677C TO 677T MUTATION IN THE 5,10-METHYLENETETRAHYDROFOLATE REDUCTASE(MTHFR) GENE AND PLASMA HOMOCYST(E)INE LEVELS IN PATIENTS WITH TIA ORMINOR STROKE

It was the aim of this study to determine the associations of clinical and laboratory data with plasma homocyst(e)ine levels in patients wit h transient ischemic attack (TIA) or minor stroke (MS), with special r eference to their 677C to T mutation status in the 5,10-methylenetetra hydrofolate reductase (5,10-MTHFR) gene. Seventy-six patients with TIA or MS were investigated at least 3 months after their (last) clinical event. By means of univariate analysis, significant correlations of h omocyst(e)ine levels with male gender (P<0.02), age (P<0.0005), creati nine levels (P<0.0002), folate levels (inversely, P<0.05), and alcohol use (P<0.02) were found, but not with vitamin B-12 levels. Multivaria te regression analysis, including age, creatinine levels, and folate l evels as independent variables, revealed age (P<0.01) and creatinine l evels (P<0.02) to be significantly correlated with homocyst(e)ine leve ls. After adjustment for age, creatinine levels and homocyst(e)ine lev els remained significantly correlated to each other (P<0.005), whereas the relation between folate levels and homocyst(e)ine levels was no l onger significant (P=0.10). Mutation-positive patients exhibited moder ately and statistically non-significantly higher homocyst(e)ine levels than mutation-negative patients, particularly those who were homozygo us positive. Homocyst(e)ine levels were closely correlated with creati nine levels (P<0.0002) and with folate levels (inversely, P<0.05), but only in mutation-positive and not in mutation-negative patients. Homo zygous positive, heterozygous positive, and mutation-negative patients did not differ with respect to clinical and laboratory data concernin g 'risk factors for stroke' or co-existing vascular disease. In conclu sion, the associations of creatinine levels and, inversely, of folate levels with plasma homocyst(e)ine levels in patients with TIA or MS ar e dependent on the 5,10-MTHFR mutation status. Significant correlation s between these variables were found only in mutation-positive but not in mutation-negative patients. (C) 1998 Elsevier Science B.V.