淀粉样蛋白A1位点rs12218基因多态性与急性缺血性脑卒中后抑郁易感性及影响因素分析

Association of rs12218 Polymorphism in Amyloid A1 Gene with Susceptibility to Depression after Acute Ischemic Stroke and Its Influencing Factors

目的研究淀粉样蛋白A1(SAA1)位点rs12218基因多态性与急性缺血性脑卒中后抑郁易感性之间的关系。方法选择2017年1月至2020年6月456例首发急性脑卒中患者为研究对象,根据抑郁状况评估结果分为脑卒中后抑郁(PSD)组158例和非PSD组298例。采用酶联免疫吸附法(ELISA)检测并比较2组患者SAA1表达情况,并采用TaqMan探针法检测患者血液中SAA1基因rs12218基因多态性。比较2组患者基因多态性分布情况以及临床特征;并采用单因素和多因素Logistic回归分析影响PSD的独立危险因素。结果SAA1基因rs12218位点存在3种基因型:CC、CT、TT;PSD组和非PSD组中3种基因型期望值和观测值符合Hardy-Weinberg平衡定律(χ^(2)=4.423,P=0.110;χ^(2)=0.309,P=0.857);2组基因型分布之间差异有统计学意义,PSD组CC型基因频率和C等位基因频率高于非PSD组(P<0.05);PSD组患者血清SAA1水平较非PSD组明显升高(P<0.001)。单因素和多因素Logistic回归分析结果显示,性格内向、独居、入院时NIHSS评分、关键脑部位梗死、合并并发症以及SAA1水平升高、SAA1基因rs12218位点多态性均为影响PSD的独立危险因素(P<0.05)。结论PSD患者血清SAA1表达水平呈显著高表达,且SAA1位点rs12218基因多态性与PSD紧密相关,C等位基因突变会增加PSD易感性。

Objective To study the relationship between rs12218 polymorphism in serum amyloid A1(SAA1)gene and susceptibility to depression after acute ischemic stroke.Methods A total of 456 patients who had a first-ever acute ischemic stroke between January 2017 and June 2020 were divided into post-stroke depression(PSD)group(158 cases)and non-PSD group(298 cases)according to the results of depression assessment.The expression of SAA1 was detected by ELISA,and SAA1 gene rs12218 polymorphism was determined using the TaqMan probe method.The genetic polymorphism distribution and clinical characteristics were compared between the two groups.Univariate and multivariate logistic regression models were used to analyze the independent risk factors for PSD.Results There were 3 genotypes at the rs12218 locus of SAA1 gene:CC,CT and TT.The expected and observed values of the 3 genotypes in both PSD and non-PSD groups conformed to the Hardy-Weinberg equilibrium(χ^(2)=4.423 and 0.309,respectively;P=0.110 and 0.857,respectively).Both CC genotype frequency and C allele frequency in PSD group were higher than those in non-PSD group(P<0.05).Furthermore,SAA1 level in PSD group was higher than that in non-PSD group(P<0.001).The univariate and multivariate logistic regression analysis showed that introversion,living alone,NIHSS score at admission,infarction in key cerebral areas,complications,elevated SAA1 level,and SAA1 gene rs12218 polymorphism were independent risk factors for PSD(P<0.05).Conclusion SAA1 is highly expressed in PSD patients,and rs12218 polymorphism is closely related to PSD.Mutations in the C allele increase the susceptibility to PSD.