H型高血压患者MTHFR基因多态性及叶酸补充对同型半胱氨酸浓度的影响
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摘要
目的探讨H型高血压患者亚甲基四氢叶酸还原酶(methylenetetra hydrofolate reductase,MTHFR)基因多态性(C677T)及叶酸补充对同型半胱氨酸(homocysteine,Hcy)浓度的影响。方法选取四川省人民医院350例H型高血压患者,抽取其静脉血,采用聚合酶链反应(polymerase chain reaction,PCR)金磁微粒层析法检测MTHFR基因多态性。并给予每位患者800μg/d叶酸片,连续服用3个月,检测治疗前后所有患者的Hcy浓度并比较其变化情况。结果 H型高血压患者MTHFR基因多态性C677T中3种基因型CC型为92例,CT型为169例,TT型为89例,治疗前CC基因型组血浆Hcy浓度为(13.52±2.63)μmol/L,CT基因组型(14.36±4.25)μmol/L,TT基因组型为(18.56±6.24)μmol/L。连续服用3个月的叶酸片800μg/d后,CC基因型组血浆Hcy浓度为(11.25±1.94)μmol/L,CT基因组型(12.05±3.46)μmol/L,TT基因组型为(14.24±4.42)μmol/L。与治疗前比较,CC基因组,CT基因组,TT基因组血浆Hcy浓度均有明显的下降,差异有统计学意义(P<0.01);其中TT基因型血浆Hcy浓度下降幅度最大,差异有统计学意义(P<0.01)。结论采用叶酸片治疗可有效降低H型高血压患者血浆Hcy浓度,其中以MTHFR基因中TT型下降最明显。
Objectives To investigate the effects of polymorphism of methylenetetra hydrofolate reductase(MTHFR)gene(C677 T)and folic acid supplementation on plasma concentration of homocysteine(Hcy)in patients with H-type hypertensive. Methods Totally 350 patients with H-type hypertension in Sichuan Academy of Medical Sciences &Sichuan Provincial People′s Hospital were selected and their venous bloods were extracted. Polymorphism of MTHFR gene was detected by polymerase chain reaction-restriction fragment length polymorphism. Plasma concentrations of Hcy were detected after giving 800 μg/d folic acid tablets for 3 months continuously in the patients. Results Plasma concentrations of Hcy were(13.52±2.63)μmol/L,(14.36±4.25)μmol/L,(18.56±6.24)μmol/L in CT genotype group,TT genotype group and CC genotype group,respectively. After giving 800 μg/d folic acid tablets for 3 months continuously,plasma concentrations of Hcy were(11.25±1.94)μmol/L,(12.05±3.46)μmol/L,(14.24±4.42)μmol/L in CT genotype group,TT genotype group and CC genotype group,respectively. Plasma concentrations of Hcy were much lower in CT genotype group,TT genotype group and CC genotype group after treatment than those of the 3 groups before treatment(P<0.01),among the 3 groups,plasma concentrations of Hcy in TT genotype group decreased the most(P<0.01). Conclusions Folic acid treatment can effectively reduce plasma concentration of Hcy in patients with H-type hypertension,and TT type of MTHFR gene is the most obvious.
Objectives To investigate the effects of polymorphism of methylenetetra hydrofolate reductase(MTHFR)gene(C677 T)and folic acid supplementation on plasma concentration of homocysteine(Hcy)in patients with H-type hypertensive. Methods Totally 350 patients with H-type hypertension in Sichuan Academy of Medical Sciences &Sichuan Provincial People′s Hospital were selected and their venous bloods were extracted. Polymorphism of MTHFR gene was detected by polymerase chain reaction-restriction fragment length polymorphism. Plasma concentrations of Hcy were detected after giving 800 μg/d folic acid tablets for 3 months continuously in the patients. Results Plasma concentrations of Hcy were(13.52±2.63)μmol/L,(14.36±4.25)μmol/L,(18.56±6.24)μmol/L in CT genotype group,TT genotype group and CC genotype group,respectively. After giving 800 μg/d folic acid tablets for 3 months continuously,plasma concentrations of Hcy were(11.25±1.94)μmol/L,(12.05±3.46)μmol/L,(14.24±4.42)μmol/L in CT genotype group,TT genotype group and CC genotype group,respectively. Plasma concentrations of Hcy were much lower in CT genotype group,TT genotype group and CC genotype group after treatment than those of the 3 groups before treatment(P<0.01),among the 3 groups,plasma concentrations of Hcy in TT genotype group decreased the most(P<0.01). Conclusions Folic acid treatment can effectively reduce plasma concentration of Hcy in patients with H-type hypertension,and TT type of MTHFR gene is the most obvious.
引文
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[2]GANGULY P,ALAM S F.Role of homocysteine in the development of cardiovascular disease[J].Nutr J,2015,14(1):6.
[3]陶国枢.关注H型高血压的防治[J].保健医苑,2013,5(5):9.
[4]吴绍燕,左中.同型半胱氨酸与高血压相关性的Meta分析[J].国际检验医学杂志,2012,33(23):2920-2922.
[5]FU H J,ZHAO L B,XUE J J,et al.Elevated serum homocysteine levels may contribute to the pathogenesis of cerebral infarction[J].J Mol Neurosci,2015,56(3):553.
[6]谢立,张文颖.螺内酯治疗顽固性高血压疗效的影响因素分析[J].今日药学,2017,27(3):194-198.
[7]WALD D S,LAW M,MORRIS J K.Homocysteine and cardiovascular disease:evidence on causality from a meta-analysis[J].BMJ(Clinical research ed.),2011,325(7374):1202-1206.
[8]王拥军,刘力生,饶克勤,等.我国脑卒中预防策略思考:同时控制高血压和高同型半胱氨酸水平[J].中华医学杂志,2008,88(47):3316-3318.
[9]WOOK S,CHOOK P,CHAN L L,et al.Long-term improvement in homocysteine levels and arterial endothelial function after1-year.[J].AMJ,2002,112(7):535-539.
[10]KLERK M,VERHOEF P,CLARKE R,et al.MTHFR 677C→T polymor-phism and risk of coronary heart disease:a metaanalysis[J].JAMA,2002,288(16):2023-2031.
[11]ZAPPACOSTA B,GRAZIANO M,PERSICHILLI S,et al.5,10-Methylenetetrahydrofolate resuctase MTHFRC677T and A1298C polymorphisms:genotype frequency and association with homocysteine and folate levels in middle-southern Italian adults[J].Cell Biochem Funct,2014,32(1):1.