缺血性卒中：女性比男性更易受遗传因素影响

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Sex Differences in Heritability of Ischemic Stroke

A Systematic Review and Meta-Analysis

Background and Purpose— Using data from Oxfordshire, UK, we recently showed that women are more likely than men to have a family history of stroke in female versus male first degree relatives. To test the generalizability of this finding, we did a comprehensive systematic review of all available published and unpublished data.

Methods— Studies were included in the present review if they reported the frequency of family history of stroke in relation to sex of parent or proband. Where necessary, we contacted authors of studies to obtain unpublished data. Data from the Oxford Vascular Study (OXVASC) and 3 other Oxford cohorts (1925 patients) were secondarily pooled with the data from other studies.

Results— We obtained data from 18 studies (7941 patients), including unpublished data from 7 studies. Female probands were slightly more likely to have a parental history of stroke than male probands (pooled OR=1.15; 95% CI: 1.03 to 1.29; P(sig)=0.028; P(het)=0.45). Maternal history of stroke was more common than paternal history (pooled OR=1.25; 1.15 to 1.37; P(sig)<0.00001; P(het)=0.12). However, the maternal excess was only present in female probands (pooled OR=1.47; 1.27 to 1.70; P(sig)<0.00001; P(het)=0.11). In contrast, male probands were no more likely to have maternal than paternal history of stroke (pooled OR=1.02; 0.88 to 1.17, P(sig)=0.43; P(het)=0.09).

Conclusions— Women with stroke are more likely than men to have a parental history of stroke, which is accounted for by an excess maternal history of stroke. This finding could be explained by sex-specific genetic, epigenetic, or nongenetic mechanisms.

Stroke. 2008;39:16-23
缺血性卒中：女性比男性更易受遗传因素影响
一项系统综述及Meta分析
背景及目的:最近来自英国牛津郡的研究数据表明，第一代亲属中女性比男性更易遗传获得脑卒中疾病。为了研究这个发现的遗传性，我们对所有出版及未出版的数据作了一项综合系统综述。
方法：研究包括目前已发表综述中所有有关脑卒中遗传与性别相关的论述，而且若有必要，我们会联系文章的作者索取未发表的数据。来自牛津血管疾病研究中心的病例和其他3个牛津队列研究的1925个病例的数据作为上述研究的次级数据来源。
结果：我们获得了18项研究的7941个病例资料，包括7项研究中尚未出版的数据。女性有中风先兆的患者比男性有中风先兆者更易从亲代遗传脑卒中疾病。（汇集比例＝1.15；95％可信区间：1.03～1.29；P(sig)=0.028; P(het)=0.45 ）而且，女性更易从母亲那里遗传此疾病，而男性从其父亲那里遗传的可能性小得多。
结论：若亲代有脑卒中病史，则后代中女性比男性更易罹患此病，这可以用过多的母系中风病史证实。这个发现可以用性连锁基因遗传、后天以及非遗传机制解释。