| Objective: Many previous studies had found that the polymorphism of MTHFR C677 T and plasma homocysteine level was related to the pathogenesis of ischemic stroke,respectively.MTHFR C677 T gene has an effect on the concentration of homocysteine.The existing researches lacked the exploration of the interaction between both of above on ischemic stroke.Therefore,this research will explore the relationship between the synergistic effect of MTHFR C677 T gene and homocysteine level and ischemic stroke.Methods: 1.Trial design: a retrospective case-control study.2.Subjects: According to the inclusion and exclusion criteria,the cases were divided into case group and control group,collected from October 1,2018 to July 31,2019.The case group newly sufferred from ischemic stroke,the control group didn't have the history of ischemic stroke.3.Data collection: sex,age,smoking history,drinking history,body mass index(BMI),hypertension history,diabetes mellitus history,coronary heart disease history,ischemic stroke history,TG,LDL-C,plasma homocysteine and MTHFR 677 genotype were collected.4.Statistical analysis: the statistical description of the measurement data was carried out,and the normality test was carried out by Shapiro-Wilk test,and the median(X25%,X75%)was used to represent the abnormal distribution.The count data was described statistically and represented by constituent ratio.The equilibrium test of the two groups of data was carried out by using rank sum test or chi-square test.Spearman test was used for correlation test.Two classification Logistic regression was used for regression analysis.Results: 1.There was no significant difference in age,BMI index,hypertension,coronary heart disease,TG and LDL-C between the control group and the case group.There were significant differences in the sex,smoking,drinking,diabetes and MTHFR C677 T between the control group and the case group(P < 0.05).There was a significant difference in homocysteine level between the both(P < 0.05).2.The plasma Hcy level increased with the increase of the T allele of the MTHFR 677.The Spearman-related test showed that the plasma Hcy level was associated with the MTHFR 677 genotype(r = 0.327,P <0.001).3.The boundary value of homocysteine was 15 ?mol/ L(?15 ?mol / L was normal and > 15 ?mol/ L was abnormal).According to the above,homocysteine was divided into two levels.According to MTHFR 677 genotype,it was divided into 3 genotypes.In summary,according to Plasma homocysteine level and MTHFR 677 genotype,they were divided into 6 groups.The composition of plasma homocysteine+MTHFR 677 genotype between case group and control group has statistically significant difference(?2=15.596,P=0.008).4.The results of two classification logistic regression analysis showed that smoking(P = 0.015),diabetes(P =0.006)and plasma homocystein+ MTHFR 677 genotype(P = 0.017)were the risk factors for ischemic stroke.After adjusting for sex,smoking,drinking and diabetes,normal homocystein+TT(P < 0.05,OR=2.786,95%CI=1.205~6.442)?abnormal homocystein+CT(P < 0.05,OR=2.52,95%CI=1.049~6.054)and abnormal homocystein+TT(P < 0.05,OR=3.539,95%CI=1.596~7.845)increased the risk of ischemic stroke compared with normal homocystein+CC.Conclusions 1.The results illustrated that plasma homocysteine level was correlated with MTHFR 677 genotype and Positively correlated with the number of T alleles at MTHFR 677 site.2.This study found that the synergistic influence of plasma homocysteine level and MTHFR C677 T was a risk factor for ischemic stroke.The risk was different by different subgroups.The factors of normal homocystein+TT?abnormal homocystein+CT and abnormal homocystein+TT increased the risk of ischemic stroke compared with normal homocystein+CC.3 According to the results of the study,it is speculated that high level of homocysteine may increase the risk of ischemic stroke in CT genotype,while in TT/CC genotype the concentration of homocysteine may not affect the risk of ischemic stroke. |
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