Published Online
on June 5, 2003

A more recent version of this article appeared on July 1, 2003

This Article Full Text (PDF) All Versions of this Article: 34/7/1617    most recent 01.STR.0000078370.12085.02v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sun, L. Articles by Hui, R. Search for Related Content PubMed PubMed Citation Articles by Sun, L. Articles by Hui, R. Related Collections Genetics of Stroke Intracerebral Hemorrhage Risk Factors for Stroke

Submitted on February 16, 2003
Accepted on February 27, 2003

Pentanucleotide TTTTA Repeat Polymorphism of Apolipoprotein(a) Gene and Plasma Lipoprotein(a) Are Associated With Ischemic and Hemorrhagic Stroke in Chinese. A Multicenter Case-Control Study in China

Li Sun MD; Zhaohui Li MD; Hongye Zhang MD; Aiqun Ma MD; Yuhua Liao MD; Daowen Wang MD; Bingrang Zhao MD; Zhiming Zhu MD; Jizong Zhao MD; Zhen Zhang BS; Wei Wang BS; and Rutai Hui MD, PhD^*

From the Sino-German Laboratory for Molecular Medicine and Center for Molecular Cardiology, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences (L.S., Z.L., H.Z., Z. Zhang, W.W., R.H.), Beijing, China; First Teaching Hospital, Xi'an Jiao Tong University (A.M.), Xi'an City, China; Department of Cardiology, Tongji Hospital (Y.L.) and Cardiovascular Institute, Union Hospital (D.W.), Huazhong University of Science and Technology, Wuhan City, China; Tianjin Cardiovascular Institute (B.Z.), Tianjin, China; Hypertension Research Center of Daping Hospital, (Z. Zhu), Chongqing City, China and Beijing Neurology Institute (J.Z.), Beijing, China.

^* To whom correspondence should be addressed. E-mail: huirutai{at}sglab.org.

Background and Purpose--It is still inconclusive whether high plasma lipoprotein(a) [Lp(a)] level is a risk factor for stroke. Small sample size and different ethnic groups and methodologies might be contributors to the conflicts in study results. The purpose of the present study was to investigate the association between plasma Lp(a) levels, pentanucleotide TTTTA repeat (PNTR) polymorphism of the apolipoprotein(a) [apo(a)] gene, and Chinese stroke in a case-control study.

Methods--We recruited 1825 cases with stroke (44.3% cerebral atherothrombosis, 28.3% lacunar infarction, and 27.3% intracerebral hemorrhage) and 1817 controls from 7 centers in China. Lp(a) concentrations were quantified by enzyme-linked immunosorbent assay. The PNTR polymorphism of the apo(a) gene was determined by polymerase chain reaction-polyacrylamide gel electrophoresis. Conditional multivariate logistic regression analysis was used to identify independent risk factors for stroke and its subtypes.

Results--Lp(a) levels were significantly higher in cases than in controls (median, 28.5 versus 23.1 mg/dL; P<0.001), leading to a 1.97-fold (95% CI, 1.64 to 2.37) increase in risk for overall stroke, 2.0-fold (95% CI, 1.59 to 2.52) increase for atherothrombotic type, 2.05-fold increase (95% CI, 1.59 to 2.63) for lacunar type, and 1.64-fold increase (95% CI, 1.21 to 2.21) for hemorrhagic type. The number of PNTR negatively correlated with Lp(a) levels. Low-number repeats (sum of both alleles <16) of apo(a) PNTR were associated with both atherothrombotic stroke (odds ratio, 1.41; 95% CI, 1.04 to 1.91) and hemorrhagic stroke (odds ratio, 1.62; 95% CI, 1.09 to 2.37).

Conclusions--Our results indicate for the first time that low numbers of apo(a) PNTR and plasma Lp(a) levels are independently associated with both ischemic and hemorrhagic stroke in Chinese.

Key words: apolipoproteins • lipoproteins • polymorphism • stroke

This article has been cited by other articles:

				W. Song, J. Chen, K. Sun, H. Yu, and R. Hui No Association of PLIN Polymorphisms With Hemorrhagic and Ischemic Stroke Stroke, February 1, 2008; 39(2): 470 - 472. [Abstract] [Full Text] [PDF]

				B. Smolders, R. Lemmens, and V. Thijs Lipoprotein (a) and Stroke: A Meta-Analysis of Observational Studies Stroke, June 1, 2007; 38(6): 1959 - 1966. [Abstract] [Full Text] [PDF]

				J M Staton, M S Sayer, G J Hankey, J Attia, A Thakkinstian, Q Yi, V J Cole, R Baker, and J W Eikelboom Association between phosphodiesterase 4D gene and ischaemic stroke. J. Neurol. Neurosurg. Psychiatry, September 1, 2006; 77(9): 1067 - 1069. [Abstract] [Full Text] [PDF]

				Y. Wang, W. Zhang, Y. Zhang, Y. Yang, L. Sun, S. Hu, J. Chen, C. Zhang, Y. Zheng, Y. Zhen, et al. VKORC1 Haplotypes Are Associated With Arterial Vascular Diseases (Stroke, Coronary Heart Disease, and Aortic Dissection) Circulation, March 28, 2006; 113(12): 1615 - 1621. [Abstract] [Full Text] [PDF]

				E. Zambrelli, E. Emanuele, S. Marcheselli, L. Montagna, D. Geroldi, and G. Micieli Apo(a) size in ischemic stroke: Relation with subtype and severity on hospital admission Neurology, April 26, 2005; 64(8): 1366 - 1370. [Abstract] [Full Text] [PDF]

				J. F. Arenillas, C. A. Molina, P. Chacon, A. Rovira, J. Montaner, P. Coscojuela, E. Sanchez, M. Quintana, and J. Alvarez-Sabin High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis Neurology, July 13, 2004; 63(1): 27 - 32. [Abstract] [Full Text] [PDF]

				M. J. Alberts Genetics of Cerebrovascular Disease Stroke, February 1, 2004; 35(2): 342 - 344. [Full Text] [PDF]