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Methylenetetrahydrofolate reductase polymorphisms and homocysteine-lowering effect of vitamin therapy in Singaporean stroke patients.
Stroke. 2006 Feb; 37(2):456-60.S

Abstract

BACKGROUND AND PURPOSE

Increased plasma total homocysteine (tHcy) levels are a risk factor for stroke and can be reduced with vitamin therapy. However, data on the tHcy-lowering effects of vitamins are limited largely to white populations. Thus, we aimed to determine in Singaporean patients with recent stroke: (1) the efficacy of vitamin therapy (folic acid, vitamin B12, and B6) on lowering tHcy, and (2) whether efficacy is modified by Methylenetetrahydrofolate reductase (MTHFR) gene polymorphism(s).

METHODS

A total of 443 eligible patients were recruited after presenting with ischemic stroke within the past 7 months. Patients were randomized to receive either placebo or vitamins. Fasting blood samples collected at baseline and at 1 year were assayed for levels of plasma tHcy. Patients were genotyped for MTHFR C677T and A1298C polymorphisms.

RESULTS

Mean baseline tHcy was similar in the 2 groups (placebo 13.7 micromol/L; vitamins 14.0 micromol/L; P=0.70). At 1 year, mean tHcy was 14.5 micromol/L in the placebo group compared with 10.7 micromol/L in the vitamin group (difference 3.8 micromol/L; 95% CI, 2.8 to 4.8 micromol/L; P<0.0001). MTHFR C677T genotype was an independent determinant of tHcy levels at baseline (P=0.005), but A1298C was not (P=0.08). Neither polymorphism significantly influenced the effect of vitamin therapy on tHcy at 1 year. The magnitude of the reduction in tHcy levels at 1 year with vitamin therapy was similar, irrespective of MTHFR genotypes.

CONCLUSIONS

Vitamin therapy reduces mean tHcy levels by 3.8 micromol/L in the Singaporean stroke population studied. MTHFR C677T but not A1298C is independently associated with tHcy levels at baseline, and neither impacts the tHcy-lowering effect of vitamins used in this study.

Authors+Show Affiliations

Department of Neurology, Singapore General Hospital, Singapore.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16397167

Citation

Ho, Grace Y-H, et al. "Methylenetetrahydrofolate Reductase Polymorphisms and Homocysteine-lowering Effect of Vitamin Therapy in Singaporean Stroke Patients." Stroke, vol. 37, no. 2, 2006, pp. 456-60.
Ho GY, Eikelboom JW, Hankey GJ, et al. Methylenetetrahydrofolate reductase polymorphisms and homocysteine-lowering effect of vitamin therapy in Singaporean stroke patients. Stroke. 2006;37(2):456-60.
Ho, G. Y., Eikelboom, J. W., Hankey, G. J., Wong, C. R., Tan, S. L., Chan, J. B., & Chen, C. P. (2006). Methylenetetrahydrofolate reductase polymorphisms and homocysteine-lowering effect of vitamin therapy in Singaporean stroke patients. Stroke, 37(2), 456-60.
Ho GY, et al. Methylenetetrahydrofolate Reductase Polymorphisms and Homocysteine-lowering Effect of Vitamin Therapy in Singaporean Stroke Patients. Stroke. 2006;37(2):456-60. PubMed PMID: 16397167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methylenetetrahydrofolate reductase polymorphisms and homocysteine-lowering effect of vitamin therapy in Singaporean stroke patients. AU - Ho,Grace Y-H, AU - Eikelboom,John W, AU - Hankey,Graeme J, AU - Wong,Chen-Ru, AU - Tan,Siew-Li, AU - Chan,Jesscia B-C, AU - Chen,Christopher P L-H, Y1 - 2006/01/05/ PY - 2006/1/7/pubmed PY - 2006/3/2/medline PY - 2006/1/7/entrez SP - 456 EP - 60 JF - Stroke JO - Stroke VL - 37 IS - 2 N2 - BACKGROUND AND PURPOSE: Increased plasma total homocysteine (tHcy) levels are a risk factor for stroke and can be reduced with vitamin therapy. However, data on the tHcy-lowering effects of vitamins are limited largely to white populations. Thus, we aimed to determine in Singaporean patients with recent stroke: (1) the efficacy of vitamin therapy (folic acid, vitamin B12, and B6) on lowering tHcy, and (2) whether efficacy is modified by Methylenetetrahydrofolate reductase (MTHFR) gene polymorphism(s). METHODS: A total of 443 eligible patients were recruited after presenting with ischemic stroke within the past 7 months. Patients were randomized to receive either placebo or vitamins. Fasting blood samples collected at baseline and at 1 year were assayed for levels of plasma tHcy. Patients were genotyped for MTHFR C677T and A1298C polymorphisms. RESULTS: Mean baseline tHcy was similar in the 2 groups (placebo 13.7 micromol/L; vitamins 14.0 micromol/L; P=0.70). At 1 year, mean tHcy was 14.5 micromol/L in the placebo group compared with 10.7 micromol/L in the vitamin group (difference 3.8 micromol/L; 95% CI, 2.8 to 4.8 micromol/L; P<0.0001). MTHFR C677T genotype was an independent determinant of tHcy levels at baseline (P=0.005), but A1298C was not (P=0.08). Neither polymorphism significantly influenced the effect of vitamin therapy on tHcy at 1 year. The magnitude of the reduction in tHcy levels at 1 year with vitamin therapy was similar, irrespective of MTHFR genotypes. CONCLUSIONS: Vitamin therapy reduces mean tHcy levels by 3.8 micromol/L in the Singaporean stroke population studied. MTHFR C677T but not A1298C is independently associated with tHcy levels at baseline, and neither impacts the tHcy-lowering effect of vitamins used in this study. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/16397167/Methylenetetrahydrofolate_reductase_polymorphisms_and_homocysteine_lowering_effect_of_vitamin_therapy_in_Singaporean_stroke_patients_ L2 - https://www.ahajournals.org/doi/10.1161/01.STR.0000199845.27512.84?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -