Short telomere length in blood leucocytes contributes to the presence of atherothrombotic stroke and haemorrhagic stroke and risk of post-stroke death.
Short telomere length in blood leucocytes contributes to the presence of atherothrombotic stroke and haemorrhagic stroke and risk of post-stroke death.
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DOI：
10.1042/cs20120691
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发表时间：
2013-07
期刊：
影响因子：
6
通讯作者：
Weili Zhang;Yu Chen;Yuyao Wang;Peng Liu;Mei Zhang;Chan-na Zhang;F. Hu;R. Hui
中科院分区：
文献类型：
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作者：
Weili Zhang;Yu Chen;Yuyao Wang;Peng Liu;Mei Zhang;Chan-na Zhang;F. Hu;R. Hui
生物衰老的个体间差异可能会影响中风的易感性。到目前为止，卒中和端粒缩短之间的关系仍然没有定论；出血性卒中的数据也很少。中国病例对照研究包括1756例(动脉粥样硬化血栓767例，腔隙性脑梗塞503例，出血性卒中486例)和1801例对照。对中风患者进行前瞻性随访，中位数为4.5年(范围为0.1-6.0年)。与端粒长度最低至最高的三分位数相比，端粒长度较短的个体患动脉粥样硬化性卒中的风险较高[多变量OR(优势比)1.37[95%可信区间](P=0.015)；出血性卒中[多变量OR1.48(95%CI，1.08~2.02)；P=0.016]。特别是，在有中风家族史的受试者中，动脉粥样硬化性中风(95%CI，1.87-3.48；P趋势<；0.0001)和出血性中风(95%CI，1.62-3.36；P趋势<；0.0001)的发生率显著增加2.55倍。在随访期间，记录了338例复发中风和312例死亡(181例死于中风或冠心病，131例死于其他原因)。在随访患者中未观察到与卒中复发的关联，而端粒较短的动脉粥样硬化性血栓患者卒中后死亡的风险增加69%[相对风险1.69(95%CI，1.07-2.67)；P=0.02]。最后，我们比较了12对循环白细胞和颈动脉内膜切除术患者颈动脉粥样硬化斑块的端粒长度；血管壁组织和白细胞端粒长度呈正相关。总之，较短的端粒长度可能是动脉粥样硬化性血栓形成和出血性卒中的存在以及卒中后死亡风险的潜在标志。
Inter-individual differences in biological aging could affect susceptibility to stroke. To date, the relationship between stroke and telomere shortening remain inconclusive; and sparse data are available for haemorrhagic stroke. A Chinese case-control study was conducted, comprising 1756 cases (767 atherothrombosis, 503 lacunar infarction and 486 haemorrhagic strokes) and 1801 controls. Stroke patients were prospectively followed up for a median of 4.5 (range, 0.1-6.0) years. Individuals with shorter telomere length had a higher presence of atherothrombotic stroke {multivariate OR (odds ratio) 1.37 [95% CI (confidence interval), 1.06-1.77]; P=0.015} or haemorrhagic stroke [multivariate OR 1.48 (95% CI, 1.08-2.02); P=0.016] in comparison of the lowest to highest tertile of telomere length. Particularly, in subjects with a family history of stroke, there was a significant 2.55-fold increased presence of atherothrombotic stroke (95% CI, 1.87-3.48; Ptrend<0.0001) and a 2.33-fold increased presence of haemorrhagic stroke (95% CI, 1.62-3.36; Ptrend<0.0001). During the follow-up, 338 recurrent strokes and 312 deaths (181 from stroke or coronary heart disease and 131 from other causes) were documented. Associations with stroke recurrence were not observed in the follow-up patients, whereas atherothrombotic stroke cases with shorter telomeres had 69% increased risk of post-stroke death [relative risk, 1.69 (95% CI, 1.07-2.67); P=0.02]. Finally, we compared telomere lengths in 12 paired samples of circulating leucocytes and carotid atherosclerotic plaques from patients undergoing carotid endarterectomy; there was a positive correlation between vessel wall tissue and leucocyte telomere length. In conclusion, shorter telomere length may serve as a potential marker for the presence of atherothrombotic and haemorrhagic stroke and for the risk of post-stroke death.