Northern Ireland Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, UK.
Proc Nutr Soc. 2010 Feb;69(1):156-65. doi: 10.1017/S0029665109991728. Epub 2009 Dec 3.
High blood pressure (BP) and elevated homocysteine are reported as independent risk factors for CVD and stroke in particular. The main genetic determinant of homocysteine concentrations is homozygosity (TT genotype) for the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene, typically found in approximately 10% of Western populations. The B-vitamins folate, vitamin B12 and vitamin B6 are the main nutritional determinants of homocysteine, with riboflavin more recently identified as a potent modulator specifically in individuals with the TT genotype. Although observational studies have reported associations between homocysteine and BP, B-vitamin intervention studies have shown little or no BP response despite decreases in homocysteine. Such studies, however, have not considered the MTHFR C677T polymorphism, which has been shown to be associated with BP. It has been shown for the first time that riboflavin is an important determinant of BP specifically in individuals with the TT genotype. Research generally suggests that 24 h ambulatory BP monitoring provides a more accurate measure of BP than casual measurements and its use in future studies may also provide important insights into the relationship between the MTHFR polymorphism and BP. Further research is also required to investigate the association between specific B-vitamins and BP in individuals with different MTHFR genotypes in order to confirm whether any genetic predisposition to hypertension is correctable by B-vitamin intervention. The present review will investigate the evidence linking the MTHFR C677T polymorphism to BP and the potential modulating role of B-vitamins.
高血压（BP）和高同型半胱氨酸被报道为心血管疾病和中风的独立危险因素。同型半胱氨酸浓度的主要遗传决定因素是亚甲基四氢叶酸还原酶（MTHFR）基因中 C677T 多态性的纯合子（TT 基因型），这种基因型在约 10%的西方人群中常见。同型半胱氨酸的主要营养决定因素是叶酸、维生素 B12 和维生素 B6，最近发现核黄素（riboflavin）在 TT 基因型个体中是一种有效的调节剂。尽管观察性研究报告了同型半胱氨酸与血压之间的关联，但 B 族维生素干预研究显示，尽管同型半胱氨酸降低，但血压反应很小或没有。然而，这些研究没有考虑到 MTHFR C677T 多态性，该多态性与血压有关。首次表明，核黄素是 TT 基因型个体血压的重要决定因素。研究表明，24 小时动态血压监测比偶然测量更能准确地衡量血压，未来的研究也可能为 MTHFR 多态性与血压之间的关系提供重要的见解。为了证实高血压的遗传易感性是否可以通过 B 族维生素干预来纠正，还需要进一步研究不同 MTHFR 基因型个体中特定 B 族维生素与血压之间的关系。本综述将调查与 MTHFR C677T 多态性与血压相关的证据，并探讨 B 族维生素的潜在调节作用。
