ASSOCIATION OF PLASMA HOMOCYSTEINE LEVEL AND N^5, N^(10) -METHYLENETETRAHYDROFOLATE REDUCTASE GENE POLYMORPHISM WITH CEREBRAL INFARCTION

Objective. To investigate the relationship of plasma homocysteine (Hcy) level to stroke and genetic factor to elevated plasma Hcy level.Methods. The plasma Hcy level was measured by capillary electrophoresis- ultraviolet detection and the gene polymorphism of N5, N10 - methylenetetrahydrofolate reductase (MTHFR) was studied with PCR - RFLP assay in 43 patients with cortical cerebral infarction and 42 healthy controls.Results. The plasma Hcy level of the patients ( 19. 3 + 6. 0 μ mol/L) was markedly higher than that of the controls (13.7 + 5.4 μ mol/L) ( t = 4. 16, P ＜ 0. 001). There are 3 genotypes, C/C, C/T and T/T, about base - variation of MTHFR gene at locus 677. The plasma Hcy level of the subjects with T/T genotype was higher than that of subjects with other genotypes. However, the frequencies of each genotype and allele were not significantly different between the patients and the controls.Conclusions. The elevated plasma Hcy level is a risk factor for atherothrombotic cerebral infarction, and is related to the C→T mutation at locus 677 of MTHFR gene.

Single nucleotide polymorphism C677T in the methylenetetrahydrofolate reductase gene might be a genetic risk factor for infertility for Chinese men with azoospermia or severe oligozoospermia

Aim： To analyze the distribution of the single nucleotide polymorphism （SNP） C677T in the methylenetetrahydrofolate reductase （MTHFR） gene in 355 infertile Chinese patients with idiopathic azoospermia or severe oligozoospermia and 252 fertile Chinese men as controls to explore the possible association of the SNP and male infertility. Methods： Using the polymerase chain reaction （PCR）-restriction fragment length polymorphism technique, the allele and genotype distribution of SNP C677T in the MTHFR gene were investigated in both patients and controls. Results： The frequencies of allele T （40.9% vs 30.4%, P = 0.002, odds ration [OR] = 1.58, 95% confidence interval [CI]： 1.24-2.02） and mutant homozygote （TT） （18.3% vs. 11.5%, P = 0.023, OR = 1.72, 95% CI： 1.07-2.76） as well as carrier with allele （TT ＋ CT） （63.4% vs. 49.2%, P = 0.0005, OR = 1.79, 95% CI： 1.29-2.48） in infertile patients were significantly higher than those in controls. After patient stratification, the significant differences in distribution of the SNP between each patient subgroup and control group still remained. Conclusion： Our findings indicate that there is an association of SNP C677T in the MTHFR gene with male infertility, suggesting that this polymorphism might be a genetic risk factor for male infertility in Chinese men.

Methylenetetrahydrofolate reductase C677T and A1298C polymorphisms and gastric cancer susceptibility

AIM: To identify the association between methylenetetrahydrofolate reductase (MTHFR) polymorphisms and gastric cancer (GC) susceptibility.

Association Between Homocysteine Level and Methylenetetrahydrofolate Reductase Gene Polymorphisms in Type 2 Diabetes Accompanied by Dyslipidemia

Objective To investigate the association between total homocysteine(tHcy)level in plasma and methylenetetrahydrofblate reductase(MTHFR)C677T and A1298C genetic polymorphisms in a Chinese Han nationality population with type 2 diabetes mellitus(T2DM)accompanied by dyslipidemia.Methods This case-control study enrolled T2DM patients with dyslipidemia and without dyslipidemia respectively.Sanger dideoxy-mediated chain-termination method was used to detect the gene polymorphisms of MTHFR C677T and A1298C.Plasma tHcy and lipid levels were measured as well.The genotype frequency and allele frequency between the dyslipidemia and non-dyslipidemia groups were compared by using Chi-square test.Plasma tHcy level ofT2DM patients who carried the different genotypes was compared by Student's t test.Results Finally,82 T2DM patients with dyslipidemia and 94 ones without dyslipidemia were included in this study.There was a significant correlation between tHcy level and MTHFR C677T gene polymorphism inT2DM patients(t=2.27,P=0.02).Moreover,the plasma tHcy level in the dyslipidemia patients who carried MTHFR 677TT genotype was significantly higher than that in those with CT+CC genotype(13.62+6.97 vs.10.95+3.62pmol/L,t=2.2O,P=0.03);while for patients without dyslipidemia,comparison of the tHcy level between those who carried the above two alleles showed no significantly difference(13.34±6.03 vs.12.04±5.09μmol/L,t=1.08,P=0.29).Conclusion MTHFR 677TT genotype might associate with higher tHcy level in T2DM patients with dyslipidemia.

Folate levels in mucosal tissue but not methylenetetrahydrofolate reductase polymorphisms are associated with gastric carcinogenesis

AIM: To evaluate whether folate levels in mucosal tissue and some common methylenetetrahydrofolate reductase (MTHFR) variants are associated with the risk of gastric cancer through DNA methylation. METHODS: Real-time PCR was used to study the expression of tumor related genes in 76 mucosal tissue samples from 38 patients with gastric cancer. Samples from the gastroscopic biopsy tissues of 34 patients with chronic superficial gastritis (CSG) were used as controls. Folate concentrations in these tissues were detected by the FOL ACS: 180 automated chemiluminescence system. MTHFR polymorphisms were analyzed by PCR-RFLP, and the promoter methylation of tumor-related genes was determined by methylation-specific PCR (MSP). RESULTS: Folate concentrations were significantly higher in CSG than in cancerous tissues. Decreased expression and methylation of c-myc accompanied higher folate concentrations. Promoter hypermethylation and loss of p16INK4A in samples with MTHFR 677CC were more frequent than in samples with the 677TT or 677CT genotype. And the promoter hypermethylation and loss of p21WAF1 in samples with MTHFR 677CT were more frequent than when 677CC or 677TT was present. The 677CT genotype showed a non-significant higher risk for gastric cancer as compared with the 677CC genotype. CONCLUSION: Lower folate levels in gastric mucosal tissue may confer a higher risk of gastric carcinogenesisthrough hypomethylation and overexpression of c-myc.

Methylenetetrahydrofolate Reductase Gene Polymorphism C677T is Associated with Increased Risk of Coronary Heart Disease in Chinese Type 2 Diabetic Patients

Objective Chronic cardiovascular diseases induced by long-term poor blood glucose control are the main cause of death in patients with type 2 diabetes mellitus(T2DM).Previous researches report that methylenetetrahydrofolate reductase gene(MTHFR)polymorphisms might influence the occurrence of coronary heart disease(CHD)in T2DM patients.The purpose of this study was to evaluate whether MTHFR C677T and A1298C mutations are associated with the risk of CHD inT2DM patients.Methods A total of 197 subjects with T2DM were studied,of which 95 patients with CHD.The genotypes of MTHFR C677T and A1298C were analyzed by using dideoxy chain-termination method,and compared between patients with CHD and those without CHD.Results We found that the frequency of the 677T allele was significantly higher in T2DM patients with CHD than those without CHD(P=0.011).However,there was no significant difference in any of the examined haplotypes between T2DM patients with and without CHD.Furthermore,the 677T allele was associated with a higher risk of CHD development in diabetic patients with lower homocysteine(Hey)levels(≤15μmol/L)(P=0.006),while no effect of MTHFR gene polymorphism on the incidence of CHD was found in patients with higher Hey levels(>15 μmol/L)(P=0.491).Conclusion The MTHFR C677T gene polymorphism is associated with the risk of CHD of diabetic patients and could be used as an effective marker for CHD in Chinese diabetic populations with normal Hey levels.

Is the C677T polymorphism in methylenetetrahydrofolate reductase gene or plasma homocysteine a risk factor for diabetic peripheral neuropathy in Chinese individuals?

The present study enrolled 251 diabetic patients, including 101 with neuropathy and 150 without neuropathy. Of the 150 patients, 100 had no complications, such as retinopathy, nephropathy, or neuropathy. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to identify methylenetetrahydrofolate reductase gene variants. Plasma homocysteine levels were also measured. Homocysteine levels and the frequency of hyperhomocysteinemia were significantly higher in patients with diabetic peripheral neuropathy compared with diabetic patients without neuropathy （P 〈 0.05）. In logistic regression analysis with neuropathy as the dependent variable, the frequency of C677T in methylenetetrahydrofolate reductase was significantly higher in patients with diabetic peripheral neuropathy compared with patients without diabetic complications. Homocysteine levels were significantly higher in patients with diabetic peripheral neuropathy carrying the 677T allele and low folic acid levels. In conclusion, hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in Chinese patients with diabetes. The C677T polymorphism in methylenetetrahydrofolate reductase and low folic acid levels may be risk factors for diabetic peripheral neuropathy in Chinese patients with diabetes.

Association of methylenetetrahydrofolate reductase C677T polymorphism and serum lipid levels in the Guangxi Bai Ku Yao and Han populations

Objectives The association of methylenetetrahy-drofolate reductase(MTHFR) gene polymorphism and serum lipid profiles is still controversial in diverse ethnics.Bai Ku Yao is an isolated subgroup of the Yao minority in China. The aim of the present study was to eveluate the association of MTHFR C677Tpolymorphism and several environmental factors with serum lipid levels in the Guangxi Bai Ku Yao and Han populations.Methods A total of 780 subjects of Bai Ku Yao and 686 participants of Han Chinese were randomly selected from our previous stratified randomized cluster samples.Genotyping of the MTHFR C677T was performed by polymerase chain reaction and restriction fragment length polymorphism combined with gel electrophoresis,and then confirmed by direct sequencing.Results The levels of serum total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol(LDL-C), apolipoprotein(Apo) AI and ApoB were lower in Bai Ku Yao than in Han(P【0.05-0.001).The frequency of C and T alleles was 77.4%and 22.6%in Bai Ku Yao,and 60.9%and 39.1%in Han(P【0.001);respectively.The frequency of CC,CT and TT genotypes was 58.7%,37.3%and 4.0%in Bai Ku Yao,and 32.6%,56.4%and 11.0%in Han(P【 0.001);respectively.The levels of TC and LDL-C in both ethnic groups were significant differences among the three genotypes(P【0.05-0.01).The T allele carriers had higher serum TC and LDL-C levels than the T allele noncarriers. The levels of ApoB in Han were significant differences among the three genotypes(P【0.05).The T allele carriers had higher serum ApoB levels as compared with the T allele noncarriers. The levels of TC,TG and LDL-C in Bai Ku Yao were correlated with genotypes(P【0.05-0.001),whereas the levels of LDL-C in Han were associated with genotypes(P【 0.001).Serum lipid parameters were also correlated with sex, age,body massindex,alcohol consumption,cigarette smoking, and blood pressure in the both ethnic groups.Conclusions The differences in serum TC,TG,LDL-C and ApoB levels between the two ethnic groups might partly result from different genotypic and allelic frequencies of the MTHFR C677Tor differentMTHFR gene-enviromental interactions.

Polymorphisms in methylenetetrahydrofolate reductase gene: Their impact on liver steatosis and fibrosis of chronic hepatitis c patients

Aim & Background: The mechanism of steatosis in Hepatitis C virus infection is multifactorial;therefore, it is complex and unclear. The aim of this study was to investigate the effects of methylentetrahydrofolate reductase (MTHFR) gene polymorphisms on the course of chronic hepatitis C virus infection and the development of steatosis due to hepatitis C virus. Methods: This study included 109 patients with chronic hepatitis C virus infection. Necroinflammatory activity, degrees of fibrosis and steatosis and MTHFR gene polymorphisms were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to determine MTHFR C677T and A1298C polymorphisms. Results: Fibrosis was correlated with age (r = 0.336, p = 0.002), platelet (r = ?0.448, p < 0.0001), ALT (r = 0.241, p = 0.026), AST (r = 0.361) and GGT (r = 0.224, p = 0.039). Steatosis was only correlated with fibrosis. MTHFR C677T and A1298C polymorphisms did not have a significant effect on the degree of steatosis (p = 0.857, p = 0.202 respectively). There was a relation between MTHFR C677T and the degree of fibrosis but not A1298C (p = 0.014, p = 0.187 respectively). Conclusion: We found that MTHFR C677T polymorphism contributed to the development of fibrosis in patients with chronic hepatitis C virus infection.

A review of methylenetetrahydrofolate reductase in one-carbon metabolism and psychiatric disorders

Methylenetetrahydrofolate reductase(MTHFR)is a key enzyme for the critical process of one-carbon circulation,which convert5,10-methylenetetrahydrofolate to5-methyltetrahydrofolate and participate in folate and homocysteine conversion correlated to methyl group supply.The enzyme activity decline depends on the gene polymorphism.MTHFR impacts on the methylation process which is related to psychiatric diseases.Studies have shown association between MTHFR gene polymorphisms and mental disorders,some of which stratified by folate and cobalamin levels.In this review,we will summarize the testimony on the relationship between methylation and MTHFR polymorphism as well as the implication on psychiatric diseases by MTHFR mutation.

Women with Methylenetetrahydrofolate Reductase Gene Polymorphism and the Need for Proper Periconceptional Folate Supplementation

Maternal folate supplementation is critical for fetal development. Women with MTHFR （methylenetetrahydrofolate reductase） gene polymorphisms may not be getting the proper folate form to support fetal development. The objectives of this review were to： （1） undertake a comprehensive review on the association of MTHFR polymorphisms with the risk for various congenital diseases and other adverse pregnancy outcomes, （2） assess the efficacy and safety of current folic acid and other supplementations in women with the MTHFR polymorphism, and （3） provide guidance on the appropriate supplementation for women of childbearing potential with the MTHFR gene polymorphism in order to decrease these adverse pregnancy outcomes. Our assessments show that women with MTHFR gene polymorphism cannot efficiently convert folic acid to L-5-methyl-tetrahydofolate, the predominant active form of folic acid, due to reduced MTHFR enzymatic activity. L-5-methyl-tetrahydrofolate is currently commercially available under several brand names. Based on our comprehensive review and knowledge of the biochemistry of the folates, we recommend that L-5-methyltetrahydrofolate be given in combination with folic acid to women with MTHFR polymorphism that are pregnant or planning to become pregnant. Further study is needed to determine the optimal dose.

1098例不良妊娠女性亚甲基四氢叶酸还原酶基因多态性分析

目的 探讨不良妊娠女性亚甲基四氢叶酸还原酶(MTHFR)基因A1298C、C677T位点多态性分布及叶酸代谢能力,为叶酸的个体化补充提供依据。方法 选择2017年1月—2020年12月聊城市东昌府区妇幼保健院收治的1 098例非正常妊娠女性作为研究对象。采用荧光定量聚合酶链反应(PCR)检测MTHFR基因A1298C、C677T位点的不同基因型在1 098例不良妊娠女性中的分布,并进行叶酸代谢能力评估;分析并比较A1298C、C677T位点基因型在不同地区不良妊娠女性中的分布差异。结果 MTHFR基因C677T位点的突变基因型(TT+CT)频率为89.25%,明显高于A1298C位点的突变基因型CC和AC(突变频率为24.59%),差异具有统计学意义(P<0.05)。1 098例不良妊娠女性中,较弱及弱叶酸代谢能力者占比为91.26%。在我国不同地区的不良妊娠女性中,A1298C位点的突变基因型分布频率为22.0%~50.0%,C677T位点的突变基因型分布频率为44.7%~88.5%,C677T位点的突变率较高。结论 不良妊娠女性的MTHFR基因具有较高的突变率,且叶酸代谢能力多低于正常水平,应个体化补充叶酸,提高叶酸补充效率,降低不良妊娠发生率。

Correlation between methylenetetrahydrofolate reductase gene C677T polymorphism and preeclampsia in pregnant women

Objective: To study the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and preeclampsia in pregnant women. Methods: Pregnant women who were diagnosed with preeclampsia in Jianshi People's Hospital between July 2014 and March 2017 were selected as the PE group of the research, and healthy pregnant women who received antenatal care and gave birth in Jianshi People's Hospital during the same period were selected as the control group of the research. The MTHFR gene C677T polymorphism in peripheral blood, the contents of homocysteine (Hcy) metabolism indexes and the expression of apoptosis genes and invasion genes were determined. Results: The proportion of MTHFR gene C677T locus TT genotype in peripheral blood of PE group was significantly higher than that of control group while the proportion of CT and CC genotypes were significantly lower than those of control group;Hcy levels in serum and placenta as well as FasL, Caspase-8, Bax, Caspase-9 and Caspase-3 mRNA expression in placenta of PE women with TT genotype were significantly higher than those of PE women with CT genotype and CC genotype while folic acid levels in serum and placenta as well as Notch-1, N-cadherin, Vimentin, CatL and CatB mRNA expression in placenta were significantly lower than those of PE women with CT genotype and CC genotype. Conclusion: MTHFR gene C677T locus mutation can participate in the occurrence of preeclampsia by affecting the Hcy metabolism as well as the expression of apoptosis genes and invasion genes.

Correlation of methylenetetrahydrofolate reductase polymorphism with Hcy metabolism and inflammatory response in patients with recurrent cerebral infarction

Objective:To study the correlation of methylenetetrahydrofolate reductase (MTHFR) polymorphism with Hcy metabolism and inflammatory response in patients with recurrent cerebral infarction.Methods: 40 patients with recurrent cerebral infarction who were treated in Yulin Third Hospital between December 2013 and December 2016 were selected as recurrent group, 58 patients with primary cerebral infarction were selected as primary group, and 60 healthy volunteers were selected as control group. Peripheral blood MTHFR gene C677T polymorphism and serum levels of Hcy metabolism indexes and inflammatory response indicators were determined.Results: CC genotype constituent ratio of recurrent group was significantly lower than that of primary group and control group while CT genotype and TT genotype constituent ratio were significantly higher than those of primary group and control group;serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in recurrent group and primary group were significantly higher than those in control group while VitB12 and FA levels were significantly lower than those in control group;serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in recurrent group were significantly higher than those in primary group while VitB12 and FA levels were significantly lower than those in primary group. Serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in patients with CC genotype were significantly lower than those in patients with CT genotype and TT genotype while VitB12 and FA levels were significantly higher than those in patients with CT genotype and TT genotype;serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in patients with CT genotype were significantly lower than those in patients with TT genotype while VitB12 and FA levels were significantly higher than those in patients with TT genotype.Conclusion: MTHFR gene C677T polymorphism is closely related to the recurrence of cerebral infarction, and allele C mutation to T will affect Hcy metabolism and aggravate inflammatory response.

贵阳地区孕产妇5,10-亚甲基四氢叶酸还原酶和甲硫氨酸合成酶还原酶基因多态性研究

目的研究贵阳地区孕产妇5,10-亚甲基四氢叶酸还原酶(MTHFR)和甲硫氨酸合成酶还原酶(MTRR)基因多态性,为叶酸个性化增补方案提供参考依据。方法选取2018年11月至2019年10月于贵州中医药大学附属第一医院建档的3600名健康孕产妇作为研究对象,均进行MTHFR C677T、A1298C位点及MTRR A66G位点突变检测。分析贵阳孕产妇MTHFR和MTRR基因位点多态性分布及贵阳孕产妇叶酸代谢利用能力风险,比较不同地区叶酸代谢基因位点多态性分布。结果贵阳孕产妇MTHFR C677T位点频率分别为CC(37.78%)、CT(47.58%)及TT(14.64%),等位基因频率分别为C(61.57%)和T(38.43%);MTHFR A1298C位点频率分别为AA(62.39%)、AC(33.31%)及CC(4.31%),等位基因频率分别为A(79.04%)和C(20.96%);MTRR A66G位点频率分别为AA(57.67%)、AG(36.39%)及GG(5.94%),等位基因频率分别为A(75.86%)和G(24.14%)。贵阳地区孕产妇MTHFR C677T位点TT纯合突变型频率低于郑州及胶东地区孕产妇,整体叶酸代谢利用水平高于郑州与胶东地区孕产妇,差异有统计学意义(P<0.05)。此外,贵阳地区孕产妇MTHFR C677T位点TT纯合突变型频率低于绍兴地区高同型半胱氨酸(Hcy)水平孕产妇,而MTHFR A1298C位点AC杂合突变型、CC纯合突变型频率高于绍兴地区高Hcy水平孕产妇,差异有统计学意义(P<0.05)。贵阳地区孕产妇与其他地区MTHFR A1298C及MTRR A66G位点突变频率比较差异无统计学意义。结论因不同地区人口遗传结构特征,叶酸代谢相关的MTHFR C667T、MTHFR A1298C、MTRR A66G 3个基因位点频率分布具有明显地域差异,特别是MTHFR C677T位点的地区差异显著,需根据地区基因突变情况实施个性化的叶酸增补方案。

MTHFR基因多态性及血清AFP水平与胎儿神经管畸形的关系

目的分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性及血清甲胎蛋白(AFP)与胎儿神经管畸形的关系。方法选取2018年1月至2023年11月在陕西省宝鸡市妇幼保健院引产或分娩的50例胎儿神经管畸形产妇作为观察组,另选取150例胎儿健康产妇作为对照组。比较两组MTHFR基因多态性分布情况及血清AFP水平,比较观察组不同MTHFR基因多态性血清AFP水平,采用多因素Logistic回归分析胎儿神经管畸形的危险因素。结果观察组MTHFR C677T基因CT基因型+TT基因型、MTHFR A1298C基因AC基因型+CC基因型比例及血清AFP水平高于对照组,差异均有统计学意义(P<0.05)。观察组MTHFR C677T基因CT基因型+TT基因型产妇血清AFP水平高于CC基因型,MTHFR A1298C基因AC基因型+CC基因型产妇血清AFP水平高于AA基因型,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,MTHFR C677T基因CT基因型+TT基因型、MTHFR A1298C基因AC基因型+CC基因型是发生胎儿神经管畸形的危险因素(P<0.05)。结论MTHFR C677T基因、MTHFR A1298C基因多态性及血清AFP水平与胎儿神经管畸形有关,在预测胎儿神经管畸形方面有一定应用价值。

血清成纤维细胞生长因子-21、亚甲基四氢叶酸还原酶基因多态性与妊娠期亚临床甲状腺功能减退症的相关性

目的 探究血清成纤维细胞生长因子-21(FGF-21)、亚甲基四氢叶酸还原酶(MTHFR)基因多态性与妊娠期亚临床甲状腺功能减退症(SCH)的相关性。方法 选取2022年7月至2023年7月山西省临汾市人民医院收诊的妊娠期SCH患者106例为SCH组,另选取院内同期孕检的健康妊娠期女性106例为健康组。收集两组病历资料,筛查SCH的相关因素,分析血清FGF-21、MTHFR基因多态性对SCH发生的评估效能。结果 SCH组的空腹血糖、血清促甲状腺素(TSH)、FGF-21高于健康组(P<0.05);两组CC、CT、TT基因型分布频率比较,差异有统计学意义(P<0.05)。SCH组T等位基因分布频率高于健康组(P<0.05)。多因素分析结果显示,血清FGF-21(OR=3.330,95%CI:1.138~9.743)、MTHFR基因多态性(OR=4.104,95%CI:1.403~12.008)是SCH发生的影响因素(P<0.05)。血清FGF-21、MTHFR基因多态性单一及联合诊断SCH发生的受试者操作特征曲线下面积分别为0.738、0.670、0.851。结论 血清FGF-21水平升高、MTHFR基因TT基因型的妊娠期女性SCH发生风险更高,两项联合具有一定的诊断价值。

脑梗死患者同型半胱氨酸、5,10-亚甲基四氢叶酸还原酶基因多态性与颈动脉粥样硬化的相关性

目的探讨脑梗死患者急性期血清同型半胱氨酸（homocysteine,Hcy）、5,10-亚甲基四氢叶酸还原酶（methylenetetrahydrofolate,MTHFR）基因多态性与颈动脉粥样硬化之间的相关性。方法研究共纳入90例急性脑梗死患者和40例正常人,用循环酶法测定血清Hcy水平;用彩色多普勒超声检查颈动脉颅外段;采用聚合酶链反应-限制性内切酶片段长度多态性方法检测MTHFR基因型多态性。结果病例组颈总动脉（CCA）及颈内动脉（ICA）内中膜厚度（IMT）较对照组显著增厚（1.07±0.30）mm vs（0.87±0.33）mm,（1.00±0.31）mm vs（0.65±0.16）mm（均P〈0.01）。病例组较对照组颈动脉斑块发生率显著增高（74.4%vs 45.0%,P〈0.01）。病例组中不稳定斑块占所有斑块的比例较对照组中有增高的趋势,但差异无统计学意义（P〉0.05）。C/C、C/T、及T/T基因型人群血清Hcy水平分别为12.95（9.50~16.58）μoml/L,19.08（12.05~25.63）μoml/L,28.32（18.00~36.80）μoml/L,呈递增趋势,各组间差异有统计学意义（均P〈0.05）。Logistic回归分析显示在校正了传统的危险因素后,Hcy仍然是颈动脉粥样硬化的独立危险因素（P〈0.01）;MTHFRC677T基因多态性未进入回归方程。结论血清Hcy升高是脑梗死独立危险因素;MTHFRC677T基因多态性与颈动脉粥样硬化无相关性。

H型高血压急性缺血性脑卒中患者亚甲基四氢叶酸还原酶C677T基因多态性及其与肾功能的相关性

目的观察H型高血压急性缺血性脑卒中患者亚甲基四氢叶酸还原酶(MTHFR)C677T的基因多态性,分析其与H型高血压急性缺血性脑卒中患者肾功能的相关性。方法选择153例H型高血压急性缺血性脑卒中患者为观察组,同期158例非H型高血压急性缺血性脑卒中患者为对照组。两组均采集外周静脉血,采用PCR扩增和微阵列技术检测MTHFR C677T基因型,测算全身免疫炎症指数(SII),采用日立7600型全自动生化分析仪检测两组血清肌酐,据此测算肾小球滤过率(eGFR)。采用多元线性回归分析法分析MTHFR C677T基因型与H型高血压急性缺血性脑卒中患者同型半胱氨酸(Hcy)、eGFR的相关性,采用Spearman相关分析法分析SII与H型高血压急性缺血性脑卒中患者eGFR、Hcy的相关性。结果与对照组相比,观察组患者TT基因型分布频率最高,T等位基因频率最高(χ^(2)分别为19.188、5.138,P均<0.05)。观察组、对照组患者SII分别为583.54(384.97,903.73)、425.03(310.26,583.16),二者相比,P<0.05。与CC、CT基因型比较,TT基因型的H型高血压急性缺血性脑卒中患者血清Hcy水平高,eGFR水平低(F分别为28.544、3.749,P均<0.05)。MTHFR C677T TT基因型与H型高血压急性缺血性脑卒中患者血清Hcy呈正相关(β=4.173,P<0.05),与eGFR呈负相关(β=-6.559,P<0.05)。SII与H型高血压急性缺血性脑卒中血清Hcy水平呈正相关(r=0.226,P<0.05),与eGFR呈负相关(r=-0.129,P<0.05)。结论H型高血压急性缺血性脑卒中患者MTHFR C677T基因型主要为TT型。MTHFR C677T TT基因型的H型高血压急性缺血性脑卒中患者可能更易引起肾功能下降。

不同5,10-亚甲基四氢叶酸还原酶基因型人群叶酸补服效果评价

目的对不同5,10-亚甲基四氢叶酸还原酶(MTHFR)基因型人群叶酸补服的效果进行评价。方法根据MTHFRC677T基因型将113名健康女性分为CC、CT、TT3组,每组内再随机分为干预组和对照组,干预组给予口服叶酸片400μg/d,服药2个月,对照组不补服叶酸。分别于基线和干预2个月后检测血浆叶酸、红细胞叶酸、血浆同型半胱氨酸(Hcy)水平。结果基线时,TT基因型血浆叶酸低于CC基因型和CT基因型,而TT基因型血浆Hcy高于CC基因型和CT基因型(P<0.05或P<0.01)。补服叶酸2个月后,干预组血浆叶酸水平和红细胞叶酸水平均不同程度的升高,血浆Hcy水平下降。其中,TT基因型的血浆叶酸上升最明显(相较于CC和CT,均P<0.05);其血浆Hcy下降也最显著(相较于CT,P<0.05)。Logistic回归分析显示,MTHFR基因型为TT是血浆Hcy偏高的危险因素,其风险是CC型的8.078倍。结论对于3种MTHFR基因型叶酸干预均可升高血浆叶酸和红细胞叶酸,降低血浆Hcy水平。TT基因型发生叶酸代谢障碍、血浆Hcy偏高的风险最高。尚不能证实小剂量补服叶酸可以降低血浆Hcy偏高的风险。