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目的:研究中国汉族人群中亚甲基四氢叶酸还原酶基因C677T多态性与睡眠时间之间的相互作用对卒中发病危险的影响。方法:在病例-对照研究和流行病学调查中,分别对245例脑梗死患者,222例脑出血患者及282例无脑血管病对照人群进行了自我报告的睡眠时间分析以及亚甲基四氢叶酸还原酶基因C677T多态性的分析,通过多元logistic回归分析亚甲基四氢叶酸还原酶基因C677T多态性与睡眠时间之间的相互作用对卒中发病危险的影响。结果:经过调整主要混杂因素,多元logistic回归分析显示:(1)睡眠时间延长(每晚睡眠>8 h)与脑梗死发病危险显著相关(OR=3.90;95%CI:2.43~6.26);但与脑出血发病危险无显著相关(OR=1.16,95%CI:0.71~1.92);另一方面,失眠(睡眠时间<6 h)与脑梗死及脑出血发病危险均无显著相关。(2)亚甲基四氢叶酸还原酶基因TT基因型显著增加脑梗死发病危险(OR=2.01;95%CI:1.12~3.61);而亚甲基四氢叶酸还原酶基因C677T多态性与脑出血发病危险无显著相关(OR=1.16,95%CI:0.71~1.92)。(3)亚甲基四氢叶酸还原酶基因TT基因型与睡眠时间延长之间的相互作用对脑梗死发病危险的影响具有显著的协同作用(OR=6.22;95%CI:2.44~15.83)。结论:亚甲基四氢叶酸还原酶基因TT基因型和睡眠时间延长是增加脑梗死发病危险的独立危险因素。中国汉族人群中亚甲基四氢叶酸还原酶基因TT基因型与睡眠时间延长具有对脑梗死发病危险的显著协同作用。
Objective: To investigate the influence of the interaction between methylenetetrahydrofolate reductase gene C677T polymorphism and sleep time on the risk of stroke in Chinese Han population. METHODS: In a case-control study and epidemiological investigation, 245 patients with cerebral infarction, 222 patients with cerebral hemorrhage and 282 patients without cerebrovascular disease were studied for their self-reported sleep-time analysis and methylenetetrahydrogen The polymorphism of folic acid reductase gene C677T was analyzed by multivariate logistic regression analysis of the impact of the interaction between methylenetetrahydrofolate reductase gene C677T polymorphism and sleep time on stroke risk. Results: After adjustment for major confounders, multivariate logistic regression analysis showed that: (1) prolonged sleep (sleep> 8 h per night) was significantly associated with the risk of cerebral infarction (OR = 3.90; 95% CI: 2.43-6.26) (OR = 1.16, 95% CI: 0.71-1.92). On the other hand, insomnia (sleep time <6 h) had no significant correlation with the risk of cerebral infarction and cerebral hemorrhage. (2) TT genotype of methylenetetrahydrofolate reductase gene significantly increased the risk of cerebral infarction (OR = 2.01; 95% CI: 1.12-3.61); while the methylenetetrahydrofolate reductase gene C677T polymorphism The risk of developing cerebral hemorrhage was not significantly correlated (OR = 1.16, 95% CI: 0.71 to 1.92). (3) The interaction between methylenetetrahydrofolate reductase gene TT genotype and prolongation of sleep time had a significant synergistic effect on the risk of cerebral infarction (OR = 6.22; 95% CI: 2.44-15.83). Conclusion: TT genotype of methylenetetrahydrofolate reductase and prolonged sleep time are independent risk factors for increasing the risk of cerebral infarction. The TT genotype of methylenetetrahydrofolate reductase gene in Chinese Han population and prolonged sleep time have a significant synergistic effect on the risk of cerebral infarction.