| Backgroud: Coronary heart disease (CHD) is one of the most serious diseasesendangering human health and life. Although increasingly in-depth study of coronaryheart disease, but its incidence has gradually increased. Moreover, the average age ofCHD patients are getting younger and younger. The risk factors of CHD includehypertension, hyperlipemia, alcohol, smoke, obesity and diabetes mellitus etc. However,many of the CHD patients have no such traditional risk factors. Thus it seems veryimportant to find out new CHD risk factors, so as to put off or reverse the pathologiccourse of atherosclerosis and reduce the clinical symptoms.There come more and more evidences showing that high level homocysteine (Hcy)in the blood is a new independent risk factor of CHD. However, there are evidencesshowing that the results from different regions and different ethnic groups observedchange. It is highly possible that there are different relevant risk factors or relevantgenes in different CHD population.Objective: To study the correlation among plasma homocysteine (Hcy) level and theirkey enzyme of metabolic-MTHFR C677T mutation and CHD in different regions basedwith the same nation, and to investigate whether elevated Hcy and MTHFR C677Tmutation will increase the risk of CHD.Methods: Randomly selected392patients who were inpatients of Chinese PLAGeneral Hospital from Jan.2011to March2012and who had received coronaryangiography. All patients were divided into two groups: South and North populationaccording to place of origin location, and the boundary is Qinling-huaihe River.According to coronary angiography, all patients were divided into CHD group (n=260)and control group (n=132). Venous blood of the patients were collected, then Hcy weredetected by cycle enzymatic assay and MTHFR C677T mutation were determined by polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLR)were detected.Results1.(1) The plasma Hcy level in the CHD group was significantly higher than that in thecontrol group, and the difference was statistically significant (North P=0.0001andSouth P=0.0097). The plasma Hcy level in the North population was significantlyhigher than that in the South population in the CHD group (P=0.0157).(2) Plasma Hcylevels in the CHD group, North and South between the populations of different gender,age, smoking history, drinking history, history of hypertension, coronary heart diseasefamily history of patients despite differences, but no statistical significance.(3)Theplasma Hcy level increased with the severity of sub-types of CHD. The plasma Hcylevel in acute myocardial infarction (AMI) patients is higher than that in stable anginapectoris (SAP) and unstable angina pectoris (UAP) patients. SAP vs UAP P=0.4445;SAP vs AMI P=0.0386; UAP vs AMI P=0.0646, and the difference between AMI andSAP had statistically significance.(4)In patients with lesions in0,1,2,3vessels, theirHcy level tended to increase, with the number of vessel to be involved.2.(1)There was no significance in the difference of the genotype distribution and allelefrequencies distribution in the North and South population between CHD group andcontrol group. Coronary heart disease and control groups in the same population, thegenotype distribution of the northern population (coronary heart disease group vscontrol group) χ2=11.5282, P=0.0031; southern population (coronary heart diseasegroup vs control group), χ2=8.4077, P=0.0149.The allele frequencies of the northernpopulation (coronary heart disease group vs control group) χ2=6.2694, p=0.0123;southern population (coronary heart disease group vs control group) χ2=4.4374, P=0.0352, the differences were statistically significant (P <0.05).(2)There was statisticallysignificance between the plasma Hcy level of patients with different genotypes in thesame group and same population. The plasma Hcy level of patients with TT and CTgenotypes was higher than that with CC genotype. Conclusion1.(1) There is a high correlation between elevated plasma Hcy and CHD both in theNorth and South population. That the plasma Hcy level in the North population thanthat in the South population in CHD group suggested that there was a highercorrelation between elevated plasma Hcy and CHD in North population.(2) there wasno correlation between plasma Hcy and other traditional risk factors.(3) With theincrease in the number of coronary arteries with lesions, plasma Hcy tended toincrease gradually, indicating that plasma Hcy was related to coronary arteries lesionseverity.2.(1)MTHFR C677T gene polymorphism was significantly related to CHD. The C677Tmutation may be a genetic susceptibility factor. There was slightly difference in theMTHFR C677T gene polymorphism between North and South population, but therewas no statistically significance.(2)MTHFR C677T gene polymorphism was closelyrelated to plasma Hcy level. And TT homozygous mutation significantly increasedHcy levels.(3)MTHFR C677T gene polymorphism and Hcy were all independent riskfactors of CHD in both North and South populations. |
PDF Full Text Request