Comprehensive Assessment of the Impact of Clinical-Anamnestic and Genetic Factors on the Risk of Strokes in Children

N.Ye. Smulskaia

Abstract


The objective of the study — to carry out a comprehensive clinical-anamnestic and genetic analysis (polymorphism of genes MTHFR (C677T), MTHFR (A1298C), MTRR (A66G), ACE (I/D), FII (G20210A), FV (G1691A)) in order to evaluate their impact on the development of stroke in childhood. The study found that the best reliable predictive models for the risk of different types of stroke in children include the gestational age at birth and the presence of gene polymorphism. The best predictive model for the risk of ischemic stroke (IS) in children was a three-component model that included gestational age, stay in intensive care in the neonatal period and the C677T polymorphism of the gene MTHFR, predictive value — 82.78 %. The best reliable predictive model for the risk of hemorrhagic stroke (HS) in children was also a three-component one with predictive value 74.23 %, which, in addition to gestational age, included A66G polymorphism of gene MTRR and the I/D polymorphism of ACE gene; the risk of stroke in the age group 0–28 days is being affected by polymorphism of genes ACE, MTHFR (C677T), MTRR, in a subgroup of 29 days — 1 year — polymorphism MTHFR (C677T), in the age group older than 6 years — a significant effect of genotype GG of gene MTRR (p < 0.05); the earliest debut of IS and HS was observed in children with DD genotype of ACE gene (p < 0.001), as well as GG of gene MTRR (p < 0.05). In children with stroke, when compared with the control group, different types of stroke were more common in families.


Keywords


children; stroke; risk factors; genes

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DOI: https://doi.org/10.22141/2224-0713.4.74.2015.78230

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