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Mabhida SE, Muhamed B, Sharma JR, Apalata T, Nomatshila S, Mabasa L, Benjeddou M, Masilela C, Ziqubu K, Shabalala S, Johnson R. Methylenetetrahydrofolate Reductase Polymorphism (rs1801133) and the Risk of Hypertension among African Populations: A Narrative Synthesis of Literature. Genes (Basel) 2022; 13:genes13040631. [PMID: 35456437 PMCID: PMC9027465 DOI: 10.3390/genes13040631] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 02/07/2023] Open
Abstract
In this review, we have gathered and analyzed the available genetic evidence on the association between the methylenetetrahydrofolate reductase gene (MTHFR), rs1801133 and the risk of Hypertension (HTN) in African populations, which was further compared to the global data evidence. This review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and Human Genome Epidemiology Network (HuGENet) guidelines. Literature was retrieved through major search databases, including PubMed, Scopus, Web of Science, and African Journal Online. We identified 64 potential studies, of which 4 studies were from the African continent and 60 studies were reported globally. Among the studies conducted in Africa, only two (n = 2) reported a significant association between the MTHFR (rs1801133) and the risk of developing HTN. Only one (n = 1) study population was purely composed of black Africans, while others were of other ethnicities. Among studies conducted in other continents (n = 60), forty-seven (n = 47) studies reported a positive association between MTHFR (rs1801133) and the risk of developing HTN, whereas the remaining studies (n = 14) did not show a significant association. Available literature suggests an apparent association between rs1801133 and HTN in global regions; however, such information is still scarce in Africa, especially in the black African population.
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Affiliation(s)
- Sihle E. Mabhida
- Biomedical Research and Innovation Platform, South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa; (S.E.M.); (J.R.S.); (L.M.); (S.S.)
- Department of Biotechnology, Faculty of Natural Science, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7535, South Africa;
| | - Babu Muhamed
- Division of Infections Disease, University of Tennessee Health Sciences Center (UTHSC), Memphis, TN 38163, USA;
| | - Jyoti R. Sharma
- Biomedical Research and Innovation Platform, South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa; (S.E.M.); (J.R.S.); (L.M.); (S.S.)
| | - Teke Apalata
- Division of Medical Microbiology, Department of Laboratory-Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa;
- National Health Laboratory Services, Mthatha 5100, South Africa
| | - Sibusiso Nomatshila
- Division of Preventive Medicine and Health Behavior, Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa;
| | - Lawrence Mabasa
- Biomedical Research and Innovation Platform, South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa; (S.E.M.); (J.R.S.); (L.M.); (S.S.)
| | - Mongi Benjeddou
- Department of Biotechnology, Faculty of Natural Science, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7535, South Africa;
| | - Charity Masilela
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa; (C.M.); (K.Z.)
| | - Khanyisani Ziqubu
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa; (C.M.); (K.Z.)
| | - Samukelisiwe Shabalala
- Biomedical Research and Innovation Platform, South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa; (S.E.M.); (J.R.S.); (L.M.); (S.S.)
- Division of Medical Microbiology, Department of Laboratory-Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5100, South Africa;
- National Health Laboratory Services, Mthatha 5100, South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform, South African Medical Research Council (SAMRC), Tygerberg 7505, South Africa; (S.E.M.); (J.R.S.); (L.M.); (S.S.)
- Centre for Cardio-Metabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
- Correspondence: ; Tel.: +27-21-938-0866
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Meng H, Huang S, Yang Y, He X, Fei L, Xing Y. Association Between MTHFR Polymorphisms and the Risk of Essential Hypertension: An Updated Meta-analysis. Front Genet 2021; 12:698590. [PMID: 34899823 PMCID: PMC8662810 DOI: 10.3389/fgene.2021.698590] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Since the 1990s, there have been a lot of research on single-nucleotide polymorphism (SNP) and different diseases, including many studies on 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphism and essential hypertension (EH). Nevertheless, their conclusions were controversial. So far, six previous meta-analyses discussed the internal relationship between the MTHFR polymorphism and EH, respectively. However, they did not evaluate the credibility of the positive associations. To build on previous meta-analyses, we updated the literature by including previously included papers as well as nine new articles, improved the inclusion criteria by also considering the quality of the papers, and applied new statistical techniques to assess the observed associations. OBJECTIVES This study aims to explore the degree of risk correlation between two MTHFR polymorphisms and EH. METHODS PubMed, EMBASE, the Cochrane Library, CNKI, and Wan Fang electronic databases were searched to identify relevant studies. We evaluated the relation between the MTHFR C677T (rs1801133) and A1298C (rs1801131) polymorphisms and EH by calculating the odds ratios (OR) as well as 95% confidence intervals (CI). Here we used subgroup analysis, sensitivity analysis, cumulative meta-analysis, assessment of publication bias, meta-regression meta, False-positive report probability (FPRP), Bayesian false discovery probability (BFDP), and Venice criterion. RESULTS Overall, harboring the variant of MTHFR C677T was associated with an increased risk of EH in the overall populations, East Asians, Southeast Asians, South Asians, Caucasians/Europeans, and Africans. After the sensitivity analysis, positive results were found only in the overall population (TT vs. CC: OR = 1.14, 95% CI: 1.00-1.30, P h = 0.032, I 2 = 39.8%; TT + TC vs. CC: OR = 1.15, 95% CI: 1.01-1.29, P h = 0.040, I 2 = 38.1%; T vs. C: OR = 1.14, 95% CI: 1.04-1.25, P h = 0.005, I 2 = 50.2%) and Asian population (TC vs. CC: OR = 1.14, 95% CI: 1.01-1.28, P h = 0.265, I 2 = 16.8%; TT + TC vs. CC: OR = 1.17, 95% CI: 1.04-1.30, P h = 0.105, I 2 = 32.9%; T vs. C: OR = 1.10, 95% CI: 1.02-1.19, P h = 0.018, I 2 = 48.6%). However, after further statistical assessment by FPRP, BFDP, and Venice criteria, the positive associations reported here could be deemed to be false-positives and present only weak evidence for a causal relationship. In addition, when we performed pooled analysis and sensitivity analysis on MTHFR A1298C; all the results were negative. CONCLUSION The positive relationships between MTHFR C677T and A1298C polymorphisms with the susceptibility to present with hypertension were not robust enough to withstand statistical interrogation by FPRP, BFDP, and Venice criteria. Therefore, these SNPs are probably not important in EH etiology.
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Affiliation(s)
- Hao Meng
- Department of Cardiovascular Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shaoyan Huang
- Department of Endocrinology, Shaogauan First People's Hospital, Shaoguan, China
| | - Yali Yang
- Department of Cardiovascular Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Xiaofeng He
- Department of science and education, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Liping Fei
- Department of Cardiovascular Medicine, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Yuping Xing
- Neurology Department, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
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Du X, Xiao L, Sun R, Li K, Liang L, Song L, Liu Z. A prospective cohort study of MTHFR C677T gene polymorphism and its influence on the therapeutic effect of homocysteine in stroke patients with hyperhomocysteinemia. BMC Neurol 2020; 20:128. [PMID: 32278343 PMCID: PMC7149884 DOI: 10.1186/s12883-020-01701-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 03/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hyperhomocysteinemia (HHCY) is a risk factor for cardiovascular and cerebrovascular diseases. The C677T 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism increases homocysteine (HCY) levels. This study analyzed the relationship between C677T MTHFR polymorphism and the therapeutic effect of lowering HCY in stroke patients with HHCY. METHODS Baseline data were collected from stroke patients with HHCY for this prospective cohort study. The C677T MTHFR genotype was detected by polymerase chain reaction-restriction fragment length polymorphism and the therapeutic effect to reduce HCY was compared. RESULTS Of 200 stroke patients 162 (81.0%) completed follow-up and were evaluated. Most of them responded well to treatment (103 cases, 63.5%), but 59 (36.4%) patients were in the poor efficacy group. There was a significant difference in terms of age (P < 0.001), hypertension (P = 0.041), hyperuricemia (P = 0.042), HCY after treatment (P < 0.001), and MTHFR genotype (P < 0.001) between the poor efficacy and effective groups, with increased frequency of the TT genotype in the poor efficacy group. Logistic regression showed that the T allele was associated with poor efficacy (OR = 0.733, 95%CI: 0.693, 0.862, P < 0.001). In the codominant model the TT genotype was associated with poor outcome (OR = 0.862, 95%CI: 0.767, 0.970, P = 0.017) and this was also the case in the recessive model (OR = 0.585, 95%CI: 0.462, 0.741, P < 0.001) but there was no association between CT and TT in the dominant model. CONCLUSIONS The T allele and TT genotype of the MTHFR C677T polymorphism was associated with poor HCY reduction treatment efficacy in stroke patients with HHCY. TRIAL REGISTRATION The registration number of the clinical trial is ChiCTR1800020048. Registration date: December 12, 2018.
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Affiliation(s)
- Xiaoxia Du
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China.
| | - Lin Xiao
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Rong Sun
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Kunpeng Li
- Case Statistics Office, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Lin Liang
- Department of Clinical Laboratory, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Luping Song
- Department of Neurorehabilitation, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Zhizhong Liu
- Department of Clinical Laboratory, School of Rehabilitation Medicine, Capital Medical University, Beijing Bo'Ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China.
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Zhang T, Jiang Y, Zhang S, Tie T, Cheng Y, Su X, Man Z, Hou J, Sun L, Tian M, Zhang Y, Li J, Ma Y. The association between homocysteine and ischemic stroke subtypes in Chinese: A meta-analysis. Medicine (Baltimore) 2020; 99:e19467. [PMID: 32195946 PMCID: PMC7220264 DOI: 10.1097/md.0000000000019467] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The findings on the association between elevated plasma homocysteine levels and the risk of the trial of org 10172 in acute stroke treatment (TOAST) of ischemic stroke have been inconsistent in Chinese. So far, there is no meta-analysis about the association between Hcy and the TOAST subtypes of ischemic stroke in Chinese. This study; therefore, aimed to evaluate whether elevated homocysteine levels are associated with the TOAST subtypes of ischemic stroke using a meta-analysis. MATERIALS AND METHODS A systematic search of electronic databases were conducted for studies reporting homocysteine levels in ischemic stroke and the TOAST of ischemic stroke to April 18, 2018. The data were extracted after the application of inclusion and exclusion criteria. All the data were analyzed using Stata software version 9.0 (Stata Corp LP, College Station, TX). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS Thirteen studies comprising 3114 participants (2243 patients and 871controls) met the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that the ischemic stroke group had significantly higher levels of homocysteine than controls (SMD = 1.15, 95% CI = 0.85-1.45, P < .05). The subgroup analyses suggested that the groups of patients with large-artery atherosclerosis, small-vessel occlusion, cardioembolism, stroke of other determined etiology and stroke of undetermined etiology had significantly higher levels of homocysteine compared to those in the control group (large-artery atherosclerosis: SMD = 2.12, 95% CI = 1.40-2.84, P < .05; small-vessel occlusion: SMD = 1.10, 95% CI = 0.72-1.48, P < .05; CE: SMD = 1.17, 95% CI = 0.64-1.71, P < .05; stroke of other determined etiology: SMD = 0.88, 95% CI = 0.53-1.24, P < .05; stroke of undetermined etiology: SMD = 1.50, 95% CI = 0.66-2.33, P < .05, respectively). CONCLUSION This meta-analysis found that ischemic stroke patients and the TOAST of ischemic stroke patients in Chinese had significantly higher homocysteine levels than the controls, suggesting that serum homocysteine levels may be a risk factor for ischemic stroke and the TOAST subtypes of ischemic stroke in Chinese.
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Affiliation(s)
- Tao Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yuan Jiang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Shuhua Zhang
- Tengzhou Central People's Hospital, Zaozhuang, Shandong province, China
| | - Tingting Tie
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yan Cheng
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Xiaoming Su
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Zhu Man
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jing Hou
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Li Sun
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Meiyuan Tian
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yaogang Zhang
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Jianhua Li
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
| | - Yanyan Ma
- Qinghai University Affiliated Hospital, Xining, Qinghai Province
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Fu L, Li YN, Luo D, Deng S, Wu B, Hu YQ. Evidence on the causal link between homocysteine and hypertension from a meta-analysis of 40 173 individuals implementing Mendelian randomization. J Clin Hypertens (Greenwich) 2019; 21:1879-1894. [PMID: 31769183 DOI: 10.1111/jch.13737] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/18/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022]
Abstract
Numerous researchers have investigated the associations among methylenetetrahydrofolate reductase gene (MTHFR) C677T polymorphism, homocysteine (Hcy) concentration, and hypertension. However, the results are controversial. Thus, a meta-analysis implementing Mendelian randomization approach was conducted to examine the hypothesis that elevated Hcy concentration plausibly contributes to increased risk of hypertension. Based on several inclusion and exclusion criteria, eligible studies were selected to explore the correlation between MTHFR C677T and hypertension risk, MTHFR C677T and Hcy concentration in hypertension, and Hcy concentration and hypertension, and they were evaluated by odds ratios (ORs), effect size (ES), and standard mean difference with their corresponding 95% confidence intervals (95% CIs), respectively. Moreover, Mendelian randomization was implemented to evaluate the relationship between Hcy and hypertension. Consequently, 14 378 cases and 25 795 controls were involved in this study and the results showed that MTHFR C677T led to an elevated risk of hypertension (for T vs C: OR = 1.27, 95% CI = 1.17-1.37; for TT vs CC: OR = 1.53, 95% CI = 1.30-1.79). Additionally, in hypertensive subjects, the pooled Hcy concentration in individuals of TT genotype was 7.74 μmol/L (95% CI: 5.25-10.23) greater than that in individuals of CC genotype. Moreover, the pooled Hcy concentration in hypertensive was 0.69 μmol/L (95% CI: 0.50-0.87) greater than that in controls. The estimated causal OR associated with hypertension was 1.32 for 5 μmol/L Hcy increment. Via MTHFR C677T polymorphism, the findings in the present study demonstrated that there exists evidence on causal link between Hcy concentration and the risk of hypertension.
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Affiliation(s)
- Liwan Fu
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Ya-Nan Li
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Dongmei Luo
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China.,Department of Information and Computing Science, School of Mathematics and Physics, Anhui University of Technology, Maanshan, China
| | - Shufang Deng
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Baihui Wu
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Yue-Qing Hu
- State Key Laboratory of Genetic Engineering, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China.,Shanghai Center for Mathematical Sciences, Fudan University, Shanghai, China
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Paradkar MU, Padate B, Shah SAV, Vora H, Ashavaid TF. Association of Genetic Variants with Hyperhomocysteinemia in Indian Patients with Thrombosis. Indian J Clin Biochem 2019; 35:465-473. [PMID: 33013017 DOI: 10.1007/s12291-019-00846-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 08/20/2019] [Indexed: 11/24/2022]
Abstract
Hyperhomocysteinemia known to be associated with increased thrombotic tendency has been considered as a risk factor for coronary artery disease, atherosclerosis, venous thrombosis, and stroke. There are three main genes MTHFR, cystathionine beta-synthase (CBS) and methionine synthase (MS) and it's genetic variant that are known to influence the homocysteine metabolism leading to hyperhomocysteinemia. There is scarcity of Indian data on hyperhomocysteinemia and genetics variants in patients with thrombosis. Hence the objective of present study was to determine MTHFR, CBS, and MS genetic variants in thrombosis patients from Indian population. Genetic variant analysis was performed on thrombosis patients to detect MTHFR C677T (rs1801133), MTHFR A1298C (rs1801131), MS A2756G (rs1805087) and CBS T833C (rs5742905) mutations. The mutant allele frequencies of MTHFR 677T, MTHFR 1298C, MS2756G and CBS 833C were observed to be 16.1%, 37.5%, 34.1% and 5.8% respectively. MTHFR 677TT genotype was observed to be significantly associated with elevated homocysteine (Hcy) levels (64.65 μmol/L) alleles as compared to CC alleles (32.43 μmol/L) and CT alleles (30.54 μmol/L). MTHFR A1298C, MS A2756G and CBS T833C genotypes did not showed significant association with higher Hcy levels. Thus, in Indian patients with thrombosis only MTHFR T677T genotype was observed to be significantly associated with hyperhomocysteinemia.
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Affiliation(s)
- Minal Umesh Paradkar
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Balkrishna Padate
- Department of Hemato-Oncology and Bone Marrow Transplant, P. D. Hinduja Hospital & Medical Research Centre, Veer Savrkar Marg, Mumbai 400016, India
| | - Swarup A V Shah
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Hiral Vora
- Research Laboratories, P. D. Hinduja Hospital & Medical Research Centre, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai 400016, India
| | - Tester F Ashavaid
- Department of Laboratory Medicine, Biochemistry Laboratory, P. D. Hinduja Hospital & Medical Research Center, Lalita Girdhar Bldg (S1), Veer Savarkar Marg, Mahim, Mumbai, 400 016 India
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Kumar M, Goudihalli S, Mukherjee K, Dhandapani S, Sandhir R. Methylenetetrahydrofolate reductase C677T variant and hyperhomocysteinemia in subarachnoid hemorrhage patients from India. Metab Brain Dis 2018; 33:1617-1624. [PMID: 29926428 DOI: 10.1007/s11011-018-0268-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/06/2018] [Indexed: 12/19/2022]
Abstract
Methylenetetrahydrofolate reductase (MTHFR) polymorphism (C677T, A1298C) has been implicated in increased plasma homocysteine (Hcy) levels. The present study was designed to investigate the association between MTHFR polymorphism and increased Hcy levels in subarachnoid haemorrhage (SAH) patients. A total of 150 subjects from North India were included in the study, comprising of 100 SAH patients and 50 healthy controls. Plasma Hcy levels was determined and MTHFR polymorphism (C677T, A1298C) was screened by High resolution melting (HRM) analysis. Plasma Hcy levels were found to be significantly higher (p < 0.001) in SAH patients than in healthy controls. No significant difference in the genotype and allele frequency of MTHFR A1298C was observed. However, frequency of MTHFR C677T genotype, CT (53% vs. 20%; p < 0.001) and TT (15% vs. 2%; p < 0.05) was significantly higher in SAH group as compared to healthy controls. The frequency of T allele (41.5% vs. 12%; p < 0.001) was also found to be higher in SAH patients in comparison to healthy controls. Furthermore, Hcy levels were higher in SAH patients with TT genotype than in patients having CT genotype, whereas CC genotype had lower Hcy levels. The study suggests that higher frequency of MTHFR C677T allele may contribute to etiopathology of SAH through increase in Hcy levels.
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Affiliation(s)
- Mohit Kumar
- Department of Biochemistry, Basic Medical Sciences Block-II, Panjab University, Sector-25, Chandigarh, 160014, India
| | - Sachin Goudihalli
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Kanchan Mukherjee
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sivashanmugam Dhandapani
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Rajat Sandhir
- Department of Biochemistry, Basic Medical Sciences Block-II, Panjab University, Sector-25, Chandigarh, 160014, India.
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Rashed L, Abdel Hay R, AlKaffas M, Ali S, Kadry D, Abdallah S. Studying the association between methylenetetrahydrofolate reductase (MTHFR) 677 gene polymorphism, cardiovascular risk and lichen planus. J Oral Pathol Med 2017; 46:1023-1029. [PMID: 28463405 DOI: 10.1111/jop.12588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is a reported relation between hyperhomocysteinemia and lichen planus (LP). An increase in homocysteine (Hcy) and the risk of cardiovascular disease (CVD) in patients with methylenetetrahydrofolate reductase (MTHFR) mutation has been described. OBJECTIVE To detect MTHFR (C677T) gene polymorphism, and to find its association with CVD risk, Hcy and folic acid levels in patients with LP. METHODS This hospital-based case-control study included 110 patients with LP: 70 with cutaneous LP (CLP) and 40 with oral LP (OLP). A total of 120 age- and sex-matched healthy subjects were used as controls. Three millilitre venous blood sample was taken for detection of MTHFR gene polymorphism by PCR-RFLP technique and for measurement of the lipid profile. Hcy and folic acid were measured by ELISA. Hypertension was evaluated. RESULTS There were significantly higher prevalence of hypertension with higher Hcy, triglycerides and cholesterol levels and lower folic acid and HDL levels among patients' groups. Hypertension with higher Hcy and cholesterol levels together with lower folic acid and HDL levels have been found in OLP when compared to CLP. Patients showed a significant higher percentage of the MTHFR 677 TT genotype (P=.003) and of the MTHFR 677 T allele (P=.042) compared to controls. Moreover, there was a higher prevalence of MTHFR 677 T allele in patients with CLP. CONCLUSION MTHFR 677 gene polymorphism may be a risk factor for the development of the LP, and to predispose these patients to higher risk of CVD.
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Affiliation(s)
- Laila Rashed
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania Abdel Hay
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa AlKaffas
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shereen Ali
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.,Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Dina Kadry
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sara Abdallah
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Kamberi B, Kamberi F, Spiroski M. Vascular Genetic Variants and Ischemic Stroke Susceptibility in Albanians from the Republic of Macedonia. Open Access Maced J Med Sci 2016; 4:556-564. [PMID: 28028391 PMCID: PMC5175499 DOI: 10.3889/oamjms.2016.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Acute first-ever ischemic stroke (FIS) is a heterogeneous, polygenic disorder. The contribution of vascular genetic variants as inherited causes of ischemic stroke has remained controversial. AIM To examine the association of genetic variants in vascular factors with the occurrence of FIS. MATERIAL AND METHODS The current research was performed in a group of 39 patients with FIS (study group) and 102 healthy volunteers (control group). We analyzed the prevalence of vascular genetic variants in following genes: factor V, prothrombin, methylenetetrahydrofolate reductase (MTHFR), factor XIII, plasminogen activator 1, endothelial protein C receptor (EPCR), apolipoprotein B, apolipoprotein E, β-fibrinogen, human platelet antigen 1, angiotensin-converting enzyme (ACE), endothelial nitric oxide synthase (eNOS) and lymphotoxin alpha. RESULTS It was found that heterozygous LTA 804C>A and FXIII V34L Leu/Leu were significantly more frequent in patients with FIS than in control group (p = 0.036 and p = 0.017, respectively). The frequency of FXIII V34L Val/Val was significantly lower in patients with FIS than in control group (p = 0.020). Other frequencies of vascular gene variants in patients with FIS and in control group were not significantly different. CONCLUSIONS This is the first comprehensive study to present data indicating that polymorphism of vascular genes in the prevalence of acute FIS exists in the Albanian population from the Republic of Macedonia. Variations in these genes have been detected in patients with acute FIS, suggesting that their combination might act in a susceptible or protective manner in this Albanian population.
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Affiliation(s)
- Bajram Kamberi
- Neurological Department, Clinical Hospital, Tetovo, Republic of Macedonia
| | - Farije Kamberi
- School Medical Centre, “Nikolla Shtejn” Tetovo, Republic of Macedonia
| | - Mirko Spiroski
- Institute of Immunobiology and Human Genetics, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Raina JK, Sharma M, Panjaliya RK, Bhagat M, Sharma R, Bakaya A, Kumar P. Methylenetetrahydrofolate reductase C677T and methionine synthase A2756G gene polymorphisms and associated risk of cardiovascular diseases: A study from Jammu region. Indian Heart J 2016; 68:421-30. [PMID: 27316508 PMCID: PMC4912384 DOI: 10.1016/j.ihj.2016.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/12/2016] [Accepted: 02/07/2016] [Indexed: 02/07/2023] Open
Abstract
Aim Potent risk factors at both genetic and non-genetic levels are accountable for susceptibility and instigation of different cardiovascular phenotypes. Recently, homocysteine is being identified as an important predictor for cardiovascular diseases. Homocysteine remethylation plays a key role in the synthesis of methionine and S-adenosine methionine. Methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) genes are known to regulate the homocysteine remethylation reaction and higher homocysteine level is significantly associated with diverse cardiovascular phenotypes. In this context, we aimed to carry out a study on the association of MTHFR (C677T) and MTR (A2756G) gene polymorphism with CVD in population of Jammu region of J&K state. Materials and methods A total of 435 individuals were enrolled (195 CVD patients and 240 controls) for the case–control study. Genotyping of MTHFR C677T and MTR A2756G gene polymorphism was done by PCR-RFLP technique. Biochemical parameters were estimated by biochemical analyser. Results Metabolic variables such as serum LDL-C, TC and TG were significantly higher in patients (p < 0.0001), whereas serum HDL-C was higher in controls. Majority of the patients were having history of hypertension (57.44%; p < 0.0001) as a concomitant condition. The evaluation of genetic association showed that, MTHFR C6877T (OR: 8.89, 95% CI: 2.01–39.40) and MTR A2756G (OR: 1.48, 95% CI: 1.09–2.00) polymorphisms associated with higher risk of CVD. Conclusion The present study reveals significant differences in nongenetic variables among patients and control as well as association of gene polymorphisms with CVD risk.
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Affiliation(s)
- Jyotdeep K Raina
- Human Genetics Research cum Counselling Centre, University of Jammu, 180006, India
| | - Minakashee Sharma
- Human Genetics Research cum Counselling Centre, University of Jammu, 180006, India
| | - Rakesh K Panjaliya
- Human Genetics Research cum Counselling Centre, University of Jammu, 180006, India
| | | | - Ravi Sharma
- Human Genetics Research cum Counselling Centre, University of Jammu, 180006, India; Department of Zoology, University of Jammu, India
| | - Ashok Bakaya
- Department of Cardiology, Acharaya Shri Chander College of Medical Sciences and Hospital (ASCOMS), Sidhra, Jammu, India
| | - Parvinder Kumar
- Principal Investigator, Human Genetics Research cum Counselling Centre, University of Jammu, 180006, India; Assistant Professor, Department of Zoology, University of Jammu, India.
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Gupta S, D'souza P, Dhali TK, Arora S. Serum Homocysteine and Total Antioxidant Status in Vitiligo: A Case Control Study in Indian Population. Indian J Dermatol 2016; 61:131-6. [PMID: 27057010 PMCID: PMC4817435 DOI: 10.4103/0019-5154.177764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Oxidative stress is considered as an initial pathogenic event in melanocyte destruction. These free radicals are scavenged by antioxidants, whose sum of activity in serum is measured by total antioxidant status (TAS). In addition, homocysteine (Hcy) may mediate melanocyte destruction via increased oxidative damage. However, previous studies investigating these parameters in vitiligo provide equivocal results. AIMS To study and compare serum Hcy and TAS levels in vitiligo patients with controls and also to correlate these parameters with the various disease characteristics. The present study further looked into any correlation between serum Hcy and TAS in vitiligo. MATERIALS AND METHODS A case control study was conducted on 82 vitiligo patients and 83 controls aged 18-45 years after excluding factors which could potentially alter serum Hcy or TAS levels. Disease characteristics were studied and blood samples were obtained for measuring serum Hcy and TAS levels. RESULTS TAS levels were lower in vitiligo patients than controls (1.79 ± 0.51 vs. 2.16 ± 0.63 mmol/L; P < 0.001) and had a negative correlation with disease activity (r = -0.410, P < 0.001). However, serum Hcy levels were comparable between vitiligo patients (18.68 ± 9.90 μmol/L) and controls (20.21 ± 13.39 μmol/L) (P = 0.406). No significant correlation was found between serum Hcy and serum TAS levels. CONCLUSIONS Serum TAS may be further investigated to establish its role as biomarker for vitiligo since its levels also correlate with disease activity. However, serum Hcy may not be a reliable marker in Indian population probably because of differences in dietary habits.
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Affiliation(s)
- Shikha Gupta
- Department of Dermatology, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Paschal D'souza
- Department of Dermatology, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Tapan Kumar Dhali
- Department of Dermatology, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Sarika Arora
- Department of Biochemistry, ESI-PGIMSR, Basaidarapur, New Delhi, India
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Kalpage HA, Sumathipala DS, Goonasekara HW, Dissanayake VH. A Study on Hereditary Thrombophilia and Stroke in a Cohort from Sri Lanka. J Stroke Cerebrovasc Dis 2016; 25:102-9. [DOI: 10.1016/j.jstrokecerebrovasdis.2015.08.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/20/2015] [Accepted: 08/28/2015] [Indexed: 11/25/2022] Open
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Fekih-Mrissa N, Mrad M, Klai S, Mansour M, Nsiri B, Gritli N, Mrissa R. Methylenetetrahydrofolate reductase (C677T and A1298C) polymorphisms, hyperhomocysteinemia, and ischemic stroke in Tunisian patients. J Stroke Cerebrovasc Dis 2013; 22:465-9. [PMID: 23642756 DOI: 10.1016/j.jstrokecerebrovasdis.2013.03.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 01/17/2013] [Accepted: 03/09/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The present study evaluated the role of the methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C gene polymorphisms and correlated these results with plasma homocysteine (Hcy) levels in Tunisian ischemic stroke (IS) patients. METHODS Overall, 84 patients with IS were included and compared with 100 healthy controls. The most common stroke risk factors were investigated. Fasting plasma Hcy levels were measured. Genotyping of the MTHFR C677T and A1298 polymorphisms was studied by polymerase chain reaction. RESULTS Aside from tobacco and alcohol use, the other studied factors were significant risk factors for IS. Mean plasma Hcy levels were significantly higher in IS patients than in controls (16.1 ± 8.28 μmol/L versus 8.76 ± 3.48 μmol/L, P < 10(-3)). Significant associations were found with both the MTHFR 677(CT + TT) and 1298 (AC + CC) genotypes in comparison with controls (P < 10(-3)). A significant synergistic interaction was also found with the double heterozygote MTHFR 677CT/1298AC (P < 10(-3)). Homocysteine levels were significantly higher in IS patients with the MTHFR C677T variant (CT and TT genotypes) (P < 10(-3)); however, the difference was not significant with the MTHFR A1298C variant (AC and CC genotypes) (P = .31). CONCLUSION The MTHFR C677T and A1298 polymorphisms (individually or in concert) and hyperhomocysteinemia represent important risk factors for IS. Elevated Hcy levels were found to be associated with the MTHFR C677T variant; however, no significant association was found with the MTHFR A1298C variant.
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Affiliation(s)
- Najiba Fekih-Mrissa
- Laboratory of Molecular Biology, Department of Hematology, Military Hospital, Tunisia.
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Yadav S, Hasan N, Marjot T, Khan MS, Prasad K, Bentley P, Sharma P. Detailed analysis of gene polymorphisms associated with ischemic stroke in South Asians. PLoS One 2013; 8:e57305. [PMID: 23505425 PMCID: PMC3591429 DOI: 10.1371/journal.pone.0057305] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/20/2013] [Indexed: 11/30/2022] Open
Abstract
The burden of stroke is disproportionately high in the South Asian subcontinent with South Asian ethnicity conferring a greater risk of ischemic stroke than European ancestry regardless of country inhabited. While genes associated with stroke in European populations have been investigated, they remain largely unknown in South Asians. We conducted a comprehensive meta-analysis of known genetic polymorphisms associated with South Asian ischemic stroke, and compared effect size of the MTHFR C677T-stroke association with effect sizes predicted from homocysteine-stroke association. Electronic databases were searched up to August 2012 for published case control studies investigating genetic polymorphisms associated with ischemic stroke in South Asians. Pooled odds ratios (OR) for each gene-disease association were calculated using a random-effects model. We identified 26 studies (approximately 2529 stroke cases and 2881 controls) interrogating 33 independent genetic polymorphisms in 22 genes. Ten studies described MTHFR C677T (108 with TT genotype and 2018 with CC genotype) -homocysteine relationship and six studies (735 stroke cases and 713 controls) described homocysteine-ischemic stroke relationship. Risk association ORs were calculated for ACE I/D (OR 5.00; 95% CI, 1.17–21.37; p = 0.03), PDE4D SNP 83 (OR 2.20; 95% CI 1.21–3.99; p = 0.01), PDE4D SNP 32 (OR 1.57; 95% CI 1.01–2.45, p = 0.045) and IL10 G1082A (OR 1.44; 95% CI, 1.09–1.91, p = 0.01). Significant association was observed between elevated plasma homocysteine levels and MTHFR/677 TT genotypes in healthy South Asians (Mean difference (ΔX) 5.18 µmol/L; 95% CI 2.03–8.34: p = 0.001). Our results demonstrate that the genetic etiology of ischemic stroke in South Asians is broadly similar to the risk conferred in Europeans, although the dataset is considerably smaller and warrants the same clinical considerations for risk profiling.
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Affiliation(s)
- Sunaina Yadav
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
| | - Nazeeha Hasan
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
| | - Thomas Marjot
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
| | - Muhammad S. Khan
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Paul Bentley
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
| | - Pankaj Sharma
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, United Kingdom
- * E-mail:
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Dhar S, Chatterjee S, Ray S, Dutta A, Sengupta B, Chakrabarti S. Polymorphisms of methylenetetrahydrofolate reductase gene as the genetic predispositions of coronary artery diseases in eastern India. J Cardiovasc Dis Res 2011; 1:152-7. [PMID: 21187870 PMCID: PMC2982204 DOI: 10.4103/0975-3583.70922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Gene–environment interaction is an important aspect in the development of coronary artery disease (CAD). The mutation (677C-T) of methylenetetrahydrofolate reductase (MTHFR) gene results in a decrease of the enzyme activity that leads to mild hyperhomocysteinemia. Elevated plasma level of homocysteine has been recognized as an independent risk factor for cardiovascular disease. A case–control study was designed to assess whether the prevalence of some MTHFR gene polymorphisms have any role in the development of CAD. Materials and Methods: The study included unrelated 217 cases with CAD and 255 healthy controls. DNA was extracted from peripheral blood. MTHFR genotypes were identified by seeing the presence or absence of 677C→T mutation obtained by PCR followed by Hinf1 restriction digestion. Multiple logistic regression analysis was carried out to find association between studied genotypes and lifestyle as well as biochemical risk factors. Results: The T allele was found to be associated with the disease. Significant associations were found with smoking, hypertension, diabetes, and family history of CAD. Conclusion: The results indicate that MTHFR 677C-T polymorphism has significant association with CADs in the population of eastern India.
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Affiliation(s)
- Soujatya Dhar
- Thalassemia Research Unit, Vivekananda Institute of Medical Sciences 99, Sarat Bose Road, Kolkata - 700 026, West Bengal, India
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Somarajan BI, Kalita J, Mittal B, Misra UK. Evaluation of MTHFR C677T polymorphism in ischemic and hemorrhagic stroke patients. A case-control study in a Northern Indian population. J Neurol Sci 2011; 304:67-70. [PMID: 21406306 DOI: 10.1016/j.jns.2011.02.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 01/11/2011] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The present study was aimed to evaluate MTHFR C677T gene polymorphism in patients with ischemic stroke (IS) and intracerebral hemorrhage (ICH) and compare it with controls. METHODS 207 patient with IS and 215 with CT/MRI proven ICH were included and compared with 188 healthy controls. The stroke risk factors, location of IS, its vascular territory and in ICH the location of hematoma were noted. MTHFR C677T polymorphism was studied by polymerase chain reaction. RESULTS Hypertension was present in 65.9% of ICH and 48.8% of IS. Other stroke risk factors were not significantly different. The frequency of the CC genotype in controls was 68.6%. CT in 28.7% and TT in 2.7%, whereas it was 75.3%, 20.5% and 4.2% in ICH and 66.2%, 39.4% and 2.4% respectively in IS. The frequency of these genotypes as well as allele frequency was not different in IS, ICH as compared to controls, however variant allele was more frequent in IS compared to ICH. Homocysteine level was higher in IS patients with variant genotype INTERPRETATION MTHFR C677T gene polymorphism was neither associated with hemorrhagic nor ischemic stroke. However raised homocysteine levels were found to be associated with MTHFRC677-TT genotype in IS patients.
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Affiliation(s)
- B I Somarajan
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Tripathi M, Vibha D. Stroke in young in India. Stroke Res Treat 2010; 2011:368629. [PMID: 21234342 PMCID: PMC3017944 DOI: 10.4061/2011/368629] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 11/10/2010] [Indexed: 01/13/2023] Open
Abstract
Stroke in young has special significance in developing countries. This is so because some etiologies like cardioembolic infections are more common than in developed countries, and the affection of economically productive group adds further to the overall disease burden. The paper discusses the burden of stroke in young and its implications in a developing country like India along with an approach to identifying different causes that are known to occur in this age group.
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Affiliation(s)
- Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Karadeniz M, Erdogan M, Zengi A, Eroglu Z, Tamsel S, Olukman M, Saygili F, Yilmaz C. Methylenetetrahydrofolate reductase C677T gene polymorphism in Turkish patients with polycystic ovary syndrome. Endocrine 2010; 38:127-33. [PMID: 20960113 DOI: 10.1007/s12020-010-9370-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 06/28/2010] [Indexed: 11/28/2022]
Abstract
Higher Levels of Hcy are associated with several clinical conditions, among them non-insulin-dependent diabetes mellitus, endometrial dysplasia and hypertension with insulin resistance, and polycystic ovary syndrome. The purpose of this study was to investigate the serum homocystein levels and other metabolic parameters in relationship with the MTHFR C677T gene polymorphism in patients with PCOS. Our study included 86 young women with PCOS constituting the study group and 70 healthy women constituting the control group. Homocystein levels, metabolic, and hormonal parameters were measured, and genetic analysis of the MTHFR C677T gene polymorphism was performed in all the subjects. A statistically significant difference was observed in mean homocystein levels between patients with PCOS when compared to the control group. The MTHFR 677 CC genotypes had significantly higher proportions in the control group compared to the PCOS patients (χ(2) = 21.381, P < 0.001). Our data show that homocystein levels were higher than normal subjects in patients with PCOS and that the MTHFR C677T gene polymorphism does not influence homocystein levels of patients with PCOS.
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Affiliation(s)
- Muammer Karadeniz
- Endocrinology and Metabolism Disease, Ege University Medical School, Bornova, Izmir, Turkey.
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Misra UK, Kalita J, Srivastava AK, Agarwal S. MTHFR Gene Polymorphism and Its Relationship with Plasma Homocysteine and Folate in a North Indian Population. Biochem Genet 2009; 48:229-35. [DOI: 10.1007/s10528-009-9312-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Accepted: 11/03/2009] [Indexed: 10/20/2022]
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Bayir A, Ak A, Ozdinç S, Seydanoğlu A, Köstekçi SK, Kara F. Acute-phase vitamin B12 and folic acid levels in patients with ischemic and hemorrhagic stroke: is there a relationship with prognosis? Neurol Res 2009; 32:115-8. [PMID: 19825273 DOI: 10.1179/016164109x12445616596201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of this study was to investigate blood folic acid and vitamin B12 levels in patients with ischemic and hemorrhagic stroke patients and correlate these levels with prognosis. METHODS Patients presenting within 3 hours of onset of ischemic or hemorrhagic strokes were approached for participation in the study. Diagnosis was made by clinical examination and head computed tomography scan. Venous blood samples were taken for determination of blood folic acid and vitamin B12 levels. Parameters were evaluated with respect to stroke type and according to Glasgow coma scale (< or =8 or > or =9). RESULTS Eighty-seven patients with ischemic stroke (mean age: 65 +/- 10 years, 53% male) and 27 patients with hemorrhagic stroke (mean age: 60 +/- 10 years, 56% male) were included in the study. A significant direct correlation was found between Glasgow coma scale and mean plasma B12 levels in ischemic, but not hemorrhagic, stroke (r=112.75 and p=0.007, respectively). A significant direct correlation was found between Glasgow coma scale and mean plasma folic acid levels in hemorrhagic, but not ischemic, stroke (r=1.03 and p=0.017, respectively). In patients with Glasgow coma scale < or =8 (either hemorrhagic or ischemic stroke), a significant direct correlation was found between Glasgow coma scale and blood vitamin B12 levels. Vitamin B12 levels were significantly lower in patients with Glasgow coma scale < or =8 than in patients with Glasgow coma score > or =9 (p=0.04). CONCLUSIONS In patients with ischemic stroke, low vitamin B12 levels, and in patients with hemorrhagic stroke, low blood folic acid levels, are associated with lower Glasgow coma scale values and higher hospital mortality.
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Affiliation(s)
- Ayşegül Bayir
- Department of Emergency Medicine, Meram Faculty of Medicine, Selçuk University, Meram, Konya 42080, Turkey.
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De Silva DA, Woon FP, Chen CLH, Chang HM, Wong MC. Ethnic South Asian ischaemic stroke patients have a higher prevalence of a family history of vascular disease compared to age, gender and diabetes-matched ethnic Chinese subjects. J Neurol Sci 2009; 285:118-20. [DOI: 10.1016/j.jns.2009.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 05/26/2009] [Accepted: 06/10/2009] [Indexed: 10/20/2022]
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Biswas A, Ranjan R, Meena A, Akhter MS, Yadav BK, Munisamy M, Subbiah V, Behari M, Saxena R. Homocystine levels, polymorphisms and the risk of ischemic stroke in young Asian Indians. J Stroke Cerebrovasc Dis 2009; 18:103-10. [PMID: 19251185 DOI: 10.1016/j.jstrokecerebrovasdis.2008.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 08/22/2008] [Accepted: 09/11/2008] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Homocysteine has been for a fairly long time been debated to be a risk factor for stroke. Opinions are divided as to whether raised levels of homocysteine seen in stroke patients are the cause or consequence of stroke. A large number of studies have been conducted in the Caucasian as well as on the Oriental population, which tend to suggest contradictory findings at many times. However, there have been no reports forthcoming from the Asian Indian population, which is a genetically different population than the previously studied populations. SUBJECTS AND METHODS In our present study, we looked at homocysteine levels and four commonly seen polymorphisms of homocysteine metabolizing enzymes and their respective prevalence in 120 acute onset ischemic stroke patients compared with an equal number of age and gender matched healthy population. We also tested the influence of folic acid dosage (5 mg OD) on the levels of homocysteine and the allied vitamin supplements, vitamin B12 and folate in smaller groups selected from the larger group. RESULTS AND CONCLUSIONS We found homocysteine levels to be significantly raised in the stroke population compared with healthy controls [patients: 12 micromol/L (range: 5.3-39.1 micromol/L), controls: 11.2 micromol/L (range: 6.2-14.2 micromol/L); P =0.001]. There was an almost total response to folic acid dosage as all hyperhomocysteinemic patients showed lowering of homocysteine levels in response to the dosage. The MTHFR 677 C > T polymorphisms showed association with both homocysteine levels as well as stroke (P < 0.001). Nutritional deficiency plays a dominant role in hyperhomocysteinemic conditions in our stroke population, however. Genetic determinants of homocysteine level may also have some part in determining hyperhomocysteinemic conditions in the Asian Indian populations.
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Affiliation(s)
- Arijit Biswas
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Dhamija RK, Gaba P, Arora S, Kaintura A, Kumar M, Bhattacharjee J. Homocysteine and lipoprotein (a) correlation in ischemic stroke patients. J Neurol Sci 2009; 281:64-8. [PMID: 19285692 DOI: 10.1016/j.jns.2009.02.341] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 02/10/2009] [Accepted: 02/13/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND Homocysteine and Lipoprotein (a) have been recognized as risk factors for coronary heart disease. However, their role in ischemic stroke is still not defined. Therefore the present study was undertaken to evaluate their levels and relationship in patients of ischemic stroke. METHODS The study was conducted in consecutive patients admitted with a diagnosis of acute ischaemic stroke and age and sex matched healthy controls. Plasma homocysteine and serum l lipoprotein (a) levels were determined in the fasting venous blood samples using ELISA and immunoturbidimetric assay respectively. RESULTS 66 patients with ischaemic stroke (30 males, 36 females) of mean age 54.43+/-1.97 years and 72 controls (39 males, 33 females) of mean age 53.86+/-1.88 years were studied. Mean plasma homocysteine levels in the stroke patients and control groups were 28.40+/-2.08 micromol/L and 11.16+/-1.09 micromol/L respectively (p<0.001). Odds ratio for raised homocysteine levels in stroke cases was 15.7. Plasma homocysteine levels showed a positive correlation with smoking (Pearson's correlation coefficient=0.324 and p-value of 0.008), (Odds ratio=5.71). Serum Lipoprotein (a) levels in stroke cases and control group were 57.33+/-4.40 mg/dl and 23.46+/-1.09 mg/dl respectively, (p<0.001), (Odds Ratio=8.62). A positive correlation was also observed between Homocysteine and Lipoprotein (a) levels with Pearson's correlation coefficient of 0.75 and p-value<0.001. CONCLUSIONS Raised homocysteine and serum lipoprotein (a) levels were found to be independently associated with ischemic stroke with a significant positive correlation between the two parameters. Elevated homocysteine levels may modulate the toxicity of lipoprotein (a) in ischemic stroke.
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Affiliation(s)
- Rajinder K Dhamija
- Department of Medicine, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
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C677T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of ischemic stroke in Polish subjects. J Appl Genet 2009; 50:63-7. [DOI: 10.1007/bf03195654] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kalita J, Kumar G, Bansal V, Misra UK. Relationship of homocysteine with other risk factors and outcome of ischemic stroke. Clin Neurol Neurosurg 2009; 111:364-7. [PMID: 19185985 DOI: 10.1016/j.clineuro.2008.12.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 11/14/2008] [Accepted: 12/24/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Hyperhomocysteinemia (HH) is an emerging risk factor for ischemic stroke but its role in outcome is controversial. We compare the risk factors, nature of stroke and outcome of patients with and without hyperhomocysteinemia. PATIENTS AND METHODS CT proven ischemic stroke patients were included. The conventional risk factors such as diabetes, hypertension, hyperlipidemia, obesity, smoking, and family history of stroke were recorded. Dietary history was noted. Fasting serum homocysteine (Hcy), B12 and folic acid were estimated after 1 month of stroke. Severity of stroke was assessed by Canadian Neurological Scale (CNS) and outcome at 3 months by Barthel Index (BI) score into good (BI > or = 12) and poor (BI < 12). Serum Hcy, B12 and folic acid were also estimated in 200 normal healthy volunteers. RESULTS There were 198 patients with ischemic stroke whose median age was 56 years and 36 were females. In the study group, 41.4% patients were vegetarian, 55.1% hypertensive, 24.7% diabetic, 30.8% smoker, 61.1% sedentary and 28.8% obese. 23.2% had past history of stroke and 21.7% had stroke in their first degree relative. Serum cholesterol was elevated in 11.7% and LDL in 10.8% patients. Serum Hcy was elevated in 60.6% and serum B12 low in 25.7% and folic acid in 42.1%. Hcy levels correlated with serum B12 and LDL. Patients with hyperhomocysteinemia had significantly better outcome at 3 months. Hcy levels in stroke patients did not significantly differ from controls. CONCLUSION Hyperhomocysteinemia is found in 60.6% stroke patients, which is related to low serum B12 level. Patients with hyperhomocysteinemia had a better 3-month outcome.
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Affiliation(s)
- Jayantee Kalita
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow 226014, India
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Prothrombotic polymorphisms, mutations, and their association with pediatric non-cardioembolic stroke in Asian-Indian patients. Ann Hematol 2008; 88:473-8. [PMID: 18836720 DOI: 10.1007/s00277-008-0613-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Accepted: 09/22/2008] [Indexed: 01/22/2023]
Abstract
Genes involved in the hemostatic mechanism are logical candidate genes for association studies in prothrombotic conditions such as stroke. Since the underlying etiology in pediatric strokes is different than adults, looking for genetic causes would be the logical thing to do in the pediatric stroke population. Fifty-eight Asian-Indian stroke patients below 15 years of age and equal number of age- and sex-matched healthy controls were the subjects for the study. The subjects were screened for 13 polymorphisms and three mutations spread across seven different candidate genes involved in the hemostatic system. Of the 13 polymorphisms and three mutations studied, four polymorphisms, HPA-I, TAFI 147Ala>Thr, methylene tetrahydrofolate reductase (MTHFR) 677 C>T, and MTHFR 1298 A>C, showed significant association with the disease phenotype. MTHFR 677 C>T showed the strongest association and therefore may have a strong predisposing role for pediatric strokes. Gene-gene interaction studies showed a strong interaction between HPA-I and MTHFR 677 C>T polymorphism. The wild type of both these polymorphisms synergistically showed a strong protective effect [p < 0.0001, O.R: 10.06(4.26-23.71)]. Polymorphisms in HPA-I and MTHFR may have important predisposing roles in the development of pediatric stroke.
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Trabetti E. Homocysteine,MTHFR gene polymorphisms, and cardio-cerebrovascular risk. J Appl Genet 2008; 49:267-82. [DOI: 10.1007/bf03195624] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Titlic M, Pavelin S, Tonkic A, Jukic I, Buca A, Andelinovic S. Thrombosis of sinus sagitalis during puerperium caused by thrombophilic gene mutation. J Thromb Thrombolysis 2007; 25:270-2. [PMID: 17574520 DOI: 10.1007/s11239-007-0061-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 05/17/2007] [Indexed: 12/01/2022]
Abstract
Cerebral veno-sinus thrombosis (CVT) during puerperium may have fatal consequences. A nonspecific clinical picture must be complete with computed tomography of the brain and digital substract angiography of the brain blood vessels, and, once the clinical diagnosis is confirmed, coagulation tests and genetic analysis of the coagulation factor are to be made as well. Genetic polymorphisms associated with thrombophilia such as factor V Leiden, prothrombin G20210A, MTHFR C677T, ACE and PIA1/A2 may be the cause of the hypercoagulability that results in CVT.
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Affiliation(s)
- Marina Titlic
- Department of Neurology, Split University Hospital, Spincićeva 1, Split 21 000, Croatia.
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