Medknow Publications on behalf of the Neurological Society of India
Abstract
Background: Homozygosity for MTHFR C677T polymorphism can lead to
significantly high homocysteine levels and hyperhomocysteinemia is an
important risk factor for thrombotic events. Aims: The aim was to
determine role of MTHFR C677T polymorphism in North Indians with
ischemic stroke. Settings and Design: In a prospective study, the
subjects of stroke were recruited from the neurology clinic of the
hospital. Controls were healthy individuals from the Hematology clinic
without any history of stroke. Materials and Methods: Plasma
homocysteine levels were measured by enzyme immuno assay method after 3
months of acute episode. Serum folate and Vitamin B12 levels were
estimated by competitive inhibition radioassay. MTHFR polymorphism was
detected by PCR-RFLP using Hinf I enzyme. Statistical analysis: The
analysis of significance of results was done using SPSS software
package. A pvalue < 0.05 was taken as significant. Results:
Thirty-two acute ischemic stroke patients (aged 1-44 years) were
studied. Fourteen (43.8%) had recurrent stroke. Nine (28%) had multiple
infarcts. Four of 32 patients (12.5%) had high homocysteine levels.
Three out of these 4 hyper-homocysteinemia patients were homozygous (
TT ) for MTHFR polymorphism (2 with recurrent stroke). Two of three
homozygous cases with TT genotype had low serum folate. Five of 32
stroke cases (18.8%) were heterozygous ( CT ) genotype. Conclusions:
Primary hyper-homocysteinemia appears to be an important risk factor
for ischemic stroke in North Indians, most due to MTHFR C677T
homozygosity. Folate levels may modify the presentation of the MTHFR TT
genotype