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MTHFR and the risk for cerebral venous thrombosis--a meta-analysis
Liliana O Gouveia1, Patrícia Canhão
1Department of Neurosciences (Neurology), Hospital Santa Maria, Lisboa, Portugal.
Background:
The association between methylenotetrahydrofolate reductase (MTHFR) 677TT and the increased risk of venous thrombosis is uncertain. Studies of this polymorphism in cerebral venous thrombosis (CVT) are inconclusive.
Objectives:
With a systematic review, we aimed to collect all case-control studies comparing the frequency of this polymorphism in CVT patients (cases) and healthy controls.
Methods:
We used the MEDLINE, Cochrane Library and the ISI web of knowledge electronic databases and reference lists of retrieved articles in order to identify published case-control studies that evaluated the presence of MTHFR 677C>T polymorphism in CVT. Two reviewers independently selected studies. We compared the frequency of 677TT between cases and controls using the Mantel-Haenszel method, a fixed and a random-effects model in the pooled data.
Results:
Nine case-control studies were included. The pooled analysis included 382 patients with CVT and 1217 controls. The frequency of 677TT genotype among CVT patients was not significantly higher compared with controls (15.7% versus 14.6%; OR=1.12, 95% confidence interval (95% CI) 0.80 to 1.58; p=0.50). There was significant heterogeneity between studies.
Conclusions:
This meta-analysis confirmed that there is currently insufficient data supporting that 677TT genotype is a risk factor for CVT. These results imply a continuing searching for the cause of CVT in patients with this polymorphism.
Insights
The methylenotetrahydrofolate reductase (MTHFR) 677TT genotype is not a confirmed risk factor for cerebral venous thrombosis (CVT). Current evidence is insufficient to link this MTHFR variant to an increased risk of CVT.
Area of Science:
- Genetics
- Neurology
- Thrombosis
Background:
- The link between methylenotetrahydrofolate reductase (MTHFR) 677TT genotype and venous thrombosis risk is unclear.
- Previous studies on MTHFR 677TT in cerebral venous thrombosis (CVT) have yielded inconclusive results.
Purpose of the Study:
- To systematically review and pool data from case-control studies.
- To compare the frequency of the MTHFR 677TT polymorphism in CVT patients versus healthy controls.
Main Methods:
- Systematic literature search of MEDLINE, Cochrane Library, and ISI Web of Knowledge.
- Inclusion of nine case-control studies involving 382 CVT patients and 1217 controls.
- Meta-analysis using Mantel-Haenszel, fixed, and random-effects models to compare genotype frequencies.
Main Results:
- No significant difference in MTHFR 677TT genotype frequency between CVT patients (15.7%) and controls (14.6%).
- Pooled odds ratio (OR) was 1.12 (95% CI 0.80 to 1.58; p=0.50), indicating no increased risk.
- Significant heterogeneity was observed across the included studies.
Conclusions:
- This meta-analysis indicates insufficient evidence to support MTHFR 677TT genotype as a risk factor for CVT.
- Further research is needed to identify the causes of CVT in individuals with this polymorphism.
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