J Korean Neurol Assoc > Volume 21(2); 2003 > Article

Journal of the Korean Neurological Association 2003;21(2): 134-140.

"무증상 뇌경색의 독립적 위험인자인 고호모시스테인혈증 -MTHFR 677TT 유전자형을 가진 환자군에서 엽산과 역함수관계 -"

최병옥 , 김용성 김옥준 서정호 김남근

이화여자대학교 의과대학 신경과학교실,포천중문 의과대학교 신경과학교실,임상의학연구소,경남대학교 생화학교실

"Hyperhomocysteinemia as an Independent Risk Factor for Silent Brain Infarction - Inverse Correlation with Folate in Patients with MTHFR 677TT Genotype"

Byung Ok Choi

"Department of Neurology, College of Medicine, Ewha Womans University Department of Neurology, and Institute for Clinical Research College of Medicine, Pochon CHA University, Department of Chemistry, Kyungnam University"

Abstract

"Background : Silent brain infarction (SBI) are common in elderly people and are associated with an increased risk of clinically apparent stroke. Hyperhomocysteinemia is also an independent risk factor for ischemic stroke. This study was undertaken to determine whether hyperhomocysteinemia was associated with SBI, and also to find prevention against SBI through correlation among homocysteine, folate, and vitamin B12. Methods : We enrolled 103 SBI patients and 107 healthy individuals and checked their fasting plasma homocysteine levels and analyzed the C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene. Results : The plasma homocysteine levels in subjects with SBI (12.91 ±5.84 μmol l /L) were significantly higher than those in subjects without SBI (10.21 ±3.92 μmol/L; p < 0.0001). When plasma homocysteine levels were stratified into high (≥13.3 μmol/L), moderate (10.0 to 13.2 μmol/L), and low (≤9.9 μmol/L) groups, the adjusted odds ratio (AOR) for SBI was significantly greater in subjects with high group compared with in subjects with low group (AOR, 3.58; 95% CI, 1.69 to 7.58: p = 0.0009). When we combined each MTHFR genotype with SBI patients and controls, the plasma homocysteine concentrations showed a significant inverse correlation with folate only in SBI patient with MTHFR 677 TT genotype (correlation coefficient: -0.495; p = 0.023). Conclusions : Hyperhomocysteinemia is an independent risk factor for SBI. Our findings show that reducing plasma hommocysteine level by folate intake may prevent SBI in patients with homozygous C677T mutation in the MTHFR gene.Key Words : Silent brain infarction, Homocysteine, Folate, MTHFR, Risk factor"