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DOI: 10.1055/s-0037-1615091
The Methylenetetrahydrofolate Reductase TT677 Genotype Is Associated with Venous Thrombosis Independently of the Coexistence of the FV Leiden and the Prothrombin
A20210 MutationPublication History
Received
23 September 1997
Accepted after resubmission
05 January 1998
Publication Date:
07 December 2017 (online)
Summary
A polymorphism, C→T677, in the methylenetetrahydrofolate reductase (MTHFR) gene has been identified as a cause of mild hyperhomocysteinemia, a risk factor for venous thrombosis. We have investigated the frequency of the TT genotype in 277 consecutive patients with confirmed deep venous thrombosis and 431 healthy subjects. The TT MTHFR genotype was more frequent in patients than in controls (25.6% vs. 18.1%; p = 0.016). The risk of thrombosis among carriers of this genotype was significantly increased [odds ratio: 1.6 (95% CI: 1.1-2.3)]. The estimated risk associated with the TT genotype was 2.0 (95% CI: 1.3-3.1) in subjects with (n = 122), and 1.3 (95% CI: 0.8-2.0) in those without (n = 155) predisposing (hereditary, acquired or circumstantial) risk factors for venous thrombosis. Factor V Leiden and prothrombin G→A20210 are known risk factors for venous thrombosis. After stratification for FV Leiden and prothrombin A20210 mutations, a significant association was also observed. After adjustment for sex, FV Leiden and prothrombin A20210 mutation, the estimated risk of venous thrombosis among carriers of the TT MTHFR genotype was 1.7 (95% CI: 1.2-2.6). The TT MTHFR genotype is independently associated with venous thrombosis, mainly among individuals with a high risk profile.
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References
- 1 Kniffin WD, Baron JA, Barret J, Birkmeyer JD, Anderson Jr. FA. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med 1994; 154: 861-6.
- 2 De Stefano V, Finazzi G, Mannucci PM. Inherited thrombophilia. Pathogenesis, clinical syndromes and management. Blood 1996; 87: 3531-44.
- 3 Lane DA, Mannucci PM, Bauer KA, Bertina RM, Bochkov NP, Boulyjenkov V, Chandy M, Dahlbäck B, Ginter EK, Miletich JP, Rosendaal FR, Seligsohn U. Inherited thrombophilia. Part 1. Thromb Haemost 1996; 76: 651-62.
- 4 Falcon C, Cattaneo M, Panzeri D, Martinelli I, Mannucci PM. High prevalence of hyperhomocyst(e)inemia in patients with juvenile venous thrombosis. Arterioscler Thromb 1994; 14: 1080-3.
- 5 Fermo I, Viganò-D’Angelo S, Paroni R, Mazzola G, Calori G, D’Angelo A. Prevalence of moderate hyperhomocysteinemia in patients with early-onset venous and arterial occlusive disease. Ann Intern Med 1995; 123: 747-53.
- 6 den Heijer M, Koster T, Blom HJ, Bos GMJ, Briët E, Reitsma PH, Vandenbroucke JP, Rosendaal FR. Hyperhomocysteinemia as a risk factor for deep-vein thrombosis. N Engl J Med 1996; 334: 759-62.
- 7 Engbersen AMT, Franken DG, Boers GHJ, Stevens EMB, Trijbels FJM, Blom HJ. Thermolabile 5,10-methylenetetrahydrofolate reductase as a cause of mild hyperhomocysteinemia. Am J Hum Genet 1995; 56: 142-50.
- 8 Frosst P, Blom HJ, Milos R, Goyette P, Sheppard CA, Matthews RG, Boers GHJ, den Heijer M, Kluijtmans LAJ, van de Heuvel LP, Roen R. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 1995; 10: 111-3.
- 9 De Franchis R, Mancini FP, D’Angelo A, Sebastio G, Fermo I, De Stefano V, Margaglione M, Mazzola G, Di Minno G, Andria G. Elevated total plasma homocysteine and C→T mutation of 5,10 methylenetetrahydrofolate reductase gene in thrombotic vascular disease. Am J Hum Genet 1996; 59: 262-4.
- 10 Arruda VR, von Zuben PM, Chiaparini LC, Annichino-Bizzacchi JM, Costa FF. The mutation Ala677→Val in the methylene tetrahydrofolate reductase gene: a risk factor for arterial disease and venous thrombosis. Thromb Haemost 1997; 77: 818-21.
- 11 Ma J, Stampfer MJ, Hennekens CH, Frosst P, Selhub J, Horsford J, Malinow MR, Willet WC, Rozen R. Methylenetetrahydrofolate reductase polymorphism, plasma folate, homocysteine, and risk of myocardial infarction in US physicians. Circulation 1996; 94: 2410-6.
- 12 Deloughery TG, Evans A, Sadeghi A, McWilliams J, Henner WD, Taylor LM, Press RD. Common mutation in methylenetetrahydrofolate reductase. Correlation with homocysteine metabolism and late-onset vascular disease. Circulation 1996; 94: 3074-8.
- 13 Poort SR, Rosendaal FR, Reitsma PH, Bertina RM. A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996; 88: 3698-703.
- 14 Ames PRJ, Pyke S, Iannaccone L, Brancaccio V. Antiphospholipid antibodies, haemostatic variables and thrombosis. A survey of 144 patients. Thromb Haemost 1995; 73: 768-73.
- 15 Ames PRJ, Catello T, Iannaccone L, Brillante M, Cimino R, Brancaccio V. Coagulation activation and fibrinolytic imbalance in subjects with idiopathic antiphospholipid antibodies. A crucial role for acquired free protein S deficiency. Thromb Haemost 1996; 76: 190-4.
- 16 Margaglione M, Di Minno G, Grandone E, Vecchione G, Celentano E, Cappucci G, Giordano M, Grilli M, Simone P, Fusilli S, Panico S, Mancini M. Raised plasma fibrinogen concentrations in subjects attending a metabolic ward. Relation to family history and vascular risk factors. Thromb Haemost 1995; 73: 579-83.
- 17 Koeleman BPC, Reitsma PH, Allaart CF, Bertina RM. Activated protein C resistance as an additional risk factor for thrombosis in protein C-deficient families. Blood 1994; 84: 1031-5.
- 18 Margaglione M, D’Andrea G, Cappucci G, Grandone E, Giuliani N, Colaizzo D, Vecchione G, Di Minno G. Detection of factor V Leiden mutation using SSCP. Thromb Haemost 1996; 76: 814-5.
- 19 Grandone E, Margaglione M, Colaizzo D, Cappucci G, Paladini D, Martinelli P, Montanaro S, Pavone G, Di Minno G. Factor V Leiden, C→T MTHFR polymorphism and genetic susceptibility to preeclampsia. Thromb Haemost 1997; 77: 1052-4.
- 20 Heijboer H, Brandjes D, BÅller HR, Sturk A, ten Cate JW. Deficiencies of coagulation-inhibiting and fibrinolytic proteins in outpatients with deep-vein thrombosis. N Engl J Med 1990; 323: 1512-6.
- 21 Miletich JP, Prescott SM, White R, Majerus PW, Bovill EG. Inherited predisposition to thrombosis. Cell 1993; 72: 477-80.
- 22 Christensen B, Frosst P, Lussier-Cacan S, Selhub J, Goyette P, Rosenblatt DS, Genest J, Rozen R. Correlation of a common mutation in the methylenetetrahydrofolate reductase gene with plasma homocysteine in patients with premature coronary artery disease. Arterioscler Thromb Vasc Biol 1997; 17: 569-73.
- 23 Stampfer MJ, Malinow MR, Willet WC, Newcomer LM, Upson B, Ullmann D, Tishler PV, Hennekens CH. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992; 268: 877-81.
- 24 Selhub J, Jacques PF, Bostom AG, D’Agostino RB, Wilson PWF, Belanger AJ, O’Leary DH, Wolf PA, Schaefer EJ, Rosenberg IH. Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med 1995; 332: 286-91.
- 25 Cattaneo M, Tsai MY, Bucciarelli P, Taioli E, Zighetti ML, Bignell M, Mannucci PM. A common mutation in the methylenetetrahydrofolate reductase gene (C677T) increases the risk for deep-vein thrombosis in patients with mutant Factor V (Factor V:Q506). Arterioscler Thromb Vasc Biol 1997; 17: 1662-6.
- 26 Tosetto A, Missiaglia E, Frezzato M, Rodeghiero F. The VITA project: C677T mutation in the methylene-tetrahydrofolate reductase gene and the risk of venous thromboembolism. Br J Haematol 1997; 97: 804-6.
- 27 Ames PRJ, Tommasino C, D’Andrea G, Iannaccone L, Brancaccio V, Margaglione M. Thrombophilic genotypes in subjects with idiopathic anti-phospholipid antibodies. Prevalence and significance. Thromb Haemost 1998; 79: 46-9.
- 28 Ridker PM, Hennekens CH, Selhub J, Miletich JP, Malinow R, Stampfer MJ. Interrelation of hyperhomocyst(e)inemia, factor V Leiden, and risk of future venous thromboembolism. Circulation 1997; 95: 1777-82.
- 29 Guttormsen AB, Ueland PM, Nesthus I, Nygård O, Schneede J, Vollset SE, Refsum H. Determinants and vitamin responsiveness of intermediate hyperhomocysteinemia (>40 mmol/liter). The Hordaland Homocysteine Study. J Clin Invest 1996; 98: 2174-83.