宁波江北地区汉族青壮年亚甲基四氢叶酸还原酶基因C677T多态性和体力活动与缺血性脑卒中的关系

The relationship between polymorphisms of methylene tetrahydrofolate reductase gene C677T,physical activity and ischemic stroke in young Han adults in Jiangbei District,Ningbo

目的研究宁波江北地区汉族人群亚甲基四氢叶酸还原酶基因C677T(MTHFR C677T)多态性与体力活动之间相互作用对青壮年急性缺血性脑卒中(AIS)发病危险的影响,探讨其与缺血性脑卒中的关系,为急性缺血性脑卒中一级预防提供理论依据。方法采用病例-对照研究方法,选取2015年1月-2018年1月宁波大学医学院附属医院神经内科收治的78例青壮年急性缺血性脑卒中(AIS组)患者,82例健康体检者(对照组)为研究对象,应用聚合酶链反应-限制性内切酶长度多态性方法(PCR-RFLP)检测MTHFR C677T基因多态性。采用SPSS 19.0软件进行t检验和χ^(2)检验,用Hardy-Weinberg平衡检验确认样本的群体代表性,应用多因素非条件Logistic回归分析缺血性脑卒中与体力活动、MTHFR C677T基因型的关联,体力活动与MTHFR C677T基因型协同作用对缺血性脑卒中发病的影响。结果 AIS组T等位基因的频率与对照组比较,差异无统计学意义(P> 0.05)。AIS组低体力活动占比高于对照组(P <0.05)。多因素非条件Logistic回归分析结果显示,MTHFR C677T基因型TT、低体力活动均是危险因素。经过调整主要混杂因素后,MTHFR C677T基因型TT的患病风险是基因型CC的2.717倍(P <0.05)。MTHFR C677T基因型TT与低体力活动的相互作用对青壮年缺血性脑卒中发病危险具有显著的协同作用(OR=4.53,95%CI:1.360~9.753,P <0.05)。结论 MTHFR C677T TT型基因及低体力活动是急性缺血性脑卒中发病的独立危险因素,MTHFR C677T基因型TT与低体力活动的相互作用对宁波江北地区青壮年缺血性脑卒中发病危险具有显著的协同作用。

Objective To study the effects of MTHFR C677 T polymorphism and physical activity on the risk of acute ischemic stroke( AIS) in young adults of Han nationality in Jiangbei Distirct of Ningbo. To explore its relationship with ischemic cerebral apoplexy,and provide theoretical basis for acute ischemic stroke in primary prevention. Methods The A case-control study was conducted to select 78 young patients with acute ischemic stroke( AIS) admitted to the Department of Neurology,Affiliated Hospital of School of Medicine of Ningbo University from January 2015 to January 2018,and 82 healthy people( control group)as the study subjects. The polymorphism of MTHFR C677 T gene was detected by polymerase chain reaction-restriction length polymorphism( PCR-RFLP). SPSS 19. 0 statistical software was used for t test and χ^(2) test. The population representation of the sample was confirmed by Hardy-Weinberg equilibrium test. Multivariate Logistic regression was used to analyze the correlation between ischemic stroke,physical activity and MTHFR C677 T genotype,and the synergistic effect of physical activity and MTHFR C677 T genotype on the incidence of ischemic stroke. Results There was no statistical significance on the difference in the frequency of T alleles between AIS group and control group( P > 0. 05). The proportion of low physical activity in AIS group was higher than that in control group( P < 0. 05). Multivariate Logistic regression analysis showed that MTHFR C677 T genotype TT and low physical activity were risk factors. After adjusting for major confection factors,the risk of MTHFR C677 T genotype TT was 2. 717 times higher than genotype CC( P < 0. 05). The interaction between MTHFR C677 T genotype TT and low physical activity had a significant synergistic effect on the risk of ischemic stroke in young adults( OR = 4. 53,95% CI: 1. 360-9. 753)( P < 0. 05). Conclusion MTHFR C677 T TT gene and low physical activity are independent risk factors for acute ischemic stroke. The interaction between MTHFR C677 T genotype TT and low physical activity has a significant synergistic effect on the risk of ischemic stroke in young adults in Jiangbei Distiric of Ningbo.