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Homocysteine, vitamins and gene mutations in peripheral arterial disease

H Stricker1, G Soldati, T Balmelli

  • 1Servizio di Angiologia, Ospedale Regionale Locarno, Locarno, Switzerland. hans.stricker@eoc.ch

Insights

Elevated homocysteine (tHcy) shows a modest association with peripheral artery obstructive disease (PAOD), particularly in women. The MTHFR gene TT genotype also had a weak, non-significant link to PAOD.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Nutritional Biochemistry

Background:

  • Peripheral artery obstructive disease (PAOD) is a significant cardiovascular risk.
  • Elevated plasma homocysteine (tHcy) is a potential risk factor for vascular diseases.
  • MTHFR gene mutations are implicated in homocysteine metabolism.

Purpose of the Study:

  • To investigate the association between plasma homocysteine (tHcy), vitamin B12, folate levels, and MTHFR gene mutations in patients with PAOD.
  • To compare these markers between PAOD patients and healthy controls.

Main Methods:

  • A case-control study involving 51 PAOD patients undergoing angioplasty and age/sex-matched controls.
  • Analysis of plasma homocysteine (tHcy), vitamin B12, and folate levels.
  • Assessment of MTHFR gene mutations (specifically the TT genotype).

Main Results:

  • No significant difference in mean tHcy between PAOD patients and controls.
  • A trend towards higher tHcy in PAOD patients, especially in the highest percentile (OR 2.8).
  • Female PAOD patients showed significantly higher tHcy than female controls (P=0.05), with a strong association for tHcy above the 95th percentile (OR 10.5).
  • The MTHFR TT genotype was more prevalent in PAOD patients (24%) than controls (12%), but the association was not statistically significant (OR 2.3).

Conclusions:

  • A modest association exists between elevated tHcy and PAOD, primarily observed in female patients at the highest homocysteine levels.
  • The MTHFR gene TT genotype shows a weak, non-significant association with PAOD.
  • Further research may clarify the role of homocysteine and MTHFR genotype in PAOD pathogenesis, especially in specific demographic groups.

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