Jui-Wen Peng1、Oswald Ndi Nfor 2、Chien Chang Ho3,4、Shu-Yi Hsu3、Ming-Chih Chou1*、Yung-Po Liaw 2,5
Stroke is a complex health condition caused by several factors. We assessed the possible interaction of the Cytochrome P450 2C9 (CYP2C9) rs4918758 polymorphism with sex in triggering an ischemic stroke. We included 9,197 women and 8,625 men from the Taiwan Biobank (TWB). Data collected between 2008 and 2015 were linked to records in the National Health Insurance Database (NHIRD). We estimated Odds Ratios (OR) for ischemic stroke using logistic regression analysis. We found that ischemic stroke was present in 441 women and 468 men had. Combined TC+CC of rs4918758 did not enhance ischemic stroke risk [OR (95% CI)=1.04 (0.90-1.21]. Compared to women, men did not confer risk for ischemic stroke ([OR (95% CI)=1.03 (0.87-1.22]. There was an interaction between sex and rs4918758 polymorphism (p for interaction=0.0019). After categorizing by sex, significant odds ratios were found in men with combined TT+CC of rs4918758 but not women [OR, 1.32 (1.07-1.63) vs. 0.83 (0.68-1.02)]. Further stratification by genotypes of rs4918758 polymorphism, TT was protective against ischemic stroke [0.59 (0.44-0.80)] in men compared to women. However, combined TT+CC was causative [1.36 (1.10-1.68)]. Our analyses indicated that TT of rs4918758 was protective whereas combined TT+CC appeared to enhance ischemic stroke risk in Taiwanese men compared to women. This study extends knowledge on the genetic basis of ischemic stroke.