Is Apolipoprotein Genotype a Reason For the Excessive Incidence of Stroke in Persian Population?

Background Stroke is a complex, pathologically heterogeneous disease, with varying rates of incidence and mortality worldwide. The incidence of stroke in Iran is considerably greater than that in most western countries, which may be due to the genetic background. Objectives This is the first case-control study in an Iranian population to assess the association between stroke subtypes and APOE Ɛ2/3/4 genotype. Patients and Methods APOE e4 genotypes were analyzed in 153 patients (age: 51.4 ± 13.7 years) with stroke and 153 healthy controls (age: 50.0 ± 12.2 years) matched for age and sex. Stroke subtypes were diagnosed by computed tomography scans and magnetic resonance imaging. Moreover, control subjects were matched for some stroke risk factors. The APOE genotype was detected by a multiplex tetra-primer amplification refractory mutation system (multiplex T-ARMS) polymerase chain reaction of exon 4. Data were coded and entered in SPSS Windows (version 11.5). Results The APOE genotype distribution in stroke patients differed significantly from that in the healthy controls (P: 0.031). Moreover, a strong association was observed between the hemorrhagic subtype and e2/e3 genotype (P = 0.001), with a moderate association with male cases and controls (P = 0.04). Conclusions We report that e2/e3 genotype of APOE gene may play a role particularly in hemorrhagic stroke and male sex is associated with this genotype. This difference may be a cause for the incidence of early stroke in patients in east-Iran.