From the Department of Neurology and Rehabilitation Medicine (R.P.S., P.S., J.O., C.J.M., M.L.F., D.W.), University of Cincinnati College of Medicine, OH; Department of Neurology (S.J.K.), Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine, MD; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest University, Winston-Salem, NC; and Center for Genomic Medicine (C.D.A., J.R.), Massachusetts General Hospital, Boston.
Neurology. 2018 Jul 31;91(5):e410-e420. doi: 10.1212/WNL.0000000000005908. Epub 2018 Jun 29.
ε2 and ε4 alleles have been associated with lobar intracerebral hemorrhage (ICH) in predominately white populations; we sought to evaluate whether this held true among black and Hispanic populations.
The Ethnic/Racial Variations of Intracerebral Hemorrhage study is a prospective, multicenter case-control study of ICH among white, black, and Hispanic participants. Controls were recruited to match cases based on age, ethnicity/race, sex, and geographic location. genotyping and ICH location was determined blinded to clinical data.
There were 907 cases of lobar ICH and 2,660 controls with results. Both ε (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.0, = 0.01) and ε (OR 2.0, 95% CI 1.5-2.6, < 1 × 10) were associated with lobar ICH among white participants. Among black participants, neither ε (OR 1.0, 95% CI 0.7-1.5, = 0.97) nor ε (OR 1.0, 95% CI 0.7-1.4, = 0.90) were independent risk factors for lobar ICH. Similarly, among Hispanic participants, neither ε (OR 1.0, 95% CI 0.6-1.8, = 0.89) nor ε (OR 1.2, 95% CI 0.8-1.7, = 0.36) were associated with lobar ICH. Hypertension was a significant risk factor for lobar ICH in all 3 racial/ethnic groups.
In contrast to Caucasian patients, in which amyloid risk factors predominate in lobar ICH, we found that hypertension was the predominant risk factor for lobar ICH. While alleles are a risk factor for lobar ICH in white patients, they appear to have a much lower effect in lobar ICH in African American and Hispanic American populations. This suggests ε and ε do not affect lobar ICH risk homogeneously across ethnic populations. In addition, hypertension has a prominent role in lobar ICH risk, particularly among minorities.
ε2 和 ε4 等位基因与大脑皮质下出血（ICH）有关，主要发生在白种人群中；我们试图评估这一结论是否适用于黑人和西班牙裔人群。
“种族间颅内出血的变异研究”是一项前瞻性、多中心的脑出血病例对照研究，纳入了白种人、黑种人和西班牙裔参与者。对照组根据年龄、种族/民族、性别和地理位置与病例相匹配。在不了解临床数据的情况下进行基因分型和 ICH 定位。
共有 907 例皮质下出血病例和 2660 例对照，结果显示：ε（比值比[OR] 1.5，95%置信区间[CI] 1.1-2.0， = 0.01）和 ε（OR 2.0，95% CI 1.5-2.6， < 1 × 10）与白人参与者的皮质下出血有关。在黑人参与者中，ε（OR 1.0，95% CI 0.7-1.5， = 0.97）和 ε（OR 1.0，95% CI 0.7-1.4， = 0.90）均不是皮质下出血的独立危险因素。同样，在西班牙裔参与者中，ε（OR 1.0，95% CI 0.6-1.8， = 0.89）和 ε（OR 1.2，95% CI 0.8-1.7， = 0.36）均与皮质下出血无关。高血压是所有 3 个种族/民族组皮质下出血的一个显著危险因素。
与白种患者中以淀粉样蛋白危险因素为主的皮质下出血不同，我们发现高血压是皮质下出血的主要危险因素。虽然 等位基因是白种患者皮质下出血的一个危险因素，但在非裔美国人和西班牙裔美国人群中，它们对皮质下出血的影响似乎要低得多。这表明 ε 和 ε 对不同种族人群的皮质下出血风险没有一致性影响。此外，高血压在皮质下出血风险中起着重要作用，尤其是在少数民族中。
