허혈성 뇌졸중과 두개내 대혈관질환에서 Plasminogen Activator Inhibitor의 유전자 다형성

Abstract

Background: Ischemic stroke is a complex, multifactorial disorder and there have been many studies about several genetic variants increasing the risk of myocardial infarction and cerebrovascular disease. The objective of this study was to determine the association between variants of specific genes and ischemic stroke or intracranial artery disease. Methods: We analyzed the relationship between ACE D/I polymorphism, stromelysin 5A/6A polymorphism, PAI-1 4G/5G genotype and the risk of cerebrovascular disease as a case-control study of 169 cases of ischemic stroke and 96 cases of community controls. Participants were evaluated for known cerebrovascular risk factors, and genotypes were measured by polymerase chain reaction (PCR) methods in DNA obtained from blood. Results: There was no significant association between ACE and stromelysin-1 genotypes with all types of ischemic stroke. But, after adjustment for known cerebrovascular risk factors, ischemic stroke occurred more often in patients with a 4G genotype than in patients homozygous for the 5G allele (OR: 2.3; 95% CI 1.1 to 5.1). Among many subtypes of ischemic stroke, large artery disease (OR: 2.2; 95% CI 1.0 to 4.7), especially intracranial large artery disease (OR: 3.1; 95% CI 1.4 to 7.0) showed a significant association with the 4G allele. Conclusions: These findings are suggestive of an important contribution of PAI-1 polymorphism to ischemic stroke and intracranial large artery disease in Korean population. We can deduce that different prevalence of 4G allele may be a key factor in the pathogenesis of various vascular diseases.