RESUMEN
OBJECTIVE: To evaluate the associations of oral contraceptives (OC) exposure, angiotensinogen (AGT) gene polymorphism and joint effects on the risk of stroke in Chinese women. METHODS: On the basis of a prospective female cohort of contraceptive use, the first-ever-developed (FED) stroke cases, as well as, two sets of age-(± 3 years) and region-matched controls (including neighborhoods and hospitalized patients) were recruited. Between 1 July 2000 and 30 June 2009, a total of 453 FED stroke cases and 919 controls were recruited. Genotyping for polymorphisms of AGT gene was detected by Taqman method. RESULTS: (1) The risk of stroke gradually increased with the cumulative time of OC use in women (P < 0.0001). Compared with the non-users, the risk of hemorrhagic stroke slightly increased among those with OC use (OR = 1.83, 95%CI: 1.25 - 2.66). (2) Women with AG/GG genotypes of A-6G locus or CA/AA genotypes of C11535A locus indicated that there was a slightly reduced risk of stroke (OR = 0.78, 95%CI: 0.61 - 0.99; OR = 0.73, 95%CI: 0.56 - 0.95). (3) Women with AA genotypes of A-20C locus and AG/GG genotypes of A-6G, when incorporated with CA/AA genotypes of C11535A locus with OC, it could increase the risk of hemorrhagic stroke (OR = 1.99, 95%CI: 1.34 - 2.97; OR = 1.84, 95%CI: 1.15 - 2.94; OR = 1.73, 95%CI: 1.06 - 2.85). CONCLUSION: The AGT gene polymorphisms showed that they did have an impact on the risk of stroke. And the joint effect between women using OC and AGT gene polymorphisms could slightly increase the risk of stroke.
Asunto(s)
Angiotensinógeno/genética , Anticonceptivos Orales/efectos adversos , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/genética , Anciano , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Persona de Mediana Edad , Factores de RiesgoRESUMEN
OBJECTIVE: To evaluate the associations of oral contraceptives (OC) exposure, angiotensin-converting enzyme (ACE) gene polymorphism and their joint actions with the risk of stroke in Chinese women. METHODS: A case-control study, based on a set cohort, was carried out. Incident cases of stroke identified between July 1 1997 and June 30 2009 were enrolled. One hospital control and healthy community control were matched on region and age (± 3 years). A total of 453 women with stroke and 919 controls were recruited. I/D gene polymorphism was detected by polymerase chain reaction (PCR) and amplification fragment length polymorphism (AFLP), A-240T polymorphism were detected by TagMan. RESULTS: (1) The risk of stroke gradually increased with the cumulative time of OC being used in women (P < 0.0001). Compared with non-users, the risk of stroke significantly increased among those with cumulative time of using OC longer than 20 years (adjusted OR was 2.07, with 95%CI as 1.30 - 3.29). (2) ID/DD genotype of I/D locus indicated significantly an increased risk of hemorrhagic stroke (adjusted OR, 2.37; 95%CI, 1.46 - 3.84). (3) Women with ID/DD genotype of I/D locus or with TA/TT genotype of A-240T locus and using OC could significantly increase the risk of hemorrhagic stroke (adjusted OR was 4.59; with 95%CI as 2.21 - 9.51 and OR was 2.50; with 95%CI as 1.42 - 4.38). (4) Data from multivariate analyses showed that both OC and ID/DD genotypes were important risk factors for hemorrhagic stroke. CONCLUSION: ID/DD and TA/TT genotypes of ACE gene, OC and their joint action might increase the risk of stroke, especially on hemorrhagic stroke in Chinese women.