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

在一项以人口为基础的研究中，我们研究了 年轻女性与血浆心肌梗死(MI)的风险 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)在基因中的多态 5，10-亚甲基四氢叶酸还原酶(MTHFR)。面对面 访谈和非禁食血液样本来自79名妇女 &lt；45岁被诊断为心肌梗塞，386人人口统计相似 受试者生活在华盛顿州西部，1991年至 1995年。与对照受试者相比，病例患者的平均分更高 总同型半胱氨酸浓度(13.4±5.2比11.1±4.4)mol/L，P=.0004； 较低的平均叶酸浓度(12.4 13.4对16.112.2nmol/L， P=0.18)。维生素B-12的浓度没有差异 病例患者和对照受试者之间的差异(346.8 188.4比349.7 132.4 pmol/L，P=0.90)。在对心血管风险进行调整后 因素，我们发现tHCY 15.6mol/L的女性在 患心肌梗死的风险大约是患有10.0mol/L(或， 2.3；95%可信区间为0.94~5.64)。叶酸为8.39nmol/L的女性有~50%的 患心肌梗死的风险比服用叶酸的女性低5.27nmol/L(OR，0.54%；95% CI，0.23至1.28)。与维生素B-12无关 集中精神。在对照组中，12.7%的受试者为纯合子 MTHFR T677等位基因，这些女性的血浆tHCY水平较高，而血浆tHCY水平较低 血浆叶酸水平高于其他基因型的女性。10%的案例 患者为T677等位基因纯合子，没有 T677纯合子与心肌梗死风险的相关性。这些数据支持 假设血浆tHCY升高和血浆叶酸降低是 年轻女性心肌梗死的危险因素。虽然纯合性对于 MTHFR T677与血浆tHCY升高和血浆叶酸降低有关， 这种遗传特征不是心肌梗死的危险因素。 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.