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The Journal of Internal Korean Medicine > Volume 28(2); 2007 > Article
The Journal of Internal Korean Medicine 2007;28(2): 262-274.
제2형 당뇨병 환자에서 허혈성 뇌졸중 발생과 Interleukin-1 Receptor Antagonist 및 Peroxisome Proliferator-Activated Receptor-γ2 유전자 다형성과의 관계
장원만, 이병철, 안세영, 두호경, 안영민
경희대학교 한의과대학 신계내과학교실
The Association of Interleukin-1 Receptor Antagonist and Peroxisome Proliferator-Activated Receptor-γ2 Pro12Ala Polymorphism with Ischemic Stroke in Type 2 Diabetes Mellitus Patients.
Won-man Jang, Byung-cheol Lee, Se-young Ahn, Ho-kyung Doo, Young-min Ahn
Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University, Seoul, Korea.
Correspondence  Young-min Ahn ,Tel: 02-958-9097, Fax: 02-958-9158, Email: omdan@hanmail.net
  Published online: June 30, 2007.
ABSTRACT
Objective :
It has been reported that two-repeats (IL1RN*2) of interleukin-1 receptor antagonist (IL-1Ra) gene is associated with ischemic stroke, and that Ala allele of the common Pro12Ala polymorphism in PPAR-γ2 isoform is associated with reduced risk for type 2 DM and its complications. The aim of the present study is to assess the association of IL-1Ra and PPAR-γ2 Pro12Ala polymorphism with the presence of ischemic stroke in the case of diabetic and non-diabetic patients.

Methods :
Genomic DNA was obtained from 373 healthy subjects, 157 DM subjects without ischemic stroke (known DM duration ≥10 years) and 302 ischemic stroke patients (including with DM). IL-1Ra polymorphism was analyzed by polymerase chain reaction (PCR), and PPAR-γ2 polymorphism by restriction fragment length polymorphism after PCR.

Results:
IL1RN*1/IL1RN*2 genotype was associated with significantly increased risk for DM (OR=2.86, P = 0.0008) and ischemic stroke (OR=2.74, P = 0.0016). Pro/Ala genotype was associated with the reduced risk for DM (OR=0.53, P = 0.0491) and ischemic stroke (OR=0.38, P = 0.0039). They were also associated with the reduced risk for ischemic stroke in the DM patients compared with DM without ischemic stroke (OR=0.25, P = 0.0321).

Conclusions:
IL1RN*2 allele could be an accelerating factor, not a predictive marker for ischemic stroke in type 2 DM. The Pro/Ala genotype of PPAR-γ2 Pro12Ala polymorphism may be associated with reduced risk for ischemic stroke with type 2 DM. Therefore it could be a useful predictive marker for ischemic stroke in Korean type 2 DM.
Key words: ischemic stroke, type 2 diabetes mellitus, Interleukin-1 receptor antagonist, peroxisome proliferator-activated receptor-γ2, polymorphism
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