载脂蛋白E基因多态性与缺血性脑卒中危险因素的相关性

Correlation between apolipoprotein E gene polymorphism and risk factors of ischemic stroke

目的分析载脂蛋白E(ApoE)基因多态性与缺血性脑卒中危险因素的相关性。方法选取2019年10—12月河北医科大学第一医院神经内科门诊就诊的1027例缺血性脑卒中患者,采用聚合酶链式反应(PCR)-荧光探针技术检测ApoE基因多态性的分布。进一步筛选后共纳入716例住院患者,根据ApoE等位基因将患者分为ε2等位基因携带组(ε2/ε2、ε2/ε3)、ε3等位基因携带组(ε3/ε3)、ε4等位基因携带组(ε3/ε4、ε4/ε4),并排除ε2/ε4基因型(由于其对血脂代谢的相反作用)。分析ApoE基因多态性与缺血性脑卒中危险因素的相关性。结果缺血性脑卒中患者ApoE基因多态性的性别分布差异无统计学意义(P>0.05)。ε2、ε3和ε4等位基因携带组患者脂蛋白a[Lp(a)]、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平及高胆固醇血症发病率比较,差异有统计学意义(P<0.05)。单因素Logistic回归分析显示,ApoEε4等位基因(OR=1.924,95%CI为1.235~2.997,P=0.004)、糖尿病(OR=1.963,95%CI为1.367~2.820,P<0.001)是高胆固醇血症发生的危险因素。多因素Logistic回归分析显示,以ε3/ε3基因型为参照,ApoEε4等位基因与高胆固醇血症的风险增加相关(OR=1.943,95%CI为1.240~3.043)。结论ApoE基因多态性与缺血性脑卒中患者高胆固醇血症相关,与ε3等位基因携带者相比,ε4等位基因携带者罹患高胆固醇血症的风险显著增加。

Objective To analyze the correlation between apolipoprotein E(ApoE)gene polymorphism and risk factors of ischemic stroke.Methods Totally 1027 patients with ischemic stroke treated in the Department of Neurology of the First Hospital of Hebei Medical University from October to December 2019 were selected,and polymerase chain reaction(PCR)-fluorescent probe technique was used to detect the distribution of ApoE gene polymorphism.After further screening,716 hospitalized patients were selected.According to ApoE allele,the patients were divided into group ofε2 allele carriers(ε2/ε2,ε2/ε3),group ofε3 allele carriers(ε3/ε3)and group ofε4 allele carriers(ε3/ε4,ε4/ε4),andε2/ε4 allele was excluded due to its opposite effect on blood lipid metabolism.Correlation between ApoE gene polymorphism and risk factors of ischemic stroke was analyzed.Results There was no significant difference in the gender distribution of ApoE gene polymorphism in patients with ischemic stroke(P>0.05).There were significant differences in the levels of lipoprotein a[Lp(a)],triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and the incidence of hypercholesterolemia among the groups ofε2,ε3 andε4 allele carriers.Univariate Logistic regression analysis showed that ApoEε4 alleles(OR=1.924,95%CI,1.235 to 2.997,P=0.004)and diabetes mellitus(OR=1.963,95%CI,1.367 to 2.820,P<0.001)were risk factors of hypercholesterolemia.Multivariate Logistic regression analysis showed that ApoEε4 allele was associated with the increased risk of hypercholesterolemia whenε3/ε3 genotype was considered as the reference(OR=1.943,95%CI,1.240 to 3.043).Conclusion ApoE gene polymorphism is associated with hypercholesterolemia in patients with ischemic stroke.Compared withε3 allele carriers,ε4 allele carriers have a significantly increased risk of hypercholesterolemia.