Abstract
Increased serum lipoprotein(a) levels are an independent risk factor for ischemic cerebrovascular disease, even in normocholesterolemic and normotri-glyceridemic subjects. The aim of the present study was to investigate apolipo-protein(a) genetic polymorphism in patients with ischemic cerebrovascular disease and to assess its influence on serum lipoprotein(a) levels, since previous data on this topic are lacking. Apolipoprotein(a) genetic polymorphism was determined by immunoblotting in 88 men with ischemic cerebrovascular disease (43 atherothrombotic, 25 lacunar, and 20 of unknown type) and in 129 (100 men and 29 premenopausal women) healthy subjects as a control group. Apolipoprotein(a) phenotype frequencies in patients with ischemic cerebrovascular disease did not differ from those of controls. Both patients and controls with phenotype S2 had higher serum lipoprotein(a) levels than those with phenotype S4. It should be emphasized that serum lipoprotein(a) levels were significantly higher in patients with S4 phenotype compared with controls with the same phenotype (12 ± 1.4 and 7 ± 1.4 mg/dl, mean ± SEM, respectively, p < 0.05) as well as for those with S2 phenotype (30 ± 7.9 and 10 ± 2.5 mg/dl, respectively, p < 0.005). Comparison of the apolipoprotein(a) phenotype frequencies showed no significant differences between the 43 patients with atherothrombotic stroke and the 25 with lacunar infarction. However, the Lps1 allele was found more frequently among patients with atherothrombotic stroke, whereas the Lps4 allele was more common among patients with lacunar infarction. Apolipoprotein(a) genetic polymorphism clearly influences serum lipoprotein(a) levels in patients with ischemic cerebrovascular disease, although environmental and/or other genetic factors not related to apolipopro-tein(a) polymorphism must play a role in raised serum lipoprotein(a) levels in these patients.
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