RESUMO
Background: APOE polymorphism is believed to confer susceptibility to coronary heart disease [CHD] and Alzheimer's disease. It is well known that patterns of APOE polymorphisms differ between populations and ethnic groups, although most of the data available so far have been in whites
Subjects and Methods: We evaluated the frequencies of APOE genotypes and their relationships with serum levels of lipids, lipoproteins and apolipoproteins in two groups of Gulf Arab citizens: a control population of healthy voluntary blood donors [n=106], and a group of patients presenting to the lipid clinic for the first time with combined hyperlipidaemia [CH] [n=41]. In both groups, fasting serum total cholesterol [TC], triglycerides [TG], HDL, LDL and apolipoprotein A1 and B levels were measured by routine autoanalyzer methods, and APOE genotyping was performed by validated PCR methods. The lipid and lipoprotein levels were related to the specific APOE allele frequencies
Results: Allele frequencies were 5.7% for E2, 85.4% for E3, and 9.0% for E4 in the healthy blood donor group. An essentially similar pattern was seen in the patients with CH. This APOE allelic distribution conforms to patterns described in Chinese, whites and South Asians. In both the blood donor and CH groups there were no consistent links between specific APOE pattern and serum lipoproteins, as would have been predicted from APO E2 and APO E4 frequencies
Conclusion: We conclude that APOE allelic patterns in healthy Kuwaiti blood donors and a smaller group of patients with CH do not satisfactorily predict circulating blood levels of lipids and lipoproteins
RESUMO
To report on stroke subtypes, associated risk factors and outcome in Kuwait. The records of 62 patients [30 male, 32 female] admitted with diagnosis of stroke to Kuwait Oil Company Hospital, Kuwait, a tertiary care hospital, during a 5-year period [1995-1999], were retrospectively reviewed. Small artery infarction was the most common subtype and occurred in 37 subjects [59.7%]; less common were atherosclerotic large artery strokes [19 patients, 30.6%] and strokes of cardio-embolic origin [6 patients, 9.7%]. Identifiable risk factors or associated morbidities were hypertension [72.5%], diabetes mellitus [69.4%], ischaemic heart disease [14.5%], history of migraine [8.1%], lone atrial fibrillation [5.0%], and valvular heart disease [1.6%]. The most important determinants of a deleterious 30-day outcome, as indicated by severe disability or death, were female gender, lack of use of anti-platelet drugs, presence of a large artery infarction stroke subtype, and cardio-embolic stroke. Prevalence of hypertension and diabetes is high among patients with stroke in Kuwait, with rates higher than those found in any previous reports from the Gulf region. Two unusual observations were that women had a rather high frequency of stroke, and infarction of the small artery was more common than that of the large artery. Outcome, as indicated by severe disability or death, was worse among women, elderly patients, and those with large artery atherosclerotic and cardio-embolic strokes. There is some evidence that such a deleterious outcome might be ameliorated with use of anti-platelet drugs