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Apolipoprotein E polymorphisms and ischaemic stroke: a two-center Greek study.

D Chatzistefanidis1, S Giannopoulos1, K Spengos2

  • 1Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.

European Journal of Neurology
|January 30, 2014
PubMed
Summary

The apolipoprotein E (apoE) ε3/ε3 genotype shows a protective effect against ischemic stroke, particularly in women. However, traditional risk factors like age and hypertension significantly outweigh this genetic protection.

Keywords:
apolipoprotein Eapolipoprotein E alleleslipid metabolismpolymorphismsstroke

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Area of Science:

  • Genetics
  • Neurology
  • Cardiovascular Medicine

Background:

  • Apolipoprotein E (apoE) is a key plasma protein involved in lipoprotein metabolism.
  • Three common apoE isoforms (E2, E3, E4) exist, with potential implications for stroke risk.
  • Existing literature on apoE's role in stroke is inconclusive, necessitating further investigation.

Purpose of the Study:

  • To investigate the role of apolipoprotein E (apoE) isoforms in first ischemic stroke.
  • To examine the interaction between apoE isoforms and environmental risk factors in stroke occurrence.
  • To analyze these associations within the Greek population.

Main Methods:

  • A case-control study involving 329 first-ever ischemic stroke patients and 361 controls.
  • Exclusion of cardioembolic strokes and autoimmune/prothrombotic conditions.
  • Assessment of risk factors (hyperlipidemia, hypertension, diabetes, smoking) and apoE allele determination.

Main Results:

  • The apoE ε3/ε3 genotype demonstrated a protective effect against ischemic stroke (OR 0.674), especially in females.
  • Multivariate analysis indicated that traditional risk factors (age, BMI, hypertension, dyslipidemia, diabetes, smoking) significantly outweighed the genetic effect in both genders.
  • No significant association was found between apoE alleles and BMI, cholesterol, triglycerides, or HDL plasma levels.

Conclusions:

  • The apoE ε3/ε3 genotype may offer a protective role against ischemic stroke, particularly in women.
  • However, the impact of established risk factors (age, BMI, hypertension, dyslipidemia, diabetes, smoking) on stroke occurrence is substantial and overshadows the genetic protective effect.