II genotype of the angiotensin-converting enzyme gene increases the risk for subarachnoid hemorrhage from ruptured aneurysm.
OBJECTIVE
Evidence exists in support of a role of genetic factors in susceptibility to aneurysmal subarachnoid hemorrhage (SAH) in humans. Meta-analysis of 2 previous studies showed that the I allele of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism was a weak, but significant, risk factor for aneurysmal SAH. Moreover, a recent study has shown that the local renin-angiotensin system (RAS) is involved in the development of intracranial aneurysm. The aim of this study was to investigate the association between ACE I/D polymorphism and a risk for aneurysmal SAH in a Polish population.


METHODS
Ninety patients with aneurysmal SAH (mean age: 48.9+/-14.0 years) and 128 healthy controls matched for age and sex were genotyped for the ACE I/D polymorphism. Aneurysmal SAH was diagnosed by cranial computed tomography and/or lumbar puncture and digital subtraction angiography. ACE gene polymorphism was detected by polymerase chain reaction amplification of the intron 16-specific I/D fragments, 490-bp and 190-bp, respectively.


RESULTS
The ACE genotype distribution in patients with aneurysmal SAH (II, 52.2%; ID, 15.6%; DD, 32.2%) differed significantly from controls (II, 23.4%; ID, 50.8%; DD, 25.8%) (P<0.001). A logistic regression model showed that the II genotype of ACE gene was independent from female sex and smoking as a risk factor for aneurysmal SAH (OR, 4.57; 95% CI, 2.35 to 8.90).


CONCLUSIONS
Here we report that II genotype of ACE gene is a risk factor for aneurysmal SAH.
Slowik
Agnieszka
A
Department of Neurology, Jagiellonian University, 31-503 Krakow, Botaniczna 3, Poland. slowik@neuro.cm-uj.krakow.pl
Borratynska
Anna
A
Pera
Joanna
J
Betlej
Marek
M
Dziedzic
Tomasz
T
Krzyszkowski
Tadeusz
T
Czepko
Ryszard
R
Figlewicz
Denise A
DA
Szczudlik
Andrzej
A
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011044:Poland; D011110:Polymorphism, Genetic; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000235:genetics*
D007703:Peptidyl-Dipeptidase A