Dyslipidemia is characterized by increased total
Dyslipidemia is characterized by increased total cholesterol, LDL-C, and triglyceride levels, and decreased HDL-C levels. However, the association of ApoA1 polymorphism with serum HDL-C level remains controversial. The polymorphisms of ApoA1+84 TC, but not MspI, are associated with serum HDL-C. The -75AA mCAP of ApoA1 is independently associated with a high serum HDL-C in Turkish adults. By contrast, the -75AA genotype of ApoA1 is associated with low serum HDL-C in Tunisians. In our study, HDL-C level was not associated with ApoA1 rs5070 polymorphism in Taiwanese stroke patients. Likewise, Minnich et al demonstrated that ApoA1-75A/G polymorphism was not correlated with serum HDL-C level. ApoA1-75A/G is also not associated with 83 C/T polymorphism with HDL-C. These observations suggested that the association of ApoA1 polymorphism with HDL-C level differs among distinct ethnic regions. Our findings also demonstrated that ApoA1 rs5070 polymorphism was correlated with a family history of stroke. Chien et al revealed that a low risk of triglyceride was found in ApoA1-75A/A haplotype compared with the G/G haplotype. Furthermore, ApoA1-3013C and ApoA1-75G haplotypes were significantly associated with high triglyceride levels in Taiwanese people.
Diabetes is a major risk factor of CAD and stroke; diabetes is also associated with high mortality among patients with such diseases. Megherbi et al revealed that ischemic stroke occurs more frequently in diabetic patients than in hemorrhage stroke or nonstroke patients. Ischemic stroke (45.4%) also yields a higher percentage than hemorrhage stroke (37.0%) among diabetic patients in Taiwan. In our study, a significantly higher number of patients with LAA (p<0.001) and SVO (p<0.001), but not those with HICH, were diabetic. Compared with the AA allele, the ApoA1 AG+GG genotype in male diabetic patients, but not in female diabetic patients, was 1.90-fold more likely to develop LAA, but not SVO or HICH, although ApoA1 rs5070 A/G polymorphism was not significantly associated with stroke subtypes. To our knowledge, this study is the first to demonstrate the association of apolipoprotein gene polymorphism with stroke in male diabetic patients. The gender-specific association of APOA1 polymorphism with clinical presentations has also been reported; in particular, ApoA1-75GA heterogenotype is associated with high blood pressure and a low fasting serum glucose level in males but not in females. APOA1-75 polymorphism also contributes to plasma cholesterol efflux capacity in females. Therefore, the significant association of rs5070 AG+GG genotype with LAA is gender dependent.
One strength of our study is that all samples came from a population of pure Han origin, avoiding confounding factors of different ethnic backgrounds. Additionally, all ischemic stroke patients were carefully classified based on the results of investigations and the Trial of Org 10172 in Acute Stroke Treatment definition, leading to a safer conclusion regarding the relationship of the ApoA1 gene and stroke. Nonetheless, our study had some limitations. First, although the current study is a retrospective analysis, all participants were collected prospectively, which might avoid some flaws of a retrospective study. Second, given the relatively small sample size, our study might have had insufficient detection of minor effects of risk factors other than diabetes.
Introduction Intrauterine insemination (IUI) with or without ovarian stimulation is a common treatment for infertility. Despite the popularity of this assisted reproductive technique, IUI is widely used to improve pregnancy rates with mild male factor, unexplained infertility, cervical factor, anovulation, and minimal and mild endometriosis. It is a simple and relatively less invasive and less expensive procedure than other forms of assisted reproductive technology. The minimum requirements for performing the procedure are: (1) ovulation in the IUI cycle; (2) patency of at least one fallopian tube; (3) insemination with an adequate number of motile sperm; and (4) the absence of documented or suspected active cervical, intrauterine, or pelvic infection.