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Apolipoprotein E gene polymorphism and the risk of subarachnoid hemorrhage: a meta-analysis of case–control studies

  • Clinical Article - Brain Injury
  • Published:
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Abstract

Background

Studies investigating the association between the apolipoprotein E gene (APOE) polymorphism and the risk of subarachnoid hemorrhage (SAH) have reported inconsistent results. So we performed a meta-analysis to estimate the association between APOE polymorphism and SAH susceptibility.

Methods

Relevant studies published before 5 November 2015 were identified by searching PubMed, Embase, EBSCO, and ISI web of knowledge. The strength of relationship between the APOE gene and SAH susceptibility was assessed using odds ratio (OR) and corresponding 95 % confidence interval (95 % CI).

Results

A total number of six case–control studies including 638 SAH cases and 2,341 controls were identified. No association was found in dominant model or allele contrast genetic model (ε4 dominant model: OR = 1.06, 95 % CI = 0.91–1.25; ε3 dominant model: OR = 0.99, 95 % CI = 0.97–1.01; ε2 dominant model: OR = 0.99, 95 % CI = 0.78–1.25; ε4 versus ε3: OR = 1.14, 95 % CI = 0.96–1.35; ε4 versus ε2: OR = 1.07, 95 % CI = 0.90–1.28; ε3 versus ε2: OR = 1.00, 95 % CI = 0.96–1.04) for APOE polymorphism and SAH susceptibility. In the subgroup analyzed that was stratified by ethnicity, increased risk of SAH was found in Asian subjects when ε4 allele compared with ε3 allele (ε4 vs ε3, OR = 1.55, 95 % CI = 1.07–2.52).

Conclusions

Our meta-analysis suggested that there is no association between APOE polymorphism and SAH risk for overall population. Due to several limitations in the present study, well-designed epidemiological studies with large sample size among different ethnicities should be performed in the future.

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Author notes

    Authors and Affiliations

    1. Department of Neurosurgery, The First Hospital of Hebei Medical University, Shijiazhuang, China

      Di Zhao & Guo-biao Wu

    2. Department of Neurosurgery, Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing, China

      Zhenhai Zhang

    3. Department of Neurosurgery, Tangshan Gongren Hospital, Tangshan City, China

      Hong-yu Wang

    4. Centralized Procurement Center for Medical Instruments of Hebei, Shijiazhuang, China

      Fei Gao

    5. Department of TCM Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China

      Xu-dong Duan

    6. Hebei Medical University, Shijiazhuang, China

      Ying-ying Lu

    7. Department of Neurosurgery, The Second Hospital of Hebei Medical University, No. 215 West Heping Road, Shijiazhuang, 050005, China

      Zhi-ming Wang & Jian Song

    8. Hebei Medical Science and Technology Development Research Center, Shijiazhuang, China

      Dian-ping You

    9. Institute of Medical Information of Hebei, Shijiazhuang, China

      Yi Qu

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    1. Di Zhao
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    Comments

    It is difficult to get excited about a negative study, in other words a study that shows us, even if elegantly so, that our knowledge is not advanced by the results. But I do believe that the current report has value for the readership even though it is exactly that, a negative report. The authors have done a meta-analysis of previously reported associations between apolipoprotein E gene polymorphism and SAH. They find, like some but not all previous authors, that there is no tangible association to report. The question lingers whether certain populations, like Asian peoples, have an association still, and those reports must be considered on their own merits. We can say about this report that the methods are sound and the conclusions, as best as can be drawn from a meta-analysis, should be taken as valid.

    Christopher Miranda Loftus

    Illinois, USA

    Di Zhao and Guo-biao Wu contributed equally to this work

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    Zhao, D., Zhang, Z., Wu, Gb. et al. Apolipoprotein E gene polymorphism and the risk of subarachnoid hemorrhage: a meta-analysis of case–control studies. Acta Neurochir 158, 1515–1522 (2016). https://doi.org/10.1007/s00701-016-2824-2

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