缺血性脑血管病中载脂蛋白E表型的患病率。一项病例对照研究。

Prevalence of apolipoprotein E phenotypes in ischemic cerebrovascular disease. A case-control study.

作者信息

Couderc R, Mahieux F, Bailleul S, Fenelon G, Mary R, Fermanian J

机构信息

Department of Biochemistry, Hôpital Tenon, France.

出版信息

Stroke. 1993 May;24(5):661-4. doi: 10.1161/01.str.24.5.661.

DOI:10.1161/01.str.24.5.661

PMID:8488520

Abstract

BACKGROUND AND PURPOSE

Apolipoprotein E polymorphism may influence the early development of coronary artery disease. We investigated the putative role of apolipoprotein E phenotypes in cerebral infarction.

METHODS

The apolipoprotein E phenotypes of 69 patients (mean +/- SD age, 72 +/- 11 years) who had suffered completed stroke or a transient ischemic attack and 68 sex- and age-matched control subjects free of cerebrovascular disease were determined by isoelectric focusing. The relative frequency of the apolipoprotein E phenotypes in the general population was estimated in 498 healthy blood donors (mean age, 37 years).

RESULTS

The prevalences of hypertension, diabetes mellitus, obesity, and intermittent claudication were significantly higher in patients than in control subjects. Serum lipid and apolipoprotein B concentrations and the composition of very low density lipoproteins were not significantly different between patients and control subjects. Apolipoprotein A-I and E levels were significantly lower in patients. Cholesterol levels were higher in male patients than in male control subjects (5.10 +/- 1.46 versus 4.41 +/- 0.80 mmol/L; p = 0.036), and the ratio of apolipoprotein A-I to B was lower (0.77 +/- 0.29 versus 1.03 +/- 0.37; p < 0.001). The E3/E3 phenotype was more frequent in control subjects (85%) than in patients (72.5%; p < 0.05) and healthy blood donors (64%; p < 0.02). The E3/E2 phenotype was more frequent in patients (10.1%) than in control subjects (1.4%; p < 0.05). A stepwise logistic regression showed that the presence of stroke was significantly related to high blood pressure (p < 0.0001), low apo E levels (p < 0.008), obesity (p < 0.041), the apo E phenotype (p < 0.05), and diabetes mellitus (p < 0.05).

CONCLUSIONS

The E3/E3 phenotype may protect against early vascular morbidity, and the epsilon 2 gene may be a risk factor for cerebrovascular morbidity, possibly related to diabetes, hypertension, and/or obesity.

摘要

背景与目的

载脂蛋白E多态性可能影响冠状动脉疾病的早期发展。我们研究了载脂蛋白E表型在脑梗死中的假定作用。

方法

采用等电聚焦法测定69例发生完全性卒中或短暂性脑缺血发作的患者（平均年龄±标准差为72±11岁）以及68例年龄和性别匹配的无脑血管疾病对照者的载脂蛋白E表型。在498名健康献血者（平均年龄37岁）中估计了一般人群中载脂蛋白E表型的相对频率。

结果

患者中高血压、糖尿病、肥胖和间歇性跛行的患病率显著高于对照者。患者与对照者之间的血脂、载脂蛋白B浓度以及极低密度脂蛋白的组成无显著差异。患者的载脂蛋白A-I和E水平显著较低。男性患者的胆固醇水平高于男性对照者（5.10±1.46对4.41±0.80 mmol/L；p = 0.036），载脂蛋白A-I与B的比值较低（0.77±0.29对1.03±0.37；p < 0.001）。E3/E3表型在对照者中（85%）比在患者中（72.5%；p < 0.05）和健康献血者中（64%；p < 0.02）更常见。E3/E2表型在患者中（10.1%）比在对照者中（1.4%；p < 0.05）更常见。逐步逻辑回归显示，卒中的存在与高血压（p < 0.0001）、低载脂蛋白E水平（p < 0.008）、肥胖（p < 0.041）、载脂蛋白E表型（p < 0.05）和糖尿病（p < 0.05）显著相关。