Skip to main content
Top
Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Stroke | Research article

The association of MTHFR C677T variant with increased risk of ischemic stroke in the elderly population: a meta-analysis of observational studies

Authors: Guilin Chang, Zheng Kuai, Jia Wang, Jiayu Wu, Kan Xu, Ying Yuan, Yu Hu

Published in: BMC Geriatrics | Issue 1/2019

Login to get access

Abstract

Background

C677T point mutation in methylenetetrahydrofolate reductase (MTHFR) gene have been found to be associated with ischemic stroke in general population, while the results seem inconsistent. We aim to assess the association between variant MTHFR C677T variant and increased risk of ischemic stroke and focus on the elderly population.

Methods

We searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies. Odds ratios (ORs) were calculated with the two-tailed 95% confidence intervals (CIs) by using a random effects model to evaluate any possible association. Among the Chinese and non-Chinese populations, we conducted a subgroup analysis.

Results

The electronic database search yielded 1,358 citations as of December 2017; finally, nine case-control studies involving 3,337 subjects fulfilled our eligibility criteria for inclusion in the study. The pooled results showed that MTHFR C677T variant increased the risk of ischemic stroke (OR = 1.23, 95%CI 1.06–1.43, P = 0.0067 for CT + TT vs. CC; OR = 1.18, 95%CI 1.01–1.38, P = 0.0333 for CT vs. CC; OR = 1.41, 95%CI 1.14–1.75, P = 0.0016 for TT vs. CC; OR = 1.27, 95%CI 1.05–1.54, P = 0.0145 for TT vs. CC + CT; OR = 1.18, 95%CI 1.06–1.31, P = 0.0023 for T-allele vs. C-allele). Further subgroup analyses in the Chinese population indicated that MTHFR C677T variant was associated with a higher risk of ischemic stroke.

Conclusion

Our findings showed that T-allele increases risk for stroke in the pooled sample. This association was statistically significant in the Chinese cohorts and showed a similar trend in the non-Chinese cohorts. (Word count: 237).
Literature
1.
go back to reference Amal Al-Hashmi. Stroke is the second leading cause of mortality worldwide and is the most common cause of long term disability, J Neurol Neurophysiol. 2016, 7:4 (Suppl). Amal Al-Hashmi. Stroke is the second leading cause of mortality worldwide and is the most common cause of long term disability, J Neurol Neurophysiol. 2016, 7:4 (Suppl).
2.
go back to reference Marini C, Triggiani L, Cimini N, Ciancarelli I, De Santis F, Russo T, Baldassarre M, di Orio F, Carolei A. Proportion of older people in the community as predictor of increasing stroke incidence. Neuroepidemiology. 2001 May;20(2):91–5.CrossRef Marini C, Triggiani L, Cimini N, Ciancarelli I, De Santis F, Russo T, Baldassarre M, di Orio F, Carolei A. Proportion of older people in the community as predictor of increasing stroke incidence. Neuroepidemiology. 2001 May;20(2):91–5.CrossRef
3.
go back to reference Yao X-y, Lin Y, Geng J-l, Sun Y-m, Chen Y, Shi G-w, Xu Q, Li Y-s. Age- and gender-specific prevalence of risk factors in patients with first-ever ischemic stroke in China. Stroke Res Treat. 2012;2012:136398.PubMedPubMedCentral Yao X-y, Lin Y, Geng J-l, Sun Y-m, Chen Y, Shi G-w, Xu Q, Li Y-s. Age- and gender-specific prevalence of risk factors in patients with first-ever ischemic stroke in China. Stroke Res Treat. 2012;2012:136398.PubMedPubMedCentral
4.
go back to reference Wang Z, Hu S, Sang S, Luo L, Chuanhua Y. Age–period–cohort analysis of stroke mortality in China. Stroke. 2017;48:271–5.CrossRef Wang Z, Hu S, Sang S, Luo L, Chuanhua Y. Age–period–cohort analysis of stroke mortality in China. Stroke. 2017;48:271–5.CrossRef
5.
go back to reference Wu X, Zhu B, Fu L, Wang H, Zhou B, Zou S, Shi J. Prevalence, incidence, and mortality of stroke in the Chinese island populations: a systematic review. PLoS One. 2013 Nov 8;8(11):e78629.CrossRef Wu X, Zhu B, Fu L, Wang H, Zhou B, Zou S, Shi J. Prevalence, incidence, and mortality of stroke in the Chinese island populations: a systematic review. PLoS One. 2013 Nov 8;8(11):e78629.CrossRef
6.
go back to reference WHO. Global Status Report on Noncommunicable Diseases. Geneva: WHO; 2014. p. 2014. WHO. Global Status Report on Noncommunicable Diseases. Geneva: WHO; 2014. p. 2014.
7.
go back to reference United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2013. New York, NY: United Nations; 2013. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2013. New York, NY: United Nations; 2013.
8.
go back to reference Deb P, Sharma S, Hassan KM. Pathophysiologic mechanisms of acute ischemic stroke: an overview with emphasis on therapeutic significance beyond thrombolysis. Path Physiol. 2010 Jun;17(3):197–218. Deb P, Sharma S, Hassan KM. Pathophysiologic mechanisms of acute ischemic stroke: an overview with emphasis on therapeutic significance beyond thrombolysis. Path Physiol. 2010 Jun;17(3):197–218.
9.
go back to reference Wang X, Cheng S, Brophy VH, Erlich HA, Mannhalter C, Berger K, Lalouschek W, Browner WS, Shi Y, Ringelstein EB, Kessler C, Luedemann J, Lindpaintner K, Liu L, Ridker PM, Zee RY, Cook NR. A meta -analysis of candidate gene polymorphisms and ischemic stroke in 6 study populations: Association of lymphotoxin-alpha in nonhypertensive patients. Stroke. 2009 Mar;40(3):683–95.CrossRef Wang X, Cheng S, Brophy VH, Erlich HA, Mannhalter C, Berger K, Lalouschek W, Browner WS, Shi Y, Ringelstein EB, Kessler C, Luedemann J, Lindpaintner K, Liu L, Ridker PM, Zee RY, Cook NR. A meta -analysis of candidate gene polymorphisms and ischemic stroke in 6 study populations: Association of lymphotoxin-alpha in nonhypertensive patients. Stroke. 2009 Mar;40(3):683–95.CrossRef
10.
go back to reference Jood K, Ladenvall C, Rosengren A, Blomstrand C, Jern C. Family history in ischemic stroke before 70 years of age: the Sahlgrenska Academy study on ischemic stroke. Stroke. 2005;36:1383–7.CrossRef Jood K, Ladenvall C, Rosengren A, Blomstrand C, Jern C. Family history in ischemic stroke before 70 years of age: the Sahlgrenska Academy study on ischemic stroke. Stroke. 2005;36:1383–7.CrossRef
11.
go back to reference Munshi A, Kaul S. Genetic basis of stroke: an overview. Neurol India. 2010;58:185–90.CrossRef Munshi A, Kaul S. Genetic basis of stroke: an overview. Neurol India. 2010;58:185–90.CrossRef
12.
go back to reference Sarecka-Hujar B, Kopyta I, Pienczk-Reclawowicz K, Reclawowicz D, Emich-Widera E, Pilarska E. The TT genotype of methylenetetrahydrofolate reductase 677C>T polymorphism increases the susceptibility to pediatric ischemic stroke: meta-analysis of the 822 cases and 1,552 controls. Mol Biol Rep. 2012;39:7957–63.CrossRef Sarecka-Hujar B, Kopyta I, Pienczk-Reclawowicz K, Reclawowicz D, Emich-Widera E, Pilarska E. The TT genotype of methylenetetrahydrofolate reductase 677C>T polymorphism increases the susceptibility to pediatric ischemic stroke: meta-analysis of the 822 cases and 1,552 controls. Mol Biol Rep. 2012;39:7957–63.CrossRef
13.
go back to reference Mejia Mohamed EH, Tan KS, Ali JM, Mohamed Z. TT genotype of the methylenetetrahydrofolate reductase C677T polymorphism is an important determinant for homocysteine levels in multi-ethnic Malaysian ischaemic stroke patients. Ann Acad Med Singap. 2011;40(4):186–91.PubMed Mejia Mohamed EH, Tan KS, Ali JM, Mohamed Z. TT genotype of the methylenetetrahydrofolate reductase C677T polymorphism is an important determinant for homocysteine levels in multi-ethnic Malaysian ischaemic stroke patients. Ann Acad Med Singap. 2011;40(4):186–91.PubMed
14.
go back to reference Li CM, Zhang C, Lu XL, Feng HY, Su QX, Zeng Y, Zhang HL, Qiu SL. Relationship between methylenetrahydrofolate reductase g ene and ischemic stroke. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006;18:264–7.PubMed Li CM, Zhang C, Lu XL, Feng HY, Su QX, Zeng Y, Zhang HL, Qiu SL. Relationship between methylenetrahydrofolate reductase g ene and ischemic stroke. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006;18:264–7.PubMed
15.
go back to reference Bhagwat VR, Yadav AS, Rathod IM. Homocysteine, lipid indices and antioxidants in patients with ischaemic heart disease from Maharashtra. India Singapore Med J. 2009;50:418–24.PubMed Bhagwat VR, Yadav AS, Rathod IM. Homocysteine, lipid indices and antioxidants in patients with ischaemic heart disease from Maharashtra. India Singapore Med J. 2009;50:418–24.PubMed
16.
go back to reference Kelly PJ, Rosand J, Kistler JP, Shih VE, Silveira S, Plomaritoglou A, Furie KL. Homocysteine, MTHFR 677C->T polymorphism, and risk of ischemic stroke: results of a meta-analysis. Neurology. 2002;59:529–36.CrossRef Kelly PJ, Rosand J, Kistler JP, Shih VE, Silveira S, Plomaritoglou A, Furie KL. Homocysteine, MTHFR 677C->T polymorphism, and risk of ischemic stroke: results of a meta-analysis. Neurology. 2002;59:529–36.CrossRef
17.
go back to reference Li P, Qin C. Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and susceptibility to ischemic stroke: a meta-analysis. Gene. 2014 Feb 10;535(2):359–64.CrossRef Li P, Qin C. Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and susceptibility to ischemic stroke: a meta-analysis. Gene. 2014 Feb 10;535(2):359–64.CrossRef
18.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA group: preferred reporting items for systematic reviews and meta analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA group: preferred reporting items for systematic reviews and meta analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.CrossRef
20.
go back to reference Schwarzer G, Carpenter JR, Rücker G. Meta-analysis with R (use-R!). Switzerland: Springer International Publishing; 2015.CrossRef Schwarzer G, Carpenter JR, Rücker G. Meta-analysis with R (use-R!). Switzerland: Springer International Publishing; 2015.CrossRef
21.
go back to reference Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295:676–80.CrossRef Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295:676–80.CrossRef
22.
go back to reference Jackson D, White IR, Riley RD. Quantifying the impact of between-study heterogeneity in multivariate meta-analyses. Stat Med. 2012;31:3805–20.CrossRef Jackson D, White IR, Riley RD. Quantifying the impact of between-study heterogeneity in multivariate meta-analyses. Stat Med. 2012;31:3805–20.CrossRef
23.
go back to reference Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295(6):676–80.CrossRef Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295(6):676–80.CrossRef
24.
go back to reference Lv Q-Q, Lu J, Sun H, Zhang J-S. Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with ischemic stroke in the eastern Chinese Han population. Genet Mol Res. 2015;14(2):4161–8.CrossRef Lv Q-Q, Lu J, Sun H, Zhang J-S. Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with ischemic stroke in the eastern Chinese Han population. Genet Mol Res. 2015;14(2):4161–8.CrossRef
25.
go back to reference Zhou B-S, Guo-Yun B, Li M, Chang B-G, Zhou Y-P. Tagging SNPs in the MTHFR gene and Risk of ischemic stroke in a Chinese population. Int J Mol Sci. 2014;15:8931–40.CrossRef Zhou B-S, Guo-Yun B, Li M, Chang B-G, Zhou Y-P. Tagging SNPs in the MTHFR gene and Risk of ischemic stroke in a Chinese population. Int J Mol Sci. 2014;15:8931–40.CrossRef
26.
go back to reference Xiong L, Hu M, Zhang X, Jing Z, Li T, Li G, Liu J, Yu Y, Meng F, Wang Z. Association between Glu298Asp/ 677C-T single nucleotide polymorphism in the eNOS/ MTHRF gene and blood stasis syndrome of ischemic stroke. Gene. 2012;511:475–9.CrossRef Xiong L, Hu M, Zhang X, Jing Z, Li T, Li G, Liu J, Yu Y, Meng F, Wang Z. Association between Glu298Asp/ 677C-T single nucleotide polymorphism in the eNOS/ MTHRF gene and blood stasis syndrome of ischemic stroke. Gene. 2012;511:475–9.CrossRef
27.
go back to reference Zhang Yan, Xie Ru-ping, Shen Yang, Fan Dong-sheng. Interaction between methylenetetrahydrofolate reductase C677T gene polymorphism and sleep duration on risk of stroke pathogenesis. Journal of Peking university (Health Sciences), 2008, 40(3):262–269. Zhang Yan, Xie Ru-ping, Shen Yang, Fan Dong-sheng. Interaction between methylenetetrahydrofolate reductase C677T gene polymorphism and sleep duration on risk of stroke pathogenesis. Journal of Peking university (Health Sciences), 2008, 40(3):262–269.
28.
go back to reference Kawamoto R, Kohara K, Oka Y, Tomita H, Tabara Y, Miki T. An association of 5,10-Methylenetetrahydrofolate Reductase (MTHFR) gene polymorphism and ischemic Strok. J Stroke Cerebrovasc Dis. 2005;14(2):67–74.CrossRef Kawamoto R, Kohara K, Oka Y, Tomita H, Tabara Y, Miki T. An association of 5,10-Methylenetetrahydrofolate Reductase (MTHFR) gene polymorphism and ischemic Strok. J Stroke Cerebrovasc Dis. 2005;14(2):67–74.CrossRef
29.
go back to reference Yoo J-H, Choi G-D, Kang S-S. Pathogenicity of Thermolabile Methylenetetrahydrofolate Reductase for vascular dementia. Arterioscler Thromb Vasc Biol. 2000;20:1921–5.CrossRef Yoo J-H, Choi G-D, Kang S-S. Pathogenicity of Thermolabile Methylenetetrahydrofolate Reductase for vascular dementia. Arterioscler Thromb Vasc Biol. 2000;20:1921–5.CrossRef
30.
go back to reference Press RD, Beamer N, Evans A, DeLoughery TG, Coull BM. Role of a common mutation in the Homocysteine regulatory enzyme Methylenetetrahydrofolate Reductase in ischemic stroke. Diagn Mol Pathol. 1999;8(1):54–8.CrossRef Press RD, Beamer N, Evans A, DeLoughery TG, Coull BM. Role of a common mutation in the Homocysteine regulatory enzyme Methylenetetrahydrofolate Reductase in ischemic stroke. Diagn Mol Pathol. 1999;8(1):54–8.CrossRef
31.
go back to reference Harmon DL, Doyle RM, Meleady R, Doyle M, Shields DC, Barry R, Coakley D, Graham IM, Whitehead AS. Genetic analysis of the Thermolabile variant of 5,10-Methylenetetrahydrofolate Reductase as a risk factor for ischemic stroke. Arterioscler Thromb Vasc Biol. 1999;19:208–11.CrossRef Harmon DL, Doyle RM, Meleady R, Doyle M, Shields DC, Barry R, Coakley D, Graham IM, Whitehead AS. Genetic analysis of the Thermolabile variant of 5,10-Methylenetetrahydrofolate Reductase as a risk factor for ischemic stroke. Arterioscler Thromb Vasc Biol. 1999;19:208–11.CrossRef
32.
go back to reference Kostulas K, Crisby M, Huang W-X, Lannfelt L, Hagenfeldt L, Eggertsen G, Kostulas V, Hillert J. A methylenetetrahydrofolate reductase gene polymorphism in ischaemic stroke and in carotid artery stenosis. Eur J Clin Investig. 1998;28:285–9.CrossRef Kostulas K, Crisby M, Huang W-X, Lannfelt L, Hagenfeldt L, Eggertsen G, Kostulas V, Hillert J. A methylenetetrahydrofolate reductase gene polymorphism in ischaemic stroke and in carotid artery stenosis. Eur J Clin Investig. 1998;28:285–9.CrossRef
33.
go back to reference Alluri RV, Mohan V, Komandur S, Chawda K, Chaudhuri JR, Hasan Q. MTHFR C677T gene mutation as a risk factor for arterial stroke: a hospital based study. Eur J Neurol. 2005 Jan;12(1):40–4.CrossRef Alluri RV, Mohan V, Komandur S, Chawda K, Chaudhuri JR, Hasan Q. MTHFR C677T gene mutation as a risk factor for arterial stroke: a hospital based study. Eur J Neurol. 2005 Jan;12(1):40–4.CrossRef
34.
go back to reference Banecka-Majkutewicz Z, Gasecki D, Banecka JJ. Hyperhomocysteinemia - important risk factor for ischemic stroke. Udar Mozgu - Problemy Interdyscyplinarne. 2005;7(2):61–5. Banecka-Majkutewicz Z, Gasecki D, Banecka JJ. Hyperhomocysteinemia - important risk factor for ischemic stroke. Udar Mozgu - Problemy Interdyscyplinarne. 2005;7(2):61–5.
35.
go back to reference Zhu XY, Hou RY, Pan XD, Wang YC, Zhang ZS, Guo RY. Association between the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and ischemic stroke in the Chinese population: a meta-analysis. Int J Neurosci. 2015;125(12):885–94.CrossRef Zhu XY, Hou RY, Pan XD, Wang YC, Zhang ZS, Guo RY. Association between the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and ischemic stroke in the Chinese population: a meta-analysis. Int J Neurosci. 2015;125(12):885–94.CrossRef
36.
go back to reference Casas JP, Bautista LE, Smeeth L, Sharma P, Hingorani AD. Homocysteine and stroke: evidence on causal link from mendelian randomisation. Lancet. 2005 Jan 15–21;365(9455):224–232.CrossRef Casas JP, Bautista LE, Smeeth L, Sharma P, Hingorani AD. Homocysteine and stroke: evidence on causal link from mendelian randomisation. Lancet. 2005 Jan 15–21;365(9455):224–232.CrossRef
37.
go back to reference Morita H, Taguchi J, Kurihara H, Kitaoka M, Kaneda H, Kurihara Y, Maemura K, Shindo T, Minamino T, Ohno M, Yamaoki K, Ogasawara K, Aizawa T, Suzuki S, Yazaki Y. Genetic polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) as a risk factor for coronary artery disease. Circulation. 1997;95(8):2032–6.CrossRef Morita H, Taguchi J, Kurihara H, Kitaoka M, Kaneda H, Kurihara Y, Maemura K, Shindo T, Minamino T, Ohno M, Yamaoki K, Ogasawara K, Aizawa T, Suzuki S, Yazaki Y. Genetic polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) as a risk factor for coronary artery disease. Circulation. 1997;95(8):2032–6.CrossRef
39.
go back to reference AAD Gayathri Upeksha Amarakoon, Neil Fernandopulle. Detection of C677T & A1298C mutations within the MTHFR gene by PCR and RFLP assays and assessment of risk factor of Hyperhomocysteinemia. World Scientific News, 2016, WSN 53(3):253–274. AAD Gayathri Upeksha Amarakoon, Neil Fernandopulle. Detection of C677T & A1298C mutations within the MTHFR gene by PCR and RFLP assays and assessment of risk factor of Hyperhomocysteinemia. World Scientific News, 2016, WSN 53(3):253–274.
40.
go back to reference Yu HH, Zhang WL, Shi JP. Relationship between methylenetetrahydrofolate reductase gene C677T polymorphism and susceptibility of ischemic stroke: a meta-analysis. 2011 Aug 9; 91(29): 2060–2064. Yu HH, Zhang WL, Shi JP. Relationship between methylenetetrahydrofolate reductase gene C677T polymorphism and susceptibility of ischemic stroke: a meta-analysis. 2011 Aug 9; 91(29): 2060–2064.
41.
go back to reference Shi JP, Chen WD, Zhou JQ, Xue MM, Xue F, Li HZ, Xu ZP. Investigation of single nucleotide polymorphismsin phosphodiesterase 4D gene in Mongol and Han patients with ischemic stroke in Inner Mongolia. Genet Mol Res. 2015;14(3):10281–7.CrossRef Shi JP, Chen WD, Zhou JQ, Xue MM, Xue F, Li HZ, Xu ZP. Investigation of single nucleotide polymorphismsin phosphodiesterase 4D gene in Mongol and Han patients with ischemic stroke in Inner Mongolia. Genet Mol Res. 2015;14(3):10281–7.CrossRef
42.
go back to reference Liu L, Wang D, Wong KS, Wang Y. Stroke and stroke care in China: huge burden, significant workload, and a national priority. Stroke. 2011;42:3651–4.CrossRef Liu L, Wang D, Wong KS, Wang Y. Stroke and stroke care in China: huge burden, significant workload, and a national priority. Stroke. 2011;42:3651–4.CrossRef
43.
go back to reference Fenech M. The role of folic acid and vitamin B12 in genomic stability of human cells. Mutat Res. 2001;475:57–67.CrossRef Fenech M. The role of folic acid and vitamin B12 in genomic stability of human cells. Mutat Res. 2001;475:57–67.CrossRef
44.
go back to reference Pancharuniti N, Lewis CA, Sauberlich HE, Perkins LL, Go R, Alvarez JO, Macaluso M, Acton RT, Copeland RB, Cousins AL, Gore TB, Cornwell PE, Roseman JM. Plasma homocysteine, folate and vitamin B12 concentrations and risk for early-onset coronary artery disease. Am J Clin Nutr. 1994;59:940–8.CrossRef Pancharuniti N, Lewis CA, Sauberlich HE, Perkins LL, Go R, Alvarez JO, Macaluso M, Acton RT, Copeland RB, Cousins AL, Gore TB, Cornwell PE, Roseman JM. Plasma homocysteine, folate and vitamin B12 concentrations and risk for early-onset coronary artery disease. Am J Clin Nutr. 1994;59:940–8.CrossRef
45.
go back to reference Perry IJ, Refsum H, Morris RW, Ebrahim SB, Ueland PM, Shaper AG. Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet. 1995;346:1395–139.CrossRef Perry IJ, Refsum H, Morris RW, Ebrahim SB, Ueland PM, Shaper AG. Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet. 1995;346:1395–139.CrossRef
46.
go back to reference Collaboration, H.S. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002:288, 2015–2022. Collaboration, H.S. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002:288, 2015–2022.
47.
go back to reference Tran IWP, Christensen B, Sibani S, Rozen R. A second genetic polymorphism in methylenetetrahydrofolate reductase (MTHFR) associated with decreased enzyme activity. Mol Genet Metabol. 1998;64:169–72.CrossRef Tran IWP, Christensen B, Sibani S, Rozen R. A second genetic polymorphism in methylenetetrahydrofolate reductase (MTHFR) associated with decreased enzyme activity. Mol Genet Metabol. 1998;64:169–72.CrossRef
Metadata
Title
The association of MTHFR C677T variant with increased risk of ischemic stroke in the elderly population: a meta-analysis of observational studies
Authors
Guilin Chang
Zheng Kuai
Jia Wang
Jiayu Wu
Kan Xu
Ying Yuan
Yu Hu
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1304-y

Other articles of this Issue 1/2019

BMC Geriatrics 1/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.