title: Interaction of genetic risk factors confers higher risk for thrombotic stroke in male Chinese: a multicenter case-control study.
abstract: Stroke is a polygenic or multifactorial disease, and each single susceptibility gene has modest effects. We hypothesize that combined effects of multiple genes might confer a higher stroke risk than a single susceptibility gene. To test our hypothesis we initially recruited 2000 stroke patients (44.3% thrombosis, 28.3% lacunar infarction and 27.4% intracerebral hemorrhage) and 2000 controls, and examined 6 polymorphisms in 5 candidate genes for stroke. Plasma lipoprotein(a) [Lp(a)] level was defined as a categorical variable and also included. Interactions between genetic risk factors were detected by the multifactor dimensionality reduction (MDR) method and further evaluated by multivariate logistic regression analyses. A significant combined effect on stroke due to the C677T polymorphism of methylenetetrahydrofolate reductase (MTHFR), the T2354A polymorphism of 5-lipoxygenase activating protein (ALOX5AP), and Lp(a) level, was detected using the MDR method. Furthermore, the combination of MTHFR 677TT, ALOX5AP 2354AA and Lp(a) elevation (Lp(a) concentration > or = 30 mg/dL) was found to be strongly associated with thrombotic stroke in males (OR, 10.419; 95%CI, 2.602 to 41.749; P= 0.001) using the multivariate logistic regression model. In conclusion, our results show that a combination of genetic risk factors can confer a higher risk for stroke than a single risk factor, indicating that people with multiple genetic risk factors have a higher risk of stroke and should be targets for prevention of this disease.
authors.affiliation: Sino-German Laboratory for Molecular Medicine and Key Laboratory for Clinical Cardiovascular Genetics, FuWai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, P. R. China.
authors.forename: Chun-Duo
authors.initials: CD
authors.lastname: Shen
authors.forename: Wei-Li
authors.initials: WL
authors.lastname: Zhang
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Yi-Bo
authors.initials: YB
authors.lastname: Wang
authors.forename: Yi-Song
authors.initials: YS
authors.lastname: Zhen
authors.forename: Ru-Tai
authors.initials: RT
authors.lastname: Hui
mesh_terms: D016022:Case-Control Studies; D002681:China; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020521:Stroke / Q000235:genetics*