title: Homozygous ALDH2*2 Is an Independent Risk Factor for Ischemic Stroke in Taiwanese Men.
abstract: The *2 allele of the aldehyde dehydrogenase 2 gene (ALDH2) is the most common variant in Asian populations. The variant resulting in enzyme dysfunction was highly related to coronary artery disease. Recently, genome-wide association studies also discovered that the 12q24 locus near ALDH2 gene was associated with hypertension and ischemic stroke. This study intended to further investigate whether the above variant of ALDH2 increases the risk for ischemic stroke in Taiwanese.
  
  
  
  A case-control study was conducted on 914 patients with acute ischemic stroke and 746 nonstroke controls. Polymerase chain reaction and sequencing were used to identify the ALDH2 genotype. Vascular risk factors, stroke subtypes, vascular stenosis, and stroke outcomes were analyzed.
  
  
  
  ALDH2 genotypes differed significantly between male controls (*1/*1 versus *1/*2 versus *2/*2=53.8% versus 39.9% versus 6.4%) and male patients with ischemic stroke (*1/*1 versus *1/*2 versus *2/*2=51.5% versus 37.3% versus 11.2%; P=0.048). No significant difference was found between groups for female patients (P=0.228). Multivariate logistic regression analysis revealed that the ALDH2*2/*2 genotype was an independent risk factor for ischemic stroke in male patients (odds ratio, 1.93 [95% confidence interval, 1.07-3.46]; P=0.028). Further analysis of men with ischemic stroke demonstrated that the polymorphism of ALDH2 was not related to vascular risk factors, severity of vascular atherosclerosis, stroke subtypes, and stroke functional outcomes.
  
  
  
  The study demonstrated that ALDH2*2/*2 may be an independent risk factor for ischemic stroke in Taiwanese men, but not in Taiwanese women.
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Yueh-Feng
authors.initials: YF
authors.lastname: Sung
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lu
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Jiunn-Tay
authors.initials: JT
authors.lastname: Lee
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Hung
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.).
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.). tsghpeng@gmail.com hychiou@tmu.edu.tw.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.affiliation: From the Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.-F.S., C.-C.L., G.-S.P.); Department of Neurology (Y.-F.S., J.-T.L., G.-S.P.) and Division of Endocrinology and Metabolism, Department of Internal Medicine (Y.-J.H.), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, College of Medicine, Taipei Medical University and Shuang Ho Hospital, Taiwan (C.-J.H.); Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan (J.-S.J.); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taiwan (H.-Y.C.); and Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.-S.P.). tsghpeng@gmail.com hychiou@tmu.edu.tw.
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000071396:Aldehyde Dehydrogenase, Mitochondrial / Q000235:genetics*; D000483:Alleles; D002545:Brain Ischemia / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D055106:Genome-Wide Association Study; D005838:Genotype; D006720:Homozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011110:Polymorphism, Genetic; D020521:Stroke / Q000235:genetics*; D013624:Taiwan
chemical_list: C096127:ALDH2 protein, human; D000071396:Aldehyde Dehydrogenase, Mitochondrial
keywords: Taiwan; aldehyde dehydrogenase; genetic association studies; men; risk factors