H型高血压MTHFR C677T基因多态性、同型半胱氨酸与肾功能的相关性研究

Association of MTHFR677 C/T Gene Polymorphism,Homocysteine and Renal Function in Patients with H-type Hypertension

目的探讨H型高血压亚甲基四氢叶酸还原酶基因(MTHFR)677C/T多态性、血清同型半胱氨酸(Hcy)与肾功能的关系。方法选择2016年8月至2018年8月在我院确诊的H型高血压患者414例,肾功能正常361例,肾功能异常53例,分析一般临床资料、MTHFR 677C/T基因多态性、血清Hcy、肌酐(Cr)和估算肾小球滤过率(e GFR)。结果肾功能异常组Hcy[(26.3±9.5)μmol/L vs.(15.6±8.6)μmol/L]和Cr[(179.6±45.3)μmol/L vs.(73.6±43.6)μmol/L]高于正常组,差异有统计学意义(P<0.05),正常组eGFR[(71.8±21.5)m L/min.1.73m^2vs.(96.4±31.8)m L/min·1.73m^2]低于异常组,差异有统计学意义(P<0.05);多元线性回归分析显示Hcy与Cr呈正相关性(P<0.005),与e GFR呈负相关性(P<0.005),MTHFR基因分型与Cr和e GFR均无相关性(P>0.05)。结论H型高血压血清Hcy升高可增加肾脏损害,应采取积极措施降压、降Hcy,预防肾功能减退。

Objective To investigate the relationships between M-type hypertrophic methylenetetrahydrofolate reductase gene(MTHFR)677 C/T polymorphism,serum homocysteine(Hcy)and renal function.Methods 414 patients with H-type hypertension diagnosed in our hospital from August 2016 to August 2018 were selected,including 361 cases of normal renal function and 53 cases of abnormal renal function,and the general clinical data,MTHFR 677 C/T gene polymorphism,serum Hcy,creatinine(Cr),and estimated glomerular filtration rate(e GFR)were analyzed.Results Hcy[(26.3±9.5)μmol/L vs.(15.6±8.6)μmol/L]and Cr[(179.6±45.3)μmol/L vs.(73.6±43.6)μmol/L]in the renal dysfunction group were higher than those in the normal group(P<0.05),and e GFR[(71.8±21.5)m L/min·1.73 m^2 vs.(96.4±31.8)m L/min·1.73 m^2]in the normal group was lower than that in the abnormal group(P<0.05);Multiple linear regression analysis showed that Hcy was positively correlated with Cr(P<0.005)and negatively correlated with e GFR(P<0.005).There was no correlation between MTHFR genotype and Cr and e GFR(P>0.05).Conclusion Increased serum level of Hcy in H-type hypertension can increase renal damage,and positive measures should be taken to reduce blood pressure and reduce level of Hcy to prevent renal dysfunction.