Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Metabolism. 2010 May;59(5):728-33. doi: 10.1016/j.metabol.2009.09.017. Epub 2009 Nov 14.
Low folate and high homocysteine levels are emerging as important risk factors for atherosclerosis and predictors of early coronary heart disease. We evaluated folate and homocysteine levels, compared them with endothelial function, and analyzed their association with the methylenetetrahydrofolate reductase (MTHFR) and endothelial nitric oxide synthase genotypes. We recruited 71 young healthy male nonsmokers without overt cardiovascular or renal disease. Plasma homocysteine levels were enhanced 2-fold in the subjects with the MTHFR 677T/T compared with the others (P = .0001) and also enhanced in the subjects with the endothelial nitric oxide synthase -786C allele (P = .031). Homocysteine levels were independently predicted only by the MTHFR genotype. A relationship between folate and homocysteine levels was not significant. Plasma folate levels were associated independently either with high-density lipoprotein cholesterol levels or with endothelial function in the brachial artery. These results suggest that low folate levels may be a risk factor for cardiovascular diseases regardless of homocysteine levels and that the subjects with lower folate levels should be recommended for dietary folic acid supplementation to elevate endothelial function and probably increase high-density lipoprotein cholesterol levels.
叶酸水平低和高同型半胱氨酸水平是动脉粥样硬化的重要危险因素和早期冠心病的预测因子。我们评估了叶酸和同型半胱氨酸水平，将其与内皮功能进行了比较，并分析了它们与亚甲基四氢叶酸还原酶（MTHFR）和内皮型一氧化氮合酶基因型的关系。我们招募了 71 名无明显心血管或肾脏疾病的年轻健康男性非吸烟者。与其他基因型相比，MTHFR 677T/T 基因型的受试者血浆同型半胱氨酸水平升高了 2 倍（P=0.0001），内皮型一氧化氮合酶-786C 等位基因的受试者也升高了（P=0.031）。同型半胱氨酸水平仅受 MTHFR 基因型独立预测。叶酸和同型半胱氨酸水平之间没有显著的关系。血浆叶酸水平与高密度脂蛋白胆固醇水平或肱动脉内皮功能独立相关。这些结果表明，无论同型半胱氨酸水平如何，低叶酸水平可能是心血管疾病的危险因素，建议叶酸水平较低的受试者通过饮食补充叶酸来提高内皮功能，并可能增加高密度脂蛋白胆固醇水平。
