Ankara and Research Hospital, Department of Physical Medicine and Rehabilitation, 06340 Cebeci/Ankara, Turkey.
Rheumatol Int. 2013 Jun;33(6):1519-24. doi: 10.1007/s00296-012-2552-8. Epub 2012 Dec 18.
The aim of this study was to determine the intima-media thickness (IMT) in carotid arteries and to assess the relation of these values with plasma homocysteine (pHcy) levels and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with Ankylosing spondylitis (AS). Serum lipids, vitamin B12, folic acid, pHcy and acute phase protein levels were measured in all cases. MTHFR C677T gene polymorphisms were determined, and IMT of main carotid artery were evaluated ultrasonographically in all subjects. Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity score and Bath Ankylosing Spondylitis Metrology Index were used to assess disease activity and spinal mobility. Fifty AS patients (mean age of 36.6 ± 4.79 years) and 50 control subjects (36.34 ± 4.72 years) were included in the study. Plasma homocysteine levels of AS patients and control group were also similar (14.26 ± 9.96 vs. 11.81 ± 5.53 μmol/L). Hyperhomocysteinemia was present in 11 subjects in patient group (22.0 %), while it was seen in 5 subjects in the control group (10.0 %). The MTHFR C677T genotype distribution was as follows: CC 31 (62 %), CT 14 (28 %), TT 5 (10 %) in AS patients. The mean carotid IMT values were also found to be similar between the groups. The most important factor influencing pHcy level was found as MTHFR 677TT genotype. We indicated no difference of atherosclerosis indices revealed by IMT values and pHcy levels AS patients and control subjects. But an association between MTHFR 677 gene polymorphism and pHcy levels was concluded, which may suggest that MTHFR 677 TT polymorphism may be a potential prognostic factor for cardiovascular disease in patients with AS.
本研究旨在测定颈总动脉内-中膜厚度（IMT），评估其与血清同型半胱氨酸（pHcy）水平和亚甲基四氢叶酸还原酶（MTHFR）C677T 基因多态性的关系。所有患者均测定血脂、维生素 B12、叶酸、pHcy 和急性期蛋白水平，所有受试者均行颈动脉超声检查评估 MTHFR C677T 基因多态性和主要颈动脉内-中膜厚度。采用 Bath 强直性脊柱炎疾病活动指数、强直性脊柱炎疾病活动评分和 Bath 强直性脊柱炎测量指数评估疾病活动度和脊柱活动度。本研究纳入 50 例强直性脊柱炎患者（平均年龄 36.6 ± 4.79 岁）和 50 例对照组（平均年龄 36.34 ± 4.72 岁）。结果显示，两组患者 pHcy 水平相似（14.26 ± 9.96 vs. 11.81 ± 5.53 μmol/L）。患者组中 11 例（22.0%）存在高同型半胱氨酸血症，对照组中 5 例（10.0%）存在高同型半胱氨酸血症。MTHFR C677T 基因型分布为：CC 31 例（62%）、CT 14 例（28%）、TT 5 例（10%）。两组颈动脉 IMT 值相似。结果显示，影响 pHcy 水平的最重要因素是 MTHFR 677TT 基因型。本研究表明，AS 患者和对照组的 IMT 值和 pHcy 水平的动脉粥样硬化指标无差异。但得出 MTHFR 677 基因多态性与 pHcy 水平之间存在关联的结论，这提示 MTHFR 677TT 多态性可能是 AS 患者心血管疾病的潜在预后因素。
