MTHFR gene polymorphism is susceptible to diabetic retinopathy but not to diabetic nephropathy in Japanese type 2 diabetic patients.

AIMS: Previously, we have proposed that methylenetetrahydrofolate reductase (MTHFR) gene polymorphism (C677T) could be a risk factor for diabetic retinopathy. To support our suggestion, we examined in detail the association of MTHFR polymorphism with diabetic retinopathy and nephropathy in Japanese type 2 diabetic patients. METHODS: Subjects (n=190) were free of cardiovascular diseases and were not on hemodialysis. Retinopathy was assessed according to fundamental differentiation; nephropathy was determined according to urinary albumin level; and MTHFR genotype was determined by polymerase chain reaction-restriction fragment length polymorphism. We also analyzed how hyperglycemia affected these three conditions in 131 patients with glycosylated hemoglobin > or =6.5% and fasting blood sugar > or =110 mg/dl. RESULTS: The frequency of 677T/677T homozygous subjects with retinopathy was higher than the frequencies of the other two genotypes, and a significant difference was observed in the distribution of the genotypes (677C/677C, 41.9%; 677C/677T, 31.1%; 677T/677T, 61.5%; P<.05). The susceptibility of 677T/677T homozygote to retinopathy approached significance [odds ratio (OR)=2.17; 95% confidence interval (95% CI)=0.87-5.42]. However, in the population with hyperglycemia, the 677T/677T homozygote modified the risk for retinopathy (OR=4.30; 95% CI=1.42-13.1), especially the risk for nonproliferative retinopathy. In contrast, the 677T/677T homozygote did not affect the risk for nephropathy (OR=1.17; 95% CI=0.45-3.05), even in subjects with hyperglycemia (OR=1.50; 95% CI=0.50-4.48). CONCLUSIONS: Our results are highly suggestive of an important role for MTHFR genotype in susceptibility to retinopathy under hyperglycemia, but not to nephropathy. Preventive therapies based on MTHFR polymorphism could delay the onset of retinopathy in type 2 diabetic patients.

Assessment of acyl groups and reaction conditions in the competition between perhydrolysis and hydrolysis of acyl resorufins for developing an indicator reaction for fluorometric analysis of hydrogen peroxide.

Perhydrolysis of acetyl resorufin (AR) was reported previously to work as a fluorometric indicator reaction for glucose determination using only glucose oxidase. However, hydrolysis of AR in blank solution rendered the working concentration range of this method less than two orders of magnitude. To exclude or at least significantly reduce this interference, acyl groups and reaction conditions in the competition between perhydrolysis and hydrolysis of various acyl resorufins were assessed. Fluorometric evaluation of reactions in the presence or absence of H202 in phosphate buffer (pH 7.5, 100 mm)-CH3CN at 25 degrees C demonstrated that in tert-butylacetyl, isobutyryl, cyclohexanecarbonyl and pivaloyl resorufins (TBAR, IBR, CHR and PVR, respectively) among 10 acyl resorufins examined here, the competitive situation was shifted in a much more favorable way to perhydrolysis than in AR, although fluorometric responses due to their H2O2-dependent deacylation were suppressed in comparison with AR. Examination of the effects of pH, components and concentrations of buffers as well as reaction temperature established reaction conditions that not only allowed perhydrolysis of each of these four compounds to prevail over hydrolysis more effectively, but also improved the H2O2-based fluorometric responses. Thus, perhydrolysis of TBAR, IBR, CHR and PVR in phosphate buffer (pH 8.0, 20 mM)-CH3CN at 25 degrees C worked effectively as fluorometric indicator reactions for H2O2 analysis, affording a calibration curve over a concentration range of three orders of magnitude. Taking sensitivity, reproducibility and the response for blank solution into consideration, PVR seemed to be the best choice as a fluorochromogen for H2O2 determination under these conditions. For H2O2 analysis at lower pH, perhydrolysis of IBR in phosphate buffer (pH 7.5, 20 mm)-CH3CN was shown to effectively function as an indicator reaction. Applicability of the fluorometric methods with PVR and IBR to blood glucose determination was also discussed, comparing with Trinder's method with phenol, 4-aminoantipyrine and peroxidase (POD).