Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
First Clinical Medical College of Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2023 Jun 16;102(24):e33980. doi: 10.1097/MD.0000000000033980.
It has been shown the methylenetetrahydrofolate reductase (MTHFR) 677TT (rs 1801133) genotype predicts histopathological alterations in the incisura of patients with chronic atrophic gastritis (CAG). MTHFR is a crucial enzyme in fatty acid (FA) metabolism. This study aimed to evaluate the influence of FA supplementation in CAG patients without Helicobacter pylori infection and the MTHFR C677T (rs 1801133) genotype as a potential CAG predictor.
A total of 96 CAG patients, aged 21 to 72 years old, were enrolled in this study. After 6 months of treatment, histopathological outcomes were compared among patients treated with weifuchun (WFC) (1.44 g 3 times per os per day), those treated with WFC and FA (5 mg once daily), and those treated with WFC, FA, and vitamin B12 (VB12) (0.5 mg 3 times per day) based on the Operative Link on Gastritis/Intestinal Metaplasia assessment staging systems.
Atrophic lesions in patients treated with WFC and FA improved more than in patients treated only with WFC therapy (78.1% vs 53.3%, P = .04). Atrophic or intestinal metaplasia (IM) lesions in the incisura of patients with the TT genotype were better than those in patients with the CC/CT genotype (P = .02).
The treatment of CAG patients with 5 mg of FA supplements daily for 6 months improved their gastric atrophy status, especially for the Operative Link on Gastritis/Intestinal Metaplasia assessment stages I/II. Moreover, our study is the first to reveal that patients with the MTHFR 677TT genotype require more timely and effective FA treatment than those with the CC/CT genotype.
亚甲基四氢叶酸还原酶（MTHFR）677TT（rs1801133）基因型已被证明可预测慢性萎缩性胃炎（CAG）患者切迹的组织病理学改变。MTHFR 是脂肪酸（FA）代谢的关键酶。本研究旨在评估在无幽门螺杆菌感染的 CAG 患者中补充 FA 的影响，以及 MTHFR C677T（rs1801133）基因型作为 CAG 预测因子的潜在作用。
本研究共纳入 96 例年龄在 21-72 岁的 CAG 患者。经过 6 个月的治疗，根据胃炎/肠上皮化生的操作链接评估分期系统，比较了仅接受维福春（WFC）治疗、WFC 联合 FA 治疗和 WFC、FA 和维生素 B12（VB12）治疗的患者之间的组织病理学结果。
与仅接受 WFC 治疗的患者相比，WFC 和 FA 联合治疗的患者的萎缩性病变改善更为明显（78.1% vs. 53.3%，P=0.04）。TT 基因型患者切迹处的萎缩或肠上皮化生（IM）病变好于 CC/CT 基因型患者（P=0.02）。
6 个月每天补充 5mg FA 可改善 CAG 患者的胃萎缩状况，尤其是对胃炎/肠上皮化生的操作链接评估分期 I/II 期患者。此外，本研究首次揭示 MTHFR 677TT 基因型患者比 CC/CT 基因型患者更需要及时有效的 FA 治疗。
