Association Between CYP2C19 Gene Polymorphisms And Lipid Metabolism In Patients With Ischemic Stroke In Chinese

Objective:To elucidate the relationship between CYP2C19 gene polymorphisms and serum lipid levels in patients with ischemic stroke?IS?and explore the clinical significance of CYP2C19 gene polymorphisms and IS recurrence.Methods:A total of 230 patients with IS from the Department of Neurology,the First Affiliated Hospital of Nanchang University Hospital were enrolled,comparied with100 control subjects.Through the electronic medical record system of Nanchang University First Affiliated Hospital,the relevant clinical data,serum lipid levels and other biochemical indicators of IS patients were queried.Detection of CYP2C19genotype by real-time quantitative PCR.Kruskal-Wallis test,univariate and multivariate Logistic regression analysis,COX regression analysis,and Kaplan-Meier survival curve were used to analyze the relationship between CYP2C19 gene polymorphisms and blood lipids,and its relationship with IS recurrence.Results:1.The levels of TG,TC,LDL-c,ApoB were significantly higher in the IS group than the control group?P<0.001?.The level of HDL-c and ApoA₁ was significantly lower in the IS group than the control group?P<0.001?;2.The multivariate regression analysis showed that lower ApoA₁ levels?OR=0.001,95%CI:0.000-0.011,P<0.001?and higher ApoB levels?OR=72.753,95%CI:1.790-2957.475,P=0.023?were significant predictive factors in IS patients.3.The median(25^th,75^th)of serum TC,LDL-c,and ApoB in poor metabolizers?PM?were 4.60?3.98,5.32?,2.98?2.33,3.38?,and 0.84?0.70,1.01?.The median(25^th,75^th)of serum TC,LDL-c,and ApoB in the extensive metabolizers?EM?were4.05?3.53,4.84?,2.44?1.99,3.09?,and 0.75?0.63,0.86?.The levels of TC,LDL-c,ApoB were significantly higher in the PM group than the EM group?P<0.02?.4.The follow-up data of 151?66%?patients were obtained in this study,9?6%?died due to stroke,and 17?11%?recurred.Patients with higher ApoB levels had higher risk of IS recurrence?HR:10.219;95%CI:1.457-1.745,P=0.019?.Compared with EM,IM and PM had higher risk of IS recurrence?P<0.01?.Conclusion:Our study indicates that CYP2C19 gene polymorphisms are related to lipid metabolism in patients with IS,PM patients have higher serum TC,LDL-c,and ApoB levels.In addition,patients with CYP2C19 PM and IM have a higher risk of IS recurrence.