Relationship of homocysteine and MTHFR C677T gene polymorphism with morning blood pressure surge
LI Rong1,2WANG Fang2LIAN Zhe-xun1▲
1.Department of Cardiology,Affliated Hospital of Qingdao University,Shandong Province,Qingdao 266003,China;
2.Department of Cardiology,The Third People′s Hospital of Qingdao City,Shandong Province,Qingdao 266041,China
Abstract：Objective To explore the relationship between plasma homocysteine(Hcy)and methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms with morning blood pressure surge(MBPS).Methods A total of 122 patients with essential hypertension diagnosed and treated in our hospital from November 2015 to December 2016 were selected.According to 24 ambulatory blood pressuremonitoring(ABPM)results,the difference between morning systolic blood pressure and night sleep systolic blood pressure was less than 35 mmHg (1 mmHg=0.133 ka),the control group (n=52)had no MBPS phenomenon,and the observation group(n=70)had MBPS phenomenon.All subjects were tested with blood from the anterior elbow vein on an empty stomach in the morning,and the level of urinary microalbumin,serum uric acid,serum creatinine and blood urea nitrogen were detected by automatic biochemical analyzer.The level of plasma Hcy was detected by circulating enzyme method and MTHFR C677T genotype was detected by PCR fluorescence method.The relationship between the level of plasma Hcy and the distribution of MTHFR C677T genotype with morning peak blood pressure was observed.Results The Hcy level of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The TT frequency of MTHFR C677T genotype in observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The plasma Hcy level of TT genotype in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).Logistic regression analysis showed that Hcy level was a risk factor for the occurrence of MBPS(P＜0.05).The genotype of MTHFR 677 TT was a risk factor for the occurrence of MBPS(P＜0.05).Conclusion Hcy level and MTHFR 677TT genotype were closely related to MBPS,and the pure and mutation of MTHFRC 677T results in the increase of Hcy level,which indirectly participates in the formation of MBPS.
Abhinand PA，Manikandan M，Mahalakshmi R，et al.Metaanalysis study to evaluate the association of MTHFR C677T polymorphism with risk of ischemic stroke[J].Bioinformation，2017，13（6）：214-219.
[3]
Kumar A，Kumar P，Prasad M，et al.Association of C677T polymorphism in the methylenetetrahydrofolatereductase gene（MTHFR gene）with ischemic stroke：a meta-analysis[J].Neurol Res，2015，37（7）：568-577.
[4]
Sheppard JP，Hodgkinson J，Riley R，et al.Prognostic significance of the morning blood pressure surge in clinical practice：a systematic review[J].Am J Hypertens，2015，28（1）：30-41.
[5]
Caliskan M，Caliskan Z，Gullu H，et al.Increased morning blood pressure surge and coronary microvascular dysfunction in patient with early stage hypertension[J].J Am Soc Hypertens，2014，8（9）：652-659.
[7]
Huo Y，Li J，Qin X，et al.Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China：the CSPPT randomized clinical trial[J].JAMA，2015，313（13）：1325-1335.
[8]
Trovato FM，Catalano D，Ragusa A，et al.Relationship of MTHFR gene polymorphisms with renal and cardiac disease[J].World J Nephrol，2015，4（1）：127-137.
[9]
Li J，Jiang S，Zhang Y，et al.H-type hypertension and risk of stroke in chinese adults：A prospective，nested case-control study[J].J TranslInt Med，2015，3（4）：171-178.
[10]
Wang JG，Kario K，Park JB，et al.Morning blood pressure monitoring in the management of hypertension[J].J Hypertens，2017，35（8）：1554-1563.
[11]
K1vrak A，Ozbic，er S，Kalkan GY，et al.Morning blood pressure surge and arterial stiffness in newly diagnosed hypertensive patients[J].Blood Press，2017，26（3）：181-190.
[12]
Roussotte FF，Hua X，Narr KL，et al.The C677T variant in MTHFR modulates associations between brain integrity，mood，and cognitive functioning in old age[J].Biol Psychiatry Cogn Neurosci Neuroimaging，2017，2（3）：280-288.
[13]
Amaral FM，Miranda-Vilela AL，Lordelo GS，et al.Interactions among methylenetetrahydrofolate reductase（MTHFR）and cystathionine β-synthase（CBS）polymorphismsa cross-sectional study：multiple heterozygosis as a risk factor for higher homocysteine levels and vaso-occlusive episodes[J].Genet Mol Res，2017，16（1）.
[14]
Kaypakll O，Gür M，Harbal1oglu H，et al.High morning blood pressure surge is associated with oxidative stress and paraoxonase 1 activity in newly diagnosed hypertensive patients[J].Clin Exp Hypertens，2016，38（8）：680-685.
[15]
Boushey CJ，Beresford SA，Omenn GS，et al.A quantitative assessment of plasma homocysteine as a risk factor for vascular disease.Probable benefits of increasing folic acid intakes[J].JAMA，1995，274（13）：1049-1057.
[16]
Li Y，Huang T，Zheng Y，et al.Folic acid supplementation and the risk of cardiovascular diseases：a meta-analysis of randomized controlled trials[J].J Am Heart Assoc，2016，5（8）：e003768.
[17]
Wuillemin WA，Solenthaler M.Hyperhomocysteinemia：a risk factor for arterial and venous thrombosis[J].Vasa，1999，28（3）：151-155.
[18]
Qin X，Li Y，He M，et al.Folic acid therapy reduces serum uric acid in hypertensive patients：a substudy of the China Stroke Primary Prevention Trial（CSPPT）[J].Am J Clin Nutr，2017，105（4）：882-889.
京公网安备 11010502046607号