒长度与中风之间的关系不一致，主要是由于亚型、环境和遗传的不同发病机制。我们旨在通过一项包括 543 例病例（224 例动脉粥样硬化性中风、94 例出血性中风和 225 例腔隙性梗死）和 616 例对照的病例对照研究，以及在一项包括相同诊断标准的 773 例病例和 875 例对照的独立研究中复制该研究，来评估白细胞端粒是否会导致中国南方地区的中风。端粒与对照组的年龄呈负相关（相关系数γ=-0.28，P<0.001），与动脉粥样硬化性中风患者的年龄呈负相关（γ=-0.17，P=0.012）。端粒最低三分位的个体发生动脉粥样硬化性中风的风险较高[比值比 2.33，95%置信区间（CI）1.42-3.83；P=0.003]，而腔隙性梗死的发生率较低[比值比 0.49，95%CI 0.30-0.81；P=0.007]。在第二项复制研究中也得到了类似的结果。进一步的荟萃分析显示，与端粒较短相关的缺血性中风的 pooled 风险增加了 12%（95%CI 1.04-1.18），但这种关联在回顾性研究中和按研究设计和种族分层时在亚洲人中更强。我们的数据首次提供了证据，表明在中国南方中风人群中，白细胞端粒与动脉粥样硬化性中风和腔隙性梗死独立相关。
