Cardiology Department, Nicosia General Hospital, 215 Old Road Nicosia-Limassol, Strovolos, Nicosia, Cyprus.
Hellenic J Cardiol. 2012 May-Jun;53(3):189-94.
Increased levels of homocysteine are known to be associated with coronary artery disease (CAD). The most common form of genetic hyperhomocysteinemia results from MTHFR polymorphisms. To examine the role of homocysteine levels and MTHFR polymorphisms in premature CAD and acute myocardial infarction (MI) in the Cypriot population, a case control study was performed in Nicosia General Hospital.
Sixty-three male patients less than 50 years old who presented with MI in Nicosia General Hospital were compared with 54 controls without CAD. Fasting homocysteine and lipids were tested within 24 hrs from admission, while MTHFR C677T and A1298C polymorphisms were also tested.
Mean homocysteine levels were 14.5 mol/L in patients and 12.3 mol/L in controls (p=0.017). Mutant homozygous MTHFR C677T was present in 17.7% of the patients and 19.2% of the controls (p=0.838), while mutant homozygous MTHFR A1298C was found in 16.1% of patients and 13.5% of controls (p=0.690). Mean homocysteine levels were 12.6 mol/L in patients with single-vessel CAD and 15.5 mol/L in patients with multi-vessel CAD (p=0.025). Lower HDL appeared to be associated with higher levels of homocysteine with an odds ratio of 0.901, indicating that for each unit increase in HDL, the expected odds of having high homocysteine levels decreased by approximately 10%.
Higher levels of homocysteine are associated with acute MI and multi-vessel disease in Cypriot patients under the age of 50. The existence and extent of disease are not associated with MTHFR polymorphisms. Lower HDL is associated with higher levels of homocysteine.
已知同型半胱氨酸水平升高与冠状动脉疾病（CAD）有关。最常见的遗传性高同型半胱氨酸血症是由于 MTHFR 多态性引起的。为了研究同型半胱氨酸水平和 MTHFR 多态性在塞浦路斯人早发 CAD 和急性心肌梗死（MI）中的作用，在尼科西亚综合医院进行了一项病例对照研究。
尼科西亚综合医院 63 名年龄小于 50 岁的 MI 患者与 54 名无 CAD 的对照组进行比较。在入院后 24 小时内检测空腹同型半胱氨酸和血脂，同时检测 MTHFR C677T 和 A1298C 多态性。
患者的平均同型半胱氨酸水平为 14.5 μmol/L，对照组为 12.3 μmol/L（p=0.017）。患者中突变纯合 MTHFR C677T 为 17.7%，对照组为 19.2%（p=0.838），而患者中突变纯合 MTHFR A1298C 为 16.1%，对照组为 13.5%（p=0.690）。单支血管 CAD 患者的平均同型半胱氨酸水平为 12.6 μmol/L，多支血管 CAD 患者为 15.5 μmol/L（p=0.025）。较低的高密度脂蛋白（HDL）似乎与较高的同型半胱氨酸水平相关，优势比为 0.901，这表明每增加一个单位的 HDL，同型半胱氨酸水平升高的预期几率就会降低约 10%。
塞浦路斯 50 岁以下患者的同型半胱氨酸水平升高与急性 MI 和多支血管疾病相关。MTHFR 多态性与疾病的存在和严重程度无关。较低的 HDL 与较高的同型半胱氨酸水平相关。
