Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis patients without Helicobacter pylori infection : a case control study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:italic>Background:</jats:italic> Previous reports indicate that the methylenetetrahydrofolate reductase (MTHFR) 677C&gt;T polymorphism plays a role in gastric cancer. However, whether it influences the development and progression of atrophic gastritis remains unclear. We aimed to determine the possible association between the MTHFR 677C&gt;T polymorphism and the severity of atrophic gastritis.<jats:italic>Methods:</jats:italic> A total 128 patients without<jats:italic> Helicobacter pylori</jats:italic> infection were included in the study. The presence and severity of gastric atrophy was assessed by histology using OLGA and OLGIM Gastritis Staging System. MTHFR 677C&gt;T genotyping was performed by digital fluorescence molecular hybridization. Categorical variables were analyzed by percentages using the χ<jats:sup>2</jats:sup> test.<jats:italic>Results:</jats:italic> In this study, the TT genotype was significantly more frequent among <jats:italic>Helicobacter pylori</jats:italic>-negative patients aged ≤44 years (age ≤44 years vs. &gt;44 years, P=0.039). Patients with the TT genotype showed a higher ratio of incisura with atrophy or intestinal metaplasia (TT vs. CC+CT, P=0.02). Furthermore, the TT genotype was associated with more severe lesions compared with the CC+CT genotypes (TT vs. CC+CT for atrophy: P=0.07; for intestinal metaplasia: P=0.01; for moderate-to-severe lesions: P=0.01). OLGA and OLGIM stages III-IV were observed more frequently in patients with the TT genotype compared with the CC+CT genotypes (for OLGA: P=0.003; for OLGIM: P=0.036).<jats:italic>Conclusions:</jats:italic> The MTHFR 677C&gt;T TT genotype showed an increased risk of moderate-to-severe lesions by OLGA and OLGIM stages, and these results suggest that the MTHFR C677T polymorphism may serve as a predictive marker for precancerous gastric lesions, especially in <jats:italic>Helicobacter pylori</jats:italic>-negative patients aged ≤44 years.</jats:p>

The combination of methylenehydrofolate reductase C677T polymorphism screening and gastrointestinal tumor markers detection may be an early screening method for gastrointestinal cancer related to helicobacter pylori infection

“…Our study confirmed that H.pylori infection was related to gender and age. 38 Our study also found that the blood pressure (BP) in patients with H.pylori infection were higher than those without H.pylori infection. It was suggested that H.pylori infection might be a risk factor for cardiovascular and cerebrovascular diseases, 43 , 44 although the BP was in the normal range.…”

“…This is similar to a study that TT genotype increases moderate to severe atrophic gastritis and gastric mucosal intestinal metaplasia in Chinese Han population without H.pylori infection. 38 Although many studies have shown that MTHFR C677T polymorphism was associated with gastrointestinal cancer, the specific relationship was not clear. 18 , 38 , 39 We speculated that the specificity of MTFHR C677T polymorphism for gastrointestinal cancer during H.pylori infection might be related to the site of cancer origin.…”

“… 38 Although many studies have shown that MTHFR C677T polymorphism was associated with gastrointestinal cancer, the specific relationship was not clear. 18 , 38 , 39 We speculated that the specificity of MTFHR C677T polymorphism for gastrointestinal cancer during H.pylori infection might be related to the site of cancer origin. 19 , 40 The previous studies have reported that there was association between MTHFR C677T polymorphism and gastric cancer in Chongqing, and CT and TT genotypes were protective factors for gastric cardia cancer, and TT genotype was a risk factor for gastric body cancer.…”