Association Between PPAR? Gene Polymorphism And Atherosclerotic Cerebral Infarction

Objective: To investigate the relationship between peroxisome proliferator activated receptor ?(PPAR?)gene polymorphism and large artery atherosclerotic cerebral infarction(LAA)and the location of vascular stenosis(intracranial,extracranial and extracranial segments);To explore the relationship between smoking,hypertension,diabetes and the interaction of PPAR?gene and LAA cerebral infarction;Other susceptibility genes or protective genes related to cerebral infarction were screened out,which could provide basis for early detection of susceptible population of cerebral infarction.Methods: Scientific exclusion and inclusion criteria were used to collect 270 patients with LAA type cerebral infarction(cerebral infarction group)who were hospitalized in the Department of Neurology,Affiliated Hospital of Qingdao University between August 2016 and December 2017,and 236 healthy persons(control group)who were examined in the physical examination center of Affiliated Hospital of Qingdao University at the same time.The cerebral infarction group showed vascular stenosis according to the results of imaging examination.The sites were further divided into three subgroups: intracranial group,extracranial group and extracranial group.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to detect the genotypes of PPAR delta gene(rs9794,rs2267668)in 270 patients with cerebral infarction of Shandong Han nationality and 236 healthy people during the same period,and to analyze the relationship between different genotypes and cerebral infarction.;Multivariate logistic regression analysis was used to examine the relationship between various factors and cerebral infarction;The genetic polymorphisms with statistical significance were stratified according to smoking history,hypertension history,diabetes history,coronary atherosclerotic heart disease history and other factors.Results: 1.The GG/GC genotype and G allele frequencies of rs9794 locus in cerebral infarction group were significantly lower than those in control group [GG/GC genotype frequencies were 30.37%(82/270)and 44.07%(104/236),OR = 0.554 95% CI 0.384-0.798 P < 0.05;G allele frequencies were 17.59%(95/540)and 24.15%(114/472),OR = 0.67095% CI 0.494-0.910 P < 0.05].There was no significant difference between the two groups(P > 0.05).Multivariate logistic regression analysis showed that GG/GC genotype at rs9794 locus and high density lipoprotein cholesterol(HDL)were protective factors for cerebral infarction(OR = 0.616,95% CI 0.407-0.932 P = 0.022;OR = 0.428,95% CI 0.216-0.849 P< 0.05);history of hypertension,diabetes mellitus,coronary heart disease,smoking,systolic pressure,low density lipoprotein cholesterol(LDL)were protective factors for cerebral infarction.Risk factors for cerebral infarction risk factors(OR = OR = 1.869,95% CI1.057-3.302 P = 0.031,OR = 1.934,OR = 1.934,95% CI 1.084-3.449 P = 0.026,95% CI1.084-3.449 P = 0.026,OR = 1.843,95% CI 1.047-3.244 P = 0.034,OR = 0.034,OR = 1.034,OR = 1.821,95% CI 1.063-3.120 P = 0.029,OR = 0.029,OR = 1.032,95% CI1.011-1.054-1.054,95% CI 1-1.011-1.055 P < 0.01).2.Further subgroup analysis showed that there was no significant difference in genotype and allele frequencies of the two SNPs(rs9794,rs2267668)of PPAR ? gene among the three subgroups(P > 0.05).The stenosis rates of the intracranial,extracranial and extracranial segments of the internal carotid artery were 33.70%,24.07% and 42.22% respectively.3.The stratified analysis of smoking history,hypertension history,diabetes history and history of coronary atherosclerotic hard heart disease showed that the risk of cerebral infarction in patients with PPAR ?(rs9794)GG/GC genotype without smoking,hypertension history,diabetes history and coronary atherosclerotic hard heart disease history was significantly reduced(OR = 0.538 95% CI 0.348-0.832 P = 0.005,OR = 0.328 95% CI).0.181-0.595 P=<0.001,OR=0.528 95% CI 0.332-0.841 P=0.007,OR=0.418 95% CI0.279-0.627 P<0.001).Conclusions: 1.The G allele of rs9794 of PPAR ? gene reduces the susceptibility to cerebral infarction and may be a protective factor in the occurrence and development of cerebral infarction.2.Traditional risk factors such as smoking history,hypertension history,diabetes history and history of coronary atherosclerotic heart disease weaken the protective effect of GG/GC genotype at rs9794 locus on cerebral infarction.3.The polymorphisms of PPAR ? gene rs9794 and rs2267668 were not correlated with the location of vascular stenosis in LAA-type cerebral infarction.The incidence of intracranial artery stenosis in LAA-type cerebral infarction group was higher than that in extracranial artery stenosis group.