AB068. Association between MTHFR C677T and carotid intima medial thickness progression in post-ischemic stroke patient

Background and objective: Substitution of c.677C > T in methylenetetrahydrofolate reductase (MTHFR) gene contributes to increase blood level of homocysteine (Hcy). Hyperhomocysteinemia is believed to have association with vascular damage leads to atherosclerosis. Defect MTHFR may influence vascular progression in post ischemic stroke. Carotid intima media thickness (c-IMT) has been known as vascular marker for atherosclerosis and predictor for ischemic stroke. The study aims to determine association between MTHFR C677T and c-IMT progression in post-ischemic stroke patients.

Methods: Seventy one of post-ischemic stroke patients were included in epidemiological prospective observational cohort study. Genotyping MTHFR gene polymorphism was done using PCR-RFLP with HinfI restriction enzyme. Blood Hcy level was determined using enzyme immunoassay (EIA) method. Carotid duplex ultrasound was used to evaluate c-IMT in 1st, 6th, and 12th month after the onset of stroke.

Results: The genotype distribution of MTHFR C677T in samples was CC (81.9%), CT (13.9%) and TT (4.2%). No significant differences in mean Hcy levels between genotype TT and others (CT and CC) were identified (P=0.250). Mean c-IMT showed no significant differences between genotype TT and others at evaluation in 1st month (P=0.979), 6th month (P=0.670) and 12th month (P=0.770). All samples with genotype TT were observed to have increase c-IMT level at evaluation in 1st, 6th and 12th month.

Conclusions: The presence of homozygote TT of MTHFR C677T may contribute to increase c-IMT level. However, this study found no association between MTHFR C677T with hyperhomocysteinemia as well as an increase in c-IMT in post-ischemic stroke patients.

Keywords: Methylenetetrahydrofolate reductase (MTHFR); homocysteine (Hcy); c-IMT; post-ischemic stroke