| Abstrakt: |
The effect of the combined 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C→T and 1298A→C genotype on total homocysteine (tHcy), folate, and vitamin B12plasma levels was investigated in 983 subjects, including 415 hemodialysis patients, 179 peritoneal dialysis patients, and 389 healthy individuals. Mean tHcy plasma concentrations were 27.2 ± 15.8 μmol/L in hemodialysis patients, 25.4 ± 19.1 μmol/L in peritoneal dialysis patients, and 8.9 ± 3.5 μmol/L in healthy individuals. Hyperhomocysteinemia (tHcy 15 μmol/L) was detected in 81.6% of patients and 2.6% of controls. Multiple stepwise regression analysis showed that the MTHFR677C→T/1298A→C genotype (CC/AA, CC/AC, CC/CC, CT/AA, CT/AC, TT/AA), vitamin use, age, folate and vitamin B12plasma level were significant predictors of tHcy plasma levels. Analysis of variance showed that this effect of MTHFRgenotypes on tHcy level was caused by significantly greater tHcy levels in 677TT/1298AA hemodialysis and peritoneal dialysis patients versus other genotypes. Compound heterozygous controls (677CT/1298AC genotype) had significantly greater tHcy levels compared with 677CC/1298AA controls. There was no major effect of MTHFRpolymorphisms on folate and vitamin B12plasma concentrations. This study shows that the MTHFR677TT/1298AA genotype, but not the 677CT/1298AC genotype, is a significant predictor of tHcy plasma levels in dialysis patients. © 2001 by the National Kidney Foundation, Inc. |
