Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University school of Medicine, Taipei, Taiwan.
Institutes of Biochemistry, Microbiology, and Immunology, Chung Shan Medical University, Taichung, Taiwan; Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan.
Gene. 2019 Feb 5;684:76-81. doi: 10.1016/j.gene.2018.10.050. Epub 2018 Oct 24.
Stroke is a leading cause of death and serious disability worldwide. Now, evidences indicate that dyslipidemia may play an important role in stroke. APOA1 and APOA5 involve in lipid metabolism. In this study, we investigated the association of APOA1 rs670 and APOA5 rs662799 with different stroke subtypes in the Han Chinese population of Taiwan.
A total of 1751 participants, including 459 control subjects, 606 large artery atherosclerosis (LAA), 339 small vessel occlusion (SVO), and 347 hypertensive intracranial hemorrhage (HICH), were enrolled. The presence of rs670 and rs662799 was analyzed through polymerase chain react ion and matrix-assisted laser desorption/ionization-time-of-flight-mass spectrometry.
Notably, the frequency of the rs662799 C allele was significantly lower in the SVO patients than in the controls (24.36% vs. 29.74%, P = 0.024). The frequencies of heterozygote TC [odd ratio (OR) = 0.732, 95% confidence interval (CI) = 0.544-0.984, P = 0.038] and TC + CC (OR = 0.719, 95% CI = 0.542-0.953, P = 0.022) genotypes were significantly lower in the SVO patients than in the controls. In addition, triglyceride levels in individuals carrying the rs662799 TC + CC genotype were significantly higher than in those carrying the TT genotype, especially in older age, female, and body mass index (BMI) ≥ 25 groups. On the contrary, the low-density lipoprotein-cholesterol (LDL-C) was significantly lower in rs662799 TC + CC genotype than TT genotype. The BMI was significantly lower in subjects with rs662799 TC + CC genotype than those with TT genotype, especially in older age and female. High-density lipoprotein-cholesterol (HDL-C) levels were higher in individuals carrying the rs670 GG genotype than in those carrying the AG + AA genotype, especially in BMI < 25 group. Logistic regression analysis showed that the rs662799 C allele (TC + CC) was an independent protective factor for SVO after adjustment for conventional risk factors (OR = 0.709, 95% CI = 0.526-0.956; P = 0.024).
GG genotype of rs670 is correlated with high serum HDL-C levels, whereas TC + CC genotype of rs662799 is associated with high serum triglyceride and low LDL and BMI levels. In addition, the rs662799 C allele (TC + CC) is an independent protective factor for SVO in the Han Chinese population in Taiwan.
卒中是全世界范围内导致死亡和严重残疾的主要原因。目前，有证据表明血脂异常可能在卒中发病中起重要作用。APOA1 和 APOA5 参与脂质代谢。本研究旨在探讨载脂蛋白 A1（APOA1）rs670 和载脂蛋白 A5（APOA5）rs662799 与台湾汉族人群不同卒中亚型的相关性。
共纳入 1751 例受试者，包括 459 例对照、606 例大动脉粥样硬化性卒中（LAA）、339 例小血管闭塞性卒中（SVO）和 347 例高血压性颅内出血（HICH）。采用聚合酶链反应和基质辅助激光解吸/电离-飞行时间质谱法分析 rs670 和 rs662799 的存在情况。
值得注意的是，SVO 患者 rs662799 C 等位基因的频率明显低于对照组（24.36%比 29.74%，P=0.024）。杂合子 TC [比值比（OR）=0.732，95%置信区间（CI）=0.544-0.984，P=0.038]和 TC+CC（OR=0.719，95%CI=0.542-0.953，P=0.022）基因型在 SVO 患者中的频率明显低于对照组。此外，携带 rs662799 TC+CC 基因型的个体的甘油三酯水平明显高于携带 TT 基因型的个体，尤其是在年龄较大、女性和 BMI≥25 组。相反，rs662799 TC+CC 基因型的低密度脂蛋白胆固醇（LDL-C）水平明显低于 TT 基因型。携带 rs662799 TC+CC 基因型的个体的 BMI 明显低于携带 TT 基因型的个体，尤其是在年龄较大和女性中。携带 rs670 GG 基因型的个体高密度脂蛋白胆固醇（HDL-C）水平高于携带 AG+AA 基因型的个体，尤其是在 BMI<25 组。Logistic 回归分析显示，在调整传统危险因素后，rs662799 C 等位基因（TC+CC）是 SVO 的独立保护因素（OR=0.709，95%CI=0.526-0.956；P=0.024）。
rs670 的 GG 基因型与血清 HDL-C 水平升高相关，而 rs662799 的 TC+CC 基因型与血清甘油三酯升高、LDL-C 降低和 BMI 降低相关。此外，rs662799 C 等位基因（TC+CC）是台湾汉族人群 SVO 的独立保护因素。
