Liang Zhe, Fan Fangfang, Liu Bo, Li Kaiyin, Chen Hongyu, Jia Jia, Huo Yong, Li Jianping, Zhang Yan
Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China.
Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China.
Nutrients. 2024 Dec 31;17(1):159. doi: 10.3390/nu17010159.
The relationship between folate concentrations and stroke risk remains unestablished, and the mediation effect of homocysteine (Hcy) and interaction effect of methylenetetrahydrofolate reductase () gene polymorphism has yet to be investigated. This cohort study involved 4903 subjects derived from a Chinese community population. The association between folate and first stroke was examined in Cox proportional hazard regression models. The mediation analyses involving Hcy and the undiscovered modification of the genotype were assessed. The mean (SD) age of subjects was 56.7 (8.8) years old, and 37.0% were male. A total of 407 strokes, 375 ischemic strokes and 47 hemorrhagic strokes occurred during the mean (SD) follow-up of 9.3 (1.8) years. The participants in the highest folate quartile (≥8.2 ng/mL) exhibited a lower stroke risk compared to those in the lowest quartile (hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.50-0.93, = 0.017; for trend = 0.009). Hcy significantly mediated 14.51% of the relationship between folate and stroke in the fully adjusted model. Only in individuals with the genotype but not / genotype was folate adversely correlated with stroke (HR: 0.88, 95% CI: 0.79-0.97, for interaction = 0.026) and ischemic stroke (HR: 0.88, 95% CI: 0.80-0.98, for interaction = 0.035). Insufficient folate concentrations were associated with a heightened 10-year stroke risk, in which Hcy concentrations played a crucial mediating role. gene polymorphism could potentially modify the folate-stroke relationship.
叶酸浓度与中风风险之间的关系尚未明确，同型半胱氨酸（Hcy）的介导作用及亚甲基四氢叶酸还原酶（）基因多态性的交互作用仍有待研究。这项队列研究纳入了4903名来自中国社区人群的受试者。在Cox比例风险回归模型中检验了叶酸与首次中风之间的关联。评估了涉及Hcy的介导分析以及未发现的基因型修饰。受试者的平均（标准差）年龄为56.7（8.8）岁，男性占37.0%。在平均（标准差）9.3（1.8）年的随访期间，共发生407次中风，其中375次为缺血性中风，47次为出血性中风。与叶酸水平处于最低四分位数的参与者相比，处于最高四分位数（≥8.2 ng/mL）的参与者中风风险更低（风险比[HR]：0.68，95%置信区间[CI]：0.50 - 0.93， = 0.017；趋势 = 0.009）。在完全调整模型中，Hcy显著介导了叶酸与中风之间14.51%的关系。仅在具有基因型而非/基因型的个体中，叶酸与中风（HR：0.88，95% CI：0.79 - 0.97，交互作用 = 0.026）和缺血性中风（HR：0.88，95% CI：0.80 - 0.98，交互作用 = 0.035）呈负相关。叶酸浓度不足与10年中风风险升高相关，其中Hcy浓度起关键介导作用。基因多态性可能会改变叶酸与中风的关系。
