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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Arterial Occlusive Disease | Research article

Association of methylenetetrahydrofolate reductase (MTHFR) variant C677T and risk of carotid atherosclerosis: a cross-sectional analysis of 730 Chinese Han adults in Chongqing

Authors: Xulei Peng, Yongli Zhou, Xiaoxing Wu, Xiaolin Wang, Huili Bai, Yongqiang Li, Zhichao Wang, Xuan Chen, Yonghong Wang

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

Uncertainty still remains on the correlation of methylenetetrahydrofolate reductase (MTHFR) variant C677T with risk of carotid atherosclerosis (CAS), and there is a lack of reports on C677T/MTHFR in the Asian population. The association of C677T/MTHFR polymorphisms with CAS in the Chinese Han population in Chongqing was investigated in the present study.

Methods

Subjects (n = 730, 214 females and 516 males, Han ethnicity) who provided an informed consent were randomly selected from the general population of Chongqing, China. Polymerase chain reaction-restriction fragment length polymorphism and Sanger sequencing genotyping assays were used to determine the MTHFR genotypes. The atherosclerosis index of the intima-media thickness (IMT) was measured by high-resolution ultrasound to evaluate the CAS. Less than 1.0 mm was considered as normal for IMT, 1.0–1.5 mm was considered as thickening, and ≥ 1.5 mm and a local bulge thickened in the lumen was considered as CAS. According to the carotid ultrasonography results, these subjects were divided into two groups: CAS-group (IMT ≥ 1.0 mm) and control group (IMT < 1.0 mm).

Results

The frequency of C/T heterozygotes, T/T homozygotes genotype was significantly higher in the subjects with CAS (62% vs. 36.9%; 16.2% vs. 9.5%; 47.2% vs. 27.9%, P < 0.05), while the frequency of C/C homozygotes and C allele was significantly lower (21.8% vs. 53.7%; 52.8% vs. 72.1%, P < 0.05), when compared to the control group. The risk of CAS was higher for subjects with C/T heterozygotes and T/T homozygotes (OR = 4.06, 95% CI: 2.76–5.98, P < 0.001 and OR = 3.14, 95% CI: 1.73–5.69, P < 0.001, respectively), when compared to the subjects with the C/C genotype. In the model 1 (CT + TT versus CC), C677T/MTHFR was significantly associated with the prevalence of CAS, and the all adjusted OR values for CAS were 3.87 (95% CI, 2.67 to 5.62) in all, 17.18 (95% CI, 7.27 to 40.49) in women and 2.57 (95% CI, 1.65 to 3.99) in men after adjusting for potential confounding factors.

Conclusions

The present study suggests that a mutation in the methylenetetrahydrofolate reductase gene is a risk factor of CAS in the Chinese Han population.
Literature
1.
go back to reference Albert SM. Insights on the early-life origins of Alzheimer's disease: relevance for primary prevention? Neuroepidemiology. 2015;45(4):255–6.CrossRef Albert SM. Insights on the early-life origins of Alzheimer's disease: relevance for primary prevention? Neuroepidemiology. 2015;45(4):255–6.CrossRef
2.
go back to reference Skovierova H, Vidomanova E, Mahmood S, Sopkova J, Drgova A, Cervenova T, Halasova E, Lehotsky J. The Molecular and Cellular Effect of Homocysteine Metabolism Imbalance on Human Health. Int J Mol Sci. 2016;17(10):1733. Skovierova H, Vidomanova E, Mahmood S, Sopkova J, Drgova A, Cervenova T, Halasova E, Lehotsky J. The Molecular and Cellular Effect of Homocysteine Metabolism Imbalance on Human Health. Int J Mol Sci. 2016;17(10):1733.
3.
go back to reference Werstuck GH, Lentz SR, Dayal S, ., Hossain GS, Sood SK, Shi YY, Zhou J, ., Maeda N, ., Krisans SK, Malinow MR: Homocysteine-induced endoplasmic reticulum stress causes dysregulation of the cholesterol and triglyceride biosynthetic pathways. J Clin Investig 2001, 107(10):1263.CrossRef Werstuck GH, Lentz SR, Dayal S, ., Hossain GS, Sood SK, Shi YY, Zhou J, ., Maeda N, ., Krisans SK, Malinow MR: Homocysteine-induced endoplasmic reticulum stress causes dysregulation of the cholesterol and triglyceride biosynthetic pathways. J Clin Investig 2001, 107(10):1263.CrossRef
4.
go back to reference Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, Boers GJ, den Heijer M, Kluijtmans LA, van den Heuvel LP, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet. 1995;10(1):111–3.CrossRef Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, Boers GJ, den Heijer M, Kluijtmans LA, van den Heuvel LP, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet. 1995;10(1):111–3.CrossRef
5.
go back to reference Bennouar N, Allami A, Azeddoug H, Bendris A, Laraqui A, El Jaffali A, El Kadiri N, Benzidia R, Benomar A, Fellat S, et al. Thermolabile methylenetetrahydrofolate reductase C677T polymorphism and homocysteine are risk factors for coronary artery disease in Moroccan population. J Biomed Biotechnol. 2007;2007(1):80687.PubMedPubMedCentral Bennouar N, Allami A, Azeddoug H, Bendris A, Laraqui A, El Jaffali A, El Kadiri N, Benzidia R, Benomar A, Fellat S, et al. Thermolabile methylenetetrahydrofolate reductase C677T polymorphism and homocysteine are risk factors for coronary artery disease in Moroccan population. J Biomed Biotechnol. 2007;2007(1):80687.PubMedPubMedCentral
6.
go back to reference Morita H, Kurihara H, Tsubaki S, Sugiyama T, Hamada C, Kurihara Y, Shindo T, Oh-Hashi Y, Kitamura K, Yazaki Y. Methylenetetrahydrofolate reductase gene polymorphism and ischemic stroke in Japanese. Arterioscler Thromb Vasc Biol. 1998;18(9):1465.CrossRef Morita H, Kurihara H, Tsubaki S, Sugiyama T, Hamada C, Kurihara Y, Shindo T, Oh-Hashi Y, Kitamura K, Yazaki Y. Methylenetetrahydrofolate reductase gene polymorphism and ischemic stroke in Japanese. Arterioscler Thromb Vasc Biol. 1998;18(9):1465.CrossRef
7.
go back to reference Spence JD, Malinow MR, Barnett PA, Marian AJ, Freeman D, Hegele RA. Plasma homocyst(e) ine concentration, but not MTHFR genotype, is associated with variation in carotid plaque area. Stroke. 1999;30(5):969–73.CrossRef Spence JD, Malinow MR, Barnett PA, Marian AJ, Freeman D, Hegele RA. Plasma homocyst(e) ine concentration, but not MTHFR genotype, is associated with variation in carotid plaque area. Stroke. 1999;30(5):969–73.CrossRef
8.
go back to reference China. CoC-C-VDoGSo, Association CCoCPoCMD. Chinese expert consensus on the diagnosis and treatment of hypertension in the elderly(2017). Chin J Intern Med. 2017;56(11):885–93. China. CoC-C-VDoGSo, Association CCoCPoCMD. Chinese expert consensus on the diagnosis and treatment of hypertension in the elderly(2017). Chin J Intern Med. 2017;56(11):885–93.
9.
go back to reference Dyslipidemia JCftRotGfPaTo. Guidelines for the prevention and treatment of dyslipidemia in Chinese adults (revised 2016). Chin Circ J. 2016;16(10):15–35. Dyslipidemia JCftRotGfPaTo. Guidelines for the prevention and treatment of dyslipidemia in Chinese adults (revised 2016). Chin Circ J. 2016;16(10):15–35.
10.
go back to reference Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, Mcdonald JM, Marian P. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;57(6):436–72.CrossRef Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, Mcdonald JM, Marian P. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;57(6):436–72.CrossRef
11.
go back to reference Malinow MR, Bostom AG, Krauss RM. Homocyst(e) ine, diet, and cardiovascular diseases: a statement for healthcare professionals from the nutrition committee, American Heart Association. Circulation. 1999;99(1):178–82.CrossRef Malinow MR, Bostom AG, Krauss RM. Homocyst(e) ine, diet, and cardiovascular diseases: a statement for healthcare professionals from the nutrition committee, American Heart Association. Circulation. 1999;99(1):178–82.CrossRef
12.
go back to reference Hu EA, Steffen LM, Grams ME, Crews DC, Coresh J, Appel LJ, Rebholz CM. Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Am J Clin Nutr. 2019;110(3):713–21. Hu EA, Steffen LM, Grams ME, Crews DC, Coresh J, Appel LJ, Rebholz CM. Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Am J Clin Nutr. 2019;110(3):713–21.
13.
go back to reference Lechner K, von Schacky C, McKenzie AL, Worm N, Nixdorff U, Lechner B, Krankel N, Halle M, Krauss RM, Scherr J. Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. Eur J Prev Cardiol. 2020;27(4):394-406. Lechner K, von Schacky C, McKenzie AL, Worm N, Nixdorff U, Lechner B, Krankel N, Halle M, Krauss RM, Scherr J. Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. Eur J Prev Cardiol. 2020;27(4):394-406.
14.
go back to reference Clarke R, Daly L, Robinson K, Naughten E, Cahalane S, Fowler B, Graham I. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med. 1991;324(17):1149.CrossRef Clarke R, Daly L, Robinson K, Naughten E, Cahalane S, Fowler B, Graham I. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med. 1991;324(17):1149.CrossRef
15.
go back to reference Nozomu I, Tomohiro K, Yoshihiro K, Toshifumi M, Takashi A, Shunroku B, Jun O, Hitonobu T, Toshio O. Association of methylenetetrahydrofolate reductase gene polymorphism with carotid atherosclerosis depending on smoking status in a Japanese general population. Stroke. 2003;34(7):1628–33.CrossRef Nozomu I, Tomohiro K, Yoshihiro K, Toshifumi M, Takashi A, Shunroku B, Jun O, Hitonobu T, Toshio O. Association of methylenetetrahydrofolate reductase gene polymorphism with carotid atherosclerosis depending on smoking status in a Japanese general population. Stroke. 2003;34(7):1628–33.CrossRef
16.
go back to reference Kawamoto R, Kohara K, Tabara Y, Miki T, Doi T, Tokunaga H, Konishi I. An association of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and common carotid atherosclerosis. J Hum Genet. 2001;46(9):506–10.CrossRef Kawamoto R, Kohara K, Tabara Y, Miki T, Doi T, Tokunaga H, Konishi I. An association of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and common carotid atherosclerosis. J Hum Genet. 2001;46(9):506–10.CrossRef
17.
go back to reference Pramukarso DT, Faradz SM, Sari S, Hadisaputro S. Association between methylenetetrahydrofolate reductase (MTHFR) polymorphism and carotid intima medial thickness progression in post ischaemic stroke patient. Ann Transl Med. 2015;3(21):324.PubMedPubMedCentral Pramukarso DT, Faradz SM, Sari S, Hadisaputro S. Association between methylenetetrahydrofolate reductase (MTHFR) polymorphism and carotid intima medial thickness progression in post ischaemic stroke patient. Ann Transl Med. 2015;3(21):324.PubMedPubMedCentral
18.
go back to reference Jain M, Pandey P, Tiwary NK, Jain S. MTHFR C677T polymorphism is associated with hyperlipidemia in women with polycystic ovary syndrome. J Hum Reprod Sci. 2012;5(1):52–6.CrossRef Jain M, Pandey P, Tiwary NK, Jain S. MTHFR C677T polymorphism is associated with hyperlipidemia in women with polycystic ovary syndrome. J Hum Reprod Sci. 2012;5(1):52–6.CrossRef
19.
go back to reference Hanson NQ, Aras O, Yang F, Tsai MY. C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase gene: incidence and effect of combined genotypes on plasma fasting and post-methionine load homocysteine in vascular disease. Clin Chem. 2001;47(4):661–6.CrossRef Hanson NQ, Aras O, Yang F, Tsai MY. C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase gene: incidence and effect of combined genotypes on plasma fasting and post-methionine load homocysteine in vascular disease. Clin Chem. 2001;47(4):661–6.CrossRef
20.
go back to reference Maria Grazia A, Nicoletta B, Franca C, Debora B, Elisabetta A, Serena M, Samantha M, Maria Giovanna C, Andrea B, Aldo C. Methylenetetrahydrofolate reductase gene C677T polymorphism, homocysteine, vitamin B12, and DNA damage in coronary artery disease. Hum Genet. 2003;112(2):171–7.CrossRef Maria Grazia A, Nicoletta B, Franca C, Debora B, Elisabetta A, Serena M, Samantha M, Maria Giovanna C, Andrea B, Aldo C. Methylenetetrahydrofolate reductase gene C677T polymorphism, homocysteine, vitamin B12, and DNA damage in coronary artery disease. Hum Genet. 2003;112(2):171–7.CrossRef
21.
go back to reference Bharatkumar VP, Nagaraja D, Christopher R. Hyperhomocysteinemia and methylenetetrahydrofolate reductase C677T polymorphism in cerebral veno-sinus thrombosis. Clin Appl Thromb Hemost. 2014;20(1):78–83.CrossRef Bharatkumar VP, Nagaraja D, Christopher R. Hyperhomocysteinemia and methylenetetrahydrofolate reductase C677T polymorphism in cerebral veno-sinus thrombosis. Clin Appl Thromb Hemost. 2014;20(1):78–83.CrossRef
22.
go back to reference Yan-Yan L. Relationship of serum homocysteine and high sensitivity C-reactive protein in elderly people with essential hypertension. Int J Clin Pract. 2010;64(9):1318–9.CrossRef Yan-Yan L. Relationship of serum homocysteine and high sensitivity C-reactive protein in elderly people with essential hypertension. Int J Clin Pract. 2010;64(9):1318–9.CrossRef
23.
go back to reference Sethi AS, Lees DM, Douthwaite JA, Dawnay AB, Corder R. Homocysteine-induced endothelin-1 release is dependent on hyperglycaemia and reactive oxygen species production in bovine aortic endothelial cells. J Vasc Res. 2006;43(2):175–83.CrossRef Sethi AS, Lees DM, Douthwaite JA, Dawnay AB, Corder R. Homocysteine-induced endothelin-1 release is dependent on hyperglycaemia and reactive oxygen species production in bovine aortic endothelial cells. J Vasc Res. 2006;43(2):175–83.CrossRef
24.
go back to reference Kloppenborg RP, Nederkoorn PJ, Graaf YVD, Geerlings MI. Homocysteine and cerebral small vessel disease in patients with symptomatic atherosclerotic disease. The SMART-MR study. Atherosclerosis. 2011;216(2):461–6.CrossRef Kloppenborg RP, Nederkoorn PJ, Graaf YVD, Geerlings MI. Homocysteine and cerebral small vessel disease in patients with symptomatic atherosclerotic disease. The SMART-MR study. Atherosclerosis. 2011;216(2):461–6.CrossRef
25.
go back to reference Codoñer-Franch P, Tavárez-Alonso S, Murria-Estal R, Megías-Vericat J, Tortajada-Girbés M, Alonso-Iglesias E. Nitric oxide production is increased in severely obese children and related to markers of oxidative stress and inflammation. Atherosclerosis. 2011;215(2):475–80.CrossRef Codoñer-Franch P, Tavárez-Alonso S, Murria-Estal R, Megías-Vericat J, Tortajada-Girbés M, Alonso-Iglesias E. Nitric oxide production is increased in severely obese children and related to markers of oxidative stress and inflammation. Atherosclerosis. 2011;215(2):475–80.CrossRef
26.
go back to reference Ma J, Stampfer MJ, Hennekens CH, Frosst P, Selhub J, Horsford J, Malinow MR, Willett WC, Rozen R. Methylenetetrahydrofolate reductase polymorphism, plasma folate, homocysteine, and risk of myocardial infarction in US physicians. Circulation. 1996;94(10):2410–6.CrossRef Ma J, Stampfer MJ, Hennekens CH, Frosst P, Selhub J, Horsford J, Malinow MR, Willett WC, Rozen R. Methylenetetrahydrofolate reductase polymorphism, plasma folate, homocysteine, and risk of myocardial infarction in US physicians. Circulation. 1996;94(10):2410–6.CrossRef
27.
go back to reference Harmon DL, Woodside JV, Yarnell JW, Mcmaster D, ., Young IS, Mccrum EE, Gey KF, Whitehead AS, Evans AE: The common 'thermolabile' variant of methylene tetrahydrofolate reductase is a major determinant of mild hyperhomocysteinaemia. Qjm 1996, 89(8):571–577.CrossRef Harmon DL, Woodside JV, Yarnell JW, Mcmaster D, ., Young IS, Mccrum EE, Gey KF, Whitehead AS, Evans AE: The common 'thermolabile' variant of methylene tetrahydrofolate reductase is a major determinant of mild hyperhomocysteinaemia. Qjm 1996, 89(8):571–577.CrossRef
28.
go back to reference Jacques PF, Bostom AG, Williams RR, Ellison RC, Eckfeldt JH, Rosenberg IH, Selhub J, ., Rozen R, . Relation between folate status, a common mutation in methylenetetrahydrofolate reductase, and plasma homocysteine concentrations. Circulation 1996, 93(1):7.CrossRef Jacques PF, Bostom AG, Williams RR, Ellison RC, Eckfeldt JH, Rosenberg IH, Selhub J, ., Rozen R, . Relation between folate status, a common mutation in methylenetetrahydrofolate reductase, and plasma homocysteine concentrations. Circulation 1996, 93(1):7.CrossRef
29.
go back to reference Dierkes J, Jeckel A, Ambrosch A, Westphal S, Luley C, Boeing H. Factors explaining the difference of total homocysteine between men and women in the European investigation into Cancer and nutrition Potsdam study. Metab Clin Exp. 2001;50(6):640–5.CrossRef Dierkes J, Jeckel A, Ambrosch A, Westphal S, Luley C, Boeing H. Factors explaining the difference of total homocysteine between men and women in the European investigation into Cancer and nutrition Potsdam study. Metab Clin Exp. 2001;50(6):640–5.CrossRef
30.
go back to reference Malinow MR, Duell PB, Hess DL, Anderson PH, Kruger WD, Phillipson BE, Gluckman RA, Block PC, Upson BM. Reduction of plasma homocyst(e) ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med. 1998;338(15):1009.CrossRef Malinow MR, Duell PB, Hess DL, Anderson PH, Kruger WD, Phillipson BE, Gluckman RA, Block PC, Upson BM. Reduction of plasma homocyst(e) ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med. 1998;338(15):1009.CrossRef
31.
go back to reference Efird JT, Hong MK. Computing differential sample size for case-control studies of gene-environment interaction. Ethn Dis. 2008;18(2 Suppl 2):S2 -25-29.PubMed Efird JT, Hong MK. Computing differential sample size for case-control studies of gene-environment interaction. Ethn Dis. 2008;18(2 Suppl 2):S2 -25-29.PubMed
32.
go back to reference Hamajima N, Mutoh H, Eguchi H, Honda H. Minimal sizes of cases with a susceptible genotype and minimal odds ratios among susceptible individuals in case-control studies. Asian Pac J Cancer Prev. 2005;6(2):165–9.PubMed Hamajima N, Mutoh H, Eguchi H, Honda H. Minimal sizes of cases with a susceptible genotype and minimal odds ratios among susceptible individuals in case-control studies. Asian Pac J Cancer Prev. 2005;6(2):165–9.PubMed
33.
go back to reference Senemar S, Saffari B, Sharifkazemi MB, Bahari M, Jooyan N, Dehaghani ED, Yavarian M. 5,10-methylene tetrahydrofolate reductase C677T gene polymorphism, homocysteine concentration and the extent of premature coronary artery disease in southern Iran. EXCLI J. 2013;12:437–48.PubMedPubMedCentral Senemar S, Saffari B, Sharifkazemi MB, Bahari M, Jooyan N, Dehaghani ED, Yavarian M. 5,10-methylene tetrahydrofolate reductase C677T gene polymorphism, homocysteine concentration and the extent of premature coronary artery disease in southern Iran. EXCLI J. 2013;12:437–48.PubMedPubMedCentral
34.
go back to reference Abd El-Aziz TA, Mohamed RH. Influence of MTHFR C677T gene polymorphism in the development of cardiovascular disease in Egyptian patients with rheumatoid arthritis. Gene. 2017;610:127–32.CrossRef Abd El-Aziz TA, Mohamed RH. Influence of MTHFR C677T gene polymorphism in the development of cardiovascular disease in Egyptian patients with rheumatoid arthritis. Gene. 2017;610:127–32.CrossRef
Metadata
Title
Association of methylenetetrahydrofolate reductase (MTHFR) variant C677T and risk of carotid atherosclerosis: a cross-sectional analysis of 730 Chinese Han adults in Chongqing
Authors
Xulei Peng
Yongli Zhou
Xiaoxing Wu
Xiaolin Wang
Huili Bai
Yongqiang Li
Zhichao Wang
Xuan Chen
Yonghong Wang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01505-1

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