Schlaganfall

A. V. Khaw; Ch. Kessler

doi:10.1055/s-0037-1616973

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 2006; 26(04): 287-297
DOI: 10.1055/s-0037-1616973

Research Articles

Schattauer GmbH

Schlaganfall

Epidemiologie, Risikofaktoren und GenetikStroke: epidemiology, risk factors, and genetics

A. V. Khaw

¹Klinik und Poliklinik für Neurologie (Direktor: Prof. Dr. C. Kessler) der Ernst-Moritz-Arndt-Universität Greifswald

,

Ch. Kessler

¹Klinik und Poliklinik für Neurologie (Direktor: Prof. Dr. C. Kessler) der Ernst-Moritz-Arndt-Universität Greifswald

› Institutsangaben

Abstract

Zusammenfassung

Der Schlaganfall stellt eine große globale gesundheitspolitische und ökonomische Herausforderung dar. Die Eindämmung des Schlaganfalls kann nur durch genaue Kenntnis der Risikofaktoren und ggf. präventive Intervention erfolgen. Es werden unbeeinflussbare biologische Faktoren (z. B. Geschlecht, Lebensalter, ethnische Herkunft) von proatherosklerotischen bzw. prothrombotischen Risikofaktoren (Hypertonie, Diabetes mellitus, Fettstoffwechselstörungen, serologische und hämostaseologische Faktoren) und kardialer Komorbidität unterschieden. Immer wichtiger werden so genannte Lifestyle-Faktoren (z. B. Rauchen, körperliche Inaktivität und Alkoholkonsum). Neben diesen traditionellen Risikofaktoren hat in den vergangenen Jahren die Beschäftigung mit den genetischen Grundlagen des Schlaganfalls enorm zugenommen. Bei der Suche nach Kandidatengenen werden genetische Varianten (Polymorphismen) funktionell relevanter Gene in Fallkontrollstudien untersucht. Metaanalysen haben eine signifikante Assoziation des Faktor-V-Leiden-Arg506Gln-Polymorphismus, des MTHFR-C677T-Polymorphismus und des ACE-Insertions- Deletions-Polymorphismus zum Schlaganfall gezeigt. Große Hoffnung wird auf populationsbasierte, genomweite Linkage-Analysen gesetzt.

Summary

Stroke constitutes a major global challenge for health policy and healthcare economics. Reducing stroke burden requires extensive knowledge of risk factors and, if applicable, preventive control. Risk factors may be categorized in non-modifiable biological factors, such as age, gender, race/ethnicity; proatherosclerotic/prothrombotic factors (hypertension, diabetes, dyslipidaemia, other serologic and haemostasis factors); cardiac comorbidity (CAD, CHF, atrial fibrillation); lifestyle factors, which play an increasing role, e.g. smoking, physical inactivity, alcohol consumption. These traditional risk factors are extended by rapidly growing efforts in elucidating genetic backgrounds for stroke. Genetic polymorphisms of functionally or pathophysiologically important proteins are investigated in the setting of case-control-studies for their role as candidate genes. Metaanalyses have corroborated the association of the factor V-Leiden arg506gln, MTHFR-C677T, and ACE-insertion- deletion polymorphisms with stroke. Current population- based, genome-wide linkage analyses face high expectations for identifying new genetic risk factors.

Schlüsselwörter

Schlaganfall - Epidemiologie - Risikofaktoren - Genetik

Keywords

Stroke - epidemiology - risk factors - genetics

Volltext

Referenzen

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