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The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism

Year 2013, Volume: 2013 Issue: 2, 197 - 203, 01.02.2013
https://doi.org/10.5152/balkanmedj.2013.7159

Abstract

Background: Methylenetetrahydrofolate reductase (MTHFR) polymorphisms have recently raised the interest as a possible thrombophilic factors. Aims: We aimed to assess the frequency of the methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms in idiopathic venous thromboembolism (VTE) in a Romanian population and the associated risk of VTE. Study Design: We performed a case-control transversal study including 90 patients diagnosed with VTE and 75 sex- and age-matched controls. Methods: MTHFR C677T and A1298C polymorphisms were detected using PCR-RFLP method. Results: The homozygous MTHFR 677TT genotype, present in 18.8% of patients with VTE versus 6.6% of controls, was significantly associated with VTE (p= 0.021, OR= 3.26, 95%CI (1.141-9.313)). The heterozygous MTHFR A1298C genotype, presenting the highest prevalence in the VTE group (34.4%) as well as in controls (37.3%), was not associated with VTE (p=0.7). No associations were found for heterozygous MTHFR C677T (with a frequency of 32.2% in VTE and 37.3% in controls, p=0.492), respective homozygous MTHFR A1298C genotype (with a frequency of 1.1% in VTE and 2.6% in controls, p=0.456). Conclusion: Among MTHFR polymorphisms, only homozygosity for MTHFR 677TT may be considered a risk factor for VTE; the MTHFR A1298C polymorphism is not significantly associated with an increased risk of VTE. Turkish Başlık: İdiyopatik Venöz Tromboembolisi Olan Romanyalı Hastalarda Metilentetrahidrofolat Redüktaz Geninin Homozigot Polimorfizmlerinin Önemi Anahtar Kelimeler: Metilentetrahidrofolat redüktaz C677T polimorfizm, metilentetrahidrofolat redüktaz A1298C polimorfizm, venöz tromboemboli, trombofili Arka Plan: Metilentetrahidrofolat redüktaz (MTHFR) polimorfizmlerine karşı, muhtemel trombofilik faktörler olduklarından, yakın zamanda ilgi artışı olmuştur. Amaç: Romanyalı popülasyonda idiyopatik venöz tromboembolide (VTE) metilentetrahidrofolat redüktaz (MTHFR) C677T ve A1298C polimorfizmlerinin sıklığını ve VTE ile ilişkili riski değerlendirmeyi amaçladık. Çalışma Tasarımı: VTE tanısı almış 90 hasta ile yaş ve cinsiyet açısından eşleştirilmiş 75 kontrolü içeren transvers vaka-kontrol çalışması yaptık. Yöntemler: PCR-RFLP metotu kullanılarak MTHFR C677T ve A1298C polimorfizmleri saptandı. Bulgular: VTE'li hastaların %18.8'ine karşılık kontrollerin %6.6'sında mevcut olan homozigot MTHFR 677TT genotipi, VTE ile anlamlı şekilde ilişkiliydi (p= 0.021, OR= 3.26, %95CI (1.141-9.313)). VTE grubunda (%34.4) ve de kontrollerde (%37.3) en yüksek prevalansı gösteren heterozigot MTHFR A1298C genotipi VTE ile ilişkili değildi (p=0.7). Heterozigot MTHFR C677T (Sıklığı VTE'de %32.2 ve kontrollerde %37.3, p=0.492) ve homozigot MTHFR A1298C genotipi (Sıklığı VTE'de %1.1 ve kontrollerde %2.6, p=0.456) için de ilişki bulunmadı. Sonuç: MTHFR polimorfizmleri arasında sadece MTHFR 677TT homozigotluğu VTE için bir risk faktörü olarak kabul edilebilir; MTHFR A1298C polimorfizmi VTE riskinde anlamlı artış ile ilişkili değildir.

References

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  • 29. Margaglione M, D’Andrea G, d’Addedda M, Giuliani N, Cappucci G, Iannaccone L, et al. The methylenetetrahydrofolate reductase TT677 genotype is associated with venous thrombosis independently of the coexistence of the FV Leiden and the prothrombin A20210 mutation. Thromb Haemost 1998;79:907-11.
  • 30. Koch HG, Nabel P, Junker R, Auberger K, Schobess R, Homberger A, et al. The 677T genotype of the common MTHFR thermolabile variant and fasting homocysteine in childhood venous thrombosis. Eur J Pediatr 1999;158 Suppl 3:S113-6. [CrossRef]
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  • 36. Ray JG, Shmorgun D, Chan WS. Common C677T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of venous thromboembolism: meta-analysis of 31 studies. Pathophysiol Haemos Thromb 2002;32:51-8. [CrossRef]
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The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism

Year 2013, Volume: 2013 Issue: 2, 197 - 203, 01.02.2013
https://doi.org/10.5152/balkanmedj.2013.7159

Abstract

References

  • 1. Whire RH. The epidemiology of venous thromboembolism. Circulation 2003;107 Suppl 1:I4-8.
  • 2. Anderson FA Jr, Spencer FA. Risk factors for venous thromboembolism. Circulation 2003;107 Suppl 1:I9-16. [CrossRef]
  • 3. Lovricevic I, Franjic BD, Tomicic M, Vrkic N, De Syo D, Hudorovic N, et al. 5, 10-Methylenetetrahydrofolate reductase (MTHFR) 677 C --> T genetic polymorphism in 228 Croatian volunteers. Coll Antropol 2004;28:647-54.
  • 4. Pepe G, Camacho Vanegas O, Giusti B, Brunelli T, Marcucci R, Attanasio M, et al. Heterogeneity in world distribution of the thermolabile C677T mutation in 5,10-Methylenetetrahydrofolate reductase. Am J Hum Genet 1998;63:917-20. [CrossRef]
  • 5. Wilcken B, Bamforth F, Li Z, Zhu H, Ritvanen A, Redlund M, et al. Geographical and ethnic variation of the 677C>T allele of 5,10 methylenetetrahydrofolate reductase (MTHFR): findings from over 7000 newborns from 16 areas world wide. J Med Genet 2003;40:619-25. [CrossRef]
  • 6. Mayor-Olea A, Callejón G, Palomares AR, Jiménez AJ, Gaitán MJ, Rodríguez A, et al. Human genetic selection on the MTHFR 677C>T polymorphism. BMC Med Genet 2008;9:104. [CrossRef]
  • 7. Guéant-Rodriguez RM, Guéant JL, Debard R, Thirion S, Hong LX, Bronowicki JP, et al. Prevalence of methylenetetrahydrofolate reductase 677T and 1298C alleles and folate status: a comparative study in Mexican, West African, and European populations. Am J Clin Nutr 2006;83:701-7.
  • 8. Castro R, Rivera I, Ravasco P, Jakobs C, Blom HJ, Camilo ME et al. 5,10-Methylenetetrahydrofolate reductase 677C-->T and 1298A- ->C mutations are genetic determinants of elevated homocysteine. QJM 2003;96:297-303 [CrossRef]
  • 9. Chango A, Boisson F, Barbé F, Quilliot D, Droesch S, Pfister M, et al. The effect of 677C-->T and 1298A-->C mutations on plasma homocysteine and 5,10-methylenetetrahydrofolate reductase activity in healthy subjects. Br J Nutr 2000;83:593-6. [CrossRef]
  • 10. Kupeli E, Verdi H, Simsek A, Atac FB, Eyuboglu FO. Genetic mutations in Turkish population with pulmonary embolism and deep venous thrombosis. Clin Appl Thromb Hemost 2011;17:E87-94. [CrossRef]
  • 11. Moheimani F, Jackson DE. Venous thromboembolism: classification, risk factors, diagnosis, and management. ISRN Hematol 2011;2011:124610. 12. Almawi WY, Tamim H, Kreidy R, Timson G, Rahal E, Nabulsi M, et al. A case control study on the contribution of factor V-Leiden, prothrombin G20210A, and MTHFR C677T mutations to the genetic susceptibility of deep venous thrombosis. J Thromb Thrombolysis 2005;19:189-96. [CrossRef]
  • 13. Nizankowska-Mogilnicka E, Adamek L, Grzanka P, Domagala TB, Sanak M, Krzanowski M, et al. Genetic polymorphisms associated with acute pulmonary embolism and deep venous thrombosis. Eur Respir J 2003;21:25-30. [CrossRef]
  • 14. Jang MJ, Jeon YJ, Choi WI, Choi YS, Kim SY, Chong SY, et al. The 677C>T Mutation of the MTHFR Gene Increases the Risk of Venous Thromboembolism in Koreans and a Meta-Analysis From Asian Population. Clin Appl Thromb Hemost 2012 Feb 12. [Epub ahead of print].
  • 15. Bezemer ID, Doggen CJ, Vos HL, Rosendaal FR. No association between the common MTHFR 677C->T polymorphism and venous thrombosis: results from the MEGA study. Arch Intern Med 2007;167:497-501. [CrossRef]
  • 16. Naess IA, Christiansen SC, Romundstad PR, Cannegieter SC, Blom HJ, Rosendaal FR, et al. Prospective study of homocysteine and MTHFR 677TT genotype and risk for venous thrombosis in a general population--results from the HUNT 2 study. Br J Haematol 2008;141:529-35. [CrossRef]
  • 17. Keijzer MB, Borm GF, Blom HJ, Bos GM, Rosendaal FR, den Heijer M. No interaction between factor V Leiden and hyperhomocysteinemia or MTHFR 677TT genotype in venous thrombosis. Results of a meta-analysis of published studies and a large caseonly study. Thromb Haemost 2007;97:32-7.
  • 18. Key NS, McGlennen RC. Hyperhomocyst(e)inemia and thrombophilia. Arch Pathol Lab Med 2002;126:1367-75.
  • 19. Grody WW, Griffin JH, Taylor AK, Korf BR, Heit JA; ACMG Factor V. Leiden Working Group. American College of Medical Genetics consensus statement on factor V Leiden mutation testing. Genet Med 2001;3:139-48. [CrossRef]
  • 20. Baglin T, Gray E, Greaves M, Hunt BJ, Keeling D, Machin S, et al. Clinical guidelines for testing for heritable thrombophilia. Br J Haematol 2010;149:209-20. [CrossRef]
  • 21. Cushman M. Inherited risk factors for venous thrombosis. Hematology Am Soc Hematol Educ Program 2005:452-7. [CrossRef]
  • 22. Mansilha A, Araujo F, Severo M, Sampaio SM, Toledo T, Albuquerque R. Genetic polymorphisms and risk of recurrent deep venous thrombosis in young people: prospective cohort study. Eur J Vasc Endovasc Surg 2005;30:545-9. [CrossRef]
  • 23. Alfirevic Z, Simundic AM, Nikolac N, Sobocan N, Alfirevic I, Stefanovic M, et al. Frequency of factor II G20210A, factor V Leiden, MTHFR C677T and PAI-1 5G/4G polymorphism in patients with venous thromboembolism: Croatian case control study. Biochemia Medica 2010;20:229-35. [CrossRef]
  • 24. Avdonin PV, Kirienko AI, Kozhevnikova LM, Shostak NA, Babadaeva NM, Leont’ev SG, et al. C677T mutation in methylenetetrahydrofolate reductase gene in patients with venous thromboses from the central region of Russia correlates with a high risk of pulmonary artery thromboembolism. Ter Arkh 2006;78:70-6.
  • 25. Spiroski I, Kedev S, Antov S, Arsov T, Krstevska M, DzhekovaStojkova S, et al. Association of methylenetetrahydrofolate reductase (MTHFR-677 and MTHFR-1298) genetic polymorphisms with occlusive artery disease and deep venous thrombosis in Macedonians. Croat Med J 2008;49:39-49. [CrossRef]
  • 26. Tatarskyy P, Kucherenko A, Livshits L. Allelic polymorphism of F2, F5 and MTHFR genes in population of Ukraine. Tsitol Genet 2010;44:3-8.
  • 27. Pernod G, Biron-Andreani C, Morange PE, Boehlen F, Constans J, Couturaud F, et al. Recommendations on testing for thrombophilia in venous thromboembolic disease: A French consensus guideline. J Mal Vasc 2009;34:156-203. [CrossRef]
  • 28. Baytan B, Meral AG, İlçöl YO, Günay U. The prevalence of factor V Leiden (1691G-A)and methylenetetrahydrofolate reductase C677T mutations in healthy newborns in Bursa, Turkey. Turk J Hematol 2007;24:90-2.
  • 29. Margaglione M, D’Andrea G, d’Addedda M, Giuliani N, Cappucci G, Iannaccone L, et al. The methylenetetrahydrofolate reductase TT677 genotype is associated with venous thrombosis independently of the coexistence of the FV Leiden and the prothrombin A20210 mutation. Thromb Haemost 1998;79:907-11.
  • 30. Koch HG, Nabel P, Junker R, Auberger K, Schobess R, Homberger A, et al. The 677T genotype of the common MTHFR thermolabile variant and fasting homocysteine in childhood venous thrombosis. Eur J Pediatr 1999;158 Suppl 3:S113-6. [CrossRef]
  • 31. Dordević V, Rakićević L, Spasić M, Miković D, Kovać M, Radojković D. Factor V Leiden, FII G20210A, MTHFR C677T mutations as risk factors for venous thrombosis during pregnancy and puerperium. Vojnosanit Pregl 2005;62:201-5. [CrossRef]
  • 32. Angelopoulou K, Nicolaides A, Constantinou Deltas C. Prevalence of genetic mutations that predispose to thrombophilia in a Greek Cypriot population. Clin Appl Thromb Hemost 2000;6: 104-7. [CrossRef]
  • 33. Salomon O, Steinberg DM, Zivelin A, Gitel S, Dardik R, Rosenberg N, et al. Single and combined prothrombotic factors in patients with idiopathic venous thromboembolism: prevalence and risk assessment. Arterioscler Thromb Vasc Biol 1999;19:511-18. [CrossRef]
  • 34. García-Hernández MC, Romero Casanova A, Marco Vera P. Clinical comments on genetic marker prevalence (factor V Leiden, prothrombin 20210A and homozygous methylenetetrahydrofolate reductase form [Ho-MTHFR]): based on a study conducted in Health Department No. 19 of the Valencian Community. Rev Clin Esp 2007;207:26-8. [CrossRef]
  • 35. Couturaud F, Oger E, Abalain JH, Chenu E, Guias B, Floch HH, et al. Methylenetetrahydrofolate reductase C677T genotype and venous thromboembolic disease. Respiration 2000;67:657-61 [CrossRef]
  • 36. Ray JG, Shmorgun D, Chan WS. Common C677T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of venous thromboembolism: meta-analysis of 31 studies. Pathophysiol Haemos Thromb 2002;32:51-8. [CrossRef]
  • 37. Den Heijer M, Lewington S, Clarke R. Homocysteine, MTHFR and the risk of venous thrombosis: a meta-analysis of published epidemiological studies. J Thromb Haemost 2005;3:292-9. [CrossRef]
  • 38. Obeidat NM, Awidi A, Sulaiman NA, Abu-Khader IB. Thrombophilia-related genetic variations in patients with pulmonary embolism in the main teaching hospital in Jordan. Saudi Med J 2009;30:921-5.
  • 39. Tsai AW, Cushman M, Tsai MY, Heckbert SR, Rosamond WD, Aleksic N, et al. Serum homocysteine, thermolabile variant of methylene tetrahydrofolate reductase (MTHFR), and venous thromboembolism: Longitudinal Investigation of Thromboembolism Etiology (LITE). Am J Hematol 2003;72:192-200. [CrossRef]
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There are 51 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Cristina Hotoleanu This is me

Adrian Trifa This is me

Radu Popp This is me

Daniela Fodor This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 2013 Issue: 2

Cite

APA Hotoleanu, C., Trifa, A., Popp, R., Fodor, D. (2013). The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism. Balkan Medical Journal, 2013(2), 197-203. https://doi.org/10.5152/balkanmedj.2013.7159
AMA Hotoleanu C, Trifa A, Popp R, Fodor D. The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism. Balkan Medical Journal. February 2013;2013(2):197-203. doi:10.5152/balkanmedj.2013.7159
Chicago Hotoleanu, Cristina, Adrian Trifa, Radu Popp, and Daniela Fodor. “The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients With Idiopathic Venous Thromboembolism”. Balkan Medical Journal 2013, no. 2 (February 2013): 197-203. https://doi.org/10.5152/balkanmedj.2013.7159.
EndNote Hotoleanu C, Trifa A, Popp R, Fodor D (February 1, 2013) The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism. Balkan Medical Journal 2013 2 197–203.
IEEE C. Hotoleanu, A. Trifa, R. Popp, and D. Fodor, “The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism”, Balkan Medical Journal, vol. 2013, no. 2, pp. 197–203, 2013, doi: 10.5152/balkanmedj.2013.7159.
ISNAD Hotoleanu, Cristina et al. “The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients With Idiopathic Venous Thromboembolism”. Balkan Medical Journal 2013/2 (February 2013), 197-203. https://doi.org/10.5152/balkanmedj.2013.7159.
JAMA Hotoleanu C, Trifa A, Popp R, Fodor D. The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism. Balkan Medical Journal. 2013;2013:197–203.
MLA Hotoleanu, Cristina et al. “The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients With Idiopathic Venous Thromboembolism”. Balkan Medical Journal, vol. 2013, no. 2, 2013, pp. 197-03, doi:10.5152/balkanmedj.2013.7159.
Vancouver Hotoleanu C, Trifa A, Popp R, Fodor D. The Importance of Homozygous Polymorphisms of Methylenetetrahydrofolate Reductase Gene in Romanian Patients with Idiopathic Venous Thromboembolism. Balkan Medical Journal. 2013;2013(2):197-203.