The clinical effects of methylenetetrahydrofolate reductase C677T gene mutation on mild vascular cognitive impairment in patients with cerebral infarction / 中华老年医学杂志

ABSTRACT

Objective To study the clinical effects of methylenetetrahydrofolate reductase(MTHFR) C677T gene mutation on mild vascular cognitive impairment(VCI)in patients with cerebral infarction.Methods The prospective study was conducted in 180 patients with atherosclerotic acute cerebral infarction hospitalized from June 2015 to May 2016.180 patients were divided into normal homocysteine(Hcy)group (Hcy 5.46～16.20 μmol / L,n=130)and high Hcy group(Hcy＞16.20 μmol / L,n=50).MTHFR C677T genotypes were detected by polymerase chain reaction-restriction endonuclease fragment length polymorphism.The VCI state and risk factors for VCI were analyzed with Montreal Cognitive Assessment scale(MoCA)and Mini Mental State Examination(MMSE)score in patients with acute cerebral infarction on admission and 14 days,30 days and 90 days after admission.Results MMSE and MoCA scores at 14 days,30 days,90 days after admission were lower in high Hcy group than in normal Hcy group(P＜0.05 or P＜0.01).MMSE and MoCA scores were lower in T/T genotype than in C/C genotype(P＜0.05)at 14 day after admission,and lower in C/T genotype than in C/C genotype at 30 day and 90 day follow up(P＜0.05or P＜0.01).Logistic regression analysis showed that Hcy may be independent risk factors for mild VCI(OR =1.274,95％CI1.027～1.264,P=0.018).Conclusions MTHFR C677T gene mutations may cause hyper-homocysteinemia,and promote the emergence of VCI in patients with cerebral infarction.MTHFR C677T gene mutations may be a genetic susceptibility factor for VCL