Effects of MTHFR Gene Polymorphism and Folate Supplementation on One-Year Outcome of Secondary Prevention for Ischemic Stroke
OBJECTIVE:To investigate the effects of MTHFR C677T and A1298C genes as well as folate supplementation on the recurrence and improvement of ischemic stroke.METHODS:Patients with primary ischemic stroke and National Institutes of Health Stroke Neurological Deficiency Scale(NIHSS)score from 6 to 19 points admitted to the 960th Hospital of Joint Logistics Support Force of PLA and Tai'an Central Hospital from Mar.2018 to Feb.2019 and Jun.2021 to May 2022 were collected,those patients who received conventional secondary prevention after treatment and discharged from hospital were set as non-exposed group,and those patients who received folate orally(0.4 mg for once,3 times a day)based on conventional secondary prevention were set as exposed group.Patients in the non-exposed group and exposed group were paired according to the principle of proximity of NIHSS scores,with 117 cases in each group,which were tested for MTHFR rs677 and rs1298 genotypes.A cohort study was carried out to inspect the correlation between MTHFR gene polymorphisms and folate supplementation with stroke recurrence within 1 year and the decline degree of NIHSS scores within 1 year.RESULTS:The distribution of each genotype of MTHFR in both groups was in accordance with the Hardy-Weinberg law of genetic equilibrium.Logistic analysis showed that recurrence within 1 year in stroke patients was associated with higher NIHSS scores at the first attack(P=0.042,OR=3.193,95%CI=1.104-9.238),while it was not associated with MTHFR gene polymorphisms and folate supplementation during secondary prevention.Results of multivariate linear regression showed that the decline degree of NIHSS scores within 1 year in stroke patients was associated with carrying both MTHFR C677T and A1298C genes(P=0.040,95%CI=0.081-3.178)and with the complication of hyperhomocysteinemia(HHcy)at the first attack(P=0.046,95%CI=0.021-4.059),while it was not associated with folate supplementation during secondary prevention.CONCLUSIONS:Under the condition of conventional secondary prevention implementation,ischemic stroke recurrence is associated with the severity at the first attack and independent of MTHFR gene polymorphisms.MTHFR C677T and A1298C as well as HHcy worked against ischemic stroke recovery within a year,yet is not associated with folate supplementation.
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