Leng Song, Zhao Ai, Zhang Jian, Wu Wei, Wang Qian, Wu Shan, Chen Li, Zeng Qiang
Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing, China.
Health Management Center, The Second Hospital of Dalian Medical University, Dalian, China.
Front Cardiovasc Med. 2021 Jun 24;8:638322. doi: 10.3389/fcvm.2021.638322. eCollection 2021.
Hyperhomocysteinemia (Hhcy) has been recognized as a risk factor of several chronic diseases. There is accumulating evidence that both genetic and dietary factors had a notable impact on the risk of Hhcy. The present study aims to investigate the interaction effect on Hhcy between methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and dietary intake. Data were collected in a cross-sectional survey conducted in China; 3,966 participants with complete information on sociodemographic characteristics, anthropometric measurements, and dietary intake were included in the analyses. Dietary patterns were identified by factor analysis combined with cluster analysis. Blood samples were collected and genotypes were tested. Both the multiplicative statistical model and the additive model were conducted to investigate the interactive effects. Proportions of genotypes among participants were 29.2% for , 47.4% for , and 23.4% for . Three dietary patterns were identified, namely, the balanced pattern, the snack pattern, and the high-meat pattern. Compared with the balanced pattern, the other two patterns were associated with an elevated risk of Hhcy [the snack pattern: odds ratio (OR) 1.2, 95% confidence interval (CI) 1.0-1.5; the high-meat pattern: OR 1.3, 95% CI 1.1-1.6] after adjustment for age group, gender, residential region, and genotypes. A multiplicative interaction between the high-meat pattern and genotype was observed, and synergistic effects between both the snack pattern and the high-meat pattern with were identified. Our results indicated that polymorphism and dietary patterns had interactive effects on Hhcy among the Chinese population. Subsequent targeted and appropriate dietary guidelines should be recommended for high-risk populations or patients of Hhcy carrying specific genotypes.
高同型半胱氨酸血症（Hhcy）已被公认为多种慢性疾病的危险因素。越来越多的证据表明，遗传因素和饮食因素对Hhcy风险均有显著影响。本研究旨在探讨亚甲基四氢叶酸还原酶（MTHFR）基因多态性与饮食摄入对Hhcy的交互作用。数据收集于在中国进行的一项横断面调查；分析纳入了3966名具有社会人口学特征、人体测量和饮食摄入完整信息的参与者。通过因子分析结合聚类分析确定饮食模式。采集血样并检测基因型。采用乘法统计模型和加法模型来研究交互作用。参与者中基因型的比例分别为：CC型占29.2%，CT型占47.4%，TT型占23.4%。确定了三种饮食模式，即均衡模式、零食模式和高肉模式。在调整年龄组、性别、居住地区和MTHFR基因型后，与均衡模式相比，其他两种模式与Hhcy风险升高相关[零食模式：比值比（OR）1.2，95%置信区间（CI）1.0 - 1.5；高肉模式：OR 1.3，95% CI 1.1 - 1.6]。观察到高肉模式与TT基因型之间存在乘法交互作用，并且确定了零食模式和高肉模式与CT基因型之间存在协同效应。我们的结果表明，MTHFR多态性和饮食模式在中国人群中对Hhcy有交互作用。应针对携带特定基因型的Hhcy高危人群或患者推荐后续有针对性的适当饮食指南。
