title: Interaction of angiotensin-converting enzyme and apolipoprotein E gene polymorphisms in ischemic stroke involving large-vessel disease.
abstract: A relationship between apolipoprotein E (Apo E) genotype and angiotensin-converting enzyme (ACE) insertion-deletion (Ins-Del) mutation and stroke was suggested. We investigated the association of Apo E4 and ACE Ins/Del genotypes with stroke risk and changes in serum lipids in 228 consecutive Tunisian stroke patients, and 323 age-and gender-matched controls. Comparable frequencies of ACE Ins/Del alleles were seen between patients and controls. The prevalence of Apo epsilon3 allele and Apo E3/E3 were lower (P < 0.001), while the frequency of Apo epsilon4 allele and epsilon4-containing genotypes (E3/E4 and E4/E4) were elevated (P < 0.001) among patients. Higher proportion of Apo E4-carrying + ACE Del/Del positive cases were seen in young (<50 years) patients (P = 0.012), and was associated with large vessel stroke (P = 0.035). Mean serum cholesterol, LDL, HDL, and triglycerides were comparable between E4-containing and no E4-containing and ACE Del/Del-positive patients. Apo E4 and ACE Del/Del genotype combination substantially increase stroke risk, supporting the notion that interactions of multiple gene variants influence stroke pathogenesis.
authors.affiliation: Research Unit of Hematological and Autoimmune Diseases, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia.
authors.forename: Sarra
authors.initials: S
authors.lastname: Saidi
authors.forename: Walid
authors.initials: W
authors.lastname: Zammiti
authors.forename: Lamia B
authors.initials: LB
authors.lastname: Slamia
authors.forename: Sofyan B
authors.initials: SB
authors.lastname: Ammou
authors.forename: Wassim Y
authors.initials: WY
authors.lastname: Almawi
authors.forename: Touhami
authors.initials: T
authors.lastname: Mahjoub
mesh_terms: D000367:Age Factors; D000368:Aged; D000483:Alleles; D053318:Apolipoprotein E3 / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D016022:Case-Control Studies; D015897:Comorbidity; D044127:Epigenesis, Genetic; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000453:epidemiology / Q000235:genetics*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors; D017384:Sequence Deletion; D014416:Tunisia / Q000453:epidemiology
chemical_list: D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D008055:Lipids; D007703:Peptidyl-Dipeptidase A