中青年急性心肌梗死与MTHFR基因多态性及血浆Hcy水平的相关性  

Associations of young and middle-aged acute myocardial infarction with MTHFR gene polymorphism and plasma homocysteine level

作　　者：郑丽梅[1] 李大鹏[1] 张桂霞[1] 张明亮[1] ZHENG Li-mei;LI Da-peng;ZHANG Gui-xia;ZHANG Ming-liang(Second Division of Cardiology Department,Jiamusi Central Hospital,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]佳木斯市中心医院心内二科

出　　处：《中国临床研究》2019年第5期604-607,共4页Chinese Journal of Clinical Research

基　　金：黑龙江省卫生计生委科研课题(2017-424);佳木斯市2017年度重点科研课题(170160)~~

摘　　要：目的探讨中青年人急性心肌梗死(AMI)与亚甲基四氢叶酸还原酶(MTHFR)基因多态性及血浆同型半胱氨酸(Hcy)水平的相关性。方法选择2017年3月至2018年6月接受治疗的中青年AMI患者95例及同期体检的健康者88例为研究对象。采集研究对象空腹静脉血进行检测,收集血清检测叶酸、维生素B12(VitB12)、血尿酸(UA)水平,收集血浆测定Hcy水平,提取白细胞中基因组DNA,检测MTHFR基因C677T位点的多态性;采用Spearman法对MTHFR基因多态性及Hcy水平进行相关性分析,对影响AMI的因素进行Logistic回归分析。结果心肌梗死组高血压比例、高血糖比例及Hcy水平高于对照组,UA、VitB12及叶酸水平低于对照组(P<0.05,P<0.01)。两组基因型分布有显著统计学差异(P<0.01),心肌梗死组T/T基因型比例最高,对照组C/T基因型比例最高;心肌梗死组的C等位基因频率低于对照组,T等位基因频率高于对照组(P<0.05);在对照组中T/T基因型的Hcy水平显著高于C/C基因型(P<0.05);心肌梗死组中Hcy水平呈T/T基因型>C/T基因型>C/C基因型(P<0.05)。Spearman相关性分析结果显示,MTHFR基因C677T位点多态性与Hcy水平显著相关(r=0.689,P=0.000),调整年龄、性别、BMI、吸烟史、饮酒、血压等影响因素后,MTHFR基因C677T多态性与Hcy水平有相关性(r=0.645,P=0.000);Logistic回归分析结果显示,高血压、高血糖、高Hcy水平均是影响AMI的独立危险因素,而UA、VitB12、叶酸均是AMI的保护因素,血浆高Hcy水平患者的AMI发病风险是血浆Hcy正常者的2.336倍。结论中青年人AMI与MTHFR基因C677T的多态性、血清Hcy水平升高均密切相关,其均是导致AMI的危险因素。Objective To investigate the associations of methylenetetrahydrofolate reductase ( MTHFR ) gene polymorphism and plasma homocysteine ( Hcy) level with young and middle-aged acute myocardial infarction ( AMI).Methods Ninety-five young and middle-aged AMI patients( AMI group) treated from March 2017 to June 2018 and 88 healthy people( control group) at the same time were selected as the subjects.Fasting venous blood was collected for serum detection of folic acid,vitamin B12 ( VitB12 ) and uric acid ( UA) and plasma detection of Hcy.Genomic DNA was extracted from white blood cells,and MTHFR gene C677T locus polymorphism was detected.Spearman method was used to analyze the correlation between MTHFR gene polymorphism and Hcy level.Logistic regression analysis was used to analyze the influencing factors of AMI.Results The proportion of patients with hypertension and hyperglycemia in AMI group was significantly higher than those in control group( P < 0.05,P < 0.01).Compared with control group,the levels of UA,VitB12 and folic acid decreased,and the level of Hcy increased significantly in AMI group ( P < 0.05, P < 0.01).There were significant differences in genotypes between the two groups( P < 0.01).The proportion of T /T genotype was highest in MI group and the C /T genotype was highest in the control group.C allele frequency in AMI group was significantly lower and T allele frequency was significantly higher than that in control group ( P < 0.05).In control group,Hcy level of T /T genotype was significantly higher than that of C/C genotype( P < 0.05).Hcy levels in AMI group were T/T genotype > C/T genotype > C/C genotype( P < 0.05).Spearman correlation analysis showed that MTHFR gene polymorphism was correlated with Hcy level ( r = 0.689, P = 0.000).After adjusting for age, sex, BMI, smoking history, alcohol consumption and blood pressure,the correlation between them remained ( r = 0.645, P = 0.000 ).Logistic regression analysis showed that hypertension,hyperglycemia and high Hcy level were the independent risk facto

关 键 词：急性心肌梗死 同型半胱氨酸 亚甲基四氢叶酸还原酶基因多态性 相关性 

分 类 号：R542.22[医药卫生—心血管疾病]