| Coronary atherosclerotic heart disease or coronary heart disease (CHD) refers toheart disease which caused by coronary atherosclerosis luminal stenosis orobstruction,coronary atherosclerosis luminal stenosis or obstruction leads tomyocardial ischemia hypoxia.CHD is more common clinical cardiovascular disease,whose morbidity and mortality is higher and can seriouly influence the quality ofhuman life.CHD has many risk factors,such as age, gender, diet, obesity, livingenvironment, gene polymorphism, blood lipid metabolic abnormalities, diabetes andhigh blood pressure.In recent years, a large number of epidemiological and clinicalstudies have confirmed that high homocysteine levels (hyper homocysteinemia, HHcy)is atherosclerosis independent risk factors for cardiovascular disease.The plasmahomocysteine levels is influenced by many factors,MTHFR gene polymorphism canblock the metabolic process of HCY, then plasma HCY will accumulat in thebody.As far as we know the most safe and effective methode to reduce homocysteineis folic acid.Folic acid could reduce plasma Hcy have been reported by manyresearches,but the relevant reports about the influnce of MTHFR gene polymorphism on folicacid in lowering plasma homocyteine are rare.We have enterd an agingsociety and aging population are increasing gradually.Because the diet contains toolittle folic acid food or gastrointestinal absorption function, the elder people are morelikely to suffer from cardiovascular disease,their HCY levels in the body are morelikely to be on the high side,so it is meaningful to choose the elderly patients as theresearch objects. Our study is to discusse the HCY levels distribution rule in elderlypatients with CHD in different MTHFR genotype and investigate the influence ofMTHFR genepolymorphism on folic acid in loweing plasma homocysteine.ObjectiveDiscusse the change of plasma HCY levels in elderly patients with coronaryheart disease (CHD) in different methylene tetrahydrofolate reductase（MTHFR）genotype；Investigate the influence of MTHFR gene polymorphism on folic acidin lowering plasma homocysteine in elderly CHD patients.MethodsIn the First Affiliated Hospital of Zhengzhou University, A total of180elderlyCHD patients（Aged60~80years, mean age68.63±5.80）were randomized into twogroups. They were separately treated with folicacid5mg once daily and controlgroup(No application of folic acid).Fluorescence polarization method to detect the plasmaHCY levels，MTHFR (C677T）gene detection kit (PCR chip hybridization method)determination of MTHFR genotypes.After8weeks, The changes in plasma HCYwere be observed and analyzed by MTHFR genotypes(TT vs CC vs CT).ResultsPlasma Hcy of the three genotypes has a statistical significance at baseline(P<0.001), among which TT genotype patient’s plasma HCY level is thehightest,while CC and CT genotype plasma HCY has no difference (P=0.057).8weeks after treatment, the plasma HCY of the TT genotype patients in folicacid treatment group decline24%,CC and CT genotype patients decline about6%and15%separately.CC、CT and TT genotype patients in the control group slightlydecrease.Conclusions1．Plasma HCY of the three genotypes has a statistical significance,TT genotypeis the highest,but plasma HCY between CC and CT genotypes has no statisticalsignificance (P=0.057); Baseline levels of HCY:TT19.54±6.89μmol/L95％CI（17.67~21.40)； CT14.85±6.74μmol/L95％CI （13.22~16.48）； CC12.62±5.70μmol/L95％CI（11.11~14.13）。2．In the folic acid treatment group, plasma HCY of the three genotyps alldecline and the drop difference between the three genotyps has a statisticalsignificance F=25.43(P <0.001);After8weeks,the plasma HCY levels of TTgenotype drop the most about24%,CC/CT genotypes fall about6%、15%respectively,and the drop difference beteween CC and TTgenotyps has no statisticalsignificance.3．In the control group,the plasma HCY levels of the three genotyps has nostatistical significance F=0.60(P=0.55)；The drop difference between the threegenotyps has no statistical significance either. |
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