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Age-dependent association of apolipoprotein E genotypes with stroke subtypes in a Japanese rural population.

Abstract

BACKGROUND AND PURPOSE

The association between apolipoprotein E (apoE) polymorphisms and stroke has been controversial. These controversies may be due to inaccurate classification of stroke and differences in age ranges. We investigated the association between apoE genotypes and stroke subtypes (confirmed by CT or MRI findings) by case-control study in a Japanese rural population.

METHODS

First-ever-stroke patients (n=322; cerebral infarction, n=201, intracerebral hemorrhage, n=84, and subarachnoid hemorrhage, n=37) aged 40 to 89 years were recruited from Hokuetsu Hospital, Japan. Healthy controls (n=1126) were selected from the general population in the same area. ApoE genotypes were determined by restriction fragment-length polymorphism analysis.

RESULTS

Compared with apoE epsilon3/epsilon3 subjects, epsilon2 carriers had a 2-fold risk of cerebral infarction (OR 1.9, 95% CI 1.1 to 3.2). Among cerebral infarction patients, epsilon2 carriers had increased risks of cortical infarction (OR 2.4, 95% CI 1.3 to 4.6) (an anatomic subtype) and atherothrombosis (OR 3.9, 95% CI 1.7 to 9.0) and cardioembolism (OR 4.9, 95% CI 1.6 to 14.4) but not lacunar infarction (clinical subtypes). ApoE epsilon4 carriers had a 2. 5-fold risk of subarachnoid hemorrhage (OR 2.5, 95% CI 1.1 to 5.4). ApoE epsilon2/epsilon2 subjects had an increased risk of intracerebral hemorrhage (OR 4.4, 95% CI 1.0 to 19.7). ApoE epsilon3/epsilon4 subjects showed approximately 2-fold increased risk of atherothrombosis (OR 2.1, 95% CI 1.0 to 4.1) and intracerebral hemorrhage (OR 1.8, 95% CI 1.0 to 3.3). The association between epsilon2 and stroke was accentuated in subjects aged 70 years or older but not in those aged 40 to 69 years.

CONCLUSIONS

Our study suggests that apoE epsilon2 is a risk factor for atherothrombosis, cardioembolism, and intracerebral hemorrhage, whereas epsilon4 is a risk factor for atherothrombosis, intracerebral hemorrhage, and subarachnoid hemorrhage. The occurrence of stroke may be affected by interaction between age and apoE gene polymorphisms.

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  • Authors+Show Affiliations

    ,

    Department of Physiology, School of Medicine, Tokyo Medical and Dental University, Japan. kokubo.epi@mri.tmd.ac.jp

    , , , ,

    Source

    Stroke 31:6 2000 Jun pg 1299-306

    MeSH

    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Alleles
    Apolipoprotein E2
    Apolipoprotein E4
    Apolipoproteins E
    Cerebral Hemorrhage
    Cerebral Infarction
    Gene Frequency
    Genetic Predisposition to Disease
    Genotype
    Humans
    Intracranial Embolism
    Japan
    Middle Aged
    Polymorphism, Genetic
    Polymorphism, Restriction Fragment Length
    Prospective Studies
    Rural Population
    Stroke
    Subarachnoid Hemorrhage

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10835448

    Citation

    Kokubo, Y, et al. "Age-dependent Association of Apolipoprotein E Genotypes With Stroke Subtypes in a Japanese Rural Population." Stroke, vol. 31, no. 6, 2000, pp. 1299-306.
    Kokubo Y, Chowdhury AH, Date C, et al. Age-dependent association of apolipoprotein E genotypes with stroke subtypes in a Japanese rural population. Stroke. 2000;31(6):1299-306.
    Kokubo, Y., Chowdhury, A. H., Date, C., Yokoyama, T., Sobue, H., & Tanaka, H. (2000). Age-dependent association of apolipoprotein E genotypes with stroke subtypes in a Japanese rural population. Stroke, 31(6), pp. 1299-306.
    Kokubo Y, et al. Age-dependent Association of Apolipoprotein E Genotypes With Stroke Subtypes in a Japanese Rural Population. Stroke. 2000;31(6):1299-306. PubMed PMID: 10835448.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Age-dependent association of apolipoprotein E genotypes with stroke subtypes in a Japanese rural population. AU - Kokubo,Y, AU - Chowdhury,A H, AU - Date,C, AU - Yokoyama,T, AU - Sobue,H, AU - Tanaka,H, PY - 2000/6/3/pubmed PY - 2000/7/6/medline PY - 2000/6/3/entrez SP - 1299 EP - 306 JF - Stroke JO - Stroke VL - 31 IS - 6 N2 - BACKGROUND AND PURPOSE: The association between apolipoprotein E (apoE) polymorphisms and stroke has been controversial. These controversies may be due to inaccurate classification of stroke and differences in age ranges. We investigated the association between apoE genotypes and stroke subtypes (confirmed by CT or MRI findings) by case-control study in a Japanese rural population. METHODS: First-ever-stroke patients (n=322; cerebral infarction, n=201, intracerebral hemorrhage, n=84, and subarachnoid hemorrhage, n=37) aged 40 to 89 years were recruited from Hokuetsu Hospital, Japan. Healthy controls (n=1126) were selected from the general population in the same area. ApoE genotypes were determined by restriction fragment-length polymorphism analysis. RESULTS: Compared with apoE epsilon3/epsilon3 subjects, epsilon2 carriers had a 2-fold risk of cerebral infarction (OR 1.9, 95% CI 1.1 to 3.2). Among cerebral infarction patients, epsilon2 carriers had increased risks of cortical infarction (OR 2.4, 95% CI 1.3 to 4.6) (an anatomic subtype) and atherothrombosis (OR 3.9, 95% CI 1.7 to 9.0) and cardioembolism (OR 4.9, 95% CI 1.6 to 14.4) but not lacunar infarction (clinical subtypes). ApoE epsilon4 carriers had a 2. 5-fold risk of subarachnoid hemorrhage (OR 2.5, 95% CI 1.1 to 5.4). ApoE epsilon2/epsilon2 subjects had an increased risk of intracerebral hemorrhage (OR 4.4, 95% CI 1.0 to 19.7). ApoE epsilon3/epsilon4 subjects showed approximately 2-fold increased risk of atherothrombosis (OR 2.1, 95% CI 1.0 to 4.1) and intracerebral hemorrhage (OR 1.8, 95% CI 1.0 to 3.3). The association between epsilon2 and stroke was accentuated in subjects aged 70 years or older but not in those aged 40 to 69 years. CONCLUSIONS: Our study suggests that apoE epsilon2 is a risk factor for atherothrombosis, cardioembolism, and intracerebral hemorrhage, whereas epsilon4 is a risk factor for atherothrombosis, intracerebral hemorrhage, and subarachnoid hemorrhage. The occurrence of stroke may be affected by interaction between age and apoE gene polymorphisms. SN - 0039-2499 UR - https://www.unboundmedicine.com/medline/citation/10835448/Age_dependent_association_of_apolipoprotein_E_genotypes_with_stroke_subtypes_in_a_Japanese_rural_population_ L2 - http://Insights.ovid.com/pubmed?pmid=10835448 DB - PRIME DP - Unbound Medicine ER -