静脈血栓塞栓症の危険因子としての赤血球メチルフォラートと血ホモシステイン:マッチした症例対照試験
Isabelle Quéré1, Thomas V Perneger, Jacqueline Zittoun
1Internal Medicine Department University Hospital Saint Eloi, Montpellier, France. i-quere@chu-montpellier.fr
Lancet (London, England)
|March 13, 2002
まとめ
赤血球メチルフォラート濃度は,静脈血栓塞栓症のリスクのある個人を特定するのに役立ちます. メチルフォラート濃度の低下は,血栓のリスクの増加と強く関連しています.
科学分野:
- バイオケミストリー バイオケミストリー
- 遺伝学 遺伝学とは
- クリニカル・メディシン 臨床医学
背景:
- 適度な高ホモシステイン血症は,静脈血栓塞栓症 (VTE) の既知の危険因子です.
- VTEリスクにおけるホモシステインとメチルフォラートなどのリメチル化経路の成分との特定の役割は不明である.
- このケース・コントロール研究では,ホモシステインリメチル化経路の重要な成分とVTEリスクとの関係を調査しています.
研究 の 目的:
- ホモシステインリメチル化経路の主要成分と静脈血栓塞栓症のリスクとの関連性を分析する.
- 赤血球メチルフォラート濃度がVTEリスクのバイオマーカーとして機能するかどうかを判断する.
主な方法:
- 深静脈血栓症または肺栓塞と診断された243人の患者と,年齢と性別を合わせた対照群を対象に,症例対照研究が行われました.
- 測定対象は,血ホモシステイン,メチオニン,葉酸,赤血球総葉酸,メチル葉酸,および5,10-メチレンテトラヒドロ葉酸還元酵素 (MTHFR) C677T遺伝子型でした.
- 他の確立されたVTEリスク要因も評価されました.
主要な成果:
- 血ホモシステイン濃度は,症例と対照群の間で有意に異なっていた.
- 赤血球メチルフォラート濃度とVTEリスクの間には,濃度に依存する強い関連が観察され,メチルフォラート濃度が低下するにつれて確率比が増加しました.
- 低メチオニン濃度,高体量指数,がん歴,VTEの家族歴,経口避妊薬の使用,およびファクターVライデン変異も独立してVTEのリスク増加と関連していました.
- 赤血球メチルフォラートとVTEリスクの関連性は,MTHFR C677T遺伝子型の影響を受けた.
結論:
- 赤血球メチルフォラート濃度測定は,静脈血栓塞栓症のリスクが高い個人を特定するのに役立ちます.
- この発見は,VTEリスクの階層化のためのメチルフォラート濃度の評価の潜在的な臨床的有用性を強調しています.
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