MYOCARDIAL INFARCT: YOUNG WOMEN: PLASMA HOMOCYSTEINE, FOLATE, MTHFR GENE VARIANT

在一项基于人群的研究中，我们研究了 年轻女性心肌梗死（MI）的风险和血浆 总同型半胱氨酸（tHCY）、叶酸、维生素B-12和一种常见的胞嘧啶 胸腺嘧啶（T）多态性的基因， 5，10-亚甲基四氢叶酸还原酶（MTHFR）。 面对面 从79名妇女中获得了访谈和非空腹血液样本 <45岁诊断为MI，386例人口统计学相似 1991年至1999年间居住在华盛顿州西部的对照组受试者 1995. 与对照组相比，病例组平均 tHcy浓度（13.4 ± 5.2 vs 11.1 ± 4.4 mol/L，P=.0004）和 较低的平均叶酸浓度（12.4 ± 13.4对16.1 ± 12.2 nmol/L， P=0.18）。 维生素B-12浓度无差异 病例组和对照组之间的差异（346.8 ± 188.4 vs349.7 132.4 pmol/L，P= 0.90）。 调整心血管风险后 我们发现，tHCY 15.6 mol/L的妇女在 与tHCY <10.0 mol/L的女性相比， 2.3; 95% CI，0.94至5.64）。 叶酸水平为8.39 nmol/L的女性， 与叶酸<5.27 nmol/L的女性相比，MI的风险较低（OR，0.54; 95% CI，0.23至1.28）。 与维生素B-12无关 浓度. 在对照受试者中，12.7%为纯合子， MTHFR T677等位基因，这些妇女的血浆tHCY水平较高， 血浆叶酸水平高于其他基因型。 百分之十的案件 患者为T677等位基因纯合子， T677纯合性与心肌梗死风险的相关性。 这些数据支持 假设血浆tHCY升高和血浆叶酸水平降低是 年轻女性心肌梗死的危险因素。 虽然纯合性 MTHFR T677与血浆tHCY增加和血浆叶酸水平低有关， 这种遗传特征不是MI的危险因素， 人口

In a population-based study, we examined the relationship between the risk of myocardial infarction (MI) among young women and plasma total homocysteine (tHCY), folate, vitamin B-12, and a common cytosine to thymine (T) polymorphism in the gene for 5,10-methylenetetrahydrofolate reductase (MTHFR). In-person interviews and non-fasting blood samples were obtained from 79 women <45 years old diagnosed with MI and 386 demographically similar control subjects living in western Washington state between 1991 and 1995. Compared with control subjects, case patients had higher mean tHcy concentrations (13.4 5.2 versus 11.1 4.4 mol/L, P=.0004) and lower mean folate concentrations (12.4 13.4 versus 16.1 12.2 nmol/L, P=0.18). There was no difference in vitamin B-12 concentrations between case patients and control subjects (346.8 188.4 versus 349.7 132.4 pmol/L, P=.90). After adjusting for cardiovascular risk factors, we found that women with tHCY 15.6 mol/L were at approximately twice the risk of MI as women with tHCY <10.0 mol/L (OR, 2.3; 95% CI, 0.94 to 5.64). Women with folate 8.39 nmol/L had an ~50% lower risk of MI than women with folate <5.27 nmol/L (OR, 0.54; 95% CI, 0.23 to 1.28). There is no association with vitamin B-12 concentration. Among control subjects, 12.7% were homozygous for the MTHFR T677 allele, and these women had higher plasma tHCY and lower plasma folate than women with other genotypes. Ten percent of case patients were homozygous for the T677 allele, and there was no association of homozygosity for T677 with MI risk. These data support the hypothesis that elevated plasma tHCY and low plasma folate are risk factors for MI among young women. Although homozygosity for MTHFR T677 is related to increased plasma tHCY and low plasma folate, this genetic characteristic is not a risk factor for MI in this population.