Kaohsiung Journal of Medical Sciences
Volume 23, Issue 10 , Pages 491-497, October 2007

Association of Apolipoprotein E Polymorphism with Ischemic Stroke Subtypes in Taiwan

  • Chiou-Lian Lai

      Affiliations

    • Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Ching-Kuan Liu

      Affiliations

    • Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Ruey-Tay Lin

      Affiliations

    • Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Chih-Ta Tai

      Affiliations

    • Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Chih-Ta Tai, Department of Neurology, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 24 July 2006; accepted 5 February 2007.

Article Outline

The aim of this study was to clarify whether the apolipoprotein E gene (APOE) is related to ischemic stroke subtypes in Taiwan's Chinese population. Using the classification of Cerebrovascular Diseases III, 143 patients with lacunar infarction, 114 patients with atherothrombotic infarction, and 112 healthy controls were enrolled. APOE genotype was determined using polymerase chain reaction. Regarding the distribution of APOE genotypes, the frequency of ɛ3/ɛ4 genotypes in lacunar patients was significantly different from that in control subjects, by logistic regression, using ɛ3/ɛ3 as a reference group. There was no significant difference between atherothrombotic patients and the control group in the distribution of APOE genotypes or alleles. The present finding suggests that there is a probable association between ɛ3/ɛ4 genotype and lacunar infarcts, but not atherothrombotic infarcts. This indicates that genetic factors may play a role, at least partially, in lacunar infarction in Taiwan's Chinese population.

Key Words:  apolipoprotein E , ischemic stroke , Taiwan

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Khaw KT . Epidemiology of stroke . J Neurol Neurosurg Psychiatry . 1996;61:333–338
  2. Kanter MC , Sherman DG . Strategies for preventing stroke . Curr Opin Neurol Neurosurg . 1993;6:60–65
  3. 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;31:1299–1306
  4. Sacco RL , Kargman DE , Gu O , Zamanillo MC . Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the northern Manhattan stroke study . Stroke . 1995;26:4–20
  5. Davis LE , Xie JG , Zou AH , et al.   Deep cerebral infarcts in the People's Republic of China . Stroke . 1990;21:394–396
  6. Feldmann E , Daneault N , Kwan E , et al.   Chinese-white difference in the distribution of occlusive cerebrovascular disease . Neurology . 1990;40:1541–1545
  7. Weusberg LA . Lacunar infarcts. Clinical and computed tomographic correlation . Arch Neurol . 1982;39:37–40
  8. Iso H , Jacobs DR , Wentworth D , et al.   Serum cholesterol levels and six year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Interventional Trial . N Engl J Med . 1989;320:722–740
  9. Luthra K , Prasad K , Kumar P , et al.   Apolipoprotein E gene polymorphism in cerebrovascular disease: a case-control study . Clin Genet . 2002;62:39–44
  10. Mahley RW . Apolipoprotein E: cholesterol transport protein with expanding role in cell biology . Science . 1998;240:622–630
  11. de Knijft P , van den Maagdenberg AMJM , Frants R , et al.   Genetic heterogeneity of apolipoprotein E and its influence on plasma lipid and lipoprotein levels . Hum Mutat . 1994;4:178–194
  12. Pedro-Botet J , Senti M , Nogues X , et al.   Lipoprotein and apolipoprotein profile in men with ischemic stroke . Stroke . 1992;23:1556–1562
  13. Couderc R , Mahieux F , Bailleul S , et al.   Prevalence of apolipoprotein E phenotypes in ischemic cerebrovascular disease. A case-control study . Stroke . 1993;24:661–664
  14. Kuusisto J , Mykkanen L , Kervinen K , et al.   Apolipoprotein E4 phenotype is not an important risk factor for coronary heart disease or stroke in elderly subjects . Arterioscler Thromb Vasc Biol . 1995;15:1280–1286
  15. Hifuchi S , Arai H , Nakagawa T , et al.   The apolipoprotein E gene in Binswanger's disease and vascular dementia . Clin Genet . 1996;50:459–461
  16. Basun H , Corder EH , Guo Z , et al.   Apolipoprotein E polymorphism and stroke in a population sample aged 75 years or more . Stroke . 1996;27:1310–1315
  17. Marin DB , Brenda B , Marin ML , et al.   The relationship between apolipoprotein E, dementia, and vascular illness . Atherosclerosis . 1998;140:173–180
  18. Slooter AJC , Bots ML , Havekes LM , et al.   Apolipoprotein E and carotid artery atherosclerosis. The Rotterdam study . Stroke . 2001;32:1947–1952
  19. Topic E , Simundic AM , Stefanovic M , et al.   Polymorphism of apolipoprotein E (APOE), methylenetetrahy-drofolate reductase (MTHFR) and paraoxonase (PON1) genes in patients with cerebrovascular disease . Clin Chem Lab Med . 2001;39:346–350
  20. Bachman DL , Wolf PA , Linn RT , et al.   Prevalence of dementia and probable senile dementia of the Alzheimer's type in the Framingham study . Neurology . 1992;42:115–119
  21. Duara R , Barker WW , Lopez-Alberola R , et al.   Alzheimer's disease: interaction of apolipoprotein E genotype, family history of dementia, gender, education, ethnicity, and age of onset . Neurology . 1996;46:1575–1579
  22. Mak YT , Chiu H , Woo J , et al.   Apolipoprotein E genotype and Alzheimer's disease in Hong Kong elderly Chinese . Neurology . 1996;46:146–149
  23. Hong CJ , Liu TY , Liu HC , et al.   ɛ4 allele of apolipoprotein E increases risk of Alzheimer's disease in a Chinese population . Neurology . 1996;46:149–175
  24. Katzman R , Zhang MY , Chen PJ , et al.   Effects of apolipoprotein E in dementia and aging in the Shanghai survey of dementia . Neurology . 1997;49:779–785
  25. Kim HC , Kim DK , Choi IJ , et al.   Relation of apolipoprotein E polymorphism to clinically diagnosed Alzheimer's disease in the Korean population . Psy Clin Neurosci . 2001;55:115–120
  26. Hallman DM , Boerwinkle E , Saha N , et al.   The Apolipoprotein E polymorphism: a comparison of allele frequencies and effects in nine populations . Am J Hem Genet . 1991;49:338–349
  27. Eggertsen G , Tegelman R , Ericsson S , et al.   Apolipoprotein E polymorphism in a healthy Swedish population: variation of allele frequency with age and relation to serum lipid concentrations . Clin Chem . 1993;39:2125–2129
  28. Gerdes LU , Klausen LC , Sihm I , et al.   Apolipoprotein E polymorphism in a Danish population compared to findings in 45 other study populations around the world . Genet Epidemiol . 1992;9:155–167
  29. Liu HC , Hong CJ , Wang SJ , et al.   ApoE genotype in relation to AD and cholesterol: a study of 2,326 Chinese adults . Neurology . 1990;59:962–966
  30. Special Report from the National Institute of Neurological Disorders and Stroke. Classification of Cerebrovascular Diseases III . Stroke . 1990;21:637–676
  31. Wenham PR , Price WH , Blandell G . Apolipoprotein E genotyping by one-stage RCR . Lancet . 1991;337:1158–1159
  32. Hixson JE . Apolipoprotein E polymorphisms affect atherosclerosis in young males. Pathobiological determinants of atherosclerosis in Youth (PDAY) research group . Arterioscler Thromb Vasc Biol . 1991;11:1237–1244
  33. Fisher CM . Lacunar strokes and infarcts: a review . Neurology . 1990;32:871–876
  34. He J , Klag MJ , Wu Z , Whelton PK . Stroke in the People's Republic of China . Stroke . 1995;26:2222–2227
  35. Horowitz DR , Tuhrim S , Weinberger JM , et al.   Mechanisms in lacunar infarction . Stroke . 1992;23:325–327
  36. Zannad F , Visvikis S , Gueguen R , et al.   Genetics strongly determines the wall thickness of the left and right carotid stenosis . Hum Genet . 1998;103:183–188
  37. Caplan LR , Gorelick PB , Hier DB . Race, sex and occlusive cerebrovascular disease: a review . Stroke . 1986;17:648–655
  38. Shimano H , Ishibashi S , Murase T , et al.   Plasma lipoprotein in patients with multi-infarct dementia . Atherosclerosis . 1989;79:257–260
  39. Martins IJ , Hone E , Foster JK , et al.   Apolipoprotein E, cholesterol metabolism, diabetes, and the convergence of risk factors for Alzheimer's disease and cardiovascular disease . Mol Psychiat . 2006;11:721–736
  40. Du L , Du Y , Huang X . Association of apolipoprotein E gene polymorphism with essential hypertension and its complication . Clin Exp Med . 2003;2:175–179
  41. von Reuten GM , von Budingen HJ . Ultrasound Diagnosis of Cerebrovascular Disease . New York: Georg Thieme; 1993;
  42. Schultz UGR , Rothwell PM . Differences in vascular risk factors between etiological subtypes of ischemic stroke. Importance of population-based studies . Stroke . 2003;34:2050–2059

PII: S1607-551X(08)70006-8

doi:10.1016/S1607-551X(08)70006-8

Kaohsiung Journal of Medical Sciences
Volume 23, Issue 10 , Pages 491-497, October 2007

Article Tools