Role of methylenetetrahydrofolate reductase 677C→T polymorphism in the development of myocardial infarction: evidence from an original study and updated meta-analysis
Role of methylenetetrahydrofolate reductase 677C→T polymorphism in the development of myocardial infarction: evidence from an original study and updated meta-analysis
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DOI：
10.1007/s13258-016-0424-4
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发表时间：
2016-05
期刊：
影响因子：
2.1
通讯作者：
Wenbin Zhang;Min Wang;Pei Zhang;Zhimin Xue;G. Fu;J. Ge;Yi Luan
中科院分区：
文献类型：
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作者：
Wenbin Zhang;Min Wang;Pei Zhang;Zhimin Xue;G. Fu;J. Ge;Yi Luan
亚甲基四氢叶酸还原酶（MTHFR）基因变异677C→T被认为是白种人心肌梗死（MI）的危险因素，但尚不清楚这是否适用于中国人或其他亚洲人群。总共招募了551名对照和304名年龄匹配的中国心肌梗死患者。测定MTHFR基因型。随后进行了一项荟萃分析，以确定亚洲MTHFR与心肌梗死之间的关系。高血压、糖尿病、低密度脂蛋白等常规危险因素在两组间无显著差异。病例和对照的基因型频率符合Hardy-Weinberg平衡。心肌梗死患者CC、CT和TT基因型的频率分别为28、46和26 %，对照组为31、52和17 % （p= 0.006）。心肌梗死患者的t等位基因频率高于对照组（49比43%，优势比= 0.785,95%可信区间= 0.644-0.958,p= 0.017）。包括本研究在内，共纳入16项研究，涉及4053例患者和6791例对照。MTHFR 677C→T多态性的隐性基因型模型与亚洲人更高的心肌梗死风险显著相关，而非显性基因型模型。TT纯合子与CC野生型、CT杂合子以及CT和CC组合相比，心肌梗死风险分别增加了48%、37%和47%。因此，我们得出结论，MTHFR基因变异677C→T是中国人群心肌梗死的危险因素，而TT基因型与亚洲人群心肌梗死风险显著增加有关。
The methylenetetrahydrofolate reductase (MTHFR) gene variant 677C→T is considered a risk factor for myocardial infarction (MI) in Caucasians, but it remains unclear whether this applies to Chinese or other Asian populations. A total of 551 controls and 304 age-matched Chinese MI patients were recruited. MTHFR genotypes were determined. A subsequent meta-analysis was performed to determine the association between MTHFR and MI in Asia. Conventional risk factors such as hypertension, diabetes mellitus and low-density lipoprotein exhibited no significant differences between the two groups. Genotype frequencies among cases and controls were compatible with Hardy–Weinberg equilibrium. The frequencies of CC, CT and TT genotypes were 28, 46 and 26 % for patients with MI and 31, 52 and 17 % for the matched control group (p= 0.006). T-allele frequency in MI patients was higher than in controls (49 vs. 43 %, odds ratio = 0.785, 95 % confidence interval = 0.644–0.958,p= 0.017). A total of 16 studies including ours were identified, involving 4053 patients and 6791 controls. A recessive genotype model of MTHFR 677C→T polymorphism, but not a dominant genotype model, was significantly associated with greater MI risk in Asians. MI risk increased 48, 37 and 47 % for the TT homozygote compared with the CC wild type, CT heterozygote and the combination of CT and CC. Thus, we conclude that the MTHFR gene variant 677C→T is a risk factor for MI in the Chinese population and the TT genotype is associated with a significant increase in MI risk in Asia.