Serebrovasküler hastalıklarda apolipoprotein E polimorfizmi
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2017
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info:eu-repo/semantics/embargoedAccess
Özet
Giriş ve amaç: Ateroskleroz strok için en önemli risk bir faktörü, apolipoprotein E (apo E) polimorfizmide ateroskleroz patogenezinde rol oynayan genetik fakt.orierdendir.Apo E genotipi ile strok arasındaki ilişki tam olarak bilinmemektedir. Bu çalışmanın amadan; a) apo E genotipi ile akut serebral infarktüs ve intraserebral hemoraji arasındaki ilişkiyi araştırmak, b)serebrovasküler hastalığın risk faktörleri ile apo E genotipini ilişkilendirmek, c) akut inmeyi takibeden mortalite ile apo E genotipinin ilişkisini incelemek, d) apo E genotipini primer koruyucu tedavi ile ilişkilendirmek. Metod: Akut İskemik ve Hemorojik Strok tanısı ile yatırılan ve radyolojik olarak tanısı kesinleşen 100 hasta ile aynı yaşla uyumlu 30 sağlıklı birey alındı. İnme fenotipini serebral enfarktüs ya da intrakranial hemoraji, belirlemek için, akut olaydan sonra 10 gün içinde Beyin Bilgisayarlı Tomografi veya Manyetik Rezonans Görüntüleme çekilmiştir. Serebral infarktüslü hastalar, Oxfordshire Toplumda İnme Projesi Sınıflandırmasına (OCSP) göre alt tiplere ayrılmışlardır, intrakranial hemoraji lezyon yerine sınıflandınldı. "High Pure PCR Template Preparation Kit", 'Light Cycler-Apo E Mutation Detection Kit (codon 112 and 158) ",. Light Cycler-Red 640 işaretli prob ve Light Cycler-Red 705 işaretli prob kullanılarak allel analizi yapıldı ve hastaların allel tipleri ortaya çıkarıldı. Çalışmaya alınan tüm hastalan n ayrıntılı nörolojik ve sistemik muayeneleri, rutin laboratuar tetkikleri (kan sayımı, elektrolitler, kan şekeri, lipit değerleri ve diğer parametreler), total apo E, elektrokardiyografi (EKG), göğüs radyografisi, ekokardiyografi yapıldı. Bulgular: Çalışmaya katılan stroklu hastaların ve kontrollerini karşılaştırılması sonuçlan incelendiğinde, LDL-Kolesterol, total kolesterol, LVH değişkenleri arasında önemli fark olduğu bulundu (p<0.05). 73 Strok'lu hastaların 24'ü (%24) hastanede yattığı sûrede ex oldu. Hastaların ortalama ex günü 4.1± 1.2'idi. Strok'lu hastaların ex olan ve hayata kalanların karşılaştırılmalı sonuçlan incelendiğinde;Sis-Ta, İskemik kalp hastalığı öyküsü, LDL-c değişkenleri arasında önemli fark olduğu bulundu. (p<0.05) Strok hastalarının apo E genotipleri ile değişkenlere bakıldığında VLDL- e24, Dias-TA-e34.Total kolesterol e34,e44 ve carotis arterlerde aterom plağı varlığı- e34, e44 arasında anlamlı korelasyon bulundu. Apo E genotipleri ile serebra! infarktüsün OCSP alt tipleri ve intrakraniyal hemoraji alt tipleri arasındaki ilişki anlamlı bulunmadı. (p>0.05) Sonuç; 1- Iskemik ve hemorojik strok ile apo E genotipinin polimorüzmi arasında risk faktörü olarak bir ilişki saptanamamıştır. 2-Akut inmeyi takip eden tüm nedenlere bağlı mortalitenin patogenezi ile apo E genotipinin polimorfizmini ilişkilendiren bir bulgu elde edilmemiştir. Anahtar kelimeler Apolipoprotein E; serebrovasküler hastalık; Apo E genotipi; risk faktörleri; mortalite
Introduction and Objectives: Atherosclerosis is an important risk factor for stroke and apolipoprotein E (apo E) polimorphism is one of the genetic factors that plays a role in the pathogenesis of atherosclerosis. Currently, the exact relationship between Apo E genotype and stroke is unknown. The objectives of this study are to; a) investigate the relationship between apo E genotype, acute cerebral infarction and intracerebral hemorrhage, b) establish a relationship between apo E genotype and risk factors for cerebrovascular disease, c) investigate the relationship betweeen acute stroke mortality and apo E genotype, d) establish a relationship between apo E genotype and primary preventive therapy. Method: 100 hospitalized patients who were diagnosed clinically and radiologically as acute ischemic or hemorrhagic stroke and 30 healthy subjects in the same age group were chosen for this study. Cranial CT or MRI was performed to determine the stroke phenotype (cerebral infarction, CI or intracranial hemorrhage, ICH) in the first 10 days after the acute event The patients with cerebral infarction were classified according to the Oxfordshire Community Stroke Project (OCSP) Classification (OCSP). Intracranial hemorrhages were classified according to the location of the lesions. Allel analysis was performed to determine the allel type of the patients by using the '"High Pure PCR Template Preparation Kit", "Light Cycler-Apo E Mutation Detection Kit (codon 112 and 158)", "Light Cycler-Red 640 and Light Cycler-Red 705 marked probes". Detailed neurologic and systemic examinations of all the patients and the healthy subjects under the study were performed as well as routine laboratuary examinations (complete blood count, electrolytes, blood glucose, lipids and other parameters), total apo E, electrocardiography (ECG), chest radiography, and echocardiography. 75 Results: There was a statistically significant difference in LDL-Cholesterol, Total Cholesterol and LVH variables between the stroke patients and the healthy control group (p<0.05). During the study, 24 out of 100 stroke patients (24%) died while on treatment in the hospital. The avarage period for patient deaths were 4.1± 1.2 days. There was a statistically significant difference (p<0.05) in Sis-Ta, history of ischemic heart disease and LDL-c variables between the stroke patients who survived and the patients who did not survive. While studying apo E genotype of stroke patients and variables, a significant congelation was found between VLDL-e24, Dias-TA-e34.Total Cholesterol e34,e44 and atherom plaques-e34,e44 in carotis arteries. The relationship between Apo E genotypes with OCSP subtypes of cerebral infarction and intracranial hemorrhage was not statistically significant (p>0.05). Conlusion: 1- There was no statistically significant relation between ischemic and hemorrhogic stroke and apo E genotype polimorphism as a risk factor. 2-There was no significant finding to establish a relationship between pathogenesis of all kinds of mortalities after acute stroke and apo E genotype polimorphism. Key Words: Apolipoprotein E; cerebrovascular disease; Apo E genotype; risk factors; mortality.
Introduction and Objectives: Atherosclerosis is an important risk factor for stroke and apolipoprotein E (apo E) polimorphism is one of the genetic factors that plays a role in the pathogenesis of atherosclerosis. Currently, the exact relationship between Apo E genotype and stroke is unknown. The objectives of this study are to; a) investigate the relationship between apo E genotype, acute cerebral infarction and intracerebral hemorrhage, b) establish a relationship between apo E genotype and risk factors for cerebrovascular disease, c) investigate the relationship betweeen acute stroke mortality and apo E genotype, d) establish a relationship between apo E genotype and primary preventive therapy. Method: 100 hospitalized patients who were diagnosed clinically and radiologically as acute ischemic or hemorrhagic stroke and 30 healthy subjects in the same age group were chosen for this study. Cranial CT or MRI was performed to determine the stroke phenotype (cerebral infarction, CI or intracranial hemorrhage, ICH) in the first 10 days after the acute event The patients with cerebral infarction were classified according to the Oxfordshire Community Stroke Project (OCSP) Classification (OCSP). Intracranial hemorrhages were classified according to the location of the lesions. Allel analysis was performed to determine the allel type of the patients by using the '"High Pure PCR Template Preparation Kit", "Light Cycler-Apo E Mutation Detection Kit (codon 112 and 158)", "Light Cycler-Red 640 and Light Cycler-Red 705 marked probes". Detailed neurologic and systemic examinations of all the patients and the healthy subjects under the study were performed as well as routine laboratuary examinations (complete blood count, electrolytes, blood glucose, lipids and other parameters), total apo E, electrocardiography (ECG), chest radiography, and echocardiography. 75 Results: There was a statistically significant difference in LDL-Cholesterol, Total Cholesterol and LVH variables between the stroke patients and the healthy control group (p<0.05). During the study, 24 out of 100 stroke patients (24%) died while on treatment in the hospital. The avarage period for patient deaths were 4.1± 1.2 days. There was a statistically significant difference (p<0.05) in Sis-Ta, history of ischemic heart disease and LDL-c variables between the stroke patients who survived and the patients who did not survive. While studying apo E genotype of stroke patients and variables, a significant congelation was found between VLDL-e24, Dias-TA-e34.Total Cholesterol e34,e44 and atherom plaques-e34,e44 in carotis arteries. The relationship between Apo E genotypes with OCSP subtypes of cerebral infarction and intracranial hemorrhage was not statistically significant (p>0.05). Conlusion: 1- There was no statistically significant relation between ischemic and hemorrhogic stroke and apo E genotype polimorphism as a risk factor. 2-There was no significant finding to establish a relationship between pathogenesis of all kinds of mortalities after acute stroke and apo E genotype polimorphism. Key Words: Apolipoprotein E; cerebrovascular disease; Apo E genotype; risk factors; mortality.
Açıklama
Anahtar Kelimeler
Apolipoprotein E, Serebrovasküler hastalıklar, Apo E genotipi, Risk faktörleri, Mortalite, Cerebrovascular disease, Apo E genotype, Risk factors, Mortality
