The Correlation Study Of Homocysteine Level,Polymorphisms Of Methylenetetrahydrofolate Reductase Gene And Coronary Atherosclerosis

Objective:To study the relationship between serum homocysteine(Hcy)level and the degree of coronary artery stenosis in patients with coronary heart disease(CHD),and to further explore the effect of Hcy level and methylenetetrahydrofolate reductase(MTHFR)C677T genotype on the degree of coronary artery stenosis.Methods: From April 2018 to December 2019,233 patients with CHD diagnosed by coronary angiography(CAG)in the Department of Cardiology of our hospital were collected as the study object.The CAG results were used to quantitatively calculate the degree of coronary atherosclerotic stenosis according to the Gensini score.The subjects used enzyme circulation method to measure the concentration of Hcy in fasting serum and polymerase chain reaction(PCR)and fluorescence probe were used to detect the C677 T genotype of MTHFR gene.HHcy-CHD group was divided into HHcy-CHD group(Hcy?15?mol/L)and normal Hcy-CHD group(NHcy-CHD group,Hcy<15?mol/L).HHcy-CHD group was divided into subgroups according to whether HHcy-CHD group was combined with essential hypertension.Gensini scores of all CHD patients were divided into subgroups according to the three quantiles.The correlation between Hcy level and Gensini score was analyzed.The relationship between C677 T genotype and HHcy was studied by regression analysis.The risk factors of stenosis degree of coronary atherosclerosis were discussed.Results: There was no statistical significance in NHcy-CHD group and HHcy-CHD group(P > 0.05).The Gensini score of HHcy-CHD group was higher than that of NHcy-CHD group(P < 0.05).The Gensini score of HHcy with hypertension group(H-type hypertension group)was higher than that of HHcy without hypertension group(P < 0.05).In NHcy-CHD group,CC genotype frequency of C677 T was higher than that of HHcy-CHD group,while TT genotype frequency was lower than that of HHcy-CHD group,the difference was statistically significant(P < 0.001).In NHcy-CHD group,allele C frequency of C677 T was higher than that of HHcy-CHD group,and the difference was statistically significant(P < 0.001).The frequency of CC genotype in the first quantile of Gensini integral was higher than that in the third quantile,while TT genotype frequency was lower than that in the third quantile,the difference was statistically significant(P < 0.001).The frequency of C allele in the first quantile of Gensini score was higher than that in the third quantile,while the frequency of T allele was lower than that in the third quantile,the difference was statistically significant(P < 0.001).The Hcy level of TT patients was higher than that of CC and CT patients,and the difference was statistically significant(P < 0.01).Pearson correlation analysis showed that serum Hcy level was positively correlated with Gensini score in CHD patients(r = 0.360,P < 0.001).Logistic regression analysis showed that CT +TT genotype increased the risk of HHcy(OR: 1.998,95CI: 1.067-3.410).Multiple linear regression results showed that HHcy(? = 1.020,P < 0.001),CT and TT genotype(?= 19.031,P < 0.001)of C677 T locus were the influencing factors of Gensini score.Conclusion: In CHD patients,the higher Hcy level,the more severe the degree of coronary atherosclerosis stenosis;TT genotype and allele T at C677 T of MTHFR gene are closely related to the degree of coronary atherosclerosis stenosis,and Hcy of TT genotype is at a high level;H-type hypertension aggravates the degree of coronary atherosclerotic stenosis.