Relationship Between Methylenetetrahydrofolate Reductase C677T Gene Polymorphism And Left Ventricular Hypertrophxy With Hypertension

Objective:This study was performed to explore the effects of plasma homocysteine(Hcy),5,10-methylenetetrahydrofolate reductase(MTHFR)C677T and clinical biochemical indicators on the left ventricular hypertrophy(LVH)among hypertensive Chinese Han population.Methods:This cross-sectional study included 456 hypertensive patients who were in hospital from 2012.01 to 2016.10.The personal information was collected,including age,weight,height,personal history and antihypertensive drugs.Clinical biochemical indicators were tested,including plasma Hcy,liver and renal function indices,serum lipid,fasting blood glucose(FBG),C-reactive protein(CRP)and so on.MTHFR C677T polymorphism was analyzed by by taqman probe and fluorescent quantitative PCR.Cardiac structure and function indicators were measured by transthoracic echocardiography,including left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),E peak and A peak.According to these indicators,we calculated left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI)and left ventricular relative wall thickness(LVRWT).According to LVMI,132 cases were elected out as essential hypertension with LVH group and 324 cases as non-left ventricular hypertrophy(NLVH)group.According to LVMI and LVRWT,essential hypertension was divided into 4 subgroups:normal geometry(NG)group 144 cases,concentric remodeling(CR)group 202 cases,concentric hypertrophy(CH)group 74 cases,and eccentric hypertrophy(EH)group 36 cases.We explored the relationship between Hcy,MTHFR C677T polymorphism,clinical biochemical indicators and LVH.Results:(1)Compared with the NLVH group,the LVH group had higher systolic blood pressure(SBP),Hcy and cystatin C(Cys--C).However,there were no significance between two groups about these personal information.(2)The frequency of TT genotype and T allele in LVH group was higher than those in NLVH group(P<0.05).(3)The level of Hcy in TT genotype was higher than that in CT and CC genotype(P<0.01).The values of LVMI,IVST and LVPWT in CT and TT genotype,were higher than that in CC(P<0.01).(4)Subgroup analysis of the patients with essential hypertension showed that there were significant differences in genotype frequency and level of Hcy among different subgroups,and highest frequency of TT genotype and highest level of Hcy were in EH group.(5)In a logistic regression analysis,1umol/1 increase in Hcy was associated with a 7.9%increase in the incident risk of LVH.Genetic model analysis showed that after adjusting risk factors,MTHFR additive model were significantly associated with LVH in hypertensive patients[odds ration 2.264(95%CI 1.337-3.834),P = 0.002].Conclusion:Hcy and MTHFR C677T polymorphism were an independent risk factor for LVH.TT genotype carriers or T allele carriers had a higher susceptibility to LVH incidence,especially EH.