天津医药

• 论著 •    

不同 5,10-亚甲基四氢叶酸还原酶基因型人群叶酸补服效果评价

张爽   

  1. 天津市妇女儿童保健中心
  • 收稿日期:2012-09-07 修回日期:2012-12-28 出版日期:2013-07-15 发布日期:2013-07-15
  • 通讯作者: 张爽

Effects of Folic Acid Supplement on Subjects with Different Methylenetetra-Hydrofolate Reductase C677T Genotypes

ZHANG Shuang   

  1. Tianjin Women's and Children’ s Health Center, Tianjin 300070, China
  • Received:2012-09-07 Revised:2012-12-28 Published:2013-07-15 Online:2013-07-15
  • Contact: ZHANG Shuang

PDF (PC)

2887

摘要：

【摘要】 目的  对不同5,10-亚甲基四氢叶酸还原酶(MTHFR)基因型人群叶酸补服的效果进行评价。方法  根据MTHFRC677T基因型将113名健康女性分为CC、CT、TT3组,每组内再随机分为干预组和对照组,干预组给予口服叶酸片400μg/d,服药2个月,对照组不补服叶酸。分别于基线和干预2个月后检测血浆叶酸、红细胞叶酸、血浆同型半胱氨酸(Hcy)水平。结果   基线时,TT基因型血浆叶酸低于CC基因型和CT基因型,而TT基因型血浆Hcy高于CC基因型和CT基因型(P<0.05或P<0.01)。补服叶酸2个月后,干预组血浆叶酸水平和红细胞叶酸水平均不同程度的升高,血浆Hcy水平下降。其中,TT基因型的血浆叶酸上升最明显(相较于CC和CT,均P<0.05);其血浆Hcy下降也最显著(相较于CT,P<0.05)。Logistic回归分析显示,MTHFR基因型为TT是血浆Hcy偏高的危险因素,其风险是CC型的8.078倍。结论  对于3种MTHFR基因型叶酸干预均可升高血浆叶酸和红细胞叶酸,降低血浆Hcy水平。TT基因型发生叶酸代谢障碍、血浆Hcy偏高的风险最高。尚不能证实小剂量补服叶酸可以降低血浆Hcy偏高的风险。 

关键词: 10-亚甲基四氢叶酸还原酶(FADH2), 叶酸, 高半胱氨酸, 基因型, 干预性研究, 妇女

Abstract: [Abstract]  Objective  To evaluate the effect of folic acid supplement in different 5,10-methylenetetrahydrofolate reductase (MTHFR) genotype. Methods    113 healthy women from Tianjin were divided into CC(24), CT(58), TT(31) groups according their MTHFR C677T genotype, then in each group subjects were randomly divided into intervention (400 μg/d folic acid supplement) and control(usual diet) groups. Plasma folate, red blood cell (RBC) folate, plasma Hcy concentration were measured at baseline and two months of intervention. Results   The plasma folate was lower (P = 0.003, P = 0.015), and the plasma Hcy was higher (P <0.001, P <0.001) in the TT genotype than that in the CC/CT genotype. After two months of intervention, the plasma folate, RBC folate concentration increased while the plasma Hcy concentration decreased in all three intervention groups. Although the plasma Hcy concentration decreased most in TT genotype, the final average concentration is still larger than 10umol/L (10.09 ± 1.30umol/L). Logistic regression analysis showed that the MTHFR CT, TT genotype was a risk factor of high Hcy concentration, OR=8.078, 95%CI: 1.929-33.834; folic acid supplementation can reduce the risk of high Hcy concentration, OR =0.465, 95%CI: 0.189-1.146. Conclusion   Folic acid supplement can significantly increase plasma folate and red cell folate concentration, and reduce plasma Hcy concentration in all MTHFR genotypes. However, women with TT genotype might need to take longer or higher dose of folic acid.

Key words: 10-methylenetetrahydrofolate reductase (FADH2), folic acid, homocysteine, Genotype, intervention study, women