Hyperhomocysteinemia, Low Folate Concentrations, And Methylene Tetrahydrofolate Reductase C677T Mutation In Acute Mesenteric Venous Thrombosis

ObjectiveAcute mesenteric venous thrombosis (AMVT) was first reported by Fagge and was recognized as a distinct clinical entity by Warreen in 1935. But its etiopathogenisis is still unclear. Methylene tetrahydrofolate reductase (MTHFR) C677T and hyperhomocysteinemia (hyper-Hcy) were considered risk factors for thromboembolism. Thus, through a case-control study, we examined the potential association among hyperhomocysteinemia (hyper-Hcy), low serum folate and vitamin B12 levels, and the common C677T mutation of the MTHFR gene in patients with AMVT.Method63 patients with AMVT and 75 sex-and age-matched healthy controls were recruited and their plasma Hey, folate and vitamin B12 levels were respectively measured by HPLC and immunological assays. The polymorphism of MTHFR C677T was detected by PCR-RFLP.ResultThe mean plasma Hey levels were significantly higher in patients with AVMT compared with controls (23.5±8.8 versus 12.6±6.6μmol/L, P＜0.01). The fasting Hey correlated negatively with folate (AMVT:r=-0.42, P＜0.01; Control:r=-0.40, P＜0.01). The frequency of homozygous (TT) genotype in MTHFR C677T mutation was significantly higher in patients with AMVT than that in control subjects (33% versus 17%;χ2=6.31, P＜0.05; OR=2.80; 95%CI,1.25-6.25). Comparing with the control subjects, the mean serum vitamin B12 levels were lower in patients, but it was not statistically significant (365±88 pmol/L versus 408±108 pmol/L, P>0.05).ConclusionHyper-Hcy and low serum folate levels were associated with an increased risk of AMVT. The homozygous (TT) genotype of MTHFR gene mutation may be a crucial hereditary risk factor in the development of AMVT for Chinese population.