Alhazzani Adel Ali, Kumar Amit, Selim Magdy
Department of Neurology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
J Stroke Cerebrovasc Dis. 2018 May;27(5):1252-1261. doi: 10.1016/j.jstrokecerebrovasdis.2017.12.006. Epub 2018 Feb 23.
Ischemic stroke is a complex, multifactorial, and polygenic disease. Reports on relationship between Factor V G1691A single nucleotide gene polymorphism and ischemic stroke have revealed inconsistent results. We conducted an updated meta-analysis to determine the role of Factor V single nucleotide gene polymorphism in ischemic stroke.
We searched the literature using academic electronic databases that is, PubMed, Trip Data Base, EBSCO, and Google Scholar, last search up to September 2017. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from fixed or random effects models whichever applicable using software STATA version 13 (StataCorp LP, College Station, TX).
Forty case-control studies met the inclusion criteria, which included 6860 cases and 18,025 controls. Altogether, 19 studies in young adults (age < or = 40 years) and 17 studies were conducted in old stroke (age > 40). Four studies did not report the mean age at recruitment. Significant association between Factor V G1691A gene polymorphism and risk of ischemic stroke were observed under dominant model (OR 1.40; 95% CI: 1.22 to 1.62, P value <.001). Stratified analysis suggested substantial association of Factor V gene polymorphism and risk of ischemic stroke in cases with onset at young age (OR 1.84; 95% CI: 1.47 to 2.30), but was not statistical significant in cases at old age (>40 years).
Factor V G1691A single nucleotide gene polymorphism was associated with risk of ischemic stroke mainly in young adults. Further research with adequately powered prospective studies in homogenous subjects are required to determine the nature of association in young stroke.
缺血性中风是一种复杂的、多因素的、多基因疾病。关于凝血因子V基因G1691A单核苷酸多态性与缺血性中风之间关系的报道结果并不一致。我们进行了一项更新的荟萃分析，以确定凝血因子V基因单核苷酸多态性在缺血性中风中的作用。
我们使用学术电子数据库（即PubMed、Trip数据库、EBSCO和谷歌学术）检索文献，最后一次检索截至2017年9月。使用STATA 13版软件（StataCorp LP，德克萨斯州大学站），根据适用情况从固定效应模型或随机效应模型计算合并比值比（OR）和95%置信区间（CI）。
40项病例对照研究符合纳入标准，其中包括6860例病例和18025例对照。总共，19项研究针对年轻人（年龄≤40岁），17项研究针对老年中风患者（年龄>40岁）。4项研究未报告招募时的平均年龄。在显性模型下，观察到凝血因子V基因G1691A多态性与缺血性中风风险之间存在显著关联（OR 1.40；95%CI：1.22至1.62，P值<.001）。分层分析表明，凝血因子V基因多态性与年轻时发病的缺血性中风风险存在显著关联（OR 1.84；95%CI：1.47至2.30），但在老年患者（>40岁）中无统计学意义。
凝血因子V基因G1691A单核苷酸多态性主要与年轻人缺血性中风风险相关。需要在同质人群中进行有足够效力的前瞻性研究，以进一步确定年轻中风患者中这种关联的性质。
