A prospective cohort study of MTHFR C677T gene polymorphism and its influence on the therapeutic effect of homocysteine in stroke patients with hyperhomocysteinemia

Abstract

Background: Hyperhomocysteinemia (HHCY) is a risk factor for cardiovascular and cerebrovascular diseases. The C677T 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism increases homocysteine (HCY) levels. This study analyzed the relationship between C677T MTHFR polymorphism and the therapeutic effect of lowering HCY in stroke patients with HHCY. Methods: Baseline data were collected from stroke patients with HHCY for this prospective cohort study. The C677T MTHFR genotype was detected by polymerase chain reaction-restriction fragment length polymorphism and the therapeutic effect to reduce HCY was compared. Results: Of 200 stroke patients 162 (81.0%) completed follow-up and were evaluated. Most of them responded well to treatment (103 cases, 63.5%), but 59 (36.4%) patients were in the poor efficacy group. There was a significant difference in terms of age (P < 0.001), hypertension (P = 0.041), hyperuricemia (P = 0.042), HCY after treatment (P < 0.001), and MTHFR genotype (P < 0.001) between the poor efficacy and effective groups, with increased frequency of the TT genotype in the poor efficacy group. Logistic regression showed that the T allele was associated with poor efficacy (OR = 0.733, 95%CI: 0.693, 0.862, P < 0.001). In the codominant model the TT genotype was associated with poor outcome (OR = 0.862, 95%CI: 0.767, 0.970, P = 0.017) and this was also the case in the recessive model (OR = 0.585, 95%CI: 0.462, 0.741, P < 0.001) but there was no association between CT and TT in the dominant model. Conclusions: The T allele and TT genotype of the MTHFR C677T polymorphism was associated with poor HCY reduction treatment efficacy in stroke patients with HHCY.

Association Of the Methylene Tetrahydrofolate Reductase (MTHFR) Gene Polymorphism with Susceptibility to Recurrence of Cardiovascular Outcomes Among Ischemic Stroke- A Randomized Controlled Trial

“…11; 15 The present study findings showed that the combined frequency of CT genotype was 14.4% from MTHFR C677T polymorphism. A slightly higher frequency found in previous studies among hyperhomocysteinemia with cardiovascular patients of CT genotype frequency as 23% in Pakistan, 16 30.4% in South India, 8 52% in West India, 31% in China, 17 and 41% in Italy. 18 Although these studies did not have the same comparator group as in the present study, which includes hyperhomocysteinemia among ischemic stroke between both vitamin and control, groups, which leads to variation in the frequency of MTHFR polymorphism.…”

Traditional risk factors and combined genetic markers of recurrent ischemic stroke in adults

“…This polymorphism was significantly associated with ischemic stroke recurrence in our study. In various studies MTHFR polymorphisms were linked to elevated homocysteine levels 31 . Zhang et al suggest that hyperhomocysteinemia can predict the risk of stroke recurrence and mortality in patients with stroke 32 .…”

“…In various studies MTHFR polymorphisms were linked to elevated homocysteine levels. 31 Zhang et al suggest that hyperhomocysteinemia can predict the risk of stroke recurrence and mortality in patients with stroke. 32 Previous studies have…”

Relationship between MTHFR C677T, homocysteine, and ischemic stroke in a large sample of the Han Chinese population

“…This result is consistent with previous reports. [27][28][29] One possible explanation is that the MTHFR C677T variant increases the risk of developing ischemic stroke, at least in part, by elevating homocysteine levels.…”