| Cardiovascular diseases are the seldom and serious side effect during using combined oral contraceptive (COC) .Recently a multicenter research from WHO show that women using COC have a risk-increase of cardiovascular disease such as myocardial infraction and stroke if they are over 35 years old, smoking or being hypertension synchronously. Owing to the diversity of cardiovascular disease morbidity resulted from the differences between China and other countries, it is not sure whether the conclusions drawn from those countries are correct in China. It is argued that the possible gene-environmental interaction underlay the onset of the cardiovascular diseases. Therefore, we should evaluate the mode and intensity of the interaction so as to clarify the biomarkers and special environmental risk factors which are related to stroke in women. To reach this target, a population-based epidemiological study on stroke was conducted in the two high-risk areas of Taicang and Rudong counties of Jiangsu Province.Part I A Study on the Relationship between the Genetic Polymorphisms of Angiotensin-converting Enzyme and Susceptibility to Stroke in Chinese WomenAlthough the capability to produce different plasma ACE levels varied among different individuals and might be determined by polymorphisms of ACE gene, some special environmental risk factors (such as HC) may also be involved in developing stroke in female population. Epidemiological studies have demonstrated that interaction of genetic event and environmental risk factors play an important role in pathogenesis of stroke. Thus, we used PCR-based RFLP analysis to explore the genotype frequencies of polymorphisms in the ACE gene I/D and 2350 loci in stroke cases and stroke-free controls, and evaluate the association between polymorphisms of ACE gene and HC-induced susceptibility to stroke.1. The distribution of genotypes ACE gene in cases and controlsThe wild-type homozygote DD genotype frequencies of ACE I/D loci were 51.0% and 39.3%, respectively, in cases and controls, and the mutant-type homozygote II genotype frequencies were 9.8% and 16.7%, respectively. The risk for stroke in those with DD genotype was significantly higher than those with II genotype, with an adjusted OR of 2.39 (95%CI=1.27-4.49) ;The wild-type homozygote AA genotype frequencies of ACE 2350 loci were 48.1% and 54.2%, respectively, in cases and controls. Compared to AA genotype, individuals with 2350AG and 2350GG genotypes have a no significant risk- increase of stroke (OR=1.24, 95%CI=0.82-1.86 for 2350AG and OR = 1.31, 95%CI=0.65-2.62 for 2350GG, respectively);2> A stratified analysis between ACE gene polymorphisms and risk factors on strokeAmong individuals with a history of HC use for five years , there was a strong evidence that having the ID/DD genotype elevated stroke risk compared with those who did not have that genotype(ORa:2.94; 95% CI: 1.17-7.38);Of the same II/AA genotype carrier, individuals which were being hypertension have a risk-increase of stroke ( OR = 8.55, 95%CI = 2.34-31.17;/OR = 7.66, 95%CI =4.08-14.37);Of the same AA genotype carrier, individuals with a family history of stroke have a risk-increase of stroke ( OR = 2.19, 95%CI = 1.07-4.52). Among individuals without a family history of stroke , there was a evidence that having the ID/DD genotype elevated stroke risk compared with those II genotype (OR=2.34, 95%CI =1.16-4.70)3. Comparison of ACE gene polymorphisms in different racesThe genotype frequencies of ACE I/D were discrepant in different research and races. The frequencies of DD genotype were 44.4% in highest, 9.1% in lowest, and the frequencies of DD genotype were39.9% in our study, which were consistent with the results from Japan and Taiwan.There also existed significant difference among races in the polymorphism of ACE 2350 loci. The frequencies of A allele were about 35% in Western Asian populations but fluctuated in Eastern Asians.Part II Surveillance of stroke Incidence and Mortality in some Areas of Jiangsu ProvinceTo investigate the incidence and mortality o...
|
PDF Full Text Request