Methylene tetrahydrofolate reductase polymorphism as an atherosclerotic coronary risk factor among patients with coronary artery disease

ABSTRACT

Recently several studies revealed discrepancies about the association of methylenetetrahydrofolate reductase [MTHFR] gene polymorphism and the development atherosclerotic coronary artery disease [ACAD] in different races and population. The present study aimed to study MTHFR gene polymorphism among the controls and evaluate it as a risk factor for ACAD Egyptian patients. The study was conducted on 30 patients [58.7 +/- 6.02 years old]. Compared to age matehed 30 normal subjects. All patients underwent complete clinical ECG, enzymatic, assessment and coronary angiography fasting polymerase chain reaction-restricion fragment length polymorphism analysis was used to detect the C677T variants of the MTHFR gene in 30 patients with ACAD versus 30 healthy controls. Their serum homocysteine level was determined by ELISA technique. Fasling blood glucose, creatinine, cholesterol, high density lipoprotein cholesterol [HDL-C] and triglyceride were estimated by spectrophometric method, and low density lipoprotein cholesterol [LDL-C] was calculated. Frequencies of MTHFR CC, CT and TT genotypes were 50%, 30% and 20% in ACAD patient group versus 56.7%, 26.6% and 16.7% in control. Palients with ACAD showed significantly higher plasma homocyteine concentrations than control [12.03 +/- 3.4 imol/L VS 10.77 +/- 1.9 Rmol/L, P<0.05]. When palients and controls were classified according to their genotypes, no significant difference was found among the different genotypes in control group, as well as, between them and CC, CT type in patients group. In contrast, patients with MTHFR TT genotype had significantly higher homocysteine concentration compared to the same genotype in control group [17.01 +/- 3.4 Rmol/L VS 11.1 +/- 0.89 Rmol/L]. Furthermore, they had higher serum cholesterol and lower HDL-C, which have been correlated to their serum homocysteine concentrations. Relalive risk estimation revealed that palients with TT genotype were at greater risk than CT and CC genotypes. It could be concluded that MTHFR TT genotype could be considered as a risk factor that could interact with other environmental factors and contribute to ACAD