Department of Neurology, Jinling Hospital, Southern Medical University, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Neuromolecular Med. 2018 Jun;20(2):225-232. doi: 10.1007/s12017-018-8485-y. Epub 2018 Mar 19.
Elevated C-reactive protein (CRP) levels increase the risk of poor functional disability in patients with ischemic stroke (IS). This study aimed to investigate the association between CRP gene polymorphisms and 3-month functional disability of large artery atherosclerotic (LAA) stroke in Han Chinese. Patients with first-ever LAA IS were prospectively enrolled in Nanjing Stroke Registry Program between August 2013 and October 2015. Five single-nucleotide polymorphisms (SNPs) (rs876537, rs2794520, rs3093059, rs7553007 and rs11265260) in CRP gene related to CRP levels in Asian by genome-wide association study were genotyped. The functional outcome at 3 months after the index stroke was assessed by the modified Rankin scale. Associations between genotypes and functional outcome of LAA IS were analyzed with logistic regression model. A total of 690 eligible patients (507 males) were evaluated. SNPs rs11265260 (multivariate-adjusted, p = 0.022), rs2794520 (multivariate-adjusted, p = 0.036) and rs3093059 (multivariate-adjusted, p = 0.027) were significantly associated with elevated CRP in acute IS. Two SNPs, rs3093059 (dominant model: adjusted OR 2.49; 95% CI 1.55-4.00; recessive model: adjusted OR 3.67; 95% CI 1.22-11.03) and rs11265260 (dominant model: adjusted OR 2.51; 95% CI 1.56-4.02; recessive model: adjusted OR 4.70; 95% CI 1.63-13.56) independently predicted 3-month poor outcome of first-ever LAA IS, after adjusting for covariates. In addition, haplotype analysis indicated that haplotype GCTGC (adjusted OR 1.76; 95% CI 1.05-2.95; p = 0.031) increased the poor outcome risk. SNPs rs3093059 and rs11265260 in CRP gene may influence the 3-month functional outcome of first-ever LAA IS in Han Chinese.
C-反应蛋白(CRP)水平升高会增加缺血性卒中(IS)患者不良功能残疾的风险。本研究旨在探讨 CRP 基因多态性与汉族大动脉粥样硬化性(LAA)卒中患者 3 个月功能残疾的关系。前瞻性纳入 2013 年 8 月至 2015 年 10 月南京卒中登记研究项目中首次发生 LAA IS 的患者。对与亚洲人群 CRP 水平相关的 CRP 基因中的 5 个单核苷酸多态性(SNP)(rs876537、rs2794520、rs3093059、rs7553007 和 rs11265260)进行基因分型。采用改良 Rankin 量表评估指数卒中后 3 个月的功能结局。采用 logistic 回归模型分析基因型与 LAA IS 功能结局的关系。共评估了 690 例符合条件的患者(507 例男性)。SNP rs11265260(多变量校正,p=0.022)、rs2794520(多变量校正,p=0.036)和 rs3093059(多变量校正,p=0.027)与急性 IS 时 CRP 升高显著相关。两个 SNP,rs3093059(显性模型:调整 OR 2.49;95%CI 1.55-4.00;隐性模型:调整 OR 3.67;95%CI 1.22-11.03)和 rs11265260(显性模型:调整 OR 2.51;95%CI 1.56-4.02;隐性模型:调整 OR 4.70;95%CI 1.63-13.56)可独立预测首次发生的 LAA IS 3 个月的不良预后,校正协变量后。此外,单体型分析表明,单体型 GCTGC(调整 OR 1.76;95%CI 1.05-2.95;p=0.031)增加了不良预后的风险。CRP 基因中的 rs3093059 和 rs11265260 可能影响汉族人首次发生 LAA IS 的 3 个月功能结局。