Abstract
Background: The apolipoprotein E (ApoE) genetic variation may be involved in the development of Cerebral Infarction (CI). Serum lipid levels are known risk factors for CI, but the effect of the ApoE gene polymorphism on lipid metabolism remains unclear. This retrospective cohort study aimed to determine the role of ApoE genotypes in CI risk and the relationships between ApoE gene polymorphism and serum lipid levels among the population of northwest China.patients and methods: 517 CI patients and 517 non-CI controls were enrolled in the study. Polymerase chain reaction and hybridization were used to test the ApoE gene polymorphisms.results: Patients with CI had a significantly higher frequency of ε3/ε4 genotype (OR =2.057, 95% CI = 1.477–2.864, P<0.001) and ε4 allele (OR =1.818, 95% CI = 1.364–2.424, P<0.001) than control participants. When stratifying by age and sex, it was found that statistically significant differences in the distribution and frequencies of the ε3/ε4 genotype(OR =3.067, 95% CI = 1.675–5.614, P<0.001 in age ≤60 years; OR =1.735, 95% CI = 1.156–2.604, P=0.008 in age >60 years and OR =2.206, 95% CI = 1.474–3.301, P<0.001 in males) and ε4 allele (OR =1.709, 95% CI = 1.201–2.432, P=0.001) in males and ε4 allele (OR =2.072, 95% CI = 1.281–3.353, P=0.003 in age ≤60 years; OR =1.704, 95% CI = 1.189–2.444, P=0.003 in age>60 years; OR =1.709, 95% CI = 1.201–2.432, P=0.001 in males and OR =2.046, 95% CI = 1.246–3.361, P=0.004 in females ) were observed between patients and controls. ε4 carriers had significantly lower ApoE level and higher low-density lipoprotein cholesterol (LDL-C), ApoB and ApoB/ApoA-I levels than ε2 carriers in both two groups. Additionally, control participants with ε4 carriers had significantly higher levels of lipoprotein and lower total cholesterol (TC) levels than ε2 carriers, CI patients with ε4 carriers had significantly lower level of ApoA-I than ε2 carriers. After adjusting for other established risk factors, drinking, hypertension, lipoprotein, triglycerides (TG) and ε4 allele were significant independent risk factor for CAD. ε4 allele presence was associated with a nearly two-fold higher CI risk.Conclusions: This study provides evidence that ε4 allele, drinking, hypertension, lipoprotein and TG levels are independent risk factor for CI among patients in Northwest China. Also, these data might be clinically useful in allowing for more individualized preventive and therapeutic strategies.