The Relationship Between Carotid Intima Thickness With MTHFR Gene Polymorphism In Elderly Patients With Type H Hypertension

Objective: To investigate the relationship between carotid artery intima thickness and methylentyahydrofotate reductasa(MTHFR)gene polymorphism in patients with type H hypertension,so as to provide a theoretical basis for early diagnosis and early intervention to reduce the occurrence of cardiovascular diseases and improve the prognosis of patients.Methods: 274 hypertensive patients who were treated in Hefei Second People's Hospital from August 2016 to December 2018 were selected as the subjects of hypertension,and 180 healthy persons who received physical examination in our hospital during the same period were selected as the subjects of the control group.Plasma homocysteine(Hcy)levels in hypertensive patients were measured by enzyme linked immunosorbent assay(ELISA).According to the test and examination results,they were divided into H hypertension group(Hcy > 10 mu mol/L,196 cases)and non H hypertension group(Hcy < 10 micron mol/L,78 cases).The intima media thickness(IMT)and carotid atherosclerotic plaque in the patients with type H hypertension subgroup were detected by color ultrasound phenomenon.According to the results,they were divided into group H1 with IMT increase of common carotid artery and / or the presence of carotid atherosclerotic plaque(88 cases)and group H2 without IMT increase of the common carotid artery and carotid atherosclerosis(108 cases).The clinical data of each group were collected and the clinical features were observed.The biochemical indexes,such as blood sugar,blood lipid and Hcy,the results of genotyping and carotid artery and plaque examination were detected and collected,and the frequency of different genotypes of MTHFR C677 T in each group was compared.The related biochemical indexes and carotid artery color Doppler ultrasound findings in two subgroups of H1 and H2 groups in H hypertension group were compared.SPearman correlation analysis and Logistic regression analysis were used to analyze the correlation between H type hypertension and IMT genotype in patients with type H hypertension.Results:(1)there were no significant differences in age,sex composition,BMI and smoking history between H1 group,H2 group,non H hypertension group and control group(P > 0.05).The levels of SBP and DBP in group H1,H2 group and non H type hypertension group was significantly higher than those of the control group(P < 0.05).There were no significant differences in blood glucose(GLU),three acylglycerol(TG),low density lipoprotein(LDL)and total cholesterol(TC)in group H1,H2 group,non H hypertension group and non H hypertension group(P > 0.05).Uric acid(UA)and creatinine(Cr)levels in type H hypertension group were significantly higher than those in non H hypertension group and the control group(P < 0.05).Hcy level,the incidence of Hcy,and IMT in the H type hypertension group were significantly higher than those in the non H hypertension group and the control group(P < 0.05).The H1 group's were also significantly higher than those of the H2 group,the non H type hypertension and the control group(P < 0.05).There was no significant difference in the Hcy level between the non H hypertensive group and the control group(P > 0.05),while IMT was significantly higher than that in the control group(P < 0.05).(2)The frequencies of MTHFR C677 T genotypes and allele frequencies in H1 group,H2 group,non H type hypertension group and control group were statistically significant(P > 0.05).The genotype frequency of group H1 was significantly different from those of group H2,non H hypertension group and control group,the allele T frequency was significantly higher than that of the H2 group,non H type hypertension and the control group(P > 0.05).Genotype frequencies of group H2 were also significantly different from those of control group(P < 0.05),but there was no significant difference compared with non H type hypertension(P > 0.05),the frequency of allele T was significantly higher than that of non H hypertensive group and control group(P < 0.05).There were no significant differences in genotype frequency and allele frequency between non H hypertensive group and control group(P > 0.05).(3)In the control group,the H1 group,the H2 group and the non H hypertensive group,Hcy levels and the IMT of different MTHFR C677 T genotypes were statistically significant(P > 0.05),The Hcy and IMT of TT genotype were higher than those of CT genotype and CC genotype,and CT genotype were higher than those of CC genotype.(4)there was a positive correlation between the genotype of MTHFR C677 T and the level of Hcy(r=0.783,P=0.000)in the hypertensive group.After adjusting the factors such as age,sex and BMI,the genotype of MTHFR C677 T was still positively correlated with the level of Hcy(r=0.770,P=0.000).Hcy level was positively correlated with IMT(r=0.591,P=0.000),and H hypertension group had a higher correlation(r=0.793,P=0.000).The risk of carotid intima thickening or carotid atherosclerotic plaque in patients with type H hypertension with TT genotype is 2.213 times as high as that of the CC genotype and the CT genotype(OR=2.213,95%CI:1.097-4.186,P=0.023).After adjusting the traditional factors such as age,sex,and BMI,the risk of TT genotypes suffering from H type hypertension with carotid intima thickening and carotid atherosclerotic plaques was 2.090 times higher than that of CC genotype and CT genotype(OR=2.090,95%CI:1.072-4.101,P=0.030).Conclusions:(1)the MTHFR C677 T mutation may increase the risk of H hypertension by increasing the level of plasma Hcy,and the TT genotype of MTHFR C677 T is a risk factor for the prevalence of H type hypertension.(2)the polymorphism of MTHFR C677 T gene is significantly associated with the thickening of the carotid intima-media thickness in patients with type H hypertension,and the mutation of TT genotype may be a genetic predisposing factor.Plasma Hcy is an influential factor in IMT of type H hypertension.The polymorphism of plasma Hcy and MTHFR C677 T gene is important for predicting carotid atherosclerosis in patients with type H hypertension and H type hypertension,and further reducing the incidence of carotid artery vascular damage and related complications.