MTHFR基因多态性及其他相关因素与Hhcy的相关性研究

Research on the Correlation between MTHFR Gene Polymorphism and Other Related Factors with Hhcy

摘要: 目的：探讨亚甲基四氢叶酸还原酶(5, 10-methylenetetrahydrofolate reductase, MTHFR)基因多态性及其他相关因素与高同型半胱氨酸血症(hyper homocysteinermia, Hhcy)的相关性，为Hhcy防治提供数据支撑。方法：2017年11月至2019年10月，纳入北华大学附属医院神经内科就诊患者300例作为研究对象。以血浆同型半胱氨酸(homocysteinermia, Hcy)浓度15.4 umol/L为限定值，将患者分组为Hcy正常组(<15.4 umol/L，135例)与Hhcy组(≥15.4 umol/L，165例)。收集患者一般资料、既往病史，并记录其血清中FPG、TG、TC、HDL-C、LDL-C水平以及MTHFR基因型。数据处理采用SPSS 22.0软件。运用t检验、χ²检验及Logistic回归方法进行统计学分析，认定P < 0.05存在统计学差异。结果：1. 单因素分析显示：男性(P < 0.001)、年龄(P < 0.001)、高血压(P = 0.022)、糖尿病(P = 0.006)、HDL (P = 0.019)、FBG (P = 0.041)、MTHFR基因型(P < 0.001)在两组间存在统计学差异。Hhcy组中吸烟(P = 0.051)、饮酒(P = 0.359)、冠心病(P = 0.636)、TG (P = 0.395)、TC (P = 0.210)、LDL (P = 0.713)比例与Hcy正常组无明显差异。2. 多因素分析显示：性别、年龄、高血压、糖尿病以及MTHFR基因TT型与Hhcy发生存在相关性(P < 0.05)。其中年龄 ≥ 60岁、合并高血压病史、MTHFR基因TT型是Hhcy的危险因素(OR > 1)，女性以及合并糖尿病是Hhcy发生的保护性因素(OR < 1)。结论：高龄(≥60岁)、合并高血压病史或MTHFR基因TT型是Hhcy的危险因素。

Abstract: Objective: To investigate the correlation between MTHFR gene polymorphisms and other related factors and hyperhomocysteinemia (Hhcy), and to provide data support for the prevention and treatment of Hhcy. Methods: From November 2017 to October 2019, 300 patients admitted to the Neurology Department of the Affiliated Hospital of North China University were included as research subjects. The patients were divided into two groups according to the limit value of homocysteine (Hcy) in plasma (15.4 umol/L), with 135 cases in the normal Hcy group (<15.4 umol/L) and 165 cases in the Hhcy group (≥15.4 umol/L). The general information, past medical history, and serum levels of FPG, TG, TC, HDL-C, and LDL-C were collected, and the MTHFR gene type was recorded. Data processing was performed using SPSS 22.0 software. The t-test, χ² test, and Logistic regression method were used for statistical analysis, with a P value of<0.05 considered to indicate a statistically significant difference. Results 1. Univariate analysis showed that there were statistically significant differences between the two groups in gender (P < 0.001), age (P < 0.001), hypertension (P = 0.022), diabetes (P = 0.006), HDL (P = 0.019), FPG (P = 0.041), and MTHFR gene type (P < 0.001). The proportions of smoking (P = 0.051), alcohol consumption (P = 0.359), coronary heart disease (P = 0.636), TG (P = 0.395), TC (P = 0.210), LDL (P = 0.713) in the Hhcy group were not significantly different from those in the Hcy normal group. 2. Multivariate analysis showed that gender, age, hypertension, diabetes, and MTHFR gene TT type were associated with the occurrence of Hhcy (P < 0.05). Among them, age ≥ 60 years, hypertension history, and MTHFR gene TT type were risk factors for Hhcy (OR > 1), while female gender and diabetes were protective factors for Hhcy (OR < 1). Conclusion: Advanced age (≥60 years) and a history of hypertension or the TT genotype of the MTHFR gene are risk factors for Hhcy.