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Published in: Arthritis Research & Therapy 2/2010

Open Access 01-04-2010 | Research article

A1298C polymorphism in the MTHFRgene predisposes to cardiovascular risk in rheumatoid arthritis

Authors: Rogelio Palomino-Morales, Carlos Gonzalez-Juanatey, Tomas R Vazquez-Rodriguez, Luis Rodriguez, Jose A Miranda-Filloy, Benjamin Fernandez-Gutierrez, Javier Llorca, Javier Martin, Miguel A Gonzalez-Gay

Published in: Arthritis Research & Therapy | Issue 2/2010

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Abstract

Introduction

We determined the contribution of the methylene tetrahydrofolate reductase (MTHFR) 677 C>T and 1298 A>C gene polymorphisms to the susceptibility to rheumatoid arthritis (RA). We also assessed whether these two MTHFR gene polymorphisms may be implicated in the development of cardiovascular (CV) events and subclinical atherosclerosis manifested by the presence of endothelial dysfunction, in a series of Spanish patients with RA.

Methods

Six hundred and twelve patients fulfilling the 1987 American College of Rheumatology classification criteria for RA, seen at the rheumatology outpatient clinics of Hospital Xeral-Calde, Lugo and Hospital San Carlos, Madrid, were studied. Patients and controls (n = 865) were genotyped using predesigned TaqMan SNP genotyping assays.

Results

No significant differences in allele or genotype frequencies for the MTHFR gene polymorphisms between RA patients and controls were found. Also, no association between the MTHFR 677 C>T polymorphism and CV events or endothelial dysfunction was observed. However, the MTHFR 1298 allele C frequency was increased in patients with CV events after 5 years (38.7% versus 30.3%; odds ratio = 1.45; 95% confidence interval = 1.00 to 2.10; P = 0.04) and 10 years (42.2% versus 31.0%; odds ratio = 1.62; 95% confidence interval = 1.08 to 2.43; P = 0.01) follow up. Moreover, patients carrying the MTHFR 1298 AC and CC genotypes had a significantly decreased flow-mediated endothelium-dependent vasodilatation (4.3 ± 3.9%) compared with those carrying the MTHFR 1298 AA genotype (6.5 ± 4.4%) (P = 0.005).

Conclusions

Our results show that the MTHFR 1298 A>C gene polymorphism confers an increased risk for subclinical atherosclerosis and CV events in patients with RA.
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Literature
1.
go back to reference Gonzalez-Gay MA, Gonzalez-Juanatey C, Martin J: Rheumatoid arthritis: a disease associated with accelerated atherogenesis. Semin Arthritis Rheum. 2005, 35: 8-17. 10.1016/j.semarthrit.2005.03.004.CrossRefPubMed Gonzalez-Gay MA, Gonzalez-Juanatey C, Martin J: Rheumatoid arthritis: a disease associated with accelerated atherogenesis. Semin Arthritis Rheum. 2005, 35: 8-17. 10.1016/j.semarthrit.2005.03.004.CrossRefPubMed
2.
go back to reference Dessein PH, Joffe BI, Veller MG, Stevens BA, Tobias M, Reddi K, Stanwix AE: Traditional and nontraditional cardiovascular risk factors are associated with atherosclerosis in rheumatoid arthritis. J Rheumatol. 2005, 32: 435-442.PubMed Dessein PH, Joffe BI, Veller MG, Stevens BA, Tobias M, Reddi K, Stanwix AE: Traditional and nontraditional cardiovascular risk factors are associated with atherosclerosis in rheumatoid arthritis. J Rheumatol. 2005, 32: 435-442.PubMed
3.
go back to reference Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ, Piñeiro A, Garcia-Porrua C, Miranda-Filloy JA, Ollier WE, Martin J, Llorca J: HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum. 2007, 57: 125-132. 10.1002/art.22482.CrossRefPubMed Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ, Piñeiro A, Garcia-Porrua C, Miranda-Filloy JA, Ollier WE, Martin J, Llorca J: HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum. 2007, 57: 125-132. 10.1002/art.22482.CrossRefPubMed
4.
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: 1149-1155. 10.1056/NEJM199104253241701.CrossRefPubMed 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: 1149-1155. 10.1056/NEJM199104253241701.CrossRefPubMed
5.
go back to reference Haagsma CJ, Blom HJ, van Riel PL, van't Hof MA, Giesendorf BA, van Oppenraaij-Emmerzaal D, Putte van de LB: Influence of sulphasalazine, methotrexate, and the combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis. Ann Rheum Dis. 1999, 58: 79-84. 10.1136/ard.58.2.79.PubMedCentralCrossRefPubMed Haagsma CJ, Blom HJ, van Riel PL, van't Hof MA, Giesendorf BA, van Oppenraaij-Emmerzaal D, Putte van de LB: Influence of sulphasalazine, methotrexate, and the combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis. Ann Rheum Dis. 1999, 58: 79-84. 10.1136/ard.58.2.79.PubMedCentralCrossRefPubMed
6.
go back to reference Jacques PF, Bostom AG, Wilson PW, Rich S, Rosenberg IH, Selhub J: Determinants of plasma total homocysteine concentration in the Framingham Offspring cohort. Am J Clin Nutr. 2001, 73: 613-621.PubMed Jacques PF, Bostom AG, Wilson PW, Rich S, Rosenberg IH, Selhub J: Determinants of plasma total homocysteine concentration in the Framingham Offspring cohort. Am J Clin Nutr. 2001, 73: 613-621.PubMed
7.
go back to reference Hernanz A, Plaza A, Martin-Mola E, De Miguel E: Increased plasma levels of homocysteine and other thiol compounds in rheumatoid arthritis women. Clin Biochem. 1999, 32: 65-70. 10.1016/S0009-9120(98)00093-9.CrossRefPubMed Hernanz A, Plaza A, Martin-Mola E, De Miguel E: Increased plasma levels of homocysteine and other thiol compounds in rheumatoid arthritis women. Clin Biochem. 1999, 32: 65-70. 10.1016/S0009-9120(98)00093-9.CrossRefPubMed
8.
go back to reference Choi HK, Hernan MA, Seeger JD, Robins JM, Wolfe F: Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet. 2002, 359: 1173-1177. 10.1016/S0140-6736(02)08213-2.CrossRefPubMed Choi HK, Hernan MA, Seeger JD, Robins JM, Wolfe F: Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet. 2002, 359: 1173-1177. 10.1016/S0140-6736(02)08213-2.CrossRefPubMed
9.
go back to reference Morgan SL, Baggott JE, Lee JY, Alarcon GS: Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. J Rheumatol. 1998, 25: 441-446.PubMed Morgan SL, Baggott JE, Lee JY, Alarcon GS: Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. J Rheumatol. 1998, 25: 441-446.PubMed
10.
go back to reference Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, Boers GJ, den Heijer M, Kluijtmans LA, Heuvel van den LP, Rozen R: A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet. 1995, 10: 111-113. 10.1038/ng0595-111.CrossRefPubMed Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, Boers GJ, den Heijer M, Kluijtmans LA, Heuvel van den LP, Rozen R: A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet. 1995, 10: 111-113. 10.1038/ng0595-111.CrossRefPubMed
11.
go back to reference Weisberg I, Tran P, Christensen B, Sibani S, Rozen R: A second genetic polymorphism in methylenetetrahydrofolate reductase (MTHFR) associated with decreased enzyme activity. Mol Genet Metab. 1998, 64: 169-172. 10.1006/mgme.1998.2714.CrossRefPubMed Weisberg I, Tran P, Christensen B, Sibani S, Rozen R: A second genetic polymorphism in methylenetetrahydrofolate reductase (MTHFR) associated with decreased enzyme activity. Mol Genet Metab. 1998, 64: 169-172. 10.1006/mgme.1998.2714.CrossRefPubMed
12.
go back to reference Put van der NM, Gabreëls F, Stevens EM, Smeitink JA, Trijbels FJ, Eskes TK, Heuvel van den LP, Blom HJ: A second common mutation in the methylenetetrahydrofolate reductase gene: an additional risk factor for neural-tube defects?. Am J Hum Genet. 1998, 62: 1044-1051. 10.1086/301825.PubMedCentralCrossRefPubMed Put van der NM, Gabreëls F, Stevens EM, Smeitink JA, Trijbels FJ, Eskes TK, Heuvel van den LP, Blom HJ: A second common mutation in the methylenetetrahydrofolate reductase gene: an additional risk factor for neural-tube defects?. Am J Hum Genet. 1998, 62: 1044-1051. 10.1086/301825.PubMedCentralCrossRefPubMed
13.
go back to reference Rubini M, Padovan M, Baricordi O, Fotinidi M, Govoni M, Trotta F: The c.1298A>C polymorphism in the methylenetetrahydrofolate reductase gene is associated with rheumatoid arthritis susceptibility in Italian patients. Clin Exp Rheumatol. 2008, 26: 163-LetterPubMed Rubini M, Padovan M, Baricordi O, Fotinidi M, Govoni M, Trotta F: The c.1298A>C polymorphism in the methylenetetrahydrofolate reductase gene is associated with rheumatoid arthritis susceptibility in Italian patients. Clin Exp Rheumatol. 2008, 26: 163-LetterPubMed
14.
go back to reference Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988, 31: 315-324. 10.1002/art.1780310302.CrossRefPubMed Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988, 31: 315-324. 10.1002/art.1780310302.CrossRefPubMed
15.
go back to reference Palomino-Morales R, Gonzalez-Juanatey C, Vazquez-Rodriguez TR, Torres O, Miranda-Filloy JA, Llorca J, Martin J, Gonzalez-Gay MA: Lack of association between macrophage migration inhibitory factor-173 gene polymorphism with disease susceptibility and cardiovascular risk in rheumatoid arthritis patients from Northwestern Spain. Clin Exp Rheumatol. 2010, 28: 68-72.PubMed Palomino-Morales R, Gonzalez-Juanatey C, Vazquez-Rodriguez TR, Torres O, Miranda-Filloy JA, Llorca J, Martin J, Gonzalez-Gay MA: Lack of association between macrophage migration inhibitory factor-173 gene polymorphism with disease susceptibility and cardiovascular risk in rheumatoid arthritis patients from Northwestern Spain. Clin Exp Rheumatol. 2010, 28: 68-72.PubMed
16.
go back to reference Pego-Reigosa R, Garcia-Porrua C, Pineiro A, Dierssen T, Llorca J, Gonzalez-Gay MA: Predictors of cerebrovascular accidents in giant cell arteritis in a defined population. Clin Exp Rheumatol. 2004, 22 (Suppl 36): S13-S17.PubMed Pego-Reigosa R, Garcia-Porrua C, Pineiro A, Dierssen T, Llorca J, Gonzalez-Gay MA: Predictors of cerebrovascular accidents in giant cell arteritis in a defined population. Clin Exp Rheumatol. 2004, 22 (Suppl 36): S13-S17.PubMed
17.
go back to reference Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, Garcia-Porrua C, Llorca J, Vidan J, Hajeer AH, Ollier WE, Mattey DL, Gonzalez-Gay MA: HLA-DRB1 status influences endothelial dysfunction in long-term treated patients with rheumatoid arthritis. Am J Med. 2003, 114: 647-652. 10.1016/S0002-9343(03)00133-5.CrossRefPubMed Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, Garcia-Porrua C, Llorca J, Vidan J, Hajeer AH, Ollier WE, Mattey DL, Gonzalez-Gay MA: HLA-DRB1 status influences endothelial dysfunction in long-term treated patients with rheumatoid arthritis. Am J Med. 2003, 114: 647-652. 10.1016/S0002-9343(03)00133-5.CrossRefPubMed
18.
go back to reference Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, Garcia-Porrua C, Llorca J, Gonzalez-Gay MA: Active but transient improvement of endothelial function in rheumatoid arthritis patients undergoing long-term treatment with anti-tumor necrosis factor alpha antibody. Arthritis Rheum. 2004, 51: 447-450. 10.1002/art.20407.CrossRefPubMed Gonzalez-Juanatey C, Testa A, Garcia-Castelo A, Garcia-Porrua C, Llorca J, Gonzalez-Gay MA: Active but transient improvement of endothelial function in rheumatoid arthritis patients undergoing long-term treatment with anti-tumor necrosis factor alpha antibody. Arthritis Rheum. 2004, 51: 447-450. 10.1002/art.20407.CrossRefPubMed
19.
go back to reference Gonzalez-Juanatey C, Llorca J, Miranda-Filloy JA, Amigo-Diaz E, Testa A, Garcia-Porrua C, Martin J, Gonzalez-Gay MA: Endothelial dysfunction in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Arthritis Rheum. 2007, 57: 287-293. 10.1002/art.22530.CrossRefPubMed Gonzalez-Juanatey C, Llorca J, Miranda-Filloy JA, Amigo-Diaz E, Testa A, Garcia-Porrua C, Martin J, Gonzalez-Gay MA: Endothelial dysfunction in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Arthritis Rheum. 2007, 57: 287-293. 10.1002/art.22530.CrossRefPubMed
20.
go back to reference Gonzalez-Gay MA, Gonzalez-Juanatey C, Vazquez-Rodriguez TR, Martin J, Llorca J: Endothelial dysfunction, carotid intima-media thickness, and accelerated atherosclerosis in rheumatoid arthritis. Semin Arthritis Rheum. 2008, 38: 67-70. 10.1016/j.semarthrit.2008.02.001.CrossRefPubMed Gonzalez-Gay MA, Gonzalez-Juanatey C, Vazquez-Rodriguez TR, Martin J, Llorca J: Endothelial dysfunction, carotid intima-media thickness, and accelerated atherosclerosis in rheumatoid arthritis. Semin Arthritis Rheum. 2008, 38: 67-70. 10.1016/j.semarthrit.2008.02.001.CrossRefPubMed
22.
go back to reference Szczeklik A, Sanak M, Jankowski M, Dropiñski J, Czachór R, Musiał J, Axenti I, Twardowska M, Brzostek T, Tendera M: Mutation A1298C of methylenetetrahydrofolate reductase: risk for early coronary disease not associated with hyperhomocysteinemia. Am J Med Genet. 2001, 101: 36-39. 10.1002/ajmg.1315.CrossRefPubMed Szczeklik A, Sanak M, Jankowski M, Dropiñski J, Czachór R, Musiał J, Axenti I, Twardowska M, Brzostek T, Tendera M: Mutation A1298C of methylenetetrahydrofolate reductase: risk for early coronary disease not associated with hyperhomocysteinemia. Am J Med Genet. 2001, 101: 36-39. 10.1002/ajmg.1315.CrossRefPubMed
23.
go back to reference Weisberg IS, Jacques PF, Selhub J, Bostom AG, Chen Z, Curtis Ellison R, Eckfeldt JH, Rozen R: The 1298A→C polymorphism in methylenetetrahydrofolate reductase (MTHFR): in vitro expression and association with homocysteine. Atherosclerosis. 2001, 156: 409-415. 10.1016/S0021-9150(00)00671-7.CrossRefPubMed Weisberg IS, Jacques PF, Selhub J, Bostom AG, Chen Z, Curtis Ellison R, Eckfeldt JH, Rozen R: The 1298A→C polymorphism in methylenetetrahydrofolate reductase (MTHFR): in vitro expression and association with homocysteine. Atherosclerosis. 2001, 156: 409-415. 10.1016/S0021-9150(00)00671-7.CrossRefPubMed
24.
go back to reference Antoniades C, Shirodaria C, Leeson P, Baarholm OA, Van-Assche T, Cunnington C, Pillai R, Ratnatunga C, Tousoulis D, Stefanadis C, Refsum H, Channon KM: MTHFR 677 C>T polymorphism reveals functional importance for 5-methyltetrahydrofolate, not homocysteine, in regulation of vascular redox state and endothelial function in human atherosclerosis. Circulation. 2009, 119: 2507-2515. 10.1161/CIRCULATIONAHA.108.808675.CrossRefPubMed Antoniades C, Shirodaria C, Leeson P, Baarholm OA, Van-Assche T, Cunnington C, Pillai R, Ratnatunga C, Tousoulis D, Stefanadis C, Refsum H, Channon KM: MTHFR 677 C>T polymorphism reveals functional importance for 5-methyltetrahydrofolate, not homocysteine, in regulation of vascular redox state and endothelial function in human atherosclerosis. Circulation. 2009, 119: 2507-2515. 10.1161/CIRCULATIONAHA.108.808675.CrossRefPubMed
25.
go back to reference Mager A, Lalezari S, Shohat T, Birnbaum Y, Adler Y, Magal N, Shohat M: Methylenetetrahydrofolate reductase genotypes and early-onset coronary artery disease. Circulation. 1999, 100: 2406-2410.CrossRefPubMed Mager A, Lalezari S, Shohat T, Birnbaum Y, Adler Y, Magal N, Shohat M: Methylenetetrahydrofolate reductase genotypes and early-onset coronary artery disease. Circulation. 1999, 100: 2406-2410.CrossRefPubMed
26.
go back to reference Hermans MP, Gala JL, Buysschaert M: The MTHFR CT polymorphism confers a high risk for stroke in both homozygous and heterozygous T allele carriers with type 2 diabetes. Diabet Med. 2006, 23: 529-536. 10.1111/j.1464-5491.2006.01841.x.CrossRefPubMed Hermans MP, Gala JL, Buysschaert M: The MTHFR CT polymorphism confers a high risk for stroke in both homozygous and heterozygous T allele carriers with type 2 diabetes. Diabet Med. 2006, 23: 529-536. 10.1111/j.1464-5491.2006.01841.x.CrossRefPubMed
27.
go back to reference Xin XY, Song YY, Ma JF, Fan CN, Ding JQ, Yang GY, Chen SD: Gene polymorphisms and risk of adult early-onset ischemic stroke: a meta-analysis. Thromb Res. 2009, 124: 619-24. 10.1016/j.thromres.2009.07.007.CrossRefPubMed Xin XY, Song YY, Ma JF, Fan CN, Ding JQ, Yang GY, Chen SD: Gene polymorphisms and risk of adult early-onset ischemic stroke: a meta-analysis. Thromb Res. 2009, 124: 619-24. 10.1016/j.thromres.2009.07.007.CrossRefPubMed
28.
go back to reference Klerk M, Verhoef P, Clarke R, Blom HJ, Kok FJ, Schouten EG: MTHFR studies collaboration group. MTHFR 677C→T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA. 2002, 288: 2023-2031. 10.1001/jama.288.16.2023.CrossRefPubMed Klerk M, Verhoef P, Clarke R, Blom HJ, Kok FJ, Schouten EG: MTHFR studies collaboration group. MTHFR 677C→T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA. 2002, 288: 2023-2031. 10.1001/jama.288.16.2023.CrossRefPubMed
Metadata
Title
A1298C polymorphism in the MTHFRgene predisposes to cardiovascular risk in rheumatoid arthritis
Authors
Rogelio Palomino-Morales
Carlos Gonzalez-Juanatey
Tomas R Vazquez-Rodriguez
Luis Rodriguez
Jose A Miranda-Filloy
Benjamin Fernandez-Gutierrez
Javier Llorca
Javier Martin
Miguel A Gonzalez-Gay
Publication date
01-04-2010
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 2/2010
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2989

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