Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Department of Neurology, First People's Hospital of Foshan, Foshan, People's Republic of China.
Aging (Albany NY). 2023 Jan 13;15(1):108-118. doi: 10.18632/aging.204460.
This study aims to determine whether APOE alleles would affect the functional outcome in acute ischemic stroke (AIS) and whether the relationship between inflammation and stroke-related disability varies according to APOE genotypes. We retrospectively collected the demographic and clinical data of AIS patients within one week of symptom-onset through medical records review. The primary outcome was dependence or death, defined as modified Rankin scale (mRS) score of 2-6, which was assessed at 3 months. Among 1929 enrolled patients, the prevalence of APOE ε4 carriers was 17.73% (342/1929). There were 394 AIS patients (394/1929, 20.43%) showed poor function outcome of 90-day mRS (2-6), of whom 147 (147/342, 42.98%) were APOE ε4 carriers and 247 (247/1587, 15.56%) were non-ε4 carriers. There was a significant increased probability of poor functional outcome after AIS among APOE ε4 carriers versus non-ε4 carriers (adjusted-OR 4.62, 95% CI 3.51 to 6.09, < 0.001). Among ε4 carriers, high neutrophil-to-lymphocyte ratio (NLR) was significantly associated with stroke-related disability (P = 0.035); however, no significant association was observed among non-ε4 carriers. Our study showed that the APOE ε4 carriers had worse functional outcome after AIS as compared with non-ε4 carriers. APOE genotype may modify the relationship between NLR and 3-month stroke outcome.
本研究旨在确定 APOE 等位基因是否会影响急性缺血性脑卒中（AIS）的功能结局，以及炎症与卒中相关残疾之间的关系是否因 APOE 基因型而异。我们通过病历回顾，回顾性收集了症状发作后一周内 AIS 患者的人口统计学和临床数据。主要结局是依赖或死亡，定义为改良 Rankin 量表（mRS）评分 2-6，在 3 个月时进行评估。在 1929 名入组患者中，APOE ε4 携带者的患病率为 17.73%（342/1929）。有 394 名 AIS 患者（394/1929，20.43%）在 90 天 mRS（2-6）上表现出较差的功能结局，其中 147 名（147/342，42.98%）为 APOE ε4 携带者，247 名（247/1587，15.56%）为非 ε4 携带者。APOE ε4 携带者发生 AIS 后发生不良功能结局的可能性明显高于非 ε4 携带者（校正 OR 4.62，95%CI 3.51-6.09，<0.001）。在 ε4 携带者中，高中性粒细胞与淋巴细胞比值（NLR）与卒中相关残疾显著相关（P=0.035）；然而，在非 ε4 携带者中未观察到显著相关性。我们的研究表明，与非 ε4 携带者相比，APOE ε4 携带者在发生 AIS 后功能结局较差。APOE 基因型可能会改变 NLR 与 3 个月卒中结局之间的关系。
