뇌혈관 협착을 가진 환자에서 아포지단백질 E의 유전형과 대뇌 소혈관 질환과의 연관성
Association between Apolipoprotein E Genotype and Cerebral Small Vessel Disease in Patients with Cerebral Artery Stesnosis
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Background: The relationship between Apolipoprotein E (APOE) genotype and subcortical lesions, such as microbleeds, lacunes, and subcortical white matter changes, is controversial to conclude yet. If the subcortical lesions are combined with large artery disease, the role of APOE genotype become difficult to recognize as an independent risk factor for the disease. The pre-sent study evaluated relationship between APOE genotype and each subcortical lesion in patients having large artery diseases. Methods: We included 139 patients having marked luminal narrowing (>50%) in intra- and/or extra-cranial vessels on mag-netic resonance angiography. Presence of lacunes and microbleeds, and severity of subcortical white matter changes were ob-served using T2-weighted and gradient echo images. APOE genotype was performed by the HhaI restriction enzyme methods. The relationship between APOE genotypes and subcortical lesions such as lacunes, microbleeds, and subcortical white matter changes was analyzed. Results: APOE e4 genotype was independently associated with the presence of microbleeds (P= 0.02). Although lacunes showed relationship with the presence of microbleeds and large artery disease, no relationship was observed between lacunes and APOE genotype. Subcortical white matter changes had relationship with age, fibrinogen level, and microbleeds. However, the subcortical lesions showed no relationship with APOE genotype like as lacunes. Conclusion: The present study showed the relationship of APOE e4 genotype with the cerebral microbleeds in patients having large artery disease. These findings suggested that APOE e4 genotype could be an independent risk factor for the development of micro-bleeds even though patient has large artery disease simultaneously. (Korean J Stroke 2008;10:119-124)
Abstract
Background: The relationship between Apolipoprotein E (APOE) genotype and subcortical lesions, such as microbleeds, lacunes, and subcortical white matter changes, is controversial to conclude yet. If the subcortical lesions are combined with large artery disease, the role of APOE genotype become difficult to recognize as an independent risk factor for the disease. The pre-sent study evaluated relationship between APOE genotype and each subcortical lesion in patients having large artery diseases. Methods: We included 139 patients having marked luminal narrowing (>50%) in intra- and/or extra-cranial vessels on mag-netic resonance angiography. Presence of lacunes and microbleeds, and severity of subcortical white matter changes were ob-served using T2-weighted and gradient echo images. APOE genotype was performed by the HhaI restriction enzyme methods. The relationship between APOE genotypes and subcortical lesions such as lacunes, microbleeds, and subcortical white matter changes was analyzed. Results: APOE e4 genotype was independently associated with the presence of microbleeds (P= 0.02). Although lacunes showed relationship with the presence of microbleeds and large artery disease, no relationship was observed between lacunes and APOE genotype. Subcortical white matter changes had relationship with age, fibrinogen level, and microbleeds. However, the subcortical lesions showed no relationship with APOE genotype like as lacunes. Conclusion: The present study showed the relationship of APOE e4 genotype with the cerebral microbleeds in patients having large artery disease. These findings suggested that APOE e4 genotype could be an independent risk factor for the development of micro-bleeds even though patient has large artery disease simultaneously. (Korean J Stroke 2008;10:119-124)
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