叶酸及亚甲基四氢叶酸还原酶基因C677T多态性与心肌梗死的关系

Relationship between folate and methylenetetrahydrofolate reductase gene C677T polymorphisms and acute myocardial infarction

目的 :研究血清叶酸浓度与亚甲基四氢叶酸还原酶 (MTHFR)基因C6 77T多态性与老年心肌梗死的关系。方法 :选择 96例老年急性心肌梗死患者为实验组和 82例对照 ,采用PCR RFLP检测MTHFR基因6 77位点的基因型 ,并检测血清叶酸浓度。结果 :两组基因型分布符合Hardy Weinberg平衡 (P >0 .0 5 )。实验组TT基因型和T等位基因频率均高于对照组 ,为 0 .2 7∶0 .12和 0 .5 2∶0 .32 (P均 <0 .0 1)。实验组的血清叶酸浓度明显低于对照组 ,为 (5 .91± 2 .0 8) μmol/L∶(7.85± 2 .6 0 ) μmol/L(P <0 .0 1)。实验组的血清叶酸浓度按基因型分类时 ,CC型、CT型和TT型分别为 (6 .82± 2 .70 ) μmol/L、(6 .0 2± 1.84 ) μmol/L和 (4.92± 1.4 7) μmol/L ,TT型分别与CC、CT型比较 ,差异均存在显著 (P均 <0 .0 1)。经Logistic回归分析得出 :血清叶酸水平与TT基因型均是心肌梗死的危险因素 ,OR分别为 4 .6 4 6 (95 %CI:2 .198- 9.82 0 )和 3.2 86 (95 %CI:1.32 1- 8.170 )。血清叶酸浓度低于 6 μmol/L时合并TT基因型与心肌梗死的关系更明显 ,OR从 3.2 86增大至 7.393(95 %CI:1.6 39- 33.343)。结论 :血清叶酸水平、MTHFR基因C6 77T多态性与老年心肌梗死相关。低血清叶酸水平时携带MTHFR基因TT型使老年心肌梗死的患病?

Objective:To investigate the relationship between folate serum concentration and methylenetetrahydrofolate reductase gene C677T polymorphisms and acute myocardial infarction in the elderly patients.Methods:To amplify MTHFR 677C/T locus,the polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) was used in 96 aged with acute myocardial infarction and 82 control individuals and serum folate was detected in these people.Results:The allelic distribution of the AMI group and the control group accorded with the Hardy-Weinberg equilibrium(P>0.05).TT genotype and T allely frequency in the AMI group were higher than that in the control group(0.27 vs 0.12;0.52 vs 0.32)(both P<0.01).Compared with the control group,serum folate concentration in the AMI group was lower,[(5.91±2.08)μmol/L vs (7.85±2.60)μmol/L](P<0.01).Serum folate concentration was not the same among different genotypes in the AMI group,CC genotype was (7.87±2.92)μmol/L;CT genotype was (6.48±1.97)μmol/L;TT genotype was (5.69±2.23)μmol/L,( CC or CT vs TT,both P<0.01). One of the results of logistic regression analysis was that TT genotype and serum folate concentration both were risk factors of AMI in the old.The other was TT genotype and lower plasma folate concentration had interaction in old AMI people.OR increased from 3.286(95%CI:1.321-8.170)to 7.393(95%CI:1.639-33.343).Conclusion:Methylenetetrahydrofolate reductase gene C677T polymorphisms and serum folate concentration may be related with acute myocardial infarction in the old. With lower serum folate concentration, the old people with TT genotype may increase acute myocardial infarction morbility.