Background: To determine the interaction effect between APOE polymorphism and lipid concentrations and alcohol use on spontaneous deep intracerebral hemorrhage (SDICH) risks. Methods: We enrolled 217 SDICH patients and 280 controls. Anthropometrics, personal history, and concentrations of total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-c), and triglyceride were collected. Genotyping was determined by PCR-based restriction and electrophoresis assay. Associations were tested adjusting for multiple covariables. Results: Compared with the commonest genotype ε3ε3, ε2ε3 was inversely associated with TC (p = 0.023) and LDL-c concentrations (p = 0.005) in women. No APOE-alcohol interaction effect on lipids concentration was found. However, in men, there was a marginal effect of interaction between alcohol and APOE genotype ε2ε3 vs. ε3ε3 on SDICH risks (p = 0.003), which is independent of TC concentration. In the male non-alcohol group, SDICH proportion was lower in the subjects carrying APOE ε2ε3 (27.6%) than in those with ε3ε3 (41.1%). In contrast, in the male alcohol consumption group, APOE ε2ε3 was associated with a higher SDICH rate (77.8%) compared to ε3ε3 (58.0%). Conclusions: Male subjects carrying genotype ε2ε3 tend to have a higher SDICH risk than those who have ε3ε3 when they have alcohol exposure, but may have more benefit from alcohol abstinence.
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