Clinical Research Center, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
J Thromb Thrombolysis. 2013 Jul;36(1):77-83. doi: 10.1007/s11239-012-0807-6.
Hyperhomocysteinemia is considered a risk factor for atherosclerosis. Methyltetrahydrofolate reductase (MTHFR) gene mutation and low level of plasma vitamin B12 and folate could take part in the etiology of peripheral arterial disease (PAD). We examined whether plasma vitamin B12 and folate levels and MTHFR-C677T polymorphism are associated with the risk of PAD. The study comprised 293 patients (107 females, 186 males, mean age of 66 ± SEM0.7 years) and 293 sex-matched control subjects (mean age of 62 ± SEM0.8 years). We also determined plasma lipid profile, hs-CRP, creatinine, vitamin B12, folate and total homocysteine (tHcy) for all patients and controls. Odds ratios were non-significant for different genotypes of MTHFR-C677T polymorphism. There was a significant lower level of vitamin B12 in PAD patients. 43 and 25 % of patient and control populations were in the lowest quartile of vitamin B12 (<188 pmol/L), respectively. Plasma level of vitamin B12 in the lowest quartile significantly increased tHcy level in PAD patients, and it was independent of plasma folate level. Low level of plasma vitamin B12 was independently associated with hyperhomocysteinemia in PAD patients. The prevalence of the MTHFR-C677T mutation was not significantly different in patients with PAD compared with controls.
高同型半胱氨酸血症被认为是动脉粥样硬化的一个危险因素。亚甲基四氢叶酸还原酶(MTHFR)基因突变和低水平的血浆维生素 B12 和叶酸可能参与周围动脉疾病(PAD)的病因。我们研究了血浆维生素 B12 和叶酸水平以及 MTHFR-C677T 多态性是否与 PAD 的风险相关。该研究包括 293 例患者(107 名女性,186 名男性,平均年龄 66 ± SEM0.7 岁)和 293 名性别匹配的对照组(平均年龄 62 ± SEM0.8 岁)。我们还为所有患者和对照组测定了血脂谱、hs-CRP、肌酐、维生素 B12、叶酸和总同型半胱氨酸(tHcy)。不同 MTHFR-C677T 多态性基因型的比值比无显著性差异。PAD 患者的维生素 B12 水平显著降低。患者和对照组人群中分别有 43%和 25%处于维生素 B12 最低四分位数(<188 pmol/L)。维生素 B12 水平处于最低四分位数的 PAD 患者的 tHcy 水平显著升高,且独立于血浆叶酸水平。低水平的血浆维生素 B12 与 PAD 患者的高同型半胱氨酸血症独立相关。与对照组相比,PAD 患者的 MTHFR-C677T 突变率无显著差异。