MTHFR C677T 유전자 다형성과 허혈성 뇌졸중의 상관 관계
Association between MTHFR C677T Polymorphism and Ischemic Stroke
2
조회
0
다운로드
5
인용
0
참고문헌
초록
Abstract
Background: Hyperhomocysteinemia is an independent risk factor for ischemic stroke. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism has been known to result in reduced MTHFR enzyme activity, and induced hyperhomocysteinemia. Recently, a significant association with ischemic stroke was identified for the homozygous T allele of the MTHFR polymorphism by meta-analysis. This current study was undertaken to determine whether MTHFR C677T polymorphism was associated with ischemic stroke in the Korean population. Methods: We enrolled 1292 patients with ischemic stroke and 457 healthy individuals and measured their fasting plasma homocysteine levels and analyzed the C677T polymorphisms in the MTHFR gene. Results: The prevalence of the homozygous mutation was significantly higher in ischemic stroke patients (23.9%) than in controls (13.8%; p<0.01). Homocysteine levels in the plasma were significantly higher in ischemic stroke patients (11.76±4.94 µmol/L) than in controls (9.21±3.26 µmol/L: p<0.001). In controls, the homocysteine levels were significantly higher in the TT genotype than in the CC+CT genotypes (adjusted odds ratio (AOR), 1.22; 95%CI, 1.11-1.34). When the homocysteine levels were stratified into high (≥11.80 µmol/L), moderate (8.80 to 11.79 µmol/L), and low (<8.80 µmol/L) groups, the AOR was significantly greater in subjects with the high group compared with the low group (AOR, 3.61; 95%CI, 2.63 to 4.95). The AOR and 95% confidence intervals was 1.74 (1.27 to 2.37) for the TT genotype in patients with ischemic stroke compared to controls. Conclusions: We found that the MTHFR C677T polymorphism is an independent risk factor for ischemic stroke in Koreans, and our findings may have the predictive value of ischemic stroke by analyzing genetic defects.
참고문헌 (30)
- Radziszewska B, "Clinical research in primary stroke prevention:needs,opportunities,and challenges", 25, pp.91~104 (2005)
- Clarke R, "Hyperhomocysteinemia:an independent risk factor for vascular disease", 324, pp.1149~1155 (1991)
- Hankey GJ, "Homocysteine and vascular disease", 354, pp.407~413 (1999)
- Markus HS, "A common polymorphism in the methylenetetrahydrofolate reductase gene,homocysteine,and ischemic cerebrovascular disease", 28, pp.1739~1743 (1997)
- Fa bender K, "Homocysteine in cerebral macroangiography and microangiopathy", 353, pp.1586~1587 (1999)
- Brattstrom L, "Common methylenetetrahydrofolate reductase gene mutation leads to hyperhomocysteinemia but not to vascular disease:the result of a meta-analysis", 98, pp.2520~2526 (1998)
- Eikelboom JW, "Association between high homocyst(e)ine and cerebral infarction due to large-and small-artery disease but not other etiologic subtypes of cerebral infarction", 31, pp.1069~1075 (2000)
- Verhoef P, "A prospective study of plasma homocyst(e)ine and risk of ischemic stroke", 25, pp.1924~1930 (1994)
- Demuth K, "Opposite effects of plasma homocysteine and the methylenetetrahydrofolate reductase C677T mutation on carotid artery geometry in asymptomatic adults", 18, pp.1838~1843 (1998)
- Evers S, "Features,symptoms,and neurophysiological findings in stroke associated with hyperhomocysteinemia", 54, pp.1276~1282 (1997)
- Morita H, "Methylenetetrahydrofolate reductase gene polymorphism and ischemic stroke in Japanese", 18, pp.1465~1469 (1998)
- Casas JP, "Meta-analysis of genetic studies in ischemic stroke:thirty-two genes involving approximately 18,000 cases and 58,000 controls", 61, pp.1652~1661 (2004)
- Casas JP, "Homocysteine and stroke:evidence on a causal link from mendelian randomisation", 365, pp.224~232 (2005)
- Frosst P, "A candidate genetic risk factor for vascular disease:a common mutation in methylenetetrahydrofolate reductase", 10, pp.111~113 (1995)
- "cause or effect", pp.315~323
- Homocysteine studies collaboration, "Homocysteine and risk of ischemic heart disease and stroke", 288, pp.2015~2022 (2002)
- Wald DS, "Homocysteine and cardiovascular disease:evidence on causality from a meta-analysis", 325, pp.1202~1206 (2002)
- Choi BO, "Homozygous C677T Mutation in the MTHFR Gene as an Independent Risk Factor for Multiple Small-Artery Occlusions", 111, pp.39~44 (2003)
- Park SM, "Mutant type of methylenetetrahydrofolate reductase gene C677T polymorphism is a risk factor for lacunar infarction case-control study of 457 patients", pp.5~
- Kim SB, "The relationship assessment between hyperhomocysteinemia and C677T MTHFR gene polymorphism in patients with ischemic stroke", 20, pp.346~352 (2002)
- Lee GY, "The relative risk assessment between C677T MTHFR gene polymorphism and multiple celebral infarction Methylenetetrahydroffolate reductase gene polymorphism in Korean patients with migraine or ischemic stroke", pp.176~180
- Goyette P, "Seven novel mutations in the methylenetetrahydrofolate reductase gene and genotype", phenotype correlations in severe methylenetetrahydrofolate reductase deficiency, 1995, pp.56, 1052~1059
- Chango A, "folate status and plasma homocysteine in healthy French adults of the Supplementation en Vitamines et Mineraux Antioxydants", pp.891~896
- McCully KS, "Vascular pathology of homocysteinemia:implications for the pathogenesis of arteriosclerosis", 56, pp.111~128 (1969)
- Homocysteine Lowering Trialists Collaboration, "Lowering blood homocysteine with folic acid based supplements:meta-analysis of randomised trials", 316, pp.894~898 (1998)
- Flammer Y, "Effect of homocysteine-lowering therapy with folic acid and vitamin B6 on clinical outcome after percutaneous coronary intervention", pp.973~979
- Toole JF, "Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke the Vitamin Intervention for Stroke Prevention", mali(w mr), pp.565~575
- VITATOPS trial study group, "Vitamins to Prevent Stroke rationale and design of an international randomised trial of homocysteine-lowering multivitamin theraphy in patients with recent transient ischemic attack or stroke", pp.120~126 (2002)
- Boushey CJ, "A quantitative assessment of plasma homocysteine as a risk factor for vascular disease:probable benefits of increasing folic acid intakes", 274, pp.1049~1057 (1995)
- Malinow MR, "Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease", 338, pp.1009~1015 (1998)
